D American Indian Enrollment

 

 

 

Revised 04/26/2022

Policy

American Indian and Alaska Native customers that qualify for ALTCS are enrolled based on the following policies:

 

If the customer...

Then the customer is enrolled in...

Has a developmentally disability

One of the following DDD health plan choices

·        United Healthcare Complete Plan;

·        Mercy Care Plan; or

·        DDD American Indian Health Plan (DDD AIHP)

NOTE           When enrolling with DDD AIHP, the customer can also choose to have behavioral health services provided by the Tribal Regional Behavioral Health Authority (TRBHA).

Currently resides or resided within the bounds of a tribal nation prior to placement in an off-reservation nursing facility (on-reservation status)

The tribe that serves that reservation. The customer does not have to be a member of the contracting tribe. 

Example:

A Hopi customer living within the bounds of the Navajo Tribal Nation is enrolled with the Navajo Nation.

NOTE          If the tribal nation is not served by one of the seven tribes identified as an American Indian program contractor, the person is enrolled in Native American Community Health (NACH).

EXCEPTION:

Persons who reside within the bounds of a tribal nation, but lack any tribal membership are enrolled with an elderly and/or physically disabled (EPD) program contractor.

Lives in a home and community-based services (HCBS) setting that is not within the bounds of a tribal nation

An EPD program contractor based on the customer’s county of fiscal responsibility.

 

 

Definitions

 

Term

Definition

American Indian Program Contractors

Seven American Indian tribes deliver case management services and provide directly or arrange for services to American Indians who are elderly and/or physically disabled and reside on-reservation. These tribes are:

·        Gila River Indian Community;

·        Hopi Tribe;

·        Navajo Nation;

·        Pascua Yaqui Tribe;

·        San Carlos Apache Tribe;

·        Tohono O’Odham Nation; and

·        White Mountain Apache Tribe.

 

Native American Community Health Center (NACHC)

NACHC provides case management services to elderly and/or physically disabled American Indian ALTCS customers who live on-reservation and do not receive ALTCS case management from a tribe.

 

 

Legal Authority

This requirement applies to the following program:

 

Program

Legal Authorities

ALTCS –American Indian Customers

ARS 36-2932 and 2933

AAC R9-28-415