These videos give an overview of the various Home and Community-Based Services (HCBS) available in Kentucky for providers who want to learn how to start or operate an HCBS agency in the state. Each video explains the purpose of the service, provider requirements, licensing process, and how the program functions. Use these videos to better understand the responsibilities, standards, and steps involved in becoming or working with approved HCBS providers in Kentucky. Explore each section to find the service that best matches your goals or area of interest.
Respite Care
RESPITE CARE SERVICES PROVIDER IN KENTUCKY
PROVIDING RELIEF TO FAMILY CAREGIVERS WHILE ENSURING CONTINUITY OF QUALITY CARE FOR PARTICIPANTS
Respite Care Services in Kentucky offer temporary, short-term care for individuals who typically receive ongoing support from unpaid family caregivers. These services are essential in preventing caregiver burnout and ensuring the continued safety and stability of participants in their home or community setting. Respite care is an authorized support under several Kentucky Medicaid Home and Community-Based Services (HCBS) waiver programs.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Administers Medicaid funding and enrollment for respite care providers
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Defines respite care standards and monitors service delivery under HCBS waivers
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance and integration of respite care within person-centered Medicaid planning
Agency: Managed Care Organizations (MCOs) under Kentucky Medicaid
Role: Approve service authorizations, credential providers, and manage billing and outcome tracking
2. SERVICE OVERVIEW
Respite Care Services provide temporary, substitute care for a participant when their usual caregiver is unavailable, needs relief, or has an emergency.
Authorized providers may deliver:
Short-term in-home care
Care in an alternate setting (licensed respite facility or staff residence, depending on waiver)
Hourly, daily, or overnight supervision
Assistance with Activities of Daily Living (ADLs): bathing, dressing, eating, mobility
Medication reminders and behavioral support
Social and recreational engagement
Coordination with the primary caregiver and waiver case manager
Services must be documented in the participant’s Person-Centered Service Plan (PCSP) and cannot replace full-time residential care.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Kentucky Secretary of State
Obtain an IRS EIN and Type 2 NPI
Enroll with Medicaid through the Medicaid Partner Portal Application (MPPA)
Maintain liability and, if applicable, property insurance (for facility-based respite)
Comply with Kentucky caregiver requirements (background checks, CPR/First Aid)
Develop a Respite Care Services Policy & Procedure Manual
Ensure HIPAA compliance and implement participant safety procedures
Secure proper site inspections and licensing if respite is provided in a facility
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment
Apply via MPPA as a provider of Respite Services under the relevant waiver(s)
Complete MCO credentialing and contracting
Step 2: Documentation Submission
Provide proof of business registration, insurance, background checks, staff credentials, and policy manual
Step 3: Authorization & Service Delivery
Collaborate with case managers and caregivers to coordinate coverage
Obtain MCO service authorization
Deliver temporary care and submit claims using approved HCPCS codes
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and NPI verification
General liability insurance; facility insurance if applicable
Respite Services Policies & Procedures Manual, including:
Intake forms and caregiver release documentation
Staff credentialing and emergency contact logs
Participant consent, care plan alignment, and safety protocols
Medication reminders and ADL logs
Grievance procedures and participant rights materials
Incident reporting and supervision protocols
HIPAA compliance and billing documentation systems
6. STAFFING REQUIREMENTS
Role: Respite Care Aide / Direct Support Worker
Requirements: Experience in personal care or caregiving; CPR/First Aid certified; background check clearance
Role (optional): Licensed Nurse or Behavior Support Staff (if required by participant’s needs or waiver)
Requirements: Licensed in Kentucky; supports medical or behavioral respite clients
All staff must complete:
Training in ADL support, HIPAA, and person-centered care
Emergency response and abuse prevention protocols
Annual continuing education or waiver-specific training requirements
7. MEDICAID PROGRAMS & HCBS WAIVERS
Respite Care Services are reimbursed under the following Kentucky waivers:
Supports for Community Living (SCL) Waiver
Michelle P. Waiver (MPW)
Home and Community Based (HCB) Waiver
Acquired Brain Injury (ABI and ABI-LTC) Waivers
Model II Waiver (MIIW)
Service settings may include:
Participant’s home
Provider’s home or staff-operated residence (as allowed by waiver)
Licensed respite facility or approved alternate site
8. TIMELINE TO LAUNCH
Phase: Business Formation and Policy Manual Development
Timeline: 1–2 months
Phase: MPPA Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Staff Hiring and Caregiver Training
Timeline: 1–2 months
Phase: Service Coordination and Respite Program Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Provider Enrollment (MPPA): https://mppa.ky.gov
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY RESPITE CARE PROVIDER
WCG supports caregiver organizations, group homes, and home care agencies in launching Medicaid-compliant respite care programs that strengthen family care systems across Kentucky.
Scope of Work:
Business registration and MPPA enrollment
MCO credentialing and compliance document preparation
Development of Respite Services Policy & Procedure Manual
Staff hiring protocols, CPR/First Aid tracking, and background screening guides
Billing templates, consent forms, and incident reporting tools
Intake checklists and caregiver coordination workflows
Website and branding options for family outreach and MCO referrals
Adult Foster Care
ADULT FOSTER CARE SERVICES PROVIDER IN KENTUCKY
PROVIDING FAMILY-LIKE LIVING ARRANGEMENTS WITH PERSONALIZED SUPPORT IN A COMMUNITY SETTING
Adult Foster Care Services in Kentucky offer home-based living arrangements for adults who require 24-hour supervision, support with daily activities, and a safe, stable environment. These services are delivered in licensed private homes operated by trained providers and are a part of Kentucky Medicaid’s Home and Community-Based Services (HCBS) waiver programs. The goal of adult foster care is to promote independence, dignity, and community integration while avoiding institutional placement.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Administers Medicaid reimbursement, provider enrollment, and waiver policy compliance
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Licenses adult foster care homes, sets standards for home operations, and monitors care quality
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight to ensure participant rights and person-centered living environments
Agency: Managed Care Organizations (MCOs)**
Role: Authorize adult foster care as part of the participant’s care plan, manage provider credentialing and service billing
2. SERVICE OVERVIEW
Adult Foster Care (AFC) involves placing Medicaid-eligible adults in certified private homes where the provider offers personal support, supervision, and daily care in a non-institutional setting.
Services include:
Room and board
Assistance with Activities of Daily Living (ADLs): bathing, grooming, dressing, toileting, eating, mobility
Medication reminders or administration (if permitted by waiver rules and provider’s training)
Meal preparation and nutritional oversight
Housekeeping and laundry
Socialization and support with community participation
Health monitoring and emergency response
All services must be based on a participant’s Person-Centered Service Plan (PCSP) and conducted in accordance with waiver-specific rules.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business or residence with the Kentucky Secretary of State (as applicable)
Obtain IRS EIN and Type 2 NPI if operating as an agency
Apply for Adult Foster Care Home certification through DAIL
Enroll through the Medicaid Partner Portal Application (MPPA)
Complete home inspection for safety, accessibility, and cleanliness
Maintain liability and homeowner’s or renter’s insurance
Submit background checks for all household members over age 18
Develop a Provider Policy & Procedure Manual for AFC services
Ensure HIPAA compliance and emergency planning
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: AFC Home Certification
Apply through DAIL for approval to operate a certified adult foster care home
Complete training, safety inspections, and environmental assessments
Step 2: Medicaid Enrollment
Register as an AFC service provider through MPPA
Complete MCO credentialing based on waiver requirements
Step 3: Participant Placement & Authorization
Collaborate with case managers to identify eligible individuals
Receive MCO authorization for placement
Initiate care, submit documentation, and bill Medicaid for approved services
5. REQUIRED DOCUMENTATION
AFC Home Certification approval letter
IRS EIN and NPI (if applicable)
Home inspection records and insurance documentation
Adult Foster Care Provider Policy & Procedure Manual, including:
Intake and admission forms
Participant service plan logs and daily care notes
Staff (if applicable) background checks and training logs
Emergency plans and contact protocols
Medication tracking and health monitoring forms
Participant rights, grievance procedures, and visitor policies
Incident reporting and monthly progress summaries
Medicaid billing templates and audit documentation tools
6. STAFFING REQUIREMENTS
Role: Adult Foster Care Provider (Live-in or On-site Caregiver)
Requirements: Age 21 or older; background check; CPR/First Aid certified; completion of AFC provider training
Role (optional): Relief Staff or Overnight Support
Requirements: Cleared background check; trained in ADL support and home emergency procedures
All staff and household members must complete:
Abuse, neglect, and exploitation prevention training
HIPAA and confidentiality training
Fire safety and infection control procedures
Ongoing annual training on person-centered service delivery
7. MEDICAID PROGRAMS & HCBS WAIVERS
Adult Foster Care Services are reimbursable under the following waivers:
Supports for Community Living (SCL) Waiver
Michelle P. Waiver (MPW)
Acquired Brain Injury (ABI and ABI-LTC) Waivers
Service settings must be:
Certified private residences with no more than a set number of participants (typically 1–3)
Approved by DAIL and meet all fire, safety, and program criteria
Non-institutional and support participant choice, dignity, and autonomy
8. TIMELINE TO LAUNCH
Phase: Home Preparation and Certification
Timeline: 2–3 months
Phase: Medicaid Enrollment and MCO Credentialing
Timeline: 1–2 months
Phase: Staff (if applicable) and Compliance Setup
Timeline: 1 month
Phase: Participant Matching and Service Launch
Timeline: Rolling, based on referrals and care plan authorization
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Partner Portal Application (MPPA): https://mppa.ky.gov
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY ADULT FOSTER CARE PROVIDER
WCG supports individuals, families, and organizations interested in launching certified Adult Foster Care programs to support Medicaid waiver participants in a home-based setting.
Scope of Work:
Home certification prep and DAIL licensing assistance
MPPA enrollment and MCO credentialing
Provider Policy & Procedure Manual tailored for AFC
Participant intake forms, emergency plans, and daily documentation logs
Background check coordination and household safety reviews
Medicaid billing templates and compliance preparation
Branding, intake packets, and outreach tools for case managers and referral agencies
Supported Employment
SUPPORTED EMPLOYMENT SERVICES PROVIDER IN KENTUCKY
EMPOWERING INDIVIDUALS WITH DISABILITIES TO ACHIEVE INDEPENDENCE THROUGH MEANINGFUL EMPLOYMENT
Supported Employment Services in Kentucky help individuals with intellectual/developmental disabilities (ID/DD) or brain injuries find, secure, and maintain competitive integrated employment. These services, covered under specific Medicaid Home and Community-Based Services (HCBS) waivers, promote workforce inclusion, skill development, and long-term job success with individualized supports.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Administers Medicaid reimbursement, enrollment, and regulatory compliance for supported employment services
Agency: Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID)**
Role: Provides oversight and quality assurance for service delivery under ID/DD and ABI waiver programs
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures person-centered employment practices and compliance with federal Medicaid HCBS requirements
Agency: Managed Care Organizations (MCOs)**
Role: Authorize supported employment services, manage claims, and ensure coordination with care teams
Agency: Office of Vocational Rehabilitation (OVR)**
Role: Collaborates with providers for time-limited supports under the Employment First framework; services must be coordinated with OVR when available
2. SERVICE OVERVIEW
Supported Employment Services assist participants in preparing for, obtaining, and maintaining jobs in community-based settings. Services are individualized and delivered in accordance with the participant’s Person-Centered Service Plan (PCSP) and must comply with Employment First principles.
