HCS/SCS/SB 230 - This act modifies several provisions relating to health care, including: (1) newborn screening; (2) infection reporting; (3) the Perinatal Advisory Council; (4) telehealth services; (5) physical disability specialty plates and tags; and (6) data collection by health care professional boards.
NEWBORN SCREENING (Section 191.332)
This act requires the Department of Health and Senior Services, beginning January 1, 2016, to expand current newborn screening requirements to include severe combined immunodeficiency, also known as bubble boy disease.
This provision is identical to HB 1315 (2015).
INFECTION REPORTING (Sections 192.020 and 192.667)
This act requires the Department of Health and Senior Services to include carbapenem-resistant enterobacteriaceae (CRE) in its list of communicable or infectious diseases which must be reported to the Department.
Under current law, the Department is required to disseminate reports to the public based on data compiled showing infection incidence rate for certain infections for hospitals and ambulatory surgical centers. This act adds other infections to be reported including hospital and ambulatory surgical center procedure infections that meet certain requirements, central line-related bloodstream infections, health care-associated infections specified by the Centers for Medicare and Medicaid Services (CMS), and other categories of infections established by the Department through rule. The Department shall make such reports available to the public for at least 2 years.
This act requires the Infection Control Advisory Panel to make recommendations to the Department regarding the appropriateness of using CMS' reporting requirements by January 1, 2016. The panel recommendations shall address which hospitals shall be required, as a condition of licensure, to use specified national networks for data collection, risk analysis and adjustment, or public reporting of infection data. After considering the panel's recommendations, the Department shall implement guidelines from the Centers for Disease Control and Prevention National Healthcare Safety Network, or its successor. As a condition of licensure, those hospitals that meet the minimum public reporting requirements shall participate in the National Healthcare Safety Network program. Those hospitals shall permit the program to disclose facility-specific data. Those facilities not participating in the program shall submit facility-specific data to the Department as a condition of licensure.
This act also provides that no later than August 28, 2016, each hospital and ambulatory surgical center, excluding mental health facilities, shall establish an antibiotic stewardship program for evaluating the judicious use of antibiotics, especially antibiotics that are the last line of defense against resistant infections. The stewardship program procedures shall be made available upon inspection to the Department. Hospitals shall meet specified national standards for reporting antimicrobial usage or resistance and shall authorize the National HealthCare Safety Network, or its successor, to disclose to the Department facility-specific reported data. Such data shall not be disclosed to the public except under specific circumstances. Beginning January 1, 2017, and every year thereafter, the Department shall report the General Assembly on the incidence, type, and distribution of antimicrobial-resistant infections in the state.
These provisions are identical to HCS/HB 1066 (2015), HCS/SCS/SB 10 (2015), and provisions of HCS/SCS/SB 197 (2015), HCS/SS/SCS/SB 354 (2015), HCS/SCS/SB 380 (2015); substantially similar to SCS/HCS/HB 1066 (2015); and similar to SCS/SB 10 (2015), SB 10 (2015), HB 1066 (2015), and SB 910 (2014).
PERINATAL ADVISORY COUNCIL (Section 192.380)
This act establishes the Perinatal Advisory Council, which shall be comprised of representatives from specified community and health organizations and professions. After receiving public input, the Council shall make recommendations for the division of the state into neonatal and maternal care regions. The Council shall establish criteria for levels of birthing center care and base its levels of care designations upon evidence and best practices as identified by the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists. By January 1, 2017, and every year thereafter, hospital license applications shall include the appropriate level of maternal care and neonatal care designations as determined by the Council. By the same date, any hospital operated by a state university shall report to the Department of Health and Senior Services, upon the Department's request, the appropriate level of maternal care designation and neonatal care designation. The Department may partner with appropriate nationally recognized nonprofit organizations with relevant expertise to administer the provisions of this act.
This provision is identical to provisions in HCS/SS/SCS/SB 354 (2015); substantially similar to HCS/SCS/SB 354 (2015) and provisions in HCS/SCS/SB 107 (2015), HCS/SCS/SB 146 (2015), HCS/SCS/SB 197 (2015), and HCS/SB 533 (2015); and similar to SB 342 (2015) and HB 735 (2015).
TELEHEALTH SERVICES (Sections 208.671, 208.673, 208.675, 208.677, and 208.686)
This act specifies the licensed individuals who shall be considered eligible health care providers for the provision of telehealth services. Additionally, this act specifies the originating sites where a MO HealthNet participant may receive telehealth services, as well as requiring that such originating sites ensure the immediate availability of clinical staff during the telehealth encounter if a participant requires assistance.
