CHAPTER 113 Substitute for HOUSE BILL No. 2169 An Act concerning nursing; amending K.S.A. 65-1133 and K.S.A. 1999 Supp. 65-1124, 65-1136, 65-1153 and 74-1106 and repealing the existing sections. Be it enacted by the Legislature of the State of Kansas:

      Section  1. K.S.A. 1999 Supp. 65-1124 is hereby amended to read as
follows: 65-1124. No provisions of this law shall be construed as prohib-
iting:

      (a) Gratuitous nursing by friends or members of the family;

      (b) the incidental care of the sick by domestic servants or persons
primarily employed as housekeepers;

      (c) caring for the sick in accordance with tenets and practices of any
church or religious denomination which teaches reliance upon spiritual
means through prayer for healing;

      (d) nursing assistance in the case of an emergency;

      (e) the practice of nursing by students enrolled in accredited schools
as part of a clinical course offered through a school of professional or
practical nursing or programs program of advanced registered profes-
sional nursing approved by the board nor nursing by graduates of such
schools or courses pending the results of the first licensure examination
scheduled following such graduation but in no case to exceed 90 days,
whichever comes first in the United States or its territories;

      (f) the practice of nursing in this state by legally qualified nurses of
any of the other states as long as the engagement of any such nurse
requires the nurse to accompany and care for a patient temporarily re-
siding in this state during the period of one such engagement not to
exceed six months in length, and as long as such nurses do not represent
or hold themselves out as nurses licensed to practice in this state;

      (g) the practice by any nurse who is employed by the United States
government or any bureau, division or agency thereof, while in the dis-
charge of official duties;

      (h) auxiliary patient care services performed in medical care facilities,
adult care homes or elsewhere by persons under the direction of a person
licensed to practice medicine and surgery or a person licensed to practice
dentistry or the supervision of a registered professional nurse or a licensed
practical nurse;

      (i) the administration of medications to residents of adult care homes
or to patients in hospital-based long-term care units, including state op-
erated institutions for the mentally retarded, by an unlicensed person who
has been certified as having satisfactorily completed a training program
in medication administration approved by the secretary of health and
environment and has completed the program on continuing education
adopted by the secretary, or by an unlicensed person while engaged in
and as a part of such training program in medication administration;

      (j) the practice of mental health technology by licensed mental health
technicians as authorized under the mental health technicians' licensure
act;

      (k) performance in the school setting of nursing procedures when
delegated by a licensed professional nurse in accordance with the rules
and regulations of the board;

      (l) performance of attendant care services directed by or on behalf
of an individual in need of in-home care as the terms ``attendant care
services'' and ``individual in need of in-home care'' are defined under
K.S.A. 65-6201 and amendments thereto;

      (m) performance of a nursing procedure by a person when that pro-
cedure is delegated by a licensed nurse, within the reasonable exercise of
independent nursing judgment and is performed with reasonable skill and
safety by that person under the supervision of a registered professional
nurse or a licensed practical nurse; or

      (n) the practice of nursing by an applicant for Kansas nurse licensure
in the supervised clinical portion of a refresher course.;

      (o) the practice of nursing by graduates of approved schools of pro-
fessional or practical nursing pending the results of the first licensure
examination scheduled following such graduation but in no case to exceed
120 days, whichever comes first; or

      (p) the teaching of the nursing process in this state by legally qualified
nurses of any of the other states while in consultation with a licensed
Kansas nurse as long as such individuals do not represent or hold them-
selves out as nurses licensed to practice in this state.

      Sec.  2. K.S.A. 65-1133 is hereby amended to read as follows: 65-
1133. (a) An accredited educational and training program for advanced
registered nurse practitioners is a program conducted in Kansas which
has been approved by the board as meeting the standards and the rules
and regulations of the board. An institution desiring to conduct an edu-
cational and training program for advanced registered nurse practitioners
shall apply to the board for accreditation and submit satisfactory proof
that it is prepared to and will maintain the standards and the required
curriculum for advanced registered nurse practitioners as prescribed by
this act and by the rules and regulations of the board. Applications shall
be made in writing on forms supplied by the board and shall be submitted
to the board together with the application fee fixed by the board. The
accreditation of an educational and training program for advanced reg-
istered nurse practitioners shall expire two years after the granting of such
accreditation by the board. An institution desiring to continue to conduct
an accredited educational and training program for advanced registered
nurse practitioners shall apply to the board for the renewal of accredita-
tion and submit satisfactory proof that it will maintain the standards and
the required curriculum for advanced registered nurse practitioners as
prescribed by this act and by the rules and regulations of the board.
Applications for renewal of accreditation shall be made in writing on
forms supplied by the board and. Each program shall be submitted submit
annually to the board together with the application an annual fee fixed
by the board board's rules and regulations to maintain the accredited
status.

