For most middle and upper class older persons, AHCCCS (Arizona Healthcare Cost Containment System– Arizona’s Medicaid program) and ALTCS (Arizona Long-term Care System) cannot be relied upon as the solution to financing home care, assisted living, or home health care. However, there are persons with low income and few assets. As well as individuals in a better financial position who have not planned only to then suffer an abrupt illness or accident. Many of these individuals and couples can be helped with a strategy to establish their ALTCS eligibility.
Many aspects of ALTCS—uncertainty, instability, restrictive eligibility and coverage, increased cost recovery even from future generations—are clear messages that our clients should avoid ALTCS if at all possible. Moreover, with the ever-present possibility of federal and state legislative or regulatory changes, as well as the current budget crisis, the future of ALTCS is too uncertain for rational financial planning very far into the future. Currently, AHCCCS and ALTCS, under a federal mandate, are increasingly aggressive in collecting from the estates of anyone who received AHCCCS or ALTCS after age 55. This “estate recovery” program requires recovery from the probate estates of the deceased ALTCS recipient.
Although some of our work inevitably focuses on attaining AHCCS and ALTCS eligibility, these programs provides a limited bundle of benefits. We cannot rely on a financing system that provides only minimal benefits in order to meet all of the needs of our clients. We must do more, if we can; and where resources are available we can do more, but only if we put in place a plan that provides supplemental care services for our client-elders.