Advocacy and Policy

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.

2026 legislative wrap-up for long-term care advocates in Kansas.

On March 19, 2026, a Washington Post article highlighted a recent Office of Inspector General for the Department of Health and Human Services investigation that brought renewed national attention to a troubling reality inside America’s nursing homes: powerful antipsychotic drugs are being used not as treatment, but as control. The report found that some facilities are misdiagnosing residents with schizophrenia to justify prescribing antipsychotic medications. These drugs are often not approved for people with dementia and carry serious risks, including falls, strokes, and even death. In many cases, these medications are used to manage behaviors that are not dangerous, such as calling out, resisting care, or expressing distress. The result is what advocates have long warned about: the use of chemical restraints to sedate residents for staff convenience. A National Problem Decades in the Making The misuse of antipsychotic drugs in long-term care has been documented for years. In April 2024, KABC highlighted this issue in our advocacy work, noting that hundreds of thousands of nursing home residents nationwide are given antipsychotic medications, often without appropriate clinical justification. These drugs carry an FDA “black box” warning for use in older adults with dementia due to an increased risk of death. Federal efforts over the past decade have aimed to reduce unnecessary use, yet as of early 2026, approximately 17% of long-stay nursing home residents in the United States are still receiving antipsychotic medications. At the same time, recent federal policy discussions in March 2026 have raised concerns among advocates that loosening reporting requirements could reverse progress made in reducing inappropriate use. Kansas Is Not Immune This issue hits close to home. In 2022, the Kansas Legislature’s Senior Care Task Force released a report to the 2023 Legislature identifying the administration of antipsychotic medications and protections against abuse and neglect as critical areas for reform. The Task Force emphasized that these medications could have serious and even fatal consequences for older adults, particularly when used inappropriately. Advocates in Kansas have reported that up to 26% of nursing home residents, and nearly 40% of those with dementia, have been prescribed antipsychotic medications in recent years, despite well-documented risks. While some facilities have made progress, reductions in use have stalled in recent years, raising concerns that systemic issues remain unresolved. Why It Happens At its core, the misuse of antipsychotic drugs is often a symptom of deeper systemic problems, many of which have been exacerbated since the COVID-19 pandemic. Experts and investigators point to: Chronic understaffing, intensified since 2020 Lack of training in dementia care Pressure to manage behaviors quickly Lack of person-centered practices in care Gaps in oversight and accountability Non-drug approaches, like personalized care, meaningful activities, and addressing unmet needs, are widely recognized as best practice. But they require time, staffing, and resources that many facilities continue to lack in 2026. When those supports are missing, medication restraint becomes the default. What Proper Care Should Look Like Clinical guidance has long been clear, and yet remains unchanged in 2026. Antipsychotic medications should be a last resort, used only when: Non-drug interventions have failed The resident poses a risk to themselves or others The benefits outweigh the serious risks Even then, they should be used cautiously, closely monitored, and regularly reevaluated. The Path Forward for Kansas Kansas has an opportunity, and an obligation, to act. Building on the 2022 Senior Care Task Force recommendations, advocates continue in 2025–2026 to call for: Expanded access to geriatric mental health specialists Stronger oversight and enforcement Improved training in dementia and person-centered care Greater transparency for residents and families Meaningful solutions to the ongoing staffing crisis At its heart, this is about dignity. Older adults in Kansas adult care homes deserve care that respects their humanity, not treatment that silences it.

Kansas Advocates for Better Care testified on FE waiver funding and supported bills on decision-making, dementia training, and memory care standards.

Updates from the January 23rd Bob Bethell Joint Committee.

KABC’s January 2026 legislative update covers the compressed Kansas session, budget cuts, Medicaid risks, and priorities to protect older Kansans.

Kansas families face a fragmented dementia care system. Learn the policy gaps and solutions to support older adults and caregivers.

