Tag: week

During week 10 of the Kansas legislative session, committees continued to conduct hearings and work bills still alive after Turnaround, including many bills addressing numerous child welfare issues and bills related to licensure and scope of practice for healthcare providers, eligibility for childcare assistance, and medical marijuana.

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, LinkedIn, and Instagram. Previous editions of Health at the Capitol can be found on our ARCHIVE PAGE.

On Monday, March 13, Gov. Kelly announced the release of the state’s most recent cancer prevention and control plan, which outlines how the state will allocate resources over the next five years to prevent cancer and reduce the burden on Kansans who have been diagnosed with cancer and their families. The plan includes proposals to increase the healthcare workforce, increase early detection, expand providers’ understanding of the resources available to patients and survivors, and reduce unhealthy behaviors. The plan was the result of an 18-month collaboration between the Kansas Department of Health and Environment (KDHE) and the Kansas Cancer Partnership (KCP). The KCP has multiple workgroups and regional coalitions that include oncologists, survivors, and advocates.

On Wednesday, March 15, the Governor announced a statewide initiative to increase awareness of the Affordable Connectivity Program (ACP), a program to help low-income families pay for high-speed internet. The ACP is a $14.2 billion federal broadband benefit that provides eligible households a monthly discount of up to $30 per month (up to $75 per month for households on qualifying tribal lands) and a one-time $100 discount toward a laptop, desktop computer, or tablet. ACP-eligible households include families with income at or below 200 percent of the federal poverty level and those who qualify for the Lifeline Program, the Supplemental Nutrition Assistance Program (SNAP), free and reduced-price school lunch, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), or other government-funded programs. There are 438,634 Kansas households eligible for the ACP, but to date only 93,244 of those eligible have enrolled.

 On Friday, March 17, the Governor announced that the state is receiving a $1 million, one-year federal planning grant from the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration to support the transition of community mental health centers (CMHCs) to become certified community behavioral health clinics (CCBHCs). During the 2021 session, legislators passed Senate Substitute for House Bill (HB) 2208, which established a new model for providing behavioral health services and established a process for the state’s CMHCs to become certified as CCBHCs beginning in 2022.

House Health and Human Services Committee

(Rep. Brenda Landwehr, Chair)

On Monday, March 13, the Committee worked Senate Bill (SB) 180, which had been re-referred to the Committee after it was withdrawn from the House calendar. The bill would establish the Women’s Bill of Rights and specify that for purposes of any state law or rules and regulations an individual’s “sex” means such individual’s biological sex, either male or female, at birth. The bill would state that with respect to biological sex, separate accommodations are not inherently unequal. SB 180 also would require schools, state agencies, or political subdivisions that collect vital statistics to identify individuals within the data as either male or female at birth. Following lengthy discussion of a proposed amendment, the amendment was withdrawn and action on the bill was suspended.

The Committee then held a hearing on Substitute for SB 131, which would allow an exemption from state licensure requirements for physicians and other health professionals licensed in good standing in another state when practicing medicine in Kansas on a limited basis during certain sporting events as detailed in the bill. Proponent testimony was provided by Sen. Jeff Pittman and representatives of the Kansas State Board of Healing Arts, Kansas Academy of Family Physicians, and American Medical Society of Sports Medicine. Sen. Pittman stated that Kansas is one of four states without a sports waiver as proposed in the bill. The representative for the Board of Healing Arts stated the Board was generally in favor of the waiver but offered two amendments for consideration. Written-only proponent testimony was submitted by a representative of the Kansas Chiropractic Association. There was no opponent or neutral testimony submitted. Committee members asked questions regarding taxes for sports teams entering the state, how the liability of these professionals would be handled (would be covered by their liability coverage in their home state), the current practice for allowing sports teams’ physicians to practice in Kansas, and the sporting events that would qualify under the bill.

The Committee then worked the bill and amended it to (1) replace the word “physician” with “any individual” in provisions limiting the practice of sports waiver participants in Kansas, and (2) delete provisions stating the Board may enter into agreements with medical and osteopathic licensing boards. The bill was then passed favorably out of Committee, as amended.

On Wednesday, March 15, the Committee held an informational briefing on HB 2453, which would enact the dentist and dental hygienist compact to provide interstate practice privileges for dentists and dental hygienists. The compact is similar to six other licensure interstate compacts enacted by the Legislature and would set minimum requirements for participation, including a criminal background check, minimum education requirements, as well as completion of a clinical assessment and continuing professional development requirements for licensure renewal. The compact would take effect when there are seven participating states. To date, six states have considered similar legislation but have not enacted it. Presentations were provided by representatives of the Council of State Governments (CSG), Association of Dental Support Organizations, Kansas Dental Association, and Kansas Dental Hygienists Association. The representative for CSG stated that the compact was created through a cooperative agreement between the federal Department of Defense (DoD) and CSG, as the DoD recognizes that interstate compacts are the best long-term solution for licensure issues for military spouses. Interested stakeholders will be meeting before the 2024 session The representative for the Association of Dental Support Organizations stated that a formal hearing on the bill is not requested at this time and interested stakeholders will be meeting to reach consensus on a bill that will be considered during the 2024 session. Committee members asked questions regarding whether out-of-state dentists licensed under the compact could own practices in Kansas, the number of professionals that could benefit from this legislation, if the compact would impact the availability of mobile dental services and adding a fee for licensure into the bill (other compact agreements include a $25 fee for an individual seeking licensure).

On Thursday, March 16, the Committee resumed work on SB 180 and considered a revised amendment to remove all the introductory “Whereas” clauses and add a new section to state that “individuals born with a medically verifiable diagnosis of disorder/differences in sex development shall be provided legal protections and accommodations afforded under the Americans with Disabilities Act (ADA) and applicable Kansas statutes.” During discussion of the amendment, Rep. John Eplee and Rep. William Clifford responded to Committee members’ questions regarding the medical conditions that would qualify for ADA protection, the protection or rights that would be afforded for individuals with these medical conditions, the definition of disability under the ADA, and how the bill would be enforced. The amendment was approved and the bill, as amended, was passed favorably out of Committee.

Senate Public Health and Welfare Committee

(Sen. Beverly Gossage, Chair)

On Monday, March 13, the Committee held a hearing on HB 2024, which would amend the Newborn Infant Protection Act within the Revised Kansas Code for Care of Children to provide an alternate means to legally surrender an infant pursuant to the Act. Proponent testimony was provided by a private citizen. Written-only proponent testimony was provided by Tanya Keys, Deputy Secretary, Kansas Department for Children and Families, and T. J. Wyssmann, Fire Chief, City of McPherson. Written-only opponent testimony was provided by a representative of the Adoptee Rights Law Center in Minnesota. Committee members asked questions regarding how authorities would know if a child was of American Indian heritage, the structure and safety features of the newborn safety device, what would happen if a parent would change their mind after surrendering an infant, organizational responsibilities for building and monitoring the newborn safety device and 24-hour monitoring, and what types of facilities could host a newborn safety device. The Committee subsequently worked the bill on March 14, and passed it favorably out of Committee.

On Tuesday, March 14, the Committee held a hearing on HB 2338, which would designate Sickle Cell Disease Awareness Week as the third full week of September and would require an annual review of the topic by an advisory council established by the Secretary of KDHE to advise KDHE on newborn screening guidelines. The bill would authorize KDHE, under the guidance of any appropriate advisory council, to develop a publicly available report from the advisory council meetings and activities. An average of six children born in Kansas each year are diagnosed with sickle cell disease. Proponent testimony was provided by a representative of the Uriel E. Owens Sickle Cell Disease Association of the Midwest, a Kansas City-based organization that serves the sickle cell community. Written-only proponent testimony was provided by Alyson Dalrymple, Deputy Director, Bureau of Family Health, KDHE. Committee members asked questions about the newborn screening panel and inheritance of the genetic mutation.

The Committee then worked HB 2033, which would change the criteria used to refer youths to juvenile crisis intervention centers (CICs) by adding definitions for “behavioral health crisis” and changing the phrase “mental health crisis” to “behavioral health crisis” in multiple statutes. In the Revised Kansas Code for Care of Children, the term “behavioral health crisis” would mean “behavioral and conduct issues that impact the safety or health of a child, members of the child’s household or family, or members of the community, including, but not limited to, non-life-threatening mental health and substance abuse concerns.” The Committee approved a technical amendment to the bill and passed it favorably out of Committee, as amended.

On Wednesday, March 15, the Committee held a hearing on HB 2325, which would add maternity centers to the definition of “healthcare provider” for purposes of the Healthcare Provider Insurance Availability Act. Currently, only maternity centers owned by a doctor or nurse midwife meet the requirements and have access to coverage under the Act. Proponent testimony was provided by an owner of a birthing center and an insurance agent. Neutral testimony was provided by Clark Schultz, Executive Director, Health Care Stabilization Fund. Committee members asked questions about the ownership of birthing centers, the proviso last year that addressed a similar bill, and the standards of birthing centers.

