Press Releases

HealthWave backlog taking toll on safety-net clinics

TOPEKA — Six months ago, Community Health Center of Southeast Kansas was just about breaking even.

Now, it’s losing $10,000 a month.

“Very simply, it used to be that one out of every five children we’d see was uninsured, now it’s one out of every three,” said Krista Postai, executive director of the Pittsburg safety net clinic.

“When 48 percent of your patients are children, that kind of increase is going to have major financial impact,” she said. “We can’t weather this storm much longer.”

Postai said applications and renewals that once took two to three weeks to process are now taking two, three, sometimes four months. The delays are causing cash-flow troubles.

The safety net clinic in Hutchinson is having the same problems.

“We’ve noticed that each month we’re seeing more and more uninsured children,” said Kathy Ireland, chief operations officer at PrairieStar Health Center.

“We’ve been following up with parents to make sure they know about HealthWave or that they have to re-enroll if they’ve been on for a year,” Ireland said. “What they’re telling us is, ‘Oh, yeah, I did that two or three months ago, but I haven’t heard anything back.’”

Until the applications are approved or renewed, the children are uninsured.

HealthWave is the state’s health insurance program for children in low- and modest-income families. Depending on a family’s income, the child is covered through either Medicaid or the State Children’s Health Insurance Program, better known by its acronym, SCHIP.

Generally, Medicaid coverage is retroactive for up to three months before a family applies for HealthWave. SCHIP coverage is not retroactive; it begins when the child is declared eligible.

HealthWave is the name Kansas uses for the combined programs.

Ireland said she wasn’t sure how much the delays in application processing were costing the clinic.

“It doesn’t seem to bother the parents so much because we keep providing the services — that’s our mission,” she said. “What they don’t seem to think about is that one trip to the hospital could wipe them out. The other thing is that it means less money for the clinic, which makes it harder to see the uninsured.”

HealthWave applications and renewals are supposed to be in and out of the Kansas Family Medical Clearinghouse in two to three weeks — six weeks at the most.

Reports from the Kansas Health Policy Authority, which oversees the clearinghouse, show that in August 2008, one application and one renewal had been at the clearinghouse more than 41 days.

By August this year, 1,417 applications and 2,096 renewals had been parked at the clearinghouse more than 41 days.

Last week, the clearinghouse had at least 15,527 HeathWave applications waiting to be processed and 3,740 had been in the system for more than 40 days.

No one at the health policy authority is surprised.

In a May 1 press release, the agency warned that “as many as 50,000 Kansans could be denied timely access to medical care in the months ahead unless the state provides additional resources to deal with the growing backlog of applications.”

The backlog coincided with thousands of Kansans being laid off, losing their health insurance, and realizing their children were eligible for HealthWave.

The warning was repeated in a May 4 letter sent to all 165 Kansas legislators.

Health policy authority officials asked lawmakers for an additional $1.5 million to hire enough workers to clear the backlog. Legislators, however, denied the request, citing revenue shortfalls.

Since then, health policy authority officials have found ways to hold off the projected 50,000-person backlog.

“After the fiscal year began, we identified unexpected resources and devoted them to (paying) overtime at the clearinghouse,” Andy Allison, executive director at the health policy authority, wrote in an e-mail to KHI News Service.

“We are very concerned about the backlog, but also pleased it is not as bad as we feared,” Allison wrote.

But from a safety-net clinic administrator’s perspective a 15,000-person backlog isn’t much better than 50,000-person backlog.

“When I look at that, I see 15,000 kids who ought to have health insurance and don’t,” Postai said. “I appreciate everything KHPA has done to get the number down to 15,000, but somewhere in all this discussion there’s a judgment taking place that says, ‘This is an acceptable amount, and that’s not an acceptable amount.’

“Well, I’m here to tell you 15,000 is not an acceptable amount,” she said. “It’s too many.”

Legislators said they weren’t sure what to make of the backlog.

