Full Transcript

Voice over 0:00
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.

Theresa Freed 0:21
Thanks for joining us for an episode of Health at the Capitol. We’re here for another season, another session, getting ready to kick off the 2026 legislative session here in Kansas. And so, as always, the Kansas Health Institute very interested in following all of the legislative activit- activity, especially pertaining to health. And so to help us with some of the analysis, I have with us our legislative team. So Linda Sheppard leading the team, and then Valentina Blanchard, we were talking about how we, we screw up the name, and there you go. But anyway, so even though we’ve had a nice long break between the sessions, there’s still been a lot of activity that’s happening. So we’ll go over quite a bit of that, but also talk about what’s coming up. So let’s go ahead and start with Linda if you want to give us kind of a recap,

Linda Sheppard 1:10
Right. So since, since the 2025 session ended, the legislature has been extremely busy. There were a lot of interim committees that met, some of them starting like, really shortly after the session ended, and some of them continued clear into December. So there was a lot of activity going on. But looking, looking forward this year, the session starts next week on the 12th of January. That’s a little late, but they always start on the second Monday of the, of January, and so we just happen to have a really late start date this, this session. This is going to be a really interesting session this year, because they are continuing that accelerated schedule of getting the session done in a very short amount of time, and it even feels faster, based on the schedule that we’ve seen at this point. The session starts on the 12th, turnaround is on February 19th, and then they will have first adjournment on March 27th. So you’re seeing it’s just a whirlwind of things going on. And then, right now, though, they’ll take that break on the 27th, come back on the ninth of April. And so technically, we could be done with the entire session the first full week of April. So there’s a, there’s going to be a lot to keep up with.

Theresa Freed 2:36
And we saw this happen last year. And so what were some of the, I guess pros and cons of that, that speed, that pace?

Linda Sheppard 2:43
Well, sir, I mean for us, specifically for KHI and for Valentina and I, that was a real challenge, because in past sessions, you know, there’s been sort of a warm up period that you go through, at the. So the first week or two of the session, you know, things were not moving very quickly and, and so we were, we were able to kind of relax a little bit and, and keep up with what was going on. But with this change last year to this accelerated schedule, the, the legislators jumped right in. The committees started meeting immediately for their full periods of time, and started working bills, and holding bill hearings immediately. So it really, there wasn’t, none of that warm up period. It was, it was get moving quickly and get those bills going. And so that, that’s the challenge. I think, for, you know, for just people in general who have interests in particular bills, that the, the additional challenge was that, was that they needed to be really up and running very quickly. And those hearings were happening very fast, and so they didn’t, they didn’t have as much time to get themselves prepared for that. But yeah, I think it’s, it’s, it was a big switch for all of us that last year.

Theresa Freed 3:54
Yeah, for sure, there’s lots to, lots to talk about today, lots to talk about during this session. So we’ll kind of dive in a little bit to some of the, the hot topics. So a lot of discussion, you know, obviously, about federal impacts at the state level, but also cost and affordability. We hear about that quite a bit. And I think that theme is, is kind of playing out in the healthcare system quite a bit too. So, Val, what do you want to talk about first, what’s, what’s the next thing that we need to be paying attention to?

Valentina Blanchard 4:23
So let’s start with interstate compacts. And interstate compacts are what allow licensed professionals to practice, maybe they have a license in a different state, and they come to Kansas, and they just have a smoother transition into the licensure process in Kansas. And we could see some movement as Kansas continues to try to address workforce shortages, we could see some additional professions being interested in joining a compact.

Theresa Freed 4:49
Looking at the rural parts of the state and the challenges that they face with getting those professionals in those areas. How does that help?

Valentina Blanchard 4:56
Yeah, absolutely. It’s all about access, especially in those rural areas. But there are also some challenges that the legislature has talked through, including oversight and scope of practice and some other issues kind of related to short-term fixes versus long-term workforce stability.

Theresa Freed 5:13
Okay. And then our next topic is, is looking at our education system, a little bit. Very hot topic about cell phone use among elementary school and high school. You know, we’ve heard news in Australia about, you know, some different things they’re doing to really, not crack down on, but to really monitor and implement some safeguards for children. So what is Kansas doing in there?

