Week 7 of the 2021 Session
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As the weather finally turned more seasonal, Week 7 of the session was a busy one for legislators and stakeholders interested in health-related topics. Lawmakers considered bills related to funding for local health departments, certified community behavioral health centers and medical marijuana. At the end of the week the Senate Judiciary Committee held more than five hours of hearings on a bill that would make significant changes to the Kansas Emergency Management Act (KEMA) and the powers of the Governor, the Secretary of the Kansas Department of Health and Environment (KDHE), and city, county and school officials when responding to public health disasters. The REACH Healthcare Foundation and United Methodist Health Ministry Fund distributed a poll showing that more than 86 percent of Kansans support the expansion or maintenance of telehealth programs, which have become important for ensuring that Kansans all across the state continue to receive health care during the pandemic.
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 Facebook, Twitter and LinkedIn. Previous editions of Health at the Capitol can be found on our ARCHIVE PAGE.
(Sen. Kellie Warren, Chair)
On Wednesday, February 24, the Committee held a hearing on SB 273, which would amend KEMA to (1) provide procedures for declaration and extension of state of disaster emergencies; (2) limit powers granted to the Governor during a state of disaster emergency; (3) define public health disasters and establishing special provisions therefor; (4) create the Joint Committee on Emergency Management; and (5) prescribe the powers, duties and functions of the Secretary of KDHE, city and county government and the board of education of each school district to control the spread of disease and establishing judicial review thereof. Committee members asked questions about various sections of the bill, including the role of the Joint Committee; the role of the Attorney General (AG) and opinions from the office of the AG; authority being delegated to the Legislative Coordinating Council (LCC); declaring new disaster emergencies; what qualifies as “accepted science”; school provisions; recourse for intangible losses; distinctions in the bill regarding local disasters and statewide disasters; legislative oversight over federal funding; and court operations and need for civil recourse during a disaster. Neutral testimony was offered by a representative of the Kansas Association of Counties.
On Thursday, February 25, the Committee continued the hearing on SB 273. Proponents included representatives of the Kansas Chamber of Commerce, Kansas Association of Community College Trustees, Kansas Policy Institute, Sen. Mark Steffen and Attorney General Derek Schmidt. Neutral testimony was provided by representatives of the Kansas Association of Chiefs of Police, Kansas Sheriffs Association, Kansas Peace Officers Association, Kansas Association of School Boards and Kansas Association of Local Health Departments (KALHD). Opponent testimony was provided by Will Lawrence, Chief of Staff to Gov. Laura Kelly and KDHE Secretary Lee Norman. After a rigorous question and answer session, Chair Warren closed the hearing and the Committee worked the bill, which was amended to:
- Make violations of KEMA a class A non-person misdemeanor;
- Clarify that if a claim is brought to a district court it will be an action under K.S.A. Chapter 60;
- Clarify that city and county health officers are to issue recommendations not orders;
- Add additional oversight by the Joint Committee for any federal funding that comes into a state during a national disaster;
- Clarify that a meeting of the Joint Committee can be held by electronic communication if the Chair deems it necessary;
- Define “accepted science”;
- Provide for legislative investigative authority;
- Clarify that a school within a school district, is “any school or attendance center of such” school, including nonpublic schools;
- Clarify which provisions apply to community and technical colleges, as well as their process for seeking a court hearing;
- Specify that nothing in the Act shall be construed to “limit or otherwise restrict the sale, purchase, transfer, ownership, storage, carrying or transporting of firearms or ammunition, or any component or combination thereof…”;
- Change the requirement for submission of an executive order (EO) to the Joint Committee to be concurrent with submission to the AG;
- Place the decision to restrict access to any healthcare services to be “determined solely by the healthcare facility or healthcare provider”;
- Require that any order limiting the movement or gathering of individuals be narrowly tailored;
- Add additional restrictions on the Governor’s authority during a state of public health disaster emergency by limiting the Governor’s authority to close businesses or mandate immunizations or healthcare requirements or restrictions that violate constitutional rights.
The Committee then approved a motion to create a substitute bill incorporating the amendments and passed it favorably out of Committee.
