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KDADS warns of potential HCBS waitlists and hospital staffing gaps; House and governor diverge on funding
Summary
Kansas Department for Aging and Disability Services told Ways and Means the House added some targeted items but excluded other governor priorities — including provider compliance grants and full funding for contract staffing at Larned — and asked the committee to restore reappropriations and consider funding to avert waiver waitlists.
Kansas Department for Aging and Disability Services (KDADS) officials told the Senate Ways and Means Committee that their fiscal requests include funding to avoid wait lists for home‑and‑community‑based services (HCBS) waivers and to address staff shortages at the state hospitals, and they urged the committee to restore previously approved reappropriations.
Dayton Lemunyan of the Kansas Legislative Research Department (KLRD) reviewed KDADS’ budget pages and told the committee the agency had $282.3 million in total reappropriations for FY25; the legislative budget committee lapsed roughly $150.5 million and the House restored a subset, including $45.1 million tied to HCBS FMAP savings. Lemunyan said the HCBS FMAP funds derive from public health emergency savings and are required to be spent on HCBS projects or returned to the federal government.
KDADS Secretary Laura Howard pressed the committee to consider five priorities not fully reflected in the House recommendation, including funding to prevent waiting lists for three waivers — the frail elderly waiver, technology‑assisted waiver and brain injury waiver — and a reduced ask of $10 million (down from an earlier $45 million request) to help providers comply with rules and expand capacity.
Secretary Howard said the state has seen increases in waiver participation — roughly 7% for the frail elderly waiver, 11% for the technology‑assisted waiver and 6% for the brain injury waiver — and asked the committee to consider $8.6 million in SGF across those three waivers to avert wait lists. “We would request that you would consider additional funds to avert us having to start a waiting list for those programs,” she said.
State hospitals and contract staffing KDADS and hospital staff described ongoing reliance on contract nursing and the operational strain at Larned and Osawatomie state hospitals. Deputy Secretary Scott Bruner said Larned has 94 acute psychiatric care beds, roughly 140 forensic beds for criminal defendants and about 350 beds for civil commitment of sexually violent predators (statutory program); he told the committee state employees can staff only a portion of current capacity and contract labor fills the gap.
Bruner said the average length of stay for acute treatment is about 14 days at Osawatomie and slightly longer at Larned; competency restoration placements run longer (roughly several months on average). He and Secretary Howard said travel nurses and contract staff have been used to preserve capacity while the state recruits permanent staff.
Budget items added by the House Lemunyan summarized several House additions for FY26 that were not in the agency request, including a nursing facility add‑on payment (about $75.5 million all funds, estimated as $20 per day), additional IDD waiver slots (the House added roughly $22.4 million to serve about 320 individuals), grants to community mental health centers and partial rebase funding for nursing facility rates.
What was left out Howard noted the governor recommended additional provider compliance grants and contract staffing funding for state hospitals; the House did not adopt all of those recommendations. She asked the committee to restore $2.7 million of lapsed FY25 reappropriations tied to an electronic health records project and committed staffing costs, and she asked the committee to consider restoring the governor’s contract staffing funding that was recommended but not included by the House.
Committee discussion Senators questioned the scale of the staffing shortages and the costs of travel nurses. Senator Alley asked whether the problem was location or pay; agency witnesses said both play a role, especially at Larned, where housing and geographic isolation compound recruitment challenges. Committee members discussed options including higher pay and sign‑on or retention bonuses; KDADS said bonuses and recent pay increases have helped but do not yet fill all vacancies.
No final votes were recorded during the hearing; KDADS asked the committee for follow‑up consideration on reappropriations, waiver funding to avoid wait lists and state hospital staffing funding.