Valentina Blanchard 5:39
Yeah, so this is a pretty hot topic right now. Kansas had a task force back in 2024, that recommended that, that school districts do implement some sort of policy to limit cell phone use in school. And I know they did a survey, and there were quite a few districts that have implemented, but they kind of left it up to the districts on what that looked like. But we are seeing more state involvement in that. 31 states plus DC have passed some sort of statewide policy related to what that needs to look like. There were bills introduced in 2024 and 2025 and we know that the State Board of Education in Kansas is currently working with legislators to draft another bill.

Theresa Freed 6:21
Okay. And so, does it have a lot of momentum right now and in Kansas? So are we seeing any pressure from from advocacy groups or parents or, you know, who are the interests?

Valentina Blanchard 6:32
Yeah, I mean, I think both of those. And there’s a couple different approaches too. There’s approaches to education policy and focusing in school. There’s also the mental health aspect of, of children and cell phones. And Australia, as you said, passed, is passing a bill that will ban social media for people under 16. And so there’s, there’s a lot of different groups that are involved in this.

Theresa Freed 6:54
Okay, anything else to add to that?

Linda Sheppard 6:56
Well, I think one thing that is interesting is, as Valentina mentioned, the, that we, we do understand that the Board of Education is working really closely with the legislature and trying to come up with a bill. I think there is, there’s a little bit of discussion about whether or not, you know, whether or not the, the there, we, we have a bill that basically tells the, all of the school districts across the state what to do and how to do it, versus some folks who are really interested in allowing each of the districts to sort of, come up with their own policies and handle it the way that they want to. So I think that will certainly be part of the discussion, is what, you know, which way do we go? Do we go a full blown bill that tells everybody what to do? Or do we allow the districts to come up with their own way that they want to implement that?

Theresa Freed 7:44
And do you anticipate that to come up pretty early in session?

Linda Sheppard 7:47
Yeah, I think, I think we will. I mean, we, as I said, we already have heard that the, that they are working on that bill, so I expect to see it early.

Theresa Freed 7:55
Alright, we’ll continue to follow that one. Another, always important topic is child welfare. So can you talk about some of the potential bills that we can expect?

Valentina Blanchard 8:05
Yeah, so child welfare, we’re kind of looking at two different topics, both child welfare as a whole, and then also the foster care aspect of child welfare. And so in the 2025 session, they passed a bill to create the Office of Early Childhood, and that will consolidate the early childhood services and programs in the state. That’s currently, has a transition team that’s working on establishing that. And so we’ll kind of see what that looks like going into January 2026 and how they are presenting to the legislature. In terms of child welfare from a foster care standpoint, I think, I mean that is always a priority of the legislature. That will always, there will always be interim committees and working groups that are really working on placement stability and workforce shortages and and things like that. So they have some things under works in terms of the data systems that are being used, and so I think we’ll see some potential asks from DCF on funding for those types of things. But I think really the placement stability and really looking at the upstream prevention of trying to keep children in homes, as first priority, I think they’ll still be focusing on.

Theresa Freed 9:21
Alright, so another topic that we’re hearing a lot about, mostly from the federal level, but we’re seeing that kind of trickle down into the state, and that’s the vaccination rates in Kansas. And so can you talk a little bit about what that looks like here?

Valentina Blanchard 9:35
Yeah, so obviously, there has been a lot of conversation at the federal level and some adjustments to, to some of the recommendations that have been made previously, and Kansas continues to see a decline in routine childhood vaccination rates, which is consistent with national trends. People are concerned that lower vaccination rates can lead to health care costs and cause strain on the public health infrastructure so, you know, Kansas had its measles outbreak in this year, earlier, and 12 counties were affected. And most of, the majority of cases were in children aged 10 and younger, which is when those routine childhood vaccinations happen, so.

Theresa Freed 10:14
Alright, and so now we’re going to talk a little bit about the interim committees and some of the activity there. And so first, just a little 101 kind of background. What is the intent or the purpose of the interim sessions? What did they do, and how does that lead into the regular session?

Linda Sheppard 10:33
You know when, when I first started working on legislative monitoring here at KHI, you know, we didn’t see as many as we see now. And it has become very common for there to be 10, 15, different committees, and that annually the legislature, there will be some issue that will come up that the legislature starts to talk about, typically, or has had ongoing conversations about. And they are looking for an additional opportunity to have some more intense conversations, have some more intense information gathering, that they can’t do during the session. So we have really started to see the number of these interim committees build on a lot of different topics. In many cases, those interims are actually, the legislature will actually say we are going to create this task force or this special committee, and then they are given a charge, whatever it is that they’re supposed to work on during that interim period. So they’re, you know, when it, what it used to be, the session went from January to April or May, and now this is pretty much all year long, because those, those interims start very shortly after, you know, with, just with maybe a month or so break before they start the interims.

