Week 1 of the 2025 Session

21 Min Read

Jan 23, 2025

By

Linda J. Sheppard, J.D., Valentina Blanchard, M.P.H., L.M.S.W.,

Alexa Heseltine

The 2025 session began on Monday, Jan. 13. This year it’s scheduled for 90 calendar days with adjournment set for April 12. Under Article 2, Section 8 of the Kansas Constitution, the “duration of regular sessions held in even-numbered years shall not exceed ninety calendar days.”  However, both Senate President Ty Masterson and Speaker of the House Dan Hawkins have expressed support for returning to the “roots in our constitution” and finishing the work of the Legislature in 90 days, even though the Constitution does not provide length guidelines for odd-numbered years. A significant change for 2025 will likely be more committee meetings on Fridays, which have typically been pro forma days with no committee work. 

 This edition of Health at the Capitol looks at health-related policy issues announced or discussed during the first week of session. Kansas Health Institute (KHI) intern Alexa Heseltine contributed to this edition. 

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 Facebookand LinkedIn. Previous editions of Health at the Capitol can be found on our ARCHIVE PAGE.

On Friday, Jan. 10, Gov. Laura Kelly signed Executive Order(EO) 25-01, which directs the Kansas Department for Children and Families (DCF) to manage federal benefits for eligible youth in foster care, such as those administered by the Social Security Administration, Department of Veterans Affairs and Railroad Retirement Board. DCF will be responsible for ensuring that the benefits are preserved, spent and ultimately dispersed for the benefit of the child. No benefits can be used to reimburse DCF for the contractual maintenance of the child while in DCF’s custody. The program requirements in the EO must be fully implemented by July 1, 2025.  

Also on Jan. 10, Republican priorities for the 2025 session were announced by Masterson and  Hawkins, including a focus on government efficiency, school vouchers, and a ban on transgender minors accessing gender-affirming health care. Masterson had previously announced on Dec. 17, the creation of a new Committee on Government Efficiency (COGE), which will be chaired by Sen. Renee Erickson. COGE is charged with exploring ways to “restructure and reform state government to reduce spending and increase government efficiency.”   

On Tuesday, Jan. 14, Rep. Troy Waymaster, chair of the House Appropriations Committee, introduced House Bill (HB) 2007, a legislative budget bill for fiscal years ending June 30, 2025, June 30, 2026 and June 30, 2027. The budget bill is the result of the work of the newly formed Special Committee on Legislative Budget, which met during November and December. Hawkins stated on Jan. 15 that Chair Waymaster has also asked all state agencies to provide a 7.5 percent reduced resource proposal for their FY 2026 budgets, which will be reviewed by the standing budget committees. 

On Wednesday, Jan. 15, the Governor delivered her 2025 State of the State address to the Legislature. In her comments, Gov. Kelly spoke about early childhood education and child care, the proposed Office of Early Childhood, public school funding, her proposal to address childhood hunger by providing free school lunches to more than 35,000 students, the state’s water supply, including the need to stabilize the Ogallala Aquifer, maximize the capacity of state reservoirs, and development of a comprehensive, long-term water supply plan. The Governor also spoke about Medicaid expansion.  

On Thursday, Jan. 16, Budget Director Adam Proffitt presented the Governor’s proposed budget for fiscal year 2026 to a joint meeting of the Senate Ways and Means and House Appropriations Committees, which includes $10.6 billion in State General Fund (SGF) spending, a 0.7 percent increase over the budget passed by the Legislature in 2024. The Governor’s budget proposal includes: 

  • $13.4 million to expand child care slots and build child care workforce capacity 
  • $5.5 million to eliminate co-payments for students on reduced lunch, providing free school meals to more than 35,000 students 
  • $72.6 million for Special Education State Aid 
  • $500,000 to cover certain Advanced Placement (AP) test fees for students of low-income families 
  • $90 million for water infrastructure projects 
  • $2.6 million to establish Behavioral Health Intervention Teams for Child Welfare Providers to increase placement stability for youth in foster care  
  • $2 million for capacity building for hospitals and other health care facilities 
  • $20 million for Home and Community Based Services provider grants 
  • Funding for growth in Frail/Elderly, Brain Injury and Technology Assistance waiver utilization 
  • Funding to complete stand-up of the Community Support waiver for people with intellectual and developmental disabilities who do not need continuous, 24-hour support.  

