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Health at the Capitol Week 10: March 25, 2019

By Linda J. Sheppard, J.D., Hina B. Shah, M.P.H., Sydney McClendon, Peter F. H. Barstad | March 25, 2019

Health at the Capitol Week 10: March 25, 2019

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 FacebookTwitter and LinkedIn. Previous editions of Health at the Capitol can be found on our archive page.

Week 10 of the 2019 Session

On March 21, the House passed House Bill (HB) 2066, a bill to expand Medicaid under the provisions of the federal Affordable Care Act, on a vote 69-54. HB 2066 originally was a bill updating the scope of practice and other requirements for advanced practice registered nurses. It was amended on March 20 to replace all the contents of the bill with the contents of HB 2102, one of the governor’s Medicaid expansion bills introduced in late January. The bill also was amended to require expansion enrollees to pay a $25 individual monthly fee (up to $100 per month for households) and provides for suspension of enrollees’ coverage following three consecutive calendar months of nonpayment of the fee. The amended bill also includes a provision that prohibits coverage or reimbursement for any abortion services.

On the same day the Senate took final action on its Mega budget bill, which now goes to the House. The House is scheduled to debate its budget bill during the week of March 25. 

House Health and Human Services Committee
(Rep. Brenda Landwehr, C​hair)

On March 19, the committee received a briefing from Medicaid Inspector General Sarah Fertig and held a hearing on HB 2389, which would amend the Kansas Pharmacy Act to require certain prescription orders to be transmitted electronically. Proponents of the bill included the Kansas Association of Chain Drug Stores, the Kansas Board of Pharmacy and Walmart. Rachelle Colombo of the Kansas Medical Society (KMS) provided neutral testimony, indicating support for the bill if it were amended to restrict the bill to Schedules II-IV Controlled Substances that contain opiates. Immediately following the hearing, the committee worked the bill, which included adopting the proposed amendment, and it passed favorably out of committee.

On March 20 and 21, the committee held a hearing on HB 2402, which would authorize certain business entities to hire physicians and chiropractors. The bill is a modified version of HB 2146, which provided for certain business entities to engage in the corporate practice of medicine. Proponents of the bill included Blue Cross Blue Shield (BCBS) of Kansas City, Cerner and the Kansas Chamber of Commerce. Opponents included the Kansas Association of Osteopathic Medicine, the Kansas Optometric Association, KMS and the Kansas Chiropractic Association. Neutral testimony was provided by the Kansas State Board of Healing Arts. Committee members asked questions regarding rural health care access, liability for corporations and the impact to the Health Care Stabilization Fund. Following the hearing, the committee reviewed and adopted multiple compromise amendments, including one that would hold corporations to many of the same standards currently in statute to govern physicians. The amended bill then was passed favorably out of committee.

Senate Public Health and Welfare Committee
(Sen. Gene Suellentrop, Chair)

On March 18, the committee held a hearing on Senate Bill (SB) 223, which would provide for the licensure of certified anesthesiologist assistants (CAAs) in Kansas. Proponents for the bill, including physician anesthesiologists, CAAs and anesthesiology assistant associations, argued that while the bill does not mandate any hospital or county hire CAAs, it would provide another potential solution to a serious workforce shortage. Opponents, primarily certified registered nurse anesthetists (CRNAs), argued that allowing CAAs to practice in the state would drive out CRNAs and that a better solution to the shortage problem would be to expand CRNA programs. The Kansas Department of Health and Environment (KDHE) and the Kansas State Board of Healing Arts (KSBHA) provided neutral testimony.

On March 19, the committee held a hearing on HB 2103, which amends 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). Proponent testimony was presented by Rebekah Gaston on behalf of the Kansas Department for Children and Families (DCF) and Rachel March with Saint Francis Ministries. Written only proponent testimony also was provided by the Honorable Daniel Cahill, District Judge for the 29th Judicial District, and Dena Hubbard from the Kansas Chapter of the American Academy of Pediatrics. No neutral or opponent testimony was offered. The committee passed HB 2103 out favorably.

On March 20, the committee held a hearing on SB 232, which would amend provisions related to adult care home licensure and receivership. Kimberly Lynch, chief counsel for the Kansas Department for Aging and Disability Services (KDADS), and Cindy Luxum from the Kansas Health Care Association testified in support of the bill. Rachel Monger then offered neutral testimony on behalf of LeadingAge Kansas. No opponent testimony was offered. The committee amended the bill to broaden the definition of “insolvent” and add some clarifying language and passed it out favorably. 

On March 21, the committee held a hearing on SB 231, which would require drug rebate revenues associated with Medicaid enrollees to be deposited into the state general fund. The only testimony provided was from Sen. Jim Denning in support.

Lastly, Chair Suellentrop opened discussion on SB 223, related to licensure and practice of CAAs. An amendment was offered by Sen. Barbara Bollier to allow CAAs to practice only in four of the largest counties in Kansas, allow counties to opt-in, and ban CAAs from taking the training spots from CRNAs for the next three years. After debate among the committee and conferees on the amendment, the Chair announced on March 22 that work on SB 223 was being suspended for this year, but the bill would be available to be revisited during the 2020 session. 

Also, on March 22, the committee also held a hearing on SB 234, which would require electronic prescriptions for controlled substances. Proponents of the bill included Walmart, the Kansas Board of Pharmacy and the Kansas Association of Chain Drug Stores. Julie Hein, representing the Kansas Association of Chain Drug Stores, encouraged the committee to consider adopting the amendments made to a similar bill, HB 2389, by the House Health and Human Services Committee on March 19.  Chair Suellentrop stated he would be asking Senate leadership to allow the committee to continue discussion on the bill during the week of March 25. 

House Children and Seniors Committee
(Rep. Susan Concannon, Chair)

On March 18, the committee held a hearing on SB 162, which would require notification to the governor and Legislature of missing foster youth. The bill includes assessment of a fine (not to exceed $500) to the contractor if a child is not reported missing within 24 hours. Sen. Molly Baumgardner testified in favor of the bill and discussed the need for more factual data, accountability, transparency and collaboration. Written-only testimony submitted by Christie Appelhanz of the Children's Alliance of Kansas, supported the transparency and accountability outline in the bill but noted the bill does not address the reasons why children are going missing. Rebekah Gaston of DCF provided neutral testimony about the current notification process for missing children and available reports. Committee members asked questions related to the penalty and where the moneys collected would go, the lack of a fiscal note, report structure and the role of the Legislature with the proposed notification.

On March 22, the committee held a hearing on HB 2403, which would establish the joint committee on child system oversight. Interim DCF Secretary Laura Howard and Joey Hentzler of Kansas Appleseed testified in favor of the bill and discussed the need for oversight and continuing work on implementation of the recommendations made by the Child Welfare System Task Force. Committee members asked about the need for this new committee and the fiscal note. The committee then worked the bill, adopted an amendment to change the scope of topics and require that the committee be convened on or before January 1, 2020, and it passed favorably out of committee.

The committee also held a hearing on HB 2404, which would establish the Kansas senior services task force. Proponents, which included representatives of the Kansas Health Care Association, AARP, Midland Care and LeadingAge Kansas, lauded the bill and the crucial timing for this population group, and proposed amendments to include additional membership to the task force. Neutral conferees discussed the need for parity in representation on the task force and the need for input from a broad group of stakeholders. Committee members asked questions about membership composition, amended the bill to add a representative of AARP to the task force membership, and then passed it favorably out of committee.

House Social Services Budget Committee
(Rep. Will Carpenter, Chair)

On March 18, the committee held an informational hearing on performance-based budgeting. After receiving an overview from the Legislative Research Department, they heard presentations from Janis DeBoer, deputy secretary for KDADS, Dan Lewien, chief financial officer for DCF, and Dan Thimmesch, chief fiscal officer for the Kansas Department of Health and Environment (KDHE).

House Insurance Committee
(Rep. Jene Vickrey, Chair)

On March 18, Chair Vickrey reported that the Kansas Insurance Department (KID) had provided him with responses to questions that arose when the committee amended SB 32 (Farm Bureau bill) on March 13.  Lee Modisett of KID was present and explained that the amendment converted the Farm Bureau proposal to a self-funded association health plan, which would be subject to federal rules and oversight.

Senate Financial Institutions and Insurance Committee
(Sen. Rob Olson, Chair)

On March 20, the committee created Senate Substitute for HB 2143, by inserting the text of various bills related to the regulation of association health plans and small employer health plans (SBs 29, 30, 34, 36) and SB 32 (the Farm Bureau bill) into HB 2143, which would have amended provisions of the Insurance Code to update instructions related to risk-based capital requirements. The bill was then passed out favorably. 

On March 21, the committee held a hearing on SB 228, a bill requested by KID that would increase license and renewal fees for third party administration organizations. Immediately following the hearing, the bill was passed out favorably. 

House Rural Revitalization Committee
(Rep. Don Hineman, Chair)

On March 19, the committee held an informational hearing on children issues in rural areas. Annie McKay of Kansas Action for Children discussed the importance of disaggregating data, disparities and what other states are doing for early intervention. Melissa Rooker of the Kansas Children's Cabinet and Trust Fund discussed prioritizing the needs of children, funding mechanisms and programs/services available for early childhood. Amanda Peterson of the Kansas State Department of Education discussed an upcoming needs assessment and community engagement sessions that will be conducted around the state. Committee members asked questions related to barriers in accessing services, issues with the HOPE Act, relevance of data from the Kansas Communities That Care survey and the at-risk preschool program implementation.

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.