Kansas Assisted Living and In Home Care Medicaid Waiver Information and Rules for 2017

Introduction

Kansas provides long-term care resources to seniors through the Kansas Department of Aging and Disability Services(KDADS). KDADS oversees the Aging and Disability Resource Center(ADRC), which provides information on services for seniors who are both Medicare and Medicaid Eligible. ADRC serves the entire state in providing people of all incomes and ages with information on the full range of long-term support options. ADRC provides individual personalized options counseling services through local community specialists. The KDADS has contracted with the Southwest Kansas Area Agency on Aging, which subcontracts with the state’s 10 other Area Agencies on Aging (AAAs) to function as individual parts of the ADRC.

In addition to the localized services provided through the AAAs, theDepartment of Aging and Disability Services, Community Service and Programs Division administers the state’s home-and-community based Medicaid waiver programs.

Medicaid Waiver Programs for Assisted Living and In Home Care

Kansas Home and Community Based Services for the Frail Elderly (HCBS Frail & Elderly Waiver)

The Home and Community Based Services (HCBS) Frail Elderly (FE) waiver program provides an option for Kansas seniors who receive Medicaid and qualify functionally to receive community based services as an alternative to nursing facility care. Services include personal care, household tasks, and health services. The program promotes independence within the community and helps to offer residency in the most integrated environment.

Services

Services includedin the Frail Elderly (FE) Waiver:  Adult Day Care; Assistive Technology; Attendant Care Services; Comprehensive Support; Financial Management Services; Home Telehealth; Medication Reminder; Nursing Evaluation Visit; Oral health services; Personal Emergency Response; Sleep Cycle Support; and Wellness Monitoring

Eligibility

Generally, to qualify for the Frail Elderly waiver the applicant must meet the following criteria: 1) the applicant must be 65 years old; 2) meet Medicaid income eligibility guidelines; and 3) meet the Medicaid long-term care threshold.

  1. Health: The applicant must require a Nursing Home Level of Care. The cost of care is not a factor in determining the eligibility of an applicant who requires a nursing home level of care.
  2. Financial: Kansas’ Frail Elderly waiver has certain asset and income limits for an applicant, which in this case are the same as those receiving Medicaid assistance for long-term care in a nursing home. For 2017, the Special Income Limit (SIL) for an individual applicant is $2,205 (or 300% of the Federal Benefit Rate, or FBR). The asset, or resource, limit for an applicant is $2,000 for an individual or $3,000 if the applicant is married and applying as a couple. Kansas does not allow a Miller Trust, or Qualified Income Trust, to help bring an applicant’s income within the limit. Kansas also allows individuals to qualify through the “medically-needy” category, without a spend down provision. This means the applicant may have to cover some of the cost of services if the person’s income is over $727 a month.For the non-applicant spouse, or “community spouse,” there are rules and requirements that apply to assets and other allowances. For 2017, the Community Spouse Resource Allowance (CSRA) - the amount the non-applicant spouse can keep in assets - is $120,900. In addition, the community spouse is allowed to keep a monthly income for personal expenses and other living needs, known as the maximum monthly maintenance needs allowance, or MMMNA. For 2017, the MMMNA is $3,022.50 per month.

Practical Considerations

There is currently no waitlist for the Frail Elderly waiver and the application process has generally the normal asset and income limits for applicants who apply under the Special Income Limit. If the applicant is qualifying or financial eligibility under the medically needy category, the income level of $727 is a strict cut-off and the applicant will have to spend their own money on services to qualify.

Conclusion

Kansas is a good state for using Medicaid long-term care resources to help seniors who choose to live in their own home or a community or assisted living setting. The fact that there is no waitlist is significant, and Kansas is one of the few states where no waitlist exists for the HCBS waiver that targets the senior population over 65 years of age. Furthermore, given the strict financial criteria for eligibility and lack of a Miller Trust vehicle for income limits, a Medicaid Planning specialist can assist an applicant with strategies that may help them save money if deciding to apply for the waiver.