Monday, April 14, 2014

Remembering Dr. Robert Harder

Robert Harder, Courtesy of Cjonline
As the news has reported, Dr. Bob Harder – pastor, legislator, cabinet secretary, advocate – passed away over the weekend, released from the deepening effects of a cancer that had taken him down. This article from the Topeka Capitol Journal summarizes his career, and the words of some who knew him well are clear reminders of the kind of leadership he represented in Topeka.

I worked for Dr. Harder, when he was Secretary, and worked with him as a legislative staff person who assisted him as he used his Secretary’s pulpit to facilitate legislative support for the programs sponsored by SRS. Tough, smart, hardnosed, tenacious … all these things described him well, but lost in those descriptors would be that his work, for decades, was to build and protect a network of government and community programs that were dedicated to the needs of persons who for a variety of disadvantages were seeking to get by and improve their lives in an otherwise hard and unforgiving world.

It is impossible to count the hundreds of thousands of persons he served, as well as the thousands of professionals he helped by leading, encouraging, guiding, admonishing,  and mentoring.  Dr. Harder will be missed, but his incredibly long tenure of leadership made a permanent mark on all of us, whether we know it or not;   therefore, his mission and his work will go forward.  

Tom Laing, Executive Director

Thursday, April 10, 2014

‘Health Care Compact’ bill sent to governor despite opposition

A bill authorizing Kansas to join other states in an attempt to gain control of federal health care dollars was approved by the Legislature before it adjourned Sunday.

House Bill 2553, or the ‘Health Care Compact’ bill, would allow Kansas to petition Congress for the right to decide how health care programs are structured and funded in the state.

Kansas Insurance Commissioner Sandy Praeger joined with the Kansas AARP to oppose the measure, citing its potential to transfer oversight of the federal Medicare program to state officials.

According to the Lawrence Journal-World, Praiger said House Bill 2553 would place federal funding for all health care services and health plans under the control of the Kansas Legislature and governor. Praeger also said if state revenues fall short then the funds for Medicare and other health programs could be used to support other state function.

“It is already happening with dollars meant for highway programs and funds in other state agencies being taken and used to offset spending for other legislative priorities, caused in part by the reduction in state income taxes,” Praeger said.

KHI News Service also reported on the commissioner’s opposition.

“It could jeopardize the coverage and benefits that seniors have come to count on,” Praeger said. “Kansans have paid into this program through payroll taxes and expect to receive the benefits they have been promised.”

Gene Meyer, chief executive officer of Lawrence Memorial Hospital, said to the Lawrence Journal World that the bill had the "potential to seriously damage hospitals and physicians in our ability to continue to deliver quality care to those we serve."

The House passed the compact bill, 74-48, on March 24.

However, some critics say that the bill is merely a symbolic statement by those opposed to the Affordable Care Act. The compact could not take effect unless approved by Congress, for that to happen the Affordable Care Act would have to be repealed with Congress ceding all authority to the states for healthcare funding.  

Kansas is the eighth state to endorse the compact. If approved by Congress, the member states could receive federal Medicare and Medicaid dollars as block grants, giving them the ability to restructure the programs.

Tuesday, April 8, 2014

'Prompt pay bill' could impact future of Medicaid expansion

This week Kansas legislators completed their work on House Bill 2552, also referred to as the “prompt pay bill”.

The bill is intended to ensure the state’s Medicaid managed care contractors promptly reimburse providers, addressing widespread reports of problems getting timely payments from managed care companies.

An amendment was added to the bill by the Senate prohibiting the state from expanding Medicaid eligibility without approval from the Legislature.

The Federal Health Reform Law encourages states to expand Medicaid eligibility to include all adults earning up to 138 percent of federal poverty guidelines. Kansas is one of 19 states deciding against the recommended expansion of Medicaid.

