News

All the latest news from The REACH Healthcare Foundation


Blog: Fraying Safety Nets Worry Kansas Healthcare Leaders

Kansas is known for its intensely hot summers. But this year, debate is nearly as heated and intense among the many health providers and consumers who are increasing their call on the Administration and legislators to address an array of health care access problems. A number of public forums have been hosted over the past several weeks organized by the Alliance for a Healthy Kansas, the Kansas Department of Health and Environment and the Kansas Department for Aging and Disability Services, and the Centers for Medicare and Medicaid Services (CMS). Health and mental health program directors, hospital leaders, nursing home administrators and consumers have repeatedly expressed strong and ongoing concerns about KanCare’s operations, the state’s eligibility system backlogs, and proposed reductions in KanCare reimbursement rates. For many of the health organizations that serve uninsured and medically vulnerable people, this might be characterized as their summer of discontent.

The testimonies and stories shared at public meetings and reported in newspapers and on TV stations across the state have revealed deficiencies in our state’s Medicaid system and how these problems are straining the health care safety net that serves people who don’t have ready access to affordable health care. They are as heartbreaking as they are puzzling. It wasn’t always this way in Kansas. Once known for its strong commitment to care for those less fortunate, Kansas is quickly becoming the state of broken systems and broken promises.

For example, cuts in federal Medicare payments to Osawatomie State Hospital, one of two state-run inpatient psychiatric treatment facilities, were announced in December because of serious, unresolved issues affecting treatment as well as patient and worker safety. Application processing backlogs tied to the state’s Medicaid eligibility system left thousands of people waiting for action on their applications last year and into the current year. Nursing home operators have been asking the state for financial relief as they have struggled to carry uncompensated care costs for residents waiting on processing of Medicaid applications. The financial strain has been too much for some operators, forcing some families of Medicaid-pending residents to shop for other options due to lengthy delays.

More recently, the Kansas Hospital Association and physicians and administrators from several of its member hospitals have voiced strong concerns about a 4 percent cut in the Medicaid provider reimbursement rate approved by the Governor in May to help address state budget shortfalls. The Governor approved cuts of more than $56 million from the state’s Medicaid program, with approximately $38.2 million tied to reducing reimbursements for providers treating patients covered by KanCare. The proposed 4 percent reduction requires the approval of CMS. The Kansas Hospital Association has formally communicated its concerns in letters sent to KDHE in June and July.

A little more than a week ago, one of the REACH Foundation’s core partner grantees, Wyandot Inc., announced it was eliminating a number of full-time and part-time positions and leaving 18 job vacancies unfilled, affecting services for approximately 800 adults and children. Wyandot Inc. provides counseling, psychiatric treatment, crisis intervention and housing support for more than 7,500 adults and children, primarily in Wyandotte County. The community mental health center cited reductions in state funding for mental health services and the anticipated cuts in the KanCare reimbursement rate as the impetus for reducing services. Following last week’s announcement, Randy Callstrom, president and CEO of the agency, wrote an op-ed published in the Kansas City Star, expressing his worries about the continuous fraying of the mental health safety net system.

These troubling developments, which highlight large cracks in our increasingly strained health systems, remind us of the purpose and importance of a health care safety net where everyone is doing their part, including the state, to maintain systems of care for people in need. Medicaid, a critical component of the safety net, is funded under a cost-sharing agreement between the state and the federal government – with the federal government supporting the larger share. After 2012, when the U.S. Supreme Court ruled that state’s expansion of Medicaid under the Affordable Care Act is optional, many states chose to do so in order to close their coverage gaps for low-income citizens in need of health insurance. Through a variety of state-created plans, more low-income citizens gained access to coverage that has since enabled them to seek preventative care and better manage their chronic conditions.

Sadly, Kansas is one of 19 states (including neighboring Missouri) that have continued to opt out of this opportunity despite growing evidence that such an expansion would increase jobs, grow the economy and reduce the uncompensated care burden on our hospitals. More than 150,000 hard-working Kansans find themselves in the gap instead. While the state’s revenues continue to plummet, the Legislature has refused to access $1.9 million a day in our federal tax dollars that could be used to shore up the safety net and free up state general funds that could be used to support other priorities important to Kansans, such as education and transportation.

Last year, when the REACH Board of Directors and staff revisited our funding priorities and targets to develop the foundation’s next five-year strategic plan, we recommitted ourselves to continue to invest in a strong health care safety net along with investments aimed at expanding access to health care and reducing the coverage gap. As all of us follow political conversations about health care in the coming months, it’s important to keep in mind the missed policy opportunity to advance the health of Kansans and repair the fraying safety net by expanding KanCare, Kansas’ Medicaid program. It’s what Kansans instinctively do when faced with a challenge or learn of a neighbor in need: We take stock of the situation, identify a solution and make it happen.

