CHAPTER 115 HOUSE BILL No. 2168 (Amended by Chapters 149 and 154) An  Act authorizing physicians' assistants and advanced registered nurse practitioners to
prescribe drugs; amending K.S.A. 21-4214, 39-7,117, 65-669, 65-1130, 65-2896e, 65-
4116, 65-4123, 65-4134 and 65-4202 and K.S.A. 1998 Supp. 40-2123, 60-4403, 65-1626,
65-1627, 65-1643, 65-1660, 65-2837a, 65-4101 and 79-3606 and repealing the existing
sections; also repealing K.S.A. 1998 Supp. 65-1627i.
Be it enacted by the Legislature of the State of Kansas:

      Section  1. K.S.A. 65-1130 is hereby amended to read as follows: 65-
1130. (a) No professional nurse shall announce or represent to the public
that such person is an advanced registered nurse practitioner unless such
professional nurse has complied with requirements established by the
board and holds a valid certificate of qualification as an advanced regis-
tered nurse practitioner in accordance with the provisions of this section.

      (b) The board shall establish standards and requirements for any pro-
fessional nurse who desires to obtain a certificate of qualification as an
advanced registered nurse practitioner. Such standards and requirements
shall include, but not be limited to, standards and requirements relating
to the education and training of advanced registered nurse practitioners.
The board may require that some, but not all, types of advanced regis-
tered nurse practitioners hold an academic degree beyond the minimum
educational requirement for qualifying for a license to practice as a pro-
fessional nurse. The board may give such examinations and secure such
assistance as it deems necessary to determine the qualifications of appli-
cants.

      (c) The board shall adopt rules and regulations applicable to advanced
registered nurse practitioners which:

      (1) Establish categories of advanced registered nurse practitioners
which are consistent with nursing practice specialties recognized by the
nursing profession.

      (2) Establish education, training and qualifications necessary for cer-
tification for each category of advanced registered nurse practitioner es-
tablished by the board at a level adequate to assure the competent per-
formance by advanced registered nurse practitioners of functions and
procedures which advanced registered nurse practitioners are authorized
to perform.

      (3) Define the expanded role of advanced registered nurse practi-
tioners and establish limitations and restrictions on such expanded role.
The board shall adopt a definition of expanded the role under this sub-
section (c)(3) which is consistent with the education, training and quali-
fications required to obtain a certificate of qualification as an advanced
registered nurse practitioner, which protects the public from persons per-
forming functions and procedures as advanced registered nurse practi-
tioners for which they lack adequate education, training and qualifications
and which authorizes advanced registered nurse practitioners to perform
acts generally recognized by the profession of nursing as capable of being
performed, in a manner consistent with the public health and safety, by
persons with postbasic education in nursing. In defining such expanded
role the board shall consider: (A) The training and education required
for a certificate of qualification as an advanced registered nurse practi-
tioner; (B) the type of nursing practice and preparation in specialized
practitioner skills involved in each category of advanced registered nurse
practitioner established by the board; (C) the scope of practice of nursing
specialties and limitations thereon prescribed by national organizations
which certify nursing specialties; and (D) acts recognized by the nursing
profession as appropriate to be performed by persons with postbasic ed-
ucation and training in nursing.

      (d) An advanced registered nurse practitioner may not prescribe
drugs but may transmit prescription orders pursuant to a written protocol
as authorized by a responsible physician. Each written protocol shall con-
tain a precise and detailed medical plan of care for each classification of
disease or injury for which the advanced registered nurse practitioner is
authorized to transmit prescription orders prescribe and shall specify all
drugs which may be transmitted prescribed by the advanced registered
nurse practitioner. Any written prescription order shall include the name,
address and telephone number of the responsible physician. The advanced
registered nurse practitioner may not dispense drugs, but may request,
receive and sign for professional samples and may distribute professional
samples to patients pursuant to a written protocol as authorized by a
responsible physician. In order to prescribe controlled substances, the
advanced registered nurse practitioner shall (1) register with the federal
drug enforcement administration; and (2) notify the board of the name
and address of the responsible physician or physicians. In no case shall
the scope of authority of the advanced registered nurse practitioner ex-
ceed the normal and customary practice of the responsible physician. An
advanced registered nurse practitioner certified in the category of regis-
tered nurse anesthetist while functioning as a registered nurse anesthetist
under K.S.A. 65-1151 to 65-1164, inclusive, and amendments thereto,
shall be subject to the provisions of K.S.A. 65-1151 to 65-1164, inclusive,
and amendments thereto, with respect to medications drugs and anes-
thetic agents and shall not be subject to the provisions of this subsection.
For the purposes of this subsection, ``responsible physician'' means a per-
son licensed to practice medicine and surgery in Kansas who has accepted
responsibility for the protocol and the actions of the advanced registered
nurse practitioner involving the transmitting of prescription orders when
prescribing drugs.

      (e) As used in this section, ``drug'' means those articles and substances
defined as drugs in K.S.A. 1998 Supp. 65-1626 and 65-4101 and amend-
ments thereto.

      Sec.  2. K.S.A. 1998 Supp. 65-1626 is hereby amended to read as
follows: 65-1626. For the purposes of this act:

      (a) ``Administer'' means the direct application of a drug, whether by
injection, inhalation, ingestion or any other means, to the body of a patient
or research subject by:

      (1) A practitioner or pursuant to the lawful direction of a practitioner,
or

      (2) the patient or research subject at the direction and in the presence
of the practitioner.

      (b) ``Agent'' means an authorized person who acts on behalf of or at
the direction of a manufacturer, distributor or dispenser but shall not
include a common or contract carrier, public warehouseman or employee
of the carrier or warehouseman when acting in the usual and lawful course
of the carrier's or warehouseman's business.

      (c) ``Board'' means the state board of pharmacy created by K.S.A. 74-
1603 and amendments thereto.

      (d) ``Brand exchange'' means the dispensing of a different drug prod-
uct of the same dosage form and strength and of the same generic name
than the brand name drug product prescribed.

      (e) ``Brand name'' means the registered trademark name given to a
drug product by its manufacturer, labeler or distributor.

      (f) ``Deliver'' or ``delivery'' means the actual, constructive or at-
tempted transfer from one person to another of any drug whether or not
an agency relationship exists.

      (g) ``Direct supervision'' means the process by which the responsible
pharmacist shall observe and direct the activities of a pharmacy student
or pharmacy technician to a sufficient degree to assure that all such ac-
tivities are performed accurately, safely and without risk or harm to pa-
tients, and complete the final check before dispensing.

      (h) ``Dispense'' means to deliver prescription medication to the ulti-
mate user or research subject by or pursuant to the lawful order of a
practitioner or pursuant to the prescription of a mid-level practitioner.

      (i) ``Dispenser'' means a practitioner or pharmacist who dispenses
prescription medication.

      (j) ``Distribute'' means to deliver, other than by administering or dis-
pensing, any drug.

      (k) ``Distributor'' means a person who distributes a drug.

      (l) ``Drug'' means: (1) Articles recognized in the official United States
pharmacopoeia, or other such official compendiums of the United States,
or official national formulary, or any supplement of any of them; (2) ar-
ticles intended for use in the diagnosis, cure, mitigation, treatment or
prevention of disease in man or other animals; (3) articles, other than
food, intended to affect the structure or any function of the body of man
or other animals; and (4) articles intended for use as a component of any
articles specified in clause (1), (2) or (3) of this subsection; but does not
include devices or their components, parts or accessories, except that the
term ``drug'' shall not include amygdalin (laetrile) or any livestock remedy,
as defined in K.S.A. 47-501 and amendments thereto, if such livestock
remedy has been registered in accordance with the provisions of article
5 of chapter 47 of the Kansas Statutes Annotated.

      (m) ``Electronic transmission'' means transmission of information in
electronic form or the transmission of the exact visual image of a docu-
ment by way of electronic equipment.

      (n) ``Generic name'' means the established chemical name or official
name of a drug or drug product.

      (o)  (1) ``Institutional drug room'' means any location where prescrip-
tion-only drugs are stored and from which prescription-only drugs are
administered or dispensed and which is maintained or operated for the
purpose of providing the drug needs of:

      (A) Inmates of a jail or correctional institution or facility;

      (B) residents of a juvenile detention facility, as defined by the Kansas
code for care of children and the Kansas juvenile justice code;

      (C) students of a public or private university or college, a community
college or any other institution of higher learning which is located in
Kansas; or

      (D) employees of a business or other employer.

      (2) ``Institutional drug room'' does not include:

      (A) Any registered pharmacy;

      (B) any office of a practitioner; or

      (C) a location where no prescription-only drugs are dispensed and no
prescription-only drugs other than individual prescriptions are stored or
administered.

      (p) ``Medical care facility'' shall have the meaning provided in K.S.A.
65-425 and amendments thereto, except that the term shall also include
facilities licensed under the provisions of K.S.A. 75-3307b and amend-
ments thereto except community mental health centers and facilities for
the mentally retarded.

      (q) ``Manufacture'' means the production, preparation, propagation,
compounding, conversion or processing of a drug either directly or in-
directly by extraction from substances of natural origin, independently by
means of chemical synthesis or by a combination of extraction and chem-
ical synthesis and includes any packaging or repackaging of the drug or
labeling or relabeling of its container, except that this term shall not in-
clude the preparation or compounding of a drug by an individual for the
individual's own use or the preparation, compounding, packaging or la-
beling of a drug by: (1) A practitioner or a practitioner's authorized agent
incident to such practitioner's administering or dispensing of a drug in
the course of the practitioner's professional practice; (2) a practitioner,
by a practitioner's authorized agent or under a practitioner's supervision
for the purpose of, or as an incident to, research, teaching or chemical
analysis and not for sale; or (3) a pharmacist or the pharmacist's author-
ized agent acting under the direct supervision of the pharmacist for the
purpose of, or incident to, the dispensing of a drug by the pharmacist.

      (r) ``Person'' means individual, corporation, government, govern-
mental subdivision or agency, partnership, association or any other legal
entity.

      (s) ``Pharmacist'' means any natural person licensed under this act to
practice pharmacy.

      (t) ``Pharmacist in charge'' means the pharmacist who is responsible
to the board for a registered establishment's compliance with the laws
and regulations of this state pertaining to the practice of pharmacy, man-
ufacturing of drugs and the distribution of drugs. The pharmacist in
charge shall supervise such establishment on a full-time or a part-time
basis and perform such other duties relating to supervision of a registered
establishment as may be prescribed by the board by rules and regulations.
Nothing in this definition shall relieve other pharmacists or persons from
their responsibility to comply with state and federal laws and regulations.

      (u) ``Pharmacy,'' ``drug store'' or ``apothecary'' means premises, lab-
oratory, area or other place: (1) Where drugs are offered for sale where
the profession of pharmacy is practiced and where prescriptions are com-
pounded and dispensed; or (2) which has displayed upon it or within it
the words ``pharmacist,'' ``pharmaceutical chemist,'' ``pharmacy,'' ``apoth-
ecary,'' ``drugstore,'' ``druggist,'' ``drugs,'' ``drug sundries'' or any of these
words or combinations of these words or words of similar import either
in English or any sign containing any of these words; or (3) where the
characteristic symbols of pharmacy or the characteristic prescription sign
``Rx'' may be exhibited. As used in this subsection, premises refers only
to the portion of any building or structure leased, used or controlled by
the licensee in the conduct of the business registered by the board at the
address for which the registration was issued.

      (v) ``Pharmacy student'' means an individual, registered with the
board of pharmacy, enrolled in an accredited school of pharmacy.

      (w) ``Pharmacy technician'' means an individual who, under the direct
supervision and control of a pharmacist, may perform packaging, manip-
ulative, repetitive or other nondiscretionary tasks related to the processing
of a prescription or medication order and who assists the pharmacist in
the performance of pharmacy related duties, but who does not perform
duties restricted to a pharmacist.

      (x) ``Practitioner'' means a person licensed to practice medicine and
surgery, dentist, podiatrist, veterinarian, optometrist licensed under the
optometry law as a therapeutic licensee or diagnostic and therapeutic
licensee, or scientific investigator or other person authorized by law to
use a prescription-only drug in teaching or chemical analysis or to conduct
research with respect to a prescription-only drug.

      (y) ``Preceptor'' means a licensed pharmacist who possesses at least
two years' experience as a pharmacist and who supervises students ob-
taining the pharmaceutical experience required by law as a condition to
taking the examination for licensure as a pharmacist.