Authorized services may include:
Job exploration and career planning
Job development and customized job matching
On-the-job coaching and training
Transportation coordination (to and from work)
Workplace accommodations and natural supports development
Benefits counseling related to employment income
Follow-along support to sustain long-term employment
Coordination with employers and coworkers for inclusion
Services must lead to competitive integrated employment, meaning the job must pay at least minimum wage, occur in a typical work environment, and offer the same access to coworkers and opportunities as workers without disabilities.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll as a Medicaid provider through the Medicaid Partner Portal Application (MPPA)
Maintain liability and worker’s compensation insurance
Obtain approval or credentialing from DBHDID (based on waiver)
Hire or contract with qualified Employment Specialists or Job Coaches
Develop a Supported Employment Policy & Procedure Manual
Implement HIPAA-compliant documentation systems and service tracking tools
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment via MPPA
Apply under the relevant waiver(s) as a Supported Employment provider
Complete MCO credentialing for participation in their provider network
Step 2: Documentation Submission
Provide business license, liability insurance, service protocols, and staff credentials
Submit a coordination plan with the Office of Vocational Rehabilitation (when required)
Step 3: Service Launch & Coordination
Collaborate with waiver case managers and OVR counselors (if applicable)
Obtain service authorization through MCO
Begin job search support, placement services, and coaching as per PCSP
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and NPI confirmation
Insurance certificates (liability and workers’ comp)
Supported Employment Policy & Procedure Manual, including:
Intake and employment readiness assessment forms
Job development and placement activity logs
Job coaching session documentation
PCSP-aligned goal tracking
Employer contact logs and natural support notes
Incident reporting and critical response protocols
Staff training records, background checks, and certifications
Medicaid billing templates and audit-ready documentation systems
6. STAFFING REQUIREMENTS
Role: Employment Specialist / Job Coach
Requirements: High school diploma or equivalent (Bachelor’s preferred); experience in vocational rehabilitation, human services, or supported employment; cleared background check; valid driver’s license if providing transportation
Role (optional): Program Coordinator / Supervisor
Requirements: Oversees quality assurance, service tracking, and staff development
All staff must complete:
Person-centered planning and employment-first training
HIPAA and participant confidentiality training
Abuse, neglect, and exploitation prevention training
Transportation safety and emergency preparedness (if transporting participants)
Annual continuing education in workforce integration and disability employment practices
7. MEDICAID PROGRAMS & HCBS WAIVERS
Supported Employment Services are authorized under:
Supports for Community Living (SCL) Waiver
Michelle P. Waiver (MPW)
Acquired Brain Injury (ABI & ABI-LTC) Waivers
Service delivery settings include:
Participant’s home (for career planning)
Community-based job sites
Workplaces and employer offices
Vocational training sites
Virtual sessions (when permitted for planning or follow-along)
8. TIMELINE TO LAUNCH
Phase: Business Registration and Program Manual Development
Timeline: 1–2 months
Phase: MPPA Enrollment and MCO Credentialing
Timeline: 2–3 months
Phase: Staff Onboarding and Employer Outreach
Timeline: 1–2 months
Phase: Service Launch and PCSP Coordination
Timeline: Ongoing based on referrals and authorizations
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Provider Enrollment (MPPA):
https://mppa.ky.gov
Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID)
Website: https://dbhdid.ky.gov
Kentucky Office of Vocational Rehabilitation (OVR)
Website: https://kcc.ky.gov/Vocational-Rehabilitation
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY SUPPORTED EMPLOYMENT PROVIDER
WCG helps employment-focused providers, disability agencies, and workforce development programs launch Medicaid-compliant Supported Employment Services across Kentucky.
Scope of Work:
MPPA enrollment and MCO credentialing for supported employment
Development of Policy & Procedure Manual aligned with employment-first principles
Staff training tools, intake forms, and employer outreach templates
Billing setup for job development, coaching, and follow-along support
Coordination protocols with OVR and waiver case managers
Website and branding tools for participant and referral outreach
Personal Care Services
PERSONAL CARE SERVICES PROVIDER IN KENTUCKY
SUPPORTING INDEPENDENT LIVING THROUGH HANDS-ON ASSISTANCE WITH DAILY PERSONAL NEEDS
Personal Care Services in Kentucky are designed to help individuals with physical, cognitive, or developmental disabilities remain safely in their homes by assisting with essential daily living tasks. Authorized under Kentucky Medicaid’s Home and Community-Based Services (HCBS) waivers, personal care supports functional independence, reduces caregiver burden, and prevents premature institutionalization.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Oversees Medicaid program administration, provider enrollment, and service reimbursement for personal care
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Sets care standards and waiver-specific service criteria for elderly and disabled populations
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance and quality assurance across all Medicaid-funded home-based care services
Agency: Managed Care Organizations (MCOs) in Kentucky Medicaid
Role: Review service authorizations, credential providers, and manage billing, claims, and care coordination
2. SERVICE OVERVIEW
Personal Care Services offer hands-on, non-medical assistance with daily personal needs that individuals cannot perform independently.
Authorized providers may deliver:
Assistance with Activities of Daily Living (ADLs), including bathing, grooming, toileting, dressing, and eating
Support with ambulation and transferring (e.g., bed to chair)
Medication reminders (non-administration unless allowed by waiver or nurse delegation)
Mobility and range-of-motion assistance
Skin care and basic health monitoring (e.g., reporting changes to nurses or family)
Personal hygiene, oral care, and incontinence support
Light housekeeping directly related to care (e.g., cleaning after bathing)
All services must be documented in the participant’s Person-Centered Service Plan (PCSP) and align with waiver-specific eligibility and needs assessments.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Kentucky Secretary of State
Obtain IRS EIN and NPI (Type 2)
Enroll through the Kentucky Medicaid Partner Portal Application (MPPA)
Maintain liability and workers’ compensation insurance
Develop a Personal Care Services Policy & Procedure Manual
Hire staff who meet state qualifications (CNA preferred or required based on waiver)
Establish HIPAA-compliant service documentation systems and incident reporting protocols
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment
Apply through MPPA as a Personal Care or Attendant Care provider (waiver-specific service type)
Complete credentialing with Kentucky Medicaid MCOs
Step 2: Documentation Submission
Submit proof of business registration, insurance, policy manual, and staff qualifications
Step 3: Service Authorization & Delivery
Coordinate with case managers and waiver teams to align services with PCSP goals
Receive service authorization and begin personal care delivery
Document services and submit claims using appropriate HCPCS codes
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and NPI confirmation
General liability and workers’ compensation insurance
Personal Care Policy & Procedure Manual, including:
Care documentation templates (ADL logs, progress notes)
Participant consent, intake, and risk assessment forms
HIPAA privacy, safety, and incident response policies
Staff training documentation and supervision logs
Medication reminder protocols (if applicable)
Emergency procedures and infection control plans
Medicaid billing templates and audit-ready records
6. STAFFING REQUIREMENTS
Role: Personal Care Aide / Direct Support Worker
Requirements: CNA preferred or required by waiver; cleared background check; experience in caregiving or disability support
All staff must complete:
Orientation on Kentucky Medicaid waiver programs and participant rights
HIPAA and confidentiality training
ADL assistance techniques and mobility safety
Infection control, emergency response, and abuse prevention training
Annual continuing education and skill validations
7. MEDICAID PROGRAMS & HCBS WAIVERS
Personal Care Services are authorized under the following waivers:
Home and Community Based (HCB) Waiver
Michelle P. Waiver (MPW)
Supports for Community Living (SCL) Waiver
Acquired Brain Injury (ABI and ABI-LTC) Waivers
Model II Waiver (MIIW) (case-specific)
Services may be delivered:
In the participant’s home
At supported living facilities
In community-based residential settings (when applicable)
8. TIMELINE TO LAUNCH
Phase: Business Formation and Policy Development
Timeline: 1–2 months
Phase: Medicaid Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Staff Hiring and Compliance Preparation
Timeline: 1–2 months
Phase: Participant Referrals and Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
Kentucky Medicaid Partner Portal (MPPA): https://mppa.ky.gov
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY PERSONAL CARE PROVIDER
WCG supports caregivers, home health operators, and support service providers in launching Medicaid-compliant Personal Care programs that promote in-home independence across Kentucky.
Scope of Work:
Business registration, MPPA enrollment, and MCO credentialing
Personal Care Policy & Procedure Manual development
Staff training resources, ADL documentation logs, and incident reporting tools
Medicaid billing templates and audit preparation systems
Branding, intake forms, and family outreach materials
Coordination strategies with case managers and discharge planners
Consumer Directed Option
CONSUMER DIRECTED OPTION (CDO) SERVICES PROVIDER IN KENTUCKY
EMPOWERING PARTICIPANTS TO DIRECT THEIR OWN CARE THROUGH FLEXIBLE, PERSON-CENTERED SUPPORTS
Consumer Directed Option (CDO) Services in Kentucky allow Medicaid waiver participants to hire, train, and manage their own caregivers—often family members, friends, or trusted community members. This model provides individuals with greater control, autonomy, and flexibility over how their care is delivered. CDO is offered under several Kentucky Home and Community-Based Services (HCBS) waivers and is managed through Fiscal Management Agencies (FMAs) and Support Brokers.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Oversees all aspects of the CDO program, including waiver eligibility, reimbursement rates, and compliance
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Manages quality standards, participant rights, and waiver guidelines for CDO services
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures federal regulations for person-centered planning, consumer control, and self-directed services are upheld
Agency: Managed Care Organizations (MCOs)**
Role: Approve care plans that include CDO services and coordinate with case managers and FMAs for service delivery
Agency: Fiscal Management Agencies (FMAs)**
Role: Handle payroll, tax reporting, and provider payments on behalf of the participant/employer
2. SERVICE OVERVIEW
The Consumer Directed Option (CDO) allows participants to act as the employer of record, giving them the ability to:
Hire, supervise, and dismiss their own caregivers
Create individualized care schedules that reflect their lifestyle
Train workers in accordance with their personal preferences and needs
Receive support from a Support Broker to navigate the process
Approved services that can be delivered under CDO may include:
Personal care and hygiene assistance
Homemaker tasks (laundry, cleaning, errands)
Meal preparation
Mobility and transfer assistance
Accompaniment to appointments and community outings
Medication reminders
Safety supervision and companionship
3. ELIGIBILITY FOR CDO PARTICIPANTS
To access CDO, participants must:
Be enrolled in an eligible HCBS Medicaid waiver
Be capable of directing their own care or have a designated representative
Complete a person-centered service plan (PCSP) with assistance from a case manager
Agree to follow employer responsibilities with support from a Support Broker and FMA
Pass a home safety assessment and service plan review
4. LICENSING & PROVIDER APPROVAL REQUIREMENTS (FOR SUPPORT BROKERS & FMAS)
For individuals or entities supporting CDO as brokers or FMAs:
Register business with the Kentucky Secretary of State
Obtain EIN and NPI (as required)
Enroll with Medicaid through MPPA for CDO-specific provider types
Submit a CDO Policies & Procedures Manual
Maintain general liability and cyber/data protection insurance
Have experience in payroll systems, tax compliance, and Medicaid service models
Ensure HIPAA compliance and person-centered service delivery
5. KENTUCKY PROVIDER ENROLLMENT PROCESS (FOR BROKERS & FMAS)
Step 1: Medicaid Enrollment via MPPA
Apply under CDO Support Broker or Fiscal Management provider types
Complete credentialing through each KanCare MCO (if applicable)
Step 2: Documentation Submission
Submit operational policies, staffing plans, staff credentials, and data protection protocols
Step 3: Program Setup
Collaborate with case managers and DAIL to support participants
Set up payroll systems, timesheet tracking, and background screening processes
Begin working with participants and caregivers based on approved service plans
6. REQUIRED DOCUMENTATION
Kentucky business license or Articles of Incorporation
IRS EIN and (if applicable) Type 2 NPI
General liability and cyber/data insurance policies
CDO Policy & Procedure Manual, including:
Participant onboarding templates and representative agreements
Caregiver application and training logs
Timesheet tracking and payroll authorization forms
HIPAA, grievance, and critical incident protocols
Participant rights documentation and appeal procedures
Quality assurance tracking and broker supervision logs
Medicaid billing systems and audit-ready financial reports
7. STAFFING REQUIREMENTS (FOR CDO ENTITIES)
Role: Support Broker
Requirements: Background in social work, case management, or human services; knowledge of self-directed models; background check required
Role: Payroll/Billing Administrator (for FMAs)
Requirements: Experience in tax compliance, employee classification, and Medicaid claims
Role: IT/Data Security Specialist (recommended)
Requirements: Ensures participant and caregiver data is encrypted and HIPAA-compliant
All staff must complete:
Training in Medicaid CDO program rules
Confidentiality and participant rights education
Crisis and abuse prevention training
Annual updates on Medicaid guidelines and documentation standards
8. MEDICAID PROGRAMS & HCBS WAIVERS
CDO services are available under the following Kentucky Medicaid waivers:
Home and Community Based (HCB) Waiver
Michelle P. Waiver (MPW)
Supports for Community Living (SCL) Waiver
Acquired Brain Injury (ABI & ABI-LTC) Waivers
Service settings:
Participant’s home or community environment
Non-institutional settings that support person-centered engagement
9. TIMELINE TO LAUNCH (FOR SUPPORT AGENCIES & BROKERS)
Phase: Business Formation and Policy Manual Development
Timeline: 1–2 months
Phase: Medicaid Enrollment and MCO Credentialing
Timeline: 2–3 months
Phase: Staff Hiring, Payroll Systems, and Compliance Setup
Timeline: 30–60 days
Phase: Participant Intake and Program Launch
Timeline: Rolling, based on referrals and PCSP approvals
10. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Provider Enrollment (MPPA): https://mppa.ky.gov
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
CHFS Main Site: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY CDO PROVIDER
WCG supports agencies, nonprofits, and individuals looking to become CDO Support Brokers or Fiscal Management Agencies in Kentucky.
