Kentucky · waiver service
Home and Community Based (HCB) Waiver in Kentucky
The HCB Waiver is a Kentucky Medicaid program for older adults and people with physical disabilities who need a nursing-facility level of care but want to live at home. It covers personal care, attendant care, homemaker, adult day health and more. Family members can be paid only through the PDS self-direction option, and immediate family, guardians and spouses need written approval from the state.
Also called: HCB Waiver · HCB 2 · Home and Community Based Waiver version 2 · Kentucky HCB waiver
Who do you care for?
Quick facts
- Pay
- $29.04/hr (reported PDS max)
- Adult children & other relatives
- Sometimes
- Spouse
- Sometimes
- Parent of a minor child
- Sometimes
- Waitlist
- long
Who qualifies for Home and Community Based (HCB) Waiver
- Kentucky Medicaid eligible.
- Aged or has a physical disability.
- Meets nursing-facility level of care, as determined by the Department for Medicaid Services.
- A waiver slot is available.
Who can be paid as the caregiver
- Adult children & other relatives Sometimes
- relatives outside the immediate family can be hired through PDS; immediate family members need written DMS approval.
- Spouse Sometimes
- a spouse may be paid through PDS only with written DMS approval (unique abilities, not natural supports, and no qualified provider within 30 miles or able to meet needs).
- Parent of a minor child Sometimes
- a parent of a minor is a legally responsible individual and needs the same written DMS approval.
- Living together
- not required.
Who employs the caregiver: Either. Traditional agency services, or PDS with a financial management agency.
Spouse rules differ by program — see spouse pay in Kentucky.
How much Home and Community Based (HCB) Waiver pays
$29.04/hr (reported PDS max). PDS pay cannot exceed the agency rate for the same service. A maximum of $29.04/hr for attendant care is reported for 2026; take-home pay is lower after FMS and employer taxes.
Hours and budget: The person-centered service plan sets services; a PDS provider may not work more than 40 hours in a calendar week.
Compare with other Kentucky programs on the Kentucky caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
HCB slots are limited and a waitlist forms when full. A July 2026 DMS letter requires people on the HCB and Michelle P. waitlists to submit a provider attestation by January 31, 2027 to stay on the list.
How to apply for Home and Community Based (HCB) Waiver
- Apply at kynect.ky.gov or call 855-306-8959.
- Complete the nursing-facility level-of-care assessment.
- If slots are full, join the waitlist and file the provider attestation by January 31, 2027.
- Once enrolled, choose PDS and, for an immediate family member, submit the PDS Request Form for Immediate Family Member, Guardian, or Legally Responsible Individual.
- Medicaid Waiver Help Desk · 844-784-5614 · official site
- kynect · 855-306-8959 · official site
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Home and Community Based (HCB) Waiver questions
Can I get paid to care for my husband on the HCB waiver?
Only with written approval from the Department for Medicaid Services, and only through PDS. The state must find you have unique abilities and that a qualified provider is not available.
Is there a waiting list for the HCB waiver?
Yes, when slots are full. People on the list must file a provider attestation by January 31, 2027.
What services does the HCB waiver cover?
Personal care, attendant care, homemaker, adult day health, respite, home changes and more.
How many hours can a family member work?
No more than 40 hours of PDS in a calendar week.
Sources: apps.legislature.ky.gov · chfs.ky.gov · chfs.ky.gov · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Kentucky caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Kentucky — pick yours for the local picture.
Across the line
States that border Kentucky
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.