Also on Jan. 16, Hawkins and House Majority Leader Chris Croft introduced House Resolution (HR) 6004, the House rules for the 2025-2026 biennium. Consistent with leadership’s support for a 90-day session the resolution does not include a rule stating that a session day cannot continue after midnight. Previous rules have required the House to vote to suspend the “midnight rule” to continue working into the next day. HR 6004 was referred to the House Rules and Journal Committee, chaired by Rep. Susan Humphries, and a hearing was held on Jan. 16. The Committee will be working the resolution at a later date.

House Committee on Health and Human Services
(Rep. Will Carpenter)

On Thursday, Jan. 16, the Committee heard updates from Kansas Department of Health and Environment (KDHE) Secretary Janet Stanek. Deputy Secretary Ashley Goss and Deputy Secretary and Medicaid Director Christine Osterlund regarding: 

  • Reaccreditation of KDHE by the Public Health Accreditation Board 
  • Mobilization of staff and resources to address a tuberculosis outbreak, in collaboration with the Centers for Disease Control 
  • A 31 percent increase in the number of families served by Home Visiting programs 
  • Completion of the design and construction of the new Kansas Health and Environmental Laboratories facility and relocation to the new facility  

KDHE’s legislative initiatives for 2025 include an update of the Newborn Screening Cap to allow for program growth and expansion, and an increase in the state formula funding for local health departments.  

Stanek also reported that as of Oct. 31, 2024, there were 440,812 individuals enrolled in the state’s medical programs, including 360,672 in Medicaid; 60,597 in CHIP; and 15,845 in the Maternal and Child Health Integrated Program. Stanek added that roughly 95 percent of the Medicaid population is enrolled in the managed care program provided by the three managed care organizations (MCOs) – Healthy Blue, Sunflower Health Plan (Centene), and United Healthcare.  

Major accomplishments during 2024 included award of a 10-year $17 million grant focused on improving maternal and infant health outcomes, implementation of the KanCare 3.0 contracts, and the complete unwinding from the COVID-19 Public Health Emergency. Goals for 2025 include: 

  • Full implementation of KanCare 3.0 
  • Initiation of Transforming Maternal Health grant activities 
  • Completion of phases 2 and 3 of a rate study to understand the relationship between the fee schedule and MCO payment to providers and to compare complex payment structures, such as hospital diagnostic-related group (DRG) payment, and cost-based payments to comparable Medicaid states 
  • Research and recommendation regarding a revised Graduate Medical Education program for the state 
  • Implementation of public-facing dashboards on MCO performance and other key Medicaid data previously not available  

Committee members asked questions regarding Medicaid enrollment trends over the past five years (enrollment peaked at close to 540,000 and now is back in the 400,000s); the number of child births covered by Medicaid (right around 50 percent); the timeline for approval of policy changes that require Centers for Medicare and Medicaid Services (CMS) approval (state plan amendments typically take about 90 days; 90 days to six months for HCBS waivers; and up to a year for 1115 waivers), the scope and limitations of the Medicaid rate study (comparing rates with neighboring states (Missouri, Nebraska and Colorado) and Medicare); the nature of child care regulation changes (streamlined with significant stakeholder input), implementation of the community care coordination service (will be implementing first pilots this spring and full implementation by fall 2025); and comparison of Medicaid reimbursement rates to actual provider fees rather than other states’ reimbursement rates (limited by CMS rules but could use state general funds to increase rates above Medicare rates).  

