Interim Joint Committee on Health and Welfare Meeting Overview
Monday, August 11, 2014 8:06 AM
The Interim Joint Committee on Health and Welfare met in Frankfort on August 4. During the meeting, Cabinet for Health and Family Services (CHFS) Executive Director of Policy and Budget Beth Jurek discussed the July 1 Executive Order to reorganize CHFS and the administration of Medicaid. She stated the Cabinet is restructuring the department to reflect the change to managed care from fee for service in order to ensure managed care organizations (MCOs) are meeting the requirements of the contracts and monitor the way that clients are receiving services. CHFS is reducing the number of divisions from eight to six, which according to Jurek, will be a net decrease, with no increase in the agency. CHFS is also consolidating information technology services.
The Committee also discussed and approved the Executive Order to reorganize the Health Benefit Exchange. Under the plan, the Office of Health Information Exchange will be included in the newly established Kentucky Office of Health Benefit and Health Information Exchange that will be headed by an executive director to be appointed by the Governor. The reorganization plan eliminates one office and adds one division, with no increase in units.
The order also establishes the Division of Health Care Policy Administration within the new Exchange office that will have an Executive Director appointed by the Secretary. The reorganization also established a Division of Kentucky Access, which will be headed by a Director appointed by the Secretary. The plan establishes the Division of Kentucky Electronic Health information within the Exchange that will be headed by a Director appointed by the Secretary. The Kentucky Health Care Improvement Authority is established as an administrative body attached to the CHFS for administrative purposes.
The reorganization plan creates the kynect Advisory Board that will be appointed by the Governor and composed of 19 members, of which three will represent non-facility-based providers and four will represent facility-based health care providers licensed in the state.
The Division of Kentucky Access within the Department of Insurance is abolished and all personnel, records, files and funds are transferred to the Division of Kentucky Access within the Exchange.
According to Jurek, HB 235, the Executive Budget as passed by the General Assembly, included $30 million in fiscal year (FY) 2015 and $26 million in FY 2016 for the operating cost of the Exchange. On page 2 of the Executive Order, it states that “…, operation of kynect in Kentucky will be funded entirely with federal funds until January 1, 2015, at which time its operations will be wholly funded from revenues generated by and through the Exchange; ...”
Representative Tim Moore asked Jurek how much the state expected to pay for the Medicaid expansion. Jurek did not answer the question and after much discussion, Chair Tom Burch told Representative Moore to submit his request in writing.
Both Executive Orders were passed along party lines with 11 Democrats voting yes and 7 Republicans voting no.
Mary Begley, Commissioner of the Department for Behavioral Health, Developmental and Intellectual Disabilities, made a presentation on children’s behavioral health to the Committee. Begley reported that 20 percent of Kentucky’s children have a diagnosable behavioral health problem, 66 percent report at least one traumatic event by age 16, suicide is the second leading cause of death among youth age 10-24, 34 out of 1,000 children under 18 are in out-of-home care and there is an incarceration rate 52/1,000 for youths ages 10-17 years. She stated that 60 percent have behavioral health challenges and do not receive the help they need.
Begley noted that pre-1980s that there was high use of psychiatric facilities for children. However, in the 1980s, it was determined that isolating kids in a facility does not help children get back with the family and community.
In 2013, Begley stated that Secretary Audrey Haynes charged the CHFS with expanding and redesigning the children’s system of care. She explained the department has a multi-pronged strategy to increase access, enhance the infrastructure, provide high quality services and support improved outcomes. She claimed access has increased due to the Medicaid eligibility expansion, covered benefits expansion and expansion of provider types.