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TEAMKY Demonstration

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

Page 1 of 155 CENTERS FOR MEDICARE & MEDICAID SERVICES EXPENDITURE AUTHORITY

NUMBERS: 11-W-00306/4

21-W-00067/4 TITLE: TEAMKY Section 1115 Demonstration

AWARDEE: Kentucky Cabinet for Health and Family Services

Under the authority of section 1115(a)(2) of the Social Security Act (the Act), expenditures made by the Commonwealth of Kentucky for the services described below, which are not otherwise included as expenditures under section 1903 of the Act, must be regarded as matchable expenditures under the state’s Title XIX plan, unless otherwise specified, provided however that these expenditures are further limited by the special terms and conditions (STCs) for the TEAMKY (formerly KY Helping to Engage and Achieve Long Term Health (HEALTH)) section 1115 demonstration. Expenditures associated with the TEAMKY section 1115 demonstration are approved from January 1, 2025 through December 31, 2029.

As described further in the Centers for Medicare & Medicaid Services’ (CMS) approval letter, the Secretary of Health and Human Services has determined that the TEAMKY Section 1115 demonstration, including the granting of the waiver and expenditure authorities described below, is likely to assist in promoting the objectives of title XIX of the Social Security Act.

The following expenditure authorities shall enable Kentucky to implement the TEAMKY demonstration:

1. Residential and Inpatient Treatment for Individuals with Substance Use Disorder (SUD). Expenditures for Medicaid state plan services furnished to otherwise eligible individuals who are primarily receiving treatment and withdrawal management services for SUD who are short-term residents in facilities that meet the definition of an institution for mental disease (IMD), as describe in section XIV of the STCs.

2. Residential and Inpatient Treatment for Individuals with Serious Mental Illness (SMI). Expenditures for Medicaid state plan services furnished to otherwise eligible individuals who are primarily receiving treatment for serious mental illness (SMI) who are short-term residents in facilities that meet the definition of an IMD, and who meet the eligibility criteria described in section XV of the STCs.

3. Recovery Residence Support Services (RRSS). Expenditures for RRSS for up to 90 days, for individuals diagnosed with a SUD and meet the eligibility criteria, as described in section XIV of the STCs.

4. Health-Related Social Needs (HRSN) Services. Expenditures for allowable HRSN services not otherwise covered that are furnished to individuals who meet the qualifying