SB 501 Modifies provisions relating to health care
Sponsor: Sater
LR Number: 2231S.03T Fiscal Notes
Committee: Seniors, Families and Children
Last Action: 7/14/2017 - Signed by Governor Journal Page: S1923-1924
Title: CCS HCS SB 501 Calendar Position: 17
Effective Date: Varies
House Handler: Stephens

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Current Bill Summary


CCS/HCS/SB 501 - This act modifies several provisions relating to health care, including: (1) health care records; (2) a health care directives registry; (3) drug or alcohol overdoses; (4) epinephrine auto-injectors; (5) hospital licensure; (6) immunization education; (7) sports medicine; (8) assistant physicians; (9) physician assistants; (10) psychologist internships; (11) vaccine protocols; (12) speech-language pathologists and audiologists; (13) medication-assisted treatment; and (14) a drug take-back program.

HEALTH CARE RECORDS (Section 191.227)

This act changes the fees for the search, retrieval, and copying of a patient's health care records by a health care provider. Additionally, a health care provider may disclose a deceased patient's health care records or payment records to specified persons in the act.

This provision is identical to a provision in SCS/HCS/HB 381 (2017) and HCS/HB 144 (2017).

HEALTH CARE DIRECTIVES REGISTRY (Section 194.600)

This act requires the Department of Health and Senior Services to contract with a third party for the establishment of a health care directives registry for the purpose of providing a place to securely store an advance health care directive online and to give authorized health care providers immediate access to the directive. The third party contractor shall be solely responsible for the administration and maintenance of the registry. All data and information contained in the registry shall remain confidential and shall be exempt from the Sunshine Law. An "advance health care directive" is defined as either a power of attorney for health care or a declaration signed by an adult declarant containing the person's direction concerning a health care decision.

All documents shall be submitted electronically to the registry at intake points, such as licensed health care providers and licensed attorneys, and signed electronically with a unique identifier, such as a Social Security number, a driver's license number, or another unique government-issued identifier. The electronic submission shall be accompanied by a fee not to exceed ten dollars.

The Department may promulgate rules to carry out these provisions, which may include, but not be limited to, a determination of who may access the registry, including physicians, other licensed health care providers, the declarant, and his or her legal representative or designee.

This provision is identical to a provision in CCS/SB 50 (2017) and SB 887 (2016) and substantially similar to SS/SCS/SB 122 (2015).

DRUG OR ALCOHOL OVERDOSES (Sections 195.205 and 195.206)

Under this act, a person who, in good faith, seeks or obtains medical assistance for himself or herself or someone else who is experiencing a drug or alcohol overdose or other medical emergency shall not be arrested, charged, prosecuted, convicted, or have his or her property subject to civil forfeiture or otherwise penalized for offenses specified in the act if the evidence, charge, prosecution, conviction, seizure, or penalty was gained as a result of seeking or obtaining medical assistance.

This act shall not prevent a police officer from arresting a person for an outstanding warrant or prevent a person from being arrested, charged, or prosecuted based on an offense other than the specified offenses in the act, whether the offense arises from the same circumstances as the seeking of medical assistance. Additionally, the protection from prosecution under this act for possession offenses shall not be grounds for suppression of evidence or dismissal in charges unrelated to this act.

Finally, any police officer who is in contact with any person or persons in need of emergency medical assistance under this act shall provide appropriate information and resources for substance-related assistance.

This provision is identical to HB 294 (2017).

Additionally, this act gives the Director of the Department of Health and Senior Services, or a licensed physician with the express written consent of the Director if the Director is not a licensed physician, the authority to issue a statewide standing order for an opioid antagonist. A physician issuing such an order shall not be subject to any criminal or civil liability or professional disciplinary action associated with the order.

This provision is identical to a provision in HCS/HB 1197 (2017).

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. 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 locations where 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 also 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 the EPI auto-injector or has been previously diagnosed with an allergy. The employee or agent shall not administer or provide the auto-injector to a person who is eighteen years of age or younger without the verbal consent of a parent or guardian who is present at the time, unless the child will be in imminent danger without the use of the auto-injector.

The act specifies the required training and the procedures for making the EPI auto-injectors available to individuals other than trained persons, as long as the auto-injectors are secured and properly stored. The act also requires all basic life support ambulances and stretcher vans to be equipped with EPI auto-injectors and staffed by at least one person trained in the use of the auto-injectors.

This act exempts certain persons and entities from liability for any injuries or related damages that result from the administration or self-administration of an EPI auto-injector in accordance with the provisions of the act that may constitute ordinary negligence. The immunity shall not apply to acts or omissions constituting reckless disregard for the safety of others, or willful or wanton conduct, and shall be in addition to and not in lieu of the protections provided under the Good Samaritan emergency law. No trained person who is in compliance with this law and who in good faith and with reasonable care fails to administer the EPI auto-injector shall be liable for that failure.

This provision is identical to HB 761 (2017) and SB 677 (2016), substantially similar to SS/SCS/SB 26 (2015) and HB 96 (2015), and similar to SB 868 (2014) and HB 1568 (2014).

