State of Kansas Enrolled Bill # 424

House Substitute for Substitute for SENATE BILL No. 424 An Act relating to Kansas insurance coverage for children; duties of the secretary of social
and rehabilitation services; funds; joint committee on children's issues and duties thereof. Be it enacted by the Legislature of the State of Kansas:

Section 1. (a) The secretary of social and rehabilitation services shall
develop and submit a plan consistent with federal guidelines established
under section 4901 of public law 105-33 (42 U.S.C. 1397aa et seq.; title
XXI).

(b) The plan developed under subsection (a) shall be a capitated man-
aged care plan covering Kansas children from zero to 19 years which:

(1) Contains benefit levels at least equal to those for the early and
periodic screening, diagnosis and treatment program;

(2) provides for presumptive eligibility for children where applicable;

(3) provides continuous eligibility for 12 months once a formal de-
termination is made that a child is eligible subject to subsection (e);

(4) has performance based contracting with measurable outcomes in-
dicating age appropriate utilization of plan services to include, but not
limited to, such measurable services as immunizations, vision, hearing and
dental exams, emergency room utilization, annual physical exams and
asthma; and

(5) will provide targeted low-income children, as defined under sec-
tion 4901 of public law 105-33 (42 U.S.C. 1397aa, et seq.), coverage sub-
ject to appropriations.

(c) The secretary is authorized to contract with entities authorized to
transact health insurance business in this state to implement the health
insurance coverage plan pursuant to subsection (a) providing for several
plan options to enrollees which are coordinated with federal and state
child health care programs, except that when contracting to provide man-
aged mental health care services the secretary shall assure that contracted
entities demonstrate the ability to provide a full array of mental health
services in accordance with the early and periodic screening, diagnosis
and treatment plan. The secretary shall not develop a request for proposal
process which excludes community mental health centers from the op-
portunity to bid for managed mental health care services.

(d) When developing and implementing the plan in subsection (a),
the secretary to the extent authorized by law:

(1) Shall include provisions that encourage contracting insurers to
utilize and coordinate with existing community health care institutions
and providers;

(2) may work with public health care providers and other community
resources to provide educational programs promoting healthy lifestyles
and appropriate use of the plan's health services;

(3) shall plan for outreach and maximum enrollment of eligible chil-
dren through cooperation with local health departments, schools, child
care facilities and other community institutions and providers;

(4) shall provide for a simplified enrollment plan;

(5) shall provide cost sharing as allowed by law;

(6) shall not count the caring program for children, the Kansas health
insurance association plan or any charity health care plan as insurance
under subsection (e)(1); and

(7) may provide for payment of health insurance premiums, including
contributions to a medical savings account if applicable, if it is determined
cost effective, taking into account the number of children to be served
and the benefits to be provided.

(e) A child shall not be eligible for coverage and shall lose coverage
under the plan developed under subsection (a) of section 1, and amend-
ments thereto, if:

(1) During the prior six months, the child was covered with a com-
prehensive health insurance policy by an insurance company, health
maintenance organization or nonprofit hospital and medical insurance
corporation authorized to do business in this state and such insurance is
still available to the child; or

(2) such family has not paid the enrollee's applicable share of any
premium due.

If the family pays all of the delinquent premiums owed during the year,
such child will again be eligible for coverage for the remaining months
of the continuous eligibility period.

(f) The plan developed under section 4901 of public law 105-33 (42
U.S.C. 1397aa et seq., and amendments thereto) is not an entitlement
program. The availability of the plan benefits shall be subject to funds
appropriated. The secretary shall not utilize waiting lists, but shall monitor
costs of the program and make necessary adjustments to stay within the
program's appropriations.

Sec. 2. The secretary of social and rehabilitation services shall adopt
rules and regulations as necessary to implement and administer the pro-
visions of this act.

Sec. 3. (a) (1) None of the funds appropriated to implement this act
shall be expended for any abortion.

(2) None of the funds appropriated to implement this act shall be
expended for health benefits coverage that includes coverage of abortion.