The Committee also held a hearing on HB 2263, which would amend a provision in the Pharmacy Act of the State of Kansas to add pharmacy technicians, at least 18 years of age and under the direct supervision and control of a pharmacist, to the list of those authorized to administer vaccinations after successfully completing a course of study and training in vaccination storage, protocols, injection technique, emergency procedures, recordkeeping, and cardiopulmonary resuscitation (CPR). The bill also would require a pharmacist, pharmacy student, or pharmacy intern to be at least 18 years of age to administer a vaccine. Pharmacy technicians would be added to pharmacists, pharmacy students, and pharmacy interns as authorized to administer the influenza vaccine to persons six years of age or older; and vaccines, other than the influenza vaccine, to persons 12 years of age or older pursuant to a vaccination protocol. Proponent testimony was provided by Alexandra Blasi, Executive Secretary, Kansas Board of Pharmacy, and Aaron Dunkel, Executive Director, Kansas Pharmacists Association. Blasi reported that the Board has not seen an increase in errors or complaints related to pharmacy technicians administering vaccines, and it has been a helpful addition to pharmacy services. Written-only proponent testimony was provided by several pharmacists and written-only neutral testimony was provided by the Kansas Medical Society. Committee members asked questions about pharmacy interns and training.

The Committee also worked HB 2034, which would create in the Revised Kansas Code for Care of Children a program within KDHE for the training of and payment for Child Abuse Review and Evaluation (CARE) providers who conduct CARE exams. The bill would establish definitions, requirements, and procedures related to CARE examinations and CARE providers and create the CARE Fund. The bill would amend the Code to require the Secretary of the Kansas Department for Children and Families (DCF) or a law enforcement agency, upon investigation by law enforcement or assignment by the Secretary of any investigation of physical abuse or physical neglect that concerns a child five years of age or younger, to make a CARE referral for such child. The bill would allow, in any other investigation of physical abuse, emotional abuse, medical neglect, or physical neglect conducted pursuant to the section, the Secretary, the law enforcement agency, or the agency’s designee to make a CARE referral for such child. The Committee amended the bill to (1) set the payment rate for a CARE exam in an amount not to exceed $750, (2) ban a provider found to have submitted fraudulent charges from the CARE network, (3) require the Secretary of KDHE to report such incident to the provider’s licensing board, and (4) require such licensing board to investigate whether unprofessional conduct occurred. The bill was then passed favorably out of Committee, as amended.

On Thursday, March 16, the Committee held a hearing on HB 2264, which would establish the No Patient Left Alone Act. The Act would establish who may visit a patient in a patient care facility and would require patient care facilities to provide for in-person visitation and provide parameters for patient care facilities as to what restrictions may be asked of visitors when visiting a patient. The bill would specify that a patient care facility would not be able to take action to prevent a patient from receiving in-person visitation from any person designated by the patient if the patient has the capacity to make such designation. If the patient does not have the capacity for such designation, the patient’s agent for healthcare decisions established by a durable power of attorney would be allowed to designate visitors. Visitors could include, but would not be limited to:

• An immediate family member, domestic partner, or significant other;
• The agent for healthcare decisions established by a durable power of attorney for healthcare decisions;
• An essential caregiver; or
• A minister, priest, rabbi, or clergyperson of any religious denomination or sect to which the patient is an adherent.

The bill would prohibit patient care facilities from preventing a patient who is terminally ill or receiving end-of-life care from receiving in-person visitation from two individuals at a time. The bill also would establish that a patient may refuse in-person visitation or revoke previously granted in-person visitation from any person at any time. The bill would provide that patient care facilities may establish visitation policies by September 1, 2023, including, but not limited to, infection control protocols and education for visitors, a set schedule of dates and times when visitation is allowed, allowable visit length, and limits on number of visitors, and would not prohibit a patient care facility from taking the steps necessary to ensure eligibility with federal programs or financial participation and would not supersede any federal laws, rules, regulations, or guidance regarding patient care facilities.

Proponent testimony was provided by Rep. John Eplee and Rachel Monger, LeadingAge Kansas, who had originally provided opponent testimony during the House Health and Human Services Committee hearing on February 7. Written-only proponent testimony was provided by representatives of the Kansas Hospital Association and HCA Midwest Health. Opponent testimony was provided by a representative of Kansans for Health Freedom and two private citizens. Written-only opponent testimony was provided by a Kansas attorney and 16 private citizens. Written-only neutral testimony was submitted by a representative of the Kansas Medical Society.

The Committee began working HB 2390, which would enact the Kansas Overdose Fatality Review Board Act and exempt materials used to test for the presence of fentanyl, ketamine, flunitrazepam, and gamma hydroxybutyric acid (GHB) from the definition of “drug paraphernalia.” The bill would establish the Kansas Overdose Fatality Review Board to review information and data related to drug overdose fatalities in Kansas and to make recommendations regarding evidence-based strategies to prevent or mitigate the consequences of drug overdose. The bill would require the Board to be established before January 1, 2025. No final action was taken.

House Child Welfare and Foster Care Committee

(Rep. Susan Concannon, Chair)

 On Wednesday, March 15, the Committee held a hearing on SB 115, which would amend law governing the notice required in a hearing on a petition for adoption in the Kansas Adoption and Relinquishment Act. The bill would reorganize and clarify provisions related to notice required for independent and stepparent adoptions, private agency adoptions, and public agency adoptions. The bill would require notice in an independent and stepparent adoption to be given to:

• The parents, presumed parents, or possible parents;
• Any person who has physical custody of the child; and
• Any legal guardian of the child.

Proponent testimony was provided by Austin Vincent, Kansas Judicial Council and a representative of Saint Francis Ministries. There was no opponent or neutral testimony. Committee members asked questions regarding the number of public agency adoptions in Kansas (948 in fiscal year 2022), the notice requirements for biological parents before an adoption is finalized, whether the bill may expedite the adoption process (yes), and the implications of the termination of parental rights.

The Committee then worked HB 2299, which would amend law in the Kansas Code for Care of Children governing orders granting custody for adoption when parental rights have been terminated and would require the court to be guided by the best interests of the child. The bill would specify when a child is placed in the custody of the Secretary of DCF for the purposes of adoption when parental rights have been terminated or relinquished, the Secretary would be required to give preference, subject to the best interests of the child, in the following manner:

• If a child has been in the custody of the Secretary for less than one cumulative year:
  • First to a relative, and
  • Second to a person with whom the child has close and healthy attachments.
• If a child has been in the custody of the Secretary for one cumulative year or more:
  • To a placement that maintains the child’s close and healthy attachments.

The bill would allow a foster parent that is not selected by the Secretary for the adoptive placement but who meets the criteria above, to request direct placement of the child by the court and appeal such decision to the Kansas Court of Appeals.

The bill also would require the Secretary to consider a foster parent as a prospective adoptive parent when:

• The child has lived more than half of the child’s lifetime with the foster parent;
• The child has lived more than two years with the foster parent; or
• The Secretary otherwise determines it is in the best interests of the child.

The bill also would amend law governing jurisdiction of proceedings under the Code to specify if orders granting custody for adoption involve an American Indian child, the federal Indian Child Welfare Act (ICWA) would apply instead of the Code.

The bill was amended to:

• Change the bills effective date;
• Make the bill’s provisions retroactive to pending proceedings on the effective date of the bill;
• Further clarify how the Secretary shall give preference to adoptive placements;
• Further clarify what data the Secretary must collect under the bill’s provisions; and
• Clarify ICWA would apply in orders granting custody involving an American Indian child.

The bill was then passed favorably out of Committee, as amended.

The Committee also worked HB 2194, which would enact the Representative Gail Finney Memorial Foster Care Bill of Rights within the Revised Kansas Code for Care of Children and would enumerate the rights of children in need of care in the child welfare system and the rights of foster parents. The bill was amended to:

• Specify that ICWA applies over the Bill of Rights when an American Indian child is involved in a Child in Need of Care (CINC) case;
• Add a right provided to foster youth concerning retaliation;
• Clarify a right provided to foster parents and kinship caregivers concerning discrimination;
• Specify notification requirements of the Secretary and case management providers;
• Add a definition of “kinship caregiver” to the Code; and
• Add references to kinship caregivers throughout the bill.

The bill was then passed favorably out of Committee, as amended.

Finally, the Committee worked HB 2443, which would establish the Office of the Child Advocate as an independent state agency and the child advocate advisory board; prescribe certain powers, duties, and functions; and allow disclosure of confidential records to the child advocate. The purpose of the office is to ensure that children and families receive adequate coordination of child welfare services, child maltreatment prevention, protection, and care through services offered by DCF or DCF’s contracting entities, the Kansas Department for Aging and Disability Services (KDADS), the Department of Corrections, KDHE and juvenile courts. The bill was amended the bill to:

• Modify membership of the Board;
• Allow for the suspension or removal of Board members and for the filling of vacancies created by such action;
• Provide for the election of Board leadership positions;
• Add a limitation with respect to complaints filed and reviewed by the Child Advocate; and
• Add an additional qualification that could be considered when appointing the Child Advocate.

The bill was then passed favorably out of Committee, as amended.

