Legislators were focused on two major actions in the session’s fifth week which began February 7 ─ an override of Governor Laura Kelly’s veto of Senate Bill (SB) 355, which is the congressional reapportionment map, and the passage of a major economic development bill that will allow the state to negotiate with an unidentified company to locate a $4 billion business in the state. They also examined policies related to off-label prescribing for COVID-19 prevention and infections, exceptions from childhood vaccine requirements, the sales tax on food and updates to the foster care system. This edition of Health at the Capitol looks at health policy issues that were discussed during the fifth week of the session.
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.
After a failed attempt in the Senate on Monday to override the Governor’s veto of the redistricting map, a second vote on Tuesday was successful with a vote of 27-11. On Wednesday, the House also overrode the veto on a vote of 85-37, although it appears that one or more lawsuits may be filed challenging the constitutionality of the map. With the passage of the congressional map, the Legislature will now move on to drawing the House and Senate maps.
On Monday, the House Commerce, Labor and Economic Development Committee made several substantial amendments to SB 347, the Attracting Powerful Economic Expansion Act (APEX Act), which had been passed by the Senate on January 27, and passed it out favorably as House Substitute for SB 347. The House then passed the substitute bill on Tuesday, February 8, on a vote of 80-41, despite concerns from both sides of the aisle about the lack of information about the identity of the company and the uncertainty regarding the actual cost to the state. The bill returned to the Senate on Wednesday, February 9, was passed on a vote of 31-9, and was signed by the Governor on Thursday, February 10. Commerce Secretary David Toland then provided members of the State Finance Council with additional information about the offer being made to the unidentified company during an executive session.
House Health and Human Services Committee
(Rep. Brenda Landwehr, Chair)
On Monday, February 7, the Committee, led by Acting Chair John Eplee in the absence of Chair Brenda Landwehr, received bill requests from Alexandra Blasi, Kansas State Board of Pharmacy, and Rep. Mari-Lynn Poskin. Blasi requested a bill to create an interim legislative committee to study pharmacy workplace conditions and the effect on patient safety ─ House Bill (HB) 2698 was introduced on February 11. Poskin requested a bill to prohibit smoking in private motor vehicles when minors are present ─ HB 2695 was introduced on February 10.
Senate Public Health and Welfare Committee
(Sen. Richard Hilderbrand, Chair)
On Tuesday, February 8, the Committee worked SB 381, which would allow for the prescribing and dispensing of medications for off-label use to prevent and treat COVID-19 infections and any action taken by a prescriber under the provisions of the law would not be considered unprofessional conduct. Committee members asked questions regarding whether pharmacists would be held liable for dispensing of medication for off-label use if an unintended drug interaction were to occur; whether the prescriber would need to disclose what the medication is for; if the bill could be limited only to drugs like ivermectin and hydroxychloroquine; and whether the prescription fill request could be rejected if there is an allergic reaction. The Committee amended the bill to insert the contents of SB 398 (despite concerns from some members that SB 398 had not received a hearing in the Committee), which would require child care facilities and schools to grant religious exemptions from vaccination requirements without inquiring into the sincerity of the religious beliefs. The Committee then replaced the contents of HB 2280 (related to powers, duties and functions of the Kansas State Board of Pharmacy as passed by the House in March 2021) with the contents of both SB 381 and SB 398 and passed Senate Substitute for HB 2280 out of Committee. Note: The bill was subsequently withdrawn from the Senate calendar and rereferred back to the Committee on February 10, 2022.
On Wednesday, February 9, the Committee held a hearing on SB 387, which would amend licensure requirements for certain professions licensed by the Behavioral Sciences Regulatory Board (BSRB), including specialist clinical social workers, and allow master social workers, professional counselors, clinical professional counselors, marriage and family therapists, clinical marriage and family therapists, master’s level psychologists, clinical psychotherapists or psychologists to be eligible to take a Board-approved examination for licensure as addiction counselors. Proponent David Fye, BSRB, stated the bill would allow additional qualified mental health professionals to obtain licensure in Kansas without sacrificing public protection and enable additional individuals to become licensed addiction counselors more quickly without sacrificing protection of the public. He also noted the bill provides flexibility for practitioners to satisfy the current requirement for 50 continuing education hours and a new three-hour requirement in diversity, equity and inclusion (DEI). There was no neutral or opponent testimony. Committee members asked questions regarding the content of and purpose for the required DEI courses and how many social workers would be impacted by the bill.
