HCS/SB 528 - This act modifies various provisions regarding professional licensure. EMPLOYEES ENGAGED IN HAIR BRAIDING AT PUBLIC AMUSEMENT VENUES The act provides that an employee or employer who primarily engages in the practice of combing, braiding, or curling hair without the use of harmful chemicals shall not be subject to the licensing requirements of cosmetologists or barbers under chapter 329 while working with a licensee for a public amusement or entertainment venue (316.265). This provision is identical to provisions contained HCS/SCS/SB 672 (2014), HCS/SB 717 (2014) and to provisions contained in the truly agreed to and finally passed version of SB 808 (2014). SOCIAL SECURITY NUMBERS IN PROFESSIONAL LICENSING APPLICATIONS Under current law, every application for a renewal of a professional license, certificate, registration, or permit must contain the applicant's Social Security number. This act states that an application for a professional license renewal only has to include a Social Security number in situations where the original application did not contain a Social Security number. After the initial application for license renewal which includes a Social Security number, an applicant is no longer required to provide a Social Security number in subsequent renewal applications. This provision is substantially similar to SB 289 and SB 314 (2013) and identical to HCS/HB 2131 (2014) and to provisions contained in the truly agreed to and finally passed version of SB 808 (2014). COLLABORATIVE PRACTICE ARRANGEMENTS WITH ASSISTANT PHYSICIANS This act allows certain medical school graduates to obtain a temporary assistant physician license in order to enter into "assistant physician collaborative practice arrangements" with a physician. An assistant physician collaborative practice arrangement shall limit the assistant physician to providing only primary care services and only in medically underserved rural or urban areas of this state or in any pilot project areas. An "assistant physician", is defined as any medical school graduate who has passed the prescribed medical examinations and who has not entered into postgraduate residency training prescribed by rule of the State Board of Registration for the Healing Arts. The act prescribes the other requirements to be licensed as an assistant physician and specifies certain practices an assistant physician cannot perform. The collaborating physician is responsible at all times for the oversight of the activities of, and accepts responsibility for primary care services rendered by the assistant physician. A licensed assistant physician shall enter into an assistant physician collaborative practice arrangement within six months of his or her initial licensure and shall not have more than a six-month time period between collaborative practice arrangements during his or her licensure period (334.035, 334.036, 334.037). These provisions are substantially similar to SB 847 (2014) and identical to provisions contained in HCS/HB 1842 (2014), HCS/HB 1793 (2014), and provisions contained in the truly agreed to and finally passed versions of SB 754 (2014) and SB 716 (2014). PHYSICIAN ASSISTANTS The act specifies that physician assistants may enroll with the Department of Social Services as a Medicaid provider while acting under a supervision agreement with a physician (334.735). This provision is identical to provisions contained in the truly agreed to and finally passed versions of SB 716 (2014), SB 808, and SB 754 (2014). ADVANCED PRACTICE REGISTERED NURSE Under the act an advanced practice registered nurse is a person licensed and authorized to engage in the practice of advanced practice professional nursing, and accountable for the quality of care rendered and for consulting with or referring patients to other providers, when appropriate, and recognizing the scope of APRN practice. Advanced practice registered nursing is defined as the performance of advanced nursing with advanced education and specialized training, and includes the performance of certain acts specified in the act such as patient assessment, performing tests and procedures, and ordering medications in accordance with prescriptive authority. All licensed APRNs are authorized to prescribe medication and prescribe, administer, and dispense samples. The act provides application requirements in order to become licensed as an APRN. Once an APRN license has been issued, the license holder's APRN license and RN license shall be treated as one license for renewal purposes(335.016, 335.036, 335.046, 335.056, 335.086). These provisions are substantially similar to SCS/SB 659 (2014) and HB 1491 (2014). CLINICAL SOCIAL WORKER Currently, an applicant for clinical social worker or advanced macro social worker licensure must complete three thousand hours of supervised experience within forty-eight months. This act states that an applicant who completes at least four thousand hours of supervised experience within forty-eight calendar months shall be eligible for application of licensure at three thousand hours and shall be furnished a certificate