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Session of 2000
          SENATE BILL No. 599           By Committee on Public Health and Welfare           2-9          

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  9             AN  ACT providing for licensure of physician assistants; providing for the
10             regulation of the practice thereof; amending K.S.A. 40-2,111, 65-
11             2896a, 65-2896c, 65-2896d, 65-2896f, 65-2896g, 65-2897a, 65-2897b
12             and 75-6102 and K.S.A. 1999 Supp. 65-2896, 65-2896b, 65-2896e, 17-
13             2707, 38-135, 40-3401, 65-118, 65-4915, 65-6112, 65-6135 and 65-
14             6701 and repealing the existing sections; also repealing K.S.A. 65-
15             2896h.
16      
17       Be it enacted by the Legislature of the State of Kansas:
18             Section  1. K.S.A. 1999 Supp. 65-2896 is hereby amended to read as
19       follows: 65-2896. (a) The state board of healing arts shall maintain a reg-
20       ister of the names of physicians' physician assistants registered licensed
21       in accordance with the provisions of K.S.A. 65-2896a and amendments
22       thereto.
23             (b) All registrations licenses, except temporary registration licenses,
24       shall expire on the date of expiration established by rules and regulations
25       of the state board of healing arts and may be renewed annually upon
26       request of the registrant as required by the board. The request for re-
27       newal shall be on a form provided by the state board of healing arts and
28       shall be accompanied by the renewal fee established pursuant to this
29       section, which shall be paid not later than the expiration date of the reg-
30       istration license.
31             (c) At least 30 days before the expiration of the registration license of
32       a physician assistant, except a temporary registration license, the state
33       board of healing arts shall notify the registrant licensee of the expiration
34       by mail addressed to the registrant's licensee's last place of residence as
35       noted upon the office records of the board. If the registrant licensee fails
36       to pay the renewal fee by the date of expiration of the registration license,
37       the registrant licensee shall be given a second notice that the registrant's
38       registration licensee's license has expired and the registration license may
39       be renewed only if the renewal fee and the late renewal fee are received
40       by the state board of healing arts within the 30-day period following the
41       date of expiration and that, if both fees are not received within the 30-
42       day period, the registration license shall be considered to have lapsed for
43       failure to renew and shall be reissued only after the physician assistant

2
  1       has been reinstated under subsection (d).
  2             (d) Any registrant licensee who allows the registrant's registration li-
  3       censee's license to lapse by failing to renew as herein provided may be
  4       reinstated upon recommendation of the state board of healing arts and
  5       upon payment of the renewal fee and the reinstatement fee and upon
  6       submitting evidence of satisfactory completion of any applicable contin-
  7       uing education requirements established by the board. The board shall
  8       adopt rules and regulations establishing appropriate continuing education
  9       requirements for reinstatement of persons whose registrations licenses
10       have lapsed for failure to renew.
11             (e) The following fees shall be fixed by rules and regulations adopted
12       by the state board of healing arts and shall be collected by the board:
13             (1) For registration licensure as a physician assistant, the sum of not
14       more than $200 $150;
15             (2) for temporary registration licensure as a physician assistant, the
16       sum of not more than $30;
17             (3) for the renewal of registration a license as a physician assistant,
18       the sum of not more than $150 $100;
19             (4) for the late renewal of registration a license as a physician assis-
20       tant, the sum of not more than $250;
21             (5) for reinstatement of a physician assistant whose name has been
22       removed from the register license has been canceled, the sum of not more
23       than $250;
24             (6) for a certified statement from the board that a physician assistant
25       is registered licensed in this state, the sum of not more than $30; and
26             (7) for a copy of the registration licensure certificate of a physician
27       assistant, the sum of not more than $25; and.
28             (8) for written verification of any registration, the sum of not more
29       than $25.
30             (f) The state board of healing arts shall remit all moneys received by
31       or for the board under the provisions of this act to the state treasurer and
32       such money shall be deposited in the state treasury, credited to the state
33       general fund and the healing arts fee fund and expended all in accordance
34       with K.S.A. 65-2855 and amendments thereto.
35             (g) The state board of healing arts may adopt rules and regulations
36       necessary to carry out the provisions of this act and the act of which this
37       section is amendatory. The board shall promulgate all necessary rules and
38       regulations, not inconsistent herewith, for carrying out the provisions of
39       this act. It may also adopt rules and regulations supplementing any of the
40       provisions herein contained but not inconsistent with this act.
41             Sec.  2. K.S.A. 65-2896a is hereby amended to read as follows: 65-
42       2896a. (a) No person's name person shall be entered on the register of
43       physicians' assistants licensed as a physician assistant by the state board

3
  1       of healing arts unless such person has:
  2             (1) Presented to the state board of healing arts proof of graduation
  3       from an accredited high school or the equivalent thereof; and
  4             (2) Presented to the state board of healing arts proof that the appli-
  5       cant has successfully completed a course of education and training ap-
  6       proved by the state board of healing arts for the education and training
  7       of physicians' assistants or presented to the state board of healing arts
  8       proof that the applicant has acquired experience while serving in the
  9       armed forces of the United States which experience is equivalent to the
10       minimum experience requirements established by the state board of heal-
11       ing arts a physician assistant;
12             (3) (2) passed an examination approved by the state board of healing
13       arts covering subjects incident to the education and training of physicians'
14       assistants a physician assistant; and
15             (4) presented to the state board of healing arts a request signed by
16       the applicant's proposed responsible physician on a form provided by the
17       board which shall contain such information as required by rules and reg-
18       ulations adopted by the board
19             (3) submitted to the state board of healing arts any other information
20       the state board of healing arts deems necessary to evaluate the applicant's
21       qualifications.
22             (b) The board may refuse to enter license a person's name on the
23       register of physicians' assistants person as a physician assistant upon any
24       of the grounds for which the board may remove a person's name from
25       such register revoke such license.
26             (c) A physician's assistant shall at the time of initial registration and
27       any renewal thereof present to the state board of healing arts the name
28       and address of such person's responsible physician. Whenever a physi-
29       cian's assistant shall cease to be employed by the responsible physician,
30       such responsible physician shall notify the state board of healing arts of
31       such termination. Whenever a physician's assistant shall seek to obtain a
32       new responsible physician prior to the renewal of the physician's assis-
33       tant's annual registration, such proposed responsible physician shall notify
34       the state board of healing arts of such prospective employment and shall
35       provide a request as required by subsection (a)(4). All such notifications
36       shall be given to the state board of healing arts as soon as practicable but
37       not be less than 10 days prior to the prospective date of employment.
38             (d) (c) The state board of healing arts shall require every physician's
39       physician assistant to submit with the renewal application evidence of
40       satisfactory completion of a program of continuing education required by
41       the state board of healing arts. The state board of healing arts by duly
42       adopted rules and regulations shall establish the requirements for such
43       program of continuing education as soon as possible after the effective

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  1       date of this act. In establishing such requirements the state board of
  2       healing arts shall consider any existing programs of continuing education
  3       currently being offered to physicians' assistants.
  4             (e) (d) A person whose name has been entered on the register of
  5       physicians' physician assistants prior to the effective date of this act shall
  6       not be subject to the provisions of subsection (a), unless such person's
  7       name has been removed from the register of physicians' assistants pur-
  8       suant to the provisions of K.S.A. 65-2896b and amendments thereto.
  9             Sec.  3. K.S.A. 1999 Supp. 65-2896b is hereby amended to read as
10       follows: 65-2896b. (a) The board of healing arts may remove a person's
11       name from the register of physicians' assistants for any of the following
12       reasons:
13             (1) The person whose name is entered on the register of physicians'
14       assistants requests or consents to the removal thereof;
15             (2) the board of healing arts determines that the person whose name
16       is entered on the register of physicians' assistants has not been employed
17       as a physician's assistant or as a teacher or instructor of persons being
18       educated and trained to become physicians' assistants in a course of ed-
19       ucation and training approved by the state board of healing arts under
20       K.S.A. 65-2896a and amendments thereto at some time during the five
21       years immediately preceding the date of such determination;
22             (3) if the board determines, after notice and opportunity to be heard,
23       in accordance with the provisions of the Kansas administrative procedure
24       act, that a physician's assistant has violated any provision of K.S.A. 65-
25       2896 to 65-2897a, inclusive, and amendments thereto, or any rules and
26       regulations adopted pursuant thereto;
27             (4) if the board determines, after notice and opportunity to be heard,
28       in accordance with the provisions of the Kansas administrative procedure
29       act, that the request by the proposed responsible physician pursuant to
30       subsection (a)(4) of K.S.A. 65-2896a and amendments thereto should not
31       be approved; or
32             (5) if the board determines, after notice and opportunity to be heard,
33       in accordance with the provisions of the Kansas administrative procedure
34       act, that a physician assistant has assisted suicide in violation of K.S.A.
35       21-3406 and amendments thereto as established by any of the following:
36             (A) A copy of the record of criminal conviction or plea of guilty for a
37       felony in violation of K.S.A. 21-3406 and amendments thereto.
38             (B) A copy of the record of a judgment of contempt of court for
39       violating an injunction issued under K.S.A. 1999 Supp. 60-4404 and
40       amendments thereto.
41             (C) A copy of the record of a judgment assessing damages under
42       K.S.A. 1999 Supp. 60-4405 and amendments thereto. A licensee's license
43       may be revoked, suspended or limited, or the licensee may be publicly or

