Self-Direction and FMS in Kansas

All states: self-direction map

Kansas self-direction at a glance

Last verified against state sources: 2026-10-13.

Which Medicaid programs in Kansas offer self-direction?

Kansas offers self-direction in nine Medicaid programs that we could confirm: six older home and community based services (HCBS) waivers, the new Community Support Waiver, and two work programs called WORK and STEPS. The Kansas Department for Aging and Disability Services (KDADS) runs the waivers, and the Kansas Department of Health and Environment (KDHE) runs WORK and STEPS. All of them are delivered through the KanCare managed care organizations (MCOs), which are the health plans that manage Medicaid in Kansas. In every program the participant hires and manages the workers, and in three of them the participant also manages a budget.

• HCBS Frail Elderly (FE) Waiver: serves older adults. KDADS runs it through the KanCare MCOs. The participant has employer authority but not budget authority. Services that can be self-directed are Comprehensive Support, Enhanced Care Services and Personal Care Services.
• HCBS Intellectual/Developmental Disability (I/DD) Waiver: serves people age 5 and older with intellectual or developmental disabilities. KDADS runs it, with Community Developmental Disability Organizations (CDDOs) as the local entry point. The participant has employer authority but not budget authority. Services that can be self-directed are Enhanced Care Services, Overnight Respite Care and Personal Care Services.
• HCBS Physical Disability (PD) Waiver: serves people with physical disabilities. KDADS runs it through the KanCare MCOs. The participant has employer authority but not budget authority. Services that can be self-directed are Assistive Services, Enhanced Care Services and Personal Care Services.
• HCBS Brain Injury (BI) Waiver: serves people with brain injury. Some State documents still call it the Traumatic Brain Injury (TBI) waiver. KDADS runs it through the KanCare MCOs. The participant has employer authority but not budget authority. Services that can be self-directed are Enhanced Care Services and Personal Care Services.
• HCBS Technology Assisted (TA) Waiver: KDADS runs it through the KanCare MCOs. The participant has employer authority but not budget authority. Personal Care Services can be self-directed, within the limits of the person's assessment.
• HCBS Autism Waiver: serves children with autism spectrum disorder. KDADS runs it through the KanCare MCOs. The Kansas Self-Direction Toolkit lists Respite Care as a service that can be self-directed. We did not find a clear statement on budget authority.
• Community Support Waiver (CSW): a new waiver for Kansans age 5 and older with intellectual or developmental disabilities who do not need 24-hour paid support. KDADS operates it with KDHE, through the MCOs, CDDOs and targeted case managers. The participant has both employer authority and budget authority, with a limit of $20,000 a year per person. Services that can be self-directed are Personal Care Services, Respite, Family/Caregiver Support and Training, Non-Medical Transportation, and Individual-Directed Goods and Services (budget authority only).
• Work Opportunities Reward Kansans (WORK): a package of Medicaid State Plan services, not a waiver, for employed people with disabilities in the Working Healthy program who are on, waitlisted for, or screened for the I/DD, PD or BI waiver. KDHE runs it through the MCOs. The member is the employer of record and manages a monthly allocation, so the member has both employer authority and budget authority.
• Supports and Training for Employing People Successfully (STEPS): serves people age 16 to 64 on SSI or SSDI with behavioral health conditions, or on or waitlisted for the I/DD, PD or BI waiver, who want to work. KDHE runs it through the MCOs. Personal Assistant Services can be self-directed, and the program's FMS vendor describes the participant as the employer with an allocated budget.

Employer authority means the participant recruits, hires, schedules and supervises the workers. Budget authority means the participant also manages a set amount of money. Two KDADS sources differ on the Autism Waiver: the Kansas Self-Direction Toolkit lists six waivers including Autism, while the KDADS Self-Direction page lists five and leaves Autism out. Families on the Autism Waiver should ask their MCO care coordinator.

Who handles financial management services (FMS) in Kansas?