      (z) ``Prescription'' means, according to the context, either a prescrip-
tion order or a prescription medication.

      (aa) ``Prescription medication'' means any drug, including label and
container according to context, which is dispensed pursuant to a prescrip-
tion order.

      (bb) ``Prescription-only drug'' means any drug required by the federal
or state food, drug and cosmetic act to bear on its label the legend ``Cau-
tion: Federal law prohibits dispensing without prescription.''

      (cc) ``Prescription order'' means: (1) An order to be filled by a phar-
macist for prescription medication issued and signed by a practitioner or
a mid-level practitioner in the authorized course of professional practice;
or (2) an order transmitted to a pharmacist through word of mouth, note,
telephone or other means of communication directed by such practitioner
or mid-level practitioner.

      (dd) ``Probation'' means the practice or operation under a temporary
license, registration or permit or a conditional license, registration or per-
mit of a business or profession for which a license, registration or permit
is granted by the board under the provisions of the pharmacy act of the
state of Kansas requiring certain actions to be accomplished or certain
actions not to occur before a regular license, registration or permit is
issued.

      (ee) ``Professional incompetency'' means:

      (1) One or more instances involving failure to adhere to the appli-
cable standard of pharmaceutical care to a degree which constitutes gross
negligence, as determined by the board;

      (2) repeated instances involving failure to adhere to the applicable
standard of pharmaceutical care to a degree which constitutes ordinary
negligence, as determined by the board; or

      (3) a pattern of pharmacy practice or other behavior which demon-
strates a manifest incapacity or incompetence to practice pharmacy.

      (ff) ``Retail dealer'' means a person selling at retail nonprescription
drugs which are prepackaged, fully prepared by the manufacturer or dis-
tributor for use by the consumer and labeled in accordance with the
requirements of the state and federal food, drug and cosmetic acts. Such
nonprescription drugs shall not include: (1) A controlled substance; (2) a
drug the label of which is required to bear substantially the statement
``Caution: Federal law prohibits dispensing without prescription''; or (3)
a drug intended for human use by hypodermic injection.

      (gg) ``Secretary'' means the executive secretary of the board.

      (hh) ``Unprofessional conduct'' means:

      (1) Fraud in securing a registration or permit;

      (2) intentional adulteration or mislabeling of any drug, medicine,
chemical or poison;

      (3) causing any drug, medicine, chemical or poison to be adulterated
or mislabeled, knowing the same to be adulterated or mislabeled;

      (4) intentionally falsifying or altering records or prescriptions;

      (5) unlawful possession of drugs and unlawful diversion of drugs to
others;

      (6) willful betrayal of confidential information under K.S.A. 65-1654
and amendments thereto;

      (7) conduct likely to deceive, defraud or harm the public;

      (8) making a false or misleading statement regarding the licensee's
professional practice or the efficacy or value of a drug;

      (9) commission of any act of sexual abuse, misconduct or exploitation
related to the licensee's professional practice; or

      (10)  performing unnecessary tests, examinations or services which
have no legitimate pharmaceutical purpose.

      (ii) ``Mid-level practitioner'' means an advanced registered nurse
practitioner issued a certificate of qualification pursuant to K.S.A. 65-
1131 and amendments thereto who has authority to prescribe drugs pur-
suant to a written protocol with a responsible physician under K.S.A. 65-
1130 and amendments thereto or a physician's assistant registered
pursuant to K.S.A. 65-2896a and amendments thereto who has authority
to prescribe drugs pursuant to a written protocol with a responsible phy-
sician under K.S.A. 65-2896e and amendments thereto.

      Sec.  3. K.S.A. 1998 Supp. 65-4101 is hereby amended to read as
follows: 65-4101. As used in this act: (a) ``Administer'' means the direct
application of a controlled substance, whether by injection, inhalation,
ingestion or any other means, to the body of a patient or research subject
by: (1) A practitioner or pursuant to the lawful direction of a practitioner;
or

      (2) the patient or research subject at the direction and in the presence
of the practitioner.

      (b) ``Agent'' means an authorized person who acts on behalf of or at
the direction of a manufacturer, distributor or dispenser. It does not in-
clude a common or contract carrier, public warehouseman or employee
of the carrier or warehouseman.

      (c) ``Board'' means the state board of pharmacy.

      (d) ``Bureau'' means the bureau of narcotics and dangerous drugs,
United States department of justice, or its successor agency.

      (e) ``Controlled substance'' means any drug, substance or immediate
precursor included in any of the schedules designated in K.S.A. 65-4105,
65-4107, 65-4109, 65-4111 and 65-4113, and amendments to these sec-
tions.

      (f) ``Counterfeit substance'' means a controlled substance which, or
the container or labeling of which, without authorization bears the trade-
mark, trade name or other identifying mark, imprint, number or device
or any likeness thereof of a manufacturer, distributor or dispenser other
than the person who in fact manufactured, distributed or dispensed the
substance.

      (g) ``Deliver'' or ``delivery'' means the actual, constructive or at-
tempted transfer from one person to another of a controlled substance,
whether or not there is an agency relationship.

      (h) ``Dispense'' means to deliver a controlled substance to an ultimate
user or research subject by or pursuant to the lawful order of a practi-
tioner, including the packaging, labeling or compounding necessary to
prepare the substance for that delivery, or pursuant to the prescription
of a mid-level practitioner.

      (i) ``Dispenser'' means a practitioner or pharmacist who dispenses.

      (j) ``Distribute'' means to deliver other than by administering or dis-
pensing a controlled substance.

      (k) ``Distributor'' means a person who distributes.

      (l) ``Drug'' means: (1) Substances recognized as drugs in the official
United States pharmacopoeia, official homeopathic pharmacopoeia of the
United States or official national formulary or any supplement to any of
them; (2) substances intended for use in the diagnosis, cure, mitigation,
treatment or prevention of disease in man or animals; (3) substances
(other than food) intended to affect the structure or any function of the
body of man or animals; and (4) substances intended for use as a com-
ponent of any article specified in clause (1), (2) or (3) of this subsection.
It does not include devices or their components, parts or accessories.

      (m) ``Immediate precursor'' means a substance which the board has
found to be and by rule and regulation designates as being the principal
compound commonly used or produced primarily for use and which is
an immediate chemical intermediary used or likely to be used in the
manufacture of a controlled substance, the control of which is necessary
to prevent, curtail or limit manufacture.

      (n) ``Manufacture'' means the production, preparation, propagation,
compounding, conversion or processing of a controlled substance either
directly or indirectly by extraction from substances of natural origin or
independently by means of chemical synthesis or by a combination of
extraction and chemical synthesis and includes any packaging or repack-
aging of the substance or labeling or relabeling of its container, except
that this term does not include the preparation or compounding of a
controlled substance by an individual for the individual's own use or the
preparation, compounding, packaging or labeling of a controlled sub-
stance: (1) By a practitioner or the practitioner's agent pursuant to a lawful
order of a practitioner as an incident to the practitioner's administering
or dispensing of a controlled substance in the course of the practitioner's
professional practice; or

      (2) by a practitioner or by the practitioner's authorized agent under
such practitioner's supervision for the purpose of or as an incident to
research, teaching or chemical analysis or by a pharmacist or medical care
facility as an incident to dispensing of a controlled substance.

      (o) ``Marijuana'' means all parts of all varieties of the plant Cannabis
whether growing or not, the seeds thereof, the resin extracted from any
part of the plant and every compound, manufacture, salt, derivative, mix-
ture or preparation of the plant, its seeds or resin. It does not include the
mature stalks of the plant, fiber produced from the stalks, oil or cake
made from the seeds of the plant, any other compound, manufacture,
salt, derivative, mixture or preparation of the mature stalks, except the
resin extracted therefrom, fiber, oil, or cake or the sterilized seed of the
plant which is incapable of germination.

      (p) ``Narcotic drug'' means any of the following whether produced
directly or indirectly by extraction from substances of vegetable origin or
independently by means of chemical synthesis or by a combination of
extraction and chemical synthesis: (1) Opium and opiate and any salt,
compound, derivative or preparation of opium or opiate;

      (2) any salt, compound, isomer, derivative or preparation thereof
which is chemically equivalent or identical with any of the substances
referred to in clause (1) but not including the isoquinoline alkaloids of
opium;

      (3) opium poppy and poppy straw;

      (4) coca leaves and any salt, compound, derivative or preparation of
coca leaves, and any salt, compound, isomer, derivative or preparation
thereof which is chemically equivalent or identical with any of these sub-
stances, but not including decocainized coca leaves or extractions of coca
leaves which do not contain cocaine or ecgonine.

      (q) ``Opiate'' means any substance having an addiction-forming or
addiction-sustaining liability similar to morphine or being capable of con-
version into a drug having addiction-forming or addiction-sustaining lia-
bility. It does not include, unless specifically designated as controlled
under K.S.A. 65-4102 and amendments thereto, the dextrorotatory iso-
mer of 3-methoxy-n-methylmorphinan and its salts (dextromethorphan).
It does include its racemic and levorotatory forms.

      (r) ``Opium poppy'' means the plant of the species Papaver somni-
ferum l. except its seeds.

      (s) ``Person'' means individual, corporation, government, or govern-
mental subdivision or agency, business trust, estate, trust, partnership or
association or any other legal entity.

      (t) ``Poppy straw'' means all parts, except the seeds, of the opium
poppy, after mowing.

      (u) ``Pharmacist'' means an individual currently licensed by the board
to practice the profession of pharmacy in this state.

      (v) ``Practitioner'' means a person licensed to practice medicine and
surgery, dentist, podiatrist, veterinarian, optometrist licensed under the
optometry law as a therapeutic licensee or diagnostic and therapeutic
licensee, or scientific investigator or other person authorized by law to
use a controlled substance in teaching or chemical analysis or to conduct
research with respect to a controlled substance.

      (w) ``Production'' includes the manufacture, planting, cultivation,
growing or harvesting of a controlled substance.

      (x) ``Ultimate user'' means a person who lawfully possesses a con-
trolled substance for such person's own use or for the use of a member
of such person's household or for administering to an animal owned by
such person or by a member of such person's household.

      (y) ``Isomer'' means all enantiomers and diastereomers.

      (z) ``Medical care facility'' shall have the meaning ascribed to that
term in K.S.A. 65-425 and amendments thereto.

      (aa) ``Cultivate'' means the planting or promotion of growth of five
or more plants which contain or can produce controlled substances.

      (bb) (1) ``Controlled substance analog'' means a substance the chem-
ical structure of which is substantially similar to the chemical structure of
a controlled substance listed in or added to the schedules designated in
K.S.A. 65-4105 or 65-4107 and amendments thereto; and:

      (A) Which has a stimulant, depressant or hallucinogenic effect on the
central nervous system substantially similar to the stimulant, depressant
or hallucinogenic effect on the central nervous system of a controlled
substance included in the schedules designated in K.S.A. 65-4105 or 65-
4107 and amendments thereto; or

      (B) with respect to a particular individual, which the individual rep-
resents or intends to have a stimulant, depressant or hallucinogenic effect
on the central nervous system substantially similar to the stimulant, de-
pressant or hallucinogenic effect on the central nervous system of a con-
trolled substance included in the schedules designated in K.S.A. 65-4105
or 65-4107 and amendments thereto.

      (2) ``Controlled substance analog'' does not include:

      (A) A controlled substance;

      (B) a substance for which there is an approved new drug application;

      (C) a substance with respect to which an exemption is in effect for
investigational use by a particular person under section 505 of the federal
food, drug, and cosmetic act (21 U.S.C. 355) to the extent conduct with
respect to the substance is permitted by the exemption; or

      (D) any substance to the extent not intended for human consumption
before an exemption takes effect with respect to the substance.

      (cc) ``Mid-level practitioner'' means an advanced registered nurse
practitioner issued a certificate of qualification pursuant to K.S.A. 65-
1131 and amendments thereto, who has authority to prescribe drugs pur-
suant to a written protocol with a responsible physician under K.S.A. 65-
1130, and amendments thereto or a physician's assistant registered
pursuant to K.S.A. 65-2896a and amendments thereto who has authority
to prescribe drugs pursuant to a written protocol with a responsible phy-
sician under K.S.A. 65-2896e and amendments thereto.

