Session of 1998
                   
SENATE BILL No. 622
         
By Committee on Public Health and Welfare
         
2-10
            9             AN ACT providing for licensure of physician assistants; providing for the
10             regulation of the practice thereof; granting certain powers and impos-
11             ing certain duties upon the state board of healing arts; amending K.S.A.
12             40-2,111, 65-118, 65-6135 and 75-6102 and K.S.A. 1997 Supp. 38-135,
13             65-4915, 65-6112 and 65-6701 and repealing the existing sections; also
14             repealing K.S.A. 65-2896a, 65-2896b, 65-2896c, 65-2896d, 65-2896e,
15             65-2896f, 65-2896g, 65-2896h, 65-2897a and 65-2897b and K.S.A.
16             1997 Supp. 65-2896.
17            
18       Be it enacted by the Legislature of the State of Kansas:
19           New Section 1. The following words and phrases when used in sec-
20       tions 1 to 13, inclusive, and amendments thereto, shall have the meanings
21       respectively ascribed to them in this section:
22           (a) ``Board'' means the state board of healing arts.
23           (b) ``Direction and supervision'' means the guidance, direction and
24       coordination of activities of a physician assistant by such person's respon-
25       sible physician, whether written or verbal, whether immediate or by prior
26       arrangement, in accordance with standards established by the board by
27       rules and regulations, which standards shall be designed to ensure ade-
28       quate direction and supervision by the responsible physician of the phy-
29       sician assistant. The term ``direction and supervision'' shall not be con-
30       strued to mean that the immediate or physical presence of the responsible
31       physician is required during the performance of the physician assistant.
32           (c) ``Physician'' means any person licensed by the state board of heal-
33       ing arts to practice medicine and surgery.
34           (d) ``Physician assistant'' means a skilled person who is licensed in
35       accordance with the provisions of section 3 and amendments thereto and
36       who is qualified by academic training to provide patient services under
37       the direction and supervision of a physician who is responsible for the
38       performance of that assistant.
39           (e) ``Responsible physician'' means a physician who has accepted con-
40       tinuous and ultimate responsibility for the medical services rendered and
41       actions of the physician assistant while performing under the direction
42       and supervision of the responsible physician.
43           (f) ``Professional incompetency'' means:

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  1           (1) One or more instances involving failure to adhere to the appli-
  2       cable standard of care to a degree which constitutes gross negligence, as
  3       determined by the board.
  4           (2) Repeated instances involving failure to adhere to the applicable
  5       standard of care to a degree which constitutes ordinary negligence, as
  6       determined by the board.
  7           (3) A pattern of practice or other behavior which demonstrates a
  8       manifest incapacity or incompetence to practice medicine.
  9           (g) ``Unprofessional conduct'' means:
10           (1) Solicitation of professional patronage through the use of fraudu-
11       lent or false advertisements, or profiting by the acts of those representing
12       themselves to be agents of the licensee.
13           (2) Representing to a patient that a manifestly incurable disease, con-
14       dition or injury can be permanently cured.
15           (3) Assisting in the care or treatment of a patient without the consent
16       of the patient, the attending physician or the patient's legal representa-
17       tives.
18           (4) The use of any letters, words or terms, as an affix, on stationery,
19       in advertisements or otherwise indicating that such person is entitled to
20       practice a branch of the healing arts for which such person is not licensed.
21           (5) Willful betrayal of confidential information.
22           (6) Advertising professional superiority or the performance of pro-
23       fessional services in a superior manner.
24           (7) Advertising to guarantee any professional service or to perform
25       any operation painlessly.
26           (8) Participating in any action as a staff member of a medical care
27       facility which is designed to exclude or which results in the exclusion of
28       any person licensed to practice medicine and surgery from the medical
29       staff of a nonprofit medical care facility licensed in this state because of
30       the branch of the healing arts practiced by such person or without just
31       cause.
32           (9) Failure to effectuate the declaration of a qualified patient as pro-
33       vided in subsection (a) of K.S.A. 65-28,107, and amendments thereto.
34           (10) Transmitting and order for, dispensing, administering, selling,
35       supplying or giving any amphetamines or sympathomimetic amines, ex-
36       cept as authorized by K.S.A. 65-2837a, and amendments thereto.
37           (11) Conduct likely to deceive, defraud or harm the public.
38           (12) Making a false or misleading statement regarding the licensee's
39       skill or the efficacy or value of the drug, treatment or remedy prescribed
40       by the licensee or at the licensee's direction in the treatment of any dis-
41       ease or other condition of the body or mind.
42           (13) Aiding or abetting the practice of the healing arts by an unli-
43       censed, incompetent or impaired person.

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  1           (14) Allowing another person or organization to use the licensee's
  2       license to practice as a physician assistant.
  3           (15) Commission of any act of sexual abuse, misconduct or exploita-
  4       tion related to the licensee's professional practice.
  5           (16) The use of any false, fraudulent or deceptive statement in any
  6       document connected with the practice as a physician assistant including
  7       the intentional falsifying or fraudulent altering of a patient or medical
  8       care facility record.
  9           (17) Obtaining any fee by fraud, deceit or misrepresentation.
10           (18) Directly or indirectly giving or receiving any fee, commission,
11       rebate or other compensation for professional services not actually and
12       personally rendered, other than through the legal functioning of lawful
13       professional partnerships, corporations or associations.
14           (19) Failure to transfer patient records to another licensee when re-
15       quested to do so by the subject patient or by such patient's legally des-
16       ignated representative.
17           (20) Performing unnecessary tests, examinations or services which
18       have no legitimate medical purpose.
19           (21) Charging an excessive fee for services rendered.
20           (22) Transmitting a prescription order for, dispensing, administering,
21       distributing a prescription drug or substance, including a controlled sub-
22       stance, in an excessive, improper or inappropriate manner or quantity or
23       not in the course of the licensee's professional practice.
24           (23) Repeated failure to practice as a physician assistant with that
25       level of care, skill and treatment which is recognized by a reasonably
26       prudent similar practitioner as being acceptable under similar conditions
27       and circumstances.
28           (24) Failure to keep written medical records which accurately de-
29       scribe the services rendered to the patient, including patient histories,
30       pertinent findings, examination results and test results.
31           (25) Using experimental forms of therapy without proper informed
32       patient consent, without conforming to generally accepted criteria or stan-
33       dard protocols, without keeping detailed legible records or without having
34       periodic analysis of the study and results reviewed by a committee of
35       peers.
36           (26) Transmitting a prescription order for, dispensing, administering
37       or distributing an anabolic steroid or human growth hormone for other
38       than a valid medical purpose. Bodybuilding, muscle enhancement or in-
39       creasing muscle bulk or strength through the use of an anabolic steroid
40       or human growth hormone by a person who is in good health is not a
41       valid medical purpose.
42           (h) ``False advertisement'' means any advertisement which is false,
43       misleading or deceptive in a material respect. In determining whether

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  1       any advertisement is misleading, there shall be taken into account not
  2       only representations made or suggested by statement, word, design, de-
  3       vice or sound, or any combination thereof, but also the extent to which
  4       the advertisement fails to reveal facts material in the light of such rep-
  5       resentations made.
  6           (i) ``Advertisement'' means all representations disseminated in any
  7       manner or by any means, for the purpose of inducing, or which are likely
  8       to induce, directly or indirectly, the purchase of professional services.
  9           (j) ``Licensee'' for purposes of this section and section 4, and amend-
10       ments thereto, shall mean all persons issued a license, permit or special
11       permit pursuant to sections 1 to 13, inclusive, and amendments thereto.
12           (k) ``License'' for purposes of this section and section 4, and amend-
13       ments thereto, shall mean any license, permit or special permit granted
14       under sections 1 to 13, inclusive, and amendments thereto.
15           New Sec. 2. (a) The state board of healing arts shall maintain the
16       names of physician assistants licensed in accordance with the provisions
17       of section 3 and amendments thereto.
18           (b) All licenses, except temporary licenses, shall expire on the date of
19       expiration established by rules and regulations of the state board of heal-
20       ing arts and may be renewed annually upon request of the licensee. The
21       request for renewal shall be on a form provided by the state board of
22       healing arts and shall be accompanied by the renewal fee established
23       pursuant to this section, which shall be paid not later than the expiration
24       date of the license.
25           (c) At least 30 days before the expiration of the license of a physician
26       assistant, except temporary license, the state board of healing arts shall
27       notify the licensee of the expiration by mail addressed to the licensee's
28       last place of residence as noted upon the office records of the board. If
29       the licensee fails to pay the renewal fee by the date of expiration of the
30       license, the licensee shall be given a second notice that the licensee's
31       license has expired and the license may be renewed only if the renewal
32       fee and the late renewal fee are received by the state board of healing
33       arts within the 30-day period following the date of expiration and that, if
34       both fees are not received within the 30-day period, the license shall be
35       considered to have lapsed for failure to renew and shall be reissued only
36       after the physician assistant has been reinstated under subsection (d).
37           (d) Any licensee who allows the licensee's license to lapse by failing
38       to renew as herein provided may be reinstated upon recommendation of
39       the state board of healing arts and upon payment of the renewal fee and
40       the reinstatement fee and upon submitting evidence of satisfactory com-
41       pletion of any applicable continuing education requirements established
42       by the board. The board shall adopt rules and regulations establishing
43       appropriate continuing education requirements for reinstatement of per-

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  1       sons whose licenses have lapsed for failure to renew.
  2           (e) The following fees shall be fixed by rules and regulations adopted
  3       by the state board of healing arts and shall be collected by the board:
  4           (1) For licensure as a physician assistant, the sum of not more than
  5       $200;
  6           (2) for temporary licensure as a physician assistant, the sum of not
  7       more than $30;
  8           (3) for the renewal of license as a physician assistant, the sum of not
  9       more than $150;
10           (4) for the late renewal of license as a physician assistant, the sum of
11       not more than $250;
12           (5) for reinstatement of a physician assistant whose license has been
13       canceled, the sum of not more than $250;
14           (6) for a certified statement from the board that a physician assistant
15       is licensed in this state, the sum of not more than $30;
16           (7) for a copy of the licensure certificate of a physician assistant, the
17       sum of not more than $25; and
18           (8) for written verification of any license, the sum of not more than
19       $25.
20           (f) The state board of healing arts shall remit all moneys received by
21       or for the board under the provisions of this act to the state treasurer and
22       such money shall be deposited in the state treasury, credited to the state
23       general fund and the healing arts fee fund and expended all in accordance
24       with K.S.A. 65-2855 and amendments thereto.
25           (g) The state board of healing arts may adopt rules and regulations
26       necessary to carry out the provisions of this act and the act of which this
27       section is amendatory.
28           New Sec. 3. (a) No person shall be licensed as a physician assistant
29       by the state board of healing arts unless such person has:
30           (1) Presented to the state board of healing arts proof of graduation
31       from an accredited high school or the equivalent thereof;
32           (2) presented to the state board of healing arts proof that the appli-
33       cant has successfully completed a course of education and training ap-
34       proved by the state board of healing arts for the education and training
35       of a physician assistant or presented to the state board of healing arts
36       proof that the applicant has acquired experience while serving in the
37       armed forces of the United States which experience is equivalent to the
38       minimum experience requirements established by the state board of heal-
39       ing arts;
40           (3) passed an examination approved by the state board of healing arts
41       covering subjects incident to the education and training of a physician
42       assistant;
43           (4) presented to the state board of healing arts a request signed by

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  1       the applicant's proposed responsible physician on a form provided by the
  2       board which shall contain such information as required by rules and reg-
  3       ulations adopted by the board;
  4           (5) certified that no licensure, certification or registration as a phy-
  5       sician assistant is under current discipline, revocation, suspension or pro-
  6       bation for cause resulting from the applicant's practice as a physician
  7       assistant, unless the state board of healing arts considers such condition
  8       and agrees to licensure; and
  9           (6) submitted to the state board of healing arts any other information
10       the state board of healing arts deems necessary to evaluate the applicant's
11       qualifications.
12           (b) The board may refuse to license a person as a physician assistant
13       upon any of the grounds for which the board may revoke such license.
14           (c) A physician assistant shall at the time of initial licensure and any
15       renewal thereof present to the state board of healing arts the name and
16       address of such person's responsible physician. Whenever a physician
17       assistant shall cease to be employed by the responsible physician, such
18       responsible physician shall notify the state board of healing arts of such
19       termination. Whenever a physician assistant shall seek to obtain a new
20       responsible physician prior to the renewal of the physician assistant's an-
21       nual license, such proposed responsible physician shall notify the state
22       board of healing arts of such prospective employment and shall provide
23       a request as required by subsection (a)(4). All such notifications shall be
24       given to the state board of healing arts as soon as practicable but not be
25       less than 10 days prior to the prospective date of employment.
26           (d) The state board of healing arts shall require every physician as-
27       sistant to submit with the renewal application evidence of satisfactory
28       completion of a program of continuing education required by the state
29       board of healing arts. The state board of healing arts by duly adopted
30       rules and regulations shall establish the requirements for such program
31       of continuing education as soon as possible after the effective date of this
32       act. In establishing such requirements the state board of healing arts shall
33       consider any existing programs of continuing education currently being
34       offered to physician assistants.
35           (e) A person whose name has been entered on the register of phy-
36       sician assistants prior to the effective date of this act shall not be subject
37       to the provisions of subsection (a), unless such person's name has been
38       removed from the register of physician assistants pursuant to the provi-
39       sions of section 4 and amendments thereto. A person registered as a
40       physician assistant on the day preceding the effective date of this act shall
41       be deemed to be a licensed physician assistant under this act, and such
42       person shall not be required to file an original application under this act
43       for a license.