It depends on the program. On the older HCBS waivers the participant chooses an FMS provider from a list given by the MCO care coordinator. On the Community Support Waiver the State contracts with one FMS, GT Independence, and participants do not choose. In every case the participant is the sole legal employer of the workers.

Kansas uses the Vendor Fiscal/Employer Agent model. In plain words, the FMS provider is the participant's agent for the paperwork side of being an employer: it processes time, pays the workers and files the employer taxes. The participant stays the employer and must hold a federal employer identification number (FEIN), which the FMS provider helps obtain. KDADS said in 2015 that it moved to this model from Agency with Choice, an older setup in which an agency shared the employer role.

• FE, I/DD, PD, BI and TA waivers: the participant selects one FMS provider from the list the MCO care coordinator supplies. The KDADS FMS Manual says an FMS provider needs a provider agreement with KDADS and a contract with a KanCare MCO. The statewide list of FMS providers linked from the KDADS Self-Direction page was not available when we checked, so we cannot give a full list of names. GT Independence says on its own Kansas page that it serves these waivers and the Autism Waiver. Ask the MCO care coordinator for the current list.
• Community Support Waiver: KDADS names GT Independence as the Financial Management Service for all CSW participants. The FMS also employs support brokers, who help participants with the employer role, and buys Individual-Directed Goods and Services.
• WORK: each MCO designates one fiscal management services provider, which manages the member's monthly allocation and payroll. KDHE does not publish the names. Members should ask their MCO.
• STEPS: the KanCare STEPS page points participants to PPL (Public Partnerships LLC) for self-direction. We did not confirm whether PPL is the only FMS for STEPS under every MCO.

Pay rates work differently by program. KDADS says I/DD Waiver participants do not pick the rate paid for a self-directed service. Community Support Waiver participants set wages within State rate ranges, for example $3.60 to $6.05 per 15 minutes for Personal Care and $14.38 to $32.54 per hour for Respite. WORK members negotiate wages within their monthly allocation and individualized budget.

Who can be a paid caregiver under self-direction in Kansas?

Relatives can be paid in Kansas, with limits that depend on the relationship. Under the KDADS policy effective October 1, 2026, spouses and parents of minor children can be paid only for care that goes beyond what a spouse or parent would normally do. A court-appointed guardian or a person holding an activated durable power of attorney can be paid only after the conflict of interest is addressed. Foster parents are not paid for waiver services.

• All HCBS waivers except SED: the HCBS Personal Care Services and Limitations Policy says parents of minor children may not be paid for supervision or daily living tasks that are typical for a child of the same age. Legally responsible individuals (parents of minors, and spouses in the same home) may not be paid for household tasks done for the whole household, except for an extraordinary need. Natural guardians and spouses do not have to go through the conflict of interest step that court-appointed guardians and activated powers of attorney do.
• People who live in the home: the Toolkit says a family member or other person living in the home can be hired for most self-directed services. A worker who lives in the home cannot provide Enhanced Care Services (overnight support) or Respite Care.
• Community Support Waiver: Personal Care is the only service a legally responsible individual (parent of a minor, spouse, court-appointed guardian or activated power of attorney) can be paid for. A guardian needs a probate court finding under K.S.A. 59-3068. A relative paid for Respite must live outside the participant's home.
• WORK: conservators, guardians, payees, people holding power of attorney and WORK representatives cannot be paid to provide any WORK service.
• STEPS: we did not find published family caregiver rules. Ask the KDHE Working Healthy program or the MCO.

Hours are limited too. Personal care under the HCBS waivers is limited to 12 hours per 24-hour day unless the MCO approves more, and a participant cannot self-direct personal care while living in an assisted living facility. WORK members may not use their allocation to pay self-directed providers for more than 40 hours a week.

Does EVV apply to self-directed workers in Kansas?