      Sec.  4. K.S.A. 21-4214 is hereby amended to read as follows: 21-
4214. (a) Obtaining a prescription-only drug by fraudulent means is the:

      (1) Making, altering or signing of a prescription order by a person
other than a practitioner or a mid-level practitioner; or

      (2) delivery of a prescription order, knowing it to have been made,
altered or signed by a person other than a practitioner or a mid-level
practitioner; or

      (3) possession of a prescription order with intent to deliver it and
knowing it to have been made, altered or signed by a person other than
a practitioner or a mid-level practitioner; or

      (4) possession of a prescription-only drug knowing it to have been
obtained pursuant to a prescription order made, altered or signed by a
person other than a practitioner or a mid-level practitioner; or

      (5) providing false information to a practitioner or mid-level practi-
tioner for the purpose of obtaining a prescription-only drug.

      (b)  (1) Obtaining a prescription-only drug by fraudulent means is a
class A nonperson misdemeanor for the first offense.

      (2) Obtaining a prescription-only drug by fraudulent means is a se-
verity level 9, nonperson felony for a second or subsequent offense.

      (c) As used in this section:

      (1) ``Pharmacist,'' ``practitioner'' ``practitioner,'' ``mid-level practi-
tioner'' and ``prescription-only drug'' shall have the meanings ascribed
thereto by K.S.A. 65-1626 and amendments thereto.

      (2) ``Prescription order'' means a written, oral or telephonic order for
a prescription-only drug to be filled by a pharmacist. ``Prescription order''
does not mean a drug dispensed pursuant to such an order.

      (d) The provisions of this section shall not be applicable to prosecu-
tions involving prescription-only drugs which could be brought under the
uniform controlled substances act and to which the provisions of K.S.A.
65-4127a or 65-4127b, or K.S.A. 1995 Supp. 65-4160 through 65-4164
and amendments thereto, would be applicable.

      (e) This section shall be part of and supplemental to the Kansas crim-
inal code.

      Sec.  5. K.S.A. 39-7,117 is hereby amended to read as follows: 39-
7,117. (a) A practitioner or a mid-level practitioner as defined in subsec-
tion (ii) of K.S.A. 65-1626 and amendments thereto may prescribe pre-
scription-only drugs in accordance with this section that, in the
professional judgment of the practitioner or mid-level practitioner and
within the lawful scope of the practitioner's or mid-level practitioner's
practice, the practitioner or mid-level practitioner considers appropriate
for the diagnosis and treatment of a patient. The department of social
and rehabilitation services shall not maintain a restrictive drug formulary
under the medicaid program that restricts a physician's ability to treat a
patient with a drug that has been approved and designated as safe and
effective by the federal food and drug administration, except that the
department may limit reimbursement for a prescription-only drug upon
the recommendation of the drug utilization review committee and only
upon a finding that the drug is unsafe or is being prescribed contrary to
the federally approved guidelines. Drugs used for cosmetic purposes, fer-
tility drugs, anorexic drugs, non-legend (over the counter) drugs, and
drugs for which there is no federal financial participation shall be exempt
from the provisions of this section, except that the department is author-
ized to include drugs from these categories for reimbursement based
upon recommendations of the drug utilization review committee which
may include prior authorization requirements to control use.

      (b) Nothing in this section shall limit the authority of the department
to reimburse for multisource prescription-only drugs in accordance with
state and federal law, including state maximum allowable cost and federal
upper limit requirements of the health care financing administration.

      (c) The provisions of this section shall be effective on and after April
15, 1992, by further authorization by a concurrent resolution approved
by a majority of all members elected (or appointed) and qualified of each
house of the legislature and shall not be effective prior to that date.

      Sec.  6. K.S.A. 1998 Supp. 40-2123 is hereby amended to read as
follows: 40-2123. (a) The plan shall offer coverage to every eligible person
pursuant to which such person's covered expenses shall be indemnified
or reimbursed subject to the provisions of K.S.A. 40-2124 and amend-
ments thereto.

      (b) Except for those expenses set forth in subsection (c) of this sec-
tion, expenses covered under the plan shall include expenses for:

      (1) Services of persons licensed to practice medicine and surgery
which are medically necessary for the diagnosis or treatment of injuries,
illnesses or conditions;

      (2) services of advanced registered nurse practitioners who hold a
certificate of qualification from the board of nursing to practice in an
expanded role or physicians assistants acting under the direction of a
responsible physician when such services are provided at the direction of
a person licensed to practice medicine and surgery and meet the require-
ments of paragraph (b)(1) above;

      (3) services of licensed dentists when such procedures would other-
wise be performed by persons licensed to practice medicine and surgery;

      (4) emergency care, surgery and treatment of acute episodes of illness
or disease as defined in the plan and provided in a general hospital or
ambulatory surgical center as such terms are defined in K.S.A. 65-425,
and amendments thereto;

      (5) medically necessary diagnostic laboratory and x-ray services;

      (6) drugs and controlled substances prescribed by a practitioner, as
defined in subsection (x) of K.S.A. 65-1626 and amendments thereto, or
drugs and controlled substances prescribed by a mid-level practitioner as
defined in subsection (ii) of K.S.A. 65-1626 and amendments thereto. Cov-
erage for outpatient prescriptions shall be subject to a mandatory 50%
coinsurance provision, and coverage for prescriptions administered to in-
patients shall be subject to a coinsurance provision as established in the
plan; and

      (7) subject to the approval of the commissioner, the board shall also
review and recommend the inclusion of coverage for mental health serv-
ices and such other primary and preventive health care services as the
board determines would not materially impair affordability of the plan.

      (c) Expenses not covered under the plan shall include expenses for:

      (1) Illness or injury due to an act of war;

      (2) services rendered prior to the effective date of coverage under
this plan for the person on whose behalf the expense is incurred;

      (3) services for which no charge would be made in the absence of
insurance or for which the insured bears no legal obligation to pay;

      (4)  (A) services or charges incurred by the insured which are oth-
erwise covered by:

      (i) Medicare or state law or programs;

      (ii) medical services provided for members of the United States
armed forces and their dependents or for employees of such armed
forces;

      (iii) military service-connected disability benefits;

      (iv) other benefit or entitlement programs provided for by the laws
of the United States (except title XIX of the social security act of 1965);

      (v) workers compensation or similar programs addressing injuries,
diseases, or conditions incurred in the course of employment covered by
such programs;

      (vi) benefits payable without regard to fault pursuant to any motor
vehicle or other liability insurance policy or equivalent self-insurance.

      (B) This exclusion shall not apply to services or charges which exceed
the benefits payable under the applicable programs listed above and
which are otherwise eligible for payment under this section.

      (5) Services the provision of which is not within the scope of the
license or certificate of the institution or individual rendering such serv-
ice;

      (6) that part of any charge for services or articles rendered or pre-
scribed which exceeds the rate established by K.S.A. 40-2131 and amend-
ments thereto for such services;

      (7) services or articles not medically necessary;

      (8) care which is primarily custodial or domiciliary in nature;

      (9) cosmetic surgery unless provided as the result of an injury or
medically necessary surgical procedure;

      (10) eye surgery if corrective lenses would alleviate the problem;

      (11) experimental services or supplies not generally recognized as the
normal mode of treatment for the illness or injury involved;

      (12) service of a blood donor and any fee for failure of the insured
to replace the first three pints of blood provided in each calendar year;
and

      (13) personal supplies or services provided by a health care facility or
any other nonmedical or nonprescribed supply or service.

      (d) Except as expressly provided for in this act, no law requiring the
coverage or the offer of coverage of a health care service or benefit shall
apply to the plan.

      (e) A plan may incorporate provisions that will direct covered persons
to the most appropriate lowest cost health care provider available.

      Sec.  7. K.S.A. 1998 Supp. 60-4403 is hereby amended to read as
follows: 60-4403. (a) A licensed health care professional who administers,
prescribes or dispenses medications or procedures to relieve another per-
son's pain or discomfort, even if the medication or procedure may hasten
or increase the risk of death, does not violate K.S.A. 21-3406 and amend-
ments thereto unless the medications or procedures are knowingly ad-
ministered, prescribed or dispensed with the intent to cause death. A
mid-level practitioner as defined in subsection (ii) of K.S.A. 65-1626 and
amendments thereto who prescribes medications or procedures to relieve
another person's pain or discomfort, even if the medication or procedure
may hasten or increase the risk of death, does not violate K.S.A. 21-3406
and amendments thereto unless the medications or procedures are know-
ingly prescribed with the intent to cause death.

      (b) A licensed health care professional, family member or other le-
gally authorized person who participates in the act of, or the decision
making process which results in the withholding or withdrawal of a life-
sustaining procedure does not violate K.S.A. 21-3406 and amendments
thereto.

      (c) Providing spiritual treatment through prayer alone, in lieu of med-
ical treatment, does not violate K.S.A. 21-3406 and amendments thereto.

      Sec.  8. K.S.A. 65-669 is hereby amended to read as follows: 65-669.
A drug or device shall be deemed to be misbranded:

      (a) If its labeling is false or misleading in any particular.

      (b) If in package form unless it bears a label containing: (1) the name
and place of business of the manufacturer, the packer or the distributor,
except that in the case of a prescription drug it shall bear the name and
place of business of the person responsible for the production of the
finished dosage form of the drug, the packer and the distributor; except
that nothing in clause (1) of this paragraph shall be construed to apply to
wholesalers and the requirement of clause (1) shall be satisfied by stating
such information on the label of the drug and filing a statement with such
information with the secretary which shall be made available by the sec-
retary on request to local, public and private health agencies, poison con-
trol centers, licentiates of the healing arts, the state board of pharmacy,
consumers and others to promote the purposes of this act; in no event,
however, shall the label contain less information than required under
federal law; and (2) an accurate statement of the quantity of the contents
in terms of weight, measure, or numerical count, except that under clause
(2) of this paragraph reasonable variations shall be permitted and exemp-
tions as to small packages shall be allowed, in accordance with regulations
prescribed by the secretary, or issued under the federal act.

      (c) If any word, statement, or other information required by or under
authority of this act to appear on the label or labeling is not prominently
placed thereon with such conspicuousness (as compared with other
words, statements, designs or devices, in the labeling) and in such terms
as to render it likely to be read and understood by the ordinary individual
under customary conditions of purchase and use.

      (d) If it is for use by man and contains any quantity of narcotic or
hypnotic substance alpha-eucaine, barbituric acid, beta-eucaine, bromal,
cannabis, carbromal, chloral, coca, cocaine, codeine, heroin, marijuana,
morphine, opium, paraldehyde, peyote, or sulphonmethane, or any chem-
ical derivative of such substance, which derivative has been by the sec-
retary after investigation, found to be, and by regulations under this act,
or by regulations issued pursuant to 21 U.S.C. 352 (d), designated as,
habit forming, unless its label bears the name and quantity or proportion
of such substance or derivative and in juxtaposition therewith the state-
ment ``warning-may be habit forming.''

      (e)  (1) If it is a drug, unless its label bears, to the exclusion of any
other nonproprietary name (except the applicable systematic chemical
name or the chemical formula), (i) the established name (as defined in
subparagraph (2)) of the drug, if such there be; and (ii) in case it is fab-
ricated from two or more ingredients, the established name of each active
ingredient, including the kind and quantity of proportion of any alcohol,
and also including, whether active or not, the established name and quan-
tity or proportion of any bromides, ether, chloroform, acetanilid, acet-
phenetidin, amidopyrine, antipyrine, atropine, hyoscine, hyoscyamine, ar-
senic, digitalis, digitalis glucosides, mercury, ouabain, strophanthin,
strychnine, thyroid, or any derivative or preparation of any such sub-
stances, contained therein. The requirements for stating the quantity of
the active ingredients, other than the quantity of those specifically named
in this paragraph, shall apply only to prescription drugs. To the extent
that compliance with the requirements of clause (ii) of this subparagraph
is impracticable, exemptions shall be allowed under regulations promul-
gated by the secretary, or under the federal act.

      (2) As used in this paragraph (e), the term ``established name,'' with
respect to a drug or ingredient thereof, means (A) the applicable official
name designated pursuant to 21 U.S.C. 358, or (B) if there is no such
name and such drug, or such ingredient, is an article recognized in an
official compendium, then the official title thereof in such compendium
or (C) if neither clause (A) nor clause (B) of this subparagraph applies,
then the common or usual name, if any, of such drug or of such ingre-
dient. Where clause (B) of this subparagraph applies to an article rec-
ognized in the United States pharmacopoeia and in the homeopathic
pharmacopoeia under different official titles, the official title used in the
United States pharmacopoeia shall apply unless it is labeled and offered
for sale as a homeopathic drug, in which case the official title used in the
homeopathic pharmacopoeia shall apply.

