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KMS Update: FAQ on the new APRN statutory changes and other updates

From KMS Executive Director Rachelle Colombo:
With the passage of House Bill 2279 by the 2022 Kansas Legislature there is a lot of confusion regarding this new law, and how it affects the  practice of Advanced Practice Registered Nurses (APRNs). 

We’ve heard from many of you with specific questions about the implications of the new law. To help bring some clarity to what the law says and what it may mean for your practice, we’ve created an FAQ at www.kmsonline.org/APRN to address such questions as best as we can know at this point.

Temporary regulations implementing the new law have yet to be issued by the Kansas State Board of Nursing (KSBN). The temporary regulations must be issued before the new law becomes effective July 1, 2022, and there will likely be no opportunity for public comment prior to the temporary regulations taking effect. However, permanent regulations will then be developed and issued for public comment in the next few months by the KSBN, which will be the first time that interested parties, including KMS, will have the opportunity to provide formal comments on the regulations. Consequently, there will be a period of time, perhaps several months, before any changes to the temporary regulations could be considered and adopted. It is KMS’s intent to update this APRN FAQ tool as information becomes available and to keep you apprised via this tool and email updates.

As we have explained in previous newsletters, KMS opposed this legislation, even though it was a more limited, scaled-back version of APRN bills that have been introduced continuously over the past several years. This bill only affects the prescribing of drugs and durable medical equipment by APRNs. It eliminates the requirement that an APRN must have a written protocol from a physician that authorizes an APRN to prescribe drugs. In other words, after July 1, APRNs will not be required by law to have a written protocol in order to prescribe. However, the bill does not prohibit the use of collaborative practice agreements or other supervisory practice agreements or prescribing protocols if the employing clinic, hospital, or other health care facility chooses to continue to utilize a physician-directed/led team delivery model for their facility’s clinical services.

The only other change in the law is a new requirement that APRNs must carry medical malpractice insurance unless they are serving in active duty in the military; or practicing as a charitable health care provider; or employed by an entity that is covered by the federal or state tort claims act (which are typically state or local government-operated or affiliated facilities). 

Because the bill lacked much in the way of normal statutory guidance and specificity, it raises more questions than it answers about APRN practice. For example, while it authorizes APRNs to prescribe drugs and durable medical equipment, it does not refer to nor authorize them to do other acts that constitute the practice of medicine, such as ordering labs, imaging, performing procedures, surgery, etc.

Once the permanent regulations are promulgated and published by the KSBN, other parties will have the opportunity to comment on whether the Board’s regulations are consistent with the new legislation or exceed what was clearly authorized in the plain reading of the bill’s text. In the meantime, the next several months are likely to be somewhat confusing for all, especially physicians who work with and/or employ APRNs, as well as hospitals, nursing, and other health care facilities, as well as APRNs themselves. As noted above, we will keep you apprised of developments concerning the APRN regulations and practice, using this newsletter and our website. 

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New resources for helping health care providers screen for colon cancer
Nearly one in three adults in the U.S. aren’t getting screened for colon cancer as recommended. Yet, colon cancer has a 90% survival rate when detected early. With that in mind, the American Society for Gastrointestinal Endoscopy (ASGE) would like to invite you to join in a new effort to prevent colon cancer. ASGE encourages you to alert your peers to visit ASGE.org/Screening-Physicians and download and use the patient education resources that are featured there, including practice/office posters, patient letters, and articles that can be submitted to local newspapers. Simple awareness and proper screening for colon cancer can 9 times out of 10 save lives.

Act supporting access to mental health support for providers
In March, President Biden signed into law the Dr. Lorna Breen Health Care Provider Protection Act, which received bipartisan support. This Act increases access to mental health care for health care providers and provides financial resources and other avenues of support aimed at addressing the stigma of physician mental health.

Dr. Lorna Breen died by suicide on April 26, 2020. In a period of three weeks, Dr. Breen treated COVID-19 patients, contracted COVID-19 herself, and then returned to an emergency department overwhelmed with patients sick with COVID-19. According to the FSPHP, Dr. Breen was terrified of the stigma of having depression. She was afraid she would lose her hospital privileges and her medical license. She did not know that her state PHP was available to help and that she could receive help, confidentially, without adverse professional consequences.

The Kansas Medical Society offers a Professional Health Program to all Kansas physicians, whether or not members of KMS. To learn more about the program or contact our services, visit www.kmsonline.org/php.

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If you have questions about this update or other matters, please contact KMS Executive Director Rachelle Colombo: This email address is being protected from spambots. You need JavaScript enabled to view it.