RELATES TO:
KRS
199.011,
199.640-199.680,
199.801,
600.020(25),
42 U.S.C.
622,
672,
675
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
194A.050(1) requires the
secretary of the Cabinet for Health and Family Services to promulgate
administrative regulations necessary to operate programs and fulfill the
responsibilities vested in the cabinet.
KRS
199.641(4) and
605.090(1)(d)
authorize the cabinet to establish by administrative regulation the rate
setting methodology and the rate of payment for child-caring facilities and
child-placing agencies, consistent with the level and quality of service
provided. KRS
605.090(1)(d) authorizes the
cabinet to promulgate administrative regulations establishing conditions under
which the cabinet may place a child committed to the Department of Juvenile
Justice or the cabinet, in a child-caring facility or a child-placing agency
operated by a local governmental unit or private organization willing to
receive the child, upon the conditions established by the cabinet.
KRS
605.150(1) authorizes the
cabinet to promulgate administrative regulations to implement the provisions of
KRS Chapter 605. This administrative regulation establishes:
(a) levels of care based upon the needs of a
child for whom the cabinet has legal responsibility;
(b) a payment rate for each level and
placement setting;
(c) gatekeeper
responsibilities;
(d) provider
requirements;
(e) procedures for
classification at the appropriate level of care and placement setting;
and
(f) procedures for determination
of components of the model program cost analysis.
Section 1. Definitions.
(1) "Cabinet" is defined by
KRS
199.011(3).
(2) "Child-caring facility" or "facility" is
defined by KRS
199.011(5).
(3) "Child-placing agency" or "agency" is
defined by KRS
199.011(6).
(4) "Department" is defined by
KRS
199.011(7) and
199.641(1)(b).
(5) "Emergency shelter" is defined by
KRS
600.020(25).
(6) "Gatekeeper" means the department or
agent responsible for:
(a) Making a clinical
determination of the level of care necessary to meet a child's treatment and
service needs; and
(b) Other
administrative duties in the areas of:
1.
Assessment;
2. Placement;
3. Performance measurement; and
4. Consultation regarding children and their
needs.
(7)
"Index factor" means a specific number derived from time-study data, used to
determine payment for each level of care.
(8) "Initial level of care" means a level of
care:
(a) Assigned by the gatekeeper to a
child at the point of entry into the level of care system; and
(b) That is time-limited and effective for
the first six (6) months of a child's placement.
(9) "Level of care" means the standard
representing the treatment and service needs of a child placed by the cabinet
in out-of-home care.
(10) "Level of
care packet" means an assessment conducted by designated cabinet staff and a
collection of forms required for submission to the gatekeeper for the purpose
of determining the appropriate level of care and placement setting in
accordance with Section 2(2) of this administrative regulation.
(11) "Medically complex" means a child who is
determined to have a medical condition as defined by
922 KAR 1:495 and further
described in
922 KAR 1:350, Section
4.
(12) "Model program cost
analysis" is defined by
KRS
199.641(1)(c).
(13) "Placement coordinator" means an
individual whose responsibilities are established in
KRS
199.801.
(14) "Reassigned level of care" means a level
of care that is:
(a) Determined by the
gatekeeper after a child's level of care expires; and
(b) Authorized for a specific period of
time.
(15) "Time study"
is defined by KRS
199.641(1)(d).
(16) "Utilization review" means a
gatekeeper's examination, during a child's placement in a child-caring facility
or child-placing agency, of the child's case record and existing documentation
for the purpose of:
(a) Identifying the
child's current level of functioning, treatment, service, and supervision
needs; and
(b) Assigning the
appropriate level of care.
Section 2. Referral Process for Level of Care
System Placement.
(1) A level of care packet
shall be completed by a cabinet staff person and submitted to the gatekeeper
for a child at least forty-eight (48) months of age or a child who is medically
complex regardless of age at the time:
(a) The
child is referred for placement with a child-caring facility or child-placing
agency;
(b) A child currently
placed in a child-caring facility or a child-placing agency reaches forty-eight
(48) months of age or is found to be medically complex; or
(c) A child's level of care expires and
assignment of a new level is necessary.
