HCS/SB 1124 – This act modifies the law related to professional licensing. PROFESSIONAL REGISTRATION The act enacts provisions regulating all licensees under the purview of the division of professional registration. The act stipulates notice requirements and disciplinary measures for tax arrearage. DEAF INTERPRETERS Deaf interpreters may renew their licenses within 60 days of completing military service without penalty when their licenses expire while serving. PROFESSIONS RELATED TO BOXING AND WRESTLING The act includes professional and amateur mixed martial arts in the law regulating the boxing, wrestling, kickboxing, and karate professions. The act requires participants in bouts relating to such professions to sign written bout contracts with promoters that contain information including the contestant’s weight, the date and location of the contest, and compensation and fees. The act allows the office of athletics in the division of professional registration to assess administrative penalties up to $2,000 for violations relating to licensure. BLASTING The Missouri Division of Fire Safety shall be responsible for issuing blasting licenses for a fee not to exceed one hundred dollars. The licenses shall expire three years from the date of issuance; any attempt to renew such a license shall require documentation that an additional eight hours of explosive-related training has been completed by the individual, of which half has been completed within the year prior to the renewal request. Any training above and beyond the eight hours required for renewal shall not carry over for more than one subsequent renewal of the license. Circumstances under which a license can be suspended or revoked are laid out in the act. The decision to suspend or revoke a license may be appealed by the individual to the state blasting safety board. Any decision by the board shall be made within thirty days from receiving the appeal. The act directs any person whose license has been expired for a period of three years or less to complete the required examination and attend eight hours of training. Licenses that have been expired for more than three years require the licensee to satisfy the qualifications for initial licensure, including completing twenty hours of training and passing the examination. License reciprocity is available to anyone holding a valid license or certification from another source within the last three years provided all requirements meet or exceed the provisions laid out in this act. License reciprocity may also be granted to anyone employed as a blaster on or before December 31, 2000 and who has accumulated one thousand hours of training or education and experience; other requirements for such reciprocity are described in the act. The burden of proof lays with the division with regard to investigating the requirements of other licenses or certifications as they relate to this particular license. The act details the courses of instruction offered by the division and the process for a course of instruction to approved by the division. The division is to approve a standard examination for license qualification, and a fee not to exceed fifty dollars shall accompany the exam. Any person guilty of loading or firing explosives without a valid license shall be guilty of a Class B misdemeanor for the first offense, and a Class A misdemeanor for the second offense. Anyone found convicted of a Class A misdemeanor for this violation shall be permanently prohibited from obtaining a blaster's license. The act lays out prescriptive requirements for blasting activity in the state, including details with regard to seismograph recordings. The act directs each person using explosives in the state to register with the state fire marshal within sixty days of the effective date of the legislation. Any person not required to register on the effective date and who subsequently uses explosives, shall register with the state fire marshal within thirty days after using the explosives. A registration fee of one hundred dollars shall accompany the registration, and an annual report to the state fire marshal shall be forthcoming from the individual stating any change or addition to the information laid out in the original report. Information required for the report is laid out in the act. A fee per ton shall be submitted annually with the report, the minimum being set at five hundred dollars. In addition to the minimum fee, any person using explosives during any year shall pay a fee of one dollar and fifty cents on each ton of explosives used, this fee may be changed by rule provided that it never exceed one dollar and fifty cents per ton. The act creates a state blasting safety board. Membership, terms in office, meeting times and responsibilities of the board are all laid out in the act. Duties for the Division of Fire Safety are laid out in the act with regard to the training, testing, and licensing discussed in the act. The act requires any person using explosives in the state to notify the Division of Fire Safety in