Here is today's Kansas Commission on Disability Concerns (KCDC) Disability News message. I hope you have a wonderful day.
Martha
Martha K. Gabehart | Executive Director
Kansas Commission on Disability Concerns (KCDC)
Kansas Governor Laura Kelly
900 SW Jackson, Suite 100 | Topeka, Kansas 66612
(785) 296-6525 (direct) | (785) 260-4027 (cell)
[email protected] | www.kcdcinfo.ks.gov
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This information is from the Kansas Department for Aging and Disability Services (KDADS) Long Term Supports and Services (LTSS) Home and Community Based Services (HCBS).
Intellectually and/or Developmentally Disabled (IDD) Waiver Program Modernization Newsletter
April 2025 / Issue 4
THE Medicaid Functional Eligibility Instrument (MFEI-I/DD)
Effective Date: July 1, 2025
What It Is: The Medicaid Functional Eligibility Instrument (MFEI-IDD) will replace the BASIS tool, offering a holistic, strength-based assessment of participants’ needs and abilities.
Why It Matters: This shift allows for more accurate, personalized person-centered plans. MCOs will utilize the interRAI tools for service planning, creating a more comprehensive approach.
Sign up for the KDADS Listserv for ongoing updates and announcements. Contact KDADS with questions at [email protected].
The Goal?
To create a reliable, valid, and strengths-based assessment that could stand up to real-world challenges while remaining true to the principles of person-centered care.
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How the Medicaid Functional Eligibility Instrument (MFEI) Advances Functional Eligibility
For years, the tools Kansas used to determine Medicaid functional eligibility, like BASIS, served an important role. However, as expectations for person-centered care evolved, it became clear that the system needed to catch up. It needed something more consistent. More reliable. Most importantly, it should be more aligned with the actual support needs of individuals across the state. That’s where the Medicaid Functional Eligibility Instrument (MFEI) comes in. Under the project leadership of Dr. Carrie Wendel-Hummell and the University of Kansas School of Social Welfare, Kansas set out to build a better way forward.
The new MFEI does exactly that. Designed to replace outdated systems, it ensures that functional eligibility decisions that determine whether a person needs waiver services are made with greater precision and fairness. It does so with a tool that is consistent across populations, adaptable to different waiver programs, and validated through extensive testing.
However, developing the MFEI wasn’t just a matter of tweaking a few forms. It was a thoughtful, multi-year journey. A Stakeholder Advisory Board helped guide decisions. Focus groups challenged old assumptions. Existing instruments were weighed carefully, and in the end, the team selected the highly respected interRAI-ID as the foundation for the MFEI. From there, Kansas-specific modifications were layered in, built through a combination of evidence, experience, and a deep understanding of the individuals being served.
The result is an assessment tool that’s not just more scientifically sound but also more person-centered. Unlike BASIS, which often reduced complex support needs to yes/no skills checklists and negative behavioral reporting, the MFEI digs deeper by looking at how much support a person needs to navigate their daily world. It factors in both the frequency and intensity of behaviors. It reflects age-appropriate expectations. It even folds in pathways to connect individuals to employment supports and other services.
The end result demonstrates this. When the MFEI was tested across Kansas the outcomes showed remarkable consistency:
• 98% of adults assessed had matching eligibility outcomes between BASIS and the MFEI.
• 99% of youth showed the same result, demonstrating that the new tool preserves continuity while enhancing accuracy.
This is more than just a technical upgrade. It’s a system shift toward greater fairness, dignity, and alignment with what individuals and families truly need. In short, Kansas isn’t just modernizing how it assesses eligibility. It’s building a stronger, smarter future where evidence, consistency, and respect for individual strengths are central to every decision.
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How the MFEI and interRAI Work Together — and What Families Should Expect
Change is happening in Kansas, and for families navigating Medicaid services for individuals with intellectual and developmental disabilities (IDD), it’s important to understand the new process.
At its heart, the modernization effort introduces two tools that work together but serve different purposes:
• The MFEI (Medicaid Functional Eligibility Instrument) determines whether someone qualifies for IDD services. Think of it as the front door to the system, confirming whether a person meets the institutional level-of-care requirements and is eligible to receive waiver services.
• After waiver eligibility, the interRAI suite of tools, conducted by the MCO, comes into play. These tools help plan specific waiver services someone needs by flagging areas like social relationships, communication needs, meaningful activities, mental health, and more.
In short, MFEI decides eligibility. interRAI guides personalized service planning.
This new structure is designed to make the system fairer, stronger, and more person-centered. Families will see a shift: instead of focusing primarily on deficits, waiver eligibility assessments and service planning conversations will now highlight the person’s goals, preferences, and evolving support needs.
Importantly, families should know:
• No documentation is required for the MFEI. Verbal responses and observations during the assessment are valid and sufficient.
• The MFEI will not determine service hours. It only determines whether someone qualifies for waiver services (Level of Care).
