SESSION OF 2025
SUPPLEMENTAL NOTE ON SUBSTITUTE FOR SENATE
BILL NO. 29
As Amended by House Committee on Health
and Human Services
Brief*
Sub. for SB 29, as amended, would:
●Require the Secretary of Health and Environment
(Secretary) to have probable cause, supported by
oath or affirmation, before taking action to prevent
the introduction or spread of an infectious or
contagious disease within Kansas;
●Permit any aggrieved party to file a civil action
regarding an order made by the Secretary or a
local health officer and establish requirements for
hearings and judicial review;
●Provide for a county or joint board of health or local
health officer to recommend against rather than
prohibit public gatherings when necessary for the
control of infectious or contagious disease; and
●Remove the ability for a local health officer or the
Secretary to order law enforcement to assist in the
execution or enforcement of any order.
Requirements for Orders and Civil Action (Section 1)
The bill would require the Secretary to have probable
cause, supported by oath or affirmation, regarding any action
that is intended to exclude, isolate, quarantine, or otherwise
____________________
*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
https://klrd.gov/ restrict the movement of people within Kansas when the
Secretary seeks to prevent the introduction or spread of an
infectious or contagious disease within Kansas
The bill would provide for any party aggrieved by an
action taken pursuant to certain public health statutes to file a
civil action in the district court where the order was issued
within 30 days of its issuance.
Statutory References
The bill would permit a civil action to be filed by any
party aggrieved by an order issued pursuant to KSA 65-101
through 65-125f, which includes, but is not limited to, the
following:
●Health supervision and investigation of causes of
disease, sickness, and death;
●Confidentiality and disclosure of information
concerning non-infectious diseases;
●Tuberculosis examination, care, and treatment and
orders by health officers;
●Precautions to prevent spread of infection and
investigations;
●Actions required when a person with tuberculosis
fails to follow instructions by a health officer or
physician;
●Commitment, restraint, discharge, and
recommitment to a medical care facility;
●Penalty for violations of orders or regulations of the
Secretary;
●Preservation of individual rights to select mode of
treatment;
2- 29 ●Expenses of inpatient care, maintenance, and
treatment of tuberculosis;
●Reporting to local health authority as to infectious
or contagious diseases, immunity from liability, and
confidentiality of information;
●Duties and powers of local health officers regarding
contagious diseases;
●Non-admissions, exclusions, and readmissions to
schools and child care facilities due to infectious or
contagious disease;
●Funeral services for individuals who died while
suffering from an infectious or contagious disease;
●Quarantine of city, township, or county;
●Monetary penalty provisions for violation of certain
orders relating to contagious or infectious
diseases;
●Rules and regulations of the Secretary, testing, and
quarantine to prevent spread and dissemination of
diseases;
●Penalties for violation of rules and regulations of
the Secretary for the prevention and control of
infectious or contagious diseases;
●Authority of a local health officer or the Secretary to
make evaluation, treatment, isolation, or quarantine
orders and enforcement;
●Orders for isolation or quarantine and appeals;
●Unlawful discharge from employment due to
isolation or quarantine;
3- 29 ●Tuberculosis evaluation, treatment, and monitoring
requirements for postsecondary students; and
●Prevention and control of tuberculosis in
postsecondary educational institutions.
Isolation or Quarantine Orders
The bill would not stay or enjoin any isolation or
quarantine orders if a hearing is requested.
Timing of Hearings
The bill would require a district court, after receipt of the
petition, to conduct a hearing within 72 hours, except when
the Chief Justice has issued an order to extend or suspend
deadlines regarding court actions for health and safety
reasons (KSA 20-172(a)).
Judicial Review Standard of Strict Scrutiny
The bill would require the Court to grant the request for
relief unless the Court would find the order is narrowly
tailored to the purpose stated in the order and uses the least
restrictive means to achieve the stated purpose.
Local Health Officer Role (Section 2)
The bill would amend the role of a county or joint board
of health or local health officer to be one that may
recommend against public gatherings when necessary for the
control of infectious or contagious disease. [Note: Current law
states the county or joint board of health or local health officer
is authorized to prohibit public gatherings when necessary.]
4- 29 Enforcement of Orders (Section 3)
The bill would remove the requirement that the local
health officer or Secretary may order any sheriff, deputy
sheriff, or other law enforcement officer to assist in the
execution or enforcement of any order regarding evaluation,
treatment, isolation, or quarantine for an infectious or
contagious disease.
Background
The bill was introduced by the Senate Committee on
Public Health and Welfare at the request of Senator Murphy.
Senate Committee on Public Health and Welfare
In the Senate Committee hearing, proponent testimony
was provided by three private citizens, who generally stated
their personal experiences with various entities and public
health concerns.
