KEMA Compromise Adopted by Legislature
A compromise on amendments to the Kansas Emergency Management Act (KEMA) was reached last week and was quickly adopted by both chambers of the Legislature. The governor is expected to sign the bill.
The conference committee agreement was placed into a gutted SB 40 and easily passed in the House (118-5) and the Senate (31-8), now enrolled and before the governor to sign into law. Negotiations between the vastly differing House and Senate positions reached a breaking point, before leaders in both chambers conferred and facilitated a more productive negotiating environment.
Central to many physicians was the section regarding the role of KDHE and local health officials. The Senate bill reigned in the authority of county medical directors to the point of allowing them only to make “recommendations.” The House position held strongly to the current law, which was updated by the 2020 Legislature, allowing local health officers to issue orders that would be voted upon by the board of county commissioners.
While most in the scientific and medical communities would hold that health officers should have enhanced authority in states of public health emergencies, the law generally provides stronger deference to elected officials voted on by their constituents so as to provide a check on authoritarian powers.
Governor Kelly had indicated she much preferred the House position and is, therefore, expected to sign SB 40. A full description of the bill and its various components may be found here.
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APRN Discussion Continues
House Health and Human Services chairwoman Brenda Landwehr (R-Wichita) called a meeting last Tuesday between those representing APRNs, KAFP and KMS. The opposing sides each presented their respective positions on the legislation that has been introduced to date and attempted to establish what each side might offer as a compromise moving forward. It continued to be clear there is a fundamental difference between what the sides consider to be the practice of nursing versus the practice of nursing, although the scopes of each are clearly defined in Kansas Statutes.
Those meeting on behalf of physicians highlighted the fact that nearly all of the APRNs’ testimony focused on the collaborative practice agreements being the problem driving HB 2256 and SB 174. Subsequent to that, KMS offered ideas that could fix those agreement issues, but those were soundly rejected by APRNs.
It has been clear in their proposed legislation and discussions to date that APRNs very simply want to practice medicine as fully as physicians, but still call it nursing and receive governance by the Board of Nursing. Many have stated they believe they can function as family physicians.
On Tuesday, Rep. Landwehr said she too thought most of the APRN testimony focused on the collaborative practice agreements and said it seemed to be a disingenuous argument now. She again stated her belief that the practice of medicine should remain under the regulation of the Board of Healing Arts. She further stated that APRN legislation will be worked in her committee next year and that the Legislature will vote on it – for better or worse. She strongly urged the opposing parties to come together in the coming year and have a mutually acceptable agreement to present to the 2022 Legislature. Shy of that, she indicated, the Legislature would make that determination, in which case both parties would likely be dissatisfied with the resulting outcome.
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Immunization Bill Would Strip Authority from KDHE Secretary
There was a public hearing on SB 212 this morning that would transfer the authority for determining additional child care facility and school entry immunizations from the KDHE secretary to the Kansas Legislature. The bill’s effect would be similar to last year’s HB 2601 that failed to advance from a legislative committee.
On its face, the bill looks innocuous enough. It puts into statute the current list of required child care and school entry vaccinations and says the KDHE secretary has the authority to remove any of those deemed unsafe or unnecessary in the future. However, it goes further and strikes current law authorizing the KDHE secretary to make determinations regarding adding vaccinations to that schedule.
Interestingly, the bill was introduced by a physician member of the Senate Public Health and Welfare Committee, Sen. Mark Steffen (R-Hutchinson). He introduced similarly restrictive legislation for workplace vaccination issues.
KAFP President Dr. Chad Johanning (Lawrence) will present opposing testimony, in addition to Rep. John Eplee (R-Atchison), who is also a KAFP member and strongly opposed to this type of anti-vaccination legislation.
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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 Dr. Danelle Perry (Manhattan) for serving as FDOD last week. 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 40 – Prescribing powers, duties and functions of the board of education of each school district, the governing body of each community college and the governing body of each technical college related to the COVID-19 health emergency, adding the vice president of the senate to the legislative coordinating council, modifying the procedure for the declaration and extension of a state of disaster emergency under the Kansas Emergency Management Act (KEMA), prohibiting certain actions by the governor related to the COVID-19 health emergency and revoking all executive orders related to such emergency on Mar. 31, 2021, establishing judicial review for certain executive orders issued during a state of disaster emergency and certain actions taken by a local unit of government during a state of local disaster emergency, authorizing the legislature or the legislative coordinating council to revoke certain orders issued by the secretary of health and environment and limiting powers granted to local health officers related to certain orders.
Status: approved by House and Senate; now goes to the 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 entered opposing testimony
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 entered opposing testimony
Status: S-Public Health & Welfare hearing on 3/22
SB 213 – Prohibiting an employer from taking any adverse employment against an employee because of the employee's vaccination status *KAFP entered opposing testimony
Status: S-Commerce hearing on 2/25; Blessed for future action
SB 295 – Giving counties the authority to adopt prioritized COVID-19 vaccination plans separate from state guidelines
Status: S-Public Health & Welfare passed favorably
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; Senate passed 36-2
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; S-Public Health & Welfare passed favorably
HB 2174 – Establishing the rural hospital innovation grant program to assist rural hospitals in serving rural communities
Status: H-Health & Human Services hearing on 3/16
HB 2184 – Creating the Kansas medical marijuana regulation act
Status: H-Federal & State Affairs discussion & action on 3/23, 3/24
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 final action on 3/22
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Legislative Committee Calendar, Week of Mar. 22, 2021
Following are health-related committee meetings of interest, as known today. Please note that the calendar is subject to change. Floor debates are live-streamed and can be accessed at www.kslegislature.org, under the Audio-Visual tab.
Tuesday, March 23
9:00 a.m., H-Federal & State Affairs (exempt committee)
Discussion and possible action:
HB 2184 – Creating the Kansas medical marijuana regulation act
1:30 p.m., H-Health & Human Services
Presentation: Phase 3 and Phase 4 COVID vaccinations – KDHE representative
Wednesday, March 24
9:00 a.m., H-Federal & State Affairs (exempt committee)
Discussion & possible action:
HB 2184 – Creating the Kansas medical marijuana regulation act
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