I/DD Waivers in Kentucky

All states: Medicaid disability services map

Kentucky I/DD services at a glance

Last verified against state sources: 2026-10-28.

Who runs I/DD services in Kentucky?

Two parts of Kentucky's Cabinet for Health and Family Services share the work. The Department for Medicaid Services (DMS), the state Medicaid agency, holds authority over the I/DD waivers, sets rates, pays claims and issues the regulations. The Division of Developmental and Intellectual Disabilities (DDID), in the Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID), runs the two I/DD waivers day to day under a contract with DMS.

• Department for Medicaid Services (DMS): keeps administrative authority over the Supports for Community Living (SCL) Waiver and the Michelle P. Waiver (MPW), sets fee-for-service rates and processes claims.
• DDID within DBHDID: operates SCL and MPW, reviews SCL applications, and certifies and monitors waiver providers together with DMS.
• Front door: people apply for Medicaid through kynect, by calling the Department for Community Based Services (DCBS) at (855) 306-8959 or at a DCBS office. They then submit the waiver application through kynect or in person at an Aging and Disability Resource Center (ADRC) or a Community Mental Health Center (CMHC).
• Case management: case management is a waiver service. Participants choose a certified case management agency, and it must be conflict-free. That means the case management agency may not provide other waiver services to the same person unless no other willing case manager is within 30 miles.

What Medicaid waivers and programs serve people with I/DD in Kentucky?

Kentucky has two 1915(c) waivers for people with intellectual or developmental disabilities: the Supports for Community Living (SCL) Waiver and the Michelle P. Waiver (MPW). A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. Both serve children and adults, and both offer self-direction. SCL includes residential services, while MPW serves people who live in their own or their family's home.

• Supports for Community Living (SCL) Waiver (1915(c), control number KY.0314): serves children and adults with an intellectual or developmental disability who meet the level of care for an intermediate care facility for individuals with intellectual disabilities (ICF/IID) and Medicaid financial rules. Services include case management, Residential Support Levels I and II, Technology Assisted Residential, Shared Living, Day Training, Supported Employment, Community Access, Personal Assistance, Respite, Positive Behavior Supports, Consultative Clinical and Therapeutic Services, Community Guide, Financial Management Services, Natural Supports Training, transportation, environmental and vehicle adaptations, and Goods and Services. The current waiver period runs from May 1, 2024 to April 30, 2029. An amendment effective January 1, 2025 updated rates, added 250 slots and reserved 10 slots for Money Follows the Person, a program that helps people move out of institutions. The waiver can serve 5,416 people a year in years 2 to 5. Rules are in 907 KAR 12:010 and 12:020.
• Michelle P. Waiver (MPW) (1915(c), control number KY.0475): serves children and adults with an intellectual or developmental disability who meet nursing facility or ICF/IID level of care and live in their own or family home. It has no residential service. Services include case management, Adult Day Training, Adult Day Health, Supported Employment, Community Access, Personal Assistance, Respite, Shared Living, Positive Behavior Supports, Consultative Clinical and Therapeutic Service, occupational, physical and speech therapy, Community Guide, Financial Management, Natural Supports Training, transportation, environmental and vehicle adaptations, and Goods and Services. An amendment effective January 1, 2025 updated rates and added 500 slots. The waiver can serve 11,350 people a year in years 2 to 5. Rules are in 907 KAR 1:835.

A related program, the Community Health for Improved Lives and Development (CHILD) Waiver (KY.2486), started January 1, 2026. DMS runs it for children and youth under 21 with high-intensity behavioral health or developmental needs who meet psychiatric hospital or ICF/IID level of care and have tried other services. It is not counted as an I/DD waiver here because DMS, not DBHDID, runs it and it serves a mixed population. Kentucky's other 1915(c) waivers, ABI, ABI Long Term Care, Model II and the Home and Community Based (HCB) waiver for older adults and people with physical disabilities, are separate programs. ICF/IID facilities are the institutional option that SCL and MPW are designed to prevent.

Does Kentucky pay for I/DD services through managed care?

No. SCL and Michelle P. Waiver services are paid fee-for-service. DMS sets the rates and pays providers directly through the state Medicaid system, not through health plans. Coordination is done by the case management agency each participant chooses.

• Who pays claims: DMS, under the fee-for-service rates described in the SCL waiver application.
• Who coordinates services: certified, conflict-free case management agencies, chosen by the participant.
• Who operates the waivers: DDID within DBHDID, under contract with DMS.