Brenda R. Sharpe, President and CEO
CoverageGapInfographic


Blog: The Kansas Budget Problems and Cuts Prove a Risk to Medicaid

It’s been no secret that the Kansas budget issues have been troubling.

From the legislation putting forward an unbalanced budget to the Administration enacting $56 million in cuts to KanCare alone, the budget has been top of mind for many Kansans. Poor revenue returns for May and June have deepened the concern about more cuts in the future.

Budget cuts almost never bode well, and with ongoing budget difficulties and questions about the adequacy of K-12 education funding still putting pressure on lawmakers, many are worried that more decreases are coming to the allotments for Medicaid and other public health services.

At REACH, our goal is to achieve health equity by reducing barriers to coverage and care. These efforts are focused into three outcomes that we use to guide our actions. With the latest cut in the state’s Medicaid program, the steps we and our partners have taken toward closing the coverage gap are threatened.

Throughout the 2016 Kansas Legislative session, health care advocates, health care professionals, and concerned Kansans have repeatedly told the legislature that they strongly oppose bills that erode funding for health services. REACH’s President and CEO Brenda Sharpe expressed her concerns in a recent Message from the CEO, as did the Kansas Grantmakers in Health through a letter sent to Governor Brownback and the Legislature before the start of the 2016 Legislative session.

Kansans have been making their opposition to Medicaid cuts known, and yet they are still being made.

The Alliance for a Healthy Kansas, a new advocacy organization that aims to educate the public about KanCare expansion and put pressure on elected leaders to support a solution, has been holding forums around the state to build support for health issues. Advocates packed a statehouse committee room in May to voice their discontent with elected leaders’ lack of action on KanCare expansion. From clergy to students to health care professionals, a broad range of people spoke about the community health and economic benefits of expanding KanCare and called on elected leaders to act on the opportunity. Several forums have been held and at least five other gatherings are planned for July, including on Monday, July 11, in Johnson County.

Many healthcare professionals point to the federal funding that would come with Medicaid expansion as a possible solution. The Kansas Grantmakers in Health last year commissioned a Manatt Health Solutions study that examined the impact of expanding Medicaid on the state budget. The study found that not only would the expansion be budget neutral, it was likely to bring in more revenue than it consumed, adding to revenue savings that Kansas needs.

The Kansas budget issue is complex, and expanding Medicaid is more than just a way to alleviate some of those issues. If you want to read more about how Medicaid expansion affects budgets, the Kaiser Family Foundation hosts archives of budget surveys for all 50 states. They have also conducted a study analyzing the costs of Medicaid spending compared to the costs of other private insurers. These are just two of the many pieces analyzing Medicaid expansion; there are many more available on the Kaiser Family Foundation website.

We encourage everyone to become informed on the issue and consider attending one of the upcoming Alliance events. You also can find out more about the REACH Healthcare Foundation’s approach to closing the coverage gap and other efforts at our website.


Kansas Governor Balances State Budget with Large Cuts to Medicaid

From the President and CEO

Over the past week, we have been grappling with the news that due to continuing budget shortfalls in Kansas, the Governor’s Office has made more than $56 million in cuts to Medicaid, primarily by reducing the reimbursement rate paid to health providers who treat patients covered by KanCare, the state’s Medicaid program, by 4 percent. These cuts will trigger even bigger losses than the $56 million because the federal government provides $1.28 for every $1 the state spends on Medicaid.

We are deeply concerned about this latest action. Medicaid reimbursement rates are already low, which makes it difficult to attract and retain health providers to serve low-income populations in Kansas. We believe this reduction will have a chilling effect on efforts to recruit health providers in underserved communities and may result in some physicians dropping out of Medicaid provider networks altogether. If this occurs, then access to preventive health care and treatment will be further out of reach, leaving people without options close to home.

Unfortunately, some people believe that Medicaid is an abundantly-funded entitlement that should be trimmed. While that narrative may have taken hold in some quarters, it simply isn’t the case. Kansas already has one of the most restrictive Medicaid eligibility rates in the country – at 33 percent of the Federal Poverty Level. In plain language, a parent earning over $6,630 per year – or $127.50 per week – in a household of three makes too much money to qualify for the state’s Medicaid program.