      (f) Unless its labeling bears (1) adequate directions for use; and (2)
such adequate warning against use in those pathological conditions or by
children where its use may be dangerous to health, or against unsafe
dosage or methods or duration of administration or application, in such
manner and form, as are necessary for the protection of users. Where any
requirement of clause (1) of this paragraph, as applied to any drug or
device, is not necessary for the protection of the public health, the sec-
retary shall promulgate regulations exempting such drug or device from
such requirements. Articles exempted under regulations issued under 21
U.S.C. 352 (f) may also be exempt.

      (g) If it purports to be a drug the name of which is recognized in an
official compendium, unless it is packaged and labeled as prescribed
therein. The method of packing may be modified with the consent of the
secretary, or if consent is obtained under the federal act. Whenever a
drug is recognized in both the United States pharmacopoeia and the
homeopathic pharmacopoeia of the United States, it shall be subject to
the requirements of the United States pharmacopoeia with respect to the
packaging and labeling unless it is labeled and offered for sale as a ho-
meopathic drug, in which case it shall be subject to the provisions of the
homeopathic pharmacopoeia of the United States, and not to those of the
United States pharmacopoeia. In the event of inconsistency between the
requirements of this paragraph and those of paragraph (e) as to the name
by which the drug or its ingredients shall be designated, the requirements
of paragraph (e) shall prevail.

      (h) If it has been found by the secretary or under the federal act to
be a drug liable to deterioration, unless it is packed in such form and
manner, and its label bears a statement of such precautions, as the reg-
ulations adopted by the secretary require as necessary for the protection
of public health. No such regulations shall be established for any drug
recognized in an official compendium until the secretary shall have in-
formed the appropriate body charged with the revision of such compen-
dium of the need for such packaging or labeling requirements and such
body shall have failed within a reasonable time to prescribe such require-
ments.

      (i)  (1) If it is a drug and its container is so made, formed, or filled as
to be misleading; or (2) if it is an imitation of another drug; or (3) if it is
offered for sale under the name of another drug.

      (j) If it is dangerous to health when used in the dosage, or with the
frequency of duration prescribed, recommended, or suggested in the la-
beling thereof.

      (k) If it is, or purports to be, or is represented as a drug composed
wholly or partly of insulin, unless (1) it is from a batch with respect to
which a certificate or release has been issued pursuant to 21 U.S.C. 356,
and (2) such certificate or release is in effect with respect to such drug.

      (l) If it is, or purports to be, or is represented as a drug composed
wholly or partly of any kind of penicillin, streptomycin, chlortetracycline,
chloramphenicol, bacitracin, or any other antibiotic drug, or any deriva-
tive thereof, unless (1) it is from a batch with respect to which a certificate
or release has been issued pursuant to 21 U.S.C. 357, and (2) such cer-
tificate or release is in effect with respect to such drug. This paragraph
shall not apply to any drug or class of drugs exempted by regulations
promulgated under 21 U.S.C. 357 (c) or (d). For the purpose of this
subsection the term ``antibiotic drug'' means any drug intended for use
by man containing any quantity of any chemical substance which is pro-
duced by a microorganism and which has the capacity to inhibit or destroy
microorganisms in dilute solution (including the chemically synthesized
equivalent of any such substance).

      (m) If it is a color additive, the intended use of which in or on drugs
is for the purpose of coloring only, unless its packaging and labeling are
in conformity with such packaging and labeling requirements applicable
to such color additive, prescribed under the provisions of K.S.A. 65-667
or of the federal act.

      (n) In the case of any prescription drug distributed or offered for sale
in this state, unless the manufacturer, packer, or distributor thereof in-
cludes in all advertisements and other descriptive printed matter issued
or caused to be issued by the manufacturer, packer, or distributor with
respect to that drug a true statement of (1) the established name, as
defined in subsection (e) (2) of this section, (2) the formula showing
quantitatively each ingredient of such drug to the extent required for
labels under 21 U.S.C. 352 (e), and (3) such other information in brief
summary relating to side effects, contraindications, and effectiveness as
shall be required in regulations issued under the federal act.

      (o) If a trademark, trade name or other identifying mark, imprint or
device of another or any likeness of the foregoing has been placed thereon
or upon its container with intent to defraud.

      (p) Drugs and devices which are, in accordance with the practice of
the trade, to be processed, labeled or repacked in substantial quantities
at establishments other than those where originally processed or packed
shall be exempt from any labeling or packaging requirements of this act
if such drugs and devices are being delivered, manufactured, processed,
labeled, repacked or otherwise held in compliance with regulations issued
by the secretary or under the federal act.

      (q) A drug intended for use by man which (A) is a habit-forming drug
to which K.S.A. 65-668 applies; or (B) because of its toxicity or other
potentiality for harmful effect, or the method of its use, or the collateral
measures necessary to its use, is not safe for use except under the super-
vision of a practitioner licensed by law to administer such drug; or (C) is
limited by an approved application under 21 U.S.C. 355 or K.S.A. 65-
669a to use under the professional supervision of a practitioner licensed
by law to administer such drug, shall be dispensed only (i) upon a written
prescription of a practitioner licensed by law to administer such drug or
upon the written prescription of a mid-level practitioner as defined in
subsection (ii) of K.S.A. 65-1626 and amendments thereto, or (ii) upon an
oral prescription of such practitioner or mid-level practitioner which is
reduced promptly to writing and filed by the pharmacist, or (iii) by re-
filling, any such written or oral prescription if such refilling is authorized
by the prescriber either in the original prescription or by oral order which
is reduced promptly to writing and filed by the pharmacist. The act of
dispensing a drug contrary to the provisions of this paragraph shall be
deemed to be an act which results in a drug being misbranded while held
for sale.

      (r) Any drug dispensed by filling or refilling a written or oral pre-
scription of a practitioner licensed by law to administer such drug or by
filling or refilling a written or oral prescription of a mid-level practitioner
as defined in subsection (ii) of K.S.A. 65-1626 and amendments thereto
shall be exempt from the requirements of this section, except subsections
(a), (i) (2) and (3), (k), and (l), and the packaging requirements of sub-
sections (g) and (h), if the drug bears a label containing the name and
address of the dispenser, the serial number and date of the prescription
or of its filling, the name of the prescriber and, if stated in the prescrip-
tion, the name of the patient, and the directions for use and cautionary
statements, if any, contained in such prescription. This exemption shall
not apply to any drug dispensed in the course of the conduct of a business
of dispensing drugs pursuant to diagnosis by mail, or to a drug dispensed
in violation of paragraph (q) of this section.

      (s) The secretary may, by regulation, remove drugs subject to sub-
section (d) of this section and K.S.A. 65-669a from the requirements of
paragraph (q) of this section when such requirements are not necessary
for the protection of the public health. Drugs removed from the prescrip-
tion requirements of the federal act by regulations issued thereunder may
also, by regulations issued by the secretary, be removed from the require-
ments of paragraph (q) of this section.

      (t) A drug which is subject to paragraph (q) of this section shall be
deemed to be misbranded if at any time prior to dispensing its label fails
to bear the statement ``caution: federal law prohibits dispensing without
prescription,'' or ``caution: state law prohibits dispensing without prescrip-
tion.'' A drug to which paragraph (q) of this section does not apply shall
be deemed to be misbranded if at any time prior to dispensing its label
bears the caution statement quoted in the preceding sentence.

      (u) Nothing in this section shall be construed to relieve any person
from any requirement prescribed by or under authority of law with re-
spect to drugs now included or which may hereafter be included within
the classifications of narcotic drugs or marijuana as defined in the appli-
cable federal and state laws relating to narcotic drugs and marijuana.

      Sec.  9. K.S.A. 1998 Supp. 65-1627 is hereby amended to read as
follows: 65-1627. (a) The board may revoke, suspend, place in a proba-
tionary status or deny a renewal of any license of any pharmacist upon a
finding that:

      (1) The license was obtained by fraudulent means;

      (2) the licensee has been convicted of a felony and the licensee fails
to show that the licensee has been sufficiently rehabilitated to warrant
the public trust;

      (3) the licensee is found by the board to be guilty of unprofessional
conduct or professional incompetency;

      (4) the licensee is addicted to the liquor or drug habit to such a degree
as to render the licensee unfit to practice the profession of pharmacy;

      (5) the licensee has violated a provision of the federal or state food,
drug and cosmetic act, the uniform controlled substances act of the state
of Kansas, or any rule and regulation adopted under any such act;

      (6) the licensee is found by the board to have filled a prescription not
in strict accordance with the directions of the practitioner or a mid-level
practitioner;

      (7) the licensee is found to be mentally or physically incapacitated to
such a degree as to render the licensee unfit to practice the profession
of pharmacy;

      (8) the licensee has violated any of the provisions of the pharmacy
act of the state of Kansas or any rule and regulation adopted by the board
pursuant to the provisions of such pharmacy act;

      (9) the licensee has failed to comply with the requirements of the
board relating to the continuing education of pharmacists;

      (10) the licensee as a pharmacist in charge or consultant pharmacist
under the provisions of subsection (c) or (d) of K.S.A. 65-1648 and
amendments thereto has failed to comply with the requirements of sub-
section (c) or (d) of K.S.A. 65-1648 and amendments thereto;

      (11) the licensee has knowingly submitted a misleading, deceptive,
untrue or fraudulent misrepresentation on a claim form, bill or statement;

      (12) the licensee has had a license to practice pharmacy revoked,
suspended or limited, has been censured or has had other disciplinary
action taken, or voluntarily surrendered the license after formal proceed-
ings have been commenced, or has had an application for license denied,
by the proper licensing authority of another state, territory, District of
Columbia or other country, a certified copy of the record of the action
of the other jurisdiction being conclusive evidence thereof; or

      (13) the licensee has self-administered any controlled substance with-
out a practitioner's prescription order. or a mid-level practitioner's pre-
scription order; or

      (14) the licensee has assisted suicide in violation of K.S.A. 21-3406
and amendments thereto as established by any of the following:

      (A) A copy of the record of criminal conviction or plea of guilty for a
felony in violation of K.S.A. 21-3406 and amendments thereto.

      (B) A copy of the record of a judgment of contempt of court for vio-
lating an injunction issued under K.S.A. 1998 Supp. 60-4404 and amend-
ments thereto.

      (C) A copy of the record of a judgment assessing damages under
K.S.A. 1998 Supp. 60-4405 and amendments thereto.

      (b) In determining whether or not the licensee has violated subsec-
tion (a)(3), (a)(4), (a)(7) or (a)(13), the board upon reasonable suspicion
of such violation has authority to compel a licensee to submit to mental
or physical examination or drug screen, or any combination thereof, by
such persons as the board may designate. To determine whether reason-
able suspicion of such violation exists, the investigative information shall
be presented to the board as a whole. Information submitted to the board
as a whole and all reports, findings and other records shall be confidential
and not subject to discovery by or release to any person or entity. The
licensee shall submit to the board a release of information authorizing
the board to obtain a report of such examination or drug screen, or both.
A person affected by this subsection shall be offered, at reasonable in-
tervals, an opportunity to demonstrate that such person can resume the
competent practice of pharmacy with reasonable skill and safety to pa-
tients. For the purpose of this subsection, every person licensed to prac-
tice pharmacy and who shall accept the privilege to practice pharmacy in
this state by so practicing or by the making and filing of a renewal appli-
cation to practice pharmacy in this state shall be deemed to have con-
sented to submit to a mental or physical examination or a drug screen, or
any combination thereof, when directed in writing by the board and fur-
ther to have waived all objections to the admissibility of the testimony,
drug screen or examination report of the person conducting such exam-
ination or drug screen, or both, at any proceeding or hearing before the
board on the ground that such testimony or examination or drug screen
report constitutes a privileged communication. In any proceeding by the
board pursuant to the provisions of this subsection, the record of such
board proceedings involving the mental and physical examination or drug
screen, or any combination thereof, shall not be used in any other ad-
ministrative or judicial proceeding.

      (c) The board may suspend, revoke, place in a probationary status or
deny a renewal of any retail dealer's permit issued by the board when
information in possession of the board discloses that such operations for
which the permit was issued are not being conducted according to law or
the rules and regulations of the board.

