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What It Is

Model II Waiver (MIIW) provides Medicaid-paid, in-home services to individuals who use a ventilator for 12 or more hours a day. These individuals also require high-intensity nursing care 24 hours a day and, without MIIW services, would have to live in a hospital-based nursing facility.

Services

  • Private Duty Nursing (PDN): A MIIW participant may receive up to 16 hours of PDN a day from a registered nurse (RN), a licensed practical nurse (LPN), or a respiratory therapist (RT). The waiver participant’s assessment, ventilator dependency needs, and provider staffing determine how many hours of PDN the participant receives.

Eligibility

To qualify for MIIW services, you must:

  • Be ventilator dependent for 12 or more hours a day.
    • This is outlined in Kentucky Administrative Regulation 907 KAR 1:022  Section 7(2)(a).
  • Have a permanent tracheostomy for positive
    pressure ventilation.
  • Require 24-hour a day, high-intensity nursing care services.
  • Have a strong family support system, including a primary and secondary caregiver.
  • Have a primary caregiver who understands the purposes, responsibilities, risks, and benefits of home ventilator therapy.
  • Meet the financial qualifications for Medicaid.

Apply

If you are interested in applying for MIIW services or want to apply on someone's behalf, you can complete an application: 

As part of the application, you or your caregiver will need to complete and submit the MAP-115  and MAP-116  forms.

A registered nurse will help finish the application process by:

  • Completing a MAP-350  form.
  • Collecting a completed MAP-10  form.
    • This form requires a physician to certify an applicant needs Medicaid waiver services.
  • Conducting an assessment of the applicant using the MAP-351A  form.
  • Completing a person-centered service plan (PCSP) that details the services the applicant needs.

These documents will be submitted to our quality improvement organization (QIO). The QIO acts on Medicaid's behalf to determine if an applicant needs the level of care (LOC) required by MIIW to receive services.

Continuing MIIW Services

In order to continue receiving MIIW services, you must submit a completed MAP-10 every 60 days. You must have your LOC reassessed every six months.

Documentation