Status: Approved through December 31, 2029
Kentucky’s “TEAMKY” (formerly known as Kentucky Helping to Engage and Achieve Long Term Health (KY HEALTH) Section 1115 Demonstration was initially approved in January 2018 and received an extension in December 2024. TEAMKY allows the Commonwealth to test and develop innovative programs utilizing evidence-based interventions that drive better health outcomes and quality of life for beneficiaries.
TEAMKY includes the following components: Substance Use Disorder (SUD) 1115, Reentry 1115, Serious Mental Illness (SMI) 1115, Health Related Social Needs 1115 including a Recuperative Care Pilot, Recovery Residence Support Service (RRSS) for individuals with SUD participating in the Behavioral Health Conditional Dismissal Program, and Medicaid eligibility coverage for former foster care youth between 18 and 26 years of age who were foster care in another state.
- Public Notices and Submissions
- Approved
Substance Use Disorder (SUD) 1115 Demonstration
Status: Approved.
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 in October 2018 and implemented on July 1, 2019, allowing Kentucky to expand access to critical levels of care and adopt 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
Reentry 1115 Demonstration
Status Request: Approved.
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
before the individuals’ expected release date. 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).
Severe Mental Illness (SMI) 1115 Demonstration
Status: Approved.
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 and primarily receiving treatment for 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
Health Related Social Needs (HRSN) 1115: Recuperative Care Pilot
Status: Approved
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 with a need for additional medical support and care coordination to address health-related social needs (HRSNs) following hospitalization or planned medical procedure. Participating pilot programs must be established and currently
provide recuperative care services in Kentucky and be registered with the National Institute for Medical Respite Care (NIMRC) before Demonstration approval on December 12, 2024.
- Public Notices and Submissions
- Approved