Federal, exists in every state
Medicaid home-care programs (waivers)
Approved services at home, such as nursing or personal care, depending on the program and the child’s assessed needs.
What it is
Approved services at home, such as nursing or personal care, depending on the program and the child’s assessed needs.
A waiver can cover approved home services when its clinical and financial tests are met. The waiver team checks your child’s needs and whether a place is available. Nursing through existing Medicaid coverage is a separate route.
Kentucky waiver tests
- The named routes include Home and Community Based, Model II, Michelle P., Supports for Community Living and CHILD (Community Health for Improved Lives and Development). Each program must confirm its current age, diagnosis and institutional-care criteria for your child.
- A diagnosis alone does not establish the complete entry test. The waiver team must confirm the child’s financial rules, whether parental income is left out, when that treatment begins and whether a funded place is available.
- Volume IVA MS 2850 provides special financial treatment after qualifying waiver admission. Joining a waiting list does not itself establish that parents’ income is disregarded. Existing Medicaid coverage can support medically necessary home services without waiting for a waiver place.
What you get
- Approved home services for children who meet a program’s criteria.
Existing Medicaid coverage
- A waiver waiting list does not replace a request for medically necessary nursing under your child’s existing Medicaid coverage.
If you decide to apply
- Ask whether the discharge or home-care team should assess the actual tasks, their frequency and the skilled-care needs; your answers here cannot settle the care level.
Discharge planner or care manager
Waiting lists
- The HCB and Michelle P. programs describe waiting lists ordered by application date. Approved yearly capacity does not show how many places are open.
Good to know
A note of the tasks you do at home and how long they take helps any assessment; it is not a requirement.
Application doors
- HCB inquiries: 877-315-0589. Model II and under-21 inquiries: 844-784-5614. Michelle P. and community living inquiries: 502-564-7700.
Related Kentucky cards: Medicaid without counting parents’ income · Nursing and other care at home.
Official sources
- CHFS — Home and Community Based Waiver
- CHFS — Model II Waiver
- CHFS — Who to Call: Help with 1915(c) waiver programmes
- CHFS — Private Duty Nursing
- Waiver ages, parental income and leukemia without another diagnosis
- Waiver ages, parental income and leukemia without another diagnosis
- Waiver ages, parental income and leukemia without another diagnosis
- Waiver ages, parental income and leukemia without another diagnosis
“Could the care team assess which home services our child needs, explain the benefits and drawbacks of a waiver, and help us request it if appropriate?”
Why I’m asking: We want to be ready if home care needs change.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Register the child on the list, keep the task log, and answer the assessment call when it comes.
Your social worker
Names the waiver that takes medically fragile children in this state and helps with the registration form.
The care team
Documents the nursing-level tasks and the risk if care stops.
- Who decides
- The state waiver agency after a level-of-care assessment
- Ask your social worker
- “Which home-care program fits my child, and can we register today? Can Medicaid start home-nursing hours while we wait?”
How to apply
First step: Ask the discharge team which state home-care service or waiver fits your child's assessed needs, and how to apply.
- Register on the list this week.
- Ask the Medicaid plan for EPSDT nursing hours while you wait.
- Keep a two-week task log for the assessment.
Where it starts: State application or interest list. Assessment when a slot opens
What to gather
- A two-week log of daily tasks: what, how often, how long
- Doctor's letter naming nursing, equipment or safety needs
- Medicaid ID if the child has one
How long: Application steps, assessment timing and waiting-list availability depend on the specific state program. Ask for its current process.
What a yes looks like
A service plan with approved hours and a case manager's name.
What a no looks like, and the next move
“Does not meet level of care” or “no slot”: ask for Medicaid's rule that a child under 21 gets what is medically needed nursing through the Medicaid plan instead, and stay on the list.
Watch out
- If a suitable waiver has a waiting list, ask how and when to register and how priority is determined.
- For a child already on Medicaid, Medicaid's rule that a child under 21 gets what is medically needed home nursing can start long before a waiver slot opens. Ask for both.
- The assessment considers the child's actual care needs under the specific program's rules. No diagnosis or item of equipment guarantees approval.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 7, 2026.
What it is worth
Nursing hours, respite, personal care, equipment, home changes and a case manager. The value is the approved hours.
Covers: Case management · Respite · Personal care · Nursing (some waivers) · Adaptive equipment · Home and vehicle modifications · Caregiver training
What it costs the family: Medicaid-delivered. Patient liability depends on the state.
The eligibility facts, as published
- State specific
- yes
- Institutional level of care
- yes
- Target population
- medically fragile or technology-dependent children in most states
Decisions this site cannot make: Level of care · Service-plan necessity · Financial eligibility (child-only in institutional-deeming waivers)
Expect friction on: Interest lists · Provider shortages · Reassessment
The trap: Ask which waiver, if any, serves your child's needs and whether it has a waiting list. Request covered Medicaid services separately while any waiver application is reviewed.
What changes by state: Which waiver takes medically fragile children, the list length (Texas runs years), and whether parents' income is ignored.
Where I read this
- Home and Community-Based Services 1915(c) — Centers for Medicare & Medicaid Services, read August 27, 2026
- Full List of Medicaid Waivers and Programs — Kids’ Waivers, read August 27, 2026
- Early and Periodic Screening, Diagnostic, and Treatment — Centers for Medicare & Medicaid Services, read August 27, 2026