“I don’t like it,” said Rep. Bob Bethell, R-Alden, former chairman of the House Social Services Budget Committee. “I get concerned when I hear there are individuals out there — in this instance, children — who are in need of services that we as a state have decided we’ll provide, but when they try to get those services, they can’t. That should not be happening.”

Bethell said he wondered if the backlog could have been avoided if the health policy authority had done more to cut its administrative costs.

“Just this week I got an e-mail from the secretary at SRS (Kansas Department of Social and Rehabilitation Services), letting me know they’re getting ready to cut some upper and middle management positions because they need more people on the front line,” Bethell said. “Maybe KHPA should take a lesson from SRS.”

SRS is expected to announce its plan for cutting administrators and adding frontline workers early next month, according to an agency spokesperson.

Bethell said he expects the backlog to fuel calls for stripping the health policy authority of its independence and making it part of the governor’s cabinet.

“Right now, it’s not controlled by the governor’s office,” he said, “and the only control the Legislature has is when it sets the budget. So there’s not much oversight, they’re just sort of out there.”

Rep. Jim Ward, D-Wichita, said the health policy authority, shouldn’t be blamed for the backlog.

“What I think we all need to realize is that when we cut budgets like we have, there are consequences,” he said. “We like to tell ourselves we can keep cutting and it really doesn’t hurt anybody, but that’s wrong. It does hurt.”

Ward is a member of the House Health and Human Service Committee and the Joint Committee on Health Policy Oversight.

-Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at dranney@khi.org or at 785-233-5443, ext. 128.
Kan. minimum wage increase gets a push

House gives initial OK to bill that would raise amount to $7.25 an hour in 2010.
By John Hanna - Associated Press Writer

TOPEKA - A bill raising Kansas' lowest-in-the-nation minimum wage won House approval Wednesday, moving Democrats, labor unions and anti-poverty advocates closer to a long-standing goal.

The vote was 104-21. The Senate passed the measure last month but must consider changes made by the House before the bill can go to Gov. Kathleen Sebelius, who supports it.

The Kansas minimum wage is now $2.65 an hour, and the legislation would raise it to $7.25 an hour next January.

An estimated 17,000 to 20,000 workers are covered by the Kansas minimum wage. Most of Kansas' 1.4 million workers are covered by the federal minimum wage, which is increasing in July to $7.25 an hour from the current $6.55.

"The minimum wage is fundamental respect for people who go to work every day," said Rep. Jim Ward, a Wichita Democrat. "These are the people who have two jobs. These are the single moms. These are people who struggle to hold their heads above water."

The House added provisions allowing employers to pay workers who are less than 20 years old just $4.25 an hour for their first 90 days on the job and to automatically raise the state's wage whenever the federal government increases its figure.

Forty-five states have a minimum wage, but only six, including Kansas, set it below the federal rate, according to the U.S. Department of Labor. Twenty-seven states set their wages higher than the federal rate; in 12 states, the figure mirrors the federal one.

Democrats and their allies have been pushing to raise Kansas' minimum wage for two decades, arguing it's an embarrassment. But business groups and many Republicans, who have consistently held legislative majorities, have opposed the idea.

Groups such as the Kansas Chamber of Commerce and the National Federation of Independent Business argue that increasing the wage only raises employers' costs, causing them to cut low-wage, entry-level jobs.

Republican Rep. Mike Kiegerl of Olathe, a businessman who taught economics at four area colleges, cited a 2005 federal study showing more than 600,000 jobs lost in the U.S. from a 1990s wage increase.

"Minimum wage legislation is a bad idea. It is bad economics," Kiegerl said. "You have less opportunity for an entry-level job. Is that the message you want to send?"

But this year, some Republicans in both chambers decided to stop fighting the issue, saying it's only symbolic anyway.

The state law applies only to companies that have less than $500,000 a year in annual revenue and don't engage in interstate commerce.