(2) A level of care packet shall include the
following child-specific information:
(a)
Identifying data;
(b) Individual
strengths and limitations;
(c)
Daily living skills;
(d) Physical
health needs including:
1. Any significant
medical history;
2. Current
diagnoses, assessments, and treatment; and
3. Documentation indicating the child's
medically complex status if the child is medically complex;
(e) Behavioral health needs
including:
1. Screening tools utilized based
upon the child's age; and
2.
Current diagnoses, assessments, and treatment recommendations;
(f) Medications;
(g) History of substance abuse, high risk, or
other significant behavior including:
1.
Sexual acting out; and
2. Legal
history, status, or other court involvement;
(h) Out-of-home care placement information
including:
1. Reason for entering out-of-home
care;
2. History of abuse, neglect,
or dependency;
3. Current custody
status;
4. Current and previous
placements; and
5. Permanency
goal;
(i) Social
supports;
(j) Educational
functioning, grade level, and any special educational need; and
(k) Religious background and
practices.
(3)
(a) If a child needs placement within a
child-caring facility or a child-placing agency, a cabinet staff person shall
submit a copy of the completed level of care packet, including level
assignment, to the placement coordinator.
(b) The placement coordinator shall forward
the level of care packet to potential child-caring facilities or child-placing
agencies.
(4) If a
child-caring facility or child-placing agency accepts a child for out-of-home
placement and the cabinet approves the placement in accordance with
KRS
199.801 and
922 KAR 1:370, a cabinet staff
person shall:
(a) Complete the DPP-114, Child
Caring and Child Placing Level of Care Schedule with the level of care payment
rate for placement type:
1. As assigned by the
gatekeeper within the previous six (6) months; or
2. If there is an emergency placement, within
two (2) business days of the placement or receipt of the assigned level of
care;
(b) Arrange
transportation for the child and his or her personal belongings that are small
enough to be carried to the placement; and
(c) Notify the placement coordinator of the
selected placement.
(5)
If a child-caring facility or child-placing agency accepts an emergency
placement requested by the cabinet outside of the gatekeeper's regular working
hours, a cabinet staff person shall:
(a)
Submit a level of care packet to the gatekeeper for a child who does not have a
current level of care assignment; and
(b) Inform the placement coordinator of the
location and date of placement.
(6) The placement coordinator shall notify a
child-caring facility or child-placing agency that was not chosen for placement
upon provision of notification in accordance with subsection (4)(c) of this
section.
Section 3.
Gatekeeper Responsibilities. The gatekeeper shall:
(1) Evaluate a child referred by the cabinet
or currently placed in a child-caring facility or child-placing agency for the
purpose of establishing an initial or reassigned level of care. The child shall
be:
(a) Four (4) years of age or older;
or
(b) Determined to be medically
complex by designated cabinet staff;
(2) Within three (3) working days of receipt
of the level of care packet:
(a) Determine the
appropriate level of care according to an assessment of the child's treatment,
supervision, and service needs consistent with one (1) of the three (3) levels
of care; and
(b) Return the
completed CRP-6, Children's Review Program Notice of Level of Care Payment
Authorization Assignment, to the department and the child-caring facility or
the child-placing agency;
(3) Assess a child placed in a child-caring
facility in accordance with 42 U.S.C,
675a(c)
within the first thirty (30) days of placement;
(4) Conduct a utilization review for a child:
(a) Six (6) months from the initial placement
or reassignment and placement in a child-caring facility and child-placing
agency; and
(b)
1. Every three (3) months thereafter if the
child is in a child-caring facility; or
2. Every six (6) months thereafter if the
child is in a foster care placement or therapeutic foster care;
(5) Reassign a child's
level of care after the previous level has expired;
(6) Monitor each child-caring facility and
child-placing agency;
(7) Maintain
a confidential information system for each child served that shall include:
(a) Placement history;
(b) Level of care assignments;
(c) Length of treatment; and
(d) Discharge outcomes; and
(8) For a utilization review,
return the completed CRP-2, Children's Review Program Notice of Level of Care
Payment Authorization, to the child-caring facility or child-placing agency and
the cabinet after a level is conducted or reassigned.
Section 4. Levels of Care. A level of care
shall be assigned in accordance with this section.
(1) A Level I child shall be a child who
requires a routine home environment that:
(a)
Provides for the basic needs of the child;
(b) Provides guidance and
nurturing;
(c) Provides supervision
to meet the needs of the child;
(d)
Provides educational support;
(e)
Provides access to routine medical care; and
(f) Ensures the emotional and physical
well-being of the child.
