Brief⁽¹⁾

As amended by Senate Committee, H.B. 2074 concerns the division of the existing Department of Health and Environment into two separate agencies-a Department of Health and a Department of Environment-and a policy change in regard to the testing and reporting by name of HIV positive test results.

Restructuring of Health and Environmental Agency

As amended by Senate Committee, H.B. 2074 abolishes the existing Department of Health and Environment and the position of Secretary of Health and Environment on October 1, 1999. Pursuant to the provisions of the bill, a Kansas Department of Health and a Kansas Department of Environment are created to replace the existing agency on October 1.

The bill provides for the transfer of the powers, duties, and functions of the existing Division of Health to the Department of Health and the existing powers, duties, and functions of the Division of Environment to the Department of Environment. Existing statutory duties, regulations, contracts, licenses, permits, orders, directives, and obligations of the Department of Health and Environment will remain in effect and be allocated as appropriate to one of the new departments.

Current employees of Health and Environment who, in the opinion of either the Secretary of Health or the Secretary of Environment, are necessary to carry out the responsibilities of the new departments are transferred to the appropriate new state agency. Employees so transferred are to retain all retirement benefits and all rights of civil service to which they were entitled prior to the transfer. Appropriations also would be transferred to one of the new agencies to be used for the purpose for which the funds were originally appropriated.

H.B. 2074 requires the development of a transition plan which is to be jointly developed by the Governor and the Secretary of Health and Environment. The plan would have to be completed by October 1, 1999. The Governor, subject to Senate approval, is to appoint a Secretary to head each of the new departments. Each Secretary would be authorized to appoint classified and unclassified staff to carry out the duties of the department. Unclassified positions created by the bill for each department are: assistant secretaries, chief attorney, staff attorneys, public information officer, personal secretary, and special assistant. Salaries of the unclassified positions are to be fixed by the department heads with the approval of the Governor. All other positions authorized by the bill will be in the classified civil service. The bill would allow any current employee in a classified position that would be unclassified under the bill to remain in the classified service until he or she leaves the position. Once a vacancy occurs, the position would become unclassified. Under current law, the chief attorney, division heads, chief administrative officer of the Bureau of Oil Field and Environmental Geology, health officers, the public information officer, the Secretary's personal secretary, and special assistant are unclassified positions.

H.B. 2074 abolishes the position of Director of the Division of Health who, under existing law, must be a qualified physician with experience and educational training in the field of public health. Existing authority of the Director of Health would be assumed by the Secretary of Health. The bill also abolishes the position of Director of the Division of Environment. Under current law, the Director of Environment must have experience and educational training in the field of environment. Existing authority of the Director of Environment would be assumed by the Secretary of Environment. The bill abolishes the Office of Laboratory Services.

Various statutes that transferred authority to the Secretary of Health and Environment and the Department thereof from the previous Board of Health when the Department of Health and Environment was created in 1974 are repealed by H.B. 2074.

HIV Testing and Reporting

H.B. 2074, as amended by House and Senate committees, changes the state policy relating to testing for and reporting of HIV infection. Currently, in Kansas all testing for HIV is available anonymously and test results are not reported to state or local officials although cases of diagnosed AIDS are reported to the state.

H.B. 2074 amends existing statutes to define the term, laboratory confirmation of HIV infection, as positive test results from a confirmation test approved by the Secretary of Health and Environment and requires any physician and any laboratory director who receives a report of laboratory confirmation of HIV infection to report such information to the Secretary. Such report is to include the name and address of the person tested, the date and type of test, the test results, the name of the physician or facility requesting the test, and the sex, date of birth, county of residence, racial or ethnic group, and exposure category of the individual who was the subject of the test. Laboratory directors are also required to report the pregnancy status of the person tested. The existing disclosure provisions of paragraph (d) of K.S.A. 1998 Supp. 65-6002 are made applicable to information supplied to the Secretary relating to confirmed HIV infection.

The amendments further direct the Secretary of Health and Environment to investigate cases of HIV infection and monitor such cases, adopt rules and regulations for the prevention and control of HIV infection as necessary to protect the public health, and require the Secretary to adopt rules and regulations for maintaining confidentiality of information on HIV infection and AIDS, which at a minimum, are as strict as the guidelines of the Centers for Disease Control and Prevention. Other statutes concerning physician disclosure of infectious disease or AIDS to certain persons are amended to include laboratory confirmation of HIV infection. The section of the act (K.S.A. 65-6001 through 65-6004) that creates a criminal penalty for violating, refusing, or neglecting to obey provisions of the act or rules and regulations adopted thereunder is amended to create a new unspecified misdemeanor for the disclosure of information made confidential and prohibited from disclosure. The bill also amends the statute that requires the Secretary to maintain HIV test sites to require that an anonymous test site be available within 100 miles of any resident of the state.

The Senate Committee amendments require the Secretary of Health and Environment to report the impact of changes made in the bill to the Legislature on or before January 8, 2001. On July 1, 2001, the provisions of K.S.A. 65-6001 through 65-6010 are repealed.

The bill would become effective upon its publication in the Kansas Register although many of the sections would become effective on October 1, 1999.

Background

H. B. 2074 in its original form was the subject of a hearing by the House Committee on Health and Human Services during which numerous conferees appeared, both in support of and opposition to, the bill as introduced. All stressed the need to maintain anonymous testing for those who choose not to be identified at the time of testing. Many, who expressed reluctance to change the current policy relating to reporting of confirmed HIV, supported the change to report the names of HIV positive individuals solely because it is believed Kansas is losing federal AIDs funds due to undercounting the number of HIV infected individuals in the state. Although H.B. 2074 requires the continuation of some anonymous test sites, the new requirement for physicians and laboratories to report the names of HIV infected individuals means those persons who have a confirmed positive test will be reported to the state at such time as they seek treatment. The House Committee amendments were developed by a subcommittee with the assistance of interested individuals.

The fiscal note on the original H.B. 2074 states the Department of Health and Environment indicates a cost of $42,900 from the State General Fund and 1.0 position to conduct HIV surveillance required by the bill. The agency also estimates one medical investigator position at $34,000 and other operating expenditures of $8,900. Further, the fiscal note states the agency indicates the HIV surveillance which would occur would mean a substantial increase in workload.

The portions of H.B. 2074 that concern the division of the Department of Health and Environment into two separate state agencies reflect the provisions of Substitute for H. B. 2077 which is on the House Calendar.

Although there is no fiscal note on H.B. 2074 as amended by the Senate, the fiscal note on H.B. 2077 states the FY 2000 Governor's Budget Report separates the budget of the Department of Health and Environment into two parts. The health portion of the budget is $103,800,068 of which $21,265,949 is from the State General Fund. The fiscal note states the number of FTE positions for health functions includes 439.5 classified and 80.7 temporary positions. The Environment portion budget totals $68,811,098 of which $9,210,401 is from the State General Fund. The number of FTE positions approved for environment functions include 397.5 classified and 71.5 temporary positions. The fiscal note states that the totals for each of these numbers would change with changes in the structure of the agency into two agencies.

1. *Supplemental notes are prepared by the Legislative Research Department and do not express legislative intent. The supplemental note and fiscal note for this bill may be accessed on the Internet at http://www.ink.org/public/legislative/bill_search.html