Home and Community Based Services Kansas — HCBS Programs for Seniors

Your parent was just discharged from a Kansas hospital, and nursing home placement feels like the only option. But your parent wants to go home — and Kansas has programs designed to make that possible.

Home and Community Based Services (HCBS) in Kansas provide Medicaid-funded alternatives to nursing home placement: personal care attendants, home modifications, adult day programs, medication management, and more. The challenge is that the enrollment process runs through multiple agencies with strict eligibility criteria, and hospital discharge planners rarely walk families through it in detail.

The Frail Elderly Waiver — The Primary HCBS Program

For seniors aged 65 and older who need nursing-facility-level care but want to stay home, the Frail Elderly (FE) waiver is the main pathway. Administered through KanCare, the FE waiver covers:

• Personal care and attendant care — help with bathing, dressing, toileting, meal preparation
• Medication reminders — a trained worker ensures your parent takes medications on schedule
• Home modifications — ramps, grab bars, doorway widening, bathroom modifications for accessibility
• Adult day care — structured programs that provide social engagement and clinical monitoring during the day
• Respite care — temporary relief for family caregivers

To qualify, your parent must meet two thresholds simultaneously: functional eligibility (nursing facility level of care) and financial eligibility (KanCare income and asset limits).

How to Apply — The Step-by-Step Process

The enrollment pathway involves three separate organizations, and getting them in the right order matters.

Step 1: Contact the ADRC. Call the Kansas Aging and Disability Resource Center at 1-855-200-2372. This is the single statewide entry point. An options counselor will explain which programs your parent may qualify for and initiate the referral process. If your parent is being discharged from a hospital, ask the discharge planner to make this referral before your parent leaves — do not wait until you are home trying to figure it out alone.

Step 2: Functional assessment by Maximus. The statewide HCBS Assessing Organization — operated by Maximus — conducts the level of care evaluation. A Maximus assessor evaluates your parent's ability to perform activities of daily living (bathing, dressing, eating, transferring, toileting, continence) and determines whether they meet the clinical threshold for nursing facility placement. If they do, they are functionally eligible for the FE waiver even though the goal is to keep them at home.

Step 3: Financial eligibility through the KanCare Clearinghouse. The KanCare Clearinghouse (1-800-792-4884) processes the financial application. Kansas is a medically needy spend-down state — there is no hard income cap, and families do not need a Qualified Income Trust (Miller Trust). However, the FE waiver uses a Protected Income Level (PIL) of $2,982 per month in 2026 (300% of the Federal Benefit Rate). If your parent's income is below $2,982, they pay nothing toward waiver services. If it exceeds $2,982, the excess is their monthly spend-down contribution.

The asset limit is $2,000 for a single applicant. The primary home, one vehicle, household goods, and an irrevocable prepaid burial plan are exempt.

Step 4: MCO assignment and care plan. Once approved, your parent is enrolled in one of the three KanCare managed care organizations: Sunflower Health Plan, UnitedHealthcare Community Plan, or Healthy Blue. The MCO assigns a care coordinator who works with your family to develop a person-centered service plan — specifying exactly which HCBS services your parent receives, how many hours per week, and which providers deliver them.

Self-Directed Attendant Care

FE waiver participants can choose to self-direct their attendant care services. This means your parent (or their representative) hires, trains, schedules, and manages their own care workers instead of relying on a home care agency.

Self-direction gives families more control over who provides care — you can hire a trusted neighbor, a friend, or a family member. But Kansas imposes strict restrictions on who can be a paid self-directed worker: spouses, court-appointed guardians, conservators, and activated power of attorney agents are prohibited from serving as paid attendant care providers.

PACE — The Comprehensive Alternative

The Program of All-Inclusive Care for the Elderly (PACE) is a separate HCBS option for seniors aged 55 and older who require nursing facility level of care. PACE provides fully integrated medical and social services — primary care, specialist visits, prescription drugs, physical therapy, social activities, meals, and transportation — all coordinated through a single PACE center.

PACE is designed for seniors with complex medical needs who would otherwise be in a nursing home. Maximus conducts the initial functional evaluation for PACE applicants, the same way they assess FE waiver candidates. The difference is the service model: PACE participants attend a day center several times per week and receive all their medical care through the PACE team, while FE waiver participants receive services in their own home from independent providers.

PACE availability in Kansas is limited to certain geographic areas. Contact the ADRC at 1-855-200-2372 to determine whether a PACE center serves your parent's location.

The Senior Care Act — When KanCare Is Not an Option

If your parent's income or assets exceed KanCare limits but they still need help at home, the Senior Care Act (SCA) provides a state-funded alternative. Administered by local Area Agencies on Aging, the SCA offers personal care, homemaker assistance, and respite services on a sliding fee scale based on income.

The SCA does not require nursing facility level of care — it is designed for seniors who need support to remain independent but do not meet the strict functional or financial thresholds for Medicaid waiver programs. Contact your local AAA through the ADRC to learn about availability and fees in your parent's county.

The CARE Assessment Connection

Any senior entering a Medicaid-certified nursing facility in Kansas must complete a CARE Level I pre-admission screening, conducted by the local Area Agency on Aging. This assessment determines functional eligibility and screens for intellectual or developmental disabilities or serious mental illness that would trigger a PASRR Level II evaluation by Acentra Health.

HCBS and the CARE assessment intersect when a family is weighing nursing home placement against home-based care. If the CARE assessor confirms nursing facility level of care, that same determination supports FE waiver eligibility — giving your parent the clinical qualification to receive HCBS instead of entering a facility.

The Hospital-to-Home Kansas Guide walks through the complete HCBS enrollment process alongside the CARE screening, KanCare application, and MCO coordination steps — everything families need to navigate the transition from hospital to home-based care in Kansas.

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