Adult Day Care in Alaska

All states: adult day services map

Alaska adult day services at a glance

Last verified against state sources: 2026-10-21.

How is adult day care regulated in Alaska?

Alaska does not license adult day centers. The rules that exist come from Medicaid: a program that wants to bill the Medicaid waivers must be certified by the Division of Senior and Disabilities Services (SDS) in the Alaska Department of Health and follow its Adult Day Services Conditions of Participation. The state also pays for some adult day programs through grants.

Three layers can apply to an Alaska program, and each comes from a different source:

• Licensing (none). Alaska's centralized licensing law, AS 47.32.010(b), lists the facilities the Department of Health licenses, such as assisted living homes, home health agencies and nursing facilities. Adult day programs are not on the list.
• Medicaid (SDS certification). 7 AAC 130.220 and 7 AAC 130.250 set who can be paid for adult day and for whom. The detailed standards are in the Adult Day Services Conditions of Participation (COP-01, Rev. 9/5/17) and the general Provider Conditions of Participation for waiver services (Rev. 9/1/22). "Conditions of Participation" means the standards a provider agrees to meet in order to be paid.
• Funding (grants and VA). SDS runs an Adult Day Services grant program under AS 47.65.100, with standards set in its grant solicitation. The U.S. Department of Veterans Affairs pays for adult day health care for some veterans.

One service, no separate health model. Medicaid defines adult day services as health, social and related support services in a non-institutional community setting on a regular basis, for no more than 10 hours a day not counting transportation, planned to meet both health and social needs (7 AAC 130.250(b)). State law separately defines adult day care, for grant purposes, as nonresidential group care offering supervision, custodial care and social, recreational, physical, medical or psychological services for people at risk of institutional placement. We did not find a separate adult day health care license or service type, or a dementia-specific license or certification.

Who it serves. The Department of Health's Adult Day Services page describes the program as group care for adults with disabilities, especially those with Alzheimer's disease or related disorders, serving seniors 60 and older with functional impairments and adults under 60 with Alzheimer's disease or related disorders.

Because there is no licensing layer, the Medicaid layer is the strictest, and in practice the only, set of operating standards we could read. The grant program's standards were not publicly readable.

Do you need a license to open an adult day center in Alaska?

No. Alaska does not require a state license to run an adult day program. To bill Medicaid, though, you must enroll as a Medicaid provider and be certified by SDS as an adult day services provider, which includes an onsite review before you can start. New providers get a one-year probationary certification.

How Medicaid certification works. Under 7 AAC 130.220, a provider must enroll in Medicaid under 7 AAC 105.210 and be certified as meeting both the Provider Conditions of Participation and the Adult Day Services Conditions of Participation. The adult day service declaration (Cert-08, revised 4/2024) asks for:

• A building use permit.
• A floor diagram showing square footage.
• A program administrator appointment form.
• A policy assurances form and copies of the required written policies (listed in the next sections).

SDS conducts a pre-certification onsite review for every initial adult day location and for any change in location.

Building basics. The Conditions of Participation require the program to be at ground level unless the local fire department has approved an evacuation plan for an upper floor, and fire extinguishers must be inspected every year.

Fees. We did not find an application or certification fee in 7 AAC 130 or on the Cert-08 form. Ask SDS whether one applies.

Certificate of need. We did not find a certificate of need requirement or a moratorium for adult day. Alaska's certificate of need law was not reviewed, so confirm with the Department of Health before you sign a lease.

More than one site. The Cert-08 form lists service locations, and SDS reviews each initial location, but we did not find a rule requiring a separate certificate for each site. During the one-year probationary period, a provider may not add a service or a service location.

Renewal and reviews. After the probationary year, a provider that met its requirements is certified for two years, and later for a variable period of up to four years based on its compliance record. SDS sends a renewal notice 90 days before certification expires, and the provider must submit a new application at least 60 days before expiration. SDS monitors compliance through audits, program reviews and investigations at any service site. We did not find a fixed inspection schedule after initial certification.

Buying or closing a center. A certified provider that plans to close, sell or change ownership must give written notice to the department and to each affected participant and care coordinator at least 60 days ahead (7 AAC 130.233(d)). The Provider Conditions of Participation also require 60 days notice of a change of name, physical location, business form or ownership, and 30 days notice of a planned change of program administrator.

