• Assessment of client's medical, social, and functional status 

• Development and revision of specific care plans 

• Referrals and related activities to help obtain needed services 

• Monitoring and follow-up activities 

• Coordination between therapists, doctors, social workers, and other providers 

2. Regulations 

Case Management Services are governed by Kentucky Administrative Regulations, specifically 907 KAR 1:440 and 907 KAR 15:040. 

3. Licensing or Certification 

Case managers must meet specific qualifications, including: 

• Being licensed as a registered nurse or possessing a valid work permit as a registered nurse issued by the Kentucky Board of Nursing; or 

• Having a master's degree in social work with one year of professional experience; or 

• Having a bachelor's degree with two years of professional social work experience 

4. Responsible State Agency 

The Kentucky Cabinet for Health and Family Services, Department for Medicaid Services oversees Case Management Services. 

5. Application Process 

Providers must enroll as Medicaid providers through the Department for Medicaid Services. The specific application process is not detailed in the available results. 

6. Required Documentation 

Providers must maintain: 

• Documentation of each contact with or on behalf of the participant 

• Service records including date, duration, and itemization of services 

• Monthly progress notes 

• Critical incident reports 

• Documentation of Level of Care determinations 

• Prior authorization documentation 

7. Timeline for Approval 

The exact timeline for approval is not specified in the available results. 

8. Pre-Application Process 

There is no specific pre-application process mentioned. 

9. Pre-Application Training 

While not explicitly stated as pre-application training, case managers must meet specific educational and experience requirements. 

10. Additional Notes 

• Recipients have free choice of case management services and providers of other Medicaid services 

• Case managers cannot authorize or deny non-targeted case management Medicaid covered services 

• Services are designed to be customized to the client's specific needs 

• As of March 2025, case management continues to play a crucial role in coordinating care for individuals with complex needs in Kentucky 

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