How Kansas pays for disability services

Waiver inventory

Included the Technology Assisted waiver only because it is a significant secondary vehicle for children with co-occurring developmental disabilities. Kansas has no 1915(i) state plan HCBS benefit and no 1915(k) Community First Choice option. Targeted case management for people with I/DD is a Medicaid state plan service, not a waiver service, which is why it does not appear in the I/DD waiver rate structure.

State-only funded programs

Kansas funds several state-only lines that support people with I/DD, though none is a stand-alone state-only entitlement benefit.

• State Aid administered by Community Developmental Disability Organizations (CDDOs). CDDOs are the single point of access for I/DD eligibility determination in each catchment area and administer state aid dollars alongside HCBS. The Johnson County CDDO describes the funding stack as HCBS waivers (about 95% of I/DD service funding in Kansas), state aid dollars managed by the CDDO, ICF/IID, and private pay. A statewide state aid appropriation figure was not located. Administering agency: KDADS through the CDDO network. jocogov.org
• CDDO administrative funding to move people off the I/DD waiting list: $750,000 State General Fund proposed for FY 2027. Administering agency: KDADS. klrd.gov
• Kansas Employment First training and technical assistance: $1.0 million State General Fund, one-time, proposed for FY 2027. klrd.gov
• I/DD waiver modernization consultant contract with Public Consulting Group: $4.0 million State General Fund requested for FY 2026 to build the Community Support Waiver, implement the Special Committee on I/DD Waiver Modernization recommendations, and manage HCBS settings and conflict-of-interest compliance grants. The Legislative Budget Committee moved to delete it. klrd.gov
• Provider compliance grants for HCBS settings rule and conflict-free case management: $45.0 million State General Fund requested; the Legislative Budget Committee deleted the request. klrd.gov
• Two state-operated ICF/IIDs, Parsons State Hospital and Training Center and Kansas Neurological Institute, are funded with a mix of State General Fund and Medicaid, not state-only. Kansas closed Norton State Hospital in 1988 and Winfield State Hospital in 1998. kslegresearch.org

County / regional / local funding

Not confirmed as a distinct funding stream in this research.

Kansas organizes I/DD access through 27 CDDO catchment areas, several of which are county government departments (for example the Johnson County CDDO is a Johnson County department, and Cottonwood CDDO serves Douglas and Jefferson counties). The Johnson County CDDO FAQ lists HCBS, CDDO-managed state aid, ICF/IID, and private pay as the funding sources and does not identify a county levy. The Cottonwood CDDO eligibility page likewise does not describe a local levy. I was unable to locate an official source documenting a dedicated county mill levy for developmental disability services in Kansas, and I am not asserting one exists.

Sources checked: jocogov.org cwcddo.org jocogov.org

Funding scale

• I/DD waiver services, CMS-approved cost neutrality projection for waiver year 1 beginning July 1, 2025: $614,853,412.30 all funds, entirely inside the KanCare capitation. Source: KS.0224.R07.03 Appendix J, medicaid.gov
• Spending per participant, I/DD waiver: Factor D of $60,912.76 in waiver year 1, $61,404.27 in years 2 through 5. Same source.
• Largest service line, waiver year 1: Residential Supports at $334,555,146.80, followed by Day Supports at $165,357,360.00 and Personal Care Services at $93,687,800.00. Same source.
• Number of people served in the I/DD waiver: 10,094 unduplicated projected, 9,611 point-in-time maximum, waiver year beginning 7/1/2025. Same source.
• Waiting list, I/DD waiver: approximately 5,348 people as of August 2026, against a legislative direction to reduce it to no more than 4,000. It was approximately 4,500 in October 2024 after a legislative appropriation of $17.8 million moved roughly 1,000 people off the lists, and 4,563 in September 2021. Sources: wibw.com sentinelksmo.org kslegresearch.org
• Average wait: approximately 8 to 10 years per the Sentinel reporting, approximately 9 years per the Disability Rights Center of Kansas End the Wait campaign. Sources: sentinelksmo.org drckansas.org
• KDADS agency total, all funds: FY 2025 actual $3,385,571,561, including $1,334,169,024 State General Fund; FY 2026 final approved $3,872,263,866, including $1,587,254,414 State General Fund. Source: klrd.gov
• Total Kansas IDD spending, all programs and all funds, FY 2021: $604.5 million, split $178.8 million state (31%) and $425.7 million federal (69%). Community services for settings of six or fewer people accounted for 90.9% of spending; public institutions accounted for 6.8%. Fiscal effort was $3.32 per $1,000 of personal income, down from a peak of $4.29 in FY 2005. Source: University of Kansas State of the States in IDD, stateofthestates.ku.edu
• Kansas FMAP, FY 2026: 60.67%. State share of I/DD waiver services is therefore about 39.33%. Source: kff.org

Residential funding detail

Kansas funds residential support through a single per diem service rather than a differentiated menu.

