Supports for Community Living Waiver Branch
For links to regulations regarding SCL services and reimbursement, see "SCL Regulations" in Related Links.
The Supports for Community Living Waiver Branch offers the following supports and services. These are based on the individual's needs and are identified through an individual plan.
Supports for Community Living (SCL) service can be delivered in the ways described below. Note that certain services are exclusive to the type of delivery chosen.
- Participant-directed. This allows the participant to assist with the design of the participant's programs, and to recruit, hire, train, manage, evaluate and terminate staff, and direct the delivery of services to meet the participant's needs. The services are specifically nonresidential and nonmedical.
- Traditional. Unlike with participant-directed services, the agency supporting the participant recruits, hires, trains, manages, evaluates and terminates staff.
- Blended. This is a combination of different traditional and participant-directed services. For example, a person may choose to receive case management and physical therapy under traditional and choose to receive respite and personal care assistance under participant-directed services.
List of Services
Note: "A person" refers to someone who is receiving Supports for Community Living (SCL) Waiver funding. Within the regulations, a person is referred to as a participant.
If « appears before a service name in the descriptions, it indicates that a potential provider cannot be certified to provide the service. It is a service that is coordinated by, or its funding is secured by, the Case Manager or by a participant's representative.
- Case Management is an approach to coordinating care, supports and services for a person receiving Supports for Community Living (SCL) funding using a Person-Centered Planning process. It provides the person and his or her family with a point person/Case Manager who assists in connecting with community and waiver resources. The Case Manager works closely with the person to ensure ongoing satisfaction and that needs are met, and that health, safety and welfare assurances are in place. This service cannot be provided to a person who receives other waiver services from the case management agency or agencies that employ the Case Manager. The Case Manager is to serve as an advocate to safeguard the person's choices among many potential providers.
- Community Access Services are designed to provide an opportunity for a person to connect and become involved with clubs, associations and any other groups in the community including recreational, educational, religious, civic and volunteer opportunities with an outcome of less reliance on formal supports and an emphasis on the development of personal social networks, membership opportunities, friendships, and relationships for the person.
- Community Guide Services are available to provide information and assistance in problem solving, decision making, developing supportive community relationships, and accessing resources for a person who chooses to participant-direct his or her own services, including recruiting and hiring staff; training, managing, evaluating and terminating staff as necessary; and understanding provider qualifications, recordkeeping and other waiver requirements. In order to access Community Guide Services, the participant must have at least one participant-directed service
- «Community Transition Services offer funds for a person moving from an institution or provider-operated residential service to his or her own home. This service provides reimbursement for certain one-time setup expenses such as security deposits; essential household items such as furniture, window coverings, kitchen items, bath and bed linens; setup fees for utility access such as electricity, telephone service, water or pest eradication; cleaning; and possibly minor accessibility adaptations. The reimbursement is not to exceed $2000 per qualified move.
- Consultative Clinical and Therapeutic Service provides expertise, training and technical assistance to improve the ability of paid and unpaid caregivers to carry out therapeutic interventions specified in the person's Plan of Care. Depending on the area of need, the service may be provided by the following: certified nutritionist, licensed dietitian, licensed marriage and family therapist, licensed professional clinical counselor, licensed psychological associate, licensed psychologist, licensed psychological practitioner, licensed clinical social worker, or positive behavior support specialist.
- Day Training provides active training in a nonresidential setting to prepare a person to transition from school to adult responsibilities. This includes meaningful community involvement, career planning and prevocational activities that are designed to build positive social behavior, interpersonal competence, greater independence and workplace problem-solving skills and strategies. Day Training may also focus on retirement activities (such as participation in hobbies, clubs or other senior related activities) in the person's community and/or training to maintain skills and functioning to prevent or slow regression.
Another option for those requiring skilled nursing services or nursing supervision is Adult Day Health Care. It is provided by a licensed adult day health care center and is available to a person who is at least 21 years of age. Services should coordinate with any needed therapies listed in the person’s Plan of Care, should occur in a variety of settings in the community, and shall not be limited to fixed-site facilities or be diversional in nature.
- «Environmental Accessibility Adaptation Services are designed to enable a person to interact more independently with the person's environment. Services may include installation of a ramp, grab-bar, specialized electric and plumbing, modification of bathrooms, and widening of doorways. Funding has a lifetime limit of $8000.
- «Goods and Services include equipment, services or supplies which reduce the need for personal care or enhance independence and safety at home or in the community. This is only available through Participant Directed Services and funding is limited to $1800 per plan-of-care year.