Written-only proponent testimony was received from 19
private citizens and five precinct committee persons.
Opponent testimony was provided by representatives of
the Kansas Association of Local Health Departments, Kansas
Chamber, Kansas Department of Health and Environment
(KDHE), and the Kansas National Education Association. The
representatives generally stated their concerns regarding the
undoing of the public health infrastructure, the considerable
local financial investment that would be needed, and the
impact on the employer to act in the best interest of the
business.
Written-only opponent testimony was provided by
representatives of the American Cancer Society Cancer
Action Network, Health Forward Foundation, Immunize
Kansas Coalition, Kansas Academy of Family Physicians,
5- 29 Kansas Action for Children, Kansas Association of Counties,
Kansas Chapter American Academy of Pediatrics, Kansas
Hospital Association, Lawrence-Douglas County Public
Health, McPherson County Health Department, Nurture KC,
Saline County Health Department, a nurse practitioner, and
two private citizens.
The Senate Committee recommended a substitute bill
be passed incorporating amendments to change the authority
of a county or joint board of health or local health officer to
prohibit public gatherings to one of allowing a
recommendation against public gatherings.
House Committee on Health and Human Services
In the House Committee hearing, proponent testimony
was provided by an attorney and two private citizens, who
shared their legal and personal experience regarding an
unvaccinated minor who was issued an order from a local
health officer to isolate for 21 days due to a potential
exposure to chicken pox. The proponents suggested
amendments regarding the ability for individuals to have a
court hearing within 72 hours of receiving an order. The
private citizen generally stated concerns regarding public
health and individual liberty considerations.
Written-only proponent testimony was provided by three
private citizens.
Opponent testimony was provided by a representative
of the Kansas Association of Local Health Departments that
was substantially similar to the testimony provided to the
Senate Committee. The conferee responded to aspects of
proponent testimony by providing information about
vaccinations.
Written-only opponent testimony was provided by
representatives of the Franklin County Health Department,
Health Forward Foundation, Johnson County Department of
6- 29 Health and Environment, Kansas Action for Children, Kansas
Chapter American Academy of Pediatrics, Kansas Public
Health Association, Kansas School Nurses Organization,
Lawrence-Douglas County Public Health, Nurture KC,
Osborne County Health Department, a medical doctor, and
two private citizens.
The House Committee amended the bill to:
●Require the Secretary of Health and Environment
(Secretary) to have probable cause, supported by
oath or affirmation, regarding any action that is
intended to exclude, isolate, quarantine, or
otherwise restrict the movement of people within
Kansas when the Secretary seeks to prevent the
introduction or spread of an infectious or
contagious disease within Kansas;
●Permit the filing of a civil action in a district court by
any aggrieved party of an action undertaken by the
Secretary or others designated to act regarding the
health of the people of Kansas as set forth in KSA
65-101 through KSA 65-129f;
○Require a hearing within 72 hours while
leaving any isolation or quarantine orders in
place pending a hearing; and
○Establish the judicial review standard as strict
scrutiny; and
●Remove the requirement that a local health officer
or the Secretary may order any sheriff, deputy
sheriff, or other law enforcement officer to assist in
the execution or enforcement of any order.
Fiscal Information
According to the fiscal note prepared by the Division of
the Budget on the bill, as introduced, in 2024, KDHE and
local health departments received over 20,573 reported
7- 29 cases of infectious and contagious diseases; the vast majority
of these cases were directly reported to KDHE. Of the total,
15,484 cases were sexually transmitted infections; 1,841
cases were enteric diseases caused by consuming
contaminated food products, exposure to contaminated water,
or exposure to animals; 509 cases were vaccine-preventable
diseases; 132 cases were vector-borne diseases, including
Lyme disease and West Nile virus; 82 cases were multidrug-
resistant organisms occurring in health care facilities; and 31
cases were of animal rabies, which is a fatal disease in
humans if not treated. Overall, the fiscal effect of the bill
would increase the cost of public health investigations, which
would fall to local and state public health to cover, plus the
cost to insurance companies and Medicaid to cover additional
health care costs. There would also be costs to employers
and employees with lost work time and costs to families and
individuals that must pay for health care and other costs.
KDHE estimates new costs for state and local public health
could total up to $5.2 million in FY 2026, with case counts
and costs estimated to increase in out-years. While some
funding could be supplemented with federal funding, there
are no specific state or federal funding sources identified for
this increase. A breakdown of the increased costs is outlined
below.
KDHE states that the medical-related costs associated
with sexually transmitted infections are estimated for
chlamydia to be about $42 per infection, gonorrhea about $78
per infection, and syphilis about $1,190 per infection.
