HCS/SB 204 - This act modifies provisions relating to professional registration.
COLLABORATIVE PRACTICE ARRANGEMENTS (Sections 193.015, 195.100, 334.037, 334.104, 334.108 334.735, 334.736, 334.747, 334.749, 338.010, 630.175, and 630.875)
This act removes the definitions of "supervision", "physician assistant supervision agreement", and references to "supervision agreement" or "supervising physician" and replaces such references with "collaborative practice arrangement" or "collaborating physician". "Collaborative practice arrangement" is defined as a written agreement, jointly agreed upon protocols, or standing orders for the delivery of health care services.
A physician assistant, or an assistant physician in a collaborative practice arrangement with a physician may, under this act, prescribe any drug, controlled substance, or other treatment that is within his or her scope of practice to a patient based solely on a telephone evaluation if a previously established and ongoing physician-patient relationship exists between the physician and patient. (Section 334.108)
Under this act, a physician assistant is defined as a person who has graduated from a physician assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant, prior to 2001, or the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Programs, rather than a person accredited by the American Medical Association's Committee on Allied Health Education and Accreditation.
Current law requires a supervising physician designated in a supervision agreement to see a patient for evaluation and approve or formulate a plan of treatment for new or significantly changed conditions no more than two weeks after the patient has been seen by a physician assistant. Such supervising physician shall determine and document the completion of at least a one-month period of time during which the physician assistant shall practice with the supervising physician continuously present before practicing in a setting where a supervising physician is not continuously present. This act repeals such provisions.
Under this act, a physician may enter into a collaborative practice arrangement with a physician assistant. Such arrangements, which shall be in writing, may delegate to a physician assistant the authority to prescribe, administer, or dispense drugs, and provide treatment which is within the skill, training, and competence of the physician assistant. Such arrangements may delegate the authority to administer, dispense, or prescribe controlled substances listed in Schedules III, IV, and V, and Scheduled II-hydrocodone. Schedule III and Schedule II-hydrocodone prescriptions shall be limited to a 12-hour supply without a refill. Such arrangement shall include certain provisions set forth in the act.
Within 30 days of any change, and upon each renewal of an arrangement, the State Board of Registration for the Healing Arts shall require every physician to identify whether the physician is engaged in any collaborative practice arrangement, and report to the Board the name of each physician assistant with whom the physician has entered into such an arrangement. Such information may be made available to the public, and the Board is required to track the reported information.
A collaborating physician shall determine and document the completion of a period of time during which the physician assistant shall practice with the physician before practicing in a setting where the collaborating physician is not continuously present. This limitation, however, shall not apply to collaborative arrangements of providers of population-based public health services. No arrangement shall require a physician assistant to collaborate with any physician against the physician assistant's will. (Section 334.735)
These provisions are identical to provisions contained in HB 705 (2019).
LICENSING OF MILITARY SPOUSES (Section 324.009)
Current law allows any resident of Missouri who holds a valid current license issued by another jurisdiction to submit an application for a license in Missouri in the same occupation or profession for which such person holds the current license, along with proof of current licensure in the other jurisdiction, to the relevant oversight body in this state.
This act would allow any nonresident military spouse, to apply for a license in Missouri, provided such person also submits proof of current licensure in any jurisdiction and any required application fee.
The oversight body shall waive any examination, educational, or experience requirements for licensure for the applicant within 90 days, rather than within six months, of receiving such application, if it determines that the licensing requirements in the jurisdiction that issued the applicant's license are substantially similar to or more stringent than Missouri's licensing requirements.
Current law states that the law shall be interpreted so as to imply no conflict between it and any compact, or reciprocity agreement with other states in effect on August 28, 2018. Under this act, should any conflict arise between this act and the provisions of any compact or reciprocity agreement, the provisions of such compact or agreement shall prevail. Should a conflict arise between the provisions of the act and federal law or rule, the provisions of federal law or rule shall prevail.
Nonresident military spouses are eligible, under this act, to apply for a license with any board, department, agency, or office of a jurisdiction that issues licenses, including the boards set forth in the act.
