Alaska proposes new tool to decide who qualifies for Medicaid home care services

The Alaska Department of Health proposed Monday to adopt a new Alaska Home Care Assessment Tool for deciding who is eligible for Medicaid personal care services, Community First Choice services and home and community based waiver services. Health Commissioner Heidi Hedberg signed the notice.

Under the public review draft, the new tool would be used alongside the existing Consumer Assessment Tool for the assessments the rules identify.

The programs pay for help at home with daily activities. Community First Choice covers in-home personal care and other supports for people who qualify for admission to a facility such as a nursing home. In August, federal regulators renewed four of Alaska's Medicaid home-care waivers.

A new Service Level Computation Chart, dated Oct. 21, would replace the two charts now used to set personal care time.

The draft rewrites the list of covered personal care services. Tube feeding would be capped at six times a day. As under the current rule, it would be covered only in consumer-directed programs, where the recipient or a representative manages care, with a written plan from a physician, physician assistant or advanced practice registered nurse. Passive range-of-motion exercise, where another person moves the recipient's joints with no effort from the recipient, would still need a written plan from those providers or a physical or occupational therapist.

The department expects no cost to private individuals, other state agencies or municipalities, and no larger appropriation, according to its additional regulation notice information.

A public hearing by phone and Zoom, with no in-person attendance, runs from noon to 1 pm Dec. 2. Written comments are due by 5 pm Dec. 18. The new assessment tool can be viewed at division offices in Anchorage, Fairbanks and Juneau.

After the comment period closes, the department may adopt the rules as proposed, adopt different language or take no action.