• Participant-Directed Services (PDS)

    What Is Participant-Directed Services (PDS)

    Participant-Directed Services (PDS) allows people eligible for Medicaid waiver services to choose their own providers for nonmedical waiver services. Provider choice gives members greater flexibility in the delivery of services received.

    Kentucky Medicaid members may participate in PDS if they currently receive or are eligible for services through the Home and Community Based Waiver (HCB)Supports for Community Living Waiver (SCL), the Acquired Brain Injury Acute Waiver (ABI-A), the Long-Term Care Brain Injury Waiver (ABI LTC) or the Michelle P Waiver (MP).

    See below for more information on each waiver.

    Home and Community Based Waiver (HCB)

    The Home and Community Based Waiver (HCB) is designed to target assistance with those who have aging and/or physical disabilities.

    • KAR 1:160 Home and Community-Based Waiver Services
    • KAR 1:170 Reimbursement for Home- and Community-Based Waiver Services
    • KAR 7:010 Home and Community-Based Waiver Services Version 2
    • KAR 7:015 Reimbursement for Home- and Community-Based Waiver Services Version 2

    Supports for Community Living Waiver (SCL)

    The Supports for Community Living Waiver (SCL) is designed to target assistance for individuals with intellectual or developmental disabilities. There is a waiting list for allocation of this waiver to an individual; placement within this waiting list is determined by the Department for Behavioral Health, Developmental, and Intellectual Disabilities. This waiver may provide residential accommodations.

    • KAR 12:010  New Supports for Community Living Waiver Service and Coverage Policies
    • KAR 12:020 Reimbursement for New Supports for Community Living Waiver Services

    Acquired Brain Injury Acute Waiver (ABI-A) and Long-Term Care Brain Injury Waiver (ABI-LTC)

    The Acquired Brain Injury Acute Waiver (ABI-A) and Long-Term Care Brain Injury Waiver (ABI-LTC) is designed to target assistance for individuals with an acquired brain injury. There is a waiting list for allocation of this waiver to an individual; placement within this waiting list is determined by the Department for Medicaid Services. This waiver may provide residential accommodations.

    • KAR 3:090 Acquired Brain Injury Waiver Services
    • KAR 3:100 Reimbursement for Acquired Brain Injury Waiver Services
    • KAR 3:210 Acquired Brain Injury Long-Term Care Waiver Services and Reimbursement

    Michelle P Waiver (MPW)

    The Michelle P Waiver is designed to target assistance for individuals with intellectual or developmental disabilities. There is a waiting list for this waiver.

    • KAR 1:835 Michelle P. Waiver Services and Reimbursement

    How to Enroll

    Current Participants receiving services within HCB, SCL, ABI/LTC or MP waiver may consult with their Case Manager to discuss enrollment in PDS.

    Those not currently served under an eligible waiver, but who may qualify, can get help from home health agencies, adult day health centers, supports for community living providers or acquired brain injury providers. Regional Area Agencies on Aging and Independent Living can provide help to eligible recipients interested in enrolling with PDS.  A representative from any of these agencies may assist you with an application for a waiver through the Kentucky Benefind website.

    Once enrolled in the PDS program, a participant’s case manager is replaced by a support broker/service advisor who helps arrange for needed services. This agency representative can also help develop plans of care and budgets, direct participants to training and help with hiring service providers.

    PDS Participant Responsibilities

    • Work with assigned support brokers/service advisors to develop individual plans of care that include support spending and emergency backup plans.
    • Hire, train, schedule and terminate staff as necessary.
    • Follow the plan of care and support spending plan and stay within budget limits.
    • Meet any patient liability obligations as determined by the Department for Community Based Services.
    • Choose a representative, if needed or desired.
    • Submit paperwork correctly and on time.
    • Follow PDS rules and guidelines.

    Choosing Between PDS or Traditional Services

    If a PDS participant discovers this option does not meet expectations and personal preferences in care and service delivery, he or she may return to traditional services without loss of eligibility. The Department for Medicaid Service may also terminate a PDS participant should the member not continue to meet regulatory criteria. The support broker will help you understand your options.

    Information was taken from the Department for Aging and Independent Living website.


     
     
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