The1st meeting of the Subcommittee on Families and Children of the Interim Joint Committee on Health and Welfare was held on Wednesday, August 15, 2007, at 10:00 AM, in Room 129 of the Capitol Annex. Representative Tom Burch, Chair, called the meeting to order, and the secretary called the roll.
Members:Senator Katie Stine, Co-Chair; Representative Tom Burch, Co-Chair; Senators Charlie Borders, Tom Buford, and Joey Pendleton; Representatives Scott W. Brinkman, Ruth Ann Palumbo, Ancel Smith, Brandon Spencer, and Susan Westrom.
LRC Staff: DeeAnn Mansfield, Ben Payne, and Cindy Smith.
The first item on the agenda was an update on the First Steps Program by Dr. Steve Davis, Deputy Commissioner, Department for Public Health, Cabinet for Health and Family Services, and Kirsten Hammick, Statewide Coordinator for the First Steps Program, Cabinet for Health and Family Services. Dr Davis reminded the members that First Steps is Part C of the federal Individuals with Disabilities Education Act (IDEA). Part C requires every state to maintain and implement a state wide interagency system to provide early intervention services for infants and toddlers with disabilities and their families. Three years ago, the First Steps program was moved to the Department for Public Health. They have been able to stay within three guiding principles: (1) Children will get the services they need; (2) Families will get the support services they need; and (3) First Steps will stay within budget, which is currently about $32 million, including $12 million in state general funds. Since 2003, the program has served over 11,000 children per year. Dr. Davis said not all children with disabilities in Kentucky are being reached. The goal should be about 15,000 children. He indicated that substance abuse related births were a part of the problem with the numbers of disabled children. Recent program successes include: 95 percent of children receive services in natural environments; 85 percent of children received their plan for services within 45 days; and 14 percent of children served were at age appropriate development by age 3 years. Current efforts include improvements to public awareness and child find activities, implementation of evidence based practices, and increase local accountability.
Senator Stine asked why the numbers increased to 56 percent in 2003. Dr. Davis said it was due to better outreach, and their outreach efforts remain good. He also noted that 4-7 percent of all children born have some type of disabilities.
Senator Stine asked if some of the increase in numbers is due to substance abuse issues by the parents. Dr. Davis replied that Kentucky's substance abuse problems continue to be a concern and it does relate to some of the high numbers.
Senator Stine asked if the budget allotment had increased since the inception of KCHIP. Dr. Davis said it has not increased, and they are maintaining their child find with the current budget.
Representative Burch asked if the Interagency Coordinating Council was fully staffed. Dr. Davis said they have a very solid leader in Lynn Flynn, the new statewide chair person of the council. He noted that there are two or three slots open, including the Head Start position, but they are currently seeking to fill those positions.
The second item on the agenda was an update on the Kentucky Children's Health Insurance Program (KCHIP), by Lisa Lee, Director of Children's Health, Cabinet for Health and Family Services. Ms. Lee presented an update on K-CHIP and the reauthorization of the federal SCHIP program. In 1997 Congress established Title XXi of the Social Security Act, which provided $40 billion to expand health coverage to uninsured, low income children. Kentucky was allocated $50 million per year for five years. KCHIP was established in July, 1998. The number of children served in K-CHIP has increased from 23,000 in 1998 to 65,000 in 2006. She indicated that Kentucky is committed to providing services to children below 200 percent of the federal poverty rate. Current reauthorization bills in the House and Senate differ primarily in eligibility and the amount of money to be allotted. The House version has unlimited eligibility and the Senate version is capped at 300 percent of poverty. The House version adds $50 billion to the base and the Senate version adds $35 billion. Both bills amend the formula for allocating funds to be based on past spending. A decision on the privatization of KCHIP has not been reached.
Representative Burch asked what would happen to the KCHIP program if Congress does not increase the allotment. Ms. Lee said Kentucky would be able to maintain the program at the current budget level and could take in more children as well.
Representative Burch asked how much money Kentucky would stand to receive if Congress passed the measure. Ms. Lee said Kentucky would stand to receive about $90 million in 2008 based on the House allotment.
Senator Buford asked if the bills had been passed in Congress. Ms. Lee said both bills had passed their respective chamber, but they are still awaiting final passage of the bills.
Senator Buford asked if KCHIP currently covers autism. Ms. Lee responded that the program does cover autism.
Senator Buford asked why KCHIP was not supposed to cover children of Kentucky state employees. Ms. Lee said that it is a federal regulation, but that Kentucky decided to cover state employee children anyway.
The last item on the agenda was a presentation on Physical Activity Programs by Chris Corbin, Executive Director, Governor's Office of Wellness and Physical Activity. Mr. Corbin presented an overview of current activities. He reports that 63 percent of Kentuckians are overweight and that rates of obesity for adults in Kentucky have doubled since 1990 and rates for children have tripled in the past 30 years. In 1990, no state had an obesity rate above 19 percent. By 2006, only a couple states had rates lower than 20 percent and 20 states had rates higher than 25 percent. In 2005, 18 percent of 2 to 4 year olds in Kentucky were overweight. The financial cost of obesity in Kentucky is $1.16 billion for obesity related illness. The annual medical costs for an obese person are $732 higher than for a normal weight person. He indicated that if only 10 percent of adults in Kentucky began a regular walking program, $79 million could be saved in Kentucky in costs related to heart disease, with $5.6 billion in saving across the United States. Complications of obesity include arthritis, high blood pressure, heart attacks, diabetes, and quality of life. Kentucky is #1 in the U.S. for self-reports of fair to poor health. Mr. Corbin also discussed several current projects and initiatives and indicated that more needs to be done to reduce obesity in Kentucky.
Representative Burch asked what the difference was between the Governor's Council on Wellness and Physical Activity, the Governor's Office of Wellness and Physical Activity, and the Get Healthy Kentucky initiative. Mr. Corbin said the Governor's Office of Wellness and Physical Activity is a structure, while the Get Healthy Kentucky initiative is a program.
Representative Burch asked if Council been appointed. Mr. Corbin said they had not.
Representative Burch asked how they get close to families to encourage physical activity in the home environment. Mr. Corbin said they address children in schools, conduct workforce wellness programs, educate employers, and this is coupled with general wellness awareness.
Representative Burch asked how much help they receive on a national level. Mr. Corbin said they have support from the CDC, as well as the National Governor's Association.
Senator Stine asked if there is any correlation between the Transportation Department and the Get Healthy Kentucky initiative. Mr. Corbin said they are currently working with the Transportation Cabinet and Tourism, as well as the Rails to Trails program, which constructs trails where there are unused railroad tracks.
Senator Buford noted that there was budget language two years ago to allow the Transportation Cabinet to purchase rails without waiting for grants, but that has not been done.
Senator Buford asked for a list of schools in Kentucky that offer physical education classes. Mr. Corbin said he would get that information for the committee members.
Senator Buford noted that Governor's Office on Wellness and Physical Activity should work with cities with new housing developments to construct walk paths through the developments to encourage walking and exercise in the community.
Senator Stine asked if there is a reward for schools that meet the Governor's Challenge. Mr. Corbin said they are working on two programs, one of which would present the Good Housekeeping Seal of Approval to a school that completes the challenge. They are also working on a program that would give the title of the "Get Healthy Kentucky City" to cities that have implemented things like walkable communities, master plans and smoking bans.
The meeting was adjourned at 11:36 a.m.