With the Affordable Care Act, all states have the opportunity to expand Medicaid to people up to 138% of poverty. As we know, if Kansas had expanded KanCare this year, the federal government would have covered 100% of the cost. That 100% match will become a 95% match in 2017, 94% in 2018, and ultimately settle at 90% match in 2020 and beyond. Thirty states and the District of Columbia have recognized the financial benefit and opted to draw down the federal expansion dollars, freeing up state funds that are currently being used to pay for health services to cover other critical needs.

Other states that were considered strong holdouts, such as Oklahoma, are taking a fresh look. It’s hard to downplay the potential of that amount of federal funding. It is particularly puzzling to watch Kansas lawmakers and the Administration do just that when the state is grasping for revenues to fill its budget hole.

Over the past three years, Kansans like me and my family have heard that the revenues simply aren’t available and that the only option is to reduce state spending and thereby core services. It’s true that because of policy decisions, revenue streams have slowed to a trickle, but there are resources available to our state. Our leaders have decided to turn their backs on these resources – more than $1 billion to date – that would pay dividends in the form of a robust workforce and economy.

As Kansans wait for an explanation, health leaders and consumer advocates have launched a new alliance – the Alliance for a Healthy Kansas – and invited people who think there’s a better answer than “no” to sign on. You can find the Alliance at www.expandkancare.com, and sign up for news and information on forums and other events.

If you believe Kansas has the capability to forge its own state-based solution and should draw down our own federal tax dollars to do so, particularly when our own state resources are running thin, then join the Alliance for a Healthy Kansas, as our foundation has, and learn how Kansas can advance a pro-health and pro-growth movement.

Thank you for your engagement on this important issue.

Brenda R. Sharpe
President and CEO


Advocacy Training to Look at Rules, Opportunities

ANNOUNCEMENT

Nonprofit organizations interested in learning more about the rules and opportunities related to lobbying and advocacy can attend a workshop presented by the Alliance for Justice on Tuesday, May 24, 8:30 a.m.-12 p.m. at the Kauffman Foundation Conference Center.

The workshop will review the rules and differences regarding lobbying and advocacy, the benefits and opportunities for 501(c)(3) organizations to become engaged in advocacy efforts, and how nonprofit organizations can partner and leverage efforts with other groups. The training will presented byAbby Levine, director at Bolder Advocacy, a project of the Alliance for Justice. Levine is one of the nation’s leading experts in federal tax and election law and their impact on nonprofits.

The workshop is sponsored by the Ewing Marion Kauffman Foundation, the Francis Families Foundation, the Healthcare Foundation of Greater Kansas City, the REACH Healthcare Foundation and Support KC.

Find details and registration information here.

The Alliance for Justice is a national association of over 100 organizations dedicated to advancing justice and democracy. The Alliance provides a voice and leadership on issues related to justice and equity on behalf of a broad constituency of environmental, consumer, civil and women’s rights, children’s, senior citizens’ and other groups.


Mobile Integrated Healthcare Program Wins National Awards

ANNOUNCEMENT

In 2015, the REACH Healthcare Foundation awarded The City of Olathe Fire Department a $20,000 capacity grant to fund further development of the Mobile Integrated Healthcare (MIH) Program. The program, which deploys firefighter paramedics to medically assess individuals who request service, but do not need to visit an emergency room, determines needs and resources, and helps connect patients with the appropriate care in the community.

The MIH Program has been selected as a recipient of the 2016 Congressional Fire Services Institute (CFSI) and Masimo Excellence in Fire Service-Based EMS Award.

The CFSI/Masimo awards ceremony brings together representatives of all the national fire and emergency service organizations as well as members of Congress to advance important issues in Washington, D.C., that benefit firefighters. The awards presentation will take place on Tuesday, May 5, at the 28th Annual National Fire and Emergency Services Dinner in Washington, D.C.

Additionally, the MIH Program has been selected as the winner of the 2016 Thomas H. Muehlenbeck Award for Excellence in Local Government by the Alliance for Innovation.

Innovation Award recipients are chosen from among hundreds of nominations received by a committee consisting of national city and county managers and Alliance for Innovation staff. The selection committee looks for dedication to stretching and improving the boundaries of day-to-day government operations and practices, implementing creative business processes and improving community civic health. The awards ceremony will be held at the 2016 Transforming Local Government Conference from June 15-17 in Saint Paul, MN.


REACH Updates Non-Discrimination Policy for Grant Applicants

Announcement

This week, the REACH Foundation will notify grantees of a change in the foundation’s non-discrimination policy requirements for applicants. The REACH Foundation’s Board of Directors adopted a Diversity and Inclusion Policy several years ago that called for the foundation to promote and support diversity and inclusion not only through our organization’s governance and employment policies, but also through our grant making, and policy and advocacy efforts. The foundation’s policy included sexual orientation and gender identity from the start, but we recognized that some of our grantee partners might need time to discuss these requirements in order to adopt changes. Therefore, we allowed for a phased-in approach and worked with organizations that needed assistance with the development of policies that would meet our funding requirements.