House Insurance Committee

(Rep. William Sutton, Chair)

On Monday, March 13, the Committee worked SB 24, which would amend the definitions of “small employer” and “large employer” in K.S.A. 40-2,194, a statute pertaining to insurance coverage for autism spectrum disorder. The bill would amend the definition of “small employer” from an average of at least one but not more than 100 employees to an average of at least two but not more than 50 employees. The bill also would amend the definition of “large employer” from an average of at least 101 employees to an average of at least 51 employees. Since there was no opposition to the bill and a motion to put it on the consent calendar was approved by the Committee.

House Federal and State Affairs Committee

(Rep. Will Carpenter, Chair)

On Thursday, March 16, the Committee worked HB 2438, which would remove the requirement that a member of the Board of Emergency Medical Services (EMS) must be a certified instructor-coordinator and instead would require a member to be actively involved in teaching initial courses of instruction for certification as an emergency medical services provider. The instructor-coordinator’s certificate is associated with the teaching of emergency medical services courses. The bill was amended to add licensed physician assistant to the definition of healthcare provider and remove outdated language related to examinations and training that is no longer available to practitioners and was passed favorably out of Committee, as amended.

The committee also worked SB 116, which would create law related to firearm safety education programs conducted in public school districts. This is a companion bill to HB 2304. The Committee recommended a substitute bill incorporating the contents of HBs 2058, 2059, 2124 and 2170 (all related to wine and spirits) and deleted the provisions related to firearm safety education programs. The Committee then passed Substitute for SB 116 favorably out of Committee.

Senate Federal and State Affairs

(Sen. Mike Thompson, Chair)

On Wednesday, March 15, the Committee held a hearing on SB 135, which would create the Medical Cannabis Regulation Act. The bill would provide for licensure and regulation of the cultivation, processing, distribution, sale, and use of medical cannabis; delegate administrative duties and functions to the Secretary of KDHE, Secretary of Revenue, Board of Healing Arts, Board of Pharmacy, and Director of Alcohol and Cannabis Control; impose fines and penalties for violations of the act; establish the medical cannabis registration fund, the medical cannabis business regulation fund and the retail dispensary consultant registration fee fund; create the crimes of unlawful storage and unlawful transport of medical cannabis; and make exceptions to the crimes of unlawful manufacture and possession of controlled substances. Proponents included representatives of Kansas Natural Remedies, Kansas Cannabis Coalition, Kansas Silver Haired Legislature, Kansas Chiropractic Association, Kansas Cannabis Industry Association, Kansas Cannabis Chamber of Commerce and five private citizens. Written-only proponent testimony was submitted by representatives of the Kansas Hemp Growers, Greenlight Corporation, Solvent Smith Consulting, Robert Anderson, Ellis County Attorney, and 15 private citizens. Neutral testimony was provided by Sen. Tom Holland; Debbi Beavers, Director, Alcoholic Beverage Control Division, Kansas Department of Revenue; Doug Jorgensen, Kansas State Fire Marshal; Courtney Cyzman, Kansas State Board of Healing Arts; and representatives of the International Association of Machinists and Kansas Chamber of Commerce. Committee members asked questions regarding the membership of the Medical Cannabis Advisory Committee, the content of THC in edibles, and the addition of new approved medical conditions.

On Thursday, March 16, the Committee continued the hearing on SB 135. Opponent testimony was provided by Sen. Mark Steffen; Brian Surber, Oklahoma Bureau of Narcotics; Tony Mattivi, Director, Kansas Bureau of Investigation; and representatives of the Kansas Association of Chiefs of Police/Kansas Sheriffs Association/Kansas Peace Officers Association, Kansas Medical Society, Johnson County District Attorney’s Office, Culture Shield Network, American Family Action, and two private citizens. Written-only opponent testimony was submitted by representatives of Stand Up Kansas, the Johnson County Sheriff’s Office, Riley County Police Department, Kansas Catholic Conference, Kansans for Health Freedom, Anchor Her, Kansas Family Voice, and 19 private citizens. Committee members asked questions regarding provisions in the bill requested by law enforcement officials, concerns about children getting access to marijuana, and a Wichita ordinance that exempts the city from prosecuting marijuana cases. 

House Welfare Reform Committee

(Rep. Francis Awerkamp, Chair)

 On Tuesday, March 14, the Committee held a hearing on HB 2179, which would eliminate the requirement that families receiving childcare assistance cooperate with child support services. Proponent testimony was presented by Tanya Keys, Deputy Secretary, DCF. Keys stated that Kansas is currently not in compliance with federal law that requires a family that qualifies for childcare assistance to be eligible for 12 months. She also reported that this change will require modifications to the state’s electronic information system, which will cost $500,000. However, she noted that federal funds are available to cover this expense. Written-only proponent testimony was submitted by representatives of Child Care Aware of Kansas, Kansas Action for Children, Kansas Children’s Service League, the Family Conservancy, and United Community Services of Johnson County. Opponent testimony was provided by a representative of Opportunity Solutions Project, who requested that the Committee consider an amendment to allow continuous eligibility for 12 months rather than removing the non-cooperation requirement, as provided for in the bill. This option was suggested by the federal government as a possible option to bring Kansas into compliance. Committee members asked questions regarding notices the state has received from the federal government regarding the noncompliance (two notices have been received, one each in 2021 and 2022), the potential monetary penalty for noncompliance, and clarification regarding the suggested amendment.

On Thursday, March 16, the Committee worked HB 2179 and amended the bill to maintain the periods of ineligibility for a childcare subsidy based on a parent’s non-cooperation with child support services in current law, with the exception that reviews to determine child support compliance would be limited to specific times. Deputy Secretary Keys stated this amendment would address DCF’s concerns regarding compliance with federal law. The bill also was amended to replace references to “childcare benefits” to “childcare subsidy.”  Committee members asked questions regarding the impact of the amendment on child support cooperation and the application process for childcare subsidies. The bill was then passed favorably out of Committee, as amended.

The Committee also heard a presentation by Sarah Fertig, Medicaid Director, regarding Medicaid 101 and Recent Changes in Medicaid Funding, including the Medicaid eligibility redetermination process. Committee members asked questions regarding the age criteria for Medicaid eligibility, the estimated cost of expanding Medicaid, waivers, coverage for optional services, and the rates of payment for providers. Fertig also provided a detailed explanation regarding the per member per month payments made to the managed care organizations who coordinate care for KanCare beneficiaries.

Finally, Chair Awerkamp announced that a roundtable discussion regarding homelessness in Kansas will be scheduled. He stated that the goal of the discussion would be to gain an understanding of the causes of homelessness and identify realistic options to reduce the number of people experiencing homelessness and help them achieve self-sustainability. Conferees will include those who have worked closely with people experiencing homelessness, representatives of the business community, and individuals working in mental health, law enforcement, city government, childcare and human trafficking.

House Appropriations Committee

(Rep. Troy Waymaster, Chair)

On Wednesday, March 15, the Committee reviewed the 21 items recommended by the Social Services Budget Committee for the KDADS budget for Fiscal Year 2024. Rep. Les Mason, referring to a handout prepared by Rep. Barbara Ballard, provided a summary of the items and a brief description of the basis for the recommendations made by the Budget Committee. Committee members did not discuss the items but Chair Waymaster encouraged the members to refer to the handout prepared by Rep. Ballard when the Committee starts to put together the Mega budget bill during the week of March 20 and to reach out to Rep. Mason, as well as Rep. Ballard and Rep. Landwehr, if they have questions about the recommendations before those discussions begin.

 

 

On Wednesday, March 8, the Governor announced that the Kansas Department for Aging and Disability Services (KDADS), through its Kansas Community Suicide Prevention Grant program, has awarded $525,000 to 15 community organizations to develop strategies to prevent suicide among at-risk Kansans. The 15 grantees, located in Arkansas City, Belleville, Chanute, Clay Center, Garden City, Lawrence, Manhattan, Mission, Olathe, Paola, Seneca, Shawnee and Wichita, will be required to create plans that include conducting a community assessment, building suicide prevention infrastructure, addressing cultural competency, and ensuring suicide prevention efforts are evidence-based. The grants are intended to serve individuals of all ages.

Also on March 8, Gov. Kelly announced that Kansas is the first state to receive $15 million in U.S. Department of Treasury Digital Connectivity Technology funds. The funds will support equal access to high-speed internet, provide devices to underserved Kansans, and expand digital skills training for communities across Kansas. The Kansas Office of Broadband has been conducting meetings across the state to solicit feedback for a five-year broadband access and digital equity strategic plan.  The listening sessions have highlighted the need for laptops/computers, public wi-fi, and digital training programs.