Is there a waiting list for I/DD services in Kentucky?

Yes. As of August 17, 2026, the state reported 9,926 people waiting for the Michelle P. Waiver and 3,884 waiting for SCL. Many people are on more than one list, so the two numbers should not be added together. SCL places people by category of need and application date, and MPW places people by application date.

• Latest counts: from the DMS waiver waitlist update to the legislature in August 2026. The same report counted 19,076 unduplicated people waiting across all of Kentucky's 1915(c) waivers, but that total includes the Home and Community Based waiver for older adults and people with physical disabilities.
• SCL priority order: under 907 KAR 12:010, applicants are placed by category of need, then by the date complete application information was entered. The categories are emergency (for example, abuse or the death of a caregiver), urgent (services needed within a year) and future planning (services needed in more than a year).
• MPW order: people enter by application date while the waiver has capacity.
• How long people wait: as of September 2, 2025, the average time on the list was 2,830 days (about 7.7 years) for SCL and 1,274 days (about 3.5 years) for MPW, according to a DMS update to the legislature.
• New slots: SCL gained 250 slots and MPW 500 slots in the January 1, 2025 amendments. The 2026 to 2028 state budget included money for more MPW and SCL slots, but we did not find the enacted number.

For a person's place on a list, families can contact DBHDID at (502) 564-7700 or DDID.Info@ky.gov.

How do people apply for I/DD services in Kentucky, and how are budgets set?

People first apply for Medicaid through kynect, DCBS at (855) 306-8959 or a DCBS office. They then submit the SCL or MPW application through kynect, which uses the Medicaid Waiver Management Application (MWMA), or in person at an ADRC or a Community Mental Health Center. SCL uses the Supports Intensity Scale (SIS) to plan services and set residential support levels, and MPW uses the MAP-351 form to decide level of care.

• SCL eligibility: an intellectual or developmental disability with documented onset, shown through IQ and adaptive behavior testing, and ICF/IID level of care under 907 KAR 1:022. DBHDID reviews the application.
• MPW eligibility: an intellectual or developmental disability and nursing facility or ICF/IID level of care, determined with the MAP-351.
• Financial rules: both waivers use special waiver Medicaid financial rules.
• Assessment and support levels: in SCL, the SIS and a health risk screening tool inform the person's plan and set the residential support level. We did not find a published individual budget method for either waiver. Ask DBHDID or the case management agency.
• Starting services: once a slot is allocated, the person has 60 days to start services, with one 60-day extension allowed.

What day and residential services can I/DD providers offer in Kentucky?

Day services in Kentucky's I/DD waivers include Day Training (SCL), Adult Day Training (MPW), Supported Employment (both) and Adult Day Health (MPW). Residential services are offered only in SCL, through Residential Support Levels I and II and Technology Assisted Residential, while Shared Living is offered in both waivers. Most of these services require certification as a waiver provider under 907 KAR 7:005. The research did not find a published staff ratio for any day service.

Day and employment services

• Day Training (SCL): training in daily living, self-advocacy, adaptive and social skills, at a fixed site or in the community, including work-like settings that are not supported employment. Billed in 15-minute units, up to 160 units a week alone or combined with supported employment. The provider must be a certified waiver provider.
• Adult Day Training (MPW): supports taking part in community routines, including work-like settings and group work training such as mobile crews, at a fixed site or in the community. Billed in 15-minute units, up to 160 units a week combined with other services. The provider must be a certified waiver provider.
• Supported Employment (SCL and MPW): individual job supports for people working in integrated jobs, including person-centered job selection, job development and ongoing job coaching. Billed in 15-minute units. In SCL, person-centered job selection is capped at 120 units and job development at 90 units. A prior authorization request form is required for employment services.
• Adult Day Health (MPW): adult day health care with skilled nursing, meals, registered nurse (RN) supervision, scheduled activities and personal care. We did not find its licensing requirement or billing unit in the sources reviewed.

Residential services

• Residential Support Level I (SCL): up to 24-hour support in a home the provider owns or leases, with separate rates for homes of three or fewer people and homes of four or more. The level is set using the SIS, a health risk screen and the plan, and up to 5 unsupervised hours a day can be planned. The provider must be a group home licensed by the Office of Inspector General under 902 KAR 20:078 or a certified residential provider under 907 KAR 7:005.
• Residential Support Level II (SCL): up to 24-hour support in a home the provider does not own, with no more than three publicly funded people. Rates are based on required support hours. All adults in the home need first aid, CPR, crisis and medication training and background checks.
• Technology Assisted Residential (SCL): residential support for people who need up to 24-hour support but can use technology to reduce onsite staff, based on a plan informed by the SIS.
• Shared Living (SCL and MPW): the person lives in their own home with an unrelated live-in caregiver, and the waiver pays the caregiver's share of room and board through the provider.

Residential Support Level II, Technology Assisted Residential and Shared Living providers must be certified waiver providers under 907 KAR 7:005.

How are I/DD provider rates set and how do agencies enroll in Kentucky?

DMS sets fee-for-service rates for SCL and MPW. Most current rates come from an independent rate study by Guidehouse that built rates from median direct care wages, benefits, productivity and administrative costs. Agencies become providers by getting certified as waiver providers and enrolling in Kentucky Medicaid as provider type 33.

• Rate method: the rate study used provider cost and wage surveys from 2019 and 2022. The 2024 legislature funded 70% of the study's benchmark rates, applied only where that was higher than the existing rate. Participant-directed services are paid at the same rates as agency services.
• Latest rate change: DMS announced a 4% cut to Medicaid provider rates, including SCL and MPW, to start August 1, 2026. On July 23, 2026, DMS told providers in a rescission letter that the cut would not take effect and rates stay at current levels.
• Becoming a provider: an agency must be certified as a waiver provider under 907 KAR 7:005 and the SCL or MPW rules, then enroll as a Kentucky Medicaid provider (SCL and MPW are provider type 33). DMS and DBHDID certify providers and monitor them each year. Details are on the DMS SCL provider page.
• EVV: in-home waiver services on the state EVV list, such as personal care type services and in-home respite, need electronic visit verification (EVV) in SCL and MPW, whether delivered by an agency or through participant direction. Kentucky's state-sponsored system is Therap, and agencies may use another system that connects to the Therap aggregator, according to the DMS EVV page. Since January 1, 2026, claims for EVV-required services without a matching EVV visit are denied, per the DMS hard edit letter. We could not open the state's service code list, so ask DMS which SCL and MPW codes require EVV.
• Self-direction: participants in both waivers can direct non-medical, non-residential services, alone or blended with agency services. Financial management services, which handle payroll for self-directed workers, are provided by Community Mental Health Centers and Area Development Districts.

What is changing next for I/DD services in Kentucky?

Under 2026 House Bill 2, people on the Michelle P. Waiver waiting list must return a signed provider attestation with their primary diagnosis by January 31, 2027 to stay on the list. People who do not respond can be removed after documented outreach. People already receiving waiver services are not affected.

• Michelle P. waitlist attestation: the attestation must be signed by a physician, physician assistant, advanced practice registered nurse (APRN) or licensed psychologist, according to the DMS House Bill 2 waitlist verification letter dated July 24, 2026. The letter describes the requirement for the Michelle P. and Home and Community Based waiver lists. We did not confirm whether a similar step applies to the SCL list. Ask DBHDID.
• Waitlist report: House Bill 2 also requires the Cabinet to prepare a report on the waiting lists. In July 2026 the Secretary said it would go to the Medicaid Oversight and Advisory Board in October 2026. We did not find the report or any decision on changes to how the lists are prioritized.
• New slots: the 2026 to 2028 budget included money for more MPW and SCL slots. We did not find the final number of slots or when they will be released.

Two recent changes are already in place: EVV claim denials began January 1, 2026, and the planned 4% rate cut for August 1, 2026 was rescinded.

Kentucky I/DD sources

• Kentucky CHFS: Supports for Community Living (SCL) Waiver
• Kentucky CHFS: Michelle P. Waiver
• Kentucky DMS: SCL 1915(c) waiver application (KY.0314)
• Kentucky DMS: Michelle P. 1915(c) waiver application (KY.0475)
• Kentucky DMS: Waiver waitlist update to the legislature (August 2026)
• Kentucky DMS: 1915(c) Medicaid waivers update to the legislature (September 2025)
• 907 KAR 12:010 (SCL waiver regulation)
• Kentucky DMS: Electronic Visit Verification
• Kentucky DMS: House Bill 2 waitlist verification letter (July 2026)
• Kentucky DMS: 4% rate reduction rescission letter (July 2026)

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Developmental Disabilities vs. Mental Health: Key Differences
• Disability Services DayHab has a dilemma - how to solve it
• I/DD services in every state (map)
• Kentucky EVV requirements

Page history

• October 28, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.