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  1           New Sec. 4. A licensee's license may be revoked, suspended or lim-
  2       ited, or the license may be publicly or privately censured, or an applicant
  3       for a license or for reinstatement of a license may be denied upon a
  4       finding of the existence of any of the following grounds:
  5           (a) The licensee has committed fraud or misrepresentation in apply-
  6       ing for or securing an original, renewal or reinstated license.
  7           (b) The licensee has committed an act of unprofessional or dishon-
  8       orable conduct or professional incompetency.
  9           (c) The licensee has been convicted of a felony or class A misde-
10       meanor, whether or not related to the provisions of this act.
11           (d) The licensee has used fraudulent or false advertisements.
12           (e) The licensee is addicted to or has distributed intoxicating liquors
13       or drugs for any other than lawful purposes.
14           (f) The licensee has willfully or repeatedly violated the provisions of
15       this act, the pharmacy act of the state of Kansas or the uniform controlled
16       substances act, or any rules and regulations adopted pursuant thereto, or
17       any rules and regulations of the secretary of health and environment
18       which are relevant to the provisions of this act.
19           (g) The licensee has unlawfully invaded the field of practice of any
20       branch of the healing arts in which the licensee is not licensed to practice.
21           (h) The licensee has engaged in the practice as a physician assistant
22       under a false or assumed name, or the impersonation of another practi-
23       tioner. The provisions of this subsection relating to an assumed name
24       shall not apply to licensees practicing under a professional corporation or
25       other legal entity duly authorized to provide such professional services in
26       the state of Kansas.
27           (i) The licensee has had a license or authorization to practice the
28       healing arts revoked, suspended or limited, has been censured or has had
29       other disciplinary action taken, or an application for a license denied, by
30       the proper licensing authority of another state, territory, District of Co-
31       lumbia or other country, a certified copy of the record of the action of
32       the other jurisdiction being conclusive evidence thereof.
33           (j) The licensee has violated any lawful rule and regulation promul-
34       gated by the board or violated any lawful order or directive of the board
35       previously entered by the board.
36           (k) The licensee has cheated on or attempted to subvert the validity
37       of the examination for a license.
38           (l) The licensee has transmitted a prescription order for, sold, ad-
39       ministered, distributed or given a controlled substance to any person for
40       other than medically accepted or lawful purposes.
41           (m) The licensee has intentionally violated a federal law or regulation
42       relating to controlled substances.
43           (n) The licensee has failed to furnish the board, or its investigators

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  1       or representatives, any information legally requested by the board.
  2           (o) Sanctions or disciplinary actions have been taken against the li-
  3       censee by a peer review committee, health care facility, a governmental
  4       agency or department or a professional association or society for acts or
  5       conduct similar to acts or conduct which would constitute grounds for
  6       disciplinary action under this section.
  7           (p) The licensee has failed to report to the board any adverse action
  8       taken against the licensee by another state or licensing jurisdiction, a peer
  9       review body, a health care facility, a professional association or society, a
10       governmental agency, a law enforcement agency or a court for acts or
11       conduct similar to acts or conduct which would constitute grounds for
12       disciplinary action under this section.
13           (q) The licensee has surrendered a license or authorization to practice
14       as a physician assistant in another state or jurisdiction, has surrendered
15       the authority to utilize controlled substances issued by any state or federal
16       agency, has agreed to a limitation to or restriction of privileges at any
17       medical care facility or has surrendered the licensee's membership on any
18       professional staff or in any professional association or society while under
19       investigation for acts or conduct similar to acts or conduct which would
20       constitute grounds for disciplinary action under this section.
21           (r) The licensee has failed to report to the board surrender of the
22       licensee's license or authorization to practice as a physician assistant in
23       another state or jurisdiction or surrender of the licensee's membership
24       on any professional staff or in any professional association or society while
25       under investigation for acts or conduct similar to acts or conduct which
26       would constitute grounds for disciplinary action under this section.
27           (s) The licensee has an adverse judgment, award or settlement against
28       the licensee resulting from a medical liability claim related to acts or
29       conduct similar to acts or conduct which would constitute grounds for
30       disciplinary action under this section.
31           (t) The licensee has failed to report to the board any adverse judg-
32       ment, settlement or award against the licensee resulting from a medical
33       malpractice liability claim related to acts or conduct similar to acts or
34       conduct which would constitute grounds for disciplinary action under this
35       section.
36           (u) The licensee has knowingly submitted any misleading, deceptive,
37       untrue or fraudulent representation on a claim form, bill or statement.
38           New Sec. 5. (a) All administrative proceedings provided for under
39       sections 1 to 13, inclusive, and amendments thereto which affect any
40       licensee licensed under such sections shall be conducted in accordance
41       with the provisions of the Kansas administrative procedure act.
42           (b) Judicial review and civil enforcement of any agency action under
43       sections 1 to 13, inclusive, and amendments thereto, shall be in accord-

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  1       ance with the act for judicial review and civil enforcement of agency
  2       actions.
  3           New Sec. 6. (a) It shall be unlawful for any person who is not licensed
  4       under this act, or whose license has been revoked or suspended to engage
  5       in the practice as a physician assistant as defined by this act.
  6           (b) This section shall not apply to any person performing services
  7       pursuant to section 11 and amendments thereto.
  8           (c) No person shall use any title, abbreviation, letters, figures, sign,
  9       card or device to indicate that any person is a licensed physician assistant,
10       nor shall any person represent oneself to be a licensed physician assistant
11       unless such person has been duly licensed as a physician assistant in ac-
12       cordance with the provisions of this act.
13           (d) An unlicensed physician shall not be permitted to use the title of
14       ``physician assistant'' or to practice as a physician assistant unless such
15       person has complied with the provisions of this act.
16           (e) Any person violating the provisions of this section shall be guilty
17       of a class C misdemeanor.
18           New Sec. 7. (a) The state board of healing arts shall provide for the
19       temporary licensure of any physician assistant who has made proper ap-
20       plication for licensure, has the required qualifications for licensure, except
21       for examination, and has paid the prescribed license fee. Such temporary
22       license shall authorize the person so licensed to provide patient services
23       within the limits of the temporary license.
24           (b) A temporary license is valid:
25           (1) For one year from the date of issuance;
26           (2) until the date the results of the applicant's examination become
27       available; or
28           (3) until the state board of healing arts makes a final determination
29       on the applicant's request for licensure.
30           (c) The state board of healing arts may extend a temporary license,
31       upon a majority vote of the members of the board, for a period not to
32       exceed one year. Under no circumstances may the board of healing arts
33       grant more than one extension of a temporary license.
34           New Sec. 8. (a) The practice of a physician assistant shall include
35       medical services within the education, training and experience of the phy-
36       sician assistant that are delegated by the supervising physician. Physician
37       assistants practice in a dependent role with a responsible physician, and
38       may perform those duties and responsibilities through delegated authority
39       or written protocol. Medical services rendered by a physician assistant
40       may include but are not limited to:
41           (1) Obtaining patient histories, performing physical examinations and
42       health assessments;
43           (2) ordering or performing diagnostic and therapeutic procedures;