writing or by telephone at least two business days in advance of first using the explosives at a site where blasting has not previously occurred. The act directs any person using explosives to notify, at least two business days in advance, the responsible municipality in the jurisdiction where the blasting is taking place as well as the appropriate fire protection official. Any person using explosives within a municipality shall notify the owner or occupant of any residence or business located within a scaled distance of fifty five from the blasting site; the names of those residences or businesses shall be provided by the municipality. The act allows municipalities to enact ordinances that build upon the regulations laid out in the act. The act preempts any existing regulation except those authorized by this act and any local ordinances in St. Charles county in effect as of April 5, 2006 that deal exclusively with quarries. MASSAGE THERAPY The act authorizes the board of therapeutic massage to establish requirements for granting licenses to individuals who have completed out of state programs consisting of at least 500 hours. Businesses may not employ unlicensed individuals to provide massage therapy services. Inspection reports must be sent to massage businesses within 30 business days following the inspection. Individuals licensed in other states may teach courses in the state related to massage therapy when working as a part of an emergency response team without a license in this state. Such individuals may also provide services at special events. PRIVATE INVESTIGATORS This act creates the Board of Private Investigator Examiners within the Division of Professional Registration in the Department of Economic Development. The Board will consist of five members appointed by the Governor with the advice and consent of the Senate. Each member must be a U.S. citizen, Missouri resident, at least 30 years old, and actively engaged as a private investigator for at least five years. Board members will serve staggered terms of two years. The Board of Private Investigator Examiners Fund is also created. The act makes it unlawful for persons to engage in the private investigator business unless licensed. Consumer reporting agencies, attorneys, collection agencies, and insurers are exempted from licensure. Application requirements are specified. Licensees must be at least 21, a U.S. citizen, and comply with qualifications set by the Board. Persons must also provide proof of liability insurance of at least $250,000, and proof of workers' compensation insurance. The Board shall ensure applicants complete a course of training conducted by a certified trainer; pass a written examination; and submit to an oral interview with the Board. Complete background checks will be conducted on all applicants. The act grandfathers current private investigators and a license will be issued to such persons who show registration and good standing as a business for two years and $250,000 in business general liability insurance. The Board is given authority to review reciprocity applications. Grounds for denial of licensure are specified. Persons hired by private investigators must apply for agency licenses separately. The act specifies standards for employees of agencies. The act sets continuing education requirements – 16 hours biennially for licensees and 8 hours for employees of agencies. The Board shall set the fees for licensure. Licenses must be posted in a conspicuous place in the principal place of business of the licensee. Pocket cards will also be issued to licensees. Licenses shall expire two years after issuance and provisions for renewal are provided. Licensees may divulge to the Board, law enforcement officers, or a prosecuting attorney information acquired as to any criminal offense. Licensees are prohibited from: knowingly making a false report; causing a report to be submitted that the licensee has not exercised due diligence in ascertaining the facts; giving the impression that the licensee is connected with the federal or state government or any political subdivision; appearing as an assignee in any proceeding; manufacturing false evidence; or creating a video of any person in their home without that person's permission. Restrictions on record keeping and advertising are specified. License disciplinary procedures are specified. The Board is given rulemaking authority. The Board shall certify qualified trainers of private investigators. Persons who knowingly falsify fingerprints or photographs required to be submitted is a Class D felony. Violation of other provisions is a Class A misdemeanor unless it is a second or subsequent violation in which case it is a Class D felony. Provisions for licensure of current law enforcement officers and limitations on their conduct are specified. DENTISTS Dentists must maintain dental records for at least 7 years from the last service or 5 years from the age of majority in the case of a minor. Lab work orders must also be retained for 7 years. HEALING ARTS Currently