KMAP BULLETIN: HCBS Physical Disability Waiver Eligibility Policy

Date: 07/18/25

Effective with dates of service on or after April 1, 2025, Home and Community Based Services (HCBS) Physical Disability (PD) Waiver Program policy establishes updated eligibility criteria, reassessment timelines, and revised procedures for managing the PD waiver waitlist and outlines the responsibilities of the HCBS Assessing Entity in conducting functional eligibility screenings.

Summary of Key Changes:

The term Aging and Disability Resource Center (ADRC) is now replaced with HCBS Assessing Entity across all related processes and documentation.
The HCBS Assessing Entity is defined as “The entity under contract with the State to perform intake, functional assessments, referral and assistance, and other duties outlined in the contract.”
The HCBS Assessing Entity is responsible for conducting prescreenings to evaluate reasonable indicators of Level of Care (LOC) eligibility for the PD waiver.
Functional eligibility reassessments must now be completed every 365 days, unless the individual remains on a waitlist.
The policy clarifies roles and responsibilities between Kansas Department for Aging and Disability Services (KDADS) and the HCBS Assessing Entity in managing the eligibility and reassessment process.
Transition procedures for participants aging out of the PD waiver (i.e., turning 65) have been clarified.
Updated guidance on the definition and submission of required medical records.
Individuals with a primary diagnosis of Intellectual/Developmental Disability (I/DD) are explicitly deemed ineligible for the PD waiver.
New procedural timelines have been introduced, including a 5-day requirement for initial referral assessments and updated guidance for uploading documentation to the state’s management system.
Enhanced clarification provided for ES-3161 processing and overall waitlist procedures.

For complete guidance on HCBS PD Waiver Eligibility policy, please refer to the official policy available under the “Physical Disability” section on the KDADS website at KDADS Policies – PD.

Note: The effective date of the policy is April 1, 2025. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.

For changes resulting from this bulletin, view the updated HCBS PD Fee-for-Service Provider Manual, pages 8-36 to 8-45.