Tag Archive for: ALTCS

How Many Hours of Care Can You Get Through DDD?

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It’s the question on every family’s mind once they’re approved: How many hours of care will we actually receive? The honest answer is that there’s no flat number — DDD care hours are based on your loved one’s assessed needs, not a fixed allotment. Here’s how the process works and what shapes the number you’re authorized.

Please note: Arizona has been actively revising how care hours for minor children are assessed. The general process below still applies, but the specific assessment tool and rules have been in flux. Always confirm the current process and your loved one’s authorization with your DDD Support Coordinator.

Hours Are Based on Need, Not a Set Amount

DDD uses a person-centered approach. Rather than handing everyone the same number of hours, the program looks at what each individual actually needs to be safe, healthy, and supported at home. Two people with the same diagnosis can be authorized for very different amounts of care, because their needs differ.

This is determined through an assessment your Support Coordinator completes with your family, which then shapes your Person-Centered Service Plan (PCSP) — the document that authorizes your services.

How the Assessment Works

The process generally looks like this:

  1. Your Support Coordinator meets with you and your loved one. They gather information about daily needs, often through interview and observation.
  2. An assessment tool is used to help translate those needs into service hours for things like Attendant Care, Habilitation, and Homemaker services.
  3. Your planning team develops the service plan. You’re part of this team — your input matters.
  4. Hours are authorized in your PCSP, and services can begin.
  5. The plan is reviewed regularly, and hours can be adjusted if needs change.

Once ALTCS-approved, members complete a full person-centered service plan with their Support Coordinator and team each year, with additional reviews as needed.

What Affects the Number of Hours

Several factors influence your authorization, including:

  • The individual’s level of need across daily activities like bathing, feeding, mobility, and supervision
  • Safety considerations, such as whether the person can be left alone
  • The specific services involved (Attendant Care, Habilitation, Respite, and Homemaker are assessed differently)
  • Age and developmental stage, which shape what level of assistance is expected
  • Available natural and community supports, which the person-centered process takes into account

A Note on Recent Changes for Children

Arizona introduced a new assessment tool for home and community-based services in late 2025 and then paused it after hearing concerns from families. During that period, hours for members under 18 were handled based on their most recent prior assessment while the tool was revised. The state also outlined an Extraordinary Care Review process for children under 18 who need more direct-care or habilitation hours than an assessment shows.

Because this area has been changing, the most reliable source for your child’s current hours is your Support Coordinator. If you feel an assessment doesn’t reflect your child’s real needs, ask about the Extraordinary Care Review and your appeal rights.

If You Think Your Hours Are Too Low

You have options:

  • Talk with your Support Coordinator first. Make sure the assessment fully captured your loved one’s needs — sometimes important details get missed. (Our guide on working with your Support Coordinator has tips for these conversations.)
  • Ask about the Extraordinary Care Review if it applies to your situation.
  • Appeal a reduction or denial. If your services are reduced, denied, suspended, or terminated, you have the right to appeal. See our DDD appeals guide.

Different Services, Different Limits

Keep in mind that services follow different rules:

Frequently Asked Questions

Is there a maximum number of hours DDD will provide? Hours are based on assessed need rather than a universal cap, though specific services (like respite) may have their own limits. Your Support Coordinator can explain what applies to your loved one.

Why did my neighbor’s child get more hours than mine? Because hours reflect individual assessed needs. Even children with the same diagnosis can have very different levels of need, which leads to different authorizations.

Can our hours change over time? Yes. Plans are reviewed regularly, and authorizations can go up or down as your loved one’s needs change.

What can I do if I disagree with my hours? Start with your Support Coordinator, ask about the Extraordinary Care Review if relevant, and use your appeal rights if services are reduced or denied.

Want an advocate who understands the system? We help Arizona families navigate assessments and get the services their loved ones need. Contact us to learn more.

This article is for general information and isn’t legal or medical advice. Assessment rules and service limits change; confirm current details with your DDD Support Coordinator or at des.az.gov.

This article is for general information and isn’t legal, tax, or medical advice. The PPCG program and related rules change; confirm current details with your DDD Support Coordinator, at des.az.gov, or at azahcccs.gov.

Can I Get Paid to Take Care of My Child with a Disability in Arizona?