What are the staffing rules for adult day centers in Alaska?

For Medicaid-certified providers, Alaska requires one staff member when one participant is present, two (one may be a volunteer) when two to eight are present, and enough staff or volunteers to keep a 1 to 8 ratio beyond that. For participants with Alzheimer's disease or related disorders, the ratio is 1 to 4. These ratios come from the Medicaid Conditions of Participation, and no other layer sets one.

• Licensing: none, because Alaska does not license adult day.
• Medicaid (SDS): 1:8, with the minimums above, and 1:4 for Alzheimer's disease or related disorders (Adult Day Services COP I.B).
• Grant program: we could not read the grant solicitation, so we did not find its staffing standards.

Who counts toward the ratio. Only staff and volunteers who provide direct services count. Volunteers count only if they meet the qualification and training requirements for direct service workers.

Program administrator. The administrator must be at least 21, have one year of program management experience in a human services setting, and hold one of the following: a bachelor's degree in a human services field, an associate degree plus two years of experience, four years of experience, or rural community health aide or practitioner certification plus one year. The administrator or a qualified designee must manage on site.

Activity coordinator and direct service workers. An activity coordinator, at least 21, with a recreational therapy or related degree or two years of experience leading activities, is required. Direct service workers must be at least 18 and have a high school diploma or GED, or show they can read instructions and make record entries.

Nurses. We did not find a nurse or RN staffing requirement. Under 7 AAC 130.227, a provider may use a licensed registered nurse to administer or delegate medication administration under Board of Nursing rules, and staff who help with medications must complete the required training.

Training. Direct service workers must be trained in workplace safety, keeping a clean and healthy environment, universal precautions and infection control, fall prevention and safe transfers, and the needs of the people served, including dementia, nutrition and hydration, and health monitoring. Each direct service worker needs CPR and first aid training that meets American Heart Association or American Red Cross standards at least every two years, and all staff need critical incident reporting training at least every two years. We did not find a minimum number of training hours.

Background checks. Certified providers must follow Alaska's criminal history check rules (7 AAC 10.900 and following). Checks apply to people 16 or older who are administrators, employees, contractors or unsupervised volunteers with regular contact with participants or access to their records or money. Separately, a grant for adult day care that includes home care services may be awarded only if the grantee agrees to request criminal history information on each worker within 10 business days of hire (AS 47.65.100(e)).

Health screening. We did not find a staff TB test or vaccination requirement in the Conditions of Participation or 7 AAC 130. Ask SDS whether one applies.

What does an adult day center in Alaska have to provide?

A Medicaid-certified Alaska program must be open at least four hours a day, one or more days a week, on a regular schedule, and provide supervised activities, help with daily living tasks, snacks and fluids, and at least 60 square feet of activity space per participant. Meals and transportation, if the program offers them, must meet their own Conditions of Participation.

Hours. Services must be offered at least four hours a day, one or more days a week, with exceptions for hazardous weather, emergencies and provider holidays (Adult Day Services COP III.A). Medicaid will not pay for more than 10 hours a day, not counting transportation, unless the department finds the participant cannot benefit from other services.

Activities and personal help. Activities must be varied, age appropriate, planned with participants and supervised. Staff help with walking, eating, toileting and personal hygiene as needed, and the program posts a monthly activity calendar. Medication administration and help with self-administration are part of the service (7 AAC 130.227).

Meals. Programs serve morning and afternoon snacks, offer fluids all day, and make sure anyone present over the noon hour has a midday meal plan. Meals the program offers or arranges must meet the Meal Services Conditions of Participation, and billing Medicaid for meals requires a separate meal services certification.

Transportation. Programs must tell participants about transportation options. Transportation the program provides must meet the Transportation Services Conditions of Participation for drivers, policies, training and vehicles.

Space and building. Under the Conditions of Participation (section IV):

• At least 60 square feet of activity space, dedicated or multipurpose space commonly used for activities, for each participant present during daily hours.
• At least one toilet and one handwashing sink for every 10 participants, accessible to people with limited mobility.
• A rest area (separate or part of a common area), storage, a telephone for participants and a confidential office area.
• Separate, identifiable space if other services share the building.
• Two exit routes, one a door directly outside, plus non-slip floors, adequate lighting, noise control, and adequate heating, cooling and ventilation.

