MLM’s ‘Learning to Earning’ program to locate in Kansan building in downtown KCK

by Dale Garrison

A new emphasis on “financial literacy” and the opening of a Wyandotte County location at the old Kansan building at 8th and Ann are among several changes in Metro Lutheran Ministry’s Learning to Earning program.

“Since its inception, MLM has been a leader in rent and utility assistance in Kansas City,” said Jim Glynn, executive director. “We’ve always been one of the largest players in that arena. But, in writing a check to the landlord or to the utility company, we’re very aware it’s a short-term stopgap. However, we have not had the case management expertise and ability to go beyond that. Currently, we are repositioning our resources to do more of that.”

The focus on financial education is designed to address some of the most widespread issues facing MLM clients, said Learning to Earning manager Jacob Bosch.

“A lot of it relates to clients’ need to access credit,” he said. “The poorest of the poor struggle not only to make money, but to access the money they make. It’s difficult, even impossible, for them to get credit or bank accounts. And, every step they make takes a bite out of their money. Handling your own money if you’re poor is a job in itself.”

Bosch said some studies estimate that fees and other hurdles rarely seen by those not in poverty can amount to $40,000 over a lifetime, a huge amount given the low income. Just as troubling is the time they may lose that could be used working or seeking employment.

“Payday loan companies are a fairly visible issue, but there’s a lot more than that,” Bosch said. “Even just getting a check cashed can take half a day. Those are massive burdens that many of us don’t see. It’s literally more expensive to be poor.”

The solution starts by explaining how some practices are disastrous and then showing a better way. The Wyandotte County addition is also significant, adding to the current site at 3031 Holmes, Kansas City, Mo. The former Kansas City Kansan newspaper building is being remodeled to serve as a “Learning to Earning-Wyandotte” office.

The changes are part of a notable shift in focus for MLM that also includes longer-term priorities for emergency assistance and the Family Empowerment Initiative.

“We’re trying to focus on things that will target causes as much as possible,” Glynn said. “We’re also recruiting partners who work in these areas and can bring their expertise. It’s very exciting.”

Kansas delegation leads fight to delay physician supervision rules

by Andy Marso, KHI News Service

Topeka — U.S. Rep. Lynn Jenkins and U.S. Sen. Jerry Moran are leading a congressional effort to delay enforcement of Medicare regulations requiring physician supervision of outpatient treatments like chemotherapy and intravenous infusions.

The rules are intended to improve patient safety. But Jenkins, Moran and several advocacy groups, including the Kansas Hospital Association, said they would burden rural providers without benefiting patients.

“It really has put a lot of burden onto the hospitals for supervision of services we just had historically done and had not had any quality issues,” said Tish Hollingsworth, the hospital association’s senior director of finance and reimbursement.

The Centers for Medicare and Medicaid Services have enforced the physician supervision rule since Jan. 1. Hospitals that violate the rule risk losing Medicare reimbursement for the services provided.

Hollingsworth said her group was not aware of any hospitals being penalized yet.

“I have not heard that hospitals have had claims withheld or claims denied, because it is not the focus of any kind of audit right now,” Hollingsworth said. “But whenever there’s a regulation in place like that, we don’t know when it could become an issue.”

The U.S. House earlier this month passed H.R. 4067, co-sponsored by Jenkins, which would delay enforcement of the regulations until next year. Jenkins introduced the bill in February, but it moved slowly through the legislative process.

“Medicare policy change is not taken lightly by Congress, and bills like H.R. 4067 are a laborious process,” Tom Brandt, a spokesman for Jenkins’ office, said via email. “This bill was also in the jurisdiction of two separate House Committees – Ways and Means, and Energy and Commerce. This made the process more complicated.”

The bill awaits action in the Senate, which passed similar legislation promoted by Moran earlier in the year.

Chad Austin, senior vice president of government relations for the hospital association, said those companion bills to delay the Medicare regulations are part of a “two-pronged approach” that also includes clarifying the regulations long-term.

The long-term fix, Austin said, is contained in Senate Bill 1143, which Moran introduced. It would, in part, clarify that the physician supervision required in the new regulations is consistent with other Medicare regulations that require critical access hospitals to have a physician able to respond within 30 minutes.

