Download the Supplement to the 2023 Interim Committee Reports here: 2023-ICR-supplement (PDF)
Foreword
In the 2023 Interim, the Legislative Coordinating Council appointed 11 special committees to study 16 study topics and authorized meetings of 2 special committees created pursuant to provisions in the Appropriations Bill (HB 2184). Legislation recommended by the committees will be available in the Documents Room early in the 2024 Session. Such legislation will also be available on the Kansas Legislature’s website at: http://kslegislature.org/li/.
Joint committees created by statute met in the 2023 Interim as provided in the statutes specific to each joint committee. Several of the joint committees have reported on their activities, and those reports are contained in this publication. Legislation recommended by these committees will be available in the Documents Room early in the 2024 Session. Such legislation will also be available on the Kansas Legislature’s website at: http://kslegislature.org/li/.
This publication also contains reports of other committees, commissions, and task forces that are not special committees created by the Legislative Coordinating Council or joint committees. Reports of the following are not contained in this publication and will be published in a supplement:
Special Committee on Civil Asset Forfeiture
Special Committee on Energy and Utilities
Legislative Budget Committee
Special Education and Related Services Funding Task Force
Minutes of the meetings of the special committees, joint committees, other committees, commissions, task forces, and panels are on file in the Division of Legislative Administrative Services. A summary of each reporting entity’s conclusions and recommendations may be found beginning on page ix.
In 2012, enacted SB 155 launched a new plan to enhance career technical education (CTE) in Kansas with the purpose of better preparing high school students for college and careers. Beginning with the 2012-2013 school year, Kansas high school students could qualify for free college tuition in approved technical courses offered at Kansas technical and community colleges. The program also initially provided school districts with a $1,000 incentive for each high school student who graduated from that district with an industry-recognized credential in a high-need occupation.
The 2015 Legislature changed the incentive to a prorated amount not to exceed $750,000 in total. During the 2016 Session, the appropriated amount decreased from $750,000 to $50,000 for fiscal year (FY) 2016 and FY 2017, which was estimated to cover the cost of the certification examinations only.
The 2017 Legislature moved the $50,000 incentive funds from the Kansas Board of Regents (KBOR) to the Kansas State Department of Education for FY 2018 and FY 2019. The amount changed over the subsequent two years and then was deleted from the budget in FY 2020.
The appropriated amount for tuition was prorated in FY 2016 and FY 2017, as there was no increase in appropriations and the amount did not cover all program participants. The program was fully funded in FY 2018, FY 2019, and FY 2020.
Occupations on the qualifying credential incentive list can be found on the KBOR website. The list currently includes, but is not limited to, the following occupations:
Heavy and tractor-trailer truck drivers;
Computer support specialists;
Nursing assistants;
Automotive service technicians and mechanics;
Machinists;
Dental assistants;
Firefighters;
Carpenters;
Welders;
Electricians;
Plumbers and pipefitters;
Sheet metal workers; and
Heating, air conditioning, and refrigeration mechanics and installers.
Since the program’s inception, the number of students participating in postsecondary career technical education has grown, resulting in a growth of college credit hours generated and credentials earned by high school students. The following table, published on the KBOR website, summarizes the increase in participation over time per academic year.
2010-2011 (Baseline)
2013-2014
2016-2017
2019-2020
2020-2021
2021-2022
Participating Headcount
3,475
8,440
10,600
13,934
12,529
13,712
College Credit Hours Generated
28,000
62,195
85,150
109,226
98,681
105,509
Credentials Earned
—
1,419
1,459
1,631
981
1,656
Source: KBOR Workforce Development, Excel in CTE Initiative (SB155) website, information dated February 2023, accessed December 2023.
National Recognition
In 2013, the Career Technical Education Initiative received national recognition as one of the “Top Ten Innovations to Watch” from The Brookings Institution. The same year, Martin Kollman of KSDE and Lisa Beck of KBOR published the article “Free CTE College Tuition and Certification Funding: KS SB 155 at Work” in the September issue of Techniques, a national monthly magazine published by the Association for Career and Technical Education.
Online Courses
Students also have the opportunity to take Excel CTE courses online, available at select community and technical colleges. The following institutions are among the technical and community colleges that offer Excel CTE online eligible classes for Fall 2023/Spring 2024:
Allen Community College;
Barton Community College;
Cloud County Community College;
Colby Community College;
Cowley College;
Flint Hills Technical College;
Fort Scott Community College;
Highland Community College;
Hutchinson Community College;
Labette Community College;
Manhattan Area Technical College;
Neosho County Community College;
North Central Kansas Technical College; and
Pratt Community College.
2023 Session
SB 123 enacted during the 2023 session requires school districts to pay assessment fees for identified career technical education credentials at the student’s request. The State Board of Education and the Board of Regents have collaborated to create a list of approved eligible industry credentials for academic year 2024. The list below highlights a few of the career areas approved on the list:
KSA 76-147 allows the The Kansas Board of Regents (Board) to acquire land for building or utility construction; however, there is no required notification to the Legislature in taking this action, nor is there a statute regarding the acquisition of buildings. The Board policy states that state universities may acquire real property necessary to properly maintain and carry on a state university or the business thereof.
Kansas Hospital Mandates
In 2021, several Kansas hospitals mandated all staff receive vaccinations against COVID-19. The table below lists hospitals and hospital systems in the state that issued COVID-19 vaccine mandates, as well as the date by which staff were to complete the vaccine regimen. Some hospitals, such as AdventHealth, paused their mandates following court injunctions against federal vaccine mandates.
The U.S. Equal Employment Opportunity Commission (EEOC) issued technical guidance on the topic of vaccine requirements. According to the EEOC, employers can mandate employees receive vaccines subject to reasonable accommodation provisions in Title VII of the Civil Rights Act and the Americans with Disabilities Act.
Hospital or System
Vaccine Deadline
Ascension Via Christi
11/11/21
Lawrence Memorial Hospital Health
11/21/21
Mercy Health System
09/30/21
Stormont Vail Health
10/30/21
University of Kansas Health System Kansas City Division
12/01/21
University of Kansas Health System St Francis Campus (Topeka)
12/01/21
Advent Health
01/04/22
Health-Related Federal Vaccination Requirements
In August 2021, the Biden Administration announced it would require all staff at Medicaid-participating nursing homes to be vaccinated against COVID-19 by January 4, 2022. In September 2021, CMS extended that requirement to include staff at the following facilities, as a condition for participating in the Medicare and Medicaid programs:
According to CMS data on nursing facilities nationwide, as of October 21, 2021, an average of 64.7 percent of health care personnel in Kansas nursing care facilities had completed a COVID-19 vaccination regimen. Staff at two Kansas facilities were 100 percent vaccinated against COVID-19.