For 2017 funding, all grant applications must include a board- or trustee-adopted non-discrimination policy for both employment and service provision that includes race, color, sex, religion, age, national origin, disability, sexual orientation, gender identity and any other consideration made unlawful by applicable law. Although gender identity and sexual orientation are not currently protected classes under federal or Kansas and Missouri state law, the Board of the REACH Healthcare Foundation is committed to a broader definition of non-discrimination.

Foundation staff is available to talk with organizations about their agencies’ diversity and inclusion policies, and answer questions about this funding requirement. Members of our program team also are available to facilitate dialogue about health equity, and the role of governance and management of nonprofit and governmental health and human service providers in promoting non-discrimination, diversity and inclusion to improve the health of all people.

If you or your organization’s staff or board members have questions about this funding requirement, please contact William Moore, Ph.D., Vice President of Programs and Evaluation, at 913-432-4196. As always, we welcome your thoughts and conversation regarding this change in requirements.

Thank you for your engagement on this important issue.

Brenda R. Sharpe
President and CEO


REACH Board Elects Members with Health, Business, Educational Expertise

NEWS RELEASE

The REACH Healthcare Foundation Board of Directors, a 17-member board that provides governance and oversight to the health philanthropy, elected six members at its March 24 meeting. The elected members included individuals with oral health, higher education, nonprofit, finance and health care law experience. Five are new to the REACH Board; one is an incumbent elected to a second term. All elected members are residents of the foundation’s six-county service area.

The following individuals will begin their terms on June 1:

Arif Ahmed, Ph.D., is Associate Professor of Health Administration at the Henry W. Bloch School of Management at UMKC, where he leads the health leadership and management programs and guides development of health-related executive education. Ahmed completed a Doctor of Philosophy in Health Policy/Research and Master of Science in Public Health from the University of Illinois at Urbana-Champaign. He began his career as a dental surgeon in Dhaka, Bangladesh.

Laura Bond, JD, is an attorney with Spencer Fane LLP. She has spent much of her 25-plus year career providing legal services to health care providers and managed care entities, including hospitals, physicians, MCOs and safety net providers. Bond earned a law degree from the University of Kansas. She has served on the boards of Health Partnership Clinic, Olathe Area United Way, Olathe Chamber and the Olathe Medical Center.Angela

Angela Harse, JD, is Staff Counsel/Assistant Risk Manager at Children’s Mercy Hospital’s Office of General Counsel. She previously worked at Dentons and as a Partner and Associate at Husch Blackwell. Harse has focused her practice in the health care area, monitoring regulatory changes and developing risk mitigation strategies. She earned a law degree at UMKC School of Law. She is a member of Children’s Mercy Hospital Hands and Hearts Auxiliary Board.

Vicki Hohenstein, MBA, CFA, is Senior Vice President and Portfolio Manager and a member of Tower Wealth Managers Board of Directors at Tower Wealth Managers/Country Club Trust. Hohenstein previously was Vice President and Senior Portfolio Manager for Bank of Kansas City. Hohenstein is a REACH Board incumbent, serving on the Finance Committee, and previously served as Vice Chair of the REACH Community Advisory Committee.

Danielle Jones, MPH, is an Army Public Health Center Fellow assigned to advise the Senior Commander of the Combined Arms Center at Fort Leavenworth, Kansas. In this role, Jones provides analysis of public health programs, policies, services and protocols to enhance the readiness and resiliency of the community. She brings a background in health promotions. Jones earned a Masters of Public Health at the University of West Florida.

Lisa Thurlow, DDS, is the clinical director of the dental hygiene program at Concorde Career College in Kansas City, MO, and maintains a clinical practice at Johnson County Dental Care. Thurlow has served as president and other leadership roles for the Fifth District Dental Society of Kansas and as a Kansas Dental Association delegate. She served on the dental peer review committee for more than 15 years. Thurlow earned her Doctor of Dental Surgery at UMKC and completed her residency at the Veteran’s Administration Hospital in Kansas City, MO.

In selecting members, the REACH Board looks for candidates who represent the geographic and demographic diversity of the foundation’s six-county service area. The board also seeks candidates with experience in nonprofit management and governance, financial services, health care and volunteer service, and who share the foundation’s interest in issues that affect individual and community health.

