LTSS Roadmap - Yukon Kuskokwim in Alaska

State of Alaska

The Yukon-Kuskokwim Health Corporation (YKHC) manages a comprehensive health care system for 58 federally recognized Tribes in southwest Alaska. It is contracted with the Indian Health Service as a tribal health care provider and has been providing home care services to clients since 1995.

YKHC is one of two tribal health care organizations to provide personal care assistance (PCA) services as well as Medicaid 1915(c) waivers services. Services provided under the waivers include care coordination and respite. Under the rubric of care coordination, beneficiaries are assisted in locating and accessing transportation, medical equipment and supplies, chore services, and home modifications for accessibility. The administrative staff provides eligibility assessments of potential clients.^[1]  The support for these services is primarily covered by Medicaid with additional monies drawn from YKHC’s IHS funds.

Currently, YKHC uses two models to deliver personal care and selected Medicaid waiver services: agency-based and consumer-directed services. Through the agency-based model, YKHC oversees, manages, and supervises the provision of services for beneficiaries. With the consumer-directed models, the consumer assumes a major role in directing the management of care, including hiring, firing, training, and supervising the PCA worker. The agency is the fiscal agent, providing the beneficiary with administrative support, billing, and payroll services.^[2]