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TEAMKY Demonstration

Approval Period: January 1, 2025 through December 31, 2029

Page 13 of 155 December 31, 2022, who were in foster care under the responsibility of another state or tribe on the date of attaining 18 years of age (or such higher age as the state has elected), who were enrolled in Medicaid at the time of aging out, are now applying for Medicaid in Kentucky, and are not otherwise eligible for Medicaid.

V. BENEFITS

18. Former Foster Care Youth Benefits. Out-of-state former foster care youth will receive the same Medicaid State Plan benefits and may be subject to the same cost-sharing requirements effectuated by the state for the mandatory title IV-E foster care youth eligibility category enacted by the Adoption Assistance and Child Welfare Act of 1980 (Pub. L. 96-272).

VI. HEALTH-RELATED SOCIAL NEEDS

19. Health Related Social Needs (HRSN) Service. The state may claim FFP for expenditures for certain qualifying HRSN services identified in STC 20 and Attachment K, subject to the restrictions described below. Expenditures are limited to expenditures for items and services not otherwise covered under Title XIX, but consistent with Medicaid demonstration objectives that enable the state to continue to increase the efficiency and quality of care. All HRSN interventions must be evidence-based and medically appropriate for the population of focus based on clinical and social risk factors. The state is required to align clinical and health-related social risk criteria across services and with other relevant, non-Medicaid social support agencies, to the extent possible and appropriate. The HRSN services may not supplant any other available funding sources such as housing or nutrition supports available to the beneficiary through other local, state, or federal programs. The HRSN services will be the choice of the beneficiary; a beneficiary can opt out of HRSN services anytime; and the HRSN services do not absolve the state or its managed care plans, as applicable, of their responsibilities to make payment for other covered services. Under no circumstances will the state be permitted to condition Medicaid coverage, or coverage of any benefit or service, on a beneficiary’s receipt of HRSN services. The state must submit additional details on covered services as outlined in STC 28 (Service Delivery) and Attachment K.

20. Allowable HRSN Service. The state may cover the following HRSN services:

a. Housing interventions, including:

a) Episodic housing interventions with clinical services with room and board, limited to a clinically appropriate amount of time, including:

1) Short-term pre-procedure housing, where a provider has determined that preparatory steps are required for an upcoming procedure or