OPTOMETRISTS AND PHYSICIANS (Sections 167.194, 167.195, 192.195)

Beginning July 1, 2008, every child enrolling in kindergarten or first grade shall receive one comprehensive vision examination performed by a state licensed optometrist or physician.

The act requires the Department of Elementary and Secondary Education and the Department of Health and Senior Services to compile and maintain a list of sources to which children who may need vision examinations or children who have been found to need further examination or vision correction may be referred for treatment on a free or reduced cost basis. A child may be excused from taking a vision examination by submitting a written request to the appropriate school administrator.

Beginning July 1, 2008, all public school districts shall conduct an eye screening for each student once before the completion of first grade and again before the completion of third grade. The eye screening method shall be approved by the Children's Vision Commission, which is established in this act, and shall be performed by an appropriately trained school nurse or other trained and qualified employee of the school district. The screening results, with all identifying information removed, shall be sent, via electronic form, to the Department of Health and Senior Services.

The Children's Vision Commission shall be composed of seven members including two ophthalmologists, two optometrists, one school nurse, one representative from the Department of Elementary and Secondary Education, and one from the Missouri State School Boards Association. The duties of the Commission shall be to adopt standardized eye screening and examination tests, reporting forms, and appropriate training programs for school district staff. The Commission shall also conduct a pilot project to track the results of the eye screening versus eye examinations conducted based on the reports submitted by school districts to the Department of Health and Senior Services. By December 31, 2011, the Commission shall submit a report to the General Assembly detailing the results of the study along with data on the number of students who received a follow-up examination from an optometrist, ophthalmologist, physician, or doctor of osteopathy and the results of those examinations to determine the effectiveness of eye examinations versus eye screening. The Department of Health and Senior Services shall provide staff support to the Commission.

Further, the act alters the statutorily-allowed uses for the "Blindness Education, Screening and Treatment Program Fund." The fund shall cover additional costs for vision examinations under this act that are not covered by existing public health insurance. Subject to appropriations, moneys from the fund shall be used to pay for those additional costs, provided that the costs from the fund not exceed ninety-nine thousand dollars a year. Payment from the fund for vision examinations under this act shall not exceed the allowable state medicaid reimbursement amount for vision examinations.

This program shall sunset in five years.

BOXING, SPARRING, WRESTLING, KICKBOXING, AND FULL-CONTACT KARATE (Sections 317.001, 317.006, 317.0011, 317.013, 317.015, 317.018, 317.019)

This act modifies laws relating to the power of the Office of Athletics to regulate boxing, sparring, wrestling, kickboxing and full-contact karate contests.

Definitions are modified to include mixed martial arts and amateur and exhibition bouts under the purview of the Office of Athletics' regulatory authority.

The maximum duration for bouts is removed and the mandatory medical suspension is increased from 120 to 180 days when a participant is rendered unconscious.

The act creates guidelines for bout contracts.

Additional censure and probation measures are allowed for licensees under certain circumstances.

PRIVATE INVESTIGATORS (Sections 324.1100, 324.1102, 324.1104, 324.1106, 324.1108, 324.1110, 324.1112, 324.1114, 324.1116, 324.1118, 324.1120, 324.1122, 324.1124, 324.1126, 324.1128, 324.1130, 324.1132, 324.1134, 324.1136, 324.1138, 324.1140, 324.1142, 324.1144, 324.1146, 324.1148, 621.045)

The "Board of Private Investigator Examiners" is created within the Division of Professional Registration in the Department of Insurance, Financial Institutions and Professional Registration.

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. 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.

ARCHITECTS, ENGINEERS, LAND SURVEYORS, LANDSCAPE ARCHITECTS (Sections 327.011, 327.076, 327.077, 327.181, 327.441)

The act authorizes the Missouri Board for Architects, Professional Engineers, Professional Land Surveyors and Landscape Architects to impose civil penalties against licensed and unlicensed persons. Any person who practices architecture, engineering, land surveying or landscape architecture without a valid license may be subject to an administrative action by the board to seek a civil penalty. The board may initiate investigations against the unlicensed person and may issue subpoenas to compel attendance and testimony of witnesses.

The complaint must be filed with the Administrative Hearing Commission, which shall conduct a hearing and issue its findings of fact and conclusions of law. The duties of the commission are amended to include the ability to hear such cases. If the commission finds the unlicensed person has violated this act, then the board may issue a civil penalty not to exceed $5,000 for each day of violation, with a maximum penalty of $25,000. The unlicensed person has the right to appeal the order imposing the fine to a circuit court. Once the case is final, and the penalty is not timely paid, the Attorney General may commence an action to recover the penalty, including reasonable attorney fees and costs and a surcharge of 15% of the penalty plus 10% per year on any amounts owed. The validity and appropriateness of the final order imposing the civil penalty shall not be subject to review.

An unlicensed person may use a form of the word "engineer" without being subject to disciplinary action if the use is reflective of that person's profession and does not imply that the person is holding himself or herself out as being a professional engineer.

BOARD OF REGISTRATION FOR THE HEALING ARTS (334.120)

Currently, 5 board members must be graduates of professional schools approved and accredited as reputable by the American Medical Association or the Liaison Committee on Medical Education. This act requires at least 5 members to be graduates of professional schools accredited by the Liaison Committee on Medical Education or recognized by the Educational Commission for Foreign Medical Graduates.

NURSES (335.016, 335.036. 335.066, 335.067, 335.068, 335.076, 335.097, 383.130, 383.133)

The act defines "lapsed license status", "retired license status", and "temporary nursing staffing agency" and establishes notice and service requirements for disciplinary hearings before the full board.

