HEALTHCARE PROFESSIONALS WORKFORCE DATA COLLECTION - 324.001

The act provides that the State Board of Nursing, Board of Pharmacy, Missouri Dental Board, State Committee of Psychologists, State Board of Chiropractic Examiners, State Board of Optometry, State Board of Occupational Therapy, and State Board of Registration for the Healing Arts may enter into contractual agreements with the Department of Health and Senior Services, public institutions of higher education, and nonprofit entities in order to collect and analyze workforce data from its licensees for the purpose of future workforce planning and to assess the accessibility and availability of qualified health care services and practitioners in Missouri.

Data collection is controlled by the applicable state board requesting the collection, and the boards may release identifying data to the contractor to facilitate data analysis of the health care workforce. The data collected is the property of the board requesting the data, and shall be maintained as provided in existing law. Data shall only be released in the aggregate form in a manner that cannot be used to identify a specific individual. A board cannot request or collect income or other financial earnings information. Contractors shall maintain the confidentiality of data received and shall not release any data without approval from the applicable board.

This provision is identical to provisions in CCS/HCS/SB 635 (2016) and similar to HCS/HB 1850 (2016), SCS/HB 1466 (2016), SS/SCS/HB 1816 (2016), HCS/SB 831 (2016), HCS/HB 112 (2015), HCS/SCS/SB 197 (2015), HCS/SCS/SB 230 (2015), and HCS/SS/SCS/SB 354 (2015).

COLLABORATIVE PRACTICE - 334.037, 334.104

The act modifies provisions regarding collaborative practice arrangements between a physician and an assistant physician and a physician and an advanced practitioner registered nurse (APRN). The act specifies that in performing a review of an assistant physician or APRN's delivery of health care services, the physician does not need to be present at the practice site of the assistant physician or the APRN.

These provisions are identical to provisions in HCS/SB 831 (2016), HB 1816 (2016), and HCS/SB 835 (2016).

In a collaborative practice arrangement between a physician and an APRN the geographic proximity requirement may be waived as long as the collaborative practice arrangement includes alternative plans. A collaborating physician may enter in to a collaborative practice arrangement with up 5, rather than 3 APRNs.

These provisions are identical to provisions in HB 1697 (2016) and HB 1816 (2016).

Currently, the collaborating physician and the APRN must practice together for one month before the APRN is allowed to practice at a location where the physician is not continuously present. The act exempts a collaborating physician and APRN from this requirement when the APRN is already familiar with the patient population and the physician is new to the patient population.

These provisions are identical to provisions contained in HCS/SB 835 (2016) and HCS/SB 831 (2016).

PHYSICAL THERAPIST COMPACT - 334.1200 - 334.1233

The act creates a physical therapist compact. To participate in the compact a state must 1) participate in the Physical Therapy Compact Commission's data system; 2) have a mechanism in place for receiving and investigating complaints; 3) notify the Commission of any adverse action regarding a licensee; 4) implement a criminal background check; 5) comply with the rules of the Commission; 6) use a recognized national examination as a requirement for licensure; and 7) have continuing education as a requirement for license renewal.

A member state shall grant the compact privilege to a licensee holding a valid license in another member state. In order to have a compact privilege a licencee must 1) have an unencumbered license in his or her home state; 2) have not had any adverse action against the license in the previous 2 years; 3) notify the Commission that he or she is seeking compact privilege within a remote state; 4) pay a fee; 5) meet any jurisprudence requirements established by the remote state; and 6) report to the Commission adverse action taken by a nonmember state within 30 days from the date the adverse action is taken. The compact privilege is valid until the expiration date of the home license. The licensee providing physical therapy in a remote state is subject to the laws and regulations of the remote state. If a home state license is encumbered then the licensee shall lose the compact privilege until certain conditions are met as established in the act.

A remote state has the authority to take adverse action against a licensee's compact privilege in that state, but only a home state may impose adverse action against a license issued by the home state. Additionally, any member state may investigate violations of physical therapy statutes and rules in any other member state in which a physical therapist holds a license or compact privilege. Member states may also participate in joint investigations of licensees.

The act creates the Physical Therapy Compact Commission. Each member state shall have one delegate who shall be a current member of the member state's licensing board. The Commission shall establish bylaws and promulgate rules, which shall have the force and effect of law and shall be binding in all member states. Within the Commission, there is an executive board composed of 9 members with the authority to act on behalf of the Commission. The Commission may collect an annual assessment from each member state or impose fees on other parties to cover the cost of the operations and activities of the Commission and its staff.

The Commission shall develop, maintain, and use a coordinated database and reporting system containing licensure, adverse action, and investigative information on all licensed individuals in member states. Member states are required to submit a uniform data set to the data system on all individuals to whom the compact is applicable. The data shall include 1) identifying information; 2) licensure data; 3) adverse actions against the licensee or compact privilege; 4) nonconfidential information related to alternative program participation; 5) denial of application for licensure; and 6) any other information that may facilitate the administration of the compact.

If a member state defaults in its performance of its obligations under the compact or promulgated rules then the defaulting state may be terminated from the compact as provided in the act.

The compact shall not become effective until ten states enact the compact into law.

These sections are identical to sections in SS/SCS/HB 1816 (2016), CCS/HCS/SCS/SB 973, HB 2328 (2016), CCS #2/HCS/SS/SB 608 (2016), CCS/HCS/SB 635 (2016), HCS/SB 831 (2016), HCS/SB 835 (2016), and HCS/SCS/SB 836 (2016).

