Legislators passed more than 100 bills by the end of Drop Dead Day on Wednesday, March 23, which was the last day for consideration of non-exempt bills in both chambers. These included bills dealing with suicide prevention; licensing of pharmacy benefit managers; short-term, limited duration insurance (STLDI) health plans; scope of practice for pharmacists, occupational therapists and advanced practice registered nurses; limitations on governmental actions related to contagious and infectious diseases; redistricting; and budget bills. Both chambers reconvened on March 28 for a week of conference committees and other work to be completed before First Adjournment on Friday, April 1. This edition of Health at the Capitol looks at health policy issues that were discussed during the 11th week of the session.
Health at the Capitol is a weekly summary providing highlights of the Kansas legislative session, with a specific focus on health policy related issues. Sign up here to receive these summaries and more, and also follow KHI on Facebook, Twitter and LinkedIn. Previous editions of Health at the Capitol can be found on our ARCHIVE PAGE.
On Wednesday, March 23, the House passed its budget bill, on a vote of 73-49, without the $70 million that Gov. Laura Kelly had included to fund the state’s portion of Medicaid expansion.
House Federal and State Affairs Committee
(Rep. John Barker, Chair)
On Tuesday, March 22, House Bill (HB) 2708 was passed out of Committee. The bill would establish standards for laboratory licenses that test medical marijuana and require the director of Alcoholic Beverage Control (ABC) to adopt rules and regulations regarding testing laboratories. The Committee amended the bill to include some provisions from Senate Bill 158, passed by the House in 2021, related to the definition of medical marijuana and other terminology, laboratory licensure, licensure disqualification, licensee location requirements, and criminal history check requirements.
Senate Federal and State Affairs Committee
(Sen. Rob Olson, Chair)
On Monday, March 21, the Committee recommended that SB 522 be passed. The bill would allow local school boards to provide firearm safety education programs and the State Board of Education would be directed to establish curriculum guidelines for a standardized firearm safety education program that includes accident prevention. The bill also would provide that specific programs be used based on the grade level of students.
Conference Committee Action
Senate Substitute (Sub) for HB 2279 would amend provisions in the Kansas Nurse Practice Act (Act) governing the licensure of advanced practice registered nurses (APRNs) to, among other things, allow an APRN to prescribe drugs without a written protocol as authorized by a responsible physician, require an APRN to maintain malpractice insurance, and require national certification for initial licensure as an APRN. The bill also would modify the definition of “mid-level practitioner” in both the Pharmacy Act of the State of Kansas and the Uniform Controlled Substances Act to conform with amendments to the written protocol requirements within the Act. The substitute bill was recommended for passage by the Senate Public Health and Welfare Committee on February 21 and passed by the Senate on March 9. The Conference Committee appointed on March 15 met on March 22, but no agreement was reached at that time.
House and Senate Floor Action
Senate Bill (SB) 12, passed by the Senate on February 17, would require the Kansas Department for Children and Families (DCF) to collaborate with community partners and stakeholders to develop a plan by January 31, 2023, for implementation beginning on July 1, 2023, of performance-based contracts to provide an array of evidence-based prevention and early intervention services for families at risk for out-of-home placement, families that have a child in out-of-home care, and children awaiting adoption. The bill also would require DCF to provide a status update and recommendations for continued progress and submit a proposal for the reinvestment of savings from reduced foster care caseloads into evidence-based prevention and early intervention programs designed to prevent the need for or reduce the duration of out-of-home placements to the Governor and Legislature no later than January 31, 2024. The bill, as amended by the House Children and Seniors Committee, was passed by the House on March 23.
