100-28a-1. Fees. The following fees shall be collected by the board:
          (a)  Application for license…………………………………    $200.00
          (b)  Annual renewal of license:
          (1)  Paper renewal………………………………………….   $150.00
          (2)  On-line renewal………………………………………..  $150.00
          (c)  Late renewal of license:
          (1)  Paper late renewal……………………………………..    $215.00
          (2)  On-line late renewal……………………………………   $208.00
          (d)  License reinstatement………………………………….    $250.00
          (e)  Copy of license certificate……………………………..     $  15.00
          (f)  Certified statement of licensure………………………..      $  15.00
          (g)  Temporary license……………………………………..    $  30.00

K.A.R. 100-28a-2.  Application. (a) Each application for licensure as a physician assistant shall be submitted on a form provided by the board.  The form shall contain the following information:
(1)  The applicant’s full name;
(2)  the applicant’s home address and, if different, the applicant’s mailing address;
(3)  the applicant’s date and place of birth;
(4)  employment information for the five years immediately before the date of application;
(5)  the issue date, country, territory, District of Columbia, or state of issuance, and identifying number on any license, registration, or certification issued to the applicant to practice any health care profession; and
(6)  documentation of any prior acts constituting unprofessional conduct as defined in K.A.R. 100-28a-8.
(b)  Each applicant shall submit the following with the application:
(1)  The fee required by K.A.R. 100-28a-1;
(2)  an official transcript from an educational program approved by the board as specified in K.A.R. 100-28a-3;
(3)  a notarized copy of a diploma from an approved educational program;
(4)  a verification from each state or jurisdiction where the applicant has been issued any license, registration, or certification to practice any health care profession;
(5)  a photograph of the applicant; and
(6)  evidence provided directly to the board from the testing entity of the results of a written examination required and approved by the board as specified in K.A.R. 100-28a-4.
(c)  The applicant shall sign the application, under oath.  (Authorized by and implementing K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a04; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-3.  Education and training.  (a) Each educational program for physician assistants accredited by the accreditation review committee on education for the physician assistant, inc., or by a predecessor agency, and all other educational programs that are determined by the board to have a standard of education substantially equivalent to the accreditation criteria of the committee shall be approved by the board.
(b)  Each applicant who has acquired experience as a physician assistant while serving in the armed forces of the United States shall provide proof that the applicant is competent to perform all of the following:
(1)  Screen patients to determine need for medical attention;
(2)  review patient records to determine health status;
(3)  take a patient history;
(4)  perform a physical examination;
(5)  perform a developmental screening examination on children;
(6)  record pertinent patient data;
(7)  make decisions regarding data gathering and appropriate management and treatment of patients being seen for the initial evaluation of a problem or the follow-up evaluation of a previously diagnosed and stabilized condition;
(8)  prepare patient summaries;
(9)  initiate requests for commonly performed initial laboratory studies;
(10)  collect specimens for and carry out commonly performed blood, urine, and stool analyses and cultures;
(11)  identify normal and abnormal findings on history, physical examination and commonly performed laboratory studies;
(12)  initiate appropriate evaluation and emergency management for emergency situations, including cardiac arrest, respiratory distress, injuries, burns and hemorrhage;
(13)  counsel and instruct patients; and
(14)  administer commonly performed clinical procedures that shall include all of the following:
(A)   Venipuncture;
(B)   intradermal tests;
(C)   electrocardiogram;
(D)   care and suturing of minor lacerations;
(E)   casting and splinting;
(F)   control of external hemorrhage;
(G)   application of dressings and bandages;
(H)   administration of medications and intravenous fluids, and transfusion of blood or blood components;
(I)    removal of superficial foreign bodies;
(J)    cardiopulmonary resuscitation;
(K)   audiometry screening;
(L)   visual screening; and 
 (M) aseptic and isolation techniques.  (Authorized by K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a04; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-4.  Examination. (a) The examination approved by the board for licensure as a physician assistant shall be the physician assistant national certifying examination prepared and administered by the national commission on certification of physician assistants.
(b)  To pass the approved examination, each applicant shall achieve at least the minimum passing score of 350.
(c)  Each applicant who has passed the approved examination for a license and has not been in active practice as a physician assistant for more than one year, but less than five years from the date the  application was submitted, shall provide one of the following:
(1)  Evidence of completion of a minimum of 50 continuing education credit hours; or
(2)  proof that the applicant has passed an examination approved by the board within 12 months before the date the application was submitted, or has successfully completed a continuing education program, or other individually tailored program approved by the board.
