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Health at the Capitol Week 5 (February 18, 2021)

Week 5 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 18, 2021

Health at the Capitol Week 5 (February 18, 2021)

Week 5 of the 2021 Session

While Kansans prepared for the start of a bitter cold snap, legislators considered bills related to behavioral health, telemedicine, child welfare, and protections for older adults, and continued to receive updates about the distribution of COVID-19 vaccines.

On Monday, February 15, the Kansas Department of Health and Environment (KDHE) reported 287,450 COVID-19 cases (up 4,490 from February 8) from 105 counties with 4,406 deaths (up 209 from February 8).

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.

 

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

On Monday, February 8, the Committee worked House Bill (HB) 2160, which would establish certification and funding for certified community behavioral health clinics. The Committee amended the bill to move the implementation date from July 1, 2021, to May 1, 2022, and then passed it favorably out of Committee.

On Tuesday, February 9, the Committee held a hearing on HB 2206, which would modify certain provisions in the Kansas telemedicine act, including updating the definitions of “distant site” to allow providers to offer services in a private location and “originating site” to allow patients to receive services at home; adding a provision to specifically allow referral to specialty services via telemedicine; and requiring telemedicine providers to coordinate care to the extent possible with a patient’s regular care providers.

Proponents, including representatives from the Behavioral Health Association of Kansas, Kansas Hospital Association, University of Kansas Health System, Ascension Via Christi and Association of Community Mental Health Centers of Kansas (ACMHCK), expressed support for several amendments, including requiring payment parity; allowing providers to use the telemedicine platform of their choice when providing services; requiring the state to be consistent with the Centers for Medicare and Medicaid Services policy on telemedicine; allowing additional providers to be eligible to provide telehealth; and, if other providers are allowed to offer telehealth, ensuring that the licensing entity that oversees a specific provider type is the same entity that would regulate its use of telemedicine. Several neutral conferees supported expanding the types of providers allowed to offer telemedicine and highlighted places in the bill where language could be clearer. Committee members asked questions about how the bill would improve access to mental health services; what quality measures should be in place to monitor the use of telemedicine if payment parity were to be added to the bill; what quality measures other states use to monitor telemedicine; how many other states have enacted payment parity; why some provider types were not included in the bill; whether audio-only telemedicine options were considered; and what entity or entities will oversee providers offering telemedicine.

Following the hearing, Chair Landwehr highlighted key issues — such as payment parity and the inclusion of providers — that would need to be resolved by stakeholders prior to the Committee working the bill. She also indicated that telemedicine-related elements (e.g., an additional process to allow out-of-state physicians to provide telemedicine to Kansas residents) initially included in HB 2066, which is being considered by the House Commerce, Labor and Economic Development Committee, would be considered as potential amendments to HB 2206.

The Committee then held a hearing on HB 2208, which would reduce some requirements for licensure for the various professions regulated by the Behavioral Sciences Regulatory Board (BSRB), require BSRB to approve proposed clinical social work supervision and expand out-of-state temporary permits. Proponents, including representatives of BSRB, ACMHCK, and the Kansas Chapter of the National Association of Social Workers, indicated the bill would help address behavioral health workforce shortages in the state, bring Kansas requirements in line with other states, and continue to provide protections for consumers but also expressed some concerns about the proposed new process for individuals to become board-approved clinical supervisors for individuals seeking licensure as a clinical social worker. Committee members asked whether the bill would bring Kansas in line with licensure requirements in surrounding states; how many clinical social worker supervisors there are currently in the state; whether current clinical social worker supervisors will have to be reapproved; and how many hours will be required for clinical social workers to be approved as supervisors.

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

On Tuesday, February 9, the Committee held a hearing on Senate Bill (SB) 120, which would establish the Joint Committee on Child Welfare System Oversight and outlined the topics for the Joint Committee’s review, including the level of oversight and supervision by the Kansas Department for Children and Families (DCF) over its contracting entities related to reintegration, foster care, and adoption services; duties and responsibilities of state agencies and service providers that provide child welfare services in Kansas; level of access of those services including health, mental health and community-based services; the number of children in the child welfare system and the factors that contribute to such number; and licensing standards for case managers. DCF Secretary Laura Howard testified in favor of the bill. The Committee asked questions on the scope of the Joint Committee and how frequently it would meet. There was no opponent or neutral testimony.