Scope of Work:
MPPA enrollment and MCO credentialing for CDO roles
Policy & Procedure Manual development for brokers and payroll administrators
Timesheet, caregiver contract, and compliance template creation
HIPAA, participant rights, and grievance systems
Payroll and reporting system setup
Branding, website, and referral outreach for case managers and families
%20SERVICES%20PROVIDER%20IN%20KENTUCKY%20-%20visual%20selection.png)
Community Transition
COMMUNITY TRANSITION SERVICES PROVIDER IN KENTUCKY
FACILITATING SAFE, SUPPORTED MOVES FROM INSTITUTIONAL SETTINGS INTO COMMUNITY LIVING
Community Transition Services in Kentucky help Medicaid waiver participants transition from institutional or long-term care facilities into their own homes or community-based residential settings. These services provide essential support to ensure a smooth, stable move and to help individuals set up their new living environments safely. Covered under specific Home and Community-Based Services (HCBS) waivers, these services reduce institutional dependency and promote person-centered independence.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Oversees eligibility, provider enrollment, and Medicaid reimbursement for transition services
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Coordinates community-based living initiatives and oversees compliance for transition providers
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures Community Transition Services align with federal HCBS waiver guidelines and support community integration
Agency: Managed Care Organizations (MCOs)**
Role: Authorize transition plans, manage participant referrals, and reimburse approved services
2. SERVICE OVERVIEW
Community Transition Services are one-time, non-recurring expenses provided to help a participant establish a new home in the community after leaving a nursing facility, intermediate care facility (ICF/IID), or similar institutional setting.
Covered expenses may include:
Security and utility deposits
Furniture and essential household items (e.g., bed, table, chairs, cookware)
Basic appliances (e.g., microwave, refrigerator—if not included in lease)
Initial groceries and personal hygiene products
Health and safety items (e.g., fire extinguisher, first aid kit)
Moving costs and delivery fees
Basic home modifications (e.g., grab bars, shower chairs)
Transition coordination and support services
All purchases must be reasonable, necessary, and not otherwise available through other funding sources. Services must align with the participant’s Person-Centered Service Plan (PCSP) and be approved in advance by the MCO.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll as a Community Transition provider via the Medicaid Partner Portal Application (MPPA)
Maintain liability and general business insurance
Submit a Community Transition Services Policy & Procedure Manual
Establish vendor agreements with furniture and home goods suppliers
Implement HIPAA-compliant documentation and expense tracking systems
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment via MPPA
Apply as a provider of Community Transition or Move-In Services under appropriate HCBS waiver(s)
Complete MCO credentialing for regional provider access
Step 2: Documentation Submission
Submit business license, insurance, staff roles, and transition planning procedures
Step 3: Service Authorization & Purchase Coordination
Work with the participant’s case manager to develop a Transition Support Plan
Submit itemized budget to MCO for approval
Purchase and deliver approved items, ensuring receipts and proof of delivery
Submit documentation and claims for reimbursement
5. REQUIRED DOCUMENTATION
Kentucky Articles of Incorporation or business license
IRS EIN and NPI confirmation
Proof of liability insurance
Community Transition Services Policy & Procedure Manual, including:
Intake forms and referral acceptance process
Transition budget planning templates
Vendor purchase logs and delivery tracking
Participant consent and household inventory forms
Incident response and safety verification checklist
HIPAA compliance forms
Medicaid billing templates and reimbursement request records
6. STAFFING REQUIREMENTS
Role: Transition Coordinator / Move-In Support Specialist
Requirements: Experience in case management, housing navigation, or human services; valid driver’s license; cleared background check
Role (optional): Logistics or Delivery Assistant
Requirements: Must follow item tracking procedures and ensure proper documentation of purchases and deliveries
All staff must complete:
HIPAA and participant confidentiality training
Housing safety and community integration training
Abuse, neglect, and exploitation prevention education
Emergency preparedness and cultural sensitivity protocols
7. MEDICAID PROGRAMS & HCBS WAIVERS
Community Transition Services are available under:
Supports for Community Living (SCL) Waiver
Michelle P. Waiver (MPW)
Acquired Brain Injury (ABI & ABI-LTC) Waivers
Home and Community Based (HCB) Waiver
Eligible settings include:
Private homes or apartments (leased or owned by the participant)
Supported living residences (if participant holds tenancy rights)
Not permitted: group homes, institutions, or settings where rent and utilities are fully subsidized by another payer
8. TIMELINE TO LAUNCH
Phase: Business Formation and Vendor Sourcing
Timeline: 1–2 months
Phase: MPPA Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Policy Manual Completion and Staff Training
Timeline: 30–45 days
Phase: Participant Referrals and Service Coordination
Timeline: Ongoing, based on waiver transitions and MCO authorizations
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Partner Portal Application (MPPA): https://mppa.ky.gov
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY COMMUNITY TRANSITION PROVIDER
WCG supports housing service agencies, support coordinators, and Medicaid vendors in launching high-impact, compliant Community Transition Services across Kentucky.
Scope of Work:
MPPA Medicaid enrollment and MCO credentialing
Community Transition Policy & Procedure Manual development
Purchase log templates, inventory sheets, and consent forms
Vendor sourcing strategy and coordination tools
Budget submission checklists and billing templates
HIPAA-compliant documentation systems and audit support
Referral outreach strategies for nursing homes, hospitals, and case managers
Community Living Support
COMMUNITY LIVING SUPPORT SERVICES PROVIDER IN KENTUCKY
PROMOTING INDEPENDENCE THROUGH SKILL-BUILDING AND DAILY SUPPORT IN THE HOME AND COMMUNITY
Community Living Support (CLS) Services in Kentucky help individuals with intellectual or developmental disabilities (ID/DD), brain injuries, or complex needs to develop skills, maintain independence, and participate in their communities. CLS is a key component of Kentucky Medicaid’s Home and Community-Based Services (HCBS) waivers and is delivered in non-institutional settings, such as a participant’s home or local community.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Oversees Medicaid funding, enrollment, and reimbursement for CLS providers
Agency: Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID)
Role: Sets service standards for CLS delivery and provides waiver program oversight
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures CLS services comply with federal HCBS regulations and promote community integration and person-centered care
Agency: Managed Care Organizations (MCOs)**
Role: Authorize CLS services, credential providers, and monitor care coordination and outcomes
2. SERVICE OVERVIEW
Community Living Support (CLS) services provide direct, hands-on assistance and skill-building activities to help participants live safely and independently.
Authorized CLS activities include:
Assistance with Activities of Daily Living (ADLs): bathing, dressing, toileting, eating, mobility
Support with Instrumental ADLs (IADLs): budgeting, grocery shopping, meal prep, housekeeping
Social skills development and community integration
Medication reminders and health-related self-care training
Behavioral support and supervision
Participation in recreational or volunteer activities
Use of public transportation or navigation of the community
Support with communication and use of assistive devices
All services must be aligned with the participant’s Person-Centered Service Plan (PCSP) and may be delivered 1:1 or in small groups based on waiver guidelines.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll as a CLS provider through the Medicaid Partner Portal Application (MPPA)
Obtain any necessary DBHDID approvals or certifications based on waiver program
Maintain general liability and workers’ compensation insurance
Hire or contract qualified CLS staff with experience in disability or mental health support
Develop a Community Living Support Policy & Procedure Manual
Ensure HIPAA compliance and create systems for service documentation and quality monitoring
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment via MPPA
Apply as a provider of Community Living Support or similar service type under the appropriate waiver
Credential with all participating MCOs in your service region
Step 2: Documentation Submission
Submit business license, insurance, staff credentials, and operational policies
Provide a sample PCSP implementation template and incident reporting protocols
Step 3: Service Delivery and Documentation
Work with case managers to implement individualized care plans
Deliver services in the participant’s home or community setting
Document progress and submit claims using approved HCPCS codes
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and NPI registration
Insurance policies (liability, workers’ comp)
Community Living Support Policy & Procedure Manual, including:
Intake and service initiation forms
Daily progress note and time log templates
Individual goal tracking and PCSP implementation checklists
Incident reporting, grievance policy, and abuse prevention training
Emergency procedures and safety protocols
HIPAA compliance forms and confidentiality agreements
Staff credentialing, training, and supervision documentation
Medicaid billing templates and audit readiness files
6. STAFFING REQUIREMENTS
Role: CLS Support Worker / Direct Support Professional (DSP)
Requirements: High school diploma or equivalent; experience with individuals with disabilities preferred; background check; CPR/First Aid certified
Role: Supervisor / Program Coordinator (optional)
Requirements: Experience in waiver program administration; ensures compliance, documentation quality, and participant satisfaction
All staff must complete:
HIPAA and participant rights training
Abuse, neglect, and exploitation prevention training
Person-centered service delivery and goal tracking training
Emergency response and community safety protocol orientation
Annual continuing education or waiver-specific training
7. MEDICAID PROGRAMS & HCBS WAIVERS
Community Living Support Services are available under:
Supports for Community Living (SCL) Waiver
Michelle P. Waiver (MPW)
Acquired Brain Injury (ABI & ABI-LTC) Waivers
Delivery settings include:
Participant’s home
Community-based settings (e.g., stores, parks, libraries)
Employment or volunteer sites (as allowed by PCSP)
Note: CLS is not intended for use in institutional or group home settings where 24/7 supervision is already provided.
8. TIMELINE TO LAUNCH
Phase: Business Registration and Policy Manual Development
Timeline: 1–2 months
Phase: MPPA Medicaid Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Staff Hiring and Program Setup
Timeline: 1–2 months
Phase: Participant Referrals and Service Start
Timeline: Rolling, based on PCSP and case manager approvals
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Partner Portal Application (MPPA): https://mppa.ky.gov
Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID)
Website: https://dbhdid.ky.gov
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY CLS PROVIDER
WCG supports new and expanding providers in launching high-quality, person-centered Community Living Support programs across Kentucky.
Scope of Work:
MPPA and MCO credentialing support for CLS enrollment
Customized CLS Policy & Procedure Manual development
Intake and documentation template creation
Staff orientation tools and compliance tracking logs
Medicaid billing setup and audit documentation support
Family and case manager outreach materials
Adult Health Services
ADULT DAY HEALTH SERVICES PROVIDER IN KENTUCKY
PROMOTING COMMUNITY ENGAGEMENT, HEALTH MONITORING, AND DAILY SUPPORT FOR ADULTS IN A STRUCTURED SETTING
Adult Day Health Services (ADHS) in Kentucky provide structured, facility-based programs that offer health monitoring, social interaction, and assistance with daily activities to adults with disabilities, chronic health conditions, or age-related needs. These services are designed to prevent institutionalization and provide caregiver relief while enhancing participant well-being. ADHS is reimbursable under select Kentucky Medicaid Home and Community-Based Services (HCBS) waivers.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Administers Medicaid reimbursement and enrollment for Adult Day Health providers
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Establishes licensing and operational standards for adult day health programs
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance with Medicaid community-based service requirements
Agency: Managed Care Organizations (MCOs) under Kentucky Medicaid
Role: Authorize ADHS in participant care plans, credential providers, and process claims
2. SERVICE OVERVIEW
Adult Day Health Services provide participants with daytime supervision, socialization, and health-related support in a licensed facility.
