By Dave Ranney
The Senate Ways and Means Committee has adopted a budget proviso that’s expected to delay the implementation of “health homes” for KanCare patients with chronic illnesses such as asthma and diabetes.

The proviso, drafted by Sen. Jim Denning, a Republican from Overland Park, stipulates that no state money shall be spent on KanCare health homes for chronic conditions without the Legislature’s explicit consent in fiscal years 2015, 2016 and 2017 — through June 30, 2017. KanCare, the state’s privatized Medicaid program, began implementing health homes for 36,000 patients with severe and persistent mental illnesses in August 2014.

At the time, Kansas Department of Health and Environment officials said they hoped to roll out health homes for patients with chronic illnesses sometime in 2015. Denning’s proviso, which is expected to pass the Senate and likely meet little resistance in the House, further delays an already uncertain start-up.

“I don’t think we should be pushing another (home health) program until we see how the first one works,” Denning said. “We have anecdotal information from the mental health centers that it (health home model) is working, and the advocates say they like it,” he said. “But I think we need to wait until we have some hard outcome measures to see if A) it’s actually improving patient care and B) it’s bending the cost curve.”

In legislative circles, Denning is seen as a key figure in the state’s health care debate. He is vice chairman of the Senate budget committee and chairman of its social services budget subcommittee. He also serves on the Senate Public Health and Welfare Committee and on the Robert G. Bethell Joint Committee on Home and Community Based Services and KanCare Oversight. Outside the Legislature, Denning is a vice president with Discover Vision Centers, a network of eye clinics in the Kansas City metropolitan area.

Denning also said he was troubled by estimates that show while launching health homes for patients with chronic illnesses likely would lower the Medicaid program’s long-term costs, their start-up costs, depending on how broadly they’re implemented, could be between $45 million and $100 million.

Though KDHE officials have said the second phase of the health home expansion would focus on asthma and diabetes, federal statutes would have allowed it to include heart disease, obesity and substance abuse disorders as well. Denning’s proviso occurs as legislators look for ways to offset a projected shortfall of nearly $344 million in the budget for the current fiscal year, which ends June 30, and fill a $600 million hole in the budget for the next fiscal year.

KDHE Deputy Secretary Aaron Dunkel said the proviso, if enacted, likely would temper but not derail the agency’s interest in health homes. “It might slow us down a little bit,” he said. “But we’d already been having conversations about the SMI (severe mental illness) health homes and how, if the data shows SMI health homes to be as effective as we think they’re going to be, lessons learned might be applied to the chronic condition health home implementation.

Those conversations will continue. But between gathering information and the effect of the proviso, it would be at least another year before they’re implemented.” Across Kansas, more than 80 providers — a mix of community mental health centers, safety net clinics, county health departments, and programs for developmental and medical facilities — offer health home-type services for mental health patients. For many of the providers, the proviso was not unexpected.

“It seems a little penny wise and pound foolish, but the state is in a budget crisis, so I can’t say I’m surprised,” said Krista Postai, chief executive of the Community Health Center of Southeast Kansas, a multi-county safety net clinic based in Pittsburg. “It’s a shame because all a health home is, really, is super-duper case management,” Postai said. “

And I can absolutely prove to you that every time I’ve been able find some money to spend on case management and help people manage their disease, we’ve saved money. That’s just a fact.” Dave Sanford, chief executive at GraceMed, a group of safety net clinics in Wichita, agreed with Postai’s assessment.

“It’s very disappointing,” he said, “primarily because we believe that once health homes are in place and we’re working with that Medicaid ‘frequent flier’ population, we will have the ability to change behavior, to develop accountability, to help people achieve better outcomes and at the same time reduce the overall cost to the state.”

GraceMed and COMCARE, the community mental health center in Sedgwick County, have put together a health home for mental health patients. “As most everybody knows, most of these people with a severe mental illness are dealing with a chronic condition as well,” Sanford said. “So we’ve gotten our toes wet. It’s a SMI health home, but we’re seeing a lot of chronic conditions.”

Dave Ranney is a reporter for Heartland Health Monitor, a news collaboration focusing on health issues and their impact in Missouri and Kansas.

MANHATTAN, Kan. (AP) — A northeast Kansas man accused of causing the death of a Manhattan bicyclist will not be eligible for diversion.

Assistant Riley County Attorney James Garrison said during a hearing Monday that 33-year-old Derik Kesler of Rossville will not be eligible for diversion because of his past criminal history. Garrison did not detail Kesler’s past crimes.

Kesler faces one misdemeanor charge of vehicular homicide in the June 2014 death of 49-year-old Mark Jilka of Manhattan, who was riding his bicycle on Kansas Highway 177 south of Manhattan

The Manhattan Mercury reports  that Kesler said in a voluntary statement that he was typing a location into his phone’s GPS when his truck hit Kesler.

TOPEKA, Kan. (AP) — The Kansas Supreme Court is considering whether a lower-court panel should still review a lawsuit over state funding for public schools.

The Supreme Court directed school districts that sued the state in 2010 to declare in writing Tuesday whether they want a three-judge panel in Shawnee County District Court to have more hearings in the case.

The lower-court panel ruled in December that the state isn’t adequately funding schools.

The state asked the panel in January to reconsider. The aggrieved school districts filed their own request to block legislators from tampering with additional aid to poor districts approved last year.

The panel has a hearing scheduled for Thursday.

But the state also appealed the panel’s ruling to the Supreme Court and now wants the higher court to handle the case.

KANSAS CITY, Kan. (AP) — Firefighters have rescued a dog that fell into a partially ice-covered lake in Kansas City, Kansas.

KMBC-TV  reported Monday that police saw the canine at Big Eleven Lake and called for the city’s Fire Department’s water rescue team.

Two firefighters jumped into the frigid waters and used a lasso to capture the dog and pull it back to shore. The firefighters wore special water suits and were tethered to other personnel on land.

The dog displayed signs of signs of hypothermia after being rescued from the water. It was wrapped up and brought to a shelter.

Authorities say they’re not sure if the dog is a stray or was lost.

TOPEKA, Kan. (AP) — Kansas Secretary of State Kris Kobach is sponsoring a children’s archery tournament next month in MacLennan Park near the governor’s residence in Topeka.

Kobach’s office is holding Ad Astra Archery Tournament with the state Department of Wildlife, Parks and Tourism on April 25. The registration fee is $10 and participants can register online at www.sos.ks.gov/archery .

The competition is open to students in kindergarten through the 12th grade. Each participant will receive a T-shirt and a medal.

The event is named after the 20-foot-tall bronze statue of a Kanza Indian named “Ad Astra” on top of the Kansas Capitol dome.

Organizers also asked in a new release for donations for scholarships for young Kansas archers interested in attending the National Archery in the Schools championship this fall in Louisville, Kentucky.