The Committee then heard from Scott Brunner, Deputy Secretary of Hospitals and Facilities, Kansas Department for Aging and Disability Services (KDADS), regarding the agency’s legislative priorities for 2025, including: 

  • Establishment of the Mental Health Intervention Team Program in statute 
  • Establishment of the new South Central Regional Mental Health Hospital in Wichita in statute, which will begin taking admissions in January 2027 (groundbreaking later this month or in February) 
  • Creation of a Civil Monetary Penalty Reinvestment Fund, which will allow revenue from fines and penalties assessed against facilities for being out of compliance to be directed for the benefit of licensed providers 
  • Amendment of K.S.A. 22-3302 and 22-3303 to make outpatient, community-based treatment the default option for defendants ordered to receive evaluation and restoration, subject to a court’s discretion based on the severity of the crime and length of the potential sentence.  

Committee members asked questions regarding the flexibility of field staff to determine the assessment of fines (triggered by repeated non-compliance and fine amounts set in regulations and statutes), what the reinvestment funds would be used for (grants back to licensed providers for infrastructure, capital improvement and training), the amount of fines collected (typically $3,000-4,000 per incident but maximum is higher, $250,000 to $450,000 annually), and financial responsibility for housing criminal defendants awaiting competency evaluations (counties with partial reimbursement from KDADS at $100 per day). 

Senate Committee on Public Health and Welfare
(Sen. Beverly Gossage, Chair) 

 

The Committee met briefly on Tuesday, Jan. 14, and heard a presentation by Kansas Legislative Research Department (KLRD) regarding the report and recommendations of the interim 2024 Special Committee on Targeted Case Management (TCM). During the Special Committee’s meeting on Oct. 9, 2024, a representative of KDADS outlined the current status of the state’s plan to address the CMS requirement to completely separate TCM functions from services. The plan includes a time-limited option allowing provider agencies to provide both TCM functions and services, but not to the same individual, until July 2029. KLRD reported that next steps are to work with an advisory group to develop a road map, offer grants to provider agencies to assist in separating services, and to maintain communications with CMS.  

Recommendations from the Targeted Case Management Committee included: 

  • Distribution of a survey by KDADS to individuals on the waiver, on the waitlist and other stakeholders asking about satisfaction with Community Developmental Disability Organization and TCM providers, awareness of their ability to change their TCM provider and other feedback regarding services 
  • Development of a Kansas-specific response by KDADS to meet the requirements of CMS to prevent conflicts of interest in provider TCM, including allowing agency-based and independent case managers indefinitely, allowing all available flexibilities including a clear firewall for agency-based providers and building a robust monitoring system, including allowing exemptions in rural areas. 
  • Review of TCM provider capacity and reimbursement rates by the House and Senate standing health committees during the 2025 session 

On Thursday, Jan. 16, the Committee also heard from Michele Heydon, Commissioner, Long Term Services and Supports, KDADS, regarding targeted case management and the Intellectual and Developmental Disabilities (I/DD) Waiver. Heydon stated that TCM is a state plan service defined as assisting eligible Medicaid members in gaining access to needed medical, social, educational and other services. It is not the direct delivery of any referred service. She reported that there are currently 9,031 individuals on the I/DD Waiver, 4,552 on the waitlist and 8,501 individuals receiving TCM. She also explained the conflict of interest issue related to when the organization helping an individual plan their care is also providing the services. Heydon said there’s concern that there can be subtle ways in which the organization guides an individual to choose their services, even if those services are not the best fit for the person. Federal regulations require there to be a separation between case management and service provision to prevent conflicts of interest. Non-compliance with the rule can result in action against the state’s waivers. Conflicts of interest are specifically called out in the State’s Settings Rule Corrective Action Plan (CAP).CMS has advised the state that the CAP will remain in place until the issue is resolved, and the State’s Community Support Waiver will not be approved if Conflict Free Case Management is not in place. On Dec. 16,2024, Kansas received a letter from CMS reiterating its expectations to resolve the current conflict of interest and encouraged the state to take the necessary steps in a timely manner to ensure compliance with the conflict of interest provision in the regulation, “so CMS does not have to consider formal actions, which could include withholding federal reimbursement of impacted HCBS.” 

