by Dena K. Hubbard MD, FAAP
KAAP 2022 Advocacy Day: CARE, KanCare, and Vaccines, Oh My!
KAAP held our 3rd annual advocacy day on February 9th. Although COVID continues, we felt it was important to be visible to legislators in the State House. KAAP was well represented with 16 pediatricians and residents in attendance. We had several honorable guests including our very own Dr. Pam Shaw and KAAP Lobbyist Stuart Little. Our focus for Advocacy Day 2022 was the CARE legislation (amendment to Adrian’s Law) which will improve the way reports of physical abuse are addressed in Kansas for young children. This bill (HB 2632, SB 460) is a perfect exhibit of the mission of AAP and KAAP seized the opportunity as servant leaders in building the foundation for this legislation. See our advocacy leave-behind handout here. We had the opportunity to hear from KDADS and DCF Deputy Secretary Tanya Keys, Secretary Howard was also in attendance. We also heard from Kerrie Lonard in the newly formed Office of Child Advocate. KAAP members Drs. Killough and Hansen were able to provide clarification and insight during our Advocacy Day presentation as well as testimony during an informational hearing in House Children and Senior Services Committee about the benefits of the program and how it has operated successfully in Missouri. Hot off the press, HB 2632 passed out of committee! We are optimistic that this legislation will pass, however the next step is to get a vote in the house.
Acting KDHE Secretary Janet Stanek and State Medicaid Director Sarah Fertig attended KAAP Advocacy Day and generated a nice dialogue on issues related to extending Medicaid postpartum coverage, increasing pediatric payment rates, increasing confidence in public health and vaccinations. One of the highlights of our KAAP Advocacy Day handout is the extension of postpartum maternal Medicaid coverage to 12 months. This is an issue KAAP has been advocating for with KDHE and the KanCare team for 3 years. We know that the first year postpartum is a high-risk time for maternal morbidity and mortality and that there are great racial disparities and inequities in maternal morbidity and mortality rates in Kansas. Sixty days postpartum is inadequate coverage. Funding for this extension has been included in Governor Kelly’s budget, and we are hopeful the legislature will approve.
Of course, vaccines being critical to the prevention we do in pediatrics, we could not afford to miss an opportunity to include some education on immunizations. Advocacy Day speakers on this topic included Representative and Family physician Dr. Eplee as well as Rachelle Colombo representing Kansas Medical Society. We had a leave behind, which you can access here, with essential information about vaccines. We intentionally tried to avoid discussing the COVID vaccine as this has much passion and bias related to it. There is some really grim legislation that would affect all vaccines! What did Andy Reid say to Mahomes? “When it looks grim, be the Grimm Reaper!” While this is not the visual that we hope comes to mind with pediatricians, we will be the “Grimm Reaper” for bad vaccine legislation by advocating for kids!
Did you see the new survey from Nurture KC that found that >90% of Kansans support wellness vaccine requirements for children to attend school and childcare? Read more here. This is information to keep in mind when you hear about some of the scary and potentially deadly immunization-related bills that aim to decrease or eliminate childhood vaccine requirements.
KAAP opposes any non-medical exemptions to immunizations, but especially attempts to include “philosophical objection” that cannot be challenged. This was initially in SB 398, never received a hearing, but is now in S. Sub for HB 2280. Also included in this gut and go bill was another anti-evidenced based science SB 381 re: off label medications to treat COVID-19).
You’ve probably heard about HB 2662 aka “Parents Bill of Rights,” which includes broad immunization exemptions, process for banning books and educational materials, public confrontation of school faculty, incentives for suing a school district, removal of the affirmative defense of individual teachers found to have presented “harmful” content in class even if it was part of an approved course of study, and protections for teachers who refuse to teach curriculum that they feel violates their personal religious beliefs. It is hard to believe we are more focused on banning books but not taking precautions to ban guns from schools.
Food security efforts were progressed through HB 2215 and SB 469 allowing all Kansans with drug-related felony convictions to access the food assistance program if otherwise eligible and voted out of the House Committee on Corrections and Juvenile Justice. This is a good reminder to use trauma-informed practices and be curious, not judgmental, and ask “What happened to this person?” rather than “What is wrong with this person?” We know that substance use is often utilized to cope with the pain of psychological trauma or untreated mental health. No one wants to grow up and be a felon with drug charges. Creating barriers to accessing food, affordable housing, health care for these adults is not just punishing adults, it hurts children. There is legislation looking to eliminate state-level food sales tax as well through SB 339, however several amendments have been made which increase the cost and delay the start to 2024. Stay tuned.
Health Care Access
KAAP opposes HB 2463 which would prevent changes to KanCare for YEARS! Just as the immunization schedule should not be confined to legislation, the same applies to KanCare. It does not allow for flexibility and adaptation that is needed, like in a pandemic!
A pleasant surprise, the House Social Services budget committee recommended an increase in some pediatric outpatient code payment rates to 100% of Medicare rates! Because the Senate did not have this item, this will be negotiated during the budget conference committee process.
The Senate Ways & Means subcommittee supported the passage of HB 2250 and SB 155, which would increase the cap on newborn screenings from $2.5 million to $5 million. This passed last year as a one-year budget proviso, but passage of the legislation would allow for it in statute.
Next week marks Turnaround Day on February 24th, the official midpoint of the regular session. Overall, bill introductions will decrease significantly as the deadline has passed for the introduction of new bills in non-exempt committees. Pay attention to what business is getting done in Topeka, what are the priorities that you see in the last half of the session?
The best time to advocate is always “NOW.” Talk with your friends and family, colleagues, neighbors, and decision-makers and let them know how current decisions affect the health and well-being of children. Pediatricians are credible advocates and people are listening! We need everyone to speak up for kids!