On November 29, 2021, the U.S. District Court for the Eastern District of Missouri issued a preliminary injunction against the federal vaccine mandate for employees at CMS-regulated facilities in the 10 states, including Kansas, that filed the lawsuit [State of Missouri, et al. v. Joseph Biden, Jr., No. 4:21-cv-01329-MTS (E.D. Mo.)]. As of December 2021, two other district courts had issued injunctions against the CMS mandate, bringing the total number of states affected by the CMS mandate injunctions to 25. As a result of the injunctions, CMS announced on its website it had “suspended activities related to the implementation and enforcement of this rule pending future developments in the litigation.” The federal government appealed to the U.S. Court of Appeals for the Eighth Circuit requesting a stay of the injunction granted by the U.S. District Court for the Eastern District of Missouri, but the stay was denied. The federal government then appealed to the U.S. Supreme Court for a stay of the preliminary injunction pending appeal. On January 7, 2022, the U.S. Supreme Court heard oral arguments on the CMS mandate injunctions. On January 13, 2022, the U.S. Supreme Court in Biden v. Missouri, 142 S. Ct. 647 (2022) granted the federal government’s request for a stay of the preliminary injunction pending the government’s appeal in the U.S. Court of Appeals for the Eighth Circuit and the disposition of the government’s petition for a writ of certiorari. The federal vaccine mandate for healthcare workers began being enforced nationwide in February 2022.
In February 2022, Kansas Governor Kelly announced Kansas regulators would not enforce the federal COVID-19 vaccine mandate at hospitals and other health care facilities after negotiations with the U.S. Department of Health and Human Services.
In April 2022, Missouri and the other states asked the U.S. Court of Appeals for the Eighth Circuit to expedite hearing the merits of the case on vaccine mandate for health care workers, but the Eighth Circuit Court instead vacated the preliminary injunction and sent the case back to the U.S. District Court for the Eastern District of Missouri to proceed to a trial. The states then appealed that Eighth Circuit Court decision to the U.S. Supreme Court, which declined to hear the states’ challenge on October 3, 2022.
In June 2023, CMS published a final rule, effective August 5, 2023, withdrawing the COVID-19 health care staff vaccination requirements, including removing the requirement for COVID-19 vaccination policies and procedures for health care staff. The rule states CMS would not enforce staff vaccination provisions between June 5, 2023, and August 4, 2023.
U.S. Department of Labor Rules
In September 2021, the Biden Administration announced the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) was planning to require all employers with 100 or more employees to protect all staff from COVID-19. According to OSHA, the Vaccination and Testing Emergency Temporary Standard required covered employers to develop, implement, and enforce a mandatory COVID–19 vaccination policy, with an exception for employers that instead adopted a policy requiring employees to either get vaccinated or elect to undergo regular COVID–19 testing and wear a face covering at work in lieu of vaccination. As of January 2022, OSHA withdrew the proposed standard.
KSA 76-147 allows the The Kansas Board of Regents (Board) to acquire land for building or utility construction; however, there is no required notification to the Legislature in taking this action, nor is there a statute regarding the acquisition of buildings. The Board policy states that state universities may acquire real property necessary to properly maintain and carry on a state university or the business thereof.
The state university must submit a description of all properties they desire to purchase or acquire to the Board for approval. Such description must include:
A legal description of the property;
Anticipated use; and
The estimated cost of purchase and any cost relating to the razing or renovating and maintaining the property.
In 2019, the Board directed the universities to survey the utilization of instructional spaces and offices and assess mission critical buildings. The Board defines “mission critical” as those buildings that are predominately used for the academic and research mission of the state universities and the infrastructure that directly supports these buildings. The 2020 Report on State University Building Inventory, Space Utilization, and Facilities Condition published by the Board notes that the estimated renewal costs to address deferred maintenance for mission critical buildings is approximately $1.2 billion.
Deferred Maintenance & EBF
The Board policy definition of “deferred maintenance” is annual maintenance and necessary renewal of facilities systems and components that have been postponed, delayed, or deferred to a future budget cycle or until funds are available.
Educational Building Fund
The Educational Building Fund (EBF) was established in 1941 primarily for the construction of new buildings at state universities. The EBF receives revenue from a mill levy on all tangible property in the state that is subject to ad valorem taxation.
Currently, the fund is primarily used for deferred maintenance projects at state universities. The Board calculates EBF appropriations using an adjusted square footage formula that considers the gross square footage, building age, and complexity of the physical plant.
During the 2023 Legislative Session, the Legislature approved $45 million in Educational building funds and $20 million from the State General Fund (SGF) for state capital renewal projects.
History of Deferred Maintenance at the State Universities
The Board prepared a report in 1994 indicating that the six universities needed $288.3 million for capital improvements that included federal Americans with Disabilities Act compliance, State Fire Code requirements, improving classrooms, major remodeling of existing buildings, and new construction. The 1996 Legislature authorized the issuance of $156.5 million in bonds. The initiative was referred to as the “Crumbling Classroom Initiative.”
Because the amount financed was less than what was needed for the projects, the Board reduced the amount that would be spent for rehabilitation and repair of university buildings. Since the majority of the EBF was being used to pay the bonds for the Crumbling Classroom projects, the balance of the EBF moneys was insufficient to keep up with the routine day-to-day maintenance projects. The bond payments were made through FY 2012.
In 2004, the Board prepared a new study for the Legislature stating that the State’s universities would need an additional $584.0 million to cover the deferred maintenance costs. The study assessed the condition of 537 academic and administrative buildings as well as utilities and infrastructure components on the campuses.
In July 2005, the Legislative Division of Post Audit conducted a performance audit titled: “Regents Institutions: Reviewing Proposals for Increased Maintenance Funding at the State’s Colleges and Universities” (https://www.kslpa.org/wp-content/uploads/2019/08/r-05-16.pdf). The conclusion of the audit found that the use of the EBF to pay for the Crumbling Classroom Initiative resulted in the increase of deferred maintenance projects over time.
