The 2022 session began on Monday, January 10, with all legislators and participants back inside the Capitol. This edition of Health at the Capitol looks at health policy issues considered during their first week, including the suicide prevention hotline, mid-level licensure, and child care regulations.
Health at the Capitol is a weekly summary providing highlights of the Kansas legislative session, with a specific focus on health policy related issues. Sign up here to receive these summaries and more, and also follow KHI on Facebook, Twitter and LinkedIn. Previous editions of Health at the Capitol can be found on our ARCHIVE PAGE.
With health care facilities throughout the state sounding the alarm of their struggle to respond to the health care needs of Kansans due to the ongoing COVID-19 pandemic, Gov. Laura Kelly signed a State of Disaster Emergency Proclamation and issued two Executive Orders (EOs) on January 6 to provide the state’s hospitals, skilled nursing facilities and long-term care facilities with temporary measures to address their staffing shortages. The Governor noted in her announcement of the EOs, which will expire on January 21, that she would work with the Legislature to pass legislation to extend the provisions of her orders.
On Friday, January 14, the Kansas Department of Health and Environment (KDHE) reported that since March 2020, there have been 621,273 COVID-19 cases from all 105 counties, 17,624 hospitalizations, and 7,162 deaths.
In her fourth State of the State address, which was presented in the Capitol on Tuesday evening, January 11, Gov. Kelly announced her priorities for the session, including elimination of the sales tax on food, funding for the State Water Plan, continuing expansion of broadband throughout the state, Medicaid expansion, and increased funding for law enforcement, juvenile justice programs and mental health services.
House Health and Human Services Committee
(Rep. Brenda Landwehr, Chair)
On Wednesday, January 12, the Committee heard a presentation from Andy Brown, Commissioner of Behavioral Health Services, Kansas Department for Aging and Disability Services (KDADS), on the implementation of the 988 Suicide Prevention and Mental Health Crisis Hotline. The 988 Hotline is scheduled to be implemented nationwide by July 16, 2022. Brown noted that the Legislature has not yet passed any 988 legislation, other than initial funding, and that this session would be the opportunity to do that prior to the national implementation date. He announced that planning for implementation of the 988 Hotline has been completed and Committee members have been provided with a draft copy of the 60-page implementation plan. Brown described the state and federal funding that has already been provided to Kansas for implementation, but an additional $3 million is needed. He stated that KDADS anticipates a significant increase in the volume of hotline calls since 988 is easier for the public to remember and a public awareness campaign is planned. Three contact centers – COMCARE in Wichita, Johnson County Community Mental Health Center, and the Kansas Suicide Prevention Headquarters – have already been identified, along with an additional backup center, which will allow the state to achieve a 90 percent in-state answer rate for 988 calls by the implementation date. Brown also noted that KDADS is currently completing an application for a federal American Rescue Plan Act grant that can be used to hire the workforce for the 988 contact centers. It is expected that Kansas will receive $935,937 for the two-year grant and that 85 percent of these funds will be passed through to the contact centers for hiring staff.
Chair Landwehr stated there will be revisions to House Bill (HB) 2281, which was introduced during the 2021 session, so the bill can be considered by the Senate this session. HB 2281, which would create the Living, Investing in Values, and Ending Suicide (LIVES) Act, would establish 988 as the Suicide Prevention and Mental Health Crisis Hotline and outline the responsibilities of KDADS, the hotline centers, and service providers under the Act. The bill would also create a 988 fee in the amount of $0.50 per month for subscribers of several types of telecommunications services. Brown noted that it is expected that the fee would generate $17.5 million per year that would be used for various suicide prevention and mental health services for 988 callers. Committee members asked questions regarding how the 988 Hotline fee funds would be used; how much funding has been available in the past for suicide prevention; whether services for rural parts of the state would be a priority; and what services would be made available to individuals contacting the hotline.
Senate Public Health and Welfare Committee
(Sen. Richard Hilderbrand, Chair)
On Tuesday, January 11, the Committee heard presentations regarding certified anesthesiologist assistants (CAAs) by Courtney Cyzman, General Counsel, Kansas Board of Healing Arts (BOHA) and Dr. Kathy Perryman, an anesthesiologist. Cyzman provided an overview of BOHA’s functions and role and noted that BOHA had received a letter from the Kansas Society of Anesthesiologists requesting that BOHA confirm the authority of licensed anesthesiologists to delegate the provision of anesthesia services to CAAs acting under an anesthesiologist’s supervision consistent with the delegation and supervision requirements specified under existing Kansas law. BOHA’s opinion is that CAAs can practice under the delegatory authority of licensed anesthesiologists without a license. BOHA does not license CAAs and would not do so unless authorized by the Legislature. Dr. Perryman stated that she supports the BOHA opinion and that based on her experience working with both CAAs and Certified Registered Nurse Anesthetists (CRNAs) she believes they have comparable skill sets. She noted that efforts to get CAAs licensed in Kansas in the past have been unsuccessful because a compromise could not be reached with the Kansas Association of Nurse Anesthetists. However, she stated that delegatory authority would be a step toward licensure for CAAs. Committee members asked questions regarding differences between CAAs and CRNAs; whether there are other professions practicing under delegatory authority of a physician; and whether there are differences in wages between the two professions.
