HMCDDO Functional Assessment

On 07/01/2025, Kansas is implementing the Medicaid Functional Eligibility Instrument (MFEI) as part of a broader effort to modernize how supports for individuals with intellectual and developmental disabilities (IDD) are assessed and provided. The IDD Modernization Committee strongly recommended transitioning away from the BASIS assessment, which has long been criticized for being deficit-based and failing to provide a complete picture of an individual’s strengths and support needs. The shift to the MFEI, built on the interRAI framework, ensures that functional eligibility determinations are more accurate, standardized, and person-centered. In addition, Kansas is currently conducting a rate study to inform future rates and funding models. While new rate methodologies have not been finalized, the MFEI and interRAI tools will provide critical data to ensure that funding aligns with actual service needs rather than outdated assessment models.  

The Medicaid Functional Eligibility Instrument (MFEI) is replacing BASIS to ensure a more standardized, accurate, and person-centered approach to assessing Level of Care (LOC) eligibility for IDD waiver services. LOC evaluations determine whether a person is eligible for the IDD waiver, meaning they meet the functional criteria to receive waiver services. It is a yes/no determination based on the person’s ability to perform activities of daily living (ADLs), behavioral needs, and other support requirements. As the BASIS is deficit-focused and outdated the IDD Modernization Committee strongly recommended this transition. The MFEI, built on the validated interRAI framework, provides a holistic view of an individual’s strengths and needs, ensuring fair and transparent eligibility determinations. Additionally, Kansas cannot implement the new Community Supports Waiver without a validated LOC tool, and the MFEI is necessary to meet that requirement. The BASIS assessment was deficit-based, focusing primarily on limitations, while the MFEI captures both strengths and needs, providing a more holistic and person-centered evaluation. The BASIS never evolved to reflect modern support models, whereas the MFEI is a standardized tool aligned with national best practices for HCBS quality measures. One other major distinction is that the BASIS combined both LOC determinations and tiering (acuity assessment) into a single tool, while the MFEI is currently focused solely on LOC. LOC determines whether a person qualifies for waiver services, while acuity assessments determine the intensity of support needed and influence funding levels. Kansas is still evaluating whether MFEI data alone will be used for acuity-based rate setting or if additional factors, such as interRAI case-mix modeling, will be incorporated.