- Associated Press - Tuesday, June 21, 2016

The Wichita Eagle, June 19

Kansas hospitals are hurting, at risk

Those standing firm against expanding Medicaid in Kansas have their reasons, however politically contrived. But, as predicted, their inaction is harming the health care industry, which represents 9 percent of the state’s economy.

Gov. Sam Brownback’s 4 percent cut to Medicaid reimbursement rates as of July 1 only increases the financial stress, by further shorting health care providers already suffering from federal payment reductions. As the cut to mostly urban physicians, dentists, hospitals, nursing homes and others frees up $38 million to help balance the state budget, it fuels worries that providers will accept fewer Medicaid patients and that access to care will be jeopardized for the very poor and those with disabilities.

How many jobs will be trimmed and providers hobbled before the governor and his GOP legislative allies are persuaded that Kansas must join the 32 states that have expanded Medicaid under the Affordable Care Act? Might KanCare, Brownback’s signature 2013 privatization of Medicaid, be stronger if the state’s health care system hadn’t forfeited the $1.2 billion in federal funding since 2014 that would have accompanied Medicaid expansion?



Now, 1 in 3 rural Kansas hospitals is at risk of going the way of Independence’s Mercy Hospital, which closed last fall amid mounting financial losses. Though it’s unclear what would have been the hospital’s salvation, Medicaid expansion would have brought it an additional $1.7 million a year.

Last week Wichita-based Via Christi Health announced it would eliminate 150 positions while adding 80 bedside nursing jobs.

When asked about the effect of Medicaid cuts and lack of expansion, interim CEO Todd Conklin told The Eagle in a statement: “Our state’s decision not to expand KanCare continues to have a significant negative impact on Kansas health systems, especially those that like Via Christi serve this important part of our communities.”

Via Christi estimates the state’s refusal to expand Medicaid is costing it $14 million per year and the state’s Medicaid rate cut will mean a loss of $4.3 million more a year.

So the situation is even worse than the “the worst of both worlds” that Via Christi’s then-CEO Jeff Korsmo predicted three years ago in The Eagle: “providing more uncompensated care for Kansans still not eligible for Medicaid while receiving less money from the federal government to cover these costs.”

State lawmakers have heard all this again and again, including in packed and emotional House hearings last year. The Kansas Hospital Association has proposed an expansion plan it calls “beyond budget neutral,” in that the state’s cost of $57.5 million in 2017 would be offset by additional revenues and savings of about $159.4 million.

If state leaders are uninterested in enabling 150,000 Kansans to become insured because it would mean “expanding Obamacare,” to use the governor’s words from last week, how long can they avert their eyes from the consequences for the health care industry and overall state economy?

_____

The Lawrence Journal-World, June 16

Allowing local school districts to continue meeting the individual needs of transgender students is the right course.

A statement issued Tuesday by the Kansas State Board of Education represents a common sense approach to accommodating transgender students in Kansas.

The board action takes this issue out of the political arena and affirms the ability of local school districts to deal with these students on an individual level rather than trying to enforce a one-size-fits-all policy. Local school officials around the state already are handling these issues and their efforts aren’t aided by national guidelines - no matter how well-intentioned.

The statement unanimously approved by the board reads, “In Kansas, like many other states, our schools have been addressing transgender student needs with sensitivity and success for many years. Just as every child is unique, so too is every school community. With that understanding, we are firm in our belief that the decisions about the care, safety and well-being of all students are best made by the local school district based on the needs and desires of the students, parents and communities they serve.”

Congratulations to the state board for taking the time to confer with local school officials rather than simply issue a knee-jerk rejection of the Obama administration’s guidelines that said students should be able to use facilities and participate in activities that correspond to their gender identity. The guidelines were a response to a North Carolina law that required students to use restrooms and changing facilities that correspond to the gender listed on their birth certificates.

The dispute over the North Carolina law dragged this issue into the political arena where defenders of the law used scare tactics to raise unwarranted fears about transgender individuals. The statement by the Kansas board brought the issue back to a local, individual level that satisfied board members who wanted to head off an infringement of local control of schools, as well as those who wanted to protect the rights and interests of transgender students.

The welfare of the students, of course, should be the objective - as local districts already know. Just this week, the Lawrence school board received a report from a task force charged with improving the school experience for lesbian, gay, bisexual and transgender students. The report called for some changes in facilities as well as additional training to help teachers and staff members meet the needs of LGBT students.

