Health at the Capitol: Episode 2: Turnaround 2024

Summary: 

Join us for Health at the Capitol– a Kansas Health Institute webcast focused on health-related policy discussions and action at the Kansas Legislature.    

The latest Health at the Capitol webcast includes a discussion about turnaround and some of the health policy legislation being considered in the 2024 Kansas Legislative Session.

Transcript

Theresa Freed 0:00
Each legislative session KHI is hard at work keeping you informed on the latest health policy discussions from across the street in downtown Topeka. Health at the Capitol as a KHI production. A monthly recap with our legislative monitoring team offering you a closer look at policy work happening now in Kansas. And coming up. Here’s a look at topics from our latest episode.

Thanks for joining us for Health at the Capitol. This is a monthly recap of legislative activity. And we’re taking a look back at the last 30 days. But also, this is an opportunity for us to look ahead at what’s coming up. My name is Theresa Freed. I’m the director of strategic communication and engagement with the Kansas Health Institute. And I’m joined by Linda Sheppard who is our strategy team leader. She oversees our legislative monitoring team. And we also have Kari Bruffett, who is the president and CEO of KHI. Thank you both for joining us. Thank you Theresa. Thanks, Theresa. Al right. So let’s start off by just talking about kind of what what we’re in right now. This is known as turnaround time. So can you explain exactly what that is?

Linda Sheppard 1:08
Right. So turnaround day was last Friday. And really what that means is that any bills that are going to be active and continue to move forward throughout the rest of the session had to get through their chamber of origin. So they had a hearing in the committee where they were introduced, made it to the full chamber and then passed on out and ready to go to the other side now. So that’s that’s the way most of the bills get through. But there are some exceptions to that. For bills that were originally introduced in what is referred to as exempt committees, and there are a number of exempt committees. Appropriations, for example, those bills, even if they didn’t get through that first process, are still active and can continue to be considered during this second part of the session. Also, there are some bills that occasionally will get moved to one of those exempt committees temporarily, sometimes as short as a day and then get moved back. And so that’s considered to be blessed. And those those bills can also continue to move forward going into the next part of the session.

Theresa Freed 2:15
Alright, so a very important time for us to take a look back, but also again, looking at what’s coming up. And so our particular focus at KHI is on health policy. And so there’s been a lot of activity recently related to health policy discussions, and one of those is about public health authority. That’s a more recent discussion. Can you talk a little bit about what’s happening with that?

Linda Sheppard 2:38
Yeah. So there are a couple of bills that are still active now. That got passed the first chamber Senate Bill. So there’s Senate Bill 390, which is the Conscientious Right to Refuse Act. And this bill would prohibit employers, schools, medical facilities to take any sort of action against an individual who is refusing to be vaccinated or to take any sort of action related to some disease, that they would, that they are opposed to have a belief in an opposition to, and the bill does include a some definitions of you know, what it is that the person would indicate as far as their opposition to that. But again, the the main thing is that the action could not be taken because they refuse to take those. Included in that bill also, are is a repeal of a number of statutes that give KDHE authority to take certain kinds of action related to isolating or quarantining individuals with contagious or infectious diseases. So, there’s about three or four existing statutes that would be repealed and removing that authority away from KDHE. Another bill is Senate Bill 391. So that first bill was 390. This one is 391. This bill is very specific to what’s called the Constitutional Right to Health Freedom Act, and really does limit KDHE’s authority with regard to how they deal with infectious and contagious diseases, again, removing a lot of the authority that they have to dictate how people should respond in those kinds of situations. The bill does allow them to continue to make recommendations. So if we were to have another COVID-19 pandemic, they could certainly make recommendations about how they think those things should be handled, but their ability to have any enforcement or take any action if those actions are not undertaken would be limited or would not exist.

Kari Bruffett 4:48
So Linda, I would add that while that bill did pass the the Kansas Senate, you noted and I think our Health at the Capitol updates, note that there’s significant opposition as well, from folks in the public health community and others who presented information at the hearing about that legislation as well as proponents who also presented testimony at that as well. So interesting to see what will happen when it goes over the House and how that debate continues, and would anticipate the folks will still want to have their voices heard in that debate on the House side as well.

Linda Sheppard 5:26
Yes, thank you.

Theresa Freed 5:28
Okay. And also central to KDHE is the discussion about Medicaid. I know. It’s kind of gone up and down in different ways. And we’re certainly focused on the discussion, because we’ve recently produced some work associated with that some data to help inform some of those discussions. So Kari, do you want to talk a little bit about what’s happening with that?