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  1           (3) formulating diagnosis;
  2           (4) developing and implementing a treatment plan;
  3           (5) monitoring the effectiveness of therapeutic interventions;
  4           (6) assisting in surgery;
  5           (7) offering counseling and education to meet the patient needs; and
  6           (8) making appropriate referral.
  7       The activities listed above may be performed in any setting authorized by
  8       the responsible physician, including but not limited to: Clinics, hospi-
  9       tals, ambulatory surgical centers, patient homes, nursing homes and other
10       medical institutions.
11           (b) Physician assistants shall be considered the agents of their super-
12       vising physician in the performance of all practice-related activities, in-
13       cluding but not limited to, the ordering of diagnostic, therapeutic and
14       other medical services.
15           (c) A person licensed as a physician assistant may perform, only under
16       the direction and supervision of a physician, acts which constitute the
17       practice of medicine and surgery to the extent and in the manner au-
18       thorized by the physician responsible for the physician assistant and only
19       to the extent such acts are consistent with rules and regulations adopted
20       by the board which relate to acts performed by a physician assistant under
21       the responsible physician's direction and supervision. A physician assistant
22       may not prescribe drugs but may transmit a prescription order for drugs
23       pursuant to a written protocol as authorized by the responsible physician.
24           (d) Before a physician assistant shall perform under the direction and
25       supervision of a physician, such physician assistant shall be identified to
26       the patient and others involved in providing the patient services as a
27       physician assistant to the responsible physician. Physician assistants li-
28       censed under the provisions of this act shall keep their license available
29       for inspection at their primary place of business. A physician assistant may
30       not perform any act or procedure performed in the practice of optometry
31       except as provided in K.S.A. 65-1508 and 65-2887 and amendments
32       thereto.
33           (e) The board shall adopt rules and regulations governing the trans-
34       mitting of prescription orders for drugs by physician assistants and the
35       responsibilities of the responsible physician with respect thereto. Such
36       rules and regulations shall establish such conditions and limitations as the
37       board determines to be necessary to protect the public health and safety.
38       In developing rules and regulations relating to the transmitting of pre-
39       scription orders for drugs by physician assistants, the board shall take into
40       consideration the amount of training and capabilities of physician assis-
41       tants, the different practice settings in which physician assistants and re-
42       sponsible physicians practice, the degree of direction and supervision to
43       be provided by a responsible physician and the needs of the geographic

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  1       area of the state in which the physician assistant and the responsible
  2       physician practice. In all cases in which a physician assistant is authorized
  3       to transmit prescription orders for drugs by a responsible physician, a
  4       written protocol between the responsible physician and the physician as-
  5       sistant containing the essential terms of such authorization shall be in
  6       effect. In no case shall the scope of the authority of the physician assistant
  7       to transmit prescription orders for drugs exceed the normal and custom-
  8       ary practice of the responsible physician in the prescribing of drugs.
  9           (f) Physician assistants may authenticate with their signature any form
10       that may be authenticated by a physician's signature.
11           New Sec. 9. (a) If a responsible physician temporarily leaves the cus-
12       tomary area of practice, the responsible physician shall, by prior arrange-
13       ment, designate a physician who shall provide direction and supervision
14       to the physician assistant of such responsible physician.
15           (b) Nothing in this act shall be construed to prohibit the rendering
16       of services by a physician assistant in a setting geographically remote from
17       the supervising physician.
18           New Sec. 10. No responsible physician shall have under such per-
19       son's direction and supervision more than two physician assistants.
20           New Sec. 11. (a) Nothing in this act shall prohibit a medical care
21       facility from employing physician assistants, provided such physician as-
22       sistants shall be under the direction and supervision of a responsible phy-
23       sician. The limitation on the number of physician assistants in section 9
24       and amendments thereto shall not apply to services performed in a med-
25       ical care facility.
26           (b) Nothing in this act shall be construed to limit the authority of the
27       governing body of a medical care facility to establish rules governing the
28       conduct and qualifications of physician assistants performing acts within
29       the medical care facility.
30           New Sec. 12. The provisions of sections 1 to 13, inclusive, and
31       amendments thereto, shall not be construed to include the following per-
32       sons:
33           (a) Persons rendering services in the case of an emergency.
34           (b) Persons gratuitously administering ordinary household remedies.
35           (c) The members of any church practicing their religious tenets pro-
36       vided they shall not be exempt from complying with all public health
37       regulations of the state.
38           (d) Students while in actual classroom attendance in an accredited
39       healing arts school who after completing one year's study treat diseases
40       under the supervision of a licensed instructor.
41           (e) Students upon the completion of at least three year's study in an
42       accredited healing arts school and who, as a part of their academic
43       requirements for a degree, serve a preceptorship not to exceed 90 days

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  1       under the supervision of a licensed practitioner.
  2           (f) Persons who massage for the purpose of relaxation, muscle con-
  3       ditioning or figure improvement, so long as no drugs are used and such
  4       persons do not hold themselves out to be physicians or healers.
  5           (g) Persons whose professional services are performed under the di-
  6       rect and personal supervision or by order of or referral from a practitioner
  7       who is licensed under this act.
  8           (h) Persons in the general fields of psychology, education and social
  9       work, dealing with the social, psychological and moral well-being of in-
10       dividuals or groups, or both, so long as they do not use drugs and do not
11       hold themselves out to be the physicians, surgeons, osteopathic physicians
12       or chiropractors.
13           (i) Practitioners of the healing arts in the United States army, navy,
14       air force, public health service and coast guard or other military service
15       when acting in the line of duty in this state.
16           (j) Practitioners of the healing arts licensed in another state when and
17       while incidentally called into this state in consultation with practitioners
18       licensed in this state, or residing on the border of a neighboring state,
19       duly licensed under the laws thereof to practice a branch of the healing
20       arts, but who do not open an office or maintain or appoint a place to
21       regularly meet patients or to receive calls within this state.
22           (k) Dentists practicing their professions, when licensed and practic-
23       ing in accordance with the provisions of article 14 of chapter 65 of the
24       Kansas Statutes Annotated, or amendments thereto, and any interpreta-
25       tion thereof by the supreme court of this state.
26           (l) Optometrists practicing their professions, when licensed and prac-
27       ticing under and in accordance with the provisions of article 15 of chapter
28       65 of the Kansas Statutes Annotated, or amendments thereto, and any
29       interpretation thereof by the supreme court of this state.
30           (m) Nurses practicing their profession when licensed and practicing
31       under and in accordance with the provisions of article 11 of chapter 65
32       of the Kansas Statutes Annotated, or amendments thereto, and any in-
33       terpretation thereof by the supreme court of this state.
34           (n) Podiatrists practicing their profession, when licensed and practic-
35       ing under and in accordance with the provisions of article 20 of chapter
36       65 of the Kansas Statutes Annotated, or amendments thereto, and any
37       interpretation thereof by the supreme court of this state.
38           (o) Every act or practice falling in the field of the healing arts, not
39       specifically excepted herein, shall constitute the practice thereof.
40           (p) Pharmacists practicing their profession, when licensed and prac-
41       ticing under and in accordance with the provisions of article 16 of chapter
42       65 of the Kansas Statutes Annotated, or amendments thereto, and any
43       interpretation thereof by the supreme court of this state.

