A new report from the AFL-CIO ranks Kansas as the 10th deadliest state for workers in 2011. Kansas had 78 workplace deaths in 2011 (7 fewer than in 2010). That’s a rate of 5.9 fatalities per 100,000 workers, compared with the nationwide rate of 3.5. Kansas also had 34,400 injuries or incidents of job-related illness. The study blames the poor record in part on a lack of safety regulations and inspectors. It said that Kansas had only 14 federal job safety inspectors and no state inspectors, and that those federal inspectors inspected only 786 of the state’s 87,223 work establishments in fiscal year 2012. But job accidents are also associated with certain types of work. States with significant mining, oil and gas extraction and agriculture sectors have higher job-fatality rates.
Good for Sen. Pat Roberts, R-Kan., for leading an effort to provide more oversight of pharmacy compounding, which now is mostly unregulated. Roberts has been working for more than 10 years to strengthen regulations regarding the mixing of medications, but the issue received more urgency after dozens of people died last year from an outbreak of spinal meningitis linked to contaminated steroid injections prepared by a compounding company in Massachusetts. “It really is unfortunate that 53 people have to die and 700 get sick before we have the will to do this,” Roberts said. Though Roberts is normally leery of more regulations, he recognizes that this is needed for public safety. “We just have to get it done,” he said. He’s right.
Before passing a bill that eliminates most mandates on health insurance, shouldn’t the Kansas House first make sure that such stripped-down coverage meets the coverage standards of the Affordable Care Act? But when asked on the House floor whether the “mandate-lite” policies qualified, Rep. Phil Hermanson, R-Wichita, vice chairman of the House Insurance Committee, said he didn’t know. “At this point, I couldn’t dissect everything that’s covered or not covered,” he said. Yet the House approved the bill anyway. So would the policies qualify? No, said Linda Sheppard, director of the Kansas Insurance Department Division of Accident and Health.
Health and Human Services Secretary Kathleen Sebelius noted during a program at Harvard University last week how the U.S. Supreme Court’s ruling upholding the Affordable Care Act and the re-election of President Obama haven’t ended the attacks on Obamacare. “The politics has been relentless and continuous,” she said. “We find ourselves still having sort of state-by-state political battles.” That includes in Kansas, where Gov. Sam Brownback still hasn’t decided whether to allow a federal expansion of Medicaid. Sebelius cited some of the benefits of ACA that are already in place (such as 6 million young adults being able to remain on their parents’ insurance policies and more than 70 million people receiving preventive health services without a co-pay). She also argued that many critics won’t acknowledge how much our health care system needed reform. “Prior to the Affordable Care Act,” she said, “America spent just about twice as much as any developed country per capita on health care, and our health results looked like we were a developing country.” But is ACA fixing that or making it worse?
Our March 22 Eagle editorial, “Speak now on budget,” referred to the unsuccessful effort by state Sen. Carolyn McGinn, R-Sedgwick, to amend the Senate budget plan “to help community mental health centers recover from the deep cuts they’ve sustained.” That drew an e-mail to the editorial board from Shawn Sullivan, secretary of the Kansas Department for Aging and Disability Services, who said “the mental health centers have not received deep cuts” and cited, among other increases, an “increase of $209 million in fiscal year 2011 to $252 million in fiscal year 2014 (budget projection) for total community mental health center funding.” Sullivan’s perspective differs sharply from that of Michael J. Hammond, executive director of the Association of Community Mental Health Centers of Kansas, who has said that mental health reform dollars, which are what the system relies on to serve the uninsured and underinsured, have been “reduced by 50 percent since fiscal year 2008” and that “funding cuts to mental health reform dollars continue to place the public mental health system at a breaking point.”
The 2013 Legislature has spent time trying to undermine past legislatures’ decisions on the sales-tax sunset, the transportation plan, the state’s renewable-energy goals and more. But a new poll confirms that lawmakers should not repeal or weaken the Kansas Clean Indoor Air Act, which is more popular now than when it became law in 2010. In the poll, sponsored by Topeka-based Sunflower Foundation: Health Care for Kansans, 78 percent of registered voters and 81 percent of GOP primary voters said they support the law, which prohibits smoking in public spaces and workplaces including restaurants and bars. A January 2010 SurveyUSA poll had found that 65 percent favored a statewide smoking ban. The latest poll followed a Kansas Health Institute study last month that found “no apparent evidence that smoking bans in Kansas have been associated with a decrease in statewide restaurant and bar sales, or with a decrease in the number of establishments serving liquor.” The law does have one obvious flaw: the loophole for state-owned casinos.
