Arizona's no-waitlist structure means the growth constraint is operational — your ability to schedule, document, EVV-comply, and bill cleanly across four MCOs determines how fast you grow. CareBravo delivers all of it as completed operational work.
Arizona's ALTCS-EPD program does not have a waitlist. An applicant who scores 60+ on the Pre-Admission Screening and meets financial eligibility is entitled to services — no interest list, no slot cap, no years of waiting. This makes Arizona one of the strongest environments in the country for home care agency growth driven by clinical capacity rather than administrative queue management. The program runs through four MCO plans under new contracts effective October 2025, with AHCCCS replacing Sandata with its own EVV aggregator at the same time. Here is the operational picture.
The Arizona Long Term Care System (ALTCS) is administered by AHCCCS (Arizona's Medicaid program) under a 1115 demonstration waiver. The EPD component — Elderly and Physically Disabled — covers adults 65 and older, or adults 18–64 with a qualifying disability, who require nursing facility level of care.
There is no waitlist. Meeting the clinical eligibility (60+ PAS score) and financial eligibility requirements entitles the applicant to services. For home care agencies, this means a fundamentally different referral model than most states — growth is constrained by your clinical capacity and your MCO network relationships, not by a state-managed queue of waiting clients.
ALTCS is an MLTSS program — members receive both physical health and long-term services through a single MCO. Rates are competitive nationally, often ranging from $26–$35/hour for attendant care. Members typically receive relatively high authorized hours compared to many other states.
Medical eligibility for ALTCS is determined by Pre-Admission Screening. An assessor evaluates the applicant's ability to perform Activities of Daily Living, cognitive function, behavioral issues, and medical complexity. A score of 60+ establishes medical eligibility for ALTCS services.
The PAS is conducted by AHCCCS staff or the MCO at no cost to the applicant. The standard score of 60 is based on the care level of an intermediate nursing home. Applications that score below 60 are denied for ALTCS services.
ALTCS supports two consumer-directed options for personal care and homemaker services. Agency with Choice (AWC) allows participants to hire their own direct care worker while an agency handles payroll and compliance functions. Self-Directed Attendant Care (SDAC) gives participants full employer control, including hiring, training, and scheduling.
Eligible family members — including adult children, grandchildren, and others — can be hired as paid caregivers through these models. Spouses may also be hired in some circumstances. This flexibility can be an advantage in recruiting bilingual or culturally matched caregivers for specific client populations.
Complex contract history — current status through September 30, 2026: Arizona's ALTCS-EPD contract procurement resulted in a settlement establishing four new plans effective October 1, 2025. However, a subsequent legal challenge and court stay led AHCCCS to extend prior contracts with Mercy Care, Banner-University Family Care, and UHC through September 30, 2026. Arizona Complete Health-LTC joined under the new contract structure. Verify current plan status and geographic service area assignments directly with AHCCCS before credentialing efforts, as the situation was actively evolving in late 2025.
| Plan | Geographic Service Area | Notes |
|---|---|---|
| Mercy Care | Central and Southern GSAs (Pima County only in South) | Longest-standing ALTCS plan. Largest member base historically. |
| Banner-University Family Care | Central and Southern GSAs | Banner Health subsidiary. Academic medical center network integration. |
| UnitedHealthcare Community Plan (Arizona Physicians IPA) | Central, Northern, and Southern GSAs — statewide | Statewide presence across all three geographic service areas. Serves 10,400+ EPD members. |
| Arizona Complete Health-Long Term Care (Bridgeway) | Central, Northern, and Southern GSAs — statewide | Centene/Health Net successor. New entrant to EPD program under Oct 2025 contracts. |
Members may change plans annually during their birth month. MCO contracts with providers are negotiated as a percentage of the AHCCCS state rate — verify rate terms with each plan during credentialing, as the contracted percentage affects your effective hourly rate.
AHCCCS EVV Aggregator (October 1, 2025): AHCCCS replaced Sandata with its own in-house EVV aggregator effective October 1, 2025. Arizona uses an open EVV model — providers may use Sandata or another approved EVV vendor, but all visit data must integrate with the new AHCCCS aggregator. Providers who were integrated with Sandata needed to verify their EVV vendor had completed integration with the AHCCCS system by the launch date. Claims for EPD services go directly to each MCO (not through AHCCCS for most billing), but EVV data flows to the AHCCCS aggregator for compliance reporting.
Provider enrollment with AHCCCS requires a $750 enrollment fee (standard CMS institutional rate for 2026). Submit your application through AHCCCS's APEP (AHCCCS Provider Enrollment Portal). After AHCCCS enrollment, credential separately with each EPD plan you intend to serve. AHCCCS enrollment gives you a provider ID — MCO credentialing gives you the network status to actually get paid for EPD members enrolled in each plan.
DDD (Division of Developmental Disabilities) is a separate program from ALTCS-EPD, serving individuals with intellectual and developmental disabilities. DDD providers bill through WellSky, and DDD MCO plans (DES/DDD health plans) are separate from the EPD plans listed above.
In most states, home care agencies operating in HCBS waiver programs are constrained by the pace at which waitlisted clients receive eligibility determinations — which can be years. In Arizona, that constraint does not exist for EPD. Any applicant who scores 60+ on the PAS and meets financial eligibility receives services. Growth is limited by your clinical capacity to serve clients, your MCO network relationships, and the referral sources you build — not by a state-managed queue. Agencies with operational infrastructure in place can scale faster in Arizona than in most states because the demand side of the equation is consistently available.
As of late 2025, the three prior-contract plans (Mercy Care, Banner-University Family Care, UHC Community Plan) are operating under extended contracts through September 30, 2026, following a court stay that halted the full implementation of new contracts that were intended to begin October 1, 2025. Arizona Complete Health-LTC joined under new contract terms. A new procurement will likely follow after September 2026. Verify current plan assignments and geographic service area coverage with AHCCCS directly before building credentialing timelines, as the situation may have evolved from what is summarized here.
AHCCCS replaced Sandata as the state EVV aggregator with its own in-house system on October 1, 2025. Arizona remains an open EVV model — providers may use Sandata or any other approved EVV vendor as long as the system integrates with the new AHCCCS aggregator. Providers needed to verify their EVV vendor had completed the integration to the AHCCCS aggregator before the October 1 launch date. If your agency or vendor had not completed integration, EVV data may not have been flowing correctly to AHCCCS after the transition.
Arizona's no-waitlist structure means the growth constraint is operational — your ability to schedule, document, EVV-comply, and bill cleanly across four MCOs determines how fast you grow. CareBravo delivers all of it as completed operational work.