(d) Each applicant who has passed the examination for a license and has not been in active practice as a physician assistant for five years or more from the date the application was submitted shall provide proof that the applicant has passed an examination approved by the board within 12 months before the date the application was submitted, or has successfully completed a continuing education program or other individually tailored program approved by the board.  (Authorized by K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a03 and 65-28a04; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-5.  Continuing education.  (a) On and after February 1, 2001, each physician assistant shall submit with a renewal application one of the following:
(1)  Evidence of satisfactory completion of a minimum of 50 continuing education credit hours during the preceding year.  A minimum of 20 continuing education credit hours shall be acquired from category I if 50 hours are submitted with the renewal application; or
(2)  100 continuing education credit hours during the preceding two-year period.  A minimum of 40 continuing education credit hours shall be acquired from category I if 100 continuing education credit hours are submitted with the renewal application.
(b)  A continuing education credit hour shall be 50 minutes of instruction or its equivalent. Meals and exhibit breaks shall not be included in the calculation of continuing education credit hours.
(c)  Any applicant that does not meet the requirements for license renewal in subsection (a) may request an extension from the board. The request shall include a plan for completion of the continuing education requirements within the requested extension period. An extension of up to six months may be granted by the board if documented circumstances make it impossible or extremely difficult for the individual to reasonably obtain the required continuing education hours.
(d) Any physician assistant initially licensed within one year of a renewal registration date shall be exempt from the continuing education required by subsection (a) for that first renewal period.
(e)  The categories of continuing education credit shall be the following:
(1)  Category I:  attendance at an educational presentation approved by the board. Courses accepted by the American academy of physician assistants shall be approved by the board; and
(2)  category II: participating in or attending an educational activity that does not meet the criterion specified in paragraph (e)(1) but that is approved by the board.  Category II continuing education may include self-study or group activities.
(f)  Evidence of satisfactory completion of continuing education shall be submitted to the board as follows:
(1)  Documented evidence of attendance at or participation in category I and II activities; and
(2)  verification, on a form provided by the board, of self-study from reading professional literature or other self-study activities.  (Authorized by K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a04; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-6.  Scope of practice. A physician assistant may perform acts that constitute the practice of medicine and surgery in the following instances:
(a)  If directly ordered, authorized, and coordinated by the responsible or designated physician through the physician’s immediate or physical presence;
(b)  if directly ordered, authorized, and coordinated by the responsible or designated physician through radio, telephone, or other form of telecommunication;
(c)  if authorized on the form provided by, and presented to, the board by the responsible physician pursuant to K.S.A. 2000 Supp. 65-28a03 and amendments thereto; or
(d) if an emergency exists.  (Authorized by K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a08; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-7.  Professional incompetency: defined. “Professional incompetency” means any of the following:
(a) One or more instances involving failure to adhere to the applicable standard of care to a degree that constitutes gross negligence, as determined by the board;
(b)  repeated instances involving failure to adhere to the applicable standard of care to a degree that constitutes ordinary negligence, as determined by the board; or
(c)  a pattern of practice or other behavior that demonstrates a manifest incapacity or incompetence to perform professional services as a physician assistant.  (Authorized by K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a05; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-8.  Unprofessional conduct: defined. “Unprofessional conduct” means any of the following: (a) Being convicted of a class A misdemeanor, whether or not related to the practice as a physician assistant;
(b)  committing fraud or misrepresentation in applying for or securing an original, renewal, or reinstated license;
(c)  cheating on or attempting to subvert the validity of the examination for a license;
(d) soliciting professional services through the use of fraudulent or false advertisements;
(e)  willfully or repeatedly violating the physician assistant licensure act, the pharmacy act of the state of Kansas, or the uniform controlled substances act, or any regulations adopted pursuant to these acts;
(f)  engaging in the practice as a physician assistant under a false or assumed name, or  impersonating another practitioner;
(g)  practicing as a physician assistant without reasonable skill and safety to patients because of any of the following:
(1)  Illness;
(2)  alcoholism;
(3)  excessive use of alcohol, drugs, controlled substances, chemicals, or any other type of material; or
(4)  any mental or physical condition;
(h)  having a license, certification, or registration revoked, suspended, limited, censured, or having any other disciplinary action taken, or an application for a license denied by the proper licensing authority of another state, territory, the District of Columbia, or other country;
