Arizona ALTCS PAS Assessment Preparation

The Assessment That Determines Whether Your Young Adult Gets Funded Services

The Pre-Admission Screening — PAS — is the clinical evaluation that decides medical eligibility for Arizona's Long Term Care System (ALTCS). Financial eligibility gets your application in the door, but the PAS score determines whether AHCCCS approves long-term care funding for home and community-based services through the Division of Developmental Disabilities (DDD).

For young adults transitioning out of special education, the PAS happens around age 18, typically during the ALTCS application process. The minimum qualifying score is 40 points. Falling short means the young adult is denied ALTCS funding — and without ALTCS, DDD can only provide basic "DD-Only Support Coordination" with check-ins every 180 days, rather than the funded habilitation, attendant care, and respite hours that most families are counting on.

Getting an accurate PAS score is not about gaming the system. It is about making sure the assessor sees the full picture of your young adult's daily functioning — not the polished version they present on their best day.

What the PAS Assessment Evaluates

An AHCCCS clinical assessor conducts the PAS interview. The evaluation covers four broad domains:

Cognitive and behavioral functioning. The assessor scores the individual's ability to understand instructions, make decisions, manage frustration, and respond to unexpected changes. This includes evaluating behavioral episodes — frequency, severity, and the level of supervision required to keep the individual and others safe.

Medical complexity. Chronic conditions, medication management needs, seizure protocols, feeding or respiratory support, and any medical equipment the individual requires daily.

Activities of Daily Living (ADLs). How much assistance the individual needs with bathing, dressing, toileting, eating, mobility, and personal hygiene. The assessor looks at what happens without prompting or physical assistance — not what the individual can do when coached step by step.

Functional support needs. The assessor also considers the assistance and supervision the individual needs in daily routines and community settings, including managing money, preparing food, using transportation, communicating by phone, managing a schedule, and navigating community settings independently.

Each area contributes points to the total PAS score. The 40-point threshold is calibrated to identify individuals who need ongoing, structured support to live safely in the community.

How to Prepare for an Accurate Assessment

The most common problem families report is not that the PAS is unfair — it is that the assessor's limited snapshot did not capture the reality of daily life.

Document the "worst day," not the "best day." Parents instinctively present their child's strengths. For the PAS, the assessor needs to understand what happens when the routine breaks down — when a caregiver is unavailable, when a transition between activities triggers a meltdown, when medication side effects are at their peak. Write a one-page summary of a worst-case-scenario day and hand it to the assessor at the start of the interview.

Bring comprehensive medical records. The assessor's medical scoring depends on documentation. Bring current diagnoses from the treating neurologist, psychiatrist, or developmental pediatrician. Include any emergency room visits, hospitalization records, or incident reports from school that demonstrate medical complexity.

Bring the IEP and behavior intervention plan. The school's Functional Behavior Assessment (FBA) and Behavior Intervention Plan (BIP) provide third-party documentation of behavioral challenges, including frequency data, antecedent patterns, and the level of adult support required to manage episodes. These documents carry weight because they were written by professionals who observe the individual daily.

Include DDD records if the young adult has been a DDD member since childhood. The existing Individual Support Plan (ISP), any authorized service hours, and historical assessments from the DDD support coordinator all establish baseline needs.

Have the student and a caregiver present during the interview. Arizona expects the primary caregiver and the student to participate in the PAS interview. The caregiver can fill in details the young adult may not articulate, especially around nighttime supervision needs, behavioral escalation patterns, and the actual level of daily assistance provided.

What Happens After the Assessment

The assessor submits the PAS score to AHCCCS, which combines it with the financial eligibility determination to issue an ALTCS approval or denial. If approved, the young adult is enrolled in an ALTCS managed care plan — either Mercy Care or UnitedHealthcare Community Plan — and DDD assigns a support coordinator to build the Individual Support Plan (ISP) detailing authorized service hours.

If the PAS score falls below 40, the family can ask AHCCCS about the applicable appeal or review process and whether additional medical documentation can be submitted. Families who are denied should not assume the result is final — the initial PAS score may have missed critical information, especially if the caregiver was not present or if recent medical records were not available.

The entire sequence — ALTCS application, PAS interview, approval, managed care enrollment, and ISP development — can take time. Starting the process at age 17½, well before the young adult exits special education, prevents a gap in services between the school system and the adult DDD support structure.

The Arizona IEP Transition to Adulthood Guide includes a PAS preparation worksheet and a timeline that coordinates the ALTCS application with the DDD redetermination, SSI application, and IEP transition milestones — so families can manage all of these concurrent deadlines without losing track of any single pathway.

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