According to KHI News Service, Kansas currently has among the nation’s most restrictive Medicaid eligibility criteria. These criteria essentially limit the program to low-income children, the disabled, and the elderly. Childless adults cannot qualify regardless of their income and/or poverty status.

House Bill 2552 was approved by the Legislature, with the Medicaid provision included, and sent to Gov. Sam Brownback earlier this week for signature.

Wednesday, April 2, 2014

5 major impacts of Kansas tax cuts

Tax cuts enacted in Kansas in 2012 were among the largest ever enacted by any state. Last week the Center on Budget and Policy Priorities published a comprehensive report on how these tax cuts have affected and will affect the state.

The report states that these huge tax cuts have left Kansas’ schools and other public services stuck in the recession, and declining further — a serious threat to the state’s long-term economic vitality. Meanwhile, promises of immediate economic improvement have utterly failed to materialize.

  1. Deep income tax cuts caused large revenue losses.  Kansas’ tax cuts this year are costing the state about 8 percent of the revenue it uses to fund schools, health care, and other public services, a hit comparable to a mid-sized recession.  State data show that the revenue loss will rise to 16 percent in five years if the tax cuts are not reversed.
  2. The large revenue losses extended and deepened the recession’s damage to schools and other state services.  Most states are restoring funding for schools after years of significant cuts, but in Kansas the cuts continue.  Governor Sam Brownback recently proposed another reduction in per-pupil general school aid for next year, which would leave funding 17 percent below pre-recession levels.  Funding for other services — colleges and universities, libraries, and local health departments, among others — also is way down, and declining.
  3. The tax cuts delivered lopsided benefits to the wealthy.  Kansas’ tax cuts didn’t benefit everyone.  Most of the benefits went to high-income households.  Kansas even raised taxes for low-income families to offset a portion of the revenue loss; otherwise the cuts to schools and other services would have been greater still.
  4. Kansas’ tax cuts haven’t boosted its economy.  Since the tax cuts took effect at the beginning of 2013, Kansas has added jobs at a pace modestly slower than the country as a whole.  The earnings and incomes of Kansans have performed slightly worse than the U.S. as a whole as well.  (An exception is farmers, whose incomes improved as the state recovered from a drought.)  And so far there’s no evidence that Kansas is enjoying exceptional business growth: the number of registered business grew more slowly last year than in 2012, and the state’s share of all U.S. business establishments fell over the first three quarters of last year, the latest data available.
  5. There’s little evidence to suggest that Kansas’ tax cuts will improve its economy in the future.  No one knows for certain how Kansas’ economy will perform in the years ahead, but it isn’t likely to stand out from other states.  The latest official state revenue forecast, from November 2013, projects Kansas personal income will grow more slowly than total national personal income in 2014 and 2015.

That state’s massive tax cuts have created a large and growing revenue loss and forced further cuts in funding for schools and other public services that the state had already cut because of the recession.  The tax plan also has widened inequality and raised taxes on the lowest-income families.  Finally, a year after the cuts first took effect, the state’s economy is not performing particularly well, and there’s no evidence to suggest that the tax cuts will cause the economy to take off in the years ahead.
Read the entire Center on Budget and Policy Priorities report for more details.

Monday, March 31, 2014

Senate approves ‘prompt pay’ bill, with Medicaid provision

House to decide if KanCare managed care
contractors are required to make prompt payments
The Kansas Senate on Tuesday approved a bill designed to increase requirements that the state’s KanCare managed care contractors make prompt payments to Medicaid service providers.

According to a KHI News Service article, the bill had wide support from doctors and service providers. Supporters said payment delays could create critical cash flow problems, especially from small provider organizations.  Since Brownback’s KanCare initiative was launched earlier this year, provider groups have reported problems getting timely payments for services from the managed care companies.

