Kentucky Medicaid Waivers & Home and Community Based Programs Overview
- Waiver Policy Analyst
- Jul 18, 2024
- 2 min read
Kentucky, known as The Bluegrass State, has a well-established Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for individuals with disabilities, seniors, and those with chronic health conditions.
Administered by the Kentucky Cabinet for Health and Family Services (CHFS), Department for Medicaid Services (DMS), the state's 1915(c) HCBS waivers allow eligible participants to receive services in their homes or community settings instead of institutional care.
Key waiver programs include the Home and Community-Based (HCB) Waiver, which provides personal care, respite, and skilled nursing for seniors and individuals with physical disabilities, and the Michelle P. Waiver (MPW), which offers supports for individuals with intellectual and developmental disabilities (IDD), including habilitation and therapeutic services. Other significant programs include the Supports for Community Living (SCL) Waiver, which provides residential and community integration services, the Acquired Brain Injury (ABI) and ABI Long-Term Care (ABI-LTC) Waivers, and the Model II Waiver, which serves individuals with ventilator dependency. Kentucky also emphasizes Consumer-Directed Services (CDS), allowing participants to hire and manage their own caregivers.
Regulatory oversight in Kentucky is managed through DMS, CHFS, and the Office of Inspector General (OIG), which enforces licensing and compliance requirements for HCBS providers. The state utilizes a mix of fee-for-service and managed care models, with Kentucky Managed Care Organizations (MCOs) overseeing long-term services and supports (LTSS) integration.
Kentucky has also implemented Electronic Visit Verification (EVV) for personal care services, ensuring compliance and reducing fraud in home-based care programs. Providers must navigate Medicaid provider enrollment, prior authorization processes, and stringent compliance measures to participate in the state’s HCBS programs successfully.
With a focus on person-centered planning, rural healthcare accessibility, and cost-effective service delivery, Kentucky’s Medicaid waiver system ensures that individuals receive high-quality, community-based supports while promoting independence, dignity, and inclusion in their local communities.
Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.
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