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Parents urge more than 25 weekly day‑service hours and relief from repeated annual re‑assessments
Summary
Multiple parents testified that Kansas' 25‑hour per week IDD day‑service reimbursement and yearly re‑assessments force families into untenable choices — such as changing work or placing loved ones in residential care — and requested higher weekly limits and streamlined renewals.
Parents and guardians told the committee that the state’s 25‑hour weekly Medicaid reimbursement limit for IDD day services leaves many families without workable care, drives workforce shortages, and pressures families toward premature residential placements.
Courtney Carpenter, a single parent whose son requires one‑to‑one care, said 25 hours per week (not counting travel time) does not cover a standard working day and forces parents to miss work or scramble for unpaid respite. "When Devin was in school there were supports before and after school. Once he turned 21, the supports vanished," Carpenter said. "Parents are left with no choice but to consider group homes before they are ready."
Melanie Jacobs, a guardian, said her daughter has complex medical needs and the annual eligibility and functional assessments require repetitive documentation she termed intrusive. She described a burdensome sequence: annual MFE (Medicaid Functional Eligibility) eligibility assessment, then an interRAI assessment by the MCO, then a personal support plan and KanCare renewal — a process she said can total three hours of overlapping interviews and repeated evidence of lifelong disability.
Several witnesses asked why genetic and congenital conditions do not receive longer review intervals. "At some point, when do we say this is lifelong?" Jacobs asked.
KDADS staff acknowledged the duplication complaints and said the MFE implementation began recently; they said they are working with the managed care organizations to reduce overlap between the MFE and interRAI assessments and to streamline processes, but the department did not provide a fixed timetable for eliminating duplication.
Parents also raised pay and staffing issues for respite and personal care workers. Courtney Carpenter said available respite workers typically do not accept current pay rates; "they can go to Target and work for $19 an hour and not have to change an adult diaper," she said.
Committee members asked KDADS to specify the origins of the 25‑hour limit and whether it is a federal CMS requirement, an MCO requirement, or an administrative KDADS policy. KDADS agreed to present a formal explanation to the committee in a follow‑up briefing.
Witnesses recommended practical fixes: increase day‑service weekly hours to better match workday needs (representatives suggested a 9‑hour day Monday–Friday as a benchmark), evaluate exceptions for clearly lifelong disabilities, and coordinate MFE/InterRAI and KanCare renewal timing to reduce redundant assessments.
KDADS said it will return with clarifications on the statutory or administrative basis for the 25‑hour rule, a plan to address assessment duplication and an analysis of the fiscal impact of changing weekly limits.