(3) The term ``health benefits coverage'' means the package of serv-
ices covered by entities in subsection (c) of section 1 and amendments
thereto authorized to transact health insurance business in this state pur-
suant to a contract or other arrangement entered into under sections of
this act.

(b) The limitations established in subsection (a) shall not apply to an
abortion:

(1) If the pregnancy is the result of an act of rape, aggravated indecent
liberties with a child or incest; or

(2) if necessary to save the life of the pregnant woman.

Sec. 4. The secretary in contracting for capitated managed health
care for children shall include in the pool of persons to be covered those
eligible children covered by the Kansas medicaid program as law allows.

Sec. 5. The secretary shall enter into contracts as deemed appropri-
ate to carry out the provisions of this act. Administrative services under
this program shall be contracted with private entities. Nothing in this act
precludes the secretary from entering into a contract with the agency
medicaid management information system fiscal agent.

Sec. 6. The secretary shall advise and consult with the health care
data governing board on issues relating to children's health status.

Sec. 7. For the purpose of financially empowering parents to choose
a health plan for a child, the secretary should review and report both
verbally and in writing to the joint committee on children's issues prior
to each legislative session with recommendations regarding the following
items:

(a) Direct transfer of the annual premium for a plan chosen by an
eligible low-income family to the insurer;

(b) The use of a refundable tax credit for an eligible low-income fam-
ily to apply toward the purchase of a child's health care coverage. Such
refundable tax credit would cover most or all of the cost of the insurance
with the parents paying any difference. Additionally, an eligible low-in-
come family would receive full benefit of the credit, regardless of how
small their income tax obligation was; and

(c) The status of the Kansas insurance coverage for children's pro-
gram including all performance measures relating to the Kansas insurance
coverage for children's program.

Sec. 8. (a) There is hereby created the joint committee on children's
issues which shall be within the legislative branch of state government
and which shall be composed of 10 members. Five members shall be
members of the house of representatives and five members shall be mem-
bers of the senate. Three of the members who are representatives shall
be appointed by the speaker of the house of representatives, three mem-
bers who are senators shall be appointed by the president of the senate,
two members who are representatives shall be appointed by the minority
leader of the house of representatives and two members who are senators
shall be appointed by the minority leader of the senate. At least one
member of the committee from the house of representatives shall be a
member of the committee on insurance, one member shall be a member
of the committee on health and human services and one member shall
be a member of the committee on appropriations. At least one member
of the committee from the senate shall be a member of the committee
on financial institutions and insurance, one member shall be a member
of the committee on public health and welfare and one member shall be
a member of the committee on ways and means.

(b) All members of the joint committee on children's issues shall
serve for terms of two years ending on the first day of the regular session
of the legislature commencing in the first odd-numbered year after the
year of appointment, except that the first members shall be appointed on
the effective date of this act and shall serve for terms ending on the first
day of the regular session of the legislature commencing in 1999. If a
vacancy occurs in the office of any member of the joint committee on
children's issues, a successor shall be appointed in the same manner as
the original appointment for the remainder of the term. The chairperson
shall be appointed for a term of one year which ends on the first day of
the next occurring regular session of the legislature. The speaker of the
house of representatives shall appoint the first chairperson on the effec-
tive date of this act and shall appoint the chairperson for the term com-
mencing on the first day of the regular session of the legislature com-
mencing in 1999 for a one-year term to end on the first day of the regular
session of the legislature commencing in the year 2000. The president of
the senate shall appoint the next chairperson on the first day of the regular
session of the legislature commencing in the year 2000 for a one-year
term which ends on the first day of the next occurring regular session of
the legislature. Thereafter the appointment of the chairperson shall con-
tinue to alternate between the speaker of the house of representatives
and the president of the senate with each subsequent chairperson being
appointed for a one-year term ending on the first day of the regular
session of the legislature in the next occurring regular session of the leg-
islature after the year of appointment. If a vacancy occurs in the office of
the chairperson, a member of the joint committee who is a member of
the same house of the legislature as the member who vacated the office
shall be appointed by the speaker of the house or president of the senate,
depending on the house membership of the vacating member, to fill such
vacancy.