In 2007, Sub. for Senate Sub. for HB 2237 was passed, which created the State Educational Institution Long-Term Infrastructure Maintenance Program. Beginning in FY 2008, the bill directed the State to make annual transfers to the Board to fund deferred maintenance projects at the state universities. The transfers would total $90.0 million, including $47.0 million from SGF. In addition, the universities were to transfer the retained interest from tuition, restricted fees, and sponsored research overhead to the State University Building Maintenance Fund. Each university maintains a deferred maintenance support fund, which receives the interest income from the three other funds. The bill also authorized new tax credits for tax years 2008-2012 for contributions earmarked for deferred maintenance at universities and certain projects at community colleges. The tax credit was to sunset after tax year 2012. Due to the recession that occurred in the United States, this program was never funded.
Kansas Board of Regents Policy
The Board approved a new policy in June 2021 for university building maintenance. Beginning in FY 2023, and each year thereafter, each university must calculate a maintenance assessment as a percentage of the professionally estimated replacement cost of mission critical buildings according to an assessment schedule, culminating in a sustainable 2.0 percent of current replacement value as approved by the Board on an annual basis.
Utilizing each university’s Deferred Maintenance Projects Fund, expenditures must be itemized using a standard template for the Board’s review annually. Each state university must identify and expend campus funds (excluding EBF allocations) annually for the purpose of addressing annual maintenance according to a prioritized assessment plan reviewed by the Board. Funding for the maintenance assessment may include contributions from university, state, federal, and philanthropic sources.
It is the stated intent of the Board to use the 2.0 percent of current replacement value funds to annually maintain the buildings in proper working order and focus the use of the Educational Building Funds on strategic projects to reduce the backlog of deferred maintenance. The Board voted to allow the universities a six-year escalator to ultimately arrive at the 2.0 percent current replacement value.
The Kansas Department of Commerce (Department) serves as the State’s lead economic development agency. Under the Secretary of Commerce, there are six program groups: Administration, Business Development, Workforce Services, Community Development, International Business, and Tourism. This memo, while not exhaustive, summarizes the variety of programming and services designed to stimulate economic growth in Kansas.
Administration
The Administration Division is comprised of the Office of the Secretary, as well as the Athletic Commission, Office of Rural Prosperity, Office of Broadband Development, and the Office of Innovation.
Office of Broadband Development
The Office of Broadband Development was established to lead state efforts in bridging the digital divide in Kansas. This office is responsible for federal funds and grants provided to state that are in relation to broadband. Its four priority areas are:
Driving access to robust broadband infrastructure;
Enabling Kansans to connect through digital adoption, literacy, and inclusion programs;
Developing Kansas broadband infrastructure information services to inform investments and priorities; and
Engaging stakeholders through local, regional, and statewide partnerships.
Office of Rural Prosperity
The Office of Rural Prosperity provides leadership and advocacy for rural Kansas in the areas of Housing, Child Care/Early Education, Community Development, Health care/Wellness, Broadband Infrastructure, and Rural Workforce. This office also includes the Rural Opportunity Zones (ROZ) program which was designed to stem outmigration and help to fill high demand jobs in rural Kansas communities. Currently, there are 95 counties designated as a ROZ who are able to offer tax relief and student loan repayment assistance to new full-time residents. The Department administers the student loan repayment assistance portion of this program.
Kansas Innovation & Technology Enterprise
The Kansas Innovation & Technology Enterprise provides critical programs and ecosystem building functions in support of innovation-based business creation, expansion, and attraction. This office includes small business research and development acceleration grants, as well as the Angel Investor Tax Credit program, which was designed to assist in the early stages of commercial development.
Athletic Commission
The Athletic Commission was created to promote and regulate the state’s combat sport industry through regulating and facilitating high-quality competitive sporting events, increasing the number of licenses issued to participants and officials by expanding the industry across the State, and ensuring that judges and referees are certified by the Association of Boxing Commissions to enhance the integrity and safety of all regulated sports in the State.
Public Broadcasting Council
The Kansas Public Broadcasting Council is charged with coordinating public broadcasting activities in the state. Historically, $500,000 in state Economic Development Initiative Fund (EDIF) dollars are allocated annually through a statutory formula to nine member stations. Stations are charged with ensuring every resident has access to public media.
Business Development
The Business Development Division is responsible for growing the Kansas economy through the creation and retention of jobs and increased capital investment. Financial incentives and programs administered by the Business Development Division include:
Attracting Powerful Economic Expansion (APEX);
High Performance Incentive Program (HPIP);
Job Creation Fund (JCF);
Kansas Industrial Training and Kansas Industrial Retraining (KIT/KIR);
Minority and Women Business Development;
Private Activity Bonds; and
Promoting Employment Across Kansas (PEAK) Program.
APEX
This program provides economic development incentives for specific industries that agree to invest at least $1.0 billion within the State of Kansas. Qualified industries include advanced manufacturing; aerospace; distribution, logistics, and transportation; food and agriculture; or professional and technical services. APEX has an expiration date of December 31, 2023. Eligibility for APEX incentives for qualified firms include:
Investment tax credits;
Reimbursement of a percentage of total payroll;
Reimbursement of a percentage of eligible training and education expenses;
Reimbursement of a percentage of relocation incentives and expenses provided by a qualified firm to incentivize employees to relocate to Kansas; and
Sales tax exemption for construction costs of the qualified business facilities.
Qualified suppliers are also eligible for APEX incentives. If a supplier makes more than $10.0 million of sales to the qualified firm within the taxable year for which benefits are being sought, suppliers are eligible for:
Investment tax credit;
Partial retention of employee withholding tax;
Reimbursement of a percentage of eligible employee training and education expenses;
Partial real property tax exemption for qualified business facilities; and
Sales tax exemption for construction materials used in a qualified business facility.
High Performance Incentive Program
The Kansas High Performance Incentive Program (HPIP) is an incentive program that provides tax benefits to businesses that are willing to expand the scope of their capital investments, pay a higher than average wage, and make a significant impact in employee training. During FY 2023, 352 worksites were certified or re-certified for the HPIP program.
Job Creation Fund
The Job Creation Fund was created to promote job creation and economic development projects throughout Kansas. During FY 2023, 15 applications were received and approved. Eligibility for these projects are determined by:
Major expansion of an existing Kansas commercial enterprise;
Potential location in Kansas of the operations of a major employer;
Award of a significant federal or private sector grant that has a financial matching requirement;
Potential departure from Kansas or the substantial reduction of the operations of a major Kansas employer;
Training or retraining activities for employees of Kansas companies;
Potential closure or substantial reduction of the operations of a major state or federal institution;
Projects in counties with at least a 10.0 percent population decline during the period from 2000 to 2010; and
Other unique economic development projects.