House Substitute (Sub) for SB 19 would create the Living, Investing in Values, and Ending Suicide (LIVES) Act (Act) and implement the established 988 Suicide Prevention and Mental Health Crisis Hotline in Kansas. The bill also would outline the responsibilities of the Kansas Department for Aging and Disability Services (KDADS), hotline centers, and service providers and would establish the 988 Suicide Prevention and Mental Health Crisis Hotline Fund and direct State General Fund moneys to be transferred to the Fund. Additionally, the bill would provide certain protections from liability for service providers, create the 988 Coordinating Council, and require an annual report from the Council to the House Committee on Appropriations, Energy, Utilities and Telecommunications and the House Health and Human Services Committee, as well as the Senate Committee on Ways and Means, Utilities, and the Senate Committee on Public Health and Welfare. The bill was passed by the House on March 21, and a Conference Committee was appointed on March 23.
House Sub for SB 28 would enact the pharmacy benefits manager (PBM) licensure act and require licensure rather than registration of PBMs. It would (1) end the registration of PBMs and instead require them to be licensed; (2) require that, based upon licensure, the Kansas Insurance Department would have oversight over PBMs to allow it to hold them accountable to current law and a regulatory structure contained in the bill; and (3) amend the current maximum allowable cost (MAC) appeals process, related to reimbursement rates to pharmacies dispensing generic drugs. The bill was passed by the House on March 21.
SB 155 would update statutes related to newborn screening and designate those statutes as the Newborn Screening Act (Act); would establish the Universal Newborn Screening Program (UNSP) to be administered by the Secretary of the Kansas Department of Health and Environment (KDHE);and would remove the list of conditions in the Act and authorize the Secretary to determine the conditions to be included in the UNSP, including, but not limited to, conditions listed in the recommended uniform screening panel recommended by the U.S. Secretary of Health and Human Services. The bill also would increase the amount available for transfer from the Medical Assistance Fee Fund to the Kansas Newborn Screening Fund from a maximum of $2.5 million to a maximum of $5 million in any one fiscal year. The bill was passed by the Senate on March 23.
SB 199, passed by the Senate in March 2021, would amend law in the Insurance Code governing specially designed policies and short-term policies to update references to short-term, limited-duration insurance (STLDI) health policies. Under current law, “short-term” means an insurance policy period of 6 or 12 months, based upon policy design, which offers not more than one renewal period with or without a requirement of medical re-underwriting or medical requalification. The bill would amend this definition to update the term to “short-term limited duration” and would specify a policy period of less than 12 months and a policy that offers renewal or extension periods up to a maximum policy period of 36 months total in duration. The bill also would remove language specifying the benefits or services that could be included in specially designed policies; the definition of “specially designed policies” would be updated to provide that these policies are issued on a short-term, limited-duration basis; and remove language required to be included in contracts and application material by insurance companies issuing STLD policies. The bill, as amended by the House Insurance and Pensions Committee, was passed by the House on March 23.
SB 200, passed by the Senate on February 15, would expand the pharmacist scope of practice to include initiation of therapy for influenza, strep throat, or urinary tract infection, pursuant to a statewide protocol adopted by the Collaborative Drug Therapy Management Advisory Committee. On March 21, the House passed the bill, as amended by the House Health and Human Services Committee on March 15.
SB 335, passed by the Senate on February 17 and passed by the House on March 17, would exempt certain qualified trade, merchant, retail, and professional associations and business leagues in the state from payment of the annual premium tax to the Kansas Insurance Department. These professional associations and business leagues provide health benefits through a self-funded health plan subject to the federal Employee Retirement Income Security Act of 1974 (ERISA) but are not subject to the jurisdiction of the Kansas Insurance Department. The bill was enrolled and presented to the Governor on March 21.
SB 343, passed by the Senate on February 15, would replace references to “hearing impairment” and other similar terms in existing statutes with the terms “hard of hearing,” “hearing loss,” or “deaf” related to persons with hearing loss. The House Committee of the Whole adopted a technical amendment to the bill and passed it, as amended, on March 21, and a Conference Committee was appointed on March 22.