Authorized services may include:
Assistance with Activities of Daily Living (ADLs): toileting, grooming, mobility, eating
Medication administration and health monitoring by a licensed nurse
Therapeutic activities (music, exercise, memory support)
Social, recreational, and educational programs
Nutritionally balanced meals and snacks
Transportation to and from the center (if approved)
Care coordination with family caregivers and medical teams
Behavioral and emotional support
Fall prevention and safety monitoring
Services are outlined in each participant’s Person-Centered Service Plan (PCSP) and tailored to their functional and medical needs.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll with Kentucky Medicaid through the Medicaid Partner Portal Application (MPPA)
Obtain Adult Day Health Center certification or licensure from DAIL
Pass site inspections for safety, staffing, and ADA compliance
Maintain general liability, facility, and workers’ compensation insurance
Hire qualified staff, including RNs or LPNs for health services
Develop an Adult Day Health Services Policy & Procedure Manual
Implement HIPAA-compliant documentation systems and emergency protocols
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Licensure & Facility Setup
Apply for Adult Day Health Center licensure or certification with DAIL
Pass inspections for fire safety, health, and sanitation
Step 2: Medicaid Enrollment
Apply as an ADHS provider via MPPA
Complete MCO credentialing and network contracting
Step 3: Documentation Submission
Submit policies, staffing plans, insurance, licenses, and inspection reports
Step 4: Service Authorization & Program Launch
Coordinate with case managers to align ADHS with participant PCSPs
Obtain MCO authorization and begin services
Submit claims using approved HCPCS codes
5. REQUIRED DOCUMENTATION
Kentucky Articles of Incorporation or business license
IRS EIN and NPI confirmation
DAIL license/certification for Adult Day Health Center
Facility safety inspection reports and zoning compliance
General liability and workers’ compensation insurance
Adult Day Health Services Policy & Procedure Manual, including:
Participant intake forms and health assessments
ADL assistance and medication administration logs
Staff training and supervision records
Daily attendance logs and activity schedules
Emergency response and evacuation plans
Participant rights and grievance procedures
HIPAA compliance policies and audit documentation templates
6. STAFFING REQUIREMENTS
Role: Direct Support Staff / Program Aide
Requirements: Experience in elder or disability services; CPR/First Aid certified; background check
Role: Registered Nurse (RN) or Licensed Practical Nurse (LPN)
Requirements: Licensed in Kentucky; responsible for medication administration and health monitoring
Role (optional): Activity Coordinator, Social Worker, or Transportation Staff
Requirements: Relevant certifications or training preferred; must complete orientation and annual continuing education
All staff must complete:
HCBS participant rights and HIPAA training
Emergency drills and infection control procedures
Abuse and neglect prevention training
Continuing education as required by DAIL and waiver-specific rules
7. MEDICAID PROGRAMS & HCBS WAIVERS
Adult Day Health Services are available under:
Home and Community Based (HCB) Waiver
Acquired Brain Injury (ABI and ABI-LTC) Waivers
Model II Waiver (MIIW)
Supports for Community Living (SCL) Waiver (day services category)
Service delivery must occur in:
A licensed adult day health center
A non-residential setting approved by DAIL and meeting federal HCBS settings criteria
8. TIMELINE TO LAUNCH
Phase: Facility Licensing and Safety Certification
Timeline: 2–3 months
Phase: Medicaid Enrollment and MCO Credentialing
Timeline: 2–3 months
Phase: Staff Hiring and Program Readiness
Timeline: 1–2 months
Phase: Participant Enrollment and Service Launch
Timeline: 30–60 days
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
Medicaid Provider Enrollment (MPPA): https://mppa.ky.gov
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY ADULT DAY HEALTH PROVIDER
WCG supports adult day programs, home health agencies, and community-based nonprofits in launching Medicaid-compliant Adult Day Health Services across Kentucky.
Scope of Work:
Facility planning, licensing preparation, and fire inspection guidance
MPPA enrollment and MCO credentialing assistance
Policy & Procedure Manual for adult day services
Staffing model design and training protocols
Participant intake packets, attendance logs, and billing templates
Emergency and incident response systems
Branding, website, and outreach materials for hospital, family, and case manager referrals
Assistive Technology
ASSISTIVE TECHNOLOGY SERVICES PROVIDER IN KENTUCKY
ENHANCING INDEPENDENCE AND ACCESS THROUGH INNOVATIVE DEVICES AND PERSONALIZED SUPPORT SYSTEMS
Assistive Technology (AT) Services in Kentucky provide Medicaid-eligible individuals with specialized devices and training to help them perform tasks they would otherwise be unable to do independently. These services enable greater autonomy, communication, mobility, and safety in the home and community. Covered under Kentucky Medicaid Home and Community-Based Services (HCBS) waivers, AT services support long-term independence and functional improvement.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Manages Medicaid coverage, provider enrollment, and billing for Assistive Technology services
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Defines AT service guidelines and ensures compliance under applicable HCBS waivers
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Oversees federal regulatory compliance and person-centered use of assistive technologies
Agency: Managed Care Organizations (MCOs) under Kentucky Medicaid
Role: Authorize AT services within the participant’s care plan, credential vendors, and manage reimbursement
2. SERVICE OVERVIEW
Assistive Technology Services provide assessment, acquisition, customization, and training for devices that help individuals improve or maintain functional abilities.
Approved services and devices may include:
Speech-generating devices and communication boards
Adaptive computer hardware/software and smart home systems
Environmental control units (e.g., voice-activated lights, door openers)
Specialized keyboards, switches, or ergonomic tools
Tablets with accessibility applications (when justified)
Mobility supports not classified under durable medical equipment
AT assessments, user training, setup, and technical support
Services must align with the participant’s Person-Centered Service Plan (PCSP) and be supported by clinical recommendations or an Assistive Technology Specialist’s evaluation.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll through the Medicaid Partner Portal Application (MPPA)
Maintain liability and product warranty insurance
Employ or contract with qualified Assistive Technology Professionals (ATP), occupational therapists (OT), or speech-language pathologists (SLP) for assessments
Develop an Assistive Technology Services Policy & Procedure Manual
Ensure HIPAA compliance and maintain participant records securely
Establish procedures for product trials, evaluations, and troubleshooting
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment
Register as an AT provider through MPPA
Apply under the appropriate HCBS waiver categories (e.g., AT or Specialized Medical Equipment)
Step 2: Documentation Submission
Submit provider application with licensure, staff credentials, policy manual, and sample service forms
Provide insurance documentation and proof of equipment sourcing channels
Step 3: Service Authorization & Delivery
Complete functional assessments and/or review clinical recommendations
Submit authorization request to MCO for device and service
Deliver, install, and train participant on the device
Submit claims with HCPCS codes and service documentation
5. REQUIRED DOCUMENTATION
Kentucky business license or Articles of Incorporation
IRS EIN and NPI verification
Proof of insurance and vendor relationships
AT Services Policy & Procedure Manual, including:
Participant intake, functional needs assessments, and referral forms
Documentation templates for device trials, installation, and follow-up
HIPAA and consent forms for data protection and device use
Maintenance, replacement, and troubleshooting protocols
Clinical recommendation tracking logs
Quality assurance and participant satisfaction review systems
Medicaid billing and audit documentation tools
6. STAFFING REQUIREMENTS
Role: Assistive Technology Specialist / ATP
Requirements: Certification from RESNA or equivalent; background screening; knowledge of disability-related technology
Role (optional): Occupational Therapist / Speech Therapist
Requirements: Licensed in Kentucky; conducts assessments and provides training for AT devices
Role: Installation and Tech Support Technician
Requirements: Experience with AT device setup and user support; HIPAA-trained
All staff must complete:
Person-centered planning and PCSP alignment training
HIPAA and confidentiality certification
Device-specific orientation and safety procedures
Annual continuing education in emerging assistive technologies
7. MEDICAID PROGRAMS & HCBS WAIVERS
Assistive Technology Services are authorized under:
Supports for Community Living (SCL) Waiver
Michelle P. Waiver (MPW)
Acquired Brain Injury (ABI and ABI-LTC) Waivers
Model II Waiver (MIIW)
Home and Community Based (HCB) Waiver (in limited situations)
Delivery settings include:
Participant’s home
Day programs or schools (when authorized)
Community environments supported by case manager planning
8. TIMELINE TO LAUNCH
Phase: Business Formation and Vendor Partnership Setup
Timeline: 1–2 months
Phase: MPPA Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Staff Hiring and Device Evaluation Setup
Timeline: 1–2 months
Phase: Service Launch and Device Delivery Coordination
Timeline: Ongoing as authorizations are approved
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Partner Portal Application (MPPA): https://mppa.ky.gov
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY ASSISTIVE TECHNOLOGY PROVIDER
WCG supports tech providers, healthcare professionals, and accessibility vendors in launching high-quality, Medicaid-approved Assistive Technology services across Kentucky.
Scope of Work:
Business registration, MPPA Medicaid enrollment, and MCO credentialing
Development of AT Policy & Procedure Manual and service documentation
Staff training guides, consent forms, and needs assessment templates
Vendor sourcing strategy for adaptive devices and smart technologies
Medicaid billing system setup and compliance audit support
Coordination resources for therapists, hospitals, and school-based programs
Branding, intake kits, and educational handouts for families and caregivers
Behavioral health
BEHAVIORAL HEALTH SERVICES PROVIDER IN KENTUCKY
SUPPORTING MENTAL HEALTH, EMOTIONAL WELLNESS, AND RECOVERY THROUGH COMMUNITY-BASED CARE
Behavioral Health Services in Kentucky are designed to support individuals with mental health disorders, substance use disorders (SUD), and co-occurring conditions. These services help Medicaid members achieve stability, recovery, and community integration through person-centered, evidence-based interventions. Behavioral health services are covered under Kentucky’s State Plan Medicaid and may also be integrated into some Home and Community-Based Services (HCBS) waiver programs.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Administers Medicaid coverage, provider enrollment, and reimbursement for behavioral health services
Agency: Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID)
Role: Licenses behavioral health providers and oversees service delivery standards and quality
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures federal compliance for behavioral health services under State Plan and waiver programs
Agency: Managed Care Organizations (MCOs)**
Role: Authorize behavioral health treatment plans, credential providers, and manage billing, utilization reviews, and care coordination
2. SERVICE OVERVIEW
Behavioral Health Services help individuals manage emotional, psychological, and substance use challenges that interfere with daily life and functioning.
Covered services may include:
Diagnostic assessments and treatment planning
Individual, group, and family therapy
Crisis intervention and stabilization
Substance use disorder (SUD) treatment and peer support
Case management and community support
Medication evaluation and management (by a psychiatrist or APRN)
Targeted interventions for children, adults, and special populations (e.g., trauma survivors, justice-involved individuals)
Services must be medically necessary and documented in the participant’s Individualized Treatment Plan (ITP) or Person-Centered Service Plan (PCSP).
