Last Thursday was Turnaround Day at the Kansas Legislature.  This is the deadline for non-exempt bills to pass the first chamber (known as the house of origin), whether introduced in the House or the Senate.  Exempt bills are those that have been introduced, referred to, or acted on by exempt committees:  House and Senate Federal and State Affairs, Senate Ways and Means, Senate Assessment and Taxation, House committees on Calendar and Printing, Appropriations, Taxation or select committees of either house when so authorized.

Find a List of Legislation being tracked by KMHC here.

Each year, the Kansas Mental Health Coalition updates its consensus recommendations.  Any member may bring a proposal by submitting the recommendation in the form of an issue paper.  Please use the following issue paper format (view here) and contact the President or Lobbyist to have your item added to the meeting agenda in October or November.  This is also the time for member organizations to bring their consensus issues to the Coalition's attention - either for adoption or simply to inform.

Proposals will be discussed by the membership and adopted by consensus.  The Coalition will only promote policies that have the consensus of our members.

(June 26, 2017) The Legislature returned to Topeka for Sine Die, the ceremonial last day of the 2017 Legislative Session. 

There were no veto override efforts.  House Minority Leader Jim Ward, D-Wichita, hoped to override Governor Brownback's line item veto of a budget proviso that prohibited HCBS waiver integration, but the Senate met and adjourned quickly.  There did not appear to be enough House members present to be successful and the Senate had met and adjourned very quickly.

"I would make the motion to override the governor's veto, but our friends in the Senate had other engagements," Ward said. "Standing up for the disabled and mentally ill in Kansas wasn't on their agenda today, and they've gone home. It would be an exercise in futility, but it would be the right thing to do."

Jason Probst (D-Hutchinson) was sworn in to replace Patsy Terrell, who passed away suddenly during the veto session. 

John Wilson (D-Lawrence) announced his retirement from the House - saying that his young family and career needed his attention.  Said Wilson, "Now is actually a really great time to be in the Legislature. It's just not a really great time for me." 

Governor Brownback vetoed Sub for HB 2313 – the lottery vending machine bill that included funding for certified clubhouse programs and crisis stabilization centers.  While the Kansas Mental Health Coalition has no position regarding the authorization of lottery vending machines, the Coalition supports these two important programs that have proven outcomes benefiting people with mental illness and substance abuse issues. 

The lottery vending machines were to be a designated funding source for the Crisis Intervention Act (Sub for H 2053) and the certified clubhouse programs.  The clubhouse programs previously suffered a veto as part of the Medicaid Expansion Act - HB 2044.  The Governor directs the community mental health centers to create a pilot program for clubhouse programs from their resources in his veto message.  Read the Governor’s Veto message.

Language in HB 2002, the budget bill, provided for additional funding for community mental health centers and lapsed a portion if the lottery bill was adopted.

Governor Brownback also vetoed two provisions of the budget bill – both relating to the Kansas Department for Aging and Disability Services.  Read more.

The Legislature returns to Topeka tomorrow for Sine Die, the ceremonial last day of the 2017 Legislative Session. 

This would be the only opportunity for veto override efforts. 

Governor Brownback vetoed Sub for HB 2313 – the lottery vending machine bill that included funding for certified clubhouse programs and crisis stabilization centers.  While the Kansas Mental Health Coalition has no position regarding the authorization of lottery vending machines, the Coalition supports these two important programs that have proven outcomes benefiting people with mental illness and substance abuse issues. 

The lottery vending machines were to be a designated funding source for the Crisis Intervention Act (Sub for H 2053) and the certified clubhouse programs.  The clubhouse programs previously suffered a veto as part of the Medicaid Expansion Act - HB 2044.  The Governor directs the community mental health centers to create a pilot program for clubhouse programs from their resources in his veto message.  Read the Governor’s Veto message.

Language in HB 2002, the budget bill, provided for additional funding for community mental health centers and lapsed a portion if the lottery bill was adopted.

Governor Brownback also vetoed two provisions of the budget bill – both relating to the Kansas Department for Aging and Disability Services.  Details are below.