ADVANCED PRACTICED REGISTERED NURSES - 335.016, 335.019, 335.046, 335.056, 335.086,

The act modifies various provisions regarding advanced practice registered nurses (APRN). The act creates a license for advanced practice registered nursing and specifies that the practice of advanced practice nursing includes assessing and diagnosing health problems, planning and ordering therapeutic regimens, coordinating with or referring to another health care provider, and prescriptive authority for legend drugs and controlled substances. Advanced practice nursing is practiced in accordance with the APRN's graduate-level education and certification in one of four recognized roles: certified clinical nurse specialist, certified nurse midwife, certified nurse practitioner, and certified registered nurse anesthetist, with at least one population focus as defined in the act.

An APRN has the authority to prescribe, dispense, and administer nonscheduled legend drugs and nonscheduled legend drug samples.

In addition to other requirements, the applicant for a license shall complete the required post graduate education as provided in the act and provide documentation of certification in one of the four APRN roles from a nationally recognized certifying body approved by the Board of Nursing.

These sections are similar to HCS/HB 1866 (2016) and SB 826 (2016).

NURSING LICENSURE COMPACT - 335.360 - 335.415

This act establishes a new nursing licensure compact in which states who are members of the compact, known as party states, may issue multistate nursing licenses for the practice of registered, licensed practical, or vocational nursing. A multistate nursing license shall authorize a nurse to practice under a multistate licensure privilege in each party state. The act does not affect the requirements established by a party state for the issuance of a single-state license.

This compact shall become effective and binding on the earlier of the date of legislative enactment of this compact by no less than twenty-six states or December 31, 2018. All party states to this compact that were also parties to the prior nurse licensure compact shall be deemed to have withdrawn from the prior compact within six months after the effective date of this compact.

Under the act, a party state must adopt procedures for considering the criminal history of applicants for an initial multistate license, and require an applicant for multistate licensure to 1) meet certain educational requirements as specified in the act, 2) pass the NCLEX-RN or NCLEX-PN examination, 3) hold or be eligible for an active, unencumbered license, 4) submit fingerprints for a criminal background check, 5) not have been convicted of a felony or a misdemeanor related to the practice of nursing, or enrolled in an alternative licensure disciplinary program, and 6) have a valid Social Security number.

A nurse practicing in a party state, not his or her home state, is subject to the jurisdiction of the licensing board, courts, and laws, of the party state in which the client is located at the time service is provided. A party state may take adverse action against a nurse's multistate licensure privilege, and shall notify the administrator of the coordinated licensure information system of any disciplinary action. The administrator shall then inform the licensee's home state of any such action by another state against the licensee.

All party states shall participate in a coordinated licensure information system, which shall include information on the licensure and disciplinary history of each nurse, and shall be administered by a nonprofit organization composed of and controlled by the party states' licensing boards. Any personally identifiable information obtained from the coordinated licensure information system by a party state licensing board shall not be shared with non-party states or disclosed to other entities or individuals except to the extent permitted by the laws of the party state contributing the information.

A nurse who holds a multistate license issued by his or her home state on the effective date the compact may retain and renew the multistate license issued by the current home state. However, a nurse who changes primary state of residence after the effective date of the compact shall meet the requirements to obtain a multistate license from a new home state. A nurse may hold a multistate license issued by the home state, in only one party state at a time. If a nurse moves to a new party state, he or she must apply for licensure in the new home state, and the multistate license issued by the prior home state will be deactivated. If a nurse moves to a non-party state then the multistate license issued by the prior home state will convert to a single-state license, valid only in the prior home state.

The licensing board of each state shall have the authority to take disciplinary action against a nurse's multistate licensure privilege to practice within the party state, but only the home state shall have the power to take adverse action against a nurse's license issued by the home state.

The Interstate Commission of Nurse Licensure Compact Administrators, composed of one designee from each party state, shall have the authority to promulgate uniform rules to implement and administer the compact. Such rules shall be binding in all party states and have force and effect of law. The act sets forth procedures and requirements that the Commission must follow in order to exercise its rulemaking powers. The Commission shall meet at least once a year and the meetings shall be open to the public. The Commission shall establish bylaws or rules to govern its conduct which shall be published on the Commission's website.

If the Commission determines that a party state has defaulted in the performance of its responsibilities under the Compact and fails to cure such default, then the party state's membership in the Compact shall be terminated upon an affirmative vote of the members of the Commission.

This act shall become effective upon notification to the Revisor of Statutes by the Commission that no less than twenty-six states have enacted the Compact, or December 31, 2018, whichever occurs earlier.

These provisions are substantially similar to SB 985 (2016) and identical to provisions in SS/SCS/HB 1816 (2016), CCS #2/HCS/SS/SB 608 (2016), CCS/HCS/SB 635 (2016), HCS/SB 831 (2016), and HCS/SB 835 (2016).

OCCUPATIONAL THERAPISTS - 376.1235

This act adds services rendered by licensed occupational therapists to services that cannot require a higher co-payment or coinsurance than is required for the services of a primary care physician office visit. This act also requires health carriers to clearly state the availability of occupational therapy services. This act requires the Oversight Division of the Joint Committee on Legislative Research to perform an actuarial analysis of the cost impact health carriers, insureds, and other payers for occupational therapy coverage beginning September 1, 2016, and submit a report by December 31, 2016.

This act is identical to SB 853 (2016), HB 2430 (2016), SB 316 (2015), and HB 548 (2015) and to provisions in CCS #2/HCS/SS/SB 608 (2016) and CCS/HCS/SB 635 (2016).

JESSI BAKER