AN ACT relating to Medicaid coverage for adult day health care and in-home attendant care services.
Summary
HB 561 would require the Kentucky Department for Medicaid Services to include both adult day health care services and in-home attendant, or personal care, services in each 1915(c) Medicaid waiver program that serves adults. The bill sets a minimum coverage floor of at least 40 hours per week for adult day health care and, separately, at least 40 hours per week for in-home attendant care, and it prohibits the department from combining those limits into a single shared cap.
The bill also directs the department to adopt implementing regulations within 90 days of enactment. If federal approval is needed to avoid losing federal funds or to comply with federal law, the Cabinet for Health and Family Services or the Department for Medicaid Services must request that approval within 90 days and may delay only those portions of implementation that require federal authorization. The bill further states that its provisions serve as the specific authorization required under KRS 205.5372(1).
Impact
HB 561 would amend Kentucky Medicaid administration by creating a new statutory requirement for waiver programs serving adults to cover both adult day health care and in-home attendant care at specified minimum levels. It would constrain the Department for Medicaid Services’ discretion to set a single combined limit for these services and would likely increase access to home- and community-based long-term care options for eligible adults, especially older adults seeking to age in place. The bill would also require new administrative regulations and potentially federal waiver or state plan action before full implementation.
Sentiment
The bill’s stated purpose and findings reflect strong support for expanding Medicaid home- and community-based services for elderly Kentuckians. The text emphasizes aging in place, reduced isolation, improved health outcomes, and lower cost compared with institutional care, indicating a favorable policy rationale. No committee transcript or vote record was provided, so there is no recorded opposition or amendment history to gauge broader legislative sentiment beyond the bill’s supportive framing.
Contention
The main policy tension in HB 561 is between expanding Medicaid service access and the administrative or fiscal limits of the program. The bill responds to the Department for Medicaid Services’ use of a single coverage limit that allegedly forces beneficiaries to choose between adult day health care and in-home attendant care, and it removes that flexibility by mandating separate minimum coverage for each service. Another potential point of contention is whether the required coverage levels and implementation timeline are compatible with federal Medicaid rules and funding requirements, which is why the bill includes a federal-approval contingency.
A JOINT RESOLUTION directing the Department for Medicaid Services to provide the Legislative Research Commission with a report regarding pharmacist payment parity.