Highlights from January KanCare Oversight Committee
Libby Hastings • January 29, 2026
Highlights from the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services & KanCare Oversight
The Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight met on Friday, January 23rd, to hear updates and testimony on the state of long-term care and home- and community-based services (HCBS) in Kansas. The Bethell Committee is a joint committee of House and Senate members and will meet again in April. The committee received presentations from KanCare Managed Care Organizations (MCOs), the KanCare Ombudsman, the Long-Term Care Ombudsman, the Kansas Department for Aging and Disability Services (KDADS), and the Kansas Department of Health and Environment (KDHE), along with individual testimony. Kansas Advocates for Better Care (KABC) provided testimony, delivered by Dan Goodman, Executive Director.
KDADS Updates
KDADS shared updates on workforce capacity, policy changes, and HCBS planning:
- Surveyor staffing shortages remain a concern.
- Currently, only 7 of 12 state licensed–only surveyor positions are filled. Regional staffing varies, with the Southwest Region having just 3.5 of 6.5 positions filled, highlighting ongoing challenges in timely oversight and enforcement.
- Federal Minimum Staffing Standards repealed.
- On December 2, 2025, the U.S. Department of Health and Human Services repealed key provisions of the federal minimum staffing standards for long-term care facilities. HHS cited concerns that the rule disproportionately burdened rural and Tribal providers and could limit access to care.
- Involuntary discharge data collection.
- The FY25 budget includes a proviso requiring KDADS to collect data on involuntary transfers and discharges in state licensed–only adult care homes and report findings to the 2026 Legislature. KDADS shared their updated data on involuntary transfers and discharges from August 2024 to October 2025.
- HCBS waiver waiting lists loom.
- Public comment is open through February 14 on amendments to the Physical Disability (PD), Frail Elderly (FE), Technology Assisted (TA), and Brain Injury (BI) waivers. Proposed changes would allow waiting lists for the FE, BI, and TA waivers beginning May 1, 2026, if additional funding is not secured.
- Community Care Coordination pilot delayed.
- KanCare Governance has temporarily waived certain contract requirements for six months while KDADS, KDHE, and MCOs assessed readiness for a Community Care Coordination pilot that has already been funded but not implemented.
- Kansas Senior Resource Guide update.
- KDADS announced that the Kansas Senior Resource Guide will be published and distributed beginning in the third quarter of State Fiscal Year 2026 and updated annually, being completed in partnership with KABC.
KABC Testimony: Frail Elderly Waiver at Risk
KABC urged the committee to support additional funding for the HCBS Frail Elderly (FE) waiver, warning that projected shortfalls of $30 million ($75.2 million all funds) in FY27 could trigger an imminent waitlist affecting as many as 600 frail elders initially.
KABC emphasized that:
- A waitlist would worsen Kansas’s already low national ranking (47th) for low-care residents in nursing facilities.
- Delays in services would accelerate health decline for older Kansans who do not have time to wait.
- The Legislature added approximately $200 million in annual base funding for the nursing facility industry last session, making targeted HCBS investments a reasonable and cost-effective alternative to premature institutionalization.
Dan also noted that when the FE waiver last had a waitlist in 2003, about 20% of eligible participants were affected. Applying that ratio today could mean as many as 1,700 older Kansans waiting for services. Given that individuals typically remain on the FE waiver for just over three years before transitioning due to death or institutional placement, this population cannot afford prolonged delays.
If a waitlist cannot be avoided, KABC recommended utilizing the $20 million already allocated for Community Care Coordination, which remains unimplemented, to help individuals navigate unmet needs while awaiting waiver slots.
Long-Term Care Ombudsman: Systemic Concerns
The Long-Term Care Ombudsman highlighted persistent, systemic issues impacting residents’ rights and safety, including:
- Chronic understaffing and workforce shortages underscore the need for accountability and safe minimum staffing standards.
- Facility-initiated discharges, particularly in adult care homes. Concerns include:
- Discharges to hospitals or psychiatric units with refusal to readmit.
- Deceptive admissions practices around “aging in place.”
- Medicaid acceptance claims that result in discharge once private-pay funds are exhausted.
- Calls to require Ombudsman notification for all facility-initiated discharges, expand safe discharge definitions, and prevent unsafe placements such as homeless shelters or motels.
- Overuse of antipsychotic medications, with recommendations to expand reimbursement for non-pharmacological supports like music therapy, pet therapy, aromatherapy, and massage.
- Lack of ownership transparency and problematic ownership relationships.
- Need for increased KDADS surveyor staffing.
- Resident pharmacy choice violations, including excessive fees charged to residents who choose pharmacies outside of facility contracts.