5
  1       privately censured, or an application for a license or for reinstatement of
  2       a license may be denied upon a finding of the existence of any of the
  3       following grounds:
  4             (a) The applicant or licensee has committed fraud or misrepresenta-
  5       tion in applying for or securing an original, renewal or reinstated license
  6       including falsely certifying that no licensure, certification or registration
  7       of the licensee as a physician assistant is under current discipline, revo-
  8       cation, suspension or probation for cause resulting from the applicant's
  9       practice as a physician assistant, unless the state board of healing arts
10       considers such condition and agrees to licensure;
11             (b) The board of healing arts may remove a person's name from the
12       register of physicians' assistants or may refuse to place a person's name
13       on the register of physicians' assistants, if the board determines, after
14       notice and opportunity for hearing in accordance with the provisions of
15       the Kansas administrative procedure act, that a physician's assistant has
16       exceeded or has acted outside the scope of authority given the physician's
17       assistant by the responsible physician or by this act. the licensee has com-
18       mitted an act of unprofessional or dishonorable conduct or professional
19       incompetency;
20             (c) the licensee has been convicted of a felony or class A misdemeanor,
21       whether or not related to the provisions of this act;
22             (d) the licensee has used fraudulent or false advertisements;
23             (e) the licensee is addicted to or has distributed intoxicating liquors
24       or drugs for any other than lawful purposes;
25             (f) the licensee has willfully or repeatedly violated the provisions of
26       this act, the pharmacy act of the state of Kansas or the uniform controlled
27       substances act, or any rules and regulations adopted pursuant thereto, or
28       any rules and regulations of the secretary of health and environment
29       which are relevant to the provisions of this act;
30             (g) the licensee has exceeded the scope of their license granted by the
31       state board of healing arts;
32             (h) the licensee has engaged in the practice as a physician assistant
33       under a false or assumed name, or the impersonation of another practi-
34       tioner except that the provisions of this paragraph relating to an assumed
35       name shall not apply to licensees practicing under a professional corpo-
36       ration or other legal entity duly authorized to provide such professional
37       services in the state of Kansas;
38             (i) the licensee has had a license or authorization to practice as a
39       physician assistant revoked, suspended or limited, has been censured or
40       has had other disciplinary action taken, or an application for a license
41       denied, by the proper licensing authority of another state, territory, Dis-
42       trict of Columbia, or other country, a certified copy of the record of the
43       action of the other jurisdiction being conclusive evidence thereof;

6
  1             (j) the licensee has violated any lawful rule and regulation promul-
  2       gated by the board or violated any lawful order or directive of the board
  3       previously entered by the board;
  4             (k) the licensee has cheated on or attempted to subvert the validity of
  5       the examination for a license;
  6             (l) the licensee has transmitted a prescription order for, sold, admin-
  7       istered, distributed or given a controlled substance to any person for other
  8       than medically accepted or lawful purposes;
  9             (m) the licensee has intentionally violated a federal law or regulation
10       relating to controlled substances;
11             (n) the licensee has failed to furnish the board, or its investigators or
12       representatives, any information legally requested by the board;
13             (o) sanctions or disciplinary actions have been taken against the li-
14       censee by a peer review committee, health care facility, a governmental
15       agency or department or a professional association or society for acts or
16       conduct similar to acts or conduct which would constitute grounds for
17       disciplinary action under this section;
18             (p) the licensee has failed to report to the board any adverse action
19       taken against the licensee by another state or licensing jurisdiction, a peer
20       review body, a health care facility, a professional association or society,
21       a governmental agency, by a law enforcement agency or a court for acts
22       or conduct similar to acts or conduct which would constitute grounds for
23       disciplinary action under this section;
24             (q) the licensee has surrendered a license or authorization to practice
25       as a physician assistant in another state or jurisdiction, has surrendered
26       the authority to utilize controlled substances issued by any state or federal
27       agency, has agreed to a limitation to or restriction of privileges at any
28       medical care facility or has surrendered the licensee's membership on any
29       professional staff or in any professional association or society while under
30       investigation for acts or conduct similar to acts or conduct which would
31       constitute grounds for disciplinary action under this section;
32             (r) the licensee has failed to report to the board surrender of the
33       licensee's license or authorization to practice as a physician assistant in
34       another state or jurisdiction or surrender of the licensee's membership on
35       any professional staff or in any professional association or society while
36       under investigation for acts or conduct similar to acts or conduct which
37       would constitute grounds for disciplinary action under this section;
38             (s) the licensee has an adverse judgment, award or settlement against
39       the licensee resulting from a professional liability claim related to acts or
40       conduct similar to acts or conduct which would constitute grounds for
41       disciplinary action under this section;
42             (t) the licensee has failed to report to the board any adverse judgment,
43       settlement or award against the licensee resulting from a professional li-

7
  1       ability claim related to acts or conduct similar to acts or conduct which
  2       would constitute grounds for disciplinary action under this section;
  3             (u) the licensee has knowingly submitted any misleading, deceptive,
  4       untrue or fraudulent representation on a claim form, bill or statement.
  5             Sec.  4. K.S.A. 65-2896c is hereby amended to read as follows: 65-
  6       2896c. (a) It shall be unlawful for any person who is not licensed under
  7       this act or whose license has been revoked or suspended to engage in the
  8       practice as a physician assistant as defined by this act.
  9             (b) No person shall use the title registered physician's assistant or
10       words of like effect or the abbreviation ``R.P.A.'' any title, abbreviation,
11       letters, figures, sign, card or device to indicate that any person is a licensed
12       physician assistant, nor shall any person represent himself or herself one-
13       self to be a registered physician's licensed physician assistant unless such
14       person's name is entered on the register of the names of physicians' as-
15       sistants person has been duly licensed as a physician assistant in accord-
16       ance with the provisions of this act.
17             (b) (c) The provisions of this act shall not be construed to include the
18       following persons:
19             (1) Persons rendering gratuitous services in the case of an emergency.
20             (2) Persons gratuitously administering ordinary household remedies.
21             (3) The members of any church practicing their religious tenets pro-
22       vided they shall not be exempt from complying with all public health
23       regulations of the state.
24             (4) Students while in actual classroom attendance in an approved
25       physician assistant education and training program who after completing
26       one year's study treat diseases under the supervision of an approved
27       instructor.
28             (5) Students upon the completion of at least three years' study in an
29       approved physician assistant education and training program and who,
30       as a part of their academic requirements for a degree, serve a preceptor-
31       ship not to exceed 90 days under the supervision of a licensed physician.
32             (6) Persons whose professional services are performed under the di-
33       rect and personal supervision or by order of or referral from a practitioner
34       who is licensed under the healing arts act.
35             (7) Persons in the general fields of psychology, education and social
36       work, dealing with the social, psychological and moral well-being of in-
37       dividuals or groups provided they do not use drugs and do not hold them-
38       selves out to be physicians, surgeons, osteopathic physicians or
39       chiropractors.
40             (8) Physician assistants in the United States army, navy, air force,
41       public health service, and coast guard or other military service when
42       acting in the line of duty in this state.
43             (9) Physician assistants licensed in another state when and while in-

8
  1       cidentally called into this state in consultation with practitioners licensed
  2       in this state, or residing on the border of a neighboring state, duly licensed
  3       under the laws thereof to practice as a physician assistant, but who do
  4       not open an office or maintain or appoint a place to regularly meet pa-
  5       tients or to receive calls within this state.
  6             (10) Dentists practicing their professions, when licensed and practic-
  7       ing in accordance with the provisions of article 14 of chapter 65 of the
  8       Kansas Statutes Annotated, and amendments thereto, and any interpre-
  9       tation thereof by the supreme court of this state.
10             (11) Optometrists practicing their professions, when licensed and
11       practicing under and in accordance with the provisions of article 15 of
12       chapter 65 of the Kansas Statutes Annotated, and amendments thereto,
13       and any interpretation thereof by the supreme court of this state.
14             (12) Nurses practicing their profession when licensed and practicing
15       under and in accordance with the provisions of article 11 of chapter 65
16       of the Kansas Statutes Annotated, and amendments thereto, and any in-
17       terpretation thereof by the supreme court of this state.
18             (13) Podiatrists practicing their profession, when licensed and prac-
19       ticing under and in accordance with the provisions of article 20 of chapter
20       65 of the Kansas Statutes Annotated, and amendments thereto, and any
21       interpretation thereof by the supreme court of this state.
22             (14) Pharmacists practicing their profession, when licensed and prac-
23       ticing under and in accordance with the provisions of article 16 of chapter
24       65 of the Kansas Statutes Annotated, and amendments thereto, and any
25       interpretation thereof by the supreme court of this state.
26             (15) A dentist licensed in accordance with the provisions of article 14
27       of chapter 65 of the Kansas Statutes Annotated, and amendments thereto,
28       who administers general and local anesthetics to facilitate medical pro-
29       cedures conducted by a person licensed to practice medicine and surgery
30       if such dentist is certified by the board of healing arts under K.S.A. 65-
31       2899, and amendments thereto, to administer such general and local
32       anesthetics.
33             (d) Any person violating the provisions of this section shall be guilty
34       of a class C misdemeanor.
35             Sec.  5. K.S.A. 65-2896d is hereby amended to read as follows: 65-
36       2896d. (a) The state board of healing arts shall provide for the temporary
37       registration licensure of any physician's physician assistant who has made
38       proper application for registration licensure, has the required qualifica-
39       tions for registration licensure, except for examination, and has paid the
40       prescribed registration license fee. Such temporary registration license
41       shall authorize the person so registered licensed to provide patient serv-
42       ices within the limits of the temporary registration until the date the
43       results of the examination become available license. Not more than one

