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Theresa Freed 0:00
The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. Each legislative session KHI is hard at work keeping you informed on the latest health policy discussions from across the street in downtown Topeka. Health at the Capitol is a KHI production, a monthly recap with our legislative monitoring team offering you a closer look at policy work happening now in Kansas and coming up.
Welcome to Health at the Capitol. I’m Theresa Freed, director of strategic communication and engagement for the Kansas Health Institute. Were exploring health-related happenings at the Kansas legislature. Joining me for this discussion are Linda Sheppard and Cynthia Snyder, KHI staff members. And I’ll go ahead and have them introduce themselves, Linda.
Linda Sheppard 0:50
Hello, I’m Linda Sheppard. I am a strategy team leader here at KHI.
Cynthia Snyder 0:54
I’m Cynthia Snyder, a senior analyst here at KHI.
Theresa Freed 0:58
Alright, so I know you guys are very excited about the legislative session, we’re almost 30 days in right now. And there’s been a lot of activity already.
Linda Sheppard 1:05
There has. It was a little bit of a slow start that first week when we had that really bad weather. But they made up for it starting in the second week and have continued working on a number of health-related matters since then.
Theresa Freed 1:18
Alright, so we’re just gonna get into it. What are some of the topics that are really getting a lot of attention?
Linda Sheppard 1:25
You know, I don’t know that there’s any one particular topic that several of the committees have really picked, I think some very specific issues that they have a lot of interest in and it’s very broad across the board, different issues that they’re focusing on right now. And so it’s interesting to see the things that they’re paying attention to, things that certainly, you know, we weren’t expecting in some cases that they would be paying attention to so.
Theresa Freed 1:53
Alright, and so what’s one topic that you see carrying through the session?
Linda Sheppard 1:58
You know, one of the topics that has come up, there is in the House, there was a new committee that began last year called the Welfare Reform Committee. That was a new addition to the legislature. And it wasn’t really clear last year exactly what they were going to be focusing on. But clearly, the focus was on issues related to public assistance programs, eligibility for those things, fraud concerns, and that matter. But that committee has really taken an interest in over the summer and interim committee, and then starting in the session taken an interest in homelessness. So they have brought in a number of speakers, out-of-state speakers to talk about homelessness and what other cities and other communities and states are doing to address that, paying very close attention to how the U.S. Supreme Court is looking at some court cases that would make some decisions about how cities could respond to homelessness issues. So it’s been interesting to watch them do that, because that was certainly not something we expected to see.
Theresa Freed 3:04
And go ahead Cynthia.
Cynthia Snyder 3:05
And we’re seeing it in KDAD’s budget. So for fiscal year 25, KDADS has $40 million in one-time funding to work with communities to address homelessness infrastructure. So that was a, I believe that there, they had $46 million in state general funds enhancements and $40 million of those were with the homelessness. So we’ll see how that develops, and there’s finances to support programs that are in the budget. So we’ll see how those make it through committees.
Theresa Freed 3:40
Are we hearing any specifics on proposals that might be tied to that?
Linda Sheppard 3:43
They’re clearly looking, again, looking at things that are happening in other jurisdictions, and trying to look for ideas of things that maybe that could be done and could be adopted in Kansas. So I haven’t seen any bills. But that doesn’t mean that something couldn’t be done. But Chair, Awerkamp has certainly indicated that he would like to hold at least one or two more hearings on this on this topic. So he really digging into it.
Theresa Freed 4:10
And is there, you know, in addition to this being in KDAD’s budget, are there any issues surrounding this that we’re seeing, sort of building this momentum for this topic?
Linda Sheppard 4:21
Well, I think what, you know, again, this started a little bit last year, and then really did beef up during the summer with this interim committee that spent a lot a lot of time focusing on this. And I think what it is it is clearly a reflection of what the legislature is seeing in various communities around the state.
I live in Lawrence. Lawrence has certainly struggled with this issue and had some serious problems with the camps, both the official camp and some of the not official camps. And so I think recognizing that communities are really struggling with how to respond to this problem, and what to do to address the issue.
Theresa Freed 5:06
Alright, any other topics we want to talk about? What’s next?