On Thursday, Jan. 16, the Committee received an update from KDADS Secretary Laura Howard regarding: 

  • Expansion of the Program of All-Inclusive Care for the Elderly (PACE) program 
  • Drafting of the next four-year State Plan on Aging, including regional listening sessions and a survey to gather public input 
  • Rollout of the 988 National Suicide Prevention Lifeline, including improvement of the in-state answer rate and expansion of community-based and mobile crisis services 
  • Certification of all 26 community mental health centers in the state as Certified Community Behavioral Health Centers (CCBHCs) within the KanCare program 
  • Offers to 500 Kansans for each of the Intellectual and Developmental Disabilities (I/DD) and Physical Disability (PD) Waivers 
  • Progress on the application to CMS for a new Community Supports Waiver, which would provide less intensive supports for individuals with I/DD to live in the community and assist in reducing the waiting list for the current comprehensive I/DD Waiver 
  • Expansion of the use of a mobile vendor and Larned State Hospital staff to complete evaluations and competency restoration in jails 
  • Implementation of an electronic health records system for all four state hospitals 
  • Construction of the South Central Regional Mental Health Hospital, with groundbreaking expected this winter 
  • Licensing of providers as crisis intervention centers across the state. Legislative priorities for KDADS include establishing the Mental Health Intervention Team (MHIT) program in statute; establishing the new South Central Regional Mental Health Hospital in statute; and making community-based competency evaluations the default for court-ordered evaluations. Committee members asked questions regarding assistance for determining Medicaid eligibility for long-term care services (provided by KDHE), availability of mobile or virtual crisis services across the state, and expansion of certification of other entities as CCBHCs (paused until 2026).  

Representatives of KLRD also presented the reports and recommendations of the Robert G. (Bob) Bethell Committee on Home and Community Based Services and KanCare Oversight and the 2024 Special Committee on Sedation Dentistry.  

Draft recommendations from the Bethell Committee included: 

  • KDHE’s implementation of the graduate medical education program for the Kansas Behavioral Health Center of Excellence, with an 18-month timeline for implementation 
  • A budget proviso to address pending issues pertaining to the Children’s Health Insurance Program (CHIP) related to eligibility and regulatory changes regarding waitlists and lockout periods 
  • Social Services Budget Committee’s review of providing grant funding for local communities to make a local resource guide digitally available 
  • A budget proviso for additional substance use disorder (SUD) funding through a grant fund to supplement federal funding for those SUD providers who have expended their allocated funds 
  • A budget proviso for continued annual rebasing of the Program for All-Inclusive Care for the Elderly  (PACE) Medicaid rates.

Draft recommendations from the Sedation Dentistry Committee included: 

  • Reviewing the scope of practice of certified registered nurse anesthetists to determine if the authority procure their own medicines under a U.S. Drug Enforcement Administration license could be included 
  • An overall rate increase for dental providers, including allowing for reimbursement of partial services that do not result in a dental service being provided 
  • KDHE sharing with the Committee the Sedation Dentistry Report totals using the current Missouri reimbursement rates and rates that are 80 percent of the usual and customary rate 
  • KDHE providing a fiscal note regarding the cost to raise the dental code G0330 (the hospital facility fee) to the current Medicare rate of $3,087, and indexing the full rate in future years to the current Medicare reimbursement rate 
  • Providing a complete and accurate list of dental providers and anesthesiologists providing sedation dentistry that parents and other providers can easily access and call for assistance 
  • Consumer education regarding the importance of the connection between dental care and overall long-term health care 
  • Exploring dental incentives with the intention of recruiting more dentists in the KanCare program 
  • Support for the My Dental Care Passport (a communication tool created by Oral Health Kansas and its partners to improve dental office visits by enabling patients with disabilities to voice their specific needs).  

