The Arizona Long Term Care System, or ALTCS, was established in 1989 under the Arizona Health Care Cost Containment System (AHCCCS). Why does Arizona have its own system, is there a difference between the state’s system and Medicaid? It’s meant to help the low-income, elderly residents of Arizona, this joint federal-state program offers a variety of helpful services. ALTCS is Arizona’s very own “version” of Medicaid.