• Residential Supports, adults and children. Paid per day. The CMS Appendix J projection for waiver year 1 beginning July 1, 2025 shows 5,462 users, an average of 335 days each, at an average of $182.84 per day, totaling $334,555,146.80. This is the dominant expenditure in the waiver, at 54.4% of all I/DD waiver spending. Source: medicaid.gov
• The 2021 to 2022 Kansas Legislative Research Department overview reported published Residential Supports daily rates ranging from $46.14 to $208.81, reflecting a graduated structure by support intensity and setting size. Source: kslegresearch.org
• There is no separately named supported living, host home, or shared living service in the Kansas I/DD waiver. In-home and family settings are supported through Personal Care Services, which is available agency-directed or self-directed, plus Enhanced Care Service (a 6 to 12 hour unit at an average of $113.97), Sleep Cycle Support, Supportive Home Care, Overnight Respite Care, and Wellness Monitoring.
• ICF/IID remains a parallel institutional option, including the two state-operated facilities, Parsons State Hospital and Training Center and Kansas Neurological Institute.
• Room and board. Explicitly excluded. The waiver application states that payments for Residential Supports are not made for room and board, facility maintenance, upkeep, or improvement, consistent with 42 CFR 441.310(a)(2). Room and board falls to the person's own income, principally SSI. Same source.
• Day and residential services are currently bundled. KDADS is unbundling day services into seven separate offerings (Retirement and Leisure, Community-Based Day Habilitation, Life Skills, Career Exploration and Planning, Prevocational Services, Individual Employment Support, and Benefits Planning) with a summer 2026 launch and a rate structure still under development through a comprehensive I/DD rate study. Source: kdads.ks.gov

Rate structure link: portal.kmap-state-ks.us (the public KMAP fee schedule portal currently redirects to an authentication gateway)

Comparable service rates

Every Kansas rate above is a cost-neutrality projected average from the CMS-approved waiver application rather than a fee schedule rate, because the KMAP public fee schedule portal is authentication-gated. Rows citing the Kansas Legislative Research Department memo are marked (secondary) in the cells above and date from 2021 to 2022.

Official rate schedule links

• KMAP public fee schedule portal (redirects to authentication gateway as of August 2026): portal.kmap-state-ks.us
• CMS-approved I/DD waiver application KS.0224.R07.03, including Appendix I rate methodology and Appendix J unit costs: medicaid.gov
• Kansas Legislative Research Department I/DD waiver overview memo with published rate ranges: kslegresearch.org
• KDADS I/DD waiver program page: kdads.ks.gov
• KDADS I/DD Waiver Modernization initiatives: kdads.ks.gov
• KDADS unbundling of day services: kdads.ks.gov
• KDADS FY 2027 Budget Committee Report: klrd.gov

Notable features and flags

• August 17, 2026: House Speaker Dan Hawkins publicly challenged KDADS over roughly $24 million in one-time HCBS waiver funding that was redirected from I/DD to the Frail Elderly and Brain Injury waivers while the I/DD waiting list grew to approximately 5,348 against a legislative target of 4,000. KDADS Secretary Laura Howard responded that the funds were FY 2025 year-end savings and that the repurposing was reviewed and approved by the 2026 Legislature. The KDADS FY 2026 revised estimate does show a $24.2 million State General Fund reappropriation line for HCBS waiver services. wibw.com and klrd.gov
• FY 2027 session: the Senate Committee on Ways and Means added $69.5 million, including $26.7 million State General Fund, for a 10.0 percent reimbursement rate increase for I/DD waiver providers. The House position carried a 3.0 percent increase for HCBS waiver providers generally. klrd.gov
• July 6, 2026: KDADS announced it would implement a waiting list for the Frail Elderly HCBS waiver, the first time that waiver has had one. kdads.ks.gov
• Community Support Waiver (KS.2546.R00.00) is the state's principal waiting list strategy. It caps annual spending at $20,000 per person, excludes day and residential services, and was projected at roughly 60 percent federal and 40 percent state share, with a total cost range of $72.0 million to $149.0 million at full capacity. FY 2027 budget action ranged from adding $7.5 million (including $2.8 million State General Fund) to adding and then deleting $9.0 million across chambers. klrd.gov and klrd.gov
• Three modernization workstreams are running concurrently with a summer 2026 target: unbundling day services into seven distinct offerings, transitioning level of care determination to the Medicaid Functional Eligibility Instrument (MFEI), and implementing conflict-free case management. Rates for the unbundled services are still being set through a comprehensive I/DD rate study. kdads.ks.gov
• Self-direction is well established: Personal Care Services is projected at 3,300 self-directed users versus 400 agency-directed users in waiver year 1 beginning July 1, 2025, with Financial Management Services at $170.74 per month for 3,300 people. medicaid.gov
• Waiting list composition: a state study found 60 percent of people on the waiting list are age 20 or younger and most already have Medicaid, but Kansas lacks a systematic process to gather information about their current or anticipated needs. aol.com

Confidence

Solid: the I/DD waiver structure, participant caps, service list, cost neutrality totals, per-participant Factor D, and per-service projected volumes and unit costs all come from the CMS-approved KS.0224.R07.03 application dated August 18, 2025 for the waiver year beginning July 1, 2025. The KDADS agency budget totals, the FY 2027 rate increase proposals, and the Community Support Waiver appropriations come from the Kansas Legislative Research Department Budget Committee Report from the 2026 session. The FY 2021 total IDD spending and state versus federal split come from the University of Kansas State of the States project.

Estimated: every rate in the comparable service rates table is a cost-neutrality projected average rather than a posted fee schedule rate. Those averages are internally consistent and CMS-approved, but they blend tiers, geographies, and provider types and should not be quoted as the rate a specific provider receives. The 2021-2022 legislative rate ranges are marked as secondary and are four to five years old.

Could not find: the current published KMAP fee schedule for HCBS I/DD waiver services, because the public portal redirects to an authentication gateway. Also not found: a discrete statewide appropriation figure for CDDO state aid; any official documentation of a county mill levy or other dedicated local funding stream for developmental disability services in Kansas; separate line item budgets for Parsons State Hospital and Kansas Neurological Institute; and current census figures for either state ICF/IID.

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