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Obtain licensure or certification from DBHDID as a Behavioral Health Services Organization (BHSO)
Enroll through the Medicaid Partner Portal Application (MPPA)
Maintain liability and malpractice insurance
Employ licensed clinicians and qualified behavioral health professionals
Develop a Behavioral Health Services Policy & Procedure Manual
Implement HIPAA-compliant documentation, intake, billing, and quality systems
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: DBHDID Licensure
Apply for certification as a BHSO through DBHDID
Submit clinical staffing model, service descriptions, and compliance documentation
Complete inspections and site readiness reviews (if applicable)
Step 2: Medicaid Enrollment via MPPA
Apply as a Behavioral Health Provider or Mental Health/SUD Clinic
Complete MCO credentialing for network participation
Step 3: Program Implementation
Begin providing services per participant’s treatment plan
Submit claims using approved CPT or HCPCS codes through MCOs or fee-for-service billing
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and NPI confirmation
BHSO license or certification
Behavioral Health Services Policy & Procedure Manual, including:
Intake assessments and treatment planning templates
Progress notes and session documentation
ITP/PCSP development and review forms
Crisis and suicide prevention protocols
Participant rights and grievance policies
HIPAA and 42 CFR Part 2 compliance procedures
Staff credentialing, supervision, and licensure verification
Billing templates and audit documentation systems
6. STAFFING REQUIREMENTS
Role: Licensed Behavioral Health Professional (e.g., LCSW, LPCC, LMFT, Licensed Psychologist)
Requirements: Licensed in Kentucky; responsible for clinical treatment and therapy
Role: Behavioral Health Associate (e.g., case managers, peer support specialists)
Requirements: Certified or supervised; background checks and orientation required
Role (optional): Psychiatrist / Psychiatric APRN
Requirements: Licensed prescriber; medication management, diagnosis, and treatment planning
All staff must complete:
HIPAA and 42 CFR Part 2 training
Crisis prevention and de-escalation techniques
Trauma-informed care and cultural competency training
Annual continuing education as required by license or role
7. MEDICAID PROGRAMS & HCBS WAIVERS
Behavioral Health Services are available under:
State Plan Medicaid (Traditional Fee-for-Service and MCO plans)
Supports for Community Living (SCL) Waiver (select behavioral supports)
Michelle P. Waiver (MPW) (behavioral interventions for individuals with ID/DD)
Acquired Brain Injury (ABI & ABI-LTC) Waivers (neurobehavioral supports)
Service delivery settings include:
Outpatient clinics
Participant’s home
Community settings (e.g., schools, employment sites)
Telehealth platforms (as approved by Medicaid)
8. TIMELINE TO LAUNCH
Phase: Licensure and Staff Onboarding
Timeline: 2–3 months
Phase: Medicaid Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Documentation System and Quality Compliance Setup
Timeline: 30–45 days
Phase: Program Launch and Referral Network Development
Timeline: Ongoing
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID)
Website: https://dbhdid.ky.gov
Medicaid Partner Portal Application (MPPA):
https://mppa.ky.gov
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY BEHAVIORAL HEALTH PROVIDER
WCG supports outpatient clinics, nonprofits, and mental health professionals in launching Medicaid-compliant Behavioral Health Services across Kentucky.
Scope of Work:
DBHDID certification assistance and site readiness checklists
MPPA Medicaid enrollment and MCO credentialing
Behavioral Health Services Policy & Procedure Manual
Intake, assessment, and ITP documentation templates
Staff credentialing logs and compliance tracking
HIPAA and 42 CFR Part 2 templates and billing systems
Referral network building with schools, courts, waiver teams, and PCPs
Home Modification
HOME MODIFICATION SERVICES PROVIDER IN KENTUCKY
CREATING SAFE AND ACCESSIBLE HOMES TO SUPPORT INDEPENDENT LIVING AND QUALITY OF LIFE
Home Modification Services in Kentucky support individuals with disabilities or chronic conditions by adapting their homes to meet functional needs and ensure safety. These modifications reduce fall risk, enhance mobility, and enable individuals to remain in their communities. Covered under specific Kentucky Medicaid Home and Community-Based Services (HCBS) waivers, home modifications are critical to supporting aging in place and reducing institutional care reliance.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Administers Medicaid reimbursement and enrollment for home modification providers
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Oversees approval standards and waiver criteria for home modifications
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance and integration of environmental adaptations into person-centered planning
Agency: Managed Care Organizations (MCOs) under Kentucky Medicaid
Role: Authorize modifications through PCSPs, credential vendors, and oversee billing and quality reviews
2. SERVICE OVERVIEW
Home Modification Services involve physical changes to a participant’s residence that enhance accessibility, promote safety, and support independent living.
Approved modifications may include:
Installation of wheelchair ramps, grab bars, and stair lifts
Bathroom adaptations: roll-in showers, raised toilets, widened doorways
Kitchen accessibility improvements: lowered counters, accessible appliances
Widening of doorways or hallways
Installation of non-skid flooring or handrails
Voice-activated systems or door alarms (as allowed)
Structural changes required to accommodate durable medical equipment
All services must be identified in the participant’s Person-Centered Service Plan (PCSP) and justified as medically necessary with supporting clinical documentation.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll through the Medicaid Partner Portal Application (MPPA) as a home modification provider or vendor
Maintain general liability and construction-specific insurance (e.g., contractor bonding if applicable)
Hire or subcontract licensed general contractors, electricians, and plumbers as required
Develop a Home Modification Services Policy & Procedure Manual
Ensure compliance with ADA standards, building codes, and safety guidelines
Implement HIPAA-compliant records for participant information, estimates, and service logs
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment
Apply through MPPA as a provider of Environmental Accessibility Adaptations or Home Modifications
Complete MCO credentialing and submit vendor pricing and compliance documentation
Step 2: Documentation Submission
Submit proof of licensure, insurance, business registration, and sample project scope templates
Provide written policies for estimates, quality control, and inspection procedures
Step 3: Service Authorization & Completion
Obtain home assessment or physician recommendation
Submit modification request to MCO for review and pre-authorization
Complete project per approved scope
Submit documentation, photos, and invoice for reimbursement
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and Type 2 NPI verification
Contractor’s license (or subcontractor agreements)
General liability and construction insurance
Home Modification Services Policies & Procedures Manual, including:
Home assessment and estimate templates
Participant consent and approval forms
Project scope, timelines, and inspection logs
ADA and state building code compliance protocols
Critical incident and repair warranty procedures
Staff/subcontractor credentials and liability verification
HIPAA compliance and Medicaid billing documentation
6. STAFFING REQUIREMENTS
Role: Project Coordinator / Home Modification Manager
Requirements: Experience in housing accessibility projects; background check and contractor oversight
Role: Contractor / Licensed Tradesperson
Requirements: Kentucky licensure or certification in applicable trades; insurance and bonding
Role (optional): Occupational Therapist or Accessibility Specialist
Requirements: Provides functional assessments and adaptation recommendations (if required)
All staff and subcontractors must complete:
HIPAA compliance training
Safety and construction standards orientation
Documentation protocols for Medicaid-funded projects
Background screening and insurance verification
7. MEDICAID PROGRAMS & HCBS WAIVERS
Home Modification Services are reimbursable under:
Supports for Community Living (SCL) Waiver
Michelle P. Waiver (MPW)
Home and Community Based (HCB) Waiver
Acquired Brain Injury (ABI and ABI-LTC) Waivers
Model II Waiver (MIIW)
Delivery settings include:
Participant-owned or rented private residences
Group homes or supported living arrangements (when authorized)
Note: Modifications must not be for general home improvements or aesthetic upgrades and require clinical or case manager justification.
8. TIMELINE TO LAUNCH
Phase: Business Setup and Contractor Agreements
Timeline: 1–2 months
Phase: MPPA Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Documentation and Pricing System Development
Timeline: 1–2 months
Phase: Service Authorization and Project Launch
Timeline: Based on MCO approval (typically 30–60 days per project)
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Partner Portal Application (MPPA): https://mppa.ky.gov
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY HOME MODIFICATION PROVIDER
WCG supports contractors, rehab specialists, and accessibility vendors in launching compliant, Medicaid-approved home modification services in Kentucky.
Scope of Work:
Business setup, MPPA enrollment, and MCO credentialing
Home Modification Policies & Procedure Manual development
Templates for estimates, inspections, and HIPAA-compliant billing
Contractor vetting, licensing guidance, and pricing model setup
Documentation support for reimbursement and MCO audits
Referral coordination materials for hospitals, therapists, and case managers
Nursing Facility Transition
NURSING FACILITY TRANSITION SERVICES PROVIDER IN KENTUCKY
SUPPORTING INDIVIDUALS IN RETURNING TO COMMUNITY LIVING FROM INSTITUTIONAL SETTINGS
Nursing Facility Transition Services in Kentucky help Medicaid participants who reside in nursing homes or other institutional settings transition to community-based living. These services are part of Kentucky’s commitment to rebalancing long-term care, promoting home and community-based options, and supporting the rights of individuals to live in the least restrictive environment. Transition services are typically authorized through Medicaid waiver programs and must align with the participant’s Person-Centered Service Plan (PCSP).
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Oversees transition initiatives, Medicaid billing, and provider enrollment
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Manages oversight for waiver-based transitions, ensures participant rights, and monitors outcomes
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Enforces federal HCBS transition compliance and supports deinstitutionalization efforts through programs like Money Follows the Person (MFP)
Agency: Managed Care Organizations (MCOs)**
Role: Approve transition service plans, coordinate case management, and oversee reimbursement and service quality
2. SERVICE OVERVIEW
Nursing Facility Transition Services support eligible participants with planning, preparation, and move-in assistance to return to a home or community-based setting.
Authorized transition supports may include:
Pre-discharge planning and readiness assessments
Community housing identification and application assistance
Coordination of services such as personal care, CLS, and home modifications
Purchase of household items (in coordination with Community Transition Services)
Advocacy with discharge planners and facility staff
Linking participants to natural and formal community supports
Follow-up visits to ensure stabilization
Coordination with programs like Money Follows the Person (MFP)
Eligibility: Participant must have resided in a nursing facility or ICF/IID for a minimum period (typically 90 days) and have an approved PCSP supporting transition.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll as a Transition Services provider through the Medicaid Partner Portal Application (MPPA)
Maintain general liability and professional insurance
Employ or contract Transition Coordinators with background in housing, HCBS, or case management
Develop a Nursing Facility Transition Policy & Procedure Manual
Implement HIPAA-compliant documentation systems and participant safeguards
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment via MPPA
Apply as a provider of Nursing Facility Transition or Transition Coordination Services
Credential with all participating MCOs in your intended service region
Step 2: Documentation Submission
Submit operational policies, staffing model, insurance, and sample transition plans
Step 3: Service Authorization & Implementation
Collaborate with MCO case managers and waiver teams to build a transition plan
Support the participant’s move, ensure housing setup, and coordinate post-transition stabilization
Submit claims for authorized services using approved codes
5. REQUIRED DOCUMENTATION
Articles of Incorporation or business license
IRS EIN and NPI verification
Liability and worker’s compensation insurance
Nursing Facility Transition Services Policy & Procedure Manual, including:
Transition assessment and intake forms
Service coordination checklist and housing timeline
Communication log with nursing facility and housing partners
Participant rights, informed consent, and HIPAA forms
Critical incident protocols and follow-up documentation
Quality assurance monitoring and satisfaction surveys
Medicaid billing templates and audit documentation systems
6. STAFFING REQUIREMENTS
Role: Transition Coordinator / Community Integration Specialist
Requirements: Experience in housing navigation, case management, or disability services; background check; familiarity with Medicaid waivers and discharge planning
Role (optional): Peer Support Worker or Community Navigator
Requirements: Trained in recovery-oriented care and person-centered planning
All staff must complete:
HCBS waiver orientation and HIPAA compliance
Housing and benefits coordination training
Abuse, neglect, and exploitation prevention protocols
Emergency preparedness and post-transition follow-up planning
7. MEDICAID PROGRAMS & HCBS WAIVERS
Nursing Facility Transition Services are authorized under:
Home and Community Based (HCB) Waiver
Michelle P. Waiver (MPW)
Supports for Community Living (SCL) Waiver
Acquired Brain Injury (ABI & ABI-LTC) Waivers
Money Follows the Person (MFP) Demonstration Program
Service delivery settings include:
Nursing facilities (for discharge planning only)
Community-based residences (after transition)
Participant’s new home or apartment
8. TIMELINE TO LAUNCH
Phase: Business Formation and Policy Development
Timeline: 1–2 months
Phase: MPPA Medicaid Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Staff Hiring and Transition Tool Setup
Timeline: 30–45 days
Phase: Service Coordination and Participant Referrals
Timeline: Rolling, based on waiver team and discharge planner referrals
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Provider Enrollment (MPPA): https://mppa.ky.gov
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
Money Follows the Person Program (KY MFP): https://chfs.ky.gov/agencies/dms/dca
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY NURSING FACILITY TRANSITION PROVIDER
WCG helps nonprofit organizations, case management agencies, and housing providers launch effective, Medicaid-compliant Nursing Facility Transition Services across Kentucky.