Kansas Industrial Training and Kansas Industrial Retraining Programs
The KIT/KIR programs assist eligible employers in training workers for new jobs and retraining existing workers who would otherwise be displaced because of obsolete job skills or knowledge. Eligibility requires companies to:
Retrain at least one existing position at an average wage that meets the median wage for the county in which the project is located;
Show that the company is restructuring their business operations through one or more of the following:
Incorporation of existing technology;
Development and incorporation of new technology;
Diversification of production; or
Development and implementation of new production;
Demonstrate that employees to be trained are likely to be displaced because of obsolete or inadequate job skills or knowledge; and
Meet program guidelines that set forth limits on the number of times companies can access assistance.
Minority and Women Business Development
The Office of Minority and Women Business Development exists to assist small minority and women-owned businesses in their business development activities by providing resources to include technical, financial, business management, certification, and procurement information. In FY 2023, 106 companies were certified and 16 workshops were conducted.
Private Activity Bonds
Qualified private activity bonds are federally tax-exempt bonds. Kansas had a 2023 bond authority of $358.9 million to allocate for this purpose. The Department ensures these bonds are being used for a qualified purpose and that the State does not exceed the maximum capacity set forth by the federal government. The types of bonds qualifying for tax-exempt status are:
Exempt facility bonds;
Qualified mortgage bonds;
Qualified veterans’ mortgage bonds;
Qualified small issue bonds;
Qualified student loan bonds’
Qualified redevelopment bonds; and
Qualified 501(c)(3) bonds.
Promoting Employment Across Kansas
This program is designed to encourage economic development and job creating by incentivizing companies to locate, relocate, expand, or retain their business facilities/operations and related jobs. During the benefit period, of up to 10 years, participating companies may retain or be refunded 95.0 percent of the state withholding tax of PEAK-eligible employees that receive wages equal to or greater than the county median wage where the Kansas business facility is located. In FY 2023, 41 applications were received and approved. 27 agreements were signed with a projection of creating 2,224 new jobs and over $132.6 million in additional annual payroll over a 5 to 10 year period.
Workforce Services
The Workforce Services Division links businesses, job candidates, and educational institutions to ensure that employers can find skilled workers and workers can find employment opportunities. Employment services are provided to employers and job candidates through the state’s 26 workforce centers, virtual services, and the mobile workforce centers.
Additionally, programs under Workforce Services include:
Federal Bonding;
Foreign Labor Certification;
Jobs for Veterans Grant;
Kansas Office of Registered Apprenticeship;
Kansas Training and Retention Aligned with Industry Need;
Migrant and Seasonal Farm Worker Services;
My (Re)Employment;
Older Kansans Employment Program;
Pathway Home 2;
Rapid Response Program;
Reemployment Services and Eligibility Assessment;
Retaining Employment and Talent After Injury/Illness Network;
Senior Community Services Employment Program;
Trade Adjustment Assistance Program; and
Work Opportunity Tax Credit Program.
Community Development
The Community Development Division provides technical assistance, support, and professional staff to communities for community development-related opportunities. Its focus is to enhance the current assets of Kansas communities to help build vibrant communities that are attractive places for residents and businesses to live, work, and play.
Programs under Community Development include:
Community Service Tax Credit Program;
Individual Development Account Program;
Kansas Community Empowerment;
Kansas Creative Arts Industries Commission;
Kansas Main Street;
Neighborhood Stabilization Program; and
Small Cities Community Development Block Grant.
International
The International Division works with Kansas companies to help them sell their products and services in international markets. The Division also works to recruit international businesses to establish facilities and create jobs in Kansas. In order to provide support to the state’s international trade community and introduce more companies to the benefits of exporting, the Division provides virtual outreach activities and provides support for companies traveling through programming.
Programs under the International Division include:
State Trade Expansion Program;
Kansas International Trade Show Assistance Program; and
Kansas International Trade Marketing Assistance Program.
Tourism
The Tourism Division inspires travel to and throughout Kansas to maximize the positive impacts that tourism has on the State and local communities. Its primary function is to market the state’s travel and tourism opportunities to the general public through marketing opportunities such as travel publications, social media, photography, and print advertising.
Building a Stronger Economy Grants
In addition to the programs listed above, the Department of Commerce also oversees the BASE 2.0 grant program which includes infrastructure investments associated with economic development projects including the development of new business parks; development of infrastructure required to support business expansions; renovation of existing business parks to bring them to modern standards; and other projects that achieve the goal of expanding the state’s base of businesses and residents.
Highlights is a summary of major legislation passed during the Session. This edition contains summaries from 20 major topics, including Education Finance and Policy, Fentanyl Test Strips, Childhood Sexual Abuse Statute of Limitations, State Budget and Water Funding, and Workforce Development Laws. This audio edition is a reading of the publication from 2023.
The Division of the Budget, Department for Children and Families (DCF), Department of Health and Environment (KDHE), Department for Aging and Disability Services (KDADS), and the Legislative Research Department (Consensus Group) met on November 3, 2023, to revise the estimates for human services consensus caseload expenditures for FY 2024 and to develop estimates for FY 2025. The caseload estimates include expenditures for Temporary Assistance for Needy Families, the Reintegration/Foster Care Contracts, KanCare Regular Medical Assistance, and KDADS Non-KanCare. A chart summarizing the estimates for FY 2024 and FY 2025 is included at the end of this memorandum.
The starting point for the November 2023 estimate was the budget approved by the 2023 Legislature, as represented in HB 2184 and SB 25 with adjustments for the reappropriation of State General Fund appropriations not expended in FY 2023. The estimate for FY 2024 is a decrease of $65.8 million, or 1.3 percent, from all funding sources, including a State General Fund (SGF) decrease of $55.5 million, or 3.6 percent, compared to the FY 2024 approved amount. The estimate for FY 2025 is an increase of $122.6 million, or 2.5 percent, from all funding sources including an SGF increase of $45.9 million, or 3.1 percent, above the FY 2024 revised estimate.
KanCare is administered by KDHE through maintaining financial management and contract oversight, including contracts for regular medical services. KDADS administers the Medicaid Home and Community-Based Services waiver programs, long-term care services, mental health and substance abuse services, and the state hospitals. In addition, the Department of Corrections (DOC) administers the part of KanCare related to youth in custody. The DOC KanCare expenditures have been included in the KDHE budget since FY 2018. Throughout this memorandum, KanCare Medical estimates include all Medical KanCare expenditures for all agencies.
FY 2024
For FY 2024, the revised estimate for all human service consensus caseloads is $5.0 billion from all funding sources, including $1.5 billion SGF. This is an all funds decrease of $65.8 million, including an SGF decrease of $55.5 million, from the budget approved by the 2023 Legislature.
