What did Arizona change about its new disability assessment?

On Oct. 16, 2025, Gov. Katie Hobbs directed AHCCCS to pause the new HCBS Needs Tool for children, add an Extraordinary Care Review exception process and delay further hour cuts. Later guidance said assessments done with the tool after Oct. 1 were invalid and pre-Oct. 1 hours must be reinstated.

Why was the assessment introduced?

Lawmakers required it in an emergency funding deal in 2025, after Arizona's developmental disabilities program nearly ran out of money. The tool sets attendant care and habilitation hours for children in the Arizona Long Term Care System.

What is the Extraordinary Care Review?

A new exception process, created by emergency rule, for members under 18 who need more direct care or habilitation hours than the assessment tool shows. As of Sept. 26, 2026, the emergency rule had been renewed effective April 7, 2026.

Arizona pauses children's care-hour cuts from new assessment

Arizona paused its new HCBS Needs Tool for children on Oct. 16, 2025, restoring the care hours families had before Oct. 1 and adding an Extraordinary Care Review exception process through an emergency rule.

Direct Support News desk · October 16, 2025 · Updated September 26, 2026 · 2 min read

Arizona stopped using a new assessment tool that had begun cutting care hours for children with disabilities, about two weeks after it took effect on Oct. 1, 2025. On Oct. 16, 2025, Gov. Katie Hobbs directed the state's Medicaid agency, AHCCCS, to build an exception process for children with extraordinary needs and to delay further cuts to attendant care and habilitation hours.

The governor's office announced the change in an Oct. 16 news release, and AHCCCS put it into effect through an emergency rule effective Oct. 15, 2025. KJZZ first reported the reversal the same day, after weeks of warnings from parents that the stricter tool would reduce the hours the state pays for.

What the tool does

The HCBS Needs Tool sets how many hours of direct care (attendant care) and habilitation a child can receive through the Arizona Long Term Care System. It applies to children served by the Division of Developmental Disabilities and to children in health plans for the Elderly and Physically Disabled program. Lawmakers required the tool in an emergency funding deal earlier in 2025, after the developmental disabilities program nearly ran out of money, KJZZ reported.

Support coordinators began using it at planning meetings on Oct. 1, 2025.

What changed on Oct. 16

According to the Department of Economic Security, which runs the Division of Developmental Disabilities, AHCCCS told the division on Oct. 16 to pause the tool for members under 18. Children would not be assessed for attendant care and habilitation until the tool was revised, and their hours would be reinstated to match the last assessment completed before Oct. 1.

Updated guidance on Oct. 29 went further. Assessments done with the new tool after Oct. 1 are considered invalid, and the division must reinstate the hours children received before that date. Families who prefer the result of the Oct. 1 version can ask for a reassessment.

The exception process

The emergency rule adds more service categories for children with complex needs and a new Extraordinary Care Review for members under 18 who need more direct care or habilitation hours than the tool shows. Attorney General Kris Mayes approved the emergency rulemaking. The governor's office said regular rulemaking, with public comment, would follow.

As of Sept. 26, 2026, the AHCCCS rules page lists a renewal of the emergency rule for the HCBS Needs Tool and Extraordinary Care Review, effective April 7, 2026.

Why this matters for providers and DSPs

Assessment tools decide how many hours of support a child gets, and so how many staff hours agencies and paid family caregivers can provide and bill. Arizona's reversal shows that a state under budget pressure may lean on a stricter assessment to control costs, and that quick, documented feedback from families and providers can change the result. Agencies serving Arizona children should check that authorizations match pre-Oct. 1 hours and learn how the Extraordinary Care Review works.