From the Office of the Governor: 

Governor Sam Brownback signs budget bill, line item vetoes two provisions

Jun 25, 2017

Topeka – Kansas Governor Sam Brownback signed Senate Substitute for House Bill 2002. He issued the following statement:

“This budget, passed on the 113th day of the legislative session, unnecessarily increases government spending in several areas and fails to adopt common sense cost saving measures identified by the legislature’s own efficiency study.  However, I am signing the budget, despite my concerns about excessive spending, to avoid a break in core functions of government and to provide state workers with well-deserved pay increases.”

Pursuant to Article 2, Section 14(b) of the Constitution of the State of Kansas, the Governor returned Senate Substitute for House Bill 2002 with the following line item vetoes:

·         Limitation on the ability of KDADS to best serve vulnerable Kansans

·         Section 174 – Vetoed broad language limiting the ability of KDADS to implement changes, no matter how minor, to some programs and services.   (Section 174 printed below)

·         Redirection of funding for KDADS Clubhouse Model Program Fund

·         Section 99-(q) and Section 100-(o) – Vetoed language establishing a funding receptacle which was made unnecessary by the veto of HB 2313. Governor Brownback has directed KDADS to work with the Community Mental Health Centers to establish a pilot with Clubhouse Model Program providers in fiscal year 2018 in order to expand the scope of this program.  (Vetoed language printed below)

The Governor’s full message to the legislature can be found here.

The Governor has now signed 102 bills into law this session, vetoed four, and allowed one to become law without his signature. By law, the Kansas governor has 10 calendar days to sign the bill into law, veto the bill or allow the bill to become law without his signature.

Here is the budget language that was vetoed -

Section 99(q):  (q) In addition to the other purposes for which expenditures may be made by the above agency from moneys appropriated from the state general fund or from any special revenue fund or funds for fiscal year 2018 by this or any other appropriation act of the 2017 or 2018 regular session of the legislature, expenditures shall be made by the above agency from moneys appropriated from the state general fund or from any special revenue fund or funds for fiscal year 2018 to provide medicaid reimbursement for clubhouse rehabilitation services and to enter into contracts with certified clubhouse providers for such services: Provided, That, as used in this subsection, ‘‘clubhouse rehabilitation services’’ means a community-based psychosocial rehabilitation program in which the member, with staff assistance, is engaged in operating all aspects of the clubhouse, including food, clerical, reception, janitorial and other member services such as employment training, housing assistance and educational support, and that is designed to alleviate emotional or behavior problems with the goal of transitioning to a less restrictive level of care, reintegrating the member into the community and increasing social connectedness beyond a clinical or employment setting

Section 100(o): (o) In addition to the other purposes for which expenditures may be made by the above agency from moneys appropriated from the state general fund or from any special revenue fund or funds for fiscal year 2019 by this or any other appropriation act of the 2017, 2018 or 2019 regular session of the legislature, expenditures shall be made by the above agency from moneys appropriated from the state general fund or from any special revenue fund or funds for fiscal year 2019 to provide medicaid reimbursement for clubhouse rehabilitation services and to enter into contracts with certified clubhouse providers for such services: Provided, That, as used in this subsection, ‘‘clubhouse rehabilitation services’’ means a community-based psychosocial rehabilitation program in which the member, with staff assistance, is engaged in operating all aspects of the clubhouse, including food, clerical, reception, janitorial and other member services such as employment training, housing assistance and educational support, and that is designed to alleviate emotional or behavior problems with the goal of transitioning to a less restrictive level of care, reintegrating the member into the community and in

Section 174:  Sec. 174. (a) During fiscal year 2018 and fiscal year 2019, notwithstanding any other provision of law, no state agency shall expend any moneys appropriated for fiscal year 2018 or fiscal year 2019 from the state general fund or from any special revenue fund or funds by this or any other appropriation act of the 2017, 2018 or 2019 regular session of the legislature to integrate, consolidate or otherwise alter the structure of any of the following home and community based waiver services under the Kansas program of medical assistance, or to submit to the federal centers for medicare and medicaid services any proposal to integrate, consolidate or otherwise alter the structure of such services or to combine, reassign or otherwise alter currently designated responsibilities to provide intake, assessment or referral services for such services, if such integration, consolidation, alterations, combination or reassignment is designed or intended to be implemented prior to fiscal year 2020: Medical services; behavioral health services; transportation; nursing facilities; other longterm care; autism; frail elderly; technology assistance; physical disability; traumatic brain injury; intellectual/developmental disability; or serious emotional disturbance: Provided, That the department of health and environment and the Kansas department for aging and disability services shall prepare and submit reports to the house standing committee on appropriations, the senate standing committee on ways and means and the Robert G. (Bob) Bethell joint committee on home and community based services and KanCare oversight describing the status of any plan to integrate, consolidate or alter such waiver services or combine, reassign or otherwise alter currently designated responsibilities to provide intake, assessment or referral services for such services, including any proposed waiver applications or amendments, any service definitions and the proposed rate structure for each such service: Provided further, That the department of health and environment and the Kansas department for aging and disability services shall submit such reports on or before January 1, 2018, and March 1, 2018.

