PERSONAL CARE SERVICES PROVIDER IN KENTUCKY

Fatumata Kaba
Jul 25
3 min read

SUPPORTING INDEPENDENT LIVING THROUGH HANDS-ON ASSISTANCE WITH DAILY PERSONAL NEEDS

Personal Care Services in Kentucky are designed to help individuals with physical, cognitive, or developmental disabilities remain safely in their homes by assisting with essential daily living tasks. Authorized under Kentucky Medicaid’s Home and Community-Based Services (HCBS) waivers, personal care supports functional independence, reduces caregiver burden, and prevents premature institutionalization.

1. GOVERNING AGENCIES

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

Role: Oversees Medicaid program administration, provider enrollment, and service reimbursement for personal care

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

Role: Sets care standards and waiver-specific service criteria for elderly and disabled populations

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Ensures federal compliance and quality assurance across all Medicaid-funded home-based care services

Agency: Managed Care Organizations (MCOs) in Kentucky Medicaid

Role: Review service authorizations, credential providers, and manage billing, claims, and care coordination

2. SERVICE OVERVIEW

Personal Care Services offer hands-on, non-medical assistance with daily personal needs that individuals cannot perform independently.

Authorized providers may deliver:

Assistance with Activities of Daily Living (ADLs), including bathing, grooming, toileting, dressing, and eating
Support with ambulation and transferring (e.g., bed to chair)
Medication reminders (non-administration unless allowed by waiver or nurse delegation)
Mobility and range-of-motion assistance
Skin care and basic health monitoring (e.g., reporting changes to nurses or family)
Personal hygiene, oral care, and incontinence support
Light housekeeping directly related to care (e.g., cleaning after bathing)

All services must be documented in the participant’s Person-Centered Service Plan (PCSP) and align with waiver-specific eligibility and needs assessments.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Kentucky Secretary of State
Obtain IRS EIN and NPI (Type 2)
Enroll through the Kentucky Medicaid Partner Portal Application (MPPA)
Maintain liability and workers’ compensation insurance
Develop a Personal Care Services Policy & Procedure Manual
Hire staff who meet state qualifications (CNA preferred or required based on waiver)
Establish HIPAA-compliant service documentation systems and incident reporting protocols

4. KENTUCKY PROVIDER ENROLLMENT PROCESS

Step 1: Medicaid Enrollment

Apply through MPPA as a Personal Care or Attendant Care provider (waiver-specific service type)
Complete credentialing with Kentucky Medicaid MCOs

Step 2: Documentation Submission

Submit proof of business registration, insurance, policy manual, and staff qualifications

Step 3: Service Authorization & Delivery

Coordinate with case managers and waiver teams to align services with PCSP goals
Receive service authorization and begin personal care delivery
Document services and submit claims using appropriate HCPCS codes

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Kentucky business license
IRS EIN and NPI confirmation
General liability and workers’ compensation insurance
Personal Care Policy & Procedure Manual, including:
- Care documentation templates (ADL logs, progress notes)
- Participant consent, intake, and risk assessment forms
- HIPAA privacy, safety, and incident response policies
- Staff training documentation and supervision logs
- Medication reminder protocols (if applicable)
- Emergency procedures and infection control plans
- Medicaid billing templates and audit-ready records

6. STAFFING REQUIREMENTS

Role: Personal Care Aide / Direct Support Worker

Requirements: CNA preferred or required by waiver; cleared background check; experience in caregiving or disability support

All staff must complete:

Orientation on Kentucky Medicaid waiver programs and participant rights
HIPAA and confidentiality training
ADL assistance techniques and mobility safety
Infection control, emergency response, and abuse prevention training
Annual continuing education and skill validations

7. MEDICAID PROGRAMS & HCBS WAIVERS

Personal Care Services are authorized under the following waivers:

Home and Community-Based (HCB) Waiver
Michelle P. Waiver (MPW)
Supports for Community Living (SCL) Waiver
Acquired Brain Injury (ABI and ABI-LTC) Waivers
Model II Waiver (MIIW) (case-specific)

Services may be delivered:

In the participant’s home
At supported living facilities
In community-based residential settings (when applicable)

8. TIMELINE TO LAUNCH

Phase: Business Formation and Policy Development

Timeline: 1–2 months

Phase: Medicaid Enrollment and MCO Credentialing

Timeline: 60–90 days

Phase: Staff Hiring and Compliance Preparation

Timeline: 1–2 months

Phase: Participant Referrals and Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Kentucky Department for Medicaid Services (DMS)

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

Kentucky Cabinet for Health and Family Services (CHFS)

Website: https://chfs.ky.gov

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

Kentucky Department for Aging and Independent Living (DAIL)

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

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

WCG supports caregivers, home health operators, and support service providers in launching Medicaid-compliant Personal Care programs that promote in-home independence across Kentucky.

Scope of Work: