FRANKFORT, Ky, (July 16, 2025) - Yesterday, Commonwealth Ombudsman Jonathan Grate provided public comment on the Cabinet for Health and Family Services’ (CHFS) new Community Health for Improved Lives and Development (CHILD) Waiver Proposal. In his comment, Ombudsman Grate expressed concern that CHFS’s method for implementing the CHILD Waiver could exclude children with autism, emotional and intellectual disabilities, and related conditions from receiving the full extent of needed Medicaid benefits and services.
CHFS’s CHILD Waiver Proposal is an attempt to implement a directive made by Kentucky’s General Assembly over a year ago. During the 2024 general session, the General Assembly passed House Bill 6. Part of House Bill 6 provides CHFS with funds to develop a waiver that makes it easier for children with autism, emotional and intellectual disabilities, and related conditions to obtain needed Medicaid benefits and services.
“The General Assembly appropriated millions of dollars to ensure children with autism or emotional and intellectual disabilities could receive needed Medicaid services,”
Ombudsman Grate said. “Unfortunately, CHFS’s current proposal could bar access to essential Medicaid services for thousands of vulnerable Kentuckians, including many children who recently lost Home and Community Based services or who currently are on a Michelle P. Waiver waitlist.”
CHFS’s CHILD waiver proposal adds several more eligibility requirements that are not required by statute. These added restrictions could exclude many children who recently lost Home and Community Based services and the over 1,000 children under five-years-old on waitlists for Medicaid benefits and services, waitlists like the years-long Michelle P. Waiver waitlist. These burdensome restrictions may leave these and many other families unserved. The waiver also denies families the ability to direct their child’s care or choose trusted caregivers, even though federal Medicaid guidance actually encourages families having that choice.