Remote Support in Kentucky: Every Service It Fits, and How It Is Paid
Kentucky’s SCL waiver offers technology assisted residential services to three or fewer participants per residence who reduce in-home staff support. Any Kentucky provider agency can get Vista Enterprise™, the remote support solution, the way it gets an EHR or payroll system, with no state approval. Billing is separate. The agency’s own trained team responds and decides.
Can any Kentucky agency buy a remote support solution?
Yes. Any Kentucky provider or agency can get Vista Enterprise™, the remote support solution, which includes VistaLink™, the technology. Like an EHR or payroll system, getting it needs no approval from the Department for Medicaid Services (DMS), the Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID), or anyone else.
Billing is a separate question. It depends on the program, the service, your agency’s provider status, and each person’s plan. The rest of this page walks through every place remote support fits in Kentucky.
Where does remote support fit in Kentucky?
| Setting or program | How technology is usually paid | What to know |
|---|---|---|
| SCL waiver, technology assisted residential services | The SCL residential service, billed by the technology assisted residential service provider | Three or fewer participants per residence |
| SCL Level I and Level II residential supports | The agency’s own budget | Cameras there follow a separate human rights review |
| ICF/IID | The facility’s own cost | Federal staffing floor stays |
| Nursing homes and assisted living | The facility’s own cost | Resident privacy rules apply |
| Home care agencies | The agency’s own cost | Support between visits |
| Any agency, any setting | The agency’s own budget | No approval needed to buy |
What does Kentucky’s technology assisted residential service include?
Kentucky’s SCL waiver regulation, 907 KAR 12:010, lists technology assisted residential services as one of three residential support services, with Level I and Level II residential supports. Under the regulation, the service:
- Reduces in-home staff, with a plan. It is furnished in a participant’s residence to three or fewer participants who, through the service, reduce the amount of in-home staff support.
- Builds independence. It is for a participant who requires up to 24 hours a day of support and who is able to increase their independence with a reduced need for onsite staff, without undue risk to their health or safety.
- Covers what the person needs. To the extent the participant requires it, the service includes protective oversight or supervision, transportation, personal assistance, and medical or health care that is integral to meeting daily needs.
- Uses live, two-way technology. It is a real-time monitoring system with a two-way method of communication linking the participant to a centralized monitoring station. Devices can include an electronic sensor, a speaker or microphone, a video camera, a smoke detector, or a personal emergency response system. A video camera shall not be located in a bedroom or a bathroom.
- Runs on the provider’s own staff. The devices link the participant’s residence to remote staff employed to provide electronic support. Those staff are direct support professionals, or supervisors, who are proficient with the monitoring devices, and the provider has daily contact with the participant. The provider must have a plan so its staff are available to participants at all hours, every day of the week.
- Supports the most integrated setting. The provider uses technology to help the participant live in the most integrated setting appropriate to their needs, and arranges or provides transportation.
What has to happen before remote support starts in Kentucky?
- The person-centered team decides. The level and types of technology assisted residential services are set by the participant’s person-centered team and outlined in the person-centered service plan.
- Careful consideration. The team gives careful consideration to the participant’s medical, behavioral and psychiatric condition.
- A plan based on assessment. Technology can reduce residential staff support only under an individualized person-centered service plan that promotes increased independence, based on the participant’s Supports Intensity Scale results and a health risk screening tool, and as the team recommends.
- The participant’s choice is written down. Under Kentucky’s camera guidance, a participant must choose to have cameras in their home, and the choice is documented in the person-centered service plan, with provider policies that protect privacy, dignity and respect.
- Changes are handled right away. If a participant’s needs change, the provider immediately adjusts supervision for any acute need and reassesses the service. Longer adjustments are made with the case manager and the person-centered team.
How does Kentucky pay for remote support?
Your agency gets Vista Enterprise™ directly, as its own remote support solution. Kentucky then has one way to pay for the enabling technology a person uses:
From the agency’s own budget. Any agency can get Vista Enterprise™ as its own remote support solution, whether or not it bills a service. This is the route for ICFs, SCL Level I and Level II residences, nursing homes, assisted living and home care agencies.
1. SCL technology assisted residential services. For an SCL participant whose person-centered team chooses it, the technology assisted residential service provider is paid for the residential service, which links the person’s home to the provider’s own remote staff. The level and types of service are set in the person-centered service plan.
Sources, checked October 25, 2026: 907 KAR 12:010, Supports for Community Living waiver service and coverage policies; Kentucky Department for Medicaid Services, Camera Technical Assistance, February 20, 2026; Kentucky DBHDID, SCL services; Kentucky Medicaid, SCL provider type 33.
How do consent and privacy work in Kentucky?
The person supported decides whether remote support is used and where devices go, with help from the people they choose. The person-centered service plan is built with the participant, their person-centered team and their case manager. When the person has a guardian, that person takes part in consent. Consent is informed, voluntary and written down. Under Kentucky’s camera guidance, the participant’s choice is documented in the person-centered service plan, and the service must promote community integration, not isolation. The participant may change their mind at any time, and consent is revisited whenever the plan changes. The agency’s own trained team responds and decides, following the plan.