(i)   prescribing, selling, administering, distributing, or giving a controlled substance to any person for other than a medically accepted or lawful purpose;
(j)   prescribing, dispensing, administering, or distributing a prescription drug or substance, including a controlled substance, in an excessive, improper, or inappropriate manner or quantity, or not in the course of the licensee’s professional practice;
(k)  prescribing, dispensing, administering, or distributing an anabolic steroid or human growth hormone for other than a valid medical purpose;
(l)   prescribing, ordering, dispensing, administering, selling, supplying, or giving any amphetamines or sympathomimetic amines, except as authorized by K.S.A. 2000 Supp. 65-2837a, and amendments thereto;
(m) failing to furnish the board, or its investigators or representatives with any information legally requested by the board;
(n)  knowingly submitting any misleading, deceptive, untrue, or fraudulent representation on a claim form, bill, or statement;
(o)  representing to a patient that a manifestly incurable disease, condition, or injury can be permanently cured;
(p)  assisting in the care or treatment of a patient without the consent of the patient, the attending physician, or the patient’s legal representative;
(q)  willfully betraying confidential information;
(r)  committing conduct likely to deceive, defraud, or harm the public;
(s)  allowing another person or organization to use the physician assistant’s license to perform professional services;
(t)  committing any act of sexual abuse, misconduct, or exploitation related to the licensee’s professional practice;
(u)  failing to keep written medical records that accurately describe the services rendered to the patient;
(v)  using any false, fraudulent, or deceptive statement in any document connected with the practice of the healing arts, including the intentional falsifying or fraudulent altering of a patient or medical care facility record;
(w) performing unnecessary tests, examinations, or services that have no legitimate medical purpose; or
(x)  delegating professional responsibilities to a person if the physician assistant knows or has reason to know that the person is not qualified by education, training, or experience to perform them.  (Authorized by K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a05; effective, T-100-2-13-01, Feb. 13 2001; effective June 1, 2001.)

K.A.R. 100-28a-9.  Physician request form; content. The responsible physician request form to be presented to the board pursuant to K.S.A. 2000 Supp. 65-28a03, and amendments thereto, shall contain the following information: (a) The date and signatures of the responsible physician and the physician assistant;
(b)  the license numbers of the responsible physician and the physician assistant;
(c)  a description of the physician’s practice and the way in which the physician assistant is to be utilized;
(d) a statement that the responsible physician will always be available for communication with the physician assistant within 30 minutes of the performance of patient service by the physician assistant;
(e)  a completed drug prescription protocol on a form provided by the board specifying categories of drugs, medicines, and pharmaceuticals that the physician assistant will be allowed to prescribe, and the drugs within any category that the physician assistant will not be allowed to supply, prescribe, receive, or distribute;
(f)  the name and address of each practice location, including hospitals, where the physician assistant will routinely perform acts that constitute the practice of medicine and surgery;
(g)  signatures of all designated physicians who  routinely provide direction and supervision to the physician assistant in the temporary absence of the responsible physician, and a description of the procedures to be followed to notify a designated physician in the responsible physician’s absence;
(h)  an acknowledgment that failure to adequately direct and supervise the physician assistant in accordance with K.S.A. 2000 Supp. 65-28a01  through K.S.A. 65-28a09, and amendments thereto, or regulations adopted under these statutes by the board, shall constitute grounds for revocation, suspension, limitation, or censure of the responsible physician’s license to practice medicine and surgery in the state of Kansas;
(i)   a statement that a current copy of the form will be maintained at each practice location of the responsible physician and the physician assistant and that any changes to the form will be provided to the board within 10 days; and
(j)   an acknowledgment that the responsible physician has established and implemented a method for initial and periodic evaluation of the professional competency of the physician assistant and that evaluations will be performed at least annually.  (Authorized by and implementing K.S.A. 2000 Supp. 65-28a03; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-10.  Supervision and direction; adequacy.  Direction and supervision of the physician assistant shall be considered to be adequate if the responsible physician meets all of the following requirements: (a) At least annually, reviews and evaluates the professional competency of the physician assistant;  
(b)  at least annually, reviews any drug prescription protocol and determines if any modifications, restrictions, or terminations are required. Any of these changes shall be conveyed to the physician assistant and set forth in all copies of the protocol required by K.A.R. 100-28a-9 to be maintained and provided;                         
(c)  engages in the practice of medicine and surgery in this state;
(d) insures that the physician assistant has a current license issued by the board;