(Rep. Fred Patton, Chair)
On Wednesday, February 24, the Committee began the hearing on House Bill (HB) 2416, which would amend law regarding KEMA. This bill is similar to SB 273, which received a hearing in the Senate Judiciary Committee as noted above. Following an overview presentation of the bill, Committee members asked several clarifying questions and Chair Patton then closed the hearing and indicated testimony would be heard on February 25.
On Thursday, February 25, the Committee continued the hearing on HB 2416 and heard proponent testimony from a representative of the Kansas Chamber of Commerce and neutral testimony from representatives of the Governor’s Office and the Kansas Association of Chiefs of Police, Kansas Peace Officers Association, and Kansas Sheriffs Association. Written proponent testimony was provided by Attorney General Derek Schmidt and written neutral testimony was provided by representatives of the Heartland Institute, Kansas Justice Institute and Kansas Policy Institute. Committee members asked various questions of the conferees related to provisions in the bill and Chair Patton closed the hearing and indicated the bill would not be worked until the week of March 1.
House Health and Human Services
(Rep. Brenda Landwehr, Chair)
On Monday, February 22, the Committee held a hearing on HB 2281, which would establish and implement “988” as the suicide prevention and mental health crisis hotline in Kansas, similar to the concept of 911 as the hotline for medical emergencies. The bill also provides for the imposition of a fee to support the hotline and crisis response services in the amount of 50 cents per month per subscriber account of any exchange, wireless or other type of telecommunications service capable of contacting a hotline center. The 988 fees collected by service providers would be remitted to the State Treasurer.
On Tuesday, February 23, the Committee held a hearing on HB 2279, which would establish a licensure compact for physical therapists (PTs). Following proponent testimony, Committee members asked questions about oversight by the Kansas State Board of Healing Arts (BOHA) of out-of-state PTs practicing in Kansas via the compact. The bill was amended and passed favorably out of Committee.
The Committee also held a hearing on HB 2373, which would require KDADS to establish and implement a mobile crisis service program for individuals with an intellectual or developmental disability (I/DD). Following proponent testimony, Committee members asked how the crisis services would be funded; whether the mobile crisis units that would be developed through this bill could be combined with mobile crisis services proposed as part of HB 2281 (the 988 hotline); and how the proposed crisis services would connect with existing services provided by community mental health centers (CMHCs).
The Committee then worked HB 2209, which would establish the Psychology Interjurisdictional Compact (PSYPACT), a licensure compact for psychologists, amended the bill to adjust the effective date to January 1, 2022, and passed it favorably out of Committee.
On Wednesday, February 24, the Committee amended HB 2280, which would update statutes related to the powers, duties and functions of the State Board of Pharmacy, and passed it favorably out of Committee.
The Committee then amended HB 2281 (988 hotline) to add “lockbox” language ensuring the fee funds could only be used for the purposes outlined in the bill; allow prepaid wireless services to be charged a fee; and allow the fee fund to support mobile crisis response services for both I/DD and behavioral health needs and passed it favorably out of Committee.
Finally, the Committee amended HB 2373 to include one full-time equivalent (FTE) position for KDADS to coordinate mobile crisis services for those with I/DD and to provide that the mobile crisis services shall be funded by expenditures from the 988 hotline fund proposed in HB 2281, or any other special revenue fund established by legislation during the 2021 session to fund the hotline if HB 2281 is not passed. If no such legislation is passed, then the mobile crisis services shall be funded by expenditures from an appropriate state general fund account or special revenue fund of KDADS. The bill, as amended, was then passed favorably out of Committee.
Senate Public Health and Welfare Committee
(Sen. Richard Hilderbrand, Chair)
On Tuesday, February 23, the Committee held a hearing on Senate Bill (SB) 138, which would provide for the certification and funding for certified community behavioral health clinics (CCBHCs). This is the companion bill to HB 2160, which passed favorably out of the House Health and Human Services (HHS) Committee on February 9. Proponents included representatives of ACMHCK; the Kansas Sheriff’s Association; Kansas Mental Health Coalition; Four County Mental Health; Johnson County Mental Health Center; Concare Sedgwick County; and Spring River Health and Wellness. Neutral testimony was provided by State Medicaid Director Sarah Fertig, who recommended that the Senate bill be amended to conform to HB 2160, which requires KDADS and KDHE to implement the bill on May 1, 2022, rather than July 1, 2021. There were no opponents. Committee members asked questions about the stress on hospitals and police departments due to the waiting lists for admissions to state hospitals; if proponents support extending the implementation date; how passage of the bill would help improve the status quo; and why some of the services can’t be provided under the current setting.