Kari Bruffett 5:50
Sure. So in the first part of the session, we heard that both on the House and Senate side, we expect there would be committees that would be discussing Medicaid expansion. That hasn’t happened yet. But that still can happen. In the next part of this session, as well. The only real action related to Medicaid expansion in the legislature in the first part of the session. And Linda, you can correct me if I’m wrong is really just through the budget process. So this House Social Services Budget Committee, for example, removed the funding and the revenues associated with expansion from the KDHE, the Department of Health and Environment budget. But that’s not an unusual action for them to take. That’s something that typically has happened in the last few years with the legislature in response to the Governor’s proposals to expand Medicaid. But they’re still we expect there’ll be an opportunity for the legislation, which Linda reminded me was introduced in exempt committees. So that can be discussed later on in the session, as well. So, look forward to what that might look like and in both the House and the Senate.

Theresa Freed 6:58
Okay, and do you want to talk a little bit about some of the work that we’ve done on this topic?

Kari Bruffett 7:02
So KHI has, for many years produced estimates of Medicaid expansion, enrollment and costs and new revenues and savings and offsets and that sort of thing. We also took a closer look this year at the population, the characteristics of the population, who would be likely to expand in, to enroll in Medicaid if expanded, in particular, because the proposal to expand Medicaid that’s in legislation this year, includes a work or community engagement requirement. And so we looked at the percentage of potential enrollees who already are working or if they’re not working, and what are some of the characteristics they might have that could qualify them for exemptions in the legislation. So we’re hopeful that that data and information can be helpful to the discussion for policymakers in this next part of the session.

Theresa Freed 7:56
Alright, so we’ll definitely have to wait and see on that. Another big topic of importance and one that we’re focused on as well as behavioral health, but there are several different initiatives that have been discussed recently. So would you both like to touch on those a little bit?

Linda Sheppard 8:10
Yeah, on the behavioral health side, one of the things that I think, and this was done early on in the session, for a number of years now there has been this Mental Health Intervention Team program that’s been operating in the state. And this involves various programs that go into schools. School districts can sign up to participate in this program. And it really makes it much easier for the schools to help identify young students who are in need of behavioral health services, and then making it much easier for them and their families to access those services in the schools. And for several years now, that program has received funding from the state but it’s always been put in as a proviso into the budget. It’s not something that’s been sitting there. So this year, they did move it into actually introduced a bill. And so that bill is moving forward, and it codifies that program now, so they won’t have to do it sort of year from year to year with the proviso. So that’s really been done. One of the other things that’s interesting there has been this Kari, you’re going to have to help me because I always forget the community, certified community behavioral health clinics. CCBHCs. That ability to designate community mental health centers that CCBHCs use has been in place for some time and there is a bill right now, that is clarifying some of some of who can be eligible to participate in that program. And it’s being made very specific to community mental health centers. The way the bill was worded before it appeared that there might be some other types of facilities that would be able to participate in that program, but it’s pretty specific to community mental health centers (clinics) at this point.

Kari Bruffett 10:01
And that’s not without controversy because there are other providers and provider types that have expressed interest in being able to provide services and really provide the spectrum of services under the CCBHC designation. So it’ll be interesting to see where that goes moving forward. Yes, there was a hearing for that bill. There was a lot of lively discussion, definitely some opponents to that bill. So I’m sure that will continue on the other side.

Theresa Freed 10:28
Alright. And you’ll be watching I’m sure.

Linda Sheppard 10:29
Yes, we will.

Theresa Freed 10:30
Alright. Moving on to our next topic. And it’s one that we touched on during our initial episode here, and that was about homelessness and some of the measures or proposals associated with that. So Linda, if you want to share kind of the latest on that.

Linda Sheppard 10:45
Yeah. So I mentioned last time, we met that the Committee on Welfare Reform, this is a House committee, has been spending quite a bit of time looking at the whole issue of homelessness. So there have been a number of informational hearings that have occurred. They brought in some outside speakers who have been dealing with homelessness in other states, other communities and having them share with them some of the solutions and the things that they’ve done to try to address that problem in their own locations. And Chair Awercamp has indicated that this is something that he continues to be interested in and will continue to hold hearings on this topic going through the rest of the session. And there has not been a bill specific to this. But in the in the budget for KDADS, there was a money that was placed in there by the Governor, to provide money to communities who are trying to deal with this problem and give them a chance to use those dollars for whatever sorts of housing opportunities that they might come up with to deal with the homeless in their communities. And that was $40 million. And that $40 million was removed from KDADS’ budget, and so is not currently not available or at least not being considered right now. However, the budget bit the part of the budget for KLDADS has actually been sent back to the Welfare Reform Committee for some additional consideration and discussion. So that’s one of the things that a little bit unusual this year, but they were giving some of the committee’s who were very, very specific, in a certain topic, an opportunity to weigh in on some of these budget decisions so that conversation will continue.

