Kentucky Medicaid waiver guide
Learn how Kentucky Medicaid waiver services work, which state agency to start with, how the application process usually begins, and where to search for home and community-based services.
Last reviewed July 2026. See something out of date? Use the “Suggest an edit” button to let us know.
Kentucky runs two Medicaid waivers for people with intellectual and developmental disabilities: Supports for Community Living (SCL), the more comprehensive program including 24-hour supports, and the Michelle P. Waiver (MPW), which serves people who need less intensive help at home. Both are overseen by the Division of Developmental and Intellectual Disabilities within DBHDID, with the Department for Medicaid Services holding the waivers. Applications go through the Medicaid Waiver Management Application (MWMA), usually submitted by a Community Mental Health Center or case management provider rather than by you directly. Both waivers have waiting lists, and for SCL your position depends on which category of need you are placed in.
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People with an intellectual disability or related condition who need comprehensive supports, including 24-hour
People with intellectual or developmental disabilities who can stay at home with less intensive supports
Kentuckians with disabilities who need help remaining at home — state funded, not a Medicaid waiver
Both waivers require Medicaid eligibility and an intermediate care facility for individuals with intellectual disabilities (ICF/IID) level of care — meaning that without waiver services the person would be admitted to an ICF/IID or, for Michelle P., a nursing facility. SCL serves people with an intellectual disability or a related condition who meet the ICF/IID level of care. Michelle P. is the alternative for people who can remain at home with a more limited set of supports. The Michelle P. Waiver is governed by 907 KAR 1:835.
You must be determined to meet the level of care such that, without waiver services, you would be admitted to an ICF/IID — or, for Michelle P., an ICF/IID or a nursing facility.
SCL serves people with an intellectual disability or a related condition. Documentation of diagnosis and functional need is what the review turns on.
You must meet Medicaid eligibility requirements. Waiver services are Medicaid-funded, so this runs alongside the disability and level-of-care findings.
For SCL, your application is reviewed to determine which category you meet — future planning, urgent, or emergency. That category, not your application date alone, drives placement.
Both waivers have waiting lists. For SCL, placement is based on your category of need rather than purely on how long you have waited. When an application is submitted through MWMA it is reviewed to determine whether you meet future planning, urgent, or emergency criteria. If emergency criteria are met and emergency slots are available, the person can be allocated as an emergency. Michelle P. maintains its own separate waiting list.
In Kentucky, CMHCs and case management providers submit waiver applications through MWMA using their own logins. Start with your regional CMHC rather than trying to file alone.
Open linkApplications for 1915(c) home and community based waiver services go through the Medicaid Waiver Management Application, with a completed MAP-115 Application Intake – Participant Authorization uploaded into MWMA.
For SCL, the review decides whether you meet future planning, urgent, or emergency criteria. If you believe the situation is urgent or an emergency, make sure the CMHC documents 24-hour support needs and why existing community supports fall short. This is the step families most often under-prepare.
You must meet Kentucky Medicaid eligibility and the ICF/IID level of care. Both are assessed as part of the waiver determination.
The Hart-Supported Living Program provides state funds to help Kentuckians with disabilities remain at home and avoid institutionalization. It is not a Medicaid waiver and is worth asking about separately if you are waiting.
Exact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.
Kentucky offers Participant Directed Services (PDS), letting people hire, train, and manage their own workers — often including family members — instead of using only agency staff. PDS is available through the waivers; ask your case manager how the budget is set and what employer responsibilities come with it.
Approved waiver services are paid by Kentucky Medicaid. Once enrolled, there is generally little or no direct cost for covered services.
Michelle P. serves people who can remain at home with less intensive support, while SCL covers comprehensive and 24-hour needs. If needs are likely to grow, discuss SCL explicitly rather than assuming Michelle P. will expand to meet them.
The Hart-Supported Living Program is state-funded rather than a Medicaid waiver, so it follows different rules and can sometimes help while you wait for a waiver slot.
