Kansas Mental
Health Coalition

Legislature Wraps Up June 10 - Budget Report

June 12, 2017 5:48 PM | Amy Campbell (Administrator)

Legislature Wraps Up June 10

The Kansas Legislature went home Saturday evening after approving Senate Sub for HB 2002 – the conference committee report containing the mega-budget and omnibus budget provisions.  The budget does not meet all of the goals set out by the Coalition, but it does reverse of the negative trend for the behavioral health continuum of care over the past ten years.

The House/Senate budget negotiations were rushed this year, with the six members of the Appropriations/Ways and Means budget conference committee meeting every few hours beginning Thursday evening, after the House had adopted its budget bill, and wrapping up around midnight Friday night.

Legislators return to Topeka June 26 for Sine Die – the ceremonial last day of the session.  They may or may not have any real work to do, depending whether or not Governor Brownback pulls out his veto pen again.  He can line item veto items in the budget bill and some are predicting he will veto HB 2278, "the guns bill", which allows state hospitals and other public health facilities to continue to ban guns on their premises.  It is true that the administration requested the exemption for the state hospitals, but some believe he will oppose extending that privilege to KU Medical Center and other facilities

Budget Adjustments (these items are adjusted from the Governor’s proposal)

Following budget policy this session was a challenge with multiple bills, provisos and other moving pieces.  Below is a list of items we’ve been tracking.  Please note that there may be adjustments later, as the agencies calculate what these amendments to the Governor’s Budget Proposal really mean to their bottom lines.  The article continues below the chart.

FY 17

FY 18

FY 19

KDADS contract community providers for targeted MH residential treatment (HB 2052)

1.0   m

  SGF

Restore the 4% Medicaid provider reimbursement reductions from May 2016 allotment (HB 2002 and HB 2079)  Target date July 1 2017  

161.3 m

     AF

226.7 m

    AF

House Proviso to add CMHC funding from multiple sources = combination of grants and crisis stabilization centers funding to total $10.5 m in FY 18 and $13.2 m in FY 19 (HB 2002)    see breakout below

CMHC Grant Restoration* (HB 2002)

4.0 m

2.2 m

CMHC Grant Restoration* (HB 2002/HB 2079 assumes HMO fees meet projections)

3.5 m

5.0 m

Community Crisis Stabilization Centers (HB 2002/HB 2053 = CIA/HB 2313 assumes Lottery vending machines meet projections)

3.0 m

6.0 m

Clubhouse Model Program Fund** (HB 2002/HB 2313 assumes Lottery vending machines meet projections)

1.0 m

2.0 m

House Proviso orders KDADS to pursue certified clubhouse model programs in FY 18.  (HB 2002 – proviso replaces HB 2044 language which was vetoed due to the Medicaid Expansion addition to the bill)

Restore reimbursement for inpatient assessments at CMHCs (HB 2002)

SGF/AF

1.3/2.8

1.3/2.3

Rural Health Psychiatric Bridging Program at University of Kansas   (HB 2002/SB 32 psychiatric medical loan repayment)

1.0 m

Fund an additional 20 beds at Osawatomie State Hospital. If the facility cannot open the beds at Osawatomie State Hospital, the funding is to be used to enter into a contract to provide patient beds through third-party facilities for FY 2018.  (HB 2002)

4.7 m

4.7 m

Osawatomie State Hospital (OSH) Supplemental Operating Funds *** to replace lost federal income due to decertification and declining private pay (HB 2052/HB 2002)

2.8 m

6.6 m

Larned State Hospital (LSH) Supplemental Operating Funds to replace federal DSH recoupment due to incorrectly including SPTP numbers and declining private pay (HB 2002)

6.5 m

Senate proviso requires the agency to issue a request for proposal for the construction of a 100-bed psychiatric care facility at Osawatomie State Hospital and require the agency to report the results of the request to the Joint Committee on State Building Construction, Senate Ways and Means Committee, and House Appropriations Committee on or before January 8, 2018.  (HB 2002)

Senate proviso requires the agency to conduct an engineering survey on all buildings on the grounds of Osawatomie State Hospital to determine whether buildings can be renovated and the cost of renovations; if buildings cannot be renovated, the cost of the demolition; and that such report will be presented to the Joint Committee on State Building Construction, Senate Ways and Means Committee, and House Appropriations Committee on or before January 8, 2018. (HB 2002)

HCBS waivers provider reimbursement rate increase for wages of direct services workers (HB 2002)

20.3 m

3.0%

48.1 m

4.0%

House Floor Amendment requires KDADS to convene a mental health task force to provide a report to Legislature by Jan 8 2018 (HB 2002)

*Kansas Mental Health Coalition supported restoration of $20 million to CMHC grants, but the 2017 Legislature made a good start by restoring $7.5 million.

**Breakthrough Club of Wichita had requested opening a Medicaid reimbursement code, but the Legislature opted for a contract program at KDADS due to the uncertain fiscal note.

***Governor’s Budget Amendment No. 1, Item 7, added $13.2 million, including $8.9 million from the State General Fund for FY 2018 The Senate Committee recommended a different amount totaling $6.6 million, including $2.3 million from the State General Fund, which is a decrease of $6.6 million, all from the State General Fund, below the Governor's budget amendment. The Senate Committee also recommended the State Finance Council review the current status of funding at Osawatomie State Hospital during the 2017 legislative interim.  If the Adair Acute Care Unit is recertified before the end of FY 18, the additional money may not be needed.  (KDADS initially requested $11.7 m in FY 18 but the Governor did not include those funds in his January budget proposal.)

NOTE:  KDADS initially requested $3.9 m for hospital diversion – which would include the 12 adult diversion beds operated by KVC in Kansas City.  It is not clear to me yet how this contract is to be funded, but it could be a part of the $6.6 m supplemental funding for OSH or perhaps the $4.7 m for bed expansion.

More Budget News

There are other significant elements of the budget bill.  HB 2002 includes State Employee Wage Increases of 2.5 percent for all except elected officials and those who have had recent wage increases and 5.0 percent for employees who have not had a wage increase in five years.  Kansas will also open an on-site state employee health care clinic in Topeka at a cost of $2.7 million.

Safety net clinics received $1 million, but I’m not yet certain if that is an enhancement or restoration of lost funding.  The senior care act funding is restored to pre-FY 17 funding with $1.5 million in FY 18 and $2.1 million in FY 19.

The Office of the Inspector General is moved out of KDHE to the Attorney General’s office.

The State will transfer $6 million to KDOC for evidence based juvenile programs.

The Legislature specifically prohibits KDADS and KDHE from pursuing integration of the HCBS waivers and authorizes KDHE to extend the Kancare contracts another year.  The Legislature reversed the “capable person policy” that KDADS had implemented for HCBS waivers. 

A proviso requires KDADS to report quarterly on the number of people, cost of services, and encounter data for the individual HCBS waivers.

The Legislature rejected the Governor’s plan to securitize the Children’s Initiatives Fund / KEY fund.

The Department for Children and Families will implement Sub for SB 95 allowing for telephonic signatures for public assistance applications and report on actual costs for program implementation.

The Children’s Service League’s intensive home visitation program will receive TANF funds of $3 million.

While SB 30 is a significant income tax bill, raising $582 m in its first year, the budget still requires sweeps from the Kansas Highway Fund, transfers from the Pooled Money Investments Board, and delayed KPERs payments.  There may also be healthy internal borrowing in FY 18 to bolster the reinstatement of the 4% Medicaid cuts, since money from the increased HMO privilege fees won’t come in until March 2018.

On another note, projected receipts from expanded gaming (casinos) are dropping – reduced $2.8 m in FY 17, $6.5 m in FY 18, and $7.8 m in FY 19.  This reduces the money available in the expanded gaming addictions fund 

Finally, there is a group of legislators – including many Democrats, who believe the new education finance plan passed in SB 19 last Tuesday will not pass Supreme Court scrutiny, and they could be back in Topeka in July for a special session.  That bill spends an additional $186.6 million in FY 18 and $283.8 million in FY 19 to satisfy the Supreme Court decision that K-12 funding is inadequate.

If you have questions about the budget or any other legislation, feel free to contact Amy.

 

Contact Amy Campbell, KMHC Lobbyist by clicking here:  Lobbyist Email



(c) Kansas Mental Health Coalition, P.O. Box 4103, Topeka, KS  66604-0103         785-969-1617

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