Home and community based waiver services in Alaska

Waiver Memo

The Home and community-based waiver (HCB Waiver) program has been instituted to provide home care services to thousands of Alaskans who receive care in their homes instead of in a traditional institutional setting. For example, this may include facilities such a nursing homes or intermediate care facilities for the developmentally disabled.

Since there have been no major revisions of the program's regulations since the waiver program was instituted. Our institution of the new regulations today ensures that the institutional language in state regulations will reflect current practices will be consistent with other state and federal laws. The regulations in this memo will clarify provisions that have been proven over experience and time to have been ambiguous or to have led to confusion. Certainly, those department "old timers" (and I know many of you personally) are keenly aware of the problems with the present system and know from experience that the system needs an overhaul. I and the department will be calling upon their sagely wisdom to help us overhaul the system the way it needs to be for our project to succeed.

For the department to assure that stakeholder groups would retain a voice in the regulation process, this department has allowed for a 6-month period for waiver recipients, families and providers to be consulted before the regulations will be completely finalized. Meetings have been held with a series of stakeholders to study the changes that need to be made in the regulations that affect people with developmental and other disabilities. Since these meetings, draft regulations have been adopted and made many suggestions have been incorporated into the regulations that are now being introduced.

The stakeholder group that I have appointed to oversee the last amendments to the new regulations is composed of 14 people that represent the Governor's Council on Social Services, advocacy groups, service providers and other parents of participants in the Waiver Program. The group has addressed numerous specific issues that have resulted in new or improved language in the newly instituted regulations. Additionally, the group suggested a revised certification period of six months for the new regulations. They reminded me that one size does not fit all. Like a new ship needs a "shake down cruise" to work out details, so does the waiver agency staff and the department as a whole. This period will allow us to introduce the human factor into the Waiver Program. This will allow some of the holistic providers of the indigenous peoples of the state to substitute specific professional experience for educational degrees, on a case-by-case basis. In this way, we can allow the input of indigenous practitioners into the bureaucratic process so that the services can be custom fitted to the clients in their community.