SB 346, passed by the Senate on February 10 and amended by the House Agriculture Committee on March 17, would allow for the on-farm retail sale of milk or milk products, regulate the labeling and advertising of such products, extend the sunset date for certain milk and dairy license fees, allow the Secretary of Agriculture to declare an imminent health hazard when necessary to protect the public health, and allow the Kansas Department of Agriculture to assess a civil penalty for certain violations. The bill was passed by the House on March 21.
SB 399, passed by the Senate on February 23, which would add maternity centers to the definition of healthcare provider for purposes of the healthcare insurance provider availability act, was stricken from the House Calendar on March 23.
SB 440, passed by the Senate on February 23, would amend the Occupational Therapy Practice Act, and allow occupational therapists (OTs) to evaluate and initiate occupational therapy treatment on a patient without referral from a health care practitioner. The bill would create conditions under which an OT would be required to obtain a referral from a health care practitioner prior to continuing treatment; would not prevent a hospital or ambulatory surgical center from requiring a physician to order or make a referral for occupational therapy services for a patient currently being treated in such a facility; and would require an OT to provide written notice to a self-referring patient, prior to commencing treatment, stating that an occupational therapy diagnosis is not a medical diagnosis by a physician. The bill also would require licensed OTs actively practicing in the state to maintain professional liability insurance coverage as a condition of rendering professional occupational therapy services and would require the Board of Healing Arts to determine the minimum level of coverage for such insurance through rules and regulations. The bill was passed by the House on March 21.
SB 453, passed by the Senate on February 23 and amended by the House Health and Human Services Committee on March 16, would amend current law and require the completion of 40 hours of training in basic resident care skills for unlicensed employees working in adult care homes, who provide direct, individual care to residents, who do not administer medications to residents, and who have not completed or are participating in a course of education and training relating to resident care and treatment approved by the Secretary of KDADS.
SB 489, as amended by the Senate Public Health and Welfare Committee on March 16, would amend several existing statutes related to contagious or infectious diseases to restrict or limit the powers of the Secretary of the Kansas Department of Health and Environment (KDHE) and local health officials. The bill would replace language in current law allowing local health officers to “issue” an order requiring quarantine or isolation in certain situations with language stating that such orders may only be “recommended.” The bill was further amended by the Senate Committee of the Whole to (1) remove the Secretary’s authority to issue orders and adopt rules and regulations regarding isolation and quarantine of persons afflicted with or exposed to diseases injurious to the public health and (2) to specify that local health officers would be required to use only medically necessary and reasonable measures to prevent the spread of infectious, contagious, or communicable diseases. The bill was passed by the Senate on March 23.
SB 541, as amended by the Senate Judiciary Committee on March 11, would create law regarding actions taken by a city related to contagious or infectious disease, COVID-19 vaccination passports, and face mask requirements. The bill also would amend the Kansas Emergency Management Act and public health statutes related to contagious or infectious disease, remove the sunset provision in the COVID-19 Contact Tracing Privacy Act, and amend law related to student vaccination exemptions. The bill would require compensation for the use, restriction on use, damage, loss or destruction of property as a result of certain governmental actions; provide that orders and similar actions by public officials relating to face mask mandates, gathering limitations, business restrictions and religious gathering limitations shall not exceed 30 days in duration at a time before being renewed or allowed to expire; prohibit school officials from issuing or requiring use of a COVID-19 vaccination passport or discriminating against a student based upon COVID-19 vaccination status; require schools to recognize exemptions from vaccination requirements and face mask mandates; prescribe the 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 contagious or infectious disease; and authorize reimbursement of property taxes levied upon businesses shut down or restricted as a result of certain governmental actions related to contagious or infectious disease. The bill was further amended by the Senate Committee of the Whole to add a section of law prohibiting governmental entities or public officials from restricting worship services or activities and to provide additional restrictions on the actions of local health officers and was then passed, as amended, by the Senate on March 23.