• Service and support planning will continue to happen separately with the MCO and Targeted Case Manager. That is where goals, supports and specific service needs are discussed. The change is that now MCOs will be using a standardized assessment tool in the interRAI, whereas previously each MCO used its own approach. Standardization allows for greater consistency, fairness, and oversight in how service and support needs are identified and addressed across the system.
• Support team members, including person's served, guardians and family members, are encouraged to participate and speak up. Honest, detailed input helps ensure the assessment reflects the person’s real-life needs.
• In rare instances and only during the first year, a BASIS assessment may be administered as a secondary check if someone who was previously eligible under BASIS is found ineligible with the MFEI. Impacted individuals and families will be supported through that process if it occurs.
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Bottom Line
The MFEI opens the door; the interRAI tools map the journey. Families should expect a more holistic, collaborative planning experience, but staying engaged at every step remains key to ensuring services match reality.
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Can the interRAI be Manipulated?
Why Families Can Feel Confident — and Stay Involved
When Kansas decided to modernize eligibility and service planning for individuals with intellectual and developmental disabilities (IDD), it presented a real opportunity for improvement. The new system—anchored by the MFEI and the interRAI—is stronger, more structured, and more person-centered than anything that came before.
But an important question still lingers:
Can the new interRAI system be manipulated by managed care organizations (MCOs)?
The honest answer is that the risk of manipulation is significantly lower than what is currently in place.
Why the Risk of Manipulation Is Lower with interRAI
The good news is that interRAI assessments are designed to be much harder to manipulate than past tools, like the Needs Assessments MCOs currently use. Here’s why:
• Structured and Standardized: Every item has strict coding rules, clear definitions, and internal checks, which leaves less room for subjective interpretation.
• Strength-Based Focus: interRAI captures not only challenges, but strengths, goals, and observed behaviors, making it difficult to skew a picture of need without raising red flags.
• Auditability: Data is recorded at the item level, meaning it can be audited, compared across assessors, and tracked over time, offering a paper trail that is harder to fudge quietly.
How KDADS Is Strengthening Oversight
Most importantly, KDADS has committed to actively monitoring how MCOs use interRAI tools for person-centered planning. This includes:
• Auditing assessment data to ensure services align with recorded needs and goals.
• Reviewing trends across MCOs to detect under-documentation patterns or inconsistent practices.
• Strengthening quality assurance processes so that assessments lead to fair, person-centered outcomes.
• Addressing grievances and appeals quickly, supported by the detailed, standardized interRAI data.
This oversight ensures that the new system will not rely solely on the honor system but will have real accountability built into it.
Should Families Be Concerned?
NO—KDADS is committed to helping families be empowered and unafraid of this change. With the rollout of both the MFEI and interRAI, KDADS is stepping in to monitor how the assessments and planning tools are used, providing a much stronger layer of oversight than ever before. However, families and those served are the first and most essential safeguards in the system. By staying informed, asking the right questions, and staying engaged in planning, waiver participants and their families can ensure that services truly match real-world needs.
Here’s What Participants and Families Can Do:
• Request and Review the Service Planning Outputs
o Every interRAI assessment generates structured outputs, like CAP (Clinical Assessment Protocols or Collaborative Action Points) triggers, needs summaries, and service recommendations. Families should always ask for a copy and review it carefully.
• Validate Life Goals and Preferences
o Because interRAI ties service planning to person-centered goals, what’s listed matters deeply.
o If a goal like “employment,” “living independently,” or “improving communication skills” isn’t appropriately captured, services aligned to those goals may never be offered. Families should ensure the goals reflect the individual’s aspirations, not what seems easiest or cheapest to fulfill.
• Challenge Understated Needs
o If something feels wrong — if risks, health needs, or support requirements are understated — families should document concerns immediately, and shouldn’t hesitate to:
Elevate concerns through the MCO grievance process.
Contact their CDDO (Community Developmental Disability Organization).
File concerns with KDADS or push for reconsideration.
• Use Appeal Rights If Needed
o If services are reduced or denied, families have formal appeal rights under Medicaid law. The structured nature of the interRAI—with clearly coded items—means there’s a stronger factual basis to challenge unfair decisions than under looser, narrative tools like Needs Assessments.
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Bottom Line: Confidence with Accountability
The MFEI and interRAI are a step forward in not only better assessments but also better accountability. Participants and families can feel confident that KDADS is watching closely to ensure MCOs use these tools fairly and consistently. At the same time, staying informed and engaged helps ensure that services remain person-centered and truly reflect each individual's strengths, goals, and evolving needs.
In short:
• Stronger tools.
• Stronger oversight.
• A stronger voice for families — and a system built to support it.
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Meeting Dates
Webinars: KDADS will host regular webinars to explain how the new system works and answer stakeholder questions.
Date: Monthly (Last Thursday)
Time: 4:30 PM – 5:30 PM CST
Platform: Teams | For Meeting Link, Contact [email protected]
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Questions?
Join our open office hours, which happen twice a month.
Date: Biweekly - Tuesday
Time: 5:30 PM CST
Platform: Teams | For the Meeting Link, Contact [email protected]
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Job Vacancy Announcements
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