Articles of Interest

Kansas Lawmakers Boost Some Spending for Mental Health System – kcur.org

http://kcur.org/post/kansas-lawmakers-boost-some-spending-mental-health-system#stream/0 

New Problems Same Result: Federal Payments Still Halted for Osawatomie State Hospital – kcur.org

http://kcur.org/post/new-problems-same-result-federal-payments-still-halted-osawatomie-state-hospital

Editorial: It’s Time to Think About Replacing Osawatomie State Hospital

http://www.kansascity.com/opinion/editorials/article157965149.html

Legislature Wraps Up June 10 The Kansas Legislature went home Saturday evening after approving Senate Sub for HB 2002 – the conference committee report containing the mega-budget and omnibus budget provisions.  The budget does not meet all of the goals set out by the Coalition, but it does reverse of the negative trend for the behavioral health continuum of care over the past ten years. The House/Senate budget negotiations were rushed this year, with the six members of the Appropriations/Ways and Means budget conference committee meeting every few hours beginning Thursday evening, after the House had adopted its budget bill, and wrapping up around midnight Friday night. Legislators return to Topeka June 26 for Sine Die – the ceremonial last day of the session.  They may or may not have any real work to do, depending whether or not Governor Brownback pulls out his veto pen again.  He can line item veto items in the budget bill and some are predicting he will veto HB 2278, "the guns bill", which allows state hospitals and other public health facilities to continue to ban guns on their premises.  It is true that the administration requested the exemption for the state hospitals, but some believe he will oppose extending that privilege to KU Medical Center and other facilities Budget Adjustments (these items are adjusted from the Governor’s proposal) Following budget policy this session was a challenge with multiple bills, provisos and other moving pieces.  Below is a list of items we’ve been tracking.  Please note that there may be adjustments later, as the agencies calculate what these amendments to the Governor’s Budget Proposal really mean to their bottom lines.  The article continues below the chart. FY 17 FY 18 FY 19 KDADS contract community providers for targeted MH residential treatment (HB 2052) 1.0   m   SGF Restore the 4% Medicaid provider reimbursement reductions from May 2016 allotment (HB 2002 and HB 2079)  Target date July 1 2017   161.3 m      AF 226.7 m     AF House Proviso to add CMHC funding from multiple sources = combination of grants and crisis stabilization centers funding to total $10.5 m in FY 18 and $13.2 m in FY 19 (HB 2002)    see breakout below CMHC Grant Restoration* (HB 2002) 4.0 m 2.2 m CMHC Grant Restoration* (HB 2002/HB 2079 assumes HMO fees meet projections) 3.5 m 5.0 m Community Crisis Stabilization Centers (HB 2002/HB 2053 = CIA/HB 2313 assumes Lottery vending machines meet projections) 3.0 m 6.0 m Clubhouse Model Program Fund** (HB 2002/HB 2313 assumes Lottery vending machines meet projections) 1.0 m 2.0 m House Proviso orders KDADS to pursue certified clubhouse model programs in FY 18.  (HB 2002 – proviso replaces HB 2044 language which was vetoed due to the Medicaid Expansion addition to the bill) Restore reimbursement for inpatient assessments at CMHCs (HB 2002) SGF/AF 1.3/2.8 1.3/2.3 Rural Health Psychiatric Bridging Program at University of Kansas   (HB 2002/SB 32 psychiatric medical loan repayment) 1.0 m Fund an additional 20 beds at Osawatomie State Hospital. If the facility cannot open the beds at Osawatomie State Hospital, the funding is to be used to enter into a contract to provide patient beds through third-party facilities for FY 2018.  (HB 2002) 4.7 m 4.7 m Osawatomie State Hospital (OSH) Supplemental Operating Funds *** to replace lost federal income due to decertification and declining private pay (HB 2052/HB 2002) 2.8 m 6.6 m Larned State Hospital (LSH) Supplemental Operating Funds to replace federal DSH recoupment due to incorrectly including SPTP numbers and declining private pay (HB 2002) 6.5 m Senate proviso requires the agency to issue a request for proposal for the construction of a 100-bed psychiatric care facility at Osawatomie State Hospital and require the agency to report the results of the request to the Joint Committee on State Building Construction, Senate Ways and Means Committee, and House Appropriations Committee on or before January 8, 2018.  (HB 2002) Senate proviso requires the agency to conduct an engineering survey on all buildings on the grounds of Osawatomie State Hospital to determine whether buildings can be renovated and the cost of renovations; if buildings cannot be renovated, the cost of the demolition; and that such report will be presented to the Joint Committee on State Building Construction, Senate Ways and Means Committee, and House Appropriations Committee on or before January 8, 2018. (HB 2002) HCBS waivers provider reimbursement rate increase for wages of direct services workers (HB 2002) 20.3 m 3.0% 48.1 m 4.0% House Floor Amendment requires KDADS to convene a mental health task force to provide a report to Legislature by Jan 8 2018 (HB 2002) *Kansas Mental Health Coalition supported restoration of $20 million to CMHC grants, but the 2017 Legislature made a good start by restoring $7.5 million. **Breakthrough Club of Wichita had requested opening a Medicaid reimbursement code, but the Legislature opted for a contract program at KDADS due to the uncertain fiscal note. ***Governor’s Budget Amendment No. 1, Item 7, added $13.2 million, including $8.9 million from the State General Fund for FY 2018 The Senate Committee recommended a different amount totaling $6.6 million, including $2.3 million from the State General Fund, which is a decrease of $6.6 million, all from the State General Fund, below the Governor's budget amendment. The Senate Committee also recommended the State Finance Council review the current status of funding at Osawatomie State Hospital during the 2017 legislative interim.  If the Adair Acute Care Unit is recertified before the end of FY 18, the additional money may not be needed.  (KDADS initially requested $11.7 m in FY 18 but the Governor did not include those funds in his January budget proposal.) NOTE:  KDADS initially requested $3.9 m for hospital diversion – which would include the 12 adult diversion beds operated by KVC in Kansas City.  It is not clear to me yet how this contract is to be funded, but it could be a part of the $6.6 m supplemental funding for OSH or perhaps the $4.7 m for bed expansion. More Budget News There are other significant elements of the budget bill.  HB 2002 includes State Employee Wage Increases of 2.5 percent for all except elected officials and those who have had recent wage increases and 5.0 percent for employees who have not had a wage increase in five years.  Kansas will also open an on-site state employee health care clinic in Topeka at a cost of $2.7 million. Safety net clinics received $1 million, but I’m not yet certain if that is an enhancement or restoration of lost funding.  The senior care act funding is restored to pre-FY 17 funding with $1.5 million in FY 18 and $2.1 million in FY 19. The Office of the Inspector General is moved out of KDHE to the Attorney General’s office. The State will transfer $6 million to KDOC for evidence based juvenile programs. The Legislature specifically prohibits KDADS and KDHE from pursuing integration of the HCBS waivers and authorizes KDHE to extend the Kancare contracts another year.  The Legislature reversed the “capable person policy” that KDADS had implemented for HCBS waivers.  A proviso requires KDADS to report quarterly on the number of people, cost of services, and encounter data for the individual HCBS waivers. The Legislature rejected the Governor’s plan to securitize the Children’s Initiatives Fund / KEY fund. The Department for Children and Families will implement Sub for SB 95 allowing for telephonic signatures for public assistance applications and report on actual costs for program implementation. The Children’s Service League’s intensive home visitation program will receive TANF funds of $3 million. While SB 30 is a significant income tax bill, raising $582 m in its first year, the budget still requires sweeps from the Kansas Highway Fund, transfers from the Pooled Money Investments Board, and delayed KPERs payments.  There may also be healthy internal borrowing in FY 18 to bolster the reinstatement of the 4% Medicaid cuts, since money from the increased HMO privilege fees won’t come in until March 2018. On another note, projected receipts from expanded gaming (casinos) are dropping – reduced $2.8 m in FY 17, $6.5 m in FY 18, and $7.8 m in FY 19.  This reduces the money available in the expanded gaming addictions fund  Finally, there is a group of legislators – including many Democrats, who believe the new education finance plan passed in SB 19 last Tuesday will not pass Supreme Court scrutiny, and they could be back in Topeka in July for a special session.  That bill spends an additional $186.6 million in FY 18 and $283.8 million in FY 19 to satisfy the Supreme Court decision that K-12 funding is inadequate. If you have questions about the budget or any other legislation, feel free to contact Amy.