(e)  within 10 days, reports to the board any knowledge of disciplinary hearings, formal hearings, public or private censure, or other disciplinary action taken against the physician assistant by any state’s licensure or registration authority or any professional association;                                                                                  
(f)  within 10 days, reports to the board any litigation, threatened litigation, or claim alleging professional incompetency or professional negligence on the part of the physician assistant;      
(g)  at least every 14 days, reviews all records of patients treated by the physician assistant and authenticates this review in the patient record;
(h)  reviews patient records and authenticates the review in each patient record within 48 hours of treatment provided by the physician assistant if the treatment provided in an emergency  exceeded the authority granted to the physician assistant by the responsible physician request form required
by K.A.R.100-28a-9;
(i)   provides for a designated physician to provide supervision and direction on each occasion when the responsible physician is temporarily absent, is unable to be immediately contacted by telecommunication, or is otherwise unavailable at a time the physician assistant could reasonably be expected to provide professional services; and                                                 
(j)   delegates to the physician assistant only those acts that constitute the practice of medicine and surgery that the responsible physician believes or has reason to believe can be competently performed by the physician assistant, based upon the physician assistant’s background, training, capabilities, skill, and experience.  (Authorized by K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a02; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

Note:      Drug Prescription Protocol forms can be downloaded at
              www.ksbha.org/forms/html

K.A.R. 100-28a-11.  Duty to communicate. The physician assistant shall  communicate with the responsible or designated physician concerning a patient’s condition if the physician assistant believes that the patient’s condition may require any treatment that the physician assistant has not been authorized to perform. (Authorized by K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a08; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-12.  Designated physician. If a designated physician directs and supervises a physician assistant, the designated physician shall be deemed to have the same duties and responsibilities as those of the responsible physician.  (Authorized by K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a09;  effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-13.  Prescription-only drugs. (a) A physician assistant may prescribe a prescription-only drug or administer or supply a prescription-only drug as authorized by the drug prescription protocol required by K.A.R.100-28a-9 and as authorized by this regulation.
(b) As used in this regulation, “emergency situation” shall have the meaning ascribed to it in K.A.R. 68-20-19(a)(5).                            
(c)  A physician assistant may directly administer a prescription-only drug as follows:   
(1) If directly ordered or authorized by the responsible or designated physician;                                                              
(2)  if authorized by a written drug prescription protocol between the responsible physician and the physician assistant; or  
(3)  if an emergency situation exists.                                     
(d)(1)  A physician assistant may prescribe a schedule II controlled substance in the same manner as that in which the physician assistant may perform acts that constitute the practice of medicine and surgery as specified in K.A.R. 100-28a-6.  Except as specified in paragraph (d)(2), each prescription for a schedule II controlled substance shall be in writing.
(2)  A physician assistant may, by oral or telephonic communication, prescribe a schedule II controlled substance in an emergency situation. Within seven days after authorizing an emergency prescription order, the physician assistant shall cause a written prescription, completed in accordance with appropriate federal and state laws, to be delivered to the dispenser of the drug.
(e)  A physician assistant may orally, telephonically, or in writing prescribe a controlled substance listed in schedule III, IV, or V, or a prescription-only drug not listed in any schedule as a controlled substance in the same manner as that in which the physician’s assistant may perform acts that constitute the practice of medicine and surgery as specified in K.A.R. 100-28a-6.                 
(f)  Each written prescription order by a physician assistant shall meet the following requirements:
(1)  Contain the name, address, and telephone number of the responsible physician;
(2)  contain the name, address, and telephone number of the physician assistant;
(3)  be signed by the physician assistant with the letters “P.A.” following the signature;
(4)  contain any DEA registration number issued to the physician assistant if a controlled substance is prescribed; and      
(5)  indicate whether the prescription order is being transmitted by direct order of the responsible or designated physician, pursuant to a written protocol, or because of an emergency situation.        
(g)  A physician assistant may supply a prescription-only drug to a patient only if all of the following conditions are met:                      
(1)  If the drug is supplied under the same conditions as those in which a physician assistant may directly administer a prescription-only drug, as described in subsection (b) above;               
(2)  if the drug has been provided to the physician assistant or the physician assistant’s responsible physician or employer at no cost;
(3)  if the drug is commercially labeled and is supplied to the patient in the original prepackaged unit-dose container; and            
(4)  if the drug is supplied to the patient at no cost.                  