the State Board of Registration for the Healing Arts may revoke a physician’s license when such licensee is found guilty of a felony. The act extends this authority to cover all professions under the purview of the board. PHYSICIAN ASSISTANTS Under current law, physicians must exercise control over a physician assistant working in the same office facility of the supervising physician. The assistant may make follow-up patient examinations in hospitals, nursing homes and correctional facilities. This act requires physician assistants to provide services where the supervising physician regularly practices medicine. The physician must oversee the activities of and accept responsibility for the medical services rendered by the assistant and shall at all times be available immediately for consultation, assistance, or intervention in person or via telecommunications. The supervising physician must be personally present for supervision for 55 percent of clinic hours in any clinic location that uses assistants. The supervising physician must be no further than thirty minutes from the practice location when not personally present. Physician assistants practicing in federally designated health shortage areas may only practice at locations where supervising physicians are physically present for at least 30 percent of clinical hours and otherwise, no further than fifty miles by road using the most direct route. All applicants for physician assistant licensure who complete their training after January 1, 2007, shall have a master's degree from a physician assistant program. Physicians may only oversee three full-time equivalent licensed physician assistants. This provision does not apply to agreements of hospital employees providing in-patient care services. Physician assistants must practice for one month under supervision with the supervising physician continuously present before practicing in a setting where a supervising physician is not continuously present. The supervising physician must document the completion of this one-month period. Physician assistants must inform patients of their status as assistants and inform them of the opportunity to be seen by the supervising physician. In supervision agreements, the primary site of practice for the supervising physician must be designated. The board shall randomly review the agreements and practice under the agreements. Physicians shall not be required, by contract, to act as supervising physician for any assistant and the physician shall have the right to refuse to enter into the agreements. Contracts shall not limit the physician’s ultimate authority over protocols or standing orders or in the delegation of the physician's authority to any assistant. MEDICAL IMAGING This act creates the" Medical Imaging and Radiation Therapy Quality Assurance Act". Any person administering medical imaging and radiation therapy procedures is required to be licensed by the newly created Medical Imaging and Radiation Therapy Board of Examiners. Such Board shall be located with the division of professional registration. The act exempts certain health care professionals, such as physicians, dentists, chiropractors, podiatrists, registered nurses and certain qualified persons currently practicing medical imaging and radiation therapy from the licensure requirements. Certain education and experience requirements are enacted for applicants to be licensed as radiographers, radiation therapists, nuclear medicine technologists and dental radiographers. The act contains a grandfather provision that authorizes persons who have been practicing in three of the past five years to waive the required examination if such person demonstrates competency to the board and either passes a board-approved examination covering fundamental principles of radiographic imaging and safety or undergoes a review of medical facility training. If such persons cannot pass the board-approved examination within three attempts, then the person must submit to an on-site competency evaluation conducted by the board. Medical facilities, dental facilities, educational institutions and other public and private institutions wishing to offer programs in medical imaging and radiation therapy must meet certain requirements of the Board. The Board is granted additional powers to adopt rules, give examinations, issue temporary licenses, require continuing education as part of the renewal of a license renewal, and to discipline licensees. The act both requires the board in some instances and gives the board discretion in other instances to waive the examination, depending on the certification an applicant may possess. The Board shall investigate complaints, file charges, hold hearings, render judgements and hear appeals when warranted to seek discipline of a licensee. Further, the Board is granted subpoena power for the appearance of witnesses. The act creates the "Medical Imaging and Radiation Therapy Board of Examiners Fund" which shall receive all fees collected by the board. The act provides that none of the