Roadmap: Arizona DDD/ALTCS

0%

In Arizona, to get services covered by the state, your child must first qualify for DDD and then qualify for ALTCS.

DDD qualification

To qualify for DDD you must be a resident of Arizona, from ages 3-6 be at risk of having a developmental disability. After six you must be diagnosed with: autism, Cerebral palsy, epilepsy, or a cognitive disability. You must also be diagnosed before the age of 18. You must also show that your child has functional limitations in 3 of 7 major life areas: learning mobility, independent living, self-care, language, economic self-sufficiency, or self-direction.

Looking at these requirements, it is possible to have a child with autism who does not qualify for DDD.

Click here for the DDD eligibility packet: https://des.az.gov/sites/default/files/dl/DDD-2069A.pdf?time=1617121708084

Apply for Arizona Long Term Care System (ALTCS)

Getting DDD is the first step to get access to Arizona’s Medicaid funding you also have to become an ALTCS member. This process has a few steps in it.

1.Financial Interview

ALTCS members cannot have more than $2,000 in their name. If your child has an ABLE account or has money in a Special Needs Trust, that is okay. It is not okay if your child has money in their name in a typical bank account if that amount exceeds $2,000.

2.PAS Interview

A parent interview will be completed at home. The interviewer will have to see the child, but the child doesn’t have to stay home the whole time. Arizona is a one-party state, and if you would like to you can record the interview. Any notes the interviewer takes area part of your child’s medical history, you are allowed to make copies or take pictures of those notes.

As you answer the questions, you should answer no if your child doesn’t do something 100% of the time or if their disability prevents them from doing the described activity the way a typical child would do it. If your child has an IEP or other medical records, they will most likely collect those and compare your answers to those documents.

To qualify for ALTCS, your child will have to score 40 points or more on the PAS evaluation. If your child does not pass, you can call and request your child’s score and ask to see how the interviewer scored it. If the answers recorded by the interviewer do not match the answers you have given (which you can refer back to with your recording), you can dispute the results. If it is close, you can also dispute the results.

The PAS tool changes as your child ages: Click on the link below for the PAS tool that would apply to your child

PAS-Age 0-5
PAS-Age 6-11
PAS-Age 12 +

What does DDD/ALTCS cover?

If you get approved for DDD and ALTCS here is what can be covered for your child:

Habilitation
Home Health Aide
Home Health Nurse
Day treatment
Employment Services
Respite
Home modifications
Transportation

Therapies:

Occupational Therapy
Physical Therapy
Speech Therapy
Physical Health Services

  • Ambulatory surgery
  • Anti-hemophilic agents and related services
  • Audiology
  • Behavioral Health
  • Chiropractic services 21
  • Dental services–For members who are 21 years of age and older. These dental services are limited to a total of $1000 for each 12-month period, includes: ◦ Treatment of a medical condition such as acute pain (not Temporomandibular Joint Dysfunction-TMJ pain except for reduction of trauma) ◦ Treatment for infection or fracture of the jaw ◦ Exam with problem and treatment of the oral cavity ◦ Required radiographs ◦ Complex oral surgical procedures ◦Appropriate anesthesia ◦ Prescription of pain medication and antibiotics ◦ Prophylactic extraction of teeth in preparation for radiation treatment of cancer of the jaw, neck or head ◦ Other dental services, including dentures.
  • Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
  • Early detection health risk assessment, screening, treatment, and primary prevention
  • Emergency services
  • Eye examinations/optometry
  • Family planning
  • Foot and ankle services
  • Hospital services
  • Immunizations
  • Incontinence supplies
  • Laboratory
  • Maternity services
  • Medical foods
  • Medical supplies, Durable Medical Equipment (DME), orthotic, and prosthetic devices
  • Medically-necessary pregnancy termination (including Mifepristone [Mifeprex] or RU-486)
  • Nutrition
  • Oral health
  • Physician services
  • Podiatry services
  • Post-stabilization care services
  • Pre-natal HIV testing and counseling
  • Prescription medications
  • Primary Care Provider (PCP) services
  • Radiology and medical imaging
  • Rehabilitation therapy 22
  • Transplantation of organs, tissue, and related prescriptions
  • Transportation
  • Triage/Screening and evaluation
  • Vision Services/Ophthalmology/Optometry
  • Well visitsBehavioral Health Services
  • Behavior Analysis Services
  • Behavior Management (personal care, family support/home care training, peer support)
  • Behavioral Health Case Management Services (with limitations)
  • Behavioral Health Nursing Services
  • Emergency Behavioral Health Care
  • Emergency and Non-Emergency Transportation
  • Evaluation and Assessment
  • Individual, Group and Family Therapy, and Counseling
  • Inpatient Hospital Services
  • Non-Hospital Inpatient Psychiatric Facilities
  • Laboratory and Radiology Services for Psychotropic Medication Regulation and Diagnosis 25
  • Opioid Agonist Treatment
  • Partial Care (supervised day program, therapeutic day program, and medical day program)
  • Psychosocial Rehabilitation (living skills training; health promotion; supportive employment services)
  • Psychotropic Medication Adjustment and Monitoring
  • Rehabilitation Services (living skills training; health promotion; supported employment services)
  • Respite Care (with limitations)
  • Rural Substance Abuse Transitional Agency Services
  • Screening

Support Coordinator

Once you are approved, you will get a support coordinator, and together you will figure out which services your child will get access to, how often, and where. Your support coordinator will put out vender calls to help you find companies to provide services for your child.

Every three months you will meet with your Support Coordinator to review goals, check on progress, and adjust services if needed.