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If you are elderly, have a physical, intellectual or developmental disability, or are ventilator dependent, you may qualify for Medicaid waiver services. These are known as 1915(c) waivers. These services provide the support you need to continue to live at home. The Department for Medicaid Services (DMS) operates the following waiver programs:

Programs &
Services

​Eligibility

You may be eligible for Medicaid waiver services if:

  • You have written certification from a physician that, if Medicaid waiver services were not available, you would be admitted to a nursing facility in the immediate future.
  • You meet the nursing facility level of care defined in Kentucky Administrative Regulation 907 KAR 1:022, Section 4.
  • You choose to be at home and receive waiver services.
  • Meet the financial qualifications for Medicaid.
    • There are special financial qualifications applied to waiver programs. You can find more information on how we determine if you meet the financial qualifications here.

Apply

You can apply for waiver services for yourself or on another's behalf. It is helpful to have the following information with you:

  • Social Security number
  • Proof of identity (driver's license)
  • Proof of citizenship (birth certificate)
  • Health insurance
  • Medical bills
  • Income information
  • Resource information
  • Life insurance policies or burial reserves

News from the 1915(c) Waiver Programs

Update on Participant-Directed Services (PDS) and Out of State Travel (Published 10/25/18): The Department for Medicaid Services (DMS) is updating recent guidance on waiver participants receiving PDS while out of state. We have issued a provider letter with more information. Provider Letter - PDS and Out of State Travel 

The Department for Medicaid Services releases a response to Navigant's 1915(c) waiver assessment final report (Published Oct. 15, 2018): On Sept. 20, 2018 the Department for Medicaid Services released the Navigant Consulting, Inc. final report on its assessment of Kentucky 1915(c) Home and Community Based waiver programs. The report included 11 recommendations for improving the programs and suggested next steps. The report finalized preliminary recommendations released in April 2018 and included feedback that the department collected from stakeholders in the spring of 2018.

Following a thorough review of the final report and stakeholder feedback, 1915(c) waiver staff, department leadership and leadership of the Cabinet for Health and Family Services selected and prioritized the recommendations and developed a response to the report. It includes the following information:

  1. Recommendations the department will adopt, how the department plans to adopt them and when you can expect to see program updates.
  2. Information on opportunities to learn more about the recommendations the department will implement, ask questions and get a more detailed explanation of what they mean for you. 

Complete DMS Response to Navigant Final 1915(c) Waiver Assessment Report 

We also have created guides to our response for individuals who use waivers and for waiver providers.

Guide for individuals and their families

Guide for waiver providers

As always, we want to hear from our stakeholders. If you have questions, concerns or want to share your thoughts, please reach out to us in any of the following ways:    
  Email

Phone: (502) 564-7540
Callers can ask for Misty Peach to provide comments by phone.

Mail:
Department for Medicaid Services
Division of Community Alternatives
275 E. Main Street 6W-B
Frankfort, Kentucky 40621

We value your feedback and look forward to hearing from you. We thank all stakeholders for their continued involvement in creating a better 1915(c) waiver program in Kentucky.

The Department for Medicaid Services releases Navigant 1915(c) waiver assessment final report (Published Sept. 20, 2018): In Spring 2017 the Department for Medicaid Services began working with Navigant Consulting, Inc. to assess Kentucky 1915(c) Home and Community Based waiver programs. Navigant and the department published preliminary recommendations in April 2018, hosted public meetings and collected stakeholder feedback incorporating this feedback into Navigant final recommendations.
 
The department is excited to announce the Navigant assessment is now complete and its final report is available to the public. The report includes 11 recommendations for improving Kentucky 1915(c) waiver programs, such as standardizing the rules and processes housed in the waivers, clarifying participant-directed service policy and performing a study to improve how payment rates are set in the future. The report also describes Kentucky waiver programs, compares them to other programs nationally and recommends steps the department should take to improve them.
 
You can view the full report using the link below. Please refer to the Executive Summary for an overview of the report.

Navigant 1915(c) Waiver Assessment Final Report 

Next Steps
The department is committed to improving the commonwealth 1915(c) waiver programs, is currently reviewing the Navigant report and is determining whether and how to act upon each of the Navigant recommendations. The department will release its response to Navigant recommendations in early October.

The department has made substantial efforts to engage all types of stakeholders during the last year. We want to continue this type of engagement and build upon it.  After the response to Navigant final recommendations is released, the department intends to continue engaging with stakeholders. These activities may include the following:

  • Holding online webinars and conducting regional, in-person meetings to give stakeholders a more detailed explanation of our response and answer questions.
  • Creating an advisory panel of participants, caregivers, advocates, and providers to share their thoughts on the changes we plan to make.

The department will provide more information about formal opportunities for stakeholder engagement when we release our response next month.

The department is beginning a rate study for 1915(c) Home and Community Based waiver services, consistent with the letter dated May 1, 2018. The department will provide updates on this website regarding this study including opportunities for targeted feedback.  The department will convene a work group to provide technical assistance and feedback representative of all waiver services and populations.

Stakeholder Feedback
We value your feedback and consider it critical to improving Kentucky’s 1915(c) Home and Community Based services waivers. If you have questions, concerns or want to share your thoughts, please reach out to us.

Email

Phone: (502) 564-7540
Ask for Misty Peach who is collecting phone comments.

Mail
Department for Medicaid Services
Division of Community Alternatives
275 E. Main Street 6W-B
Frankfort, Kentucky 40621

Stakeholders who wish to receive updates about the 1915(c) waiver programs can email the address above and request to be added to our email list. Updates will also be posted to this website.

We thank all stakeholders for their continued engagement in this process and look forward to working together to create better 1915(c) waiver programs in Kentucky.

Cabinet for Health and Family Services (CHFS) Announces New Medicaid Commissioner (Published Sept. 4, 2018): In early September, Carol Steckel became the commissioner for the Department for Medicaid Services. Read more

A Message about Patient Liability (Published July 20, 2018): Changes to the collection of patient liability scheduled to take effect on Aug. 1, 2018 have been stopped. The Department for Medicaid Services has issued the following statement:

"The Cabinet for Health and Family Services Department for Medicaid Services has determined that it is in the best interest of those we serve to rescind the recent guidance on patient liability (home and community based waivers) issued earlier this year which would have gone into effect on Aug. 1, 2018. Our top priority continues to be the health and welfare of Kentuckians and the beneficiaries whom we serve. The Department for Medicaid Services will provide additional guidance after a thorough review."

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