Temporary Assistance for Needy Families
The FY 2024 revised estimate for the Temporary Assistance for Needy Families (TANF) program is $9.2 million, all from federal funds, which is an increase of $200,000 above the amount approved by the 2023 Legislature. The TANF caseload peaked in June 2020 at the beginning of the COVID-19 pandemic. Supplemental employment benefits made in response to the pandemic ended in September 2021, resulting in a brief spike in TANF, but the yearly decline in the caseloads is projected to continue. However, the rate of decline in the early months of FY 2024 is slower than projected during Spring Caseloads.
Foster Care
The FY 2024 revised estimate for the Foster Care program is $298.0 million, including $204.1 million SGF. The estimate is an increase of $8.7 million, including $2.8 million SGF, above the FY 2024 approved budget. The increase in this estimate is primarily attributable to the agency’s policy decision to amend the case management contracts to allow the case management organizations to cover actual costs in FY 2024 with savings recognized from prior years ($6.6 million including $4.4 million SGF). The decreases are partially offset by implementation of the national rule which allows the Department for Children and Families (DCF) to use kin-specific licensing or approval standards for a child’s foster home placement. With that, DCF can claim additional, Title IV-E federal dollars for the cost of foster care maintenance payments for that child. FY 2024 is a one year extension to the previous foster care case management contracts that began in 2019; new negotiated contracts will begin in FY 2025. The FY 2024 revised estimate also includes expenditures of $2.2 million all funds, including $1.9 million SGF, for the Failure to Place (FTP) program to reduce the incidence of children sleeping in offices.
KanCare Medical
The FY 2024 estimate for KanCare Medical is $4.5 billion from all funding sources, including $1.2 billion SGF. This a decrease of $71.9 million from all funding sources, including a decrease of $56.0 million SGF, from the amount approved by the 2023 Legislature. The KanCare Medical estimate includes medical expenditures for KDHE and, primarily, mental health and longterm care expenditures for KDADS.
The KanCare Medical all funds decrease is largely due to $29.7 million in reappropriations that were carried over from FY 2023. Also contributing were decreased estimates for the OneCare Kansas and Supports for Training for Employing People Successfully (STEPS) programs as these programs continue to increase the number of members served and a small decrease in the anticipated number of deliveries. The all funds decrease was partially offset by a small increase in Medicaid A and B buy-in payments as Medicare premiums increase and calendar year 2024 MCO rate increase that was 0.8 percent above spring estimates.
Additionally, expenditures to transition Community Mental Health Centers (CMHCs) to Certified Community Behavioral Health Clinics (CCBHCs) are estimated to decrease by $11.6 million, including $4.5 million SGF, below the FY 2024 approved amount to account for several CMHCs transitioning to CCBHCs partway through the year. Small decreases in long term care and brain injury populations also contributed to the overall decrease.
End of the 6.2 percent FMAP increase and Public Health Emergency
The Families First Coronavirus Response Act (FFCRA) provided a temporary 6.2 percentage point increase to the FMAP beginning on January 1, 2020. The 6.2 percent increase was originally intended to last the duration of the federal public health emergency (PHE) associated with the COVID-19 pandemic; however, the federal Omnibus bill, signed into law in December 2022, uncoupled the 6.2 percent increase from the PHE. The same legislation created a phase-down approach to phase out the 6.2 percent increase by the end of calendar year 2023. With this approach, quarter one of calendar year 2023 included a 6.2 percent increase; quarter two included a 5.0 percent increase; quarter three included a 2.5 percent increase; and quarter four included a 1.5 percent increase. It is expected that there will not be any enhanced FMAP associated with the COVID-19 pandemic beginning in January 2024.
With the phase-down approach, the FMAP for SFY 2024 is 61.67, which is an increase of 1.0 percent above the SFY 2024 base FMAP of 60.67. This included an increase of 2.5 percent in quarter one and an increase of 1.5 percent in quarter two, above the base. The anticipated savings from the increase above the base in FY 2024 is estimated to be $39.6 million. KDHE has reported that the total savings derived from the enhanced FMAP between January 1, 2020, and June 2023 (the end of FY 2023) is $959.6 million, all from the SGF.
Medicaid Unwinding
For the past three years, federal law has required states to keep Medicaid members enrolled for the duration of the COVID-19 public health emergency, as a condition of receiving the enhanced FMAP. During that time, KanCare did not complete annual re-determinations. Instead, each member’s eligibility was retained without verifying renewal eligibility. As a result, Medicaid enrollment increased from approximately 410,000 to 540,000 members between March 2020 and April 2023.
In December 2022, the federal Omnibus bill set April 1, 2023 as the end of the continuous eligibility requirement and states were required to resume re-determinations. This process is referred to as “unwinding.” Kansas began its unwinding period in March 2023 with members who had an April renewal date. The unwinding process will take place over a 12 month period with final renewal notices of the unwinding period being sent out in February 2024. It is estimated that the member count after the unwinding process will be approximately 376,000.
KDADS Non-KanCare
The estimate for KDADS Non-KanCare is $116.2 million, including $59.8 million SGF. This is a decrease of $2.8 million, including a decrease of $2.4 million SGF, from the approved in FY 2024. The decrease is due to lower nursing facility fee-for-service payments and participation in the Program of All-Inclusive Care for the Elderly (PACE) being lower than anticipated. The overall decrease is partially offset by the inclusion of the Client Assessment, Referral and Evaluation (CARE) program being in consensus caseloads. CARE is a CMS-mandated assessment used to determine appropriate placement of an individual in a long-term care facility, including nursing facilities which are funded through the consensus caseloads process.
FY 2025
The FY 2025 revised estimate for all human service consensus caseloads is $5.1 billion from all funding sources, including $1.5 billion from the State General Fund (SGF). This is an all funds increase of $122.6 million, including an increase of $45.9 million SGF, above the FY 2024 revised estimate.
Temporary Assistance for Needy Families
The FY 2025 estimate for TANF is $9.1 million, all from federal funds, which is a decrease of $100,000 from the revised estimate for FY 2024.
Foster Care
The FY 2025 estimate for the Foster Care program is $299.0 million, including $199.0 million SGF. This amount includes $9.6 million in anticipated SGF savings due to the implementation of the kin-specific licensing or approval standards for a child’s foster home placement. The Consensus Group notes that the cost for the Foster Care program is anticipated to increase with the new case management contracts set to begin in FY 2025. This current estimate does not consider these increases as the contracts were being negotiated during the writing of this memorandum. The Consensus Group anticipates a more precise estimate will be available for the April consensus estimates.