Transgender issues currently are in the national spotlight, but school districts in Kansas and elsewhere have been addressing those issues on an individual level for years. The state board took the right approach by letting the districts continue to do their job in a way that supports individual students rather than broader political agendas.

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The Kansas City Star, June 20

Kansas Medicaid backlog is inexcusable

Mistakes continue to happen in a frantic atmosphere focused on budget cuts and reducing the size of government in Kansas. The people who can least afford it keep getting hurt.

The latest outrage is Kansas’ Medicaid application backlog.

Instead of being lowered to 3,480 people as recently claimed by the state, corrected reports show the backlog actually has more than quadrupled to 15,393. Of that number, 10,961 applicants have waited more than 45 days for the state to process their applications.

That is inexcusable.

KanCare is Kansas’ privatized Medicaid program for low-income, disabled or frail elderly state residents. Susan Mosier, secretary of the state Department of Health and Environment, said in a June 10 letter to the U.S. Centers for Medicare and Medicaid Services that a company contracted by the state to handle the backlog caused the inaccuracy.

But where was the oversight from Mosier and other state officials?

Added to the problem, eligibility officials report a rise in the number of people being incorrectly denied Medicaid.

Also, Kansas foolishly continues to pass up Medicaid expansion, which would give about 150,000 low-income state residents health insurance coverage.

Concern over the size of the state’s backlog caused the federal government to wisely require biweekly reports from Kansas.

Mosier explained that the contractor has made the “necessary corrections,” including “authorization of overtime for both state staff and contractor staff” with continued assistance in processing applications from the Department of Children and Family.

Doing the job right to effectively reduce the backlog and benefit Kansans who deserve services is sure to be more expensive. But that’s the cost of doing the job right, and there should be no excuses.

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The Salina Journal, June 18

Residents deserve resolution

“Nobody in America should worry about their water source in 2016.”

We’re sure patrons of Howison Heights Water District would agree with that statement, uttered at a Tuesday meeting by Saline County Commission Chairman Monte Shadwick.

But the nearly 70 patrons of the district have been worrying about their water source for more than three years and there’s no end in sight. The district serves customers in the Big Valley Subdivision, about 3 miles north of Interstate Highway 70.

After Tim Howison, the owner of the private water district, requested a water rate increase of 127 percent in 2013 from the Kansas Corporation Commission, patrons protested, saying their water pressure was bad and so was the water itself. Patrons, who enlisted the assistance of Rep. J.R. Claeys, R-Salina, Saline County commissioners and others, have been working for a resolution since that time.

Jason Kennedy, one of the patrons, told county commissioners Tuesday that the water sometimes resembles iced tea and, because of excessive chlorination, smells “like a swimming pool,” reporter Tim Unruh wrote in a Wednesday Journal story. Other times, patrons are advised by the Kansas Department of Health and Environment to boil their water before using it because of a lack of chlorination and possible bacterial contamination.

“All we want is to be able to turn on the tap and trust that water,” Kennedy told commissioners.

Claeys arranged a meeting several years ago with KCC officials. He also was able to get through the Kansas Legislature a law that allowed the KCC to intervene in the federal bankruptcy involving Howison Heights Water District. That intervention made it possible to foreclose on or sell the utility.

County commissioners were sympathetic when approached again Tuesday by patrons, but they were told by County Counselor Mike Montoya that they have no authority over water districts.

What they could do, Montoya said, was support efforts by Ottawa County Rural Water District No. 2 to purchase Howison Heights Water District and take over its operation.

The rural water district essentially operates across the street from the Big Valley housing development. Ken Slay, chairman of Rural Water District No. 2, said at a meeting with Howison Heights patrons that the district is capable of serving the 66 active Howison Heights customers, reporter Tim Horan wrote in an Oct. 30 story.

Kennedy said the district has agreed to take over Howison Heights, but for some reason, efforts to complete the transfer have been “sluggish.”

Howison told Unruh that the sale, which has been in the works since November, “just takes a lot of time. You’ve got engineers and attorneys involved and things have to be right.”

Commissioners signed a letter to the KCC requesting “immediate action” regarding the Howison Heights district and assistance in speeding up the transfer of the district to Water District No. 2.

Let’s just hope the letter does some good and that the transfer takes place soon.

As Shadwick said, “Nobody in America should worry about their water source in 2016.”

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