Arizona In Lieu of Services ISL

What ISL Means in Arizona's DDD System

The research reports for this product do not verify a current Arizona DDD/ALTCS benefit called In Lieu of Services (ISL), a direct monetary allocation, or the specific self-directed service model described below. Do not treat this page as confirmation that an ISL option is available; ask the assigned DDD support coordinator or health plan about current service-delivery options.

If DDD confirms that a self-directed option is available, ask for its written rules before assuming that workers, adaptive equipment, community activities, or other disability-related expenses can be paid through it.

How ISL Differs From Standard Services

Under the standard ALTCS/DDD service model, the support coordinator and DDD health plan coordinate authorized service categories such as habilitation, attendant care, and respite through the member's service plan. The research reports do not verify an ISL alternative to that model.

If DDD confirms a self-directed option, compare its management rules with the standard model. Key questions include:

• Employer of record — If a current plan offers self-direction, confirm who handles worker recruitment, scheduling, supervision, and employment responsibilities
• Budget flexibility — Confirm the allowable service categories and whether funds may be used across them; do not assume broader flexibility
• Provider availability — Ask DDD what vendor and self-directed options are available in the member's area
• Administrative burden — Ask the health plan which payroll, tax, workers' compensation, and documentation responsibilities apply

Eligibility and Access

The reports do not establish ISL-specific eligibility criteria. A family seeking ALTCS-funded long-term services should first confirm DDD membership, ALTCS enrollment, and authorized services in the Person-Centered Service Plan (PCSP), then ask the assigned support coordinator whether a current self-directed option is available. Confirm in writing:

1. Whether the member is actively enrolled in ALTCS through a DDD Health Plan
2. Which service hours are authorized in the PCSP
3. Whether an ISL or other self-directed option is currently available
4. Who may manage any administrative responsibilities and what written approvals are required

Do not assume that a self-directed budget is dollar-for-dollar equivalent to vendor-delivered services or that it includes an administrative-overhead adjustment. Ask DDD or the health plan for the current calculation and authorized uses.

Practical Considerations

Worker recruitment can be a challenge with any self-directed option. Under the vendor model, the agency recruits, screens, trains, and supervises workers. Ask DDD how worker recruitment and the applicable reimbursement rules work under any option it confirms.

Record-keeping requirements depend on the option DDD confirms. Ask the health plan which spending records, time sheets, receipts, audits, and repayment rules apply.

EVV compliance — If the confirmed option uses in-home services, ask the health plan whether Arizona's Electronic Visit Verification requirements apply and follow its clock-in and clock-out instructions.

Combining self-directed options with PPCG — Do not combine or overlap a self-directed option with the Parents as Paid Caregivers program without written guidance from the support coordinator and health plan.

Is ISL Right for Your Family?

A confirmed self-directed option may suit a family that has the capacity and willingness to manage administrative responsibilities, has access to reliable workers (or can recruit them), and values scheduling flexibility over the convenience of an agency managing everything. It may suit families less well when the coordination demands and additional paperwork are already overwhelming.

If DDD confirms a self-directed option and it proves too burdensome, ask the support coordinator how to change service delivery. Do not assume a return to traditional vendor-delivered services can be made at any time.

For an overview of the DDD and ALTCS services verified for the school-to-adult transition, see the Arizona SSI at 18 & Adult Disability Benefits Guide.

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