Missouri Senate

Senate Committee Substitute

MEDICAL PRECEPTORSHIP TAX CREDIT (Section 135.690)

For all tax years beginning on or after January 1, 2023, this act authorizes a taxpayer to claim a tax credit for serving as a community-based faculty preceptor for a medical student core preceptorship or a physician assistant student core preceptorship, as such terms are defined in the act. The tax credit shall be equal to $1,000 for each preceptorship, but not to exceed $3,000 in any tax year. Tax credits authorized by the act shall not be refundable or transferable, and shall not be carried forward or backward to any other tax year. The total amount of tax credits authorized in a given year shall not exceed $200,000. Additional tax credits may be authorized provided in amount not to exceed the excess funds available in the Medical Preceptor Fund, as created by the act.

Beginning January 1, 2023, the Division of Professional Registration of the Missouri Department of Commerce and Insurance shall increase the license fees for physicians and surgeons by $7 and for physician assistants by $3, with such revenues to be deposited in the Medical Preceptor Fund. At the end of each tax year, an amount equal to the total dollar amount of tax credits claimed during the tax year shall be transferred to the General Revenue Fund.

This provision is substantially similar to a provision in HCS/SB 710 (2022), SCS/SB 801 (2022), a provision contained in SS/HB 502 (2021), HCS/SCS/SB 403 (2021), HCS/SS/SB 580 (2020), and HB 2036 (2020).

ALZHEIMER'S STATE PLAN TASK FORCE (Sections 172.800 and 191.116)

This act repeals an obsolete reference to the Alzheimer's Disease and Related Disorders Task Force. Additionally, the act changes the date that the Alzheimer's State Plan Task Force shall submit a report of recommendations from June 1, 2022, to January 1, 2023, and extends the task force expiration date from December 31, 2026, to December 31, 2027.

These provisions are identical to provisions in SCS/SB 1045 (2022).

MEDICAL STUDENT LOAN PROGRAMS (Sections 191.500, 191.515, 191.520, 191.525, 335.230, and 335.257)

This act modifies provisions of current law relating to the medical student loan program administered by the Department of Health and Senior Services by adding psychiatry, dental surgery, dental medicine, or dental hygiene students to the list of eligible students in the program, as well as adding psychiatric care, dental practice, and dental hygienists to the definition of "primary care". Additionally, this act modifies the loan amount students may be eligible to receive from $7,500 each academic year to $25,000 each academic year.

This act also modifies the Nursing Student Loan Program by modifying the amount of financial assistance available to students from $5,000 each academic year for professional nursing programs to $10,000 each academic year and from $2,500 each academic year for practical nursing programs to $5,000 each academic year.

Finally, this act modifies the Nursing Student Loan Repayment Program by removing the June and December deadlines for qualified employment verification while retaining the requirement that such employment be verified twice each year.

These provisions are identical to SB 757 (2022) and provisions in SCS/SB 1045 (2022).

THE OLDER AMERICANS ACT (Sections 192.005, 251.070, and 660.010) This act transfers authority for the implementation of the federal Older Americans Act of 1965 from the Department of Social Services to the Department of Health and Senior Services.

These provisions are identical to provisions in SCS/SB 1045 (2022).

OVERSIGHT OF HEALTH CARE FACILITIES (Sections 192.2225, 197.100, 197.256, 197.258, 197.415, 198.006, 198.022, 198.026, 198.036, 198.525, 198.526, and 198.545)

Currently, the Department of Health and Senior Services conducts at least two inspections per year for licensed adult day care programs, at least one of which is unannounced. Under this act, the Department shall be required to conduct at least one unannounced inspection per year.

Currently, the Department conducts an annual inspection of licensed hospitals. Under this act, such inspections shall instead be performed in accordance with the schedule set forth under federal Medicare law.

A hospice currently seeking annual renewal of its certification shall be inspected by the Department of Health and Senior Services. Under this act, the Department may conduct a survey to evaluate the quality of services rendered by the applicant. Additionally, current law requires annual inspections of a certified hospice and this act instead requires such inspections to be performed in accordance with the schedule set forth under federal Medicare law.

Currently, the Department conducts an inspection of licensed home health agencies at least every 1 to 3 years, depending on the number of months the agency has been in operation following the initial inspection. Under this act, such inspections shall instead be performed in accordance with the schedule set forth under federal Medicare law.

This act updates a reference to a Missouri regulation regarding long-term care facility orientation training.