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  1           (q) A dentist licensed in accordance with the provisions of article 14
  2       of chapter 65 of the Kansas Statutes Annotated who administers general
  3       and local anesthetics to facilitate medical procedures conducted by a per-
  4       son licensed to practice medicine and surgery if such dentist is certified
  5       by the board of healing arts under K.S.A. 65-2899 and amendments
  6       thereto to administer such general and local anesthetics.
  7           New Sec. 13. (a) There is established a physician assistant council to
  8       advise the board in carrying out the provisions of sections 1 to 13, inclu-
  9       sive, and amendments thereto. The council shall consist of five members,
10       all citizens and residents of the state of Kansas appointed as follows: One
11       member shall be a physician appointed by the state board of healing arts
12       who is a responsible physician for a physician assistant; one member shall
13       be the president of the state board of healing arts or a person designated
14       by the president; and three members shall be licensed physician assistants
15       appointed by the governor. The governor, insofar as possible, shall ap-
16       point persons from different geographical areas and persons who repre-
17       sent various types of practice settings. If a vacancy occurs on the council,
18       the appointing authority of the position which has become vacant shall
19       appoint a person of like qualifications to fill the vacant position for the
20       unexpired term, if any. The Kansas academy of physician assistants shall
21       recommend the names of licensed physician assistants to the governor in
22       a number equal to at least twice the positions or vacancies to be filled,
23       and the governor may appoint members to fill the positions or vacancies
24       from the submitted list. Members of the council appointed by the gov-
25       ernor on and after the effective date of this act shall be appointed for
26       terms of three years and until their successors are appointed and qualified
27       except that of the members first appointed by the governor on or after
28       the effective date of this act one shall be appointed for a term of one
29       year, one shall be appointed for a term of two years and one shall be
30       appointed for a term of three years, as designated by the governor. The
31       member appointed by the state board of healing arts shall serve at the
32       pleasure of the state board of healing arts. A member designated by the
33       president of the state board of healing arts shall serve at the pleasure of
34       the president.
35           (b) Members of the council attending meetings of the council, or
36       attending a subcommittee meeting thereof authorized by the council,
37       shall be paid amounts provided in subsection (e) of K.S.A. 75-3223 and
38       amendments thereto from the healing arts fee fund.
39           Sec. 14. K.S.A. 1997 Supp. 38-135 is hereby amended to read as
40       follows: 38-135. As used in this act:
41           (a) ``Health care provider'' means a person licensed to practice med-
42       icine and surgery by the state board of healing arts, a person who holds
43       a temporary permit to practice medicine and surgery issued by the state

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  1       board of healing arts, a person engaged in a postgraduate training pro-
  2       gram in medicine and surgery approved by the state board of healing arts,
  3       a medical care facility licensed by the department of health and environ-
  4       ment, a health maintenance organization issued a certificate of authority
  5       by the commissioner of insurance, a licensed professional nurse, a li-
  6       censed practical nurse, a   (Rx)gistered physician's licensed physician assis-
  7       tant, a professional corporation organized pursuant to the professional
  8       corporation law of Kansas by persons who are authorized by such law to
  9       form such a corporation and who are health care providers as defined by
10       this subsection, a Kansas limited liability company organized for the pur-
11       pose of rendering professional services by its members who are health
12       care providers as defined by this subsection and who are legally author-
13       ized to render the professional services for which the limited liability
14       company is organized, a partnership of persons who are health care pro-
15       viders as defined by this subsection or a Kansas not-for-profit corporation
16       organized for the purpose of rendering professional services by persons
17       who are health care providers as defined by this subsection.
18           (b) ``Parent'' means:
19           (1) A minor's parent by birth or adoption;
20           (2) a minor's legal guardian; or
21           (3) any person who under court order is authorized to give consent
22       for a minor.
23           Sec. 15. K.S.A. 40-2,111 is hereby amended to read as follows: 40-
24       2,111. As used in K.S.A. 40-2,111 through 40-2,113, and amendments
25       thereto: (a) ``Adverse underwriting decision'' means: Any of the following
26       actions with respect to insurance transactions involving insurance cover-
27       age which is individually underwritten:
28           (1) A declination of insurance coverage;
29           (2) a termination of insurance coverage;
30           (3) an offer to insure at higher than standard rates, with respect to
31       life, health or disability insurance coverage; or
32           (4) the charging of a higher rate on the basis of information which
33       differs from that which the applicant or policyholder furnished, with re-
34       spect to property or casualty insurance coverage.
35           (b) ``Declination of insurance coverage'' means a denial, in whole or
36       in part, by an insurance company or agent of requested insurance cov-
37       erage.
38           (c) ``Health care institution'' means any medical care facility, adult
39       care home, drug abuse and alcoholic treatment facility, home-health
40       agency certified for federal reimbursement, mental health center or men-
41       tal health clinic licensed by the secretary of social and rehabilitation serv-
42       ices, kidney disease treatment center, county, city-county or multicounty
43       health departments and health-maintenance organization.