Scope of Work:
MPPA enrollment and MCO credentialing
Policy & Procedure Manual tailored for transition services
Intake, discharge planning, and stabilization templates
Staff orientation materials and training logs
Housing and resource coordination workflow tools
HIPAA, consent, and billing documentation support
Outreach tools for partnerships with nursing facilities, housing agencies, and waiver teams
Community Integration
COMMUNITY INTEGRATION SERVICES PROVIDER IN KENTUCKY
BUILDING INCLUSION AND INDEPENDENCE THROUGH MEANINGFUL COMMUNITY PARTICIPATION
Community Integration Services in Kentucky help individuals with intellectual/developmental disabilities (ID/DD), brain injuries, and other complex support needs become active and valued participants in their local communities. These services are covered under specific Home and Community-Based Services (HCBS) waivers and focus on increasing social inclusion, building life skills, and supporting personal goals through structured, person-centered activities outside the home.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Oversees provider enrollment, service authorization, and Medicaid reimbursement for community-based services
Agency: Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID)**
Role: Defines quality standards and monitors outcomes for waiver programs involving community integration
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Enforces federal Home and Community-Based Settings (HCBS) regulations to ensure that services promote inclusion and individual rights
Agency: Managed Care Organizations (MCOs)**
Role: Approve service authorizations, manage credentialing, and oversee care plan implementation
2. SERVICE OVERVIEW
Community Integration Services support individuals in developing the skills and confidence necessary to engage in everyday community life in a way that reflects their personal interests, preferences, and goals.
Authorized services may include:
Accompaniment to community events, volunteer sites, or social groups
Support in accessing public resources (e.g., libraries, recreation centers, faith-based organizations)
Skill development in areas like communication, transportation use, money management, and social interaction
Facilitation of community relationships, memberships, and self-advocacy
Behavioral support and supervision to reduce isolation and promote independence
Goal-based participation in integrated activities that align with the Person-Centered Service Plan (PCSP)
Services must occur in non-institutional, community-based settings and reflect the participant’s choices and personal development goals.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll through the Medicaid Partner Portal Application (MPPA)
Obtain approval under appropriate HCBS waivers (e.g., SCL, MPW, ABI)
Maintain general liability and workers’ compensation insurance
Develop a Community Integration Policy & Procedure Manual
Hire trained staff with experience supporting individuals with disabilities in community settings
Ensure HIPAA compliance and create documentation systems for progress tracking and incident reporting
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment via MPPA
Apply under the waiver-specific provider type (e.g., Community Access, Community Living Support, Community Integration)
Complete credentialing with all MCOs serving your region
Step 2: Documentation Submission
Submit business license, insurance, service policies, and staff credentials
Provide sample activity plans, daily progress notes, and goal tracking forms
Step 3: Service Authorization & Implementation
Coordinate with waiver case managers to define individual goals
Begin service delivery based on PCSP
Document progress, submit attendance records, and bill for authorized units of service
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and NPI confirmation
Proof of insurance (liability and workers’ compensation)
Community Integration Policy & Procedure Manual, including:
Participant intake and activity planning forms
Goal tracking sheets and progress documentation templates
Incident and safety reporting protocols
Participant consent and rights documentation
Staff training, supervision logs, and community partner engagement records
HIPAA policies and confidentiality procedures
Medicaid billing logs and audit-ready records
6. STAFFING REQUIREMENTS
Role: Community Integration Specialist / Support Worker
Requirements: High school diploma or equivalent; experience with ID/DD or ABI populations preferred; cleared background check; valid driver’s license if transporting participants
Role (optional): Community Engagement Coordinator
Requirements: Develops partnerships with community organizations and oversees staff activity planning and compliance
All staff must complete:
HIPAA and participant rights training
Person-centered planning and inclusion training
Abuse, neglect, and exploitation prevention
Community safety, transportation support, and incident response procedures
Ongoing annual training in disability services and community development
7. MEDICAID PROGRAMS & HCBS WAIVERS
Community Integration Services are available under:
Supports for Community Living (SCL) Waiver
Michelle P. Waiver (MPW)
Acquired Brain Injury (ABI & ABI-LTC) Waivers
Service delivery settings include:
Public venues and community hubs
Volunteer sites, faith-based institutions, recreation centers
Participant-chosen spaces where integration and choice are prioritized
NOT permitted in segregated or institutional environments
8. TIMELINE TO LAUNCH
Phase: Business Formation and Manual Development
Timeline: 1–2 months
Phase: Medicaid Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Staff Hiring, Community Mapping, and Safety Setup
Timeline: 30–45 days
Phase: Participant Referrals and Service Launch
Timeline: Rolling, based on PCSP approvals and authorizations
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Provider Enrollment (MPPA): https://mppa.ky.gov
Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID)
Website: https://dbhdid.ky.gov
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY COMMUNITY INTEGRATION PROVIDER
WCG supports disability-focused organizations, nonprofits, and new Medicaid providers in launching high-impact, person-centered Community Integration Services across Kentucky.
Scope of Work:
MPPA Medicaid enrollment and MCO credentialing
Community Integration Policy & Procedure Manual development
Staff training materials, goal tracking forms, and activity planning templates
Safety protocols and community resource mapping tools
Documentation systems for HIPAA, billing, and quality audits
Marketing templates and referral partnerships with waiver teams and local community programs
Homemaker Services
HOMEMAKER SERVICES PROVIDER IN KENTUCKY
SUPPORTING DAILY INDEPENDENCE THROUGH HOUSEHOLD ASSISTANCE AND NON-MEDICAL HOME SUPPORT
Homemaker Services in Kentucky provide non-medical assistance to Medicaid-eligible individuals who need help maintaining a clean, safe, and functional home environment. These services support independent living for individuals with disabilities, chronic conditions, or age-related limitations. Available through specific Home and Community-Based Services (HCBS) waiver programs, homemaker services help reduce the risk of institutional care while improving quality of life.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Manages Medicaid enrollment and reimbursement for homemaker services
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Defines HCBS waiver requirements and monitors provider standards for elderly and disabled participants
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal Medicaid compliance for community-based, non-medical services
Agency: Managed Care Organizations (MCOs) in Kentucky Medicaid
Role: Authorize homemaker services, process provider credentialing, and oversee documentation and billing
2. SERVICE OVERVIEW
Homemaker Services support individuals in completing routine household tasks that they cannot perform on their own due to disability, illness, or aging.
Approved providers may deliver:
Light housekeeping (sweeping, dusting, vacuuming, mopping)
Laundry and linen changes
Dishwashing and kitchen cleaning
Grocery shopping and errands
Meal preparation (non-skilled) and cleanup
Making and changing beds
Trash disposal and household organization
Escort and support for essential errands
All services must be outlined in the participant’s Person-Centered Service Plan (PCSP) and must not duplicate services offered by personal care or nursing staff.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Kentucky Secretary of State
Obtain an EIN from the IRS and Type 2 NPI
Enroll as a Medicaid provider through the Medicaid Partner Portal Application (MPPA)
Maintain liability and workers’ compensation insurance
Develop a Homemaker Services Policy & Procedure Manual
Train all homemaker staff on cleaning safety, emergency procedures, and HIPAA
Implement participant documentation, quality monitoring, and critical incident protocols
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment
Apply via MPPA as a Homemaker or Non-Medical Support Services provider
Complete MCO credentialing for Medicaid billing eligibility
Step 2: Documentation Submission
Submit business registration, liability insurance, staff qualifications, and policy manual
Provide service area descriptions and staffing model
Step 3: Service Authorization & Delivery
Collaborate with case managers to identify household support needs
Obtain MCO service authorizations
Deliver authorized homemaker tasks and document service logs
Submit claims using applicable HCPCS codes
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and NPI confirmation
General liability and workers’ compensation insurance
Homemaker Services Policies & Procedures Manual including:
Cleaning checklist templates and service logs
Staff training and supervision documentation
Participant consent, emergency contact, and intake forms
HIPAA and participant privacy policies
Grievance procedures and rights documentation
Incident reporting and safety response protocols
Medicaid billing logs and audit-ready documentation systems
6. STAFFING REQUIREMENTS
Role: Homemaker / Home Support Worker
Requirements: Experience in housekeeping or caregiving; background check required; reliable transportation if errands are included
All staff must complete:
HIPAA and participant confidentiality training
Cleaning safety, infection control, and fall prevention procedures
Emergency response and incident reporting
Annual training in HCBS service guidelines and elder/disability sensitivity
7. MEDICAID PROGRAMS & HCBS WAIVERS
Homemaker Services are available under the following waivers:
Home and Community Based (HCB) Waiver
Michelle P. Waiver (MPW)
Supports for Community Living (SCL) Waiver
Acquired Brain Injury (ABI & ABI-LTC) Waivers
Model II Waiver (MIIW) (limited availability)
Services may be delivered in:
Private homes
Supported living environments
Community-based settings (for errands and grocery support)
8. TIMELINE TO LAUNCH
Phase: Business Formation and Manual Development
Timeline: 1–2 months
Phase: Medicaid Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Staff Hiring and Documentation Readiness
Timeline: 1–2 months
Phase: Service Launch and Claims Setup
Timeline: 30–45 days
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
Medicaid Partner Portal Application (MPPA): https://mppa.ky.gov
Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY HOMEMAKER SERVICES PROVIDER
WCG helps housekeeping agencies, senior support programs, and caregiver organizations launch Medicaid-compliant homemaker services that promote independent living across Kentucky.
Scope of Work:
Business registration and MPPA Medicaid enrollment
MCO credentialing and compliance documentation setup
Homemaker Policy & Procedure Manual development
Staff training logs, cleaning checklists, and intake forms
HIPAA templates, billing systems, and audit readiness tools
Referral strategies, outreach materials, and basic marketing support
Case Management
CASE MANAGEMENT SERVICES PROVIDER IN KENTUCKY
COORDINATING CARE, EMPOWERING PARTICIPANTS, AND SUPPORTING OUTCOMES THROUGH PERSON-CENTERED SERVICE PLANNING
Case Management Services in Kentucky are a core component of Medicaid’s Home and Community-Based Services (HCBS) waiver programs. Case managers serve as the primary coordinators of services, ensuring that participants receive timely, appropriate, and person-centered support in the least restrictive environment. Through ongoing assessment, care planning, and service monitoring, case managers help participants maintain independence and improve quality of life.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Establishes provider qualifications, care planning requirements, and billing procedures for case management
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Provides oversight and quality assurance for case managers operating under aging and disability waivers
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures that case management services comply with federal Medicaid rules for person-centered planning, conflict-free case management, and participant rights
Agency: Managed Care Organizations (MCOs)**
Role: Approve and monitor care plans, authorize services, credential providers, and process billing for HCBS participants
2. SERVICE OVERVIEW
Case Management Services assist participants with assessing needs, identifying service options, coordinating providers, and monitoring outcomes. Services are delivered in accordance with the participant’s Person-Centered Service Plan (PCSP).
