September 24, 2023

Health Mettler Institute

Healthy LifeStyle & Education

Week 9 of the 2023 Session

Week 9 of the 2023 Session

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.