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It’s one of the most common questions Arizona parents ask — and one of the most misunderstood: Can I actually be paid for the care I already give my child? For many families, the answer is yes. Arizona allows parents and family members to be paid caregivers through DDD, and it can be a genuine relief for households where caregiving makes outside employment difficult. Here’s how it works, in plain language.

Important: The rules for paying parents of minor children have been changing recently, including how care hours are assessed. This article explains the framework, but always confirm the current details with your DDD Support Coordinator, because specifics can shift.

The Short Answer

  • Parents of minor children can be paid to provide certain care through a program called Parents as Paid Caregivers (PPCG) — with specific rules and an hourly cap.
  • Family members of adult children can also be paid to provide care, generally without the same hourly cap.
  • Relatives, friends, and other trusted people can frequently be hired and trained as paid caregivers through a provider agency, even when they aren’t parents.

In other words, the person caring for your loved one often can be someone you already know and trust — including you.

How the PPCG Program Works (Parents of Minors)

The Parents as Paid Caregivers (PPCG) service model lets a parent be paid to provide direct-care services — such as Attendant Care and hourly Habilitation — to their own minor child. It began during the COVID-19 public health emergency and was later made a permanent option under Arizona’s federal Medicaid waiver.

A few key rules define the program:

It pays for “extraordinary care,” not ordinary parenting

PPCG compensates parents for extraordinary care — disability-specific support that goes beyond what a parent would ordinarily do for a child of the same age without a disability, and that’s needed to keep the child healthy and safe at home. Routine parenting tasks — general housekeeping, laundry, meal prep, and ordinary supervision — are not billable.

There’s a weekly hour cap

As of July 1, 2025, a parent caregiver under PPCG may bill up to 40 hours per week per child. If your child is authorized for more than 40 hours, a qualified non-parent caregiver must provide the additional hours. Where two parents care for the same child, their combined paid hours can’t exceed the per-child cap; where a parent cares for two children, the limits apply per child.

You work through one agency

To be paid, the parent becomes a Direct Care Worker (DCW) employed or contracted by a single DDD-registered provider agency (a Qualified Vendor). The agency handles training, payroll, and compliance.

There are eligibility requirements

The child must be enrolled in ALTCS and authorized for Attendant Care and/or Habilitation through DDD. The parent must have formal physical and/or legal custody of the minor (biological, adoptive, or legal guardian — stepparents don’t qualify unless they legally adopt). Parents also must be at least 18, complete required training, and pass background checks. A fingerprint clearance card is generally required, though there’s an exception for a parent providing only Attendant Care who lives in the same home as the child.

Some tasks and times aren’t billable

There are guardrails on when and what a parent can bill — for example, care generally can’t be billed while the child is at school, during certain inpatient stays, or when the child isn’t present. Your agency and Support Coordinator will walk you through the current rules.

A Note on the “Extraordinary Care” Gap

Here’s something families should understand: your child’s authorized hours and what a parent is allowed to bill aren’t always the same. A child may be authorized for more care than a parent can personally claim under PPCG. This doesn’t reduce your child’s services — it changes who can provide some of those hours. Many families use a mix of parent-provided care (up to the cap) and a trusted non-parent caregiver for the rest. If you believe your child needs more hours than an assessment shows, ask your Support Coordinator about the Extraordinary Care Review process.

What About Adult Children and Other Family?

If your loved one is an adult, parents and family members can generally be paid to provide care without the 40-hour weekly cap that applies to parents of minors. And across ages, relatives and other trusted people can often be hired and trained as caregivers through an agency. There’s also a Licensed Health Aide pathway that allows certain family members to provide nursing-related services when the member is approved for private-duty nursing or skilled nursing respite — this requires specific nursing-board-approved training and working through an approved home health agency.

A Word on Taxes and Other Benefits

Two things worth knowing:

  • Payments a parent receives for providing this care may qualify as “difficulty of care” payments, which can be excluded from income for federal tax purposes in some situations. A tax professional can advise on your specific circumstances.
  • The extra income could affect eligibility for other assistance programs (like SNAP) for your household. It’s worth thinking through the full picture before you begin.

How to Get Started

  1. Confirm your child’s DDD eligibility and ALTCS enrollment. (See our DDD application guide and ALTCS guide.)
  2. Make sure Attendant Care and/or Habilitation is authorized in your child’s service plan.
  3. Talk with your Support Coordinator about choosing the PPCG service model at your planning or review meeting.
  4. Partner with a DDD-registered agency that can employ or contract with you as a Direct Care Worker and handle training and payroll.

