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Minutes for SB42 - Committee on Appropriations

Short Title

Authorizing payment of certain claims against the state.

Minutes Content for Wed, Mar 22, 2023

Chairperson Waymaster opened discussion on the budget bill which was inserted into SB42, authorizing payment of certain claims against the state.

Representative Hoffman moved, Representative Helgerson seconded, to make address changes for individuals against the state. Motion carried.

Representation Mason informed committee members that he bundled the elder care items into a balloon amendment. The Social Services Budget committee saw inter-connectivity between the four items included in the amendment. (Attachment 1)

Representative Mason moved, Representative Ballard seconded, to amend SB42 with the balloon amendment provided. Motion carried.

Representative Mason moved, Representative Ballard seconded, to amend SB42 by adding $5 million SGF in FY 2024 to establish a patient observation reimbursement program and reimburse healthcare providers, law enforcement, and other county entities for patient observation and transportation provided.  

Representative Owen stated that if he remembered the discussion on this item correctly, this is to cover the costs that law enforcement or hospitals incur when holding people longer than they should because they are not being moved fast enough. Representative Mason affirmed that if someone is in a crisis mode, then the hospital emergency room or the sheriff's office are required to stay with them, so they do not harm themselves or others and until they can be placed in the appropriate institution. Counties and hospitals are incurring un-reimbursed expenses. There is some inter-connectivity as healthcare facilities are transitioning to the Certified Community Behavior Health Clinics (CCBHCs). Representative Owens informed committee members that he isn't arguing that it needs to be addressed. The Kansas Department for Aging and Disability Services (KDADS) budget is increasing by about $100 million this year and made inquiry into whether or not the agency could absorb it into their budget. Representation Owens maintains that the majority of the delay is an organization within KDADS not moving fast enough to make these things happen, and if they moved fast enough to make them happen, they wouldn't be absorbing this additional cost.

Representative Owens moved, Representative Turk seconded, to amend the funding portion of the motion to amend SB42 so that in FY 2024, a patient observation reimbursement program be established and reimbursements made to healthcare providers, law enforcement, and other county entities for patient observation and transportation provided.

Discussion on the motion followed.

Representative Owens renewed the motion. Motion carried. 

Back on the budget.

Representation Mason informed committee members that the Governor's budget approved $3.8 million, including $1.5 million SGF, for I/DD targeted case management (TCM) which puts the hourly rate at $54. The Social Services Budget committee heard provider after provider stating that even $75 per hour is insufficient and the rate has not changed in years. Chairperson Waymaster inquired whether or not it is the same amount on a floor amendment on a Senate bill and acknowledged the affirmative from Dylan Dear, Legislative Research Department, and that it was passed by the Senate.

Representative Mason moved, Representative Ballard seconded, to amend SB42 by adding $7.4 million, including $3 million SGF, to increase the I/DD TCM rate to $75 per hour for FY 2024. Motion carried.

Representative Mason provided committee members with a handout for a budget proviso that for FY 2023 and FY 2024, no funds be spent by Kansas Department of Health and Environment (KDHE) to make the assessment for any hospital that's converted to a rural emergency hospital. (Attachment 2)

Representative Mason moved, Representative Ballard seconded, to amend SB42 by adding the budget proviso regarding no funds spent for FY 2023 and FY 2024 by KDHE to make the assessment for hospitals converting to a rural emergency hospital.

Chairperson Waymaster informed committee members that this provision does not subject those critical access hospitals changing to rural emergency hospital to the provider tax, it exempts them. Currently rural emergency hospitals are not taxed. Representative Mason informed committee members that this was for rural hospitals with less than 50 beds in order to right-size them.

Discussion on the motion followed. Representative Mason renewed the motion. Motion carried.

