Division of the Budget
Landon State Office Building Phone: (785) 296-2436
900 SW Jackson Street, Room 504 adam.c.proffitt@ks.gov
Topeka, KS 66612 Division of the Budget http://budget.kansas.gov
Adam Proffitt, Director Laura Kelly, Governor


February 27, 2023


The Honorable Beverly Gossage, Chairperson
Senate Committee on Public Health and Welfare
300 SW 10th Avenue, Room 142-S
Topeka, Kansas 66612
Dear Senator Gossage:
SUBJECT: Fiscal Note for SB 277 by Senate Committee on Ways and Means
In accordance with KSA 75-3715a, the following fiscal note concerning SB 277 is
respectfully submitted to your committee.
SB 277 would require the Kansas Department for Aging and Disability Services (KDADS)
to regulate supplemental nursing services agencies, establish a system of complaints against
supplemental nursing services agencies and their employees, and create the Supplemental Nursing
Services Agency Regulation Fund. To obtain and retain registration, a supplemental nursing
services agency would be required to:
1. Document that each temporary employee provided to healthcare facilities would
currently meet the minimum licensing, training, and continuing education standards
for the position in which the employee would be working;
2. Comply with all applicable legal requirements relating to the qualifications of
personnel employed in healthcare facilities, including the performance of criminal
history record checks in accordance with K.S.A. 39-970, and amendments thereto;
3. Not restrict, in any manner, the employment opportunities of its employees;
4. Carry medical malpractice insurance coverage for the loss, damage, or expense
incident to a claim arising out of the death or injury of any person as the result of
negligence or malpractice in the provision of healthcare services by the
supplemental nursing services agency or by any employee of the agency;
5. Carry a fidelity bond or fidelity insurance in the amount of at least $10,000;
The Honorable Beverly Gossage, Chairperson
Page 2—SB 277

6. Maintain insurance coverage for workers compensation for all nurses and nurse
aides provided or procured by the agency;
7. Comply with the applicable requirements of the Kansas withholding and
declaration of estimated tax act, K.S.A. 79-3294 et seq., and amendments thereto;
8. In any contract with any employee or healthcare facility, not require the payment
of liquidated damages, employment fees, or other compensation if any such
employee is hired as a permanent employee of a healthcare facility;
9. Document that each temporary employee provided to healthcare facilities is an
employee of the agency and is not an independent contractor;
10. Retain all records for five calendar years and organize such records so that they can
be made immediately available to the Secretary upon request; and
11. Submit a quarterly report for each facility that participates in Medicare or Medicaid
and has a contract with the supplemental nursing services agency showing the
average amount charged to the facility for each agency worker and the average
amount paid to agency workers.
Failure to comply with the above requirements would subject a supplemental nursing
services agency to revocation or nonrenewal of its registration. An original registration or renewal
application could not be denied or revoked without a hearing held pursuant to the Kansas
Administrative Procedure Act within 60 days after the KDADS’ Secretary received a request for
hearing.

Estimated State Fiscal Effect
FY 2023 FY 2023 FY 2024 FY 2024
SGF All Funds SGF All Funds
Revenue -- -- -- $50,875
Expenditure -- -- $648,188 $699,063
FTE Pos. -- -- -- 4.00
KDADS indicates that SB 277 would require an additional 4.00 FTE positions to support
the monitoring and review of additional regulation requirements of supplemental nursing agencies
in the state. Positions would include a Licensing Reviewer, a complaint line support position, an
Attorney, and an Auditor. KDADS estimates expenditures of $389,438 from the State General
Fund for these positions. Costs include salary, fringe, and other operating expenses. KDADS
estimates contractual services costs of $309,625 from all funding sources, including $258,750 from
the State General Fund. These contractual services costs would be anticipated to cover contracted
work for analytics, information technology system development and maintenance, and Office of
Administrative Hearings costs. KDADS estimates it would collect $50,875 from supplemental
nursing services agency registration fees to be deposited into the Supplemental Nursing Services
Agency Regulation Fund. The revenue estimate is based on assumed collection of 25 supplemental
The Honorable Beverly Gossage, Chairperson
Page 3—SB 277

nursing registration fees of $2,035 annually. Any fiscal effect associated with SB 277 is not
reflected in The FY 2024 Governor’s Budget Report.


Sincerely,

Adam Proffitt
Director of the Budget

cc: Leigh Keck, Department for Aging & Disability Services