Frequently Asked Questions

Can I really get paid to take care of my own child? In many cases, yes. Through the PPCG program, parents of eligible minor children can be paid to provide certain care, and family members of adult children can be paid as well.

How many hours can I be paid for? For parents of minors under PPCG, up to 40 hours per week per child (as of July 1, 2025). Additional authorized hours must be provided by a non-parent caregiver. Adult-child care generally isn’t subject to this cap.

Do I need any training or certification? Yes. You’ll become a Direct Care Worker through an agency, which means completing required training and passing background checks.

Will this affect my taxes or other benefits? It might. Payments may qualify as excludable “difficulty of care” income, but the extra earnings could affect other benefits. Consult a tax professional and consider the full household picture.

Why do the rules seem to keep changing? Arizona has been actively revising how care hours for minor children are assessed. Because of this, confirm the current rules and your child’s specific authorization with your Support Coordinator.

Interested in being paid to care for your loved one?  We are a DDD-registered agency that helps Arizona parents and family members become paid caregivers — we handle the training and paperwork so you can focus on your family. Contact us to see if you qualify.

This article is for general information and isn’t legal, tax, or medical advice. The PPCG program and related rules change; confirm current details with your DDD Support Coordinator, at des.az.gov, or at azahcccs.gov.

Homemaker Services Through DDD: What’s Covered and Who Qualifies

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Homemaker Services Through DDD: What’s Covered and Who Qualifies

When a person has a developmental disability, keeping up with household tasks can be a real challenge — and a cluttered or unsanitary home affects health and safety. Homemaker services through Arizona DDD help fill that gap, keeping the home clean and livable so your loved one can stay healthy and comfortable at home.

What Are Homemaker Services?

Homemaker services (sometimes abbreviated HSK) provide support with a variety of housekeeping tasks, allowing a DDD member to have their home kept in a clean and healthy condition. A homemaker provider helps with the kinds of routine household work that keep a home functioning, such as:

  • General cleaning and tidying
  • Laundry
  • Meal preparation
  • Shopping for essentials like food and household supplies
  • Other housekeeping tasks that maintain a safe, sanitary living environment

The purpose is simple but important: a clean, healthy home supports a healthy person.

Homemaker vs. Attendant Care: What’s the Difference?

These two services sound similar and sometimes overlap, but they focus on different things:

  • Attendant Care centers on the person — helping with bathing, grooming, feeding, toileting, and other personal-care needs (and it can include some light housekeeping to keep the home safe).
  • Homemaker services center on the home — the housekeeping tasks that keep the living environment clean and healthy.

An important nuance: homemaker services generally cover tasks the DDD member would normally do themselves but can’t because of their disability — not the household chores of everyone else living in the home. Your Support Coordinator can help clarify how this applies to your family’s situation.

Who Qualifies for Homemaker Services?

Homemaker services are available to individuals enrolled with DDD and approved for funding through the Arizona Long Term Care System (ALTCS). As with other services, the need is identified through an assessment your Support Coordinator conducts, and the service is authorized in your Person-Centered Service Plan (PCSP).

New to DDD? Begin with our guides on applying for DDD and understanding ALTCS.

How Homemaker Hours Are Determined

Like other DDD services, the amount of homemaker support you receive is based on assessed need and set through your planning process. Your Support Coordinator uses an assessment to determine appropriate hours, which are then documented in your service plan and reviewed over time. If your circumstances change, the authorization can be revisited.

For more on how hours are assessed across services, see How Many Hours of Care Can You Get Through DDD?.

Who Provides Homemaker Services?

Homemaker services are delivered by trained providers through a DDD-registered agency (a Qualified Vendor). As with other DDD services, families often have the option to choose a provider they trust.

Frequently Asked Questions

What’s the difference between homemaker and attendant care? Homemaker focuses on housekeeping tasks that keep the home clean and healthy. Attendant Care focuses on the person’s daily personal-care needs. Some families receive both.

Does homemaker service cover cleaning up after the whole family? Generally, homemaker services cover the household tasks the DDD member would normally handle but can’t due to their disability — not the chores of other household members. Your Support Coordinator can explain the specifics.

Can a family member provide homemaker services? In many cases, families can choose a trusted provider through an agency. Ask your Support Coordinator and provider agency about the options and requirements.

