Several hospitals in the state have laid off staff recently, and some officials said new health care regulations and requirements played a role in their decision. "We are facing reform at the federal level, and the new (state Medicaid) KanCare program," said Steven Perkins, CEO of South Central Kansas Medical Center in Arkansas City, which announced two weeks ago that it would cut nine staff members—seven full-time, one part-time and one "as needed" employee.