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

​

10. 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