What is Kentucky's HCB waiver?
The Home and Community Based (HCB) waiver is Kentucky's 1915(c) Medicaid waiver for adults 65 and older and people with physical disabilities who meet nursing-facility level of care under 907 KAR 1:022 and Medicaid's financial rules, paying for services that let them stay at home; it is run by the Department for Medicaid Services with the Department for Aging and Independent Living.
The governing regulations are 907 KAR 7:010 and 7:015. HCB is one of several Kentucky waivers; the others (Michelle P., Supports for Community Living, Model II, the acquired brain injury waivers) serve different populations.
What services does the HCB waiver cover in Louisville?
DMS lists adult day health care, attendant care, environmental and minor home adaptation, home-delivered meals, and non-specialized and specialized respite among HCB services, and participants can direct their own non-medical services through Participant Directed Services (PDS).
Under PDS, an HCB participant can hire their own workers, including some family members, instead of using an agency, or combine the two. In the Louisville area, adult day health is a practical anchor service: OIG's roster lists more than thirty licensed adult day health programs across Jefferson, Oldham, Bullitt and Shelby counties. The waiver does not pay rent or room and board anywhere, and it does not pay for assisted living.
Is there a waiting list for the HCB waiver in Kentucky?
Yes. The Department for Medicaid Services states there is currently a waiting list for HCB services, and placement on the list is determined by the date a completed application is received.
That makes timing the biggest practical lever: apply as soon as a parent plausibly meets nursing-facility level of care, rather than waiting for a crisis. In the meantime, KIPDA's in-home services, Meals on Wheels and caregiver programs can bridge some of the gap.
How do Louisville families apply for the HCB waiver?
First obtain financial eligibility for Medicaid through kynect or the Department for Community Based Services at (855) 306-8959; then apply for HCB services online through kynect or in person at an Aging and Disability Resource Center, which for Louisville and the six surrounding counties is KIPDA's ADRC at (502) 266-5571.
DAIL answers HCB participant questions at (877) 315-0589. Have the parent's Social Security number, income and asset records and diagnosis information ready. Kentucky's Medicaid resource limit for one person is $2,000 (907 KAR 20:025), though waiver financial rules have their own special provisions spelled out in DMS's waiver fact sheet.
At a glance
| Kentucky's HCB waiver is | Kentucky's HCB waiver is not | |
|---|---|---|
| Setting | Services in the participant's own home and community | Payment for assisted living or room and board |
| Eligibility | 65+ or physically disabled, nursing-facility level of care, Medicaid-eligible | Open to anyone who wants help at home |
| Availability | Subject to a waiting list ordered by application date | Immediate |
| Workers | Agency staff or self-directed workers under PDS | Limited to agency staff |
Sources include KRS Chapter 194A, 902 KAR 20:480, Kentucky CHFS and DMS pages, CareScout and VA rate tables as cited above; see our editorial standards.