      (b) A program to qualify as an accredited educational and training
program for advanced registered nurse practitioners must be conducted
in the state of Kansas, and the school conducting the program must apply
to the board and submit evidence that: (1) It is prepared to carry out the
curriculum prescribed by rules and regulations of the board; and (2) it is
prepared to meet such other standards as shall be established by law and
the rules and regulations of the board.

      (c) The board shall prepare and maintain a list of programs which
qualify as accredited educational and training programs for advanced reg-
istered nurse practitioners whose graduates, if they have the other nec-
essary qualifications provided in this act, shall be eligible to apply for
certificates of qualification as advanced registered nurse practitioners. A
survey of the institution or school applying for accreditation of an edu-
cational and training program for advanced registered nurse practitioners
shall be made by an authorized employee of the board or members of
the board, who shall submit a written report of the survey to the board.
If, in the opinion of the board, the requirements as prescribed by the
board in its rules and regulations for accreditation are met, it shall so
approve and accredit the program. From time to time, as deemed nec-
essary by the board, it shall cause to be made a resurvey of accredited
programs and written reports of such resurveys submitted to the board.
If the board determines that any accredited program is not maintaining
the standards required by this act and by rules and regulations prescribed
by the board, notice thereof in writing, specifying the failures of such
program, shall be given. A program which fails to correct such conditions
to the satisfaction of the board within a reasonable time shall be removed
from the list of accredited programs until such time as the program shall
comply with said standards. All accredited programs shall maintain ac-
curate and current records showing in full the theoretical and practical
courses given to each student.

      Sec.  3. K.S.A. 1999 Supp. 65-1136 is hereby amended to read as
follows: 65-1136. (a) As used in this section:

      (1) ``Provider'' means a person who is approved by the board to ad-
minister an examination and to offer an intravenous fluid therapy course
which has been approved by the board.

      (2) ``Person'' means an individual, organization, agency, institution or
other legal entity.

      (3) ``Examination'' means an intravenous fluid therapy competency
examination approved by the board.

      (4) ``Supervision'' means provision of guidance by a qualified nurse
for the accomplishment of a nursing task or activity with initial direction
of the task or activity and periodic inspection of the actual act of accom-
plishing the task or activity.

      (b) A licensed practical nurse may perform a limited scope of intra-
venous fluid therapy under the supervision of a registered professional
nurse.

      (c) A licensed practical nurse may perform an expanded scope of
intravenous fluid therapy under the supervision of a registered profes-
sional nurse, if the licensed practical nurse:

      (1) Has had one year of clinical experience and Successfully com-
pletes an intravenous fluid therapy course given by an approved a pro-
vider and passes an intravenous fluid therapy examination administered
by an approved a provider;

      (2) has had one year of clinical experience, has performed intravenous
fluid therapy prior to the effective date of this act and has successfully
passed an examination; or

      (3) has had one year of clinical experience, has successfully completed
an intravenous fluid therapy course not given by an approved provider
and has passed an intravenous fluid therapy examination not administered
by an approved provider or approved by the board and, upon application
to the board for review and approval of such course and examination, has
had the board determine has determined that such course and examina-
tion meets or exceeds the standards required under this act for an ap-
proved course and approved examination administered by a provider.

      (d) The board may adopt rules and regulations:

      (1) Which define the limited and expanded scope of practice of in-
travenous fluid therapy which may be performed by a licensed practical
nurse under the supervision of a registered professional nurse;

      (2) which restricts specific intravenous fluid therapy practices;

      (3) which prescribe standards for an intravenous fluid therapy course
and examination required of an approved provider;

      (4) which govern provider record requirements;

      (5) which prescribe the procedure to approve, condition, limit and
withdraw approval as a provider; and

      (6) which further implement the provisions of this section.

      (e) An advisory committee of not less than two board members and
five nonboard members shall be established by the board to advise and
assist the board in implementing this section as determined by the board.
The advisory committee shall meet at least annually. Members of the
advisory committee shall receive amounts provided for in subsection (e)
of K.S.A. 75-3223 and amendments thereto for each day of actual at-
tendance at any meeting of the advisory committee or any subcommittee
meeting of the advisory committee authorized by the board.