9
  1       such temporary registration shall be permitted to any one person without
  2       the majority approval of the members of the board.
  3             (b) A temporary license is valid (1) for one year from the date of
  4       issuance or (2) until the state board of healing arts makes a final deter-
  5       mination on the applicant's request for licensure. The state board of heal-
  6       ing arts may extend a temporary license, upon a majority vote of the
  7       members of the board, for a period not to exceed one year.
  8             Sec.  6. K.S.A. 1999 Supp. 65-2896e is hereby amended to read as
  9       follows: 65-2896e. (a) The practice of a physician assistant shall include
10       medical services within the education, training and experience of the phy-
11       sician assistant that are delegated by the responsible physician. Physician
12       assistants practice in a dependent role with a responsible physician, and
13       may perform those duties and responsibilities through delegated authority
14       or written protocol. Medical services rendered by physician assistants
15       may include but are not limited to: (1) Obtaining patient histories, per-
16       forming physical examinations and health assessments; (2) ordering or
17       performing diagnostic and therapeutic procedures, or both; (3) formulat-
18       ing diagnosis; (4) developing and implementing a treatment plan; (5) mon-
19       itoring the effectiveness of therapeutic interventions; (6) assisting in sur-
20       gery; (7) offering counseling and education to meet the patient needs; and
21       (8) making appropriate referrals. These activities may be performed in
22       any setting authorized by the responsible physician, including but not
23       limited to, clinics, hospitals, ambulatory surgical centers, patient homes,
24       nursing homes and other medical institutions.
25             (b) Physician assistants shall be considered the agents of their re-
26       sponsible physicians in the performance of all practice-related activities,
27       including but not limited to, the ordering of diagnostic, therapeutic and
28       other medical services.
29             (c) A person whose name has been entered on the register of physi-
30       cians' assistants licensed as a physician assistant may perform, only under
31       the direction and supervision of a physician, acts which constitute the
32       practice of medicine and surgery to the extent and in the manner au-
33       thorized by the physician responsible for the physician's physician assis-
34       tant and only to the extent such acts are consistent with rules and regu-
35       lations adopted by the board which relate to acts performed by a
36       physician's physician assistant under the responsible physician's direction
37       and supervision. A physician's physician assistant may prescribe drugs
38       pursuant to a written protocol as authorized by the responsible physician.
39             (d) Before a physician's physician assistant shall perform under the
40       direction and supervision of a physician, such physician's physician assis-
41       tant shall be identified to the patient and others involved in providing the
42       patient services as a physician's physician assistant to the responsible phy-
43       sician. Physician assistants licensed under the provisions of this act shall

10
  1       keep their license available for inspection at their primary place of busi-
  2       ness. A physician's physician assistant may not perform any act or pro-
  3       cedure performed in the practice of optometry except as provided in
  4       K.S.A. 65-1508 and 65-2887 and amendments thereto.
  5             (b) (e) The board shall adopt rules and regulations governing the pre-
  6       scribing of drugs by physicians' physician assistants and the responsibil-
  7       ities of the responsible physician with respect thereto. Such rules and
  8       regulations shall establish such conditions and limitations as the board
  9       determines to be necessary to protect the public health and safety. In
10       developing rules and regulations relating to the prescribing of drugs by
11       physicians' physician assistants, the board shall take into consideration
12       the amount of training and capabilities of physicians' physician assistants,
13       the different practice settings in which physicians' physician assistants
14       and responsible physicians practice, the degree of direction and super-
15       vision to be provided by a responsible physician and the needs of the
16       geographic area of the state in which the physician's physician assistant
17       and the responsible physician practice. In all cases in which a physician's
18       physician assistant is authorized to prescribe drugs by a responsible phy-
19       sician, a written protocol between the responsible physician and the phy-
20       sician's physician assistant containing the essential terms of such author-
21       ization shall be in effect. Any written prescription order shall include the
22       name, address and telephone number of the responsible physician. In no
23       case shall the scope of the authority of the physician's physician assistant
24       to prescribe drugs exceed the normal and customary practice of the re-
25       sponsible physician in the prescribing of drugs.
26             (c) (f) The physician's physician assistant may not dispense drugs, but
27       may request, receive and sign for professional samples and may distribute
28       professional samples to patients pursuant to a written protocol as author-
29       ized by the responsible physician. In order to prescribe controlled sub-
30       stances, the physician's physician assistant shall register with the federal
31       drug enforcement administration.
32             (d) (g) As used in this section, ``drug'' means those articles and sub-
33       stances defined as drugs in K.S.A. 65-1626 and 65-4101 and amendments
34       thereto.
35             Sec.  7. K.S.A. 65-2896f is hereby amended to read as follows: 65-
36       2896f. (a) If a responsible physician temporarily leaves his or her such
37       physician's customary area of practice, the responsible physician shall, by
38       prior arrangement, designate a physician who shall provide direction and
39       supervision to the physician's physician assistant of such responsible
40       physician.
41             (b) Nothing in this act shall be construed to prohibit the rendering of
42       services by a physician assistant in a setting geographically remote from
43       the responsible physician.

11
  1             (c) A physician assistant shall at the time of initial licensure and any
  2       renewal thereof present to the state board of healing arts the name and
  3       address of such physician assistant's responsible physician or physicians.
  4       Whenever a physician assistant obtains a new responsible physician or
  5       physicians, such responsible physician or physicians shall notify the state
  6       board of healing arts of such designation. All such notifications shall be
  7       given to the state board of healing arts as soon as practicable but not less
  8       than 10 days prior to the prospective date of employment.
  9             Sec.  8. K.S.A. 65-2896g is hereby amended to read as follows: 65-
10       2896g. No responsible supervising physician shall have under his or her
11       such physician's direction and supervision more than two (2) physicians'
12       physician assistants. The limitation on the number of physician assistants
13       in this section shall not apply to services performed in a medical care
14       facility, as defined in K.S.A. 65-425 and amendments thereto.
15             Sec.  9. K.S.A. 65-2897a is hereby amended to read as follows: 65-
16       2897a. (a) The following words and phrases when used in this act shall
17       have the meanings respectively ascribed to them in this section:
18             (a) (1) ``Direction and supervision'' means the guidance, direction and
19       coordination of activities of a physician's physician assistant by such per-
20       son's physician assistant's responsible physician, whether written or ver-
21       bal, whether immediate or by prior arrangement, in accordance with stan-
22       dards established by the board by rules and regulations, which standards
23       shall be designed to ensure adequate direction and supervision by the
24       responsible physician of the physician's physician assistant. The term ``di-
25       rection and supervision'' shall not be construed to mean that the imme-
26       diate or physical presence of the responsible physician is required during
27       the performance of the physician's physician assistant.
28             (b) (2) ``Physician'' means any person licensed by the state board of
29       healing arts to practice medicine and surgery.
30             (c) ``Physician's (3) ``Physician assistant'' means a skilled person
31       who is registered licensed in accordance with the provisions of K.S.A. 65-
32       2896a and amendments thereto and who is qualified by academic training
33       to provide patient services under the direction and supervision of a phy-
34       sician who is responsible for the performance of that assistant.
35             (d) (4) ``Responsible physician'' means a physician who has accepted
36       continuous and ultimate responsibility for the medical services rendered
37       and actions of the physician's physician assistant while performing under
38       the direction and supervision of the responsible physician.
39             (5) ``Scope of practice'' means a physician assistant practicing medi-
40       cine as delegated by a responsible physician.
41             (6) ``Supervising physician'' means a responsible physician or a phy-
42       sician designated by the responsible physician to ensure direction and
43       supervision of the physician assistant in the responsible physician's ab-

