Alaska Medicaid's Adults with Physical & Developmental Disabilities Waiver

 What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers and Waiver Funded Services, allow qualifying program participants to receive services out of the nursing homes. Medicaid’s standard benefit is to pay for nursing home residential care. However, when available, Medicaid Waivers help to provide more options for individuals. The cost of the care outside of a nursing home needs to be less than the cost of care in a nursing home.

Program Description

Alaska Adults with Physical and Developmental Disabilities (APDD), formerly called Adults with Physical Disabilities, is a Home and Community Based Waiver intended for those 21 years of age or older with autism, an intellectual disability, or a developmental disability, which results in physical impairments. APDD enables individuals who cannot live independently, to continue to live in their home, a foster home, or in assisted living, rather than in a nursing home facility. Services that may be covered under this waiver include adult day care, home modifications, respite, and assistance with activities of daily living, such as walking, eating, and bathing.

Examples of conditions that might qualify an individual for this waiver include cerebral palsy, spastic hemiplegia, intracranial injury, paraplegia, and quadriplegia. While this program is not limited to the elderly, seniors who have diagnoses, such as these, that manifested before the age of 21, may qualify for this program.

Another adult-only Alaskan waiver that might be of interest to elderly individuals is Alaskans Living Independently (ALI), previously called Older and Disabled Adults (ODA). This waiver provides similar benefits and services as APDD, though while an intellectual or developmental disability is a qualification for APDD, it is not for ALI. ALI only requires that individuals 65 years and older need a level of care consistent with that provided in a nursing home. For those who are between the ages of 21 and 64, a physical disability is an eligibility requirement. That being said, those under the age of 65 who have a physical disability, and do not have a developmental or intellectual disability, should apply for the ALI wavier. Another difference between the two waivers is that ALI allows for consumer direction, also known as self-direction, while APDD does not.

Both programs are administered the Alaska Department of Human and Social Services, Senior and Disability Services. This is a Medicaid program, which in Alaska is referred to as DenaliCare. 

 

Eligibility Guidelines

To be eligible for the Adults with Physical and Developmental Disabilities Waiver, a variety of requirements must be met, some personal, some medical and others financial.

Personal - Individuals must be at least 21 years of age and a full-time resident of Alaska. This Waiver is not intended for children.

Medical – Individuals must be diagnosed with a developmental disability, or an intellectual disability, which has manifested before the age of 21. The individual must also present with physical disabilities, requiring a nursing home level of care. An assessment of the candidate’s abilities must be completed by a care coordinator. Conditions typically eligible under this waiver include, but are not limited to autism, cerebral palsy, traumatic brain injury, paraplegia, and quadriplegia.

Financial - There are income and asset requirements that determine eligibility for this waiver. An applicant must have a monthly income that is at or under 300% of the Federal Benefit Rate. For the calendar year 2017, this equals $2,205 / month or $26,460 / year. The asset limit is $2,000, which includes liquid assets, such as bank accounts, and stocks and bonds. The primary home of an individual is considered an exempt asset, provided the individual lives in the home and their home equity is valued at less than $560,000. To be clear, the home can have a higher value, but the portion owned by the applicant (which excludes outstanding mortgage debt) cannot exceed $560,000.

 

Benefits and Services

Based on a care plan that is established by a care coordinator, various services/benefits are available as determined by an individual’s needs. Services may vary based on location.

  • Adult Day Health / Adult Day Care
  • Care Management
  • Day Habilitation / Residential Habilitation
  • Respite Care – in-home and out-of-home to provide a break for the primary caregiver
  • Supported Employment
  • Chore Services – washing windows, snow removal, moving heavy furniture 
  • Home Modifications – addition of ramps, grab bars, making doorways wheelchair accessible
  • Intensive Active Treatment – if not treated, it may result in institutionalization
  • Meals – home delivered or congregate setting
  • Residential Supported Living Services /Assisted Living / Foster Care– transportation, medication management, and assistance with activities of daily living, such as walking, eating, and bathing 
  • Specialized Medical Equipment – assists an individual with performing everyday activities
  • Personal Emergency Response System (PERS)
  • Skilled Nursing
  • Transportation – medical and non-medical

 

How to Apply / Learn More

For additional information about this program, download this brochure.  Alternatively, call your local Aging at Disability Resource Center (ADRC) at 877-625-2372.  You can also contact your local Senior & Disabilities Services Office. For the Anchorage office, call 800-478-9996 or 907-269-3666, for the Juneau office, call 866-465-3165 or 907-465-3372, and the Fairbanks office, call 800-770-1672 or 907-451-5045.