As a retired physician, Rep. Barbara Bollier, R-Mission Hills, should be a valued resource for her House colleagues when they consider health-related legislation. But as the House gave initial approval to the latest big anti-abortion bill Tuesday, it ignored her efforts to excise medically inaccurate language linking breast cancer to abortion. She made another excellent point: Legislation dealing with health issues should go through the chamber’s health committee.
The newly formed Kansas Medicaid Access Coalition – which includes more than 30 groups representing consumers, health care providers and religious organizations – is urging Gov. Sam Brownback to allow the federal expansion of Medicaid in Kansas. But Brownback continues to express doubts. “Right now, I can’t see a path that’s long-term fiscally sustainable for us in the state of Kansas to manage,” Brownback told Yahoo! Finance recently. “But if we can do something that’s a partial measure, something that we can sustain over time, I’m very willing to look at that.” A study by the Kansas Hospital Association estimated that the expansion would inject more than $3 billion into the state’s economy, create 4,000 jobs over the next seven years, and likely save the state more money than it cost. But Brownback predicted that the cost for states likely would go up due to federal budget problems.
It’s strange that as the Legislature talks about denying the University of Kansas Medical Center a requested $10 million to build a new health education building, the Senate would vote 33-7 to create a Midwest Stem Cell Therapy Center at KU estimated to cost $10 million over 10 years. Funding for the stem-cell center would come from federal grants, private gifts and other funds, according to a legislative note. “If Kansas could take a leadership position in that, it could be a highly useful thing for people to get treatments,” said Gov. Sam Brownback, who supports the new center but also recommended $10 million in state funding for a health education building at KU. Some KU faculty and administrators also have expressed support for the center, which would do non-embryonic stem-cell research. But such an important decision about the KU Medical Center and the Kansas Board of Regents should not start with a Statehouse mandate. And it’s hard to see why the center should take precedence over KU’s plan for the new $75 million medical building, which will help it train more physicians.
Include Insurance Commissioner Sandy Praeger among those supporting an expansion of Medicaid in Kansas. She said the expansion of Medicaid would help low-income Kansans who are not getting the care they need, the Topeka Capital-Journal reported. It also doesn’t make sense to forgo hundreds of millions of dollars in federal funding and have that money go to other states, she noted. Not expanding also would hurt hospitals, because federal subsidies for treating those without insurance are declining (in anticipation that Medicaid is expanding). “That could mean the difference, especially for some of our rural hospitals, between being able to keep their doors open (or not),” Praeger said.
The Kansas Chamber of Commerce’s political action committee and Americans for Prosperity spent tens of thousands of dollars on campaign mailers last year claiming that moderate GOP state lawmakers supported the Affordable Care Act. But since most of those moderates were defeated, has the new Legislature worked to “stop Obamacare”? No. “I’m not surprised,” former Senate President Steve Morris of Hugoton told the Topeka Capital-Journal. “The whole thing was bogus to start with.” So why did groups treat the federal law like a major state legislative issue? “Candidates polled voters, and if Obamacare elicited the greatest emotional response from the voters, then that was the issue the candidate ran with,” said Clayton Barker, executive director of the Kansas Republican Party. “Emotional voters turn out and vote – and in an election, votes are what matters.” How do those voters feel now?
Sixty percent of Kansans support the federal expansion of Medicaid in our state, according to a survey released last week by the Kansas Hospital Association. And nearly 3 in 4 Kansans think the state should maximize federal funds and prevent Kansas tax dollars from going to other states. Not expanding Medicaid would mean forgoing these funds and result in significant hardship on hospitals, because the Affordable Care Act reduces payments to hospitals that serve low-income uninsured patients (in expectation that many of these patients would be joining Medicaid). “It amounts to real cuts to hospitals,” said KHA president Tom Bell.