Current law requires the Department to inspect long-term care facilities at least twice a year, one of which shall be unannounced. Under this act, the Department shall be required to conduct at least one unannounced inspection per year. Additionally, current law requires that the Department issue a notice of noncompliance or revocation of a license by certified mail to each person disclosed to be an owner or operator of a long-term care facility. This act instead requires that such notice be sent by a delivery service to the operator or administrator of the facility.

Finally, this act modifies the "Missouri Informal Dispute Resolution Act" relating to informal dispute resolutions between the Department of Health and Senior Services and licensed long-term care facilities. Current law requires the Department to send to a facility by certified mail a statement of deficiencies following an inspection. This act requires that such notice be sent by a delivery service that provides dated receipt of delivery. Additionally, current law provides a facility ten calendar days following receipt of notice to return a plan of correction to the Department. This act changes the ten calendar days to ten working days.

These provisions are identical to SB 1029 (2022) and provisions in SCS/SB 1045 (2022) and substantially similar to provisions of SB 342 (2021).

ORGAN DONATION (Sections 194.210, 194.255, 194.265, 194.285, 194.290, 194.297, 194.299, 194.304, 194.321, 301.020, and 302.171)

This act modifies the "Revised Uniform Anatomical Gift Act". Currently, moneys in the Organ Donor Program Fund are limited to use for grants by the Department of Health and Senior Services to certified organ procurement organizations for the development and implementation of organ donation programs, publication of informational booklets, maintenance of an organ donor registry, and implementation of organ donation awareness programs in schools. This act modifies the fund to be used by the Department for educational initiatives, donor family recognition efforts, training, and other initiatives, as well as reimbursement for expenses incurred by the Organ Donation Advisory Committee. The Department shall no longer be required to disperse grants to organ procurement organizations, but shall have the authority to enter into contracts with such organizations or other organizations and individuals for the development and implementation of awareness programs. The fund may seek other sources of moneys, including grants, bequests, and federal funds.

Currently, applicants for motor vehicle registrations and driver's licenses may make a one dollar donation to the Organ Donor Program Fund. This act changes that to a donation of not less than one dollar.

These provisions are identical to SB 1146 (2022) and provisions in SCS/SB 1045 (2022).

This act prohibits hospitals, physicians, procurement organizations, or other person from considering COVID-19 vaccination status of a potential organ transplant recipient or potential organ donor in any part of the organ transplant process.

This provision is identical to a provision in HB 1861 (2022) and HCS/HBs 2358 & 1485 (2022).

MEDICAL MARIJUANA FACILITY BACKGROUND CHECKS (Section 195.815)

Under current law, the Department of Health and Senior Services requires all officers, managers, contractors, employees and support staff of licensed or certified medical marijuana facilities to submit fingerprints for background checks. Under this act, only employees, contractors, owners, and volunteers shall be required to submit fingerprints.

This provision is identical to HB 1736 (2022), SB 939 (2022), and a provision in HB 2623 (2022).

HOME HEALTH LICENSING (Sections 197.400 and 197.445)

Current law limits licensed home health agencies to those that provide two or more home health services at the residence of a patient according to a physician's written and signed plan of treatment. This act permits such licensed entities to provide treatment according to written plans signed by physicians, nurse practitioners, clinical nurse specialists, or physician assistants, as specified in the act.

These provisions are identical to SCS/SB 830 (2022) and substantially similar to provisions in HCS/HB 2434 (2022) and SB 177 (2021).

EXEMPTIONS FOR PROFESSIONAL LICENSING (Sections 324.005 and B)

Under this act, a professional who has a current license to practice his or her profession from another state, commonwealth, territory, or the District of Columbia shall be exempt from Missouri licensure requirements if: (1) the professional is an active duty or reserve member of the Armed Forces, a member of the National Guard, a civilian employee of the U.S. Department of Defense (DOD), an authorized contractor under federal law, or a professional otherwise authorized under the DOD; (2) the professional practices the same occupation or profession for which he or she holds a current license; and (3) the professional is engaged in the practice of a profession through a partnership with the federal Innovative Readiness Training program within the DOD. This exemption shall only apply while: (1) the professional's practice is required by the program pursuant to military orders; and (2) the services provided by the professional are within the scope of practice for individual's respective profession in Missouri.

This provision has an emergency clause.

These provisions are identical to provisions in SCS/SB 1153 (2022) and SS/HB 2149 (2022).