12
  1       sence. A supervising physician shall be subject to the same requirements
  2       imposed upon the responsible physician when the supervising physician
  3       is acting as a responsible physician.
  4             (b) As used in K.S.A. 65-2896b and amendments thereto and in this
  5       section:
  6             (1) ``Professional incompetency'' means:
  7             (A) One or more instances involving failure to adhere to the appli-
  8       cable standard of care to a degree which constitutes gross negligence, as
  9       determined by the board.
10             (B) Repeated instances involving failure to adhere to the applicable
11       standard of care to a degree which constitutes ordinary negligence, as
12       determined by the board.
13             (C) A pattern of practice or other behavior which demonstrates a
14       manifest incapacity or incompetence to practice as a physician assistant.
15             (2) ``Unprofessional conduct'' means:
16             (A) Solicitation of professional patronage through the use of fraudu-
17       lent or false advertisements, or profiting by the acts of those representing
18       themselves to be agents of the licensee.
19             (B) Representing to a patient that a manifestly incurable disease, con-
20       dition or injury can be permanently cured.
21             (C) Assisting in the care or treatment of a patient without the consent
22       of the patient, the attending physician or the patient's legal
23       representatives.
24             (D) The use of any letters, words, or terms, as an affix, on stationary,
25       in advertisements, or otherwise indicating that such person is entitled to
26       practice any health care profession for which such person is not licensed.
27             (E) Willful betrayal of confidential information.
28             (F) Advertising professional superiority or the performance of pro-
29       fessional services in a superior manner.
30             (G) Advertising to guarantee any professional service or to perform
31       any operation painlessly.
32             (H) Writing a prescription order for, dispensing, administering, sell-
33       ing, supplying or giving any amphetamines or sympathomimetic amines,
34       except as authorized by K.S.A. 65-2837a and amendments thereto.
35             (I) Conduct likely to deceive, defraud or harm the public.
36             (J) Making a false or misleading statement regarding the licensee's
37       skill or the efficacy or value of the drug, treatment or remedy prescribed
38       by the licensee or at the licensee's direction in the treatment of any disease
39       or other condition of the body or mind.
40             (K) Aiding or abetting the practice of the healing arts by an unli-
41       censed, incompetent or impaired person.
42             (L) Allowing another person or organization to use the licensee's li-
43       cense to practice as a physician assistant.

13
  1             (M) Commission of any act of sexual abuse, misconduct or exploita-
  2       tion related to the licensee's professional practice.
  3             (N) The use of any false, fraudulent or deceptive statement in any
  4       document connected with the practice as a physician assistant including
  5       the intentional falsifying or fraudulent altering of a patient or medical
  6       care facility record.
  7             (O) Obtaining any fee by fraud, deceit or misrepresentation.
  8             (P) Directly or indirectly giving or receiving any fee, commission,
  9       rebate or other compensation for professional services not actually and
10       personally rendered, other than through the legal functioning of lawful
11       professional partnerships, corporations or associations.
12             (Q) Performing unnecessary tests, examinations or services which
13       have no legitimate medical purpose.
14             (R) Charging an excessive fee for services rendered.
15             (S) Writing or transmitting a prescription order for, dispensing, ad-
16       ministering, distributing a prescription drug or substance, including a
17       controlled substance, in an excessive, improper or inappropriate manner
18       or quantity or not in the course of the licensee's professional practice.
19             (T) Repeated failure to practice as a physician assistant with that level
20       of care, skill and treatment which is recognized by a reasonably prudent
21       similar practitioner as being acceptable under similar conditions and
22       circumstances.
23             (U) Failure to keep written medical records which accurately describe
24       the services rendered to the patient, including patient histories, pertinent
25       findings, examination results and test results.
26             (V) Delegating professional responsibilities to a person when the li-
27       censee knows or has reason to know that such person is not qualified by
28       training, experience or licensure to perform them.
29             (W) Using experimental forms of therapy without proper informed
30       patient consent, without conforming to generally accepted criteria or stan-
31       dard protocols, without keeping detailed legible records or without having
32       periodic analysis of the study and results reviewed by a committee or
33       peers.
34             (X) Writing or transmitting a prescription order for, dispensing, ad-
35       ministering or distributing an anabolic steroid or human growth hormone
36       for other than a valid medical purpose. Bodybuilding, muscle enhance-
37       ment or increasing muscle bulk or strength through the use of an anabolic
38       steroid or human growth hormone by a person who is in good health is
39       not a valid medical purpose.
40             (3) ``False advertisement'' means any advertisement which is false,
41       misleading or deceptive in a material respect. In determining whether any
42       advertisement is misleading, there shall be taken into account not only
43       representations made or suggested by statement, word, design, device,

14
  1       sound or any combination thereof, but also the extent to which the ad-
  2       vertisement fails to reveal facts material in the light of such representa-
  3       tions made.
  4             (4) ``Advertisement'' means all representations disseminated in any
  5       manner or by any means, for the purpose of inducing, or which are likely
  6       to induce, directly or indirectly, the purchase of professional services.
  7             (5) ``Licensee'' for purposes of this act, shall mean all persons issued
  8       a license, or temporary license pursuant to this act.
  9             (6) ``License'' for purposes of this act, shall mean any license, or tem-
10       porary license granted by this act.
11             Sec.  10. K.S.A. 65-2897b is hereby amended to read as follows: 65-
12       2897b. (a) There is established a physician's physician assistant council
13       to advise the board in carrying out the provisions of K.S.A. 65-2896 to
14       65-2897a, inclusive, and amendments thereto. The council shall consist
15       of five members, all citizens and residents of the state of Kansas appointed
16       as follows: One member shall be a physician appointed by the state board
17       of healing arts who is a responsible physician for a physician's physician
18       assistant; one member shall be the president of the state board of healing
19       arts or a person designated by the president; and three members shall be
20       physician's licensed physician assistants appointed by the governor. The
21       governor, insofar as possible, shall appoint persons from different geo-
22       graphical areas and persons who represent various types of practice set-
23       tings. If a vacancy occurs on the council, the appointing authority of the
24       position which has become vacant shall appoint a person of like qualifi-
25       cations to fill the vacant position for the unexpired term, if any. The
26       Kansas academy of physicians' physician assistants shall recommend the
27       names of physicians' licensed physician assistants to the governor in a
28       number equal to at least twice the positions or vacancies to be filled, and
29       the governor may appoint members to fill the positions or vacancies from
30       the submitted list. Members of the council appointed by the governor on
31       and after the effective date of this act shall be appointed for terms of
32       three years and until their successors are appointed and qualified except
33       that of the members first appointed by the governor on or after the ef-
34       fective date of this act one shall be appointed for a term of one year, one
35       shall be appointed for a term of two years and one shall be appointed for
36       a term of three years, as designated by the governor. The member ap-
37       pointed by the state board of healing arts shall serve at the pleasure of
38       the state board of healing arts. A member designated by the president of
39       the state board of healing arts shall serve at the pleasure of the president.
40             (b) Members of the council attending meetings of the council, or
41       attending a subcommittee meeting thereof authorized by the council,
42       shall be paid amounts provided in subsection (e) of K.S.A. 75-3223 and
43       amendments thereto from the healing arts fee fund.

15
  1             Sec.  11. K.S.A. 1999 Supp. 17-2707 is hereby amended to read as
  2       follows: 17-2707. As used in this act, unless the context clearly indicates
  3       that a different meaning is intended, the following words mean:
  4             (a) ``Professional corporation,'' a corporation organized under this act.
  5             (b) ``Professional service,'' the type of personal service rendered by a
  6       person duly licensed by this state as a member of any of the following
  7       professions, each paragraph constituting one type:
  8             (1) A certified public accountant;
  9             (2) An architect;
10             (3) An attorney-at-law;
11             (4) A chiropractor;
12             (5) A dentist;
13             (6) An engineer;
14             (7) An optometrist;
15             (8) An osteopathic physician or surgeon;
16             (9) A physician, surgeon or doctor of medicine;
17             (10) A veterinarian;
18             (11) A podiatrist;
19             (12) A pharmacist;
20             (13) A land surveyor;
21             (14) A licensed psychologist;
22             (15) A specialist in clinical social work;
23             (16) A registered physical therapist;
24             (17) A landscape architect;
25             (18) A registered professional nurse;
26             (19) A real estate broker or salesperson.;
27             (20) A licensed physician assistant.
28             (c) ``Regulating board,'' the board or state agency which is charged
29       with the licensing and regulation of the practice of the profession which
30       the professional corporation is organized to render.
31             (d) ``Qualified person'':
32             (1) Any natural person licensed to practice the same type of profes-
33       sion which any professional corporation is authorized to practice;
34             (2) the trustee of a trust which is a qualified trust under subsection
35       (a) of section 401 of the internal revenue code of 1954, as amended, or
36       of a contribution plan which is a qualified employee stock ownership plan
37       under subsection (a) of section 409A of the internal revenue code of 1954,
38       as amended; or
39             (3) the trustee of a revocable living trust established by a natural
40       person who is licensed to practice the type of profession which any pro-
41       fessional corporation is authorized to practice, if the terms of such trust
42       provide that such natural person is the principal beneficiary and sole
43       trustee of such trust and such trust does not continue to hold title to

