Getting paid to care for a family member in Alaska
Depends.
In Alaska, whether a family member can be paid depends on the program's rules, which are below with their sources. Whether a spouse can be paid depends on the program.
Checked
Each fact below links to its official source and shows the date we checked it. How we verify
We do not sell your information. No sales calls, no lead forms.
Medicaid waiver
Alaskans Living Independently (ALI) Waiver
Checked
Who qualifies
Medicaid-eligible people at least 21 years old with physical disabilities or functional needs associated with aging, who otherwise might live in a skilled nursing facility for more than 30 days a year.
Depends.
For some services, with limitations. A provider certified by Senior and Disabilities Services may employ a relative (someone related by blood, marriage or adoption who has no legal duty under state law to support the participant) who is older than 18 and meets the provider qualifications. Relatives may provide adult day, environmental modifications, meals, nursing oversight and care management, respite, specialized medical equipment, specialized private duty nursing, transportation, host home care and residential supported living, each with limitations.
Immediate family members cannot provide care coordination.
No.
No. A spouse is a legally responsible individual, and legally responsible individuals are not permitted to provide any services on this waiver, except a court-appointed legal guardian whom the court has explicitly authorized to provide waiver services.
A spouse can be paid for personal care under Community First Choice, below.
Depends.
Only with a court order that explicitly authorizes the guardian to provide waiver services, and then only for a limited list of services, each with limitations: adult day, environmental modifications, meals, nursing oversight and care management, respite, specialized medical equipment, specialized private duty nursing and transportation.
A court-appointed guardian cannot provide care coordination.
Current Medicaid recipients who need the level of care provided in a nursing facility, an intermediate care facility for individuals with intellectual disabilities, or certain psychiatric institutions.
A person cannot receive Community First Choice services while also receiving personal care services under 7 AAC 125.
Depends.
Only when the spouse is qualified to provide personal care services and is employed by a certified Community First Choice provider. This applies to Community First Choice personal care services.
The rule also limits a spouse to 40 paid hours in a seven-day period; see the hours limit below for how Senior and Disabilities Services is applying that limit.
Depends.
Only under the same conditions as a spouse. A court-appointed legal guardian must also appoint a designee, on a department form, to act on the guardian's behalf.
No weekly limit is being enforced for a spouse or other legally responsible individual. 7 AAC 127.015(a)(3) sets a 40-hour per week limit, but Senior and Disabilities Services will not enforce it for Community First Choice personal care services and will remove it in the future, because neither CMS nor the 2023 legislation imposed an hourly limit.
Medicaid recipients whose physical condition, confirmed by an assessment, leaves them unable to perform covered daily activities such as bathing, dressing and eating on their own. In the Consumer-Directed PCS program, you choose, hire, supervise and can fire your own personal care assistant, and an agency provides administrative support.
To use the consumer-directed program, you or your representative must show the capacity to make decisions and take responsibility for managing and training your personal care assistant (7 AAC 125.140).
Depends.
No, unless the spouse is the person's court-appointed guardian and a court authorizes the guardian under AS 13.26.311(c) to provide personal care services. The personal care assistant may not be the recipient's spouse, an individual with a duty to support the recipient under state law, the recipient's representative, or the representative's designee.
Under Community First Choice, above, a spouse can be paid for personal care.
Apply for Medicaid through an interview and application with the Division of Public Assistance, which decides whether you meet the income and resource limits. Senior and Disabilities Services then assesses whether you meet the level of care requirement: nurses or other trained staff complete a functional assessment in person or by video call.
The first step is to contact your local ADRC or DDRC. It can help to have a family member or friend help you with the call or visit. The Community First Choice application is form CFC-06.
A representative of a certified personal care agency completes the PCA-08 Application for Personal Care Services with you and submits it to Senior and Disabilities Services. You choose agency-based or consumer-directed on the application.
