Arizona families can comment now on proposed ALTCS care-assessment rules

Arizona families, caregivers and care professionals have a limited opportunity to help shape rules that may affect how in-home care needs are measured for children enrolled in the Arizona Long Term Care System (ALTCS).

The Arizona Health Care Cost Containment System (AHCCCS) is accepting public comments through October 12, 2026 on proposed rules for the Home and Community Based Services Needs Tool, commonly called the HNT, and the Extraordinary Care Review process.

What the proposal covers

The HNT is used to assess whether an ALTCS member needs direct-care or habilitation services to help with activities of daily living. These can include bathing, dressing, eating and mobility, along with activities such as meal preparation, household tasks and participation in the community.

For ALTCS members under age 18, the proposed rules also address an Extraordinary Care Review, or ECR. The review may be available when a child’s healthcare decision-maker disagrees with the number of service hours produced by the assessment because of age-related limits in the tool.

AHCCCS says the proposal describes managed-care organization responsibilities before and after the ECR process is implemented. It also sets training requirements for clinicians who conduct these reviews, including annual training in person-centered service planning.

Why families and care professionals may want to comment

Assessment rules can have practical consequences for children who need help at home and for the family members and professionals who provide that help. Families may have direct experience with tasks that are difficult to capture in a standardized assessment. Providers may be able to explain how age limits, documentation rules, clinician training or review procedures work in real care settings.

The public-comment period is the formal opportunity to identify unclear language, describe likely effects and recommend specific changes before AHCCCS finalizes the rules. Comments do not need to use legal language. Clear examples and concrete suggestions are often the most useful.

How to submit a public comment

Comments must reach AHCCCS by October 12, 2026. Review the proposal on the [AHCCCS Proposed State Rules page](https://www.azahcccs.gov/PlansProviders/CurrentProviders/State/proposedrules.html) under “HCBS Needs Tool and Extraordinary Care Review.”

Written comments may be submitted by:

• Email: [AHCCCSRules@azahcccs.gov](mailto:AHCCCSRules@azahcccs.gov)
• Mail: AHCCCS Office of the General Counsel, 150 N. 18th Ave., MD 15013, Phoenix, AZ 85007
• Fax: 602-253-9115

To make a comment easy to understand, identify the HNT and ECR rulemaking, explain whether you are writing as a family member, ALTCS member, caregiver, provider or advocate, and point to the particular requirement that concerns you. Describe the likely real-world effect and, when possible, suggest the wording or safeguard you believe would address it. Avoid including private medical information that is not necessary to make your point.

What happens next

AHCCCS will review feedback before completing the exempt rulemaking process. The agency has said it is planning for the revised HNT and ECR policies to take effect on December 1, 2026.

The authority for this rulemaking is connected to Arizona’s 2026 health budget legislation, HB 4160, Chapter 132, which allowed AHCCCS to use an exempt rulemaking process for service-frequency or service-hour limits during fiscal year 2027, provided the agency gives notice and at least 30 days for public comment.

The central deadline is October 12: review the proposed rules and send your comments to AHCCCSRules@azahcccs.gov before the public-comment window closes.