KDADS outlines Medicaid-funded services, state hospitals, waivers and regulatory priorities

Deputy secretaries from the Kansas Department for Aging and Disability Services (KDADS) presented an overview of KDADS programs, Medicaid-funded services, state hospitals, regulatory responsibilities and legislative priorities at the Committee on Social Services Budget.

Secretary Laura Howard (presenting for KDADS) introduced Deputy Secretary Andy Brown (Programs) and Deputy Secretary Scott Brunner (Hospitals and Facilities) and said KDADS administers large Medicaid-funded programs, nursing-facility payments and multiple home- and community-based services (HCBS) waivers. Howard told the committee KDADS’ combined state-and-federal spending is roughly $3 billion, with approximately $1 billion in state funds and about $1.8 billion in federal funds.

Deputy Secretary Andy Brown summarized KDADS’ Aging Services Commission, Behavioral Health Services Commission and Long-Term Services and Supports (LTSS) Commission. He highlighted expansion of PACE (Program of All-Inclusive Care for the Elderly), work on Medicare fraud prevention outreach, and the renewal and amendment of several HCBS waivers. Brown listed the agency’s HCBS waivers (autism, frail and elderly, IDD, physical disability, serious emotional disturbance, technology assistance and brain injury) and said some waivers carry wait lists. He described efforts to add less-intensive community supports designed to reduce the IDD waiver waiting list and said KDADS expects to seek CMS approval for a new community-supports waiver that would offer a narrower set of services to more people on the IDD wait list.

Brown also reviewed targeted case management (TCM) changes under federal settings guidance and said KDADS is under a corrective action plan with CMS to address conflicts of interest in the IDD targeted-case-management network. He said KDADS is working with providers to transition business models and to seek grant opportunities to mitigate conflicts.

Deputy Secretary Scott Brunner described KDADS’ state hospitals (two psychiatric hospitals in Osawatomie and Larned; two hospitals for people with intellectual and developmental disabilities at Kansas Neurological Institute in Topeka and in Parsons). He said the agency supports the hospitals’ CMS certification work, operational needs and capital improvements and cited recent efforts to raise pay for direct-care staff and to adopt a single statewide electronic health record for all four campuses. Brunner said all four campuses are now live on the new electronic health record.

Brunner explained KDADS’ role in forensic competency evaluations and restorations (Larned is the state security hospital for competency restoration) and said courts’ demand for competency evaluations has exceeded Larned’s capacity. To reduce jail waits, KDADS has funded some community competency-restoration work and pays counties $100 per day for defendants awaiting admission to Larned under certain circumstances.

KDADS legislative priorities described to the committee include: (1) statutory authority for the South-Central Regional Mental Health Hospital (104 beds) under KDADS’ budget structure, (2) creation of a restricted use fund to retain civil monetary penalties for quality improvement in state-licensed facilities instead of directing those penalties to the general fund, and (3) making outpatient forensic competency-restoration in community settings the default option before inpatient commitment to Larned, where clinically appropriate.

On regulatory activity, Brunner described the agency’s Survey and Certification unit, which licenses and surveys roughly 850 facilities (308 nursing facilities plus more than 500 state-licensed sites) and oversees health occupations credentials and criminal background checks for frontline workers. He said the abuse-and-neglect hotline received nearly 7,000 calls in 2024 and that vacancy and recruitment challenges constrain survey capacity. KDADS has begun requiring supplemental nursing-service agencies to register and report pay practices; about 42 agencies registered in the initial round.

Committee members asked about waiver wait lists, the community-supports waiver, and hospital capacity. Representative Steens asked how people come off waivers and whether they have case managers; Deputy Secretary Brown said enrollment rules vary by waiver, that individuals receive eligibility and service planning and that some wait-list management improvements are possible. Representative Pazen asked about the new South-Central hospital’s capacity and whether KDADS anticipates future expansion; Brunner said the current site is sized for 104 beds and on-site expansion is limited, so future capacity changes would require other strategies such as service specialization across campuses.

Ending: KDADS leaders asked the committee for support of the agency’s legislative priorities and said they would provide additional budget and implementation detail in upcoming hearings.