KanCare Medical
The FY 2025 estimate for KanCare Medical is $4.7 billion from all funding sources, including $1.2 billion SGF. This is an increase of $109.0 million, including $46.0 million SGF, above the FY 2024 revised estimate.
The all funds increase is partially due to expenditures to meet newly clarified federal requirements that certain medical services, including personal care and private duty nursing services, be provided to any child on Medicaid who meets medical need requirements. Prior to receiving clarification from CMS, these services had been provided only to children on a qualifying waiver. This change is anticipated to add $51.2 million, including $19.6 million SGF, for FY 2025. Due to the timing of the policy change, the current estimate anticipates that expenditures accrued in FY 2024 will be paid in FY 2025. For this reason, the amount per year is anticipated to decrease in FY 2026 and beyond. Other increases above the FY 2024 approved amount include increased fee for service and Medicare buy-in payments.
In addition, the FY 2025 estimate includes $57.8 million, including $22.2 million SGF, to fully rebase the nursing facility daily reimbursement rates and to implement the CMS-mandated transition from the Resource Utilization Group (RUG) to the Patient Driven Payment Model (PDPM) system. Together, the full rebase and transition to PDPM would result in an estimated 6.8 percent increase in nursing facility daily reimbursement rates for FY 2025. This estimate will be further revised in the Spring consensus caseloads process as actual cost reports are submitted by nursing facilities and reviewed by KDADS.
The overall increase is partially offset by a decrease of $61.6 million, including $23.7 million SGF, to eliminate the add-on payment to nursing facilities based on the number of Medicaid residents served for FY 2025. The 2023 Legislature added this payment for FY 2024 only.
The FY 2025 estimate includes a modest change in the FMAP from 61.67 in FY 2024 to 61.65 in FY 2025. The shift in FMAP decreased the required state share by approximately 0.03 percent between FY 2024 and FY 2025, which is equal to approximately $1.4 million.
KDADS Non-KanCare
The estimate for KDADS Non-KanCare is $128.9 million, including $64.8 million SGF. This is an increase of $12.7 million, including $5.0 million SGF, for FY 2025 above the FY 2024 revised estimate. The increase is due to an increase in the nursing facility fee for service payments based on the 6.8 percent increase to reimbursement rates from a full rebase and transition to the PDPM system. Additionally, participation in PACE is expected to increase as the program expands into additional counties.
Human Services November 3rd, 2023 Consensus Caseload Estimates
This memorandum provides an overview of the Economic Development Initiatives Fund (EDIF), which was established in 1986.
The statutes governing the EDIF (KSA 79-4804) provide that it shall be used to finance programs:
Supporting and enhancing the existing economic foundation of the State;
Fostering growth through the expansion of current businesses; and
The establishment and attraction of new, commercial, and industrial enterprises. KSA 79-4804 also requires 50.0 percent of the funds transferred to the EDIF to be split evenly between the two Kansas congressional districts. The statute further creates three EDIF accounts and requires that all EDIF revenue be deposited into one of those three accounts. The appropriation bills have created new EDIF accounts and deposited the funding as instructed by the Legislature. The statutory EDIF accounts include:
Kansas Capital Formation Account: Used to provide, encourage, and implement capital development and formation in Kansas;
Kansas Economic Development Research and Development Account: Used to promote, encourage, and implement research and development programs and activities in Kansas and technical assistance funded through state educational institutions under the supervision and control of the Kansas Board of Regents or other Kansas colleges and universities; and
Kansas Economic Development Endowment Account: Used to provide an ongoing source of funds to support specific community infrastructure projects in Kansas that stimulate economic growth.
Distribution of Funds
The EDIF is funded through the State Gaming Revenues Fund (SGRF). A portion of state revenue from both the Lottery and parimutuel wagering is transferred to the SGRF. That Fund is used essentially as a holding fund from which further transfers are made on a monthly basis. In normal years, no more than $50.0 million may be credited to the SGRF in any fiscal year. Amounts in excess of $50.0 million are credited to the State General Fund.
The initial transfers from the SGRF, which began in 1986, were as follows:
County Reappraisal Fund (until June 30, 1989) — 30.0 percent;
Split between Juvenile Detention Facilities Fund and Correctional Institutions Building Fund (actual amount to be determined by appropriations act) — 10.0 percent; and
EDIF (to be increased to 90.0 percent as of July 1, 1989) — 60.0 percent.
During the 1988 Session, the Legislature delayed the increase in the transfer to the EDIF until July 1, 1990.
During the 1994 Session, the Legislature changed the transfers as of July 1, 1995, to the following:
Correctional Institutions Building Fund — 10.0 percent;
Juvenile Detention Facilities Fund — 5.0 percent; and
EDIF — 85.0 percent.
During the 2000 Session, the Legislature changed the transfers to the following:
EDIF – $42,432,000;
Correctional Institutions Building Fund — $4,992,000;
Juvenile Detention Facilities Fund — $2,496,000; and
Problem Gambling Grant Fund — $80,000.
During the 2009 Session, the Legislature changed the transfers to the following for FY 2009 and FY 2010:
EDIF — $40,782,869;
Correction Institutions Building Fund — $4,797,985;
Juvenile Detention Facilities Fund — $2,398,992; and
Problem Gambling Grant Fund — $80,000.
Current Transfer Sources and Amounts:
The SGRF transfers 85.0 percent of the first $50.0 million, or $42.4 million, per fiscal year in net receipts from regular lottery revenues to the EDIF. Of that amount, the following transfers are made:
State Housing Trust Fund: The State Housing Trust Fund does not have a statutorily designated revenue source. Since FY 2010, $2.0 million per year has been transferred to this fund from EDIF. The State Housing Trust Fund is used to support the Moderate Income Housing Program in the Kansas Housing Resources Corporation.
State Water Plan Fund (SWPF): KSA 79-4804 directs $2.0 million per year to be transferred from the EDIF to the SWPF.
State General Fund (SGF): There is no statutory transfer to the SGF from the EDIF; however, excess receipts in the EDIF, after transfers and appropriated expenditures, have been transferred to the SGF by action of the appropriation acts. SGF moneys have also been transferred to the EDIF when transfers and appropriated expenditures exceed receipts.
This memorandum provides information on action taken to address the national opioid epidemic, including federal legislation, treatment options in Kansas, and strategies used by other states.
