Legislative Update
Expanded Scope Legislation Held in Committees

Legislation expanding the scope of practice for APRNs and pharmacists failed to advance from House and Senate health committees this past week. Senate Public Health and Welfare chairman Richard Hildebrand (R-Galena) stated on Thursday, following a hearing on SB 200, that he did not intend to advance that bill or SB 174 this session, but warned next year would be a different story. He urged opposing parties to hammer out differences in the interim and come back next year with compromises for the committee to consider.

Last week we reported House Health and Human Services chairwoman Brenda Landwehr (R-Wichita) indicated her committee planned to take action on HB 2256 this past Thursday. KAFP issued an action alert to members and those calls and letters made a difference.

On Wednesday, the KAFP lobbyist engaged in a meeting with KMS, the Board of Healing Arts (BOHA), and APRN representatives seeking an agreeable compromise. That meeting was rather startling in that it became clear those representing APRNs did not understand Kansas statutes regarding the practice of medicine. One national entity continually made assertions that BOHA acting director said were just not true of Kansas laws and regulations.

Representatives for physicians offered a number of possible compromises for the APRNs to consider, including:
  • Physicians no longer charging fees for collaborative practice agreements (CPAs);
  • Stronger guidance on CPA language and supervision, similar to that used for physician assistants;
  • Striking language on page six of the bill that would permit nurses to engage in acts falling under the practice of medicine, as defined in statute; and,
  • Clearly delineate that anyone engaging in the practice of nursing, as defined by statute, will continue to be regulated by the Board of Nursing, but any nurse wanting to engage in the practice of medicine must be regulated by the Board of Healing Arts.

At the conclusion of that meeting, APRN representatives said they would submit their own compromise language for consideration before the committee took action on HB 2256. That never happened.

Late Thursday afternoon, Chairwoman Landwehr indicated disappointment that the parties did not come to an agreeable compromise and said her committee was, therefore, not comfortable advancing the bill this session. She said she had told lobbyists for the APRNs that they needed to work with physicians in the next year to find a compromise her committee could consider in the 2022 session.

Physicians’ advocacy efforts over the last week clearly turned the trajectory of HB 2256 around. Committee members indicated they’d heard regularly from APRNs on the legislation and some said they had been leaning toward supporting the bill. But hearing from physicians changed that. They heard how physicians and APRNs operate as team members in health care settings, both valuable in their own ways, but with differing roles and training. Most indicated that they would only vote to advance the bill if APRNs were regulated by the BOHA.

Thank you to our members who reached out to the Committee and lent your voice to oppose HB 2256 as written.
Senate Panel Hearing on Pharmacists’ Practice Expansion

The Senate Public Health and Welfare Committee on Thursday held a public hearing on SB 200, which would extend pharmacists’ scope of practice to include testing, diagnosing and initiating treatment for diseases considered low-risk, as determined by the Board of Pharmacy.

KAFP president Dr. Chad Johanning testified against the bill, leading out with the fundamental belief that patients are best served in the context of a medical home, by a physician-led team of health care professionals. He said SB 200 clearly crossed the line between pharmacy practice and medical practice. He highlighted the particular training differences between the two professions and said that administering tests was one thing, but that pharmacists were not trained to diagnose and treat patients.

He and a pediatrician conferee also testified how seemingly low-risk illnesses, such as strep, can quickly become more dangerous and lead to emergency action in a medical clinic or emergency room.

KMS executive director Rachelle Colombo expressed frustration that the pharmacists had not discussed the legislation in advance of the legislative session and urged the committee to give the parties opportunity to work out a compromise that could provide increased health care access to patients, without compromising their safety.

The committee chairman said the committee will not take action on the bill this session, but urged parties to work together in the coming year to find a compromise they can bring next session.
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. Rachel Svaty (Garden City); and Dr. Chad Johanning (Lawrence). Your time and efforts in serving as Doctor of the Day are greatly appreciated!
Bills We’re Monitoring

SB 10 – Enacting the right to earn a living act to minimize unnecessary occupational licensing and regulation. *KAFP opposes
Status: Hearing in S-Commerce on 1/27
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 92Creating 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 137 – Expanding the military spouse and service member’s expedited licensure law to all applicants who have established or intend to establish residency in Kansas, providing for licenses in an emergency declared by the legislature, allowing telemedicine by out-of-state healthcare providers and permitting the use of electronic credentials (identical to HB 2066) *KAFP opposes
Status: S-Commerce hearing on 2/23

SB 174Updating 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
SB 200Expanding the pharmacist's scope of practice to include point-of-care testing for and treatment of certain health conditions *KAFP opposes
Status: Referred to H-Health & Human Services
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
SB 213 – Prohibiting an employer from taking any adverse employment against an employee because of the employee's vaccination status
Status: S-Commerce hearing on 2/25  *KAFP opposes
HB 2061Increasing the minimum age to purchase or possess cigarettes and tobacco products from 18 to 21, and prohibiting cigarette vending machines and flavored vaping products *KAFP supports
Status: Referred to H-Federal & State Affairs
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: Passed H-Commerce, with amendments
HB 2129 – Providing for tobacco cessation benefits coverage under the state health care benefits program *KAFP supports
Status: Referred to S-Insurance & Pensions
HB 2157 – Establishing restrictions on the use of step therapy protocols by health insurance plans
Status: Hearing in H-Health & Human Services on 2/3
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 2184Creating 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
HB 2210 – Making it a crime for a doctor to perform gender reassignment surgery or hormone replacement therapy on minors
Status: Referred to H-Health & Human Services
HB 2256 – 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: H-Health & Human Services hearing on 2/17
HB 2257 – Permitting physicians to decide based on their medical judgment whether to provide patients with certain information
Status: Referred to H-Health & Human Services
HB 2258 – Enacting the right to family planning act to require contraceptives to be available at pharmacies
Status: Referred to H-Health & Human Services

HB 2259 – Permitting the use of expedited partner therapy to treat a sexually transmitted disease
Status: H-Health & Human Services recommended favorably, as amended

HB 2340 – Increasing the minimum age to 21 to purchase or possess cigarettes and tobacco products *KAFP supports
Status: H-Federal & State Affairs hearing on 2/22
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: Introduced in House
Legislative Committee Calendar, Week of Mar. 1, 2021

There are no committee meetings scheduled week. The House and Senate will dedicate their time to floor debate and advance bills in their chamber of origin, to meet the March 5 turnaround deadline for all non-exempt bills. Floor debates are live-streamed and can be accessed at www.kslegislature.org, under the Audio-Visual tab.