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.
The Veto Session
On May 1, legislators returned to Topeka for the Veto Session following the First Adjournment spring break.
First up on the agenda was consideration of the motion made by Senate Minority Leader Anthony Hensley before the Senate adjourned for the break to pull the House-passed Medicaid expansion bill out of the Senate Public Health and Welfare Committee to the Senate calendar. On a vote of 23-13, one vote short of the required 24 votes to bring the bill out of committee, the motion failed. Later attempts by proponents to bring expansion up for a vote failed. Senate leaders have stated they are committed to working on a Medicaid expansion bill during the interim period that will be ready for debate in January 2020.
The Senate also voted 27-13 to override Gov. Laura Kelly’s veto of SB 67, which would have required facilities where medication abortions are provided to post notices stating that abortions provided through the use of mifepristone might not be effective and may be reversed. Later in the day, the House failed to override the veto on a vote of 82-43, two votes short of the required 84. On May 2, in a vote to reconsider the action taken by the House on May 1, the House again failed to override the veto with a vote of 83-41, therefore the governor’s veto stands.
With the governor’s earlier veto of SB 22, the tax bill passed by the Legislature before the break, the Senate on May 2 passed a $238 million, three-year tax-cut bill (about half the size of the cuts in SB 22) and sent it to the House. HB 2033, which includes provisions related to Kansas individual income tax rules and tax cuts for individuals and corporations, also provides for reductions in the sales tax on certain food items beginning July 2020. The House adopted the bill early on May 5 and it will now head to Gov. Kelly for action.
In an attempt to pressure the Senate to allow a vote on Medicaid expansion, the House rejected the conference committee budget bill (SB 25) twice on May 3. But after three rounds of revisions and voting, the House finally approved the budget bill in the early hours of May 5. The Senate approved it shortly thereafter.
Legislators also passed SB 28, which (1) prohibits state agencies and political subdivisions from initiating child removal proceedings or child protection actions based solely upon a parent's or child’s possession or use of certain cannabidiol treatment preparations, (2) amends Kansas law related to the unlawful possession of controlled substances to provide an affirmative defense to prosecution of a crime arising out of a person’s possession of certain specified cannabidiol treatment preparations, if the person has a qualifying medical condition — as narrowly defined in the bill — or is the parent or guardian of a minor child with such a condition and the treatment is being used to treat such condition, and (3) amends statutes to grandfather certain podiatrists to perform rearfoot/ankle medical procedures.
Sine Die formal adjournment is set for May 29.
Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight
(Sen. Gene Suellentrop, Chair)
The committee met on April 29 for a full day of presentations from KanCare stakeholders and state officials. The primary issues raised by stakeholders included ongoing concerns with the Medicaid application clearing house (e.g., application processing errors), providers not being reimbursed, rising protected income levels, expanding Medicaid and workforce shortages throughout the state.
Kansas Department of Health and Environment (KDHE) Secretary Lee Norman and staff members Christine Swartz and Adam Proffitt presented an update on the KanCare program, including the Medicaid eligibility backlog, work being done to improve the processing of complex Medicaid eligibility applications, staffing changes at the clearing house, updating the 1115 HCBS waiver, Medicaid eligibility backlog and the contracts of the managed care organizations (MCOs). Committee members asked questions about the Maximus eligibility processing being moved back in-house and the process for reviewing those applications.
Kansas Department for Aging and Disability Services (KDADS) Deputy Secretary Janis DeBoer provided the committee with updates on Osawatomie State Hospital, Larned State Hospital, Parsons State Hospital and Training Center, the home- and community-based services (HCBS) waiver wait lists, and nursing facility receivership legislation. Questions from the committee primarily focused on hospital and psychiatric residential treatment facility wait lists.
Kerrie Bacon, the KanCare Ombudsman, provided written-only testimony, including the Ombudsman’s Quarterly Report, but stood for questions. Committee members asked questions about the types of calls the office receives (primarily related to Medicaid applications/eligibility and HCBS), whether improvements were being made and whether information received at the Ombudsman’s office was being translated into changes in the KanCare program.
Amy Deckard, Assistant Director for Information Management for the Kansas Legislative Research Department, provided an overview of the Human Services Caseload estimates for FY 2019 and 2020. Sarah Fertig, the Medicaid Inspector General (IG), updated the committee on activity within the IG office, including recruiting staff, becoming more familiar with Medicaid, CHIP and MediKan, and investigating eligibility fraud.
Finally, the committee heard presentations from the three KanCare managed care organizations (MCOs): Aetna Better Health of Kansas, Sunflower Health Plan and UnitedHealthcare Community Plan (UHC). Committee member questions for Aetna included how self-determination services are marketed to its partners, how many claims Aetna has denied, how Aetna is informing providers that they have been approved for their network, psychiatric residential treatment facility (PRTF) admissions, how case managers are assigned to Aetna consumers and whether Aetna enrollment aligns with what it projected when bidding to be a KanCare MCO. Questions for Sunflower were related to its foster care pilot and the Families First Prevention Services Act (FFPSA), while questions for UHC focused on outcomes related to PRTFs and how UHC members are assigned case managers.
At the end of the meeting, committee members stated they would like to hear from providers, particularly dental providers, about why they do not accept KanCare.
Other Items of Note
On May 1, the State Employees Health Plan (SEHP), in partnership with Marathon Health, opened HealthQuest Health Center at 901 S. Kansas Ave., to provide urgent care and outpatient health care services to Kansas state employees and their families. The health center, which is open to all Kansas state employees, spouses and dependent children over age 2 that have medical coverage through the SEHP, will be operated by Marathon Health and staffed with a physician, two nurse practitioners, a mental health counselor, a registered nurse and three medical assistants. The health center is separate from the State of Kansas and the State Employee Health Plan and is a pilot program, which may be expanded in future years with additional locations.
Although legislators addressed K-12 school finance early in the session, Attorney General Derek Schmidt will be presenting oral argument to the Kansas Supreme Court on May 9 that the Legislature’s passing of SB 16 provided an adequate response to the court ruling last year that public schools are not adequately funded.
Bills Signed or Vetoed by Governor Kelly During the Break
SB 15 – Provides for various revisions to statutes related to licensure for social workers at baccalaureate, master’s and specialist clinical levels, (2) amends provisions of the Adult Care Home Licensure Act related to applications for licensure, financial solvency and receivership of adult care homes, and (3) amends the naturopathic medicine scope of practice to include diagnostic imaging. (Signed 04/22/19)
SB 77 – Would create law in the Revised Kansas Code for Care of Children (CINC Code) defining a “child with sexual behavior problems” and requiring the Department for Children and Families (DCF) to take certain actions, including a referral to a child advocacy center or other mental health provider for services for the child and the child’s family, when reports of child abuse or neglect are received, and the subject of such report is a child with sexual behavior problems. (Signed 04/12/19)
HB 2103 – Amends the Kansas Code for the Care of Children Act to enable the state to qualify for additional funds under the federal Family First Prevention Services Act and allow for an enhanced federal match rate for certain child welfare system evidence-based prevention services and programs beginning on October 1. The bill also defines a qualified residential treatment program (QRTP), establishes notice and hearing requirements when a child is placed in a QRTP, requires certain court action when a QRTP placement occurs, and places additional documentation requirements on the court in a permanency hearing involving a child placed in QRTP. (Signed 04/18/2019)
HB 2104 – Amends the statute governing tests related to driving under the influence (DUI), effective July 1, 2019, and suspension of driving privileges. (Signed 04/04/19)
HB 2119 – Amends the Kansas Pharmacy Act to require certain prescription orders be transmitted electronically, permit a licensed pharmacist to administer a drug by injection in certain situations, and allow a business entity issued a certificate of authorization by the Board of Healing Arts to employ or contract with one or more licensees of the Board of Healing Arts for the purpose of providing professional services. (Signed 04/18/19)
S. Sub for HB 2167 – Requires the Kansas Department of Agriculture (KDA), in consultation with the Governor and Attorney General, to submit a plan to the U.S. Department of Agriculture (USDA) regarding how KDA will monitor and regulate commercial production of industrial hemp within the state in accordance with federal law. The bill would establish the Commercial Industrial Hemp Program, make changes to the Industrial Hemp Research Program and establish hemp processing registrations, prohibitions on specific products, sentencing guidelines and waste disposal requirements. (Signed 04/15/19)
HB 2201 – Updates existing statutory references related to the transfer of the powers, duties and functions of the Tuberculosis Control Program from the KDADS to KDHE. (Signed 04/04/19)
HB 2209 – Allows the Kansas Farm Bureau (KFB) to sell health care coverage that does not comply with the requirements of the federal Affordable Care Act, including the requirement to cover pre-existing conditions and the essential health benefits package, and exempts this coverage from the jurisdiction of the Kansas insurance Department. KFB can sell the coverage to members (membership fee is $50/year). The bill also amends several provisions in the Insurance Code related to the regulation of association health plans and small employer plans and establishes the Unclaimed Life Insurance Benefits Act. (Bill allowed to pass into law without Gov. Kelly’s signature on 04/19/19)
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.