(2) A Level II child shall be a child who:
(a) Requires a routine home environment that
meets the requirements of subsection (1) of this section;
(b) Has identified treatment needs based on
available behavioral health screening and assessment information or current
treatment recommendations;
(c) Has
a history of complex trauma related to maltreatment;
(d) Requires supervision in a structured
supportive setting with:
1. Counseling
available from professional staff;
2. Educational support; and
3. Services designed to improve physical and
behavioral health and wellbeing;
(e) May occasionally require intense levels
of intervention to maintain the least restrictive environment; and
(f) Requires a program flexible enough to
allow increased:
1. Independence if the child
is capable; or
2. Structure during
temporary periods of regression.
(3) A Level III child shall be a child who:
(a) Has significant treatment needs as
indicated by:
1. Available behavioral health
screening and assessment information or current treatment recommendations that
require specialized or frequent treatment services;
2. A determination by designated cabinet
staff that the child has a high degree of medical complexity that requires
specialized medical care;
3. The
presence of both significant behavioral health needs requiring treatment and a
determination of medical complexity by designated cabinet staff; or
4. A severe impairment or disability that
requires a caregiver to attend to all care needs of the child; and
(b) Requires a highly structured
supportive setting:
1. With frequent therapy
or therapeutic services provided by a qualified mental health professional or
other treatment professional allowed pursuant to
922 KAR 1:300 within a treatment
program designed to improve social, emotional, and educational adaptive
behavior;
2. That includes
twenty-four (24) hour supervision; or
3. That provides safe and effective care for
a severe, chronic medical condition, behavioral health issue, or other highly
specialized needs.
Section 5. Payment Methodology and Rates.
(1) Payment Methodology.
(a) The cabinet shall base a per diem rate
for the care of a child placed by the cabinet in a private child-caring
facility, upon the "model program cost analysis" defined by
KRS
199.641(1)(c).
(b) Each private child-caring facility and
child-placing agency shall report to the cabinet annually, on the DPP-888,
Instructions for Completing the Annual Cost Report and Time Study for Child
Caring and Child Placing Programs and Facilities.
(2) The cabinet shall establish an index
factor for payment on behalf of a child for whom a level of care has been
determined.
(a) The factor shall be
determined:
1. Based on the amount of
treatment provided at each level of care; and
2. By determining the median of:
a. Number of daily treatment hours, derived
from time study data, provided to children served by private child-caring
facilities and child-placing agencies; and
b. Level of care of children served by
private child-caring facilities and child-placing agencies that contract with
the cabinet.
(b)
1. For
children whose level is determined, the median level of care shall be
represented by an index factor of one (1).
2. For children whose level is not
determined, the median level of care shall be represented by an index factor
that is proportionate to the amount of treatment provided to the children in
the median level pursuant to subparagraph 1 of this paragraph.
(3) A statewide median
cost, including board, care, and treatment components, for each level of care
shall be calculated by using a utilization factor of eighty (80) percent for
residential treatment and seventy-five (75) percent for a group home.
(4) The payment rate for each level of care
shall be calculated by multiplying the median cost by the index factor specific
to that level of care. The rate for each level of care shall be adjusted by the
Consumer Price Index during each intervening period between the fiscal year
used for the cost analysis and calculation of the rate.
(5) Statewide median cost shall be
calculated:
(a) Using a utilization factor of
eighty (80) percent:
1. For an emergency
shelter with a treatment license:
a.
Board;
b. Care; and
c. Treatment components; or
2. For an emergency shelter
without a treatment license:
a. Board;
and
b. Care components;
and
(b)
Adjusting for each level of care by the Consumer Price Index during each
intervening period between the fiscal year used for the cost analysis and
calculation of the rate.
(6)
(a) To
the extent funds are available, an incentive payment for a private child-caring
facility that participates in a per diem rate contract with the cabinet shall
be determined by evaluating the performance of the child-caring facility, in
accordance with
KRS
199.641(2)(a). Measurable
performance outcomes shall include:
1. Child
safety while in the care of a private child-caring facility or child-placing
agency;
2. Child safety after
reunification with the child's family;
3. Adequate educational support;
4. Reduced time spent in out-of-home care
without an increase in the rate of out-of-home care reentry;
5. Increased placement stability during the
service period;
6. Increased
achievement of permanency goals; and
7. Increased stability in less restrictive or
permanent placement following planned discharge.
