Session of 1999
         
SENATE BILL No. 200
         
By Committee on Education
          
2-2
          
  9             AN  ACT concerning the university of Kansas school of medicine schol-
10             arships; reconciling a conflict in the definition of state medial care
11             facility or institution; amending K.S.A. 76-375 and repealing the exist-
12             ing section; also repealing K.S.A. 76-375a.
13      
14       Be it enacted by the Legislature of the State of Kansas:
15             Section  1. K.S.A. 76-375 is hereby amended to read as follows: 76-
16       375. (a) On or before December 31 in each year, the chancellor of the
17       university of Kansas, or the designee of the chancellor, shall prepare a
18       list of the areas of this state which the chancellor, or designee of the
19       chancellor, determines to be critically medically underserved areas by
20       specialty and the areas of this state which the chancellor, or designee of
21       the chancellor, determines to be medically underserved areas by specialty.
22       In preparing such a list the chancellor, or designee of the chancellor, shall
23       consult with the medical scholarship advisory committee. All state med-
24       ical care facilities or institutions, all medical centers operated in the state
25       of Kansas by the veterans administration of the United States, and all full-
26       time faculty positions at the university of Kansas school of medicine in
27       family medicine or family practice are qualified for service in both service
28       commitment area I and service commitment area II without being de-
29       termined medically underserved areas. In preparing such a list, the por-
30       tion of time of persons engaged in the practice of medicine and surgery
31       at any institution under the jurisdiction and control of the secretary of
32       social and rehabilitation services shall not be included in determining
33       whether an area is critically medically underserved or medically under-
34       served. Every such list shall note that all state medical care facilities or
35       institutions qualify for such service commitments, in addition to listing
36       those areas determined to be critically medically underserved or medi-
37       cally underserved. Critically medically underserved areas by specialty and
38       medically underserved areas by specialty established prior to the effective
39       date of this act by the secretary of health and environment shall continue
40       in effect for the purposes of this act until changed by the chancellor of
41       the university of Kansas, or the designee of the chancellor. The chancellor
42       of the university of Kansas, or the designee of the chancellor, upon a
43       finding of exceptional circumstances may modify areas or portions of areas

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  1       determined to be critically medically underserved or medically underser-
  2       ved by specialty.
  3             (b)  (1) A service commitment area shall be designated as a service
  4       commitment area I or a service commitment area II. Service commitment
  5       area I shall be any area determined by the chancellor of the university of
  6       Kansas, or the designee of the chancellor, under subsection (a) to be, for
  7       purposes of all agreements entered into under K.S.A. 76-374 and amend-
  8       ments thereto, a medically underserved area or a critically medically un-
  9       derserved area. Service commitment area II shall be, for purposes of all
10       agreements entered into under K.S.A. 76-374 and amendments thereto,
11       the state of Kansas.
12             (2) The service commitment area I or II for persons first awarded
13       scholarships after December 31, 1985, shall be an incorporated city of
14       this state as specified in subsection (d)(2) of K.S.A. 76-374 and amend-
15       ments thereto, all state medical care facilities or institutions, all medical
16       centers operated in the state of Kansas by the veterans administration of
17       the United States, and the full-time faculty positions at the university of
18       Kansas school of medicine in general internal medicine, general pediat-
19       rics, family medicine or family practice, except that, at the time any person
20       commences satisfying a service commitment under this subsection as a
21       full-time faculty member, the number of persons satisfying service com-
22       mitments or service obligations, pursuant to agreements under K.S.A. 76-
23       374 and amendments thereto or the medical student loan act, as full-time
24       faculty members pursuant to this subsection shall not exceed the number
25       equal to 25% of the total number of full-time faculty members of the
26       university of Kansas school of medicine in general internal medicine, gen-
27       eral pediatrics, family medicine or family practice.
28             (c) In selecting a service commitment area I or II, whichever is ap-
29       plicable, prior to the commencement of the full-time practice of medicine
30       and surgery pursuant to all agreements entered into under K.S.A. 76-374
31       and amendments thereto requiring service for a period of time in a service
32       commitment area I or II, whichever is applicable, the person so selecting
33       shall select such area from among those areas appearing on the list of
34       areas prepared by the chancellor of the university of Kansas, or the des-
35       ignee of the chancellor, under this section. The service commitment area
36       selected shall have appeared on any such list not more than 36 months
37       prior to the commencement of such full-time practice of medicine and
38       surgery by the person selecting such service commitment area. Upon the
39       selection of such service commitment area, the person so selecting shall
40       inform the university of Kansas school of medicine of the area selected.
41             (d) A person serving in a service commitment area I or II, whichever
42       is applicable, pursuant to any agreement under this act may serve all or
43       part of any commitment in the service commitment area initially selected