16
  1       professional corporation stock following such natural person's death for
  2       more than a reasonable period of time necessary to dispose of such stock.
  3             Sec.  12. K.S.A. 1999 Supp. 38-135 is hereby amended to read as
  4       follows: 38-135. As used in this act:
  5             (a) ``Health care provider'' means a person licensed to practice med-
  6       icine and surgery by the state board of healing arts, a person who holds
  7       a temporary permit to practice medicine and surgery issued by the state
  8       board of healing arts, a person engaged in a postgraduate training pro-
  9       gram in medicine and surgery approved by the state board of healing arts,
10       a medical care facility licensed by the department of health and environ-
11       ment, a health maintenance organization issued a certificate of authority
12       by the commissioner of insurance, a licensed professional nurse, a li-
13       censed practical nurse, a registered physician's licensed physician assis-
14       tant, a professional corporation organized pursuant to the professional
15       corporation law of Kansas by persons who are authorized by such law to
16       form such a corporation and who are health care providers as defined by
17       this subsection, a Kansas limited liability company organized for the pur-
18       pose of rendering professional services by its members who are health
19       care providers as defined by this subsection and who are legally author-
20       ized to render the professional services for which the limited liability
21       company is organized, a partnership of persons who are health care pro-
22       viders as defined by this subsection or a Kansas not-for-profit corporation
23       organized for the purpose of rendering professional services by persons
24       who are health care providers as defined by this subsection.
25             (b) ``Parent'' means:
26             (1) A minor's parent by birth or adoption;
27             (2) a minor's legal guardian; or
28             (3) any person who under court order is authorized to give consent
29       for a minor.
30             Sec.  13. K.S.A. 1999 Supp. 40-3401 is hereby amended to read as
31       follows: 40-3401. As used in this act the following terms shall have the
32       meanings respectively ascribed to them herein.
33             (a) ``Applicant'' means any health care provider.
34             (b) ``Basic coverage'' means a policy of professional liability insurance
35       required to be maintained by each health care provider pursuant to the
36       provisions of subsection (a) or (b) of K.S.A. 40-3402 and amendments
37       thereto.
38             (c) ``Commissioner'' means the commissioner of insurance.
39             (d) ``Fiscal year'' means the year commencing on the effective date
40       of this act and each year, commencing on the first day of that month,
41       thereafter.
42             (e) ``Fund'' means the health care stabilization fund established pur-
43       suant to subsection (a) of K.S.A. 40-3403 and amendments thereto.

17
  1             (f) ``Health care provider'' means a person licensed to practice any
  2       branch of the healing arts by the state board of healing arts with the
  3       exception of physician assistants, a person who holds a temporary permit
  4       to practice any branch of the healing arts issued by the state board of
  5       healing arts, a person engaged in a postgraduate training program ap-
  6       proved by the state board of healing arts, a medical care facility licensed
  7       by the department of health and environment, a health maintenance or-
  8       ganization issued a certificate of authority by the commissioner of insur-
  9       ance, a podiatrist licensed by the state board of healing arts, an optom-
10       etrist licensed by the board of examiners in optometry, a pharmacist
11       licensed by the state board of pharmacy, a licensed professional nurse
12       who is authorized to practice as a registered nurse anesthetist, a licensed
13       professional nurse who has been granted a temporary authorization to
14       practice nurse anesthesia under K.S.A. 65-1153 and amendments thereto,
15       a professional corporation organized pursuant to the professional corpo-
16       ration law of Kansas by persons who are authorized by such law to form
17       such a corporation and who are health care providers as defined by this
18       subsection, a Kansas limited liability company organized for the purpose
19       of rendering professional services by its members who are health care
20       providers as defined by this subsection and who are legally authorized to
21       render the professional services for which the limited liability company
22       is organized, a partnership of persons who are health care providers under
23       this subsection, a Kansas not-for-profit corporation organized for the pur-
24       pose of rendering professional services by persons who are health care
25       providers as defined by this subsection, a dentist certified by the state
26       board of healing arts to administer anesthetics under K.S.A. 65-2899 and
27       amendments thereto, a physical therapist registered by the state board of
28       healing arts, a psychiatric hospital licensed under K.S.A. 75-3307b and
29       amendments thereto, or a mental health center or mental health clinic
30       licensed by the secretary of social and rehabilitation services, except that
31       health care provider does not include (1) any state institution for the
32       mentally retarded, (2) any state psychiatric hospital, (3) any person hold-
33       ing an exempt license issued by the state board of healing arts or (4) any
34       person holding a visiting clinical professor license from the state board of
35       healing arts.
36             (g) ``Inactive health care provider'' means a person or other entity
37       who purchased basic coverage or qualified as a self-insurer on or subse-
38       quent to the effective date of this act but who, at the time a claim is made
39       for personal injury or death arising out of the rendering of or the failure
40       to render professional services by such health care provider, does not
41       have basic coverage or self-insurance in effect solely because such person
42       is no longer engaged in rendering professional service as a health care
43       provider.

18
  1             (h) ``Insurer'' means any corporation, association, reciprocal
  2       exchange, inter-insurer and any other legal entity authorized to write bod-
  3       ily injury or property damage liability insurance in this state, including
  4       workers compensation and automobile liability insurance, pursuant to the
  5       provisions of the acts contained in article 9, 11, 12 or 16 of chapter 40 of
  6       Kansas Statutes Annotated.
  7             (i) ``Plan'' means the operating and administrative rules and proce-
  8       dures developed by insurers and rating organizations or the commissioner
  9       to make professional liability insurance available to health care providers.
10             (j) ``Professional liability insurance'' means insurance providing cov-
11       erage for legal liability arising out of the performance of professional
12       services rendered or which should have been rendered by a health care
13       provider.
14             (k) ``Rating organization'' means a corporation, an unincorporated as-
15       sociation, a partnership or an individual licensed pursuant to K.S.A. 40-
16       930 or 40-1114, or both, and amendments thereto, to make rates for
17       professional liability insurance.
18             (l) ``Self-insurer'' means a health care provider who qualifies as a self-
19       insurer pursuant to K.S.A. 40-3414 and amendments thereto.
20             (m) ``Medical care facility'' means the same when used in the health
21       care provider insurance availability act as the meaning ascribed to that
22       term in K.S.A. 65-425 and amendments thereto, except that as used in
23       the health care provider insurance availability act such term, as it relates
24       to insurance coverage under the health care provider insurance availa-
25       bility act, also includes any director, trustee, officer or administrator of a
26       medical care facility.
27             (n) ``Mental health center'' means a mental health center licensed by
28       the secretary of social and rehabilitation services under K.S.A. 75-3307b
29       and amendments thereto, except that as used in the health care provider
30       insurance availability act such term, as it relates to insurance coverage
31       under the health care provider insurance availability act, also includes any
32       director, trustee, officer or administrator of a mental health center.
33             (o) ``Mental health clinic'' means a mental health clinic licensed by
34       the secretary of social and rehabilitation services under K.S.A. 75-3307b
35       and amendments thereto, except that as used in the health care provider
36       insurance availability act such term, as it relates to insurance coverage
37       under the health care provider insurance availability act, also includes any
38       director, trustee, officer or administrator of a mental health clinic.
39             (p) ``State institution for the mentally retarded'' means Winfield state
40       hospital and training center, Parsons state hospital and training center
41       and the Kansas neurological institute.
42             (q) ``State psychiatric hospital'' means Larned state hospital, Osawa-
43       tomie state hospital, Rainbow mental health facility and Topeka state

19
  1       hospital.
  2             (r) ``Person engaged in residency training'' means:
  3             (1) A person engaged in a postgraduate training program approved
  4       by the state board of healing arts who is employed by and is studying at
  5       the university of Kansas medical center only when such person is engaged
  6       in medical activities which do not include extracurricular, extra-institu-
  7       tional medical service for which such person receives extra compensation
  8       and which have not been approved by the dean of the school of medicine
  9       and the executive vice-chancellor of the university of Kansas medical cen-
10       ter. Persons engaged in residency training shall be considered resident
11       health care providers for purposes of K.S.A. 40-3401 et seq., and amend-
12       ments thereto; and
13             (2) a person engaged in a postgraduate training program approved by
14       the state board of healing arts who is employed by a nonprofit corporation
15       organized to administer the graduate medical education programs of com-
16       munity hospitals or medical care facilities affiliated with the university of
17       Kansas school of medicine or who is employed by an affiliate of the uni-
18       versity of Kansas school of medicine as defined in K.S.A. 76-367 and
19       amendments thereto only when such person is engaged in medical activ-
20       ities which do not include extracurricular, extra-institutional medical serv-
21       ice for which such person receives extra compensation and which have
22       not been approved by the chief operating officer of the nonprofit cor-
23       poration or the chief operating officer of the affiliate and the executive
24       vice-chancellor of the university of Kansas medical center.
25             (s) ``Full-time physician faculty employed by the university of Kansas
26       medical center'' means a person licensed to practice medicine and surgery
27       who holds a full-time appointment at the university of Kansas medical
28       center when such person is providing health care.
29             (t) ``Sexual act'' or ``sexual activity'' means that sexual conduct which
30       constitutes a criminal or tortious act under the laws of the state of Kansas.
31             Sec.  14. K.S.A. 40-2,111 is hereby amended to read as follows: 40-
32       2,111. As used in K.S.A. 40-2,111 through 40-2,113, and amendments
33       thereto: (a) ``Adverse underwriting decision'' means: Any of the following
34       actions with respect to insurance transactions involving insurance cover-
35       age which is individually underwritten:
36             (1) A declination of insurance coverage;
37             (2) a termination of insurance coverage;
38             (3) an offer to insure at higher than standard rates, with respect to
39       life, health or disability insurance coverage; or
40             (4) the charging of a higher rate on the basis of information which
41       differs from that which the applicant or policyholder furnished, with re-
42       spect to property or casualty insurance coverage.
43             (b) ``Declination of insurance coverage'' means a denial, in whole or