House Health and Human Services Committee

(Rep. Brenda Landwehr, Chair)

On Monday, March 6, the Committee held a hearing on Senate Bill (SB) 180, which would establish the Women’s Bill of Rights and specify that for purposes of any state law or rules and regulations an individual’s “sex” means such individual’s biological sex, either male or female, at birth. The bill would state that with respect to biological sex, separate accommodations are not inherently unequal and would state that laws, rules and regulations that distinguish between the sexes are subject to intermediate constitutional scrutiny. SB 180 also would require schools, state agencies, or political subdivisions that collect vital statistics to identify individuals within the data as either male or female at birth. Opponents included representatives of the Mid-America LGBT Chamber of Commerce, Kansas Legal Services, Kansas Interfaith Action, ACLU of Kansas, Equality Kansas, United School Administrators (USA) of Kansas, Kansas School Superintendents’ Association, Kansas Coalition Against Sexual and Domestic Violence, and five private citizens. Written-only opponent testimony was submitted by 49 private citizens, representatives of the Central States Synod of the Evangelical Lutheran Church in America, Kansas National Education Association, and Mainstream Coalition. Proponents included representatives of Independent Women’s Voice and the Women’s Liberation Front. Written-only proponent testimony was submitted by Kansas Family Voice and the Kansas Catholic Conference and written-only neutral testimony was submitted by the Kansas Department of Corrections. Committee members asked questions regarding the difference between gender and sex, potential legal implications of the bill, and the government’s use of the vital statistics data referenced in the bill. The bill was subsequently passed favorably out of Committee on March 7.

On Tuesday, March 7, the Committee heard a presentation by Leah Gagnon, Community Health Center of Southeast Kansas (CHC/SEK). Gagnon provided an overview of CHC/SEK, including its history, number of patients served annually, workforce, and services provided by community health workers. Committee members asked questions regarding reimbursement rates, healthcare literacy, workforce strategies, and partnerships with diverse communities.

The Committee also held a hearing on House Bill (HB) 2429, which would establish the Alternatives to Abortion Program and Alternatives to Abortion Public Awareness Program, to be  administered by the Kansas Department for Children and Families (DCF). The Alternatives to Abortion Program would serve as a statewide program to enhance and increase resources that promote childbirth to women facing unplanned pregnancies. The Alternatives to Abortion Public Awareness Program would help pregnant women who are at risk of having abortions to be made aware of the alternatives to abortion services that are available. DCF also would be required to match monies appropriated to both programs, which would be contracted by the State Treasurer to a nonprofit organization. Proponents included representatives of Kansans for Life, Kansas Catholic Conference, Nativity House KC, Catholic Charities of Northeast Kansas and Embrace of Wichita. Written-only proponent testimony was submitted by two private citizens. Written-only opponent testimony was submitted by a representative of Planned Parenthood Great Plains Votes and three private citizens. Committee members asked questions regarding current funding of pregnancy resource centers, client demographics, referrals, and the current pregnancy maintenance initiative administered by the Kansas Department of Health and Environment (KDHE).

On Wednesday, March 8, the Committee held a hearing on HB 2313, which would enact the Born-Alive Infants Protection Act. The bill would define “born alive” to mean the complete expulsion or extraction of a human being from its mother, at any stage of development, who, after such expulsion or extraction, breathes or has a beating heart, pulsation of the umbilical cord or definite movement of voluntary muscles, regardless of whether the umbilical cord has been cut and regardless of whether the expulsion or extraction occurs as a result of natural or induced labor, cesarean section or induced abortion. The bill also would establish requirements for healthcare providers and employees of medical facilities in situations when an abortion or attempted abortion resulted in a child being born alive and would define criminal and civil actions allowed for violations of the Act. Medical care facilities in which an infant was born alive would be required to submit an annual report to KDHE. Proponents included Rep. Ron Bryce, a representative of Kansans for Life and two private citizens. Written-only proponent testimony was submitted by representatives of the Kansas Catholic Conference and Kansas Family Voice and a private citizen. Written-only opponent testimony was submitted by a representative of the ACLU of Kansas. Committee members asked questions regarding levels of care for anencephalic infants, the gestational age language in the bill, and the timing of transporting a born alive infant to a hospital. The Committee then worked the bill and passed it favorably out of Committee.

The Committee also worked HB 2429 (see above) and amended the bill to (1) limit the term of the contract with a nonprofit organization to two years, (2) authorize the State Treasurer to assess an administrative fine against any nonprofit organization awarded a contract under the bill for failure to satisfy the requirements of the bill or for intentional or reckless misuse of any funds awarded under a contract, and (3) require the nonprofit organization to submit an annual report regarding the administration of the Alternatives to Abortion Program, including the number of clients enrolled in the program, number of newborns born to program participants, and number of newborns placed for adoption. The bill was then passed favorably out of Committee, as amended.

Senate Public Health and Welfare Committee

(Sen. Beverly Gossage, Chair)

On Monday, March 6, the Committee held a hearing on HB 2033, which would change the criteria used to refer youths to juvenile crisis intervention centers (CICs) by adding definitions for “behavioral health crisis” and changing the phrase “mental health crisis” to “behavioral health crisis” in multiple statutes. In the Revised Kansas Code for Care of Children, the term “Behavioral health crisis” would mean “behavioral and conduct issues that impact the safety or health of a child, members of the child’s household or family, or members of the community, including, but not limited to, non-life-threatening mental health and substance abuse concerns.” There are currently no CICs operating in Kansas. Opponent testimony was provided by a private citizen, who expressed concern that the term “behavioral health crisis” is too broadly defined and could result in violations of constitutional rights. Written-only proponent testimony was submitted by Tanya Keys, Deputy Secretary, DCF and KDADS, and representatives of the Johnson County Mental Health Center and Children’s Alliance of Kansas.

On Tuesday, March 7, the Committee heard a presentation from Leah Gagnon, CHC/SEK, similar to the presentation she made in House Health and Human Services on March 7 (see above). Committee members asked questions regarding how individuals learn about safety net services, the health center’s relationships with schools and hospitals, how patients are prioritized for community health worker services, and medical reimbursement models.

On Wednesday, March 8, the Committee worked HB 2034, as amended by the House, which would create in the Revised Kansas Code for Care of Children a program within KDHE for the training of and payment for Child Abuse Review and Evaluation (CARE) providers who conduct CARE exams. The bill would establish definitions, requirements, and procedures related to CARE examinations and CARE providers and create the CARE Fund. The bill would amend the Code to require the Secretary of DCF or a law enforcement agency, upon investigation by law enforcement or assignment by the Secretary of any investigation of physical abuse or physical neglect, pursuant to this provision, that concerns a child five years of age or younger, to make a CARE referral for such child. The bill would allow, in any other investigation of physical abuse, emotional abuse, medical neglect, or physical neglect conducted pursuant to the section, the Secretary, the law enforcement agency, or the agency’s designee to make a CARE referral for such child. Proponent testimony was provided by representatives of the Kansas Association of Chiefs of Police, Kansas Sheriffs’ Association, Kansas Peace Officers Association, and Kansas Chapter of the American Academy of Pediatrics. Written-only proponent testimony was submitted by DCF, KDHE and the Children’s Alliance of Kansas. There was no opponent testimony. Committee members asked questions regarding the referral process, previous bills on the exchange of information between law enforcement and DCF, current system of physicians preforming examinations in cases of abuse, the CARE Network pilot, and opportunities for training outside of the CARE Network.

On Thursday, March 9, the Committee held a hearing on HB 2390, as amended by the House, which would enact the Kansas Overdose Fatality Review Board Act and exempt materials used to test for the presence of fentanyl, ketamine, flunitrazepam, and gamma hydroxybutyric acid (GHB) from the definition of “drug paraphernalia.” The bill would establish the Kansas Overdose Fatality Review Board to review information and data related to drug overdose fatalities in Kansas and to make recommendations regarding evidence-based strategies to prevent or mitigate the consequences of drug overdose. The bill would require the Board to be established before January 1, 2025, and also require the Board to submit its findings and recommendations to the House Health and Human Services and Senate Public Health and Welfare committees. Proponent testimony was provided by Representative William Clifford, M.D.; Ashley Goss, Deputy Director, KDHE; Andy Brown, Commissioner Behavioral Health Services, KDADS; representatives of the Association of Community Mental Health Centers of Kansas, United Government Wyandotte County Public Health Department, and Reno County Health Department; and a private citizen. Written-only proponent testimony was submitted by representatives of the Kansas Hospital Association, BrightHouse, Kansas National Education Association, Wichita Police Department, Kansas Academy of Family Physicians, Kansas Association of Local Health Departments, DCCCA, and Sedgwick County Health Department, and private citizens. Opponent testimony was provided by one private citizen. Committee members asked questions about the national advocacy efforts to protect teens from fentanyl exposure, the payment of review board members, options for tracking the testing strips, overlap with the Child Death Review Board, confidentiality, and why this board is needed in addition to current agencies.

House Child Welfare and Foster Care Committee

(Rep. Susan Concannon, Chair)

On Monday, March 6, the Committee held a hearing on HB 2443, which would establish the Office of the Child Advocate as an independent state agency and the Child Advocate Advisory Board; prescribe certain powers, duties and functions; and allow disclosure of confidential records to the Child Advocate. The purpose of the office is to ensure that children and families receive adequate coordination of child welfare services, child maltreatment prevention, protection, and care through services offered by DCF or DCF’s contracting entities, KDADS, the Department of Corrections, KDHE and juvenile courts. Proponent testimony was provided by representatives of Kansas Appleseed and Children’s Alliance of Kansas. Written-only proponent testimony was submitted by the Association of Community Mental Health Centers of Kansas and Center for the Rights of Children. There was no opponent or neutral testimony. Committee members asked questions regarding the existing Office of the Child Advocate established by executive order, the need for additional funding for the Office, differences between the House and Senate bills to create the Office, removal of members of the advisory board, and selection of members of the Advisory Board.

