From KMS Executive Director Rachelle Colombo:
On Tuesday, the Kansas House voted to non-concur with the Senate Substitute for House Bill 2279, which would amend the APRN practice statute to permit the prescribing of drugs without a collaborative practice agreement with a physician. The bill, which did not have a public hearing in the Senate on its specific provisions, represents a significant change in health care law which needs more thorough vetting. The House signaled they agreed by voting 91-26 to send it to the conference committee for further consideration.
That means the bill will now go before a committee of three House and three Senate appointees to see if a workable compromise between the two legislative chambers can be reached. (Had the House voted to concur, the bill would have advanced as is for the governor’s signature, and she has previously signaled support for such a proposal.)
In conference committee, there is a chance that the bill could be further amended, although if the legislative conferees cannot agree on any proposed changes, it is likely the bill’s proponents will make another attempt to pressure the House to accept the current Senate version of the bill. KMS will continue to oppose the bill, and urge legislators to include our proposed amendment, which would explicitly put into law that the bill is limited to prescribing and would not otherwise permit the practice of medicine, such as performing invasive procedures or surgery — which nursing advocates have said is not their intent for the proposal.
Also still alive for consideration this session is the so-called Ivermectin bill, Senate Substitute for House Bill 2280. The Senate health committee sent the bill to the full Senate for consideration next week. The proposal would explicitly authorize physicians to prescribe Ivermectin and other drugs for off-label use to prevent or treat COVID-19, among other things. As we detailed in a previous update, KMS is opposed to this proposal as it is currently written because it undermines the ability of the Kansas State Board of Healing Arts to enforce standard of care safeguards for protecting patients, and prohibits pharmacists from exercising their professional judgment in dispensing decisions.
Yet another bill advanced by the Senate health committee last week was Senate Bill 489, which would significantly limit the authority of the KDHE secretary to take action to prevent the introduction and spread of infectious or contagious disease in the state, and also to limit the authority of local public health officers to respond to infectious or contagious diseases. KMS opposes this bill as well.
There are two other health-related bills of note that are working their way through the process. The first is House Substitute for Senate Bill 286, which would continue the governmental response to the COVID-19 pandemic in Kansas by extending the expanded use of telemedicine, the suspension of certain requirements related to medical care facilities and immunity from civil liability for certain health care providers, certain persons conducting business in this state, and covered facilities for COVID-19 claims until January 20, 2023. Now, this bill also incorporates House Bill 2620, which would create the crime of interference with the conduct of a hospital, providing criminal penalties for violation thereof and increasing the criminal penalties for battery of a healthcare provider who is employed by a hospital. KMS supports SB 286.
The other bill continuing to move through the process is Senate Bill 200, which amends the Pharmacy Act to allow pharmacists to provide initiation of treatment (“prescribing”) for certain specified conditions — influenza, strep throat, and urinary tract infections — pursuant to a statewide protocol adopted by the collaborative drug therapy management advisory committee, which is made up of physicians and pharmacists. KMS removed its objections to the bill with the addition of amendments it proposed regarding the training and qualifications required for pharmacists to implement the protocols; requirements for documentation and maintenance of records; requirements for patient inclusion and exclusion criteria; medical referral criteria; patient assessment tools based on current clinical guidelines; and follow-up monitoring or care plans.
While we are not issuing a call to action regarding any of these bills at this time, if you haven’t already, it would be helpful to briefly call or email your own representative in the House to express your concern with the APRN bill becoming law, without at least being amended as we propose.
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