DES OFFICE OF TRIBAL RELATIONS QUARTERLY NEWSLETTER October - November - December 2023

NOTABLE HIGHLIGHTS AND UPDATES

This edition features updates for program eligibility, application processes, and services available to tribal members and communities.

The ARIZONA EARLY INTERVENTION PROGRAM

The Arizona Early Intervention Program (AzEIP) is Arizona’s statewide interagency system of services and supports for families of infants and toddlers, birth through two years of age, with disabilities or delays. AzEIP is established by Part C of the Individuals with Disabilities Education Act (IDEA), which provides eligible children and their families access to services to enhance the capacity of families and caregivers to support the child’s development.

We Want to Hear From You

We appreciate hearing from our community, and that means you!

The Interagency Coordinating Council (ICC) for Infants and Toddlers is looking for parents and members of the Twenty-Two Tribes in Arizona who have had experiences with early intervention programs. The ICC is seeking parents and members of American Indian Tribes to join the Council or one of the Subcommittees to provide your input and perspective. The ICC members advise and assist the program and its partner agencies to administer, promote, coordinate, and improve early intervention services for families and professions. The mission is to improve services in early childhood programs and encourage family involvement and advocacy, by ensuring high-quality, culturally appropriate, early childhood services to the children of Arizona. Interventions in the first few years of a child's life have significant impacts on their lifelong health and economic and social well-being.

Do you have any interest in the following areas? If so, we invite you to join a committee. Note: All meetings are held virtually.

Family Engagement Committee

The Family Engagement Committee empowers family partnership by promoting positive family caregiver-child relationships. This committee meets approximately monthly.

Transition Committee

The Transition Committee provides support and direction on policies and procedures to assist with the timely and high-quality transition of children out of early intervention to preschool and/or other community services. This committee meets quarterly.

Fiscal Committee

The Fiscal Committee provides fiscal advice and assistance to support the financial stability of AzEIP. This committee meets monthly.

Development Committee

The Development Committee assists with the structure of policies and procedures, recruiting, and retaining members, and providing education for new and existing members. This committee meets quarterly.

You can find information about the ICC here: https://des.az.gov/services/developmental-disabilities/early-intervention/icc-for-infants-and-toddlers

If you have any questions please call (602) 532-9960 or email azicc@azdes.gov

Visit ICC on Facebook:

https://www.facebook.com/azearlychildhoodICC/

The Family Engagement Committee is accepting content for the ICC’s Facebook page and would like your participation.

Examples of content/post ideas include:

• Early childhood resources
• Community Events
• Family Stories
• AzEIP-related topics
• ICC committee updates

Send your suggestions: ICC Social Media - DES

DIVISION OF AGING & ADULT SERVICES

Family Caregiver Support Programs

Throughout history, the southwest has been home to many indigenous communities. The tribes lived in places with limited natural resources and adapted to migration to ensure sustainable livelihood. Today, Arizona is home to 22 tribal nations, each sovereign, unique, and culturally diverse. Caring for their aging elders today looks vastly different than it used to in tribal nations. As younger Native generations leave reservations for educational and work opportunities, more elders are aging in unfamiliar and nontraditional places, such as rehabilitation centers and nursing homes.

The DES Division of Aging and Adult Services (DAAS) serves vulnerable Arizonans and is responsive to the needs of non-English speaking, rural, and Tribal communities. DAAS, Arizona’s designated State Unit on Aging by the Administration for Community Living, helps to administer Older Americans Act (OAA) funded services to individuals in the greatest social and economic need. DAAS collaborates and contracts with eight Area Agencies on Aging (AAAs), including the Inter-Tribal Council of Arizona (ITCA) and the Navajo Nation Division of Aging and Long-Term Care Support (DALTCS). Each AAA serves older adults, individuals living with disabilities, and informal caregivers.

The Family Caregiver Reimbursement Program

DES administers the state-funded Arizona Family Caregiver Reimbursement Program (FCRP) to reimburse informal caregivers for costs incurred for home modifications (restroom/shower remodels, widening of doorways, wheelchair ramp, ramp installation, and modifying floors to prevent falls) and assistive technology (shower commode, personal care products, hospital or adjustable beds, tables, or chairs, scooters or wheelchairs, and emergency response systems). When an application is submitted, eligible purchases are reimbursed up to $1,000 or 50% of the total cost and must have taken place in the same calendar year as the application. The FCRP is open to all Arizona residents, but the program will be ending on June 30, 2024. There is still funding available, but time is running out. Applicants can apply through the Arizona Caregiver Coalition website at www.azcaregiver.org or by calling toll-free 888-737-7494. You can also access additional information on the Family Caregiver Support webpage.

The OAA-funded services aim to help delay premature and costly institutionalization for older adults and those living with disabilities. Available services depend on a person’s geographic location and functional eligibility. Some examples of services include case management, attendant care, home-delivered meals, housekeeping/homemaker services, respite care, caregiver training and support, evidence-based programs proven to help manage chronic disease, Medicare benefits counseling, and legal advocacy. ITCA and DALTCS offer information in a variety of native dialects and partner with organizations that can assist with the dissemination of outreach information. For more information about services and programs offered in your area, please call your local Area Agency on Aging or visit the DAAS website at https://des.az.gov/services/older-adults.

NEW Lifespan Respite Grant

In 2023, DAAS was awarded a new Lifespan Respite Grant to help promote aging in place for older adults in underrepresented and underserved communities. The grant will offer a $2,400 reimbursement voucher for the informal caregiver to hire their provider of choice, which could be an agency, a friend or neighbor, or another individual who provides care for their loved one. Respite care is proven to mitigate caregiver burden by providing a short period of relief to the caregiver. The respite provider may be a trusted person with whom the qualified family member is familiar and may take place within their communities. Applicants can apply through the Arizona Caregiver Coalition. More information can be found at www.azcaregiver.org or by calling toll-free 888-737-7494.

DIVISION OF BENEFITS & MEDICAL ELIGIBILITY

DES Receives Approval to Replace Stolen EBT Benefits for SNAP and TANF Cash Assistance Participants

DES announced in June a new process to replace the Supplemental Nutrition Assistance Program (SNAP) Nutrition Assistance and/or TANF Cash Assistance benefits stolen from Electronic Benefit Transfer (EBT) cards. This new process helps individuals and families affected by a nationwide trend of card skimming, card cloning, and phishing scams that have impacted EBT cardholders. “We are grateful to now have the ability to replace stolen benefits to individuals and families who need it most,” said DES Director Angie Rodgers.

“We appreciate the collaboration and approval of Arizona’s plan by the U. S. Department of Agriculture (USDA) Food and Nutrition Services and look forward to working with impacted and eligible EBT cardholders to replace their stolen benefits.”

The Consolidated Appropriations Act, of 2023 included a provision for states to reimburse stolen SNAP benefits upon federal approval, following nationwide card skimming that has targeted EBT cards. Prior to this provision, Arizona did not have the authority to replace stolen SNAP benefits. The U.S. Department of Agriculture (USDA) Food and Nutrition Service approved Arizona’s plan for the replacement of stolen SNAP benefits. The Administration of Children and Families also permitted states to align their TANF State Plan with the approved SNAP Plan to replace stolen TANF Cash Assistance benefits. Households who had their SNAP or TANF Cash Assistance benefits stolen from June 19, 2023, through September 30, 2024, have 45 days from the date of theft to submit a claim for replacement benefits. Households may report and request replacement of stolen benefits by any of the following methods:

• By calling 1 (833) 786-8823
• In writing by completing the Electronic Benefit Theft Replacement Request Form (FAA-1847A). The completed and signed form may be returned by any of the following methods:

○ By mail to DES PO Box 19009 Phoenix, AZ 85005-9009

○ By fax to (602) 257-7031 or toll-free to 1 (844) 680-9840

○ In person at any DES Family Assistance Administration (FAA) office.