20
  1       in part, by an insurance company or agent of requested insurance
  2       coverage.
  3             (c) ``Health care institution'' means any medical care facility, adult
  4       care home, drug abuse and alcoholic treatment facility, home-health
  5       agency certified for federal reimbursement, mental health center or men-
  6       tal health clinic licensed by the secretary of social and rehabilitation serv-
  7       ices, kidney disease treatment center, county, city-county or multicounty
  8       health departments and health-maintenance organization.
  9             (d) ``Health care provider'' means any person licensed to practice any
10       branch of the healing arts, licensed dentist, licensed professional nurse,
11       licensed practical nurse, advanced registered nurse practitioner, licensed
12       optometrist, registered physical therapist, licensed social worker, regis-
13       tered physicians' licensed physician assistant, licensed podiatrist or li-
14       censed psychologist.
15             (e) ``Institutional source'' means any natural person, corporation, as-
16       sociation, partnership or governmental or other legal entity that provides
17       information about an individual to an agent or insurance company, other
18       than:
19             (1) An agent;
20             (2) the individual who is the subject of the information; or
21             (3) a natural person acting in a personal capacity rather than a busi-
22       ness or professional capacity.
23             (f) ``Insurance transaction'' means any transaction involving insur-
24       ance, but not including group insurance coverage, primarily for personal,
25       family or household needs rather than business or professional needs.
26             (g) ``Medical-record information'' means personal information which:
27             (1) Relates to an individual's physical or mental condition, medical
28       history or medical treatment; and
29             (2) is obtained from a health care provider or health care institution,
30       from the individual, or from the individual's spouse, parent or legal
31       guardian.
32             (h) ``Termination of insurance coverage'' or ``termination of an insur-
33       ance policy'' means either a cancellation, nonrenewal or lapse of an in-
34       surance policy, in whole or in part, for any reason other than:
35             (1) The failure to pay a premium as required by the policy ; or
36             (2) at the request or direction of the insured.
37             Sec.  15. K.S.A. 1999 Supp. 65-118 is hereby amended to read as
38       follows: 65-118. (a) Whenever any person licensed to practice the healing
39       arts or engaged in a postgraduate training program approved by the state
40       board of healing arts, licensed dentist, physician's assistant whose name
41       has been entered on the register of physicians' assistants by the state
42       board of healing arts, licensed professional nurse, licensed practical nurse,
43       administrator of a hospital, licensed adult care home administrator, li-

21
  1       censed physician assistant, licensed social worker, teacher or school ad-
  2       ministrator knows or has information indicating that a person is suffering
  3       from or has died from a reportable infectious or contagious disease as
  4       defined in rules and regulations, such knowledge or information shall be
  5       reported immediately to the county or joint board of health or the local
  6       health officer, together with the name and address of the person who has
  7       or is suspected of having the infectious or contagious disease, or the name
  8       and former address of the deceased individual who had or was suspected
  9       of having such a disease. In the case of a licensed hospital or adult care
10       home, the administrator may designate an individual to receive and make
11       such reports. The secretary of health and environment shall, through rules
12       and regulations, make provision for the consolidation of reports required
13       to be made under this section when the person required to make the
14       report is working in a licensed hospital or adult care home. Laboratories
15       certified under the federal clinical laboratories improvement act pursuant
16       to 42 code of federal regulations, 493 shall report the results of micro-
17       biologic cultures, examinations, immunologic essays for the presence of
18       antigens and antibodies and any other laboratory tests which are indicative
19       of the presence of a reportable infectious or contagious disease to the
20       department of health and environment. The director of the division of
21       health may use information from death certificates for disease investiga-
22       tion purposes.
23             (b) Any person who is an individual member of a class of persons
24       designated under subsection (a) of this section and who reports the in-
25       formation required to be reported under such subsection in good faith
26       and without malice to a county or joint board of health, a local health
27       officer or the department of health and environment shall have immunity
28       from any liability, civil or criminal, that might otherwise be incurred or
29       imposed in an action resulting from such report. Any such person shall
30       have the same immunity with respect to participation in any judicial pro-
31       ceeding resulting from such report.
32             (c) Information required to be reported under subsection (a) of this
33       section shall be confidential and shall not be disclosed or made public,
34       upon subpoena or otherwise, beyond the requirements of subsection (a)
35       of this section or subsection (a) of K.S.A. 65-119, except such information
36       may be disclosed: (1) If no person can be identified in the information to
37       be disclosed and the disclosure is for statistical purposes;
38             (2) if all persons who are identifiable in the information to be dis-
39       closed consent in writing to its disclosure;
40             (3) if the disclosure is necessary, and only to the extent necessary, to
41       protect the public health;
42             (4) if a medical emergency exists and the disclosure is to medical
43       personnel qualified to treat infectious or contagious diseases. Any infor-

22
  1       mation disclosed pursuant to this paragraph shall be disclosed only to the
  2       extent necessary to protect the health or life of a named party; or
  3             (5) if the information to be disclosed is required in a court proceeding
  4       involving child abuse and the information is disclosed in camera.
  5             Sec.  16. K.S.A. 1999 Supp. 65-4915 is hereby amended to read as
  6       follows: 65-4915. (a) As used in this section:
  7             (1) ``Health care provider'' means: (A) Those persons and entities
  8       defined as a health care provider under K.S.A. 40-3401 and amendments
  9       thereto; and (B) a dentist licensed by the Kansas dental board, a dental
10       hygienist licensed by the Kansas dental board, a professional nurse li-
11       censed by the board of nursing, a practical nurse licensed by the board
12       of nursing, a mental health technician licensed by the board of nursing,
13       a physical therapist assistant certified by the state board of healing arts,
14       an occupational therapist registered by the state board of healing arts, an
15       occupational therapy assistant registered by the state board of healing
16       arts, a respiratory therapist licensed by the state board of healing arts, a
17       physician's physician assistant registered licensed by the state board of
18       healing arts and attendants and ambulance services certified by the emer-
19       gency medical services board.
20             (2) ``Health care provider group'' means:
21             (A) A state or local association of health care providers or one or more
22       committees thereof;
23             (B) the board of governors created under K.S.A. 40-3403 and amend-
24       ments thereto;
25             (C) an organization of health care providers formed pursuant to state
26       or federal law and authorized to evaluate medical and health care services;
27             (D) a review committee operating pursuant to K.S.A. 65-2840b
28       through 65-2840d, and amendments thereto;
29             (E) an organized medical staff of a licensed medical care facility as
30       defined by K.S.A. 65-425 and amendments thereto, an organized medical
31       staff of a private psychiatric hospital licensed under K.S.A. 75-3307b and
32       amendments thereto or an organized medical staff of a state psychiatric
33       hospital or state institution for the mentally retarded, as follows: Larned
34       state hospital, Osawatomie state hospital, Rainbow mental health facility,
35       Kansas neurological institute and Parsons state hospital and training
36       center;
37             (F) a health care provider;
38             (G) a professional society of health care providers or one or more
39       committees thereof;
40             (H) a Kansas corporation whose stockholders or members are health
41       care providers or an association of health care providers, which corpora-
42       tion evaluates medical and health care services; or
43             (I) an insurance company, health maintenance organization or ad-