On Wednesday, March 8, the Committee held an informational hearing on foster care and mental health and heard presentations from Tanya Keys, Deputy Secretary of DCF, and representatives of KVC, Saint Francis Ministries, Association of Community Mental Health Centers of Kansas, and the Kansas Health Institute. Presenters discussed the high prevalence of mental health and substance use disorders in families involved in the foster care system; challenges in accessing mental health services for children and adults; recent legislative efforts, such as implementation of the 988 Suicide and Crisis Lifeline; the potential impact of Medicaid expansion on the behavioral health system and foster care; and the shortage of mental health providers in certain areas of the state. Committee members asked questions regarding the recidivism rate of children returning to foster care, areas of the state with a shortage of behavioral health providers, the mobile family crisis response provided by Carrillon, data showing the impact of the implementation of the 988 Suicide and Crisis Lifeline, possibility of an increase in children entering foster care as individuals lose Medicaid coverage over the next few months, and whether there are strategies or policies that other states have adopted that may address some of the issues of access to care in the absence of Medicaid expansion.

House Insurance Committee

(Rep. William Sutton, Chair)

On Wednesday, March 8, the Committee worked SB 26, which would amend law relating to the financial documentation demonstrating fiscal soundness that must be submitted by a health maintenance organization (HMO) or a Medicare provider organization (MPO) when applying for a certificate of authority to provide healthcare in the state. The bill would:

• Require financial projections for a minimum of three years from the date of application;
• Limit the projections for each deficit year and for one year thereafter required when an HMO or MPO expects to incur a deficit to a maximum of five years;
• Eliminate the requirement for monthly statements of revenue and expense for the first year on a gross dollar and a per-member-per-month basis; and
• Change the required balance sheet for all financial projections from quarterly to yearly.

The Committee amended the bill to change its effective date to be upon publication in the Kansas Register and passed it favorably out of Committee, as amended.

House Federal and State Affairs Committee

(Rep. Will Carpenter, Chair)

On Tuesday, March 7, the Committee held a hearing on HB 2438, which would remove the requirement that a member of the Board of Emergency Medical Services (EMS) must be a certified instructor-coordinator and instead would require a member to be actively involved in teaching initial courses of instruction for certification as an emergency medical services provider. The instructor-coordinator’s certificate is associated with the teaching of emergency medical services courses. Proponent testimony was provided by Joseph House, Executive Director, Kansas EMS Board. Neutral testimony was provided by a representative of the Kansas Academy of Physician Assistants, who requested the Committee consider an amendment to update the language in the bill regarding the definition of a physician assistant. Committee members asked questions about challenges the bill would address, the effect the bill would have on the EMS workforce (increased number of training courses) and the deletion of language related to civil liability (provisions no longer needed if the requirement for the certification is removed).

On Wednesday, March 8, the Committee held a hearing on SB 116, which is the companion bill to HB 2304, and would provide that for the purposes of promoting the safety and protection of students and emphasizing how students should respond when encountering a firearm, school districts could provide firearm safety education programs. The State Board of Education would be required to establish curriculum guidelines for a standardized firearm safety education program that would include accident prevention. For students enrolled in kindergarten through grade five, the curriculum would be based on the “Eddie Eagle Gunsafe Program” offered by the National Rifle Association. For grades six through eight, the curriculum would be based on the “Eddie Eagle Gunsafe Program” or the “Hunter Education in Our Schools Program” offered by the Department of Wildlife and Parks. For grades nine through 12, the curriculum would be based on the “Hunter Education in Our Schools Program.” If a local board of education would elect to provide firearm safety education, the instruction would be required to be in accordance with the guidelines established by the State Board of Education. The local board of education also would be required to ensure that all students are provided the opportunity to take the course. Proponent testimony was provided by Rep. Patrick Penn and written-only proponent testimony was submitted by a member of the Kansas State Rifle Association. Written-only opponent testimony was submitted by a representative of the Kansas National Education Association. Committee members asked questions regarding the position of the Kansas State Board of Education on the bill (have not taken a position) and the availability of other curriculum options beyond the Eddie Eagle Gunsafe Program (yes).

House Welfare Reform Committee

(Rep. Francis Awerkamp, Chair)

On Tuesday, March 7, the Committee held an informational hearing regarding the concept of “good cause” related to exemptions from noncompliance with work requirements for welfare programs, including Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP). Tanya Keys, Deputy Secretary, DCF, presented the state’s policy and response when non-exempt persons who are receiving TANF or food assistance benefits may have failed or appear to be refusing to fulfill the work requirements for those programs without good cause. Keys and another DCF staff member described the process for contacting and engaging with these individuals to determine if there is good cause for their noncompliance, how individuals document their compliance with the requirements, the types of activities that qualify to meet the requirements, categories of reasons why DCF may determine there was good cause for noncompliance, and the circumstances that lead to termination of benefits when good cause is not determined. Committee members asked questions regarding options for volunteer work to satisfy the 30-hour work requirement, the verification process for determining whether the individual has satisfied the requirement, the two-month postpartum time period that allows mothers to be exempt from the work requirement to stay home with their infants, and whether the two-month postpartum period applies to individuals who have undergone an abortion procedure.

On Thursday, March 9 the Committee worked HB 2140, as amended by the Committee prior to Turnaround, which would amend law pertaining to eligibility requirements for SNAP. The bill would require DCF to assign registrants ages 50 through 59 without dependents who are not exempt under U.S.C. § 2015(d)(2) to an employment and training program as a condition of participation in SNAP. Under current law, only able-bodied adults ages 18 through 49 without dependents and individuals who are not employed at least 30 hours per week are required to participate in an employment and training program to receive SNAP benefits. U.S.C. § 2015(d)(2) is a federal law that exempts the following work registrants between the ages of 16 and 59 from a work requirement:

• An individual currently subject to and complying with a work registration requirement under another federal program or the federal-state unemployment compensation system;
• A parent or other member of a household with responsibility for the care of a dependent child under six years of age or of an incapacitated person;
• A bona fide student enrolled at least half time in any recognized school, training program, or institution of higher education (except that any such person enrolled in an institution of higher education must meet additional requirements);
• A regular participant in a drug addiction or alcoholic treatment and rehabilitation program;
• An individual employed a minimum of 30 hours per week or receiving weekly earnings that equal the federal minimum hourly rate, multiplied by thirty hours; or
• A person between the ages of 16 and 18 who is not a head of a household or who is attending school, or enrolled in an employment training program, on at least a half-time basis.

Committee members continued to discuss whether there were concerns regarding whether the amendment approved prior to Turnaround creates a conflict with federal guidelines. Chair Awerkamp reported that he had consulted with an attorney who stated there should be no conflict.  The Committee then passed the bill, as previously amended, favorably out of Committee.

During week 3 of the session, legislators held informational hearings on long-term care facilities and providers, local health departments, the home and community based services (HCBS) waivers managed by the Kansas Department for Aging and Disability Services, and the unwinding of the increased enrollment in KanCare during the federal public health emergency. They also began hearings on bills related to child welfare issues.

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 Tuesday, January 24, Gov. Kelly delivered her 2023 State of the State address and highlighted her legislative priorities for the session, including immediate elimination of the sales tax on food as well as the tax on diapers and feminine hygiene products, a four-day state sales tax holiday for school supplies, full funding for Special Education, increased funding for the Office of Registered Apprenticeship to grow the state’s skilled workforce, Medicaid expansion, legalization of medical marijuana, the expansion of Mental Health Intervention Teams in schools, funding for adult psychiatric services in the Wichita area and addressing the shortage of mental health workers across the state, and decriminalization of fentanyl test strips.

On Wednesday, January 25, Gov. Kelly announced that Camber Children’s Mental Health (previously KVC Hospitals) may begin accepting patients and providing care in early February at its new youth mental health hospital in Hays. The opening of this facility, which is intended to meet the needs of youth up to 18 years of age in the western part of the state, arose from a partnership announced in December 2021 between Camber and the Kansas Department for Aging and Disability Services (KDADS).

Also on Wednesday, the Governor announced that 10 Kansas communities are receiving a total of $1,762,212 in grants from the Kansas Department for Children and Families (DCF) to assist with the creation of Family Resource Centers. The goal of these grants is to provide support for families in their own neighborhoods and decrease the need for families to have formal contact with the agency.

On Thursday, January 26, the Senate Republican Caucus elected Sen. Rick Kloos to the position of Senate Majority Whip.