On Wednesday, February 24, the Committee held a hearing on SB 238, which would reduce certain requirements for licensure by the Behavioral Sciences Regulatory Board (BSRB), require BSRB approval to provide clinical social work supervision and expand out-of-state temporary permits to practice. The bill specifically lowers the number of hours of practice required for licensure for various professions that the BSRB regulates.
The Committee also amended SB 175, which would enact the Rural Emergency Hospital Act to provide for the licensure of rural emergency hospitals, to clarify that benefits for services performed by a rural emergency hospital would be covered by individual and group health insurance policies and other health insurance contracts stated in the bill if such services would be covered under such policies and contracts if performed by a general hospital, and passed it favorably out of Committee.
On Thursday, February 25, the Committee held a hearing on SB 200, which would expand pharmacists’ scope of practice to include point-of-care testing for and treatment of certain health conditions, including the flu, strep, COVID-19, and pre- or post-exposure prophylaxis.
On Friday, February 26, the Committee amended SB 238 to (1) strike the requirement for 200 hours of direct client contact supervision; (2) add language from SB 207 concerning the practice of telemedicine by out-of-state licensed physicians; (3) remove language requiring BSRB approval of clinical supervisors of social workers working toward licensure as clinical social workers; and (4) insert the text of SB 138 and change the implementation date of CCBHC certification and funding from May 1, 2021, to January 1, 2022. The amended bill was then recommended as Substitute for SB 238 and passed favorably out of Committee.
The Committee also worked SB 12, which would require the Kansas Department for Children and Families (DCF) to implement performance-based contracts. Some Committee members stated that while the bill is intended to provide accountability, there are concerns that it would not actually be able to deliver measurable outcomes. A motion to pass the bill out favorably failed.
House Children & Seniors
(Rep. Susan Concannon, Chair)
On Monday, February 22, the Committee held a hearing on HB 2371, which would revise the statutes that regulate child support services, food assistance, and child care assistance by removing cooperation with child support from requirements for food and child care assistance, exempt adults enrolled in school from the 20-hour-per-week work requirement for child care assistance and remove the lifetime limit for how many months those individuals can receive child care assistance.
The Committee then worked HB 2345, which would establish the Office of the Child Advocate for children's protection and services, and amended it to (1) add the Chief Justice of the Kansas Supreme court as a joint appointing authority for the Child Advocate; (2) adjust the mandatory and permissive duties of the Child Advocate; (3) clarify the Child Advocate’s relationship to the judicial and executive branches; and other technical revisions. The amended bill was then passed favorably out of Committee.
On Tuesday, February 23, the Committee held a hearing on HB 2271, which would allow changes to the Child In Need of Care code to allow adults who were formerly in foster care to voluntarily reenter foster care services until the age of 21. Currently, 38 states offer similar programs.
On Thursday, February 25, the Committee amended HB 2371 to (1) add progress, degree and minimum credit requirements for adults enrolled in school in order to be exempt from the 20 hours per week work requirement and (2) set maximum benefit periods to the educational exemptions, and passed it favorably out of Committee.
House Social Services Budget
(Rep. Will Carpenter, Chair)
On Monday, February 22, the Committee received an update on vaccine distribution from KDHE Secretary Lee Norman, who stated that there are favorable trends showing less growth in cases and deaths due to COVID-19 and described where vaccines are going; the number of doses administered (approximately 509,000); the different types of COVID-19 vaccines; safety of the vaccines; the process of getting vaccines from manufacturers to administration sites; how vaccines are currently being allocated across counties; provider network and planning and data problems; rational for the distribution phases for the vaccines; continuing challenges with communication between WebIZ (the state tracking system) and the federal system for tracking and recording vaccines; how the state and federal government track and record vaccines; distribution to long-term care facilities; and provided an update on the Federal Retail Pharmacy Program partnership.
