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Home care programs · Kentucky

Kentucky home care programs

Kentucky pays for care at home through 9 programs. Consumer-directed care is available through Participant Directed Services (PDS). Family members can be paid caregivers in 3 of them.

Verified Oct 9, 2026Sources: official state and federal agencies

Every state
Programs
9
Consumer-directed
Yes
Family can be paid
Yes
Structured family caregiving
No
On this page
Programs

Every way Kentucky pays for care at home

Kentucky pays for care at home through 9 programs. Consumer-directed care is available through Participant Directed Services (PDS). Family members can be paid caregivers in 3 of them.

ProgramTypeCan family be paidHow it differs
Home health services (Kentucky Medicaid) (HHA)State Plan home health (42 CFR 440.70)Home healthNoSkilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.
Participant Directed Services (PDS)Self-direction option within Kentucky 1915(c) waivers (HCB, Michelle P., SCL, ABI, ABI-LTC)Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
ABI, ABI Long Term Care, and Model II waivers (ABI-LTC)1915(c) waivers KY.0333, KY.0477, KY.40146Waiver in-homeNoWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Home and Community Based Waiver1915(c) waiver KY.0144Waiver in-homeNoWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Michelle P. Waiver (MPW)1915(c) waiver KY.0475Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Supports for Community Living Waiver (SCL)1915(c) waiver KY.0314Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Programs of All-Inclusive Care for the Elderly (PACE)State Plan PACE (42 CFR Part 460)PACENoPACE: one organization covers medical care, a day center and home care for people 55 and over; run as the PACE benefit, delivered through managed-care plans.
Homecare Programstate-fundedState-fundedNot statedState-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.
Personal Care Attendant Program (PCAP)state-fundedState-fundedNot statedState-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.
Guide

Home health vs home care vs consumer-directed care in Kentucky

What each kind of program is, who employs the caregiver and when a family member can be paid.

Home health: the medical benefit

In Kentucky, skilled home health is Home health services (Kentucky Medicaid) (HHA). It is a medical benefit: a doctor or other practitioner orders nursing, therapy or home health aide visits under a written plan of care, and the visits stop when the skilled need ends.

Only a licensed home health agency enrolled with Kentucky Medicaid can bill it, and the agency's own nurses, therapists and aides make the visits. Family members are not paid under this benefit.

Home care: non-medical personal care through an agency

Help with bathing, dressing, eating and household tasks is "home care" or personal care. In Kentucky it is paid through the programs below rather than a separate agency personal care benefit.

Consumer-directed care: the person hires their own aide

Kentucky's consumer-directed option is Participant Directed Services (PDS). The person receiving care, or a representative, recruits, hires, trains, schedules and supervises the aide, and can let go of one. A fiscal intermediary runs payroll, taxes and background checks, so the person never handles wages directly.

This is the route most families use to be paid: Participant Directed Services (PDS) allows a relative to be hired as the paid aide. Which relatives qualify (adult children, parents of adults, spouses, legal guardians) and how a live-in caregiver is treated are set program by program.

Structured family caregiving: a paid live-in family caregiver

Kentucky has no structured family caregiving program. A family caregiver is paid instead through consumer-directed care (Participant Directed Services (PDS)), by the hour, as the participant's chosen aide.

Other ways Kentucky pays for care at home

Waiver in-home services: ABI, ABI Long Term Care, and Model II waivers (ABI-LTC), Home and Community Based Waiver, Michelle P. Waiver (MPW), and Supports for Community Living Waiver (SCL). These pay for in-home supports for people who meet a nursing-home or similar level of care, often with more services than state plan personal care and, in some programs, a waiting list or enrollment cap.

PACE: Programs of All-Inclusive Care for the Elderly (PACE). One PACE organization covers medical care, a day center and home care for people 55 and over who need nursing-home level care.

State-funded: Homecare Program and Personal Care Attendant Program (PCAP). Paid from state funds outside Medicaid, for people who do not qualify for Medicaid or are waiting for it.

Which one fits

  • Needs nursing, wound care, injections or therapy at home: home health (Home health services (Kentucky Medicaid) (HHA)).
  • Wants to choose the aide, including a relative where allowed: Participant Directed Services (PDS).
  • Meets nursing-home level of care and needs more than personal care: ABI, ABI Long Term Care, and Model II waivers (ABI-LTC), Home and Community Based Waiver, Michelle P. Waiver (MPW), and Supports for Community Living Waiver (SCL).
In the workspace

Kentucky program rules, side by side

Eligibility, the family caregiver rules (spouses, parents, live-in caregivers), employer of record, fiscal intermediary, caregiver training, provider requirements, how to enroll, published pay, EVV and waiting lists: 90 details across 9 programs.

ProgramFamily rulesEmployerEligibilityPay
See Kentucky's program rules — start free

Who can be paid, who employs the caregiver, what each program requires of agencies and caregivers, how to become a provider and what it pays, for all 9 programs.

  • Family caregiver rules
  • Provider requirements
  • CSV export
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Program by program

Kentucky's programs

What each program is and how it differs from the others. Locked details open in the workspace.