Some Republicans argue a business falls under the federal law by engaging in interstate commerce if it accepts credit cards or buys out-of-state supplies. They questioned whether any workers fall under the Kansas law, whatever the state's estimates.

They also acknowledged increasing the minimum wage has popular appeal, especially with unions and anti-poverty groups pushing it.

"To be bluntly honest with you, the will of the people in the communities we represent, they said we need to bring this forward," said Rep. John Grange, an El Dorado Republican. "We need to take it up."
How State Budget Cuts Effect Wichita

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Woes could force Kansas factions closer

An AP News Analysis

By JOHN HANNA -- AP Political Writer

TOPEKA, Kan. (AP) -- It's not hard to see signs at the Statehouse of a looming clash over the state's budget deficit between Republican legislative leaders and Gov. Kathleen Sebelius and her fellow Democrats.

GOP leaders continue to argue that across-the-board spending cuts are the quickest and best way to deal with the state's financial problems in the short-term. Meanwhile, Democrats argue that such cuts are thoughtless and likely to inflict damage on schools and social services when it can be avoided.

The argument seemed to sap the sense of urgency out of the Legislature during the first two weeks of its 2009 session. Sebelius and legislators must close a projected $186 million deficit by June 30, yet no bill has emerged from committee in either house.

But many legislators sense that the state's finances haven't hit bottom and the size of the projected deficit probably will grow. And that may force both Republicans and Democrats to accept ideas they now promise to fight, in a package that has to include just about everything to prevent a constitutionally prohibited shortfall.

"If you look at any of the big things that we've done the last 10 years, it's taken Democrats and Republicans cooperating," said Rep. Jim Ward, a Wichita Democrat and the assistant House minority leader.

Though the deficit is now projected at $186 million, Senate Republicans have said they want to pass a plan that would close a $300 million shortfall instead. Some Democrats are reluctant to accept the figure.

Legislators in both parties could have more information at the end of this week. The current deficit projection, from legislative researchers, is based on state revenue collections through December. If revenues continue to fall short of expectations in January -- as Republicans generally expect -- the gap between anticipated revenues and approved spending in the budget will grow.

Sebelius proposed a grab-bag of targeted spending cuts and accounting changes to close the deficit in the current budget, avoiding a cut in overall state aid to school districts and largely sparing social service programs. Higher education and local governments shoulder much of the burden.

Her proposals could close a gap of nearly $254 million, depending on how much aid the state withheld from cities and counties. They'd lose at least $10 million under her plan and up to $63 million, with the amount determined by how big the deficit gets.

Her worst-case, $254 million figure is not too far from Senate Republicans' $300 million target, a number House GOP leaders also see as reasonable. Senate Majority Leader Derek Schmidt, an Independence Republican, acknowledges GOP senators are guessing about the deficit's size but compares their efforts to duck hunting.

"The governor saw the duck in the sky. She aimed where it is and she pulled the trigger. Well, the problem is the duck's gone by the time the shot gets there," he said. "We see the duck in the sky, and we're trying to lead it a little bit so we can actually hit the target."

The philosophical divide seems much larger. Republicans like Schmidt argue that Sebelius is relying too much on accounting changes to make the budget work for the current fiscal year.

They argue that one-time fixes -- shifting regulatory fees to general government programs, for example -- don't solve the basic problem, approved spending that outstrips available revenues. Part of her plan, they say, simply pushes the state's problems into the future, perhaps even until after the term-limited Sebelius leaves office in January 2011.

Many Democrats believe such arguments are an attempt to avoid a discussion of reversing or stalling some of the tax cuts businesses and others have received over the past decade or so. State law phases out the estate and corporate franchise taxes by 2011, and Sebelius has proposed freezing the current tax rates in place.

Phasing out the two taxes are long-held Republican goals, pleasing core GOP constituencies. In avoiding deeper cuts, Democrats are preserving long-held goals of their own -- and pleasing advocacy groups normally aligned with them.

Much of the rhetoric from both camps remained less than conciliatory at the end of last week.

Sen. John Vratil, a Leawood Republican, suggested Sebelius' power to veto individual items in a budget bill or an entire bill -- a potential weapon for bringing the GOP in line -- is checked by the constitutional requirement to balance the budget in both fiscal 2009 and 2010. "She has to use that veto pen very judiciously, or she can create huge problems," he said.

Ward suggested that even with GOP majorities in both houses, Republican leaders still lack the support they need for across-the-board cuts. "I think they're just trying to get their arms around a pretty big budget deficit and trying different things," Ward said.

Yet leaders in both parties already are contemplating having to compromise if the deficit keeps growing. For example, Senate Minority Leader Anthony Hensley, a Topeka Democrat, said he doesn't rule out across-the-board cuts on top of targeted spending cuts. Instead, he sees them as a last resort, to be tried as a gap-filler if it suddenly becomes necessary later this year.

Senate President Steve Morris, a Hugoton Republican, views some of Sebelius' accounting changes in the same way. He said they might become necessary if, after making serious cuts in spending to close the shortfall, the deficit grows larger and there's little time to respond.

Thus, for all the tough talk now, legislators of all philosophical stripes may be pushed together by a worsening financial picture.
Sebelius says energy plan will create jobs

BY JEANNINE KORANDA
Eagle Topeka bureau

The state's top executives unveiled a proposal to boost renewable energy and attract "green jobs" Friday, trying to broaden an energy debate dominated by discussion of coal-fired plants in western Kansas.

Gov. Kathleen Sebelius described her plan as a bridge that could carry the state until clean coal technology is a reality.

Senate President Stephen Morris, R-Hugoton, said he supports many of the ideas but that coal needs to be part of the mix to meet the state's future energy needs.

The four-point legislative plan would:

• Allow Kansas consumers to generate their own electricity and, through net metering, sell any surplus back to power companies.

• Make mandatory a voluntary program started in 2006 to have 20 percent of the state's energy come from renewable resources, such as solar and wind, by 2020. A goal of 10 percent by 2010 already has been met.

• Require that new state buildings or leased buildings meet energy-efficiency standards.

• Create a bond program, similar to the package used to lure Cessna to build its new business jet in Wichita, that would help attract solar and wind manufacturing jobs to Kansas.

"The energy crisis that our country faces is really a tremendous opportunity for Kansans," said Lt. Gov. Mark Parkinson, a Democrat.

By making the right decisions now, Kansas could become a leader in producing renewable power for the state and country while attracting new jobs, he said.

The state has had tremendous success with a voluntary standard for increasing renewable energy, he said. A little more than a year ago, the state had 385 megawatts of renewable electricity, or about 3 percent of the capacity. Just last month, it started generating more than 1,000 megawatts.

"Now it is time to make it mandatory," he said.

Rep. Don Myers, R-Derby, who sits on the House Utilities Committee, said the standards should remain voluntary. He equated telling power companies how to produce their energy to telling aviation companies how many airplanes to build.

Parkinson said codifying the voluntary standards could attract jobs from companies that manufacture wind turbine or solar equipment. One of the other proposals aims to give those companies a financial incentive to build their products here.

The plan would allow the companies to use state bonds, which would be repaid with employee withholding taxes. The proposal would not cost extra money, since the state would not have those taxes without the new jobs, Sebelius said.

Morris, who helped craft the Cessna package, supported that idea. "It's not the only way, but I think it is a way of attracting business," he said.

But Morris said coal needs to be included in any comprehensive energy plan.

"We will continue to need more and more electricity," he said. "We cannot put our heads in the sand and say we have plenty of power, because we don't."

Much of the legislative last session focused on coal power -- specifically lawmakers' efforts to push through permits for two new coal-fired power plants near Holcomb.

Some components of this year's proposal from the governor's office were attached to the coal plant proposals last year. Lawmakers passed three, and Sebelius vetoed each bill and with them the "green" components.

House Assistant Minority Leader Jim Ward, D-Wichita, said he hoped that not everything would be "run through the coal filter" this year and the ideas would be allowed to pass or fail on their own merits.

"Don't hold up good energy ideas because you don't get the piece that you want," he said.

The legislative components are part of Sebelius' comprehensive energy strategy. She will discuss additional aspects of the plan in her State of the State address scheduled for 7 p.m. Monday.

Contributing: The Associated Press
Kansas Legislators Face Growing Shortfall

BY DION LEFLER
The Wichita Eagle

Forget $141 million.

The state budget shortfall this year is now about $186 million and growing, south-central Kansas legislators learned Thursday.

The new number was given to about 25 local legislators by Alan Conroy, director of the Kansas Legislative Research Department.

State revenue estimators pegged the expected 2009 shortfall at $141.2 million at the beginning of November.

But receipts for November and December have fallen $44.6 million short, adding to the gap lawmakers and the governor will have to close, Conroy said.

"I wish I had good news," Conroy told the lawmakers.

But, he said, "the general fund is in a precarious situation," with the national economy in a downturn, and is likely to grow worse.

The projected shortfall for the 2010 budget is about $1 billion.

The state has faced shortfalls before, but Conroy said this situation is unique because of the expected length of the recession.

He said the earliest he expects to see a turnaround will be 18 to 24 months.

The state Constitution requires a balanced budget each year.

When the legislative session starts Monday, lawmakers will be considering deep cuts.

"First of all, everything's going to be on the table," said Rep. Brenda Landwehr, R-Wichita.

That includes education and any discretionary social spending, she said.

She also said that unlike the last budgetary crisis, in 2002, she doesn't think the state can raise taxes because incomes are declining, especially for seniors who depend heavily on investments.

Local Democrats said Gov. Kathleen Sebelius has already begun to make cuts, but they think the state can't rely entirely on spending reductions to make up the shortfall.
In addition to budget cuts, Rep. Jim Ward, D-Wichita, suggested that the Legislature could consider delaying some tax reductions that have been approved but not fully implemented.

In addition, he said, the state could make accounting changes and tap income that now bypasses the general fund, such as highway and bioscience money.

"The (budget) numbers are bad, but we've been here before," he said.

He said the biggest danger would be stripping state government down so far that the traffic and educational infrastructure deteriorates and Kansas is unable to take advantage when the economy turns around.

Reach Dion Lefler at 316-268-6527
McKinney’s move creates opening for Ward

Wichita Eagle

November 20, 2008

Knowledgeable, easygoing and able to work effectively across party lines, House Minority Leader Dennis McKinney was a rising Democratic star in Kansas even before the horrific Greensburg tornado leveled his home and community last year and tested his mettle and leadership. It makes sense that Gov. Kathleen Sebelius would turn to him to fill the state treasurer’s job, newly open because of Lynn Jenkins’ win of the 2nd Congressional District seat. He will be missed in the House, but his likeliest successor would be Assistant Minority Leader Jim Ward (in photo), D-Wichita. It would be nice to have a Wichitan in that influential spot again, for the first time since Rep. Tom Sawyer, D-Wichita, left the House to run for governor in 1998.
Legislators clash on insurance, health care

BY Dion Lefler
The Wichita Eagle

A legislative forum Wednesday highlighted the deep. Divisions that have prevented the state Leglslature from passing comprehensive health-care reform.

The Republican panelists, Sen. Susan Wagle and Rep. Brenda Landwehr, talked about health care savmgs accounts and tort reform to reduce cost. The Democrats, Reps. Jim Ward and Geraldme Flaharty talked about Universal health and smoking bans.

While just about everyone agrees the health care system needs fixing, the Legislature has made only incremental changes, and consensus on major action remains elusive.

'We fundamentally disagree on some of the 'long-term, macro goals," Ward said.

The most impassioned arguments in the forum came from Wagle and Landwehr. Wagle, a cancer survivor and mother of a son with leukemua, said she saw too many patients on public health assistance who could have afforded to take responsibility for their care.