Dr. Norman then responded to questions from Committee members about the West Virginia vaccine information hotline (Kansas has a hotline and phone bank for that purpose, 866-534-3463); small pharmacies included in the Retail Pharmacy Partnerships (he named locations in specific cities); possibility of shifting vaccines to counties with the highest populations (this is part of the considerations for the distribution plan); people of color being more vulnerable to COVID-19 (KDHE is acting based on demographic data); distinctions between race and ethnicity (there are challenges on collecting data on race); prioritizing teachers and if they are included in phase 2 (yes); decision authority over who receives vaccines and who doesn’t (prioritization within phases is left up to counties); whether independent pharmacies which receive vaccines have the same decision flexibility as counties (no they are under strict federal guidance); what communities do with surplus vaccine doses (can be reallocated to other individuals); how long vaccine can be stored once thawed (Pfizer - 5 days and Moderna - 30 days); window for distribution once a vaccine vial is punctured (6 hours); if the vaccine stops transmission of the virus to others (research is inconclusive); COVID-19 variants in the state (there have been three unconnected cases of the UK strain); possibility that those other variants have been here but just not tested for (yes); and information on differences in biological response based on gender (no substantial differences).
On Tuesday, February 23, the Committee held a hearing on HB 2249, which would require the Secretary of KDHE to adopt rules and regulations to set the monthly protected income level (PIL) for persons receiving home and community-based services (HCBS) at 150 percent of federal supplemental security income (SSI). This would include any person receiving services from a Program of All-inclusive Care for the Elderly (PACE) approved by the U.S. Centers for Medicare and Medicaid Services (CMS). Proponent testimony was provided by representatives of the Disability Rights Center of Kansas, KanCare Advocates Network, Interhab, Southeast Kansas Independent Living (SKIL) Resource Center, Topeka Independent Living Resource Center, and Midland Care.
On Wednesday, February 24, the Committee held a hearing on HB 2248, which would update statutes related to the distribution of state financial assistance to local health departments (LHDs) to increase the amount they receive. Under the bill, state financial assistance would still be distributed through a state formula based on the population of counties but each LHD would be eligible, upon application, to receive a minimum of $15,000, if the allocation of total state financial assistance for the applicable fiscal year (FY) is $3 million or greater, subject to appropriation, or $7,000 if the total state financial assistance for the FY is less than $3 million. Dennis Kriesel of KALHD testified in support of the bill and noted that the minimum amount of $7,000 has not been adjusted since 1992.
The Committee then discussed HB 2249. Following a motion to amend the bill to increase the PIL to 200 percent of the SSI, Chair Carpenter suspended the hearing pending publication of a fiscal note.
House Federal and State Affairs
(Rep. John Barker, Chair)
On Monday, February 22, the Committee held a hearing on HB 2340, which would amend the Kansas Cigarette and Tobacco Products Act to increase the minimum age from 18 to 21 years to purchase or possess cigarettes, electronic cigarettes, consumable materials, and tobacco products (referred to as “Tobacco 21” ), prohibit the use of electronic cigarettes under the Kansas Clean Indoor Air Act and amend K.S.A. 72-6285, which currently prohibits the use of tobacco products in school buildings to include the four abovementioned products. The bill also increases compliance checks of retailers to ensure compliance with the age requirements for the sale of tobacco products to two (from one) unannounced controlled buys per year. The bill would also bring Kansas law into conformity with the federal T21 law. Proponents of the bill, including Rep. John Eplee and representatives of the Kansas Chapter American Academy of Pediatrics, Fuel True (formally known as the Petroleum Marketers and Convenience Store Association of Kansas), Kansas Association of School Boards, Oral Health Kansas, Kansas Public Health Association, Olathe Public Schools USD 233, Kansas National Education Association, and HGC Consulting, testified in support of conformity with federal law and the strengthening of the policies of school districts across the state and enforcement of those policies. However, some proponents were concerned about the lack of an increase in licensing fees as a dedicated funding mechanism for enforcement and that the bill retains current penalties on youth for purchase, use and possession (PUP) of “regulated products” when there is evidence that penalizing youth is not an effective tobacco control strategy and these types of laws have been found to disproportionately impact minorities, specifically African Americans and Hispanic youth. Neutral conferees representing the Tobacco Free Kansas Coalition and KDHE, expressed similar concerns. There were no opponents.