Representative Ballard provided committee members with more information about number 17 on the Review Prior to Finalization of the Budget handout from Tuesday. This is about 14(c) certificates that allow employers to hire I/DD individuals at sub-minimum wages. This amendment will not keep them segregated, but allow them to integrate them into a business model. There are 23 Kansas providers that are using the 14(c) certifications. Centers for Medicare and Medicaid Services (CMS) has already passed a final rule greatly limiting the funding that can come from their funds for any 14(c) location. Kansas was the first state to enact Employment First legislation which is competitive, integrated employment. This is one-time money to be given to the 23 Kansas providers as grants to ease them into a new business model to ensure they are not losing money and still employing individuals with I/DD, because a federal ruling forced them anyway.

Representative Ballard moved, Representative Mason seconded, to amend SB42 by adding $1 million SGF for one-time expenditures to establish a grant program for Kansas-based sheltered workshops to transition away from the use of 14(c) certificates and sub-minimum wage employment for individuals with I/DD for FY 2024.

Discussion on the motion followed. Representative Ballard renewed the motion. Motion carried.

Representative Ballard provided committee members with more information about number 27 on the Review Prior to Finalization of the Budget handout from Tuesday. The amendment is to provide reimbursement to organizations that provide substance use and disorder treatment for uninsured individuals. Part of this is block grants only for individuals at less than 200 percent of the poverty level. The wait list has grown from one week to six weeks. If these individuals are left untreated, they will end up in emergency rooms and then be treated for other disorders.

Representative Ballard moved, Representative Mason seconded, to amend SB42 by adding $5 million SGF to provide reimbursement to organizations who provide substance use and disorder treatment for uninsured individuals for FY 2024.

Discussion on the motion followed.

Representative Landwehr moved, seconded by Representative Owens, a substitute motion to amend SB42 by adding $5 million for the funding to come from the Problem Gambling and Other Addiction Fund, if monies are available, and if not, to revert back to SGF to ensure it does get funded.

Discussion on the substitute motion followed.

Representative Landwehr renewed the substitute motion. Motion carried.

Back on the budget as amended.

Representative Owens informed committee members about his concerns with each college that is struggling with declining enrollment requesting funds, because he believes that it is more of a business operational decision. He acknowledges that Emporia State is doing remarkable work and trying to right-size their organization.

Representative Owens moved, Representative Landwehr seconded, to amend SB42 by removing $9 million SGF to a newly appropriated Investment Model account for FY 2024 for Emporia State University.

Discussion on the motion followed.

Chairperson Waymaster reminded committee members that next year there will be individual budgets for the Board of Regents and all universities as opposed to having it all be enveloped into the Board of Regents budget.  This will allow discussion and scrutiny in regards to the particular universities. It will put more pressure on the Chair of the Higher Education Budget committee, because there will be individual budgets for the six Regent universities and possibly Washburn.

Representative Owens renewed the motion. Division was called. Motion failed from a vote of 10 for to 12 against.

Back on the budget as amended.

Representative Rahjes requested consideration on the Kansas State University Extension Systems and Agricultural Research Program referenced on the Items for Omnibus Consideration handout, page 2, first item. K-State 105 was announced publicly in the capital a few weeks ago. The program began about a year ago with a challenge grant to encourage and engage universities to raise some match money and economize. K-State pushed to be one of the driving forces for job creation and other economic incentives and transpired was K-State 105. The name derives from the state's 105 counties and K-State is in each county through the extension service. It brings the extensions expertise and helps the vision of the new University President, Dr. Richard Linton, in reinvigorating K-State to be the model new land-grant university. K-State was the first land-grant institution and extension has always been very strong. The Master Gardener program and 4-H are a couple of the extensions. These dollars will be going to train agents in the field, help local communities with their grant writing, offer business technical assistance, leadership development. K-State has raised matching dollars and this request will get the program going and building awareness of the program.

Representative Rahjes moved, Representative Carlin seconded, to amend SB42 by adding $5 million SGF to the COOP extension service account for the K-State 105 program for FY 2024 and FY 2025.

Representative Hoffman voiced concern about adding the funding for FY 2025, because it gives the idea that it will be funded annually. He would like to have them funded in FY 2024 and have K-State next year report their progress and what they need in FY 2025.

