I/DD Waivers in Alaska

All states: Medicaid disability services map

Alaska I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Alaska?

The Alaska Department of Health is the state Medicaid agency, and its Division of Senior and Disabilities Services (SDS) runs the I/DD waivers day to day through its Intellectual and Developmental Disabilities (IDD) Unit. SDS decides who has a developmental disability, keeps the waiting list, approves support plans and certifies providers. Private care coordination agencies, certified by SDS, help each person apply and plan services.

• Department of Health: the single state Medicaid agency. It administers the waivers, and its Office of Rate Review sets provider rates.
• Senior and Disabilities Services (SDS): operates the IDD, ISW and APDD waivers. Its IDD Unit determines eligibility and level of care, and its Provider Certification and Compliance Unit certifies agencies.
• Front door: a person applies to SDS for a Developmental Disability Determination. Regional Developmental Disabilities Resource Connection (DDRC) offices help families with the paperwork.
• Case management: the participant chooses a private, SDS-certified care coordination agency. The care coordinator completes the waiver application, writes the person-centered support plan and handles renewals. SDS approves each support plan.

What Medicaid waivers and programs serve people with I/DD in Alaska?

Alaska has three 1915(c) waivers that mainly serve people with I/DD. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. The IDD and APDD waivers were renewed for July 1, 2026 to June 30, 2031, and the ISW was amended on July 1, 2026. All three are listed on the state's HCBS waivers page.

• People with Intellectual and Developmental Disabilities (IDD) Waiver (1915(c), control number AK.0260): serves Medicaid-eligible people of any age with a developmental disability who meet the level of care of an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). It has room for up to 2,160 people in the first waiver year, rising to 2,200 in year 5, and reserves 10 slots a year for people moving over from the ISW. Services include care coordination, day habilitation, employment services, residential habilitation (group home, family home, in-home supports and supported living), host home care, respite, intensive active treatment, nursing oversight, meals, environmental modifications, specialized medical equipment, specialized private duty nursing and transportation. See the IDD waiver application.
• Individualized Supports Waiver (ISW) (1915(c), control number AK.1566): serves people of any age with I/DD at ICF/IID level of care whose needs are less intensive and can be met within a set budget. It is limited to 600 people at a time and 620 a year. In waiver year 1 the individual budget limit was $25,608 and the cost limit $38,412, both indexed to rate inflation. Residential habilitation is limited to in-home supports and supported living. Other services include care coordination, day habilitation, employment services, respite, adult host home care, intensive active treatment and transportation. See the ISW application.
• Adults with Physical and Developmental Disabilities (APDD) Waiver (1915(c), control number AK.0262): serves adults 21 and older with I/DD who also have physical disabilities or aging-related needs and meet nursing facility level of care. Services include adult day services, care coordination, day habilitation, employment services, residential habilitation, respite, host home care, intensive active treatment and environmental modifications. See the APDD application.

Alaska's other two waivers, Alaskans Living Independently (ALI) and Children with Complex Medical Conditions (CCMC), are related programs. CCMC serves some children with developmental disabilities but is aimed at children with complex medical needs. ICF/IID level of care is the institutional standard the IDD and ISW waivers are measured against. We did not find a state source on how many ICF/IID facilities operate in Alaska.

Does Alaska pay for I/DD services through managed care?

No. Alaska pays I/DD waiver providers fee-for-service through the Department of Health, and no managed care plan delivers I/DD waiver services. Private care coordination agencies certified by SDS coordinate each person's services, and SDS approves the support plan before services start.

• Who pays claims: the Department of Health, at rates set by its Office of Rate Review.
• Who coordinates services: the participant's chosen care coordinator, who builds the person-centered support plan for SDS approval.

Is there a waiting list for I/DD services in Alaska?