On Monday, October 13th, Dan Goodman, Executive Director of Kansas Advocates for Better Care (KABC), delivered testimony before the Robert G. Bethell Joint Committee on Home & Community Based Services & KanCare Oversight. His remarks focused on the urgent need to strengthen Kansas’ long-term care system through sustainable funding and workforce investments. Goodman urged legislators to provide additional funding for the Home and Community-Based Services (HCBS) Frail Elderly waiver , noting projected shortfalls of $27 million in FY26 and $70 million in FY27. Without intervention, hundreds of older Kansans could face placement on a waitlist as early as this fall—delaying access to critical in-home services and increasing the risk of premature institutionalization. He also highlighted the need to support and stabilize the state’s long-term care workforce by exploring innovative approaches used in other states. For example, New Mexico’s Competitive Pay for Professionals program has helped attract and retain workers by linking higher wages to improved reimbursement rates and accountability measures. Goodman suggested Kansas consider similar models to strengthen its caregiving workforce and ensure providers can offer competitive pay. KABC remains committed to advocating for policies that promote quality care, protect older adults, and sustain a strong, well-supported caregiving system across Kansas. Read KABC’s full testimony here: View Testimony (PDF) Watch a full recording of the committee here: YouTube Link

On October 1st and 2nd, the 2025 Special Committee on Health and Social Services met, with the first day devoted to nursing home surveying and credentialing. The joint committee of both House and Senate members heard from the Kansas Department for Aging and Disability Services (KDADS), the Long-Term Care Ombudsman, industry representatives from Kansas and out of state, administrators, and contractors. Notably absent were the voices of consumers, their family members, and facility staff , the people most affected by long-term care policy. The committee heard information about: Survey Backlogs and Staffing Challenges KDADS contracts with the federal government to inspect adult care homes for health and safety compliance. KDADS has struggled for years to meet federal requirements, due in large part to recruiting and retaining nurse surveyor positions. More than half of the 60 approved positions were vacant earlier this year. As a result, Kansas currently averages 19.9 months between nursing home inspections , far beyond the federal requirement of 12-15.9 months. With just over 300 federally licensed facilities in the state, timely inspections are critical to protecting residents. To address this, KDADS eliminated 15 vacant positions and raised starting pay: up to $60,000 for multidisciplinary surveyors and $67,000 for RNs . The agency is also considering incentives to encourage more RNs to work as surveyors. Kansas has one of the highest rates of the most serious deficiencies, known as Immediate Jeopardy (IJ) deficiencies, in the nation , citations for situations where resident health and safety are at serious risk. The committee explored the possibility of privatizing the survey process. Resident Rights at Risk Testimony also revealed troubling practices in some nursing homes, including charging residents $200–$300 per month in “pharmacy provider” or “medication set-up” fees if they choose to use an outside pharmacy. This practice undermines residents’ right to choose their own providers and unfairly penalizes private-pay residents, already shouldering an average of $7,000–$8,000 per month in nursing home costs. Involuntary Discharges and the Ombudsman’s Recommendation The Long-Term Care Ombudsman urged lawmakers to expand discharge reporting requirements. As she noted: “Federal regulations require a notice to be sent to our office for a facility-initiated transfer (involuntary discharge) in federally licensed nursing homes, but that is not the case for state licensed homes, assisted livings, home pluses and residential health care facilities. With the help of our office, we can often help resolve the reason for the discharge notice to prevent a resident transfer or support the resident to ensure a transition occurs safely.” The committee heard concerns from representatives of the nursing home industry and decided to delay making a recommendation on this issue, noting that additional information is needed. KABC has advocated for not only strengthening the reporting requirements but also giving residents of assisted living facilities the same right to appeal an involuntary discharge that nursing home residents enjoy. Raising the Personal Needs Allowance The Personal Needs Allowance (PNA) for nursing home residents is a monthly stipend that Medicaid recipients can use for personal expenses. In Kansas, the PNA is just $62 per month. Many residents express concern that this amount is insufficient to cover basic personal expenses such as haircuts or undergarments. An immediate increase to the allowance is needed, along with an ongoing adjustment to keep pace with rising costs. The Long-Term Care Ombudsman recommended a PNA increase to the national average of $72 with an additional annual Cost of Living Adjustment. KABC’s Position KABC will continue to advocate for: • Strong oversight of nursing homes. • Resident rights protections, including freedom of choice in providers. • Central inclusion of residents and staff voices in all policy discussions. You can watch the hearing on the Kansas Legislature’s YouTube channel here . KABC will continue to monitor these conversations closely as the 2026 legislative session approaches.