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Scope of Practice, T21 and Vaping Take Center Stage in Hearings

from Prepared by: Dodie Wellshear, Ad Astra Government Relations

The first month of the 2019 legislative session rolled out rather slowly, but has certainly picked up the pace with February's arrival. With just over two weeks remaining until Turnaround Day – the date by which most bills must have passed their originating chamber – committees are busy holding hearings and acting on any legislation they want to advance this session.

Last Monday, February 4th, the House Health and Human Services (HHHS) Committee held an informational hearing on youth vaping. Chairwoman Landwehr planned to allow 30 minutes for the hearing, which stretched easily into 60 minutes due to committee interest and questions. Informational hearings are just that: they provide education and information, not specific to a particular bill or bill passage.

Nearly every committee member expressed concern about the mushrooming growth in youth use of e-cigarettes, vapes and JUULs, as well as the link between these products and nicotine addiction while the adolescent brain is yet forming. Committee members expressed an enthusiastic interest in the T21 legislation to be introduced next year, which would raise the age of legally purchasing these products from 18- to 21-years of age.

The Senate Public Health and Welfare (SPHW) is scheduled to hold a similar hearing on Tuesday, February 12th. Rep. (Dr.) John Eplee is testifying on behalf of KAFP.

Two bills have been scheduled for hearings, HB 2082 and HB 2066, that would expand the scope of practice for pharmacists and APRNs in Kansas.

KAFP testified in opposition to HB 2082 *on Wednesday, February 6, in the HHHS Committee. While pharmacists maintain this is necessary to address issues in in cases where patients would not otherwise get certain medications – chiefly psychotropic medications – the does not place limits on the types of drugs or the circumstances under which pharmacists could administer injectable medications. It would require that physicians not wanting pharmacists to give the injections must state such when prescribing.

In testimony, KAFP stressed its demonstrated commitment to advocating strongly for policies and practices that protect patient safety and best ensure healthy outcomes for our patients. To that end and in legislation that relies heavily on appropriate physician-pharmacist collaboration, there has been no formal discussion between pharmacists and physicians to more carefully define and understand the need for this legislation.

On Tuesday, February 12th, the HHHS Committee has scheduled a hearing on HB 2066,* which would allow APRNs independent (no collaborative physician agreement) and virtually unlimited scope of practice in Kansas. Dr. Jeremy Presley, KAFP president, will provide testimony opposing this bill.

This type of bill has been proposed by the APRNs for more than a decade and still does not provide oversight and limitations needed to ensure patient safety. Key to the entire legislation is that APRNs are adamant they do not want to be regulated by the Kansas Board of Healing Arts, as are all other health professionals practicing medicine in our state. Instead, they are demanding full and independent practice of medicine under the Board of Nursing which, since its inception, has not contemplated nurses practicing as physicians under their regulatory authority.

There are many on the HHHS Committee who are new to the committee and the Legislature, and do not adequately understand the very real patient risk associated with passage of these kinds of bills. It will be our job to help them understand that these bills pose risks to patient safety and are not merely "turf battles."
[*These link to the page that pulls up both the full bill and the fi more

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