“While CMS believes they’re providing some guidance, there’s still some clarification from our perspective that needs to be resolved,” Austin said.

Specifically, Austin said, hospitals are unsure what level of physician supervision has to be provided to comply with the regulations.

Julie Brookhart, a CMS regional spokeswoman, said via email that for most of the outpatient therapies affected, the standard is “direct supervision,” in which “the physician or non-physician practitioner must be immediately available to furnish assistance and direction throughout the performance of the procedure.”

But some procedures call for modified levels of supervision, like “general supervision,” in which the “procedure is furnished under the physician’s overall direction and control but the physician’s presence is not required during the performance of the procedure” or “personal supervision,” in which the physician must be physically present in the room for the duration of the procedure.

CMS announced the rule in 2009 but exempted rural critical access hospitals until this year and made changes at those hospitals’ suggestion in the interim.

“We issued non-enforcement instructions of these requirements in critical access hospitals and small rural hospitals for a few years to allow them time to meet the requirements,” Brookhart said. “These non-enforcement instructions ended at the end of 2013. We are currently enforcing these requirements in these hospitals.”

Austin said because hospitals remain unsure what it means to have a physician “immediately available” under the direct supervision guidelines, Kansas’ 84 critical access hospitals should be protected from any attempts to recoup Medicare reimbursements related to such procedures until the rules are revised.

His group joined the American Hospital Association, National Rural Health Association and Anderson County Hospital in writing letters supporting the delay in the bill Jenkins co-sponsored.

Anderson County’s letter said that by applying the supervision rules even to hospital-employed practitioners in rural health clinics, CMS made it nearly impossible to comply.

Dennis Hachenberg, the hospital’s CEO, wrote that the CMS rule presented a “significant hardship and expense to rural hospitals.”

“It will limit the ability to provide our outpatients with basic therapeutic services such as IV infusions, initial antibiotic therapy, emergency cardiac drugs and blood transfusions,” Hachenberg wrote. “These are services that have been provided in rural communities safely through the years and will ultimately impact access to important services for the patients and communities we serve.”

The KHI News Service is an editorially independent initiative of the Kansas Health Institute. It is supported in part by a variety of underwriters. The News Service is committed to timely, objective and in-depth coverage of health issues and the policy-making environment. All News Service stories and photos may be republished at no cost with proper attribution, including a link back to KHI.org when a story is reposted online. More about the News Service is at khi.org/newsservice or contact 785-233-5443.
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Job fair brings employers together with job seekers

Employers and job seekers came together at a job fair today at the Reardon Convention Center, Kansas City, Kan. (Photo by William Crum)
Employers and job seekers came together at a job fair today at the Reardon Convention Center, Kansas City, Kan. (Photo by William Crum)

by William Crum

A job fair today at the Reardon Convention Center in Kansas City, Kan., was well attended.

The sponsors of the job fair included Workforce Partnership, the Hilton Garden Inn, Kansas City Kansas Community College and Technical Education Center, Unified Government of Wyandotte County, and KansasWorks.

Dozens of companies were represented at the fair, all seeking possible new employees.

Companies and organizations that were represented included the Unified Government of Wyandotte County, Target department stores and Jack-in-the-Box restaurants. All were there to talk about future opportunities that they might have.

Workforce Partnership was there to help the applicants write resumes. The mobile Workforce Partnership had a mobile unit where an applicant could come there and write a resume with the help of a trained professional.

A lot of employers prefer to come to Wyandotte County because of the employees’ strong work ethic.

Employers and job seekers came together at a job fair today at the Reardon Convention Center, Kansas City, Kan. (Photo by William Crum)
Employers and job seekers came together at a job fair today at the Reardon Convention Center, Kansas City, Kan. (Photo by William Crum)

Employers and job seekers came together at a job fair today at the Reardon Convention Center, Kansas City, Kan. (Photo by William Crum)
Employers and job seekers came together at a job fair today at the Reardon Convention Center, Kansas City, Kan. (Photo by William Crum)

Employers and job seekers came together at a job fair today at the Reardon Convention Center, Kansas City, Kan. (Photo by William Crum)
Employers and job seekers came together at a job fair today at the Reardon Convention Center, Kansas City, Kan. (Photo by William Crum)