      (d) The board may revoke, suspend, place in a probationary status or
deny a renewal of the registration of a pharmacy upon a finding that: (1)
Such pharmacy has been operated in such manner that violations of the
provisions of the pharmacy act of the state of Kansas or of the rules and
regulations of the board have occurred in connection therewith; (2) the
owner or any pharmacist employed at such pharmacy is convicted, sub-
sequent to such owner's acquisition of or such employee's employment
at such pharmacy, of a violation of the pharmacy act or uniform controlled
substances act of the state of Kansas, or the federal or state food, drug
and cosmetic act; (3) the owner or any pharmacist employed by such
pharmacy has fraudulently claimed money for pharmaceutical services;
or (4) the registrant has had a registration revoked, suspended or limited,
has been censured or has had other disciplinary action taken, or an ap-
plication for registration denied, by the proper registering authority of
another state, territory, District of Columbia or other country, a certified
copy of the record of the action of the other jurisdiction being conclusive
evidence thereof.

      (e) A registration to manufacture or to distribute at wholesale a drug
or a registration for the place of business where any such operation is
conducted may be suspended, revoked, placed in a probationary status
or the renewal of such registration may be denied by the board upon a
finding that the registrant or the registrant's agent: (1) Has materially
falsified any application filed pursuant to or required by the pharmacy
act of the state of Kansas; (2) has been convicted of a felony under any
federal or state law relating to the manufacture or distribution of drugs;
(3) has had any federal registration for the manufacture or distribution of
drugs suspended or revoked; (4) has refused to permit the board or its
duly authorized agents to inspect the registrant's establishment in ac-
cordance with the provisions of K.S.A. 65-1629 and amendments thereto;
(5) has failed to keep, or has failed to file with the board or has falsified
records required to be kept or filed by the provisions of the pharmacy
act of the state of Kansas or by the board's rules and regulations; or (6)
has violated the pharmacy act of the state of Kansas or rules and regu-
lations adopted by the state board of pharmacy under the pharmacy act
of the state of Kansas or has violated the uniform controlled substances
act or rules and regulations adopted by the state board of pharmacy under
the uniform controlled substances act.

      (f) Orders under this section, and proceedings thereon, shall be sub-
ject to the provisions of the Kansas administrative procedure act.

      Sec.  10. K.S.A. 1998 Supp. 65-1643 is hereby amended to read as
follows: 65-1643. On and after the effective date of this act, it shall be
unlawful:

      (a) For any person to operate, maintain, open or establish any phar-
macy within this state without first having obtained a registration from
the board. Each application for registration of a pharmacy shall indicate
the person or persons desiring the registration, including the pharmacist
in charge, as well as the location, including the street name and number,
and such other information as may be required by the board to establish
the identity and exact location of the pharmacy. The issuance of a regis-
tration for any pharmacy shall also have the effect of permitting such
pharmacy to operate as a retail dealer without requiring such pharmacy
to obtain a retail dealer's permit. On evidence satisfactory to the board:
(1) That the pharmacy for which the registration is sought will be con-
ducted in full compliance with the law and the rules and regulations of
the board; (2) that the location and appointments of the pharmacy are
such that it can be operated and maintained without endangering the
public health or safety; (3) that the pharmacy will be under the supervision
of a pharmacist, a registration shall be issued to such persons as the board
shall deem qualified to conduct such a pharmacy.

      (b) For any person to manufacture within this state any drugs except
under the personal and immediate supervision of a pharmacist or such
other person or persons as may be approved by the board after an inves-
tigation and a determination by the board that such person or persons is
qualified by scientific or technical training or experience to perform such
duties of supervision as may be necessary to protect the public health and
safety; and no person shall manufacture any such drugs without first ob-
taining a registration so to do from the board. Such registration shall be
subject to such rules and regulations with respect to requirements, sani-
tation and equipment, as the board may from time to time adopt for the
protection of public health and safety.

      (c) For any person to distribute at wholesale any drugs without first
obtaining a registration so to do from the board.

      (d) For any person to sell or offer for sale at public auction or private
sale in a place where public auctions are conducted, any drugs without
first having obtained a registration from the board so to do, and it shall
be necessary to obtain the permission of the board in every instance where
any of the products covered by this section are to be sold or offered for
sale.

      (e) For any person to in any manner distribute or dispense samples
of any drugs without first having obtained a permit from the board so to
do, and it shall be necessary to obtain permission from the board in every
instance where the samples are to be distributed or dispensed. Nothing
in this subsection shall be held to regulate or in any manner interfere
with the furnishing of samples of drugs to duly licensed practitioners, to
mid-level practitioners, to pharmacists or to medical care facilities.

      (f) Except as otherwise provided in this subsection (f), for any person
operating a store or place of business to sell, offer for sale or distribute
any drugs to the public without first having obtained a registration or
permit from the board authorizing such person so to do. No retail dealer
who sells 12 or fewer different nonprescription drug products shall be
required to obtain a retail dealer's permit under the pharmacy act of the
state of Kansas or to pay a retail dealer new permit or permit renewal fee
under such act. It shall be lawful for a retail dealer who is the holder of
a valid retail dealer's permit issued by the board or for a retail dealer who
sells 12 or fewer different nonprescription drug products to sell and dis-
tribute nonprescription drugs which are prepackaged, fully prepared by
the manufacturer or distributor for use by the consumer and labeled in
accordance with the requirements of the state and federal food, drug and
cosmetic acts. Such nonprescription drugs shall not include: (1) A con-
trolled substance; (2) a drug product the label of which is required to
bear substantially the statement: ``Caution: Federal law prohibits dis-
pensing without prescription''; or (3) a drug product intended for human
use by hypodermic injection; but such a retail dealer shall not be author-
ized to display any of the words listed in subsection (u) of K.S.A. 65-1626
and amendments thereto, for the designation of a pharmacy or drugstore.

      (g) For any person to sell any drugs manufactured and sold only in
the state of Kansas, unless the label and directions on such drugs shall
first have been approved by the board.

      (h) For any person to operate an institutional drug room without first
having obtained a registration to do so from the board. Such registration
shall be subject to the provisions of K.S.A. 65-1637a and amendments
thereto and any rules and regulations adopted pursuant thereto.

      (i) For any person to be a pharmacy student without first obtaining
a registration to do so from the board, in accordance with rules and reg-
ulations adopted by the board, and paying a pharmacy student registration
fee of $25 to the board.

      Sec.  11. K.S.A. 1998 Supp. 65-1660 is hereby amended to read as
follows: 65-1660. (a) Except as otherwise provided in this section, the
provisions of the pharmacy act of the state of Kansas shall not apply to
dialysates, devices or drugs which are designated by the board for the
purposes of this section relating to treatment of a person with chronic
kidney failure receiving dialysis and which are prescribed or ordered by
a physician or a mid-level practitioner for administration or delivery to a
person with chronic kidney failure if:

      (1) The wholesale distributor is registered with the board and lawfully
holds the drug or device; and

      (2) the wholesale distributor (A) delivers the drug or device to: (i) A
person with chronic kidney failure for self-administration at the person's
home or specified address; (ii) a physician for administration or delivery
to a person with chronic kidney failure; or (iii) a medicare approved renal
dialysis facility for administering or delivering to a person with chronic
kidney failure; and (B) has sufficient and qualified supervision to ade-
quately protect the public health.

      (b) The wholesale distributor pursuant to subsection (a) shall be su-
pervised by a pharmacist consultant pursuant to rules and regulations
adopted by the board.

      (c) The board shall adopt such rules or regulations as are necessary
to effectuate the provisions of this section.

      (d) As used in this section, ``physician'' means a person licensed to
practice medicine and surgery; ``mid-level practitioner'' means mid-level
practitioner as such term is defined in subsection (ii) of K.S.A. 65-1626
and amendments thereto.

      (e) This section shall be part of and supplemental to the pharmacy
act of the state of Kansas.

      Sec.  12. K.S.A. 1998 Supp. 65-2837a is hereby amended to read as
follows: 65-2837a. (a) It shall be unlawful for any person licensed to prac-
tice medicine and surgery to prescribe, order, dispense, administer, sell,
supply or give or for a mid-level practitioner as defined in subsection (ii)
of K.S.A. 65-1626 and amendments thereto to prescribe, administer, sup-
ply or give any amphetamine or sympathomimetic amine designated in
schedule II, III or IV under the uniform controlled substances act, except
as provided in this section. Failure to comply with this section by a li-
censee shall constitute unprofessional conduct under K.S.A. 65-2837 and
amendments thereto.

      (b) When any licensee prescribes, orders, dispenses, administers,
sells, supplies or gives or when any mid-level practitioner as defined in
subsection (ii) of K.S.A. 65-1626 and amendments thereto prescribes, ad-
ministers, sells, supplies or gives any amphetamine or sympathomimetic
amine designated in schedule II, III or IV under the uniform controlled
substances act, the patient's medical record shall adequately document
and the prescription order shall indicate in the licensee's or mid-level
practitioner's own handwriting, the purpose for which the drug is being
given. Such purpose shall be restricted to one or more of the following:

      (1) The treatment of narcolepsy.

      (2) The treatment of drug-induced brain dysfunction.

      (3) The treatment of hyperkinesis.

      (4) The differential diagnostic psychiatric evaluation of depression.

      (5) The treatment of depression shown by adequate medical records
and documentation to be unresponsive to other forms of treatment.

      (6) The clinical investigation of the effects of such drugs or com-
pounds, in which case, before the investigation is begun, the licensee
shall, in addition to other requirements of applicable laws, apply for and
obtain approval of the investigation from the board of healing arts.

      (7) The treatment of obesity with controlled substances, as may be
defined by rules and regulations adopted by the board of healing arts.

      (8) The treatment of any other disorder or disease for which such
drugs or compounds have been found to be safe and effective by com-
petent scientific research which findings have been generally accepted by
the scientific community, in which case, the licensee before prescribing,
ordering, dispensing, administering, selling, supplying or giving the drug
or compound for a particular condition, or the licensee before authorizing
a mid-level practitioner to prescribe the drug or compound for a partic-
ular condition, shall obtain a determination from the board of healing arts
that the drug or compound can be used for that particular condition.

      Sec.  13. K.S.A. 65-2896e is hereby amended to read as follows: 65-
2896e. (a) A person whose name has been entered on the register of
physicians' assistants may perform, only under the direction and super-
vision of a physician, acts which constitute the practice of medicine and
surgery to the extent and in the manner authorized by the physician re-
sponsible for the physician's assistant and only to the extent such acts are
consistent with rules and regulations adopted by the board which relate
to acts performed by a physician's assistant under the responsible physi-
cian's direction and supervision. A physician's assistant may not prescribe
drugs but may transmit a prescription order for drugs pursuant to a writ-
ten protocol as authorized by the responsible physician. Before a physi-
cian's assistant shall perform under the direction and supervision of a
physician, such physician's assistant shall be identified to the patient and
others involved in providing the patient services as a physician's assistant
to the responsible physician. A physician's assistant may not perform any
act or procedure performed in the practice of optometry except as pro-
vided in K.S.A. 65-1508 and 65-2887 and amendments thereto.

      (b) The board shall adopt rules and regulations governing the trans-
mitting of prescription orders for prescribing of drugs by physicians' as-
sistants and the responsibilities of the responsible physician with respect
thereto. Such rules and regulations shall establish such conditions and
limitations as the board determines to be necessary to protect the public
health and safety. In developing rules and regulations relating to the trans-
mitting of prescription orders for prescribing of drugs by physicians' as-
sistants, the board shall take into consideration the amount of training
and capabilities of physicians' assistants, the different practice settings in
which physicians' assistants and responsible physicians practice, the de-
gree of direction and supervision to be provided by a responsible physi-
cian and the needs of the geographic area of the state in which the phy-
sician's assistant and the responsible physician practice. In all cases in
which a physician's assistant is authorized to transmit prescription orders
for prescribe drugs by a responsible physician, a written protocol between
the responsible physician and the physician's assistant containing the es-
sential terms of such authorization shall be in effect. Any written pre-
scription order shall include the name, address and telephone number of
the responsible physician. In no case shall the scope of the authority of
the physician's assistant to transmit prescription orders for prescribe
drugs exceed the normal and customary practice of the responsible phy-
sician in the prescribing of drugs.

      (c) The physician's assistant may not dispense drugs, but may request,
receive and sign for professional samples and may distribute professional
samples to patients pursuant to a written protocol as authorized by the
responsible physician. In order to prescribe controlled substances, the
physician's assistant shall register with the federal drug enforcement ad-
ministration.

      (d) As used in this section, ``drug'' means those articles and substances
defined as drugs in K.S.A. 65-1626 and 65-4101 and amendments thereto.