Contact Amy Campbell, KMHC Lobbyist by clicking here:  Lobbyist Email

Tomorrow is Day 100 of the 2017 Kansas Legislative Session – Another Tax Bill Rejected

House leaders hoped to gain progress as they began the 4^th week of the Veto Session with a new tax bill – but it did not work out as planned.  The Tax Conference Committee crafted Sub for SB 30 on Monday afternoon, and the House debated the bill at 7 p.m. Monday evening.  It was a combination of income tax increases and motor fuels tax anticipated to raise about $600 million per year. 

It appeared this new tax package might pass – afternoon social media posts by several moderate interest groups supported the plan – but it failed 53-68.  Read SB 30 Summary here.  Most of the House Democrats have pledged to hold out until an education funding plan is part of the package.  Multiple Republicans spoke against the bill – saying it raised more revenue than is necessary to close the immediate budget gap.  That is unclear without an education plan.

Read the article : Kansas Votes Down Latest Plan to Roll Back Brownback Tax Plan – Kansas City Star http://www.kansascity.com/news/politics-government/article152071472.html

House and Senate leaders have been working to close the $900 million budget gap between revenues and forecast expenditures before resolving the education funding challenge put forth by the Kansas Supreme Court.  In order to do that, they would need to convince enough education supporters that there will be a separate funding bill that is sufficient to satisfy the court before the end of the session, and many just aren’t buying it. 

So, all of those who are counting on pieces of the mega-budget and omnibus budget plans must simply wait to see if tax policy can be crafted that would preserve their needs while also covering whatever new funding target the Legislature adopts for K-12 education.  (Neither the mega-budget nor omnibus budget proposals have been voted on by either chamber.)

The Senate Education Budget Committee is meeting this afternoon and Chair Jim Denning suggested they may work well into the night to put together a Senate education plan. The Senate has lagged behind the House in working on an education proposal.

The House Education Budget Committee passed a bill “without recommendation” on May 15 that would spend an additional $179 million in the 1^st year and $100 million in the 2^nd year, but it has not seen action in the full House.  Many were disappointed with that proposal, because it fell short of a plan that had been under development in the committee to increase K-12 funding $150 million per year for five years.  The bill does fund all-day kindergarten and adds $21 million for at risk students.   If that bill reaches the House floor for debate, it is certain to draw many amendments.

Last Friday, House Minority Leader Jim Ward offered a motion to pull that bill above the line for immediate House debate, but it was denied – and the Speaker called it “theatrics”.

The Supreme Court ordered the Kansas Legislature to address school funding adequacy by June 30.

The Kansas Legislature does not pay for secretaries for rank and file legislators after the 90^th day of the session,which was May 14.  Bizarrely, some legislators do not check their office messages, meaning that a constituent calling a legislative office may receive a voice message saying the office is “closed” until January.  

If you run into this problem, the majority of legislators are continuing to monitor their emails and many have alternative phone numbers on their profile at www.kslegislature.org.  This veto session could easily go well into June, and many key issues are still to be debate - so please do not stop contacting your legislators!

The Senate passed the Conference Committee Report for HB 2313 on May 18 on a vote of 21-16.

HB 2313 would amend the Kansas Lottery Act to allow the use of lottery ticket vending machines, the use of instant bingo vending machines, amend law concerning underage purchasing of lottery tickets and amends the State Debt Setoff Program.  The instant bingo vending machines language was added by the conference committee and created controversy in the Senate.

