Throughout the 2019 Kansas legislative session, Kansas Health Institute (KHI) staff will prepare a weekly summary of the highlights, 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.
Week 4 of the 2019 Session
The cold temperatures continued, along with a couple of ice storms, but legislators pressed on with their work on the budget, taxes, education and health-related issues. Bills to legalize the use of medical cannabis, Senate Bill (SB) 113 and House Bill (HB) 2163, were introduced. To date, neither of Gov. Kelly’s KanCare expansion bills, SB 54 (referred to Senate Public Health and Welfare) and HB 2102 (referred to House Appropriations), have been scheduled for hearings.
House Health and Human Services Committee
(Rep. Brenda Landwehr, Chair)
On February 4, the committee received presentations on youth use of electronic smoking devices by Rep. John Eplee, the National Alliance on Mental Illness (NAMI), a Kansas middle school student and a middle school counselor. The committee asked questions about the types of electronic smoking devices, the reasons for the rise in youth use of the devices, tobacco interference with behavioral health medications, and Tobacco 21, an initiative to raise the minimum age of legal access to tobacco products to age 21. The committee also received a presentation on family friendly work environments in Kansas from the Kansas Children's Service League (KCSL), who discussed adverse childhood experiences (ACEs) and the impact of ACEs on workforce issues.
On February 5, the committee received a presentation on the Community Care Network of Kansas (CCNK), formerly the Kansas Association for the Medically Underserved (KAMU), from CCNK chief executive officer Denise Cyzman. The presentation included information about the network and their focus on whole person care, which integrates primary care with behavioral health, dental and vision services.
On February 6, the committee held a hearing on HB 2082, which would allow pharmacists to administer a drug (e.g., an injectable) to a patient, unless the prescription prohibits it. Proponents of the bill, including the Kansas Pharmacists Association, faculty at the KU School of Pharmacy and the Kansas Board of Pharmacy, testified that HB 2082 would improve medication adherence rates, increase patient safety, reduce health care costs and help retain pharmacists in Kansas. The Kansas Medical Society provided opposing testimony, stating that appropriate conversations between physicians and pharmacists had not occurred and the current bill was too broad. Kansans for Life (KFL) provided neutral testimony, stating that KFL would remain neutral if an amendment were added prohibiting the ability of pharmacists to provide abortion pills in the absence of a physician.
Senate Public Health and Welfare Committee
(Sen. Gene Suellentrop, Chair)
On February 5, committee members heard presentations from the KanCare Ombudsman Kerrie Bacon, who discussed her role and the issues addressed by her office. Bacon also noted the office had experienced an increase in calls from 2,000 initial contacts per year in 2014 to 4,400 initial contacts per year in 2018. Committee members asked about the types of calls received, timelines with the clearinghouse, lack of confirmation on receipt of applications, and issues related to the application process. Next, committee members heard from Medicaid Inspector General Sarah Fertig, who discussed her role and function and discussed the complexities of resurrecting the inspector general role when it was transferred to the Office of the Attorney General in 2017. Fertig said her goal is to establish an audit program that examines the Medicaid program from all angles and provide ongoing reports to the Legislature. Committee members asked questions about privatization, the move from fee-for-service to a managed care organization (MCO) model, and the frequency of reports presented to the Legislature. Finally, a representative of Genzada Pharmaceuticals ‒ a subsidiary of Ionics Life Sciences Limited, based in Sterling, Kansas ‒ reported that in November 2018 the U.S. Food and Drug Administration (FDA) approved an investigational drug derived in part from Arum palaestinum (black calla lily), a native plant found in several regions of the Middle East, for cancer patients with advanced solid organ tumors or lymphoma. Safety trials for the drug will be completed in March and the company will begin multi-site clinical trials at the end of 2020.
On February 6, the committee received briefings on the Mental Health Task Force report by Kari Bruffett of KHI and Amy Campbell of the Kansas Mental Health Coalition. Committee members asked questions about changes in federal law, review of recommendations by the Governor's office, Medicaid eligibility, staffing levels with more beds, history with crisis centers and Medicaid expansion.
On February 7, committee members heard from Kyle Kessler of the Association of Community Mental Health Centers (CMHCs), who provided an overview of community mental health services in Kansas and discussed some of the major challenges the state is facing, including workforce competition with neighboring states, the moratorium on admissions to Osawatomie State Hospital (OSH) and the rising number of suicides. They also heard from Laura Howard, interim secretary of the Kansas Department for Aging and Disability Services (KDADS), who reported on programs that KDADS collaborates on in the mental health continuum, including the Mental Health Task Force, High Acuity Psychiatric Treatment Hospital for Youth (HAPHY), Psychiatric Residential Treatment Facilities (PRTFs), CMHCs, Nursing Facilities for Mental Health (NFMHs), Crisis Stabilization Units, Consumer Run Organizations (CROs), State Mental Health Hospitals and the Housing Bridge Pilot. Referring to the moratorium at OSH, Howard said she is willing to discuss lifting the moratorium with community partners but is concerned about creating an admissions crisis.
