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Health at the Capitol Week 5 (February 2020)

Week 5 of the 2020 Legislative Session

By Linda J. Sheppard, J.D., Hina B. Shah, M.P.H., Sydney McClendon, Peter F. H. Barstad | February 19, 2020

Health at the Capitol Week 5 (February 2020)

Week 5 of the 2020 Session

With the deadline passed for non-exempt committees to request bill drafts, and Turnaround Day, the halfway point of the session, coming up Thursday, Feb. 27, there is a sense of urgency in the statehouse. Read about all of the activity during Week #5 in our latest edition.

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House Health and Human Services Committee
(Rep. Brenda Landwehr, C​hair)

On Tuesday, February 11, the Committee received an informational briefing on youth suicide from Gina Meier-Hummel, appointed by the Attorney General to be the Kansas Youth Suicide Prevention Coordinator. Ms. Meier-Hummel reported on a meeting that brought together organizations and individuals focused on peer-led suicide prevention programs. Five recommendations from youth who participated in the meeting were presented to the Committee, including:

  • Preparing teachers, parents and adults to be supportive to struggling youth;
  • Ensuring that suicide prevention initiatives are youth-led;
  • Providing early, simple mental health awareness to help teens with coping skills;
  • Teaching youth coping skills that can be shared with peers; and
  • Increasing supports in homes to keep youth at home rather than isolated when they are suicidal.

Committee members asked questions about mental health awareness programming in schools; the Kansas Communities That Care survey; the impact of social media on mental health; specific stressors faced by the current generation of youth; upcoming changes to the National Suicide Prevention Lifeline, which will be moving to a 988 number (similar to 911); and reasons why schools should be focused on social-emotional learning.

On Thursday, February 13, the Committee received an informational briefing on Potential Taxpayer Funding Through Medicaid. Jeanette Pryor, Kansas Catholic Conference, and other conferees discussed the Kansas Supreme Court’s opinion in the case of Hodes & Nauser, et al, v. Schmidt, et al, that held that the “Kansas Constitution Bill of Rights protects all Kansans' natural right of personal autonomy, . . . decisions that can include whether to continue a pregnancy." Illinois Attorney Paul Benjamin Linton expressed concern that the Court’s opinion in the Hodes case could generate legal challenges to the Legislature’s prohibition on appropriated state funds being used to pay for abortions, except in cases of rape, incest or when the life of the mother is at risk and stated that overturning that ban could lead to state Medicaid funds being used to cover the cost of abortions. The Committee also heard from representatives of Kansans for Life (KFL), who indicated they cannot support the passage of Medicaid expansion without the Legislature approving a constitutional amendment stating there is no constitutional right to abortion for placement on the ballot later this year. Committee members asked questions regarding the current Medicaid eligibility standards for pregnant women; whether any lawsuits had been filed challenging the legality of previous Kansas abortion legislation since the Hodes opinion was released; the experience of other states where state funding has been allowed for abortions; and if the ban on state funding use for abortion could be challenged in court.

Senate Public Health and Welfare Committee
(Sen. Gene Suellentrop, Chair)

On Monday, February 10, Chair Suellentrop announced that the Committee would not be working this week Senate Bill (SB) 252, regarding the expansion of Medicaid and implementation of a reinsurance program.

On Tuesday, February 11, the Committee received informational testimony from the Kansas Catholic Conference, Illinois Attorney Paul Benjamin Linton, and KFL regarding the potential for the state paying for abortion procedures through Medicaid as a result of the Supreme Court’s opinion in the Hodes case.

House Insurance Committee
(Rep. Jene Vickrey, Chair)

On Monday, February 10, the Committee held a hearing on House Bill (HB) 2459, which would require health insurers that offer health benefit plans to include coverage for the diagnosis and treatment of mental illness or substance use disorder (SUD), including treatment and services for inpatient or outpatient care, and additional benefits for patients with SUD, or those who are afflicted with suicidal ideation or are actively suicidal. Proponents, including family members of suicide victims, patient advocates and mental health providers testified regarding the difficulties some patients encounter when they attempt to seek mental health services covered by their health insurance plans, and the need to ensure that individuals needing mental health services have coverage for the recommended services. Health insurers opposed to the bill testified that the bill would not apply to self-funded health plans provided by large employers, Christian ministry health plans or the Farm Bureau health benefit plan enacted by the Legislature in 2019. They also noted that many individuals are choosing to purchase high-deductible health insurance plans and plans with limited networks, which impact their out-of-pocket costs for all benefits, including mental health services. Opponents also stated that Kansas law requires the person or organizations sponsoring a health insurance mandate to submit an impact report that assesses both the social and financial effects of the mandated coverage, and also requires any new mandated health insurance coverage to apply only to the state employee health plan (SEHP) for at least one year, followed by preparation of a report by the Kansas Health Care Commission for submission to the Senate President and the Speaker of the House indicating the impact the mandate has had on the SEHP, including data on the utilization and costs of the mandated coverage. Committee members asked about alternative ways to address the problems identified by the proponents; whether there are legal requirements for insurers to provide adequate provider networks, including mental health providers; and whether appeals regarding the denial of coverage for mental health services have been submitted to the Kansas Insurance Department.