(b) The cabinet's contract with a private
child-caring facility shall specify the:
1.
Indicators used to measure the performance outcomes established in paragraph
(a) of this subsection; and
2.
Target percentages used as performance goals.
(c) Each child in the custody of the cabinet
who is placed in a private child-caring facility during the contract period
shall be included in the percentage of children for whom the cabinet expects
achievement of an outcome.
(d) At
the time the contract period expires, each private child-caring facility shall
be ranked based on the percentage of children for whom the facility achieved an
outcome. To the extent funds are available, a payment incentive shall be
distributed to a private child-caring facility that performed in the top
one-third (1/3) of the facilities.
(e) The amount of a payment incentive shall
be determined according to the funding appropriated for this purpose in the
biennial budget.
(7) In
addition to services provided on a per diem rate, the cabinet shall solicit
proposals from private child-caring facilities or child-placing agencies to
provide alternative services to children and their families. To the extent
funds are available, the alternative services:
(a) Shall be geared toward improved
performance outcomes; and
(b) May
include case management responsibilities shared between the cabinet and the
child-caring facility or child-placing agency.
(8) Payment to child-caring facilities or
child-placing agencies that provide alternative services according to
subsection (7) of this section shall be based upon expectations agreed upon
between the cabinet and the child-caring facility or child-placing agency such
as:
(a) Reduced length of stay in out-of-home
placement;
(b) Increased safety
from child abuse or neglect;
(c)
Increased number of children moving into and remaining in permanent
placement;
(d) Increased number of
children and their families cared for in close proximity to their home
communities;
(e) Increased number
of children reunified with their families;
(f) Increased accountability for success in
after care; or
(g) Decreased
reentry into state custody.
Section 6. Residential Care.
(1) A child-caring facility that cares for
children in the custody of the cabinet shall be licensed pursuant to
922 KAR 1:305 and shall meet the
standards for child-caring facilities established in
922 KAR 1:300.
(2) The facility shall comply with
922 KAR 1:300, Section 8,
Residential Treatment Program, if providing treatment-oriented
services.
(3) Only a child assigned
as Level III shall be placed in residential care.
(4) The daily rate for residential care to a
child-caring facility shall be:
(a) $193.50
per child for a child-caring facility determined by designated cabinet staff to
not meet the requirements of a specified setting for placement in accordance
with 42 U.S.C.
672(k)(2); and
(b) $336.00 per child for a child-caring
facility determined by designated cabinet staff to meet the requirements of a
specified setting for placement in accordance with
42 U.S.C.
672(k)(2).
Section 7. Emergency
Shelter Care.
(1) An emergency shelter
child-caring facility shall meet the requirements of
922 KAR 1:380. The rate for
emergency shelter care shall be:
(a) $220.59
per child per day for a child-caring facility with a treatment license;
or
(b) $165.44 per child per day
for a child-caring facility without a treatment license.
(2) If a child with an assigned level of care
enters an emergency shelter child-caring facility with a treatment license, the
emergency shelter child-caring facility shall adhere to the child's individual
treatment plan.
Section
8. Foster Care and Therapeutic Foster Care for a Child-Placing
Agency.
(1) The daily rate for foster care
shall be $51.33 per child for:
(a) A child
under the age of four (4) who has not been assigned a level; and
(b) A child over the age of four (4) with a
level I assigned level of care.
(2) The daily rates for therapeutic or
treatment foster care shall be:
(a) Level II -
$99.50 per child; and
(b) Level III
- $139.96 per child.
Section 9. Pregnant and Parenting
Teen Programs. A child-caring facility with a pregnant and parenting teen
program shall receive:
(1) A rate consistent
with the assigned level of care for the adolescent parent; and
(2) Inclusive of child care cost, the amount
established in Section 8(1) of this administrative regulation for the committed
child of an adolescent parent who is committed to the cabinet.
Section 10. Independent Living
Programs.
(2) The daily rate for an independent living
program shall be:
(a) $99.50 per child for
Level I or Level II; and
(b)
$139.96 per child for Level III.
(3) A Level III child in an independent
living setting shall require increased structure, supervision, case management,
and treatment services.