Theresa Freed 11:43
Okay. So lots of activity, and we’re very focused on those that are pertaining to health. So do you want to give us a breakdown of some of the activity?

Valentina Blanchard 11:52
Yeah, so I’ll start with the Bob Bethell committee, and I’ll just call it Bob Bethell. Officially it’s Bob Bethell Joint Committee on Home and Community Based Services and KanCare Oversight. So they, as the name says, are really focused on KanCare oversight and community-based services. They talk a lot about the different waivers for populations and in Kansas, but one of the big topics this year was the Rural Health Transformation Program that was announced by CMS. And that is, it was established by HR1 at the federal level, and that is supposed to channel $50 billion over five years to all of the states, to support state le- state led efforts in the rural area, in rural health. So an alliance was established by Governor Laura Kelly, which was a group of appointed stakeholders that provided feedback on the application that Kansas submitted. That application was submitted in November, and I think states are supposed to hear back before the end of the year. It was the initial timeline. And so I think we’ll see a lot of interest in the legislature being involved in, in what that program looks like, with the funding that Kansas gets. They also focused a little bit about AI use. Specifically, they’re interested in AI use for mental health care, and then continued support for the waivers that Kansas has, including the IDD waiver and community support waiver. They voted to recommend an additional 500 slots, which is something that they have done in previous years as well for the IDD waiver. that obviously comes with a cost. The last ask of 500 was about 34 million, but there are quite a few people on the wait list as well. As of June 2025, there are about 4,700 on that IDD wait list.

Theresa Freed 13:48
Okay. And in reference to rural health transformation, just to be clear, we are recording this before the end of the year, so decisions could happen at any point, and we’ll, of course, follow up on that as, as we get into the new year. So, alright, so next committee you want to talk about.

Valentina Blanchard 14:06
So another one that focused very specifically on health was the special committee on health and social services. And they kind of looked at two different topics, so nursing staffing shortages as well as the waivers as well. So for nursing staffing shortages, they’re really looking at contrac- so obviously, there’s a nursing, there’s shortages across most healthcare professions. But they’re looking at the difference between the nursing staff that are paid by the state and state hospitals, and the contract nurses, and they’re finding a really, a pretty big discrepancy in pay and, and people navigating towards those jobs, and that’s really, become a really big thing in Kansas. And so they’re really looking at that in hospitals and long-term care settings and behavioral health settings, and really trying to figure out a way to address some of those nursing pipeline issues and burnout, wage competition, type of things. So I think we could potentially see some legislation related to staffing ratios or reporting, some workforce incentives, and maybe some scope of practice adjustments as well, which have all been conversations in the past.

Theresa Freed 15:17
So, you know we talked a little bit about the access to care in rural areas, and you know, the ability to attract workforce in those parts of the state. Is that the central issue here? Or is it, you know, pandemic related, why are, what are the arguments for, for what’s happening, as far as shortages?

Valentina Blanchard 15:35
I think it’s a little bit of all of that. I think there’s, there’s been burnout in nursing for a while, but I think the pandemic really increased that. I think because there are these contract nursing positions, and, you know, cost of living is going up and things like that, you are going to try to find a job that, that pays as much as, as you can get. And I think they’re also, you know, they talked about some some challenges related to some of the ways that scholarships or grants work in the state, and so I think they’ll be taking a look at some of that.

Theresa Freed 16:10
Okay. Alright, what else from that committee?

Valentina Blanchard 16:13
One of the other special committees was on pharmaceutical studies, and they again tackled pretty much two issues, and that was the federal 340B program, and then PBMs, both pretty big topics. So we’ll start with 340B. For those that are unaware the, the federal 340B program is, allows eligible providers to purchase outpatient drugs at discounted prices. And so there are quite a few entities in Kansas that are part of that 340B program. It’s a pretty highly contested issues among hospitals and the FQHCs in the state, as well as the manufacturers and continued discussion for policy makers, but really for providers that, and especially safety net hospitals, that 340B program really enables them to use the savings that are, come out of that program for, to support services that are typically underfunded. So it’s really important for entities in Kansas, but there are some concerns about transparency and whether the savings actually reach the patients, which is what the program was designed for. I think some things that we could see in 2026, some increased transparency or reporting requirements, really trying to protect those 340B entities from manufacturers. There was a bill in 2025 SB 284, that passed the Senate but didn’t make it out of the House committee, so that one is still active for 2026.