This act repeals the provisions relating to the issuance of a temporary courtesy license to a nonresident spouse of an active duty member of the military.
This provision is identical to HB 1140 (2019), and is substantially similar to SCS/SB 476 (2019).
EXPANDED WORKFORCE ACCESS ACT (Section 324.025)
This act shall be known as the "Expanded Workforce Access Act of 2019".
Beginning on January 1,2020, each state licensing authority shall grant a license to any applicant who has successfully completed the eighth grade, completed an apprenticeship approved by the appropriate licensing authority or the U.S. Department of Labor, and has passed the required licensure examination, if one is deemed to be necessary under state law.
The appropriate licensing authority shall establish a passing score for such examinations, which shall not exceed the passing score that is required for a non-apprenticeship license. If there is no examination requirement for a non-apprenticeship license, no examination shall be required for applicants who complete an apprenticeship.
The number of working hours required for an apprenticeship shall not exceed the number of educational hours otherwise required for a non-apprenticeship license.
This act is substantially similar to SCS/SB 470 (2019), SB 318 (2019) and is similar to HB 472 (2019).
OCCUPATIONAL FEES (Section 324.035)
Under this act, no board, commission, or committee within the Division of Professional Registration shall utilize occupational fees, or any other fees associated with licensing requirements, or contract or partner with any outside vendor or agency for the purpose of offering continuing education classes.
This provision is identical to a provision in HB 705 (2019).
LICENSING REQUIREMENTS FOR COSMETOLOGISTS (Section 329.050)
Current law requires cosmetologist students to complete 1,500 hours of training to be licensed. Under this act, all student applicants are required to complete no less than 1,000 hours, for the classification of hairdresser.
Current law requires students to complete no less than 400 hours of training for the classification of manicurist. Under this act, when the classified occupation of manicurist is taken in conjunction with the classified occupation of cosmetologist, the student shall not be required to serve the extra 400 hours otherwise required to include manicuring of nails.
Current law requires all students to complete no less than 750 hours of training for the classification of esthetician. However, when the classified occupation of esthetician is taken in conjunction with the classified occupation of cosmetologists, the student shall not be required to serve the extra 500 hours otherwise required to include the practice of esthetics.
This provision is identical to a provision contained in HCS/HB 472 (2019).
EMBALMING APPRENTICESHIPS (Section 333.041)
This act permits an applicant for an embalmer's license to continue to be employed by a funeral establishment where the applicant successfully completed an embalming apprenticeship for up to six months pending the successful completion of all other licensure requirements, or until the applicant's embalmer's license is issued, whichever comes first.
An applicant shall not continue to practice as an embalmer apprentice without providing written notice to the State Board of Embalmers and Funeral Directors to extend his or her apprenticeship registration for up to six months. The Board shall grant the extension upon receipt of the written notice.
This provision is identical to HB 816 (2019) and a provision in SCS/HB 705 (2019).
LICENSING OF PHYSICAL THERAPISTS (Section 334.506 and 334.613)
This act modifies provisions relating to the scope of practice for physical therapists.
Under current law, a physical therapist is prohibited from initiating treatment for a new injury or illness without a prescription from an approved health care provider. This act allows a physical therapist to evaluate and initiate treatment on a patient without a prescription or referral from an approved provider provided that the physical therapist has a Doctorate of Physical Therapy degree or has completed five years of clinical practice as a physical therapist.
Current law allows a physical therapist to examine and treat any person with a recurring self-limited injury within one year of diagnosis by an approved health care provider, or a chronic illness that has been previously diagnosed, without the prescription and direction of an approved health care provider. Physical therapists are required to contact the patient's provider within 7 days of initiating services, not change an existing referral available without approval of the patient's provider, refer an approved health care provider to any patient whose medical condition is determined to be beyond the scope of practice of the physical therapist, refer a health care provider to any patient whose condition for which the services have not been improving after 6 visits, or 14 days, and notify the patient's provider prior to the continuation of treatment.
