Brain Injury (BI)

The Brain Injury (BI) waiver is a habilitative/rehabilitation and independent living program emphasizing developing new independent living skills and/or re-learning lost independent living skills due to an acquired or traumatic brain injury. Participants who have a medically diagnosed brain injury receive intensive therapies and services based on the goals of the participant, their providers, and their Managed Care Organization (MCO). The participant's progress will be evaluated every six months until they no longer need these services or they reach a plateau and can transition to another waiver for ongoing supports.

Brain injuries diagnosed as being a chromosomal or congenital condition do not qualify for the BI waiver. Suppose a brain injury is obtained before the age of 22. The individual may be considered developmentally disabled and referred to the Community Developmental Disability Organizations (CDDOs) before BI screening. CDDOs are required to assess all persons with developmental disabilities for the I/DD Program.

Services

Specialized Medical Equipment and Supplies
Home and Environmental Modification Services
Vehicle Modification Services
Financial Management Services
Home-Delivered Meals
Medication Reminder Services
Personal Emergency Response System and Installation (PERS)
Personal Care Services (PCS)
Rehabilitation Therapies: Behavior Therapy, Cognitive Rehabilitation, Physical Therapy, Speech-Language Therapy, and Occupational Therapy
Enhanced Care Services (ECS)
Transitional Living Skills (TLS): In-person services to support goals of increasing independence in the home and community

Eligibility

Be from the age of 0 up to and including 64 years.
Be a resident of the state of Kansas.
Be determined disabled or have a pending determination by the Social Security Administration.
Be financially eligible for Medicaid.
Have a documented medical diagnosis of a traumatic brain injury or acquired brain injury, signed off by an acceptable medical provider. Brain injuries due to chromosomal or congenital diagnoses do not qualify for the BI waiver. To be eligible under a BI diagnosis, the participant must meet the criteria for placement in a Traumatic Brain Injury Rehabilitation Facility. To qualify under a BI diagnosis for age four years and older, the participant must meet the level of care required for hospital placement. For ages 0 to 3 years, the participant must submit current brain injury diagnostic and treatment recommendations from the treating physician
Have active habilitation/rehabilitation need for BI therapies.
Participants between the ages of 4 and 64 years must meet the level of care criteria based on the state-approved Medicaid Functional Eligibility Instrument (MFEI) completed by the ADRC.

Enrollment

To apply for the BI waiver, contact your local Aging and Disability Resource Center. The ADRC will conduct a BI Medicaid Functional Eligibility instrument assessment to determine functional eligibility for the BI waiver. If functionally eligible, KanCare Clearinghouse will determine if the participant meets the disability and financial eligibility guidelines.

HCBS BI Attestation Form

The KDADS ADCSP HCBS BI Attestation Form may be completed by a qualified medical professional and submitted to the ADRC in place of medical records containing your brain injury diagnostic information.

Frequently Asked Questions

Expand/Contract Questions and Answers

Is there a time limit on the BI program?
The BI program is a short-term rehabilitative program. You may participate in the program as you progress in your rehabilitation and transitional living skills, at least until you no longer show habilitative/rehabilitative needs or progress.

The participant will establish goals with their provider and the MCO that will be used to track the habilitative and rehabilitative progress of their independent living skills. When the participant achieves their goals and services are no longer needed or reaches a plateau in their progress, they will have the opportunity to discontinue the BI waiver or transition to another long-term HCBS waiver program for ongoing supports.
What does supporting BI documentation mean?
Supporting BI documentation provided to the ADRC must be medical documentation of brain injury completed by a qualified medical professional. If medical documentation of brain injury is unavailable, the individual applying for waiver services must submit a Brain Injury Program Eligibility Attestation Form completed by a qualified medical professional. A Brain Injury Program Eligibility Attestation Form can be requested from ADRCs, MCOs, or KDADS-HCBS Brain Injury Program Manager.
What is self-direction?
Self-direction is an option that allows you to direct your services. The MCO Care Coordinator and individual determine these services to be essential to maintaining their health and welfare. When you choose to self-direct, you are responsible for multiple tasks, such as choosing, training, monitoring, and dismissal of the worker. TA services that you may be self-directed include ECS and PCS.
What is the difference between an acquired and traumatic brain injury?
The term “Acquired Brain Injury” is the umbrella term for all brain injuries. Brain abnormalities that are genetic, congenital (in utero/prenatally), and present at birth fall outside the scope of acquired brain injuries. The boundary between congenital and noncongenital brain injury is often difficult to indicate. In utero, the brain is in a developmental phase. A brain injury is identified after birth and results in a change in neuronal activity, which affects the physical integrity, metabolic activity, or functional ability of nerve cells in the brain.

Acquired Brain Injury (ABI) can occur at any point in a person’s life from infancy through adulthood.

A traumatic brain injury (TBI), a form of acquired brain injury, is an injury to the brain caused by an external force after birth. Common causes of traumatic brain injury include gunshot wounds, motor vehicle crashes, assaults, sports, falls, and being struck by an object.

A nontraumatic brain injury, often referred to as an ABI, includes brain injuries caused by internal factors such as lack of oxygen (hypoxia), viruses, or infectious diseases that affect the brain, like strokes or tumors, after birth.
Who do I call to get information when I need help?
- For help with authorized services, call your Managed Care Organization (MCO) Care Coordinator.
- For help with your Medicaid eligibility, contact the KanCare Clearinghouse. KDADS does not determine Client Obligation or Medicaid Spend Down. The KanCare Clearinghouse manages these items.
- For help with your waiver eligibility, contact your ADRC.

Additional Information

For additional information or assistance, you may follow the provided link to contact the KanCare Ombudsman.

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Contact Information

BI Waiver Program Manager
Susan Segelquist
785-368-6302
785-296-0256
susan.segelquist2@ks.gov

Mail
Kansas Department for Aging and Disability Services
Attention: Home- and Community-Based Services
503 S. Kansas Ave.
Topeka, KS 66603-3404

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Brain Injury (BI)

Services

Eligibility

Enrollment

HCBS BI Attestation Form

Frequently Asked Questions

Is there a time limit on the BI program?

What does supporting BI documentation mean?

What is self-direction?

What is the difference between an acquired and traumatic brain injury?

Who do I call to get information when I need help?

Additional Information

Contact Information

Seeking BI Advisory Board Members