Week 10 of the 2021 Session
During the first full week after the Turnaround break, the Legislature passed a comprehensive bill that amends various provisions of the Kansas Emergency Management Act (KEMA) related to state of disaster emergencies and worked on a number of health-related bills that had already passed one chamber. Learn more about health-related issues discussed this week in our latest edition of Health at the Capitol.
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.
On Monday, March 15, Gov. Laura Kelly announced the state will move to Phase 3 and 4 of the vaccination plan on March 22, which will make individuals between ages 16 and 64 with a preexisting medical condition and other non-healthcare workers in critical infrastructure eligible for vaccination. She stated she expects to move into the final phase of vaccinations by no later than May 1. She also announced the state will be activating more providers to administer vaccinations, including safety-net clinics, pharmacies, hospitals and medical practices, and will partner with the federal government to set up mass vaccination sites to increase the number of vaccinations possible per day.
On Tuesday, March 16, the House, on a vote of 118-5, and Senate, on a vote of 31-8, passed the Conference Committee Report on Senate Bill (SB) 40, which would prescribe the powers, duties and functions of the board of education of each school district, the governing body of each community college and the governing body of each technical college related to the COVID-19 health emergency; modify the procedure for the declaration and extension of a state of disaster emergency under KEMA; prohibit certain actions by the Governor related to the COVID-19 health emergency and revoke all executive orders related to such emergency on March 31, 2021; establish judicial review for certain executive orders issued during a state of disaster emergency and certain actions taken by a local unit of government during a state of local disaster emergency; authorize the Legislature or the Legislative Coordinating Council to revoke certain orders issued by the Secretary of the Kansas Department of Health and Environment (KDHE); and limit powers granted to local health officers. KHI will provide a detailed analysis of SB 40 at a later time.
On Monday, March 22, KDHE reported 300,125 COVID-19 cases (up 1,907 from March 15) from 105 counties with 4,850 deaths (up 15 from March 15).
House Health and Human Services
(Rep. Brenda Landwehr, Chair)
On Monday, March 15, the Committee worked Substitute for SB 238 (passed by the Senate on March 3), which includes language from House Bill (HB) 2160 (previously passed out of the Committee on February 9) and HB 2208 (passed by the House on March 3). Sub. for SB 238 would establish certification for certified community behavioral health clinics (CCBHC); prescribe the powers, duties and functions of the Kansas Department for Aging and Disability Services (KDADS) related to CCBHC certification; authorize a licensed out-of-state physician with a telemedicine waiver issued by the State Board of Healing Arts (BOHA) to practice telemedicine in Kansas; amend the disciplinary authority of the Behavioral Sciences Regulatory Board (BSRB); and modify licensure and temporary permit requirements of professional counselors, social workers, marriage and family therapists, addiction counselors, psychologists and master’s level psychologists. The Committee amended two CCBHC provisions of the bill, including removing a funding mechanism through Medicaid and creating a staggered implementation schedule requiring specific numbers of certifications by set dates, subject to receipt of applications, and allowing KDADS to certify CCBHCs in advance of the deadlines. During discussion of the amendment, Committee members asked questions about the fiscal note, potential funding mechanisms for CCBHCs and whether rural Community Mental Health Centers (CMHC) would be among the first CMHCs to transition to the CCBHC model. The amended bill was then passed favorably out of Committee.
On Tuesday, March 16, the Committee held a hearing on HB 2174, which would establish the Rural Hospital Innovation grant program to assist rural hospitals serving rural communities and prescribe the powers, duties and functions of the Secretary of KDHE related to the program. Proponent testimony was provided by representatives from the Kansas Hospital Association (KHA) and League of Kansas Municipalities. Committee members asked questions about who could provide matching funds under the grant program, whether hospitals could choose to revert back to a critical access hospital designation after becoming a rural emergency hospital (REH), whether the grant funds could go to hospitals that have already closed and why grant funds are needed in addition to the new REH designation. Following the close of the hearing the Committee added the contents of HB 2174 to SB 175, which would enact the Rural Emergency Hospital Act to provide for the licensure of REHs and is similar to HB 2261, which was previously passed out of the Committee on February 17. The Committee then passed amended SB 175 out favorably.
On Wednesday, March 17, the Committee held a roundtable to discuss payment parity for telehealth services. Roundtable participants included representatives from KHA, the Association of Community Mental Health Centers of Kansas, TeleDoc, Community Care Network of Kansas, Behavioral Health Association of Kansas, Kansas Chapter of the American Academy of Pediatrics, Kansas Medical Society, Blue Cross and Blue Shield of Kansas, Blue Cross and Blue Shield of Kansas City, Medicaid managed care organizations, America's Health Insurance Plans and providers.
Individuals in favor of payment parity indicated that it would be one way to ensure access to telehealth services and make the market more competitive for local Kansas providers, including those in rural areas or who are part of smaller organizations with less negotiation leverage. Individuals opposed to payment parity expressed concern that it could lead to higher health care costs and stifle innovation. Other key elements of the discussion included whether it would be beneficial to have a task force or study focused on this issue; when action should be taken (now or at the end of the public health emergency); for what services telehealth is most appropriate; how much it costs providers to offer telehealth; and what reimbursement for telehealth was like prior to the pandemic. Committee members suggested that all involved parties work together to establish a solution.
