Arizona Health Care Cost Containment System/Arizona Long Term Care System (ALTCS)
ALTCS Member Communication Regarding
Agency with Choice - A New Member-Directed Service Option

Overview
On January 1, 2013, individuals who receive attendant care, personal care, habilitation or homemaker services in their own home through the Arizona Long Term Care System (ALTCS) will have the opportunity to choose a new member-directed option known as Agency with Choice. Agency with Choice is not a separate “service” like attendant care, habilitation or personal care. It is a way of providing these services, which offers members the ability to play a more active role in directing their own care. Under the new model, the member will enter into a co-employment relationship with the provider agency where the provider will serve as the legal employer of record and the member will act as the day-to-day managing employer of the direct care worker.

Agency with Choice presents an exciting opportunity for members interested in directing their own care and would also like the support offered by a provider agency. Under this option, the member may elect to take on tasks such as selecting his/her direct care worker and determining the direct care worker’s schedule and duties. Under Agency with Choice the provider agency maintains the authority for hiring and firing the direct care worker and ensuring that the direct care worker meets the minimum training qualifications.

Individual Representatives
Some ALTCS members have people in their lives that help them in directing their care. Under Agency with Choice, that person is called the “individual representative.” Individual representative is defined in federal regulation as a “parent, family member, guardian, advocate, or other person authorized by the individual to serve as a representative in connection with the provision of services and supports.” The role of an individual representative is to act on the member’s behalf in choosing and directing care, including representing the member during the service planning process and approving the service plan. Federal regulations under Agency with Choice prohibit an individual representative from also serving as a member’s paid caregiver. If you are currently helping a member to direct their care and also serving as a paid caregiver and you and/or the member want to continue to do so, a service option other than Agency with Choice must be selected.

Next Steps
You do not need to take any action at this time. Your support coordinator or case manager will talk with you about the Agency with Choice option as well as the other service model options that are available to you on or after January 1, 2013, during your regularly scheduled visits. To receive services under Agency with Choice, you (member or member’s representative) must proactively choose the Agency with Choice option. You are not required to choose Agency with Choice. Other options will continue to be available to ALTCS members such as the traditional in-home care option (through a provider agency), self-directed attendant care (available to members who are elderly and/or have physical disabilities), and the independent provider/fiscal intermediary option (available to members who have developmental disabilities). More information on member-directed
options is available on the AHCCCS website at:  http://www.azahcccs.gov/shared/SDAC.aspx?ID=notices.

11/20/12