Aging in Place in Your State: Arizona
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Arizona is known as one of the United States’ havens for older adults, thanks in part to its warm-year-round climate, and its population reflects that: estimates show that between a fourth and a third of the Grand Canyon State’s residents are aged 50 or older.
This fact would naturally tend to shape some of the state’s policies relating to programs and services for elderly people, as does Arizona’s large population of tribal people: the state has the United States’ largest percentage of land within its borders designated as reservations. These factors give Arizona’s programs to help older Americans age in place a somewhat unique flavor.
But rest assured: in a state in which it’s illegal to refuse to give a person a glass of water, Arizona offers a multitude of options for its many senior residents to access programs that boost independent living and help them age in place.
The Arizona Long Term Care System is the state’s Medicaid program; it provides long-term care services, at little or no cost, to eligible residents, according to the state website.
Arizonans who are U.S. citizens (or service-eligible immigrants), age 65 or older or age 18-64 and disabled, and/or require the level of care of a nursing home are eligible to receive services through ALTCS, which is referred to as “All-Tecs”. Home- and community-based services are payable under ALTCS, but the state also expects beneficiaries to access all other benefits to which they are entitled, such as veterans’ benefits, pensions, and the like. Single applicants cannot hold assets worth more than $2,000, but that number does not count an applicant’s primary home and vehicle, burial plots and plans, household contents and personal belongings, and qualified financial instruments, like ABLE accounts, flexible spending arrangements, and education savings accounts. The spouses of married applicants can also retain some assets without penalty to the applicant, and the asset limit for couples in which both people are applying for benefits is $4,000.
Once approved for services, beneficiaries enroll with a program contractor and receive a case manager, who helps them determine what services they most need. Several home-based programs operate under the umbrella of ALTCS, including Agency with Choice, which allows program beneficiaries to select their caregivers without having to act as an employer, and Self Directed Attendant Care, which allows beneficiaries to direct their own care services using the “cash and counseling” method: participants act as employers in hiring, training, and managing the people (including family members) they choose to help them in their homes.
ALTCS has provisions for paying for both the installation of durable medical equipment and for home modifications that increase independence and the ability to continue community living. Modifications must be made only to existing structures and may not include adding significant square footage to a home. Rental properties can receive modifications as long as the owner of the home consents.
In addition, the Arizona Department of Economic Security offers various home and community-based services, including home modification benefits. Services under DES are administered by Arizona’s Area Agencies on Aging, which operate in eight units that cover the entire state, including the Navajo Nation, Diné Bikéyah, and other tribal lands.
One unique aspect of public benefits in Arizona is AzTAP, the Arizona Technology Access program. The goal of this program is to provide assistive technology that helps people with disabilities and their caregivers with products—thousands are available—that support independent, “reduce barriers and increase personal abilities,” according to the AzTAP website. Besides options that provide short-term loans of devices and loans to help people buy needed technologies, the AzTAP offers training, needs assessment, a free device exchange, and the no-cost open-ended loan of certain older devices in AzTAP’s inventory.
Tribal people whose homelands lie within Arizona’s borders can choose to enroll either in ALTCS or in the American Indian Health Program (AIHP). Both programs operate under the Arizona Health are Cost Containment System (AHCCS), and the state permits switching between programs for various services, though this can take time. Tribal members living outside tribal nations choose between plans they are eligible for, while tribal members living within tribal nations will be automatically enrolled in AIHP unless they choose a different plan. For more information on existing services for tribal people, see this previous Evolve post on aging in place in Indian Country.