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  1           (d) ``Health care provider'' means any person licensed to practice any
  2       branch of the healing arts, licensed dentist, licensed professional nurse,
  3       licensed practical nurse, advanced registered nurse practitioner, licensed
  4       optometrist, registered physical therapist, licensed social worker,   (Rx)gis-
  5       tered physicians' licensed physician assistant, licensed podiatrist or li-
  6       censed psychologist.
  7           (e) ``Institutional source'' means any natural person, corporation, as-
  8       sociation, partnership or governmental or other legal entity that provides
  9       information about an individual to an agent or insurance company, other
10       than:
11           (1) An agent;
12           (2) the individual who is the subject of the information; or
13           (3) a natural person acting in a personal capacity rather than a busi-
14       ness or professional capacity.
15           (f) ``Insurance transaction'' means any transaction involving insur-
16       ance, but not including group insurance coverage, primarily for personal,
17       family or household needs rather than business or professional needs.
18           (g) ``Medical-record information'' means personal information which:
19           (1) Relates to an individual's physical or mental condition, medical
20       history or medical treatment; and
21           (2) is obtained from a health care provider or health care institution,
22       from the individual, or from the individual's spouse, parent or legal guard-
23       ian.
24           (h) ``Termination of insurance coverage'' or ``termination of an insur-
25       ance policy'' means either a cancellation, nonrenewal or lapse of an in-
26       surance policy, in whole or in part, for any reason other than:
27           (1) The failure to pay a premium as required by the policy ; or
28           (2) at the request or direction of the insured.
29           Sec. 16. K.S.A. 65-118 is hereby amended to read as follows: 65-118.
30       (a) Whenever any person licensed to practice the healing arts or engaged
31       in a postgraduate training program approved by the state board of healing
32       arts, licensed dentist,   (phone)ysician's assistant whose name has been entered
33       on the register of physicians' assistants by the state board of healing arts
34       licensed physician assistant, licensed social worker, teacher or school ad-
35       ministrator knows or has information indicating that a person is suffering
36       from or has died from an infectious or contagious disease, such knowledge
37       or information shall be reported immediately to the county or joint board
38       of health or the local health officer, together with the name and address
39       of the person who has or is suspected of having the infectious or conta-
40       gious disease, or the name and former address of the deceased individual
41       who had or was suspected of having such a disease.
42           (b) Any person who is an individual member of a class of persons
43       designated under subsection (a) of this section and who reports the in-

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  1       formation required to be reported under such subsection in good faith
  2       and without malice to a county or joint board of health or a local health
  3       officer shall have immunity from any liability, civil or criminal, that might
  4       otherwise be incurred or imposed in an action resulting from such report.
  5       Any such person shall have the same immunity with respect to partici-
  6       pation in any judicial proceeding resulting from such report.
  7           (c) Information required to be reported under subsection (a) of this
  8       section shall be confidential and shall not be disclosed or made public,
  9       upon subpoena or otherwise, beyond the requirements of subsection (a)
10       of this section or subsection (a) of K.S.A. 65-119, except such information
11       may be disclosed: (1) If no person can be identified in the information to
12       be disclosed and the disclosure is for statistical purposes;
13           (2) if all persons who are identifiable in the information to be dis-
14       closed consent in writing to its disclosure;
15           (3) if the disclosure is necessary, and only to the extent necessary, to
16       protect the public health;
17           (4) if a medical emergency exists and the disclosure is to medical
18       personnel qualified to treat infectious or contagious diseases. Any infor-
19       mation disclosed pursuant to this paragraph shall be disclosed only to the
20       extent necessary to protect the health or life of a named party; or
21           (5) if the information to be disclosed is required in a court proceeding
22       involving child abuse and the information is disclosed in camera.
23           Sec. 17. K.S.A. 1997 Supp. 65-4915 is hereby amended to read as
24       follows: 65-4915. (a) As used in this section:
25           (1) ``Health care provider'' means: (A) Those persons and entities
26       defined as a health care provider under K.S.A. 40-3401 and amendments
27       thereto; and (B) a dentist licensed by the Kansas dental board, a dental
28       hygienist licensed by the Kansas dental board, a professional nurse li-
29       censed by the board of nursing, a practical nurse licensed by the board
30       of nursing, a mental health technician licensed by the board of nursing,
31       a physical therapist assistant certified by the state board of healing arts,
32       an occupational therapist registered by the state board of healing arts, an
33       occupational therapy assistant registered by the state board of healing
34       arts, a respiratory therapist registered by the state board of healing arts,
35       a   (phone)ysician's physician assistant   (Rx)gistered licensed by the state board of
36       healing arts and attendants and ambulance services certified by the emer-
37       gency medical services board.
38           (2) ``Health care provider group'' means:
39           (A) A state or local association of health care providers or one or more
40       committees thereof;
41           (B) the board of governors created under K.S.A. 40-3403 and amend-
42       ments thereto;
43           (C) an organization of health care providers formed pursuant to state

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  1       or federal law and authorized to evaluate medical and health care services;
  2           (D) a review committee operating pursuant to K.S.A. 65-2840b
  3       through 65-2840d, and amendments thereto;
  4           (E) an organized medical staff of a licensed medical care facility as
  5       defined by K.S.A. 65-425 and amendments thereto, an organized medical
  6       staff of a private psychiatric hospital licensed under K.S.A. 75-3307b and
  7       amendments thereto or an organized medical staff of a state psychiatric
  8       hospital or state institution for the mentally retarded, as follows: Larned
  9       state hospital, Osawatomie state hospital, Rainbow mental health facility,
10       Topeka state hospital, Kansas neurological institute, Norton state hospital,
11       Parsons state hospital and training center and Winfield state hospital and
12       training center;
13           (F) a health care provider;
14           (G) a professional society of health care providers or one or more
15       committees thereof;
16           (H) a Kansas corporation whose stockholders or members are health
17       care providers or an association of health care providers, which corpora-
18       tion evaluates medical and health care services; or
19           (I) an insurance company, health maintenance organization or ad-
20       ministrator of a health benefits plan which engages in any of the functions
21       defined as peer review under this section.
22           (3) ``Peer review'' means any of the following functions:
23           (A) Evaluate and improve the quality of health care services rendered
24       by health care providers;
25           (B) determine that health services rendered were professionally in-
26       dicated or were performed in compliance with the applicable standard of
27       care;
28           (C) determine that the cost of health care rendered was considered
29       reasonable by the providers of professional health services in this area;
30           (D) evaluate the qualifications, competence and performance of the
31       providers of health care or to act upon matters relating to the discipline
32       of any individual provider of health care;
33           (E) reduce morbidity or mortality;
34           (F) establish and enforce guidelines designed to keep within reason-
35       able bounds the cost of health care;
36           (G) conduct of research;
37           (H) determine if a hospital's facilities are being properly utilized;
38           (I) supervise, discipline, admit, determine privileges or control mem-
39       bers of a hospital's medical staff;
40           (J) review the professional qualifications or activities of health care
41       providers;
42           (K) evaluate the quantity, quality and timeliness of health care serv-
43       ices rendered to patients in the facility;

