Kentucky
ISA/ASA Tracking Tool

In-Reach Referral Form
CHFS-P&A Interim Settlement Agreement (ISA)

Across Kentucky, persons with a serious mental illness (SMI), who currently live in a Personal Care Home (PCH) or are at risk of reentry into a PCH, may apply and be provided housing assistance and services in an integrated setting. Every Community Mental Health Center (CMHC) can provide transition services to residents of personal care home who meet the eligibility criteria and want to move into their community. Individuals are eligible regardless of guardian status. They may be their own guardian, or have a private or state guardian.

Eligibility criteria include:
  • Person is at least 18 years old;
  • Has a serious mental illness;
  • Receives or may be eligible for state supplementation;
  • Meets one of the following criteria
    • Resides in a PCH and receives state supplementation; or
    • Is or will be discharged from a psychiatric hospital and has previously resided in a PCH

Across Kentucky, Community Mental Health Centers can provide transition services to residents of personal care homes who want to move into the community.

To apply for assistance click on the tracking tool below.
Referral Contact Information
Referred By
Date
05/07/2024
Phone
Email
Referral Type
In-Reach Referral Form
Individual's Name (First/Last)
Phone Number
Date of Birth
Name of
Client Counties of Choice
Guardian
Type
Name
Email
Phone
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Application Developed By: University of Kentucky's Institute for Pharmaceutical Outcomes and Policy (IPOP)