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HCS/SB 9 - This act modifies provisions related to the regulation of certain professions. ADAPTIVE QUESTIONNAIRES IN TELEHEALTH AND TELEMEDICINE This act modifies the definition of "telehealth" and "telemedicine" to include the use of adaptive questionnaires as part of asynchronous store-and-forward technology. Such adaptive questionnaires shall be sufficient to establish an informed diagnosis as though a medical interview or physical examination has been performed in person, for purposes of establishing a physician-patient relationship through telemedicine, including for purposes of prescribing any drug, controlled substance, or other treatment. The use of adaptive questionnaires shall not constitute an "electronic visit" subject to certain security and recordkeeping requirements in current law for purposes of insurance coverage of telehealth services. (Sections 191.1145, 191.1146, 334.108, and 376.1900) These provisions are identical to provisions in HCS/SB 330 (2021) and are similar to SB 284 (2021) and HCS/HB 495 (2021). MILITARY LICENSE RECIPROCITY Current law provides that any person who for at least one year has held a valid, current license issued by another state, a U.S. territory, or the District of Columbia, which allows the person to legally practice an occupation or profession in such jurisdiction may apply for an equivalent Missouri license through the appropriate oversight body, subject to procedures and limitations provided in current law. This act allows any person who holds a valid, current license issued by a branch or unit of the military to also apply for an equivalent Missouri license. (Section 324.009) These provisions are identical to provisions in HCS/SB 330 (2021) and substantially similar to provisions in the truly agreed HB 476 (2021) and the truly agreed CCS/SS#2/SCS/HB 273 (2021). OCCUPATIONAL THERAPY LICENSURE COMPACT This act adopts the Occupational Therapy Licensure Compact. The Compact allows eligible occupational therapists and occupational therapy assistants licensed in member states to practice in other member states, subject to the requirements and limitations described in the Compact. The Compact establishes procedures for a licensee to apply for a new home state license in a member state of primary residence based on their licensure in another member state. Active-duty military personnel and their spouses shall retain home state licensure during the period of active duty service without having to maintain residency. Under the Compact, only a home state may take adverse action on the home state license, while remote member states may take adverse action against the licensee's privilege to practice in the remote state. The Compact provides procedures for how member states shall coordinate in various aspects of adverse actions and investigations. The Compact establishes the Occupational Therapy Compact Commission as a joint public agency to implement and administer the Compact. The Commission may collect an annual assessment on member states or impose fees on other parties to cover its costs. The Compact creates qualified immunity from suit and liability for agents of the Commission for negligent misconduct within the scope of the agents' work with the Commission. Such agents shall also be entitled to representation and indemnity in civil actions for such misconduct. Under the Compact, the Commission shall develop a data system containing information on all licensees related to licensure, adverse actions, and investigations. Member states shall report certain information, as described in the Compact, to the Commission for use in the data system. Legislatures of member states may reject any rule promulgated by the Commission by a majority of such legislatures enacting a statute or resolution. The Compact provides procedures for oversight, dispute resolution, and enforcement of the Compact, including procedures for default and termination of membership. The Commission may also sue a member state in federal court to enforce compliance with the Compact, its rules, and its bylaws. The Compact shall become effective upon its enactment in at least ten states. The Compact supersedes all other laws that conflict with provisions of the Compact to the extent of the conflict. (Section 324.093) These provisions are identical to provisions in HCS/SB 330 (2021), SS/HB 542 (2021), the truly agreed CCS/SS#2/SCS/HB 273 (2021), and the truly agreed HB 476 (2021). PROFESSIONAL LICENSING OF INDIVIDUALS WITH CRIMINAL RECORDS Under current law, an individual with a criminal record may petition a licensing authority for a determination of whether the criminal record will disqualify the individual from obtaining a professional license. This act requires licensing authorities to notify the petitioner in writing of the grounds and reasons if the authority determines that the petitioner is disqualified. This act also removes an exemption for certain licensing authorities listed in current law from the petition requirements. This act also removes a provision in current law requiring licensing authorities to only list criminal convictions directly related to the licensed occupation for purposes of the Fresh Start Act of 2020. (Section 324.012) These provisions are identical to SCS/SB 308 (2021) and to provisions in HCS/SB 220 (2021), the truly agreed HB 476 (2021), and the truly agreed CCS/SS#2/SCS/HB 273 (2021). APPLICATION OF THE DIETITIAN PRACTICE ACT Current law provides that, for purposes of provisions of law regulating the practice of nutrition and dietetics, "medical nutrition therapy" shall mean nutritional diagnostic, therapy, and counseling services furnished by a registered dietitian or register dietitian nutritionist. Under this act, "medical nutrition therapy" shall instead mean the provision of nutrition care services for the