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Quick Reference - Therapies Process

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Home and Community-Based Therapy Services Process

Young boy with cerebral palsy working with a therapist

Home and Community-Based therapy services may be available to Division members who are also eligible for the Arizona Long-Term Care System (ALTCS).

Members who may need home and community-based therapy services should follow this process:

  1. The member or responsible person must get a prescription for a therapy evaluation from their primary care physician (PCP).
  2. The Support Coordinator will connect the member to a therapist who can provide an evaluation. The member or responsible person should provide as much information as possible during the evaluation.
  3. The therapist may take up to 21 days to complete and submit the evaluation.
  4. The therapist will determine if therapy is medically necessary.
  5. The therapist will determine the number of hours the member needs if it is medically necessary. This includes the amount, frequency, duration, and goals. This is called the plan of care.
  6. The therapist will send the plan of care to the member’s PCP for certification.
    1. The PCP may need to see the member in person before they will certify the plan of care.
  7. The Support Coordinator will authorize therapy services once the therapist sends them the certified plan of care.
  8. The PCP must recertify the plan of care at least once a year. It may happen sooner if the member’s therapy program changes.

Additional Information

  • The therapist and the member (or family) will develop the plan of care. The member’s needs, history, and goals will be considered.
  • The plan of care will include at-home therapy activities.
  • Flexibility is needed about when and where therapy services are provided.
  • A family member or a member’s unpaid or paid provider must attend therapy sessions with the member. This allows them to learn and support the member with the at-home therapy activities.
  • The therapist will assess the member’s progress toward goals. The plan of care may change based on their progress.
  • The therapist will provide quarterly progress reports to the responsible person and Support Coordinator.
  • The need for therapy may be reevaluated based on the member’s progress and current needs.

Members with questions can contact their Support Coordinator, or the DDD Customer Service Center at 1-844-770-9500, option 1.

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