Missouri Senate

House Committee Substitute

HEALTH CARE PROFESSIONAL IDENTIFICATION BADGES

(Section 197.705)

After August 28, 2011, all hospitals, ambulatory surgical centers and certain health care facilities shall require all newly hired personnel providing services in such facilities to wear identification badges prominently displaying the employee's photograph, first name, title and employer. The title of the employee shall include whether the employee is a physician, nurse, as specified under the act, or other titles as determined by the Department of Health and Senior Services. Nothing in this act shall prohibit a health care provider from placing the provider's additional specialty or designation on the badge. Personnel shall not be required to wear the badge while delivering direct care if not clinically feasible.

Compliance with this act for all current personnel may occur when any badges are issued or replaced within a reasonable time after August 28, 2011, but no later than by August 28, 2016. Nothing in this act requires the immediate replacement of identification badges worn by current personnel.

This act is substantially similar to HCS/HB 287 (2011) and SCS/SB 137 (2011).

DRIVER'S LICENSE COMPETENCY ASSESSMENT

(Section 302.291)

This act adds licensed professional counselors to the list of health care professionals who can report to the Department of Revenue a person diagnosed as having a disorder or condition that may prevent him or her from driving a motor vehicle in a safe manner. A report from a professional counselor shall provide the director with good cause to believe that the operator may be incompetent or unqualified to retain his or her driver's license and the director may require the person to submit to an examination in order to retain it.

This provision is identical to truly agreed to and finally passed HB 499 (2011).

NOTIFYING EMPLOYERS REGARDING THE LICENSURE STATUS OF EMPLOYEES

(Section 324.013)

This act requires any board, commission, committee, council, or office within the Division of Professional Registration to notify a licensee's current employer, if the employer is known, of a change in the licensee's license or disciplinary status. Employers may also provide a list of current licensed employees and make a written request to the appropriate board to be notified when there is a change in the licensure status of any of those employees.

This provision is substantially similar to SCS/HB 265 (2011) and SB 325 (2011).

ADMINISTRATIVE PROCEDURES AND POWERS OF THE BOARD OF REGISTRATION FOR THE HEALING ARTS

(Section 324.043, 324.045,334.001, 334.040, 334.070, 334.090, 334.099, 334.100, 334.102, 334.103, 334.108, 334.715, 536.063, 536.067, 536.070, 621.045, 621.100, 621.110)

This act modifies disciplinary and administrative procedure provisions that apply to professions and businesses licensed by the Division of Professional Registration or by any board committee, commission or office within the Division of Professional Registration. The act also modifies the licensing requirements and disciplinary powers of the Board of Registration for the Healing Arts.

If a person who is licensed by any board, committee, commission, or office under the Division of Professional Registration does not defend against a disciplinary proceeding, the appropriate board or the Administrative Hearing Commission is required to enter a default decision against the person. The board or the Administrative Hearing Commission may set aside the default decision for good cause if the person files a motion within thirty days after the default decision.

Evidence contesting the basis of a criminal conviction or disciplinary action from another state will not be admissible in an administrative hearing.

The Administrative Hearing Commission is required to deliver the findings of fact and conclusions of law in disciplinary cases to the appropriate agency within one hundred and twenty days of the date the case became ready for decision.

BOARD OF REGISTRATION FOR THE HEALING ARTS

The Board of Registration for the Healing Arts is authorized to list certain information about individuals who are licensed by the board and applicants for licenses from the board on its website. The board is also required to disclose confidential information to applicants for licenses and licensees without a fee, if the information is less than five years old.

The board is no longer authorized to require doctors licensed in other states to take certain examinations prior to waiving the Missouri examination requirement. The board is authorized to require another examination, more education, or further training before issuing a permanent medical license to applicants who have not actively practiced clinical medicine or held a teaching position for two of the three years before their application.

Doctors are no longer required to display their certificate of registration in the office.

The board is required to make individuals applying for a license or holding a license submit to an evaluation of their skills, a multi-disciplinary evaluation, or a substance abuse evaluation, after a hearing, if there is reasonable cause to believe that the individual is incompetent about the medical or osteopathic profession, mentally or physically incapacitated, or excessively uses or abuses alcohol or controlled substances.

The disciplinary authority of the board is modified to allow the board to discipline licensees for municipal violations, prescribing drugs through the internet without a valid physician-patient relationship, for being listed on a sex offender registry, any conduct that is unethical of unprofessional involving a minor, for a single act of negligence, for knowingly making a false statement to the board, for violating a settlement agreement with the board, for failing to comply with a treatment program, and for violating any professional trust or confidence.