treatment or management of a disease or medical condition. (Section 324.200) Under this act, no provision of law governing licensed dieticians shall interfere with any person credentialed in the field of nutrition providing advice, counseling, or evaluations related to food, diet, or nutrition within his or her scope of practice if such services do not constitute medical nutrition therapy under the Dietician Practice Act. Prior to performing any service to which the law governing licensed dieticians does not apply under the act, a credentialed non-dietician shall provide his or her name, title, business address and telephone number, a statement that he or she is not a licensed dietician, a statement that his or her information or advice may constitute alternative care, and his or her qualifications. (Section 324.206) These provisions are identical to provisions in HCS/SB 330 (2021) and the truly agreed CCS/SS#2/SCS/HB 273 (2021), are similar to SB 232 (2021), HCS/HB 475 (2021), SB 893 (2020), and HB 2000 (2020). ARCHITECTS Current law sets forth the practice of an architect in Missouri as any person who renders or offers to render or represent himself or herself as willing or able to render service or creative work which requires architectural education, training and experience. Under this act, the practice of architecture is modified to include the rendering or offering to render services in connection with the design and construction of public and private buildings, structures and shelters, site improvements, in whole or part, which have as their principal purpose human occupancy or habitation. The act sets forth the services that may be included in the practice of architecture. Only a person with the required architectural education, practical training, relevant work experience, and licensure may practice as an architect in Missouri. (Section 327.091) Current law prohibits any person from practicing architecture in Missouri unless and until such person is licensed or certificated to practice architecture in the state. Current law also exempts certain persons from this requirement. This act repeals provisions exempting persons who render architectural service in connection with the construction, remodeling, or repairing of certain commercial or industrial buildings or structures or structures containing less than two thousand square feet. All other persons exempt from the licensing requirement may engage in the practice of architecture, provided such person does not use the title "architect" or other terms set forth in the act that indicate or imply that such person is or holds himself or herself out to be an architect. This act also exempts any person who renders architectural services in connection with the construction, remodeling, or repairing of any building or structure used exclusively for agriculture purposes from the licensing requirement. Current law also exempts any person who renders architectural services in connection with the construction, remodeling or repairing of any privately owned building set forth in the act, provided such person indicates on any documents furnished in connection with such services that the person is not a licensed architect. This act repeals certain privately owned buildings from the list of buildings such person may provide services for, and adds any one building which provides for the employment, assembly, housing, sleeping, or eating of not more than 9 persons, contains less than 2,000 square feet and is not part of another building structure. (Section 327.101) Current law permits any person to apply for licensure as an architect who holds a certified Intern Development Program record with the National Council of Architectural Registration Boards. Under this act, such person may also hold a certified Architectural Experience Program record. (Section 327.131) These provisions are identical to provisions in HCS/SB 330 (2021) and similar to provisions in HCS/HB 481 (2021), SCS/SB 257 (2021), the truly agreed CCS/SS#2/SCS/HB 273 (2021), the truly agreed HB 476 (2021), HCS/SCS/SBs 673 & 560 (2020), SB 992 (2020), and HB 2575 (2021). PROFESSIONAL ENGINEERS Current law prohibits any person from practicing as a professional engineer in Missouri unless and until such person is licensed or certificated to practice engineering in the state. Current law also exempts certain persons from this requirement, including any person who is a regular full-time employee of a person, who performs professional engineering work for the person's employer if certain conditions are met. Under this act, such exempted persons shall not use the title "professional engineer" or other terms set forth in the act that indicate or imply that such person is or holds himself or herself out to be a professional engineer. This act also exempts any person who renders professional engineering services in connection with the construction, remodeling, or repairing of any privately owned building, as set forth in the act, and professional engineering services rendered in connection with a building or structure used exclusively for agriculture, so long as the person rendering either such type of services indicates on any documents furnished in connection with such services that the person is not a licensed professional engineer. Any person who renders engineering services in connection with the remodeling of any privately owned, multiple family dwelling house, flat, or apartment containing 3 or 4 families is also exempt, provided certain conditions are met. (Section 327.191) This act repeals provisions in current law requiring any person entitled to be licensed as a professional engineer to be licensed within 4 years after the date on which he or she is entitled to be licensed, and providing that if such person is not licensed within that time, the Engineering Division of the Board may require him or her to