TOPEKA — Hutchinson anesthesiologist and Sen. Mark Steffen led opposition Friday to a Kansas House bill earmarking $10 million in state funding for grants to economically distressed rural hospitals working to innovate on delivery of health care to patients.
Steffen and other members of the Senate Health and Human Services Committee deflected a proposal establishing a private-public partnership on behalf of rural hospitals that featured a 2-to-1 match from private donors for every $1 invested by the state. He objected to potential waste of taxpayer dollars on a grant program open to relatively large hospitals in Great Bend, Salina, Hays, Hutchinson and elsewhere. He also said influx of federal COVID-19 funding should have resolved any financial challenges at hospitals across Kansas.
“It’s an irresponsible use of $10 million in taxpayer money. We are struggling with our budget,” said Steffen, a Republican. “I don’t understand why we’re throwing $10 million at them.”
The Center for Health Care Quality and Payment Reform released a studying indicating 75 of Kansas’ 105 rural hospitals were operating at a financial loss and at risk of closing. Five rural Kansas hospitals have shut down since 2010. Prior to the pandemic and federal spending in response to 539,000 deaths in the United States and 4,800 in Kansas tied to COVID-19, Kansas’ status in America’s Health Rankings had fallen from eighth in the nation in 1991 to 29th in the country in 2019. The state’s decline in that ranking was unmatched.
The Republican-led House and Senate in Kansas blocked since 2014 expansion of Medicaid services to more than 100,000 lower-income residents. In early March, the Senate declined to adopt expansion legislation. Thirty-two states passed expansion laws and four GOP-leaning states approved voter ballot measures requiring expansion. In July, Medicaid expansion will come to Oklahoma and Missouri.
“In the midst of the worst public health crisis in a century,” said Vicki Hiatt, chairwoman of the Kansas Democratic Party, “Republicans in the Kansas Senate don’t think low-income working families and vulnerable Kansans who have lost their jobs due to the COVID-19 pandemic deserve health care.”
Gov. Laura Kelly, who made Medicaid expansion a top priority of her administration, said the American Relief Plan signed by President Joe Biden offered a $460 million incentive to Kansas for broadening access to preventative health services under KanCare, the state’s privatized Medicaid program.
The $10 million grant initiative endorsed by the Kansas House as well as the Kansas Hospital Association and Kansas Medical Society was excluded from Senate committee’s telehealth package folded into House Bill 2208.
Tara Mays, a lobbyist with the Kansas Hospital Association, defended the grant proposal as a way to benefit rural hospitals exploring new approaches to health-care delivery. She didn’t address to the satisfaction of senators on the committee questions about the bill’s ambigious language on authorization of grants.
“I appears to be an attempt to help our rural hospitals,” said Sen. Molly Baumgardner, R-Louisburg. “I don’t think any of us are opposed to that. It’s the vagueness that seems to be troubling. Hospitals should be, on an ongoing basis, addressing how it is that they meet the needs through delivery. That should be what they’re doing on an ongoing basis.”
The telemedicine bill approved by the Senate committee would allow the Behavioral Sciences Regulatory Board to alter licensure and permit requirements of social workers, marriage and family therapists, addiction counselors, psychologists and counselors. Another portion would enable recertification of Kansas medical facilities as “rural emergency hospitals” to lower the number of mandated beds and control costs.
In addition, the Senate committee’s bill would extend emergency waiver of regulations on use of out-of-state physicians through telemedicine adopted last year when the COVID-19 pandemic emerged.
Jill Lee, Overland Park, submitted written testimony to the Senate committee in support of preservation of telemedicine options for doctors practicing outside Kansas. She was diagnosed with stage IV colon cancer in March 2020 and began chemotheraphy. She said surgeons at University of Kansas Health System, Olathe Health and Advent Health in the Kansas City area were unwilling to operate on her despite evidence of improvement in September. She reached out to California physician Yuman Fong through telemedicine services in December and tentative plans were made to operate.
Subsequent testing revealed regrowth of her cancer and compelled additional chemotheraphy before attempting surgery, Lee said. However, the Kansas executive order allowing Fong to consult with Lee is scheduled to expire by the end of March. It is possible the Kansas Board of Healing Arts could provide Fong a temporary extension to care for Lee.
“People in need of the kind of care that can only be found out of state shouldn’t have to endanger themselves by getting on a plane and being exposed to viruses and germs. Not when technology exists that makes it possible for them to have the same appointments in the safety of their own homes,” Lee said.
“In my case, no one that we have found in the state of Kansas is willing to do the surgery that could potentially save my life. Thus, out-of-state care is necessary,” she said. “I’m a wife and a mom to a sweet 2 1/2-year-old son, both of whom I am fighting desperately to stay alive for. And I’m sure there are others in Kansas in similar shoes. Please don’t let legislation preventing telemed be the reason we aren’t here for the ones we love.”