- «Natural Supports Training is education and training provided to community members who provide unpaid support, training, companionship and supervision to the person receiving waiver services. This is only available through Participant Directed Services, and funding is limited to $1000 per plan-of-care year.
- Person-Centered Coaching is available when a barrier challenges the success of the person or the implementation of the Plan of Care. The person-centered coach is under the direction of a positive behavior support specialist or other licensed professional in the settings where the Plan of Care is implemented. The person-centered coach operates independently of a residential or day training provider.
- Personal Assistance Services enable a person to accomplish tasks that the person normally would do for himself or herself, if he or she did not have a disability. These include hands-on assistance; reminding, observing, guiding or training during an activity; assistance in managing medical care and transportation to access community services, activities and appointments, if these are not available under the Medicaid Program. Personal Assistance Services are available only to those who live in their own residence or in their family's residence.
- Positive Behavior Supports are used when there is a need to develop a plan which identifies prevention strategies to reduce significant challenging behaviors which interfere with activities of daily living, social interaction or work. The plan will instruct on replacement skills and new ways to respond to the challenging behaviors.
- Residential Support Services include:
- Level I, which are provided in a licensed group home, for no more than eight people or in a staffed residence with no more than three people living together who require up to 24 hours a day of an intense level of support, with no more than 5 unsupervised hours per day per person.
- Level II, which are provided in a family home provider setting or adult foster care setting, for no more than three people living together who require up to 24 hours a day of support.
- Technology Assisted, which are available to a person who resides in a residence with three or fewer others and requires up to 24 hours a day of support. These services should enable the person to increase his or her independence with a reduced need for on-site staff. These services require a real-time monitoring system with a two-way method of communication linking a person to a centralized monitoring station with 24-hour availability.
- Respite is a short-term support that is provided in the absence of, or to give relief to, any individual providing care to the person. It is available for a person who does not receive residential services and resides in his or her own home or family's home and is unable to independently administer self-care. Respite may be provided in the home or community.
- «Shared Living allows a person to live in a home or apartment that the person owns or leases with an unrelated caregiver who supports the person as needed. Funding is for the caregiver's share of room, utilities, and food in lieu of salary or other payment. The maximum amount of reimbursement for the caregiver's room and board is $600. This is only available through Participant Directed Services.
- «Specialized Medical Equipment and Supplies may cover the expense for a device, control or appliance specified in the person's Plan of Care which is necessary to ensure health, welfare and safety or offers greater independence in the person's home. It also may include an assessment, partial nutrition supplements, special clothing, customizing a device, or training needed to assist the person with mobility, seating, bathing, transferring or other skills, including but not limited to operating a wheelchair or operating communication devices.
- Supported Employment is designed to assist in creating personalized employment opportunities for a person when the person needs support in finding, negotiating and maintaining employment in an integrated setting with competitive wages and benefits commensurate to the job responsibilities. It may also be used to pursue job advancement. Funding through the Office of Vocational Rehabilitation must be exhausted before Supports for Community Living waiver services can be used.
- «Transportation is a service available to a person to gain access to integrated waiver and other community services, activities, resources and organizations typically utilized by the general population. This service can be provided when transportation is not otherwise and customarily available through natural supports or is included as an element of another SCL waiver service. It can be provided by a neighbor, friend or public transportation vendor, including local cabs or bus services. It is only available through Participant Directed Services. Reimbursement is limited to $265 per calendar month.
- «Vehicle Adaptation is a device, control, or service that increases the person's independence and physical safety. The adaptations may be made to the person's vehicle or to the privately-owned vehicle of the person's family. Reimbursement is limited to $6000 per 5-year period.
SCL providers include regional comprehensive care centers and public and private agencies across the state. These providers are reviewed and certified by the Department for Behavioral Health, Developmental and Intellectual Disabilities initially and at least every two years thereafter, in accordance with the standards and requirements set forth by the Kentucky Department for Medicaid Services.
SCL providers are continuously monitored to maintain quality of supports. All SCL providers have agreed to provide services according to the best practice accepted by their professional organization and to provide services in compliance with federal and state statutes regardless of age, color, creed, disability, ethnicity, gender, marital status, national origin, race, religion or sexual orientation.
How to Obtain Services
The first step is to complete an application in benefind (see the "benefind" link in Related Links) after creating an account OR ask a provider to help you with the application (see the "Provider Directory" link in Related Links). There is a waiting list for services and supports. An application will allow your name to be included on the list if you meet the criteria to receive SCL services.
Additional individuals are served based on urgency of need and chronological order, as funding becomes available. After you are selected for funding, you must then be determined to meet the level of care provided by an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) and to be eligible for the correct type of Medicaid.