- Insufficient personal needs allowance, limiting residents’ dignity and autonomy.
History of the Bethell Committee
The Bob Bethell Home and Community-Based Services and KanCare Oversight Committee was established during the 2013 session. There was strong agreement among the administration, advocates, and providers that robust legislative oversight was essential to guarantee accountability and transparency for a systems change as large and complex as KanCare. One consumer group said, “legislative oversight of KanCare will be an important tool for achieving the goals of KanCare and for ensuring transparency and accountability for consumers and all stakeholders invested in making KanCare successful."
This committee serves as a vital platform for consumers and providers to raise issues and recommend solutions. It has directed agencies and MCOs to address delays in eligibility, workforce shortages, provider rate parity, waiting lists, and more. This work is only possible through active stakeholder engagement, which helps the committee remain effective, informed, and focused on solutions.
Thank You for Making Our First-Ever Trivia Night a Success!
KABC Testifies before the Kansas Silver Haired Legislature Kansas Advocates for Better Care (KABC) is urging state leaders to provide additional funding to eliminate the waitlist for the Home and Community-Based Services (HCBS) Frail Elderly (FE) Waiver, which helps older Kansans access the services they need to remain in their homes and communities. In testimony submitted to the Kansas Silver Haired Legislature (KSHL) on October 6 th in Topeka, KABC Executive Director Dan Goodman emphasized the importance of preserving access to in-home care and preventing older adults from entering nursing facilities before they need that level of care. The FE waiver waitlist, implemented July 6, 2026, has already affected hundreds of older Kansans. Without additional funding, more people could face delays in receiving essential services, potentially accelerating health declines and increasing the likelihood of premature nursing home placement. KABC is recommending $31 million in additional funding for the FE waiver in fiscal year 2027 to address projected funding shortfalls and help eliminate the waitlist. Kansas Silver Haired Legislature Sets 2027 Priorities On October 7 and 8, 65 delegates representing regions across Kansas gathered on the floor of the Kansas House of Representatives in Topeka for the Kansas Silver Haired Legislature's annual session. During the session, delegates approved five resolutions outlining their legislative priorities for 2027. The resolutions focus on supporting older Kansans' independence, financial security, access to care and participation in civic life. The five priorities are: Fund senior transportation Protect in-home care Increase funding for the FE waiver to help older Kansans receive care in their homes and communities. KABC supports this priority and is urging the state to add $31 million in funding for fiscal year 2027 to eliminate the FE waiver waitlist. Strengthen Medicaid Raise the Personal Needs Allowance Increase the Personal Needs Allowance for nursing home residents who receive Medicaid Protect senior voting rights These priorities address interconnected challenges facing older Kansans, from accessing transportation and affordable care to maintaining independence and financial security. The Importance of Care at Home The FE waiver was established to help older Kansans access community-based services that allow them to remain in their homes for as long as possible, delaying or avoiding the need for more costly institutional care. These services can make a significant difference in an older adult's ability to maintain independence, health and quality of life. When needed support is unavailable, however, individuals and families may have fewer options for managing care at home. Kansas already faces challenges in this area. According to the United Health Foundation's America's Health Rankings, Kansas ranks 47th in the nation for placing low-care residents in nursing facilities. KABC is concerned that limiting access to home- and community-based services could contribute to further premature institutionalization. The Cost of Delayed Access The potential impact of the waitlist is significant. According to KABC's testimony, the state faces a projected $31 million shortfall for the FE waiver in fiscal year 2027, putting access to critical in-home services at risk. Historical data also illustrate the potential scope of the problem. In 2003, a similar FE waiver waitlist affected approximately 20% of eligible participants. The Kansas Department for Aging and Disability Services (KDADS) reports that 9,306 Kansans are currently eligible for the waiver. Applying that historical 20% figure to today's eligible population suggests that approximately 1,861 older Kansans could be affected in fiscal year 2027. While this estimate is based on a historical comparison, it underscores the potential consequences of insufficient funding. Investing in Older Kansans The goal is to help older Kansans receive the services they need when they need them, rather than risk declining health or entering institutional care because community-based options are unavailable. As Dan Goodman emphasized in his testimony, investing in home- and community-based services offers an opportunity to support older adults' independence while potentially avoiding the greater costs associated with premature institutionalization. The Kansas Silver Haired Legislature's 2027 priorities provide a framework for addressing the needs of older Kansans across the state. KABC's support for increased FE waiver funding aligns with the Legislature's call to protect in-home care and ensure older adults have meaningful choices about where and how they receive care. KABC will continue advocating for policies and resources that protect older Kansans' access to quality long-term care, wherever they call home.