House Children and Seniors Committee
(Rep. Susan Concannon, Chair)
On February 4, committee members heard a presentation on suicide prevention from Monica Kurz from Headquarters Inc., which houses the Headquarters Counseling Center, National Suicide Prevention Lifeline (NSPL) crisis center and Kansas Suicide Prevention Resource Center (KSPRC). She reported that suicide deaths in Kansas increased by 45 percent from 1999 to 2016. She also said volunteer staff responding to high numbers of calls from the NSPL sometimes divert calls out of state, which might endanger federal funding, which requires at least 70 percent of calls to be answered in-state. Kurz also discussed the role of the KSPRC in training professionals across the state to use evidence-based strategies for screening, assessment and management of suicide risk. The committee also heard a presentation on the community mental health system from Kyle Kessler of the Association of Community Mental Health Centers of Kansas. Kessler provided an overview of the role of CMHCs, funding sources and components of their Mental Health 2020 Initiative and discussed the organization focus on the topics of suicide, child welfare and opioid addiction and provided information on youth waiting for behavioral health treatment in hospitals and psychiatric residential treatment facilities (PRTFs).
On February 5, the committee held a hearing on HB 2103, which would amend the revised Kansas code for child in need of care (CINC) to provide requirements for placement of a child in a qualified residential treatment program (QRTP) as part of the Families First Prevention Services Act (FFPSA). Although the federal act requires Kansas to make a few statutory changes to receive the additional federal funding, most of the changes can be made through rules and regulations by the Kansas Department for Children and Families. There was no opponent or neutral testimony.
On February 6, the committee held an informational hearing on KanCare eligibility issues for the Elderly, Disabled and Long-term Care Medical programs. A representative of the Kansas Department of Health and Environment (KDHE) presented testimony about the challenges with program contractor Maximus and efforts to bring processing of the program back in-house starting January 1, 2020. Other conferees discussed their community-based programs and facilities in the state, and inefficiencies and processing backlogs. Committee members asked questions about the contractor, repercussions for poor performance, and transition back to state function and the associated costs.
House Social Services Budget Committee
(Rep. Will Carpenter, Chair)
On February 4, the committee resumed informational hearings, including an update from Amy Campbell of the Kansas Mental Health Coalition on the Mental Health Task Force and its recommendations. Questions from the committee focused on the logistics of implementing those recommendations – particularly the feasibility and effect of adding more beds and whether those beds would be Medicaid-eligible. Committee members also heard from Barbara Andres, who explained the clubhouse model and the benefits it provides as a dynamic community center. Gail Cozad, on behalf of KCSL, gave an overview of a few of their programs, including Kansas Post Adoption Resource Center (K-PARC), Adopt Kansas Kids (AKK) and Healthy Families America. Cheryl Rathbun from Saint Francis Ministries presented information about their child welfare case management programs, discussed the development of PRTFs and presented recommendations on how to get back to helping them operate as intended.
On February 5, the informational hearings concluded with three presentations. Becky Ross, Medicaid Coordinator for KDHE, provided an overview of the new OneCare Kansas program and answered questions on the population definition, timeframe and the administrative fee cap. Deb Stidham with KAAP discussed SUD and responded to questions about KAAP opposition to medical marijuana, the use of motivational interviewing and harm reduction, and the problem gambling and addiction fund. Joni Haitt from FosterAdopt Connect asked for funding for three programs, and responded to questions about their contract status, referral process, capacity in which they are asking for funding, and qualifications of behavioral interventionists. Lastly, Steve Solomon gave an overview of TFI Family Services.
On February 6, committee members heard an overview of the budgets for the Kansas Neurological Institute (KNI) and Parsons State Hospital and Training Center (PSHTC). Georgianna Correll, budget director for KDADS, and the superintendents of both hospitals were there to provide more background information on the hospitals and answer questions. Related to KNI, committee members asked questions about projected funding shortfalls and lower treatment costs, Medicaid reimbursements, patient admissions, Title XIX funding, planned versus categorized expenditures, staff vacancies and turnover rate, and the admissions process. The committee adopted all the governor’s budget recommendations for those agencies, but recommended an additional $500,000 for FY 2019 and $1 million in FY 2020 for Parsons State Hospital.
On February 7, committee members heard a budget recommendation overview and testimony for the Kansas Commission on Veterans Affairs Office (KVCAO), the Kansas Guardianship Program and the Healthcare Stabilization Fund (HCSF).
House Insurance Committee
(Rep. Jene Vickrey, Chair)
On February 4, the committee held hearings on HB 2059, related to exempting association health plans from requirements for small employer health plans, and HB 2053, amending existing Kansas law related to short-term, limited-duration health insurance (STLDI) plans. Legislative staff also presented an informational briefing on STLDI.
On February 6, the committee considered final action on HB 2041, related to unfair or deceptive acts or practices under a life insurance policy for living organ donors, and recommended the bill be passed.
Senate Financial Institutions and Insurance Committee
(Sen. Rob Olson, Chair)
On February 5, the committee held hearings on SBs 34 and 31, related to exempting association health plans from certain requirements governing small employer health plans, and SB 32, introduced by the Kansas Farm Bureau, which would exempt its proposed health benefit plan from the jurisdiction of the Kansas Insurance Department. The committee amended SB 32 to specify that the health care coverage described in the bill would not be considered insurance, to permit reinsurance for the coverage, and to require submission of a signed, certified actuarial statement of plan reserves annually to the Kansas Insurance Department (KID). The bill passed out of committee.
On February 6, the committee held a hearing on SB 35, amending Kansas law related to short-term, limited duration health insurance plans.
The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. KHI believes evidence-based information, objective analysis and civil dialogue enable policy leaders to be champions for a healthier Kansas. Established in 1995 with a multiyear grant from the Kansas Health Foundation, KHI is a nonprofit, nonpartisan educational organization based in Topeka.