House Health and Human Services Committee

(Rep. Brenda Landwehr, Chair)

On Monday, January 23, the Committee heard a presentation by Sonja Bachus, CEO, Community Care Network of Kansas (CCNK), who provided an overview of the three types of community-based primary care clinics that are members of CCNK, including 19 federally qualified health centers (FQHCs), 3 look-alikes (LALs), and 10 community-based clinics. In 2022, 332,087 unique patients received care in 1,043,199 visits to the clinics. She also noted that of the patients accessing healthcare services, 30.46 percent have coverage through Medicaid/CHIP, 29.08 percent have private insurance, 29.16 percent are uninsured, 10.91 percent have Medicare, and 0.40 percent have other public coverage (e.g., TriCare, VA Health Care). In 2021, FQHCs and LALs wrote off more than $50 million in sliding fee discounts and bad debt. Bachus explained that in addition to healthcare services, the clinics also provide translation services, care coordination, transportation and food pantries. She also shared that the biggest challenges for the clinics are workforce shortages, threats to the 340B program (a federal program that allows qualifying healthcare facilities to purchase prescription drugs at a discounted price), and lack of funding. Committee members asked questions regarding the 340B program concerns, the competition for grant funds among clinics, reimbursement rates for Medicaid patients, practicums for students, and potential cost savings if Medicaid were expanded.

On Thursday, January 26, the Committee heard from Linda MowBray, CEO, Kansas Healthcare Association and Kansas Center for Assisted Living, who noted that her organizations represent not only individuals living in nursing homes and assisted living facilities, but also the staff, management and profession as a whole. MowBray presented information regarding the classifications of care in Kansas, a risk map published by the Agency for Health Care Administration (AHCA) showing that 51 percent of long-term care facilities in Kansas are at risk for closure (either a wing or whole facility), a census of currently available beds, a recent jobs report showing the loss of workforce, and a document describing the future population of Kansas and the increase in older age groups.

Also on Thursday, January 26, the Committee heard from Rachel Monger, President and CEO, LeadingAge Kansas. Monger stated that her organization, which has 160 members, is a state association for nonprofit and faith-based senior care organizations. She reported that since the pandemic, 49 facilities have either closed, de-licensed, or closed portions of their facilities and noted that funding and workforce appear to be the two main causes for these closures. Monger shared that not only have labor costs increased due to contract labor and healthcare staffing agencies, but workforce numbers have shrunk by 10 percent while reliance on staffing agencies has grown by 90 percent at a cost increase of 270 percent. She noted that in November, facilities had to turn away 1,191 individuals due to staffing shortages. She stated that her organization’s legislative agenda for this session includes continued full funding for Medicaid reimbursement rates and provider costs, prohibiting staffing agencies from having non-compete and buyout clauses in their contracts, and support for workforce development and worker-friendly policies. Committee members asked questions about efforts to keep people in their homes and out of nursing facilities, and how prohibiting non-compete and buyout clauses would help facilities and whether there are examples or models from other states addressing this issue. Monger stated that last year Iowa addressed the non-compete clause issue in a bill.

Senate Public Health and Welfare Committee

(Sen. Beverly Gossage, Chair)

On Tuesday, January 24, the Committee heard from Dennis Kriesel, Executive Director, Kansas Association of Local Health Departments (KALHD), about the key services provided by the association to the 100 local health departments (LHDs) in Kansas. He also described the local, federal and state funding provided to LHDs and noted that the funding through the state formula provides a minimum of $7,000 per LHD, although the minimum was temporarily raised to $12,000 by proviso since state fiscal year (FY) 2021. KAHLD is seeking a bill to make the base $12,000 and adjust the formula to base plus population. Kriesel also presented a list of services directly provided by LHDs, including blood lead testing, breastfeeding support, car seats, chronic disease management, dental preventative services, diabetes education, family planning/women’s health, health promotion, health screening, immunizations, laboratory services, preparedness, school health services, and senior services.

On Wednesday, January 25, the Committee heard presentations from Children’s Alliance of Kansas, KidsTLC, FosterAdopt Connect, and Children’s Advocacy Centers of Kansas. Rachel Marsh, CEO, Children’s Alliance of Kansas, reported that Kansas has an unusually high number of adolescents entering care compared to the national norm and stated that providers have noted that courts are more often ordering adolescents to enter care to access services, and less often for reasons attributed to child maltreatment or neglect. Committee members asked questions regarding the reasons Kansas has higher numbers of older children in foster care, the cost savings of providing assistance to families at risk of having a child enter foster care, census and average length of stay in a psychiatric residential treatment facility, and reasons for problematic sexual behaviors in children.

On Thursday, January 26, the Committee heard a presentation from Wyatt Beckman, Senior Analyst,  Kansas Health Institute (KHI), who provided data regarding youth (age 15-24) suicide rates in Kansas, including trends and means of suicide. He noted that with 21.3 suicides per 100,000 for the period of 2016-2020, Kansas had the 10th highest suicide rate in the nation for that age group. Kansas had the 11th highest rate in the nation over the same time period for youth age of 10-14, at 3.6 suicides per 100,000. Committee members asked questions regarding the reasons why suicide rates are lower in some states, the gender differences when looking at suicide attempts and lethality of attempts, and the impact of the pandemic.

Also on Thursday, January 26, the Committee heard a presentation from Linda Sheppard, Senior Analyst & Strategy Team Leader at KHI, who presented information about the enrollment of 107,784 Kansans in health insurance coverage through the Kansas marketplace during the 2022 Open Enrollment Period, including demographic information, the use of Advanced Premium Tax Credits to pay for coverage, and premiums paid in the seven rating areas across the state. Committee members asked questions regarding the total number of health insurance plans available in Kansas, financial assistance specifically available to households with incomes of 100 to 250 percent of the federal poverty level, and whether the “family glitch” (the unaffordability of health insurance for family members of employees with employer coverage) had been addressed by the federal government.

Child Welfare and Foster Care Committee

(Rep. Susan Concannon, Chair)

On Monday, January 23, the Committee held a hearing on House Bill (HB) 2024, which would amend the Infant Protection Act to allow for the surrender of infants in a designated Infant Refuge Bassinet without civil penalty. The Infant Refuge Bassinet, or Baby Box, is a device or container designed to safely accept infants being surrendered. The bill outlines requirements for facilities that chose to install the bassinet, such as the location of the bassinet and an automatic lock, temperature control and alarm on the bassinet. The facility must also be staffed 24 hours a day, seven days a week so the bassinet can be checked at least twice a day and the alarm system frequently tested. In jurisdictions that have implemented similar programs, local fire departments, health departments and hospitals are common locations for refuge bassinets to be located. Committee members asked questions regarding the facilities that may or may not install a refuge bassinet, the cost of installation and maintenance, how to hold child abusers accountable when surrendering their children, and current statistics on how many infants are surrendered (20 infants in Kansas between 2018 and 2021).

On Wednesday, January 25, the Committee held a hearing on HB 2034, which would require a referral of an alleged victim of physical child abuse or neglect for an examination as part of an investigation, and create a program housed under the Kansas Department of Health and Environment (KDHE) to provide training and payment for such examinations. The legislation does not include examination for sexual abuse. A similar bill introduced during the 2022 session died in committee. Conferees included representatives of Kansas law enforcement associations and the Kansas Chapter of American Academy of Pediatrics, as well as Alyson Dalrymple, Deputy Director of KDHE, and Deanne Dinkel, Director of Safety & Thriving Families and Performance Improvement at DCF (written only). Committee members asked questions regarding why KDHE and DCF are jointly involved in this program and why there is a special payment method for the exam, the care referral process, non-cooperation from parents, and potentially allocating funding for training law enforcement to identify signs of physical abuse.

Social Services Budget Committee

(Rep. Les Mason, Chair)

On Monday, January 23, Secretary Laura Howard, Kansas Department for Aging and Disability Services (KDADS), presented an overview of the agency’s budget and indicated that most of the funding is for services for aging, people with disabilities and behavioral health. KDADS oversees four state hospitals, including two for individuals with intellectual and developmental disabilities and two psychiatric state hospitals, each with individual budgets. Committee members asked questions about difficulties in hiring staff, masking requirements in facilities, contracted nursing staff, the state’s ranking in national suicide rates, the federal medical assistance percentage (FMAP), and the community supports waiver.

On Thursday, January 26, Secretary Howard made a presentation about HCBS waivers in Kansas, including each specific waiver and the population served by that waiver. She explained that an HCBS waiver is an authorization from Medicaid that allows a beneficiary to get services at home or in a community setting, rather than being required to enter an institution such as a nursing facility. Kansas currently administers seven HCBS waivers, including autism, frail elderly (FE), intellectual and developmental disability (I/DD), physical disability (PD), serious emotional disturbance (SED), technology assisted (TA) and brain injury (BI). Sec. Howard noted that the I/DD waiver currently serves 9,044 Kansans and has 4,813 on the waiting list and the PD waiver currently serves 6,051 individuals and has 2,542 on the waiting list. The FE waiver serves a little over 6,759 Kansans and does not have a waiting list. The smallest waiver is the autism waiver, currently serving 53 people with 432 on the proposed recipient list. The remainder of waivers do not have waiting lists.

Secretary Howard stated that the Kansas University Center on Developmental Disabilities (KUCDD) is conducting a study of the I/DD waiver waiting list to gain a better understanding of the current and future service needs of the individuals on the list, develop a methodology to identify individuals at risk for crises, inform decisions regarding system capacity building, and reduce the waiting list for services. This project began in July 2022 and runs through March 2023.