Approved activities include:
Comprehensive needs assessments and re-assessments
Development and updates of the PCSP
Coordination of waiver and non-waiver services (e.g., medical, behavioral, housing)
Facilitating interdisciplinary team meetings
Monitoring health and safety status
Addressing gaps in care or changes in condition
Advocacy and crisis intervention
Documentation and reporting to DMS or MCO
All case management must be conflict-free, meaning the case manager cannot deliver or have a financial interest in other HCBS services received by the participant.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll through the Medicaid Partner Portal Application (MPPA)
Maintain general liability and professional liability insurance
Employ or contract with qualified case managers (social workers, nurses, or human service professionals)
Develop a Case Management Services Policy & Procedure Manual
Ensure HIPAA compliance, quality assurance procedures, and secure documentation systems
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment via MPPA
Apply as a Case Management Provider under the relevant HCBS waiver program
Complete MCO credentialing for waiver-based case management
Step 2: Documentation Submission
Submit proof of licensure, staff qualifications, insurance coverage, and program policies
Step 3: Program Implementation
Establish referral networks, intake procedures, and care coordination workflows
Begin service delivery per PCSP authorization and submit documentation for billing
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and NPI verification
Professional liability and general liability insurance
Case Management Policy & Procedure Manual, including:
Intake and assessment templates
Person-Centered Service Plan (PCSP) documentation
Care coordination logs and service referral tracking
Risk mitigation, incident reporting, and follow-up forms
HIPAA and participant consent forms
Staff credentialing and ongoing training logs
Monthly monitoring and quarterly reassessment tools
Medicaid billing templates and audit readiness protocols
6. STAFFING REQUIREMENTS
Role: Case Manager
Requirements: Bachelor’s or Master’s degree in social work, nursing, or a human services field; minimum of one year of experience with the waiver’s target population; cleared background check
Role: Program Supervisor (optional)
Requirements: Responsible for oversight of documentation, quality assurance, and staff development
All staff must complete:
Person-centered planning training
HIPAA and participant rights education
Abuse, neglect, and exploitation prevention training
Emergency response and crisis management protocols
Annual continuing education to maintain licensure and program quality
7. MEDICAID PROGRAMS & HCBS WAIVERS
Case Management Services are authorized under:
Home and Community Based (HCB) Waiver
Michelle P. Waiver (MPW)
Supports for Community Living (SCL) Waiver
Acquired Brain Injury (ABI & ABI-LTC) Waivers
Model II Waiver (MIIW)
Delivery settings may include:
Participant’s home
Community settings
Virtual (telehealth) or phone-based follow-up when allowed
8. TIMELINE TO LAUNCH
Phase: Business Formation and Policy Manual Development
Timeline: 1–2 months
Phase: Medicaid Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Staff Hiring and Referral Network Setup
Timeline: 30–45 days
Phase: Program Launch and Care Plan Coordination
Timeline: Ongoing as referrals and authorizations are received
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Provider Enrollment (MPPA): https://mppa.ky.gov
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY CASE MANAGEMENT PROVIDER
WCG supports licensed professionals, nonprofits, and human services organizations in launching conflict-free, Medicaid-compliant Case Management Services across Kentucky.
Scope of Work:
MPPA and MCO enrollment for HCBS case management
Case Management Policy & Procedure Manual development
Intake, assessment, and PCSP template creation
Staff onboarding tools and licensure compliance checklists
Quality assurance systems and monthly monitoring forms
Referral outreach materials and relationship building strategies with MCOs, waiver teams, and hospitals
Transportation Services
TRANSPORTATION SERVICES PROVIDER IN KENTUCKY
ENSURING ACCESS TO CARE AND COMMUNITY THROUGH SAFE, RELIABLE, NON-EMERGENCY MEDICAL TRANSPORTATION
Transportation Services under Kentucky Medicaid ensure that waiver participants can safely access medical appointments, adult day health centers, employment programs, and other approved destinations. These services reduce barriers to healthcare and community engagement and are typically offered through Non-Emergency Medical Transportation (NEMT) providers or as a component of Home and Community-Based Services (HCBS) waivers.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Oversees Medicaid transportation policies, provider enrollment, and reimbursement structures
Agency: Kentucky Transportation Cabinet (KYTC)**
Role: May regulate safety and vehicle standards in coordination with Medicaid rules
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures federal compliance for Medicaid-funded transportation services
Agency: Managed Care Organizations (MCOs) under Kentucky Medicaid
Role: Authorize transportation services within care plans, manage provider contracting, and process claims
Agency: Transportation Brokers (e.g., Modivcare)**
Role: Coordinate ride scheduling, driver dispatch, and mileage tracking on behalf of MCOs and Medicaid
2. SERVICE OVERVIEW
Non-Emergency Medical Transportation (NEMT) provides scheduled rides for Medicaid participants to medically necessary and HCBS-approved services.
Approved services include:
Rides to primary care and specialist appointments
Transportation to adult day health programs or employment services
Pharmacy or diagnostic lab visits
Trips to Medicaid-approved community engagement or therapy sessions
Accompaniment by personal care aides or guardians (with prior approval)
Mileage reimbursement for self-arranged trips (if permitted)
Transportation services must be authorized in the participant’s Person-Centered Service Plan (PCSP) and arranged through the assigned transportation broker or MCO.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll as a transportation provider through the Medicaid Partner Portal Application (MPPA)
Register vehicles with KYTC and maintain DOT-compliant insurance
Pass criminal background checks and driving record reviews for all drivers
Develop a Transportation Services Policy & Procedure Manual
Train drivers on safety, CPR/First Aid, HIPAA, and participant sensitivity
Secure agreements with transportation brokers (e.g., Modivcare)
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment
Apply through MPPA under the appropriate provider type (e.g., NEMT or waiver transportation services)
Complete credentialing with each MCO and/or transportation broker
Step 2: Documentation Submission
Submit vehicle inspection records, insurance, driver credentials, and operational policies
Step 3: Service Authorization & Scheduling
Receive transport referrals from case managers or transportation brokers
Coordinate trip schedules, track mileage, and confirm pickup/drop-off logs
Submit trip documentation and bill through broker portals or Medicaid billing systems
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and NPI confirmation
DOT-compliant vehicle registration and insurance
Transportation Services Policy & Procedure Manual, including:
Driver background checks, certifications, and training logs
Trip logs, mileage forms, and dispatch records
Participant consent and emergency contact documentation
Wheelchair-accessible procedures and vehicle safety checklists
HIPAA compliance and participant rights policies
Critical incident response and mechanical breakdown procedures
Medicaid and broker billing protocols with audit trail documentation
6. STAFFING REQUIREMENTS
Role: Transportation Driver
Requirements: Valid Kentucky driver’s license; clean driving record; background check; CPR/First Aid; defensive driving certification preferred
Role (optional): Transportation Dispatcher or Scheduler
Requirements: Familiarity with route optimization and HIPAA-compliant communication systems
All staff must complete:
HIPAA and confidentiality training
Emergency response and first aid certification
Sensitivity training for aging and disability populations
Defensive driving and wheelchair passenger securement
7. MEDICAID PROGRAMS & HCBS WAIVERS
Transportation Services are authorized under:
Home and Community Based (HCB) Waiver
Michelle P. Waiver (MPW)
Supports for Community Living (SCL) Waiver
Acquired Brain Injury (ABI & ABI-LTC) Waivers
Model II Waiver (MIIW)
State Plan Medicaid (through NEMT contracts)
Service Settings May Include:
Participant’s residence
Hospitals, clinics, therapy centers
Adult day health or employment programs
Community locations tied to waiver goals
8. TIMELINE TO LAUNCH
Phase: Business Setup and Vehicle Readiness
Timeline: 1–2 months
Phase: MPPA Medicaid Enrollment and MCO/Broker Credentialing
Timeline: 2–3 months
Phase: Staff Hiring, Driver Training, and Dispatch System Setup
Timeline: 30–60 days
Phase: Contract Execution and Trip Coordination Launch
Timeline: Ongoing based on referrals and broker partnerships
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Provider Enrollment (MPPA): https://mppa.ky.gov
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
Modivcare (Common Medicaid Transportation Broker): https://www.modivcare.com
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY TRANSPORTATION SERVICES PROVIDER
WCG supports local businesses, healthcare transportation agencies, and independent drivers in launching compliant Medicaid-approved transportation programs in Kentucky.
Scope of Work:
MPPA and MCO credentialing for NEMT or waiver-based transportation
Policy & Procedure Manual tailored to transportation services
Templates for driver documentation, trip logs, and emergency procedures
Broker onboarding, mileage reimbursement tools, and route tracking support
HIPAA, safety, and participant rights training materials
Website development and outreach materials for referral networks
Home Health
HOME HEALTH SERVICES PROVIDER IN KENTUCKY
DELIVERING CLINICAL CARE AND RECOVERY SUPPORT IN THE COMFORT OF PARTICIPANTS’ HOMES
Home Health Services in Kentucky offer skilled, medically necessary care to individuals recovering from illness or managing chronic conditions while residing in their own homes. These services are covered under the Kentucky Medicaid State Plan and, in certain circumstances, may also support individuals enrolled in Home and Community-Based Services (HCBS) waivers. Home Health Services reduce unnecessary hospitalizations, support faster recovery, and promote long-term wellness and independence.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Administers Medicaid payment, licensing regulations, and quality standards for home health agencies
Agency: Kentucky Office of Inspector General (OIG)**
Role: Licenses and inspects Home Health Agencies (HHAs) and ensures compliance with state health regulations
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Oversees federal regulations for Medicare-certified and Medicaid-participating home health agencies
Agency: Managed Care Organizations (MCOs)**
Role: Authorize care plans, credential providers, and process billing for eligible Medicaid members
2. SERVICE OVERVIEW
Home Health Services are prescribed by a physician and delivered by skilled clinicians in the participant’s home. These services are clinical, time-limited, and focus on medical stabilization, recovery, or health maintenance.
Approved services include:
Skilled nursing (e.g., wound care, medication administration, chronic condition monitoring)
Physical therapy
Occupational therapy
Speech-language pathology
Medical social services
Home health aide services (support with ADLs under nurse supervision)
All services must be ordered by a licensed physician and documented in a Plan of Care (POC) reviewed every 60 days or sooner, as required.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Obtain a Home Health Agency License from the Kentucky Office of Inspector General (OIG)
Enroll with Medicaid via the Medicaid Partner Portal Application (MPPA)
Obtain CMS certification if planning to serve Medicare and Medicaid clients
Maintain professional liability and general business insurance
Develop a Home Health Services Policy & Procedure Manual
Employ licensed clinicians and trained home health aides
Ensure HIPAA compliance and implement electronic health records (EHRs) or secure documentation systems
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Licensure through OIG
Apply for and receive a Home Health Agency license from the Kentucky Office of Inspector General
Pass initial site inspection, staffing review, and policy audit
Step 2: Medicaid Enrollment via MPPA
Apply as a Home Health provider through the Medicaid Partner Portal Application
Credential with all MCOs serving your geographic region
Step 3: Clinical Setup & Physician Collaboration
Establish relationships with referring physicians for orders and care plan oversight
Train staff on POC documentation, medical necessity criteria, and billing protocols
5. REQUIRED DOCUMENTATION
Articles of Incorporation or business license
IRS EIN and Type 2 NPI confirmation
OIG Home Health Agency License
Professional liability and malpractice insurance
Home Health Policy & Procedure Manual, including:
Intake assessments and physician order templates
Plan of Care (POC) and service authorization forms
Nursing and therapy visit documentation templates
Medication administration records and wound care logs
HIPAA policies, informed consent, and emergency procedures
Staff licensure tracking, clinical supervision notes, and continuing education logs
Medicaid billing templates, documentation checklists, and audit tools
6. STAFFING REQUIREMENTS
Role: Registered Nurse (RN)
Requirements: Licensed in Kentucky; responsible for skilled nursing visits, supervisory visits, and care coordination
Role: Physical, Occupational, or Speech Therapist
Requirements: Licensed in respective disciplines; responsible for therapy evaluations and treatments
Role: Home Health Aide
Requirements: Trained per federal and state standards; provides ADL support under RN supervision
Role: Medical Social Worker (optional)
Requirements: Licensed or certified social worker; assists with psychosocial support and care planning
All staff must complete:
HIPAA and confidentiality training
Infection control and safety protocol training
Emergency response and clinical documentation training
Annual continuing education to maintain licensure
7. MEDICAID PROGRAMS & COVERAGE
Home Health Services are available through:
Kentucky Medicaid State Plan (standard medical necessity criteria apply)
Managed Care Medicaid Plans (services authorized by MCOs)
Select HCBS Waivers for short-term skilled support in exceptional cases
Service delivery settings include:
Private homes
Non-institutional supported living environments
NOT covered in facilities where equivalent care is already provided (e.g., hospitals or nursing homes)
8. TIMELINE TO LAUNCH
Phase: Business Registration and Policy Manual Development
Timeline: 1–2 months
Phase: OIG Licensure and Site Readiness
Timeline: 2–3 months
Phase: Medicaid Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Staff Hiring, Referral Network Development, and Launch
Timeline: Rolling, based on physician orders and service authorizations
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Provider Enrollment (MPPA): https://mppa.ky.gov
Kentucky Office of Inspector General – Home Health Licensing
Website: https://chfs.ky.gov/agencies/oig
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY HOME HEALTH PROVIDER
WCG assists nurse entrepreneurs, clinics, and health systems in launching fully licensed, Medicaid-compliant Home Health Agencies across Kentucky.