How do I add homemaker services to my plan? Talk with your Support Coordinator about the need. They’ll complete an assessment and, if appropriate, authorize the service in your Person-Centered Service Plan.

 

Need a hand keeping the home healthy and safe? We provide reliable homemaker services to Arizona DDD families, helping your loved one live comfortably at home. Contact us to learn more.

This article is for general information and isn’t legal or medical advice. Program rules change; confirm current details with your DDD Support Coordinator or at des.az.gov.

 

Respite Care in Arizona: Relief for Caregivers, Explained

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Respite Care in Arizona: Relief for Caregivers, Explained

Caring for a loved one with a developmental disability is a labor of love — and it’s also constant. You’re responsible for their care around the clock, and it’s easy to reach a point where you have nothing left for yourself. Respite care exists for exactly this reason: to give you a break, knowing your loved one is in good hands.

What Is Respite Care?

Respite is a short-term service that provides a trained person to supervise and care for your loved one for a period of time, so that you — the primary caregiver — can rest and recharge. The entire point of respite is the “break”: a chance to step away, run errands, attend to your own health, spend time with your other children, or simply breathe.

Respite care can be provided in your home or out in the community, and it’s designed to meet the person’s social, emotional, and physical needs during the respite period.

Why Respite Matters

Caregiver exhaustion is real, and it isn’t a sign of weakness — it’s a sign of how much you’re carrying. Running on empty affects your health, your patience, and ultimately your ability to care for your loved one. Respite is one of the most practical tools available to protect your well-being so you can keep showing up for your family.

If you’re feeling stretched to the limit, you’re not alone. Our article on caregiver burnout offers more strategies for protecting your own health.

Who Qualifies for Respite?

Respite is available to individuals enrolled with DDD and approved for funding through the Arizona Long Term Care System (ALTCS). Like other services, it’s authorized through your Person-Centered Service Plan (PCSP) based on an assessment your Support Coordinator completes with your family.

If you’re still working through the basics, see our guides on applying for DDD and how ALTCS works.

How Respite Hours Work

Respite is typically authorized up to an annual limit, and the amount is set through your planning process. Because these limits and the way hours are assessed can change, ask your Support Coordinator for the current respite allowance and how it applies to your situation. Planning your respite hours thoughtfully across the year helps you make the most of them — you might save some for a family event, a medical appointment, or a stretch when you know you’ll need extra support.

Who Provides Respite Care?

Respite is delivered by trained providers through a DDD-registered agency. And here’s a detail many families appreciate: you can often bring on someone you already know and trust — a relative, family friend, or other caregiver — to be hired and trained as your respite provider through an agency, as long as they meet the training and background requirements. This means your loved one can be cared for by a familiar face while you take your break.

Making the Most of Respite

A few tips from families who’ve been there:

  • Use it before you’re desperate. Respite works best as regular maintenance, not just crisis relief.
  • Plan around your calendar. Look ahead to appointments, events, and busy seasons.
  • Build a relationship with your provider. Consistency helps your loved one feel comfortable and helps you relax while you’re away.
  • Don’t feel guilty. Taking care of yourself is part of taking care of your family.

Frequently Asked Questions

What’s the difference between respite and attendant care? Attendant Care provides ongoing daily support for the individual’s personal-care needs. Respite is specifically about giving the caregiver a break, providing short-term supervision and care so you can step away.

Can respite be provided in my home? Yes. Respite can take place in your home or in the community, depending on what works best for your family and your loved one’s plan.

Can a family member be my respite provider? Often, yes — a trusted relative or friend can be hired and trained through an agency, provided they meet the requirements.

How much respite will we get? Respite is generally subject to an annual limit set through your service plan. Because these amounts can change, confirm the current allowance with your Support Coordinator.

 

You deserve a break.  We provide dependable respite care to Arizona families — so you can rest knowing your loved one is safe and supported. We can even help you bring on a caregiver you already trust. Contact us to learn more.

This article is for general information and isn’t legal or medical advice. Program rules and service limits change; confirm current details with your DDD Support Coordinator or at des.az.gov.

Habilitation Services: How They Help Your Child Build Independence

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Habilitation Services: How They Help Your Child Build Independence

Every parent of a child with a developmental disability shares a hope: that their child will grow more capable, more confident, and more independent over time. Habilitation is the DDD service built around exactly that goal. Rather than simply doing tasks for your child, habilitation teaches your child to do more for themselves — one step at a time.

