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KAAP Legislative Update

by Dena K. Hubbard MD, FAAP

GOOD NEWS!

One of my favorite quotes from Stacey Abrams’s presentation at the AAP Advocacy Conference was “educate, advocate, agitate.” That’s exactly what KAAP members and staff did this year!

The regular 2022 Kansas legislative session has concluded. This session was one where our offense and defense teams were critical. Legislators will be meeting next week to deal with Congressional maps (currently at the Kansas Supreme Court) and vetoes. Sine die, the official end of the session, will likely occur in late May or early June. Thanks to our KAAP public policy committee and KAAP members for advocating for Kansas children! Here’s a brief summary of the good, the bad, and the ugly from the 2022 session.

The Good:

Offense:

  • CARE Network Policy & Funding Proviso “Adrian’s Law”
    • KAAP was invited to present to the Joint Committee on Child Welfare System Oversight on behalf of pediatricians regarding the proposed Adrian’s Law recommendations requiring physical evaluation of potential child abuse victims. Drs. Jennifer Hansen and Emily Killough along with KAAP lobbyists, legislative staff, and KAAP ED Mel Hudelson have been instrumental in representing KAAP and pediatricians, educating legislators in Topeka, and writing HB 2632. The CARE proviso creates a triage system in Kansas for reviewing child abuse reports and education for physicians and other clinicians to provide childcare exams. While the bill did not pass, the Omnibus budget includes a one-year proviso that enacts the policy for one year and includes the funding of $757,000 for 2023. We will be back with a new bill for the 2023 legislative session, and we are thankful for the hard work from Dr. Hansen, Dr. Killough, and Mallory Lutz, the KAAP lobbyist who helped get this program off the ground!

  • Increase for Pediatric Medicaid Payment Rates (some)
    • The KAAP Pediatric Council members Drs. Kathy Cain, Jennifer Mellick, and Rebecca Reddy testified before the KanCare Oversight Committee in December about the urgent need for an increase in Medicaid payment for pediatric codes. They have been working on this for several years. Many other KAAP members submitted written testimony to the committee and this collective effort led to an addition of $2.9 million in the state budget for Medicaid pediatric payments. Pediatric payment rates have not been increased in 25 years! KAAP is actively working with the Kansas State Medicaid Director (one of our guest speakers at Advocacy Day!) on the details of the increase and will share those with you as soon as we have them. This is one important step to help increase access to healthcare for newborns and young children to ensure they are growing healthy and thriving at such an important developmental stage.  Additionally, this is an important step in our ability to serve children on Medicaid, including in rural areas.
  • Extension of Postpartum Medicaid Coverage
    • Medicaid postpartum coverage was extended from 60 days to 12 months! This is another win that has been in the works since 2018! Healthier moms mean healthier babies, and this extension now means that moms will have access to care during the most critical time after delivery. This extension ensures access to critical physical and mental health care services that directly impact both mom, baby, and family. This was a critical step in improving postpartum care and outcomes for Kansas moms and babies.
  • Other
    • Other good news includes increase in funding for newborn screening and preserved immunization requirements by KDHE for school and daycare.

Defense:

Most egregious bills, including HB 2280 (expanding religious exemptions; off-label prescribing of ivermectin and hydroxychloroquine for COVID) did not advance. Hot off the press, SB 34 (included components of SB 489 & SB 541), was just recently vetoed by the Governor. This legislation would have prohibited local governments from enforcing measures in response to contagious/infectious diseases and restricted tests and vaccines to those only fully approved by FDA. As this narrowly passed in both chambers, it is unlikely to have an override.

Governor Kelly’s vetoes were sustained for these bills which KAAP opposed: SB 160 Transgender sports bill, SB 58 Parent Bill of rights, and SB 199 Short-term limited duration health plans.

The Bad:

HB 2387 passed which means no changes to KanCare MCO contracts, and no RFP issued until January 2023.

Regarding food insecurity, while we had advocated for immediate elimination of the food sales tax, there will instead be a gradual reduction of sales tax on groceries from current 6.5% to 4% in 2023, 2% in 2024, and 0% in 2025. Considering the generous state balance, this was disappointing.

The Ugly:

Unfortunately, HB 2448 SNAP work/training requirements which the Governor vetoed was overridden.

So what does this all mean? It means your voice matters! There are many ways to advocate and not all include legislative process. Reach out to KAAP staff or public policy committee if you are interested in learning more about and participating in our KAAP advocacy efforts. The AAP advocacy website also has great resources including email list for regular advocacy updates and alerts and the advocacy action center. https://www.aap.org/en/advocacy/

One simple but powerful action we can take immediately and make a difference: help patients vote. The AAP has partnered with Vot-ER https://vot-er.org/, started by an ER physician, to empower physicians and other health care team members to integrate the democratic process into the health care system. The right to vote is the foundation of our democracy and critical for public health. We know that healthcare in and of itself is only responsible for a fraction of a patient’s overall “health.” Addressing social determinants of health cannot be done through healthcare alone. Voting has been linked to health outcomes in adults, and there is some recent evidence for child health as well. Likewise, disparities in social, economic, health have a strong correlation to voting. Our responsibility as pediatricians is to advance the health and well-being of ALL children.  It is critical that we speak up and ensure individuals most significantly impacted by inequities are heard regardless of their age, sex, gender, race, or health status. Get involved with Vot-ER’s work or with Civic Health Month by helping patients and colleagues register to vote. (Vot-ER is a nonpartisan 501(c)3 organization.) Learn more:  Vot-ER informational flyer.