Senate Sub for HB 2062, as recommended by the Senate Public Health and Welfare Committee on March 30, 2021, would prohibit any state officer; any state agency; the board of county commissioners; any employee of a state officer; state agency or board of county commissioners; or the governing body of any city- or county-established and operated home for the aged or county hospital from restricting a resident’s or patient’s right to receive or refuse visitors in their private room or restrict any other reasonable accommodation to receive visitors for the purpose of controlling or preventing the transmission of an infectious disease. A board of trustees of a city- or county-established and operated home for the aged also would be prohibited from restricting residents in such manner. Every resident of a city- or county-established and operated home for the aged or every patient of a county hospital, or such resident’s or patient’s legal representative, would have the right to waive, in writing, any restrictions imposed to control or prevent the transmission of an infectious disease by the county, a city within such county, an employee of such county, or any federal or state agency at any time, including during a state or local disaster emergency declared pursuant to statute. The bill was passed over by the Senate on March 23 and retains a place on the Senate Calendar.
House Bill (HB) 2110, passed by the House on February 23, would require the State Employee Health Plan (SEHP), for plan year 2023, provide coverage for the diagnosis and prescribed treatment for pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), for the purpose of studying the utilization and cost of such coverage. The bill also would require the State Employees Health Care Commission to submit a report to the President of the Senate and the Speaker of the House on or before March 1, 2024, stating the impact that the mandated coverage for PANS and PANDAS had on the SEHP. The bill was passed by the Senate on March 23.
HB 2151, passed by the House on February 18, 2021, and amended by the Senate Public Health and Welfare Committee on March 29, 2021, would create and amend law regarding elder and dependent adult abuse multidisciplinary teams and would require the Attorney General to appoint a Kansas elder and dependent abuse multidisciplinary team coordinator and, within limits of available appropriations, appoint such additional staff as necessary to support the coordinator. The Attorney General would be required to submit an annual report to the Legislature, on or before the first day of each regular legislative session, on the implementation and use of the teams; and the statute creating the Abuse, Neglect, and Exploitation of Persons Unit (Unit) in the Office of the Attorney General (OAG) would be amended to allow the Unit to assist in any investigation or discussion of any elder and dependent adult abuse multidisciplinary team, pursuant to the bill. The bill was passed over by the Senate on March 23 and retains a place on the Senate Calendar.
HB 2253, passed by the House on March 21 and referred to Senate Public Health and Welfare Committee, updates certain provisions of the Prescription Monitoring Program Act relating to program data, storage and access; increases the membership of the Advisory Committee; and provides for setup and annual maintenance fees for program data integration.
Senate Sub for HB 2262, which would amend schedules I, II, IV and V of the Uniform Controlled Substances Act and other statutes, was passed by the House on February 24, 2021, and the substitute bill was recommended for passage by the Senate Public Health and Welfare Committee on March 30, 2021. The bill was amended by the Senate Committee on February 4, 2022, at the request of the State Board of Pharmacy, to exempt federal Food and Drug Administration (FDA)-approved drug products containing an active ingredient derived from marijuana from the definition of marijuana. During the hearing on the bill, it was noted that at least one drug containing an active ingredient derived from marijuana is likely to be approved between the 2022 and 2023 legislative sessions. It was noted that the amendment does not specify any particular product and would allow any FDA-approved drug product containing an active ingredient derived from marijuana to be available with a prescription. The bill was passed by the Senate on February 17, and a Conference Committee was appointed on March 21.
Senate Sub for HB 2280 would allow prescribers to prescribe drugs approved by the U.S. Food and Drug Administration (FDA) ─ including, but not limited to, hydroxychloroquine sulfate and ivermectin ─ for the off-label use of preventing or treating COVID-19 infection. The bill also would provide that recommendations, prescriptions, uses or opinions of a prescriber related to the treatment of COVID-19, including treatment that is not recommended or regulated by the Kansas State Board of Healing Arts, KDHE or the FDA, would not be considered unprofessional conduct. The bill also would amend the Pharmacy Act to prohibit pharmacists from refusing to fill or refill any prescription on the basis of such prescription being used to treat or prevent a COVID-19 infection and would amend law relating to child care facilities and schools to provide that children and students enrolling in a child care facility, school or preschool or day care facility operated by a school, would be exempt from immunizations required by the Secretary of KDHE if such immunizations would violate sincerely held religious beliefs and such an exemption would be granted without inquiring into the sincerity of the request. The substitute bill, as amended, was recommended for passage by the Senate Public Health and Welfare Committee on March 21 and passed by the Senate on March 23.