Senate Public Health and Welfare
(Sen. Richard Hilderbrand, Chair)
On Monday, March 15, the Committee heard an update on the pandemic and vaccine distribution from KDHE Secretary Lee Norman. Committee members expressed concerns about KDHE’s decision to not give counties more flexibility to move forward with implementing subsequent phases, and Chair Hildebrand noted that cancer patients under 65 haven’t been able to get the vaccine when others who are younger and healthier have been vaccinated. Committee members asked about where Kansas ranks nationally in vaccine distribution (38th); the storage of vaccines (new Johnson & Johnson vaccine does not need to be frozen so better for counties that don’t have freezer space); the flexibility of phases compared to other states (Kansas’ plan is approved by the CDC); and if an individual can test positive for COVID-19 after receiving the vaccine (yes).
The Committee also heard from Julie Gibbs, Health Director of Riley County, who spoke about the county’s experience of not being able to tailor its distribution plan differently than the state’s approach. The state temporarily paused shipments of the vaccine to Riley County when it elected to move on to Phase 3 until the county’s plan was reconciled with the state’s guidelines and approved.
The Committee then held a hearing on SB 295, which would allow a board of county commissioners acting as a board of health to adopt a resolution prescribing the county’s plan for distribution or administration of COVID-19 vaccines and would also allow a county’s prioritized vaccination plan to differ from a vaccination plan or recommendation from KDHE, but would require the county’s plan to comply with federal law and recommendations. It would also allow KDHE to retain the authority to allocate vaccinations to counties on a schedule determined by KDHE but would prohibit it from reducing or delaying vaccination allotments or taking any action that has the effect of reducing or delaying vaccination allotments based upon a county’s decision related to distribution or administration. Jim Howell, Sedgwick County Commissioner, provided proponent testimony and explained his desire to move Sedgwick County forward to allow citizens with the most fragile health conditions to receive the vaccine as soon as possible. Written opponent testimony was submitted by KDHE Sec. Lee Norman. SB 295 was passed favorably out of Committee on March 17.
On Friday, March 19, the Committee held a hearing on HB 2208, which would authorize a licensed out-of-state physician with a telemedicine waiver issued by BOHA to practice telemedicine in Kansas; amend the disciplinary authority of the BSRB; and modify licensure and temporary permit requirements of professional counselors, social workers, marriage and family therapists, addiction counselors, psychologists and master’s level psychologists. The bill, which was unanimously passed by the House on March 3, is very similar to SB 238, which was passed by the Senate on March 3. Proponents included representatives of the BSRB and Americans for Prosperity. There was no neutral or opponent testimony.
The Committee then worked HB 2208 and added the contents of SB 138, which would establish certification and funding for CCBHCs, and also amended the bill to include the amendment that the House provided, which adds a staggered date for the certification of CCBHCs between May 1, 2022, and July 1, 2024, and further amended the bill to add the Rural Emergency Hospital Act (SB 175). The Committee also discussed adding HB 2174 into HB 2208, which provides $10 million in grant assistance to rural hospitals, but Committee members expressed support for having a separate hearing before taking action on that bill. Lastly the Committee made the underlying bill a substitute bill and then passed it out favorably as Senate Substitute for HB 2208.
House Children and Seniors
(Rep. Susan Concannon, Chair)
On Wednesday, March 17, the Committee held a hearing on SB 120, which would establish the Joint Committee on Child Welfare System Oversight; outline the topics for Joint Committee review; provide for the appointment and compensation of Joint Committee members; establish the frequency of meetings; require an annual report to designated House and Senate leadership and certain standing committees; allow for professional services; and authorize the Joint Committee to make recommendations and introduce legislation. Although HB 2115 (the companion bill) was passed by the House on February 18, it differs from SB 120 because the two bills are based on different versions of the 2019 bill — the Senate used the original bill text while the House used the amended bill text. Chair Concannon stated that HB 2115 is better and a conference committee would need to be convened to agree upon one bill. Kansas Department for Children and Families (DCF) Secretary Laura Howard and representatives of the Children's Alliance of Kansas and Kansas Association of School Boards expressed their support for the bill and Sec. Howard stated that DCF estimates no fiscal impact. Rachel Marsh of the Children’s Alliance discussed the benefit of aligning the language in SB 120 with the amendments already included in HB 2115, which reflect a broad understanding of the child welfare system as encompassing child abuse prevention, maltreatment investigations, services to safely reduce the need for foster care, and foster care and adoption — across multiple silos, using a data-driven focus. There was no opponent or neutral testimony.