Theresa Freed 17:40
And what else?

Valentina Blanchard 17:42
They also talked about pharmacy benefit managers, which, again, is another hot topic across states and at the federal levels. The interim discussions really focused on drug pricing transparency, pharmacy reimbursement and then practices that are affecting those independent pharmacies, especially in the rural areas, is where people are seeing that. So PBMs essentially influence what the patient pays at the counter. And so, and which drugs are covered, and whether really pharmacies are able to get reimbursed for, for their services. So I think we’ll see transparency and reporting requirement things around there as well. I don’t know that there’s going to be a lot of state level restructuring, because there is so much happening at the federal level as well. But I think that there might be some talk about the state’s role in data collection and oversight, so.

Linda Sheppard 18:37
Yeah, well, while, while they did talk about it in this particular interim committee. I mean, Val is right. There is, there has been this ongoing discussion and bills being considered at the federal level to try to regulate those pharmacy benefit managers, the PBMs more broadly. And I think that, you know, as a state, I mean, I think we’re, you know, it would be nice if the, if the federal government would sort of handle that, but there have been a number of other states that have tried to take some action on their own. But it is, it is a very complex entity. Those PBMs are very complex and, and at least up to this point, there hasn’t been a lot of transparency about how they handle, how they handle certain things, how they price certain things, how they decide what the reimbursement rates are going to be for, to the various pharmacists. So it’s, it’s, it’s a complicated situation that you know, the state may want to address, if the federal, you know, if Congress is not able to to get that done, but it would take a lot of work.

Theresa Freed 19:41
That was a lot of information, so a lot to consider as we head into the legislative session. And in this short span of time, you know, a big question is, what can actually get done in that amount of time? So, Linda, you want to talk about that?

Linda Sheppard 19:41
Yeah. So I think it’s going to be really interesting to see how many of these issues, that they’re able to address at all or even fully during this session. This session, in addition to the fact that it’s this continuation of this accelerated schedule, this is also an election year. So the, all of the House members are up for re-election this year, and then we also have the statewide election for Governor and Attorney General, Insurance Commissioner and Secretary of State. And so there are some legislators, obviously, who are running for re-election, and then also some of them who are actually running for higher office. And I think they will, you know, part of this accelerated schedule will give them that opportunity. They obviously, they’re anxious to get back out there and do their campaigning activities again. So there is a little bit of that extra pressure on there. In addition to that, there are just the other things that they have to do all of the time. So the budget, that’s something they have to do every year. This is an interesting thing also, last year, they changed the process for using the budget. So in the past, at the beginning of the session, the governor would come out with her budget proposal and the legislature would kind of work from that. Last year they started a situation where, actually the legislature comes up with their budget proposal and starts working, and actually produces a bill and starts working that. And the expectation is that they’re going to continue that process again this year. So Republican legis- leadership has indicated that they’re, they think they’ll have bills to introduce very early on. One of the interim committees is a special committee on the state budget. They started meeting in the fall and met in November, and actually started working some of the, the typical things that they would be doing, so getting budget presentations from the state agencies already, so really getting a jump on that. So the expectation is they’ll have bill, budget bills to introduce, starting in January, coming from both chambers. And the way they do it is they’ll both work their bills and then, then try to come together on a consensus for that at the end. But again, that’s a very different process than has happened in the past, but it is starting earlier, so we’ll expect that. As far, as far as the budget itself. I mean, obviously here at KHI, we’re very interested in the funding for all of the, the human services and health, health-related programs, but, you know, the governor has indicated she wants them to work on funding for special education, so that’s going to be on their list. One of the other things that I was going to mention, and this is also an interest, specifically, of the governor, but it also did come from one of the interim committees, was, the legislature last year, created a water Water Program Task Force. And this is a group that has been charged with looking at the quality of water and the quantity of water that’s available to Kansans, and how that’s going to move into the future, and then starting to come up with some recommendations on how to address some of those shortage areas that we know are already going to be occurring within the next, next couple decades. So that, that task force actually started meeting very quickly after the session ended. They’ve met six times between the end of the session and December. And they are, will be providing a preliminary report to the legislature at the end of January and, and they don’t have their final report available until a year from now. But again, that’s something that the, that the governor is very interested in, and there’s certainly a lot of interest in the legislature, to the point where they felt it, the need to create that task force, that spent a lot of time looking at this issue and will continue to work on it over the next year.

