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Committee hears about home- and community-based services waitlists and new maternal health grant activities
Summary
Kansas officials and KHI researchers told the Committee on Welfare Reform that waitlists for some home- and community-based services remain large and that a federal grant will fund efforts to improve maternal health access in rural 'maternity deserts.'
Kansas Health Institute and KDHE officials told the Committee on Welfare Reform that waitlists for home- and community-based services (HCBS) remain a significant access issue and that the state is beginning activities under a federal maternal health grant intended to expand access and improve outcomes.
Sheena Schmidt summarized updated waitlist figures (October 2024 data) showing that the largest waitlist is for intellectual and developmental disabilities (IDD): “the biggest waitlist is for intellectual developmental disabilities and they have 9,000 enrollees with 4,500 on the waitlist,” she said. Schmidt said other waiver groups have few or no people waiting. The presenters noted that waivers allow states to provide HCBS services as an alternative to institutional care but that waivers can impose caps or create waiting lists.
KDHE officials also described year-one goals for a TMOD (Transforming Maternal Outcomes Demonstration) grant that will focus on three pillars: access and infrastructure in areas they called maternity deserts; quality improvement; and graduate medical education expansion to support obstetric care availability. Bobbi Graff Hendrickson said one concrete access problem the grant aims to address is long travel distances for prenatal and obstetric care, giving an example of a patient needing to drive six hours for obstetric services.
Why this matters: Long waitlists for waiver services and gaps in maternal-care access can affect the health and independence of Kansans with disabilities and pregnant people in rural areas. Officials said the grant work will target service availability and quality in underserved areas.
Key details
- HCBS waivers: Waivers permit states to tailor long-term services and supports in community settings. Kansas operates multiple waivers; updated October 2024 figures showed substantial IDD demand with thousands waiting to receive waiver services.
- Maternal health grant goals: KDHE said year-one TMOD activities include (1) increasing access and infrastructure in rural maternity deserts, (2) pursuing quality-improvement initiatives, and (3) exploring graduate medical education expansions to increase clinician capacity.
Ending
Committee members asked KDHE and KHI to follow up with more detail on waitlist composition and metrics and on the planned timeline and measures for the TMOD grant activities.