Yes. SDS keeps the DD Registry, which holds the waiting lists for the IDD waiver and the ISW. On June 30, 2024, 443 people were on the IDD waiver list and 158 were on the ISW list, according to the state's FY2024 DD Registry report. This is the latest count the state has published.

• IDD waiver list: ranked by a needs score from the Developmental Disabilities Registration and Review (DDRR) form, not by date. The average wait was 30 months on June 30, 2024. SDS routinely selects 50 new IDD waiver entrants each waiver year, and more if enrollment falls below the maximum. In FY2024 it selected 85 people.
• ISW list: people are drawn in date order once the waiver is full. The ISW list began July 1, 2023, when the waiver reached its 600-person limit. The average wait was 5 months on June 30, 2024, and SDS selected 154 people from it in FY2024.
• Reserved slots: the IDD waiver reserves 10 slots a year for people moving from the ISW.
• APDD: a 2022 state plan said APDD had no waiting list. We did not find a newer statement.

We did not find a DD Registry report for FY2025. For a person's place on a list, families can ask SDS or their regional DDRC office.

How do people apply for I/DD services in Alaska, and how are budgets set?

A person first applies to SDS for a developmental disability determination, then submits a DDRR form to be placed on the DD Registry. When the person is drawn from the list, SDS sends a Notice to Proceed with a list of local care coordinators, and the chosen care coordinator submits the waiver application. Regional DDRC offices can help with each step.

• Eligibility: a developmental disability as defined in Alaska law (AS 47.80.900(6)), Medicaid financial eligibility through the Division of Public Assistance, and ICF/IID level of care (IDD waiver and ISW) or nursing facility level of care (APDD).
• Assessment tool: SDS uses the ICAP (Inventory for Client and Agency Planning) for ICF/IID level of care, and a Qualified Intellectual Disabilities Professional makes the IDD waiver determination. For APDD, SDS began moving from the Consumer Assessment Tool (CAT) to the interRAI-based Alaska Home Care Tool on July 1, 2026, using both tools for about a year.
• Budgets and limits: the ISW has an individual budget limit ($25,608 in waiver year 1) and a cost limit ($38,412). Day habilitation is capped at 624 hours a year from all providers combined unless SDS approves more for a critical need. We did not find a published support level or budget system for the IDD waiver.
• Paid family caregivers: legally responsible individuals may be paid for up to 40 hours a week of in-home supports or supported living. Court-appointed guardians are excepted.

What day and residential services can I/DD providers offer in Alaska?

I/DD waiver providers in Alaska can offer day habilitation and employment services, plus adult day services under APDD. Residential options are group homes, family homes, in-home supports, supported living and host homes. Every service needs SDS certification, and group, family and host homes also need a state license. Rates below are from the FY27 Chart of Waiver Services Rates (effective July 1, 2026), before the regional factor.

Day and employment services

• Day habilitation (IDD, ISW, APDD): individual or group activities for people age 3 and older that build self-help, social and adaptive skills, or offer meaningful retirement activities, mostly in community settings. No license is required, but the provider needs SDS certification and must follow the Day Habilitation Conditions of Participation. Billed in 15-minute units (T2021): $16.55 individual and $10.91 group. Capped at 624 hours a year, with no more than 10% of units in residential settings and 10% by distance delivery. The research did not find a published staff ratio.
• Employment services (IDD, ISW, APDD): pre-employment learning, work experiences, job training, job coaching and ongoing support to keep a job or self-employment. Not allowed in sheltered workshops or other isolating settings. SDS certification is required. Supported employment is billed in 15-minute units (T2019): $19.02 individual and $12.33 group. The research did not find a published staff ratio.
• Adult day services (APDD only): group health, social and support services in a community setting. No state license, but SDS certification and the Adult Day Services Conditions of Participation apply. Staff ratio is 1:8, or 1:4 for participants with Alzheimer's disease or related disorders. Billed by the half day (S5101, $122.14) plus 15-minute units (S5100, $8.51).