23
  1       ministrator of a health benefits plan which engages in any of the functions
  2       defined as peer review under this section.
  3             (3) ``Peer review'' means any of the following functions:
  4             (A) Evaluate and improve the quality of health care services rendered
  5       by health care providers;
  6             (B) determine that health services rendered were professionally in-
  7       dicated or were performed in compliance with the applicable standard of
  8       care;
  9             (C) determine that the cost of health care rendered was considered
10       reasonable by the providers of professional health services in this area;
11             (D) evaluate the qualifications, competence and performance of the
12       providers of health care or to act upon matters relating to the discipline
13       of any individual provider of health care;
14             (E) reduce morbidity or mortality;
15             (F) establish and enforce guidelines designed to keep within reason-
16       able bounds the cost of health care;
17             (G) conduct of research;
18             (H) determine if a hospital's facilities are being properly utilized;
19             (I) supervise, discipline, admit, determine privileges or control mem-
20       bers of a hospital's medical staff;
21             (J) review the professional qualifications or activities of health care
22       providers;
23             (K) evaluate the quantity, quality and timeliness of health care serv-
24       ices rendered to patients in the facility;
25             (L) evaluate, review or improve methods, procedures or treatments
26       being utilized by the medical care facility or by health care providers in
27       a facility rendering health care.
28             (4) ``Peer review officer or committee'' means:
29             (A) An individual employed, designated or appointed by, or a com-
30       mittee of or employed, designated or appointed by, a health care provider
31       group and authorized to perform peer review; or
32             (B) a health care provider monitoring the delivery of health care at
33       correctional institutions under the jurisdiction of the secretary of
34       corrections.
35             (b) Except as provided by K.S.A. 60-437 and amendments thereto
36       and by subsections (c) and (d), the reports, statements, memoranda, pro-
37       ceedings, findings and other records submitted to or generated by peer
38       review committees or officers shall be privileged and shall not be subject
39       to discovery, subpoena or other means of legal compulsion for their re-
40       lease to any person or entity or be admissible in evidence in any judicial
41       or administrative proceeding. Information contained in such records shall
42       not be discoverable or admissible at trial in the form of testimony by an
43       individual who participated in the peer review process. The peer review

24
  1       officer or committee creating or initially receiving the record is the holder
  2       of the privilege established by this section. This privilege may be claimed
  3       by the legal entity creating the peer review committee or officer, or by
  4       the commissioner of insurance for any records or proceedings of the
  5       board of governors.
  6             (c) Subsection (b) shall not apply to proceedings in which a health
  7       care provider contests the revocation, denial, restriction or termination
  8       of staff privileges or the license, registration, certification or other au-
  9       thorization to practice of the health care provider. A licensing agency in
10       conducting a disciplinary proceeding in which admission of any peer re-
11       view committee report, record or testimony is proposed shall hold the
12       hearing in closed session when any such report, record or testimony is
13       disclosed. Unless otherwise provided by law, a licensing agency conduct-
14       ing a disciplinary proceeding may close only that portion of the hearing
15       in which disclosure of a report or record privileged under this section is
16       proposed. In closing a portion of a hearing as provided by this section,
17       the presiding officer may exclude any person from the hearing location
18       except the licensee, the licensee's attorney, the agency's attorney, the
19       witness, the court reporter and appropriate staff support for either coun-
20       sel. The licensing agency shall make the portions of the agency record in
21       which such report or record is disclosed subject to a protective order
22       prohibiting further disclosure of such report or record. Such report or
23       record shall not be subject to discovery, subpoena or other means of legal
24       compulsion for their release to any person or entity. No person in at-
25       tendance at a closed portion of a disciplinary proceeding shall at a sub-
26       sequent civil, criminal or administrative hearing, be required to testify
27       regarding the existence or content of a report or record privileged under
28       this section which was disclosed in a closed portion of a hearing, nor shall
29       such testimony be admitted into evidence in any subsequent civil, crim-
30       inal or administrative hearing. A licensing agency conducting a discipli-
31       nary proceeding may review peer review committee records, testimony
32       or reports but must prove its findings with independently obtained tes-
33       timony or records which shall be presented as part of the disciplinary
34       proceeding in open meeting of the licensing agency. Offering such tes-
35       timony or records in an open public hearing shall not be deemed a waiver
36       of the peer review privilege relating to any peer review committee testi-
37       mony, records or report.
38             (d) Nothing in this section shall limit the authority, which may oth-
39       erwise be provided by law, of the commissioner of insurance, the state
40       board of healing arts or other health care provider licensing or disciplinary
41       boards of this state to require a peer review committee or officer to report
42       to it any disciplinary action or recommendation of such committee or
43       officer; to transfer to it records of such committee's or officer's proceed-

25
  1       ings or actions to restrict or revoke the license, registration, certification
  2       or other authorization to practice of a health care provider; or to terminate
  3       the liability of the fund for all claims against a specific health care provider
  4       for damages for death or personal injury pursuant to subsection (i) of
  5       K.S.A. 40-3403 and amendments thereto. Reports and records so fur-
  6       nished shall not be subject to discovery, subpoena or other means of legal
  7       compulsion for their release to any person or entity and shall not be
  8       admissible in evidence in any judicial or administrative proceeding other
  9       than a disciplinary proceeding by the state board of healing arts or other
10       health care provider licensing or disciplinary boards of this state.
11             (e) A peer review committee or officer may report to and discuss its
12       activities, information and findings to other peer review committees or
13       officers or to a board of directors or an administrative officer of a health
14       care provider without waiver of the privilege provided by subsection (b)
15       and the records of all such committees or officers relating to such report
16       shall be privileged as provided by subsection (b).
17             (f) Nothing in this section shall be construed to prevent an insured
18       from obtaining information pertaining to payment of benefits under a
19       contract with an insurance company, a health maintenance organization
20       or an administrator of a health benefits plan.
21             Sec.  17. K.S.A. 1999 Supp. 65-6112 is hereby amended to read as
22       follows: 65-6112. As used in this act:
23             (a) ``Administrator'' means the administrator of the emergency med-
24       ical services board.
25             (b) ``Ambulance'' means any privately or publicly owned motor ve-
26       hicle, airplane or helicopter designed, constructed, prepared and
27       equipped for use in transporting and providing emergency care for in-
28       dividuals who are ill or injured.
29             (c) ``Ambulance service'' means any organization operated for the
30       purpose of transporting sick or injured persons to or from a place where
31       medical care is furnished, whether or not such persons may be in need
32       of emergency or medical care in transit.
33             (d) ``Attendant'' means a first responder, emergency medical tech-
34       nician, emergency medical technician-intermediate, emergency medical
35       technician-defibrillator or a mobile intensive care technician certified
36       pursuant to this act.
37             (e) ``Board'' means the emergency medical services board established
38       pursuant to K.S.A. 65-6102, and amendments thereto.
39             (f) ``Emergency medical service'' means the effective and coordinated
40       delivery of such care as may be required by an emergency which includes
41       the care and transportation of individuals by ambulance services and the
42       performance of authorized emergency care by a physician, professional
43       nurse, physician's a licensed physician assistant or attendant.

26
  1             (g) ``Emergency medical technician'' means a person who holds an
  2       emergency medical technician certificate issued pursuant to this act.
  3             (h) ``Emergency medical technician-defibrillator'' means a person
  4       who holds an emergency medical technician defibrillator certificate issued
  5       pursuant to this act.
  6             (i) ``Emergency medical technician-intermediate'' means a person
  7       who holds an emergency medical technician intermediate certificate is-
  8       sued pursuant to this act.
  9             (j) ``First responder'' means a person who holds a first responder cer-
10       tificate issued pursuant to this act.
11             (k) ``Hospital'' means a hospital as defined by K.S.A. 65-425, and
12       amendments thereto.
13             (l) ``Instructor-coordinator'' means a person who is certified under
14       this act to teach initial courses of certification of instruction and contin-
15       uing education classes.
16             (m) ``Medical adviser'' means a physician.
17             (n) ``Medical protocols'' mean written guidelines which authorize at-
18       tendants to perform certain medical procedures prior to contacting a phy-
19       sician, or professional nurse authorized by a physician. These protocols
20       shall be developed and approved by a county medical society or, if there
21       is no county medical society, the medical staff of a hospital to which the
22       ambulance service primarily transports patients.
23             (o) ``Mobile intensive care technician'' means a person who holds a
24       mobile intensive care technician certificate issued pursuant to this act.
25             (p) ``Municipality'' means any city, county, township, fire district or
26       ambulance service district.
27             (q) ``Nonemergency transportation'' means the care and transport of
28       a sick or injured person under a foreseen combination of circumstances
29       calling for continuing care of such person. As used in this subsection,
30       transportation includes performance of the authorized level of services of
31       the attendant whether within or outside the vehicle as part of such trans-
32       portation services.
33             (r) ``Operator'' means a person or municipality who has a permit to
34       operate an ambulance service in the state of Kansas.
35             (s) ``Person'' means an individual, a partnership, an association, a
36       joint-stock company or a corporation.
37             (t) ``Physician'' means a person licensed by the state board of healing
38       arts to practice medicine and surgery.
39             (u) ``Physician's Physician assistant'' means a person who is registered
40       licensed in accordance with the provisions of K.S.A. 65-2896a, and
41       amendments thereto and who is acting under the direction of a respon-
42       sible physician.
43             (v) ``Professional nurse'' means a licensed professional nurse as de-

