Lt. Governor Lynn Rogers’ testimony to the Kansas House Rural Revitalization Committee:
Mr. Chairman and members of the Rural Revitalization Committee, thank you for inviting me to discuss the Office of Rural Prosperity. Thank you, also, for the significant work you do on this committee – the issues before you are of critical importance to the entire state. I have been watching your work and join your interest in solving the issues before us.
During my career in agricultural banking I spent 31 years traveling across Kansas. I’ve lived the majority of my adult life in Wichita but grew up on a small family farm just outside a rural community of just over 700 people. I still feel at home when visiting rural communities.
Last year I traveled across Kansas once more, visiting rural communities in every corner of the state – from Seneca to Liberal, and Goodland to Baxter Springs. I had conversations with thousands of Kansans, and was always disappointed to hear a common frustration – they consistently felt that leaders in Topeka do not listen to them and that all too often they do not have a seat at the table. As a result, Governor Kelly and I, along with the Acting Secretary of Commerce David Toland began drafting a plan to prioritize the needs of rural Kansas. Together we created the blueprint for the Office of Rural Prosperity, which includes:
• Developing Rural housing,
• Revitalizing Main Street corridors,
• Investing in Rural Infrastructure,
• Supporting Rural Hospitals and Medical Professional Recruitment,
• Making State Government Work for Rural Kansas,
• Incentivizing Active Tourism, and
• Supporting Agribusiness.
We want to do this without duplicating what is already in place, focusing a lens on what resources are available. We will highlight successful communities and projects so that those who want to do something similar or are just starting the process have a roadmap.
Since taking office just over 60 days ago, I’ve met with countless stakeholders to discuss their ideas and how to work collaboratively. I’ve talked with mayors, local community leaders, state associations and their affiliate members, staff from the USDA, business leaders from regional economic development alliances, agricultural producers, experts in rural broadband, and many others. I’ve learned – as I am sure you all have – that there is much to do. My initial focus will be to cultivate partnerships, develop a strategic plan, and advocate for rural healthcare.
Our vision for the Office of Rural Prosperity is that it will be a non-partisan initiative that continues across future administrations. Within our administration, state agencies will play a critical role in the Office of Rural Prosperity. As such I’ll be convening regular sub-cabinet meetings that include secretaries and staff from the:
● Kansas Department of Commerce,
● Kansas Department of Agriculture,
● Kansas Department of Transportation,
● Kansas Department of Health and Environment,
● Kansas Department of Wildlife Parks and Tourism, and the
● Kansas Water Office.
The sub-cabinet will work to identify areas where services overlap and how our administration can coordinate existing programs across agencies to maximize their impact.
The Governor and I recognize the needs of our rural communities are unique, and there is no one-size-fits-all approach. We must look at a variety of multi-faceted policies and programs that will empower local leaders with the resources they need. In other words, we must help Kansas communities and local leaders carve out their own route to prosperity.
While significant progress can be made administratively, we know that we cannot do this on our own and that it will require partnership with the Legislature. I have been meeting regularly with the leadership of this committee to garner their initial input, update them on our progress, and find opportunities for us to collaborate.
Developing a strategic plan
A long-term strategic plan for the Office of Rural Prosperity will lay out a specific mission and vision, defining the focus and scope of the state of Kansas’ efforts and investments in rural areas.
In the coming weeks, I will be facilitating a statewide listening tour. Scheduled stops will include meetings with community leaders and stakeholders to garner their input, as well as public sessions, where residents will be invited to share their perspective. The Office of Rural Prosperity and the sub-cabinet agencies will work with local partners to host, organize, and facilitate these regional discussions. Upon completion of the initial tour, we will create a report that we will share with you.
Advocating for Rural Healthcare
A little over a month ago I launched The Rural Prosperity Healthcare Tour. So far, I’ve toured hospitals and visited with community leaders in Emporia, Marysville, Hutchinson, and McPherson about a topic that is literally a life or death situation for some rural Kansans – Medicaid Expansion.
Even though I still have ten scheduled hospital visits remaining on the Rural Healthcare Tour, I’ve already gathered a great deal of information about the challenges rural hospitals are facing.
While in Emporia, the hospital CEO shared that this year they are estimating a $386,000 operating loss. They rely on gifts and grants to keep their budget positive. KDHE estimates expansion would provide Newman Regional Health with an average of $2.3 million in additional annual revenue, taking them from a loss to profitability.
Hospital administrators in Marysville are anticipating a struggle to compete for health professionals, primarily nurses and behavioral health professionals, with hospitals across the state line. Nebraska expanded Medicaid last year and are seeing many positive benefits, including an increased workforce. This is to our detriment. Community Memorial Healthcare would receive additional revenue of nearly $350,000 annually, which they could use for competitive salaries and wages. It would move the hospital from breaking even to profitability.
