Alaska program
Nurses and carers at home through Alaska Medicaid
Alaska Medicaid can pay for nursing and help with daily care at home after a needs review.
What it is
Alaska Medicaid can pay for nursing and help with daily care at home after a needs review.
Hospital care can leave a family doing difficult work at home. Nursing and personal-care services cover different needs, and each has its own review. A diary of daytime and overnight care helps the team describe what is needed.
Eligibility rules
- Your child needs Alaska Medicaid. Senior and Disabilities Services assesses personal-care needs.
- Private-duty nursing is for a Medicaid recipient under 21 who meets a demanding clinical test, including a life-threatening condition and continuous nursing needs that can safely be met at home. Personal Care Services and Community First Choice have different functional and assessment rules; ordinary care expected for a child of the same age is not enough. EPSDT can support review of medically necessary covered-category services for a child under 21, but does not itself establish the hours or provider.
- Home nursing is for a child who needs a nurse for at least eight hours a day. Help with daily care (an attendant) has a different, lighter test.
What you get
- Approved nursing care at home, with the team checking covered care, staffing and any family charges.
- Help with daily living after a personal-care assessment.
What the help includes
- Private duty nursing is requested through the Medicaid fiscal agent. Personal care uses a separate PCA-08 application and assessment.
- The written approval names the service and number of hours.
- A parent can sometimes be paid for approved daily-care hours (up to 40 hours a week) if hired through a certified agency. A parent cannot be paid as the nurse.
- Community First Choice has its own institutional-level-of-care and service-plan tests. A parent must be qualified and employed by a certified provider before the paid-family-care rule can apply.
If you decide to apply
- Ask the oncology team to send the nursing request, with the doctor’s orders and a week’s care diary.
- For personal care, ask Senior and Disabilities Services about form PCA-08 and the home assessment.
Alaska Medicaid fiscal agent for nursing; Senior and Disabilities Services for personal care — 907-269-3666 · Official page ↗
After you ask
- A refusal should explain which care or hours were denied. The notice gives the appeal deadline.
- The oncology team's description of tasks and medical needs supports review under Alaska Well Child/EPSDT.
- Approval of hours does not mean a worker has been found. The social worker and discharge team can document unfilled hours, ask about other qualified agencies and agree on a safe interim plan. The state confirms the applicable decision deadline and local options. A denial or reduction should give hearing rights. An unfilled shift does not establish that the family can replace nursing care.
- Alaska Medicaid generally requires a written fair-hearing request within 30 days of the notice date, with a good-cause route for late requests. The ordinary final-decision standard is 90 days after receipt. For an existing service being cut, the social worker can help request continued care before the effective cut date. Continuation or reinstatement has conditions, and Medicaid may seek repayment if its decision is upheld. The clinical team can support urgent review; the hearing office confirms the applicable expedited process.
Good to know
An approval for hours does not establish that staff are available in your community. Personal care is described as covering most Alaska communities, not all.
Other details
- The Children with Complex Medical Conditions waiver and Medicaid case management may also help coordinate care.
- Relevant Alaska rules: 7 AAC 110.525–.530 (private-duty nursing), 7 AAC 125.010 (personal care), 7 AAC 127.015 (Community First Choice), and 7 AAC 49.030, .180 and .190 (hearings).
Official sources
“Could home nursing or personal care take some of this work off our family? What hours and limits might apply, and would you help us request an assessment if it fits?”
Why I’m asking: I want to understand what help could be available for the care our child needs at home.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Describe a full day and a full night at home, and keep a diary for a week before the assessment.
Your social worker
The team sends the nursing request; the assessor visits for personal care.
The care team
The doctor writes the orders and the hours the child needs.
- Who decides
- Alaska Medicaid for nursing; Senior and Disabilities Services for personal care.
- Ask the care team
- “Can you send a private duty nursing authorisation request to the Alaska Medicaid fiscal agent, and help us apply for a personal-care assessment?”
How to apply
First step: Ask the oncology team this week to send the nursing request, and apply for personal care with form PCA-08.
- Ask the oncology team to send a private duty nursing authorisation request to the Alaska Medicaid fiscal agent.
- Apply for personal care with form PCA-08 and ask Senior and Disabilities Services for the assessment.
- Ask both offices, in writing, how long the decision takes.
Official application / program page ↗
Where it starts: Your provider sends the nursing authorisation request. For personal care, apply using form PCA-08.
What to gather
- A week's diary of care at home, day and night
- The doctor's orders
- Your child's Alaska Medicaid details
How long: The agency confirms the applicable decision standard and local staffing. A PDN approval period of up to 60 days is not the application decision deadline.
What a yes looks like
An authorisation naming the service and the number of hours.
What a no looks like, and the next move
Ask which hours were refused and why, and appeal by the date on the letter. Alaska Well Child cover for a child under 21 is the argument to make.
Watch out
- The agency confirms the applicable decision standard and local staffing. A PDN approval period of up to 60 days is not the application decision deadline.
- Personal care is described as covering most Alaska communities, not all of them.
- Under the rule amended October 19, 2024, a qualified legally responsible parent, spouse or guardian can be paid for approved CFC personal care through a certified provider, capped at 40 hours per seven days across the specified CFC and waiver services for that recipient. Ordinary PCS exclusions differ; PDN excludes immediate family and household members.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Nursing hours and personal-care help at home, once Alaska Medicaid is in place.
Covers: Private duty nursing hours at home · Personal care, after an assessment, using form PCA-08 · EPSDT review of medically necessary services within federal Medicaid benefit categories for children under 21; it does not establish nursing hours or staffing
What it costs the family: Medicaid coverage and cost-sharing exemptions depend on the service and recipient. The express state child exemption is under 18, not everyone under the EPSDT age limit.
The eligibility facts, as published
- Coverage
- Alaska Medicaid
- Age
- Private-duty nursing is for Medicaid recipients under 21; ordinary PCS and CFC have separate rules, not a blanket under-21 cutoff.
- Assessment
- PDN requires intensive continuous nursing needs, a safe home plan and approval; continuous care is at least 8 hours in 24, with authorized nursing less than 24 hours/day. PCS requires functional assessment beyond ordinary same-age care. CFC also has its own institutional-level-of-care test.
Expect friction on: The agency confirms the applicable decision standard and local staffing. A PDN approval period of up to 60 days is not the application decision deadline. · Personal care is described as available in most Alaska communities, not all
The trap: The agency confirms the applicable decision standard and local staffing. A PDN approval period of up to 60 days is not the application decision deadline.
Where I read this
- Private Duty Nursing service authorization request — Alaska Department of Health, read September 10, 2026
- Personal Care Services and CFC conditions of participation — Alaska Department of Health, read September 10, 2026
- Personal Care Services — Alaska Department of Health, read September 10, 2026
- Early and Periodic Screening, Diagnostic and Treatment (Alaska Well Child Program) — Alaska Department of Health, read September 10, 2026
- Senior and Disabilities Services: Nursing — Alaska Department of Health, read September 10, 2026