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Health at the Capitol Week 9 (March 2020)

Week 9 of the 2020 Legislative Session

By Linda J. Sheppard, J.D., Hina B. Shah, M.P.H., Sydney McClendon, Peter F. H. Barstad | March 18, 2002

Health at the Capitol Week 9 (March 2020)

Week 9 of the 2020 Session

During Week 9, the health-related committees received informational briefings on a variety of topics, legislators continued to review and approve budgets, and a number of new bills were introduced, such as House Bill (HB) 2736 related to the construction of a new laboratory for the Kansas Department of Health and Environment (KDHE), Senate Bill (SB) 495, which would reinstate the Kansas uninsurable health insurance plan (the Kansas high risk pool), HBs 2740 and 2742 which concern medical marijuana, and House Concurrent Resolution (HCR) 5024, a new resolution to amend the Kansas Bill of Rights. However, with rising concerns about the growing number of new coronavirus cases around the state and how that may impact the Legislature’s schedule for the rest of the session, these new bills may or may not be heard this session.

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

On Tuesday, March 10, the Committee received an update on kidney disease and organ donation from Stephanie Meyer, a living kidney donor and member of the local advisory board of the National Kidney Foundation (NKF). Ms. Meyer provided an overview of the rates of kidney disease and transplants in the U.S., as well as NKF advocacy efforts. Committee members asked about the process to become a kidney donor, the number of individuals on the kidney transplant wait list and changes to the organ distribution process.

The Committee also received an informational briefing on the Kansas State Board of Healing Arts (KSBHA) from Tucker Poling, who serves as Interim Executive Director and General Counsel for the board. He provided an overview of KSBHA, which licenses and regulates 17 professions in the state. Committee members asked about the qualifications and training for investigators employed by KSBHA, whether KSBHA would be able to handle licensing and regulating additional professions (e.g., advanced practice registered nurses), and how the process for midwifery licensure has been implemented and regulated. 

On Wednesday, March 11, the Committee received a presentation on the cost of health care from Robert F. St. Peter, M.D., President & CEO of the Kansas Health Institute (KHI), and Linda J. Sheppard, J.D., Senior Analyst & Strategy Team Leader at KHI. They discussed the rise in health care costs and strategies states are using to contain health care costs. Committee members asked about the currently uninsured population in Kansas who would be eligible for Medicaid if expanded, differences in health care costs in rural and urban areas, why the U.S. spends more on health care than other countries, the cost of research and development work by pharmaceutical manufacturers, the impact that manufacturers’ coupons can have on prescription drug prices, and how the elimination of the individual mandate penalty under the Affordable Care Act has impacted the cost of health insurance premiums.

On Thursday, March 12, the Committee received an informational briefing on the Kansas Newborn Screening Program from Heather Smith, Director of Special Health Services at KDHE. The program, which began in 1965, screens newborns across the state for 32 conditions, with the goal of identifying infants who will benefit from early intervention or treatment. In 2018, the program screened more than 34,000 infants. Committee members asked about the screened health conditions, where screening information is stored and who has access to it, whether families pay for screenings and the cost of the screenings.

The Committee also received a briefing on the University of Kansas Alzheimer’s Disease Center (ADC) from Dr. Russell Swerdlow and Dr. Jeffrey Burns, Co-Directors of ADC, who discussed the origin of ADC, its current research focus, rates of Alzheimer’s disease in the U.S. and Kansas, and ADC’s long-term goals. Michelle Niedens, Director of the Cognitive Care Network, spoke about the Network’s focus on extending the dementia care capability of primary care providers across the state, moving the model of dementia care to one focused on patient empowerment, and improving outcomes for patients and caregivers while reducing costs. Committee members asked about evidence of how lifestyle interventions can mitigate or slow the progression of Alzheimer’s disease, the impact of the Mediterranean diet, and what indicators ADC looks at when assessing the risk of the disease.  

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

On Tuesday, March 10, the Committee heard from Michael New, Visiting Assistant Professor of Social Research and Political Science at the Catholic University of America and Associate Scholar at the Charlotte Lozier Institute in Washington, who argued that expanding Medicaid eligibility in Kansas likely would increase the overall incidence of abortion. While noting that Kansas Medicaid does not currently fund elective abortions, he suggested that the Kansas Supreme Court’s recent ruling in Hodes & Nauser v. Schmidt, and legal precedent in other states, could result in the court requiring the state to fund elective abortions for Medicaid-eligible women in the future. Questions and discussion focused on family planning, current eligibility levels for women, and current state policy related to abortion coverage.

On Wednesday, March 11, the Committee held a hearing on SB 407, which would require the Kansas Department for Aging and Disability Services (KDADS) to operate acute psychiatric inpatient beds for children in Hays and Garden City. Proponents, including Sen. Rick Billinger, Kyle Kessler of the Kansas Association of Community Mental Health Centers, Stanton County Commissioner John Smith, and Amy Campbell with the Kansas Mental Health Coalition, stressed the need for additional psychiatric acute care beds for children. Committee members asked about the proponents’ views on Medicaid expansion, capacity at private facilities, staffing issues, beds being filled by out-of-state youth, and past funding for Juvenile Crisis Intervention Centers. KDADS Secretary Laura Howard provided informational testimony, and stated that KDADS supports the bill but has concerns about the number of beds it would mandate in each location, and discussed work being done by KDADS to meet the mental health needs of Kansas children. The Committee asked about the number of mandated beds and utilization of psychiatric acute care beds in the past.

