Medicaid waiver
Arizona Long Term Care System (ALTCS) Attendant Care
Checked
- Who qualifies
-
Arizona residents who are aged, blind, disabled, or have a developmental disability, meet ALTCS financial limits, and are at immediate risk of institutionalization in a nursing facility or an intermediate care facility for individuals with intellectual disabilities (you must need that level of care, but you do not need to live in a facility). You must also be a citizen or qualified immigrant, have or apply for a Social Security Number, and live in an approved living arrangement such as your own home.
For a single applicant, countable resources cannot be more than $2,000. A married applicant may be able to set aside some resources for a spouse living in the community.
Source: Filing an Application for the Arizona Long Term Care System (ALTCS), DE-828 (AHCCCS, rev 12/2025)Checked
- Can a family member be paid
-
Yes. Yes. Direct care workers can include family members as paid caregivers. AHCCCS defines family members as a spouse, adult children and stepchildren, sons- and daughters-in-law, grandchildren, siblings and stepsiblings, parents, stepparents and adoptive parents, grandparents, mothers- and fathers-in-law, and brothers- and sisters-in-law.
Every direct care worker, family members included, must hold CPR and first aid certification, meet the training and background check requirements, and provide no more than 16 hours of paid care within a 24-hour period.
- Can a spouse be paid
-
Depends. Yes, under the Spouse as Paid Caregiver option, with limits. The member must live in their own home, the care must be extraordinary care (beyond what a spouse would ordinarily do if the member did not have a disability or chronic illness), and the spouse must be employed or contracted by a direct care worker agency (or, for members served by DDD, through the Independent Provider Network). The spouse is paid no more than a non-spouse caregiver would be for similar care.
The member must be told they can choose an attendant care provider other than their spouse, and the case manager records that choice at least once a year. AHCCCS says its revised HCBS Needs Tool and Extraordinary Care Review policies go live on December 1, 2026 (HNT/ECR FAQ, July 24, 2026). The changes are aimed at members under 18, and AHCCCS says adults are not subject to the tool's age limits, but this policy may be revised then: re-check after December 1, 2026.
- Hours limit
-
A spouse cannot be paid for more than 40 hours of services in a seven-day period, and the total care from the spouse and any other direct care worker cannot exceed 40 hours in a seven-day period. Any paid caregiver can provide no more than 16 hours of paid care within a 24-hour period.
AHCCCS says its revised HCBS Needs Tool and Extraordinary Care Review policies go live on December 1, 2026 (HNT/ECR FAQ, July 24, 2026). The changes are aimed at members under 18, and AHCCCS says adults are not subject to the tool's age limits, but this policy may be revised then: re-check after December 1, 2026.