This act repeals such provisions, and requires a physical therapist to refer to an approved health care provider any patient whose condition is determined to be beyond the scope of practice, or any patient who does not demonstrate measurable or functional improvement after 10 visits or 21 business days, or consult with a provider if, after such time, the patient has demonstrated measurable or functional improvement and the therapist believes that continuation of physical therapy or treatment is reasonable and necessary. The physical therapist, however, is prohibited from providing further services after such time period until a consultation with the health care provider has occurred. Continued physical therapy services or treatment following the consultation with a provider shall proceed in accordance with the direction of the provider, and the physical therapist shall notify the provider of continuing physical therapy services every 30 days after the initial consultation, unless otherwise directed.
This act repeals the provision of current law providing that certain physical therapy treatments may be delegated by physical therapists to physical therapist assistants if the patient's provider has been informed.
This act repeals the provision of current law permitting the State Board of Registration for the Healing Arts to file a complaint with the Administrative Hearing Commission against any physical therapist who is practicing or offering to practice professional physical therapy independent of the prescription and direction of a person licensed and registered as a physician and surgeon, physician's assistant, chiropractor, dentist, podiatrist, or advanced practice registered nurse, and instead allows such a complaint to be filed against any candidate for licensure or any licensed physical therapist who evaluates or treats a patient in a manner inconsistent with the act.
These provisions are substantially similar to HCS/HB 410 (2019) and are similar to HB 2090 (2018).
CONTINUING EDUCATION REQUIREMENTS FOR OPTOMETRISTS (Section 336.080)
This act adds a provision requiring a licensed optometrist to obtain two hours, out of the required 32 hours of continuing education, in the area of Missouri jurisprudence.
This provision is identical to a provision contained in SCS/HB 705 (2019).
PSYCHOLOGIST LICENSEES (Sections 337.020 and 337.029)
Under current law, any person seeking to obtain a license as a psychologist shall make an application to the Committee of Psychologists and shall pay the required application fee. The Committee is not permitted to charge an application fee until such time as the application has been approved, and if an application is denied, no application fee shall be charged. This act repeals such provision.
Current law permits a psychologist licensed in another jurisdiction to receive a license in Missouri, provided the psychologist passes a written exam on Missouri law and regulations governing the practice of psychology. Such person must also meet one of several listed criteria set forth under current law. This act removes one listed criteria allowing a psychologist who is currently licensed or certified as a psychologist in another jurisdiction that is then a signatory to the Association of State and Provincial Psychology Board's reciprocity agreement to be eligible for a license in Missouri.
PSYCHOLOGIST LICENSE RENEWAL (Section 337.050)
When applying for a renewal of a license, a psychologist shall submit proof of the completion of at least 40 hours of continuing education credit within the two-year period immediately preceding the date of the application for renewal of the license, with a minimum of three out of the 40 hours of continuing education dedicated to professional ethics.
This provision is identical to a provision contained in HB 705 (2019).
LICENSING OF PLUMBERS (Section 341.170)
This act removes the age requirement for applicants for licensure to become master plumbers, journeyman plumbers, and master drainlayers.
This provision is identical to a provision contained in HCS/HB 472 (2019).
PROPERTY DESCRIPTIONS (Section 442.135)
Under this act, if a property is subdivided and a new property description is created, such description shall include the name and professional license number of the person that created the property description.
This act prohibits any person from submitting for recording, a conveyance of any property unless the property description receives such information.
This provision is identical to HCS/HB 770 (2019).
HA #1: THIS AMENDMENT CHANGES THE TITLE FROM "PROFESSIONAL LICENSURE" TO "PROFESSIONAL SERVICES".
HA #2: THIS AMENDMENT MODIFIES PROVISIONS RELATING TO PRISONER COMPLAINTS AGAINST A PSYCHOLOGIST LICENSE (SECTION 337.068) AND REAL ESTATE LICENSEES. (SECTION 339.190)
PROVISIONS OF THIS AMENDMENT RELATING TO PRISONER COMPLAINTS AGAINST A PSYCHOLOGIST LICENSEE ARE IDENTICAL TO HB 441 (2019), AND ARE SUBSTANTIALLY SIMILAR TO SB 451 (2019). PROVISIONS RELATED TO REAL ESTATE LICENSEES ARE IDENTICAL TO HCS/HB 106 (2019), AND SUBSTANTIALLY SIMILAR TO SB 36 (2019).