What Is Habilitation?

Habilitation (often abbreviated HAH for hourly habilitation) is a service that teaches self-help, socialization, and adaptive skills to help a person with a developmental disability increase their independence and participate more fully in their community. It’s about building ability, not just managing daily needs.

Habilitation uses a range of teaching methods, including:

  • Self-help skills broken into small, learnable steps
  • Behavioral support and intervention
  • Sensory and motor skill development
  • Socialization and communication skills
  • Adaptive skills for daily living

The common thread is skill-building. A habilitation provider might work with your child on getting dressed independently, following a morning routine, communicating a need, managing frustration, or navigating a social situation — gradually reducing the amount of help needed as skills grow.

Habilitation vs. Attendant Care: What’s the Difference?

This is the question families ask most, and the distinction is important:

  • Attendant Care is hands-on help with daily tasks — bathing, feeding, hygiene. The provider does the task with or for the person.
  • Habilitation teaches the person to do the task themselves, building skills and independence over time.

Many families receive both services, and they complement each other beautifully. Attendant Care meets today’s needs; habilitation invests in tomorrow’s independence.

How Skill-Building Works in Practice

Habilitation is intentional and goal-oriented. Skills are taught in steps, so a big goal like “prepare a simple meal” gets broken down into manageable pieces — washing hands, gathering ingredients, using kitchen tools safely, following a sequence. Each small win builds toward greater confidence and capability.

The specific goals are individualized. They’re identified through your planning process and reflect what matters most for your child’s growth and daily life. Because the focus is on progress, habilitation goals evolve as your child develops.

Who Qualifies for Habilitation?

Like other DDD services, habilitation is available to individuals enrolled with DDD and approved for funding through the Arizona Long Term Care System (ALTCS). The service and the number of authorized hours are determined through your Support Coordinator’s assessment and your Person-Centered Service Plan (PCSP).

New to the process? Start with applying for DDD and understanding ALTCS.

Who Provides Habilitation?

Habilitation is delivered by trained Direct Support Professionals who work for a DDD-registered provider agency. They complete required training to support skill development safely and effectively. As with Attendant Care, families can often choose their provider — and in some cases, a parent of a minor child may be able to provide paid habilitation. See Can I Get Paid to Take Care of My Child? for the details.

Why Habilitation Matters

It’s easy to focus on immediate needs when you’re caring for a child with a disability. Habilitation asks a different, hopeful question: What could your child learn to do next? Whether it’s brushing their own teeth, greeting a neighbor, or managing a morning routine, these skills add up to a more independent, self-directed life — which is the heart of what DDD is designed to support.

Frequently Asked Questions

What does habilitation actually teach? Self-help skills, social and communication skills, adaptive daily-living skills, and behavioral or sensory/motor development — all taught in small, achievable steps and tailored to your child’s goals.

Can my child receive both habilitation and attendant care? Yes, many children do. The two services work together — one builds skills while the other meets daily care needs.

Is habilitation only for children? No. While it’s often associated with children, habilitation supports skill-building for eligible individuals across ages, based on their needs and goals.

How are habilitation hours determined? Through your Support Coordinator’s assessment and your service plan. Learn more in our guide on how many hours of care you can get through DDD.

 

Want to help your child grow more independent? We provide skilled, caring habilitation services to Arizona DDD families — and we’ll build a plan around your child’s goals. Contact us to learn more.

This article is for general information and isn’t legal or medical advice. Program rules change; confirm current details with your DDD Support Coordinator or at des.az.gov.

What Is Attendant Care? A Guide for Arizona DDD Families

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What Is Attendant Care? A Guide for Arizona DDD Families

Attendant Care is one of the most widely used services Arizona DDD families rely on — and for good reason. It provides the hands-on, day-to-day support that helps a person with a developmental disability stay safe, healthy, and comfortable in their own home. If you’re new to DDD or just hearing about this service, here’s everything you need to know.

What Attendant Care Covers

Attendant Care (sometimes called “total care”) provides the support a person needs to remain in their own home and take part in work or community life. A trained provider helps with the everyday tasks the individual can’t safely or fully do on their own, such as:

  • Bathing, grooming, and hygiene
  • Dressing
  • Toileting
  • Eating and feeding
  • Meal preparation
  • Light housekeeping that keeps the home safe and sanitary
  • Mobility assistance and help moving around the home

The goal is straightforward: help the person have a safe and clean home, stay healthy, and eat well.