(c) A quorum of the joint committee on children's issues shall be six.
All actions of the joint committee shall be taken by a majority of all of
the members of the joint committee.

(d) The joint committee on children's issues shall have the authority
to meet at any time and at any place within the state on the call of the
chairperson.

(e) The provisions of the acts contained in article 12 of chapter 46 of
the Kansas Statutes Annotated, and amendments thereto, applicable to
special committees shall apply to the joint committee on children's issues
to the extent that the same do not conflict with the specific provisions of
this act applicable to the joint committee.

(f) Members of the committee shall receive compensation, travel ex-
penses and subsistence expenses as provided in K.S.A. 75-3212 and
amendments thereto when attending meetings of the committee.

(g) The joint committee on children's issues shall have the services
of the legislative research department, the office of revisor of statutes and
other central legislative staff service agencies.

(h) The joint committee on children's issues shall oversee the imple-
mentation and operation of the children's health insurance plans created
under the provisions of this act, including the assessment of the perform-
ance based contracting's measurable outcomes as set forth in subsection
(b)(4) of section 1 and amendments thereto and other children's issues
as the committee deems necessary.

Sec. 9. (a) There is hereby established in the state treasury the chil-
dren's health care programs fund in the department of the secretary of
social and rehabilitation services.

(b) Of the moneys received by the state pursuant to the tobacco lit-
igation settlement agreement entered into or any judgment rendered,
regarding the litigation against tobacco industry companies and related
entities, 50% of such moneys shall be credited to the children's health
care programs fund.

(c) All moneys credited to the children's health care programs fund
shall be used for the purposes of providing additional funding for chil-
dren's health care, services for children and tobacco use prevention and
cessation programs.

(d) All expenditures from the children's health care programs fund
shall be made in accordance with appropriation acts upon warrants of the
director of accounts and reports issued pursuant to vouchers approved
by the secretary of social and rehabilitation services or the secretary's
designee.

Sec. 10. (a) There is hereby established in the state treasury the Kan-
sas insurance coverage for children fund.

(b) The secretary is authorized to apply for and receive grants, gifts
and donations from nonfederal sources for the purposes set out under
this act.

(c) The secretary shall remit all moneys received under subsection
(b) to the state treasurer who shall deposit such moneys in the Kansas
insurance coverage for children fund.

(d) On or before the 10th day of each month, the director of accounts
and reports shall transfer from the state general fund to the Kansas in-
surance coverage for children fund interest earnings based on: (1) The
average daily balance of moneys in such fund for the preceding month;
and (2) the net earnings rate for the pooled money investment portfolio
for the preceding month.

(e) All expenditures from the Kansas insurance coverage for children
fund shall be made in accordance with appropriation acts upon warrants
of the director of accounts and reports issued pursuant to vouchers ap-
proved by the secretary or the secretary's designee for the purposes of
this act.

Sec. 11. On July 1, 1998, the director of accounts and reports shall
transfer $12,000,000 from the state general fund to the Kansas insurance
coverage for children fund.

Sec. 12. If any provision or clause of this act or application thereof
to any person or circumstances is held invalid, such invalidity shall not
affect the other provisions or applications of the act which can be given
effect without the invalid provision or application, and to this end the
provisions of this act are declared to be severable.

Sec. 13. This act shall take effect and be in force from and after its
publication in the Kansas register.

I hereby certifiy that the above Bill originated in the
Senate, and passed that body

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Senate adopted
Conference Committe Report __________________________________

__________________________________

President of the Senate.

__________________________________

Secretary of the Senate.

Passed the House
as amended __________________________

House adopted
Conference Committee Report __________________________

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Speaker of the House.

__________________________________

Chief Clerk of the House.

Approved __________________________

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Governor.