House Appropriations Committee

(Rep. Troy Waymaster, Chair)

On Wednesday, January 25, the Committee heard a presentation by Christine Osterlund, Deputy Director of Medicaid Operations, KDHE, regarding the impact of the federal Omnibus Appropriations bill, passed in late December, on the Federal Medical Assistance Percentage (FMAP) for Medicaid. Osterlund noted that the state’s base rate is 59.76 percent but the state had been receiving 6.2 percentage point enhanced funding for Medicaid during the federal public health emergency. She reported that under the Omnibus bill, the enhanced funding will be reduced each quarter during 2023 until it ends on December 31. She noted that the federal Centers for Medicare and Medicaid Services will be providing guidance to states regarding reporting and notice requirements in conjunction with the state’s review of eligibility of the current 533,000 KanCare enrollees that will be occurring over 12 months and pointed out that the state’s failure to comply with all reporting and notice requirements could result in the loss of the enhanced funding. The first date that the state will be allowed to terminate coverage due to ineligibility will be April 1.

Senate Ways and Means Committee

(Sen. Rick Billinger, Chair)

On Tuesday, January 24, the Committee heard the same presentation by Christine Osterlund, KDHE, that was presented to the House Appropriations Committee (above), and also received a summary of the Report of the 2022 Special Committee on Intellectual and Developmental Disabilities Waiver Modernization from Dayton LaMunyon, Kansas Legislative Research Department. In response to questions from Committee members regarding the community supports waiver recommended by the interim committee, Mandy Flower, Assistant Commissioner, Long-Term Services and Supports, KDADS, stated that the new waiver could benefit some individuals and families who have been on the waiting list for the comprehensive I/DD waiver and could be an alternative for some individuals who are currently on the comprehensive waiver but do not need all the services provided under that waiver. She also responded to questions regarding the interim committee’s recommendation for a $20,000 cap on the community supports waiver, the removal of some children from the autism waiver, and whether other states are also experiencing waiting lists for an I/DD waiver.

The Committee also heard a presentation by John Calvert, Director of the Safe and Secure Schools Unit, Kansas State Department of Education, regarding the mental health intervention team program. Calvert stated that the program focuses on K-12 students and their families by identifying students who may need mental health services and linking them to the existing statewide behavioral health system and resources within the mental health providers network. He noted that the key to this program is the liaisons who work in each school district with students and their families to obtain services through existing community mental health centers. He noted that the program, which began with the 2018-2019 school year with nine pilot schools and 45 liaisons, served 1,708 students, including 212 foster care students. During the first half of the 2022-23 school year, the program included 67 school districts, 150 liaisons, and had served 4,801 students, including 447 foster care students.

Corrections and Juvenile Justice Committee

(Rep Stephen Owens, Chair)

On Monday, January 23, the Committee held a hearing on HB 2033, which would change the criteria used to refer and admit juveniles to a juvenile crisis intervention center. This bill is a reaction to 2016 Senate Bill (SB) 367, which changed the way youth with justice involvement enter the system. The bill would amend language in K.S.A. 65-536, which is the statute that creates juvenile crisis intervention centers and that allows juveniles who are experiencing a mental health crisis and are likely to cause harm to themselves or others to be admitted to an intervention center. This section would be amended to change the reference from mental health crisis to behavioral health crisis. A behavioral health crisis is defined to mean behavioral or conduct issues that impact the safety or health of a child, members of the child’s household or family or members of the community, including, but not limited to, non-life-threatening mental health and substance abuse concerns. Proponents included representatives of the Johnson County Mental Health Center, Children’s Alliance of Kansas, and Tanya Keys, Deputy Secretary, DCF, who all noted that amending this language will allow more youth to be served by the intervention centers operating in the state. There was no opposition or neutral testimony.

On Thursday, January 26, the Committee took final action on HB 2033, and passed it favorably out of committee. Rep. Carl Maughan, who voted against the bill, expressed concerns that the definition of behavioral health crisis was too broad and could potentially include things like smoking, drinking or acting out, which could result in too many youth entering the system.

House K-12 Education Budget Committee

(Rep. Kristey Williams, Chair)

On Tuesday, January 24, the Committee held a hearing on HB 2060, which would establish the special education and related services funding task force. The bill provides for a 10-member task force, with members appointed by legislative leadership and other organizations. Members would be appointed on or before July 1, 2023.

The 2023 session began on Monday, January 9, following the swearing in of Gov. Laura Kelly for her second term of office, along with all members of the House, including 32 who are new, and two members of the Senate. The day after being sworn in, Gov. Kelly tested positive for COVID-19 and announced that her planned State of the State address would be rescheduled to January 24. Two days later, after several negative tests, it was determined that she did not have COVID-19, and she returned to work at the Capitol on Friday, January 13.

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.

Prior to the start of the session, the Kansas Department of Revenue announced on January 3 that state revenue collections in December 2022 were $1.1 billion, which was $140.1 million, or 14.8 percent, more than the monthly estimate. Including December’s collections, the state has collected $105 million above the estimates for Fiscal Year (FY) 2023. Also on January 3, Gov. Kelly announced that Budget Director Adam Proffitt had been appointed Secretary of Administration but would continue in his role as budget director.

On January 5, Senate President Ty Masterson announced that Sen. Beverly Gossage was replacing Sen. Richard Hilderbrand as chair of the Senate Public Health and Welfare Committee, following his resignation effective on January 8.

On Friday, January 6, the Legislative Budget Committee, chaired by Sen. Rick Billinger, received an update from Ethan Belshe, Director of Public Affairs for the Office of Recovery, regarding recent action taken on COVID-19 relief funds by the Strengthening People and Revitalizing Kansas (SPARK) Executive Committee. Belshe stated that on December 21, 2022, the State Finance Council approved a total of $374 million in COVID-19 relief funds for broadband infrastructure and adoption, the modernization and improvement of government services, economic development, and health and education initiatives recommended by the SPARK Executive Committee. Included in the health and education initiatives is $66 million for health facilities and program expansion, $38 million for child care and community resource capacity accelerator, and $5 million for early childhood data integration and system enhancements. Belshe noted that additional details on the competitive funding opportunities, including the timeline and process to apply for funding through the approved programs, will be coming from the administering agencies by the end of February.

The Committee also heard from Christine Osterlund, Deputy Director of Medicaid Operations, Kansas Department of Health and Environment (KDHE), who provided an overview of the impact of the federal Omnibus Appropriations bill, passed in late December, on the Federal Medical Assistance Percentage (FMAP) for Medicaid. Osterlund noted that during the federal Public Health Emergency (PHE), Kansas received a temporary increase to the FMAP rate of 6.2 percentage points. Under the Omnibus Act, the temporary increase in FMAP will be phased-down over calendar year 2023 and is phased-out entirely at the end of 2023. During the PHE, states did not terminate Medicaid eligibility unless (1) the beneficiary moved out of state, (2) the beneficiary died, or (3) the beneficiary asked for coverage to be terminated. As a result, the number of Kansans receiving Medicaid and Children’s Health Insurance Program (CHIP) benefits has increased significantly since March 2020. Osterlund stated that in February 2020, 405,716 individuals were enrolled in KanCare programs, but on November 1, 2022, 530,482 individuals were enrolled. Kansas will begin processing annual redeterminations for KanCare eligibility in April 2023 and will have up to 12 months to initiate all redeterminations for individuals enrolled in Medicaid and CHIP. After the process is completed, KDHE estimates enrollment will be closer to the pre-PHE level.

On Tuesday, January 10, Gov. Kelly signed the first Executive Order (EO) of the year, EO No. 23-01, that will establish an Early Childhood Transition Task Force. The 13-member Task Force will include the Secretaries, or designees, of KDHE and the Kansas Department for Children and Families (DCF), the executive director of the Kansas Children’s Cabinet and Trust Fund, the Commissioner of Education, and representatives of state or local chambers of commerce, philanthropic organizations, early childhood service providers, and advocacy organizations. The Governor also may invite two members from each of the Senate and the House to participate as full voting members. The mission of the Task Force is the creation of a framework for a model single-agency governance structure for early childhood programming that consolidates initiatives and funding under the leadership of a new cabinet-level position, and the Task Force is specifically charged with conducting an analysis of the current early childhood delivery system in Kansas and how it is financed, with a specific focus on gaps, inefficiencies, and redundancies. The Task Force will conduct a series of stakeholder engagement meetings to elicit feedback on the current early childhood governance structure and to better understand the needs of parents, families, providers and businesses, and draft a transition plan to ensure the continuous operation of state services upon the creation of the new state agency. An interim report to the Governor is due on July 1, 2023, and the Task Force’s final report is due on January 1, 2024.

Also on January 10, Speaker of the House Dan Hawkins and Senate President Ty Masterson held a press conference and announced an eight issue legislative agenda – “A Better Way” – for 2023. The agenda included several health-related issues, including less governance of healthcare, ending mandates and supporting crisis pregnancy centers.