Home health services (Kentucky Medicaid) (HHA)

Home health

State Plan home health (42 CFR 440.70) · Kentucky Department for Medicaid Services (DMS)

Skilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.

Can family be paid?No
How to get set up
Provider track · 7 steps
  1. Form the business
  2. 6 more steps: forms, fees, timelines and links
Family / participant track · 4 steps
  1. Medicaid coverage
  2. 3 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredFamily caregiver rulesEmployer of recordProvider requirementsHow to become a providerEVVWaiting list or capManaged-care plansHow it differs, in detailSetup checklistUnlock the details →

Participant Directed Services (PDS)

Consumer-directed

Self-direction option within Kentucky 1915(c) waivers (HCB, Michelle P., SCL, ABI, ABI-LTC) · Kentucky DMS with DAIL; PDS coordination through support brokers

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 3 steps
  1. Financial management service
  2. 2 more steps: forms, fees, timelines and links
Family / participant track · 6 steps
  1. Be in a waiver with PDS
  2. 5 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

ABI, ABI Long Term Care, and Model II waivers (ABI-LTC)

Waiver in-home

1915(c) waivers KY.0333, KY.0477, KY.40146 · Kentucky DMS

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?No
How to get set up
Provider track · 4 steps
  1. Form the business
  2. 3 more steps: forms, fees, timelines and links
Family / participant track · 4 steps
  1. Apply for waiver-supportive Medicaid
  2. 3 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredFamily caregiver rulesEmployer of recordProvider requirementsWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Home and Community Based Waiver

Waiver in-home

1915(c) waiver KY.0144 · Kentucky DMS (with DAIL)

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?No
How to get set up
Provider track · 6 steps
  1. Form the business
  2. 5 more steps: forms, fees, timelines and links
Family / participant track · 7 steps
  1. Apply for waiver-supportive Medicaid
  2. 6 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capRecent changesHow it differs, in detailSetup checklistUnlock the details →

Michelle P. Waiver (MPW)

Waiver in-home

1915(c) waiver KY.0475 · Kentucky DMS (with DBHDID)

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 5 steps
  1. Form the business
  2. 4 more steps: forms, fees, timelines and links
Family / participant track · 5 steps
  1. Apply for waiver-supportive Medicaid
  2. 4 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredFamily caregiver rulesEmployer of recordProvider requirementsEVVWaiting list or capRecent changesHow it differs, in detailSetup checklistUnlock the details →

Supports for Community Living Waiver (SCL)

Waiver in-home

1915(c) waiver KY.0314 · Kentucky DMS with DBHDID

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 5 steps
  1. Form the business
  2. 4 more steps: forms, fees, timelines and links
Family / participant track · 4 steps
  1. Apply for waiver-supportive Medicaid
  2. 3 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredFamily caregiver rulesEmployer of recordProvider requirementsEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Programs of All-Inclusive Care for the Elderly (PACE)

PACE

State Plan PACE (42 CFR Part 460) · Kentucky DMS

PACE: one organization covers medical care, a day center and home care for people 55 and over; run as the PACE benefit, delivered through managed-care plans.

Can family be paid?No
How to get set up
Provider track · 6 steps
  1. Form the PACE organization
  2. 5 more steps: forms, fees, timelines and links
Family / participant track · 7 steps
  1. Check the service area
  2. 6 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredFamily caregiver rulesEmployer of recordProvider requirementsHow to become a providerWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Homecare Program

State-funded

state-funded · Kentucky Department for Aging and Independent Living (DAIL) through Area Agencies on Aging and Independent Living

State-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 3 steps
  1. Form the business
  2. 2 more steps: forms, fees, timelines and links
Family / participant track · 3 steps
  1. Contact the ADRC/AAAIL
  2. 2 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredEmployer of recordProvider requirementsHow to become a providerWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Personal Care Attendant Program (PCAP)

State-funded

state-funded · Kentucky DAIL through regional PCAP providers

State-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 1 step
  1. DAIL-contracted regional program
Family / participant track · 4 steps
  1. Apply to the regional PCAP
  2. 3 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetEmployer of recordCaregiver requirementsProvider requirementsWaiting list or capHow it differs, in detailSetup checklistUnlock the details →
FAQ

Frequently asked questions

Can family members get paid to be caregivers in Kentucky?

Yes. Participant Directed Services (PDS), Michelle P. Waiver (MPW), and Supports for Community Living Waiver (SCL) let a family member be the paid caregiver. Which relatives qualify, including spouses and parents of minor children, is set program by program.

Does Kentucky have consumer-directed care?

Yes: Participant Directed Services (PDS). The person receiving care hires and directs their own aide, and a fiscal intermediary handles payroll.

Does Kentucky have structured family caregiving?

No. Kentucky does not run a structured family caregiving program. Family caregivers are paid through consumer-directed care instead.

What is the difference between home health and home care in Kentucky?

Home health (Home health services (Kentucky Medicaid) (HHA)) is medical: nursing, therapy and aide visits ordered by a practitioner and delivered by a licensed home health agency. Home care is non-medical help with daily activities, based on functional need.

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