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It does this through "Medicaid Waivers," which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services.
This Kentucky Medicaid waiver provides care and support services to the elderly in their homes, allowing them to avoid institutionalization in a nursing home should they choose to do so.
Free assistance is available to residents to find affordable local care. The Home and Community Based Waiver for the Aged considers the applicant's residence, age, functional ability, income, and assets.
Residence – an applicant must be a resident of the state of Kentucky.
Married applicants are permitted higher income levels, if only one spouse is applying for the program. However, an exception to this income limits exists for persons with unusually high care expenses.
Functional Ability - participants must require nursing home level care and be willing and able to receive that care in their home or community.
Income - In 2017, an unmarried applicant is allowed income up to 300% of the federal benefit rate.
Certain family members and friends can be hired as paid caregivers.
One might hear "consumer direction" referred to as "Cash and Counseling," as that was the original grant name that tested the concept of consumer control (or direction) over their caregivers.