On Wednesday, January 12, the Committee heard presentations regarding CRNAs from Alissa Blau, Kansas Association of Nurse Anesthetists, Carol Moreland, Kansas State Board of Nursing, and Donna Nyght, University of Kansas Nurse Anesthesia Education. All the conferees expressed their concerns about the BOHA opinion regarding CAAs practicing under delegatory authority without a license and specifically noted concerns about controlled substances being handled by unlicensed providers. They also noted the differences in education and training for CRNAs and CAAs and argued that they should not be classified as having the same or similar skillsets. They also stated that CRNA programs are having difficulty finding training sites for their students because there are more CAAs working at hospital sites and there aren’t enough CRNAs at those sites to provide training and clinical experience for their students. Committee members asked questions regarding how many CRNA and CAA programs are available statewide; the difference between the two professions and their education paths; the conflict in job placements; shortages of CRNAs; and the work relationship between CAAs and CRNAs in care team settings.
On Thursday, January 13, the Committee heard additional presentations regarding CAAs from Rachelle Colombo, Kansas Medical Society, Dr. Jeremy Cook, Kansas Society of Anesthesiologists, and Spencer Jones, Kansas Academy of Anesthesiologist Assistants. All three expressed their support for CAAs being licensed to practice under delegatory authority and the importance of ensuring that CAAs are practicing under the authority of licensed anesthesiologists. They noted that 17 states have authorized CAAs to practice under delegated authority and stated that the quality of care provided by CAAs is just like that provided by CRNAs. The conferees also stated that CAAs are crucial to the field of anesthesia and that CAA programs were developed by anesthesiologists because there was a need for another mid-level professional in the field. Committee members asked questions regarding why anesthesiologists prefer hiring CAAs over CRNAs; the potential increase of CAAs working in Kansas if licensure was available; and the impact of allowing CAAs to be licensed.
Sen. Pat Pettey reminded Committee members about the 2022 Kansas Mental Health Summit scheduled for April 13-14, 2022. The Summit, which is being hosted by the Kansas Judiciary, will be focused on improving court and community response to behavioral health issues.
Sen. Mark Steffen introduced Senate Resolution No. 1724, which resolves that “healthy children should not be subjected to forced vaccination; naturally immune individuals who have recovered from COVID-19 should not be subjected to any restrictions or vaccine mandates; and all health agencies and institutions should stop interfering with physicians treating individual patients.”
House Children and Seniors Committee
(Rep. Susan Concannon, Chair)
On Wednesday, January 12, the Committee heard a presentation about health and safety regulations of child care facilities from Kelli Mark, Bureau of Family Health, KDHE, and health and safety child care assistance programs from Dr. Carla Whiteside-Hicks, Temporary Assistance for Needy Families (TANF) and Early Childhood Assistance Programs, Kansas Department for Children and Families. Mark provided an overview on child care licensing regulations and requirements, the types of licensing, child care licensing data, and the results of a recent fingerprinting pilot program designed to streamline the background check process. Whiteside-Hicks provided an overview of the Child Care and Development Block Grant and the requirements and duties to maintain this grant funding that has been in place since 2014.
The Committee also received briefings from Mitch Rucker, Kansas Action for Children, Tanya Bulluck, Child Start, Inc., Jennifer Adhima, Kansas Head Start Association, Callie Hoffman, Kansas Parents as Teachers Association, and Emily Barnes, Child Care Coalition of Kansas/Barnes Child Care. Rucker discussed the low wages for child care providers and the high cost of care for parents. He noted that most child care providers make an average of $9.00 an hour and suggested that legislators could consider incentivizing buy-in for building a system for affordable, high quality child care with a tax credit to help businesses offset the cost of child care as a benefit for their employees. He also noted his support for expanding access to the child care systems outlined by Whiteside-Hicks. Bulluck stated that her organization, located in Wichita, works to support families, child care providers, and communities by connecting families with child care, supporting quality improvement for child care providers, and partnering with communities to develop local solutions for challenges and the collection of data. She noted that many families struggle with finding quality child care that is right for them. Adhima stated that her organization oversees 26 Head Start grantees in the state and that these grantees collectively operate Head Start programs in 85 counties as part of the early learning system in Kansas. She stated that concerns from these programs include the complex social needs of young children, a shortage of qualified classroom staff, and low wages. Hoffman stated that her organization supports families that provide primary child care for their family because they are unable to afford or find quality child care. Parent educators facilitate home schooling by providing learning materials, making home visits, and lesson planning. She also noted that her organization partners with the Kansas Health Foundation, the Sunflower Foundation, and other public/private partners to ensure the sustainability of their program. Committee members asked questions regarding the fingerprinting pilot program and how it streamlined the background check process; how the Legislature could help with the low wage concerns; the impact of Lexie’s Law (passed in 2012) on the health and safety of children; and discussed regulatory requirements and potential funding sources to increase wages for child care providers without raising the cost for families.