take and satisfactorily pass an examination before issuing him or her a license. (Section 327.241) These provisions are identical to provisions in HCS/SB 330 (2021) and HCS/HB 481 (2021), and are substantially similar to SCS/SB 257 (2021), SS/HB 542 (2021), the truly agreed CCS/SS#2/SCS/HB 273 (2021), and the truly agreed HB 476 (2021), and are similar to provisions in HCS/SCS/SBs 673 & 560 (2020), SB 992 (2020), and HB 2575 (2021). LANDSCAPE ARCHITECTS Current law permits any person who is of good moral character, 21 years of age, who has a degree in landscape architecture, and has at least three years of landscape architectural experience to apply to the Missouri Board for Architects, Professional Engineers, Professional Land Surveyors and Professional Landscape Architects for licensure as a professional landscape architect. This act repeals the age requirement, and also provides that an applicant who may not have a degree in landscape architecture may instead have an education which, in the opinion of the Board, equals or exceeds the education received by a graduate of an accredited school. This act also requires an applicant to have taken and passed all sections of the landscape architectural registration examination administered by the Council of Landscape Architectural Registration Boards. (Section 327.612) These provisions are identical to provisions in HCS/SB 330 (2021) and HCS/HB 481 (2021), and are substantially similar to SCS/SB 257 (2021), SS/HB 542 (2021), the truly agreed CCS/SS#2/SCS/HB 273 (2021), and the truly agreed HB 476 (2021), and are similar to provisions in HCS/SCS/SBs 673 & 560 (2020), SB 992 (2020), and HB 2575 (2021). DENTISTRY Under this act, the practice of dentistry shall include the prescription and administration of vaccines related to dental care. The act authorizes a dentist to prescribe and administer vaccines to a person with whom the dentist has established a patient relationship or during an emergency for which the physician has been deployed by the Governor or a state agency. The Missouri Dental Board shall recognize one or more training courses on the storage, prescription, and administration of vaccines, as described in the act. A dentist prescribing and administering vaccines shall obtain a certificate of successful completion of such a training course to be produced upon request. The dentist shall inform the patient that the administration of the vaccine will be entered into the ShowMeVax system administered by the Department of Health and Senior Services. The patient shall sign a form provided by the dentist consenting to the inclusion of such information into the system. If the patient does not want such information shared in the ShowMeVax system, the dentist shall provide a written report within 14 days of administration of the vaccine to a patient's primary care provider, if provided by the patient. Dentists shall also be required to review the patient's vaccination history in the ShowMeVax system, prior to administering a vaccine, and comply with all applicable recordkeeping requirements. A dentist shall not delegate the administration of a vaccine or administer a vaccine to a child under the age of 7 or under ages recommended by the Centers for Disease Control and Prevention. (Sections 332.071 and 332.368) These provisions are identical to provisions in HCS/SB 330 (2021) and similar to SB 322 (2021). This act authorizes the Missouri Dental Board to collaborate with the Department of Health and Senior Services and the Office of Dental Health to approve pilot projects to examine new methods to extend care to underserved populations, including techniques that are inconsistent with or unauthorized by existing states and rules if the pilot project's plan has a clearly state objective that the Board approves, has finite start and termination dates, clearly defines the new methods to demonstrate whether the methods improve access to or quality of care, identifies specific and limited locations and populations for participation, clear minimum guidelines and standards to protect patient safety, clearly-defined measurement criteria to evaluate outcomes, and intervals for reporting outcomes to the Board during and at the end of the project. (Section 332.600) These provisions shall expire on December 31, 2026. These provisions are identical to provisions in HCS/SB 330 (2021). PRISONER COMPLAINTS AGAINST A PSYCHOLOGIST'S LICENSE Under current law, if the State Committee of Psychologists finds merit to a complaint made by a prisoner under the care and control of the Department of Corrections or who has been ordered to be taken into custody, detained, or held as a sexually violent predator, and takes further investigative action, no documentation may appear on file nor may any disciplinary action be taken in regards to the licensee's license unless there are grounds for the denial, revocation, or suspension of a license. This act includes complaints made by individuals who have been ordered to be evaluated in a criminal proceeding involving mental illness. Under this act, a psychologist subject to the complaint by an individual who has been ordered to be evaluated in a criminal proceeding involving mental illness prior to August 28, 2021, may submit a written request to destroy all documentation regarding the complaint, and notify any other licensing board in another state, or any national registry who had been notified of the complaint, that the Committee found the complaint to be unsubstantiated. (Section 337.068) These provisions are identical to provisions in SS/HB 542 (2021), HCS/SB 330 (2021), the truly agreed CCS/SS#2/SCS/HB 273 (2021), the truly agreed HB 476 (2021), and SB 556 (2020), and are substantially similar to HB 1962 (2020) and provisions in HB 319 (2021) and HCS/SCS/SBs 673 & 560 (2020). MATT KIMMINAU
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