The board's authority to issue an emergency suspension or restriction of a licensee's license is modified to allow additional reasons for an emergency suspension or restriction, including: sexual conduct with a patient, sexual misconduct with a minor, possession or use of a controlled substance, a court finding that the licensee is incapacitated, habitual intoxication or dependence on alcohol or a controlled substance or failing to comply with a treatment program. The procedure for issuing emergency restrictions or suspensions is also modified. Emergency suspensions will take effect when the documents are served, rather than after a preliminary hearing before the Administrative Hearing Commission. The emergency restriction or suspension may be appealed to the circuit court.

The board is also authorized to initiate hearings before itself when disciplining a licensee's license for certain actions. The board's disciplinary decision is appealable to the circuit court.

Doctors who prescribe any drug, controlled substance, or other treatment through the internet are required to meet certain requirements to establish that there is a valid physician-patient relationship. These requirements do not apply to treatment provided in a hospital, hospice program, in accordance with a collaborative practice agreement, or in conjunction with a physician assistant.

The board's authority to discipline athletic trainers is also modified.

These provisions are similar to SCS/SB 303 (2011) and HCS/HB 732 (2011).

LIMITED TEACHING LICENSE FOR DENTAL INSTRUCTORS

(Section 332.425)

This act allows the Missouri Dental Board to issue a limited teaching license to an instructor at an accredited dental school. This limited teaching license only allows the licensee to practice within the accredited dental school programs. Individuals who receive a limited teaching license must meet specified requirements, including evidence of spoken written proficiency in the English language, but will not be required to have graduated from an accredited dental school.

This provision is similar to HB 591 (2011) and HCS/SB 325 (2011).

VETERINARY LEGEND DRUGS

(Sections 338.010, 338.140, 338.150, 338.220, and 338.240)

This act modifies the authority of the Board of Pharmacy with regard to certain drugs used in veterinary medicine.

This act also adds a veterinarian to the advisory committee appointed by the Board of Pharmacy to make recommendations to it about rules and regulations dealing with drug distribution and manufacturing. The advisory committee is also required to review and make recommendations to the Board of Pharmacy regarding rules and regulations about veterinary legend drugs.

Businesses that only hold a class L pharmacy permit will not be required to have a pharmacist on site, except for when noncontrolled drugs for use in animals are being compounded. A pharmacist is responsible for reviewing the activities and records of class L pharmacies.

These provisions are similar to HCS/SB 325 (2011) and HB 1814 (2010).

REAL ESTATE LICENSEES

(Section 339.190)

Currently, licensed real estate brokers and salespersons have immunity from liability for statements made by certain individuals, such as an inspector, unless the individual was employed by the real estate licensee, selected by and engaged by the licensee, or the licensee knew the statement was false or acted in reckless disregard as to whether the statement was true or false. This act specifies that if the real estate broker or salesperson only orders a report or inspection, that does not mean the licensee selected or engaged the individual, so the real estate licensee would still have immunity from liability for the statements the individual made.

This provision is identical to HCS/HB 220 (2011) and HCS/SB 325 (2011).

PEER REVIEW PROCESS FOR LICENSED ARCHITECTS, LANDSCAPE ARCHITECTS, PROFESSIONAL LAND SURVEYORS, OR PROFESSIONAL ENGINEERS

(Section 537.033)

This act authorizes the establishment of a peer review process for architects, landscape architects, professional land surveyors, or professional engineers.

Peer reviewers and each person who testifies before them, provides information to them, acts upon their recommendation, or participates in the peer review process are immune from civil liability for these actions, as long as the actions are performed in good faith, without malice and are reasonably related to the scope of inquiry of the peer review process.

Certain documents created during the peer review process are privileged and are prohibited from being released to any person. These documents are not admissible in any judicial or administrative action for failure to provide appropriate architectural, landscape architectural, land surveying, or engineering services. A person who participated in the peer review process shall not be permitted or required to disclose information they learned from the peer review process.

This act does not limit the authority of the Board for Architects, Professional Engineers, Professional Land Surveyors and Landscape Architects to obtain information from a peer reviewer or to require disclosure of otherwise confidential information developed outside of the peer review process.

This act is identical to HB 568 (2011) and similar to SB 326 (2011).

EMILY KALMER