The Children's Mental Health Home and Community Based Services Waiver provides funding for specialized community based services to children or youth who otherwise might need institutional care in a State Mental Health Hospital.

Federal law allows states to waive Medicaid rules to permit states to operate programs in ways different from normal Medicaid rules.  The waiver makes available an expanded array of community-based services and supports in a child-centered and family-oriented system of care.

The goal of the SED Waiver is to allow children and youth to live with their families whenever possible, and to be included as productive members of their community.

The Waiver program is managed by Mental Health, Substance Abuse Prevention Treatment and Recovery (MHSAPTR) within the Division of Health Care Policy.  MHSAPTR coordinates with SRS divisions of Medical Services, Economic and Employment Services, and Community Mental Health Centers.  The Waiver was implemented statewide on January 1, 1998. 

The SED waiver serves children ages 4-22 who would require State Mental Health Hospital services if they did not receive home and community based services.  While youth may remain on the waiver up to age 22, the maximum age for initial eligibility is 18.  Exceptions to the minimum and maximum age requirements can be requested by the CMHC.

Children and youth served by the waiver are eligible for all Medicaid services available in the Medicaid State Plan.  
In addition, the waiver established 4 new or expanded services:  Wraparound Facilitation, Parent Support and Training, Respite Care, and Independent Living Services.

The Waiver addresses needs of children and youth requiring an intensive level of intervention.  A clinical eligibility process determines children and youth who meet the criteria for the waiver.  Family choice is an important part of the process. 


Once a child is determined eligible for the waiver, the family has a choice of accepting a community-based plan of care or pursuing admission to a State Mental Health Hospital.  Parent support staff can assist families in this decision making process by providing information about services  and options.

There are two areas of eligibility a youth must meet for the waiver: CLINICAL and FINANCIAL (also known as Medicaid).

Clinical: A QMHP at the Community Mental Health Center is responsible for determining clinical eligibility.
Financial/Medicaid:
SRS area/local office staff determine if the youth meets the financial eligibility.  Only the youth's income/assets are considered, not the parents.

A child/youth receiving waiver services will receive a medical card that will pay for the services in the plan of care.  
The medical card will also cover physical health needs such as doctor, dentist and medication.

Once a child/youth is found eligible and the family chooses the waiver, an individualized plan of care is developed by the child and family team.  The team includes the family, service providers, educators, other community stakeholders and persons the family chooses.


The wraparound plan is a strengths based plan.  It utilizes child and family strengths as well as needs in the development of treatment goals and objectives. The plan also identifies who is responsible for activities and timelines for accomplishing goals.

The child and family team develops a wraparound plan to meet the individual needs of the the child and family. The team addresses crisis planning, identifies goals, accesses formal and informal  supports and resources, and monitors services. The team meets and reviews the plan to make sure things are working and decide on needed changes.


The most successful wrap around teams convey unconditional care and long term support of the family after formal services are no longer needed.


The plan of care defines and guides efforts to achieve identified outcomes.  The plan attempts to match child and family needs with an array of service options.  Not only is child and family satisfaction a priority, but so is their quality of life.  

For example, successful community involvement by the child in age and developmentally appropriate activities is one measure of how a child's life has been impacted by services.  

It is expected that a strengths-based, child-entered, family-driven and community-based plan will help a child make gains in his/her ability to live successfully.

  A critical element to the success of the plan is the coordination and collaboration with other agencies and people who are involved with the child and family. 

A necessary condition for operation of the waiver is to demonstrate that the waiver costs less or no more than State Mental Health Hospital services.  Data indicates this requirement is currently being met.  State funds are used in the waiver program to leverage federal Medicaid dollars.  

This combination of state and federal dollars provides funding support for the waiver.  Currently, there are approximately 1,000 children/youth being served by the waiver in Kansas.