Missouri Senate

House Committee Substitute

REMOVAL OF A LAW ENFORCEMENT OFFICER - 71.1000

The act establishes procedures for a governing body of a political subdivision to follow prior to the removal of a law enforcement officer from employment. Such procedures include notice to the officer, a statements of facts supporting just cause for removal, opportunity for the officer to be heard, and a simple majority vote by the governing body that the burden of just cause has been met for removal. The just cause standard is met if the officer is unable to perform the duties with reasonable competence as a result of a mental condition, has committed any act that constitutes reckless disregard for safety, has misrepresented a material fact for any improper or unlawful purpose, acts in a manner for the sole purpose of furthering his or her self-interest in a manner inconsistent with the interest of the public, violates any law which constitutes a felony, or is found to be insubordinate or in violation of a policy.

This provision is identical to HCS/SCS/SB 146 (2015).

YOUTH SUICIDE AWARENESS AND PREVENTION EDUCATION - 170.047, 170.048

Beginning in the 2016-2017 school year, any licensed educator may annually complete up to two hours of training or professional development in youth suicide awareness and prevention as part of the professional development hours required for State Board of Education certification.

The Department of Elementary and Secondary Education must develop guidelines for training or professional development in youth suicide awareness and prevention. The Department must also develop materials that may be used for such training or professional development.

Each district must adopt a policy for youth suicide awareness and prevention by July 1, 2017. The Department of Elementary and Secondary Education must develop a model policy by July 1, 2016 that districts may adopt. The Department must cooperate, consult with, and seek input from organizations that have expertise in youth suicide awareness and prevention. By July 1, 2020, and at least every three years thereafter, the Department must request information and seek feedback from districts on their experience with the policy for youth suicide awareness and prevention. The Department shall review this information and may use it to adapt the department's model policy. The Department must post the information it receives from districts on its website that it deems relevant. The Department must not post any confidential information or any information that personally identifies a student or school employee.

These provisions are identical to SCS/SB 328 (2015) and to provisions contained in HCS/SCS/SB 146 (2015).

PROPRIETARY SCHOOLS REGULATION, YOGA EXEMPTION - 173.616

The act specifies that a yoga teacher training course, program, or school shall be exempt from proprietary school regulations.

HEALTH INFORMATION ORGANIZATION - 191.236, 191.237, 191.238

This act creates the Missouri Health Information Exchange Commission, which shall have the authority to develop a health information organization approval process. The approval process shall include compliance with commonly and equally applied standards relating to interoperability between approved health information organizations, transparency, financial and operational sustainability, and data security. The Commission shall also develop re-approval and investigational processes.

Additionally, this act requires the state to end the practice of conveying "state designated entity" status to any health information organization, as well as requiring the state to cease awarding and funding single feasible source vendor contracts to health information organizations operating within the state. Instead, only approved health information organizations shall be qualified to respond to contracting procurement opportunities. The state shall not restrict the availability of or access to any state agency-sponsored data sets.

Finally, this act requires approved health information organizations to exchange standard-based clinical summaries for patients and clinical and claims data from any agency within the state with all other approved health information organizations within the state. Failure to do so shall result in the suspension or revocation of approval status and the immediate termination of any contracts, grants, and any other form of state funding.

These provisions are identical to HCS/SCS/SB 146 (2015).

PERINATAL ADVISORY COUNCIL - 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 HCS/SCS/SB 146 (2015) and similar to SCS/SB 342 (2015) and HCS/SCS/SB 230 (2015).

DEATH CERTIFICATE PROCEDURE - 193.015, 193.145

This act adds advanced practice registered nurses, assistant physicians, and physician assistants to specified phases of the death certification process, including data provision, certification of death, and authorization for the final disposition of the decedent's body.

The funeral director or person in charge of final disposition of the body shall enter into the electronic death registration system personal data from the next of kin, medical certification if so designated by the person responsible for such certification, and any other information or data as required.

The person authorized to complete the medical certification may designate another to enter the medical certification information into the electronic death registration system if the authorized person has signed a statement stating the cause of death.

Any person completing the medical certification or entering data into the electronic death registration system shall be immune from civil liability for such certification completion, data, entry, or determination of cause of death, unless such person acts with gross negligence or willful misconduct.

The act states that the Department of Health and Senior Services must notify physicians, physician assistants, assistant physicians, and advanced practice registered nurses of the requirements provided in the act regarding the electronic vital records system.