licensing requirements will take effect until such time as the board receives a specific appropriation and initial rules have been promulgated. Any violation of this act shall be a Class A misdemeanor. NURSES The state board of nursing may request an expedited hearing from the administrative hearing commission, if the board concludes the nurse has committed an act constituting clear and present danger to the public health and safety. After 15 days from the complaint, and after a preliminary hearing, the board may immediately restrict or suspend the license. Temporary authority to restrict or suspend the license becomes final if the nurse does not request a full hearing within thirty days. Dismissal of the action does not preclude subsequent action on the same grounds. If the licensee does not inform the board of the licensee’s current place of employment and residence, upon a violation of a disciplinary action and, if the licensee does not answer the default notice, the board may impose additional disciplinary actions without a hearing. COUNSELORS AND THERAPISTS The act creates the Board of Counselors and Therapists which combines the Committee for Professional Counselors and the State Committee of Marital and Family Therapists into one committee. Standards for reciprocal licenses are established. The act requires applicants for licensure to have completed a course of study leading to a master’s, specialist’s, or doctoral degree with a major in counseling and acceptable supervised counseling experience. SOCIAL WORKERS Currently, out of state licensed clinical social workers who have had no violations, suspensions or revocations may be licensed in Missouri if they have passed a written exam and either are licensed in another state, received a masters or doctoral degree from a program accredited by the council of social work education, have been licensed for five years, have not been the subject of disciplinary action, or are currently licensed in a state that has similar reciprocity laws. This act changes those requirements to allow out of state license holders who have not been the subject of disciplinary action for five years to be licensed if the applicant received a masters or doctoral degree from a program accredited by the council of social work education and has been licensed for five years, or is currently licensed in a state with substantially similar requirements. Continuing education requirements relating to ethics are required. PHARMACISTS This act allows the state board of pharmacy to grant a certificate of medication therapeutic plan authority to pharmacists. This authority will allow pharmacists to accept a prescription order for a medication therapeutic plan and administer the plan if the prescription order is specific to each patient for care by a specific pharmacist. Written protocol from the physician who refers the patient for medication therapy services is required and must only come from a physician and not under any person under a collaborative practice arrangement or supervision agreement. To earn a certificate the applicant must complete a board approved course of academic clinical study beyond a bachelors of science in pharmacy including clinical assessment skills. The state board of registration for the healing arts and the state board of pharmacy shall promulgate rules regulating prescription orders for medication therapy services. Amends the definition of "practice of pharmacy" to include the administration of vaccines by written protocol authorized by a physician and administering medication therapeutic plans. Veterinary prescription orders are also included in the definition. The act removes the one year limit for intern pharmacist licenses. The act bars persons other than the patient or the patient’s authorized representative to accept prescriptions unless the person is at a pharmacy. The board may issue and enforce cease and desist orders relating to unauthorized practices. Licensure requirements may be waived in the case of emergencies declared by the governor or by resolution of the legislature. REAL ESTATE BROKERS This act defines "advertising" for the purposes of real estate broker solicitations. Currently, communications of certain entities are not regulated with respect to real estate brokers when real estate advertising is incidental to the operations of the entity. This act adds "Internet communications" to this category. Under current law, an applicant for a broker license must be a licensed salesperson for at least one year or have, within six months of the application successfully completed the required curriculum from a school accredited by the Missouri Real Estate Commission. This act requires the applicant to be a licensed salesperson for at least two years and complete the required curriculum. Under current law a licensee's or applicant's license shall be revoked or refused if the licensee or applicant has pleaded guilty to or been found guilty of certain offenses. This act imposes the same action upon licensees or applicants that have pleaded