The Committee also worked and amended SB 12 (introduced in 2021), which would require DCF to collaborate with community partners and stakeholders to develop a plan by January 31, 2023, for implementation beginning on July 1, 2023, of performance-based contracts to provide an array of evidence-based prevention and early intervention services for families at risk for out-of-home placement, families that have a child in out-of-home care, and children awaiting adoption. The bill would also require DCF to provide a status update and recommendations for continued progress and submit a proposal for the reinvestment of savings from reduced foster care caseloads into evidence-based prevention and early intervention programs designed to prevent the need for or reduce the duration of out-of-home placements to the Governor and Legislature no later than January 31, 2024. The Committee then passed the bill, as amended, favorably out of Committee.
On Friday, February 11, the Committee worked and amended SB 168, which would update certain provisions of the prescription monitoring program act; SB 276, which would establish certain procedural safeguards, in compliance with the federal Americans with Disabilities Act, to protect the interests of children parented by blind individuals or children who could be parented by blind individuals, and to protect the rights of parents and prospective parents who are blind; and SB 387 (as described above, but without the DEI requirement) and passed them favorably out of Committee.
House Children and Seniors Committee
(Rep. Susan Concannon, Chair)
On Wednesday, February 9, the Committee held an informational hearing on efforts in child abuse investigations. Melissa Hudelson, Kansas Chapter, American Academy of Pediatrics, provided testimony in favor of HB 2632, which would:
- Require a forensic medical evaluation of an alleged victim of child abuse or neglect as part of an investigation;
- Create a program in the Kansas Department of Health and Environment (KDHE) to provide training and payment for child abuse review and evaluation examinations; and
- Define child abuse review and evaluation providers, networks and examinations and child abuse medical resource centers.
Hudelson stated the bill would provide the framework and workforce for appropriate and timely follow-up for reports of child physical abuse and neglect and provide a system of support for Kansas physicians and medical providers to participate in the Child Abuse and Review Evaluation (CARE) Provider Network, joining states like Missouri that have already implemented the program. The bill allows for appropriate compensation for CARE providers, who have received specialized training and certification to perform thorough exams. Three years of additional training is needed to be considered a professional in this area. Jennifer Hanson, M.D., stressed the need to increase the workforce of physicians receiving CARE certification, especially in rural areas. She defined a CARE provider as a medical provider who participates in initial and ongoing training on the medical evaluation of child maltreatment, including recognition of abusive injuries and testing and treatment for children when abuse is suspected.
The Committee also held a hearing on HB 2582, which would amend existing law governing access, exchange and disclosure of information in the Code for Care of Children to require DCF to disclose confidential agency records of a child alleged or adjudicated to be a child in need of care to law enforcement agencies investigating alleged or substantiated reports or investigations of abuse or neglect. Ed Klumpp, Kansas Sheriffs Association, stated that while communication between DCF and investigators has already improved they continue to receive reports with key information redacted. He offered an amendment to add language to the bill that would allow investigators to have access to “name and contact information of persons alleging the abuse or neglect and DCF employees or contract employees investigating the allegations” in addition to the records and reports already listed in the bill.
On Thursday, February 10, the Committee worked HB 2582 (discussed above). Rep. Timothy Johnson moved to amend the bill with the additional language proposed by Klumpp on February 9, the amendment was adopted, and the Committee passed the bill favorably out of Committee, as amended.
