Alaska Online Public Notices #225847

Alaska proposes amendments to five Medicaid community-services waivers

Alaska is seeking public input on amendments to five Medicaid home- and community-based services waivers; this is a policy and program notice, not a purchase solicitation. - Government buyer: Alaska Department of Health, Division of Senior and Disabilities Services (SDS); statewide. - Waivers covered: Alaskans Living Independently (ALI), Adults with Physical and Developmental Disabilities (APDD), Children with Complex Medical Conditions (CCMC), People with Intellectual and Developmental Disabilities (IDD), and Individualized Supports Waiver (ISW). - Proposed changes: Update eligibility and reassessment rules, service and provider specifications, safeguards, grievance and hearing language, and rate-setting methods. The IDD and ISW propose replacing ICAP assessments with DDAT-C/DDAT tools validated by interRAI. APDD also describes a phased transition from CAT to the Alaska Home Care Assessment Tool. Assessment transitions are expected to take about a year. - Services covered by the waivers: Care coordination; adult day services/day habilitation; employment services; residential habilitation and supported living; respite; environmental modifications; host home care; intensive active treatment; meals; nursing oversight and care management; specialized private duty nursing; specialized medical equipment; and transportation. - Notable service limits and requirements: Environmental modifications are generally capped at $40,000 per participant over 36 months, with a 270-day project limit. Respite is generally limited to 520 hourly hours or 14 daily days per year. Meals are limited to two per day. Some habilitation services have annual hour limits; non-medical trips over 20 miles generally require approval. The Individualized Supports Waiver also addresses distance delivery limits for certain services. - OEMs and vendors: No products are being purchased and no commercial vendors or product manufacturers are identified. interRAI is mentioned in connection with assessment tools; it is not identified as a procurement vendor. - Timing and scale: Amendments are proposed for implementation in 2027. Approval periods vary by waiver, with requests generally for three years and some materials describing five-year projections. Stated capacity includes 3,054 annual participants for ALI, 600 participants at a time and up to 620 annually for ISW, and APDD annual limits rising from 200 to 240. - Procurement details: No product quantities, product part numbers, contract value, or commercial performance period are provided. Stakeholders are invited to submit comments to the SDS contact identified in the notice.

Description

The Alaska Department of Health, Division of Senior and Disabilities Services, is requesting public comments on proposed amendments to five Alaska 1915(c) home and community-based services waivers before submitting them to the Centers for Medicare and Medicaid Services. Proposed changes include transitioning the IDD and ISW waivers from ICAP assessments to DDAT-C and DDAT tools, alongside updates to waiver language, eligibility and reassessment processes, services and provider specifications, safeguards, grievance policies, and rate-setting methodologies. Written comments were accepted through 5:00 p.m. on December 21, 2026, and the notice provides contact details and draft waiver amendments.

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