Tribal Arizona Long Term Care System
Overview of the Tribal ALTCS
The Tribal Arizona Long Term Care System (Tribal ALTCS) Program provides Medicaid services to elderly and/or physically disabled American Indians who are determined eligible for ALTCS. Members will remain eligible for Tribal ALTCS if they continue to meet the Medicaid medical and financial requirements. A member will be enrolled with Tribal ALTCS if he/she lives on or lived on a reservation prior to admission into an off-reservation facility.
Tribal ALTCS is an integrated health plan that covers the following services:
- Acute Medical and Behavioral Health Services
- Long Term Care Services
- Adult Day Health Care Services
- Attendant Care
- Community Transition Service
- Dental
- DME/Medical Supplies
- Emergency Alert System
- Habilitation Services
- Home Delivered Meals
- Home Health Agency Services
- Home Modification
- Homemaker Services
- Hospice Services (HCBS and Institutional)
- Nursing Facility Services
- Personal Care
- Respite Care (In-home)
- Respite Care (Institutional)
- Therapies
- Transportation
Tribal ALTCS Programs
AHCCCS (Arizona Health Care Cost Containment System) works in partnership with seven Tribes and one urban American Indian Health Center. The partnership is formed by an Intergovernmental Agreement or Contract to provide long term care case management services to respective tribal members enrolled in ALTCS.
An Intergovernmental Agreement (IGA) with AHCCCS is developed with each tribe listed below to provide case management services to enrolled tribal members who qualify for ALTCS:
- Gila River Indian Community
- Hopi
- Navajo Nation
- Pascua Yaqui
- San Carlos Apache
- Tohono O’Odham Nation
- White Mountain Apache
Native American Community Health Center has a Contract with AHCCCS to provide case management services to enrolled tribal members who qualify for ALTCS:
- Ak-Chin Indian Community
- Cocopah Tribe
- Colorado River Indian Tribes
- Fort McDowell Yavapai Nation
- Fort Mohave Indian Tribe
- Havasupai Tribe
- Hualapai Tribe
- Kaibab-Paiute Tribe
- Quechan Tribe
- Salt River Pima-Maricopa Indian Community
- Tonto Apache Tribe
- Yavapai Apache Nation
- Yavapai Prescott Tribe
| Long Term Care Tribal Contractors | Website | Phone Number |
|---|---|---|
| Gila River Indian Community | https://grhc.org | 602-528-1200 |
| Hopi Tribe | www.hopi-nsn.gov | 928-734-3551 |
| Navajo Nation – Chinle Office | 928-674-2236 | |
| Navajo Nation - Fort Defiance Office | www.nndss.navajo-nsn.gov | 928-871-7988 |
| Navajo Nation - Tuba City Office | 928-283-3250 | |
| Navajo Nation - Dilkon Office | 928-657-8036 | |
| Pascua Yaqui Tribe | www.pascuayaqui-nsn.gov | 520-879-6020 |
| San Carlos Apache Tribe | 928-475-2138 | |
| Tohono O'Odham Nation | www.tonation-nsn.gov | 520-383-6075 |
| White Mountain Apache Tribe | www.wmat.nsn.us | 928-338-1242 |
| Native Health | www.nativehealthphoenix.org | 602-279-5262 |
Long Term Care Services Authorization
The Tribal ALTCS Case Manager assigned to the member is responsible for creating and submitting the prior authorization.
There are specific services that require an authorization by the AHCCCS Administration (Division of Fee-For-Service Management (DFSM) Prior Authorization (PA) Unit).
Providers should work with the assigned Tribal ALTCS case manager to obtain Prior Authorization before rendering services to avoid delays in payments.
Long Term Care Payments
Authorized long term care services are paid at the fee-for-service (FFS) rate and reimbursed through the AHCCCS FFS System.
(Tribal ALTCS Programs only authorize services and provide case management services. They do not reimburse providers for services).
Additional information about ALTCS
ALTCS provides services and settings for members who are elderly and/or have physical disabilities and/or have developmental disabilities. For more information, see the AHCCCS Medical Policy Manual, Chapter 1200 - Arizona Long Term Care System Services and Settings for Members Who Are Elderly and/or Have Physical Disabilities and/or Have Developmental Disabilities
Tribal ALTCS Case Management Resources
Tribal ALTCS Programs shall establish a system of record keeping that maintains case file documentation in a secure and organized manner. Case Managers are responsible for maintaining complete and comprehensive case file documentation for each member. Below are forms utilized by Tribal ALTCS Case Managers.
- Exhibit 1620-2, ALTCS Member Change Report
- Exhibit 1620-3, Uniform Assessment Tool and Guidelines
- Exhibit 1620-7, Fee-For-Service (FFS) Out-of-State Nursing Facility Placement Request Form
- Exhibit 1620-8, Contractor Change Request Form
- Exhibit 1620-9, ALTCS Enrollment Transition Information (ETI) Form
- Exhibit 1620-12, Spouse Attendant Care Acknowledgement of Understanding Form
- Exhibit 1620-13, ALTCS Member Service Plan
- Exhibit 1620-14, ALTCS Member Contingency Back-Up Plan
- Exhibit 1620-15, Assisted Living Facility (ALF) Residency Agreement
- Exhibit 1620-16, Assisted Living Facility (ALF) Financial Change Agreement
- Exhibit 1620-17, HCBS Member Needs Assessment
Becoming an AHCCCS/ALTCS Provider
Information about becoming an AHCCCS ALTCS Provider can be found in the Provider Enrollment section on the AHCCCS website.