The Behavioral Health Policy Team is comprised of subject matter experts for behavioral health services who provide policy guidance for the provider types and regulations listed below.
Behavioral Health Regulations and Provider Types
Kentucky Administrative Regulations
Contact the Behavioral Health Policy Team-
DMS Issues
Pilots, Grants, and Demonstrations
Kentucky Medicaid supports the expansion of behavioral health services and the Behavioral Health Policy Team oversees a variety of pilots, grants and demonstrations designed to increase access and quality of care for Kentuckians.
TEAMKY 1115 Demonstration
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.
Jump to TEAMKY 1115 Demonstration Webpage
1915(i) State Plan Amendment
To meet the needs of Kentucky citizens living with serious mental illness (SMI) or substance use disorder (SUD) and address the priorities included in Senate Joint Resolution (SJR) 72, Kentucky Medicaid is developing a 1915(i) State Plan Amendment (SPA). The SPA is a companion to the TEAMKY 1115 demonstration and will provide home and community based services to individuals who do not yet meet institutional level of care, will be available statewide, and will not have capped slots.
Individuals may be eligible for the SPA if:
- They are age 18 older and have a primary diagnosis of either SMI or SUD.
- They have functional impairment.
- They meet duration / episodic criteria.
The SPA will offer a variety of services including: housing-related supports, supported education and employment, transportation, medication management, caregiver respite, assistive technology and case management. To receive some of these services, participants will need to meet certain assessment tool thresholds and risk factors.
Kentucky Medicaid is working toward submitting the SPA to the Centers for Medicare and Medicaid Services for approval. Activities to date include reviewing and comparing similar programs in other states, interviewing the leaders of those programs, interviewing SMI and SUD stakeholders in Kentucky, the SPA design and drafting process, and public comment. To learn more about the SPA, review the following materials.
To contact DMS about the SPA,
email Kentucky Medicaid or call (855) 459-6328.
Multisystemic Therapy Pilot
Kentucky Medicaid has extended the original Multisystemic Therapy Pilot Project through July 2026. MST is an evidence-based, intensive treatment process that focuses on diagnosed behavioral health disorders and environmental systems (family, school, peer groups, culture, neighborhood and community) that contribute to or influence an individual’s involvement or potential involvement in the juvenile justice system. MST uses family strengths to promote positive coping activities and works with caregivers to reinforce positive behaviors, reduce negative behavior and increase family accountability and problem-solving. Kentucky Medicaid, the Department for Community Based Services (DCBS), and the Department of Juvenile Justice (DJJ) partner with three pilot providers licensed by the MST Institute to deliver this intensive service:
• Home of the Innocents
• CHNK Behavioral Health
• KVC Kentucky
Myers and Stauffer are engaged to independently evaluate the MST pilot project to inform future plans for this service within Kentucky Medicaid.
Contact Sherri Staley, MST project manager.
Certified Community Behavioral Health Clinic (CCBHC) Demonstration
The CCBHC demonstration is authorized through Section 223 of the Protecting Access to Medicare Act of 2014 (PAMA) which established the CCBHC model and outlines the creation of a demonstration program to implement CCBHCs and assess their effectiveness. In 2015, Kentucky was awarded a CCBHC Planning Grant and in August 2020, was selected to participate in the CCBHC demonstration. Kentucky’s CCBHC Demonstration began January 1, 2022.
Kentucky has certified four Community Mental Health Centers (CMHC) to participate in the demonstration, Pathways, Northkey Community Care, Seven Counties Services and New Vista. These CMHCs are currently enrolled as a new Medicaid provider type, PT 16-CCBHC, established for use during the demonstration. (Provider type 16-CCBHC is separate and apart from Provider Type-30-CMHC.) CCBHCs are reimbursed through a prospective payment system (PPS) based on historical costs.
CCBHCs must incorporate evidence-based practices and other supports based on a community needs assessment, as well as provide comprehensive care coordination to assist people with navigating behavioral health care, physical health care, and any needed social services. Directly or through formal partnerships, CCBHCs must provide:
1. Crisis Services
2. Outpatient Mental Health and Substance Use Services
3. Person- and Family-Centered Treatment Planning
4. Community-Based Mental Health Care for Veterans
5. Peer Family Support and Counselor Services
6. Targeted Care Management
7. Outpatient Primary Care Screening and Monitoring
8. Psychiatric Rehabilitation Services
9. Screening, Diagnosis and Risk Assessment
In addition to the above service requirements, CCBHCs must have the ability to report quality measures data as required by the CCBHC authorizing statute and as outlined in SAMHSA CCBHC Criteria (updated March 2023). Quality measures data is reported to the state annually, 9 months after the end of each demonstration year.
Kentucky’s CCBHC demonstration currently runs through December 31, 2027.
Contact the CCBHS Team- CCBHC@ky.gov