Status: Currently approved through Sept. 30, 2024 with extension request pending.
Kentucky’s Section 1115 Demonstration was initially approved January 2018. Kentucky received a temporary extension of “TEAMKY” (formerly known as Kentucky Helping to Engage and Achieve Long Term Health (KY HEALTH) through Sept. 30, 2024. TEAMKY allows KY to test and develop innovative programs utilizing evidence-based interventions that drive better health outcomes and quality of life for beneficiaries and currently includes the following components: Substance Use Disorder (SUD) 1115, Reentry 1115, and Medicaid eligibility coverage for former foster care youth between 18 and 26 years of age who were foster care in another state.
Components of TEAMKY currently pending approval includes: Serious Mental Illness (SMI) 1115, a Recuperative Care Pilot and coverage of Recovery Residence Support Services.
- Public Notices and Submissions
- Approved
Substance Use Disorder (SUD) 1115 Demonstration
Status: Currently approved through Sept. 30, 2024 with extension request pending.
Kentucky’s SUD Section 1115 Demonstration is available to all Medicaid beneficiaries, to ensure a broad continuum of care is available across the Commonwealth for individuals with SUD. The SUD Implementation Plan was approved October 2018 and implemented July 1, 2019. Under the SUD Demonstration, Kentucky has expanded access to critical levels of care and adopted the American Society for Addiction Medicine (ASAM) Criteria as the standard evidence-based treatment for SUD.
Under the Demonstration, SUD residential treatment is defined as a statewide average length of stay (ALOS) of 30 days and includes a waive of the institution for mental disease (IMD) exclusion to allow residential reimbursement for up to 96 beds per location (amended November 2019 from 192 beds to 96) for programs meeting DMS established provider qualifications.
- Public Notices and Submissions
- Approved Materials
- Resources
Reentry 1115 Demonstration
Status Request: Approved July 2024
On July 2, 2024 Kentucky received authority to provide limited coverage for a targeted set of services furnished to incarcerated adults in Kentucky state prisons and youth placed in youth development centers (YDCs) 60 days prior to the individuals’ expected date of release. The pre-release benefit package is designed to improve care transitions for individuals returning to the community, including by promoting continuity of coverage and proactively identifying and planning for physical, behavioral health and health related social needs (HRSNs).
- Approved Materials
- Resources
Severe Mental Illness (SMI) 1115 Demonstration
Status Request: Pending approval.
Kentucky submitted an amendment request on May 31, 2023 to the TEAMKY 1115 to allow reimbursement for medically necessary short-term, defined as a state-wide average length of stay of 30 days for inpatient treatment services within settings that qualify as institutions for mental diseases (IMDs) for Medicaid-eligible adults with serious mental illness (SMI).
The request is a component of Kentucky’s comprehensive plan to expand treatment and community support services for adults with SMI.
- Public Notices and Submissions
- Approved Materials
- Resources
SMD #18--011
Recuperative Care Pilot
Status: Pending approval.
On May 31, 2023, Kentucky submitted an amendment request to TEAMKY 1115 to allow the Commonwealth to pilot a Recuperative Care service, also known as Medical Respite, for adult beneficiaries who are homeless or at risk of homelessness that do not meet hospital level of care with need for additional medical support and care coordination to address health related social needs (HRSNs). Participating pilot programs must already be established and currently providing recuperative care services in Kentucky and registered with the National Institute for Medical Respite Care (NIMRC).
- Public Notices and Submissions
- Approved Materials
- Resources
SHO#21-001