House Committee on Child Welfare and Foster Care
(Rep. Cyndi Howerton, Chair)

On Thursday, Jan. 16, the Committee held an informational hearing on EO 25-01, which directs DCF to preserve federal benefits for children in foster care in dedicated accounts for their future use, rather than using these funds to offset foster care costs as previously done. Testimony was provided by DCF Secretary Laura Howard, DCF General Counsel and Chief Litigation Counsel Marc Altenbernt, Deputy Assistant State Treasurer Tom Treacy, Deputy General Counsel John Hedges of the State Treasurer’s Office, and representatives of Kansas Appleseed Center for Law and Justice and Children’s Alliance of Kansas. Committee members asked questions regarding financial literacy training for youth and caregivers, safeguards for fund access, the role of the Social Security Administration (already responsible for these processes), and budget implications for DCF.  

House Social Services Budget Committee
(Rep. David Buehler, Chair)

On Tuesday, Jan. 14, the Committee heard a presentation by KLRD staff regarding reports and recommendations from three 2024 interim committees, including the Special Committee on Targeted Case Management, Special Committee on Sedation Dentistry, and the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight (Bethell Committee). See summary above for the Jan. 14 and Jan. 16 presentations to the Senate Public Health and Welfare Committee. 

The Bethell Committee report also included its requests for the introduction of legislation during the 2025 session, including: 

  • Codification of the 2024 omnibus budget proviso language regarding funding for the Mental Health Intervention Team program and keeping the program within KDADS. 
  • A change in the “home plus” definition in K.S.A. 39-923 to increase the maximum number of beds from 12 to 16 for both stand-alone home-plus facilities and adult care home wings that convert to a separate but contiguous home-plus facility. 
  • Adoption of a written policy governing the negotiated procurement of managed care organizations (MCOs) to provide Medicaid services pursuant to a contract with the Kansas Program of Medical Assistance that includes prohibition on the destruction of records, adoption of a tie-break procedure, and a requirement for transparency with the Legislature to the full extent permitted by law. 
  • Allowing a rural emergency hospital (REH) to be granted a waiver from the physical environment requirement of a new facility for skilled nursing beds that need to be included for hospitals to be able to transition to an REH, without having to meet the requirements for a new facility.  

On Thursday, Jan. 16, the Committee heard updates from Secretary Laura Howard regarding KDADS and DCF. (See a summary of the KDADS presentation above for the Senate Public Health and Welfare Committee on Jan. 16.) Deputy Secretary Scott Brunner and Deputy Secretary for Programs Andy Brown responded to Committee members’ questions regarding how individuals are removed from waitlists and overall management of the waitlists, how implementation of the Community Support Waiver may reduce the waitlists, and plans for expansion of the South Central Regional Mental Health Hospital in the future (will ultimately provide 104 beds, but additional expansion is limited by the design of the building and the site).  

For the DCF update, Howard reported that between July 1 and Nov. 30, 2024, 1,053 children entered foster care, and 1,240 children existed foster care. Other accomplishments during 2024 included reduced need to bring children into the Secretary’s custody through the Family First Prevention Services Act, with data showing that 89 percent of children and youth who reached 12 months from the time of referral to the program remained at home. Howard also noted that multiple Support-Opportunity-Unity-Legal Relationships (SOUL) Family Legal Permanencies were finalized since July 1, the effective date of the law. Sec. Howard stated that DCF’s legislative priorities for the 2025 session include: 

  • Reducing the number of days a child in the custody of the Secretary can be authorized for secure placement by a court from 60 to 45 days 
  • Reducing the number of months within which courts must hold a Child in Need of Care (CINC) permanency hearing from 12 to nine months 
  • Distinguishing in statue that poverty is not neglect and prohibiting separation of a child from a parent solely due to poverty  

Committee members asked questions regarding the balance on child support owed, specific expenditures under DCF’s FY 2025 approved budget for Economic and Employment Support and Information Technology; the number of DCF employees; and the increased cost of Adult Protective Services investigations. Howard stated that additional details for these issues would be presented to the Committee during the week of Jan. 20.  

