Kentucky · HCB waiver Updated October 7, 2026

Kentucky HCB Waiver Case Management: Requirements and Software Guide

What Kentucky's Home and Community Based waiver regulation asks of case managers, what has to live in MWMA, and where an agency's own case management software fits beside it.

Source and date

This guide summarizes 907 KAR 7:010, Home and community based waiver services version 2, as published by the Kentucky Legislative Research Commission and read on October 7, 2026. The Kentucky Department for Medicaid Services (DMS), the approved waiver and DMS provider letters control current requirements and can change how these rules apply.

Direct answer: Kentucky's HCB waiver requires conflict-free case management, contact with each participant at least monthly, and a person-centered service plan kept in the Medicaid Waiver Management Application (MWMA). HCB waiver case management agencies can use One Care Portal beside MWMA for caseloads, visit schedules, contact notes, follow-up and supervisor review. One Care Portal does not connect to MWMA.

Who the HCB waiver serves

The HCB waiver is one of Kentucky's 1915(c) home and community based services programs. Under Section 4 of the regulation, a person is eligible when they:

are determined by the department to meet nursing facility level of care;
could be admitted to a nursing facility by a physician's order without waiver services;
are screened by the department; and
meet Kentucky Medicaid eligibility requirements.

The application is made through MWMA, with the MAP-115 and MAP-350 forms uploaded there. The department redetermines level of care at least once every twelve months, and sooner if function or condition changes.

Services under the waiver

Section 5 lists the HCB waiver services:

Conflict free case management
Attendant care
Specialized respite care
Environmental or minor home adaptations
Adult day health care (ADHC) services
Goods and services
Home delivered meals

Participant-directed services (PDS) include home and community supports, non-specialized respite care, goods and services, environmental or minor home adaptations, and PDS coordination. Services are prior authorized by the department and provided under the participant's person-centered service plan.

What the regulation asks of a case manager

Section 8 sets the case management requirements. The ones that shape daily work are below.

Requirement	What 907 KAR 7:010 says	Section
Qualifications	A bachelor's degree in a health or human services field plus one year of experience in the field or the equivalent in aging or disabilities; or a registered nurse with two years of experience in aging or disabilities or a master's degree in a health or human services field.	8(1)
Supervision	A case management supervisor with at least four years of experience as a case manager in aging or disabilities, who also meets the case manager qualifications.	8(2)
First meeting	Meet the participant, guardian or legal representative within seven days of receiving a referral from an independent assessor.	8(3)
Contact frequency	Contact at least monthly by telephone or face to face. A face-to-face visit every other month, in an ADHC center or the participant's residence, and at least three times a calendar year in the participant's residence.	8(7)(b)
Conflict free	The case management provider does not also provide another 1915(c) waiver service to the same participant, unless it is the only willing and qualified HCB waiver provider within thirty miles of the participant's residence. An exemption uses the MAP 531 form in MWMA and is requested again at reassessment or at least annually.	8(5)
Arrange, not provide	Arrange for a service but not provide a service directly, and ensure services are provided in line with the person-centered service plan.	8(7)(a), (c)
Lead the team	Lead the person-centered service planning team and coordinate services through team meetings with every agency involved in the plan.	8(4)(f)
Document	Document the participant's interactions and communications with other agencies involved in the plan, and personal observations.	8(4)(h)
Keep MWMA current	Reflect in MWMA when a participant is terminated from the program, admitted to a hospital or skilled nursing facility, transferred to another 1915(c) waiver, or moves to a different address.	8(4)(m)
Explain PDS	Give information about participant-directed services when the first plan is developed, at least annually after that, and when asked.	8(4)(n)

For the contact rule in detail, and what to record at each contact, see the Kentucky HCB waiver contact notes guide.

The person-centered service plan and MWMA

Section 7 requires a person-centered service plan for each participant, developed by the participant or their guardian or legal representative, the case manager or service advisor, the person-centered team, and anyone else the participant chooses. The case manager or service advisor enters the plan into MWMA and updates it there. The participant or their authorized representative completes a MAP-116 and uploads it into MWMA before or when the plan is uploaded. If the plan includes ADHC services, it addresses the ADHC plan of treatment.

