AK Alaskans Living Independently

Published on
July 6, 2023
Last updated
February 29, 2024
Written by
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Katie Wilkinson
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Learn how the ALI Waiver recognizes and compensates family caregivers, empowering them with financial support for their role in the healthcare system.
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The AK Alaskans Living Independently Waiver is a Medicaid program specifically tailored to support individuals with disabilities who aspire to live independently in their communities. By fostering a person-centered approach and promoting the dignity and autonomy of individuals, the ALI Waiver plays a vital role in supporting Alaskans to live fulfilling lives within their communities.

This blog post aims to provide reliable information about the ALI Waiver, including how it supports family caregivers and the compensation process. By advocating for caregiver pay and highlighting the importance of recognizing their contributions, this article aims to raise awareness and empower caregivers in Alaska.

Overview of Alaskans Living Independently (ALI) Waiver

ALI Waiver is a Medicaid waiver program in Alaska. This program provides financial assistance and support services to eligible individuals and their families. By recognizing the importance of family caregivers, the ALI Waiver acknowledges their integral role in enabling independent living. The program empowers individuals to maintain their dignity and autonomy through personalized assistance and resources while receiving the necessary support to thrive within their chosen communities. The ALI Waiver emphasizes the value of community integration and strives to enhance the overall quality of life for those it serves.

The primary purpose of the ALI Waiver is to offer an alternative to institutional care by providing a range of services. It supports individuals to remain in their communities. The waiver aims to enhance individuals' quality of life, maintain their dignity, and foster a sense of belonging and independence. It acknowledges individuals with disabilities or aging have the right to choose their living arrangements and receive support as per their unique needs.

The ALI Waiver targets individuals who meet the eligibility criteria established by the State of Alaska. This waiver generally serves individuals with disabilities, including intellectual or developmental disabilities, physical disabilities, and mental health conditions. Additionally, the ALI waiver caters to older adults who require assistance to continue living in their communities.

The goals and objectives of the ALI Waiver encompass several aspects:

  1. It aims to prevent institutionalization by offering home and community-based services as a viable and preferred option for individuals needing long-term care.
  2. The waiver seeks to enhance access to a comprehensive range of supports and services by addressing the unique needs of each individual, promoting their independence and well-being.
  3. It recognizes and supports the critical role of family caregivers by providing financial compensation and assistance, acknowledging their dedication and contribution to the care of their loved ones.

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Eligibility requirements

To be eligible for the Alaskans Living Independently (ALI) Waiver, individuals must meet specific criteria established by the State of Alaska. While the eligibility requirements may vary based on individual circumstances, the following factors are typically considered:

  • Residency: Applicants must be residents of Alaska and have proof of residence.
  • Age: The ALI Waiver primarily serves older adults aged 65 and older. However, individuals under the age of 65 with disabilities may also qualify.
  • Functional Limitations: Individuals must have functional limitations to help with daily living activities or instrumental activities of daily living (IADLs). These limitations include bathing, dressing, meal preparation, medication management, or transportation difficulties.
  • Level of Care: Applicants must require a level of care provided in a nursing home or other institutional settings.
  • Income Limits: There are income limits to qualify for the ALI Waiver, which may vary based on the specific waiver program. These limits consider the individual's income and assets to determine financial eligibility.
  • Asset Limits: In addition to income limits, asset limits are also in place. Applicants must have limited assets, such as savings and investments, to qualify for the waiver.

Application Process and Determining Eligibility

The application process for the Alaskans Living Independently (ALI) Waiver involves several steps to determine eligibility and access the program's benefits. Here is an overview of the typical application process:

  • Contacting the Alaska Division of Senior and Disabilities Services (SDS) or the local Aging and Disability Resource Center (ADRC): Individuals interested in applying for the ALI Waiver should contact these agencies to initiate the process. They can provide detailed information and guidance specific to the waiver program.
  • Initial Screening and Assessment: The applicant will undergo an initial screening to determine basic eligibility. This may involve a phone interview or the completion of an eligibility questionnaire. The screening process helps identify individuals who meet the preliminary criteria for the waiver.
  • Complete the Application Form: Once deemed preliminarily eligible, the applicant must complete the official application form for the ALI Waiver. The form will require personal information, details about the applicant's disability or functional limitations, and financial information.
  • Gather Supporting Documentation: The applicant must gather supporting documents to accompany the application. These may include proof of Alaska residency, identification documents, proof of income, documentation of disability or functional limitations, and any other relevant information specified by the application form.
  • Functional Assessment: In some cases, the applicant may need to undergo a functional assessment conducted by a healthcare professional to evaluate the individual's care needs and helps determine their eligibility for the waiver.
  • Submit the Application: The form and supporting documentation should be submitted to the agency responsible for processing ALI Waiver applications. It is important to ensure all required information is included and the application is submitted within the specified timeframe.
  • Application Review and Decision: The agency will review the application, assess eligibility based on the provided information and documentation, and decide on the applicant's acceptance into the ALI Waiver program. The review process may take some time, and the applicant will be informed or notified of the decision in writing.