Linda Sheppard 5:10
You know, Theresa, as you know, I have a lot of interest in health insurance. And one of the things that came up during the Senate Financial Institutions and Insurance Committee, they had the opportunity every year, Commissioner Schmidt comes and speaks to the committee’s and just kind of gives them an update of what’s going on in the department and things that have happened over the past year, issues that she’s interested in. And, surprisingly enough, one of the issues that came up from the committee members, the legislators, was that they were asking her about her ability to regulate and respond to some concerns that they’re hearing from their constituents about the marketing of Medicare Advantage products, which obviously a product for seniors. And the unfortunate piece of this is is that those Medicare products are regulated by the federal government, not by states. And but they you know, they were really anxious to hear from her about that what if anything she could do to, to address that. So it was something that she certainly did share with them, the fact that that she didn’t have that direct authority, but did indicate that there are some discussions going on between the leadership of the National Association of Insurance Commissioners and some of the folks from from CMS about whether or not there are some authority that they may want to give back to states at some point in the future, because they’re recognizing that there are issues with how that product is marketed, how it’s described, and that there’s some some real misunderstanding among seniors who are buying that product.
Theresa Freed 6:49
So when we talk about federal health insurance or health coverage, programs, Medicaid certainly is something that is getting a lot of attention right now. So can you kind of talk about what the current discussion is there?
Linda Sheppard 7:01
You know, we have had, the governor has certainly spoken out about her interest in getting Medicaid expansion passed in the state. And she has worked on introducing bills on a regular basis over the last few years, that that, frankly, just haven’t gotten a hearing. And so she, she wants to, again, this year introduce bills, both in the House and the Senate, and did make a statement that she was hoping that there would be a hearing on those bills by this past Monday. And that did not happen. But that, you know, she did, certainly did go, you know, out of her way over the summer and into the fall, trying to travel around the state and talk to people about Medicaid expansion. And I don’t think anybody denies that there is certainly some interest among Kansans across the state to at least have that discussion.
Theresa Freed 8:03
And so this might be a good opportunity for us to talk a little bit about some of the products that the Kansas Health Institute has developed that kind of help in that discussion, which, you know, we’re firm believers in providing fact-based information to help drive health policy discussions. So if you want to talk a little bit about some of those.
Linda Sheppard 8:21
Yeah, obviously we did our Medicaid Primer again this year, which is something that we do every year in conjunction with the Kansas Legislative Research Department, that just provides the legislators and frankly, anybody with some real background about the Medicaid program in Kansas, and the eligibility groups for that program, and then a lot of data and history about that program over the period of time that it’s been been in place. We also are, you know, for several years now, KHI has prepared an issue brief that would provide an estimate of if Medicaid expansion were to happen in Kansas, the number of Kansans that potentially would be eligible for coverage if expansion occurred, and we’ve continue to update that that projection of what those numbers would be based on the Census data that comes out every year. And then something that actually we haven’t done for a while. And I think, you know, we’re looking at working on again this year is taking a look back at some of the states who did expand early on starting right in 2014. When that when it first became available, and looking at the experiences that they had, what did they expect with enrollment and what did actually happen? What kind of impact did it have on the health of their, of their citizens? What kind of impact did it have on their economy, and their health care system? So, look, going back and looking at these and because I think those questions continue to come up of, you know, will this happen if we expand Medicaid? Will, this happen? Will this really work this way that we think and so I think going back and look at those experiences, the states that have already done it. And now, you know, we’ve got, you know, almost 10 years of experience to look back on. So there’s a lot of information to consider.
Theresa Freed 10:15
Moving on to any other topics that we want to hit or getting some attention there at the legislature?
Linda Sheppard 10:20
Um, you know, I and, Cynthia, you know, I think that this was something that you and I talked about that was very interesting, which was a different approach that Social Services Budget Committee took this year, with regard to looking at some of the items that were in the governor’s proposed budget that came out with regard to things that, enhancements to their budget that they were interested in. So I think the way that the way that Chair Mason handled that this year was was different than why he did it last year.
Cynthia Snyder 10:48
Right. So this year, they had the previews of the enhancements for the three largest health-related budgets. So KDADS, DCF and KDHE. And so it gave each of the secretaries and their staff an opportunity to present to the the legislative committee members, ask questions. Whereas when you look at the full budget, and all the enhancements, and any changes the governor may have looked at, as one package, it’s a lot of information very quickly. So this really gave legislators a chance in the committee to have a preview, maybe think about some additional questions that they have to follow up. So as those budget hearings take place, that they’ll be in a better position to ask questions, be informed, ask interim questions between to get follow-up information. So I think it’ll really make the process much more smooth.