The next application cycle will begin in fall 2016. The deadline to apply for consideration for 2017 is December 15, 2016. Eligibility and application information is available on the Board of Directors section of the web site.


What We're Reading at REACH: Health in the Region

Feature:  What We’re Reading at REACH

In our work, we come across a number of news items and reports related to the REACH Foundation’s funding priorities and strategic goals. “What we’re reading at REACH” is a collection of links to noteworthy articles and announcements that have caught our attention.


Heartland Health Monitor Series

This week KCUR 89.3 FM introduced a series of stories about health in the region, including stories that highlight health issues in Johnson and Wyandotte counties in Kansas. One story looks at differences in health outcomes across the two counties, and highlights health data that describes the disparities. Find stories in the series:

From KCUR’s Heartland Health Monitor


KanCare Forum Highlights Business Interests, Legislator Perspectives

A group of more than two dozen hospitals, chambers of commerce, business and health organizations, and foundations sponsored a forum to discuss expansion of KanCare and learn from the experience of Indiana, which secured a waiver from the Centers for Medicare and Medicaid to implement its own state-based approach to Medicaid expansion.

From Heartland Health Monitor


KHI Issue Brief: Uninsured Rate Drops Significantly After First Year of ACA Marketplace

A recently published issue brief by Kansas Health Institute reports on changes in the insurance status of Kansans. The brief analyzes recently released health insurance coverage data from the U.S. Census Bureau’s American Community Survey. The brief reports that the uninsurance rate for Kansas dropped from 12.3 percent in 2013 to 10.2 percent in 2014 following the first full year of implementation of the health insurance expansion provisions of the Affordable Care Act (ACA).

KHI Issue Brief


Expanding health coverage options tops REACH policy priorities

Resources and Reports

The REACH Foundation was established in 2003 with a mandate to increase access to health care coverage and services to improve the health of uninsured and medically underserved individuals in our service area. To accomplish this, we believe it is essential to advocate for a robust health and human service safety net system and for public policies that address health care access and disparities in our region. Review the foundation’s 2016 Policy Priorities.

Kansas Policy Priorities

Missouri Policy Priorities

 


Major Health Foundations of Kansas Urge Legislators, Governor to Expand KanCare

News Release

Foundation CEOs point to new research that finds KanCare expansion would generate state budget savings and revenue gains while insuring 150,000 Kansans

TOPEKA — Leaders of the state’s six major health foundations today sent a letter to Kansas legislators and the governor urging them to give KanCare expansion “serious consideration and an open debate,” pointing to new research that shows potential savings for the Kansas budget.

“The potential benefit to the state budget alone indicates that legislators can no longer afford to simply say ‘no’ to KanCare expansion. We call upon legislators to give KanCare expansion serious consideration and an open debate, allowing diverse opinions a chance to be heard in committee and on the chamber floors,” reads the letter signed by the six foundations, which comprise the Kansas Grantmakers in Health (KGIH).

The letter cited a new analysis by Manatt Health Solutions commissioned for KGIH that found with KanCare expansion and the favorable federal funding match offered, Kansas could expect to save much of what it currently spends for providing critical services to the uninsured, including up to:

  • $75.3 million that Kansas spends annually for mental and behavioral health care.
  • $28.9 million that Kansas spends each year to reimburse hospitals and clinics for the uncompensated care they provide.
  • $9.3 million that Kansas spends annually for medical services to prison inmates.
  • $4.1 million that Kansas spends each year for the MediKan program.

The analysis concluded: “It appears that Kansas should be able to generate sufficient savings and revenue gains to cover the costs of expansion between 2016 and 2020 – in other words, expansion should be budget neutral. In fact, expansion may generate savings and new revenue in excess of the costs of expansion during this period.”

The letter from the foundations said the potential benefit to the state budget alone merited serious consideration of KanCare expansion. “Kansas’ severe and growing budget crisis recently prompted legislators to pay a consultant $2.6 million in hopes of finding more savings and efficiencies. Yet for two years, Kansas has ignored a policy decision that could be saving the state millions of dollars right now, while providing more than 150,000 uninsured Kansans health coverage: KanCare expansion,” the letter continues. “Many of the states that have embraced expansion are led by Republican governors and conservative legislatures. If they can find state-based solutions, so can Kansas.”

The full text of the letter from the foundations is attached.

The Kansas Grantmakers in Health is comprised of: Health Care Foundation of Greater Kansas City, Kansas Health Foundation, REACH Healthcare Foundation, Sunflower Foundation, United Methodist Health Ministry Fund, and Wyandotte Health Foundation. More information on each is attached.