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- Federal Minimum Staffing Standards repealed.
- On December 2, 2025, the U.S. Department of Health and Human Services repealed key provisions of the federal minimum staffing standards for long-term care facilities.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.
Kansas Advocates for Better Care testified on FE waiver funding and supported bills on decision-making, dementia training, and memory care standards.
In 2025, KABC marked a major milestone: 50 years of advocating for the safety, dignity, and rights of older Kansans. Our newly released 2025 Impact Report reflects a year of meaningful progress, powerful advocacy, and deep community connection. This past year, KABC assisted hundreds of residents and families through direct advocacy, strengthened long-term care oversight through legislative work, and expanded access to information with the launch of a statewide senior resource directory in partnership with KDADS. We also amplified resident voices through media coverage, testified before legislative committees, and successfully countered efforts that would have weakened long-term care safety standards. As part of our 50th anniversary, we brought advocacy into the community with new events like Revving Up Joy, a classic car show connecting residents and neighbors, and a public screening of No Country for Old People , sparking critical conversations about the realities of long-term care in America. None of this work is possible without the support of our donors, partners, board members, and volunteers. Your commitment fuels our mission and helps ensure older Kansans are seen, heard, and protected. Read our full 2025 Impact Report here .