By August 30, 2015, the Division of Community and Public Health shall create a working group to evaluate the electronic vital records system, develop recommendations, and must report such findings to the General Assembly by January 1, 2016.

These provisions are identical to provisions contained in SCS/HCS/HB 618 (2015) and substantially similar to SB 517 (2015) and HB 1113 (2015).

FINAL DISPOSITION AND DISINTERMENT OF A DEAD BODY - 194.119, 214.208

This act provides that if a funeral director has knowledge that there are multiple people who have equal priority to choose and control the final disposition of a dead human body and who do not agree on the disposition, then the decision of the majority of the people with equal priority shall control the disposition.

The act also states that a person who owns a cemetery is authorized to disinter an individual's remains and rebury or reinter the remains at another location pursuant to written instructions signed and acknowledged by a person who was the next-of kin, as defined in statute, at the time of death. If the next-of-kin at the time of death is no longer living then a majority of certain adult members, as specified in statute, may authorize the disinterment.

Currently, cemetery owners are not liable to the deceased person's family for a disinterment, relocation or delivery of deceased human remains performed pursuant to statute. This act provides that cemetery owners, cemetery operators, funeral directors, funeral establishment or any other entity involved in the process shall not be liable in such situations.

These provisions are identical to the perfected version of SCS/SB 416 (2015).

PRESCRIPTIVE AUTHORITY - 195.070, 334.037, 334.104, 334.747

This act allows certain advanced practice registered nurses, physician assistants, and assistant physicians to prescribe Schedule II - hydrocodone. Hydrocodone prescriptions are limited to a one five day supply without refill.

This provision is identical to SCS/SB 313 (2015).

GENDER PAY EQUALITY - 286.350

The act requires the Department of Labor and Industrial Relations to create best practice guidelines in gender pay equality for state and local government and private businesses. The guidelines shall be submitted to the General Assembly and shall take effect upon the passage of a concurrent resolution by both houses.

This provision is identical to HCS/HB 44 (2015) and similar to SCS/SB 144 (2015).

DISABLED PLACARDS AND LICENSE PLATES - 301.142

This act adds physical therapists to the list of authorized health care practitioners who may issue a statement for his or her patient to receive a disabled placard or license plate.

This provision is identical to provisions contained in SCS/HCS/HB 1002 (2015) and similar to HCS/SCS/SB 197 (2015).

CRITERIA FOR REGULATING PREVIOUSLY UNREGULATED PROFESSIONS AND OCCUPATIONS - 324.001, 621.280

This act provides that the state shall not impose a substantial burden on an individual's pursuit of his or her occupation or profession unless there is an compelling interest for the state to protect the general welfare. If a compelling interest does exist, then the regulation adopted shall be substantially related to the public interest to be protected.

The act establishes certain criteria under which to review all bills purposing to regulate an occupation or profession not previously regulated. If the legislature determines that the state has a compelling interest in regulating the occupation or profession then the least restrictive type of regulation shall be implemented.

An applicant group, defined as an organization or individual that proposes that any occupation or profession be regulated, shall submit a written report to the applicable standing committees in the Senate and House of Representatives containing certain information as specified in the act including a definition of the problem and why regulation of the profession is necessary, harm to the public by not regulating the profession and efforts to address the harm caused, alternatives to the regulation, the benefit to the public if the regulation becomes law, and the expected costs of regulation.

The act states that practitioners actively engaged in a newly regulated occupation or profession for at least one year prior to the effective date of the regulation statute shall have a property right in their continued legal ability to engage in their occupation or profession. The decision of any newly created board or commission charged with regulating or licensing an occupation or profession to refuse licensure to a pre-existing practitioner shall be in writing, specify the reasons for denial, and inform the practitioner of the right to appeal before the Administrative Hearing Commission.

These provisions are substantially similar to provisions contained in HCS/SCS/SB 146 (2015) and HCS/HB 634 (2015).

HEALTHCARE PROFESSIONALS WORKFORCE DATA - 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.

These provisions are identical to HCS/HB 112 (2015).

OPINIONS ISSUED BY BOARDS UNDER THE DIVISION OF PROFESSIONAL REGISTRATION - 324.023

This act provides that certain professional boards and commissions, as specified in the act, which license professions may issue oral or written opinions addressing topics relating to the qualifications, functions, or duties of any profession licensed by such board or commission. The opinions are for educational purposes, are not binding on the licensee, and cannot be used as the basis for discipline against a licensee. A board or commission shall not address topics relating to the qualifications, functions, or duties of any profession licensed by a different board or commission.

