Kansas hospitals are moving ahead with plans to put a Medicaid expansion plan before lawmakers despite election results that returned Gov. Sam Brownback to office and solidified conservatives’ control of the Legislature. Democrat Paul Davis favored expansion but came up short in his bid to upset Brownback, a Republican who thus far has opposed expansion. Also, several Democratic House members who likely would have favored expansion lost narrowly to GOP challengers. Similar results across the country prompted national observers to declare expansion unlikely in Kansas and four other states where candidates who opposed expansion won close governor’s races. “No one would say it was a good night for the prospects of Medicaid expansion,” Joan Alker, director of the Center for Children and Families at Georgetown University, told Kaiser Health News. Twenty-eight states and the District of Columbia have expanded Medicaid eligibility, while Kansas and 20 other states have not. Policymakers in two states are considering the issue, according to the nonpartisan Kaiser Family Foundation.  Signals sent When talking to reporters on election night, Brownback gave no indication that he had changed his mind on Medicaid expansion. “If you’re talking about Obamacare,” he said, “we’ll look at things another day for that.” Tom Bell, chief executive of the 136-member Kansas Hospital Association, doesn’t expect an immediate change of heart. But now that the election is over, Bell said, he has reason to believe the Brownback administration and some legislative leaders will be more open to discussing expansion. “Yes, we’ve had folks in the administration that have indicated that after the election this…...

A once-obscure effort by a group of states to get out from under federal health care regulations has become an issue in the final days of the Kansas governor’s race. On Wednesday, Democratic lieutenant governor candidate Jill Docking teamed with Republican Insurance Commissioner Sandy Praeger at a Wichita news conference to criticize Republican Gov. Sam Brownback for signing a bill authorizing Kansas' membership in a multi-state health care compact. Docking, Democrat Paul Davis’ running mate, said the compact could put the “Medicare benefits of Kansas seniors at risk.” If the compact is approved by Congress, its nine member states could suspend federal health care regulations within their borders and take over several programs now administered by the federal government. Docking, Praeger and other critics of the compact charge that it opens the door to a possible state takeover of Medicare, the health care program that serves approximately 450,000 Kansas seniors. “Supporters of the (compact) bill may tell you it does not affect Medicare, but that is just false,” Praeger said. “It would be a serious mistake to turn Medicare over to state control.” The issue has been gaining momentum in recent weeks, partially because of an effort by legislative supporters of the compact to stifle a Johnson County advisory group’s effort to publish their concerns about it in a newsletter mailed to country residents. On Thursday, State Budget Director Shawn Sullivan entered the fray. In a column sent to Kansas media outlets from Gov. Sam Brownback’s office, Sullivan, a former nursing home administrator, sought to address what he called “the considerable misinformation”…...

The top-of-the-ticket races may be commanding the most attention in this year’s Kansas election, but significant issues also are in play in some of the down-ballot contests. The insurance commissioner’s race is one example. Like the higher-profile races, it features candidates with very different perspectives on key issues. But unlike those races, the contestants remain largely unknown to Kansas voters. A poll taken as the race heads into its final week showed Republican Ken Selzer leading Democrat Dennis Anderson by double digits – but nearly half of voters didn’t know either candidate. Nonetheless, some big issues are in play, including the Affordable Care Act, the controversial federal health reform law. Selzer, a conservative, wants to see it repealed. Anderson carefully avoids endorsing the law but says he supports the goal behind it of making affordable health coverage available to millions more Americans. “The core issue is how do we provide protection for the most people?” Anderson says, adding that using tax credits to help the uninsured purchase coverage ultimately will reduce the number of hidden charges built into insurance policies and hospital bills. “People don’t often understand that the population that doesn’t have coverage costs us in terms of higher commercial insurance premiums or additional social programs,” Anderson says. “If they get ill and they go to a hospital and they can’t pay, who pays the bill? Well, we all do. It’s just that we’re distributing it in kind of an invisible way right now.” Selzer, on the other hand, opposes the ACA as an unnecessary intrusion into the private marketplace. He says…...