by the State Committee for Social Workers acknowledging the completion of additional hours (337.615, 337.645). The act also specifies that a licensed master social worker shall not practice independently the scope of practice reserved for clinical social workers or advanced macro social workers (337.643). These provisions are identical to HB 1875 (2014) and to provisions contained in the truly agreed to and perfected version of SB 808 (2014). PHARMACY The act adds to the description of the "practice of pharmacy" the administration of hepatitis A, hepatitis B, diphtheria, tetanus, and pertussis vaccines by written protocol authorized by a physician. Also, a pharmacist shall administer vaccines in accordance with the treatment guidelines established by the Centers for Disease Control and Prevention and rules jointly promulgated by the Board of Pharmacy and the State Board of Registration for the Healing Arts. A pharmacist shall receive additional training for the administration of vaccines as required by the Board of Pharmacy. Within fourteen days of administering a vaccine a pharmacist shall provide specified information to the patient's primary health care provider (338.010). This provision is identical to provisions contained in HCS/SB 717 (2014) and the truly agreed to and finally passed versions of SB 754 (2014), SB 716 (2014), and SB 808 (2014). The act provides that a federally employed pharmacist who does not hold him or herself out as a Missouri licensed pharmacist and who is engaged in the practice of pharmacy while in the performance of official duties shall not require a Missouri pharmacist license (338.020). This provision is identical to SB 717 (2014), HB 1636 (2014), and provisions contained in HCS/HB 2131 (2014), and the truly agreed to and finally passed version of SB 808 (2014). The act provides that pharmacists may label prescription drugs using either a sequential number or a unique identifier (338.059). The act states that the Board of Pharmacy may inspect Class B hospital pharmacies that are not under the inspection authority of the Department of Health and Senior Services. The Board and the Department of Health and Senior Services may jointly promulgate rules governing medication services by a pharmacist at or within a hospital. A drug distributor license is not required to transfer medication from a Class B hospital pharmacy to a hospital clinic for patient care. Medication dispensed by a hospital to a hospital patient for use outside of the hospital shall be dispensed only by a prescription order for medication therapy from a physician. All pharmacists providing medication therapy services must obtain a certificate of medication therapeutic plan authority as provided by rule. There shall be an advisory committee, with members appointed by the Board, which will make recommendations to the Board and review all rules jointly promulgated by the Board and the Department (338.165). The act defines a "Class B Hospital Pharmacy," and provides that any hospital that holds a pharmacy license on the effective date of the act shall be eligible to obtain a Class B pharmacy license without the payment of a fee (338.220). These provisions are substantially similar to provisions contained in SCS/SB 942 (2014), HCS/SB 717 (2014), HB 2285 (2014), and HCS/SB 2131 (2014), and the truly agreed to and finally passed versions of SB 808 (2014) and SB 754 (2014). HEARING INSTRUMENT SPECIALISTS The act modifies the definition of "hearing instrument" or "hearing aid" by adding language to provided that a wearable instrument is one which provides more than fifteen decibel full-on gain via a two cc coupler at any single frequency from two hundred through six thousand cycles per second (346.010). In order to obtain a license as a hearing instrument specialist the applicant must successfully pass a qualifying examination (346.055). These provisions are identical to provisions contained in the truly agreed to and finally passed version of SB 808 (2014) and similar to HB 1988 (2014). MEDICALLY UNDERSERVED AREAS The act provides that the Department of Health and Senior Services shall establish and administer a program to increase the number of medical clinics in medically underserved areas. A county or municipality may establish a medical clinic in an underserved area by contributing start up money for the clinic and may qualify for a matching grant disbursed by the Department from the "Medical Clinics in Medically Underserved Areas Fund", which is established in the act. The Department of Health and Senior Services shall not provide more than one hundred thousand dollars to such county or municipality in a fiscal year unless the Department makes a specific finding of need in the area. The Department shall also promulgate rules establishing eligibility criteria for a medically underserved area, the requirement that a medical clinic utilize an assistant physician in a collaborative practice arrangement, and establish minimum and maximum start up contributions to be matched with grant money and disbursement of such funds (Section 1). JESSICA BAKER