Michelle P Waiver vs SCL Waiver in Kentucky: Services, Waitlists, and Which to Apply For

Both the Michelle P. Waiver and the Supports for Community Living (SCL) Waiver require the same clinical eligibility — ICF/IID level of care — and both serve Kentuckians with intellectual and developmental disabilities. But they fund different services, operate under different waitlist rules, and play different roles in long-term planning.

What SCL Covers That Michelle P. Doesn't

The critical difference is residential services. The SCL waiver is the only Kentucky Medicaid waiver that funds community-based residential options — staffed group homes, adult foster care, and shared living arrangements. SCL also covers case management, day training, behavioral supports, supported employment, and respite.

The Michelle P. Waiver provides many of the same non-residential services (personal care, respite, behavioral supports, day training) but caps them at 40 hours per week and does not fund any residential placement. If your adult child can live at home with family support, Michelle P. may meet immediate needs. If they will eventually need supervised housing, only SCL covers that.

How the Waitlists Work

SCL waitlist: Placement is determined by category of need — crisis, urgent, or future planning. Application date does not determine priority. A family applying under the "future planning" category for a 14-year-old may wait behind someone who applied later but was classified as "urgent" due to a caregiving crisis. Average wait times for SCL approach eight years.

Michelle P. waitlist: Strictly chronological. The date your completed application is received determines your position. No priority categories. This makes the application date strategy straightforward — apply as early as possible.

Why Consider Both

Some families consider applying to both, but they should confirm with the local CMHC or relevant waiver office whether concurrent applications are appropriate for their circumstances:

• Michelle P.'s chronological waitlist rewards early applications — your position only improves over time
• SCL's category-based system can change if circumstances change; if an immediate caregiving crisis develops, submit an SCL Emergency Request Form to request priority consideration
• The programs have different service scopes: Michelle P. provides non-residential supports, while SCL is the waiver that funds community-based residential services

Conflict-Free Case Management

Both waivers operate under federal Conflict-Free Case Management requirements. The agency providing your case management cannot be the same agency providing your direct services (day training, residential support, etc.). An exemption exists only if the participant requests it and submits evidence that no other qualified case manager is available within 30 miles.

This matters when choosing providers. If your child's day program is run by Agency A, your case manager generally must come from Agency B, unless the participant requests and qualifies for the 30-mile exemption. Some families in rural Kentucky counties face real access challenges under this rule.

The Cost Behind Each Waiver

The annual per-participant expenditure reflects the scope difference. In fiscal year 2025, Kentucky spent an average of $118,978 per person on SCL (reflecting intensive residential services) versus $59,441 per person on Michelle P. (non-residential only). HCB averaged $67,791 per person.

These numbers explain why waitlists are long — each SCL slot costs twice what a Michelle P. slot costs, and the state budget is finite.

Making the Decision

Compare both options with the local CMHC or relevant waiver office. If an immediate caregiving crisis develops while the individual is on the SCL waitlist, submit an SCL Emergency Request Form to request priority consideration.

The Kentucky IEP Transition to Adulthood Guide includes a waiver comparison matrix with service-by-service breakdowns and a dual-application timeline keyed to the IEP transition plan.

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