2009 Kansas Legislative Update

In what was a historical 2009 Kansas legislative session, the state saw its governor appointed and confirmed as the U.S. Secretary of Health & Human Services and saw the federal government pass the American Recovery and Reinvestment Act. However, the legislative session was marked ultimately by the state budget debate as legislators faced, from the outset, steeply declining revenue projections for both fiscal years 2009 and 2010. Below are the outcomes of several legislative items of interest to the University of Kansas Medical Center community:

 

Appropriations and Funding

• Budget Cuts: During the session, legislators passed three major pieces of budget legislation, including an FY 2009 budget rescission bill, an FY 2010 mega budget bill, and an FY 2010 omnibus budget bill. All three bills included cuts for state agencies, KU Medical Center included. The rescission bill initially cut KUMC's budget by approximately $5.2 million, while the mega budget bill upped the cut to $8.8 million and the omnibus budget bill ultimately brought our total cut to $12 million. The omnibus bill also cut the Kansas Medical Student Loan program by approximately $80,000, though the cut will fortunately not have an impact on awards in FY 2010.

• The University of Kansas Cancer Center: The Legislature, for the fourth consecutive year, included a direct appropriation to the University of Kansas Cancer Center. The appropriation was ultimately subject to the same reduction as KUMC's regular state appropriation, and is included in the totals listed above.

• Wichita Center for Graduate Medical Education: The Legislature appropriated an additional $5.9 million to the Wichita Center for Graduate Medical Education through the omnibus budget bill. Of the $5.9 million, $3.5 will be from state general funds from additional monies received from tobacco settlement funds, and $2.4 million will be made available by the Kansas Health Policy Authority by way of a federal match.

 

University of Kansas School of Pharmacy Bonding Authority

In the 2008 session, the Legislature authorized $50 million for the University of Kansas School of Pharmacy expansion project - $20 million in bonding authority and $30 million from potential expanded lottery act revenues. As the year passed, however, $30 million from expanded lottery act revenues became unrealistic. This session, the Legislature instead worked to authorize through the mega budget bill an additional $30 million in bonding authority for the construction and remodeling of the School of Pharmacy.

Health Care Stabilization Fund

The Health Care Stabilization Fund (the "Fund") was established by the Legislature in 1989 and has, for many years, provided necessary liability coverage for KUMC physician-faculty and residents by establishing a "self-insurance" program. Through a provision contained in the mega budget bill, legislators kept the Fund's current "self-insurance" structure in place, but capped the demands the Fund may make from state general funds at approximately $2.8 million.

Liability Coverage for Medical Students

Under medical school curriculum, students receive clinical training during their third and fourth years. Traditionally, by proviso in annual budget bills, medical students at KU have been defined as state employees under the state's tort claims act, so as to extend them the protection of tort claims law when rendering services on behalf of a state agency. Medical students are not yet licensed health care providers and thus do not yet qualify for liability coverage under the Health Care Stabilization Fund. This session, legislators passed S.B. 8, making permanent the inclusion of medical students in the statutory definition of an "employee" for the purposes of the tort claims act, eliminating the need for an annual budgetary proviso.

State Institution Construction Improvement Projects

The Legislature also passed S.B. 9, exempting KUMC and other state universities from certain state agency requirements for construction projects or construction project services. These exemptions will only apply to projects that are financed completely with non-state funds, and will allow state universities to use an "alternative project delivery" process. S.B. 9 also provides that the Board of Regents will "adopt rules and regulations necessary for the implementation and administration of the provisions" of the bill.

Geriatric Fellowship Addition to Kansas Medical Student Loan Program

The Kansas Medical Student Loan Program provides support to medical students for tuition and living expenses in return for an agreement to enter a primary care residency and then practice in an underserved area of Kansas after residency. This session the Legislature passed H.B. 2297, which adds a "fellowship training in geriatric medicine" to the list of "approved postgraduate residency training programs." The change will allow students in the program to participate in a geriatric medicine fellowship after residency, prior to starting their service in an underserved area.