(h)  A physician assistant shall not administer, supply, or prescribe a prescription-only drug for any quantity or strength in excess of the normal and customary practice of the responsible physician. (Authorized by K.S.A. 2000 Supp. 65-28a03; implementing K.S.A. 2000 Supp. 65-28a08; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-14. Different practice location. (a) “Different practice location” means an office or location that is maintained or utilized by a responsible physician to regularly meet patients or to receive calls and that is not the primary practice location of the responsible physician.
(b) A physician assistant may perform acts that constitute the practice of medicine and surgery at a different practice location only if all of the following conditions are met:
(1) Before providing any services at the different practice location, the physician assistant has spent a minimum of 80 hours since being licensed under the immediate or physical supervision and direction of a physician licensed in this state.
(2) A physician licensed in this state periodically sees and treats patients at the different practice location.
(3) Written notice is conspicuously posted that the different practice location is staffed primarily by a physician assistant.  (Authorized by K.S.A. 2004 Supp. 65-28a03; implementing K.S.A. 65-28a08; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001; amended July 22, 2005.)
       
K.A.R. 100-28a-15.  Licensure; expiration. (a) Except as specified in subsection (b), each physician assistant license issued by the board shall expire on December 31 of each year.               
(b)  A license issued or reinstated from October 1 through December 31 shall expire on December 31 of the following year.  (Authorized by and implementing K.S.A.  2000 Supp. 65-28a03; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-16.  Reinstatement; lapsed and revoked licenses. (a) Each applicant who has not been in active practice as a physician assistant in another state or jurisdiction and who desires to reinstate a license that has been lapsed for failure to renew shall submit proof of continuing medical education as follows:                
(1)  If the time since the license lapsed has been one year or less, no continuing medical education shall be required in addition to that which would have been necessary had the license been renewed before expiration.                                                                          
(2) If the time since the license lapsed has been more than one year but less than five years, the applicant shall provide one of the following:   
(A) Evidence of completion of a minimum of 50 hours of continuing education credit within 12 months before the date the application for reinstatement was submitted; or
(B) proof that the applicant has passed an examination approved by the board within 12 months before the date the application for reinstatement was submitted, or has successfully completed a continuing education program or other individually tailored program approved by the board.                                                                         
(3) If the time since the license lapsed has been five years or more, the applicant shall provide proof of passage of an examination approved by the board within 12 months before the date the application for reinstatement was submitted, or proof of successful completion of a continuing education program or other individually tailored program approved by the board.                                                        
(b) Each applicant who has been in active practice as a physician assistant in another state or jurisdiction that requires a license, registration, or certification to practice and who desires to reinstate a license that has been lapsed for failure to renew shall submit proof of the current license, registration, or certification and proof of compliance with the continuing medical education requirements of that state or jurisdiction.                                         
(c)  Each applicant seeking reinstatement of a revoked license shall successfully complete an individually tailored program approved by the board.  (Authorized by and implementing K.S.A. 2000 Supp. 65-28a03; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.)

K.A.R. 100-28a-17.  Limitation on number of physician assistants supervised.  (a) A responsible physician shall not provide direction and supervision to more than two physician assistants without the board’s prior approval.
(b) Each responsible physician wishing to provide direction and supervision to more than two physician assistants shall provide a written and signed request to the board with the following information:
(1) The name of each physician assistant to whom the responsible physician proposes to provide direction and supervision; and
(2) the reason for the request.
(c) The reasons for requesting approval to provide direction and supervision to more than two physician assistants shall include at least one of the following:
(1) The usual number of hours worked each week by one or more of the physician assistants is less than full time.
(2) The usual number of days worked each week by one or more of the physician assistants  is less than full time.
(3) One or more of the physician assistants will temporarily leave the responsible physician’s direction and supervision. (Authorized by K.S.A. 65-28a03, as amended by L. 2004, Ch. 117, Sec. 17; implementing K.S.A. 65-28a10, as amended by L. 2004, Ch. 117, Sec. 7; effective July 22, 2005.)

K.A.R. 100-28a-18.  Physician assistant; ownership of corporation or company.  (a) Licensed physician assistants shall not hold more than 49 percent of the total number of shares issued by a professional corporation that is organized to render the professional services of a physician, surgeon or doctor of medicine, or osteopathic physician or surgeon.
(b) Licensed physician assistants shall not contribute more than 49 percent of the total amount of capital to a professional liability company that is organized to render the professional services of a physician, surgeon or doctor of medicine, or osteopathic physician or surgeon.  (Authorized by K.S.A. 17-2716 and K.S.A. 2004 Supp. 65-28a13; implementing K.S.A. 2004 Supp. 65-28a13; effective July 22, 2005.)