Critical incidents

Section 9 sets the reporting clock for whoever witnesses or discovers a critical incident:

Act immediately to protect the participant's health, safety and welfare.
If the incident requires reporting of abuse, neglect or exploitation, report it through MWMA immediately.
Otherwise, report it through MWMA within eight hours of discovery.

The HCB waiver provider investigates immediately, involves the participant's case manager, and records the investigation report in MWMA. The case manager follows up to make sure the participant's health, safety and welfare are not jeopardized.

Records

Under Section 3, an HCB waiver provider maintains a case record, fiscal reports and service records, and critical incident reports for each participant. The regulation says the case record is maintained in MWMA. Its contents include the approved assessment, the person-centered service plan, the signed MAP-350, the names of the case manager and independent assessor, level of care determinations, prior authorization requests and decisions, and documentation of each contact with, or on behalf of, the participant.

Fiscal reports, service records and critical incident reports are kept at least six years from the date a covered service is provided. A longer period applies for minors or when federal rules require it.

Where One Care Portal fits beside MWMA

MWMA is where the regulation puts the waiver's official records. Running an agency's day is separate work: who is assigned to whom, which visits are scheduled, which notes are waiting on a supervisor. That is the work Kentucky HCB waiver case management agencies can use One Care Portal for.

Stays in MWMA

Waiver application, MAP-115 and MAP-350
Level of care determinations
Person-centered service plan entry and updates, MAP-116
The case record the regulation describes
Critical incident and investigation reports
Participant status changes

Your agency's working system

Assigned caseloads, calendars and visit schedules
Contact notes with required fields, signatures and attestation
Follow-up items that carry forward between notes
Authorization records with expiration visibility
Participant and staff documents with expiration dates
Supervisor review: approve a note or return it with feedback
Reports and audit history

Important boundary: One Care Portal does not connect to MWMA and sends nothing to it. Direct KYMMIS claim submission is not assumed. One Care Portal is not certified, endorsed or approved by Kentucky. Because Section 3 places the case record in MWMA, ask Kentucky DMS or check your agency's policy for which documents your agency must enter or upload there. Each agency's forms, permissions, reporting, authorizations and billing route are confirmed before implementation.

Pricing is pay as you go and month to month: a $299/month platform fee plus $7.99 per active participant. Onboarding and implementation scope are reviewed during the demo. See pricing and the Case Management Care Module.

From a Kentucky HCB waiver case manager

“File maintenance is easy. Making our contact notes online is easy and quicker.”

Amy, a case manager for the home- and community-based waiver in Kentucky, in her published customer story. This is Amy's own statement, not a universal performance claim.

Watch Amy's story

See it with a Kentucky HCB caseload in mind

In 30 minutes we walk through caseloads, visit scheduling, contact notes and supervisor review, and we tell you plainly what would need configuration for your agency. Bring your blank forms and note templates.

Do not submit participant names, records, service details, or other PHI through the booking form.

Frequently asked questions

How often must a Kentucky HCB waiver case manager contact a participant?

Under 907 KAR 7:010, Section 8(7)(b), the case manager contacts the participant at least monthly by telephone or face to face. A face-to-face visit is required every other month, in an adult day health care center or the participant's residence, and at least three times a calendar year in the participant's residence. Confirm current requirements with Kentucky DMS.

What is conflict-free case management in the Kentucky HCB waiver?

Under 907 KAR 7:010, Section 8(5), a provider that gives case management to a participant cannot also provide another 1915(c) waiver service to that participant, unless it is the only willing and qualified HCB waiver provider within thirty miles of the participant's residence. An exemption uses the MAP 531 form, uploaded into MWMA, and is requested again at reassessment or at least annually.

Does case management software replace MWMA?

No. Kentucky's Medicaid Waiver Management Application (MWMA) is where the regulation places the case record, the person-centered service plan and critical incident reports. Agency software sits beside it for caseloads, schedules, contact notes, follow-up and supervisor review. One Care Portal does not connect to MWMA.

What software can Kentucky HCB waiver case managers use?

Kentucky HCB waiver case management agencies can use One Care Portal for assigned caseloads, visit schedules, contact notes, authorization records, documents and supervisor review. Pricing is a $299/month platform fee plus $7.99 per active participant, month to month. It is not certified by Kentucky, and each agency's forms, permissions, reporting and billing route are confirmed before implementation.