Chair Concannon announced that she is planning a series of informational hearings that will take place throughout the legislative session on Wednesdays. State Treasurer Lynn Rogers requested the introduction of a bill to update the Kansas ABLE (Achieving a Better Life Experience) Act law, which allows for the creation of tax-free savings accounts for persons with disabilities so the funds can be used for qualifying disability expenses. The current law only allows conservators or guardians to open an account, but the update will make that available to family members.
House Judiciary Committee
(Rep. Fred Patton, Chair)
On Thursday, January 13, the Committee held a 36-minute, urgent hearing on HB 2477, which was drafted in response to codify the provisions in the EOs issued by Gov. Kelly on January 6, in conjunction with her State of Disaster Proclamation. HB 2477, relating to suspending licensure and other requirements for adult care homes, would:
- Provide several opportunities for the extension of deadlines, for occupational licenses, certificates, or registrations issued by KDADS;
- Allow KDADS to issue temporary licenses, certificates or registrations under certain conditions to persons who were previously licensed;
- Allow KDADS to extend the deadline for continuing education requirements;
- Allow the waiver of late fees associated with any license, certificate or registration;
- Allow temporary aide authorizations for persons with minimum training or those who were not previously licensed, certified or registered by any state if the person is competent to perform the duties of the position;
- Reinstate the use of temporary aids in adult care homes that meet minimum requirements in limited, specific circumstances, with adult care home residents that require minimal assistance with activities of daily living;
- Allow KDADS to issue a provisional license to an adult care home that submits a checklist and a detailed plan for isolation and cohorting of residents in response to the COVID-19 pandemic;
- Relax some restrictions for supervision requirements for mid-level providers, such as physician assistants;
- Allow a health care professional licensed in another state and in good standing to receive expanded practice privileges without going through normal reciprocity provisions; and
- Allow those with licensure that has lapsed in the last five years in good standing, to be licensed, registered, renewed, or reinstated without satisfying regulatory or statutory requirements such as examination, fingerprinting, and license fees.
The provisions of HB 2477 would expire on May 15, 2022.
Proponents of the bill, including Rachel Monger, Leading Age Kansas, Tara Mays, Kansas Hospital Association, and Linda MowBray, Kansas Health Care Association, testified about the hardships facing adult care homes and hospitals and stated that workforce shortages in nursing homes are dire. Neutral testimony was provided by Courtney Cyzman and Susan Gile, BOHA, and there was no opponent testimony. Committee members asked questions regarding the impact of not passing legislation before the Governor’s EOs expire on January 21 and for clarification regarding the effective date of the bill. The Committee passed a motion to suspend the rules and briefly worked the bill, and then passed it out of Committee on a unanimous vote.
Note: The Senate Judiciary Committee also reviewed the EOs during an informational hearing on January 13.
Senate Federal and State Affairs Committee
(Sen. Rob Olson, Chair)
On Tuesday, January 11, the Committee heard presentations regarding medical marijuana and House Substitute for Senate Bill (SB) 158 from Andrew Finzen, Kansas Legislative Research Department (KLRD), and Jason Long, Office of the Revisor of Statutes. Finzen provided background and a summary of other states’ medical marijuana and non-medical (recreational) marijuana legislation. Long provided a review of the history of H Sub for SB 158, which was worked and revised extensively by the House Federal and State Affairs Committee before it was passed by the House at the end of the 2021 session and passed to the Senate. Committee members asked questions regarding the implementation of medical marijuana legislation in other states and the potential impacts of passing medical marijuana legislation. On January 13, the bill was withdrawn from the Committee and referred to the Senate Interstate Cooperation Committee.
House Appropriations Committee
(Rep. Troy Waymaster, Chair)
On Wednesday, January 12, during a Joint Meeting of the House Appropriations and Senate Ways and Means Committees, members heard a presentation from Adam Proffitt, Director of the Budget, regarding the contents of the Governor’s fiscal year (FY) 2023 budget and her plans to invest $2.38 billion state general funds of one-time funding for items including “zero[ing]” the state food sales tax effective July 1, 2022; paying cash for projects approved by the State Finance Council for the Docking state office building and the KDHE laboratories; an $8 million transfer to the State Water Plan Fund; $20 million for moderate income housing; $29.3 million to KDADS to increase mental health services across the state; $3 million for the Mental Health Intervention Team program; $2.4 million to Osawatomie State Hospital to support lifting the moratorium and social detox program funding; improvements to KanCare, including standardizing rates for services across the brain injury, physical disability, frail elderly and Intellectual/Developmental Disability (I/DD) waivers, increasing the I/DD private nursing rates to $43 per hour; extending Medicaid coverage for pregnant women to 12 months postpartum; and expanding Medicaid beginning on January 1, 2023.