Services and supports 

The Alaskans Living Independently (ALI) Waiver offers comprehensive services and support designed to help eligible individuals with disabilities or older adults live independently in their communities. These services aim to meet their unique needs and enhance their overall quality of life. The following is an overview of the services and supports available under the ALI Waiver:

  • Personal Care Services: Aid with activities of daily living (ADLs) such as bathing, dressing, grooming, and toileting.
  • Homemaker Services: Help with household tasks like meal preparation, cleaning, and laundry.
  • Respite Care: Temporary relief for family caregivers, allowing them to take breaks and attend to personal needs.
  • Assistive Technologies: Provision of specialized devices or equipment to assist with mobility, communication, and daily activities.
  • Behavioral Supports: Support and interventions for individuals with behavioral challenges or mental health needs.
  • Community Integration Services: Assistance in participating in community activities and events to foster social connections.
  • Home and Vehicle Modifications: Adaptations to homes and vehicles to improve accessibility and safety.
  • Skilled Nursing Services: Medical services provided by registered nurses, such as wound care or medication management.
  • Specialized Therapies: Access to physical, occupational, and speech therapy to enhance functioning and independence.
  • Case Management: Individualized care coordination to ensure all necessary services are provided efficiently.
  • Transportation Services: Assistance with transportation to medical appointments, community activities, and essential errands.
  • Adult Day Services: Structured day programs providing social engagement and activities for participants.
  • Personal Emergency Response Systems (PERS): Devices allowing individuals to call for emergency help.
  • Transition Services: Support individuals transitioning from institutional settings to the community.

The ALI Waiver emphasizes home and community-based services (HCBS) to enable individuals to remain in their preferred living environments while receiving necessary support. These services promote community integration, individual choice, and independence, reducing the reliance on institutional care.


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Compensation for caregivers

Yes, the ALI Waiver does compensate unpaid family caregivers for their services. Recognizing the crucial role of family caregivers, the waiver acknowledges their dedication and provides financial compensation. The process and requirements for accessing caregiver compensation under the ALI Waiver typically involve the following steps:

  • Eligibility Assessment: The caregiver must care for an eligible individual enrolled in the ALI Waiver who meets the caregiver compensation criteria.
  • Caregiver Agreement: The caregiver and the care recipient must enter a formal caregiver agreement outlining the scope of caregiving responsibilities and the associated compensation.
  • Documentation: Caregivers are usually required to submit documentation supporting their role as the primary caregiver. This may include verifying their relationship to the care recipient and documentation of their eligibility for the ALI Waiver.
  • Training and Certification: In some cases, caregivers may need to complete training and certification programs to ensure they meet the necessary qualifications to provide care.
  • Payment Processing: Once the caregiver agreement and documentation are approved, the caregiver will be eligible for compensation. Payment is typically processed regularly, such as monthly or bi-weekly.
  • Reporting and Documentation: Caregivers may be required to maintain records or submit reports documenting the care provided, such as time logs, task sheets, or other relevant documentation. It allows the services being compensated to align with the agreed-upon caregiver agreement.

Caregivers should contact the agency responsible for administering the ALI Waiver to obtain specific information on the caregiver compensation process. They can guide the necessary documentation, reporting procedures, and additional requirements that caregivers must fulfill.

Limitations and challenges 

The Alaskans Living Independently (ALI) Waiver, while providing valuable support to eligible individuals and their caregivers, faces certain limitations and challenges, which should be acknowledged. 

1. Funding Constraints: The ALI Waiver may experience funding constraints like many Medicaid waiver programs. Limited funding can result in challenges in providing services to all eligible individuals, potentially leading to waiting lists or delays in accessing needed support.

2. Waiting Lists: Due to high demand and limited resources, there may be waiting lists for enrollment in the ALI Waiver, which can prolong the time it takes to receive the required services and support, delaying the program's benefits.

3. Coverage Gaps: While the ALI Waiver aims to provide a comprehensive range of services, certain services or supports may not be covered or have limitations. These coverage gaps can pose challenges for individuals requiring specific assistance or specialized care.

4. Eligibility Criteria: The specific eligibility criteria for the ALI Waiver may pose challenges for some individuals. Meeting the requirements related to income limits, asset limits, and functional limitations can be a barrier for certain applicants, potentially limiting access to the program's benefits.

5. Service Availability: Depending on the geographic location and availability of service providers, individuals enrolled in the ALI Waiver may face challenges accessing certain services.

6. Administrative Processes: Navigating the application and administrative processes associated with the ALI Waiver can sometimes be complex and time-consuming and may pose challenges for individuals and caregivers already dealing with the demands of caregiving and managing other responsibilities.

Despite these limitations and challenges, the ALI Waiver remains crucial in supporting independent living and assisting individuals with disabilities. Continued efforts to address these challenges can enhance the program's effectiveness, allowing eligible individuals to receive the necessary support promptly and efficiently.

A Note from Givers

Caregivers, your unwavering dedication deserves recognition and support. Complete our survey to assess your eligibility for compensation through programs like the ALI Waiver. Your well-being is paramount, and accessing the assistance you deserve can make a significant difference.

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