      Sec.  14. K.S.A. 65-4116 is hereby amended to read as follows: 65-
4116. (a) Every person who manufactures, distributes or dispenses any
controlled substance within this state or who proposes to engage in the
manufacture, distribution or dispensing of any controlled substance
within this state shall obtain annually a registration issued by the board
in accordance with the uniform controlled substances act and with rules
and regulations adopted by the board.

      (b) Persons registered by the board under this act to manufacture,
distribute, dispense or conduct research with controlled substances may
possess, manufacture, distribute, dispense or conduct research with those
substances to the extent authorized by their registration and in conformity
with the other provisions of this act.

      (c) The following persons need not register and may lawfully possess
controlled substances under this act, as specified in this subsection:

      (1) An agent or employee of any registered manufacturer, distributor
or dispenser of any controlled substance if the agent or employee is acting
in the usual course of such agent or employee's business or employment;

      (2) a common or contract carrier or warehouseman or an employee
thereof whose possession of any controlled substance is in the usual
course of business or employment;

      (3) an ultimate user or a person in possession of any controlled sub-
stance pursuant to a lawful order of a practitioner or a mid-level practi-
tioner or in lawful possession of a schedule V substance;

      (4) persons licensed and registered by the board under the provisions
of the acts contained in article 16 of chapter 65 of the Kansas Statutes
Annotated, and amendments thereto, to manufacture, dispense or dis-
tribute drugs are considered to be in compliance with the registration
provision of the uniform controlled substances act without additional pro-
ceedings before the board or the payment of additional fees, except that
manufacturers and distributors shall complete and file the application
form required under the uniform controlled substances act;

      (5) any person licensed by the state board of healing arts;

      (6) any person licensed by the state board of veterinary examiners;

      (7) any person licensed by the Kansas dental board; and

      (8) a mid-level practitioner; and

      (8) (9) any person who is a member of the Native American Church,
with respect to use or possession of peyote, whose use or possession of
peyote is in, or for use in, bona fide religious ceremonies of the Native
American Church, but nothing in this paragraph shall authorize the use
or possession of peyote in any place used for the confinement or housing
of persons arrested, charged or convicted of criminal offenses or in the
state security hospital.

      (d) The board may waive by rules and regulations the requirement
for registration of certain manufacturers, distributors or dispensers if the
board finds it consistent with the public health and safety, except that
licensure of any person by the state board of healing arts, Kansas dental
board or the state board of veterinary examiners shall constitute compli-
ance with the registration requirements of the uniform controlled sub-
stances act by such person for such person's place of professional practice.
Evidence of abuse as determined by the board relating to a person li-
censed by the state board of healing arts shall be submitted to the state
board of healing arts and the attorney general within 60 days. The state
board of healing arts shall, within 60 days, make findings of fact and take
such action against such person as it deems necessary. All findings of fact
and any action taken shall be reported by the state board of healing arts
to the board of pharmacy and the attorney general. Evidence of abuse as
determined by the board relating to a person licensed by the state board
of veterinary examiners shall be submitted to the state board of veterinary
examiners and the attorney general within 60 days. The state board of
veterinary examiners shall, within 60 days, make findings of fact and take
such action against such person as it deems necessary. All findings of fact
and any action taken shall be reported by the state board of veterinary
examiners to the board of pharmacy and the attorney general. Evidence
of abuse as determined by the board relating to a dentist licensed by the
Kansas dental board shall be submitted to the Kansas dental board and
the attorney general within 60 days. The Kansas dental board shall, within
60 days, make findings of fact and take such action against such dentist
as it deems necessary. All findings of fact and any action taken shall be
reported by the Kansas dental board to the board of pharmacy and the
attorney general.

      (e) A separate annual registration is required at each place of business
or professional practice where the applicant manufactures, distributes or
dispenses controlled substances.

      (f) The board may inspect the establishment of a registrant or appli-
cant for registration in accordance with the board's rules and regulations.

      (g)  (1) The registration of any person or location shall terminate
when such person or authorized representative of a location dies, ceases
legal existence, discontinues business or professional practice or changes
the location as shown on the certificate of registration. Any registrant who
ceases legal existence, discontinues business or professional practice, or
changes location as shown on the certificate of registration, shall notify
the board promptly of such fact and forthwith deliver the certificate of
registration directly to the secretary or executive secretary of the board.
In the event of a change in name or mailing address the person or au-
thorized representative of the location shall notify the board promptly in
advance of the effective date of this change by filing the change of name
or mailing address with the board. This change shall be noted on the
original application on file with the board.

      (2) No registration or any authority conferred thereby shall be as-
signed or otherwise transferred except upon such conditions as the board
may specifically designate and then only pursuant to the written consent
of the board.

      Sec.  15. K.S.A. 65-4123 is hereby amended to read as follows: 65-
4123. (a) Except as otherwise provided in K.S.A. 65-4117 and amend-
ments thereto or in this subsection (a), no schedule I controlled substance
may be dispensed. The board by rules and regulations may designate in
accordance with the provisions of this subsection (a) a schedule I con-
trolled substance as a schedule I designated prescription substance. A
schedule I controlled substance designated as a schedule I designated
prescription substance may be dispensed only upon the written prescrip-
tion of a practitioner. Prior to designating a schedule I controlled sub-
stance as a schedule I designated prescription substance, the board shall
find: (1) That the schedule I controlled substance has an accepted medical
use in treatment in the United States; (2) that the public health will ben-
efit by the designation of the substance as a schedule I designated pre-
scription substance; and (3) that the substance may be sold lawfully under
federal law pursuant to a prescription. No prescription for a schedule I
designated prescription substance may be refilled.

      (b) Except when dispensed by a practitioner, other than a pharmacy,
to an ultimate user, no controlled substance in schedule II may be dis-
pensed without the written prescription of a practitioner or a mid-level
practitioner. In emergency situations, as defined by rules and regulations
of the board, schedule II drugs may be dispensed upon oral prescription
of a practitioner or a mid-level practitioner reduced promptly to writing
and filed by the pharmacy. No prescription for a schedule II substance
may be refilled.

      (c) Except when dispensed by a practitioner, other than a pharmacy,
to an ultimate user, a controlled substance included in schedule III or IV
which is a prescription drug shall not be dispensed without a written or
oral prescription of a practitioner or a mid-level practitioner. The pre-
scription shall not be filled or refilled more than six months after the date
thereof or be refilled more than five times.

      (d) A controlled substance shall not be distributed or dispensed other
than for a medical purpose. Prescriptions shall be retained in conformity
with the requirements of K.S.A. 65-4121 and amendments thereto.

      Sec.  16. K.S.A. 65-4134 is hereby amended to read as follows: 65-
4134. A practitioner engaged in medical practice or research or a mid-
level practitioner acting in the usual course of such mid-level practitioner's
practice is not required or compelled to furnish the name or identity of
a patient or research subject to the board, nor may he such practitioner
or mid-level practitioner be compelled in any state or local civil, criminal,
administrative, legislative or other proceedings to furnish the name or
identity of an individual that the practitioner or mid-level practitioner is
obligated to keep confidential.

      Sec.  17. K.S.A. 65-4202 is hereby amended to read as follows: 65-
4202. As used in this act: (a) ``Board'' means the state board of nursing.

      (b) The ``practice of mental health technology'' means the perform-
ance, under the direction of a physician licensed to practice medicine and
surgery or registered professional nurse, of services in caring for and
treatment of the mentally ill, emotionally disturbed, or mentally retarded
for compensation or personal profit, which services:

      (1) Involve responsible nursing and therapeutic procedures for men-
tally ill or mentally retarded patients requiring interpersonal and technical
skills in the observations and recognition of symptoms and reactions of
such patients, the accurate recording of such symptoms and reactions and
the carrying out of treatments and medications as prescribed by a licensed
physician or a mid-level practitioner as defined in subsection (ii) of K.S.A.
65-1626 and amendments thereto; and

      (2) require an application of techniques and procedures that involve
understanding of cause and effect and the safeguarding of life and health
of the patient and others; and

      (3) require the performance of duties that are necessary to facilitate
rehabilitation of the patient or are necessary in the physical, therapeutic
and psychiatric care of the patient and require close work with persons
licensed to practice medicine and surgery, psychiatrists, psychologists,
rehabilitation therapists, social workers, registered nurses, and other pro-
fessional personnel.

      (c) A ``licensed mental health technician'' means a person who law-
fully practices mental health technology as defined in this act.

      (d) An ``approved course in mental health technology'' means a pro-
gram of training and study including a basic curriculum which shall be
prescribed and approved by the board in accordance with the standards
prescribed herein, the successful completion of which shall be required
before licensure as a mental health technician, except as hereinafter pro-
vided.

      Sec.  18. K.S.A. 1998 Supp. 79-3606 is hereby amended to read as
follows: 79-3606. The following shall be exempt from the tax imposed by
this act:

      (a) All sales of motor-vehicle fuel or other articles upon which a sales
or excise tax has been paid, not subject to refund, under the laws of this
state except cigarettes as defined by K.S.A. 79-3301 and amendments
thereto, cereal malt beverages and malt products as defined by K.S.A. 79-
3817 and amendments thereto, including wort, liquid malt, malt syrup
and malt extract, which is not subject to taxation under the provisions of
K.S.A. 79-41a02 and amendments thereto, motor vehicles taxed pursuant
to K.S.A. 79-5117, and amendments thereto, tires taxed pursuant to
K.S.A. 1998 Supp. 65-3424d, and amendments thereto, and drycleaning
and laundry services taxed pursuant to K.S.A. 1998 Supp. 65-34,150, and
amendments thereto;

      (b) all sales of tangible personal property or service, including the
renting and leasing of tangible personal property, purchased directly by
the state of Kansas, a political subdivision thereof, other than a school or
educational institution, or purchased by a public or private nonprofit hos-
pital or public hospital authority or nonprofit blood, tissue or organ bank
and used exclusively for state, political subdivision, hospital or public hos-
pital authority or nonprofit blood, tissue or organ bank purposes, except
when: (1) Such state, hospital or public hospital authority is engaged or
proposes to engage in any business specifically taxable under the provi-
sions of this act and such items of tangible personal property or service
are used or proposed to be used in such business, or (2) such political
subdivision is engaged or proposes to engage in the business of furnishing
gas, water, electricity or heat to others and such items of personal prop-
erty or service are used or proposed to be used in such business;

      (c) all sales of tangible personal property or services, including the
renting and leasing of tangible personal property, purchased directly by
a public or private elementary or secondary school or public or private
nonprofit educational institution and used primarily by such school or
institution for nonsectarian programs and activities provided or sponsored
by such school or institution or in the erection, repair or enlargement of
buildings to be used for such purposes. The exemption herein provided
shall not apply to erection, construction, repair, enlargement or equip-
ment of buildings used primarily for human habitation;

      (d) all sales of tangible personal property or services purchased by a
contractor for the purpose of constructing, equipping, reconstructing,
maintaining, repairing, enlarging, furnishing or remodeling facilities for
any public or private nonprofit hospital or public hospital authority, public
or private elementary or secondary school or a public or private nonprofit
educational institution, which would be exempt from taxation under the
provisions of this act if purchased directly by such hospital or public hos-
pital authority, school or educational institution; and all sales of tangible
personal property or services purchased by a contractor for the purpose
of constructing, equipping, reconstructing, maintaining, repairing, en-
larging, furnishing or remodeling facilities for any political subdivision of
the state, the total cost of which is paid from funds of such political
subdivision and which would be exempt from taxation under the provi-
sions of this act if purchased directly by such political subdivision. Nothing
in this subsection or in the provisions of K.S.A. 12-3418 and amendments
thereto, shall be deemed to exempt the purchase of any construction
machinery, equipment or tools used in the constructing, equipping, re-
constructing, maintaining, repairing, enlarging, furnishing or remodeling
facilities for any political subdivision of the state. As used in this subsec-
tion, K.S.A. 12-3418 and 79-3640, and amendments thereto, ``funds of a
political subdivision'' shall mean general tax revenues, the proceeds of
any bonds and gifts or grants-in-aid. Gifts shall not mean funds used for
the purpose of constructing, equipping, reconstructing, repairing, enlarg-
ing, furnishing or remodeling facilities which are to be leased to the do-
nor. When any political subdivision of the state, public or private non-
profit hospital or public hospital authority, public or private elementary
or secondary school or public or private nonprofit educational institution
shall contract for the purpose of constructing, equipping, reconstructing,
maintaining, repairing, enlarging, furnishing or remodeling facilities, it
shall obtain from the state and furnish to the contractor an exemption
certificate for the project involved, and the contractor may purchase ma-
terials for incorporation in such project. The contractor shall furnish the
number of such certificate to all suppliers from whom such purchases are
made, and such suppliers shall execute invoices covering the same bearing
the number of such certificate. Upon completion of the project the con-
tractor shall furnish to the political subdivision, hospital or public hospital
authority, school or educational institution concerned a sworn statement,
on a form to be provided by the director of taxation, that all purchases so
made were entitled to exemption under this subsection. As an alternative
to the foregoing procedure, any such contracting entity may apply to the
secretary of revenue for agent status for the sole purpose of issuing and
furnishing project exemption certificates to contractors pursuant to rules
and regulations adopted by the secretary establishing conditions and stan-
dards for the granting and maintaining of such status. All invoices shall
be held by the contractor for a period of five years and shall be subject
to audit by the director of taxation. If any materials purchased under such
a certificate are found not to have been incorporated in the building or
other project or not to have been returned for credit or the sales or
compensating tax otherwise imposed upon such materials which will not
be so incorporated in the building or other project reported and paid by
such contractor to the director of taxation not later than the 20th day of
the month following the close of the month in which it shall be deter-
mined that such materials will not be used for the purpose for which such
certificate was issued, the political subdivision, hospital or public hospital
authority, school or educational institution concerned shall be liable for
tax on all materials purchased for the project, and upon payment thereof
it may recover the same from the contractor together with reasonable
attorney fees. Any contractor or any agent, employee or subcontractor
thereof, who shall use or otherwise dispose of any materials purchased
under such a certificate for any purpose other than that for which such a
certificate is issued without the payment of the sales or compensating tax
otherwise imposed upon such materials, shall be guilty of a misdemeanor
and, upon conviction therefor, shall be subject to the penalties provided
for in subsection (g) of K.S.A. 79-3615, and amendments thereto;

