CCS#2/HCS/SCS/SB 716 - This act modifies provisions relating to public health. MENINGOCOCCAL VACCINE (Section 174.335) Under this act, each student attending a public institution of higher education who lives in on-campus housing must receive the meningococcal vaccine unless he or she has a medical or religious exemption. This provision is identical to a provision in CCS/HCS/SS#2/SB 754 (2014); and similar to SCS/HCS/HB 2125 (2014) and SCS/SB 748 (2014). UMBILICAL CORD BLOOD BANK (Section 191.761) Beginning July 1, 2015, this act requires the Department of Health and Senior Services to transport collected, donated umbilical cord blood samples to a nonprofit umbilical cord blood bank located in St. Louis City in existence as of the effective date of the act. The collection sites shall only be those facilities designated and trained by the blood bank in the collection and handling of umbilical cord blood specimens. This provision is identical to a provision in CCS/HCS/SS#2/SB 754 (2014); SCS/HCS/HB 2125(2014)and HCS/HB 1193 (2014). DIABETES CARE AND CONTROL (Section 191.990) The MO HealthNet Division and the Department of Health and Senior Services shall collaborate to coordinate goals and benchmarks in each individual agency's plans to reduce the incidence of diabetes in Missouri, improve diabetes care, and control complications associated with diabetes. A report on such collaboration shall be submitted to the General Assembly by January 1 of each odd-numbered year. The act specifies the topics to be addressed in the report regarding diabetes. The requirement of this act shall be limited to diabetes information, data, initiatives, and programs within each agency prior to the effective date of this act, unless there is unobligated funding for diabetes in each agency that may be used for new research, data collection, reporting, or other requirements of this act. This provision is identical to a provision in CCS/HCS/SS#2/SB 754(2014); SCS/HCS/HB 2125(2014). SHOW-ME ECHO PROGRAM (Section 191.1140) Subject to appropriations, the University of Missouri shall manage the "Show-Me Extension for Community Health Care Outcomes (ECHO) Program". The Department of Health and Senior Services shall collaborate with the University of Missouri in utilizing the program to expand the capacity to safely and effectively treat chronic, common, and complex diseases in rural and underserved areas of the state and to monitor outcomes of such treatment. The program is designed to utilize current telehealth technology to disseminate knowledge of best practices for the treatment of chronic, common, and complex diseases from a multidisciplinary team of medical experts to local primary care providers who will deliver the treatment protocol to patients, which will alleviate the need of many patients to travel to see specialists and will allow patients to receive treatment more quickly. The program shall utilize local community health care workers with knowledge of local social determinants as a force multiplier to obtain better patient compliance and improved health outcomes. This provision is identical to HB 2154 (2014) and to a provision in CCS/HCS/SS#2/SB 754(2014); SCS/HCS/HB 2125 (2014). COLLABORATIVE PRACTICE ARRANGEMENTS WITH ASSISTANT PHYSICIANS (Sections 195.070, 334.035, 334.036, 334.037, Section 1) 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. These provisions are identical to provisions contained in CCS/HCS/SS#2/SB 754 (2014); HCS/HB 1842 (2014) and HCS/HB 1793 (2014) and substantially similar to SB 847 (2014). OFFERS OF INFLUENZA IMMUNIZATIONS (Section 197.168) Each year between October 1st and March 1st and in accordance with Centers for Disease Control and Prevention recommendations, each hospital shall offer prior to discharge immunizations against influenza virus to all inpatients 65 years of age and older unless contraindicated for such patient so long as there is approval of the attending physician or other practitioners authorized to order vaccinations or as authorized by physician-approved hospital policies or protocols for influenza. This provision is identical to a provision in CCS/HCS/SS#2/SB 754(2014); SCS/HCS/HB 2125 (2014). SHOW-ME HEALTHY BABIES (Section 208.662) This act establishes the Show-Me Healthy Babies Program within the Department of Social Services as a separate children's health insurance program for any low-income unborn child. For an unborn child to be eligible for enrollment in the program, the mother of the child must not be eligible for coverage under the Medicaid Program as administered by the state and must not have access to affordable employer-subsidized health care insurance or other affordable health care coverage that includes coverage for the unborn child. The unborn child must be in a family with income eligibility of no more than 300% of the federal poverty level or the equivalent modified adjusted gross income unless the income eligibility is set lower by the General Assembly through appropriations. The act delineates all of the parameters of the program. This act is identical to HB 1065 (2014) and to a provision in CCS/HCS/SS#2/SB 754 (2014); SCS/HCS/HB 2125 (2014). PHYSICIAN ASSISTANT AS A MO HEALTHNET PROVIDER (Section 334.735) This provision allows for a physician assistant to enroll with the Department of Social Services as a MO HealthNet provider while acting under a supervision agreement between the physician and physician assistant. This provision is identical to a provision in HCS/SB 528 (2014) and in CCS/HCS/SS#2/SB 754 (2014); HCS/SCS/SB 808 (2014). PHARMACIST PROVIDED VACCINATIONS (Section 338.010) 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. This provision is identical to a provision contained in HCS/SB 528 (2014); HCS/SCS/SB 808 (2014); HCS/HB 1683 (2014); CCS/HCS/SS#2/SB 754(2014); and SCS/HCS/HB 2125 (2014). INSURANCE BENEFIT DETERMINATIONS (Section 376.1363) This act reduces the time in which a health carrier must make a determination of benefits from two working days to 36 hours, including one working day, after obtaining all necessary information regarding a proposed admission, procedure, or service. This provision is substantially similar to a provision in SB 761(2014) and HCS/HB 1799 (2014). VULNERABLE PERSON ABUSE INVESTIGATIONS (Sections 630.017 and Section 2) This act provides that upon receipt of a report of possible vulnerable person abuse, the Department of Mental Health shall complete all investigations within 60 days, unless good cause for the failure to complete the investigation is documented. This act also provides procedures for the screening and assessment of persons receiving services from the Department that address the interaction between physical and mental health to ensure that all potential causes of changes in behavior or mental status caused by or associated with a medical condition are assessed. Such guidelines shall be issued by the Department. The Department shall develop training that addresses appropriate assessment of behavior or mental status changes. The provisions of this act relating to screening and assessments shall only apply to state owned or operated facilities and not to long-term care facilities or hospitals. ADRIANE CROUSE