The State Board of Nursing may establish an impaired nurse program and require nurses to enter treatment as a condition for licensure.

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.

Documentation relating to an unsubstantiated claim and those not constituting a violation are deemed sealed records under the act. Sealed records shall not be disclosed without written permission of the licensee. The board must notify the licensee if it seals any records in relation to that professional.

Advanced Practice Registered Nurses are authorized to use the acronym APRN in relation to their practices.

The act stipulates that reports made to the board are not in violation of the Federal Health Insurance Portability and Accountability Act.

Under current law, officials of hospitals and ambulatory surgical centers must report disciplinary actions taken against a licensed health care professional to their respective licensing authority. This act requires temporary nursing staffing agencies to do the same and requires the facts to be described with as much detail and information as possible.

OPTOMETRISTS (Sections 336.010, 336.020, 336.030, 336.040, 336.050, 336.060, 336.070, 336.080, 336.140, 336.160, 336.220, and 336.225)

The act Modifies the definition of "the practice of optometry" and relocates provisions relating to the scope of practice found in other sections into this definition.

The act allows for reciprocity for out-of-state licensees. The act raises the continuing education requirements from 8 hours annually to 32 hours within a 2 year period.

The 30 day notice requirements for board meetings is removed.

Optometrists who are only authorized to administer diagnostic pharmaceutical agents shall refer patients to a physician under certain circumstances.

Advertising is allowed for all optometrists as long as the name of the licensee is displayed at all practice locations.

SOCIAL WORKERS (Sections 337.600, 337.603, 337.604, 337.612, 337.615, 337.618, 337.622, 337.627, 337.630, 337.636, 337.643, 337.644, 337.646, 337.647, 337.653, 337.665, and 337.689)

Currently, clinical and baccalaureate social workers are licensed. This act expands licensing to two additional groups: advanced macro social workers and master social workers.

Applicants for licensure as a clinical social worker must complete 3,000 hours of supervised clinical experience with a qualified clinical supervisor instead of a licensed clinical social worker.

All licensees shall complete 3 hours in ethics presented by a social worker with a degree.

The act differentiates between the four types of licensure as follows:

CLINICAL SOCIAL WORKER REQUIREMENTS

• Master's degree from a program accredited by the council of social work education or a doctorate from a program acceptable to the committee.

• 3,000 hours supervised clinical experience with a qualified clinical supervisor.

• Passing score on an approved exam.

• 18 years old, of good moral character, a U.S. citizen or legally present, and free of felony convictions during the 10 years prior to application.

MASTER SOCIAL WORKER REQUIREMENTS

• Master's or doctorate degree from a program accredited by the council of social work education.

• Passing score on an approved exam.

• 18 years old, of good moral character, a U.S. citizen or legally present, and free of felony convictions during the 10 years prior to application.

ADVANCED MACRO SOCIAL WORKER REQUIREMENTS

• Master's degree from a program accredited by the council of social work education or a doctorate from a program acceptable to the committee.

• 3,000 hours supervised clinical experience with a qualified macro supervisor.

• Passing score on an approved exam.

• 18 years old, of good moral character, a U.S. citizen or legally present, and free of felony convictions during the 10 years prior to application.

BACCALAUREATE SOCIAL WORKER REQUIREMENTS

• Baccalaureate degree from a program accredited by the council of social work education.

• 3,000 hours of supervised clinical experience with a qualified baccalaureate supervisor.

• Passing score on an approved exam.

• 18 years old, of good moral character, a U.S. citizen or legally present, and free of felony convictions during the 10 years prior to application.

REAL ESTATE APPRAISERS (Sections 339.100, 339.200, 339.205)

The Real Estate Commission is authorized to impose civil penalties upon licensed and unlicensed individuals in the same manner described in the above sections relating to architects, engineers, land surveyors, and landscape architects.

AUDIOLOGISTS (Sections 345.015, 345.030, 345.033, 345.045, 345.055, 346.015, 346.030, 346.035, 346.055, 346.060, 346.110)

The act adds fitting, programming, and dispensing of assistive listening devices and other amplification systems to the definition of the practice of audiology.

Licensed audiologists who sell devices shall deliver a purchase agreement to the purchaser containing information including the terms of the sale, name of the manufacturer, make, model, whether the item is used and other details.

Under current law, hearing instrument retailers must employ a licensed hearing aid specialist. Under the act, the retailers may employ a licensed audiologist in lieu of a specialist.

The act also phases in education requirements for applicants for instrument specialist licenses or hearing instrument specialist-in-training permits.

HEALTH CARE PROFESSIONALS (Section 537.035)

The definition of "health care professional", for purposes of determining who is subject to peer review, is modified to include physical therapists, emergency medical technicians and emergency medical dispatchers. The act provides that a peer review committee may be comprised of members appointed by a board of trustees or chief executive officer of a licensed ambulance service, a licensed emergency medical response agency, or any not-for-profit organization that provides for ambulance services, as long as the governing body of such not-for-profit organization consists of elected officials or individuals appointed by a mayor, board of alderman, city council, county commission, county legislature, or ambulance district. A committee may also be comprised of members appointed by a mayor, city council, board of alderman, county commission, county legislature, or ambulance district. Th act also provides immunity from civil liability for members of a peer review committee that performs certain acts at the recommendation of the committee.

This act is similar to HB 718 (2007), SB 16 (2007), SB 308 (2007), HB 776 (2007), SB 527 (2007), HB 117 (2007), SB 31 (2007), HB 830 (2007), SB 542 (2007), HB 953 (2007), SB 584 (2007), HB 278 (2007), HB 919 92007).

CHRIS HOGERTY