Arizona DDD Services After 18

The Age-18 DDD Redetermination

DDD eligibility does not automatically carry over from childhood to adulthood. When a DDD member turns 18, DES requires a formal redetermination of eligibility — the family submits Form DDD-2114A (Application for Redetermination of Eligibility at Age 18) confirming that the individual still meets the adult diagnostic and functional criteria.

The adult eligibility standard requires:

1. A qualifying diagnosis — Autism Spectrum Disorder, Cerebral Palsy, Epilepsy, Cognitive Disability (Intellectual Disability), or Down Syndrome, with onset documented before age 18
2. Functional limitations in at least 3 of 7 major life areas — self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency

The redetermination application must be signed by the adult individual or their legal representative, such as a court-appointed guardian. Parents who haven't established legal authority before the 18th birthday cannot sign on the individual's behalf, which creates urgency for families to plan how the adult will sign and how supporters or a legal representative will participate.

What Services Are Available After High School

Once DDD eligibility is confirmed and the individual is enrolled in ALTCS (which funds the long-term services), the Person-Centered Service Plan (PCSP) authorizes a combination of:

Habilitation — Skill-building services that help the individual develop daily living capabilities. This includes training in personal hygiene routines, cooking safety, money management, community navigation, social interaction, and workplace skills. Habilitation can be delivered at home, in community settings, or through day programs operated by qualified DDD vendors.

Attendant Care — Direct assistance with activities of daily living that the individual cannot perform independently: bathing, dressing, toileting, feeding, grooming, and mobility transfers. Attendant care is authorized in hours per week based on the HCBS Needs Tool (HNT) assessment of the individual's functional limitations.

Respite Care — Temporary relief for primary caregivers, delivered either in the home or at a licensed respite facility. Respite hours give parents and family caregivers a break from continuous care responsibilities.

Day Treatment and Training (DTT) — Structured programs that provide socialization, community engagement, and skill development outside the home during weekday hours — essentially the adult replacement for the school day structure that ends at graduation.

Supported Employment — Job coaching, worksite accommodations support, and ongoing assistance to help the individual maintain competitive integrated employment. Coordinated with DES Vocational Rehabilitation services.

Therapies — Speech-language pathology, occupational therapy, and physical therapy as clinically indicated, authorized through the DDD Health Plan.

DDD Health Plans — Mercy Care vs. UnitedHealthcare

After ALTCS approval, the family must select one of two integrated DDD Health Plans within 30 days:

Mercy Care — One of the two integrated DDD Health Plans.

UnitedHealthcare Community Plan — The other integrated DDD Health Plan; ask DDD which plan models and service areas apply to the member.

Under the Coordinated Plan, the MCO manages physical and behavioral health while DDD retains primary management of long-term support services (habilitation, attendant care, respite). Under the Direct Plan, a single MCO manages everything — physical, behavioral, and all LTSS — through one integrated delivery system.

Families can switch plans during the annual open enrollment period (during the member's birth month) or within 30 days of initial enrollment.

The Support Coordinator Role

Every DDD member is assigned a Support Coordinator who serves as the central point of contact between the family, the health plan, and service providers. The support coordinator:

• Conducts the initial and annual PCSP meeting to identify the individual's goals, preferences, and service needs
• Authorizes the specific number of weekly hours for each service type
• Connects families with qualified DDD vendors (contracted agencies that deliver habilitation, attendant care, and respite)
• Coordinates with the health plan for medical and behavioral health referrals
• Monitors service delivery and adjusts authorizations as the individual's needs change

If you're unsatisfied with your assigned support coordinator, you can request a reassignment through the DDD Customer Service Center at 844-770-9500 (Option 1).

DDD Without ALTCS — Support Coordination Only

Not every DDD-eligible individual qualifies for ALTCS. If the individual scores below 40 points on the Pre-Admission Screening (PAS) or exceeds the financial limits, they are placed in one of two limited categories:

• DD-Only Support Coordination — Basic support coordination services with no income or resource limit, but no funded direct services (habilitation, attendant care, respite)
• Targeted Support Coordination (TSC) — For individuals who have standard AHCCCS Medicaid (usually via SSI) but don't meet the ALTCS institutional-level-of-care threshold

In both categories, the support coordinator can connect families with community resources and help navigate other benefit systems, but cannot authorize the ALTCS-funded home and community-based services.

For the complete application sequence — from DDD redetermination to ALTCS screening to health plan selection — the Arizona SSI at 18 & Adult Disability Benefits Guide walks through each form and deadline with a transition timeline worksheet.

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