Section
11. Programs with Decoupled Rates. A child-caring facility or
child-placing agency providing highly specialized behavioral health services
may be paid for board and treatment services separately through agreement with
the:
(1) Department for the cost of room,
board, and watchful oversight; and
(2) Department for Medicaid Services or its
designee for behavioral health treatment services.
Section 12. Provider Requirements.
(1) A child-caring facility or child-placing
agency shall:
(a) Inform the department of the
levels of care the facility or agency has the ability to serve;
(b) Demonstrate its ability to provide
services, either directly or by contract, appropriate to the assigned level for
each child, including:
1. Room, board, and
other activity contributing to housing, food, clothing, school supplies, or
personal incidentals;
2. Clinical
services including:
a. The evaluation and
treatment of behavioral health needs; and
b. Identification and alleviation of related
trauma symptoms, disability, or distress experienced by a child who follows a
specific individual treatment plan targeted to identify a problem;
and
3. Support services
that:
a. Identify necessary resources and
coordinate services provided by a range of agencies or professionals;
b. Allow a child to cope with the trauma,
disability, or distress;
c. Provide
access to improving the educational or vocational status of the child;
and
d. Provide essential elements
of daily living;
(c) Submit the following reports in time for
the reports to be received by the gatekeeper within thirty (30) days prior to
the utilization review due date:
1. To the
gatekeeper, a Child and Adolescent Needs and Strengths assessment report
completed within the past six (6) months or another supplemental tool approved
by the gatekeeper; and
2. To the
gatekeeper and designated cabinet staff, a copy of the CRP-7, Children's Review
Program Application for Level of Care Payment (ALP):
a. On a quarterly basis, for a private child
care residential placement; or
b.
On a semiannual basis for a foster care placement;
(d) Provide outcomes data and
information as requested by the gatekeeper; and
(e) Obtain accreditation within two (2) years
of initial licensure or within two (2) years of acquiring an agreement with the
cabinet, whichever is later, from a nationally-recognized accreditation
organization, such as:
1. The Council on
Accreditation; or
2. The Joint
Commission.
(2) Emergency shelters without a treatment
license shall be exempt from the accreditation requirements specified in
subsection (1)(e) of this section.
Section 13. Utilization Review and
Authorization of Payment.
(1) The child-caring
facility or child-placing agency shall submit to the gatekeeper the reports
established in Section 12(1)(c) of this administrative regulation for the
utilization review in time for the reports to be received by the gatekeeper
within thirty (30) days prior to the utilization review due date.
(2) If the child-caring facility or
child-placing agency fails to submit the reports as established in Section
12(1)(c) of this administrative regulation in time for the reports to be
received by the gatekeeper within thirty (30) days prior to the utilization
review due date, the cabinet shall:
(a)
Suspend payments until the necessary information has been submitted to the
gatekeeper;
(b) If a child's level
is reduced after untimely reports are received by the gatekeeper, make an
adjustment for overpayment retroactive to the first utilization review due date
that was missed; or
(c) If a
child's level is increased as a result of delinquent reports, apply a higher
rate beginning the day after the untimely reports are received by the
gatekeeper.
(3) If the
child-caring facility makes timely submission of the reports, and if the:
(a) Level of care remains unchanged, payments
shall continue unchanged;
(b) Level
of care is reduced, and the:
1. Child remains
in the same placement, the lower level of care shall be effective on the 31st
day following the utilization review due date; or
2. Child is placed in another child-caring
facility or child-placing agency after the utilization review due date, the
rate for the lower level shall be effective on the day the child is placed;
or
(c) Level of care is
increased, the rate for the higher level of care shall be effective the day
after the utilization review due date.
(4) If the child-caring facility,
child-placing agency, or cabinet staff disagrees with the level of care
assigned by the gatekeeper, the child-caring facility, child-placing agency, or
cabinet staff may request a redetermination as established in Section 14 of
this administrative regulation.
Section 14. Redetermination.
(1) If the child-caring facility,
child-placing agency, or cabinet staff disagrees with the level of care
assigned by the gatekeeper, the child-caring facility, child-placing agency, or
cabinet staff may request a redetermination of the assigned level by providing
to the gatekeeper:
(a) New information that
supports the request for a new level; and
(b) Completion of the "request for
redetermination" section of one (1) of the following forms:
1. CRP-2, Children's Review Program Notice of
Level of Care Payment Authorization, for a utilization review;
2. CRP-4, Children's Review Program Notice of
Level of Care Redetermination;
3.
