Selection Process for 2011 Priorities
Starting in August 2010, the Health Commission’s Committees solicited input from Health Commissioners, committee members, the Health Department and community stakeholders (including, but not limited to, Partnership for Children, Metropolitan Organization for Racial and Economic Equality or MORE2, Communities Creating Opportunity or CCO, and the Mother and Child Health Coalition) for suggested legislative priorities that the Health Commission should submit to the City Council’s Legislative Committee. 

Health Department staff, committee members and staff from outside stakeholder agencies compiled background information for each suggested priority, which was then provided to the relevant committee(s). Committee members and representatives of stakeholder agencies were asked to provide testimony during September committee meetings. Each committee selected a prioritized list of suggested federal and/or state legislative priorities to send to the full Health Commission.

The following criteria was used as part of the prioritization process

• Impact on Health Outcomes/Health Priorities for Kansas City
• Positive Impact on Needs of Uninsured/Underinsured and/or Safety Net System
• Social Justice/Health Equity
• Level of Support Available and/or Needed to Advance Item
• Availability of Resources
• Realistic Possibility That Progress Will Be Made
• Impact on Chronic Disease Management

Legislative Priorities
Federal:

1. Continued support for full funding and implementation of the Prevention and Public Health Fund created by the Affordable Care Act.

a. Provide support to address:

• Obesity prevention
• Tobacco prevention and cessation
• Management of chronic diseases
• Promote integration of health and mental health
• Continuation of home visitation portion of Prevention and Public Health Fund

2. Oppose efforts to repeal Patient Protection and Affordable Care Act of 2010.

a. Support retention of health reform provisions including:

• Increased coverage for dependent children
• Elimination of pre-existing condition exclusions, lifetime benefit caps and co-pays for preventative services
• Closing Medicare “donut hole”
• Provide incentives for small businesses to offer health insurance
• Expand coverage for persons currently uninsured

3. Support a federal allocation of $500,000 to support expansion of the Aim4Peace Program to cover additional high-crime areas of Kansas City.

4. Support enabling legislation and additional funding for Public Health emergency preparedness.

5. Continued support for Title V – MCH Block Grant funding to address disparities in infant mortality locally and nationwide. 

State:

1. Support maintenance and expansion of MO HealthNet.

• Simplify and expedite enrollment
• Require school districts to use federally approved Opt-Out Form for applications to participate in the Free/Reduced Lunch Program
• Change MO HealthNet administrative renewals to include pre-populated forms
• Expand eligibility
• Improve access under state law or provisions of federal health reform law

Enhancement of the MO HealthNet program will have the added benefit of

• Ending current cost shifting to users covered by private insurance
• Ensuring economic development benefit for MO.  If Medicaid funds are not used in MO, other states will receive a bigger boost for their economies through additional Medicaid spending.
• Creating additional options for small businesses and families to provide/obtain insurance coverage.

2. Support enabling legislation that reduces tobacco consumption and exposure in Missouri.

• Raise MO excise tax on tobacco products to $1.00 per pack for cigarettes and/or oppose efforts to pass a smaller tax that would not improve tobacco prevention trends for the state.
• Remove state preemption against local tobacco tax increases
• Adopt policies to support smoking cessation and invest in cessation strategies and interventions beyond the MO Quitline.

3. Support legislative action for proven methods and activities that address social determinants of health and reduce health inequities.

• Restore appropriate funding for the Department of Health and Senior Services Office of Minority Health to ensure continued response to health disparities
• Allow for continued/expanded use of land banks to offset property vacancies created by foreclosures and tax delinquency in order to improve neighborhood livability
• Implement a mandatory, automatic mediation requirement for home foreclosures in order to improve neighborhood livability
• Reduce caps on interest and fees charged by payday lending companies and/or allow for creation of community-based alternative lending institutions

4. Support maintenance and expansion of state funding for public health, mental health, and other health-related programs for vulnerable populations as a mechanism to contain costs and reduce cost shifting.

Generally Supported Legislative Items
Federal - support convening of a federal Transportation Equity Network “Jericho Table.”

State - support enabling legislation and additional funding for Public Health emergency preparedness, and provide liability protection for qualified volunteers such as Medical Reserver Corp, who provide medical services during a public health emergency.

Structure

Past years have seen Health Commission forward as many as twenty priorities to City Council for consideration.

The Health Commission made a conscious effort to reduce number of 2011 legislative priorities for consideration to those that are most critical and worthy of full attention, submitting five federal and four state priorities.

Of the priorities submitted for consideration and supported by the Health Commission, the following have been accepted by City Council for presentation before the Missouri General Assembly:

• Continuation of state funding for mental health and public health efforts.
• Retention of Earnings Tax in Kansas City and St. Louis.
• Opposition of efforts to undermine local control for Kansas City.
• Restoration of public transit funding for the KCATA.
• Establishment of a reasonable interest rate cap on short-term loans.
• Enactment of mandatory foreclosure mediation legislation.
• Support for streamlined enrollment procedure for eligible children in MO HealthNet’s Children’s Health Insurance Program.
• Legislation to significantly increase the excise tax on tobacco products.
• Support enabling legislation to allow Kansas City to establish a land bank to take ownership of vacant, abandoned, and foreclosed properties.