Ever wonder how to get help with daily living tasks or skills through the Alaska Medicaid Home and Community Based Waiver (HCBW) or Personal Care Services (PCS)?
To get help from the Waiver program or Personal Care Services, first you need to have Medicaid. Medicaid is health insurance for people with low income. People get Medicaid by applying for it with the Division of Public Assistance. Medicaid pays for medical care. It can also pay for help with everyday living and activities, like a Personal Care Assistant (PCA).
To get Medicaid, adults need to have income below a certain limit. A child with a disability might qualify, whether or not their family is eligible for Medicaid. People who have disabilities may become eligible for Long-Term Care Medicaid even if their income is too high for regular Medicaid.
Eligibility for Long-Term Care Medicaid
When someone with a disability needs help with daily living, they might need reminders or help to do everyday tasks. They may need the same kind of help as people in nursing homes. They might need similar help to people with developmental disabilities living in care facilities. The person must have medical records that show the disability and health conditions.
You may qualify for Personal Care Services or the Waiver if you need someone to help hands-on with everyday activities. Here are some examples:
Getting out of bed, turning while in bed, bathing and showering
Preparing meals and help to eat them
Using the toilet, including changing briefs/pull-ups and cleaning up.
Help doing household tasks like laundry and washing dishes
Moving about from room to room at home and help with going places in the community.
Help with taking medicine and limited everyday medical needs.
People with intellectual and developmental disability may qualify if the disability started before the person turned 22. A medical expert must write the diagnosis. Examples: Autism, seizures, cerebral palsy, and others. A person with a developmental disability may think, act, or communicate very differently than others their age without a disability. They could need special help to learn everyday life skills and safety skills and lots of reminders or someone to help them every day. The person likely learns very differently than people without a disability and will probably need this kind of help for their whole life.
Where to start getting help in Alaska?
The Aging and Disability Resource Centers and Developmental Disabilities Resource Connections programs can help. They cover every region of Alaska. They can help you understand what you need, show you what choices are available and help you apply for Medicaid or get help to apply. For more information call the Aging and Disability Resource Center (ADRC) toll free number, 1-855-565-2017.
What is a care coordinator? What do they do?
When you connect with the ADRC, you may learn that you likely qualify for the Medicaid Waiver. If you do, the ADRC will give you a list of care coordinators to select from. Care coordinators help people get services at home or in the community. They also help with medical, social, educational and other services that aren't paid for by Medicaid.
Care coordinators help people through a process led by the person receiving the help and their chosen team. They assist with completing and submitting applications for services at home or in the community. Once someone is eligible, care coordinators help the person set goals, plan services and pick service providers. They help create the first support plan and review and update it each year. They stay in contact with the person by visiting them and holding meetings about services.
Care coordinators do not do the following: fill out Medicaid applications, take people to do errands or shopping, schedule transportation or other services for the client. They do not accompany clients on medical appointments or arrange care outside of the Waiver or Personal Care Services. They cannot do things that are a conflict of interest.
If you have questions or would like to find out if you qualify, start by calling the Aging and Disability Resource Center, statewide toll-free number 1-855-565-2017.
Want to connect with the Senior and Disabilities Training team? Join us on Zoom for family and individual office hours the first and third Monday of each month, noon to 1 p.m. For information and the Zoom link, email SDSTraining@alaska.gov or call 907-269-3685.
Kara Thrasher-Livingston is a Training Unit Manager and Kat Sowa-Lapinskas a Care Coordinator Liaison for the Alaska Division of Senior and Disabilities Services.
