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Originally published April 3, 2013 at 10:52 a.m., updated April 3, 2013 at 4:06 p.m.
TOPEKA House and Senate negotiators appear headed toward approval of a controversial bill that critics fear would make possible quarantining people infected with or exposed to HIV.
After the committee debated for a half-hour adding language to the bill that would have explicitly excluded the possibility of HIV quarantine, negotiators asked Kansas State Epidemiologist Charlie Hunt whether further changes to the bill were necessary.
Hunt said adding such an exemption wouldn't affect the intent of Substitute House Bill 2183 — which would give public health officials authority to order certain health care workers to be tested for infectious diseases to prevent their spread.
However, he said he considered the language unnecessary. He said if state officials wanted to add HIV/AIDS to the list of diseases subject to quarantine — which currently includes measles, pertussis, bacterial meningitis and tuberculosis, among others — doing so would require public comment and a change in state regulations.
"We would have to explicitly add HIV or AIDS to the list of specific requirements for isolation and quarantine. And, again, the administrative regulations process is one where we gather input from stakeholders as we're developing those regulations. Once we get that done, the proposed regulations are posted, there's a 60-day public comment period, there is a hearing before the joint committee on rules and regulations, and then there's a public hearing. And so it's a very involved process," he said. "If at any point HIV or AIDS was put in there, I think that there would be a great deal of concern — and rightfully so."
That explanation seemed to satisfy most negotiators, who "agreed to disagree" — a procedural move which means only four of six votes would be needed to send the bill back to each chamber for final approval.
Negotiators plan to meet again at 1 p.m. tomorrow in 281-N.
Last week, in response to national news reports that they said were based on a "false premise," state health officials said they have no intention of quarantining people infected with or exposed to HIV.
Kansas law since 1988 explicitly bars quarantine of people with HIV/AIDS. If passed, HB 2183 as currently written would repeal that language.
That is the critics' main concern with the bill, said Thomas Witt, director of the Kansas Equality Coalition.
"We're disappointed that the quarantine exclusion is going to be struck from current statute. There's absolutely no medical reason to do it — it's administrative convenience," Witt told KHI News Service following the meeting, which was attended by about two dozen people.
He said the 60-day public comment period and public hearing were inadequate because they can be circumvented by an "emergency" rules procedure. That happened in June of 2011 when it came to new regulations for abortion clinics, said Holly Weatherford of the ACLU of Kansas.
"The lengthy process that was described by the state epidemiologist, which is accurate, did not happen when they were promulgating the rules and regs for that issue," Weatherford said.
After the meeting, KHI News Service asked Hunt about those concerns. He said he would not comment on the abortion facility regulations.
"All I can tell you is that for disease regulations, that will be a very deliberative process," Hunt said.
Asked why the existing statute needed to be repealed in order to accomplish the rest of HB 2183, Hunt said current law only addresses HIV. If those statutes were not modified, he said, the language in HB 2183 would be at odds with current law.
Sen. Laura Kelly, a Topeka Democrat, said her concerns with the bill had been addressed when negotiators last week added "medically necessary and reasonable" to the requirements for quarantine of any disease.
However, she said widespread concerns over the bill justified adding an explicit exemption for HIV/AIDS.
"I believe the statute — as we've amended it — would probably take care of the issue. But, I don't know about you, my inbox has been inundated with emails from all over the country. What we are doing here in Kansas is really having an impact. Whether it's real or emotional doesn't matter," Kelly said.
"I think in this case we need to respond to the outcry," she said. "Put one line in there that says 'Under no circumstances ... (could) somebody whose sole diagnosis is HIV or AIDS" be quarantined, Kelly said, noting that somebody with a dual diagnosis — such as HIV and tuberculosis — could be isolated and quarantined.
Rep. David Crum, an Augusta Republican, asked Kelly whether she thought the public outcry was largely based on misunderstanding of the bill.
"Yes, I do. And I've tried to explain that to them — that what we've done here is really address the issue that they're concerned with," Kelly said. "But what we could do is address the other issue they're concerned with: just the symbolism. And we can do that without making any difference in what this law does ... and I think we should."
Sen. Mary Pilcher-Cook, a Shawnee Republican, said adding an exemption for HIV/AIDS would set a dangerous precedent for other groups to ask for exemptions from quarantine.
"I think compromise can be a very good thing many times. This really hits to the heart of our Constitution, though, I believe. Or Declaration of Independence that 'All men are created equal.' When we put language in our laws to purposefully discriminate, it would truly violate our Constitution and I think the very principles that our country stands on," Pilcher-Cook said. "I wish we could get our friends on board, but I appreciate the 'agree to disagree'."
Negotiators also agreed to roll three other health bills into HB 2183:
• Senate Bill 210, which would clear the way for the regulatory duties of the Kansas Health Information Exchange to be transferred to KDHE, the state health department. In July, KDHE officials proposed taking over the quasi-governmental KHIE as a way to save money, and in September the KHIE board agreed to move forward with the proposal. The decision came at the same time that health information exchange was beginning in Kansas.
• Substitute for HB 2166, which would give KDHE authority to adopt rules and regulations for establishing the value of life estates, under the Medical Assistance Recovery Program.
• HB 2343, which would create a dedicated fund for KDHE's laboratories — a 50-person operation that performs a variety of services, including testing for sexually transmitted diseases, blood lead analysis, water testing, DNA typing, and radiation detection.
Negotiators also agreed to disagree on HB 199, which would require the University of Kansas Medical Center to create a center for conducting adult stem cell research. The bill was introduced at at the urging of Senate President Susan Wagle, a Republican from Wichita, and Sen. Pilcher-Cook.
Pilcher-Cook, the bill’s primary sponsor, said during the Senate debate last month that members of her family suffered from Huntington’s Disease.
“I don’t know if stem cells are going to help, but I do know that we’re breaking ground in different areas of research every day,” said Pilcher-Cook. “Kansas needs to be on the leading edge of the research.”
Wagle has credited the role of umbilical cord stem cells in cancer treatment as having saved her son's life.
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