COMMUNITY TRANSITION SERVICES PROVIDER IN KENTUCKY

Fatumata Kaba
Jul 25
4 min read

FACILITATING SAFE, SUPPORTED MOVES FROM INSTITUTIONAL SETTINGS INTO COMMUNITY LIVING

Community Transition Services in Kentucky help Medicaid waiver participants transition from institutional or long-term care facilities into their own homes or community-based residential settings. These services provide essential support to ensure a smooth, stable move and to help individuals set up their new living environments safely. Covered under specific Home and Community-Based Services (HCBS) waivers, these services reduce institutional dependency and promote person-centered independence.

1. GOVERNING AGENCIES

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

Role: Oversees eligibility, provider enrollment, and Medicaid reimbursement for transition services

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

Role: Coordinates community-based living initiatives and oversees compliance for transition providers

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Ensures Community Transition Services align with federal HCBS waiver guidelines and support community integration

Agency: Managed Care Organizations (MCOs)

Role: Authorize transition plans, manage participant referrals, and reimburse approved services

2. SERVICE OVERVIEW

Community Transition Services are one-time, non-recurring expenses provided to help a participant establish a new home in the community after leaving a nursing facility, intermediate care facility (ICF/IID), or similar institutional setting.

Covered expenses may include:

Security and utility deposits
Furniture and essential household items (e.g., bed, table, chairs, cookware)
Basic appliances (e.g., microwave, refrigerator—if not included in lease)
Initial groceries and personal hygiene products
Health and safety items (e.g., fire extinguisher, first aid kit)
Moving costs and delivery fees
Basic home modifications (e.g., grab bars, shower chairs)
Transition coordination and support services

All purchases must be reasonable, necessary, and not otherwise available through other funding sources. Services must align with the participant’s Person-Centered Service Plan (PCSP) and be approved in advance by the MCO.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll as a Community Transition provider via the Medicaid Partner Portal Application (MPPA)
Maintain liability and general business insurance
Submit a Community Transition Services Policy & Procedure Manual
Establish vendor agreements with furniture and home goods suppliers
Implement HIPAA-compliant documentation and expense tracking systems

4. KENTUCKY PROVIDER ENROLLMENT PROCESS

Step 1: Medicaid Enrollment via MPPA

Apply as a provider of Community Transition or Move-In Services under appropriate HCBS waiver(s)
Complete MCO credentialing for regional provider access

Step 2: Documentation Submission

Submit business license, insurance, staff roles, and transition planning procedures

Step 3: Service Authorization & Purchase Coordination

Work with the participant’s case manager to develop a Transition Support Plan
Submit an itemized budget to MCO for approval
Purchase and deliver approved items, ensuring receipts and proof of delivery
Submit documentation and claims for reimbursement

5. REQUIRED DOCUMENTATION

Kentucky Articles of Incorporation or business license
IRS EIN and NPI confirmation
Proof of liability insurance
Community Transition Services Policy & Procedure Manual, including:
- Intake forms and referral acceptance process
- Transition budget planning templates
- Vendor purchase logs and delivery tracking
- Participant consent and household inventory forms
- Incident response and safety verification checklist
- HIPAA compliance forms
- Medicaid billing templates and reimbursement request records

6. STAFFING REQUIREMENTS

Role: Transition Coordinator / Move-In Support Specialist

Requirements: Experience in case management, housing navigation, or human services; valid driver’s license; cleared background check

Role (optional): Logistics or Delivery Assistant

Requirements: Must follow item tracking procedures and ensure proper documentation of purchases and deliveries

All staff must complete:

HIPAA and participant confidentiality training
Housing safety and community integration training
Abuse, neglect, and exploitation prevention education
Emergency preparedness and cultural sensitivity protocols

7. MEDICAID PROGRAMS & HCBS WAIVERS

Community Transition Services are available under:

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

Eligible settings include:

Private homes or apartments (leased or owned by the participant)
Supported living residences (if participant holds tenancy rights)
Not permitted: group homes, institutions, or settings where rent and utilities are fully subsidized by another payer

8. TIMELINE TO LAUNCH

Phase: Business Formation and Vendor Sourcing

Timeline: 1–2 months

Phase: MPPA Enrollment and MCO Credentialing

Timeline: 60–90 days

Phase: Policy Manual Completion and Staff Training

Timeline: 30–45 days

Phase: Participant Referrals and Service Coordination

Timeline: Ongoing, based on waiver transitions and MCO authorizations

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: h ttps://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 COMMUNITY TRANSITION PROVIDER

WCG supports housing service agencies, support coordinators, and Medicaid vendors in launching high-impact, compliant Community Transition Services across Kentucky.

Scope of Work: