Category Archives: Health and Social Services

The bulk of this memorandum was originally published in the 2019 Briefing Book. At that time, the purpose was to inform readers about recent federal legislation that changed how Title IV-E funds could be accessed and spent by states. That information has since been edited for length and clarity. Additionally, a review of Families First in Kansas has been added.

This memorandum provides information related to Medicaid Home and Community Based Services (HCBS) waivers and current waiver services available in Kansas. [Note: The current KanCare contracts will end December 31, 2024. The Secretary of Health and Environment has indicated the new contracts will not be based upon the current 1115 waiver.]

The access to mental health services in Kansas currently follows a multi-prong approach aiming to provide care in the least restrictive environment. There are many different combinations of access depending on the type of services needed, the age of the person receiving care, and how the service will be paid. This memorandum provides information on the types of government-resourced services available to Kansans.

During the 2021 Session, the Legislature passed Senate Sub. for HB 2208, which included a requirement for the Kansas Department for Aging and Disability Services (KDADS) to establish a certification process for certified community behavioral health clinics (CCBHCs), a Medicaid provider type, and complete the transition to the CCBHC model by SFY 2025.

KDADS certified six CCBHCs in SFY 2022, three in SFY 2023, 11 in SFY 2024, and has six planned in SFY 2025. Currently, 20 of the planned 26 CCBHCs are certified in Kansas.

The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, jointly referred to as the Affordable Care Act (ACA), passed in March 2010, included a section that addressed the expansion of the Medicaid program. This historical memorandum is a synopsis of the ACA as to Medicaid Expansion and the immediate impact of the U.S. Supreme Court decision through federal fiscal year (FFY) 2013. The memorandum does not address the current status of Medicaid expansion adoption in states.

This memorandum discusses telemedicine (or telehealth, used interchangeably) laws in Arkansas, Colorado, Illinois, Iowa, Kansas, Missouri, Nebraska, Oklahoma, and Texas, as well as recent telemedicine-related Kansas legislation and 2023 legislation in Arkansas, Illinois, Oklahoma, and Texas.

The Federal Medical Assistance Percentage (FMAP) determines the state and federal shares of funding for Medicaid, Adoption Assistance, and Foster Care. It is determined annually by the Secretary of Health and Human Services and is based on each state’s per capita personal income compared with the average per capita personal income in other states.

According to the Rural Health Information Hub, Kansas has 82 critical access hospitals, 187 rural health clinics, 54 federally qualified health center sites located outside of urbanized areas, and 26 short-term hospitals located outside of urbanized areas. Additionally, the Center for Healthcare Quality and Payment Reform reports there are currently 104 rural hospitals, 60 of which are at risk of closing. These hospitals continue to face a shortage of health care workers, which has been exacerbated by the COVID-19 pandemic. This memorandum describes the reasons for that shortage and the State’s response to it.

Prior to 2017, the Patient Protection and Affordable Care Act (ACA) contained a provision requiring all individuals to purchase health insurance. This provision was referred to as the “individual mandate.” If an individual failed to purchase minimum health coverage, a penalty (the “shared responsibility payment”) would be collected from that person. The penalty was assessed and collected in the same manner as taxes and paid to the Internal Revenue Service for deposit in the U.S. Treasury.

Several court cases have considered whether the shared responsibility payment, and the ACA more broadly, are constitutional. This memorandum provides information on cases regarding the ACA heard before the U.S. Supreme Court in 2012, 2015, and 2021.

Over the past decade, fentanyl that is made and distributed illegally has been increasingly found in the drug supply across the United States, contributing to significant increases in drug overdose deaths. According to the National Institute on Drug Abuse, more than 106,000 persons in the United States died from drug-involved overdose in 2021, more than double the 52,404 deaths recorded in 2015. The U.S. Centers for Disease Control and Prevention (CDC) reports that more than 150 people die every day from overdoses related to synthetic opioids such as fentanyl. To address this issue, states introduced more than 600 bills during the 2023 legislative session and enacted at least 103 laws with fentanyl-related provisions.

Because fentanyl is nearly undetectable when combined with other drugs, fentanyl test strips are one tool that can help identify the substance in other drugs. While fentanyl test strips have often been included in states’ criminal statutes on drug paraphernalia, many state legislatures have enacted exclusions in recent years to make fentanyl test strips legally available for distribution.

This memorandum provides more information on fentanyl and fentanyl test strips, including recent research, federal actions, and state legislation.