      (e) all sales of tangible personal property or services purchased by a
contractor for the erection, repair or enlargement of buildings or other
projects for the government of the United States, its agencies or instru-
mentalities, which would be exempt from taxation if purchased directly
by the government of the United States, its agencies or instrumentalities.
When the government of the United States, its agencies or instrumen-
talities shall contract for the erection, repair, or enlargement of any build-
ing or other project, it shall obtain from the state and furnish to the
contractor an exemption certificate for the project involved, and the con-
tractor may purchase materials for incorporation in such project. The
contractor shall furnish the number of such certificates to all suppliers
from whom such purchases are made, and such suppliers shall execute
invoices covering the same bearing the number of such certificate. Upon
completion of the project the contractor shall furnish to the government
of the United States, its agencies or instrumentalities concerned a sworn
statement, on a form to be provided by the director of taxation, that all
purchases so made were entitled to exemption under this subsection. As
an alternative to the foregoing procedure, any such contracting entity may
apply to the secretary of revenue for agent status for the sole purpose of
issuing and furnishing project exemption certificates to contractors pur-
suant to rules and regulations adopted by the secretary establishing con-
ditions and standards for the granting and maintaining of such status. All
invoices shall be held by the contractor for a period of five years and shall
be subject to audit by the director of taxation. Any contractor or any agent,
employee or subcontractor thereof, who shall use or otherwise dispose of
any materials purchased under such a certificate for any purpose other
than that for which such a certificate is issued without the payment of
the sales or compensating tax otherwise imposed upon such materials,
shall be guilty of a misdemeanor and, upon conviction therefor, shall be
subject to the penalties provided for in subsection (g) of K.S.A. 79-3615
and amendments thereto;

      (f) tangible personal property purchased by a railroad or public utility
for consumption or movement directly and immediately in interstate
commerce;

      (g) sales of aircraft including remanufactured and modified aircraft,
sales of aircraft repair, modification and replacement parts and sales of
services employed in the remanufacture, modification and repair of air-
craft sold to persons using directly or through an authorized agent such
aircraft and aircraft repair, modification and replacement parts as certified
or licensed carriers of persons or property in interstate or foreign com-
merce under authority of the laws of the United States or any foreign
government or sold to any foreign government or agency or instrumen-
tality of such foreign government and all sales of aircraft, aircraft parts,
replacement parts and services employed in the remanufacture, modifi-
cation and repair of aircraft for use outside of the United States;

      (h) all rentals of nonsectarian textbooks by public or private elemen-
tary or secondary schools;

      (i) the lease or rental of all films, records, tapes, or any type of sound
or picture transcriptions used by motion picture exhibitors;

      (j) meals served without charge or food used in the preparation of
such meals to employees of any restaurant, eating house, dining car, hotel,
drugstore or other place where meals or drinks are regularly sold to the
public if such employees' duties are related to the furnishing or sale of
such meals or drinks;

      (k) any motor vehicle, semitrailer or pole trailer, as such terms are
defined by K.S.A. 8-126 and amendments thereto, or aircraft sold and
delivered in this state to a bona fide resident of another state, which motor
vehicle, semitrailer, pole trailer or aircraft is not to be registered or based
in this state and which vehicle, semitrailer, pole trailer or aircraft will not
remain in this state more than 10 days;

      (l) all isolated or occasional sales of tangible personal property, serv-
ices, substances or things, except isolated or occasional sale of motor
vehicles specifically taxed under the provisions of subsection (o) of K.S.A.
79-3603 and amendments thereto;

      (m) all sales of tangible personal property which become an ingre-
dient or component part of tangible personal property or services pro-
duced, manufactured or compounded for ultimate sale at retail within or
without the state of Kansas; and any such producer, manufacturer or
compounder may obtain from the director of taxation and furnish to the
supplier an exemption certificate number for tangible personal property
for use as an ingredient or component part of the property or services
produced, manufactured or compounded;

      (n) all sales of tangible personal property which is consumed in the
production, manufacture, processing, mining, drilling, refining or com-
pounding of tangible personal property, the treating of by-products or
wastes derived from any such production process, the providing of serv-
ices or the irrigation of crops for ultimate sale at retail within or without
the state of Kansas; and any purchaser of such property may obtain from
the director of taxation and furnish to the supplier an exemption certifi-
cate number for tangible personal property for consumption in such pro-
duction, manufacture, processing, mining, drilling, refining, compound-
ing, treating, irrigation and in providing such services;

      (o) all sales of animals, fowl and aquatic plants and animals, the pri-
mary purpose of which is use in agriculture or aquaculture, as defined in
K.S.A. 47-1901, and amendments thereto, the production of food for
human consumption, the production of animal, dairy, poultry or aquatic
plant and animal products, fiber or fur, or the production of offspring for
use for any such purpose or purposes;

      (p) all sales of drugs, as defined by K.S.A. 65-1626 and amendments
thereto, dispensed pursuant to a prescription order, as defined by K.S.A.
65-1626 and amendments thereto, by a licensed practitioner or a mid-
level practitioner as defined by K.S.A. 65-1626 and amendments thereto;

      (q) all sales of insulin dispensed by a person licensed by the state
board of pharmacy to a person for treatment of diabetes at the direction
of a person licensed to practice medicine by the board of healing arts;

      (r) all sales of prosthetic and orthopedic appliances prescribed in
writing by a person licensed to practice the healing arts, dentistry or
optometry. For the purposes of this subsection, the term prosthetic and
orthopedic appliances means any apparatus, instrument, device, or equip-
ment used to replace or substitute for any missing part of the body; used
to alleviate the malfunction of any part of the body; or used to assist any
disabled person in leading a normal life by facilitating such person's mo-
bility; such term shall include accessories attached or to be attached to
motor vehicles, but such term shall not include motor vehicles or personal
property which when installed becomes a fixture to real property;

      (s) all sales of tangible personal property or services purchased di-
rectly by a groundwater management district organized or operating un-
der the authority of K.S.A. 82a-1020 et seq. and amendments thereto,
which property or services are used in the operation or maintenance of
the district;

      (t) all sales of farm machinery and equipment or aquaculture ma-
chinery and equipment, repair and replacement parts therefor and serv-
ices performed in the repair and maintenance of such machinery and
equipment. For the purposes of this subsection the term ``farm machinery
and equipment or aquaculture machinery and equipment'' shall include
machinery and equipment used in the operation of Christmas tree farm-
ing but shall not include any passenger vehicle, truck, truck tractor, trailer,
semitrailer or pole trailer, other than a farm trailer, as such terms are
defined by K.S.A. 8-126 and amendments thereto. Each purchaser of
farm machinery and equipment or aquaculture machinery and equipment
exempted herein must certify in writing on the copy of the invoice or
sales ticket to be retained by the seller that the farm machinery and
equipment or aquaculture machinery and equipment purchased will be
used only in farming, ranching or aquaculture production. Farming or
ranching shall include the operation of a feedlot and farm and ranch work
for hire and the operation of a nursery;

      (u) all leases or rentals of tangible personal property used as a dwell-
ing if such tangible personal property is leased or rented for a period of
more than 28 consecutive days;

      (v) all sales of food products to any contractor for use in preparing
meals for delivery to homebound elderly persons over 60 years of age and
to homebound disabled persons or to be served at a group-sitting at a
location outside of the home to otherwise homebound elderly persons
over 60 years of age and to otherwise homebound disabled persons, as
all or part of any food service project funded in whole or in part by
government or as part of a private nonprofit food service project available
to all such elderly or disabled persons residing within an area of service
designated by the private nonprofit organization, and all sales of food
products for use in preparing meals for consumption by indigent or home-
less individuals whether or not such meals are consumed at a place des-
ignated for such purpose;

      (w) all sales of natural gas, electricity, heat and water delivered
through mains, lines or pipes: (1) To residential premises for noncom-
mercial use by the occupant of such premises; (2) for agricultural use and
also, for such use, all sales of propane gas; (3) for use in the severing of
oil; and (4) to any property which is exempt from property taxation pur-
suant to K.S.A. 79-201b Second through Sixth. As used in this paragraph,
``severing'' shall have the meaning ascribed thereto by subsection (k) of
K.S.A. 79-4216, and amendments thereto;

      (x) all sales of propane gas, LP-gas, coal, wood and other fuel sources
for the production of heat or lighting for noncommercial use of an oc-
cupant of residential premises;

      (y) all sales of materials and services used in the repairing, servicing,
altering, maintaining, manufacturing, remanufacturing, or modification of
railroad rolling stock for use in interstate or foreign commerce under
authority of the laws of the United States;

      (z) all sales of tangible personal property and services purchased di-
rectly by a port authority or by a contractor therefor as provided by the
provisions of K.S.A. 12-3418 and amendments thereto;

      (aa) all sales of materials and services applied to equipment which is
transported into the state from without the state for repair, service, al-
teration, maintenance, remanufacture or modification and which is sub-
sequently transported outside the state for use in the transmission of
liquids or natural gas by means of pipeline in interstate or foreign com-
merce under authority of the laws of the United States;

      (bb) all sales of used mobile homes or manufactured homes. As used
in this subsection: (1) ``Mobile homes'' and ``manufactured homes'' shall
have the meanings ascribed thereto by K.S.A. 58-4202 and amendments
thereto; and (2) ``sales of used mobile homes or manufactured homes''
means sales other than the original retail sale thereof;

      (cc) all sales of tangible personal property or services purchased for
the purpose of and in conjunction with constructing, reconstructing, en-
larging or remodeling a business or retail business which meets the
requirements established in K.S.A. 74-50,115 and amendments thereto,
and the sale and installation of machinery and equipment purchased for
installation at any such business or retail business. When a person shall
contract for the construction, reconstruction, enlargement or remodeling
of any such business or retail business, such person shall obtain from the
state and furnish to the contractor an exemption certificate for the project
involved, and the contractor may purchase materials, machinery and
equipment for incorporation in such project. The contractor shall furnish
the number of such certificates to all suppliers from whom such purchases
are made, and such suppliers shall execute invoices covering the same
bearing the number of such certificate. Upon completion of the project
the contractor shall furnish to the owner of the business or retail business
a sworn statement, on a form to be provided by the director of taxation,
that all purchases so made were entitled to exemption under this subsec-
tion. All invoices shall be held by the contractor for a period of five years
and shall be subject to audit by the director of taxation. Any contractor
or any agent, employee or subcontractor thereof, who shall use or oth-
erwise dispose of any materials, machinery or equipment purchased un-
der such a certificate for any purpose other than that for which such a
certificate is issued without the payment of the sales or compensating tax
otherwise imposed thereon, shall be guilty of a misdemeanor and, upon
conviction therefor, shall be subject to the penalties provided for in sub-
section (g) of K.S.A. 79-3615 and amendments thereto. As used in this
subsection, ``business'' and ``retail business'' have the meanings respec-
tively ascribed thereto by K.S.A. 74-50,114 and amendments thereto;