Kentucky's First Steps program provides early intervention for infants and toddlers, separately from the waivers.
School districts provide special education under an IEP. Waiver services are separate and additional. Apply to the waiver waiting lists well before school services end.
Because SCL placement depends on category of need, a change — a caregiver's health, a loss of housing, escalating behavioral needs — can justify re-review. Contact your CMHC and DDID rather than waiting quietly.
Adult supports run through SCL and Michelle P. Medicaid financial eligibility is generally assessed on the person's own income once they are an adult, which changes the picture for many families.
If eligibility or a waiver service is denied, reduced, or ended, you have the right to appeal and to request a Medicaid fair hearing within the deadline printed on your notice. Kentucky Protection & Advocacy is the state's designated protection and advocacy system and provides free information, referral, and legal advocacy.
Protection & Advocacy system for Kentucky
1-800-372-2988Visit siteWaiver questions and waitlist inquiries — DDID.info@ky.gov
Visit siteKentucky Medicaid's SCL waiver page
Visit siteKentucky Medicaid's Michelle P. waiver page
Visit siteFree disability rights and appeals help — 502-564-2967 locally
1-800-372-2988Visit siteLocal help & referrals — dial 211
Visit siteBy category of need, not simply by date. Your application is reviewed to determine whether you meet future planning, urgent, or emergency criteria. If emergency criteria are met and emergency slots are available, you can be allocated as an emergency.
Documentation. If your Community Mental Health Center is seeking an emergency SCL allocation, it must provide details about 24-hour support needs and explain why other community supports are not sufficient. A vague application tends to land in a lower category, so make sure the specifics are written down.
In practice, no. Community Mental Health Centers and case management providers submit waiver applications through the Medicaid Waiver Management Application using their own logins. Start by contacting your regional CMHC.
SCL is the comprehensive waiver, covering residential and 24-hour supports. Michelle P. serves people who can remain at home with a lighter set of supports such as personal care, respite, and homemaker services. They have separate waiting lists.
Ask about the Hart-Supported Living Program. It provides state funds — not Medicaid waiver dollars — to help Kentuckians with disabilities live at home and avoid institutionalization, and it follows different rules than the waivers.
Both waivers require Medicaid eligibility and an intermediate care facility for individuals with intellectual disabilities (ICF/IID) level of care — meaning that without waiver services the person would be admitted to an ICF/IID or, for Michelle P., a nursing facility. SCL serves people with an intellectual disability or a related condition who meet the ICF/IID level of care. Michelle P. is the alternative for people who can remain at home with a more limited set of supports. The Michelle P. Waiver is governed by 907 KAR 1:835.
contact your community mental health center, apply through mwma with the map-115, make the category-of-need case properly, establish medicaid and level of care, then enroll and choose providers. Start with Kentucky Division of Developmental and Intellectual Disabilities.
Covered services vary by waiver and assessed need, and commonly include in-home supports, respite, supported employment, day services, behavior support, residential supports. Confirm specifics with the state and provider.
Both waivers have waiting lists. For SCL, placement is based on your category of need rather than purely on how long you have waited. When an application is submitted through MWMA it is reviewed to determine whether you meet future planning, urgent, or emergency criteria. If emergency criteria are met and emergency slots are available, the person can be allocated as an emergency. Michelle P. maintains its own separate waiting list.
Approved waiver services are generally covered by Medicaid at little or no direct cost once enrolled, though some enrollees may owe a monthly patient responsibility based on income.
Kentucky Medicaid's SCL waiver page, including eligibility and services.
KentuckyDDID programs, the SCL Waiver Branch, and the Hart-Supported Living Program.
KentuckyThe regulation governing Michelle P. waiver services and reimbursement.
KentuckyFree protection and advocacy services, including appeals help.
KentuckyFind waiver providers and services in Kentucky on Waiverly.
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