Two Versions: Attendant Care and Attendant Care Supervision

It’s worth knowing there are two variations of this service:

  • Attendant Care provides hands-on assistance with personal-care tasks the person can’t do independently — feeding, bathing, grooming, toileting, meal prep, and so on.
  • Attendant Care Supervision provides constant supervision for individuals who can’t safely be left alone.

Your Support Coordinator and team determine which fits your loved one’s needs during the planning process.

Who Qualifies for Attendant Care?

Attendant Care is available to individuals who are enrolled with DDD and approved for funding through the Arizona Long Term Care System (ALTCS). Approval is based on need. Your DDD Support Coordinator, along with you as the parent or guardian, completes a needs assessment — usually based on an interview and observation — to determine the level of support required. It’s approved for people of various ages and disabilities who meet DDD’s criteria.

If you’re still working through eligibility, start with our guides on applying for DDD and how ALTCS funds these services.

How Are Attendant Care Hours Decided?

The number of hours you’re authorized isn’t arbitrary — it comes out of a formal assessment your Support Coordinator conducts, which feeds into your Person-Centered Service Plan (PCSP). The plan reflects the individual’s specific needs and is reviewed regularly. If your loved one’s needs change, the authorization can be revisited.

We cover this in detail in our article on how many hours of care you can get through DDD, including recent changes to how children’s hours are assessed.

Who Provides Attendant Care?

Attendant Care is delivered by trained Direct Care Workers who work for a DDD-registered provider agency (a “Qualified Vendor”). Providers must complete the state-mandated Direct Care Worker training and meet ongoing requirements.

Here’s something many families love: you can often choose who provides the care. In many cases, a family member, friend, or trusted person can be hired and trained as your provider through an agency — and in some situations, parents of minor children can even be paid to provide this care. We explain the rules in Can I Get Paid to Take Care of My Child?.

Getting Started With Attendant Care

Once your loved one is DDD-eligible and ALTCS-approved:

  1. Talk with your Support Coordinator about your need for Attendant Care.
  2. Complete the needs assessment so the appropriate hours can be authorized.
  3. Choose a provider agency to deliver the service.
  4. Schedule shifts with your provider, staying within the hours DDD has authorized.

If you use providers from more than one agency, your Support Coordinator will need to split your authorized hours between them.

Frequently Asked Questions

What’s the difference between Attendant Care and Habilitation? Attendant Care focuses on doing daily tasks with or for the person — bathing, feeding, hygiene. Habilitation focuses on teaching skills to build independence. Many families receive both. See our habilitation guide for more.

Can a family member provide Attendant Care? Often, yes. A family member, friend, or other trusted person can be hired and trained through a provider agency, as long as they meet the training and background requirements.

How many hours will we get? It depends on your loved one’s assessed needs. There’s no flat number — it’s determined through your Support Coordinator’s assessment and your service plan.

Does Attendant Care cost anything? For individuals approved through ALTCS, these services are covered. Your Support Coordinator can explain any specifics for your situation.

 

Looking for compassionate Attendant Care in Arizona? We are a DDD-registered agency that helps families get quality, reliable support at home — and we can help you bring on a trusted caregiver you already know. Contact us to get started.

This article is for general information and isn’t legal or medical advice. Program rules change; confirm current details with your DDD Support Coordinator or at des.az.gov.

What Is ALTCS and How Does It Connect to DDD Services?

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What Is ALTCS and How Does It Connect to DDD Services?

If you’ve started exploring services for a loved one with a developmental disability, you’ve probably run into two sets of initials: DDD and ALTCS. They’re related but not the same, and the difference confuses almost every family at first. Here’s how the two programs fit together — and why you’ll likely need both.

The Short Version

DDD decides who is eligible. ALTCS pays for the long-term services.

  • The Division of Developmental Disabilities (DDD) determines whether a person has a qualifying developmental disability.
  • The Arizona Long Term Care System (ALTCS) is Arizona’s Medicaid program for long-term care. It provides the funding that pays for services like attendant care, habilitation, and respite.

Think of DDD as the door and ALTCS as the funding that makes what’s behind that door affordable. Most families who want funded, ongoing in-home services go through both.

