Approved:         February 2, 2006              

Minutes of the House Health and Services Committee

 The meeting was called to order by Chairman Jim Morrison at 1:30 P.M. on February 1, 2006, in Room 526-S of the Capitol.

 All members were present except Representatives Watkins and Kilpatrick, both of whom were excused.

 Committee staff present:
    Melissa Calderwood, Kansas Legislative Research Department
    Mary Galligan, Kansas Legislative Research Department
    Renae Jefferies, Revisor of Statutes’ Office
    Gary Deeter, Committee Secretary

Conferees appearing before the committee:
    Phyllis Zorn, Hays, citizen
    Miranda Zorn, citizen
    Robert Twillman, LIFE Project Pain management and Public Policy Task Forces
    Chip Wheelen, Executive Director, Kansas Association of Osteopathic Medicine
    Jerry Slaughter, Executive Director, Kansas Medical Society

Others attending:
    See attached list.

The minutes for 1-31 were approved.

The Chair opened the hearing on HB 2649.

Phyllis Zorn, Hays, told a personal story about her daughter’s surgery, a sequence of events that accelerated from an infection to an abscess to surgery without adequate anesthesia. (Attachment 1)   She learned that doctors sometimes undertreat for pain, fearing repercussions from the Board of Healing Arts for over-prescribing.

Miranda Zorn, the daughter in the story above, further related the ordeal of enduring surgery with inadequate pain medication.  (Attachment 2)   She encouraged members to pass the bill.

Robert Twillman, LIFE Project Pain management and Public Policy Task Forces, spoke as a proponent.  (Attachment 3)   He said poor pain management is a significant public health concern, costing the American economy $110 billion per year as estimated by the National Institutes of Health, an unnecessary financial and human cost.  He noted that sections 2 and 3 of the bill express rights already extant, that no new rights are created in these sections.  He said section 5, by deleting a reference to the principle of double effect, which is intended to reassure physicians that pain management will not be construed as assisted suicide, actually perpetuates the inaccurate idea that patients are in danger of inadvertently being killed by proper pain medication.  He recommended eliminating those clauses.   Regarding section 6 of the bill, he commented that the intent is to clarify unprofessional conduct regarding the prescribing of drugs; he suggested an amendment to section six stating that an inadequate prescription is as unprofessional as an excessive prescription.

Deanne Bacco, Executive Director, Kansas Advocates for Better Care, provided written testimony as a proponent.  (Attachment 4)

Chip Wheelen, Executive Director, Kansas Association of Osteopathic Medicine, said the physicians he represents endorse the principle of the bill and appreciate the organizations that seek to promote a better quality of life for those dealing with pain.  (Attachment 5)   He identified three categories of pain patients:  those who have been injured or undergone surgery, those who must endure long-term pain, and those who try to manipulate physicians to obtain opiates; he stated that the first and second categories have legitimate need for proper pain medication.  Commenting on sections of the bill, he said section 2 is an acceptable statement of public purpose as long as it does not create a new cause of action for litigation.  He suggested reshaping the language of sections 2 and 3 to eliminate the possibility of creating a new right.  He also suggested that section 3 should state what is not intended by the bill.  Offering amendments which he said would clarify the intent of the bill, he suggested language that would protect physicians from disciplinary action if they followed the guidelines of the Board of Healing Arts.  He also commended the language provided by Jerry Slaughter.  (See Attachment 6)

Jerry Slaughter, Executive Director, Kansas Medical Society, offered written testimony with recommended language to strengthen the bill.  (Attachment 6)  Representative Bethell, stating that the proposed amendments increased the effectiveness of the bill, said that he had prepared a balloon amendment for the committee’s consideration.

Answering questions, Mr. Wheelen said avenues of redress are available with or without the bill:  filing a complaint with the Board of Healing Arts and, if a person suffers damages, recovering those damages through a lawsuit; he noted that the bill attempts to protect physicians from unnecessary disciplinary action.  To another question, he said if the bill passes, all those licensed to prescribe medications would need to adjust the statutory language in their practice acts to accommodate the bill.  He replied that the bill would not create a new standard of care.

A fiscal note on HB 2649 was included for members.  (Attachment 7)

The Chair closed the hearing and asked members for bill introductions.

Representative Kiegerl requested a bill that would bring Kansas into compliance with federal law regarding a baby inadvertently delivered alive during an abortion procedure. The motion was made, seconded and passed to accept the bill as a committee bill.

Representative Bethell requested a bill that would require reporting to the Board of Nursing the employment and termination dates of licensed nurses.  The committee accepted sponsorship of the bill.

The Chair requested three bills on behalf of the Kansas Sheriff’s Association: (1) extending the current statute prohibiting the unlawful sale or distribution of controlled substances within 1000 feet of school to include licensed day-care centers, public parks, playgrounds, and premises or structures used by a public school district; (2) extending the current law prohibiting the unlawful sale or distribution of depressants, stimulants, or hallucinogenic drugs within 1000 feet of school to include licensed day-care centers, public parks, playgrounds, and premises or structures used by a public school district; and (3) adjusting the sentencing guidelines grid to reflect the changes in the criminal code.  A motion was passed sponsor all three bills.

 Staff Melissa Calderwood gave a briefing on HB 2678, which she said repeals the present law regarding free-standing renal dialysis facilities dispensing drugs.  She noted that a similar bill (HB 2225) went through the committee and the House in 2005 and was sent to the Senate Public Health and Welfare Committee, which held hearings but took no action on the bill.
 
A fiscal note was provided for members.  (Attachment 8)

Staff Mary Galligan briefed the committee on SB 263.  She said the bill changes the composition of the Board of Emergency Medical Services to require one of three members active in the profession to be an administrator.  She said because of Senate amendments, the fiscal note was no longer applicable.  The number of members would not change, only the composition of membership.

A fiscal note (Attachment 9) and a supplemental note (Attachment 10) were also available to members.

The meeting was adjourned at 2:44 p.m.
   The next meeting is scheduled for Thursday, February 2, 2006.