Division of Long-Term Services and Supports

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

Hospice
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 
Nurse Aide Training
Kentucky Level of Care System
View LTSS Webinars and Trainings​ 

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 and 907 KAR 3:100 ABI Reimbursement
907 KAR 3:210 ABI LTC
907 KAR 7:010 HCB and 907 KAR 7:015 HCB Reimbursement​
907 KAR 1:595 MIIW
907 KAR 1:835 MPW
907 KAR 12:010 SCL and 907 KAR 12:020 SCL Reimbursement
907 KAR 1:030 Home Health​ and 907 KAR 1:031 Home Health Reimbursement
907 KAR 13:010 PDN​ and 907 KAR 13:015 PDN Reimbursement
Nursing Facility Regulations
907 KAR 1:450 Nurse Aide Training 
907 KAR 1:330 Hospice and 907 KAR 1:340 Hospice Reimbursement

LTSS News and Updates

​1915(c) HCBS Waiver Application Updates: DMS is amending all six 1915(c) HCBS waivers to retain several Appendix K policies that were in place during the COVID-19 public health emergency. DMS submitted the proposed amendments to 1915(c) HCBS waiver applications to the Centers for Medicare and Medicaid Services (CMS) on Nov. 3, 2023 (MIIW) and Nov. 9, 2023 (ABI, ABI LTC, HCB, MPW and SCL). Upon submission of the amended waivers, all Appendix K policies will remain in place until each waiver application is approved and takes effect. All Appendix K policies not included permanently in ​the waiver will be discontinued after the effective date of the amended waivers. DMS is working with CMS to identify effective dates for each waiver application to allow adequate time to notify stakeholders and for transition​​. ​Review the Appendix K webinar recording and presentation​ for details on which policies will be made permanent. 

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. 

DMS Response to Formal Public Comment

Appendix K Flexibilities and Policy Decisions: At a Glance 

To receive updates on this process, you can subscribe to email updates or email DMS​

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​. ​

COVID-19 and Appendix K Information: ​All COVID-19 and Appendix K information for the 1915(c) HCBS waiver program has moved to the Home- and Community-Based Services Waiver Information section of the Medicaid COVID-19 webpage.​​

Contact Information

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