      (f) On and after July 1, 1995, no licensed practical nurse shall perform
intravenous fluid therapy unless qualified to perform intravenous fluid
therapy under this section and rules and regulations adopted by the board.

      (g) Nothing in this section shall be construed to prohibit the perform-
ance of intravenous fluid therapy by a registered professional nurse.

      (h) Nothing in this section shall be construed to prohibit performance
of intravenous fluid therapy by a licensed practical nurse when performed
by delegation of a person licensed to practice medicine and surgery or
dentistry.

      (i) This section shall be part of and supplemental to the Kansas nurse
practice act.

      Sec.  4. K.S.A. 1999 Supp. 65-1153 is hereby amended to read as
follows: 65-1153. The board may grant a temporary authorization to prac-
tice nurse anesthesia as a registered nurse anesthetist: (a) For a period of
not more than one year to graduates of a school of nurse anesthesia ac-
credited by the board pending results of the initial examination; or

      (b) for 180 days for the needed amount of time to complete the clinical
portion of a refresher course and the temporary authorization may be
renewed by the board for one additional period of not to exceed 180 days;
and; or

      (c) for a period not to exceed 90 120 days. The 90-day temporary
permit may be renewed for an additional 30 days but not to exceed a
combined total of 120 days.

      Sec.  5. K.S.A. 1999 Supp. 74-1106 is hereby amended to read as
follows: 74-1106. (a) Appointment, term of office. (1) The governor shall
appoint a board consisting of 11 members of which six shall be registered
professional nurses, two shall be licensed practical nurses, one shall be a
licensed mental health technician and two shall be members of the gen-
eral public, which shall constitute a board of nursing, with the duties,
power and authority set forth in this act.

      (2) Upon the expiration of the term of any registered professional
nurse, the Kansas state nurses association shall submit to the governor a
list of registered professional nurses containing names of not less than
three times the number of persons to be appointed, and appointments
shall be made after consideration of such list for terms of four years and
until a successor is appointed and qualified.

      (3) On the effective date of this act, the Kansas federation of licensed
practical nurses shall submit to the governor a list of licensed practical
nurses containing names of not less than three times the number of per-
sons to be appointed, and appointments shall be made after consideration
of such list, with the first appointment being for a term of four years and
the second appointment being for a term of two years. Upon the expi-
ration of the term of any licensed practical nurse, a successor of like
qualifications shall be appointed in the same manner as the original ap-
pointment for a term of four years and until a successor is appointed and
qualified.

      (4) Upon the expiration of the term of any mental health technician,
the Kansas association of human services technologies shall submit to the
governor a list of persons licensed as mental health technicians containing
names of not less than three times the number of persons to be appointed,
and appointments shall be made after consideration of such list for terms
of four years and until a successor is appointed and qualified.

      (5) Each member of the general public shall be appointed for a term
of four years and successors shall be appointed for a like term.

      (6) Whenever a vacancy occurs on the board of nursing, it shall be
filled by appointment for the remainder of the unexpired term in the
same manner as the preceding appointment. No person shall serve more
than two consecutive terms as a member of the board of nursing and
appointment for the remainder of an unexpired term shall constitute a
full term of service on such board. With the expiration of terms for the
registered professional nurse from education and one public member in
July, 2003, the next appointments for those two positions will be for only
one year. Thereafter the two positions shall be appointed for terms of four
years.

      (b) Qualifications of members. Each member of the board shall be a
citizen of the United States and a resident of the state of Kansas. Regis-
tered professional nurse members shall possess a license to practice as a
professional nurse in this state with at least five years' experience in nurs-
ing as such and shall be actively engaged in professional nursing in Kansas
at the time of appointment and reappointment. The licensed practical
nurse members shall be licensed to practice practical nursing in the state
with at least five years' experience in practical nursing and shall be actively
engaged in practical nursing in Kansas at the time of appointment and
reappointment. The governor shall appoint successors so that the regis-
tered professional nurse membership of the board shall consist of at least
two members who are engaged in nursing service, at least two members
who are engaged in nursing education and at least one member who is
engaged in practice as an advanced registered nurse practitioner or a
registered nurse anesthetist. The licensed mental health technician mem-
ber shall be licensed to practice as licensed mental health technician in
the state with at least five years' experience and shall be actively engaged
in the field of mental health technology in Kansas at the time of appoint-
ment and reappointment. The consumer members shall represent the
interests of the general public. Each member of the board shall take and
subscribe the oath prescribed by law for state officers, which oath shall
be filed with the secretary of state.

