Legislators, lobbyists highlight hot-button health policy issues ahead of 2023 session
Workforce shortages, Medicaid expansion and mental health top agendas
The nonpartisan, nonprofit Kansas Health Institute hosted a forum Tuesday with legislators and lobbyists to discuss health policies likely to surface in the 2023 legislative session opening in January. (Kansas Reflector screen capture from Zoom video)
TOPEKA — Kansas Chamber president Alan Cobb said the Legislature should thoroughly examine whether schools and colleges were driving unnecessary inflation of academic requirements of people enrolled in programs leading to an occupational license.
Cobb, who leads the business lobbying organization, raised the issue during a panel discussion of health issues likely to be raised during the 2023 legislative session opening in January.
“It’s too often driven by those who are providing the training,” Cobb said. “Why do we have 1,500 clock hours to be a cosmetologist? The public is not demanding that. It’s many times the cosmetology schools. That sounds a little skeptical (or) cynical, but there’s something to that.”
In the health professions, an interim committee of the Legislature began examination into whether the state’s occupational licensing requirement of 90 hours of instruction for certified nurse assistants was out of step with the 75-hour mandate of the federal government. In Kansas, state licensing boards are involved in setting education requirements implemented by schools and colleges.
Kansas Health Institute, a nonprofit organization in Topeka advocating for policymaking through nonpartisan research and education, hosted legislators and lobbyists for a conversation about issues of importance to them as well as topics likely to emerge in the 2023 Legislature. The House and Senate have large Republican majorities, while Democratic Gov. Laura Kelly won a second term on Nov. 8.
Chad Austin, president of the Kansas Hospital Association, said the Legislature would certainly review reform of education and tax policy to address the substantial workforce shortage gripping the health care industry.
He said 80% of Kansas counties had an insufficient number of primary-care health workers. It goes beyond nursing, he said, to include radiology technicians, respiratory therapists, dietary aides and environmental service staff, he said.
He said the Kansas hospitals were struggling with a wave of retirements, staff departing for jobs in nonhospital settings and employees pivoting to second careers. Hospital staff turnover and vacancies are higher than three years ago, he said. Stress of COVID-19 was a factor, but other contributing factors included availability of affordable housing and child care.
Austin said the Legislature should reconsider a bill that didn’t survive the 2022 session that would help provide greater physical security for health care workers in hospitals. There also are issues with flexibility of telehealth services, staffing among teachers in health education programs and overall financial sustainability of hospitals, he said.
Rep. Susan Ruiz, a Kansas City, Kansas, Democrat on the panel, said the Legislature should resolve Republican opposition to expansion of eligibility for Medicaid. The GOP-led Legislature or GOP governors have thwarted enactment of Medicaid reform since 2014, effectively blocking $5.9 billion in federal funding that would have flowed through the health care system in Kansas.
Kelly in the past proposed plans to add more than 100,000 lower-income Kansans to the program, and she promised to submit a new recommendation in January.
“I hear from constituents and small business owners about the need for Medicaid expansion,” Ruiz said. “I know it’s not a topic that everyone agrees on.”
Glenda DuBoise, state director of AARP Kansas, endorsed Medicaid expansion as did Austin of the hospital association.
She said AARP would add to the wish list further investment in broadband internet services to widen the sweep of telehealth programs and to help the elderly avoid isolation through online contact with families. Tens of millions of federal dollars, partly in response to the COVID-19 pandemic, have been invested in Kansas broadband during the past two years.
“We’re very excited about the possibility of knowing that we will be about to get that into more homes, into rural areas of the state,” DuBoise said.
Sen. Molly Baumgardner, a Republican from Louisburg, said she expected the Legislature to continue working to address youth suicide, to explore weaknesses in the foster care system and to tackle challenges of modernizing programs for children with developmental disabilities.
The senator anticipated lawmakers would prioritize a review of services to children with dyslexia and other cognitive reading issues.
“We have seen some steps forward, but it really is time to revisit. Have the benchmarks been met and what are schools truly doing in classrooms?” Baumgardner said. “Being able to read, for a child, is so critical.”
Wichita Rep. Brenda Landwehr, a Republican, said she would hope the Legislature considered options for providing mental health services to children in family court due to divorce of the parents. She also wants to place into state law funding for mental health programs in K-12 schools. So far, she said, the school-based initiative has relied on year-to-year renewal of financing.
“It’s now got a track record of a lot of success,” Landwehr said. “There isn’t a year that has gone by that we don’t hear about a life that has been saved.”
In response to a question, Landwehr said a bill legalizing medical marijuana in Kansas would be first taken up by the Senate. In 2022, the House adopted a bill outlining regulation of marijuana for medical uses. The Senate didn’t consider that measure. Kelly has endorsed legalizing medical marijuana.
Cobb, president of the Kansas Chamber, said the legislation should be drafted to enable Kansas employers to deal with workplace substance abuse issues in a manner consistent with consumption of alcohol on the job. He said businesses in the Kansas Chamber were split on the issue of medicinal marijuana.
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