No cameras are required in bedrooms, bathrooms or other personal spaces. In SCL Level I and Level II residential settings, Kentucky’s camera guidance requires Human Rights Committee due process before any camera is used, even with the person’s consent. In technology assisted residential services, the same guidance treats camera use as the participant’s choice, written in the person-centered service plan, and not a rights restriction. In SCL, a positive behavior support plan that recommends a rights restriction goes to the local human rights committee.
What if our staffing stays the same, as in an ICF or a fully staffed group home?
An agency in Kentucky can keep every in-person shift and still use remote support, because technology can raise quality even with full staff.
Even a fully staffed overnight shift cannot be in every room at once, stay fully alert through every hour of the night, or carry every detail from one shift to the next. When nothing answers those human limits, they quietly become limits on the outcomes people supported can reach. That is a limit of people, not a failing of staff.
Enabling technology for human services helps with those gaps without replacing anyone. It gives trained people better information and more of their time for the moments that need a person in the room.
- Fewer night checks that wake people up. For people whose plans do not call for hands-on checks through the night, a door opening on a schedule interrupts sleep and privacy. Non-wearable sensors the person agreed to can let overnight staff know when something may need a person. Whether a plan moves away from scheduled checks is decided through the person’s plan, by the person and their team, with input from the agency’s own nurse or clinician.
- Better information. Plain-language daily reports on sleep, activity and safety events give nurses and the team a fuller picture than a shift note alone.
- Closing gaps in data and judgment. A steady record across shifts means handoffs rest on more than memory, and a change that is hard to read in the middle of the night comes to a trained person with the facts in front of them.
Know the limits.
- Federal ICF rules set the staffing floor. In an intermediate care facility for individuals with intellectual disabilities (ICF/IID), federal rules require responsible direct care staff on duty around the clock when people are present, awake in some living units, plus minimum direct care staff ratios. Remote support adds to on-site staff. It does not replace them.
- Privacy comes first. Federal rules require ICFs to give each person the opportunity for personal privacy. CMS guidance for surveyors says video or audio never takes the place of staff. No cameras are required in bedrooms, bathrooms or other personal spaces. Non-wearable sensors fit that approach.
- The facility pays. An ICF/IID is paid as a facility, not through a person’s waiver plan, so an ICF that uses Vista Enterprise™ pays for it as its own operating cost.
- ICF terms apply. In an ICF/IID, the person’s plan is the Individual Program Plan (IPP), developed by an interdisciplinary team that includes the person and the qualified intellectual disability professional (QIDP). A move away from scheduled night checks is decided by that team, including the person and their legal guardian where they have one, with input from the facility’s own nurse, and written into the IPP. If the change could affect the person’s protection or rights, the facility’s specially constituted committee reviews it, and it goes ahead only with written informed consent from the client, their legal guardian, or a parent if the client is a minor.
- In Kentucky, technology assisted residential services are an SCL waiver service, so an ICF does not bill them.
- Group homes and privacy. Federal home and community-based settings rules give each person privacy in their sleeping or living unit. Any limit on that must be based on a specific assessed need, written into the person’s plan, and agreed to with informed consent.
Can nursing homes and assisted living in Kentucky use remote support?
Yes. Nursing homes and assisted living communities get Vista Enterprise™ the same way any agency does, and the facility’s own trained team responds and decides.
- Nursing homes. Federal rules give each resident a right to personal privacy and to be free from restraints that are not needed to treat medical symptoms, and require the facility to give each resident adequate supervision and assistance devices to prevent accidents. Better information can help staff see who needs them without waking everyone. Each resident decides whether devices go in and can say no, and a resident representative decides for the resident only as far as the resident, a court or state law gives them that role. CMS guidance for surveyors treats devices that alert staff when a resident moves as position change alarms, so the facility’s care team checks, in each care plan, that a device does not keep a resident from moving freely or disturb their sleep. Remote support does not prevent falls, and it is not a promise that every fall will be noticed. A trained person on the facility’s own team decides each step. Nursing homes are paid as facilities, so Vista Enterprise™ is the facility’s own purchase. In-person staffing rules do not change.
- Assisted living. Assisted living is licensed by each state, not under the federal nursing home rules, so each community follows its own state’s licensing rules for resident rights, privacy and consent. Where Medicaid home and community-based services (HCBS) pay for a resident’s services there, the federal HCBS settings rules also apply, including privacy in the person’s sleeping or living unit, a door they can lock, and a say in choosing any roommate. Technology placed with each resident’s consent gives staff better information between scheduled visits.
- In Kentucky, nursing homes and assisted living communities follow the state’s own licensing rules alongside the federal ones.
How does remote support help home care agencies in Kentucky?
Home care agencies send aides into people’s homes for set hours. Between visits, no one from the agency is there. Remote support helps with that gap: the person keeps their privacy, and the agency’s own trained team can learn when something may need attention and decide who should go.
- Better visits. Aides arrive knowing how the night went.
- Earlier notice. Changes in routine can show up before they become a crisis.
- In Kentucky, home care agencies follow the state’s own licensing rules.