House Social Services Budget Committee
(Rep. Will Carpenter, Chair)
On Wednesday, February 9, the Committee considered budget recommendations for KDHE for FY 2023 and approved $800,000 State General Funds (SGF) for distribution to local health departments; $3.5 million All Funds, $1.4 million SGF, to increase the availability of adult dental services in KanCare; $2.9 million All Funds, $886,200 SGF to raise pediatric primary care provider reimbursement rates to 100 percent of Medicare reimbursement rates; $9.4 million All Funds, $4.2 million SGF, to raise all emergency medical services provider codes to 65 percent of the 2021 rural Medicare rates and raise the ground ambulance mileage rates to 100 percent of the 2021 rural Medicare rates; raise the cap from $2.5 million to $5 million to transfer funds from the Medical Assistance Fee Fund to the Kansas Newborn Screening Program Fund; add $2 million SGF to increase availability of early intervention services provided through the Tiny-K program; add language to instruct the agencies involved in developing the human services caseloads estimates to advise and consult with the ranking members of the House Social Services Budget Committee and Senate Human Services Subcommittee on the development and adjustment of the human services consensus caseload estimates; allow the Board of Pharmacy to provide data in the state’s prescription drug monitoring program to designated representatives of KDHE to authorize Medicaid program practitioners to report data when Medicaid prescriptions are filled; $1 million for the breast and cervical cancer early detection program; and add $68.5 million SGF and delete $664.5 million federal funds to remove funding for Medicaid expansion, add language to lapse the funding if expansion is passed during the 2022 session and to note that the Committee recognizes that K.S.A. 39-709(e)(2) requires that Medicaid expansion be approved by the Legislature.
Senate Financial Institutions and Insurance Committee
(Sen. Jeff Longbine, Chair)
On Monday, February 7, the Committee worked SB 335, which would amend K.S.A. 40-2222b to exempt certain business entities that provide health insurance in the state but are not subject to the jurisdiction of the Kansas Insurance Commissioner (i.e., association health plans subject to regulation by the U.S. Department of Labor) from payment of the annual one percent premium tax and passed it favorably out of Committee.
House Appropriations Committee
(Rep. Troy Waymaster, Chair)
On Monday, February 7, the Committee heard a presentation by Rep. Susan Humphries, Chair, Higher Education Budget Committee, regarding the proposed budget for the Kansas Board of Healing Arts (BOHA) for FY 2022 and FY 2023. Rep. Humphries reported that the Budget Committee concurred with the Governor’s recommendations for FY 2022 and FY 2023, with the addition of the following language: “not allowing expenditures to be made to investigate or take disciplinary action against any physician who, in the medical judgment and experience of such physician: a) provides treatment or prescribes a prescription drug approved by the U.S. Food and Drug Administration for an off-label use to prevent or treat an infection or a disease caused by an infection in a patient; b) has discussed and presented all treatment options that are appropriate for and available to such patient; and c) determines there is a valid medical purpose for such treatment . . .”
Following a request by Rep. Kristey Williams that the proposed language be removed or revised, Committee members discussed the appropriateness of policy issues being included in agency budgets; noted that the Public Health and Welfare Committee was holding a hearing on SB 381, which includes provisions addressing the same issue being addressed by the proposed budget language; and asked questions regarding the process that triggers an investigation by BOHA and how those investigations are conducted and resolved. Rep. Williams’ motion to strike the language was passed by the Committee. Rep. Humphries’ motion to include a comment in the agency’s document requesting that BOHA “proceed with caution as they investigate off-label prescribing” complaints was approved by the Committee.
Senate Assessment and Taxation Committee
(Sen. Caryn Tyson, Chair)
On Thursday, February 10, the Committee worked SB 339, which would reduce the state rate of sales and compensating use tax on food and food ingredients, including prepared foods, from 6.5 percent to zero percent beginning on January 1, 2023; provides for the continued levy of city and countywide sales taxes on the sales of food and food ingredients; and discontinues the current nonrefundable food sales tax credit after tax year 2022. The Committee considered several amendments to the bill including delaying the effective date of the food sales tax change to January 1, 2024 (adopted); adding the text of SB 359 (expansion of the eligible uses for the zero percent state rate for sales tax for certain utilities and the levying of sales tax on such sales by cities and counties and authorizing cities and counties to exempt such sales from such city or county taxes, adopted); adding the text of SB 327 (exclusion of delivery charges that are separately stated on an invoice or similar document from the sales price for purposes of retail sales and compensating use tax, adopted); allow Washburn University to continue to have sales taxing authority; allow locals and any other sales taxing authorities the option to remove the sales tax on food (go all the way to zero, adopted); insert language from SB 342 (related to amounts credited to the state highway fund, not adopted); and adding the text of SB 228, with amendment of the start and ending dates in the bill (allowing for retention of sales taxes by retailers on the admission of viewing of movies or films and the sales of concessions sold onsite at the retailer’s place of business, adopted). The Committee then passed the bill, as amended, favorably out of Committee.