Remember that headline-grabbing report last week that said Kansas was the only state in the nation to see a significant increase in its uninsured rate? Well, it’s looking more and more suspect. Some officials were immediately skeptical when the Gallup-Healthways Well-Being Index survey results were released, showing that the adult uninsured rate in Kansas had increased by 5.1 percentage points, jumping from 12.5 percent in 2013 to 17.6 percent by mid-year 2014. Kansas Insurance Commissioner Sandy Praeger was among the doubters. She said the number appeared to be “an anomaly” because a spike of that magnitude from one year to the next “would be unprecedented.” But others seized on the numbers to score political points. Some said Kansas’ decision to join 23 other states in not expanding Medicaid contributed to the increase. Others said the number was evidence that the Affordable Care Act was failing to achieve its primary goal of reducing the number of uninsured – if only in Kansas. But upon closer inspection, neither contention appears to be the case. Increases not decreases Even though Kansas didn’t expand Medicaid eligibility, enrollment is up significantly over last year because of something known as the woodwork effect. Increased attention to health insurance issues, due to the ACA, has caught the attention of people who already were eligible for the program and prompted them to enroll. Approximately 426,000 Kansans are enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) — together known as KanCare, the state’s managed care program — up from just under 399,000 in July 2013, according to state officials. About half…...

The same groups that used the wedge issue of Obamacare to unseat moderate Republican senators two years ago are targeting several House members for defeat in Tuesday’s GOP primary. But this time around, their efforts are being countered by groups that have organized to reverse the recent conservative tide in Kansas politics. TheKansas Values Institute and the Kansas Traditional Republican Majority are spending tens of thousands of dollars to defend moderate Republican Statehouse incumbents against charges that they failed to support conservative-led efforts to transfer control of federal health care programs to the state, block Medicaid expansion and repeal the state’s renewable energy standards. Targets of the ouster effort include Republican House members Barbara Bollier, Mission Hills; Stephanie Clayton, Overland Park; Blaine Finch, Ottawa; Russ Jennings, Lakin; Tom Sloan, Lawrence; and Kent Thompson, Iola. The Kansas Chamber and the Koch Industries-backed group Americans for Prosperityare the main players in the effort, just as they were in 2012 when they succeeded in defeating Senate President Steve Morris and several other moderate GOP state senators.  They are supporting Neil Melton, a Prairie Village banker, against Bollier; Jennifer Flood, a software consultant from Overland Park, against Clayton; Bob Fluke, chairman of the Franklin County Republican Party from Ottawa, against Finch; Stan Rice, a marketing director for a rural telephone and cable company who lives in Lakin, against Jennings; Jeremy Ryan Pierce, from Lawrence, against Sloan; and, Chad VanHouden, from Chanute, against Thompson. “It’s not about advocating the election or defeat of certain candidates, it’s about getting our issues out,” said Jeff Glendening, director of Americans for AFP-Kansas. “That’s…...

The now well-established local food movement in and around the university community of Lawrence is in danger of stalling unless a concerted effort is made to expand its reach beyond an already committed group of consumers and build more demand for locally grown or produced fruits, vegetables and meats. That’s the conclusion of a recent report commissioned by the Douglas County Food Policy Council with funding from the U.S. Department of Agriculture and the Kansas Health Foundation. The report, from Virginia-based consultant Anthony Flaccavento, suggests establishing a 19-county food hub in northeast Kansas to “grow the local food economy to the benefit of farmers and consumers in the region.” Such a hub would connect local farmers and ranchers to new markets and coordinate the distribution of their products to ensure a reliable supply to consumers – from individuals to restaurants to institutional buyers at schools, jails and hospitals. Expanding demand for and production of local produce and meat won’t be easy, Flaccavento says. But there is sufficient market potential to make it work if producers take an organized approach and are willing to be patient. “We do think it’s feasible,” Flaccavento says. “But we think it will take several years, probably in the range of five years to hit break even.” By the end of the fifth year, hub farmers could be generating up to $2.3 million in additional sales, the report says. Getting to that point will require careful planning and implementation to fill “critical gaps” in the existing local food system. The gaps include the lack of a central…...