On Wednesday, February 12, the Committee held a hearing on HB 2557, which would require any large group health insurance policy, individual health insurance policy, and other health care plan (as described), issued or renewed on or after January 1, 2012, that covers prescription insulin to cap total cost-sharing for a 30-day supply of insulin to no more than $100. Proponents of the bill testified regarding the financial burden on individuals with diabetes who need insulin for their condition and the risk of diabetes complications when they are unable to purchase it. Committee members asked questions regarding who would be responsible to cover the cost above the $100 cap, the rise in the number of individuals diagnosed with diabetes, and the reasons for the rising cost of insulin. Bill Sneed, on behalf of America’s Health Insurance Plans (AHIP), provided neutral testimony but requested the Committee take no action on the bill but continue to study the issue.

Senate Financial Institutions and Insurance Committee
(Sen. Rob Olson, Chair)

No health-related issues were addressed this week.

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

On Wednesday, February 12, the Committee held a hearing on HB 2550, which would increase reimbursement rates for providers of home and community-based services under the Intellectual/Developmental Disability (I/DD) waiver. All proponents of the bill stressed the importance of the funding increases to raise wages to attract and retain quality staff to provide improved care and quality of life for individuals receiving those services.

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

On Thursday, February 13, the Committee held a hearing on HB 2563, which would increase the minimum age to purchase or possess cigarettes and tobacco products from age 18 to 21 (referred to as “Tobacco 21”), add vaping to the Kansas Indoor Clean Air Act, prohibit cigarette vending machines, raise the retailer licensing fee from $25 to $100, and prohibit all flavored vaping products (except menthol). KHI provided neutral testimony focusing on the most recent data on youth smoking and vaping. Proponents discussed the rationale for each provision in the bill, the number of Kansas residents concerned about the issue, the inability to detect vapor, and the burden of smokers on private employers. Opponents objected to the flavor ban provision (citing it was too strict or not strict enough), infringement on personal rights, the absence of language that would allow localities to increase the minimum age to 25, removal of the possession penalty on a minor (which is no longer defined in the bill), and the impact on jobs. Committee members asked questions about FDA guidance, conforming with the federal law, nicotine content and retailer licensing fees. Chair Barker stated that the bill will not be worked immediately but encouraged conferees to meet with Committee members individually.

House Education
(Rep. Steve Huebert, Chair)

On Thursday, February 13, the Committee held a hearing on HB 2601, which would specify in law which immunizations are required for children in licensed childcare facilities and schools, a responsibility now held by the Kansas Department of Health and Environment (KDHE). Proponents included more than 250 individuals, most of whom were private citizens and parents of children who became ill about the same time as receiving a vaccine or individuals who attributed a chronic condition to receiving a vaccine as a child. They argued that KDHE was mandating unnecessary vaccines, individuals should have medical choice, religious exemptions should be upheld, and vaccines are harmful in many instances. Opponents, including KDHE Secretary Dr. Lee Norman, members of the Immunize Kansas Coalition (IKC), private citizens, medical professionals, and dozens of individuals representing local health departments, health care providers, school nurses, schools and school districts, trade associations and advocacy groups, argued the importance of vaccinations for individual and public health. They argued that regulatory authority should remain with KDHE. Legislators asked why the Hepatitis A vaccine was added to the mandated list, inquired about herd immunity and the cost of vaccinations, and asked whether members of the Advisory Committee on Immunization Practices (ACIP) might be benefiting from patents and the sale of vaccines.

House Appropriations
(Rep. Troy Waymaster, Chair)

On Tuesday, February 11, the Committee held a hearing on Executive Reorganization Order (ERO) No. 44, which would rename the Kansas Department for Children and Families (DCF) as the Department of Human Services (DHS). The ERO also would transfer the functions of the Kansas Department for Aging and Disability Services (KDADS) and the functions of the Department of Corrections (DOC) regarding juvenile services programs and juvenile facilities and institutions, excluding the Larned juvenile correctional facility, to the new DHS. Proponent testimony was received from DCF and KDADS Secretary Laura Howard, who described the potential benefits of the ERO and a new DHS. Committee members asked about how the consumer experience would change under the ERO; if the ERO has the potential to impact the Home and Community Based Services (HCBS) waiver waiting lists; costs associated with the ERO, including both one-time costs and ongoing costs; how data sharing will improve; and how current services will be maintained in a larger agency. Melody Pappan, from Cowley County Youth Services and chair of the Community Advisory Committee (CAC), provided neutral testimony and indicated that, while the CAC was testifying as neutral, they were concerned about separating juvenile services from the Department of Corrections without adequate safeguards in place. She proposed that there be a deputy secretary responsible for juvenile justice within DHS and recommended that community agency directors be included in the transition process.

Committee members then discussed the ERO, expressing concern that creating a larger agency would not make things more efficient; oversight of specific populations (e.g., older adults, children) would be lost under a larger agency; it would be more difficult to understand where funds are being used in a larger agency; and consolidating the agencies would not solve the issues (e.g., child welfare) it is proposed to solve. Other members expressed support for the ERO, indicating that the administration should have the flexibility to improve agency functioning the way it sees fit. A motion made by Rep. Will Carpenter to disapprove the ERO passed by a vote of 15-7. Two substitute motions — one to approve the ERO and another to pass it out without recommendation —also were introduced and both failed by a vote of 7-15.

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.