Despite rising STD cases in Kansas, lawmakers hesitant to approve new treatment method

Health care providers in Kansas want lawmakers to approve a new way to fight the rise in sexually transmitted diseases, but they’re facing broad skepticism.

On Monday the House Committee on Health and Human Services considered a bill that would allow doctors to prescribe medications to treat the partners of those diagnosed with a sexually transmitted infection without an in-person examination. Last week, the Senate committee heard an identical bill.

The legislation does not provide a limit on the number of prescriptions a doctor can issue if a patient has multiple sexual partners, and it requires providers to send written information to sexual partners they did not examine in office.

This treatment method, called expedited partner therapy, is already utilized in 46 other states. It enjoys endorsements from nearly every nationally recognized medical association, including the American College of Obstetricians and Gynecologists.

Kansas has also experienced an uptake in STI cases over the past decade — on par with a national trend that the Centers for Disease Control and Prevention has classified as a public health crisis — and has significantly higher rates of syphilis.

Many sexually transmitted infections, such as gonorrhea, can be treated with a period of abstinence and a penicillin prescription.

Lawmakers were skeptical about the method because it would allow a provider to prescribe medicine without ever seeing the patient.

Sen. Mark Steffen, a Hutchinson Republican who is a physician, said prescribing medicine without seeing the patient violates informed consent and leads to a lower quality of care.

“This is clearly a degradation of quality of care whether we want to admit it here in this group or not,” he said during a Feb. 8 Senate Committee on Health and Human Services hearing.

On the House side, Rep. Ron Bryce, a Coffeyville Republican who is also a physician, echoed Steffen’s concerns. There is no other health care scenario where a doctor can legally prescribe medicine without any direct consultation, he said.

“In any other area of health care that would be malpractice,” he said.

Proponents of the bill, however, said the method is key to stopping reinfection and to combating rising STI cases across the country. They said that certain groups of people — such as men, who are less likely to exhibit symptoms of STIs, and people who have lower incomes or lack insurance — are far less likely to seek treatment, putting their sexual partners at risk for reinfection.

Kimberly Kern, a pharmacist at Walgreens, said there are many reasons why a person may not seek treatment. When a person cannot miss work, lacks transportation or does not have access to appointments, she said their accessibility to care is interrupted.

“Removing the step of needing an in-person consultation bridges the gap, it provides more accessibility and reduces the stigma surrounding STIs in addition to reducing health care costs,” she said.

And proponents say cumbersome wait times for appointments make it harder to get quality care, since treatment is most effective when it’s timely and administered when sexual partners are abstinent.

They pointed to a plethora of negative health effects that can result from delayed treatment for STIs such as infertility, preterm births in pregnant women and ectopic pregnancies.

Kelly Fritz, a volunteer with the Miami County Health Department, said she cold called a number of health care facilities, asking when their first available appointment was for a new patient. April 5, nearly two months out, was the soonest she could get an appointment.

She said waiting to treat infected parties is dangerous.

“These are all barriers to care, testing, treatment and public health,” she testified. “In the face of all these barriers, expedited partner therapy is one tool that could have an impact on the increasing number of newly identified cases by reducing ongoing transmission and preventing reinfection of the original patient.”

The bill says the expedited treatment applies to any patient diagnosed with a sexually transmitted disease, which lawmakers say is too vague, hypothetically applying to conditions such as COVID-19 or lice. The measure also does not require providers to keep medical records of sexual partners who are treated, one of the main points of contention for lawmakers.

Rep. Susan Ruiz, a Shawnee Democrat, said she was undecided about the bill but supported its intent. She said language should be added that allows for proper documentation of patients.

“There should be some language in there,” she said. “Because when you prescribe medication you have to know things like height, weight, that kind of thing. So I understand that. That’s a part of the medical practice that can’t really change.”

Susan Gile, the director of the Kansas State Board of Healing Arts, provided neutral testimony. She said the legislation contains too many unknowns and gray areas, such as unknown allergies.

“If we have a female in a domestic violence situation, maybe they don’t want to tell their partner they have an STI,” she said. “Maybe they didn’t get it from their partner and they’re afraid. Maybe they’re slipping it into someone’s food without knowing they have a penicillin allergy.”

Proponents said that pharmacists “have all the training and the ability” to provide all necessary consultation to patients picking up a prescription.

The bill also allows anyone over the age of 16 to participate in expedited partner therapy, which Rep. John Eplee, an Atchison Republican who is a physician, said was “a little on the young side.” He said he wanted to research what other states had done before making a decision.

Sen. Cindy Holscher, an Overland Park Democrat, addressed some lawmakers’ concerns about ensuring the prescriptions ended up in the right hands, saying family members pick up prescriptions for others all the time. She called the legislation a “no brainer.”

“This is a $2 pill for treatment,” she said. “Whereas if this goes untreated, we’re talking about a potential case of an expectant mother enduring a ruptured membrane, or other very traumatic, problematic situations.”

Sen. Renee Erickson, a Wichita Republican, and Sen. Beverly Gossage, a Eudora Republican who chairs the Senate committee, both said they needed more information before deciding to support or oppose the measure.