ADULT FOSTER CARE SERVICES PROVIDER IN KENTUCKY

Fatumata Kaba
Jul 25
4 min read

PROVIDING FAMILY-LIKE LIVING ARRANGEMENTS WITH PERSONALIZED SUPPORT IN A COMMUNITY SETTING

Adult Foster Care Services in Kentucky offer home-based living arrangements for adults who require 24-hour supervision, support with daily activities, and a safe, stable environment. These services are delivered in licensed private homes operated by trained providers and are a part of Kentucky Medicaid’s Home and Community-Based Services (HCBS) waiver programs. The goal of adult foster care is to promote independence, dignity, and community integration while avoiding institutional placement.

1. GOVERNING AGENCIES

Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)

Role: Administers Medicaid reimbursement, provider enrollment, and waiver policy compliance

Agency: Kentucky Department for Aging and Independent Living (DAIL)

Role: Licenses adult foster care homes, sets standards for home operations, and monitors care quality

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure participant rights and person-centered living environments

Agency: Managed Care Organizations (MCOs)

Role: Authorize adult foster care as part of the participant’s care plan, manage provider credentialing, and service billing

2. SERVICE OVERVIEW

Adult Foster Care (AFC) involves placing Medicaid-eligible adults in certified private homes where the provider offers personal support, supervision, and daily care in a non-institutional setting.

Services include:

Room and board
Assistance with Activities of Daily Living (ADLs): bathing, grooming, dressing, toileting, eating, mobility
Medication reminders or administration (if permitted by waiver rules and the provider’s training)
Meal preparation and nutritional oversight
Housekeeping and laundry
Socialization and support with community participation
Health monitoring and emergency response

All services must be based on a participant’s Person-Centered Service Plan (PCSP) and conducted in accordance with waiver-specific rules.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business or residence with the Kentucky Secretary of State (as applicable)
Obtain an IRS EIN and a Type 2 NPI if operating as an agency
Apply for Adult Foster Care Home certification through DAIL
Enroll through the Medicaid Partner Portal Application (MPPA)
Complete home inspection for safety, accessibility, and cleanliness
Maintain liability and homeowner’s or renter’s insurance
Submit background checks for all household members over age 18
Develop a Provider Policy & Procedure Manual for AFC services
Ensure HIPAA compliance and emergency planning

4. KENTUCKY PROVIDER ENROLLMENT PROCESS

Step 1: AFC Home Certification

Apply through DAIL for approval to operate a certified adult foster care home
Complete training, safety inspections, and environmental assessments

Step 2: Medicaid Enrollment

Register as an AFC service provider through MPPA
Complete MCO credentialing based on waiver requirements

Step 3: Participant Placement & Authorization

Collaborate with case managers to identify eligible individuals
Receive MCO authorization for placement
Initiate care, submit documentation, and bill Medicaid for approved services

5. REQUIRED DOCUMENTATION

AFC Home Certification approval letter
IRS EIN and NPI (if applicable)
Home inspection records and insurance documentation
Adult Foster Care Provider Policy & Procedure Manual, including:
- Intake and admission forms
- Participant service plan logs and daily care notes
- Staff (if applicable) background checks and training logs
- Emergency plans and contact protocols
- Medication tracking and health monitoring forms
- Participant rights, grievance procedures, and visitor policies
- Incident reporting and monthly progress summaries
- Medicaid billing templates and audit documentation tools

6. STAFFING REQUIREMENTS

Role: Adult Foster Care Provider (Live-in or On-site Caregiver)

Requirements: Age 21 or older; background check; CPR/First Aid certified; completion of AFC provider training

Role (optional): Relief Staff or Overnight Support

Requirements: Cleared background check; trained in ADL support and home emergency procedures

All staff and household members must complete:

Abuse, neglect, and exploitation prevention training
HIPAA and confidentiality training
Fire safety and infection control procedures
Ongoing annual training on person-centered service delivery

7. MEDICAID PROGRAMS & HCBS WAIVERS

Adult Foster Care Services are reimbursable under the following waivers:

Supports for Community Living (SCL) Waiver
Michelle P. Waiver (MPW)
Acquired Brain Injury (ABI and ABI-LTC) Waivers

Service settings must be:

Certified private residences with no more than a set number of participants (typically 1–3)
Approved by DAIL and meets all fire, safety, and program criteria
Non-institutional and support participant choice, dignity, and autonomy

8. TIMELINE TO LAUNCH

Phase: Home Preparation and Certification

Timeline: 2–3 months

Phase: Medicaid Enrollment and MCO Credentialing

Timeline: 1–2 months

Phase: Staff (if applicable) and Compliance Setup

Timeline: 1 month

Phase: Participant Matching and Service Launch

Timeline: Rolling, based on referrals and care plan authorization

9. CONTACT INFORMATION

Kentucky Department for Medicaid Services (DMS)

Website: https://chfs.ky.gov/agencies/dms

Medicaid Partner Portal Application (MPPA): https://mppa.ky.gov

Kentucky Department for Aging and Independent Living (DAIL)

Website: https://chfs.ky.gov/agencies/dail

Kentucky Cabinet for Health and Family Services (CHFS)

Website: https://chfs.ky.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY ADULT FOSTER CARE PROVIDER

WCG supports individuals, families, and organizations interested in launching certified Adult Foster Care programs to support Medicaid waiver participants in a home-based setting.

Scope of Work:

Home certification prep and DAIL licensing assistance
MPPA enrollment and MCO credentialing
Provider Policy & Procedure Manual tailored for AFC
Participant intake forms, emergency plans, and daily documentation logs
Background check coordination and household safety reviews
Medicaid billing templates and compliance preparation
Branding, intake packets, and outreach tools for case managers and referral agencies