Theresa Freed 23:43
When you have a governor who is approaching the end of that term, what does that look like? Are there initiatives that you know the governor maybe may have spearheaded or promised or you know wanted to achieve, and in some last minute pushes to get those out.

Linda Sheppard 24:03
So, I mean, the water issue. That, that was something that came up in her, in her state of the state speech last year and, and she has mentioned, so it is definitely one of her pet projects, and something that she’s very interested in, very concerned about, and wants to make sure that the state addresses this. You know, one of the things, talking about the budget again, one of the things I think she, she is hoping for, is some additional funding, that communities can apply for grants to do particular water projects in their, in their communities and do that. So I think that will be something she’s asking for. You know, Val mentioned her, one of her major accomplishments, or something that she was very happy with was, was the creation of the Office for Early Childhood. That’s something that she’d been working on for quite a while. And then I think again, this, this focus on the legislature, has been working on, you know, public education funding on and off for years, and she really is focused now on the funding for special education. So there have been some separate discussions on that particular topic, but I think that’s definitely one of the, the other things that she’d really like to see them get completed this year.

Theresa Freed 25:15
Well, for the last couple of years, we’ve talked about pushes for Medicaid expansion.

Linda Sheppard 25:22
With, with the current federal administration, there really, you know, there really isn’t just that same kind of support for it. And, and as you know, our legislature has, has not been interested in talking much about Medicaid expansions, for the past few years. So I don’t anticipate that, that we’ll see any of that. On the, on the flip side, I think that we will see, you know, again, as Val mentioned about the Rural Health Transformation Program. I think that’s something that’s going to be of great interest to the legislature. That, you know, that all happened in a very short period of time because of the way that the federal government set up that grant program. So Kansas, you know, submitted our, our application, you know, early in November. Think they’re going to want to, to understand exactly what was put in that application. And that’s, I mean, there’s a lot of dollars that are available to be spent, so I think they’ll be interested in looking to see what that is. I also think the legislators may be interested in a little bit more information about HR1. So the federal, what people call the One Big, Beautiful Bill. A lot of changes to Medicaid and also some of the other public assistance programs, so SNAP and TANF. And I think that they’re going to want to make sure that they understand how that impacts what we do in Kansas, and if there’s any, if there’s any need to do anything in Kansas law to either conform or comply with any of those new requirements that are under HR1. So it’ll, it’ll be another thing that they’re, I think they’re at least going to be curious about, and want to make sure that they understand what the impact of that federal legislation is.

Theresa Freed 26:57
And speaking about federal health policy, we have been monitoring since last year, when the activity really picked up. Things that are happening at the federal level related to health and how that impacts Kansas. And so that informational campaign is called Hill to the Heartland. And so we are really, we’ve done a lot, monitoring both the news coming out of the federal government, but also providing some in-depth analysis. So we kind of alternate between our weeks of offering just those updates, what’s happening in the news and from trusted sources, and then some of the topics that we’ve covered include, gosh, there’s so many things that we’ve done, blogs about SNAP benefits and-

Linda Sheppard 27:41
Changes to Medicaid. We tried to do a little bit of an extra analysis when HR1 was first passed, and so, yeah, we, we tried to keep up with with all the latest news, but also go a little bit more in-depth for some of the things that we can that we know are likely to have a big impact on, on the state.

Theresa Freed 27:58
Yes, and KHI has a small but mighty team thats focused both on the state legislature but also federal government. So of course, visit our website at khi.org to get more information about both of those things, and lots more, including recent publications and research. And of course, our convenings. We host lots of different convenings where we talk about these in-depth talc- topics as well, and those are free, open to the public, and we invite everybody to join us. So thanks for joining us for this episode, and we’ll see you next time.

Voice over 28:30
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Transcribed by https://otter.ai