Senate Financial Institutions and Insurance
(Sen. Jeff Longbine, Chair)
On Thursday, March 18, the Committee held a hearing on SB 199, which would amend existing law related to short-term, limited duration insurance (STLDI) policies to extend the policy period of these policies to less than 12 months or extension periods up to a maximum of 36 months total duration and require the addition of a notice to consumers that STLDI policies are not required to comply with federal Affordable Care Act requirements. Proponent testimony was provided by Sen. Beverly Gossage and opponent testimony was provided by Christina Cowart, American Cancer Society Cancer Action Network. Chair Longbine stated that since the hearing was scheduled on short notice and he had received several requests from others to testify on the bill, the hearing would remain open and may be continued at a later date.
House Appropriations and Senate Ways and Means
(Rep. Troy Waymaster, Chair; Sen. Rick Billinger, Chair)
On Wednesday, March 17, the House Appropriations Committee held a hearing on HB 2046, and the Senate Ways and Means Committee held a hearing on the companion legislation, SB 154, both of which would increase reimbursement rates for providers of home and community-based services (HCBS) under the intellectual or developmental disability (I/DD) waiver, make appropriations for the rates and provide for legislative review of the waiting list for services. The legislation would create a schedule for rate increases through fiscal year 2024, and establish an annual rate increase formula for fiscal year 2025 and beyond. The legislation would also direct the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight (Joint Committee) to review and make findings and recommendations regarding the number of individuals waiting to receive HCBS under the I/DD waiver during the Joint Committee’s meetings during the second half of 2021 and the first half of 2022. The Joint Committee would submit its findings in its annual report to the Legislature at the beginning of the 2022 and 2023 regular sessions.
(Rep. Fred Patton, Chair)
On Thursday, March 19, the Committee held a hearing on SB 283, which would amend the business liability provision in the COVID-19 Response and Reopening for Business Liability Protection Act to apply to actions accruing on or after March 12, 2020, and prior to termination of the State of Disaster Emergency related to the COVID-19 public health emergency; amend existing law related to the use of telemedicine to replace a requirement that an out-of-state physician notify BOHA and meet certain conditions with a requirement that the physician hold a temporary emergency license granted by BOHA and extend the date of this section for one year, to March 31, 2022; and amend a statute allowing BOHA to grant temporary emergency licenses to practice professions overseen by BOHA to add a provision allowing an applicant to practice in Kansas pursuant to such license upon submission of a non-resident health care provider certification form to the Kansas Health Care Stabilization Fund and without paying the annual premium surcharge required by the Health Care Provider Insurance Availability Act; and extend the expiration of the statute to March 31, 2022. Proponent testimony was presented by representatives of the Kansas Chamber of Commerce and the Kansas Hospital Association. All other proponent, neutral, and opponent testimony was written only.
(Sen. Kellie Warren, Chair)
On Tuesday, March 16, the Committee held a hearing on HB 2126 (passed by the House on March 4), which would amend the COVID-19 Response and Reopening for Business Liability Protection Act by replacing the definition of “adult care facility” with the definition of “covered facility” and would replace an affirmative defense available for an adult care facility in a civil action for damages, administrative fines, or penalties for a COVID-19 claim with immunity from liability for a covered facility if such facility was in substantial compliance with public health directives applicable to the activity giving rise to the cause of action when the cause of action accrued. Covered facilities would include an adult care home, community mental health center, crisis intervention center, community service provider, community developmental disability organization, and an institution (as defined in the Developmental Disabilities Reform Act.)
Proponents, including representatives of LeadingAge Kansas, Progressive Healthcare Alliance, Kansas Health Care Association and Kansas Center for Assisted Living, stated the bill is necessary to keep long-term care facilities financially viable and that it provides the same protections as are currently in place for all other health care facilities. Opponents, including representatives of the Kansas Trial Lawyers Association, AARP, Kansas Advocates for Better Care, and the Kansas Bar Association, argued the bill would fail to keep long-term care facilities accountable and would result in a decline in the quality of care for residents. Committee members asked questions about substantial compliance, why opponents were not more active in advocating for residents earlier on in the COVID-19 pandemic and why other facilities and health departments have not been held to the same level of accountability.
Human Services Subcommittee, Senate Ways and Means
(Sen. Carolyn McGinn, Chair)
On Wednesday, March 17, the Subcommittee held an informational hearing on the T1000 Specialized Medical Care (T1000) code as related to the Medicaid Technical Assistance (TA) Waiver. The TA waiver program serves individuals from birth through 21 years of age who are chronically ill or medically fragile and dependent upon a ventilator or other medical device to compensate for the loss of vital bodily function. Eligible individuals require substantial and on-going daily care by a nurse comparable to the level of care provided in a hospital setting to avert death or further disability. Amy Penrod, Commissioner, Aging and Disability Community Services and Programs Commission, KDADS, stated that T1000 is a key TA waiver service that provides long-term registered nurse or licensed practical nurse support to waiver participants. Committee members asked clarifying questions about rates and available data. Amy Campbell spoke on behalf of T1000 providers, who are requesting that the T1000 reimbursement rate be increased. Other presenters included representatives of Maxim Healthcare Services, Craig HomeCare, Thrive SPC, and Children’s Mercy Hospital. Committee members asked questions about patient care settings and services; workforce licensure and competitive wages; liability and staffing; in-home services compared to in-patient services; and competition for skilled nursing staff.
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.