Kansas updates IDD waivers and assessments

Kansas is moving forward with a modernization of its Intellectual and Developmental Disabilities (IDD) waiver system. The update includes a new waiver option, changes to functional eligibility assessments, conflict-free case management requirements, and a planned unbundling of day services.

These changes are expected to affect how providers manage eligibility workflows, structure service delivery, and prepare for future billing and documentation updates tied to new service definitions.

Key waiver and assessment updates

A central change is the introduction of a Community Supports Waiver (CSW). Kansas describes the CSW as a new waiver option designed for individuals who do not require 24-hour supports. The waiver is intended to expand access to services, increase flexibility, and support greater self-direction. Kansas is also replacing its current functional assessment approach. The state will replace the BASIS assessment with the Modified Functional Eligibility Instrument (MFEI), which is based on interRAI. The intent of this shift is to create more consistent and person-centered eligibility determinations beginning July 1, 2025. For providers, this assessment transition is expected to drive updates across intake, eligibility, and reassessment processes. Workflows will need to align with the MFEI tool, including updated documentation and timelines.

Compliance and service definition shifts

Kansas is aligning its case management approach with federal conflict-of-interest requirements through conflict-free case management (CFCM). The stated goal is to ensure case management functions are independent from direct service delivery. The state is also planning to unbundle day services by separating them into clearer, more specific service definitions. Kansas identifies transparency, flexibility, and compliance with the HCBS Settings Rule as the purpose of this change. Unbundling is not expected to take effect before July 1, 2026.

For provider organizations, these items may require operational planning on two fronts. First, organizations that provide both case management and direct services may need to restructure operations to meet conflict-free case management requirements. Second, as day services are unbundled and new service definitions are implemented, billing and documentation processes may change.

Operational impact and national context

Taken together, Kansas’s approach reflects national trends in Medicaid Home and Community Based Services (HCBS) reform. The state’s waiver updates, eligibility system changes, and compliance steps are areas that other states are closely watching as they evaluate their own waiver renewals, eligibility systems, and alignment with federal HCBS rules.