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Health at the Capitol Week 3 (February 3, 2021)

Week 3 of the 2021 Legislative Session

By Linda J. Sheppard, J.D., Peter F. H. Barstad, Hina B. Shah, M.P.H., Sydney McClendon | February 03, 2021

Health at the Capitol Week 3 (February 3, 2021)

Week 3 of the 2021 Session

During the week leading up to a very subdued celebration of Kansas Day, the 160th birthday of the state, legislators focused on a wide variety of health-related issues including COVID-19, behavioral health, social service agency budgets, and a constitutional amendment concerning abortion. 

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

 

On Monday, January 25, Senate Bill (SB) 14 became the first bill to be signed by Governor Kelly this session. The bill amends the statute ratifying and continuing the COVID-19-related state of disaster emergency created by 2020 Special Session House Bill (HB) 2016; ratifies and continues the state of disaster emergency declaration (which was set to expire on January 26) until March 31, 2021; amends the Kansas Emergency Management Act (KEMA) to extend through 2021 a provision prohibiting the Governor from proclaiming any new state of disaster emergency related to the COVID-19 health emergency without approval by at least six legislative members of the State Finance Council; amends provisions of existing law related to telemedicine, temporary emergency licensure by the Board of Healing Arts, temporary licensure measures for additional health care providers, and business immunity from liability for COVID-19 claims; and amends KEMA to limit the Governor’s closure or cessation of business activity by limiting its application to a state of disaster related to the COVID-19 public health emergency.

On January 25, the Governor also issued Executive Reorganization Order (ERO) No. 47, which, in part, renames the Kansas Department for Children and Families (DCF) to the Kansas Department of Human Services (KDHS); authorizes KDHS and the Secretary of Human Services to administer all programs and services currently administered by DCF; and abolishes the Kansas Department for Aging and Disability Services (KDADS) and transfers all jurisdiction, powers, functions and duties from KDADS to KDHS. The ERO, unless it is disapproved by either house of the Legislature, would take effect on July 1, 2021.

On Wednesday, January 27, Governor Kelly signed Executive Order (EO) No. 21-02, which extends eight EOs issued in 2020 in response to the COVID-19 pandemic, including the extension of professional and occupational licenses; amended licensure, certification and registration for persons and licensure of adult care homes; temporarily prohibiting certain foreclosures and evictions; and provisions related to drivers’ license and vehicle registration and regulation. She also announced that the state has conducted more than 2 million COVID-19 tests to date, and over 1.1 million Kansans have been tested at least once.

On Thursday, January 28, the Senate, on a vote of 28-11, approved House Concurrent Resolution (HCR) 5003, which would amend the Kansas Constitution to create a new section in the Bill of Rights concerning the regulation of abortion. Since HCR 5003 was also approved by the House on January 22, the resolution will now be submitted to Kansas voters on August 2, 2022.

On Monday, February 1, the Kansas Department of Health and Environment (KDHE) reported 276,668 COVID-19 cases (up 7,413 from January 25) from 105 counties with 3,809 deaths (up 187 from January 25).

House Health and Human Services 
(Rep. Brenda Landwehr, Chair)

On Tuesday, January 26, the Committee held a joint meeting with the Senate Public Health and Welfare Committee to receive another update from KDHE Secretary Lee Norman on the agency’s COVID-19 vaccine distribution efforts. Similar to the meeting held the previous week, Secretary Norman responded to Committee members questions, including whether Kansas was ordering the full vaccine allotment allowed (yes); whether the first and second vaccine doses for Moderna and Pfizer are the same and are interchangeable (the doses are the same strength and are interchangeable); what the methodology is for distributing doses to counties (per capita basis); why individuals can be vaccinated in a county they do not live in (to be responsive to requests for local autonomy, as well as situations where individuals live in one county and work in another); how distribution efforts have changed since the start of Phase 1 (all vaccines are now being routed through local health departments for distribution); whether widespread vaccination will end the public health emergency (emergency will likely end once herd immunity of roughly 80 percent is reached); whether the state has considered only administering one dose of the two-dose vaccines to vaccinate more individuals in the state more quickly (this is being discussed but no decisions will be made without guidance and clearance from the federal government); what the rates of COVID-19 reinfection are (relatively low, although a common data source does not yet track this); what actions are being taken for infected inmates who are part of the outbreak at the Topeka Correctional Facility (isolation and cohorting); whether the free testing program for long-term care facilities will continue beyond January 31 (yes, if additional federal funds are made available); the reason for differences in vaccine reports between the CDC, news outlets and KDHE (data lags and differences in what is tracked across multiple federal and state reporting systems); and how vaccinations in long-term care facilities that are not part of the federal program that includes a partnership with national pharmacy chains are being handled (the state is actively working to vaccinate residents in those facilities). Three documents, including a PowerPoint presentation on COVID-19 vaccine distribution, vaccination FAQs, and the Kansas Vaccine Distribution Manual for local health departments, were submitted to the Committee by KDHE.

On Thursday, January 28, the Committee heard a presentation about the Mental Health Intervention Team (MHIT) Program, which tries to increase access to mental health services by bringing services into Kansas schools. During the 2020-2021 school year, 56 school districts and 17 community mental health centers (CMHCs) are participating in the program. Presenters included representatives from the Association of Community Mental Health Centers of Kansas, Kansas Department of Education, and three school districts. Committee members asked questions about how school districts apply to participate in the program, including having multiple buildings participate in the program; how funding for the program works; and protection of child health information.

Senate Public Health and Welfare Committee
(Sen. Richard Hilderbrand, Chair)

On Tuesday, January 26, and Wednesday, January 27, the Committee heard presentations on the Report of the Special Committee on Mental Health Modernization and Reform, similar to presentations made to the House Health and Human Services Committee on January 19 and 20. On Tuesday, Committee members asked questions about moratoriums on state hospital admissions; the Mental Health in America rankings (which measures the prevalence of mental illness and rates of access to care for adults); whether any community colleges currently offer an associate's degree in health sciences or other areas highlighted in the workforce investment plan recommendation; and what research KDHE has conducted on the reimbursement rate increase to inform long-term decision making.

On Wednesday, January 27, Committee members asked about the state’s participation in the “Stepping Up” program, a national initiative to reduce the number of people with mental illness in jails that was announced by Governor Kelly on Tuesday; whether legislation is needed to eliminate the requirement for parents to “opt in” for their children to participate in school surveys or questionnaires asking questions about personal beliefs or practices; additional information on school behavioral health screenings logistics and reimbursement; research showing success with preventive services, especially related to depression and suicide; whether any recommendations included faith-based partnerships; and clarification on whether legislation is needed for the telehealth facility fee recommendation.

On Thursday, January 28, the Committee heard from representatives of Oral Health Kansas, the Kansas Dental Association and Delta Dental of Kansas about the 2021 Kansas Oral Health Report Card, reimbursement rates for dental services in KanCare, the Kansas Mission of Mercy free dental clinic, and dental insurance coverage rates in Kansas. (See our website for a report on dental insurance coverage in Kansas.) Committee members asked questions about the number of dental providers in KanCare, why some dental providers enroll in KanCare but do not participate in the program, and the relationship between parents receiving dental care and their children receiving dental care.

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

On Monday, January 25, the Association of Community Mental Health Centers of Kansas (ACMHCK) provided an overview of the Kansas community mental health center (CMHC) system. Committee members asked questions about patient experiences and barriers to accessing telehealth services; the cost of CMHC services; what veterans services are provided; the prevalence rates of mental health disorders in the state among students; suicide prevention efforts for persons age 15-24; plans for expanding the MHIT program; and the Certified Community Behavioral Health Clinic (CCBHC) model, including what it is, differences from the current delivery model, implementation, resources required and next steps to bring it to Kansas.

On Tuesday, January 26, following a presentation by Melissa Johnson, chairperson for the Kansas State Child Death Review Board (CDRB) on the Board’s 2020 Annual Report, the Committee held a hearing on HB 2062, which would amend existing Kansas law relating to the confidentiality of state child death review board records to allow the board to disclose records and information to various parties, including individual members of the Legislature or legislative committees that have legislative responsibility for enabling or appropriating legislation; law enforcement agencies; and county and district attorneys. Proponents discussed the allowance for more information to be provided to law enforcement and district attorneys for case investigations; access to the Child Death Review Case Reporting System for de-identified record keeping; and access for researchers with confidentiality agreements in place to use de-identified information for research purposes. Committee members asked questions about the national case reporting system and how many other states use it; whether it allows a state to break down data by race/ethnicity and other characteristics; and whether state-to-state comparisons can be made.

On Thursday, January 28, the Committee held a hearing on HB 2114, which would establish the Kansas Senior Care Task Force. Proponents of the bill supported the membership decisions and the need to have this group convene and develop solutions. Neutral conferees of the bill discussed the lack of consumer voice and imbalance in the number of institutional compared to consumer-based organizations, and the need to consider lessons-learned from COVID-19. There were no opponents. Committee members asked questions about adding a consumer to the task force and whether the membership could be expanded.

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

On Monday, January 25, the Committee received an overview of the budgets for KDHE, DCF and KDADS. The Kansas Legislative Research Department (KLRD) provided an overview of the Human Services Caseload estimates, which estimate the enrollment and utilization of Kansas entitlement programs and are a large part of the budget for KDHE, KDADS and part of DCF. KLRD also presented high-level overviews of the KDHE, DCF and KDADS budgets. The Committee will examine each budget in greater detail during the coming weeks before ultimately making recommendations to the House Appropriations Committee. Chair Carpenter noted that the estimates for various funds stated in the budget will likely change by the time the Committee works it.

On Wednesday, January 27, the Committee held an informational hearing on nursing facilities and state hospitals in Kansas. KDADS presented a high-level overview of the Nursing Facility Program in Kansas and reported there are currently 326 licensed nursing facilities in Kansas. KDADS Deputy Secretary Scott Brunner described the survey and certification program for nursing facilities and also discussed current priorities and past issues with required adult care home infection control surveys during the COVID-19 pandemic, which has disrupted regular survey activities.

Deputy Secretary Brunner also provided a state hospital overview and discussed turnover and vacancy rates, as well as key points regarding state hospital funding, and then provided in-depth information on each of the hospitals and issues facing state hospitals, including moratoriums on admissions; staff recruiting and retention; and capacity for sexual predator treatment. He also responded to Committee member questions about detainee eligibility for the state security program, changing needs for aging populations, and supervision of those released from the sexual predator treatment program.

House Federal and State Affairs
(Rep. John Barker, Chair)

On Tuesday, January 26, the Committee held a hearing on HB 2056, which would add new sections to the Kansas Food, Drug and Cosmetic Act to regulate the manufacture, preparation, distribution and sales of products containing kratom. Kratom, a tropical tree native to Southeast Asia with leaves that contain compounds that can have psychotropic effects, has in recent years been used as an herbal alternative to medical treatment to manage withdrawal symptoms caused by addiction to opioids or other addictive substances. Proponents included a representative of the American Kratom Association, and a private citizen, and opposition testimony was provided by the Kansas Department of Agriculture (KDA). Committee members asked questions about how the product is consumed and processed; whether it has nutritional value; where it is sold; side effects, withdrawal and toxicity associated with kratom; national sales of kratom; and KDA’s ability to regulate it.

On Thursday, January 28, the Committee discussed HB 2056 and noted that the bill provides safety for Kansans by placing appropriate regulation through KDA and that kratom may help people overcome drug addiction. Committee members discussed the reasons why KDA would regulate the product instead of KDHE and asked further questions. They also discussed the 2016 Food and Drug Administration warning on the product. Members opposed to the bill suggested stronger language addressing the safety of kratom is needed. Chair Barker noted that the Legislature approved the sale of kratom in Kansas in 2018 but this bill would establish a regulatory structure for the substance. The bill was passed favorably out of Committee with no amendments.

House Taxation
(Rep. Adam Smith, Chair)

On Thursday, January 28, the Committee held a hearing on HB 2091, which would create a new refundable food sales tax credit and repeal the existing nonrefundable food sales tax credit, beginning in tax year 2021. The new tax credit amount would be determined by tax filing status and could be claimed by all taxpayers with income at or below specified federal adjusted gross income levels. Proponent testimony was provided by representatives of Kansas Action for Children, Sisters of Charity in Leavenworth, Kansas Interfaith Action, Center for Law and Justice, Kansas Appleseed, and the City of Oberlin, and no neutral or opponent testimony was provided. The Kansas Department of Revenue has estimated the bill would decrease SGF revenues by $53.9 million in Fiscal Year (FY) 2022, $55.5 million in FY 2023, and $57.2 million in FY 2024.

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.