      (c) Duties and powers. (1) The board shall meet annually at Topeka
during the month of September and shall elect from its members a pres-
ident, vice-president and secretary, each of whom shall hold their re-
spective offices for one year. The board shall employ an executive ad-
ministrator, who shall be a registered professional nurse, who shall not
be a member of the board and who shall be in the unclassified service
under the Kansas civil service act, and shall employ such other employees,
who shall be in the classified service under the Kansas civil service act as
necessary to carry on the work of the board. As necessary, the board shall
be represented by an attorney appointed by the attorney general as pro-
vided by law, whose compensation shall be determined and paid by the
board with the approval of the governor. The board may hold such other
meetings during the year as may be deemed necessary to transact its
business.

      (2) The board may adopt rules and regulations not inconsistent with
this act necessary to carry into effect the provisions thereof, and such
rules and regulations may be published and copies thereof furnished to
any person upon application.

      (3) The board shall prescribe curricula and standards for professional
and practical nursing programs and mental health technician programs,
and provide for surveys of such schools and courses at such times as it
may deem necessary. It shall accredit such schools and approve courses
as meet the requirements of the appropriate act and rules and regulations
of the board.

      (4) The board shall examine, license and renew licenses of duly qual-
ified applicants and conduct hearings upon charges for limitation, sus-
pension or revocation of a license or accreditation of professional and
practical nursing and mental health technician programs and may limit,
deny, suspend or revoke for proper legal cause, licenses or accreditation
of professional and practical nursing and mental health technician pro-
grams, as hereinafter provided. Examination for applicants for registration
shall be given at least twice each year and as many other times as deemed
necessary by the board. The board shall promote improved means of
nursing education and standards of nursing care through institutes, con-
ferences and other means.

      (5) The board shall have a seal of which the executive administrator
shall be the custodian. The president and the secretary shall have the
power and authority to administer oaths in transacting business of the
board, and the secretary shall keep a record of all proceedings of the
board and a register of professional and practical nurses and mental health
technicians licensed and showing the certificates of registration or licenses
granted or revoked, which register shall be open at all times to public
inspection.

      (6) The board may enter into contracts as may be necessary to carry
out its duties.

      (7) The board is hereby authorized to apply for and to accept grants
and may accept donations, bequests or gifts. The board shall remit all
moneys received by it under this paragraph (7) to the state treasurer at
least monthly. Upon receipt of any such remittance, the state treasurer
shall deposit the entire amount thereof in the state treasury, and such
deposit shall be credited to the grants and gifts fund which is hereby
created. All expenditures from such fund shall be made in accordance
with appropriation acts upon warrants of the director of accounts and
reports issued pursuant to vouchers approved by the president of the
board or a person designated by the president.

      (8) A majority of the board of nursing including two professional
nurse members shall constitute a quorum for the transaction of business.

      (d) Subpoenas. In all investigations and proceedings, the board shall
have the power to issue subpoenas and compel the attendance of wit-
nesses and the production of all relevant and necessary papers, books,
records, documentary evidence and materials. Any person failing or re-
fusing to appear or testify regarding any matter about which such person
may be lawfully questioned or to produce any books, papers, records,
documentary evidence or relevant materials in the matter, after having
been required by order of the board or by a subpoena of the board to do
so, upon application by the board to any district judge in the state, may
be ordered by such judge to comply therewith. Upon failure to comply
with the order of the district judge, the court may compel obedience by
attachment for contempt as in the case of disobedience of a similar order
or subpoena issued by the court. A subpoena may be served upon any
person named therein anywhere within the state with the same fees and
mileage by an officer authorized to serve subpoenas in civil actions in the
same procedure as is prescribed by the code of civil procedure for sub-
poenas issued out of the district courts of this state.

      (e) Compensation and expenses. Members of the board of nursing
attending meetings of such board, or attending a subcommittee meeting
thereof authorized by such board, shall be paid compensation, subsistence
allowances, mileage and other expenses as provided in K.S.A. 75-3223,
and amendments thereto.

 Sec.  6. K.S.A. 65-1133 and K.S.A. 1999 Supp. 65-1124, 65-1136, 65-
1153 and 74-1106 are hereby repealed.
 Sec.  7. This act shall take effect and be in force from and after its
publication in the statute book.

Approved April 19, 2000.
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