nolo contendere to the same offenses. REAL ESTATE APPRAISERS Under the act, the Real Estate Appraisers Commission may administer oaths, issue and enforce subpoenas and demand the production of certain evidence in relation to a proceeding regarding real estate appraisers. The commission may also issue inactive certificates and licenses. In order to renew a license the applicant must present evidence amenable to the commission, of having completed adequate continuing education requirements. The commission may no longer waive continuing education requirements. VETERINARIANS The act gives the Missouri Veterinary Medical Board the authority to require application, registration, and examination fees by rule. NURSING HOME ADMINISTRATORS Under the act, if an applicant fails the examination required for licensure three times, the applicant must complete the board-prescribed course of instruction, reapply for the examination and pass the examination before he or she will be licensed. Examination scores from other states shall not be recognized after the applicant fails the examination for a third time. The Missouri Board of Nursing Home Administrators may renew a temporary emergency license if the applicant shows that the applicant is qualified for licensure, has filed for licensure and the examination results have not been received by the board. As an alternative to the refusal to issue or renew the license, the board may issue a probationary license. The order shall contain a statement of the terms and conditions of the probation and that the person subject to the probation has thirty days to request a hearing before the Administrative Hearing Commission. The board may cause a complaint to be filed with the Administrative Hearing Commission for a violation of any laws or regulations relating to convalescent, nursing or boarding homes, or a violation of professional trust or confidence. A complaint may also be filed if the individual has served as the operator or principal involved in the operation of a facility during which time the facility has had its license revoked, has entered into a consent agreement to contain a probationary license, or has had a license denied or surrendered while under investigation. The board may reject any application for five years for a licensee whose license has been revoked or surrendered. The act imposes certain qualifications for board members. Current licensees may request inactive status for their license if the licensee submits evidence of completion of ten hours of continuing education in the area of patient care. Inactive status shall expire on June 30th of the year following the year of issuance subject to renewal. Inactive status may be carried for six years before ultimate expiration. Procedures for reactivation are included in the act. HEALTH CARE PROFESSIONALS PEER REVIEW The act allows a board of trustees or chief executive officer of a licensed ambulance service, emergency response agency, or not-for-profit organization that provides or contracts for ambulance services to appoint persons to a peer review committee. DIVISION OF PROFESSIONAL REGISTRATION The director of the division shall retain personnel to render necessary services to the division and boards including accountants, lawyers and investigators. ADMINISTRATIVE HEARING COMMISSION The act allows for service by publication if service cannot be accomplished in person or by certified mail. Copies of findings of fact shall be mailed to the licensee and to any attorney representing the licensee. DISQUALIFICATION LISTS The Department of Health and Senior Services must provide disqualification lists to recognized schools of nursing, medicine or other health profession if requested. This act is similar to SS/SCS/SB 882, SCS/SB 1018, SCS/SB 1032, SCS/SB 897, SCS/SB 710, SB 1219, HB 1517, HB 1090, HB 1168, HB 1260, HB 1339, HB 1553, HB 1656, HB 1657, HB 1658, HB 1662, HB 1664, HB 1693, HCS/HB 1700, and HB 1823 (2006). CHRIS HOGERTY HA 1 – MODIFIES REPORTING REQUIREMENTS FOR COLLABORATIVE PRACTICE AND PHYSICIAN ASSISTANT AGREEMENTS. HA 2 – MODIFIES CONTINUING EDUCATION REQUIREMENTS AND RENEWAL OF REGISTRATION FOR ON-SITE DISPOSAL SYSTEMS CONTRACTORS. HA 3 – MODIFIES THE DEFINITION OF QUARRY FOR THE PURPOSES OF BLASTING REGULATIONS. HA 4 – MAKES TECHNICAL CORRECTIONS TO THE PROPOSED MISSOURI BLASTING SAFETY ACT. HA 5 – MODIFIES RECIPROCITY FOR OUT OF STATE HEALTH CARE PROVIDERS TO PRACTICE IN THE STATE IN CONJUNCTION WITH THE SUSAN G. KOMEN BREAST CANTER WALK. HA 6 – CORRECTS DATES IN SECTION 335.068. HA 7 – MODIFIES PROVISIONS RELATING TO PHARMACISTS TO ALLOW THE ADMINISTRATION OF VIRAL INFLUENZA VACCINES. HSA 1 TO HA 8 – MODIFIES LAW RELATING TO PHYSICIAN ASSISTANT AGREEMENTS. HA 9 – ESTABLISHES THE WELL-BEING COMMITTEE UNDER THE BOARD OF PHARMACY. HA 10 – STRIKES A PROVISION FROM THE BILL THAT BARRED PHYSICIANS FROM ENTERING A COLLABORATIVE PRACTICE ARRANGEMENT WITH A NURSE WHO EMPLOYS A COLLABORATING PHYSICIAN. HA 11 – EXEMPTS VETERINARIANS FROM PAYING MUNICIPAL OR CORPORATION TAX OR LICENSING FEES.