Missouri Senate

House Committee Substitute

DIABETES CARE AND CONTROL (Section 191.990)

The MO HealthNet Division and the Department of Health and Senior Services shall collaborate to coordinate goals and benchmarks in each individual agency's plans to reduce the incidence of diabetes in Missouri, improve diabetes care, and control complications associated with diabetes. A report on such collaboration shall be submitted to the General Assembly by January 1 of each odd-numbered year. The act specifies the topics to be addressed in the report regarding diabetes.

The requirement of this act shall be limited to diabetes information, data, initiatives, and programs within each agency prior to the effective date of this act, unless there is unobligated funding for diabetes in each agency that may be used for new research, data collection, reporting, or other requirements of this act.

This provision is identical to a provision in CCS/HCS/SCS/SB 716 (2014); and SCS/HCS/HB 2125 (2014).

SHOW-ME ECHO PROGRAM (Section 191.1140)

Subject to appropriations, the University of Missouri shall manage the "Show-Me Extension for Community Health Care Outcomes (ECHO) Program". The Department of Health and Senior Services shall collaborate with the University of Missouri in utilizing the program to expand the capacity to safely and effectively treat chronic, common, and complex diseases in rural and underserved areas of the state and to monitor outcomes of such treatment.

The program is designed to utilize current telehealth technology to disseminate knowledge of best practices for the treatment of chronic, common, and complex diseases from a multidisciplinary team of medical experts to local primary care providers who will deliver the treatment protocol to patients, which will alleviate the need of many patients to travel to see specialists and will allow patients to receive treatment more quickly.

The program shall utilize local community health care workers with knowledge of local social determinants as a force multiplier to obtain better patient compliance and improved health outcomes.

This provision is identical to HB 2154; and to a provision in CCS/HCS/SCS/SB 716 (2014); and SCS/HCS/HB 2125 (2014).

EPINEPHRINE AUTO-INJECTORS (SECTION 196.990)

This act allows a physician to prescribe epinephrine (EPI) auto-injectors in the name of an authorized entity for use in certain emergency situations, and pharmacists, physicians, and other persons authorized to dispense prescription medications may dispense EPI auto-injectors under a prescription issued in the name of an authorized entity. An "authorized entity", is defined as any entity or organization at or in connection with which allergens capable of causing anaphylaxis may be present, including but not limited to restaurants, recreation camps, youth sports leagues, amusement parks, and sports arenas.

This act allows such authorized entities to acquire and stock a supply of EPI auto-injectors under a prescription issued in accordance with the provisions of the act. An employee or agent of an authorized entity or any other person who has completed the required training shall be allowed to use the EPI auto-injector on the premises of or in connection with the authorized entity to provide it to any individual who the employee, agent or other person believes in good faith is experiencing anaphylaxis regardless of whether the individual has a prescription for it or has been previously diagnosed with an allergy.

The act specifies the required training and the procedures for making the EPI auto-injectors available to individuals other than trained persons so long as the auto-injectors are stored in a locked secure container and in accordance with the manufacturer's specifications. The act also delineates the procedures for authorized entities reporting each incident involving use of the EPI auto-injectors to the Department of Health and Senior Services.

This act protects certain persons and entities from liability for any injuries or related damages that result from the administration of, or failure to administer an EPI auto-injector to a person 18 years of age or older in accordance with the provisions of the act that may constitute ordinary negligence. The immunity shall not apply to acts or omissions constituting gross, willful, or wanton negligence and shall be in addition to and not in lieu of protections provided under Section 537.037, RSMo, the Good Samaritan emergency law. Also, the administration of the EPI auto-injector under this act shall not constitute the practice of medicine.

This provision is identical to SB 868 (2014); is identical to a provision in SCS/HCS/HB 2125 (2014).

MO RX PRESCRIPTION DRUG PROGRAM ELIGIBILITY CHANGES(SECTION 208.790)

This act provides that applicant household income limits for eligibility shall be subject to appropriations, but in no even shall applicants have household income that is greater than 185% of the federal poverty level for the applicable family size for the applicable year as converted to the MAGI equivalent net income standard. The Department of Social Services shall promulgate rules outlining standards for documenting proof of household income.

MO RX PRESCRIPTION DRUG PROGRAM EXPIRATION DATE EXTENSION(SECTION 208.798)

This act extends the expiration date of the MO RX Prescription Drug Program from 2014 to 2017.

PHARMACY LICENSURE (SECTIONS 338.059; 338.165; and 338.220)

This act provides that pharmacists may label prescription drugs using either a sequential number or a unique identifier.

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 patient for use outside of the hospital shall be labeled as provided by rules jointly promulgated by the Department and the Board, and shall be dispensed only by a prescription order 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.

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.

These provisions are identical to SCS/SB 942 (2014) and to a provision in SCS/HCS/HB 2125 (2014).

ADRIANE CROUSE