The Johnson County Department of Health and Environment has joined the vanguard of local and state health departments that have gained national accreditation. It is one of only 44 across the nation and the first in Kansas. The Public Health Accreditation Board, a relatively new organization bent on standardizing and improving the quality of health departments, recently announced that the Johnson County agency and a dozen others across the U.S. had gained accreditation. The board is an independent organization that administers the national public health accreditation program. “Each time PHAB’s Accreditation Committee meets, we are excited to see a growing number of health departments for their review,” said PHAB chief executive Kaye Bender. “The group of health departments achieving accreditation this week is our largest group to date. They represent a diverse array of sizes and organizational structures of health departments, all committed to continuous improvement of their work to protect the public’s health.” The Kansas City, Mo., health department not quite a year ago became one of the first in the nation to gain PHAB accreditation. A number of other Kansas counties were laying groundwork to gain accreditation as early as 2011 and continue to work toward the goal. Lougene Marsh, director of the Johnson County department, said, "we are quite excited around here," by the news they received from the board. The department began the process in August 2011, she said, and then had a site visit from the accrediting team in April. Marsh said the Sedgwick County Health Department and the Lawrence-Douglas County Health Department might not…...

The inaugural edition of a Heritage Foundation news site features an interview with Gov. Sam Brownback explaining “how Obamacare’s Medicaid expansion hurts states.” The interview http://dailysignal.com/2014/06/03/interview-brownback-discusses-medicaid-expansion-hurts-states/ is featured in the Daily Signal, a new online publication “supported by the resources and intellectual firepower” of the foundation, which describes its mission as promoting “conservative public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values, and a strong national defense.” Just last week http://www.khi.org/news/2014/may/30/medicaid-expansion-supporters-stage-statehouse-ral/ Brownback told reporters in Topeka that he remains “open to Medicaid expansion,” adding that he was monitoring attempts by Republican governors in other states to take a more private-sector approach to expanding coverage. But that openness wasn’t apparent in the Heritage interview. Asked why Republican governors in Iowa, Indiana, Pennsylvania and other states were moving forward, Brownback said: “There is a lot of pressure to do it. And there is this presentation that this is free money from the federal government.” 'Wait and watch' Brownback said he believes his “wait and watch” strategy remains the best course of action because he isn’t convinced that the federal government will live up to its obligation to pay 100 percent of expansion costs for the first three years and not less than 90 percent thereafter.  Mounting federal debt will make it impossible, he said. “Do you think that a fiscally solid, prudent state like the state of Kansas is going to end up with a 90/10 ratio on Medicaid when the federal government is staring at that much cost? They’re going to up our percentage,”…...

A $25 million gift from the Hall Family Foundation has generated the funds needed by the University of Kansas to move forward with a critical building project on its medical center campus. The gift, announced Tuesday at the KU Med Center, gives the university most of the $75 million needed to construct a new medical education building. The new facility will replace an aging building that doesn’t meet modern classroom standards and needs more than $5 million in repairs. “We’ve been limited by the size and capabilities of our current health education facility. Well, that’s about to change,” said KU Chancellor Bernadette Gray-Little. “Once complete, the new building will allow us to increase the number of doctors that we train each year and train them in technologically advanced environments that are required by modern health care education curricula.” Currently, KU admits 211 students to the medical school each year. The new building will give it the capacity to admit up to 260. “It positions KU to address the state’s doctor shortage head on,” Gray-Little said. The medical school was recently re-accredited but evaluators flagged its aging classroom facilities. Construction of the new building should eliminate those concerns going forward, said Doug Girod, executive vice chancellor of the medical school. “It will eliminate that situation entirely,” Girod said. University officials have been working for years to piece together funding for the building project. They raised $15 million internally and successfully lobbied lawmakers and Gov. Sam Brownback to issue $25 million in state construction bonds.  The Hall foundation gift brings the total…...