This act establishes a statewide home telemonitoring program. Home telemonitoring services are health care services that require scheduled remote monitoring of data related to a patient's health. The act specifies the individuals for whom home telemonitoring services may be made available. Additionally, no originating site for home telemonitoring shall be required to maintain immediate availability of on-site clinical staff during the telemonitoring service. If the Department of Social Services determines that home telemonitoring is not cost effective, the Department may discontinue the program and stop providing reimbursement through MO HealthNet for such services.
This act addresses the use of asynchronous store-and-forward technology in the practice of telehealth services for MO HealthNet recipients. "Asynchronous store-and-forward" is defined in the act as the transfer of a patient's clinically important digital samples, such as still images, videos, audio, and text files, and relevant data from an originating site through the use of a camera or similar recording device that stores digital samples that are forwarded via telecommunication to a distant site for consultation by a consulting provider without requiring the simultaneous presence of the patient and the patient's treating provider. The Department of Social Services, in consultation with the departments of Mental Health and Health and Senior Services, shall promulgate rules governing the use of asynchronous store-and-forward technology in the practice of telehealth in MO HealthNet. The act also specifies reimbursement for asynchronous store-and-forward services for the treating provider and the consulting provider.
This act establishes the "Telehealth Services Advisory Committee" to advise the Department of Social Services and propose rules relating to telehealth services through asynchronous store-and-forward technology. The act specifies the committee members, appointments, and other terms.
These provisions are substantially similar to HCS/SCS/SB 38 (2015), HCS/HB 319 (2015), HB 965 (2015), and HB 1014 (2015), and similar to HB 319 (2015).
PHYSICAL DISABILITY SPECIALTY PLATES AND TAGS (Section 301.142)
This act adds physical therapists to the list of authorized health care practitioners who may sign statements necessary for a person to receive a windshield placard or special plates for a temporary or permanent physical disability.
This provision is identical to HCS/HB 720 (2015) and provisions in SCS/HCS/HB 1002 (2015), HCS/SCS/SB 197 (2015), HCS/SS/SCS/SB 354 (2015), HCS/SCS/SB 380 (2015), and substantially similar to HCS/SCS/SB 38 (2015), HCS/SB 458 (2015), HCS/SCS/SB 107 (2015), HCS/SCS/SB 146 (2015), and CCS#2/HCS/SB 254 (2015).
DATA COLLECTION BY HEALTH CARE PROFESSIONAL BOARDS (Section 324.001)
This act provides that the State Board of Nursing, Board of Pharmacy, Missouri Dental Board, State Committee of Psychologists, and State Board of Registration for the Healing Arts may enter into contractual agreements with the Department of Health and Senior Services, public institutions of higher education, and nonprofit entities in order to collect and analyze workforce data from its licensees for the purpose of future workforce planning and to assess the accessibility and availability of qualified health care services and practitioners in Missouri.
Data collection is controlled by the applicable state board requesting the collection, and the boards may release identifying data to the contractor to facilitate data analysis of the health care workforce. The data collected is the property of the board requesting the data, and shall be maintained as provided in existing law. Data shall only be released in the aggregate form in a manner that cannot be used to identify a specific individual. A board cannot request or collect income or other financial earnings information. Contractors shall maintain the confidentiality of data received and shall not release any data without approval from the applicable board.
This provision is identical to HCS/HB 112 (2015), HCS/SCS/SB 197 (2015), and HCS/SS/SCS/SB 354 (2015).
HA #1 - AUTHORIZED ENTITIES MAY ACQUIRE AND USE EPINEPHRINE AUTO-INJECTORS IN SPECIFIED SITUATIONS; ADDS OPTOMETRISTS TO TELEHEALTH PROVISIONS
HA #2 - MODIFIES PERINATAL ADVISORY COUNCIL PROVISION REGARDING PREGNANCY TERMINATION AND CERTIFIED PROFESSIONAL MIDWIVES
HA #3 - MODIFIES PROVISIONS RELATING TO PERSONAL CARE ATTENDANTS AND ELECTRONIC VISIT VERIFICATION; CONTAINS AN EMERGENCY CLAUSE
HA #4 - PROVIDERS OF BEHAVIORAL, SOCIAL, AND PSYCHOPHYSIOLOGICAL SERVICES FOR THE PREVENTION, TREATMENT, OR MANAGEMENT OF PHYSICAL HEALTH PROBLEMS SHALL BE REIMBURSED UTILIZING SPECIFIC REIMBURSEMENT CODES