Representative Hoffman moved, Representative Mason seconded, a substitute motion to amend SB42 by adding $5 million SGF to the COOP extension service account for the K-State 105 program for FY 2024.

Discussion on the substitute motion followed. Representative Hoffman renewed the motion. Motion failed.

Representative Rahjes moved, Representative Carlin seconded, to amend SB42 by adding $5 million SGF to the COOP extension service account for the K-State 105 program for FY 2024 and FY 2025, and K-State to report progress annually to the Agriculture and Natural Resources Budget committee and possibly report to the Appropriations Committee. Motion carried.

Representative Howe informed committee members that two universities requested bonding authority for some projects. Wichita State has requested bonding authority for two projects and Emporia State has one project. Wichita has a capital improvement project for the construction and equipment of the NIAR Technology and Innovation Building on the Innovation Campus of Wichita State University. Another project on Wichita State University is for capital improvement, for the renovation and equipment of the university stadium on the campus. Emporia State has a capital improvement project to demolish certain facilities and to construct, renovate, develop, and equip a new Department of Nursing and student wellness center on campus. Representative Howe noted that all three of these bonding authority requests the debt service for any bond to capital improvement projects shall be financed by Appropriations from an appropriate special revenue fund or funds. (Attachment 3)

Representative Howe moved, Representative Helgerson seconded, to amend SB42 for bonding authority of Wichita State University and Emporia State University.

Chairperson Waymaster noted that the Senate has the exact same language in their bill. The Appropriations Committee had actual bills introduced to have this authority, but with the time frame, it needs to be included in the budget bill.

Representative Howe renewed this motion. Motion carried.

Representative Williams reminded committee members that the topic of the legislature being the ones that determine where and how funding is dispersed had been discussed last year and this year. This amendment addresses the topic for FY 2024 and FY 2025. Any federal grants applied for or received by such agencies that concern monies from the federal government are subject to the provision listed. (Attachment 4)

Representative Williams moved, Representative Landwehr seconded, to amend SB42 for any federal grants that are applied for or received from the federal government in FY 2024 and FY 2025. Motion carried.

Representative Curtis informed committee members of the proposed amendment to add $200,000 SGF to the Kansas Judicial Branch for grants to the Kansas Legal Services (KLS) for the purposes of conducting expungement fairs for FY 2024. The reason for placing the funds in the Kansas Judicial Branch is that they already act as a mechanism for other grants to KLS. This funding will provide 8 to 10 additional expungement fairs a year. For two years, there was a bill that would provide an automated process for expungement of criminal records that failed to come above the line. Expungement fairs remove barriers to employment, housing, and education opportunities and is supported by the business community.

Representative Curtis moved, Representative Helgerson seconded, to amend SB42 by adding $200,000 SGF to the judicial branch for the purposes of expungement fairs. Motion carried.

Representative Landwehr provided committee members with more information about number 28 on the Review Prior to Finalization of the Budget handout from Tuesday. The expansion is for Ascension St. Joseph in Wichita for a separate emergency room for those dealing with mental health issues and additional beds. The request is to build the facility and then they will function as normal.

Representative Landwehr moved, Representative Mason seconded, to amend SB42 by restoring the $22 million with ARPA, if funds are available and if not, SGF for emergency room mental health bed expansion for FY 2024. Motion carried.

Representative Landwehr informed committee members of the proposed amendment to add $2 million for pregnancy resource centers. There are 50 organizations across the state that work to get private donations, as well as grants. They help women get through pregnancy. Some facilities have the ability to do pregnancy tests. Sometimes fathers are involved, for example when the mother passed away a few weeks after the baby was born and utilized the services from the pregnancy resource center. HB 2429 did pass out of the Health and Human Services committee, and Representative Landwehr wants to expedite the process and run it through the budget as a proviso. (Attachment 5)

Representative Landwehr moved, Representative Mason seconded, to amend SB42 by adding $2 million SGF for pregnancy resource centers.

Discussion on the motion followed.