HA # 3: THIS AMENDMENT CREATES A STATEWIDE MECHANICAL CONTRACTOR LICENSE, AND MODIFIES PROVISIONS RELATING TO ADVANCED PRACTICE REGISTERED NURSES.
PROVISIONS OF THIS AMENDMENT ARE IDENTICAL TO HB 326 (2019), SCS/HCS/HB 301 (2019), AND ARE SUBSTANTIALLY SIMILAR TO SB 376 (2019).
HA #4: THIS AMENDMENT MODIFIES PROVISIONS RELATING TO A TAX CREDIT FOR CONTRIBUTIONS TO A PREGNANCY RESOURCE CENTER.
HA #5: THIS AMENDMENT MODIFIES PROVISIONS RELATING TO CERTIFICATES OF AUTHORITY FOR ARCHITECTS, ENGINEERS, LAND SURVEYORS, AND LANDSCAPE ARCHITECTS.
HA #6: THIS AMENDMENT REMOVES HAIR CLEANSING FROM THE DEFINITION OF "CLASS CH - HAIRDRESSER".
THIS AMENDMENT IS IDENTICAL TO HCS/HB 349 (2019).
HA #7: THIS AMENDMENT MODIFIES PROVISIONS RELATING TO PAYMENTS FOR HEALTH CARE SERVICES. (SECTIONS 374.500 TO 376.1385)
PROVISIONS OF THIS AMENDMENT ARE SIMILAR TO HCS/HB 751 (2019), SCS/SB 298 (2019).
HA #8: THIS AMENDMENT ESTABLISHES THE TAXPAYER PROTECTION ACT.
THIS AMENDMENT IS SUBSTANTIALLY SIMILAR TO HB 943 (2019) AND HB 585 (2019).
HA #9: THIS AMENDMENT MODIFIES PROVISIONS RELATING TO INSURANCE HOLDING COMPANIES. THIS AMENDMENT IS IDENTICAL TO HB 632 (2019), SB 54 (2019), AND IS SUBSTANTIALLY SIMILAR TO SB 347 (2019) .
HA #10: THIS AMENDMENT MODIFIES PROVISIONS RELATING TO HEALTH CARE, AND ESTABLISHES THE TASK FORCE ON SUBSTANCE ABUSE PREVENTION AND TREATMENT, AND THE "ENSURING ACCESS TO HIGH QUALITY CARE FOR THE TREATMENT OF SUBSTANCE USE DISORDERS ACT."
PROVISIONS OF THIS AMENDMENT ARE SIMILAR TO SCS/HB 240(2019) and HCS/SB 275 (2019), SS/HB 219 (2019).
HA #11: THIS AMENDMENT MODIFIES PROVISIONS RELATING TO HEALTH CARE, INCLUDING REMOVING THE SUNSET PROVISION ON THE UTILIZATION OF TELEHEALTH BY NURSES.
THIS AMENDMENT IS SIMILAR TO PROVISIONS CONTAINED IN SS/HB 219 (2019) AND SB 358 (2019)
HA #12: THIS AMENDMENT MODIFIES PROVISIONS FOR ACCESS TO ANTIPSYCHOTIC DRUGS FOR MO HEALTHNET USERS.
THIS AMENDMENT IS SUBSTANTIALLY SIMILAR TO HB 867 (2019).
HA #13: THIS AMENDMENT REQUIRES THE BOARD OF REGISTRATION FOR THE HEALING ARTS TO ESTABLISH EDUCATIONAL PROGRAMS FOR AN EMERGENCY MEDICAL TECHNICIAN-PARAMEDIC TO RECEIVE THE EDUCATION AND TRAINING NEEDED TO BECOME A PHYSICIAN ASSISTANT.
HA # 14: THIS AMENDMENT MODIFIES THE DEFINITION OF "INTOXICATING LIQUOR TO INCLUDE "POWDERED ALCOHOL".
THIS AMENDMENT IS SUBSTANTIALLY SIMILAR TO HB 65 (2019).