Extrapolated to Kansas 2024 counts, the total cost would be
approximately $493,920 for chlamydia, $248,742 for
gonorrhea, and $458,150 for syphilis per year. Estimating a
doubling of case counts if Kansas no longer mandated
reporting of sexually transmitted infections and no longer
investigated cases or located contacts to begin treatment, the
direct medical costs of sexually transmitted infections is
estimated to increase by $1.2 million per year for chlamydia,
gonorrhea, and syphilis. The agency also noted that in
addition to these costs, the approximate cost associated with
human immunodeficiency virus (HIV) is $420,285 per lifetime;
8- 29 extrapolated to Kansas 2024 case counts, that would be
$63.0 million over the lifetime of these patients, which would
increase to $126.1 million.
For gastrointestinal diseases, KDHE currently estimates
a cost of $1,850 per individual and believes case counts
could double if Kansas no longer mandated reporting of these
diseases, no longer investigated cases to identify the source
of the infection, and no longer helped guide the Department
of Agriculture’s restaurant inspections resulting from illness
complaints. This would increase the total cost for these cases
by approximately $3.4 million.
Using a cost estimate of $284 per patient for the 509
cases of vaccine-preventable diseases reported in Kansas in
2024, KDHE estimates a direct medical cost of $144,556.
Again assuming these cases would double if Kansas no
longer mandated reporting of these diseases and no longer
provided vulnerable settings like schools and day cares
infection prevention and control guidance for outbreaks, the
direct medical costs would increase by $144,556.
KDHE estimates the cost per Lyme disease patient to be
approximately $11,838 per patient; extrapolated to Kansas
2024 case counts, that would total $94,704. The cost of
uncomplicated West Nile Virus infection is estimated to be
about $1,000 per case, while neuroinvasive cases are
estimated at $27,500 per case. In 2024, Kansas reported 12
non-neuroinvasive cases and 11 neuroinvasive cases,
approximating a medical cost of $314,500. In total, in 2024,
Kansas reported 132 cases of vector-borne diseases, which
are transmitted to humans from mosquitoes and ticks. If these
conditions are no longer reported to KDHE, the agency would
not have any insight into the geographic area of exposure
and would not be able to guide local and state collection and
testing of these vectors or local control methods like mosquito
spraying. Again assuming cases would double, the costs
would increase by $409,204 for these types of cases.
9- 29 In addition to the local and state public health increases,
KDHE reports that depending on the infection type of
carbapenem-resistant Enterobacteriaceae, the median cost of
a single infection can range from $22,484 to $66,031 for
hospitals and $10,440 to $31,621 for third-party payers. In
2024, Kansas had 81 reported confirmed carbapenemase-
producing organism infections, for an approximate cost to
third-party payers ranging from $845,640 to $2.6 million.
Currently, in response to these reports, KDHE works with
hospitals and long-term care facilities to quickly put into place
additional infection prevention and control measures and
screening for these antibiotic-resistant organisms to help
control the spread. In the absence of these measures, using
an estimate of double the amount of these infections, the cost
estimate would increase to a range of $1.7 million to $5.1
million.
The Office of Judicial Administration (OJA) states
enactment of the bill could increase the number of cases filed
in district courts because it creates a civil cause of action.
This could result in more time spent by judicial and non-
judicial personnel processing, researching, and hearing these
cases. OJA estimates enactment of the bill could result in the
collection of docket fees and fines assessed in those cases
filed under the bill’s provisions, which would be deposited to
the State General Fund. Enactment of the bill would not affect
other revenues to the Judicial Branch. However, a fiscal effect
cannot be estimated. The Kansas Department of Education
and the Kansas Board of Regents report that enactment of
the bill would have no direct fiscal effect for the agencies,
school districts, or universities. Any fiscal effect associated
with the bill is not reflected in The FY 2026 Governor’s
Budget Report.
The Kansas Association of Counties reports that
enactment of the bill could result in a fiscal effect on local
governments, but a total fiscal effect could not be estimated.
The League of Kansas Municipalities stated enactment of the
bill would have no fiscal effect on cities.
10- 29 KDHE notes that there are an estimated 8,060 law
enforcement officers and over 5,000 emergency medical
service workers in Kansas. On average, per year,
approximately 30.0 percent of these staff experience an
occupational needle stick injury resulting in 3,918 bloodborne
exposures per year. For each needlestick injury, the
Occupational Safety and Health Administration recommends
immediate medical evaluation, repeat testing for HIV,
Hepatitis B and Hepatitis C, and post-exposure prophylaxis
for Hepatitis B and HIV at no cost to the employee. KDHE
states the potential cost to local governments would exceed
$16.0 million dollars.
Health; local health officer; county or joint board of health; public gatherings;
infectious disease; isolation order; quarantine order; sheriff; law enforcement officer
11- 29