      (dd) all sales of tangible personal property purchased with food
stamps issued by the United States department of agriculture;

      (ee) all sales of lottery tickets and shares made as part of a lottery
operated by the state of Kansas;

      (ff) on and after July 1, 1988, all sales of new mobile homes or man-
ufactured homes to the extent of 40% of the gross receipts, determined
without regard to any trade-in allowance, received from such sale. As used
in this subsection, ``mobile homes'' and ``manufactured homes'' shall have
the meanings ascribed thereto by K.S.A. 58-4202 and amendments
thereto;

      (gg) all sales of tangible personal property purchased in accordance
with vouchers issued pursuant to the federal special supplemental food
program for women, infants and children;

      (hh) all sales of medical supplies and equipment purchased directly
by a nonprofit skilled nursing home or nonprofit intermediate nursing
care home, as defined by K.S.A. 39-923, and amendments thereto, for
the purpose of providing medical services to residents thereof. This ex-
emption shall not apply to tangible personal property customarily used
for human habitation purposes;

      (ii) all sales of tangible personal property purchased directly by a non-
profit organization for nonsectarian comprehensive multidiscipline youth
development programs and activities provided or sponsored by such or-
ganization, and all sales of tangible personal property by or on behalf of
any such organization. This exemption shall not apply to tangible personal
property customarily used for human habitation purposes;

      (jj) all sales of tangible personal property or services, including the
renting and leasing of tangible personal property, purchased directly on
behalf of a community-based mental retardation facility or mental health
center organized pursuant to K.S.A. 19-4001 et seq., and amendments
thereto, and licensed in accordance with the provisions of K.S.A. 75-
3307b and amendments thereto. This exemption shall not apply to tan-
gible personal property customarily used for human habitation purposes;

      (kk) on and after January 1, 1989, all sales of machinery and equip-
ment used directly and primarily for the purposes of manufacturing, as-
sembling, processing, finishing, storing, warehousing or distributing ar-
ticles of tangible personal property in this state intended for resale by a
manufacturing or processing plant or facility or a storage, warehousing or
distribution facility, and all sales of repair and replacement parts and
accessories purchased for such machinery and equipment:

      (1) For purposes of this subsection, machinery and equipment shall
be deemed to be used directly and primarily in the manufacture, assem-
blage, processing, finishing, storing, warehousing or distributing of tan-
gible personal property where such machinery and equipment is used
during a manufacturing, assembling, processing or finishing, storing,
warehousing or distributing operation:

      (A) To effect a direct and immediate physical change upon the tan-
gible personal property;

      (B) to guide or measure a direct and immediate physical change upon
such property where such function is an integral and essential part of
tuning, verifying or aligning the component parts of such property;

      (C) to test or measure such property where such function is an in-
tegral part of the production flow or function;

      (D) to transport, convey or handle such property during the manu-
facturing, processing, storing, warehousing or distribution operation at
the plant or facility; or

      (E) to place such property in the container, package or wrapping in
which such property is normally sold or transported.

      (2)  For purposes of this subsection ``machinery and equipment used
directly and primarily'' shall include, but not be limited to:

      (A) Mechanical machines or components thereof contributing to a
manufacturing, assembling or finishing process;

      (B) molds and dies that determine the physical characteristics of the
finished product or its packaging material;

      (C) testing equipment to determine the quality of the finished prod-
uct;

      (D) computers and related peripheral equipment that directly control
or measure the manufacturing process or which are utilized for engi-
neering of the finished product; and

      (E) computers and related peripheral equipment utilized for research
and development and product design.

      (3) ``Machinery and equipment used directly and primarily'' shall not
include:

      (A) Hand tools;

      (B) machinery, equipment and tools used in maintaining and repair-
ing any type of machinery and equipment;

      (C) transportation equipment not used in the manufacturing, assem-
bling, processing, furnishing, storing, warehousing or distributing process
at the plant or facility;

      (D) office machines and equipment including computers and related
peripheral equipment not directly and primarily used in controlling or
measuring the manufacturing process;

      (E) furniture and buildings; and

      (F) machinery and equipment used in administrative, accounting,
sales or other such activities of the business;

      (4) for purposes of this subsection, ``repair and replacement parts and
accessories'' means all parts and accessories for exempt machinery and
equipment, including but not limited to dies, jigs, molds, and patterns
which are attached to exempt machinery or which are otherwise used in
production, short-lived replaceable parts that can be readily detached
from exempt machinery or equipment, such as belts, drill bits, grinding
wheels, cutting bars and saws, and other replacement parts for production
equipment, including refractory brick and other refractory items for kiln
equipment used in production operations;

      (ll) all sales of educational materials purchased for distribution to the
public at no charge by a nonprofit corporation organized for the purpose
of encouraging, fostering and conducting programs for the improvement
of public health;

      (mm) all sales of seeds and tree seedlings; fertilizers, insecticides,
herbicides, germicides, pesticides and fungicides; and services, purchased
and used for the purpose of producing plants in order to prevent soil
erosion on land devoted to agricultural use;

      (nn) except as otherwise provided in this act, all sales of services ren-
dered by an advertising agency or licensed broadcast station or any mem-
ber, agent or employee thereof;

      (oo) all sales of tangible personal property purchased by a community
action group or agency for the exclusive purpose of repairing or weath-
erizing housing occupied by low income individuals;

      (pp) all sales of drill bits and explosives actually utilized in the explo-
ration and production of oil or gas;

      (qq) all sales of tangible personal property and services purchased by
a nonprofit museum or historical society or any combination thereof, in-
cluding a nonprofit organization which is organized for the purpose of
stimulating public interest in the exploration of space by providing edu-
cational information, exhibits and experiences, which is exempt from fed-
eral income taxation pursuant to section 501(c)(3) of the federal internal
revenue code of 1986;

      (rr) all sales of tangible personal property which will admit the pur-
chaser thereof to any annual event sponsored by a nonprofit organization
which is exempt from federal income taxation pursuant to section
501(c)(3) of the federal internal revenue code of 1986;

      (ss) all sales of tangible personal property and services purchased by
a public broadcasting station licensed by the federal communications
commission as a noncommercial educational television or radio station;

      (tt) all sales of tangible personal property and services purchased by
or on behalf of a not-for-profit corporation which is exempt from federal
income taxation pursuant to section 501(c)(3) of the federal internal rev-
enue code of 1986, for the sole purpose of constructing a Kansas Korean
War memorial;

      (uu) all sales of tangible personal property and services purchased by
or on behalf of any rural volunteer fire-fighting organization for use ex-
clusively in the performance of its duties and functions;

      (vv) all sales of tangible personal property purchased by any of the
following organizations which are exempt from federal income taxation
pursuant to section 501 (c)(3) of the federal internal revenue code of
1986, for the following purposes, and all sales of any such property by or
on behalf of any such organization for any such purpose:

      (1) The American Heart Association, Kansas Affiliate, Inc. for the
purposes of providing education, training, certification in emergency car-
diac care, research and other related services to reduce disability and
death from cardiovascular diseases and stroke;

      (2) the Kansas Alliance for the Mentally Ill, Inc. for the purpose of
advocacy for persons with mental illness and to education, research and
support for their families;

      (3) the Kansas Mental Illness Awareness Council for the purposes of
advocacy for persons who are mentally ill and to education, research and
support for them and their families;

      (4) the American Diabetes Association Kansas Affiliate, Inc. for the
purpose of eliminating diabetes through medical research, public edu-
cation focusing on disease prevention and education, patient education
including information on coping with diabetes, and professional education
and training;

      (5) the American Lung Association of Kansas, Inc. for the purpose of
eliminating all lung diseases through medical research, public education
including information on coping with lung diseases, professional educa-
tion and training related to lung disease and other related services to
reduce the incidence of disability and death due to lung disease;

      (6) the Kansas chapters of the Alzheimer's Disease and Related Dis-
orders Association, Inc. for the purpose of providing assistance and sup-
port to persons in Kansas with Alzheimer's disease, and their families and
caregivers; and

      (ww) all sales of tangible personal property purchased by the Habitat
for Humanity for the exclusive use of being incorporated within a housing
project constructed by such organization.

      (xx) all sales of tangible personal property and services purchased by
a nonprofit zoo which is exempt from federal income taxation pursuant
to section 501(c)(3) of the federal internal revenue code of 1986, or on
behalf of such zoo by an entity itself exempt from federal income taxation
pursuant to section 50 501 (c)(3) of the federal internal revenue code of
1986 contracted with to operate such zoo and all sales of tangible personal
property or services purchased by a contractor for the purpose of con-
structing, equipping, reconstructing, maintaining, repairing, enlarging,
furnishing or remodeling facilities for any nonprofit zoo which would be
exempt from taxation under the provisions of this section if purchased
directly by such nonprofit zoo or the entity operating such zoo. Nothing
in this subsection shall be deemed to exempt the purchase of any con-
struction machinery, equipment or tools used in the constructing, equip-
ping, reconstructing, maintaining, repairing, enlarging, furnishing or re-
modeling facilities for any nonprofit zoo. When any nonprofit zoo shall
contract for the purpose of constructing, equipping, reconstructing, main-
taining, repairing, enlarging, furnishing or remodeling facilities, it shall
obtain from the state and furnish to the contractor an exemption certifi-
cate for the project involved, and the contractor may purchase materials
for incorporation in such project. The contractor shall furnish the number
of such certificate to all suppliers from whom such purchases are made,
and such suppliers shall execute invoices covering the same bearing the
number of such certificate. Upon completion of the project the contractor
shall furnish to the nonprofit zoo concerned a sworn statement, on a form
to be provided by the director of taxation, that all purchases so made were
entitled to exemption under this subsection. All invoices shall be held by
the contractor for a period of five years and shall be subject to audit by
the director of taxation. If any materials purchased under such a certifi-
cate are found not to have been incorporated in the building or other
project or not to have been returned for credit or the sales or compen-
sating tax otherwise imposed upon such materials which will not be so
incorporated in the building or other project reported and paid by such
contractor to the director of taxation not later than the 20th day of the
month following the close of the month in which it shall be determined
that such materials will not be used for the purpose for which such cer-
tificate was issued, the nonprofit zoo concerned shall be liable for tax on
all materials purchased for the project, and upon payment thereof it may
recover the same from the contractor together with reasonable attorney
fees. Any contractor or any agent, employee or subcontractor thereof,
who shall use or otherwise dispose of any materials purchased under such
a certificate for any purpose other than that for which such a certificate
is issued without the payment of the sales or compensating tax otherwise
imposed upon such materials, shall be guilty of a misdemeanor and, upon
conviction therefor, shall be subject to the penalties provided for in sub-
section (g) of K.S.A. 79-3615, and amendments thereto;

      (yy) all sales of tangible personal property and services purchased by
a parent-teacher association or organization, and all sales of tangible per-
sonal property by or on behalf of such association or organization;

      (zz) all sales of machinery and equipment purchased by over-the-air,
free access radio or television station which is used directly and primarily
for the purpose of producing a broadcast signal or is such that the failure
of the machinery or equipment to operate would cause broadcasting to
cease. For purposes of this subsection, machinery and equipment shall
include, but not be limited to, that required by rules and regulations of
the federal communications commission, and all sales of electricity which
are essential or necessary for the purpose of producing a broadcast signal
or is such that the failure of the electricity would cause broadcasting to
cease;

      (aaa) all sales of tangible personal property and services purchased
by a religious organization which is exempt from federal income taxation
pursuant to section 501 (c)(3) of the federal internal revenue code, and
used exclusively for religious purposes; and

      (bbb) all sales of food for human consumption by an organization
which is exempt from federal income taxation pursuant to section 501
(c)(3) of the federal internal revenue code of 1986, pursuant to a food
distribution program which offers such food at a price below cost in
exchange for the performance of community service by the purchaser
thereof.

 Sec.  19. K.S.A. 21-4214, 39-7,117, 65-669, 65-1130, 65-2896e, 65-
4116, 65-4123, 65-4134 and 65-4202 and K.S.A. 1998 Supp. 40-2123, 60-
4403, 65-1626, 65-1627, 65-1627i, 65-1643, 65-1660, 65-2837a, 65-4101
and 79-3606 are hereby repealed.

 Sec.  20. This act shall take effect and be in force from and after April
1, 2000, and its publication in the statute book.

Approved April 16, 1999.
__________