HOSPITAL LICENSURE (Sections 197.005, 197.040, 197.050, 197.070, 197.071, 197.080, and 197.100)

Under this act and beginning July 1, 2018, compliance with Medicare conditions of participation shall be deemed to constitute compliance with the standards for hospital licensure in this state. Nothing in this act shall preclude the Department of Health and Senior Services from promulgating regulations, with specific statutory authorization, to define separate regulatory standards that do not duplicate the Medicare conditions of participation. Regulations promulgated by the Department that duplicate or conflict with Medicare conditions of participation shall lapse and expire on and after July 1, 2018.

These provisions contain a delayed effective date of July 1, 2018.

These provisions are identical to provisions in CCS/SB 50 (2017) and SB 518 (2017) and substantially similar to HB 1069 (2017).

IMMUNIZATION EDUCATION (Section 198.053)

Under this act, all Missouri assisted living facilities shall, no later than October 1 each year, notify residents and staff where in the facility the latest edition of the Vaccine Informational Sheet published by the Centers for Disease Control and Prevention has been posted. Nothing in this act shall be construed to require any assisted living facility to pay for an influenza vaccination, allow the Department of Health and Senior Services to promulgate any rules to implement this provision, or cite any facility for acting in good faith to post the Vaccine Informational Sheet.

This provision is identical to a provision in HCS/SCS/SB 334 (2017) and HCS/SB 363 (2017) and similar to HB 778 (2017).

PROFESSIONAL REGISTRATION (Section 324.003)

This act provides the acceptable ways in which a professional licensee may submit payment, application, requests for educational time extensions, or notify his or her licensing board for changes to items required as part of licensure to the Division of Professional Registration or its component boards, committees, offices, and commissions.

This provision is substantially similar to a provision in HCS/SB 125 (2017).

SPORTS MEDICINE (Section 334.010)

This act permits a physician to travel into Missouri with an athletic team and provide sports-related medical services to specified individuals related to the athletic team, band, dance team, or cheerleading squad, so long as the physician is currently licensed to practice medicine in another state and has a written agreement with an athletic team located in the state where the physician is licensed. The act prohibits such physician from providing medical services at a health care facility in Missouri.

This provision is identical to SB 494 (2017), SCS/HCS/HB 122 (2017), and SCS/HB 815 (2017).

ASSISTANT PHYSICIANS (Section 334.036)

This act modifies the definition of "assistant physician" to allow any medical school graduate who has met the requirements to be an assistant physician between August 28, 2014, and August 28, 2017, to be deemed to be in compliance with the requirements of becoming an assistant physician.

This provision is identical to a provision in CCS/SB 50 (2017) and HCS/HB 330 (2017).

PHYSICIAN ASSISTANTS (Section 334.735)

Under current law, physician assistants may only dispense drugs, medicines, devices, or therapies pursuant to a physician supervision agreement. This act removes this requirement.

This provision is identical to SB 455 (2017) and substantially similar to a provision in SCS/HB 815 (2017).

PSYCHOLOGIST INTERNSHIPS (Sections 337.010 and 337.025)

This act changes the experience requirements for initial licensure as a psychologist. Under the provisions of the act, supervised professional experience may be accrued through preinternship, internship, predoctoral postinternship, or postdoctoral experiences. Each applicant shall complete 1,500 hours or supervised professional experience as part of his or her required internship, along with an additional 2,000 hours through preinternship, predoctoral postinternship, internship, or postdoctoral experiences.

These provisions are identical to SB 397 (2017) and substantially similar to provisions in SCS/HCS/HB 316 (2017).

VACCINE PROTOCOLS (Section 338.010)

This act requires pharmacists to administer vaccines by protocol in accordance with treatment guidelines established by the Centers for Disease Control and Prevention.

SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS (Section 345.051)

This act provides that license renewal for speech-language pathologists and audiologists shall occur no less frequently than every three years. Additionally, the continued competence requirements for licensed speech-language pathologists and audiologists may include up to 30 hours triennially of continuing education, examination, self-evaluation, peer review, performance appraisal, or practical simulation.

This provision is identical to a provision contained in CCS/SB 50 (2017), HCS/SB 125 (2017), and SCS/HB 815 (2017) and similar to a provision contained in HB 813 (2017).

MEDICATION-ASSISTED TREATMENT (Sections 478.004 and 487.200)

This act allows participants in drug courts, family courts, and veterans courts to receive medication-assisted treatment under the care of a licensed physician if the participant requires such treatment for substance abuse dependence. A participant assigned to a substance abuse treatment program for substance abuse or dependence shall not be in violation of the terms or conditions of the program on the basis of his or her participation in medication-assisted treatment.

These provisions are identical to provisions contained in HCB 1 (2017), HCS/HB 219 (2017), and HCS/HB 1197 (2017) and similar to HB 710 (2017).

DRUG TAKE-BACK PROGRAM (Section 1)

This act gives the Missouri Board of Pharmacy the ability to allocate funds to develop a drug take-back program to collect and dispose of Schedule II and III controlled substances.

This provision is substantially similar to a provision in HCS/HB 1197 (2017).

JAMIE ANDREWS