One of my favorite quotes from Stacey Abrams’s presentation at the AAP Advocacy Conference, was “educate, advocate, agitate.” That’s exactly what KAAP members and staff did this year!

The regular 2022 Kansas legislative session has concluded. This session was one where our offense and defense teams were critical. Legislators will be meeting next week to deal with Congressional maps (currently at the Kansas Supreme Court) and vetoes. Sine die, the official end of the session, will likely occur in late May or early June. Thanks to our KAAP public policy committee and KAAP members for advocating for Kansas children! Here’s a brief summary of the good, the bad, and the ugly from the 2022 session.

The Good:

Offense:

  • CARE Network Policy & Funding Proviso “Adrian’s Law”
    • KAAP was invited to present to the Joint Committee on Child Welfare System Oversight on behalf of pediatricians regarding the proposed Adrian’s Law recommendations requiring physical evaluation of potential child abuse victims. Drs. Jennifer Hansen and Emily Killough along with KAAP lobbyists, legislative staff, and KAAP ED Mel Hudelson have been instrumental in representing KAAP and pediatricians, educating legislators in Topeka, and writing HB 2632. The CARE proviso creates a triage system in Kansas for reviewing child abuse reports and education for physicians and other clinicians to provide childcare exams. While the bill did not pass, the Omnibus budget includes a one-year proviso that enacts the policy for one year and includes the funding of $757,000 for 2023. We will be back with a new bill for the 2023 legislative session, and we are thankful for the hard work from Dr. Hansen, Dr. Killough, and Mallory Lutz, the KAAP lobbyist who helped get this program off the ground!
  • Increase for Pediatric Medicaid Payment Rates (some)
    • The KAAP Pediatric Council members Drs. Kathy Cain, Jennifer Mellick, and Rebecca Reddy testified before the KanCare Oversight Committee in December about the urgent need for an increase in Medicaid payment for pediatric codes. They have been working on this for several years. Many other KAAP members submitted written testimony to the committee and this collective effort led to an addition of $2.9 million in the state budget for Medicaid pediatric payments. Pediatric payment rates have not been increased in 25 years! KAAP is actively working with the Kansas State Medicaid Director (one of our guest speakers at Advocacy Day!) on the details of the increase and will share those with you as soon as we have them. This is one important step to help increase access to healthcare for newborns and young children to ensure they are growing healthy and thriving at such an important developmental stage.  Additionally, this is an important step in our ability to serve children on Medicaid, including in rural areas.
  • Extension of Postpartum Medicaid Coverage
    • Medicaid postpartum coverage was extended from 60 days to 12 months! This is another win that has been in the works since 2018! Healthier moms mean healthier babies, and this extension now means that moms will have access to care during the most critical time after delivery. This extension ensures access to critical physical and mental health care services that directly impact both mom, baby, and family. This was a critical step in improving postpartum care and outcomes for Kansas moms and babies.
  • Other
    • Other good news includes increase in funding for newborn screening and preserved immunization requirements by KDHE for school and daycare.

Defense:

Most egregious bills, including HB 2280 (expanding religious exemptions; off-label prescribing of ivermectin and hydroxychloroquine for COVID) did not advance. Hot off the press, SB 34 (included components of SB 489 & SB 541), was just recently vetoed by the Governor. This legislation would have prohibited local governments from enforcing measures in response to contagious/infectious diseases and restricted tests and vaccines to those only fully approved by FDA. As this narrowly passed in both chambers, it is unlikely to have an override.

Governor Kelly’s vetoes were sustained for these bills which KAAP opposed: SB 160 Transgender sports bill, SB 58 Parent Bill of rights, and SB 199 Short-term limited duration health plans.

The Bad:

HB 2387 passed which means no changes to KanCare MCO contracts, and no RFP issued until January 2023.

Regarding food insecurity, while we had advocated for immediate elimination of the food sales tax, there will instead be a gradual reduction of sales tax on groceries from current 6.5% to 4% in 2023, 2% in 2024, and 0% in 2025. Considering the generous state balance, this was disappointing.

The Ugly:

Unfortunately, HB 2448 SNAP work/training requirements which the Governor vetoed was overridden.

So what does this all mean? It means your voice matters! There are many ways to advocate and not all include legislative process. Reach out to KAAP staff or public policy committee if you are interested in learning more about and participating in our KAAP advocacy efforts. The AAP advocacy website also has great resources including email list for regular advocacy updates and alerts and the advocacy action center. https://www.aap.org/en/advocacy/

One simple but powerful action we can take immediately and make a difference: help patients vote. The AAP has partnered with Vot-ER https://vot-er.org/, started by an ER physician, to empower physicians and other health care team members to integrate the democratic process into the health care system. The right to vote is the foundation of our democracy and critical for public health. We know that healthcare in and of itself is only responsible for a fraction of a patient’s overall “health.” Addressing social determinants of health cannot be done through healthcare alone. Voting has been linked to health outcomes in adults, and there is some recent evidence for child health as well. Likewise, disparities in social, economic, health have a strong correlation to voting. Our responsibility as pediatricians is to advance the health and well-being of ALL children.  It is critical that we speak up and ensure individuals most significantly impacted by inequities are heard regardless of their age, sex, gender, race, or health status. Get involved with Vot-ER’s work or with Civic Health Month by helping patients and colleagues register to vote. (Vot-ER is a nonpartisan 501(c)3 organization.) Learn more:  Vot-ER informational flyer.

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