Yes. Electronic visit verification (EVV) applies to self-directed personal care workers in Kansas, the same as agency workers. Workers use the system the State designates, AuthentiCare, or a State-approved third-party system that sends its data to AuthentiCare. The FMS provider the participant chose sets the workers up in the system and trains the participant and the workers.

• Same list of services: the KanCare EVV FAQ says the list of service codes that need EVV is the same whether or not care is self-directed.
• Pay depends on it: a State provider bulletin says services that need EVV must be captured and claimed through AuthentiCare, and that since March 1, 2025 the health plans reject original claims not submitted through it. This applies to self-directed services billed by FMS providers.
• FMS providers: a KDADS FMS policy directs the MCOs to end an FMS provider's contract if the provider does not comply with the EVV requirement.
• Community Support Waiver: Personal Care Services and Respite require EVV. All direct service workers, including relatives and legally responsible individuals, must use the EVV system to record their hours, and the FMS helps them do so.
• WORK: personal assistance and night support require EVV. The data passes through AuthentiCare, but WORK claims do not have to be created and sent for payment through the EVV system.
• STEPS: PPL says STEPS workers clock in and out with its Time4Care mobile app or by telephone.

The only published exemption we found is for personal care delivered inside licensed congregate settings (assisted living, residential health care, home plus and boarding care). We did not find an EVV exemption for live-in caregivers. We also did not confirm which EVV tool Community Support Waiver workers use. For either question, ask the FMS provider or the KDHE EVV team at KDHE.EVV@ks.gov.

What is changing next for self-direction in Kansas?

We did not find an announced upcoming change to self-direction in Kansas as of our last check on October 13, 2026. The biggest changes are recent ones that are already in effect, and programs are still settling into them. FMS organizations and families should watch how the new Community Support Waiver rolls out.

• Community Support Waiver: the Governor's office announced that CMS approved the waiver on July 1, 2026, with an effective date of October 1, 2026 and 500 projected enrollees in the first year. It is the first KDADS waiver on this page with budget authority and a single State-contracted FMS. The KDADS participant page still used wording such as "once the CSW opens" when we checked, so we could not confirm that enrollment has begun. Ask KDADS at KDADS.CSW@ks.gov.
• Family caregiver policy: the HCBS Personal Care Services and Limitations Policy was revised on April 30, 2026 and again effective October 1, 2026. The current version adds Community Support Waiver provisions and says the older regulation K.A.R. 30-5-307 no longer applies to family caregiving.
• Background check audits: a State provider bulletin dated May 29, 2026 requires HCBS providers, including FMS providers, to document a set of background checks. MCOs audit 100 percent of HCBS provider employees each quarter, starting with the July 1 to September 30, 2026 period.

One practical gap remains. The statewide list of FMS providers for the older waivers was not available on the KDADS site when we checked. Until it is restored, the MCO care coordinator is the place to get the current list.

Kansas self-direction sources

• KDADS: Self-Direction
• KDADS: Kansas Self-Direction Toolkit
• KDADS: HCBS Personal Care Services and Limitations Policy (effective October 1, 2026)
• KDADS: Financial Management Services (FMS) Manual (revised December 21, 2015)
• KDADS: Community Support Waiver for participants
• KDADS: Community Support Waiver document (dated July 2, 2026)
• KDADS: Community Support Waiver comparison with the I/DD Waiver
• KanCare: Electronic Visit Verification frequently asked questions
• KanCare: WORK Program Policy Manual (revised January 1, 2026)

Related reading

• Self-Directed Medicaid Home Care Services in 2026
• Understanding Self-Direction and FMS
• Self-Direction Fiscal Intermediary: A Guide for Participant-Directed Care
• Why Do Self-Directed Participants Choose Your FMS as Their Fiscal Intermediary?
• Self-direction in every state (map)
• Kansas EVV requirements

Page history

• October 13, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for FMS organizations and agencies that support self-direction. If you would like to talk through your program, contact Ankota or read more about Ankota's self-direction and FMS software.