Scope of Work:
OIG licensure prep and policy manual development
MPPA Medicaid enrollment and MCO credentialing
Staff onboarding templates, visit note logs, and clinical protocols
HIPAA documentation systems and audit readiness tools
Billing setup for nursing, therapy, and aide services
Marketing materials and referral strategies for physicians and discharge planners
Meal & Nutrition
MEAL AND NUTRITION SERVICES PROVIDER IN KENTUCKY
SUPPORTING HEALTH AND INDEPENDENCE THROUGH NUTRITIONAL PLANNING, EDUCATION, AND MEAL SUPPORT
Meal and Nutrition Services in Kentucky are designed to help Medicaid-eligible individuals maintain proper nutritional health while living independently in the community. These services are offered under Kentucky Medicaid’s Home and Community-Based Services (HCBS) waiver programs and focus on supporting individuals with disabilities, seniors, or those with chronic conditions who are at risk of malnutrition or food insecurity.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Administers Medicaid and HCBS waivers, oversees provider enrollment and reimbursement for nutrition services
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Oversees HCBS waivers for aging populations, establishes nutrition-related service standards
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance and person-centered service delivery across Medicaid-funded nutrition programs
Agency: Managed Care Organizations (MCOs) in Kentucky Medicaid
Role: Authorize services, credential providers, and manage billing and service quality outcomes
2. SERVICE OVERVIEW
Meal and Nutrition Services include the provision of meals and professional dietary support to promote well-being, manage chronic conditions, and support independent living.
Approved providers may offer:
Home-delivered meals (hot, cold, frozen, shelf-stable options)
Congregate/community-based meals (where applicable)
Nutritional risk screening and individualized meal planning
Medical Nutrition Therapy (MNT) under referral
Education on meal preparation, budgeting, and food safety
Caregiver training on dietary needs and mealtime support
Coordination with primary care, dietitians, and case managers
Services must be based on the participant’s Person-Centered Service Plan (PCSP) and may require dietary or physician documentation for MNT components.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Kentucky Secretary of State
Obtain IRS EIN and NPI (Type 2)
Enroll as a Medicaid provider through the Kentucky Medicaid Partner Portal Application (MPPA)
Maintain liability insurance and food service permits from the local health department
Employ or contract with a Licensed Dietitian/Nutritionist (LDN) or Registered Dietitian (RD) for nutrition assessments and menu development
Follow food safety guidelines per Kentucky Department for Public Health and USDA
Develop a Meal and Nutrition Services Policy & Procedure Manual
Implement HIPAA-compliant records and participant service documentation systems
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Medicaid Enrollment
Apply via the Kentucky MPPA system for HCBS provider types (e.g., Home-Delivered Meals, Nutrition Counseling, MNT)
Credential with Kentucky’s MCOs (e.g., Aetna Better Health, Humana Healthy Horizons, WellCare, etc.)
Step 2: Documentation Submission
Submit business license, insurance, staff credentials, food service licenses, and nutrition policies
Step 3: Service Authorization & Delivery
Obtain referral or physician’s order if required
Coordinate with case managers to align meals and services with the PCSP
Deliver meals and/or provide counseling services
Submit claims using appropriate HCPCS/CPT codes
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Kentucky business license
IRS EIN and NPI confirmation
General liability insurance and food handler certification
Licensure for RD/LDN staff
Meal and Nutrition Services Policy & Procedure Manual including:
Menu planning templates and dietary intake logs
Nutrition risk assessments and care plan documentation
Participant consent forms and grievance procedures
Food delivery logs and service quality tracking
Emergency meal delivery protocols
Staff credentialing, training logs, and supervision policies
HIPAA compliance, billing records, and audit templates
6. STAFFING REQUIREMENTS
Role: Meal Preparation Staff / Delivery Driver
Requirements: Food handler’s permit; training in food safety and handling; background screening clearance
Role: Registered Dietitian / Licensed Dietitian-Nutritionist (RD/LDN)
Requirements: Licensed in Kentucky; responsible for assessments, menu oversight, and nutritional education
All staff must complete:
HIPAA and participant confidentiality training
Food safety, hygiene, and infection control procedures
Emergency response training and delivery tracking procedures
Ongoing continuing education for RDs/LDNs
7. MEDICAID PROGRAMS & HCBS WAIVERS
Meal and Nutrition Services may be authorized under the following waivers:
Supports for Community Living (SCL) Waiver
Michelle P. Waiver (MPW)
Home and Community Based (HCB) Waiver
Acquired Brain Injury (ABI and ABI-LTC) Waivers
Model II Waiver (MIIW)
Services must be outlined in the Person-Centered Service Plan (PCSP) and may include:
Routine meal delivery to participant’s home
Congregate meals with community interaction
Medical Nutrition Therapy via physician referral
Nutrition education sessions or caregiver support training
8. TIMELINE TO LAUNCH
Phase: Business Registration and Licensing
Timeline: 1–2 months
Phase: MPPA Medicaid Enrollment and MCO Credentialing
Timeline: 60–90 days
Phase: Staff Hiring, Menu Development, and Quality Controls
Timeline: 1–2 months
Phase: Service Launch and Claims Setup
Timeline: 30–45 days
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
MPPA Provider Portal (for enrollment): https://mppa.ky.gov
Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY MEAL & NUTRITION PROVIDER
WCG assists community nutrition providers, nonprofit kitchens, and health professionals in launching Medicaid-compliant meal and nutrition programs across Kentucky.
Scope of Work:
Business registration, MPPA Medicaid enrollment, and MCO credentialing
Nutrition Policy & Procedure Manual development
Menu templates, meal logs, and diet tracking tools
Food handler certifications and staff training guides
Billing setup with nutrition-related codes and documentation tools
Referral and intake forms for RDs and meal services
Branding, website setup, and outreach materials to coordinate with hospitals, case managers, and waiver teams
Residential Care
RESIDENTIAL CARE SERVICES PROVIDER IN KENTUCKY
DELIVERING 24/7 SUPPORT IN COMMUNITY-BASED SETTINGS FOR INDIVIDUALS WITH COMPLEX CARE NEEDS
Residential Care Services in Kentucky provide around-the-clock assistance in supervised, home-like settings for individuals who require support with daily living tasks, health monitoring, and community participation. Offered under several Kentucky Medicaid Home and Community-Based Services (HCBS) waivers, residential services aim to promote independence, dignity, and inclusion for participants who cannot live alone or with family caregivers.
1. GOVERNING AGENCIES
Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Manages Medicaid reimbursement, provider enrollment, and service integrity
Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Oversees compliance with residential care standards under specific waiver programs
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Enforces federal person-centered planning, safety, and quality-of-care regulations
Agency: Managed Care Organizations (MCOs) in Kentucky Medicaid
Role: Authorize residential service plans, credential providers, and ensure billing and documentation compliance
2. SERVICE OVERVIEW
Residential Care Services support participants in provider-operated homes with 24/7 staff supervision and assistance to promote independent living within a structured, community-based environment.
Approved services may include:
ADL assistance (bathing, dressing, toileting, eating, mobility)
Medication administration or reminders (per state policy and staff licensure)
Meal planning and preparation
Housekeeping, laundry, and safety monitoring
Community access and engagement
Behavioral supports and skill development
Supervision and overnight monitoring
Health tracking and appointment support
All services must align with the participant’s Person-Centered Service Plan (PCSP) and be delivered in certified or licensed settings approved under the applicable waiver.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll with Medicaid via the Medicaid Partner Portal Application (MPPA)
Obtain KDADS or DAIL licensing or certification for residential settings (based on waiver type)
Maintain property, liability, and workers’ compensation insurance
Pass environmental safety and health inspections
Hire and train staff with background checks, CPR/First Aid certification, and HCBS training
Develop Residential Care Policies & Procedures Manual
Implement HIPAA-compliant documentation and risk management systems
4. KENTUCKY PROVIDER ENROLLMENT PROCESS
Step 1: Facility Licensing and Setup
Secure appropriate licensure or certification from DAIL for group home or staffed residence
Complete site inspections for fire safety, accessibility, and staffing requirements
Step 2: Medicaid Enrollment via MPPA
Register as a residential care provider for applicable waivers
Complete MCO credentialing and network participation agreements
Step 3: Documentation Submission
Submit business license, staff credentials, site inspection reports, insurance, and policy manual
Step 4: Service Authorization & Launch
Coordinate with case managers and caregivers to complete ISP
Receive MCO authorization and begin service delivery
Submit claims using approved T-codes or HCPCS codes for residential supports
5. REQUIRED DOCUMENTATION
Kentucky Articles of Incorporation or business license
IRS EIN and NPI confirmation
KDADS/DAIL facility license or certification
Liability, property, and workers’ compensation insurance
Residential Services Policy & Procedure Manual, including:
Admission/intake forms and ISP implementation procedures
House rules, emergency plans, and daily log templates
ADL, behavioral support, and medication administration documentation
Staffing schedules, training logs, and supervision reports
Participant rights, HIPAA compliance, and grievance policy
Critical incident and abuse prevention protocols
Medicaid billing systems and audit tools
6. STAFFING REQUIREMENTS
Role: Direct Support Professional (DSP) / Residential Aide
Requirements: Experience with developmental disabilities or elderly care; background check; CPR/First Aid; HCBS training
Role: Residential Supervisor / Program Manager
Requirements: Oversee staff and site operations; ensure compliance, documentation, and staff development
Role (if needed): Nurse or Behavior Support Staff
Requirements: Licensed in Kentucky for nursing/clinical tasks as applicable to the participant’s care plan
All staff must complete:
Abuse, neglect, and exploitation training
HIPAA and participant rights training
Fire safety and emergency response
Person-centered care and ISP implementation
Ongoing continuing education
7. MEDICAID PROGRAMS & HCBS WAIVERS
Residential Care Services are available under:
Supports for Community Living (SCL) Waiver
Acquired Brain Injury (ABI and ABI-LTC) Waivers
Model II Waiver (MIIW)
Michelle P. Waiver (for specific planned respite or transitional housing supports)
Service settings must be:
Small, community-integrated homes (not institutional)
Operated under KDADS/DAIL certification standards
Aligned with participants’ autonomy, choice, and privacy rights
8. TIMELINE TO LAUNCH
Phase: Facility Preparation and Licensing
Timeline: 2–3 months
Phase: Medicaid and MCO Enrollment
Timeline: 2–3 months
Phase: Staff Hiring and Training
Timeline: 1–2 months
Phase: ISP Coordination and Program Launch
Timeline: 30–60 days
9. CONTACT INFORMATION
Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms
Medicaid Provider Enrollment (MPPA): https://mppa.ky.gov
Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail
Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY RESIDENTIAL CARE PROVIDER
WCG partners with developmental disability providers, community living operators, and supported housing organizations to launch licensed, Medicaid-compliant Residential Care programs in Kentucky.
Scope of Work:
Facility readiness and licensing prep
MPPA Medicaid enrollment and MCO credentialing
Residential Policy & Procedure Manual development
Staff hiring protocols, emergency plans, and HIPAA tools
ISP documentation systems and service logs
Medicaid billing templates and audit readiness checklists
Branding, community outreach, and family engagement support
Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.