We did not find a separate space requirement for dementia care.

Written policies. The Provider Conditions of Participation require written policies on background checks, complaint management, confidentiality of health information (including a Notice of Privacy Practices), conflicts of interest, critical incident reporting, emergency response training, employee evaluation, financial accountability, independence and inclusion, medication management, person-centered practice, quality improvement, restrictive interventions, ending services, and training. Complaints must be reviewed each calendar quarter for patterns. Updated policies are submitted at renewal. We did not find a required policy review schedule, advisory council or emergency drill frequency.

Participant handbook. Each program gives participants a brochure or handbook covering days and hours, who is served and what services are offered, eligibility, admission and discharge, the agency's values, participant rights, confidentiality, Adult Protective Services mandatory reporting, critical incident reporting, medication, transportation and meal policies, emergency procedures and the grievance policy.

What rules protect participants in Alaska adult day centers?

For Medicaid participants, the provider must evaluate each new participant within 14 days, complete a signed adult day service plan within 30 days, and reevaluate at least every six months. Providers must give 30 days written notice before ending services, report critical incidents to SDS within one business day, and keep records for seven years.

Who can enroll. Medicaid adult day requires enrollment in the ALI or APDD waiver, inclusion in the participant's approved person-centered support plan, and prior authorization (7 AAC 130.250(a)). We did not find a physician order, physical exam or TB screening requirement for enrollment.

Participant file. Each file must include a signed service contract with consent for services, an emergency care agreement with emergency contacts, and a signed rights and responsibilities agreement (Adult Day Services COP III.C).

Care plan. Evaluation within 14 days of admission, a signed service plan within 30 days, and reevaluation at least every six months.

Ending services. A waiver provider must give written notice to the department, the participant and the care coordinator at least 30 days before ending services. If continuing would put someone's safety at risk, the provider may end services sooner but must still give notice and refer to protective services if needed (7 AAC 130.233). We did not find a list of discharge reasons specific to adult day.

Critical incidents. Providers must have a system to identify, respond to, investigate and report critical incidents, and train staff on it. A missing participant, harmful behavior, misuse of a restrictive intervention, a death, an injury or medication error that needs medical evaluation, or a police response must be reported to SDS within one business day (7 AAC 130.224).

Records. Under 7 AAC 105.230, Medicaid providers keep records showing the participant, the service, how much was provided, the date and who provided it, and keep them at least seven years from the date of service, even if the business is sold or closes. We did not find a required format for a daily attendance log.

How does Medicaid pay for adult day in Alaska?

Alaska Medicaid pays for adult day through two home and community based waivers run by SDS: Alaskans Living Independently (ALI) and Adults with Physical and Developmental Disabilities (APDD). From July 1, 2026, centers bill $122.14 for a half day (S5101) and $8.51 per 15 minutes (S5100) for time beyond that, multiplied by a regional factor based on location.

The two waivers. ALI serves older adults and adults with physical disabilities. APDD serves adults with physical and developmental disabilities. Both are administered by SDS. The service must be in the participant's approved support plan and prior authorized. The IDD, IDD-ISW and CCMC waivers do not include adult day, because 7 AAC 130.250 covers only the ALI and APDD categories.

• Half day (S5101): $122.14, one unit per day, for a service period of at least one hour and up to four hours.
• 15 minutes (S5100): $8.51 per unit for time beyond the half day.
• Regional factors: rates are multiplied by a factor for the provider's area, for example 1.03 for Fairbanks, 1.12 for Kodiak and 1.49 for Bethel and Dillingham.
• Source: the state's Chart of Waiver Services Rates, FY 27, effective July 1, 2026.

Limits. Medicaid will not pay for more than 10 hours of adult day a day, not counting transportation, unless the department finds the participant cannot benefit from other services. It also will not pay for adult day that duplicates personal care or other waiver services.

Transportation. Transportation is a separate waiver service under 7 AAC 130.290, billed apart from the adult day rate (codes T2003 and T2001 in the research). Meals are billed only with a separate meal services certification.