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  1           (L) evaluate, review or improve methods, procedures or treatments
  2       being utilized by the medical care facility or by health care providers in
  3       a facility rendering health care.
  4           (4) ``Peer review officer or committee'' means:
  5           (A) An individual employed, designated or appointed by, or a com-
  6       mittee of or employed, designated or appointed by, a health care provider
  7       group and authorized to perform peer review; or
  8           (B) a health care provider monitoring the delivery of health care at
  9       correctional institutions under the jurisdiction of the secretary of correc-
10       tions.
11           (b) Except as provided by K.S.A. 60-437 and amendments thereto
12       and by subsections (c) and (d), the reports, statements, memoranda, pro-
13       ceedings, findings and other records submitted to or generated by peer
14       review committees or officers shall be privileged and shall not be subject
15       to discovery, subpoena or other means of legal compulsion for their re-
16       lease to any person or entity or be admissible in evidence in any judicial
17       or administrative proceeding. Information contained in such records shall
18       not be discoverable or admissible at trial in the form of testimony by an
19       individual who participated in the peer review process. The peer review
20       officer or committee creating or initially receiving the record is the holder
21       of the privilege established by this section. This privilege may be claimed
22       by the legal entity creating the peer review committee or officer, or by
23       the commissioner of insurance for any records or proceedings of the
24       board of governors.
25           (c) Subsection (b) shall not apply to proceedings in which a health
26       care provider contests the revocation, denial, restriction or termination
27       of staff privileges or the license, registration, certification or other au-
28       thorization to practice of the health care provider. A licensing agency in
29       conducting a disciplinary proceeding in which admission of any peer re-
30       view committee report, record or testimony is proposed shall hold the
31       hearing in closed session when any such report, record or testimony is
32       disclosed. Unless otherwise provided by law, a licensing agency conduct-
33       ing a disciplinary proceeding may close only that portion of the hearing
34       in which disclosure of a report or record privileged under this section is
35       proposed. In closing a portion of a hearing as provided by this section,
36       the presiding officer may exclude any person from the hearing location
37       except the licensee, the licensee's attorney, the agency's attorney, the
38       witness, the court reporter and appropriate staff support for either coun-
39       sel. The licensing agency shall make the portions of the agency record in
40       which such report or record is disclosed subject to a protective order
41       prohibiting further disclosure of such report or record. Such report or
42       record shall not be subject to discovery, subpoena or other means of legal
43       compulsion for their release to any person or entity. No person in at-

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  1       tendance at a closed portion of a disciplinary proceeding shall at a sub-
  2       sequent civil, criminal or administrative hearing, be required to testify
  3       regarding the existence or content of a report or record privileged under
  4       this section which was disclosed in a closed portion of a hearing, nor shall
  5       such testimony be admitted into evidence in any subsequent civil, crim-
  6       inal or administrative hearing. A licensing agency conducting a discipli-
  7       nary proceeding may review peer review committee records, testimony
  8       or reports but must prove its findings with independently obtained tes-
  9       timony or records which shall be presented as part of the disciplinary
10       proceeding in open meeting of the licensing agency. Offering such tes-
11       timony or records in an open public hearing shall not be deemed a waiver
12       of the peer review privilege relating to any peer review committee testi-
13       mony, records or report.
14           (d) Nothing in this section shall limit the authority, which may oth-
15       erwise be provided by law, of the commissioner of insurance, the state
16       board of healing arts or other health care provider licensing or disciplinary
17       boards of this state to require a peer review committee or officer to report
18       to it any disciplinary action or recommendation of such committee or
19       officer; to transfer to it records of such committee's or officer's proceed-
20       ings or actions to restrict or revoke the license, registration, certification
21       or other authorization to practice of a health care provider; or to terminate
22       the liability of the fund for all claims against a specific health care provider
23       for damages for death or personal injury pursuant to subsection (i) of
24       K.S.A. 40-3403 and amendments thereto. Reports and records so fur-
25       nished shall not be subject to discovery, subpoena or other means of legal
26       compulsion for their release to any person or entity and shall not be
27       admissible in evidence in any judicial or administrative proceeding other
28       than a disciplinary proceeding by the state board of healing arts or other
29       health care provider licensing or disciplinary boards of this state.
30           (e) A peer review committee or officer may report to and discuss its
31       activities, information and findings to other peer review committees or
32       officers or to a board of directors or an administrative officer of a health
33       care provider without waiver of the privilege provided by subsection (b)
34       and the records of all such committees or officers relating to such report
35       shall be privileged as provided by subsection (b).
36           (f) Nothing in this section shall be construed to prevent an insured
37       from obtaining information pertaining to payment of benefits under a
38       contract with an insurance company, a health maintenance organization
39       or an administrator of a health benefits plan.
40           Sec. 18. K.S.A. 1997 Supp. 65-6112 is hereby amended to read as
41       follows: 65-6112. As used in this act:
42           (a) ``Administrator'' means the administrator of the emergency med-
43       ical services board.

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  1           (b) ``Ambulance'' means any privately or publicly owned motor ve-
  2       hicle, airplane or helicopter designed, constructed, prepared and
  3       equipped for use in transporting and providing emergency care for in-
  4       dividuals who are ill or injured.
  5           (c) ``Ambulance service'' means any organization operated for the
  6       purpose of transporting sick or injured persons to or from a place where
  7       medical care is furnished, whether or not such persons may be in need
  8       of emergency or medical care in transit.
  9           (d) ``Attendant'' means a first responder or an emergency medical
10       technician, an emergency medical technician-intermediate, an emergency
11       medical technician-defibrillator or a mobile intensive care technician
12       whose primary function is ministering to the needs of persons requiring
13       emergency medical services.
14           (e) ``Board'' means the emergency medical services board established
15       pursuant to K.S.A. 65-6102, and amendments thereto.
16           (f) ``Emergency medical service'' means the effective and coordinated
17       delivery of such care as may be required by an emergency, including
18       services provided by first responders, care and transportation of individ-
19       uals by ambulance services and the performance of authorized emergency
20       care by a person licensed to practice medicine and surgery, a licensed
21       professional nurse, a   (Rx)gistered physician's licensed physician assistant,
22       emergency medical technician, emergency medical technician-interme-
23       diate, emergency medical technician-defibrillator or a mobile intensive
24       care technician.
25           (g) ``Emergency medical technician'' means any person who has suc-
26       cessfully completed a course of training, approved by the board, in pre-
27       liminary emergency medical care and who holds a valid emergency med-
28       ical technician certificate under this act.
29           (h) ``Emergency medical technician-defibrillator'' means any person,
30       currently certified as an emergency medical technician or emergency
31       medical technician-intermediate, who has successfully completed a train-
32       ing program in cardiac defibrillation approved by the board and who holds
33       a valid emergency medical technician-defibrillator certificate under this
34       act.
35           (i) ``Emergency medical technician-intermediate'' means any person,
36       currently certified as an emergency medical technician or emergency
37       medical technician-defibrillator, who, has successfully completed a course
38       of training approved by the board which includes training in veni-punc-
39       ture for blood sampling and administration of intravenous fluids and ad-
40       vanced patient assessment and who holds a valid emergency medical tech-
41       nician-intermediate certificate under this act.
42           (j) ``First responder'' means a person who has successfully completed
43       a course of training in preliminary emergency care, who holds a valid first

