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Minutes for HB2358 - Committee on Federal and State Affairs
Short Title
Permitting mid-level practitioners to provide medical certification to attest to an individual's cause of death to file a death certificate.
Minutes Content for Tue, Jan 30, 2024
The Chair opened the hearing on HB2358. The Revisor provided an overview of the bill. He stated this bill amends the uniform vital statistics act. There is a balloon amendment dealing with who will be able to sign off on the cause of death. Current law says it has to be a physician; this bill would add coroner, deputy coroner or special deputy coroner, or a mid-level practitioner. The amendments would change that to a "cause of death certifier" and the definition of the cause of death certifier means a person licensed to practice medicine and surgery by the state board of healing arts, a physician assistant licensed by the state board of healing arts, an advanced practice registered nurse licensed by the state board of nursing or a district coroner, deputy coroner or special deputy coroner. It also provides that a cause of death certifier who makes a certification of a cause of death in good faith is immune from civil liability for such certification (Attachment 1).
The Chair recognized Pam Scott, Executive Director, Kansas Funeral Home Directors (KFDA), testified in support of HB2358 (Attachment 2). She stated that funeral directors often have difficulty getting physicians to timely complete the medical certification portion of the death certificate, which they are responsible for. The timely filing of death certificates is important to families across the state that have experienced the death of a loved one. A funeral director cannot inter or dispose of a body until a death certificate is filed. This sometimes results in delaying a funeral service, burial or cremation. Also, the family is unable to take care of end-of-life estate matters such as closing bank accounts, filing for benefits and obtaining the proceeds of life insurance if they do not have a death certificate. The KFDA hopes you will help solve this problem by passing HB2358 with the proposed amendment. Several Committee members had questions.
Doug Smith, Executive Director, Kansas Academy of Physician Assistants was recognized by the Chair as a proponent of HB2358 (Attachment 3). He stated that currently in Kansas physician assistants are not allowed to pronounce death so this would allow them to indicate the cause of death on death certificates. They support the bill and the amendment that has been offered by the sponsors. In response to a question, he stated that currently PA's can pronounce a cause of death but they cannot declare a person dead.
The Chair recognized Melanie Urban, Pawnee Valley Community Hospital, as a proponent of HB2358 (Attachment 4). She stated that they are short-staffed right now, and it would help to have APRNs be able to sign death certificates. The passage of HB2358 is essential to rural healthcare.
Dr. Karen Trees, Nurse Practitioner, was recognized by the Chair as a proponent of HB2358 (Attachment 5). She is the co-owner of Phoenix Health Care Clinic, a nurse practitioner owned and managed primary care clinic/urgent care clinic in Johnson County. She testified concerning incidences of two separate patient deaths and the problems they experienced in getting a death certificate signed by a doctor since nurse practitioners are not allowed to sign death certificates and no doctors were present at the times of the deaths or had recently treated the patients. In addition, she stated that nurse practitioners also are not allowed to transition patients to Hospice; only physicians can do that. In addition to being a death certifier, nurse practitioners need to be able to transition patients to Hospice for continuation of care. They also agree with the physician assistants that the language of mid-level practitioners needs to be changed. Discussion by the Committee followed.
Chairperson Carpenter noted that there is written proponent testimony from Representative Doug Blex (Attachment 6); Carol Moreland, Kansas State Board of Nursing (Attachment 7); Cathy Gordon (Attachment 8); Jessica Koprivica, Quisenberry Funeral Home (Attachment 9); and Michelle Knowles (Attachment 10).
The Chair that there are no opponents to the bill. He closed the hearing on HB2358.
Chairperson Carpenter stated that they will work HB2358 next Tuesday, February 6, 2024.
There being no further business, the meeting was adjourned at 9:40 a.m.