Attendance documentation to bill. Under 7 AAC 105.230(d), documentation must be written within 14 days after the service, and a provider may not bill without records made at the time of service. Time-based codes need actual start and stop times, pre-filled time sheets are not allowed, and 15-minute units follow an 8-minute rounding rule. Because the half-day unit requires at least one hour of service, arrival and departure times matter for every claim. We did not find a rule requiring an electronic sign-in or attendance system for adult day.

Other Medicaid options. We did not find a PACE program or a managed long-term services plan operating in Alaska in primary sources.

Can a private-pay adult day center operate in Alaska without Medicaid?

Yes. Because adult day is not a licensed facility type under AS 47.32, a private-pay program that does not bill Medicaid has no state license requirement. The Medicaid Conditions of Participation apply only to certified providers, and grant terms apply only to grantees.

What we did not find. We did not find a state rule limiting what a program that is neither licensed nor Medicaid-certified may do, such as personal care, nursing or medication help, and we did not find a state consumer protection rule specific to private-pay adult day contracts. Local building, fire and business rules may still apply, so check with your city or borough. Families choosing a private-pay program can ask whether it is SDS-certified, since certified programs must meet the staffing, space and participant rules on this page.

State grants. SDS funds an Adult Day Services grant program for frail older people and similarly disabled adults under AS 47.65.100. The current grant solicitation covers FY2025 through FY2027. Grant-funded programs must charge fees on a sliding scale tied to income, no higher than cost, and may not deny service only because someone cannot pay.

Veterans. The U.S. Department of Veterans Affairs offers Adult Day Health Care to enrolled veterans who are eligible for community care and meet clinical criteria, where a program is available, through VA, State Veterans Homes or community organizations, possibly with a copay. We did not find Alaska-specific VA adult day contracts.

Older Americans Act. We did not confirm whether federal Older Americans Act funds pay for adult day in Alaska. Ask SDS.

The market. We did not find a state count of adult day centers. The Department of Health's Adult Day Services page shows a map of centers. We did not find an Alaska adult day association.

What is changing next for adult day in Alaska?

As of our last check on October 21, 2026, we did not find an upcoming change to Alaska's adult day rules or Medicaid adult day payment. Two recent or scheduled items matter for operators.

• Rate increase, July 1, 2026. Waiver rates rose 3.2 percent for state fiscal year 2027, bringing adult day to $122.14 per half day (S5101) and $8.51 per 15 minutes (S5100), up from $118.35 and $8.25 (FY 27 rate chart).
• Grant period ends June 30, 2027. The current Adult Day Services grant period runs through FY2027. We did not find a published date for the next grant solicitation, so grant-funded programs should watch the state's public notices and ask SDS.

Alaska adult day sources

• Alaska Department of Health: Adult Day Services
• AS 47.32.010: facilities licensed by the Department of Health
• 7 AAC 130.200 to 130.319: Medicaid home and community based waiver services
• SDS: Adult Day Services Conditions of Participation (Rev. 9/5/17)
• SDS: Provider Conditions of Participation for HCBS Waiver Services (Rev. 9/1/22)
• SDS: Cert-08 Service Declaration, Adult Day Services
• 7 AAC 105.230: Medicaid provider records
• Alaska Department of Health: Chart of Waiver Services Rates, FY 27
• AS 47.65: grants for adult day care
• SDS: Adult Day Services Program grant solicitation, FY2025 to FY2027

Related reading

• The Compliance Curve: Why Adult Day Services Should Learn from Home Care Before They Have To
• How to Differentiate Your Adult Day Care Center: A Guide for Operators
• Effective Transportation Tracking for Elder Day Centers
• Simplifying Payments with Electronic Billing for Adult Day Care
• Adult day services in every state (map)
• Adult Day Care Services and Reference Guide

Other states with no state adult day license

Alabama, Colorado, Connecticut, District of Columbia, Idaho, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Michigan, Mississippi, New Jersey, New York, North Dakota, Ohio, Oregon, South Dakota, Vermont, Washington, West Virginia, Wisconsin. See every state on the adult day services map.

Page history

• October 21, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for adult day centers, covering attendance, care plans, transportation and billing. If you would like to talk about running your center, contact Ankota or read more about Ankota's adult day care software.