Turnaround Deadline Has Passed
The 2021 Legislature has officially passed the mid-point of the session, but the fate of many weighty bills is still uncertain. The House and Senate spent this past week debating bills that will advance this session, by ensuring they passed, at least, their house of origin.
Legislators will be on break until Wednesday, allowing legislative staff time to update bills and complete their work on the bills moving on this session. Upon their return, legislators have just two-and-a-half weeks for committees to finalize work on bills moving forward.
A number of bills were “blessed” – exempted from the turnaround calendar deadline – by House and Senate leadership, including SB 174, even though they have stated they have no intention of running that legislation this session.
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APRN, Pharmacist Scope of Practice Expansion Bills Held Back
Bills that would have allowed APRNs and pharmacists to engage in the statutory practice of medicine have been held back for the 2021 session. HB 2256, regarding APRNs, and SB 200, regarding pharmacists, will be removed from the calendar and are officially “dead” for the session. SB 174, identical to HB 2256, was “blessed” by Senate leaders, but the Public Health and Welfare Committee chairman announced that his committee has no intention of entertaining the bill further this legislative session.
KAFP and KMS negotiations with those representing APRNs reached a breaking point this past week, following numerous meetings between stakeholders. House leaders asked the parties to come together in an attempt to negotiate a potential compromise on HB 2256. Compromises around the collaborative practice agreements (CPA) and regulatory oversight were offered by the physician groups, but the APRNs refused to negotiate or offer any compromise language of their own.
The central issues of HB 2256 (and SB 174) remain that: APRNs would be able to engage in the independent practice of medicine, apart from a CPA; there are no limits placed on nurses engaging in the full practice of medicine, as defined in Kansas law; and APRNs would continue to be regulated by the Board of Nursing, even when engaging in the practice of medicine.
KAFP members are to be commended for their strong legislative engagement on these bills. The House Health and Human Services Committee was poised last week to take action on HB 2256, but physician input left a majority of committee members reluctant to advance the legislation. House and Senate leaders have strongly urged the parties to negotiate a compromise prior to the 2022 legislative session, but APRN representatives have to date been unwilling to yield on any compromise offers.
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KEMA Proposal Could Impact County Health Officers
A Senate bill passed last week that would significantly curb executive powers in cases of emergency declarations and, additionally, would add checks to the power of county health officers during states of emergency.
SB 273 is an attempt by the majority party to place a stronger check on the powers of the governor, as contained in the Kansas Emergency Management Act (KEMA). While legislators addressed this to an extent in last year’s KEMA legislation, the Senate bill goes much further in actually removing state of emergency management from the executive branch – primarily the governor and KDHE secretary – by allowing the legislature and a special KEMA committee with statewide representation to have a greater say in actions taken in a state of emergency or disaster.
The bill places a greater check and burden on local officials, including health officers, under KEMA, primarily by allowing health officers only to make recommendations to the local governing board in states of emergency. New Section 3 of the bill says the governing body of a city may use only accepted scientific means as justification to issue an order to prevent the spread of disease. Further, the governing body would not be able to issue an order that (1) substantially burdens or inhibits the gathering or movement of individuals or operation of any religious, civic, business or commercial activity, whether for-profit or not- for-profit, unless such order includes justification of the accepted scientific reasons for such order and how such order is narrowly tailored to accomplish remediation of such infectious or contagious disease; or (2) burdens or inhibits the operation of any religious gathering or activity. Any person aggrieved by an order of the governing body may request a hearing to occur within 72 hours, then may request a hearing in a district court.
Sections 16 and 17 clarify that health officers would be prohibited from ordering schools and colleges, private or public, to cease operation.
Section 18 furthers by allowing local health officers to only make recommendations to the board of county commissioners of the county affected by such recommendation. The county commission may then issue an order that does not: (1) substantially burden or inhibit the gathering or movement of individuals or operation of any religious, civic, business or commercial activity, whether for- profit or not-for-profit, unless such order includes justification of the accepted scientific reasons for such order and how such order is narrowly tailored to accomplish remediation of such infectious or contagious disease; (2) burden or inhibit the operation of any religious gathering or activity; or (3) have the effect of limiting travel between counties. Any person aggrieved by an order of the board may request a hearing to occur within 72 hours, then may request a hearing in a district court.
The House also passed a KEMA bill, HB 2416, which takes a significantly more cautious approach to changing current law. For the most part, the House ensures greater oversight by the Legislature, with a provision allowing for the Attorney General to opine, on emergency orders by the Governor. Governor Kelly signaled last week that she prefers by far the House approach to KEMA legislation.