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  1       by such person. If such person moves from one service commitment area
  2       I or II to another service commitment area I or II, as applicable, such
  3       person shall notify the university of Kansas school of medicine of such
  4       person's change of service commitment area. Service in any such service
  5       commitment area I or II, as applicable, selected from the appropriate lists
  6       of service commitment areas, shall be deemed to be continuous for the
  7       purpose of satisfying any agreement entered into under this act. Any
  8       service commitment area I or II, as applicable, selected after the initially
  9       selected service commitment area I or II shall have appeared on a service
10       commitment area I list or on a service commitment area II list, as appli-
11       cable, which shall have been prepared not more than 12 months prior to
12       the move by such person from one service commitment area I or II to
13       another service commitment area I or II, as applicable.
14             (e)  (1) A person awarded a scholarship prior to January 1, 1986, may
15       satisfy the obligation to engage in the full-time practice of medicine and
16       surgery in a service commitment area I even though such person is en-
17       gaged in such practice in two or more locations within the state of Kansas,
18       at least one of which is not located in a service commitment area I, if the
19       person is engaged in the full-time practice of medicine and surgery in
20       such locations pursuant to a practice affiliation agreement approved by
21       the chancellor of the university of Kansas, or the designee of the
22       chancellor.
23             (2) A person awarded a scholarship prior to January 1, 1986, may
24       satisfy the obligation to engage in the full-time practice of medicine and
25       surgery in either service commitment area I or service commitment area
26       II by performing at least 100 hours per month of on-site primary care as
27       defined in K.S.A. 76-374 and amendments thereto at a medical facility
28       operated by a local health department or nonprofit organization in this
29       state serving medically indigent persons. As used in this paragraph, "med-
30       ically indigent" means a person: (A) Who is unable to secure health care
31       because of inability to pay for all or a part of the costs thereof due to
32       inadequate personal resources, being uninsured, being underinsured, be-
33       ing ineligible for governmental health benefits; or (B) who is eligible for
34       governmental benefits but is unable to obtain medical services.
35             (3) A person awarded a scholarship prior to January 1, 1986, may
36       satisfy the obligation to engage in the full-time practice of medicine and
37       surgery in either service commitment area I or II by engaging in such
38       full-time practice of medicine and surgery, other than in a primary care
39       specialty, anywhere in the state of Kansas with the exception of the fol-
40       lowing counties: Douglas, Johnson, Leavenworth, Sedgwick, Shawnee or
41       Wyandotte, except that the full-time practice of medicine and surgery
42       within the six listed counties will qualify if the selected county is desig-
43       nated as a service commitment area I or II in accordance with the pro-

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  1       visions of this section, or whenever there are fewer than three persons
  2       engaged in the full-time practice of medicine and surgery in a designated
  3       specialty in the selected county. Any person who satisfies the obligation
  4       to engage in the full-time practice of medicine and surgery in accordance
  5       with this subsection (e)(3) shall remain obligated to repay the amounts
  6       received for living expenses as prescribed in subsection (a)(5) of K.S.A.
  7       75-376 and amendments thereto. As used in this subsection (e)(3), "pri-
  8       mary care" means general pediatrics, general internal medicine or family
  9       practice.
10             (f) A person awarded a scholarship in accordance with the provisions
11       of K.S.A. 76-373 through 76-377a and amendments thereto may satisfy
12       the obligation to engage in the practice of medicine and surgery, under
13       an agreement entered into pursuant to K.S.A. 76-374 and amendments
14       thereto even though such person is engaged in practice in an area not
15       designated a medically underserved area by specialty, or a critically med-
16       ically underserved area by specialty, through employment on a part-time
17       basis by the state of Kansas which has been approved by the chancellor
18       of the university of Kansas, or the designee of the chancellor, for the
19       practice of medicine and surgery at any state medical care facility or
20       institution.
21             (g) In connection with the determination of critically medically un-
22       derserved areas and medically underserved areas under this section, the
23       chancellor of the university of Kansas, or the designee of the chancellor,
24       shall assess annually the need in the state as a whole for medical services
25       provided by persons engaged in the practice of medicine and surgery and
26       shall report thereon annually to the legislature. Each report shall include
27       any recommendations for needed legislation, including any recom-
28       mended amendments to this act, which relate to the need for such med-
29       ical services in the various areas of this state.
30             (h) There is hereby established the medical scholarship advisory com-
31       mittee. Members of the medical scholarship advisory committee shall be
32       appointed by the chancellor of the university of Kansas as follows: (1)
33       One member shall be from the office of the chancellor of the university
34       of Kansas; (2) one member shall be a representative of the Kansas medical
35       society; (3) one member shall be a member of the Kansas legislature; (4)
36       one member shall be a student at the university of Kansas school of med-
37       icine; and (5) one member shall be a representative of the Kansas hospital
38       association. The medical scholarship advisory committee shall meet pe-
39       riodically upon the call of the chancellor, or the designee of the chancel-
40       lor, and shall make recommendations to the chancellor, or the designee
41       of the chancellor, in regard to the administration of the provisions of this
42       act.
43             (i) The chancellor of the university of Kansas may appoint a medical

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  1       scholarship program coordinator for the purpose of planning and admin-
  2       istering the provisions of this act. The coordinator shall be in the unclas-
  3       sified service under the Kansas civil service act.
  4             (j) For all purposes under this section, service or employment after
  5       June 30, 1988, on a part-time basis (1) pursuant to a practice affiliation
  6       agreement approved by the chancellor of the university of Kansas, or the
  7       chancellor's designee, or (2) at a state medical care facility or institution,
  8       shall be on the basis of at least the equivalent of 12 time in order to satisfy
  9       the obligation to engage in the practice of medicine and surgery under
10       an agreement entered into pursuant to K.S.A. 76-374 and amendments
11       thereto.
12             (k) As used in this section, "state medical care facility or institution"
13       includes, but is not limited to, the Kansas state school for the visually
14       handicapped, the Kansas state school for the deaf, any institution under
15       the secretary of social and rehabilitation services, as defined by subsection
16       (b) of K.S.A. 76-12a01 and amendments thereto, any institution under
17       the commissioner of juvenile justice, as defined by K.S.A. 38-1602, and
18       amendments thereto, the Kansas soldiers' home, the Kansas veterans'
19       home and any correctional institution under the secretary of corrections,
20       as defined by subsection (d) of K.S.A. 75-5202 and amendments thereto,
21       but shall not include any state educational institution under the state
22       board of regents, as defined by subsection (a) of K.S.A. 76-711 and
23       amendments thereto, except as specifically provided by statute. 
24       Sec.  2. K.S.A. 76-375 and 76-375a are hereby repealed.
25        Sec.  3. This act shall take effect and be in force from and after its
26       publication in the statute book.