This provision is similar to provisions contained in HCS/SCS/SB 146 (2015), HCS/SS/SB 58 (2015), HCS/SB 392 (2015), HCS/SS/SB 457 (2015), and HCS/HB 422 (2015).

PHYSICIAN LICENSURE - 334.040, 334.280

This act removes provisions of law stating that the State Board of Registration for the Healing Arts shall not issue physician or surgeon's licenses or administer the Missouri state board examination to anyone who fails to achieve a passing score on licensing examinations within three attempts.

The act also removes the requirement that steps one, two, and three of the United States Medical Licensing Examination must be taken within a seven year period with no more than three attempts on any step of the exam.

These provisions are identical to SB 411 (2015) and similar to SS/SB 400 (2015) and HCS/HBs 671 & 683 (2015).

This act also provides that the state shall not require maintenance of licensure, as defined in the act, as a condition of physician licensure or any form of specialty medical board certification to practice medicine within the state. The State Board of Registration for the Healing Arts or any other state agency shall not discriminate against physicians who do not maintain specialty medical board certification.

This provision is identical to HB 683 (2015) and provisions contained in SS/SB 400 (2015).

COLLABORATIVE PRACTICE ARRANGEMENTS - 334.104

The act states that when a physician reviews pursuant to a collaborative practice arrangement an advanced practice registered nurse's delivery of health care services, which includes chart review, the collaborating physician need not be present at the health care practitioner's site.

Current law provides that an advanced practice registered nurse shall practice with the collaborating physician continuously present for one-month before practicing in a setting where the collaborating physician is not continuously present. This act states that this requirement does not apply to collaborative arrangements between a physician and an advanced practice registered nurse if the collaborative physician is new to a patient population to which the collaborating advanced practice registered nurse, assistant physician, or assistant physician is already familiar.

These provisions are identical to provisions contained in HCS/SCS/SB 146 (2015).

SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS - 345.015, 345.020, 345.025, 345.040, 345.050, 345.051, 345.065, 345.077, 345.080

The act also modifies provisions of law relating to the licensing of speech-language pathologists and audiologists.

The act provides that a speech-language pathology assistant must work under the direction of a speech-language pathologist who has been practicing for at least one year and is licensed by the state, employed by a federal agency, or licensed by the Missouri Department of Elementary and Secondary Education.

An applicant for registration with the Board as a speech-language pathology assistant must submit to the Board supervising speech-language pathologist information if employment is confirmed, and if not then such information must be provided after registration. An applicant must complete bachelor's level course work and clinical requirements in the field of speech-language pathology as established by the Board through rules and regulations.

The act repeals the requirement that a corporation engaged in the business of speech-language pathology or audiology who employs licensed persons must file a statement with the Board specifying that the corporation submits itself to the rules and regulations of the Board.

Current licensing requirements do not apply to a person who holds a valid certificate as a speech-language pathologist issued by the Missouri Department of Elementary and Secondary Education. This act states that licensing requirements shall not apply to such persons who hold a current certificate issued by the Department prior to January 1, 2016. Licensing requirements shall also not apply to a person completing the required number of clinical hours required to obtain registration as a speech-language pathology assistant as long as the person is under the direct supervision of a licensed speech-language pathologist and has not completed more than the number of hours required.

The act repeals provisions of law which require an applicant for licensure as a speech-language pathologist or audiologist to present written evidence of completion of a clinical fellowship.

This act states that following administrative hearing proceedings and a finding that grounds for disciplinary action have been met the Board may restrict or limit the person's ability to practice for an indefinite period of time.

All speech-language pathology assistants shall provide and maintain at all times employment information as the board deems necessary.

The act also states that no person who has served as a member of the Advisory Commission for Speech-Language Pathologists and Audiologist for two consecutive terms may be reappointed until a lapse of a least two years has occurred following the completion of the persons two consecutive terms.

Provisions of this act are similar to SCS/SB 146 (2015) and to SB 885 (2014).

CRIME VICTIMS' COMPENSATION FUND - 595.010, 595.015, 595.030

The act allows the family or next of kin of a deceased crime victim to sign a notarized statement designating a funeral home as a claimant eligible for compensation from the Crime Victims' Compensation Fund.

The definition of claimant for purposes of the statutes related to the fund is modified under this act to include a funeral home designated to receive compensation.

This provision is identical to SB 333 (2015) and HB 390 (2015).

JESSI BAKER