Representative Helgerson moved, Representative Woodard seconded, a substitute motion to amend SB42 by adding $2 million for pregnancy resource centers and family planning services.

Discussion on the substitute motion followed. Representative Helgerson renewed the motion. Division was called. Motion failed from a vote of 7 for and 16 against.

Representative Landwehr moved, Representative Mason seconded, to amend SB42 by adding $2 million SGF for pregnancy resource centers.

Discussion on the motion followed. Representative Landwehr renewed the motion. Motion carried. Representative Helgerson requested his nay vote be recorded.

Representative Ballard informed committee members that the membership dues raised for the Midwest Higher Education Compact from $95,000 to $115,000. Kansas has saved well over $3 million dollars as an example of being members of the Midwest Higher Education.

Representative Ballard moved, Representative Rahjes seconded, to amend SB42 by adding $20,000 SGF for the Midwest Higher Education Compact for the full payment of the dues for FY 2024.

Discussion on the motion followed. Representative Ballard renewed the motion. Motion carried.

Representative Rahjes moved, Representative Hoffman seconded, items 1, 4, 5, 6, 7, 8 and 9 on the Review Prior to Finalization of the Budget handout from Tuesday to omnibus, dealing with the water office and then the balance from the Department of Agriculture. Motion carried.

Representative Corbet stated that he had a provisio regarding out-of-state deer license cost, regardless of hunting success. If they are not successful, the Kansas Department of Wildlife and Parks keeps the hunter's fees currently. This proviso would state the Kansas Department of Wildlife and Parks cannot keep the license fee, unless the hunter gets a deer tagged. (Attachment 6)

Discussion on the motion followed.

Representative Corbet moved, Representative Tarwater seconded, to amend SB42 by adding the proviso that out-of-state deer licenses purchasers are required to purchase a hunting license and the Kansas Department of Wildlife and Parks cannot keep the hunting license fee unless the purchaser gets a deer tagged. Motion carried.

Back on the budget as amended.

Representative Hoffman informed committee members of a proposed proviso regarding KDADS and re-determinations of Medicaid eligibility. Some nursing homes are concerned that those re-determinations are going to further slow down new determinations for Medicaid eligibility. This proviso would simply would make new determinations for Medicaid eligibility for admission to adult care homes a priority, ahead of those re-determinations. The proviso also gives the agency leeway on the prioritization if it interferes with the getting re-determinations done in time for federal law. (Attachment 7)

Representative Hoffman moved, Representative Mason seconded, to amend SB42 by adding the proviso to prioritize new determinations of medicaid eligibility for admissions to adult care homes before re-determinations of continued eligibility.

Discussion on the motion followed. Representative Hoffman renewed the motion. Motion carried.

Back on the budget bill as amended.

Representative Ousley informed committee members of a proposed amendment to add $30,000 SGF and .5 full-time employee for FY 2024 for an outreach position for the Kansas State School for the Deaf. The school wants to make the half-time position, a full-time position for parent-to-parent support. (Attachment 8) (Attachment 9)

Representative Ousley moved, Representative Woodard seconded, to amend SB42 by adding $30,000 SGF and a .5 full-time employee for the Kansas State School of the Deaf. Discussion on the motion followed. Representative Landwehr informed committee members that this topic is something to consider at omnibus, in order to get more details. There was extensive discussion on their budgets.

Representative Landwehr moved, Representative Estes seconded, a substitution motion to review the Kansas State School for the Deaf parent-to-parent support position at omnibus. Motion carried.

Chairperson Waymaster informed committee members that the Appropriations Committee will not be discussing any type of pay increases for state employees until omnibus, to allow for review of the latest consensus revenue estimates group on April 20th and the new number for FY 2023 and FY 2024.

Representative Hoffman moved, Representative Helgerson seconded, to recommend House Substitute for SB42, as amended favorably for passage. Motion carried.

The meeting adjourned at 11:01 a.m.

The next scheduled meeting of the Appropriations Committee is March 23, 2023.