As Gov. Sam Brownback decides whether to allow an expansion of Medicaid in Kansas, he should listen to New Jersey Gov. Chris Christie (in photo), who this week became the eighth GOP governor to approve the expansion. Christie, who has been a fierce critic of the federal health care law, carefully reviewed the issue and concluded that the expansion is “the smart thing to do for our fiscal and public health.” He noted that it would provide insurance to tens of thousands of low-income residents, help keep hospitals financially healthy and actually save his state money. A study by the Kansas Hospital Association found the same would be true in Kansas –and that the expansion would inject more than $3 billion into the Kansas economy over the next seven years. However, none of that appeared to matter to a Kansas House panel, which approved a resolution Tuesday opposing the expansion.
Officers of the Medical Society of Sedgwick County are hoping that Gov. Sam Brownback allows the federal expansion of Medicaid. Society president Bart Grelinger told The Eagle editorial board that the Medicaid program in Kansas is currently “one of the worst in the nation” in terms of eligibility criteria, and that “there is not really a downside” to the expansion. Donna Sweet, society president-elect, said that Medicaid should be expanded for compassion reasons, but that it also makes economic sense. A study released last week by the Kansas Hospital Association estimated that the expansion would inject more than $3 billion into the state’s economy, would create 4,000 jobs over the next seven years, and could save the state more money than it costs.
There likely was no governor who opposed federal health care reform more than Florida Gov. Rick Scott (in photo). But when it came to deciding whether to allow a federal expansion of Medicaid, Scott put the interests of citizens before his own ideology and preferences – as Gov. Sam Brownback also should do. Scott said last week: “Quality health care services must be accessible and affordable for all – not just those in certain ZIP codes or tax brackets.… While the federal government is committed to paying 100 percent of the cost of new people in Medicaid, I cannot, in good conscience, deny the uninsured access to care.”
At least state Sen. Michael O’Donnell, R-Wichita, backed away Monday from his bill to prohibit health departments from becoming nationally accredited. But he wasted people’s valuable time by giving credence to the unfounded fears of Sedgwick County Commissioners Karl Peterjohn and Richard Ranzau that the federal government is trying to take over local health departments. As state Sen. Laura Kelly, D-Topeka, noted, the Legislature shouldn’t have been dragged into a Sedgwick County dispute. State and local health officials also seemed frustrated. “All of this took time and money that could have been spent in better ways,” said Dan Partridge, director of the Lawrence-Douglas County Health Department.
It’s good that the state has at least partly responded to concerns from doctors and hospitals about KanCare, the state’s newly privatized Medicaid program. The Kansas Medical Society and the Kansas Medical Group Management Association asked the state to extend for another 90 days the transition period when patients can continue to see their current doctors or doctors not yet in the new insurance networks, the Kansas Health Institute News Service reported. The medical groups cited more than two dozen problems with the transition, including billing errors, stalled payments and general confusion about which doctors the patients can see. The state declined to extend the transition period, but it announced that it would continue to deal with Medicaid service providers beyond the April 2 transition cutoff if the providers have contracts pending with the private insurance companies.
Last year 36,383 Kansans with Medicare who reached the Part D “doughnut hole” saved more than $24 million on prescription drugs as a result of discounts provided in the Affordable Care Act, according to the U.S. Department of Health and Human Services. In addition, 284,396 Kansans with traditional Medicare used one or more free preventive services in 2012, including 27,437 who each received an annual wellness checkup.
State Sen. Michael O’Donnell, R-Wichita, wouldn’t comment Monday on a bill he has proposed to prohibit county health departments from seeking national accreditation, other than saying it was prompted by “widespread concerns that many people have had.” What concerns? What people? Is this some Agenda 21 thing? Health officials are also puzzled. At least 12 health departments in Kansas, including Sedgwick County, have been working on becoming nationally accredited, the Kansas Health Institute News Service reported.
