For Arizona residents requiring long-term care, navigating the options can be overwhelming. Among the programs available, the Arizona Medicaid Self Directed Attendant Care (SDAC) program stands out by offering a unique approach to receiving care. Instead of relying solely on traditional agency-directed services, SDAC empowers individuals to take control of their care, providing flexibility and choice in how their needs are met. This guide will delve into the specifics of the Arizona SDAC program, explaining its benefits, eligibility requirements, covered services, and how to apply.
Understanding the Self Directed Attendant Care (SDAC) Program in Arizona
The Arizona Self Directed Attendant Care (SDAC) program is not a standalone program, but rather an option within Arizona’s Long Term Care System (ALTCS), which itself is a part of Arizona Medicaid (officially known as the Arizona Health Care Cost Containment System or AHCCCS). SDAC operates on a “Cash and Counseling” model, granting participants significant autonomy in managing their personal care services. This means individuals eligible for ALTCS who opt for SDAC can decide what services they need, and crucially, who provides those services.
This self-direction is a key advantage of the SDAC program. Participants can hire, train, schedule, and even dismiss their own personal care providers, often referred to as direct care workers (DCWs) or attendant care workers (ACWs). This level of control ensures that care is truly personalized and responsive to the individual’s unique circumstances and preferences. It’s important to note, however, that this option is designed for those receiving care at home and is not available for individuals residing in assisted living facilities or nursing homes.
Key Benefits of the Arizona SDAC Program
The Arizona Medicaid Self Directed Attendant Care program offers several compelling benefits that make it an attractive option for eligible individuals:
- Personalized Care: Participants are at the center of their care plan, deciding which services best address their needs. This leads to more tailored and effective care.
- Choice of Caregiver: One of the most significant advantages is the ability to hire your own caregiver. This can include family members, friends, or other individuals you trust.
- Family Caregiver Compensation: SDAC recognizes the vital role family members play in caregiving. The program allows for the hiring of family members, including adult children and, in some cases, spouses (indirectly through an agency), as paid caregivers. This can be particularly beneficial for families where a member has had to reduce work hours or leave employment to provide care.
- Flexibility and Control: Participants manage their caregiver’s schedule, training, and daily tasks, providing greater control over their care environment.
- Home-Based Care: SDAC supports individuals who prefer to receive care in the comfort and familiarity of their own homes, promoting independence and quality of life.
Eligibility for Arizona SDAC Program
To be eligible for the Arizona Medicaid Self Directed Attendant Care program, individuals must first meet the general and financial eligibility requirements for Arizona’s Long Term Care System (ALTCS):
General Requirements:
- Arizona Residency: Applicants must be residents of Arizona.
- Medicaid Eligibility: Individuals must qualify for Arizona Medicaid through ALTCS. This typically requires demonstrating a need for long-term care services due to age or disability.
- Nursing Home Level of Care: Applicants must require a level of care equivalent to that provided in a nursing home, but be able and willing to receive this care at home.
- Self-Direction Capability: Participants (or their legal representatives) must be capable of directing their own care, which includes managing a caregiver.
Financial Requirements:
Arizona Medicaid (AHCCCS) has specific income and asset limits to determine financial eligibility. These limits are subject to change annually. For 2024, the financial guidelines are generally as follows:
- Individual Income Limit: $2,829 per month (This figure is subject to change; verify current limits with AHCCCS).
- Individual Asset Limit: $2,000 (This figure is subject to change; verify current limits with AHCCCS).
- Married Couples Income Limit (both applying): $5,658 per month (This figure is subject to change; verify current limits with AHCCCS).
- Married Couples Asset Limit (both applying): $4,000 (This figure is subject to change; verify current limits with AHCCCS).
Important Financial Considerations:
- Medicaid Look-Back Period: Arizona Medicaid has a 5-year look-back period. Any asset transfers made within this period before applying for Medicaid will be scrutinized and may result in a period of ineligibility.
- Exempt Assets: Certain assets are exempt from consideration, such as the applicant’s primary home (with equity limits), one vehicle, personal belongings, household items, and burial plots.
- Over Income/Asset Limits: Individuals exceeding these limits may still qualify for Medicaid through strategies like establishing a Miller Trust (for income overage) or “spending down” assets (for asset overage). Consulting a Medicaid planning expert is recommended for those exceeding the financial limits.
Services Covered Under the SDAC Program
The Arizona Medicaid Self Directed Attendant Care program covers a range of personal care services designed to assist individuals with activities of daily living (ADLs). These services are essential for maintaining independence and safety at home and include:
- Bathing and Personal Hygiene: Assistance with showering, bathing, grooming, and oral care.
- Dressing: Help with putting on and taking off clothing.
- Toileting: Assistance with using the bathroom.
- Mobility: Support with walking, transferring, and moving around the home.
- Meal Preparation: Planning, preparing, and serving meals.
- Basic Housework: Light housekeeping tasks to maintain a safe and clean living environment.
- Shopping for Essentials: Assistance with grocery shopping and errands.
In addition to ADLs, direct care workers under the SDAC program can perform basic skilled nursing tasks if properly trained by a registered nurse. These tasks may include:
- Glucose and Insulin Monitoring
- Non-sterile Wound Care
- Enemas
The program may also cover the cost of adaptive equipment that promotes independence and safety at home, such as:
- Shower chairs
- Grab bars
- Walkers
How to Apply for the Arizona SDAC Program
The application process for the Arizona Medicaid Self Directed Attendant Care program involves several steps:
- ALTCS Application: The first step is to apply and be approved for Arizona’s Long Term Care System (ALTCS). Applications can be made at any ALTCS office location. You can find a list of locations on the AHCCCS website.
- SDAC Program Enrollment: Once approved for ALTCS, you can express your interest in the Self Directed Attendant Care option to your case manager.
- Care Plan Development: You will work with a case manager to develop a personalized care plan that outlines your service needs and how SDAC can meet them.
- Caregiver Selection and Training: You will choose and hire your direct care worker. It’s important to ensure they receive necessary training, including first aid and CPR certification.
- Fiscal Employer Agent (F/EA): The SDAC program utilizes a Fiscal Employer Agent to handle payments to caregivers and suppliers on your behalf.
Resources for Further Information:
- AHCCCS Website: The official Arizona Health Care Cost Containment System (AHCCCS) website provides comprehensive information about ALTCS and the SDAC program.
- SDAC Program Brochure: AHCCCS offers a downloadable brochure with an overview of the SDAC program.
- SDAC Program Manual: For detailed information, AHCCCS provides an in-depth program manual.
Agency with Choice: Another Consumer-Directed Option
Arizona residents should also be aware of another similar program under ALTCS called Agency with Choice. This program also allows for consumer direction of services but operates with a slightly different model, partnering with an agency. Agency with Choice can be a good alternative for those who want more support in managing their caregiver while still maintaining a degree of control.
Conclusion
The Arizona Medicaid Self Directed Attendant Care (SDAC) program offers a valuable pathway for eligible individuals to receive personalized, home-based care. By empowering participants to direct their own services and choose their caregivers, SDAC promotes independence, dignity, and a higher quality of life. If you believe the SDAC program might be right for you or your loved one, exploring the resources mentioned and contacting ALTCS for further guidance is the next step toward accessing this empowering care option.
