Adult Day Care Regulations in Alaska

Who regulates adult day care in Alaska

Adult day in Alaska is overseen by the Alaska Department of Health, Division of Senior and Disabilities Services (SDS). SDS manages Medicaid long-term care services, including the home and community-based waivers, and awards grants for local services such as adult day.

Centers that serve Medicaid waiver participants must be certified by SDS under 7 AAC 130.220 and meet 7 AAC 130.250 and the Adult Day Services Conditions of Participation (COP-01, revised September 2017). The SDS Provider Certification and Compliance Unit certifies and recertifies waiver providers and conducts desk and on-site reviews.

Types of adult day programs in Alaska

• Medicaid waiver adult day services: a facility-based program for people who can benefit from an organized program of services and activities during the day, delivered in a non-institutional community setting on a regular schedule.
• Grant-funded Adult Day Services (ADS): an SDS community grant program that offers care in a safe group setting for adults with disabilities, with therapeutic and social activities and respite for caregivers. It serves people 60 and older with functional impairments and adults under 60 with Alzheimer's disease and related disorders (ADRD).

How to get certified in Alaska

SDS states that providers must first complete certification and then Medicaid enrollment before they can offer waiver services. SDS posts guidance for initial and renewal applications for home and community-based waiver providers.

1. Submit a complete application to SDS in the format the department provides. In-state providers must meet the provider qualifications and program standards in the Provider Conditions of Participation plus the standards for each service, including adult day (7 AAC 130.220(b)).
2. Enroll in Alaska Medicaid. A provider must be both certified and enrolled to be paid for waiver services.
3. A new provider receives probationary certification for one year. A renewing provider that passed probation receives standard certification for two years, and other standard certifications may run up to four years (7 AAC 130.220(c)).
4. Renew on time: SDS sends notice at least 90 days before expiration, and the provider must submit a new application at least 60 days before expiration (7 AAC 130.220(d)).

Key requirements

The Adult Day Services Conditions of Participation set these standards, among others:

• Staffing: one staff member when only one recipient is present, one staff member plus another staff member or volunteer for two to eight recipients, and enough added staff or volunteers to keep a one to eight ratio above that. The ratio is one to four for recipients with ADRD, and volunteers counted toward it must meet direct service worker qualifications and training (Section I.B).
• Administrator: at least 21, with one year of program management experience in a human services setting and a qualifying degree or an approved mix of education and experience. Activity coordinators must be at least 21 and direct service workers at least 18 (Section I.A).
• Training: topics include workplace safety, infection control, fall prevention and safe transfers, dementia, nutrition and hydration, and monitoring health (Section I.C).
• Space: at least 60 square feet of activity space per recipient present, one toilet and one sink for every 10 recipients, two exit routes, and ground-level space unless an approved evacuation plan covers upper levels (Section IV.A).
• Schedule: services at least four hours a day, one or more days a week, on a regular schedule (Section III.A).
• Care planning: evaluation within 14 days of admission, a service plan within 30 days, and reevaluation at least every six months (Section II).
• Meals: morning and afternoon snacks, fluids throughout the day, and a plan for a midday meal (Section III.F).

Under 7 AAC 130.250, waiver adult day may not exceed 10 hours a day, excluding transportation, unless the department approves more.

Medicaid funding for adult day in Alaska

Alaska Medicaid pays for adult day through two of its home and community-based waivers: Alaskans Living Independently (ALI), a Section 1915(c) waiver for adults 21 and older who need nursing facility level of care, and Alaskans with Physical and Developmental Disabilities (APDD). Under 7 AAC 130.250, adult day must be part of the participant's approved support plan and must be prior authorized, and it may not duplicate personal care assistant services or other waiver services.

Billing basics

The SDS chart of waiver services rates (August 2026) lists two adult day codes for ALI and APDD:

• S5101, per half day: limited to one unit a day. The service period must be at least one hour, with coverage up to four hours a day.
• S5100, per 15 minutes: used for adult day beyond one half-day unit.

Alaska's electronic visit verification (EVV) page lists the personal care and home health services that require EVV. Adult day codes are not on that list, and the page does not mention adult day.

Other ways centers are paid

SDS community-based grants fund Adult Day Services alongside senior in-home services, and the Adult Day Services page lists the eligible groups described above.

Enrolled veterans who meet VA eligibility and clinical criteria can get Adult Day Health Care through the VA, which may be provided at VA medical centers, State Veterans Homes or community organizations.

Official resources

• Division of Senior and Disabilities Services
• SDS Regulations and Conditions of Participation
• Adult Day Services Conditions of Participation
• 7 AAC 130.250, Adult day services
• SDS Provider Certification and Compliance Unit
• Home and Community-Based Services Waivers
• SDS Payment and Cost Information
• Adult Day Services (grant program)

Frequently asked questions

Do I need a license to open an adult day center in Alaska?

The official sources reviewed describe certification, not a separate adult day license. To serve Medicaid waiver participants, a center must be certified by SDS under 7 AAC 130.220 and then enroll in Medicaid.

Does Alaska Medicaid pay for adult day care?

Yes. The ALI and APDD waivers cover adult day services that are in the participant's support plan and prior authorized, billed as S5101 per half day or S5100 per 15 minutes.

Who inspects adult day centers in Alaska?

The SDS Provider Certification and Compliance Unit certifies and recertifies waiver providers, conducts desk and on-site reviews, and investigates complaints.