What Is ALTCS, Exactly?

ALTCS is the long-term-care branch of Arizona’s Medicaid system (AHCCCS). It provides long-term services and supports — at little or no cost — to Arizona residents who are aged, blind, disabled, or have a developmental disability and who meet both financial and medical eligibility rules.

For people on the DDD pathway, ALTCS is what covers home and community-based services (HCBS) so that a person can be supported in their own home and community rather than in an institution.

ALTCS Financial Eligibility

ALTCS is a needs-based program, so it looks at income and assets. The key 2026 figures for a single applicant are:

  • Gross monthly income limit: $2,982 (this figure is set at 300% of the federal benefit rate and is updated each January)
  • Countable resource (asset) limit: $2,000
  • Home equity: A primary home is often exempt, with a home-equity limit of up to $752,000 in 2026

If income is over the limit, families aren’t necessarily out of luck — Arizona allows a special type of trust (often called a Miller Trust or income-only trust) to help an over-income applicant qualify. Because these rules are genuinely complex, many families consult an elder-law attorney or a certified Medicaid planner. It’s worth noting that certified planners and attorneys are optional; ALTCS does not require you to use one.

A Big Point for Families of Children

Here’s something many parents don’t realize: for a child with a developmental disability, ALTCS often looks at the child’s own income and resources rather than the parents’. That means a family that would be “over income” for regular Medicaid may still have a child who qualifies for ALTCS. The rules have nuances, so confirm your specific situation with ALTCS — but don’t assume your household income automatically disqualifies your child.

ALTCS Medical Eligibility

Financial eligibility is only half the equation. ALTCS also requires that the applicant need a nursing-facility level of care. This is determined through a medical assessment called the Pre-Admission Screening (PAS), in which an assessor interviews the applicant and caregivers and reviews medical records. Only people assessed as needing this level of care meet the medical standard — but importantly, meeting it doesn’t mean you have to live in a nursing facility. ALTCS specifically funds home and community-based services so people can stay home.

How to Apply for ALTCS

You can start an ALTCS application through the Health-e-Arizona Plus online portal, or by calling ALTCS toll-free at 1-888-621-6880. Be prepared for the process to take time — anywhere from about 60 days to several months, depending on how quickly financial and medical information comes together.

What Happens After ALTCS Approval

Once you’re approved, two things happen:

  1. You’re enrolled with a DDD Health Plan. For DDD members, that means choosing between Mercy Care and UnitedHealthcare Community Plan, which handle your medical and behavioral health care. (Which one should you pick? See our health plan comparison.)
  2. You’re assigned a DDD Support Coordinator. This person leads your Person-Centered Service Plan (PCSP) meeting, where your team identifies which services you need and how many hours are authorized. Learn how to make the most of that relationship in our guide to working with your Support Coordinator.

The Order of Operations

For most families, the path looks like this:

  1. Apply for and receive DDD eligibility
  2. Apply for and receive ALTCS (financial + medical)
  3. Choose a DDD Health Plan
  4. Meet your Support Coordinator and build your service plan
  5. Choose a provider agency to deliver your services

Frequently Asked Questions

Do I need both DDD and ALTCS? To receive funded long-term services like attendant care and habilitation, you generally need DDD eligibility and ALTCS funding. DDD confirms the disability; ALTCS pays for the services.

What’s the ALTCS income limit for 2026? For a single applicant, the gross monthly income limit is $2,982, and the countable asset limit is $2,000. These figures update every January.

What if we make too much money? An over-income applicant may still qualify by using a Miller Trust (income-only trust). And for children, ALTCS often counts only the child’s income and resources — so ask before assuming you don’t qualify.

How long does ALTCS approval take? Typically 60 days to a few months. A complete application with medical and financial documentation ready to go moves faster.

What if my child has autism but doesn’t seem to have major limitations? Eligibility depends on both a qualifying diagnosis and significant functional limitations in at least three major life areas. It’s possible to have a diagnosis and still not meet the functional-limitation threshold, which is why thorough documentation matters.

Feeling overwhelmed by the paperwork? You don’t have to figure it out alone. We help Arizona families connect the dots between DDD, ALTCS, and the services their loved ones need. Get in touch to learn more.

This article is for general information and isn’t legal, medical, or financial advice. ALTCS figures and rules change; verify current limits with ALTCS at azahcccs.gov or 1-888-621-6880.