DES has been at the forefront of mitigating EBT theft as the Department was the first state in the nation to implement the ability for clients to freeze their cards, piloting the function for nationwide use. DES continues to provide warnings, precautions, and information to clients and retailers regarding the rise in card skimming.

For more information about EBT cards, including how to prevent or report EBT theft or fraud, please visit our website.

Able-Bodied Adults Without Dependents Time Limit

As of October 1, 2023, the Able-Bodied Adults Without Dependents (ABAWD) Time Limit for receiving Nutrition Assistance (NA) benefits has returned to Arizona.

Beginning January 1, 2024, Nutrition Assistance (NA) participants who have not met an ABAWD exemption or an ABAWD work requirement and have received NA benefits since October 2023 may be subject to the time limit of three-countable months.

If you are 18 through 52 years old and don’t have a child under 18 receiving Nutrition Assistance benefits as part of your household, you might be subject to the ABAWD time limit. However, many people are exempt from the ABAWD time limit, including those residing outside Maricopa County or on tribal reservations.

NA participants living in any of these areas are not subject to the three-month time limit and, therefore, do not need to meet the work requirements. Individuals within these areas will continue to receive NA benefits if they meet the eligibility requirements during renewals. Individuals who meet one of the other exemptions (see below) are not subject to the three-month time limit.

Who is considered an Able-bodied adult without dependents (ABAWD)?

Beginning October 1, 2023, for Nutrition Assistance (NA), individuals 18 through 52 years of age, without minor dependents, and physically and mentally fit for work are considered ABAWD participants. Under federal requirements, ABAWD participants can only get three months of NA benefits in three years unless they meet the ABAWD work requirements or qualify for an exemption.

What are the ABAWD work requirements?

ABAWD participants must meet one of the following work requirements to avoid the ABAWD time limit: Work at least 20 hours per week (or an average of 80 hours per month). Including any of the following combinations:

• Employed for a minimum of 20 hours per week
• Self-employment
• Volunteer work
• In-kind work: working in exchange for food, rent, or other needs. Proof must include the value of the work and the number of hours worked.
• Participate in an approved Nutrition Assistance Employment and Training activity at least 20 hours per week or an average of 80 hours per month. Job search activities cannot exceed 10 hours a week.
• Participate in a combination of work and an approved Nutrition Assistance Employment and Training activity for at least 80 hours per month.
• Show good cause for not meeting work requirements, such as having an illness, not having transportation, or unreasonable working conditions.

The Supplemental Nutrition Assistance Program Career Advancement Network (SNAP CAN) has employment assistance to help ABAWDs meet these work requirements. For information about SNAP CAN, see SNAP CAN Provider Resources. (https://des.az.gov/snapcan-provider-resources).

What are the ABAWD Exemptions?

ABAWD participants who meet one of the following criteria do not need to participate in the work requirements to continue to receive NA benefits beyond the three-month time limit.

• Under the age of 18 or 53 years or older
• Living with a child under 18 years old who is a member of the budgetary unit, even when the child is not eligible for NA benefits
• Unable to work because of a physical or mental health reason
• Pregnant
• Homeless
• A veteran, regardless of your discharge status
• Former foster care youth between the ages of 18 to 24 who was in the custody of foster care on the day the participant turned 18 years of age, or a higher age when the foster care program offers continued foster care after 18 years of age
• Living in a geographically exempt area (on a reservation or outside of Maricopa County)

Additional Exemptions:

ABAWD participants who meet any of the following exemptions do not need to participate in the NA work requirements:

• Earn an amount equal to or more than the Federal minimum wage multiplied by 30 hours, regardless of the number of hours worked (a total of at least $217.50 per week or $870 a month
• Participate and comply with the Cash Assistance Jobs, Tribal NEW, or Tribal TANF Employment Program
• Responsible for the care of an incapacitated individual
• Participating in a drug or alcohol treatment and rehabilitation program
• Applying for or receiving Unemployment Insurance benefits
• A student enrolled at least half-time in any recognized school, including high school, training programs, or institutions of higher education
• Receiving Social Security Supplemental Income (SSI)
• Participating and complying in the Cash Assistance (CA) Jobs Program, Refugee Resettlement Program, or the Tribal Native Employment Works (NEW) Program
• Work as a migrant or seasonal farmworker not living in their home project area and meet any of the following:

o Following the job stream

o Working a minimum of 30 hours weekly

o Under contract or agreement to begin employment within 30 days

DIVISION OF COMMUNITY ASSISTANCE & DEVELOPMENT

Arizona Rental Assistance Launched October 15, 2023

Arizona Rental Assistance alleviates housing instability for eligible low-income seniors and families with children. Eligible households may receive a lump-sum assistance payment equal to three (3) times the household’s monthly rent, not to exceed $10,500. Upon approval, the applicant may use the program benefits to cover rental arrears, future rent, and rent late fees and penalties. To qualify, a household must:

• Be experiencing housing insecurity (e.g., rent arrears or eviction)
• Have at least one household member who is a child (under 18) or senior (60 or older)
• Have household income at or below 80% of the Area Median Income
• Be located in Arizona, obligated by a written lease agreement to pay rent
• Have current or recent workforce participation, such as recent employment, participation in an education program, receipt of unemployment or disability benefits, etc. (This requirement is waived when all adult household members are seniors.)

Benefits are paid to the participating landlord or directly to a tenant if a landlord does not or declines to participate. Regardless of landlord participation, rental assistance benefits must be applied to rent for the address identified in the application. Prior rental assistance recipients under the Emergency Rental Assistance Program (ERAP) are not eligible for Arizona Rental Assistance.

Applicants can apply for rental assistance online via computer or mobile device using the Housing Stability and Utility Assistance website: https://des.az.gov/ARAP. Also, an applicant can visit a Community Action Agency (CAA) to receive assistance. To find and/or contact the nearest CAA, please visit the following website: https://des.az.gov/services/basic-needs/community-action-agencies. If one cannot apply online or through a Community Navigator and requires accommodation, one can apply by phone at 1-833-912-0878 or by mailing in a paper application. The paper application is available in English and Spanish for download at https://des.az.gov/ARAP under the “How to Apply” section.

For more information and to apply, please visit the Arizona Rental Assistance website at https://des.az.gov/ARAP.

DIVISION OF CHILD CARE

Arizona's First Early Childhood Educator Apprenticeship Program Provides Participants with Opportunity, Lifelong Child Care Career Certification

The Professional Career Pathway Project (PCPP) college scholarship, funded by DES and administered by Central Arizona College (CAC), introduced the first-ever registered apprenticeship program for early childhood educators in Arizona.

A project that started over three years ago based on feedback from community stakeholders and childcare providers, the Arizona apprenticeship program seeks to support the recruitment, retention, and professional development needs of the early childhood workforce. Now with the first cohort currently in the program, the apprentices are set to graduate in 2025. Read more about the program on the DES website.

Arizona Child Care Infrastructure Grant

LISC Phoenix administered the DES grant program that provided over $60 million in funding for child care providers. Once awarded, grant money went towards improving every aspect of a child care facility, from classrooms and playgrounds, to vital equipment and safety measures.

There are several amazing stories that show the success of the program. Stories came from a preschool in Mesa, a facility in Navajo County, and providers in Tucson and Prescott Valley.

Arizona Child Care Assistance Provider Grant (AZCAP)

The Division of Child Care new external newsletter, the DCC Direct, recently announced that the Arizona Child Care Assistance Provider (AZCAP) grant supports DES child care providers who serve children eligible for DES Child Care Assistance and $68,765,000 has been distributed.

DIVISION OF DEVELOPMENTAL DISABILITIES

DDD-Tribal Health Program

The Division of Developmental Disabilities (DDD)-Tribal Health Program (THP) is a fee-for-service program administered by DDD for DDD- and ALTCS-eligible American Indian/Alaska Natives (AI/AN). THP pays for physical and behavioral health services. These services can be provided by:

• AHCCCS registered providers
• Indian Health Service (IHS)
• Tribally owned or operated organizations (638 programs/facilities)
• Urban Indian Health Centers

Call AHCCCS enrollment to get behavioral health services from a Tribal Regional Health Authority: From area codes (480), (602), and (623), call 602-417-7100. From area codes (520) and (928), call 1-800-334-5283. Members with questions about the DDD Tribal Health Program can contact the DDD Tribal Health Program: Member Services: 1-844-770-9500, option 7 or TTY/TDD 711.

DDD Health Plans

DDD members eligible for the Arizona Long-Term Care System (ALTCS) receive health care coverage from the Division of Developmental Disabilities. Health care is offered through a contract with the Arizona Health Care Cost Containment System (AHCCCS).

This health care coverage includes physical health services, behavioral health services, Children’s Rehabilitative Services for those eligible, and Long-Term Services and Supports (LTSS).

Mercy Care and UnitedHealthcare Community Plan are the DDD Health Plans open to ALTCS-eligible members statewide. The DDD health plans are responsible for the provision and administration of all physical and behavioral health services, including Behavioral Analysis, as well as LTSS, such as:

• habilitative physical therapy for members 21 and older
• augmentative and alternative communication (AAC) devices
• emergency alert system services
• nursing facilities

DDD contracted qualified vendors and specialty contractors provide all other LTSS.

The DDD Tribal Health Program is a program open to American Indian or Alaska Native members who are DDD- and ALTCS-eligible.

Contact your Support Coordinator or DDD Member Services for help with questions about your DDD Health Plan at 1-844-770-9500, option 7.

Members also can contact their DDD Health Plan at:

Mercy Care: Toll Free: 1-800-624-3879 (TTY/TDD 711) 24-Hour Nurse Help Line: 1-800-624-3879 (TTY/TDD 711) Website: mercycareaz.org

UnitedHealthcare Community Plan: Toll Free: 1-800-348-4058 24-Hour Nurse Line: 1-877-440-0255 (TTY/TDD 711) Website: uhc.com/communityplan/arizona/plans/medicaid/developmentally-disabled

Tribal Health Care: Toll Free 1-844-770-9500, option 7 Nurse Triage Line: 480-267-7267

Cultural Competency Program

Cecilia Andrade joined DDD as Cultural Competency Program Manager. Cecilia will work to create tools that will help DDD offer services that are sensitive to member culture and ethnicity. The Language Access plan calls for members to get services in the language they understand. DDD works to make all members feel comfortable. The Unit will teach DDD staff about diversity and inclusion. Unit staff also will use teaching and outreach to foster partnerships with community leaders and groups. Our new manager and the Cultural Competency Unit are ways DDD serves the different needs of our members and families. Welcome Cecilia!

Cultural Competency Member Survey

DDD asks for member feedback to improve and to provide the best possible services. DDD strives to be respectful and to respond to your needs.

Thanks to each person who completed and returned the Cultural Competency Member Survey.

Members and families with questions or concerns about cultural competency or language access, please email networkculturalcompetency@azdes.gov.

ARIZONA LONG TERM CARE (ALTCS) MEMBER HANDBOOK

Members eligible for DDD/ALTCS can review a copy of the 2021-2022 ALTCS Member Handbook on DDD’s website at https://des.az.gov/sites/default/files/media/DDD-0465A_ALTCS_Handbook_CY2122.pdf.

Call the DDD Customer Service Center at 1-844-770-9500, Option 1, to request a printed copy.

DDD CUSTOMER SERVICE CENTER

To file a grievance/complaint or to search for general resources, call the DDD Customer Service Center at 1-844-770-9500, Option 1.

GET NEWS FROM DDD

Get monthly updates and news emailed to you. Sign up at https://bit.ly/ddd-news.

CAN’T FIND SOMETHING ON OUR WEBSITE?

Call the DDD Customer Service Center at 1-844-9500, Option 1, for help.

DDD POLICY

Those who want to be notified of Division policy updates, send an email with contact information to dddpolicy@azdes.gov.

RESOURCES

Individuals with Developmental Disabilities and their families can find additional resources on the DES/DDD website at https://des.az.gov/services/disabilities/developmental-disabilities/individuals-and-families.

REPORT FRAUD, WASTE OR ABUSE

Medicaid fraud, waste and abuse (FWA) are crimes. Report fraud, waste, and abuse right away. You will not get in trouble or lose services if you report any suspected fraud, waste, or abuse.

You can report FWA to DDD by:

● Calling DDD at 1-877-822-5799

● Sending an email to dddfwa@azdes.gov

● Sending a letter to DES/DDD, Attn: Corporate Compliance Unit, 1789 W Jefferson St., Mail Drop 2HA1, Phoenix, AZ 85007

● Completing the online form, https://des.az.gov/how-do-i/report-suspected-fraud/ developmental-disabilities-fraud-waste-and-abuse

Report to AHCCCS:

Provider Fraud:

• In Arizona: 602-417-4045
• Outside Arizona: 1-888-ITS-NOT-OK (1-888-487-6686)

Report Member Fraud:

• In Arizona: 602-417-4193.
• Outside Arizona: 1-888-ITS-NOT-OK (1-888-487-6686)

If you have questions about AHCCCS fraud, abuse of the program, or abuse of a member, email the AHCCCS Office of Inspector General (OIG) at AHCCCSFraud@azahcccs.gov. or https://www.azahcccs.gov/Fraud/ReportFraud/

AHCCCS Receives Temporary Extension to Pay Parents as Caregivers of Their Minor Children (Note: The following is a press release from AHCCCS)

PHOENIX - The Arizona Health Care Cost Containment System (AHCCCS) has received a temporary extension of federal approval to pay parents for providing direct care to their minor children enrolled in the Arizona Long Term Care System (ALTCS).

The Centers for Medicare and Medicaid Services (CMS) granted the temporary extension of the State’s existing COVID-19 Appendix K authority to allow the State and CMS to continue negotiations over the demonstration amendment application submitted on September 27, 2023 that proposes to allow AHCCCS to continue the program permanently. The COVID-19 Appendix K authority will now expire March 29, 2024 or once the proposal is approved, whichever may come first.

The letter from CMS, and more information and documents, are posted on the Parents as Paid Caregivers web page.

DIVISION OF EMPLOYMENT AND REHABILITATION SERVICES

$98M Available for Youth Pre-Apprenticeship Program

The U.S. Department of Labor (DOL) announced the availability of approximately $98 million in grant funds for YouthBuild, a workforce development pre-apprenticeship program for youth ages 16 - 24. The program provides job training and other support services for youth who left high school before graduation and who also have other risk factors, including being a justice-involved youth, youth aging out of foster care, youth with disabilities, migrant farmworker youth, youth experiencing housing instability, and other disadvantaged youth populations. The grant promotes educational guidance, acquiring the necessary skills, and employment services for youth who face academic barriers that hinder career goals.

Participants of the program engage in services that lead to obtaining a high school diploma, and that foster skill development in workforce, leadership, and community service.

Grantees are required to submit Quarterly Performance reports to the DOL. The report tracks the progress of placement of employment, education, and earnings.

Electronic applications must be submitted no later than 11:59 pm Eastern Time on February 01, 2024. Federally recognized Native American tribal governments and organizations are highly encouraged to apply. To learn more about the YouthBuild funding opportunity or to apply, visit https://grants.gov/search-results-detail/350828.