CARE COORDINATION SERVICES PROVIDER IN ALASKA

Fatumata Kaba
5 days ago
4 min read

SUPPORTING INDIVIDUALS AND FAMILIES BY CONNECTING THEM TO SERVICES, RESOURCES, AND LONG-TERM SUPPORTS

Care Coordination Services in Alaska play a vital role in the Home and Community-Based Services (HCBS) Medicaid Waiver system by ensuring that individuals with disabilities, chronic health conditions, or age-related needs receive the support and services they are entitled to. Care Coordinators help develop person-centered service plans, monitor service delivery, and link individuals to appropriate community resources. These services are essential to maintaining continuity, accountability, and quality of care across all waiver programs in Alaska.

1. GOVERNING AGENCIES

Agency: Alaska Department of Health – Division of Senior and Disabilities Services (SDS)

Role: Approves care coordination agencies, sets care planning standards, and oversees service quality and compliance

Agency: Alaska Medicaid (under the Department of Health)

Role: Administers Medicaid provider enrollment, manages billing codes, and reimburses for care coordination services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Enforces federal rules for HCBS waivers, including person-centered planning and service delivery integrity

2. CARE COORDINATION SERVICE OVERVIEW

Care Coordination Services ensure that individuals receiving Medicaid Waiver services have access to comprehensive care planning, service monitoring, and support with navigating complex health and community systems. The service is essential to delivering individualized, person-centered care.

Approved providers may deliver:

Person-centered assessment and service plan development
Regular monitoring and documentation of service outcomes
Coordination with waiver service providers and healthcare professionals
Support with housing, transportation, and social service access
Crisis support and critical incident management
Advocacy for client rights and goal achievement

All care coordination must be documented and must reflect the individual’s strengths, preferences, and changing needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Alaska Division of Corporations, Business and Professional Licensing
Obtain EIN from the IRS and NPI (Type 2)
Maintain an administrative office in Alaska with secure storage for records
Demonstrate compliance with SDS training and ethical standards for care coordination
Develop documentation systems for care plans, case notes, and monitoring reports
Employ or contract qualified Care Coordinators meeting SDS credentialing standards

4. SDS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Contact SDS to request the Care Coordination Services application packet
Attend a mandatory Care Coordination orientation session

Application and Policy Submission:

Submit organizational information, service description, and internal control policies
Provide sample documentation forms for service plans, client communication logs, and case monitoring

Credentialing and Capacity Review:

Submit resumes, background checks, and certifications for all Care Coordinators
Demonstrate knowledge of SDS waiver programs, person-centered planning, and critical incident management
Show readiness to initiate and maintain individualized plans of care across multiple service providers

Approval & Medicaid Enrollment:

Once approved by SDS, enroll as a Medicaid Care Coordination provider through Alaska MMIS
Select relevant billing codes for each waiver served
Sign Medicaid provider agreement and configure electronic claim submission access

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License
IRS EIN Letter
NPI confirmation
Lease or office verification for Alaska-based operations
SDS-Compliant Policy & Procedure Manual including:
- Intake, eligibility screening, and referral protocols
- Service planning, reassessment, and documentation timelines
- Emergency and critical incident response policies
- Client rights, advocacy, and informed consent procedures
- Confidentiality and HIPAA compliance measures
- Staff credentialing, training, and supervision standards
- Billing and documentation integrity protocols
- Discharge and transition procedures

6. STAFFING REQUIREMENTS

Role: Care Coordinator

Requirements:

Minimum of a bachelor's degree in a human services field (social work, psychology, nursing, etc.)
At least one year of experience in case management, care coordination, or working with individuals with disabilities
Must complete SDS-approved Care Coordination training

All staff must complete:

SDS care coordination and HCBS waiver orientation
Training on person-centered planning, documentation, and Medicaid compliance
Annual refreshers on ethics, abuse reporting, cultural competency, and service delivery standards
Ongoing professional development and performance evaluation

7. MEDICAID WAIVER SERVICES

The following Alaska Medicaid Waivers authorize Care Coordination Services: