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Health at the Capitol Week 4 (February 11, 2021)

Week 4 of the 2021 Legislative Session

By Linda J. Sheppard, J.D., Peter F. H. Barstad, Hina B. Shah, M.P.H., Sydney McClendon, Jaron Caffrey | February 11, 2021

Health at the Capitol Week 4 (February 11, 2021)

Week 4 of the 2021 Session

While many Kansans were focused on the Kansas City Chiefs and anticipating a repeat Super Bowl win, legislators considered several bills related to the welfare of children, and Gov. Laura Kelly announced legislation to expand Medicaid (KanCare) that would also establish a regulatory framework to legalize medical marijuana and offset the state costs of expansion. Although no expansion bill was introduced during Week 4 of the session, the Governor indicated that the bill will be similar to the compromise legislation that was introduced in the 2020 session. Check out our updated Medicaid Expansion Bill Tracking Table that includes a summary of the new proposal from the Governor, as well as our recent estimate of the cost and number of new enrollees that would result if Medicaid was expanded in Kansas. As of February 2021, 38 states and the District of Columbia have adopted Medicaid expansion; and as of November 2020, 36 states and the District of Columbia have approved comprehensive, publicly available medical marijuana/cannabis program laws.
 
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 Wednesday, February 3, the Governor announced a tool that Kansans can use to locate sites administering the COVID-19 vaccine in their communities, https://kansasvaccine.gov. She noted that vaccines may not yet be available at all sites identified by the tool but more shipments of vaccine are expected in coming weeks. Kansans in phases 1 and 2 of the state’s distribution plan are currently eligible to receive the vaccine.
 
Kansas Department of Health and Environment (KDHE) Secretary Dr. Lee Norman also announced that a resident of Ellis County had been identified as having the United Kingdom (UK) variant of COVID-19. The variant, which has been found in 33 U.S. states, was first reported in the U.S. at the end of December 2020.
 
On Thursday, February 4, the Senate passed a resolution, on a vote of 28-8, urging Gov. Kelly to rescind the policy to inoculate Kansas prisoners for COVID-19 before other groups of Kansans. The Governor responded on Friday, February 5, that the policy regarding inmate vaccinations was based on guidelines from the federal Centers for Disease Control and Prevention, which has recommended that individuals who live in congregate settings be vaccinated as soon as possible.
 
On Monday, February 8, KDHE reported 282,960 COVID-19 cases (up 6,292 from February 1) from 105 counties, with 4,197 deaths (up 388 from February 1).
 

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

On Wednesday, February 3, the Committee held a hearing on House Bill (HB) 2157, which would impose restrictions on step therapy protocols. The bill would require insurers, when coverage for a prescription drug or treatment is restricted by the patient’s health insurance plan through the use of a step therapy protocol, to provide patients and prescribers with a clear, readily accessible and convenient process to request an exception from the step therapy requirements. The provisions of the bill would become effective on January 1, 2022. Proponents of the bill included representatives of St. Luke’s Health System, National Alliance on Mental Illness (NAMI) Kansas, Kansas Public Health Association, Kansas Mental Health Coalition, and the parent of a child with mental illness. Opponents, including representatives from Blue Cross and Blue Shield of Kansas, Pharmaceutical Care Management Association, Prime Therapeutics and America’s Health Insurance Plans (AHIP), discussed the cost benefits of step therapy protocols and indicated they were willing to work with the proponents to amend the bill to address their objections. Committee members asked questions regarding any cost savings to patients from the use of step therapy and which insurance plans will and will not be affected by this legislation. 

On Thursday, February 4, the Committee held a hearing on HB 2160, which would establish a process for certifying and funding certified community behavioral health clinics (CCBHC) and grant certain powers and duties to the Kansas Department for Aging and Disability Services (KDADS) and KDHE to accomplish that goal. The bill requires KDADS and KDHE to have the process in place by July 1, 2021. Proponents included representatives of the Association of Community Mental Health Centers of Kansas (ACMHCK), Johnson County Mental Health Center, High Plains Mental Health Center, Wyandot Behavioral Health Network and the Kansas Mental Health Coalition. Proponents stated that certifying CCBHCs would allow for increased funding for mental health centers and would enable the centers to be competitive with pay when hiring and retaining mental health professionals. They also noted that other states, including Missouri and Oklahoma, have already implemented CCBHC certification programs. Neutral testimony was provided by State Medicaid Director Sarah Fertig, who expressed concerns about the feasibility of implementing the provisions of the bill by the July 1, 2021, deadline and how the financial aspects of the program would impact Medicaid Section 1115 demonstration budget neutrality requirements. Committee members asked questions regarding how the timeline could be adjusted to address KDHE’s concerns; if there are locations where some of the CCBHCs are already planning to be established; and how implementing this would impact the issue of competitiveness between Kansas and neighboring states.

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

On Tuesday, February 2, the Committee held a hearing on Senate Bill (SB) 85, which would require that the Governor and Legislature be given notice when a child in foster care goes missing or spends the night in a case management contractor’s facility. Rachel Marsh, CEO of the Children's Alliance, provided proponent testimony; Greg Smith, Special Deputy Sheriff for Government, Veteran, and Crime Victim Affairs in the Johnson County Sheriff’s Office, provided opponent testimony; and Tanya Keys, Deputy Secretary of DCF, provided neutral testimony. Committee members asked questions about how legislators would be given notice under the legislation, whether there is an existing report on this issue that is provided to other branches of government, and clarification about the core concern of the opposition, which is that law enforcement is not currently included in the bill language but should be the first party contacted when a child in foster care goes missing.

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

On Monday, February 1, the Committee heard a report from KDHE Secretary Norman on COVID-19, including an explanation of the state’s new vaccine website at www.kansasvaccine.gov. He noted that the data on the website regarding the number of doses administered was not accurate and explained that this is due to reporting problems, which KDHE is working on getting fixed. He then discussed vaccine distribution and how prioritization decisions were made, and provided resources such as the Kansas vaccine finder tool at https://www.kansasvaccine.gov/160/Find-My-Vaccine. Committee members asked questions about KDHE’s plans to fix the data reporting system (Secretary Norman said KDHE is planning to have problems resolved within the next week), vaccine waste and redistribution (there has been very little waste happening in the state, and redistribution is encouraged); whether there are plans to incentivize getting a second dose (the state is working on public messaging to encourage vaccinations); can local providers sign up to become a vaccination site (yes, but there may not be vaccine doses available), what is the true number of Kansans infected with COVID-19 (Secretary Norman does believe it is higher than what is reported); can restrictions in nursing facilities be lifted once all residents and staff are vaccinated (when the majority of staff and residents are vaccinated there could be some relaxing of rules for visits/gatherings); whether state line hopping or crossing county lines is being encouraged (would prefer people get vaccinated in their home county but not concerned if they go to a nearby county, but would not encourage people to cross state lines); and whether COVID-19 vaccination is going to become an annual event like the flu shot (expects we will have a combination COVID/flu shot every year going forward).

On Thursday, February 4, the Committee heard a presentation on the Report of the Special Committee on Foster Care Oversight to the 2021 Kansas Legislature. From August through October 2020, the Special Committee, chaired by Rep. Susan Concannon, met six times to develop recommendations for program improvement and oversight, including the establishment of a statutory joint committee on child welfare oversight, which would meet quarterly and be comprised of 11 legislator members appointed by leadership, representing both parties, and be structured like the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight. The Special Committee also recommended: revisions to the Code for the Care of Children and the Juvenile Justice Code as they relate to crossover youth (youth involved or potentially involved in both the child welfare and juvenile justice systems); legislation to codify and continue reimbursement for health services, including mental health services delivered through televideo and telephone; the reintroduction of 2018 SB 319, which would allow the use of DCF or local child welfare contractors or grantees to expedite enrolling a foster child in school if the child has been moved from the child’s school of origin and foster care or permanent family placement has not been determined; and legislation to prohibit an employer from dismissing or firing an employee who is meeting court-ordered requirements for purposes of reunification with their child or children who are in the custody of the State. Court-ordered requirements include, but would not be limited to, court appearances, appointments, visitation and treatment programs. Committee members asked questions related to gaps and delays in health and school records when transferring children and restrictions imposed on families applying for Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP).

The Committee then held a hearing on HB 2115, which would establish the Joint Committee on Child Welfare System Oversight as recommended by the Special Committee. Proponents, including DCF and KDADS Secretary Laura Howard, House Majority Leader Dan Hawkins, Rep. Susan Humphries, and representatives of the Children’s Alliance of Kansas, Kansas Appleseed and the Kansas Association of School Boards, stated the bill is an important step in providing the accountability and transparency the foster care system needs. Committee members expressed support for the bill and asked questions about racial disparity data on Hispanic children.

Senate Financial Institutions and Insurance
(Sen. Jeff Longbine, Chair)

On Wednesday, February 3, the Committee held a hearing on SB 48, which would require every individual or group health insurance policy, and other types of health insurance plans that provide coverage for accident and health services and benefits for diagnostic examinations for breast cancer to apply the same cost-sharing requirements and treatment limitations to diagnostic examinations for breast cancer that are applicable to screening examinations (i.e., mammograms) for breast cancer. Under the Affordable Care Act (ACA), health plans that are subject to the provisions of the ACA are not permitted to apply cost-sharing requirements to screening examinations such as mammograms. Proponents for the bill included Sen. Dinah Sykes, a Wichita physician and a representative of the Susan G. Komen Foundation, who stated this policy would encourage women to get follow-up diagnostic testing to detect breast cancer, which would result in better outcomes and lower costs. Opponent testimony was provided by representatives of Blue Cross and Blue Shield of Kansas, Blue Cross Blue Shield of Kansas City, and America’s Health Insurance Plans (AHIP), who argued that this additional coverage mandate would increase costs and impact premiums and that the mandate would only impact Kansans who are covered by fully insured health plans that are subject to state regulation.

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

On Monday, February 1, the Committee held a hearing on HB 2088, known as "Adrian's Bill," which would amend the code for care of children concerning child abuse and neglect by requiring a visual observation of alleged victims. The bill is named after seven-year-old Adrian Jones who was tortured and killed by his father and stepmother at their home in Wyandotte County. Proponents included Rep. Louis Ruiz; Judy Conway, Adrian’s grandmother; and representatives of DCF, FosterAdopt Connect and the Children’s Alliance of Kansas. DCF reported that the change in the statute proposed in the bill would codify existing policy, meaning there would be no fiscal impact. Ed Klumpp, Kansas Association of Chiefs of Police, Kansas Sheriff's Association and Kansas Peace Officers Association, testified in opposition to the bill but stated that the objection is not to the basic principle of the bill, but rather concerns with the intent and practical application of the proposed statutory mandate without reasonable exceptions. He indicated there are cases where an investigating law enforcement agency cannot visually observe, such as when the child is no longer in their jurisdiction, is now out of state, or is under medical care. He also stated that investigations need to be fluid and allow for collaboration, and the legislation, as worded, could subject law enforcement agencies to liability, even when best practices have been followed. John Goodyear, League of Kansas Municipalities, provided neutral testimony and echoed Klumpp’s concerns about potential civil liability if observation is mandated by law but a law enforcement agency is unable to make an observation. Committee members directed questions to Klumpp about a possible amendment to reduce the burden on law enforcement agencies and then stated that the language in the bill would provide accountability.

House Commerce, Labor, and Economic Development
(Rep. Sean Tarwater, Chair)

On Monday, February 1, the Committee held a hearing on Substitute for HB 2066, which would expand the military spouse and service member’s expedited licensure law to all applicants (non-military personnel) who have established or intend to establish residency in Kansas. Charles Reimer, Office of the Revisor of Statutes, provided an overview of HB 2066 and explained that it would require licensing bodies to issue occupational credentials to military service-members or military spouses within 15 days following the submission of an application or within 45 days for all other applicants. The bill would also expand and clarify existing conditions on expedited occupational credentialing and permit temporary credentialing during states of emergency and the use of electronic credentials. Rep. Chris Croft made a motion to favorably pass HB 2066 out of Committee, but then offered a balloon amendment to address various concerns brought forward by organizations, including removal of the telemedicine provision since it is included in HB 2206, which is currently being considered in the House Health and Human Services Committee, finger printing, and various technical changes and clarifications. The Committee approved that amendment but rejected another amendment offered by Rep. Rui Xu to add the Board of Technical Professions into the bill. The committee then approved a motion by Rep. Hoffman to create a substitute bill with the changes of the balloon amendment incorporated, and passed the bill favorably out of Committee.

House Financial Institutions and Rural Development
(Rep. Jim Kelly, Chair)

On Wednesday, February 3, the Committee heard a presentation on "A Look into the Future of Rural Kansas" by Chris Harris, Senior Program Officer, Ewing Kauffman Foundation. During his presentation, Harris shared his personal background growing up and living in rural Kansas and discussed challenges facing rural communities, reasons for optimism and recommendations for the Legislature to consider, including:

  • Reviewing all rural development tools currently in place and all programs that have an impact on rural communities and examine how they could be adapted to help local leaders make it easier for business start-ups;
  • Examining ways to enhance programs with rural entrepreneurship in mind;
  • Seeking ways to enhance rural initiatives that are popping up across the state; and
  • Leveraging the power of intergenerational wealth and knowledge.

Committee members asked questions related to access to rural airports; reallocation of jobs from urban to rural communities; potentially beneficial changes to the rural opportunity zone (ROZ) program; keeping wealth in the community across generations; the impact of negative self-talk; and modernization of infrastructure.

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.