Sedgwick County to begin statewide Medicaid functional assessment July 1; documentation and payment rules change

Sedgwick County service-access staff on a county-hosted webinar outlined changes to the Medicaid Functional Eligibility Instrument, a new standardized assessment the state will use beginning July 1 to determine eligibility for Home- and Community-Based Services (HCBS) waivers.

Heather Pace, Sedgwick County service access manager, said the assessment — referred to in training materials as the MAFE or MIFI and built on the interRAI tool — will replace the BASIS assessment and be scored by a state algorithm. "The MAFE assessment is not tied to provider reimbursement at all at this time. It's only use is to determine whether or not the individual meets the minimum score in order to be level of care eligible for the waiver," Pace said.

Why it matters: The change separates the eligibility determination from the payment model that had been tied to BASIS tiers. For providers, case managers and families, the most immediate operational changes are narrower documentation requirements, new look-back windows on questions, and a longer, more detailed assessment format expected to take up to two hours initially.

Key points from the briefing

- Start date and purpose: Sedgwick staff said the county will begin using the MAFE on July 1. The instrument determines whether an individual meets the level-of-care threshold for HCBS waiver funding; it does not itself set provider payment rates during the transition year.

- Documentation: County staff said assessors will not request the wide set of supporting documents previously required. Pace told attendees, "we will…