In order to be eligible for the Supports for Community Living (SCL) Waiver, an applicant must be a resident of Kentucky, 3 years of age and up, and be developmentally or intellectually disabled. As mentioned previously, the disability must have been developed before 22 years of age. In addition, the eligibility requirements for the SCL Waiver are determined by the applicant’s capacity to care for oneself and by one’s financial situation. In short, the candidate must require the level of care that is typically provided in an Intermediate Care Facility or ICF, which is slightly less than the level of care provided in skilled nursing homes.
Financially, an individual applicant’s monthly income and countable resources (his/her assets) are critical eligibility factors. In 2022, an applicant’s monthly income cannot exceed 300% of the current Federal Benefit Rate (FBR) / Supplemental Security Income (SSI Rate). This means that an applicant cannot have income in excess of $2,523 / month, or said another way, $30,276 / year. In addition, countable resources are limited to $2,000. However, one’s primary home (given the applicant lives in the home and the equity value is $636,000 or less) and several other assets, such as a burial plot and a single vehicle, are not considered “countable” assets, and therefore, are exempt. As this waiver permits persons to reside outside of their homes (in foster care homes), some homeowners may be required to sell their homes to become eligible. However, one exception is if the applicant is married and his/her spouse continues to live in the home. If this is the case, the home will be considered an exempt asset.
Persons over the income and/or asset limit(s) may still qualify for this waiver by restructuring their finances. It is strongly recommended that one contact a professional Medicaid planner for assistance so as not to inadvertently disqualify oneself from Medicaid.
Benefits and Services
Each program participant has his or her own specific care requirements and a custom care plan is developed for each participant. This waiver allows for consumer direction of non-medical services, also referred to as self-directed care. This means that eligible participants have flexibility and choice as to what services best suit them, as well as which provider they prefer. In some cases, family members, including spouses and adult children, can be hired to provide care. Available services can be provided at home, in adult foster care, or other community living environments, but not in a skilled nursing home or an assisted living facility. A list of the services relevant to the elderly follows:
- Day training – can be provided in an adult day health care center
- Behavioral supports
- Case management
- Community living supports
- Community transition – from an institution back into one’s home. Maximum benefit amount $2,000 per eligible move.
- Home modifications – maximum lifetime benefit of $8,000
- Vehicle modifications – maximum benefit amount of $6,000 for a period of 5 years
- Personal care services
- Personal emergency response systems
- Psychological services
- Residential support service
- Respite service – in-home and out-of-home
- Shared living / adult foster care – maximum benefit amount of $600 / month
- Specialized medical equipment and supplies
- Supported employment
- Transportation – medical and non-medical
- Natural supports training – education and training for unpaid caregivers
How to Apply / Learn More
For more information about the Supports for Community Living Medicaid Waiver, click here. The application process for this waiver begins with the Kentucky Division of Developmental and Intellectual Disabilities (DDID). More information and the application paperwork can be found here.
As of 2022, a waiting list for this waiver exists. Eligible applicants are accepted into this program based on one’s application date as funding becomes available. One’s level of care need is also considered.