But Brownback campaign skeptical of the results By Jim McLean KHI News Service April 8, 2014 TOPEKA — Poll results released today indicate that the Medicaid expansion issue could be a factor in the Kansas governor’s race. The poll, conducted last week for MoveOn.org Political Action, a left-leaning group dedicated to “progressive change,” showed that 52 percent of Kansans favored expanding the health care program to more low-income adults. Approximately a third – 35 percent – said they were opposed to Medicaid expansion and 13 percent said they weren’t sure. In addition, 41 percent of voters said Brownback’s failure to expand Medicaid would make them less likely to vote for him. Public Policy Polling of Raleigh, N.C., conducted the survey, which also showed Democrat Paul Davis leading Republican incumbent Sam Brownback 45 percent to 41 percent with 14 percent undecided. The results from other states showed other GOP incumbents trailing Democratic challengers in part due to their opposition to expansion. Burdett Loomis, a University of Kansas political scientist who briefly served on the staff of former Democratic Gov. Kathleen Sebelius, said that Brownback and Republican legislative leaders opposed to the Affordable Care Act have so far been able to “shut off any consideration of Medicaid expansion.” Davis, the leader of the Democratic minority in the Kansas House, was a vocal supporter of expansion during the 2013 legislative session but has been less eager to discuss the issue since declaring his candidacy for governor, presumably due to its association with the Affordable Care Act, which remains unpopular with the public according to tracking…...

By Jim McLean - KHI News Service The ways of the Kansas Legislature are a frustrating mystery to Merilyn Douglas. The advanced practice registered nurse from Garden City is part of a group that is pushing for passage of a bill that would allow APRNs to practice independently from physicians. But that push has stalled. The bill hasn’t received a hearing in either the House or Senate and it’s too late in the legislative session for any discussion to begin. “This has happened to us three years in a row,” Douglas said. “It is frustrating. It challenges your faith in the legislative process.” Current law requires that APRNs work under a so-called “collaborative practice agreement” with a supervising doctor. Douglas and other advanced practice nurses say those agreements needlessly restrict their ability to establish their own practices and provide primary care in underserved parts of the state. “We’re a group of caring professionals who really believe that passing this bill would increase the number of health care providers for Kansans,” she said. “And it’s frustrating to work so hard and then to have one person – the chairperson of a committee – say ‘Well, I’m not ready to hear that bill yet.’” Legislative leaders aren’t ready to consider the bill largely because Kansas doctors and their veteran lobbyist, Jerry Slaughter, don’t want them to. Slaughter said lawmakers don’t like refereeing scope-of-practice disputes. So, he suggested that they wait until doctors and nurses have first…...

By Jim McLean KHI News Service TOPEKA — Medicaid expansion is nowhere to be found on Gov. Sam Brownback’s list of priorities and those of Republican legislative leaders as they work through a legislative session now dominated by school finance issues. But that didn’t stop nearly 200 expansion supporters from crowding into a wing of the Statehouse adjacent to the governor’s office on Tuesday for a noisy rally. The event was staged by more than 50 health care and social service organizations organized under the banner of the Kansas Medicaid Access Coalition. Sean Gatewood, a former Democratic legislator from Topeka and director of the coalition, outlined the case for expansion by reminding the crowd that the state’s current Medicaid program is one of the most restrictive in the nation. “If you don’t have kids and you don’t have a disability and you’re just a childless adult, there is no Medicaid for you. It doesn’t matter if you don’t make a dime,” Gatewood said. In Kansas, childless adults are not eligible for Medicaid no matter how poor they are. Adults with children are eligible but only if they earn less than 32 percent of poverty, about $630 a month for a three-person household. The federal health reform law allows states to increase Medicaid eligibility for all adults with annual earnings up to 138 percent of poverty – $15,856 for individuals and $35,325 for a family of four. And the law requires the federal government to pay 100 percent of the costs for three years. After that, the federal share gradually declines until it…...