Theresa Freed 11:42
Alright, that’s great. And other topics? I know that I’ve heard medical marijuana popping back up again.
Linda Sheppard 11:50
Um, you know, for several years now, you know, we’ve thought it was going to happen, you know, there has been a lot of time spent both during the regular session and during the interim, looking at bills. And looking at them in close detail, looking at what was happening in other states and things that that we might want to consider in legislation in Kansas. And it just hasn’t happened. I haven’t heard, nothing this year, about the possibility of, you know, of that happening. You know, there were bills that were introduced last year, potentially are still been alive. This is the second year in the biennium. So could be alive and brought to hearing again, but so far, have not are going to committee. Yes. Yeah. Not on the agenda yet. That’s exactly right. So that that’s certainly not something that we’ve seen any action on at this point.
Theresa Freed 12:46
Alright. And just last question, you know, looking ahead for the next couple of weeks, what are we expecting for activity?
Linda Sheppard 12:53
Well, as as Cynthia mentioned, you know, the the work on the budgets will really start picking up pretty quickly. And those committees, those groups that had a chance that agencies that had a chance to go and do this sort of introductory presentation, will have a chance to go back and do a full budget presentation, and the legislators will start making those decisions about what to approve, so that budget budget process will certainly be happening. And and then I just think that threre you know, there are issues that the legislators appear to be interested in that again, that we just didn’t expect them to happen and things that were kind of unusual. So KDADS he has been working on a state plan for palliative care across the state. This is something they’ve been working on for years. And that state plan has been completed. And I think that they are, KDHE is actively out there looking for opportunities to go around the state and talk about that. And I don’t know that there will be an ask to the legislature to do anything particular to help put all of that actually into, you know, into to effect but it’s something that’s been happening there for a while and they’ll certainly be looking at it.
Cynthia Snyder 14:11
We got a little preview of what the asked might be in from Dr. Porter Williamson, when she was presenting I think, to Public Health and Welfare. They’re really looking at dollars to support the continuing education credits for physicians to learn more about palliative care, and even looking at making some requirements in terms of within the existing CEUs that they’re required, that a certain proportion of those be related to palliative care. So I think we have a pretty good idea of what the ask will be.
Linda Sheppard 14:46
One thing that was was very interesting to me in and it came out of a committee that I really didn’t expect this was in was in corrections and juvenile justice. But every year the committee invites members of law enforcement. So the KBI director, some of the individuals from the Kansas Sheriffs Association and the Highway Patrol, to come and talk about issues that are of concern are of interest to them. And Director Mattivi really, very strongly stressed his concerns about the growth of the traffic and distribution of fentanyl in the state and is genuinely concerned about that, also sees as a huge threat in Kansas crimes against children, both physical and sexual abuse, as well as, you know, harm coming from social media. And so that’s something that he’s interested in, really getting, trying to get people’s attention to pay attention to those things. And then also talking about cyber attack. So you know, we’ve had some of those swatting incidents in Kansas. But you know, he mentioned that the the cyber attacks on hospitals where they lose the ability to get access to their patient records, and those kinds of things, and, you know, are sort of held hostage for ransom. So it was interesting to hear the things that law enforcement continue to be concerned about, you know, at the local level, the sheriffs continue to be concerned about the lack of mental health services that they need when they’re interacting with individuals in their communities. And also mental health services for first responders. And so not only them dealing with the individuals who who have mental health issues, but also teaching them how to do that. And then also giving them the opportunity to get services for themselves when when they experience trauma for the things that happen in our communities.
Theresa Freed 16:50
Alright, those are all very important topics. So I guess stay tuned to see if those turn into proposals to to help address some of those important issues. So again, this is Health of the Capitol. This is a new show that we are launching to help provide an update on a monthly basis, some of the things happening at the Kansas legislature but if you’d like to stay up to date, on a weekly basis, we also have a written update that we can email directly to you, and you just sign up on our at khi.org Thanks for joining us.
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Transcription provided by Otter.ai. Automated text lightly edited for accuracy and clarity.