Columnist Cal Thomas argues that President Obama’s latest compromise on the contraception mandate still doesn’t go far enough. He objects that private businesses (such as Hobby Lobby) are not exempt, and thinks that Catholic institutions might still get stuck with paying for the free coverage that will be provided by the insurance companies. But columnist Margaret Carlson faults the Catholic bishops for not accepting the compromise and moving on. “Even though the new regulation shows that the president has taken the bishops’ objections into account, they refuse once again to declare victory and move on to aiding the poor and comforting the sick,” she wrote. “They will not be satisfied, apparently, if even one employee of a Catholic-aligned institution is getting birth control through insurance.”
Gov. Sam Brownback should follow the examples of Republican Govs. Rick Snyder of Michigan, John Kasich of Ohio and Jan Brewer of Arizona, who each recently endorsed the expansion of Medicaid in their states. These governors understand that the expansion – which the federal government will fully pay for until 2016 and nearly fully cover after that – will bring needed insurance coverage to thousands of their citizens, offset reduced payments to hospitals and doctors, and provide a boost to their state economies. They put the needs of their citizens before a rigid ideology. Brownback needs to do the same.
Since 2006, there has been a 126 percent increase in mentally ill prisoners in Kansas, the Topeka Capital-Journal reported. Now, nearly 2 in 5 Kansas adult inmates are mentally ill. After the Newtown, Conn., shooting, Gov. Sam Brownback proposed redirecting $5 million in funding to community mental health centers (whose grants had been cut sharply recent years) and $5 million to new regional recovery support centers.
Gov. Sam Brownback failed to mention KanCare in his State of the State speech – remarkable given the sea change it represents for the 380,000 individuals and the providers affected by the Jan. 1 privatization of Medicaid and HealthWave. But at least in Johnson County, the 2-week-old reform is off to a rocky start, warned Kansas City Star columnist Steve Rose. Some primary care physicians and hospitals haven’t signed up with the three managed-care contractors, he said, and there have been contractual issues between providers and insurers. Anecdotes include an 8-year-old boy whose assigned primary care physician is a gynecologist and a 25-year-old man assigned to a pediatrician. A 90-day grace period “gives KanCare a short time to resolve its issues with the would-be providers, and to get the 380,000 Kansans assigned correctly to their primary care physicians and dentists,” Rose wrote.
Good for Gov. Sam Brownback for wanting to add $10 million in funding to treat Kansas’ most serious cases of mental illness. The increase was prompted by the killings at Sandy Hook Elementary School, but the mental health system in Kansas has been struggling for several years with reduced funding and increased demand. Though Medicaid spending has increased significantly in recent years, state grants to community mental health centers were cut by more than $19 million, or 52 percent, from fiscal years 2000 to 2011.
State officials are objecting to a national report that ranked Kansas and Montana as the worst-prepared states in the nation for public health emergencies, terrorism incidents and natural disasters. The “Ready or Not?” report by the nonprofit group Trust for America’s Health said that Kansas meets only 3 of 10 readiness criteria, and it blamed the low ranking in part on funding cuts in state and local public health programs, insufficient staffing at the state’s public health laboratory, and the state’s inability to meet preparedness standards set by the Emergency Management Accreditation Program, the Kansas Health Institute News Service reported. Gov. Sam Brownback complained that the report “does not provide an accurate and thorough picture of the state’s readiness.” Robert Moser, secretary of the Kansas Department of Health and Environment, faulted the changing indicators used in the ranking and its all-or-nothing scoring system. “No matter the score, the report presents a skewed view of public health readiness, draws inaccurate conclusions and in no way indicates the actual preparedness level in Kansas,” Moser said in the statement.
A new report from the AFL-CIO ranks Kansas as the 10th deadliest state for workers in 2011. Kansas had 78 workplace deaths in 2011 (7 fewer than in 2010). That’s a rate of 5.9 fatalities per 100,000 workers, compared with the nationwide rate of 3.5. Kansas also had 34,400 injuries or incidents of job-related illness. The study blames the poor record in part on a lack of safety regulations and inspectors. It said that Kansas had only 14 federal job safety inspectors and no state inspectors, and that those federal inspectors inspected only 786 of the state’s 87,223 work establishments in fiscal year 2012. But job accidents are also associated with certain types of work. States with significant mining, oil and gas extraction and agriculture sectors have higher job-fatality rates.