27
  1       fined by K.S.A. 65-1113, and amendments thereto.
  2             (w) ``Provider of training'' means a corporation, partnership, accred-
  3       ited postsecondary education institution, ambulance service, fire depart-
  4       ment, hospital or municipality that conducts training programs that in-
  5       clude, but are not limited to, initial courses of instruction and continuing
  6       education for attendants, instructor-coordinators or training officers.
  7             (x) ``Responsible physician'' means responsible physician as such term
  8       is defined under K.S.A. 65-2897a and amendments thereto.
  9             (y) ``Training officer'' means a person who is certified pursuant to this
10       act to teach initial courses of instruction for first responders and contin-
11       uing education as prescribed by the board.
12             Sec.  18. K.S.A. 1999 Supp. 65-6135 is hereby amended to read as
13       follows: 65-6135. (a) All ambulance services providing emergency care as
14       defined by the rules and regulations adopted by the board shall offer
15       service 24 hours per day every day of the year.
16             (b) Whenever an operator is required to have a permit, at least one
17       person on each vehicle providing emergency medical service shall be an
18       attendant certified as an emergency medical technician, emergency med-
19       ical technician-intermediate, emergency medical technician-defibrillator,
20       a mobile intensive care technician, a physician, a registered physician's
21       licensed physician assistant or a professional nurse.
22             Sec.  19. K.S.A. 1999 Supp. 65-6701 is hereby amended to read as
23       follows: 65-6701. As used in this act:
24             (a) ``Abortion'' means the use of any means to intentionally terminate
25       a pregnancy except for the purpose of causing a live birth. Abortion does
26       not include: (1) The use of any drug or device that inhibits or prevents
27       ovulation, fertilization or the implantation of an embryo; or (2) disposition
28       of the product of in vitro fertilization prior to implantation.
29             (b) ``Counselor'' means a person who is: (1) Licensed to practice med-
30       icine and surgery; (2) licensed to practice psychology; (3) licensed to prac-
31       tice professional or practical nursing; (4) registered to practice profes-
32       sional counseling; (5) licensed as a social worker; (6) the holder of a
33       master's or doctor's degree from an accredited graduate school of social
34       work; (7) registered to practice marriage and family therapy; (8) a regis-
35       tered physician's licensed physician assistant; or (9) a currently ordained
36       member of the clergy or religious authority of any religious denomination
37       or society. Counselor does not include the physician who performs or
38       induces the abortion or a physician or other person who assists in per-
39       forming or inducing the abortion.
40             (c) ``Department'' means the department of health and environment.
41             (d) ``Gestational age'' means the time that has elapsed since the first
42       day of the woman's last menstrual period.
43             (e) ``Medical emergency'' means that condition which, on the basis

28
  1       of the physician's good faith clinical judgment, so complicates the medical
  2       condition of a pregnant woman as to necessitate the immediate abortion
  3       of her pregnancy to avert her death or for which a delay will create serious
  4       risk of substantial and irreversible impairment of a major bodily function.
  5             (f) ``Minor'' means a person less than 18 years of age.
  6             (g) ``Physician'' means a person licensed to practice medicine and
  7       surgery in this state.
  8             (h) ``Pregnant'' or ``pregnancy'' means that female reproductive con-
  9       dition of having a fetus in the mother's body.
10             (i) ``Qualified person'' means an agent of the physician who is a psy-
11       chologist, licensed social worker, registered professional counselor, reg-
12       istered nurse or physician.
13             (j) ``Unemancipated minor'' means any minor who has never been:
14       (1) Married; or (2) freed, by court order or otherwise, from the care,
15       custody and control of the minor's parents.
16             (k) ``Viable'' means that stage of gestation when, in the best medical
17       judgment of the attending physician, the fetus is capable of sustained
18       survival outside the uterus without the application of extraordinary med-
19       ical means.
20             Sec.  20. K.S.A. 75-6102 is hereby amended to read as follows: 75-
21       6102. As used in K.S.A. 75-6101 through 75-6118, and amendments
22       thereto, unless the context clearly requires otherwise:
23             (a) ``State'' means the state of Kansas and any department or branch
24       of state government, or any agency, authority, institution or other instru-
25       mentality thereof.
26             (b) ``Municipality'' means any county, township, city, school district
27       or other political or taxing subdivision of the state, or any agency, au-
28       thority, institution or other instrumentality thereof.
29             (c) ``Governmental entity'' means state or municipality.
30             (d) ``Employee'' means any officer, employee, servant or member of
31       a board, commission, committee, division, department, branch or council
32       of a governmental entity, including elected or appointed officials and
33       persons acting on behalf or in service of a governmental entity in any
34       official capacity, whether with or without compensation and a charitable
35       health care provider. Employee includes any steward or racing judge ap-
36       pointed pursuant to K.S.A. 74-8818, and amendments thereto, regardless
37       of whether the services of such steward or racing judge are rendered
38       pursuant to contract as an independent contractor, but does not otherwise
39       include any independent contractor under contract with a governmental
40       entity except (1) employees of the United States marshal's service en-
41       gaged in the transportation of inmates on behalf of the secretary of cor-
42       rections, (2) a person who is an employee of a nonprofit independent
43       contractor, other than a municipality, under contract to provide educa-

29
  1       tional or vocational training to inmates in the custody of the secretary of
  2       corrections and who is engaged in providing such service in an institution
  3       under the control of the secretary of corrections provided that such em-
  4       ployee does not otherwise have coverage for such acts and omissions
  5       within the scope of their employment through a liability insurance con-
  6       tract of such independent contractor; and (3) a person who is an employee
  7       of a nonprofit program, other than a municipality, who has contracted
  8       with the commissioner of juvenile justice or with another nonprofit pro-
  9       gram that has contracted with the commissioner of juvenile justice to
10       provide a juvenile justice program for juvenile offenders in a judicial dis-
11       trict provided that such employee does not otherwise have coverage for
12       such acts and omissions within the scope of their employment through a
13       liability insurance contract of such nonprofit program. ``Employee'' also
14       includes an employee of an indigent health care clinic. ``Employee'' also
15       includes former employees for acts and omissions within the scope of
16       their employment during their former employment with the govern-
17       mental entity.
18             (e) ``Community service work'' means public or community service
19       performed by a person (1) as a result of a contract of diversion entered
20       into by such person as authorized by law, (2) pursuant to the assignment
21       of such person by a court to a community corrections program, (3) as a
22       result of suspension of sentence or as a condition of probation pursuant
23       to court order, (4) in lieu of a fine imposed by court order or (5) as a
24       condition of placement ordered by a court pursuant to K.S.A. 38-1663,
25       and amendments thereto.
26             (f) ``Charitable health care provider'' means a person licensed by the
27       state board of healing arts as an exempt licensee or a federally active
28       licensee, a person issued a limited permit by the state board of healing
29       arts, a physician's physician assistant registered licensed by the state board
30       of healing arts or a health care provider as the term ``health care provider''
31       is defined under K.S.A. 65-4921, and amendments thereto, who has en-
32       tered into an agreement with:
33             (1) The secretary of health and environment under K.S.A. 75-6120,
34       and amendments thereto, who, pursuant to such agreement, gratuitously
35       renders professional services to a person who has provided information
36       which would reasonably lead the health care provider to make the good
37       faith assumption that such person meets the definition of medically in-
38       digent person as defined by this section or to a person receiving medical
39       assistance from the programs operated by the department of social and
40       rehabilitation services, and who is considered an employee of the state of
41       Kansas under K.S.A. 75-6120, and amendments thereto;
42             (2) the secretary of health and environment and who, pursuant to
43       such agreement, gratuitously renders professional services in conducting

30
  1       children's immunization programs administered by the secretary; or
  2             (3) a local health department or indigent health care clinic, which
  3       renders professional services to medically indigent persons or persons
  4       receiving medical assistance from the programs operated by the depart-
  5       ment of social and rehabilitation services gratuitously or for a fee paid by
  6       the local health department or indigent health care clinic to such provider
  7       and who is considered an employee of the state of Kansas under K.S.A.
  8       75-6120 and amendments thereto. Professional services rendered by a
  9       provider under this paragraph (3) shall be considered gratuitous notwith-
10       standing fees based on income eligibility guidelines charged by a local
11       health department or indigent health care clinic and notwithstanding any
12       fee paid by the local health department or indigent health care clinic to
13       a provider in accordance with this paragraph (3).
14             (g) ``Medically indigent person'' means a person who lacks resources
15       to pay for medically necessary health care services and who meets the
16       eligibility criteria for qualification as a medically indigent person estab-
17       lished by the secretary of health and environment under K.S.A. 75-6120,
18       and amendments thereto.
19             (h) ``Indigent health care clinic'' means an outpatient medical care
20       clinic operated on a not-for-profit basis which has a contractual agreement
21       in effect with the secretary of health and environment to provide health
22       care services to medically indigent persons.
23             (i) ``Local health department'' shall have the meaning ascribed to such
24       term under K.S.A. 65-241 and amendments thereto. 
25       Sec.  21. K.S.A. 40-2,111, 65-2896a, 65-2896c, 65-2896d, 65-2896f,
26       65-2896g, 65-2896h, 65-2897a, 65-2897b and 75-6102 and K.S.A. 1999
27       Supp. 65-2896, 65-2896b, 65-2896e, 17-2707, 38-135, 40-3401, 65-118,
28       65-4915, 65-6112, 65-6135 and 65-6701 are hereby repealed.
29        Sec.  22. This act shall take effect and be in force from and after its
30       publication in the statute book.