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 (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

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10. 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