Theresa Freed 12:37
Alright, very interesting there. And then also related to KDADS, talking about intellectual and developmental disabilities, the waiver services there. So Kari, do you want to share a little bit about kind of the status of the discussion on that?

Kari Bruffett 12:49
Yeah, certainly, they’re both in the Governor’s budget and the Social Services Budget Committee and the Governor’s budget amendment as well, to add funds to add additional positions or slots for both the Home and Community Based Services Waiver for people with intellectual or developmental disabilities as well as those with physical disabilities. So, there is funding, it’s a priority that both the Governor and the legislature are addressing interesting, this year as well, there’s been some discussion of sort of setting in maximum of what the waiting lists can be for both of those waivers and then requiring each year’s budget development to make sure that the budgets proposed for those waivers ensure that the waiting lists don’t exceed those numbers. So, it will be interesting to see how that proceeds. I don’t think that’s proposed as like a permanent waiting list, for example, but it is sort of to limit the size of the waiting list and limit some of the growth of the waiting list that folks have been watching and concerned about.

Theresa Freed 13:58
Okay, again, another one. That’s, it seems this topic comes up every session. There’s always, you know, some discussion about how to address it. But it seems to be an ongoing issue that will continue to be ever present it seems.

Kari Bruffett 14:14
Yes, I absolutely. It’s a priority for the Governor’s office, for members of the legislature to be able to address the waiting list. They have people that have been waiting, in some cases more than a decade for services. And as an issue, it’s been around for more than a decade as well. And certainly, there’s advocates and others who point back to some of the promises at the beginning of the KanCare program to really commit to reducing the size of the waiting lists. So, it’ll be interesting to see not only how that progresses this year, but how that’s maintained moving forward.

Theresa Freed 14:50
And another area of focus for the Kansas legislature has been reproductive health. A number of different measures proposed during session and so Linda, do you want to tell us a little bit about one that’s getting a lot of attention.

Linda Sheppard 15:02
Yeah, one bill that that is getting a lot of attention, that would be House Bill 2749. So this would require that there be a written report that is submitted to the state with information about, questions that have been asked of women who have undergone an abortion, and this would not apply in cases of an emergency procedure. But what would require the the medical provider to ask a number of questions of the woman before the abortion, basically asking her to explain why she’s getting an abortion? What are the factors of the things that were causing her to take that action?

Theresa Freed 15:42
You talk a little bit about? What’s the conversation on both sides of those issues?

Linda Sheppard 15:45
Yeah. So again, this I think the the state’s interest in this information, at least from the appearance of the bill, is that if they were able to collect that type of information from women who are considering or are very close to having an abortion, could they take that information and use it to help women, other women in the future if those are the kinds of issues that are causing the woman to make that decision? Are there things that the state can do to help with those women and to address those problems before they make the decision about the abortion. You know, the the opponents for those bills, again, as always, this the discussion comes up about privacy and are there are their privacy concerns? Or is that being too intrusive and into a woman’s personal decisions about an abortion by asking her to explain, you know, why she’s choosing to have an abortion?

Theresa Freed 16:45
Alright. So as we wrap up, and Kari, do you want to tell us anything else going on with the legislature that we should watch?

Kari Bruffett 16:51
Well, I think it’s interesting, Theresa, it’s not legislation that’s in front of the legislature. But it’s something that is going on in the in the background that absolutely has a big influence on policy and no policymakers are watching closely is the re-procurement of the KanCare. Program. So the managed care contracts for for the Medicaid and Children’s Health Insurance Program that is underway now. That’s something that is done in a confidential way. So that’s not being done out in public in front of the legislature, for example, but certainly, for both the budget and how the program operates, those contracts will have a big influence on public policy moving forward as well. So, we’re watching that closely, and anticipate that the contracts will be signed, and per the state’s published timeline, while the legislature still is in session, maybe while they’re out on first adjournment. But while they before they finally adjourn, so will be interesting to see if any outcomes of that have any influence in discussions later, much later in the legislative session.

Theresa Freed 17:59
Alright, sounds good. And we look forward to the next Health of the Capitol so we can see what results from all this activity and the discussion that’s happening, but it’s exciting stuff. And of course, we’re watching and we’re happy to inform you. If you’d like to receive Health at the Capitol directly to your email inbox, just sign up, register on our website at khi.org Thanks for joining us.

Health at the Capitol Production Team

Theresa Freed, M.A., Host, Producer, Editor

Stewart Cole, Editor, Graphic Designer