Residential services

• Group home habilitation (IDD, APDD): daily residential habilitation in a licensed home. The home needs a state Assisted Living Home license and SDS certification. $483.15 a day (T2016), not including room and board.
• Family home habilitation (IDD and APDD for adults, IDD and CCMC for children): a shared living model in a licensed family home. Licensed as an Assisted Living Home or Foster Home, plus SDS certification. $201.30 a day for adults (S5140) and $217.84 a day for children (S5145).
• In-home supports and supported living (IDD, ISW, APDD): habilitation in the family home (in-home supports, under 18) or in an adult's supported living arrangement. No license, but SDS certification as a residential habilitation provider is required. $15.46 per 15-minute unit (T2017).
• Host home care (IDD, APDD; adult host home care in the ISW): 24-hour supportive care, not habilitation, for adults 18 and older, given by a primary caregiver who lives in a licensed host care home. It is meant partly for people leaving licensed foster homes. Needs a host care home license and SDS certification.

How are I/DD provider rates set and how do agencies enroll in Alaska?

The Department of Health's Office of Rate Review sets I/DD waiver rates from provider cost surveys and audited financial statements. Rates are rebased at least every four years, with a 5% stop-loss limit, and adjusted for inflation in the years between. The last full rebasing took effect May 1, 2023, and rates rose 3.2% on July 1, 2026.

• Rate method: rebasing uses costs from high-volume providers and is adjusted by region. In other years rates follow the CMS Home Health Agency Market Basket inflation index. Care coordination and transportation use modeled rates. The state posts its method on its payment rates and cost survey page.
• Rate chart: rates are published each year in the Chart of Waiver Services Rates and multiplied by regional factors.
• Enrollment: an agency must first be certified by the SDS Provider Certification and Compliance Unit for each service, then enroll with Alaska Medicaid. Both steps are required. Residential homes also need the state license that fits the setting.
• EVV: no IDD, ISW or APDD waiver service codes are on the state's electronic visit verification (EVV) list. EVV applies to personal care, Community First Choice (including skill building, S5108) and home health codes, using the free Therap system or an approved third-party system. Agencies that also bill those services need EVV for them.

What is changing next for I/DD services in Alaska?

As of October 23, 2026, we did not find a confirmed change with a set date for Alaska's I/DD services. The waivers were just renewed on July 1, 2026. Two items are worth watching, but neither has a published date.

• Rate rebasing: rates are rebased at least every four years, and the last rebasing took effect May 1, 2023, so the next one is due. We did not find a public notice saying when it will take effect.
• Waiting list plan: in December 2022 the Department of Health published a five-year plan to end the IDD waiting list by 2028. The plan said it would need legislative and budget action. We did not find whether the legislature has funded it.
• APDD assessment: the move from the CAT to the Alaska Home Care Tool for APDD level of care began July 1, 2026 and is expected to take about a year.

The July 2026 renewals renamed adult host home to host home care, added host care homes as respite providers and clarified which services legally responsible individuals or relatives may provide. For news on future amendments, ask SDS.

Alaska I/DD sources

• Alaska Department of Health: Home and Community-Based Services waivers
• Alaska IDD waiver application (AK.0260, effective July 1, 2026)
• Alaska Individualized Supports Waiver application (AK.1566, effective July 1, 2026)
• Alaska APDD waiver application (AK.0262, effective July 1, 2026)
• Alaska Department of Health: Intellectual and Developmental Disabilities (IDD) Unit
• Senior and Disabilities Services: FY2024 DD Registry report
• Alaska Department of Health: Developmental Disability Determination
• Alaska Department of Health: Chart of Waiver Services Rates FY27
• Senior and Disabilities Services: Provider Certification and Compliance
• Alaska Department of Health: Electronic Visit Verification

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• What is Active Support in Disability Services?
• I/DD services in every state (map)
• Alaska EVV requirements

Page history

• October 23, 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 I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.