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  1       responder certificate under this act and who provides services to individ-
  2       uals in need of emergency medical care that assist in stabilization or im-
  3       provement of such individual's condition until personnel with a higher
  4       level of training arrive at the scene and assume responsibility for the
  5       individual.
  6           (k) ``Hospital'' means a hospital as defined by K.S.A. 65-425, and
  7       amendments thereto.
  8           (l) ``Instructor-coordinator'' means any person who has successfully
  9       completed a course of training, approved by the board, to instruct attend-
10       ants and to coordinate training programs, and who holds a valid instructor-
11       coordinator certificate under this act.
12           (m) ``Medical adviser'' means a physician.
13           (n) ``Medical protocols'' mean written guidelines that have been re-
14       viewed and approved by the emergency medical committee of the county
15       medical society, which assist in the provision of medical care to a patient
16       when the attendant is not receiving immediate direction from a physician.
17       In those counties where there is no emergency medical committee of the
18       county medical society, ``medical protocols'' mean written guidelines that
19       have been reviewed and approved by the medical staff of the hospital to
20       which the ambulance service primarily transports patients, which assist
21       in the provision of medical care to a patient when the attendant is not
22       receiving immediate direction from a physician.
23           (o) ``Mobile intensive care technician'' means any person who has
24       successfully completed a course of training, approved by the board, in
25       emergency medical care, and who holds a valid mobile intensive care
26       technician certificate under this act.
27           (p) ``Municipality'' means any city, county, township, fire district or
28       ambulance service district.
29           (q) ``Nonemergency transportation'' means the care and transport of
30       a sick or injured person under a foreseen combination of circumstances
31       calling for continuing care of such person. As used in this subsec-
32       tion,transportation includes performance of the authorized level of serv-
33       ices of the attendant whether within or outside the vehicle as part of such
34       transportation services.
35           (r) ``Operator'' means a person or municipality who has a permit to
36       operate an ambulance service in the state of Kansas.
37           (s) ``Person'' means an individual, a partnership, an association, a
38       joint-stock company or a corporation.
39           (t) ``Physician'' means a person licensed by the state board of healing
40       arts to practice medicine and surgery.
41           (u) ``Training officer I'' means any person who has completed suc-
42       cessfully a course of training, approved by the board, to conduct contin-
43       uing education programs for attendants.

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  1           (v) ``Training officer II'' means any person who has: (1) Completed
  2       successfully a course of training, approved by the board, to conduct con-
  3       tinuing education programs for attendants; and (2) completed successfully
  4       a supplemental course of training, approved by the board, to conduct
  5       initial training programs for first responders.
  6           Sec. 19. K.S.A. 65-6135 is hereby amended to read as follows: 65-
  7       6135. (a) All ambulance services providing emergency care as defined by
  8       the rules and regulations adopted by the board shall offer service 24 hours
  9       per day every day of the year.
10           (b) Whenever an operator is required to have a permit, at least one
11       person on each vehicle providing emergency medical service shall be an
12       attendant certified as an emergency medical technician, emergency med-
13       ical technician-intermediate, emergency medical technician-defibrillator
14       or a mobile intensive care technician, a person licensed to practice med-
15       icine and surgery, a   (Rx)gistered physician's licensed physician assistant or
16       a   (Rx)gistered licensed professional nurse.
17           Sec. 20. K.S.A. 1997 Supp. 65-6701 is hereby amended to read as
18       follows: 65-6701. As used in this act:
19           (a) ``Abortion'' means the use of any means to intentionally terminate
20       a pregnancy except for the purpose of causing a live birth. Abortion does
21       not include: (1) The use of any drug or device that inhibits or prevents
22       ovulation, fertilization or the implantation of an embryo; or (2) disposition
23       of the product of in vitro fertilization prior to implantation.
24           (b) ``Counselor'' means a person who is: (1) Licensed to practice med-
25       icine and surgery; (2) licensed to practice psychology; (3) licensed to prac-
26       tice professional or practical nursing; (4) registered to practice profes-
27       sional counseling; (5) licensed as a social worker; (6) the holder of a
28       master's or doctor's degree from an accredited graduate school of social
29       work; (7) registered to practice marriage and family therapy; (8) a   (Rx)gis-
30       tered physician's licensed physician assistant; or (9) a currently ordained
31       member of the clergy or religious authority of any religious denomination
32       or society. Counselor does not include the physician who performs or
33       induces the abortion or a physician or other person who assists in per-
34       forming or inducing the abortion.
35           (c) ``Department'' means the department of health and environment.
36           (d) ``Gestational age'' means the time that has elapsed since the first
37       day of the woman's last menstrual period.
38           (e) ``Medical emergency'' means that condition which, on the basis
39       of the physician's good faith clinical judgment, so complicates the medical
40       condition of a pregnant woman as to necessitate the immediate abortion
41       of her pregnancy to avert her death or for which a delay will create serious
42       risk of substantial and irreversible impairment of a major bodily function.
43           (f) ``Minor'' means a person less than 18 years of age.

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

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

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  1       the local health department or indigent health care clinic to such provider
  2       and who is considered an employee of the state of Kansas under K.S.A.
  3       75-6120 and amendments thereto. Professional services rendered by a
  4       provider under this paragraph (3) shall be considered gratuitous notwith-
  5       standing fees based on income eligibility guidelines charged by a local
  6       health department or indigent health care clinic and notwithstanding any
  7       fee paid by the local health department or indigent health care clinic to
  8       a provider in accordance with this paragraph (3).
  9           (g) ``Medically indigent person'' means a person who lacks resources
10       to pay for medically necessary health care services and who meets the
11       eligibility criteria for qualification as a medically indigent person estab-
12       lished by the secretary of health and environment under K.S.A. 75-6120,
13       and amendments thereto.
14           (h) ``Indigent health care clinic'' means an outpatient medical care
15       clinic operated on a not-for-profit basis which has a contractual agreement
16       in effect with the secretary of health and environment to provide health
17       care services to medically indigent persons.
18           (i) ``Local health department'' shall have the meaning ascribed to such
19       term under K.S.A. 65-241 and amendments thereto.
20           Sec. 22. K.S.A. 40-2,111, 65-118, 65-2896a, 65-2896b, 65-2896c,
21       65-2896d, 65-2896e, 65-2896f, 65-2896g, 65-2896h, 65-2897a, 65-2897b,
22       65-6135 and 75-6102 and K.S.A. 1997 Supp. 38-135, 65-2896, 65-4915,
23       65-6112 and 65-6701 are hereby repealed.
24           Sec. 23. This act shall take effect and be in force from and after its
25       publication in the statute book.
26      
27