MISSOURI DENTAL BOARD PILOT PROJECTS (Section 332.325)

This act authorizes the Missouri Dental Board, in collaboration with the Department of Health and Senior Services and the Office of Dental Health within the Department of Health and Senior Services, to approve pilot projects designed to examine new methods of extending care to under-served populations. Such projects may employ techniques or approaches to care that may necessitate a waiver of statute or regulation and shall follow the requirements of the act regarding scope, content, and reports.

The provisions of this act shall expire on August 28, 2026, and a report of the pilot projects approved by the Board shall be submitted to the General Assembly no later than December 1, 2025.

This provision is identical SCS/SB 993 (2022) and provisions in SCS/SB 1153 (2022) and SS/HB 2149 (2022).

PHYSICAL THERAPISTS (Sections 334.530 and 334.655)

Currently, a candidate for a physical therapy or physical therapist assistant license shall submit evidence of completion of physical therapy education program to the Board of Registration for the Healing Arts. This act adds that candidates may submit evidence of eligibility to graduate from such a program within 90 days. Additionally, this act requires applicants to meet the qualifying standards for fitness to practice examinations, including those established by any entity contracted by the Board to administer the Board-approved examination. No person who has failed on 6 or more occasions to achieve a passing score on the examination shall be eligible for licensure by examination.

These provisions are identical to provisions in SS/HB 2149 (2022) and SCS/SB 1153 (2022).

AUDIOLOGISTS AND SPEECH-LANGUAGE PATHOLOGISTS (Sections 345.015, 345.022, 345.050, 345.052, and 345.085)

This act modifies provisions relating to audiology and speech-language pathology. In order to be eligible for licensure by the State Board of Registration for the Healing Arts by examination under this act, each applicant shall present written evidence of completion of a clinical fellowship. Any person in a clinical fellowship shall hold a provisional license to practice speech-language pathology or audiology and shall be issued a license if the person meets requirements set forth in the act.

This act modifies provisions relating to license reciprocity. Currently, those applicants who are licensed in another country or hold a certificate of competence issued by the American Speech-Language-Hearing Association may receive a license without an examination. This act repeals this provision and implements a provision permitting any person who, for at least one year, has held a valid, current license issued by another state, a branch or unit of the military, a U.S. territory, or the District of Columbia, to apply for an equivalent Missouri license through the Board, subject to procedures and limitations as provided in the act.

This act also adopts the Audiology and Speech-Language Pathology Interstate Compact. The purpose of the compact is to increase access to audiology and speech-language pathology services by providing for the mutual recognition of other member state licenses. The compact sets forth requirements that must be met in order for a state to join the compact. Each member state shall require an applicant to obtain or retain a license in the home state and meet the home state's qualifications for licensure or renewal of licensure as well as all other applicable state laws.

The compact creates a joint public agency known as the Audiology and Speech-Language Pathology Compact Commission. The Commission has powers and duties as listed in the compact and shall enforce the provisions and rules of the compact. The Commission shall provide for the development, maintenance, and utilization of a coordinated database and reporting system containing licensure, adverse action, and investigative information on all licensed individuals in member states.

The compact shall come into effect on the date on which the compact is enacted into law in the 10th member state. Any member state may withdraw from the compact by enacting a statute repealing the same. The compact shall be binding upon member states and shall supersede any conflict with state law.

These provisions are identical to SCS/SB 978 (2022), provisions in SCS/SB 1153 (2022).

MEDICAL RETAINER AGREEMENTS (Section 376.1800)

Current law allows for physicians to enter into contracts for the provision of health care services to an individual for an agreed-upon fee and period of time. This act provides that chiropractors and dentists may enter into the contracts as well.

This provision is identical to SCS/SB 1097 (2022) and similar to HCS/HB 2340 (2022).

REPEAL OF CERTAIN STATUTES RELATING TO THE DUTIES OF THE DEPARTMENT OF HEALTH AND SENIOR SERVICES (Sections 191.743, 196.866, and 196.868)

Currently, physicians or health care providers who are providing services to women with high-risk pregnancies are required to identify such women and report them to the Department of Health and Senior Services within 72 hours for referral for services. The provision authorizing Department services for such women has previously been repealed and this act repeals the reporting requirements for the physicians and health care providers.

Additionally, producers of ice cream, mellorine, or other frozen dessert products are required to be licensed by the Department and pay an associated license fee. This act repeals such requirement and fee.

These provisions are identical to SB 1100 (2022) and provisions in SCS/SB 1045 (2022).

SARAH HASKINS