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Home & Community-Based Services: State-Only Funded Programs in Kentucky

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Supported Living Program (1992)¹⁷

Administrative Agency: Mental Health/Mental Retardation Boards.

Population Served: Adults with ADA defined disabilities.

Annual Expenditure: N/A

Funding Source: N/A

Number of People Served: 549 FY01

Eligibility Criteria: Individuals determine own needs, manage their own plans & hire providers.

Further Information: Other information Clients apply direct to regional Mental Health/Mental Retardation Regional Board for program.

Program Name: Homecare Program⁴,¹⁷

Administrative Agency: Cabinet for Health Services, Division of Aging Services

Population Served: Elderly 60+

Annual Expenditure: $15,301,500 FY02 Appropriation

Funding Source: General Revenue

Number of People Served: 11,700 FY03

Eligibility Criteria: Individuals who do not meet the financial &/or functional eligibility requirements of Medicaid &/or individuals waiting placement on the Medicaid HCBS program or placement in a nursing home or individuals receiving Medicaid HCBS. Income limit FY02 $1,388/mth (based on FPL). No asset limit.

Further Information: Cost control: No cost caps. Service limits applied: $500/year repairs. Co-pay - 80% of cost of service. Quality control: case manager contacts monthly.

Program Name: Personal Care Attendant Program¹⁷

Administrative Agency: Cabinet for Health Services, Division of Aging Services

Population Served: Adults with severe physical disability

Annual Expenditure: N/A

Funding Source: General Revenue

Number of People Served: N/A

Eligibility Criteria: Individuals at risk of nursing home placement. Need at least 14hrs/wk -40hrs/wk care.

Further Information: Financial subsidy to clients to hire & supervise personal care attendants. Consumer direction Can be consumer directed.

Program Name: Adult Day Care & Alzheimer's Respite Program³,⁴,¹⁷

Administrative Agency: Dept of Medicaid Services

Population Served: Adults with Alzheimer's Disease or dementia.

Annual Expenditure: $2,773,800 FY02 Appropriation

Funding Source: General revenue, clients contribute

Number of People Served: 3,250 (FY02)

Eligibility Criteria: 2 ADLs, 3+ ADLs, diagnosis of dementia or related disorder. No income or asset limit.

Further Information: Cost control Co-pay on a sliding scale Other information Supportive & Therapeutic program providing supervision & care to beneficiaries for part of a 24 hour period.

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

Mth - month.

Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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