CRP-5, Children's Review Program DCBS Foster Care Utilization Review Notice of
Level Assignment, for a utilization review; or
4. CRP-6, Children's Review Program Notice of
Level of Care Payment Authorization Assignment, for a reassignment.
(2) If the request for
a redetermination is received by the gatekeeper within thirty (30) days after
the most recent utilization review due date or admission, and if the gatekeeper
assigns a higher level with a CRP-4, Children's Review Program Notice of Level
of Care Redetermination, the increased payment shall be retroactive to the most
recent of the following:
(a) The date of the
most recent utilization review due date if the complete utilization review
materials were received on or before the utilization review due date;
or
(b) The date of
admission.
(3) If the
request for redetermination is received by the gatekeeper more than thirty (30)
days after the most recent utilization review due date or admission, and if a:
(a) Higher level is assigned by the
gatekeeper with a CRP-4, the increased payment shall be effective the day after
the request is received by the gatekeeper; or
(b) Lower level is assigned by the gatekeeper
with a CRP-4, the lower payment shall be effective thirty (30) days after the
request is received by the gatekeeper.
(4) If the child-caring facility,
child-placing agency, or cabinet staff does not agree with the redetermination
as provided by the CRP-4, an appeal may be requested in accordance with Section
16 or 17 of this administrative regulation.
Section 15. Reassignment.
(1) If the level of care expires and the
child is moved to a different child-caring facility or child-placing agency
placement, a reassigned level of care shall be obtained by the:
(a) Department completing a level of care
packet for a level assignment; or
(b) New child-caring facility or
child-placing agency submitting the following within thirty (30) days of the
placement:
1. A cover letter requesting a
reassignment;
2. The most recent
Child and Adolescent Needs and Strengths assessment report or a comparable
assessment of the child; and
3.
Documentation to support the level of care assignment, such as the level of
care packet or discharge summary.
(2) The reassigned level of care rate shall
be effective on the date of admission to the new placement.
(3) If the child-caring facility or
child-placing agency disagrees with the level of care assigned by the
gatekeeper, the child-caring facility or child-placing agency may request a
redetermination as established in Section 14 of this administrative
regulation.
Section 16.
Informal Dispute Resolution.
(1) A contract
agent dissatisfied by a decision of the cabinet or a gatekeeper may seek
informal resolution by filing a request with the secretary of the cabinet, or
designee, within ten (10) days following notice of the decision.
(2) Upon receipt of a request for informal
resolution, the cabinet shall:
(a) Review the
request; and
(b) Render a written
decision on the issue raised within thirty (30) calendar days unless an
extension is granted by the secretary or designee:
1. Due to extenuating circumstances that
prolong the review; and
2. With
notice provided to the contract agent.
(3) If the dispute relates to a decrease or
denial of payment, the contract agent may request an administrative hearing in
accordance with Section 17 of this administrative regulation.
Section 17. Administrative Hearing
Process. A child-caring facility or child-placing agency may request an
administrative hearing in accordance with
922 KAR 1:320.
Section 18. Incorporation by Reference.
(1) The following material is incorporated by
reference:
(a) "CRP-2, Children's Review
Program Notice of Level of Care Payment Authorization", 01/22;
(b) "CRP-4, Children's Review Program Notice
of Level of Care Redetermination", 01/22;
(c) "CRP-5, Children's Review Program DCBS
Foster Care Utilization Review Notice of Level Assignment", 01/22;
(d) "CRP-6, Children's Review Program Notice
of Level of Care Payment Authorization Assignment", 01/22;
(e) "CRP-7, Children's Review Program
Application for Level of Care Payment (ALP)", 07/22;
(f) "DPP-114, Child Caring and Child Placing
Level of Care Schedule", 09/23; and
(g) "DPP-888, Instructions for Completing the
Annual Cost Report and Time Study for Child Caring and Child Placing Programs
and Facilities", 09/23.
(2) This material may be inspected, copied,
or obtained, subject to applicable copyright law, at the Department for
Community Based Services, 275 East Main Street, Frankfort, Kentucky 40621,
Monday through Friday, 8 a.m. to 4:30 p.m. This material may also be viewed on
the department's Web site at
https://chfs.ky.gov/agencies/dcbs/Pages/default.aspx.