Who else can remote support help in Kentucky?
It is not all about disability. Remote support is enabling technology for human services as a whole. It works for people with intellectual and developmental disabilities (IDD), older adults, people with physical disabilities, people recovering from an illness or injury, faith-based organizations that run health ministries, and the staff and families who support them.
How does VistaLink™ fit Kentucky’s rules?
VistaLink™ uses non-wearable sensors and a display in the home to send events to your agency’s own trained team, and it never acts alone. The agency’s own trained team responds and decides, following each person’s plan.
Your agency stays the provider. To bill technology assisted residential services, it must be an SCL provider certified by DDID before the service starts and recertified at least every two years, enrolled with Kentucky Medicaid as provider type 33. Its own direct support professionals deliver the remote support, with daily contact with each participant. The provider must have a plan so its staff are available to participants at all hours, every day of the week. Sources: 907 KAR 12:010; DMS provider type 33 summary.
Vista is not the direct service provider. The agency or facility is. Vista Enterprise™ supports the people who plan and give support: the person, their family or guardian where they have one, the provider’s own team, and any case manager or coordinator. It helps them follow the rights, privacy and consent rules that apply in that setting and state, and build each person’s plan around their own wants and needs. The agency’s own trained team responds and decides.
For states and government agencies
Vista can also work with the Department for Medicaid Services (DMS), the Department for Behavioral Health, Developmental and Intellectual Disabilities (DBHDID), and with other state and government agencies, for example through a procurement or a contract. Any single agency, in any state or anywhere in the world, can already get Vista Enterprise™ with no state approval.
Remote support for states and government agencies
What does remote support look like for a Kentucky agency? (composite example)
This is a composite example built from common situations. It is not a real person.
Two men on the SCL waiver share a home with technology assisted residential services. Each man and his person-centered team, including his case manager, look at his Supports Intensity Scale results and health risk screening, and decide which evening and overnight hours can move from in-home staff to technology. Each chooses non-wearable sensors and a display in the home, placed where he directs, and the choice is written into his person-centered service plan. When an event comes in, a direct support professional on the provider’s own remote team checks in the way his plan says, and sends someone in person when he needs it.
Questions and answers
Can any Kentucky agency buy a remote support solution?
Yes. Any Kentucky provider or agency can get Vista Enterprise™, which includes VistaLink™. Like an EHR, it needs no DMS or DBHDID approval. Billing follows each program’s rules.
What are technology assisted residential services in Kentucky?
A residential support service in the Supports for Community Living (SCL) waiver. It is furnished in a participant’s residence to three or fewer participants who, through the service, reduce the amount of in-home staff support, using a real-time monitoring system with a two-way method of communication that links the participant to a centralized monitoring station.
Who can use technology assisted residential services in Kentucky?
An SCL participant who requires up to 24 hours a day of support and is able to increase their independence with a reduced need for onsite staff, without undue risk to their health or safety.
Who decides how much technology assisted residential support a person gets?
The participant’s person-centered team decides the level and types of service, outlines them in the person-centered service plan, and gives careful consideration to the participant’s medical, behavioral and psychiatric condition.
Who provides the remote support in Kentucky?
The technology assisted residential service provider. Its devices link the participant’s residence to remote staff employed to provide electronic support, and those staff are direct support professionals, or supervisors, who are proficient with the monitoring devices.
Are cameras a rights restriction in Kentucky’s technology assisted residential services?
Kentucky’s 2026 camera guidance says camera use for remote or virtual support is not a rights restriction and complies with the federal HCBS settings rule, if the participant chooses it and it promotes greater independence. The choice is documented in the person-centered service plan, and the participant may change their mind at any time. No cameras are required in bedrooms, bathrooms or other personal spaces.
Can a Kentucky ICF, nursing home or assisted living facility use remote support?
Yes, as its own tool alongside on-site staff. Federal and state staffing rules still apply in full, and the facility pays for Vista Enterprise™ as its own cost. No cameras are required in bedrooms, bathrooms or other personal spaces.
Who responds when remote support is in place?
Your agency’s own trained team responds and decides, following each person’s plan. VistaLink™ never acts alone.
Is remote support in Kentucky only for disability services?
No. It fits any human service where staff cannot be everywhere at once: disability services, older adults, assisted living, nursing homes, home care and faith-based health ministries.
Book a demo
See how your Kentucky agency could run its own remote support with Vista Enterprise™ and VistaLink™.
Related pages
- Enabling technology for human services: a remote support solution for any agency
- How states pay for remote support
- Vista Enterprise™
- VistaLink™
- Remote support in the District of Columbia
- Remote support in Maryland
- Remote support in Pennsylvania
- Remote support in Virginia
- Remote support in New Jersey
- Remote support in Delaware
- Remote support in Ohio
- Remote support in Tennessee
- Remote support in Minnesota
- Remote support in Missouri
- Remote support in Indiana
- Remote support in Wisconsin
- Remote support in New York
- Remote support in Colorado
- Remote support in Washington
- How to start remote support
- Family guide to choice and consent
- Remote supports FAQ
- Enabling technology: terms, states and settings