The bill would authorize moneys in the Lottery Operating Fund be used for transfers to the Community Crisis Stabilization Centers Fund and Clubhouse Model Program Fund of the Kansas Department for Aging and Disability Services.  These are new funds that would be created at KDADS.  Funds transfers would provide 75% to the Community Crisis Stabilization Centers Fund and 25% to the Clubhouse Model Program Fund.  Funds would be limited to no more than $4 million in FY 18 and $8 million in FY 19, FY 20, FY 21, and FY 22.

If the House adopts HB 2313, the mega-budget bill proposal would likely be adjusted reduce additional funds set aside for these services – as per a proviso adopted by the House Appropriations Committee.

The bill makes lottery and casino winnings subject to state debt program and can be withheld for child support or other state debt.  Tickets purchased by underage individuals (under 18) would be void.  

Today, Congress passed the AHCA repealing the Affordable Care Act (Obamacare) with a partisan vote of 217-213. The bill will go to the Senate.  It is expected to be amended in the Senate.

The legislation would offer tax credits instead of subsidies to pay for health coverage.  It allows states to opt out of basic requirements established by the ACA, including essential health benefits, coverage for preexisting conditions, etc. It requires states to provide high risk pools to cover those with preexisting conditions, if the state chooses to opt out and offers some funding that could be used to help pay for that and health services not covered. 

The legislation changes the current cost equalization formula, allowing premiums to be lower for young people and higher for older adults.  Medicaid would no longer be funded according to beneficiaries’ needs – it would be paid on a per member basis or states could accept a limited block grant for their program.  Kansas state officials have been talking about a Medicaid block grant for over a year, hoping that would help them to eliminate the annual cost increases to the program.  (It is not clear how annual health care cost increases would be managed if the funding does not grow at a comparable rate.)

The legislation attempts to encourage policyholders to avoid lapses in coverage by requiring a 30% surcharge when policies lapse.  (This, of course, assumes that people have some choice in whether or not their policies lapse.)  

The bill will repeal the payroll tax and investment tax increases on higher income payors that were designed to help pay for the ACA.

Kansas delegation in U.S. House unanimously votes for partial Obamacare repeal, http://cjonline.com/news/local/2017-05-04/kansas-delegation-us-house-unanimously-votes-partial-obamacare-repeal

Read an article about what is in the AHCA legislation  https://www.nytimescom/2017/05/04/us/politics/major-provisions-republican-health-care-bill.html?_r=0

Senate Ways and Means Passes Several Key Bills

This afternoon, the Senate Ways and Means Committee passed several key bills. 

1. HB 2002 is the Senate’s omnibus budget bill – containing the items not addressed in the mega-budget bill.  It includes some of the Governor’s Budget Amendments, consensus caseloads adjustments and such.  After making another round of adjustments and adding new provisos this afternoon, the committee adopted Senate Sub for HB 2002 on a vote of 11-2  The Senate omnibus bill does not fully fund the Osawatomie State Hospital shortfall, but does include $2.8 m for FY 17 and $6.6 m for FY 18 (half of the Governor’s request).  The Senate committee also added provisos – the first requires the agency to issue an RFP to build a 100 bed state hospital facility at Osawatomie to be operated by the State.  The second asks the agency for a full engineering study of the buildings and property and the rehabilitation or demolition needs at Osawatomie State Hospital.  See the attached notes of the committee meeting last Friday to read the committee discussion beginning page 6 re: OSH.  (Read the notes from Senate Ways and Means Friday, April 28.)
2. HB 2130 – now contains the MCO privilege fees language needed to restore the Medicaid reimbursement cuts.  Will need to see a copy to compare with HB 2180.
3. Senate Sub for HB 2278 – contains the language from SB 235 to exempt state hospitals, KU Hospital Authority, community mental health centers, indigent care clinics and public adult care homes from the concealed carry requirements.  According to Chair Carolyn McGinn, the committee has been waiting for an amendment to be negotiated, but that amendment has not been forthcoming.  Therefore, the committee would advance this bill or would need to add the $12 million for security at the state mental health hospitals as described in the Governor’s Budget Amendment request.  (See page 2 of the notes to read the notes from the committee discussion last week on the topic of allowing guns on the state mental health hospital campus.)  The motion was offered by Senator Anthony Hensley and seconded by Senator Skubal.  A motion to amend by including college campuses was reluctantly withdrawn by Senator Tom Hawk when it appeared the amendment could scuttle the entire bill.  The bill was adopted as amended on a voice vote with one recorded “no” from Senator Alley.