On Wednesday, February 24, the Committee began a two-day hearing on HB 2184, which would enact the Kansas Medical Marijuana Regulation Act and allow registered patients and caregivers to obtain a physician’s recommendation to possess and administer medical marijuana for the medical treatment of 21 qualifying medical conditions, including chronic pain, post-traumatic stress disorder and HIV. Under the bill, the Secretary of KDHE would provide for the registration of patients and caregivers, the issuance of identification cards, and the licensure of cultivators and laboratories that test medical marijuana. The forms of medical marijuana that could be dispensed would include oils, tinctures, plant material, edibles, patches, or any form approved by the Secretary of Revenue. The BOHA would regulate the issuance of certifications to physicians allowing for the recommendation of medical marijuana for treatment and the Secretary of Agriculture would provide for the licensure and regulation of the cultivation, possession, testing and sale of medical marijuana by cultivators and laboratories. The Director of Alcoholic Beverage Control would administer the program and provide for the licensure of processors, distributors, and retail dispensaries and would establish and maintain an electronic database to monitor medical marijuana from its seed source through its cultivation, testing, processing, distribution and dispensing. The bill prohibits smoking and vaping of marijuana and also does not allow at-home growing. Fifty-seven proponents, including representatives of industry and advocacy organizations and private citizens, provided information about the medical benefits of medical marijuana, including for children and veterans, and testified in favor of the qualifying conditions in the bill, the strong regulatory framework, increased revenue through taxation and new jobs that would be brought to Kansas. Some proponents also suggested that the licensing fee should be reduced; that coverage should not be restricted to certain medical conditions; other conditions (e.g., autism) should be added with physicians being held accountable for approved conditions; and requiring KDHE to establish a quality assurance lab to address variances in labs and ensure only high-quality products are sold in the state. Chair Barker asked about research on suicide rates among veterans living in states with and without medical marijuana laws and Committee members were encouraged to reach out to conferees if they had additional questions.
On Thursday, February 25, the Committee heard testimony from opponents and neutral conferees on HB 2184. Opponents, including Rep. Eric Smith and representatives from law enforcement organizations, the Kansas Medical Society (KMS), American Academy of Pediatrics (AAP), and Kansas Bureau of Investigation (KBI), discussed research on impaired driving and the impact on DUI laws; impact on growing brains up to age 25; warnings for pregnant women; paring down the list of conditions because pain is the only condition with conclusive evidence of medical marijuana’s effectiveness; the need to regulate the percentage of THC; increased crime due to hallucinogenic levels of tetrahydrocannabinol (THC); and the need for more regulation, particularly around cultivation, transport and prescription disposal. Committee members asked about current medication disposal laws; clarification on data about rising suicide rates; what a 90-day supply looks like; why the FDA has never litigated medical marijuana; whether packaging and child safety align with other prescriptions; how the Legislature can ensure new genetically modified (GMO) marijuana with high levels of THC is not cultivated and dispensed in Kansas; and if or how cultivation is addressed in the bill. Staff from the Office of the Revisor of Statutes confirmed that the bill allows cultivators to grow marijuana and regulations will be developed by the Department of Agriculture. Neutral conferees, including representatives from the Kansas Chamber of Commerce, BOHA, League of Kansas Municipalities, ABC, and KDHE, suggested changes around employer protections; funding mechanisms for additional training or regulation; allowing cities or counties to opt in or out; and recommended that the implementation date be extended to July 1, 2023, as requested by KDHE. Committee members asked about employer protections; funding mechanisms for law enforcement to verify contents or THC level compliance and confirming that counties and cities could not deny where licenses are issued.
On Friday, February 26, SB 2340 was passed favorably out of Committee on a vote of 11-10.
(Sen. Rob Olson, Chair)
On Tuesday, February 23, the Committee held a hearing on SB 137, which would amend the occupational and professional licensing standards for regulatory agencies to receive and review applications from military spouses, military service members (on active duty or honorably discharged), any individual who has established or plans to establish residency in Kansas, or law enforcement officers. Following proponent and opponent testimony, the hearing continued on Wednesday, February 24, when the Committee heard from opponent and neutral conferees.
On Thursday, February 25, the Committee held a hearing on SB 213, which would prohibit an employer from engaging in any adverse employment action against an employee because of the employee’s decision to either receive or not receive a particular vaccination. Following proponent testimony, Committee members asked questions about where individuals can go to obtain information about adverse reactions or side effects of the vaccine and consumer protections. Opponents argued that employers should retain the right to require employees to be vaccinated and that the bill would have a much larger impact on employers who currently require other types of vaccinations.
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.