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KATS Network > Publications > The Buck Starts Here... > Home and Community Based (HCB) Waiver Program

Home and Community Based (HCB) Waiver Program

Division of Long Term Care & Community Alternatives, Department for Medicaid Services

Overview:

The Home and Community Based (HCB) Waiver program provides Medicaid coverage to individuals who are aged, or disabled, and who may, without these services, be admitted to a nursing facility. These individuals must meet nursing facility level of care to be eligible to participate in the HCB Waiver program.

The services offered under the HCB Waiver program are provided by Home Health agencies enrolled in the Medicaid program as HCB Waiver providers. These services are available statewide for individuals who are eligible to receive HCB Waiver services. There is a provision for Medicaid eligibility to be determined under a special income level for individuals who otherwise meet all requirements for receiving HCB Waiver services.

Eligibility Requirements:

To apply for services the individual must:

• Obtain a physician's order for services;
• Meet the level of care for nursing facility services as determined by the Professional Review Organization (PRO);
• Choose to be at home and receive HCB services and;
• Obtain a written certification by a physician that if HCB services were not available, nursing facility services would be ordered, and the individual may be admitted to a nursing facility in the immediate future.

AT Services Provided/Covered:

• Evaluation/Assessment
• Purchasing/Acquisition
• Selection/Design

AT Devices Provided/Covered:

• Other: Home/Worksite Modifications

Application Process:

An initial contact to determine if the recipient meets the guidelines for the program should be made with the Home Health Agency providing the HCB service.  If approved, an application for Medicaid would be made with the Department for Community Based Services in the County the recipient resides.  Please contact either the local Department for Community Based Services in your county or any Home Health Agency for more information.

Contact Information:

Division of Long Term Care and Community Alternatives

275 E. Main St.
6 W-B
Frankfort, KY 40621
(502) 564-5560
Email: dmsweb@ky.gov
Website: http://chfs.ky.gov/dms/hcb

Bridges & Potholes:

Bridges

• Allows the individual to stay at home, with a wide array of services instead of a nursing home.
• Provides a funding source for limited home modifications.

Potholes

• Individuals must qualify for Medicaid in order to access this waiver.
• The program has the option to exclude from the program those individuals for whom there is a reasonable expectation that this waiver will be more costly than the Medicaid institutional services the individual might otherwise receive.
• Approval of these services does not guarantee that the service will be available or provided, nor does it guarantee eligibility for Medicaid benefits.

• Next Section: Supports for Community Living Waiver
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