Division of Long-Term Services and Supports

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Kentucky Medicaid's Division of Long-Term Services and Supports (LTSS) oversees programs for Kentuckians who need ongoing support due to their age, a medical condition, or a disability.  LTSS offers a variety of options to meet each individual’s unique needs. 

Programs and Services

Home- and Community-Based Services  

​Acquired Brain Injury (ABI) Acute and Long-Term Care Waivers
For individuals who require acute rehabilitation or long-term support due to an acquired brain injury

Home and Community Based (HCB) Waiver
For individuals age 65 or older and/or individuals with a physical disability

Model II Waiver (MIIW)
For individuals who are ventilator-dependent for 12 or more hours per day or on an active weaning program

Michelle P. Waiver (MPW) and Supports for Community Living (SCL) Waiver
For individuals with intellectual and/or developmental disabilities ​​​

In-Home and Facility Based Long-Term Care ​

Home Health
For individuals who need short-term medical care at home due to an illness or injury

Private Duty Nursing (PDN)
For individuals who need continuous skilled nursing due to a disease, illness, or injury. 

Nursing Facilities​​​
For individuals who require facility-based ​​skilled nursing care or rehabilitation 

Program of All-Inclusive Care for the Elderly (PACE)
For individuals age 55 or older who need nursing facility level of care but want to continue living at home 

Kentucky Transitions
For individuals who wish to move out of a nursing home or institution and into the community

Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) 
For individuals with intellectual disability (ID) or related conditions who facility-based care

Intermediate Care Clinic 
Provides comprehensive medical, dental, vision, and psychiatric services to individuals with intellectual disabilities or related conditions

Providers a range of services to individuals and their families at the end of life

Related Pages

Appendix K Information for 1915(c) HCBS Waivers 
Improving Home- and Community-Based Services
Electronic Visit Verification 
Medicaid Waiver Management Application Information
Nurse Aide Trainin​g
Kentucky Level of Care System

Helpful Links​

How to Apply for Medicaid and Waiver Services
Apply for Benefits Using kynect​
Subscribe to Email Updat​es
Find Fee and Rate Schedules
Search for MAP Forms

LTSS Regulations

907 KAR 3:130 Medical Necessity
907 KAR 1:022 Nursing Facility and ICF/IID 
907 KAR 1:563 Appeals
907 KAR 3:090 ABI Acute
907 KAR 3:100 ABI Reimbursement
907 KAR 3:210 ABI LTC
907 KAR 7:010 HCB
907 KAR 7:015 HCB Reimbursement​
907 KAR 1:595 MIIW
907 KAR 1:835 MPW
907 KAR 12:010 SCL
907 KAR 12:020 SCL Reimbursement
907 KAR 1:030 Home Health​
907 KAR 1:031 Home Health Reimbursement
907 KAR 13:010 PDN​
907 KAR 13:015 PDN Reimbursement
Nursing Facility Regulations
907 KAR 1:450 Nurse Aide Training
907 KAR 3:250 PACE​  
907 KAR 1:330 Hospice
907 KAR 1:340 Hospice Reimbursement

LTSS News and Updates

Legally Responsible Individual Participant Directed Services Employees: Beginning July 1, 2024, DMS and the Department for Aging and Independent Living (DAIL) will begin a new process for reviewing requests to hire a legally responsible individual (LRI) as a Participant Directed Services (PDS) employee. Requests will be entered and reviewed using the Medicaid Waiver Management Application. DMS and DAIL held a provider training and an informational webinar for participants in June. 

Waiver Rate Study Results: DMS has released proposed rate updates based on the findings of the 1915(c) HCBS waiver rate study. The proposed rates can be reviewed on the Improving Home- and Community-Based Services webpage.

Appendix K Ends: The amended ABI, ABI LTC, HCB, MPW, and SCL waiver applications took effect on May 1, 2024. Any Appendix K flexiblity not included in the waiver application is no longer available. The following resources are available to help stakeholders understand which Appendix K policies became permanent and which were discontinued. 

If you have case-specific questions about the end of Appendix K, please email the 1915(c) Waiver Help Desk or call (844) 784-5614. If you have a general questions about Appendix K, please email DMS​.

As part of the CMS submission and approval process, DMS held a 30-day public comment period for the amended waiver applications. The public comment period ended on Oct. 27, 2023. DMS reviewed all submitted comments and issued a formal response. Additionally, DMS created a summary for stakeholders to explain the updates made to the waivers before CMS submission.

​1915(i) State Plan Amendment: DMS is developing a 1915(i) State Plan Amendment (SPA) to offer long-term services and support to individuals with severe mental illness (SMI) and substance use disorder (SUD). Interested stakeholders can review the 1915(i) SPA section of the DMS Behavioral Health Initiatives website​. ​

Contact Information