Missouri Senate

House Amendment

EMPLOYEES ENGAGED IN HAIR BRAIDING AT PUBLIC AMUSEMENT VENUES

The act provides that an employee or employer who primarily engages in the practice of combing, braiding, or curling hair without the use of harmful chemicals shall not be subject to the licensing requirements of cosmetologists or barbers under chapter 329 while working with a licensee for a public amusement or entertainment venue (316.265).

This provision is identical to provisions contained in HCS/SB 528 (2014) and HCS/SCS/SB 672 (2014).

SOCIAL SECURITY NUMBERS IN PROFESSIONAL LICENSING APPLICATIONS

Under current law, every application for a renewal of a professional license, certificate, registration, or permit must contain the applicant's Social Security number. This act states that an application for a professional license renewal only has to include a Social Security number in situations where the original application did not contain a Social Security number. After the initial application for license renewal which includes a Social Security number, an applicant is no longer required to provide a Social Security number in subsequent renewal applications (324.024).

This provision is substantially similar to SB 289 and SB 314 (2013), and identical to provisions in HCS/SB 528 (2014) and HCS/HB 2131 (2014).

PHYSICIAN ASSISTANTS

The act specifies that a physician assistant may enroll with the Department of social Services as a Medicaid provider while acting under a supervision agreement with a physician (334.735).

This provision is identical to provisions contained in HCS/SB 528 (2014).

CLINICAL SOCIAL WORKER

Currently, an applicant for clinical social worker or advanced macro social worker licensure must complete three thousand hours of supervised experience within forty-eight months. This act states that an applicant who completes at least four thousand hours of supervised experience within forty-eight calendar months shall be eligible for application of licensure at three thousand hours and shall be furnished a certificate by the State Committee for Social Workers acknowledging the completion of additional hours (337.615, 337.645).

The act also specifies that a licensed master social worker shall not practice independently the scope of practice reserved for clinical social workers or advanced macro social workers (337.643).

These provisions are identical to HB 1875 (2014) and to provisions contained in HCS/SB 528 (2014).

PHARMACY

The act adds to the description of the "practice of pharmacy" the administration of hepatitis A, hepatitis B, diphtheria, tetanus, and pertussis vaccines by written protocol authorized by a physician. Also, a pharmacist shall administer vaccines in accordance with the treatment guidelines established by the Centers for Disease Control and Prevention and rules jointly promulgated by the Board of Pharmacy and the State Board of Registration for the Healing Arts. A pharmacist shall receive additional training for the administration of vaccines as required by the Board of Pharmacy. Within fourteen days of administering a vaccine a pharmacist shall provide specified information to the patient's primary health care provider (338.010).

The act provides that a federally employed pharmacist who does not hold him or herself out as a Missouri licensed pharmacist and who is engaged in the practice of pharmacy while in the performance of official duties shall not require a Missouri pharmacist license (338.020).

This provision is identical to SB 717 (2014), HB 1636 (2014), and provisions contained in HCS/HB 2131 (2014), and HCS/SB 528 (2014).

The act provides that pharmacists may label prescription drugs using either a sequential number or a unique identifier (338.059).

INSPECTION OF CLASS B HOSPITAL PHARMACIES

The act states that the Board of Pharmacy may inspect Class B hospital pharmacies that are not under the inspection authority of the Department of Health and Senior Services. The Board and the Department of Health and Senior Services may jointly promulgate rules governing medication services by a pharmacist at or within a hospital. A drug distributor license is not required to transfer medication from a Class B hospital pharmacy to a hospital clinic for patient care. Medication dispensed by a hospital to a hospital patient for use outside of the hospital under a medical staff-approved protocol for medication therapy shall be dispensed only by a prescription order for medication therapy from a physician.

All pharmacists providing medication therapy services must obtain a certificate of medication therapeutic plan authority as provided by rule.

There shall be an advisory committee, with members appointed by the Board, which will make recommendations to the Board and review all rules jointly promulgated by the Board and the Department (338.165).

The act defines a "Class B Hospital Pharmacy," and provides that any hospital that holds a pharmacy license on the effective date of the act shall be eligible to obtain a Class B pharmacy license without the payment of a fee (338.220).

These provisions are identical to provisions contained in HCS/SB 528 (2014), and substantially similar to provisions contained in SCS/SB 942 (2014), SS/SB 754 (2014), HB 2285 (2014), and HCS/SB 2131 (2014).

HEARING INSTRUMENT SPECIALISTS

The act modifies the definition of "hearing instrument" or "hearing aid" by adding language to provide that a wearable instrument is one which provides more than fifteen decibel full-on gain via a two cc coupler at any single frequency from two hundred through six thousand cycles per second (346.010).

In order to obtain a license as a hearing instrument specialist the applicant must successfully pass a qualifying examination (346.055).

These provisions are identical to provisions contained in HCS/SB 528 (2014) and similar to HB 1988 (2014).

JESSICA BAKER

HA 1 - THIS AMENDMENT ADDS LANGUAGE WHICH PROVIDES THAT A MEDICAL STAFF PROTOCOL UNDER WHICH A PHARMACIST MAY PROVIDE THERAPY SERVICES TO HOSPITAL PATIENTS MUST INCLUDE A PROCESS WHEREBY AN EXEMPTION TO THE PROTOCOL FOR A PATIENT MAY BE GRANTED FOR CLINICAL EFFICACY AND SHALL INCLUDE AN APPEALS PROCESS TO REQUEST A CHANGE IN SPECIFIC PROTOCOL BASED ON MEDICAL EVIDENCE PRESENTED BY A PHYSICIAN.

THE AMENDMENT ALSO SPECIFIES THAT MEDICATION DISPENSED BY A "CLASS A PHARMACY LOCATED IN A HOSPITAL" TO A HOSPITAL PATIENT FOR USE OUTSIDE THE HOSPITAL UNDER A MEDICAL STAFF-APPROVED PROTOCOL CAN ONLY BE DISPENSED BY A PRESCRIPTION ORDERED BY A PHYSICIAN.

THE AMENDMENT ADDS A NEW SUBDIVISION 338.165.8 WHICH STATES THAT MEDICATION DISPENSED BY A HOSPITAL TO A PATIENT FOR USE OUTSIDE THE HOSPITAL SHALL BE LABELED AS PROVIDED BY RULES JOINTLY PROMULGATED BY THE DEPARTMENT AND THE BOARD.