HB 2340 would amend the Kansas Cigarette and Tobacco Products Act; the Kansas Indoor Clean Air Act; law concerning student health; and criminal statutes related to the use and possession of cigarettes, electronic cigarettes, consumable material, and tobacco products by persons under the age of 21. The bill would change references to the legal age to use or possess such products throughout the above Acts from 18 years of age to 21 years of age. The bill also would define the term “regulated products” to mean cigarettes, electronic cigarettes, consumable material, and tobacco products, and would replace references to either “cigarettes,” “electronic cigarettes,” or “cigarette and tobacco products” with “regulated products” throughout the bill. The bill was passed by the House on March 23.
HB 2386, as amended by the Senate Public Health and Welfare Committee on March 17, would establish requirements for the payment and reimbursement of dental services by a dental benefit plan. The bill was passed by the Senate on March 23.
Senate Sub for HB 2416 would require compensation for the use, restriction on use, damage, loss, or destruction of property as a result of certain governmental actions and would authorize reimbursement of property taxes levied upon businesses shut down or restricted as a result of certain governmental actions related to contagious or infectious disease in humans. The bill also would establish the COVID-19 retail storefront property tax relief act to provide partial refunds to certain businesses impacted by COVID-19 related to shutdowns and restrictions. The bill was passed by the Senate on March 23.
Senate Sub for HB 2448 would require DCF to assign all able-bodied adults without dependents subject to the food assistance work requirements established by federal law to an employment and training program as defined in 7 U.S.C. § 2015(d)(4). The bill would specify the provisions of the bill would only apply to those able-bodied adults without dependents aged 18 through 49. The Senate Public Health and Welfare Committee recommended the substitute bill be passed on March 21 and the Senate passed the bill on March 23.
HB 2582, passed by the House on March 16, would amend a law governing access, exchange, and disclosure of information in the Revised Kansas Code for Care of Children to require the Secretary of DCF to disclose confidential agency records of a child alleged or adjudicated to be a child in need of care to the law enforcement agency investigating the alleged or substantiated report or investigation of abuse or neglect, regardless of the disposition of such report or investigation.
HB 2632, which would expand existing Adrian’s Law to require a forensic medical evaluation of an alleged victim of child abuse or neglect as part of an investigation; create a program in KDHE for the training of and payment for Child Abuse Review and Evaluation (CARE) providers who conduct CARE exams; and would establish definitions, requirements and procedures related to CARE examinations and providers and create the CARE Fund. On March 21, the House Committee of the Whole amended the definition of “child abuse review and evaluation network” to include any medical provider associated with a child advocacy center that has the ability to conduct a CARE exam and to add a sunset date of July 1, 2026, to the bill and passed the bill, as amended. The bill was referred to the Senate Public Health and Welfare Committee on March 23.
HB 2734 would amend licensure requirements for certain professions licensed by the Behavioral Sciences Regulatory Board (BSRB). The bill would add to the list of requirements for licensure as a specialist clinical social worker an allowance for applicants who complete additional postgraduate supervised experience as determined by the Board in lieu of completing a graduate-level supervised clinical practicum as required by law. The bill also would allow a master social worker, specialist clinical social worker, professional counselor, clinical professional counselor, marriage and family therapist, clinical marriage and family therapist, master’s level psychologist, clinical psychotherapist, or psychologist currently licensed in Kansas to be eligible to take a Board-approved examination for licensure as an addiction counselor. The bill was passed by the House on March 21 and referred to the Senate Public Health and Welfare Committee on March 23.