Before approving the bill, the Senate added a provision to it stating that the state’s Medicaid program can’t be expanded in keeping with the Affordable Care Act without express approval of the Legislature. The federal health reform law encourages states to expand Medicaid eligibility to include people earning up to 138 percent of federal poverty guidelines. Kansas currently has among the nation’s most restrictive eligibility standards and essentially limits Medicaid to poor children and those who are disabled or elderly. Childless adults don’t qualify regardless of how poor they are.

The underlying legislation of the bill would allow Medicaid providers who don't get paid in timely fashion a cause of action to pursue their claims in court and allow the assessing of 12 percent extra for each month a managed care company did not fully pay or if the KanCare contractor failed to deny a claim within a certain period.

It is now up to the House to decide if it will accept the bill with the Senate's changes.

Tuesday, March 25, 2014

Developmental Disability Awareness - more than a month

March is Developmental Disability Awareness Month.
This year's theme is "Ability at Work".
Developmental Disability Awareness Month is drawing to a close, but for individuals, families, and service providers, intellectual and developmental disability (I/DD), awareness can be a lifelong struggle.

Most people have probably encountered an example of discrimination or ignorance toward someone with an intellectual or developmental disability. From saying “the r-word” to active avoidance in public, people are unknowingly perpetuating the stigma and negative stereotypes that face people with intellectual and developmental disabilities.

InterHab, a non-profit association of I/DD service providers, is focusing on assisting Kansans with intellectual and developmental disabilities in increasing their independence, productivity, integration, and inclusion into the community.

Hand-in-hand with individuals with disabilities, community leaders and lawmakers, the members of InterHab have positively impacted the state and will continue to do so throughout the year.

“We have fought hard for many years to promote awareness and protect the rights of Kansans with intellectual and developmental disabilities,” said Tom Laing, Executive Director of InterHab. “It’s important that lawmakers, along with the general public, view those with intellectual and developmental disabilities as active members of our community with individual strengths and unique contributions to our culture and economy.”

InterHab has an in-depth 2014 legislative platform emphasizing quality-based community expansion, responsive services, and system management that meets the needs of individuals with intellectual and developmental disabilities.

If you’re not a member of InterHab you can still raise awareness. Encourage your family, friends and coworkers to take time to recognize the contributions of people with intellectual and developmental disabilities. Vocalize your support on social media. Write your local senators and representatives. Most importantly, practice inclusion in your day-to-day life. Make a new friend who’s different than you, volunteer, and be respectful and mindful of people with intellectual and developmental disabilities.

Monday, March 24, 2014

Autism bill goes on to the full Senate

Last week a Senate committee endorsed a House-passed bill requiring state-regulated health insurers to cover the diagnosis and treatment of children with autism. According to a KHI News Service article, bills requiring state-regulated health insurers to cover autism have been the subject of legislative debate for the past six years.

This measure would require insurers to cover a type of therapy known as “applied behavior analysis" for up to 25 hours a week for autistic children diagnosed between birth and age 5. The treatments would be covered for four years, meaning that a child diagnosed at 2 would have access to up to 25 hours of the therapy a week until reaching age 6; a child diagnosed at 4 would have access until age 8. After the four years, coverage for the therapy could be limited to 10 hours per week. Children diagnosed after age 6 would be eligible for 10 hours per week. The coverage could end when the child turns 12.

Advocates for families with autistic children have argued that 10 hours per week wouldn't be enough and that 25 hours should be considered the bare minimum. Forty or more hours, they said, might be needed by severely autistic children.

Brandy Porter, a Manhattan attorney whose 10-year-old son, Will, is autistic, asked committee members to consider expanding the coverage to include children up to age 18.

“Cutting off the age limit at 12 would be failing our children,” she said. “It will not give them the opportunity to reach their full potential because skills will arise that can’t be taught prior to age 12.”

After the committee vote, Porter expressed support for the bill. “I’m glad something was passed,” she said. “It’s been a long six years. It’s not a perfect bill by any means, but I guess it is something. My child’s still going to get services because I pay for them out of pocket and I’m not going to stop.”

Read the entire story.