SESSION OF 2021
SUPPLEMENTAL NOTE ON HOUSE BILL NO. 2234
As Amended by Senate Committee on Public
Health and Welfare

Brief*
HB 2234, as amended, would amend the Emergency
Medical Services Act to clarify the oversight to be provided by
medical directors with regard to emergency medical services
and to provide an alternate procedure for appointment of a
medical director. The bill would define “medical oversight” to
mean to review, approve, and implement medical protocols
and to approve and monitor the activities, competency, and
education of emergency medical service providers. The term
“medical oversight” would replace existing terms describing
the oversight provided by a medical director.
Since the definition of medical oversight would include
the approval of medical protocols, the bill would amend the
definition of “medical protocols” to remove language
referencing the required approval of medical protocols by a
county medical society or the medical staff of a hospital to
which the ambulance service primarily transports patients or,
if neither are able or available, by the Medical Advisory
Council.
The bill would clarify that an operator would be required
to designate a medical director to provide medical oversight,
which includes the review, approval, and implementation of
medical protocols. However, the Emergency Medical Services
Board (Board) would be allowed to approve an alternate
procedure for medical oversight by a physician if no medical
director is available for designation by the operator. [Note:
____________________
*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.kslegislature.org
Continuing law defines “operator” as a person or municipality
who has a permit to operate an ambulance service.]
The bill would also remove the designation of a
supervising physician to clarify that an emergency medical
services provider would be protected from liability for civil
damages for implementing instructions from a physician, a
physician assistant, an advanced practice registered nurse,
or a licensed practical nurse when rendering emergency care.
Under continuing law, emergency medical services providers
are not protected from civil liability for damages resulting from
their gross negligence or willful or wanton acts or omissions.
The bill would make technical amendments.

Background
The bill was introduced by the House Committee on
Health and Human Services at the request of Representative
Eplee on behalf of the Board.

House Committee on Health and Human Services
In the House Committee hearing, proponent testimony
was provided by a representative of the Board. The Board
representative stated the bill addresses two issues: a lack of
clear expectation of the role of the medical directors in
providing medical oversight, particularly in regard to
developing care protocols and their approval and
implementation, and the increasing difficulty obtaining
medical protocol approval. The Board representative stated
the bill represents a collaborative effort to address these
topics by defining medical oversight to provide clarity, adding
the ability to approve medical protocols, and placing any
potential liability to approve protocols on the physician who is
responsible for review and implementation of the protocols
and ensuring the emergency medical services providers
working and volunteering have the ability to completely

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execute the protocols. Written-only proponent testimony was
provided by a representative of the Kansas Medical Society.
No other testimony was provided.

Senate Committee on Public Health and Welfare
In the Senate Committee hearing, a representative of
the Board provided proponent testimony.
No other testimony was provided.
The Senate Committee amended the bill to change its
effective date to upon publication in the statute book.

Fiscal Information
According to the fiscal note prepared by the Division of the
Budget on the bill as introduced, the Board indicates
enactment of the bill would have no fiscal effect. The Kansas
Association of Counties indicates there could be a fiscal
effect on counties if this expansion of duties requires a
change to the contract with the medical director. However, the
fiscal effect cannot be estimated.
Emergency medical services; medical oversight; medical director responsibilities;
approval of medical protocols; civil liability protection


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Statutes affected:
As introduced: 65-6112, 65-6124, 65-6126
As Amended by Senate Committee: 65-6112, 65-6124, 65-6126