This page provides a comprehensive overview of the upcoming changes to the HCBS I/DD Waiver Program, including the transition to the MFEI-IDD tool, the shift to a calculated floor rate, unbundling of day supports, and other important updates.

Purpose

To design a responsive, person-centered model that adapts to waiver participants' evolving needs and goals. This modernization emphasizes flexibility and empowerment, ensuring participants receive the right supports at the right time and in the right amount to achieve meaningful community integration and independence.

Announcement

Stakeholders,

After careful consideration and valuable input from key stakeholders, including Managed Care Organizations (MCOs), Community Developmental Disability Organizations (CDDOs), and Providers, we have decided to extend the go-live date for the MFEI I/DD Implementation and the interRAI Service Planning implementation to March 1, 2025.

This decision was made to ensure individuals serving in Kansas receive a smoother and more effective implementation of services to meet their needs. We can address potential challenges related to rate setting, waiver amendments, and system readiness by extending the timeline.

We understand that these changes may impact planning and operations. We are committed to providing timely updates and support throughout the implementation process.

We appreciate your understanding and continued partnership as we work to improve services for individuals with intellectual and developmental disabilities.

Thank you for your continued support.

Michele Heydon,

LTSS Commissioner

• Key Recommendations from the I/DD Modernization Committee:
  • The I/DD Modernization Committee, which met in late 2022, identified the need for significant updates to Kansas' I/DD Waiver Program. A key recommendation was to replace the existing BASIS assessment, which was found to be deficit-based and not reflective of an individual’s true level of care needs.
  • The BASIS tool often failed to capture a holistic view of a person’s abilities and strengths, resulting in less effective service planning. Moving to a more person-centered system, the committee proposed adopting the MFEI-IDD tool to better align services with each participant’s unique needs and goals.

• Development and Implementation:
  • The Medicaid Functional Eligibility Instrument – Intellectual and/or Developmental Disability (MFEI-IDD) tool is based on the interRAI and has been under development since 2015 and represents a significant shift towards a person-centered system. Unlike the BASIS tool, the MFEI-IDD offers a more holistic assessment that captures strengths and needs, ensuring that services align with each participant’s specific circumstances.
  • Why Managed Care Supports This Transition: Flexibility is essential in a managed care environment. Managed Care Organizations (MCOs) ensure adequate provider networks to deliver the necessary services to participants. By switching to the MFEI-IDD tool, in conjunction with the MCOs utilizing the full suite of interRAI tools for service planning, MCOs will be able to create more accurate, tailored care plans, supporting a shift away from rigid, one-size-fits-all approaches to funding and care that may not accurately reflect a person’s preferences, strengths, and support needs.
• Phased Approach:
  • Effective March 1, 2025: The MFEI-IDD tool will be used for the level of care (LOC) assessments for all new I/DD Waiver Program participants.
    • MCOs will begin utilizing the full suite of service planning tools from interRAI, allowing for more detailed and responsive care planning across different service areas.
  • This change is crucial for the launch of the Community Supports Waiver, which requires the MFEI-IDD to be fully in place. Learn more about the Community Supports Waiver here.

• For New IDD Waiver Participants: Starting March 1, 2025, all new I/DD Waiver entrants will receive day or residential services based on the new floor rate.
• For Existing IDD Waiver Participants: For existing waiver participants receiving a tiered service, rates will be frozen until July 1, 2026, allowing KDADS and stakeholders time to study and refine appropriate rates.
• Managed Care Flexibility: MCOs can negotiate rates above the floor, particularly for individuals with high-acuity needs, ensuring that funding can be adapted based on the intensity of care required.

• Addressing High-Need Cases:
  • KDADS is reforming how extraordinary funding is administered. The goal is to ensure a more streamlined, transparent process for accessing additional resources for individuals whose needs exceed standard service levels.
  • Why This Matters: Providers will have clearer guidelines for securing funding for high-acuity participants, ensuring better care and service continuity.

• Target Effective Date: Summer 2025
• What’s Changing: Day supports will be unbundled into more specialized service categories, such as Community-Based Day Habilitation, Career Exploration, Life Skills Services, and others. Not all unbundled services will be tiered, allowing more flexibility in tailoring care.
• Why This Matters: Unbundling these services will enable more targeted, personalized support that aligns with each participant’s goals, encouraging greater community involvement and independence. Providers can offer a clearer menu of services, helping participants and families make informed choices.

• Feedback and Input:
  • KDADS values stakeholder input and will conduct a rate study in 2025, where feedback from providers, participants, and families will help shape future rate structures.
• Upcoming Events and Opportunities:

  • The next Bi-Monthly Stakeholder Call is November 18^th at 12 p.m. CT. 

• Contact Information:
  • For specific questions or to submit feedback, please contact KDADS at kdads.hcbs-ks@ks.gov or sign up for our listserv.

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KDADS is committed to transparency throughout this transition. This page will be updated regularly with new information, documents, and answers to emerging questions. Stakeholders are encouraged to check and engage with upcoming events and feedback opportunities regularly.

FAQs

Q: What happens if a waiver participant’s needs increase?

A: Participants whose care needs increase can receive additional support through service adjustments and extraordinary funding. This ensures that higher-acuity needs are met, even between standard assessment periods.

Q: Will existing participants need to switch to the newly calculated floor rate immediately?

A: No, for IDD waiver participants in an existing tiered service, their rates will be frozen until July 1, 2026. New entrants will receive the new floor rate starting March 1, 2025.

Q: How do unbundling services benefit me as a participant?

A: Unbundling allows for more personalized, specific services, helping participants choose the supports that best fit their goals, whether it’s gaining job skills or community engagement.

Q: Will the MFEI assessment take longer than the BASIS?

A: The MFEI may take a little longer to complete, but it offers a more comprehensive and strengths-based assessment. The benefits include fewer disputes over tier scores and a more accurate representation of individual needs, leading to better service planning.

Q: What if someone was eligible under the BASIS, but the MFEI in 2025 says they are now ineligible?

A: If the MFEI assessment indicates ineligibility, KDADS will conduct a BASIS assessment to verify your eligibility status. As always, participants will have the right to appeal any negative eligibility decisions.

Q: I've heard it's really hard to negotiate with the MCOs. Is this true?

A: Negotiating with MCOs can sometimes be challenging, but KDADS is working to provide clearer guidelines and more transparency around rate negotiations. MCOs are expected to ensure adequate networks, which means they have the flexibility to negotiate higher rates where necessary to meet participant needs. Providers are encouraged to engage directly with MCOs to find mutually beneficial solutions.

Q: How will the rate study help inform rate adjustments?

A: The rate study will collect and analyze cost reports from providers across the state to get a clear picture of actual service delivery costs. This data will help KDADS set floor rates reflective of real expenses, ensuring providers are fairly compensated for their services.

Q: Will my services change with the new MFEI tool?

A: The MFEI tool is designed to create more personalized care plans. While the overall structure of your services may not change immediately, the MFEI will help ensure that your service plan aligns more closely with your unique needs and strengths.

Q: What happens if I need more support, but the calculated floor rate doesn’t cover it?

A: If your care needs increase, you can work with your provider and MCO to adjust your service plan. Additionally, KDADS offers extraordinary funding to support participants with higher-than-typical care needs, ensuring that everyone receives appropriate care regardless of their standard.