The Committee also took final action on 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. The bill was amended to clarify that reporting would be needed if a child spends any overnight period in a location that is not licensed as a placement for foster youth and to require DCF to provide an annual report to the Legislature summarizing data, outcomes and trends relating to the children reported and make recommendations to the Legislature to improve outcomes for these children. The amended bill passed favorably out of Committee.

On Thursday, February 11, the Committee held a hearing on Executive Reorganization Order (ERO) 47, which would rename DCF to the Kansas Department of Human Services (KDHS), abolish the Kansas Department for Aging and Disability Services (KDADS), and transfer the functions of KDADS to KDHS. DCF/KDADS Secretary Howard spoke in favor of the ERO, stating that it would streamline the work they do and promote efficiency by reducing bureaucracy and also explained how the unified department would be better able to provide services including SNAP, employment of those with disabilities, foster care, and behavioral health. Other proponents included representatives of the KanCare Advocates Network and ACMHCK. There was no opponent or neutral testimony. Committee members asked questions regarding why the Governor originally cut funding for the two state hospitals at Osawatomie and Larned; what is most crucial in combining the departments; how oversight will occur after the reorganization; and raised concerns over ignoring the disability aspect of combining the departments and how to appropriately address mental health.

The Committee also took final action on SBs 120 and 77, which would enact the Audiology and Speech-Language Pathology Interstate Compact, and passed both favorably out of Committee.

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

On Monday, February 8, the Committee worked HB 2114, which would establish the Kansas senior care task force. The bill was amended to add a member of the Alzheimer’s Association and a consumer of Kansas senior services, appointed by the Speaker of the Silver Haired Legislature, to the task force and passed favorably out of Committee.

The Committee also worked HB 2115, which would establish the Joint Committee on Child Welfare System Oversight (similar to SB 120 in Senate Public Health and Welfare). The bill was amended to add two additional members to the Joint Committee — one member to be appointed by the Senate Minority Leader and another member appointed by the House Majority Leader, which would bring the total membership to 13 members, and also to make some technical revisions related to the scheduling of meetings, and was then passed favorably out of Committee.

On Tuesday, February 9, the Committee worked three bills. HB 2116, which would amend K.S.A. 39-709, the statute that creates different eligibility requirements for federal assistance through the Child Care Development Fund (CCDF), to add foster care caregivers to the list of populations exempted from the 20 hour per week Childcare Assistance work requirement, was passed favorably out of Committee without amendments. HB 2150, which would create a definition of financial exploitation, requiring additional mandatory reporters and increasing investigation days in the abuse, neglect and financial exploitation of certain adults, was amended to add nursing facilities and other named facilities defined under K.S.A. 29-923 to be notified when a reported abuse is substantiated in an investigation and passed favorably out of Committee. HB 2151, which would create Kansas elder and dependent adult abuse multidisciplinary teams and a coordinator, also passed favorably out of Committee with no amendments.

House Insurance and Pensions
(Rep. Steven Johnson, Chair)

On Wednesday, February 10, the Committee held a hearing on HB 2110, which would require the State Employees Health Care Commission to provide coverage for the diagnosis and prescribed treatment of pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) beginning January 1, 2022. PANS and PANDAS involve inflammation of the brain and patients, typically children, will often exhibit symptoms that appear similar to autism or other psychiatric disorders. Proponents, including Rep. John Eplee, M.D., testified regarding the symptoms and treatments currently available for PANS and PANDAS and noted that 80 percent of children who are diagnosed early following the onset of the disease and receive treatment and medication are able to fully recover and no longer need medication. A representative of Blue Cross and Blue Shield of Kansas provided neutral testimony and encouraged Committee members to ask the proponents of the bill to conduct a financial analysis of this proposed mandate.

The Committee also held a hearing on HB 2129, which would require the State Employees Health Care Commission to provide coverage for tobacco cessation benefits for enrollees in the state health care benefits program. Cessation benefits under this bill would include any U.S. Food and Drug Administration-approved medication prescribed as a tobacco cessation treatment and would require coverage for at least four 90-day medication supported tobacco cessation attempts per year. Proponents, including representatives of the Kansas Mental Health Coalition, Kansas Public Health Association, Cancer Action Network, Oral Health Kansas, University of Kansas Cancer Center, NAMI (National Alliance on Mental Illness) Kansas and Tobacco Free Kansas, discussed the health benefits for patients who stop smoking and the need to provide smokers with multiple opportunities for cessation treatment. It was noted that under the federal Affordable Care Act, the essential health benefits required to be included in health plans subject to the federal law only provide coverage for two 90-day cessation attempts.