On Friday, Jan. 17, a representative of KLRD presented the FY 2024-FY 2026 Budget Summary for the Office of the Child Advocate (OCA) and noted that the OCA is funded entirely with state general fund dollars. This is the first year that the OCA is submitting a budget since it was previously located within the Department of Administration’s Office of Public Advocates prior to passage of the Child Advocate Act (2024 SB 115) during the 2024 session. The Act requires the OCA to ensure adequate coordination of child welfare services offered by DCF, the Kansas Department of Corrections (KDOC), KDHE, and the juvenile courts. It is also required to receive and resolve complaints that allege that DCF, or its contracting agents, by act or omission have provided inadequate protection or care of children; failed to protect the physical or mental health, safety, or welfare of a child; or failed to follow established laws, rules and regulations, or written policies. The OCA, which is staffed by Director Kerrie Lonard, three investigators and one administrative officer, is requesting to add two full-time exempt positions for case investigative analysts. Lonard explained the need for the two case investigative analysts to provide good customer service and timely response to complex child welfare cases and concerns that require thorough investigation and resolution. Current analysts are carrying high caseloads with very complex issues and Lonard anticipates an increase in complaints with expansion of the scope of the agency to include concerns and complaints related to services being provided to children who are in the custody of KDOC.

House Committee on Corrections and Juvenile Justice
(Rep. Bob Lewis, Chair)  

The Committee met on Thursday, Jan. 16 and heard a presentation from Tony Mattivi, Director of the Kansas Bureau of Investigation (KBI), regarding fentanyl, which he stated is the “greatest drug threat to Kansans.” While acknowledging that methamphetamines continue to be the “illegal drug of choice in the state,he stated the statistics regarding fentanyl use, overdose and deaths make it the number one trending criminal issue. He outlined the formation of the Joint Fentanyl Impact Team (JFIT) and a K-9 interdiction team of four canines trained in fentanyl detection handled by four KBI special agents. The objective of JFIT, which is comprised of KBI Special Agents, Kansas Highway Patrol Troopers, and U.S. Homeland Security Investigation agents, is to “identify and disrupt fentanyl trafficking and distribution networks.” Mattivi noted that between July 1 and Dec. 31, 2024, JFIT seized 91,363 fentanyl pills, 29 grams of fentanyl power, 36.9 kilograms of methamphetamines, and 960 grams of cocaine.

House Welfare Reform Committee
(Rep. Francis Awerkamp, Chair)

During the Committee’s meeting on Tuesday, Jan. 14, Chair Awerkamp announced that bill drafts had been requested related to reorganization of subsections of the public assistance statute, a waiver from Supplemental Nutrition Assistance Program (SNAP) rules to allow the state to prohibit the purchase of candy and soft drinks with food assistance, the review and comparison of data for public assistance program eligibility, requiring custodial and non-custodial parents to cooperate with child support enforcement programs or food assistance eligibility and consequences for delinquent support payments, and prohibiting counties and cities from implementing universal income programs. Chair Awerkamp noted that all may not be introduced on the House floor. The Committee then heard a presentation from staff of the Revisor’s Office regarding a bill related to reorganization of subsections of the public assistance statute, including eligibility requirements, similar to 2024 House Bill 2627, which was passed by the Committee last session. It was noted that the statute governs three programs, including Temporary Assistance for Needy Families (TANF), food assistance, and child care subsidies. Chair Awerkamp announced that the Committee would be hearing a presentation from Kansas Legislative Research Department (KLRD) staff on Jan. 21 regarding the history of changes to the state’s welfare programs.  

Senate Committee on Government Efficiency
(Sen. Renee Erickson, Chair)

During the Committee’s first meeting on Tuesday, Jan. 14, Chair Erickson stated that the Committee would “create government efficiency” and that it would be looking at “every aspect of how we do the business of government, including financial efficiencies and rules and regulation. She also noted that since the Committee’s scope is so broad, it will meet Monday through Thursday each week and most Fridays.

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