On January 12, the Governor submitted her revised budget recommendation for FY 2023 and initial budget recommendation for FY 2024. The $9.49 billion State General Fund (SGF) budget for FY 2024 includes full and immediate elimination of the state sales tax on food, effective April 1, 2023; exempting diapers and feminine hygiene products from state sales tax; creating an annual sales tax holiday for back-to-school items in August; and expanding Medicaid to low-income adults. Full details are available in the Governor’s Budget Report.

 House Health and Human Services Committee

(Rep. Brenda Landwehr, Chair)

On Tuesday, January 10, the Committee heard a presentation from Chad Austin, President and CEO, and other representatives of the Kansas Hospital Association (KHA), regarding the history of KHA, the number of community hospitals currently operating in Kansas (123), the Kansas health ranking (25th to 32nd in the country), the breakdown of payments to hospitals by payer (43 percent Medicare, 14 percent Medicaid, 33 percent commercial/private payers, 10 percent self-pay), the implementation of the rural emergency hospital model, workforce challenges (nurse and other hospital staff shortages) and possible solutions, KHA’s legislative priorities, and hospital finance challenges ($1 billion of bad debt and $257 million of charity care provided in 2019). Committee members asked questions regarding incentives for hospitals to consider the rural emergency hospital model, the percentage of Kansas critical access hospitals in financial jeopardy (55), implementation of the federal No Surprises Act, incentives for students to enter the healthcare profession, alternatives to the mental health observation program, and ways to address hospital concerns regarding prior authorization requirements.

Senate Public Health and Welfare Committee

(Sen. Beverly Gossage, Chair)

On Tuesday, January 10, the Committee heard an overview of the Behavioral Health Services (BHS) Commission by Andy Brown, BHS Commissioner, Department for Aging and Disability Services (KDADS), including the BHS organization and significant achievements over the last five years. Brown noted that KDADS has certified nine certified community behavioral health clinics (CCBHCs) to date and is on target to onboard nine more by July 1, 2023. He also stated that of the 36 high-priority recommendations of the Special Committee on Mental Health Modernization and Reform (MHMR), 16 have been fully implemented and significant progress has been made on nine more. Objectives for the next four years include: increasing access to services, expanding Medication Assisted Treatment among substance use disorder (SUD) treatment programs, investing in social determinants of health, improving integration of behavioral health services into other forms of healthcare, addressing frontline workforce shortages, creating additional specialty court programs across the state, and expanding problem gambling treatment and prevention, mobile crisis stabilization, suicide prevention infrastructure and opioid use disorder treatment/prevention.

On Wednesday, January 11, the Committee heard presentations from several KDHE officials. Secretary Janet Stanek provided an overview and highlighted priorities from the State Health Improvement Plan, including improving health and health outcomes, access to care, healthy behaviors, health literacy, and public health funding and capacity and highlighted the $30 million in Health Resources and Services Administration (HRSA) funding available to strengthen the public health workforce.

Deputy Secretary of Public Health Ashley Goss reviewed the 2023 priorities for the Division, including Healthy Kansans 2030 and public health accreditation. Healthy Kansans 2030, launched in 2021, is a statewide health assessment and strategic plan to improve the health and well-being of Kansas residents. National public health accreditation is reapplied for every five years. Kansas is ranked 31st in America’s Health Rankings.

Medicaid Director Sarah Fertig, Division of Health Care Finance, presented an overview of the Division’s responsibilities, including Medicaid application processing, oversight of the three managed care organizations (MCOs), program integrity oversight and compliance with federal Medicaid rules. Significant projects for 2023 include shifting from the umbrella Section 1115 demonstration to a 1915(b) waiver and a small 1115 demonstration, focus on prenatal care and maternal/child health outcomes, and the rebidding of Medicaid managed care contracts.

On Thursday, January 12, the Committee heard presentations from representatives of the Kansas Legislative Research Department (KLRD) about articles in the Kansas Legislator Briefing Book 2023. Briefing book articles are short summaries of topics of interest to legislators. Elizabeth Cohn, Senior Research Analyst, and Iraida Orr, Principal Research Analyst, presented six articles on health-related topics, including COVID-19 vaccine mandates, fentanyl testing strips, KanCare waivers and MCO contracts, mental health beds for adults and children, and mpox.

Child Welfare and Foster Care Committee

(Rep. Susan Concannon, Chair)

On Tuesday, January 12, the newly formed Child Welfare and Foster Care Committee met for the first time and heard a round of introductions from state, local and regional child welfare organizations including the Kansas Children’s Cabinet and Trust Fund, DCF, Kansas Division of the Child Advocate, Kansas Appleseed, Kansas Family Advisory Network, Children’s Alliance of Kansas, DCCCA, St. Francis Ministries, FosterAdopt Connect, KDC Kansas, InterHab, the Association of Community Mental Health Centers of Kansas, TFI Family Services, Kansas Children’s Service League, Boys and Girls Clubs of Kansas, Cornerstone of Care, and Children’s Advocacy Centers of Kansas.

Stuart Little, Little Government Relations, on behalf of the Kansas Chapter, American Academy of Pediatrics, requested introduction of a bill that would establish the statewide care or child abuse review and evaluation provider network. During the 2022 session, a similar bill passed the House but died during conference committee. A hearing on HB 2024, which will make it legal for infants and children to be surrendered to baby boxes rather than a person, will be held on January 23.

Welfare Reform Committee

(Rep. Francis Awerkamp, Chair)

On Tuesday, January 10, the newly formed Welfare Reform Committee met for the first time. The meeting included committee and staff introductions, a review of committee rules, a discussion on the committee’s purpose and scope, an overview of the components of welfare reform, and a presentation on the history of recent state welfare program reforms.

The purpose and scope of the new committee is to understand and evaluate the current welfare system in Kansas and to explore opportunities for improvement and returns on investment for both those receiving benefits and those paying for those benefits. The Committee will focus on traditional welfare programs such as Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP) but may also discuss larger and more complex welfare programs, such as corporate welfare. Chair Awerkamp stated that the Committee will not interfere with or duplicate the efforts of other committees, particularly those focused on unemployment, foster care, and health.

The Committee will utilize a six-component framework when reviewing a social welfare program for opportunities for reform. These components include:

1. Eligibility of persons who are intended to be targeted recipients for the intended services;
2. Delivery method by which the services may be provided;
3. Program compliance enabled by statute or other authority;
4. Funding sources for those programs;
5. Controls to protect against fraudulent activity; and
6. Effectiveness of a program to accomplish its articulated goal.

Senate Financial Institutions and Insurance

(Sen. Jeff Longbine, Chair)

On January 10, the Committee heard a presentation by Insurance Commissioner Vicki Schmidt, which included an update on the Insurance Department’s implementation of an improved producer licensing process, the work of the Consumer Assistance Division, including the recovery of $7.6 million for Kansas consumers in 2022, introduction of key staff, and a summary of the department’s legislative agenda that focuses on improving operations, providing clarity for the insurance companies doing business in the state, and protecting Kansans. Committee members asked questions regarding the state of the insurance market, the requirements for continuing education for insurance agents, and any challenges for the department. Commissioner Schmidt noted that cybersecurity for insurers is a concern and that the National Association of Insurance Commissioners is focused on working with insurers on this issue.

House Appropriations Committee

(Rep. Troy Waymaster, Chair)

Senate Ways and Means Committee

(Sen. Rick Billinger, Chair)

On January 12, the Committees held a joint meeting and received reports regarding the human services consensus caseload estimates and consensus revenue estimates for FY 2023 and 2024, and Gov. Kelly’s budget recommendation for FY 2024.

Megan Leopold, Senior Fiscal Analyst, KLRD, reported that the caseload estimates include expenditures for Temporary Assistance for Needy Families, the Reintegration/Foster Care Contracts, KanCare Regular Medical Assistance, and KDADS non-KanCare. For FY 2023, the revised estimate for all human service consensus caseloads is $4.8 billion all funds, including $1.3 billion SGF. This is an all funds increase of $259.5 million, including an SGF decrease of $198.2 million, from the budget approved by the 2022 Legislature.

J.G. Scott, Director, KLRD, reported that the state general fund revenue estimate for FY 2023 is $9.70 billion, an increase of $794.2 million above the previous estimate. The initial estimate for FY 2024 is $10.12 billion. He also described the economic forecast for Kansas, including forecasted rates for nominal growth in the national and Kansas economies, the nominal U.S. gross domestic product (GDP) and nominal Kansas gross state product for calendar years 2023 and 2024 and noted that the estimates will be further adjusted in mid-April prior to the end of the 2023 legislative session.

Budget Director Adam Proffitt talked through a slide presentation of the Governor’s budget recommendation for FY 2024 and responded to questions from the members of the committees. Questions were focused on the use of certificates of indebtedness, debt retirement, the current status of the SPARK process, funding for IT infrastructure, the statutory formula for special education funding, veterans’ homes staffing, the balance in the Rainy Day fund, pay increases for state employees, the addition of prepared foods to the food sales tax exemption, funding for mental health beds in Sedgwick County, and funding for the six Regents institutions.