Kentucky Supports for Community Living (SCL) Waiver

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers," which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services.

Waiver Description

The Department for Medicaid in the State of Kentucky offers a program called the Supports for Community Living (SCL) Waiver.  Unfortunately, this program is not relevant to elderly individuals who wish to age outside of nursing homes as the target group for the program is developmentally or intellectually disabled persons, who developed their disability prior to the age of 22.  Therefore, persons with intellectual disabilities, such as Alzheimer's, which is developed later in life are excluded from participation.

The state does offer another Medicaid waiver with similar services that serves the elderly which is referred to by several names, most commonly the Waiver for the Aged


 

Eligibility Guidelines

In order to be eligible for the Supports for Community Living (SCL) Wavier, 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 (their assets) are critical eligibility factors. In 2018, 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 $2,250 / month, or said another way, $27,000 / 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 $572,000 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 their spouse continues to live in the home. If this is the case, the home will be considered an exempt asset.

 

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. These 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:

  • Adult day health care
  • Behavioral supports
  • Case management
  • Community living supports
  • Community transition
  • Home modifications
  • 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
  • Specialized medical equipment and supplies
  • Transportation – medical and non-medical

 

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 2018, a waiting list for this waiver exists. Eligible applicants are accepted into this program based on one’s application date as funding becomes available.