Background
Opioids are natural, synthetic, or semi-synthetic chemicals that interact with specific, opioid receptors on nerve cells in the body and brain1. This interaction reduces the intensity of pain. Commonly prescribed opioids include hydrocodone (Vicodin®), oxycodone (OxyContin®, Percocet®), oxymorphone (Opana®), morphine (Kadian®, Avinza®), and codeine (used in cough suppressants). Methadone, also a prescribed opioid, can be part of a medication-assisted treatment plan for opioid use disorder2. Similarly, the opioid fentanyl — which is used to treat severe pain because it is 100 times more potent than morphine — can be obtained with a prescription. Illegally obtained fentanyl is primarily manufactured in foreign, illicit labs and then smuggled into the United States. In this form, fentanyl is often mixed with other illicit drugs and made into pills to resemble prescription opioids3.
The increase in opioid overdose deaths in the United States due to any opioid can be outlined in three distinct waves. The initial, gradual increase started in the 1990s and was closely tied to a rise in commonly prescribed opioid medications. In the 2010s, a rapid increase of opioid overdose deaths was attributed to heroin specifically. Most recently, beginning in 2013, the data shows a rapid surge in opioid overdose deaths due to other synthetic opioids, including tramadol and fentanyl.
Data specific to Kansas mirrors the national trend. According to testimony provided to the House Committee on Corrections and Juvenile Justice in February 2023 by the Kansas Department of Health and Environment (KDHE) and the Kansas Department for Aging and Disability Services (KDADS), synthetic opioid overdose deaths have increased from 39 deaths reported in 2012 to 347 deaths in 2021, a 790 percent increase4. This increase is primarily seen in the last two years of available data: The number of deaths more than doubled both years, from 70 in 2019 to 161 in 2020, and then to 347 in 2021.
As of 2021, when taking into account age distribution and population size of a state, West Virginia has the highest drug overdose mortality rate, at 90.9 deaths per 100,000, followed by Louisiana, Tennessee, and Kentucky, at 55.9, 56.6, and 55.6 deaths per 100,000, respectively. Kansas is considerably lower, at 24.3 deaths per 100,000.
Federal Actions to Address Opioids
President Obama signed into law the Comprehensive Addiction and Recovery Act and appropriated funds to each of the 50 states through the 21st Century Cures Act. Several hundred bills have been introduced in the 115th Congress that address the opioid epidemic in some capacity. President Trump issued an executive order that created a national opioid commission, and Congress, through 2017 HR 244, appropriated $113.0 million to combat the opioid crisis.
Congress passed a spending package in December 2022 that removed the federal requirement for health care practitioners to have a waiver to prescribe medication for opioid use disorder, allowing practitioners to more easily prescribe buprenorphine and increasing access to treatment. Buprenorphine is the first medication to treat opioid use disorder that can be prescribed or dispensed in physician offices. It is an opioid partial agonist that produces effects of euphoria and respiratory depression at low to moderate doses. The effects of buprenorphine are weaker than those of full opioid agonists, such methadone. When taken as prescribed, buprenorphine diminishes withdrawal symptoms and physical dependency on opioids.
In March of 2023, the U.S. Food and Drug Administration (FDA) approved the first over-the-counter nalaxone nasal spray. (see “Nalaxone Access” below for more information on nalaxone.)
Addressing Opioids in Kansas
In 2017, Governor Brownback signed HB 2217 into law, amending the Kansas Pharmacy Act to allow first responders to carry nalaxone.
In 2021, the Kansas Legislature passed the Kansas Fights Addiction Act (HB 2079), which authorized the State to use money recovered through Kansas opioid settlements to tackle substance abuse and provide addiction services across the state. The settlement funds are split into two funds: 75 percent to the Kansas Fights Addiction fund, and 25 percent to the Municipalities Fight Addiction Fund (MFAF), with $200,000 dedicated annually to K-TRACS, the Kansas prescription drug monitoring program.
In October 2022, Governor Kelly announced that the State of Kansas and the Kickapoo Tribe in Kansas (KTIK), together, have received $17.2 million in federal grant funding to address the opioid crisis. The funding will be used by KDADS and KTIK through September 2024 to increase access to treatment for substance use disorders; remove barriers to public health interventions, such as naloxone; and expand access to recovery support services.
Kansas Opioid Treatment Programs
KDADS maintains a list of Kansas Opioid Treatment Programs. Programs are primarily located in eastern Kansas, including the Kansas City area, Lawrence, Overland Park, Topeka, and Wichita. The Substance Abuse and Mental Health Services Administration (SAMHSA) also maintains an Opioid Treatment Program Directory. According to SAMHSA, every state has at least one federally certified treatment location. However, the laws concerning the programs and requirements vary by state.
Medication-assisted treatment (MAT) works to normalize brain chemistry and body functions, block the euphoric effects of opioids, and relieve physiological cravings. Through September 2025, buprenorphine, methadone, and naltrexone are considered Medicare Part B MAT drugs for opioid treatment programs.
Kansas Prescription Drug and Opioid Advisory Committee
The Kansas Prescription Drug and Opioid Advisory Committee (Committee) was formally established in 2017. It is facilitated by DCCCA, Inc., and supported by KDADS and KDHE. The Committee is a multidisciplinary stakeholder group composed of state and local government, health systems, professional associations, community-based organizations, academic institutions, public safety and first responders, and others.
In December of 2022, the Committee released the second iteration of the Kansas Overdose Prevention Strategic Plan for 2022–2027. This plan was developed with contributions from the Committee, subject matter experts, and more than 55 organizations. The plan is centered on six overarching priorities:Treatment and Recovery, Linkages to Care, Prevention, Harm Reduction, Providers and Health Systems, and Public Safety and First Responders. These six priorities intersect across strategies, including data and surveillance; policy development, evaluation, and advocacy; stigma reduction; and health equity.
The objectives, strategies, and recommendations presented within each priority reflect best or promising practices, are driven by Kansas-specific data, and aim to address multiple levels of impact. Specific strategies are targeted to increase education and awareness, prevent substance misuse and use disorder, connect individuals who use drugs with substance abuse disorder treatment and wraparound services, scale up treatment services, advance harm reduction, and expand services for justice-involved populations. The full plan can be accessed here.
With the release of the current plan, the Committee also shared their progress on strategic indicators identified during the first iteration of the plan, which was 2018 to 2022.