House Appropriations
(Rep. Troy Waymaster, Chair)

On Tuesday, February 9, the Committee heard abridged presentations on the Report of the Special Committee on Mental Health Modernization and Reform from Carlie Houchen of the Kansas Health Institute and members of the working groups convened by the Special Committee who met during the summer and fall of 2020. Ms. Houchen provided an overview of the process used to develop the recommendations and high-priority recommendations were then presented by representatives for each of the working groups. These presentations were similar to those made in the House Health and Human Services Committee on January 19 and 20 and Senate Public Health and Welfare Committee on January 26 and 27. Committee members asked questions about the certified community behavioral health clinics model; adding more fees to cell phones to fund the suicide prevention line; the recommendation related to nursing facilities for mental health; and whether Kansas has a sufficient number of beds.

On Wednesday, February 10, Rep. Will Carpenter, Chair of the House Social Services Budget Committee, reported that his Committee held a hearing on February 8 on ERO 47, which would rename DCF to KDHS, abolish KDADS and transfer the functions to KDHS. Chair Carpenter noted that only proponent testimony was presented during the hearing and that the Committee had approved a motion to disapprove the ERO on a vote of 6-2. Following discussion among the members of the Appropriations Committee about the hearing held in the Social Services Budget Committee, they also approved a motion to disapprove ERO 47.

Senate Ways and Means
(Sen. Rick Billinger, Chair)

On Thursday, February 11, the Committee received a presentation on COVID-19 vaccine distribution by KDHE Secretary Lee Norman, who provided an update regarding vaccine distribution in the state noting that the problems of not having enough vaccine and issues with the reporting of vaccinations were continuing. He explained that not all the information is being updated into WebIZ, the vaccine tracking system, and KDHE often has to follow up by phone to track down data reporting problems. He also noted that the agency has hired contractors to help resolve the issues.

Secretary Norman highlighted the two, two-dose vaccines currently available, manufactured by Pfizer and Moderna, and noted that a third, single dose vaccine from Johnson and Johnson will be released soon. He also described the federal COVID-19 vaccination plan — Operation Warp Speed (OWS) — and the complexity of the distribution and administration process and provided an overview of the five phases of distribution and the rational for prioritizing who was included in each phase. Kansas is currently in Phase 2, which includes those over the age of 65, those in congregate settings, all high-contact critical workers, and anyone from Phase 1 who has not yet been vaccinated. He stated that Kansas is receiving nearly 85,000 doses per week, and is also looking into utilizing the new Centers for Disease Control and Prevention Retail Pharmacy Program. Secretary Norman also responded to questions from Committee members about out-of-pocket cost to consumers for vaccinations (none); state general fund costs (none); number of essential workers in Phase 2 (approximately 600,000); why KDHE decided to vaccinate incarcerated individuals before others (trying to prevent outbreaks spreading into the communities through staff); how many long-term care facilities have been vaccinated (all the CMS accredited facilities have received the first dose and most have received the second dose as well); why the rate of individuals age 65-74 and 85 plus vaccinated is only 14 and 18 percent (many healthcare workers are in younger age groups); whether pharmacies that participate in the federal Retail Pharmacy Program have vaccines distributed through KDHE or by a federal agency (they are not routed through KDHE and will not count towards state allotments of vaccines); how much longer mask and social distancing restrictions will have to remain in place (until we reach herd immunity); if the second vaccine dose differs in composition from the first (no, its exactly the same); mixing a Pfizer dose and a Moderna dose (it is probably fine, but not recommended); if there are adequate booster doses statewide (yes, prime doses are matched with booster doses at the appropriate time); whether prime and booster doses are being distributed in the same locations (that is up to counties); whether families will be able to visit residents in long-term care facilities who have received both doses (some facilities are starting to relax restrictions using rapid result antigen testing); and if those who have had the vaccine can still transmit the virus (we don’t know but we will never be at zero risk).

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.