Both bills have passed their individual chambers and the fate of this legislation going forward rests in the hands of a Judiciary conference committee, comprised of the chair, vice chair and ranking minority members of the House and Senate Judiciary committees. The job of this conference committee is to hammer out a compromise between the two positions that can pass both the House and the Senate.
Given the vast difference between SB 273 and HB 2416, the negotiation process will likely be brutal. The House has indicated they believe in taking a more thoughtful and cautious approach to KEMA changes, especially when still in the throes of a global pandemic.
The Senate appears to have taken a stronger overhaul, reacting to state emergency orders and issues of the past year. In Senate debate, many highlighted concerns over orders for schools, church gatherings, and many businesses to be shut down by the governor. They cited a certain capriciousness in determining what constituted “essential” businesses, the allowance of abortions to be performed when other non-life-threatening procedures were curtailed, and restrictions on constitutional rights as the need for a more significant KEMA reform.
The Legislature is under a March 31, 2021 deadline to pass temporary legislation passed last year and extended in SB 14 earlier this session. The KAFP lobbyist is meeting with key legislators, urging the House position regarding county medical officers (which stays with current law).
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Family Doctor of the Day
KAFP is again sponsoring the Family Doctor of the Day (FDOD) program during the Kansas legislative session. Licensed physicians, including residents, volunteer to provide mostly-minor health needs to legislators and their staff. The Legislature highly values and appreciates access to these services, especially when so many are away from their hometown primary care physicians.
We want to thank the following for their service to legislators and Capitol staff members this past week: Dr. Nicholas Cahoj (St. George) and Dr. Joseph Meier (Neodesha). Your time and efforts in serving as Doctor of the Day are greatly appreciated!
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Bills We’re Monitoring
Please note that this list has been revised to remove bills that did not meet the calendar deadline. The remaining bills either advanced before the deadline, are in committees that are exempt from the deadline, or have been “blessed” (run through an exempt committee).
SB 14 – An act concerning governmental response to the COVID-19 pandemic in Kansas; extends deadline to March 31, 2021
Status: Passed Senate 34-1; Passed House 119-3; Signed by Governor
SB 92 – Creating the Kansas equal access act to authorize the use of medical marijuana
Status: Referred separately to S-Public Health & Welfare and S-Fed & State Affairs
SB 174 – Updating scope of practice requirements for advanced practice registered nurses without a supervising physician, imposing requirements therefor and updating certain licensure requirements *KAFP opposes
Status: S-Public Health & Welfare hearing on 2/18; Blessed for future action
SB 212 – Prohibiting the secretary of health and environment from permanently requiring additional immunizations to attend a child care facility or school *KAFP opposes
Status: Referred to S-Public Health & Welfare; Blessed for future action
SB 213 – Prohibiting an employer from taking any adverse employment against an employee because of the employee's vaccination status *KAFP opposes
Status: S-Commerce hearing on 2/25; Blessed for future action
HB 2066 – Expanding the military spouse and servicemember's expedited licensure law to all applicants who have established or intend to establish residency in Kansas, providing for the practice of telemedicine by out-of-state physicians, permitting the issuance of temporary licenses in emergencies and the use of electronic credentials (defers to state of license origination) *KAFP opposed, before amendment; now neutral
Status: House passed as amended 103-21
HB 2158 – Making permanent provisions for the advisory committee on trauma and the statewide trauma system regional council to conduct closed meetings and keep privileged records regarding trauma cases
Status: Passed House 121-1; referred to S-Public Health & Welfare
HB 2174 – Establishing the rural hospital innovation grant program to assist rural hospitals in serving rural communities
Status: Hearing in H-Appropriations on 2/10
HB 2184 – Creating the Kansas medical marijuana regulation act
Status: H-Federal & State Affairs hearing on 2/24 (proponents), 2/25 (opponents)
HB 2206 – Updating certain definitions, referral to specialty services and coordination of care provisions in the Kansas telemedicine act
Status: Hearing in H-Health & Human Services on 2/9; Blessed for future action
HB 2259 – Permitting the use of expedited partner therapy to treat a sexually transmitted disease
Status: House passed 75-49; S-Public Health & Welfare
HB 2340 – Increasing the minimum age to 21 to purchase or possess cigarettes and tobacco products *KAFP supports
Status: H-Federal & State Affairs passed favorably
HB 2380 – Amending the healthcare stabilization fund minimum professional liability insurance coverage requirements and the membership of the board of governors of such fund
Status: H-Insurance & Pensions; Blessed for possible future action
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Legislative Committee Calendar, Week of Mar. 8, 2021
The Legislature meets again on Wednesday, Mar. 10, 2021. Floor debates are live-streamed and can be accessed at www.kslegislature.org, under the Audio-Visual tab.
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