Table 1. Previous Strategic Plan Indicators That Met or Exceeded 2022 Target Value5
State-level Indicator
Baseline
Target
2021 Value
Provider Education
Percent of patients prescribed long-acting/extended release opioids who were opioid-naive
8.70%
5.20%
4.8% (2022 Q3)
Treatment and Recovery
Number of Buprenorphine waivered prescribers practicing in Kansas
97
150
218
Rate of Kansas prescribers who prescribed buprenorphine indicated for Medication-assisted Treat (MAT) per 100,000 residents
7.1
9.1
22.4 (2022)
Law Enforcement
Percentage of law enforcement agencies responding to the naloxone survey that indicated they allowed carry and use of naloxone
̶
50.00%
65.30%
Table 2. Previous Strategic Plan Indicators Made Progress in Intended Direction6
State-level Indicator
Baseline
Target
2021 Value
Morbidity
Age-adjusted All Drug Non-Fatal Overdose Hospitalization Rate per 100,000 population
Incidence rate of NOWS in Kansas, per 1,000 birth hospitalizations
3.4
2.6
2.9 (2020)
Provider Education
Total morphine milligram equivalents (MME) dispensed to patients per capita
196.8
75
104.2 (2022 Q3)
Rate of patients with 5+ prescribers and 5+ dispensers in a 6-month period
15.40%
0.4
1.5 (2022 Q3)
Percent of patients with 90+ daily MME of opioids
11.10%
2.20%
6.0% (2022 Q3)
Treatment and Recovery
Percentage of Kansas counties with perscribers who prescribed buprenorphine indicated for medication assisted treatment (MAT)
27.00%
100.00%
35.00%
Kansas Prescription Drug Monitoring Program
K-TRACS, the state prescription drug monitoring program (PDMP) authorized by law in 2008 (KSA 65-1683), has been operating since April 1, 2011. The program provides a database of controlled substance prescriptions that have been dispensed by Kansas pharmacies and from out-of-state pharmacies to Kansas residents. The purpose of the database is to provide up-to-date web-based patient information to assist prescribers in providing appropriate treatment to patients. Additionally, drugs classified as schedule II through IV are monitored.
The program requires pharmacists to document prescription-dispensing data on every written controlled substance prescription. It also allows both prescribers and pharmacists to check prescription histories to determine, in advance, if patients are acquiring drugs from multiple prescribers or pharmacies.
Drug Treatment Courts in Kansas
In 2022, the Kansas Legislature passed Senate Sub. for HB 2361, which required the Kansas Supreme Court to adopt rules for establishment and operation of specialty court programs within the state, including drug courts for people with substance use disorder. Drug treatment courts are established as an alternative to incarceration for those convicted of misdemeanors. They offer treatment, support, and counseling. With oversight from the court, a person with substance use disorder can complete a drug treatment program and work on lifestyle changes, often in lieu of going to jail.
As of 2023, while there is not a statewide program, the cities of Kansas City, Topeka, and Wichita have developed their own municipal- or county-level programs, and 11 of the 31 judicial districts have drug treatment courts, which includes Allen, Chase, Cowley, Douglas, Ellis, Geary, Johnson, Lyon, Reno, Riley, Sedgwick, Shawnee, and Wyandotte counties.
Strategies Used by Other States
Prescription Drug Monitoring Programs
With the launch of Missouri’s PDMP in 2023, all 50 states have PDMPs in place to track the prescribing and dispensing of all controlled substances. State requirements vary concerning who and what is tracked, who is required or authorized to check or submit information, and the frequency information needs to be checked and updated. Many states share their data with other states’ PDMPs and authorized users in those states. However, there are no federal regulations requiring states to share their information with other states or the federal government.
Limiting Prescriptions
As of 2022, 32 states have enacted a limit on initial opioid prescriptions, ranging from a three-day supply (Florida, Kentucky, Tennessee, and 7West Virginia) to a 14-day supply (Nevada, specifically for prescriptions meant to treat acute pain). A seven-day initial supply is the most common limit, with 24 states implementing a seven-day limit on all or specific types of opioid prescriptions, such as those intended for minors. Several states impose different limits depending on the prescriber or reason for treatment. For example, Pennsylvania limits prescriptions originating in emergency rooms and urgent care or those written for minors to a seven-day initial supply.
Opioid Intervention Court
Buffalo, New York, created the nation’s first opioid crisis intervention court in 2017 after determining its ordinary drug treatment court was not enough to combat the opioid crisis. The court admits people into treatment in a matter of hours instead of days, requires them to check in with a judge every day for one month, and utilizes strict curfews. It has been funded via a U.S. Justice Department grant with the intent of treating 200 people in a year. During the first nine months of the program, only one of the 92 people in the program had overdosed. Since its establishment, the state of New York has expanded the model and established a total of 35 new opioid courts through its Unified Court System, and similar specialty courts have been created in Arizona, Pennsylvania, and Wisconsin.
Good Samaritan Overdose Immunity Laws
As of May 2023, the Network for Public Health Law8 reports that 48 states and the District of Columbia have enacted at least one overdose Good Samaritan law. These laws provide immunity from arrest, charge, or prosecution for certain controlled substance possession and paraphernalia offenses when someone is either experiencing an opioid-related overdose or calling 911 to seek medical attention for someone else experiencing an opioid-related overdose. What is covered under the law varies depending on the state. Kansas’ good Samaritan law (KSA 65-2891) is limited specifically to health care providers rendering emergency services at the scene of an accident or emergency. Kansas and Wyoming are the only two states that do not have a Good Samaritan Law specific to drug overdoses.
Naloxone Access
All 50 states have passed legislation to expand access to naloxone in some form. Naloxone, also known by the brand name Narcan, is an opioid antagonist that can bind to opioid receptors and reverse or block the effects of other opioids, thereby reversing opioid-induced overdoses. It can be administered via nasal spray or injected into the outer thigh muscle, veins, or under the skin. New evidence has shown that opioid-related deaths have been reduced by 9.0 to 11.0 percent in states that have promoted naloxone. Some states, such as Arizona, Maryland, and New Mexico, have utilized Medicaid to purchase naloxone to promote access for the public. Some states are also providing naloxone to at-risk inmates, as well as training on how to use it upon their release from jail. Officials hope this will reduce overdose deaths and expand the community’s knowledge about naloxone and how to use it.
Needle Exchanges
Forty-three states and the District of Columbia have some form of a needle exchange program. Currently, only 1 in 4 drug users obtains needles from a sterile source. With the increase in the use of heroin and other drugs injected via needle, there is also a rise in the number of cases of HIV and hepatitis B and C. One way to help combat the spread of disease is to facilitate access to sterile needles via needle exchanges. The federal government lifted a ban on federal funding for needle exchanges in early 2016. Some states have also followed suit by making it easier to establish needle exchanges, as well as helping people enter a program who want to find treatment.
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