We learned in Hutchinson how important the hospital is to the entire region. Over 6,600 people work in healthcare in Reno County, more than 10% of the workforce. Hutchinson Regional Health provides a variety of services, including behavioral health, hospice and inhome care. Hutch Health would recover 26%, or $4.5 million, of their uncompensated health costs.
McPherson Hospital receives local county sales tax revenue to shore up their finances. They would gain $551,000 from expanding Medicaid. They recently raised $1.5 million in private donations to build a clinic. In essence, they are using crowd-funding to pay for their upgrades. This community is growing rapidly, as are local businesses. They know that quality healthcare is vital to their prosperity.
Four rural hospitals – Mercy Hospitals in Independence and Fort Scott, Oswego Community Hospital, and Horton Community Hospital – have all closed in the past three years. Others are struggling to meet payroll or pay utility bills. Failure to expand Medicaid was cited by all four as being partially responsible for their closing.
The impact of these closures in rural communities is profound, and it goes beyond losing local access to a hospital or an emergency room. Healthcare professionals and those employed to support them move to find employment, and no longer support local businesses. The economic impact of a hospital closure is greater than a cursory glance would expect. In a rural community healthcare accounts for 20% of a local economy, and one physician generates 26 jobs.
Given the economic impact of healthcare, the fact that 30% of our state’s rural hospitals are considered financially vulnerable is cause for concern. Across the state over 85% of hospitals currently have a negative operating margin. As a result of the state’s failure to expand Medicaid, Kansas has lost over $3 billion dollars in tax revenue to date – money paid to the federal government, that should have been used in Kansas but has gone to other states.
We not only have an economic imperative to expand Medicaid, we have a moral one as well.
Nearly 150,000 Kansans fall in the coverage gap. They are hardworking – often times underemployed – Kansans who don’t make enough money to afford quality health insurance but have incomes that are too high to qualify for KanCare.
Like Wayne Willard, in Hutchinson, who made $200 too much to qualify for KanCare coverage for he, his wife, and their four children despite working as many as 70-hours a week. When private insurance, which cost the family $600 a month, became more than they could afford he and his wife made the difficult decision of going without – meaning missed doctors’ appointments and expensive medical bills if they got sick.
Going without health insurance is a risk for anyone but it is a particularly risky decision for someone with an incurable disease like Allen who was diagnosed with juvenile (Type I) diabetes at 8 years old. As a 21-year-old college student at Cowley County Community College he worked part-time at a meat packing plant to make ends meet but couldn’t afford private insurance. Allen died of a diabetic coma over a long weekend, unable to stretch his donated insulin supply.
Allen’s and Wayne’s stories aren’t unique. More than 66% of those in the coverage gap work or are in working families. Nationally, one in four are caring for children, one in five have medical conditions that limit their ability to work, and 17% are over the age of 55.
That is why on Kansas Day the Governor proposed legislation that would expand Medicaid, invest millions of dollars in Kansas’ economy and create more than 3,800 new jobs.
This committee heard first-hand testimony from rural healthcare providers about the daily challenges they face. Throughout that testimony a common theme emerged – communities in rural Kansas need Medicaid Expansion. So, I might be preaching to the choir here – but sometimes you have to preach to the choir to get them to sing.
As the Legislature’s only committee whose exclusive focus is addressing the needs of rural Kansas, I ask that you continue to advocate for the positive impact Expansion would have on rural communities. Medicaid Expansion should not be a partisan fight or a means to keep a political score. It is about people’s lives.
And much like Medicaid Expansion, the development of our rural communities is not a political issue. It will take a collaborative effort from our administration, this committee, and the entire legislature to implement long-term sustainable solutions for some of our state’s most dire needs.
I look forward to partnering with this committee and its members in the coming months and years, and I would like to start that partnership today. I invite all of you to stop by my office here in Topeka or join me on the road during either my Rural Healthcare Tour or the statewide Listening Tour as your schedule allows over the coming months.
In return, I ask that you share your thoughts and your concerns regarding Kansas’ rural communities and how our administration can work with you. I cannot promise that we will always agree, but you will find that my door is always open and that I will be an advocate for improving the lives of rural Kansans.
I also ask that I be invited back to this committee to report on our findings from the Listening Tour and ask for your feedback on our strategic plan.
Although the task before us is complex, I am inspired by the opportunities ahead. The formation of the Office of Rural Prosperity, and of this committee, should signify to rural Kansans that they have a seat at the table. It will be incumbent upon us to make sure they are heard.