On Thursday, March 12, the Committee heard from Amy Penrod, Commissioner of the Aging & Disability Community Services and Programs (A&D CSP) Commission, regarding the Brain Injury (BI) Home and Community Based Services (HCBS) waiver. The BI waiver program currently serves individuals, both adults and children, who have sustained either an acquired or traumatic brain injury and who would otherwise require institutionalization in a BI rehabilitation facility. In August 2019, the waiver was amended to include services to adults with acquired brain injuries and a new assessment tool was developed. The waiver was amended again in December 2019 to expand eligibility to include youth age 0-15 years following the development of the Medicaid Functional Eligibility Instrument (MFEI) Youth Assessment. With these changes, the waiver has gone from being strictly a rehabilitation waiver to one with an emphasis on habilitation/rehabilitation, independent living, and relearning or gaining independent living skills. Previous access to the waiver was limited to four years, but now services continue until a participant reaches their desired goals, their progress plateaus, their services end, or they transition to a long-term waiver. As of March 1, 2020, the BI waiver was serving 465 individuals. Informational testimony also was provided by Dr. Janet Williams of Minds Matter LLC and Rocky Nichols of the Disability Rights Center of Kansas, who both urged the Legislature to work with KDADS to prevent the development of a waitlist and to provide funding for additional spots on the waiver. Committee members asked about agency efforts to prevent a waitlist, functional eligibility determinations, how the program is advertised, the range of time individuals typically remain on the waiver, the system for making payments to the managed care organizations, how funds for this program are budgeted and appropriated, and expressed concern about the likelihood of a waiting list occurring and requested the agency provide additional cost-related information for the omnibus session.  

House Insurance Committee
(Rep. Jene Vickrey, Chair)

No meetings this week.

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

No health-related issues were addressed this week.

House Appropriations
(Rep. Troy Waymaster, Chair)

On Wednesday, March 11, the Committee reviewed recommendations from the House Social Services Budget Committee (Budget Committee) for the budgets for KDADS and DCF for fiscal years (FYs) 2020 and 2021, adopted some but not all of the additions made by the Budget Committee, and approved the budgets as amended. 

On Thursday, March 12, the House Committee worked HB 2522, which would establish the Rural Hospital Innovation Grant program within KDHE. Under this program, “eligible” counties (counties other than Douglas, Johnson, Sedgwick, Shawnee or Wyandotte) could apply for rural hospital transitional assistance grants to change the current health care delivery model of a hospital to a more appropriate model for the community served. For every $1 of state funds awarded, eligible counties must provide a $2 match from private stakeholder monies, which could include hospital foundations or other organizations. An amendment was approved to keep private stakeholder contributions in the community rather than being transferred to the grant fund and allow the private stakeholders to get their money back if the grant is not received. The bill, as amended, was passed favorably out of the Committee.

On Friday, March 13, the Committee met to work the full budget amid concerns about the potential economic impact of the coronavirus pandemic. Chair Waymaster, citing examples of ways the Kansas economy is being impacted by the virus, called upon the Committee to approve a base budget and stated they would return to complete the budget at the omnibus session. The Committee then began work on HB 2594, regarding supplemental appropriations for FYs 2020 and 2021, and HB 2597, regarding appropriations for FYs 2020, 2021 and 2022. The Committee added an amendment related to technical colleges issuing transcripts to certain students and also added an amendment to incorporate the contents of HB 2714, which would increase state financial assistance to local health departments under specified circumstances, as a proviso. The contents of HB 2443, which would require resident tuition rates for certain Native American students at public postsecondary educational institutions, also was amended in as a proviso and a motion was approved to add the contents of HB 2594 into HB 2597 to create a substitute bill for HB 2597. The substitute bill was passed favorably out of the Committee. 

House Taxation Committee
(Rep. Steven Johnson, Chair)

On Monday, March 9, the Committee held a hearing on HB 2720, which would provide a refundable income tax credit for certain purchases of food and discontinue the nonrefundable food sales tax credit. Kansas Department of Revenue (KDOR) Secretary Mark Burghart provided an overview of the history of the food sales tax and statistics on usage of the credit and stated the tax credit under the bill would be determined by tax filing status and could be claimed by all taxpayers with income at or below the following federal adjusted gross income levels: $30,000 if filing status is either single or married filing separate or $40,000 if filing status is head of household or married filing jointly. The amount of the credit, which would vary by filing status, would be $60 for single and married filing separate, $180 for head of household and $240 for married filing jointly. KDOR estimates HB 2720 would decrease SGF revenues by $53.2 million in FY 2021, $54.8 million in FY 2022 and $56.5 million in FY 2023.

Proponents , including Secretary Burghart, Sister Therese Bangert with the Sisters of Charity of Leavenworth, and John Wilson, President of Kansas Action for Children, asserted the bill provides direct relief to those most in need and emphasized the health benefits of being able to afford better food. Legislators asked about the total number of past refunds claimed, the cost to eliminate the sales tax on food entirely, and models in other states.

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.