''They're talking about the HBO show they watched last night and have a new cell phone every time they come to the office," she said.

"We have created a generation who believes welfare is a job," added Landwehr, who talked about her experience as a single mother receiving government assistance.

That got a rise out of Ward who said health care is a fundamental right and the uninsured are ordinary people, most of whom work.

"I reject fundamentally that people in need of health care are poor," Ward said. "I reject fundamentally that providing health care is charity or welfare.'"

Costs are soaring Douglas Bradham, a University of Kansas health economist, said health care costs have grown at an alarming rate.

"Since 1999, the average annual premium for health insurance has risen from $4,471 to $7,129. Health care cost the United States $2.1 trillion in 2006, he said. "That's the equivalent of 16 percent of the gross domestic product. One problem is that the healthiest sector of society is also the most uninsured. About 22 percent of those ages 18-54 are uninsured, compared to 11 percent of children younger than 18 and 14 percent of people ages 54-64."

"Ofthe uninsured, 39.5 percent are white, 36.5 percent are Hispanic and 17 percent are black," he said. "Two-thirds ofthe uninsured are employed full time but either can't afford or choose not to have health insurance," he said.

"The nation's health care system, in turn, heavily rooted in employer-subsidized care, is putting the U.S. at a disadvantage," he said. "Employers operate in a global market and are having trouble competing."

For example, he cited the competitionfor an air-refueling tanker contract between Boeing Co. and Airbus parent European Aeronautic Defence and Space Co. Boeing's bids have to include health care costs for the company's workers, while Airbus employees receive health care from their governments.

Ward and Flaharty said they would continue to advocate in the Legislature for universal health care. They also said they would work for preventive care and programs to reduce smoking obesity and alcohol and drug use.

For Flaharty that includes a ban on smoking in public places.

Wagle and Landwehr both support health-care savings accounts, which would provide tax breaks to workers to set aside a portion of their salary to pay health costs. That would allow the workers to buy cheaper "catastrophic" insurance policies and pay for routine health care out of pocket.

The advantages, they said, include providing a wider range of medical choices, an incentive not to overuse the medical system and allowing people to take their health care with them when they change jobs.

"Another way to reduce individuals' costs would be to get more young adults on insurance to spread the risk across a larger, generally healthier population,"
Wagle said.

''We really need to consider a mandate for the young," she said.

In addition to cost, Landwehr, said, one reason many younger workers don't buy health insurance is that they don't think they'll get sick.

That brought head shakes of disagreement from some care providers in the audience.

Chad Roseberger, a manager with the Grace Med clinic that provides care to the uninsured, said that for 18- to 35-year-olds who don't have insurance, the issue is almost always a matter of cost.

''What they'd be paying, especially for family coverage, would take the majority of
Ward files for re-election to Kansas House

TOPEKA – Rep. Jim Ward, D-Wichita, announced today he will seek a fourth term in the Kansas House of Representatives serving the 88th District.

Throughout his six years in the Legislature, health care has been one of Ward's top priorities. In 2008, he fought for comprehensive health care reform.

"Health care should always be affordable and available when we need it," said Ward.

Ward also voted for a school funding plan that provided much needed money to Wichita schools and teachers. In addition, he successfully worked for legislation to create stronger penalties for sex offenders with the passage of "Jessica's Law" in 2006.

"We need common sense leadership in Topeka that achieves real results for working people," Ward said. "Important steps to make health care more affordable were made this year, but there is more work to do. Working families need a raise and I will continue to battle for an increase in the state's minimum wage. It's been far too long for this basic fairness."

Ward is the House Assistant Minority Leader, a position he has held since 2005. He currently serves on the Judiciary, Health and Human Services, Legislative Budget, Interstate Cooperation, and the Joint Corrections and Juvenile Justice Oversight Committees.

He represents the 88th House District, which includes southeast Wichita.

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