MENINGOCOCCAL VACCINE (Section 174.335)

Beginning in the 2015-2016 school year, 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. The Department of Higher Education must oversee, supervise, and enforce this requirement and may promulgate rules. The Department of Higher Education may consult with the Department of Health and Senior Services. This act contains a delayed effective date of July 1, 2015.

This provision is identical to SCS/SB 748 (2014).

COMMUNICABLE DISEASES (Section 191.630 to 191.631)

Current law requires persons who receive care from an emergency service provider and who have exposed the provider to blood or other potentially infectious materials to consent to a test for infectious diseases. This act amends such provisions to include Good Samaritans. This act also replaces the term "contagious or infectious disease" with a new definition for "communicable disease".

Under current law, hospitals are required to have procedures for notifying emergency care providers about the risk for exposure. This act requires a coroner and medical examiner to also have written policies and procedures for notification of an emergency care provider and Good Samaritan. The coroner or medical examiner shall include local representation of a designated infection control officer during the process to develop or review such policies.

All emergency care providers shall respond to and treat any patient regardless of the status of the patient's HIV or other communicable disease infection. Hospitals, nursing homes, and other medical facilities and practitioners who transfer patients known to have a communicable disease or to be subject to an order of quarantine or an order of isolation shall notify the emergency care providers who are providing the transportation services of the potential risk of exposure to a communicable disease, including communicable diseases of a public health threat.

This act repeals sections 192.800 t 192.808.

These provisions are identical to SB 918 (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 to HCS/SCS/SB 716 (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.

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).

VENTILATOR-ASSOCIATED PNEUMONIA INFECTION REPORTING (192.667)

Under current law, the Department of Health and Senior Services is required to disseminate reports to the public based on data compiled showing for hospitals and ambulatory surgical centers a risk-adjusted nosocomial infection incidence rate for certain infections including ventilator-associated pneumonia. This act provides that upon the recommendation of the Infection Control Advisory Panel, one or more other quality indicators designed to better measure the risk of acquiring ventilator-associated pneumonia may be substituted for a risk-adjusted nosocomial infection incidence rate in such reports.

This provision is identical to SB 864 (2014).

EPINEPHRINE AUTO-INJECTORS (SECTION 196.990)

This act allows a physician to prescribe epinephrine (EPI) auto-injectors in the name of an authorized entity for use in certain emergency situations, and pharmacists, physicians, and other persons authorized to dispense prescription medications may dispense EPI auto-injectors under a prescription issued in the name of an authorized entity. An "authorized entity", is defined as any entity or organization at or in connection with which allergens capable of causing anaphylaxis may be present, including but not limited to restaurants, recreation camps, youth sports leagues, amusement parks, and sports arenas.

This act allows such authorized entities to acquire and stock a supply of EPI auto-injectors under a prescription issued in accordance with the provisions of the act. An employee or agent of an authorized entity or any other person who has completed the required training shall be allowed to use the EPI auto-injector on the premises of or in connection with the authorized entity to provide it to any individual who the employee, agent or other person believes in good faith is experiencing anaphylaxis regardless of whether the individual has a prescription for it or has been previously diagnosed with an allergy.

The act specifies the required training and the procedures for making the EPI auto-injectors available to individuals other than trained persons so long as the auto-injectors are stored in a locked secure container and in accordance with the manufacturer's specifications. The act also delineates the procedures for authorized entities reporting each incident involving use of the EPI auto-injectors to the Department of Health and Senior Services.

This act protects certain persons and entities from liability for any injuries or related damages that result from the administration of, self-administration of, or failure to administer an EPI auto-injector in accordance with the provisions of the act that may constitute ordinary negligence. The immunity shall not apply to acts or omissions constituting gross, willful, or wanton negligence and shall be in addition to and not in lieu of protections provided under Section 537.037, RSMo, the Good Samaritan emergency law. Also, the administration of the EPI auto-injector under this act shall not constitute the practice of medicine.

This provision is identical to a provision contained in SS #2/SB 754 (2014) and SB 868 (2014).

OFFERS OF INFLUENZA IMMUNIZATION (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 SCS/SB 716 (2014).

NOTICE OF ADVERSE ACTIONS (Section 208.080)

Under current law, when a public assistance recipient's case has been closed or modified by the Family Support Division within the Department of Social Services the recipient shall have 90 days from the date of closing or modification to request an appeal. This act requires the Division to notify each recipient about the right to appeal before adverse action is taken instead of at the time of such closing or modification under current law.

This provision is identical to SCS/SB 875 (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).

MO RX PRESCRIPTION DRUG PROGRAM (Section 208.798)

This act extends the expiration date of the MO RX Prescription Drug Program from 2014 to 2017.

This provision is identical to a provision contained in SS #2/SB 754 (2014).

COLLABORATIVE PRACTICE ARRANGEMENTS WITH ASSISTANT PHYSICIANS (Sections 334.035, 334.036, 334.037; 195.070)

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 HCS/HB 1842 (2014) and HCS/HB 1793 (2014) and substantially similar to SB 847 (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).

PHARMACY LICENSURE (Sections 338.059; 338.165; and 338.220)

This act provides that pharmacists may label prescription drugs using either a sequential number or a unique identifier.

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 patient for use outside of the hospital shall be labeled as provided by rules jointly promulgated by the Department and the Board, and shall be dispensed only by a prescription order 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.

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.

This provision is substantially similar to a provision contained in SS#2/SB 754 (2014).

ADRIANE CROUSE