Approved: January 24, 2006
Date
MINUTES OF THE HOUSE HEALTH AND HUMAN SERVICES COMMITTEE
The meeting was called to order by Chairman Jim Morrison at 1:30 P.M. on January 19, 2006, in Room 526-S of the Capitol.
All members were present.
Committee staff present:
Mary Galligan, Kansas Legislative Research Department
Melissa Calderwood, Kansas Legislative Research Department
Renae Jefferies, Revisor of Statutes’ Office
Gary Deeter, Committee Secretary
Conferees appearing before the committee:
Fred Schuster, Regional Director, U.S. Department of Health and Human Services
Bob Florance, Administration on Aging, U.S. Department of Health and Human Services
Linda Vogel, Office of Public Health and Science, U.S. Department of Health and Human Services
Gary Allen, Administration for Children and Families, U.S. Department of Health and Human Services
Rosalyn Wilson, Administration for Developmental Disabilities, U.S. Department of Health and Human Services
James Scott, Centers for Medicare and Medicaid, U.S. Department of Health and Human Services
Kathryn Coleman, Centers for Medicare and Medicaid, U.S. Department of Health and Human Services
Others attending:
See attached list.
The minutes for January 18 were approved. (Motion, Representative Bethell; second, Representative Watkins)
The Chair welcomed Fred Schuster, Regional Director, U.S. Department of Health and Human Services,
Region 7 (Kansas, Missouri, Iowa, and Nebraska), who outlined a comprehensive briefing of services offered by--and new federal regulations impacting--the U.S. Department of Health and Human Services (DHHS). He then introduced Bob Florance, Administration on Aging, who reviewed programs under the auspices of the Older Americans Act, which provides structure for federal services to seniors (Attachment 1). He said that 135,000 aging Kansans benefit from these services, noting that most programs focus on helping older people stay active and healthy and protecting them from exploitation. He commented on the Aging and Disability Resource Center initiative, which provides a single point of entry for access to public long-term care support programs, stating that Kansas Department on Aging recently received a grant for $800,000 through the program.
Answering a question, Mr. Florance said a report addressing Home and Community-Based services is due in June. Representative Bethell commented that providing HCB services without going through the waiver process would provide more independence for the disabled and be less expensive for the state.
Linda Vogel, Office of Public Health and Science, DHHS, said the goal of her agency is to decrease disparities in health services; the agency works closely with the Kansas Department of Health and Environment and with county and city health offices, focusing on minorities, low-income individuals, and remote areas to provide primarily preventive, not curative, care. She noted one program, the Medical Research Corps, which places cadres of volunteers within communities to be available in emergency situations, a service presently active in Shawnee, Reno, and Douglas counties.
Gary Allen, working with Temporary Assistance for Needy Families (TANF) and Child Support Enforcement (CSE), commented on the impact the Deficit Reduction Act of 2005 (presently working its way through the U.S. Congress) will have on states (Attachment 2, Attachment 3, Attachment 4, and Attachment 5).
Rosalyn Wilson, Administration for Developmental Disabilities, commented that child-welfare and child-care programs were administered through her agency, noting that $4.8 billion was available to assist state funding for developmental disabilities programs.
James Scott, representing the Centers for Medicare and Medicaid Services (CMS), stated that the Deficit Reduction Act of 2005 would affect Kansas programs; in the long-term-care area, he said the asset- and income-transfer look-back will be extended from 3 years to 5 years and the spousal-impoverishment rules would be amended. Further, a provision would allow states to enact legislation regarding false claims to match federal requirements; another provision would assist states in investigating fraud and abuse. Families with disabled children would be allowed into Medicaid services. Responding to a question posed to Mr. Florance, he said one option being considered is to allow HCB services in a state plan.
To another question, he said the process of resolving false claims has not yet been established.
Katherine Coleman, Campaign Manager for Medicare Part D, said the prescription drug benefit is the most significant change in Medicare in the 40 years of the program, noting that pharmacists are filling 1 million prescriptions each day and that 2.5 million seniors have signed up for the program in the last 30 days. She acknowledged problems especially for dual-eligible (Medicaid/Medicare) individuals, saying that Region 7 is committed to resolving all issues and is committed to providing prescription drugs to every senior who is eligible. She outlined the process for problem resolution, saying that the agency had added significant staff and resources to effect resolution.
Members, responding to constituent complaints, posed a variety of questions. Ms. Coleman walked through the process: signing up, choosing one of 40 stand-alone drug plans, using agency resources such as www.medicare.gov, and utilizing available community assistance. She replied that vendor WellPoint had been enlisted to provide payment for individuals who could not be matched by a pharmacist, and the state of Kansas was providing back-up payment if necessary. She replied that during the past year Medicare had built local partnerships to assist seniors in signing up for the drug benefit, including training for pharmacists and lay people. She said dual-eligible individuals are automatically enrolled and that low-income individuals will be automatically assigned to a plan if they fail to sign up by May 15. She replied that any single-eligible person who fails to sign up by May 15 will be assessed a 1%-per-month penalty, which will be added to the monthly premium.
Nancy Schmidt, CMS, replied to a question that employers who retain drug benefits for retired employees have already identified themselves (about 6.4 million nationally) in order to receive a federal subsidy. A member commented that dual-eligible individuals whose monthly contributions are subsidized by Medicaid will create an additional drain on the State General Fund. Ms. Schmidt said data were not available as to how many plans grant exceptions for those drugs needed but are not on the plan’s list of drugs covered. She said the Veterans Administration covers most drugs needed by veterans, but there are a few drugs not covered by the VA. She commented that some Advantage plans offer an integrated care program that covers Medicare supplemental insurance and the drug benefit with no increase in premium.
The Chair opened the floor for bill introductions. Representative Garcia requested the committee sponsor a bill developing a mechanism to establish a central, statewide databank of qualified language interpreters. The request was approved.
Representative Bethell requested the committee sponsor a bill designating trauma facilities statewide. The request was approved by vote of the committee.
The meeting was adjourned at 3:12 p.m. The next meeting is scheduled for Monday, January 23, 2006.