Committee hears KDADS briefing on HCBS waivers, steps to reduce IDD waiting list

At a Ways and Means Committee briefing, Kansas Department for Aging and Disability Services officials described recent investments and administrative changes intended to reduce waiting lists for home- and community-based services (HCBS) and outlined next steps including a planned Community Support Waiver, grant programs and a new assessment tool.

Secretary Laura Howard opened the presentation and said the legislature’s funding allowed the agency to “remove 500 persons from each of those waivers,” and that KDADS has “been able to make some really good progress, particularly as it relates to the waiting list for persons with intellectual and developmental disabilities and the physical disability wait list.”

The nut graf: the department said it serves roughly 30,000 Kansans through seven HCBS waivers, is planning an eighth — the Community Support Waiver — and is pursuing a mix of one-time grants and ongoing budget requests to prevent new waiting lists and accelerate removal of people already on lists.

Commissioner Michelle Hayden described how the waivers work and gave details about recent outreach and offer activity. “The home and community based services waiver is an authorization from Medicaid, that allows beneficiaries to receive treatment at home and community based settings rather than be required to enter an institution,” Hayden said. KDADS reported roughly 30,000 Kansans receive HCBS services and noted growth pressure on the frail-elderly waiver, the technology-assisted (TA) waiver for children, and the brain-injury waiver.

KDADS provided counts from recent outreach rounds: for the IDD waiver the agency said it issued 779 offers, 564 were accepted and 446 people are currently active on the waiver; for the physical-disability (PD) waiver KDADS reported issuing 1,150 offers, 473 accepted and 321 active. Hayden said differences among offers issued, offers accepted and active cases reflect the time needed to complete Medicaid applications and enrollment paperwork.

The department described several programmatic steps already under way or planned: - Community Support Waiver: KDADS is developing a CMS waiver intended to serve about 500 people in fiscal year 2026 and to reduce the IDD waiting list. The agency said it plans to submit the waiver application in the fall and is working with contractor PCG (Public Consulting Group) on waiver development and a related rate study. KDADS also said it must address a corrective action plan from CMS as part of the waiver work. - Assessment tool change: KDADS will move from the BASIS assessment to the MFEI tool for reassessments beginning July 1, 2025, and plans to use MFEI data to align eligibility across waivers. - Unbundling day services: KDADS plans to “unbundle” generic day services into clearer categories by July 1, 2026, and to use grants to help providers meet the federal settings rule and provide more integrated community services. - Grants and funding: KDADS is using ARPA funds and has requested additional state funding. The secretary and commissioner listed ARPA grants, SB 15 funds targeted at sheltered workshops and wage supports, and a proposed governor’s budget that includes additional funding to support provider compliance and expansion.

Disability Rights Center representative Mike Burgess called the reduction in the IDD waiting list “good news” but urged continued work on transparency and prioritization. He said a KDADS-commissioned waiting list study suggested 60–70% of people on the list had signed up early, which inflates the raw waiting-list total and complicates planning. Burgess recommended a triage model used in other states that separates people who need services now (e.g., within 12 months), those likely to need services in 1–5 years, and those with needs further out, to allow planning and clearer communication with families.

Committee members asked about budget status. KDADS officials said the House Social Services Budget subcommittee supported partial funding to start the Community Support Waiver (a proration for the last quarter of a fiscal year) but had not included several of the governor’s larger enhancements — including $10 million the governor proposed for addressing conflict-of-interest compliance and $10 million for provider expansion.

KDADS described its corrective action plan with CMS tied to the 2014 settings final rule; agency staff said CMS reviewers found examples of conflicts of interest where targeted case managers (TCMs) or CDDOs also provided waiver services and examples of settings that CMS considered insufficiently integrated. KDADS said it has a Conflict of Interest Advisory Group, is offering grants (ARPA and other funds) to support separation of case management from service provision where required, and is testing rural-compliance options when alternatives are limited.

On growth drivers, KDADS said the TA waiver increase is driven in part by improved survival of medically complex children (the department cited conversations with Children’s Mercy Hospital) and that a policy change expanding the brain injury waiver to cover acquired brain injuries has contributed to growth in that waiver.

What was decided or directed: KDADS will continue developing the Community Support Waiver with PCG, complete a rate study, use ARPA and SB 15 funds to support provider transitions and wage initiatives, implement MFEI for reassessments after July 1, 2025, and pursue additional offers to people on the IDD and PD wait lists. The department signaled it will return to the committee with further eligibility and Medicaid-application information if requested.

Committee members and KDADS officials repeatedly emphasized communicating clearly with families about offers, application status and program changes; KDADS said it is exploring improvements to waiting-list transparency and contact methods (email, text and a potential portal) and discussed contracting with CDDOs and Centers for Independent Living to assist with outreach.

The session closed with committee appreciation for KDADS staff, a request for additional eligibility detail from the health agency (KDHE) on family income rules, and no formal committee votes reported during the briefing.

Ending: KDADS officials said they will continue outreach and the waiver-development timeline; the department asked constituents with questions to use KDADS contact channels listed on its slide materials and to monitor committee budget developments as some governor funding requests remained unsettled on the House side.