HCS/SB 164 - This act modifies provisions relating to professional licensing. COLLABORATIVE PRACTICE ARRANGEMENTS (Sections 193.015, 195.100, 334.037, 334.104, 334.108 334.735, 334.736, 334.747, 334.749, 338.010, 630.175, and 630.875)
This act removes the definitions of "supervision", "physician assistant supervision agreement", and references to "supervision agreement" or "supervising physician" and replaces such references with "collaborative practice arrangement" or "collaborating physician". "Collaborative practice arrangement" is defined as a written agreement, jointly agreed upon protocols, or standing orders for the delivery of health care services.
A physician assistant, or an assistant physician in a collaborative practice arrangement with a physician may, under this act, prescribe any drug, controlled substance, or other treatment that is within his or her scope of practice to a patient based solely on a telephone evaluation if a previously established and ongoing physician-patient relationship exists between the physician and patient. (Section 334.108)
Under this act, a physician assistant is defined as a person who has graduated from a physician assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant, prior to 2001, or the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Programs, rather than a person accredited by the American Medical Association's Committee on Allied Health Education and Accreditation.
Current law requires a supervising physician designated in a supervision agreement to see a patient for evaluation and approve or formulate a plan of treatment for new or significantly changed conditions no more than two weeks after the patient has been seen by a physician assistant. Such supervising physician shall determine and document the completion of at least a one-month period of time during which the physician assistant shall practice with the supervising physician continuously present before practicing in a setting where a supervising physician is not continuously present. This act repeals such provisions.
Under this act, a physician may enter into a collaborative practice arrangement with a physician assistant. Such arrangements, which shall be in writing, may delegate to a physician assistant the authority to prescribe, administer, or dispense drugs, and provide treatment which is within the skill, training, and competence of the physician assistant. Such arrangements may delegate the authority to administer, dispense, or prescribe controlled substances listed in Schedules III, IV, and V, and Scheduled II-hydrocodone. Schedule III and Schedule II-hydrocodone prescriptions shall be limited to a 12-hour supply without a refill. Such arrangement shall include certain provisions set forth in the act.
Within 30 days of any change, and upon each renewal of an arrangement, the State Board of Registration for the Healing Arts shall require every physician to identify whether the physician is engaged in any collaborative practice arrangement, and report to the Board the name of each physician assistant with whom the physician has entered into such an arrangement. Such information may be made available to the public, and the Board is required to track the reported information.
A collaborating physician shall determine and document the completion of a period of time during which the physician assistant shall practice with the physician before practicing in a setting where the collaborating physician is not continuously present. This limitation, however, shall not apply to collaborative arrangements of providers of population-based public health services. No arrangement shall require a physician assistant to collaborate with any physician against the physician assistant's will. (Section 334.735)
These provisions are identical to provisions contained in SCS/HB 705 (2019), SS/HB 219 (2019), HB 710 (2019), HB 758 (2019), HCS/HB 840 (2019), and HCS/SB 204 (2019).
LICENSING OF MILITARY SPOUSES (Section 324.009)
Current law allows any resident of Missouri who holds a valid current license issued by another jurisdiction to submit an application for a license in Missouri in the same occupation or profession for which such person holds the current license, along with proof of current licensure in the other jurisdiction, to the relevant oversight body in this state.
This act would allow any nonresident military spouse, to apply for a license in Missouri, provided such person also submits proof of current licensure in any jurisdiction and any required application fee.
The oversight body shall waive any examination, educational, or experience requirements for licensure for the applicant within 90 days, rather than within six months, of receiving such application, if it determines that the licensing requirements in the jurisdiction that issued the applicant's license are substantially similar to or more stringent than Missouri's licensing requirements.
Current law states that the law shall be interpreted so as to imply no conflict between it and any compact, or reciprocity agreement with other states in effect on August 28, 2018. Under this act, should any conflict arise between this act and the provisions of any compact or reciprocity agreement, the provisions of such compact or agreement shall prevail. Should a conflict arise between the provisions of the act and federal law or rule, the provisions of federal law or rule shall prevail.
Nonresident military spouses are eligible, under this act, to apply for a license with any board, department, agency, or office of a jurisdiction that issues licenses, including the boards set forth in the act.
This act repeals the provisions relating to the issuance of a temporary courtesy license to a nonresident spouse of an active duty member of the military.
This provision is identical to provisions contained in HCS/SB 204 (2019), HB 1140 (2019), and is substantially similar to SCS/SB 476 (2019).
APPRENTICESHIP PROGRAMS (Section 324.025)
This act shall be known as the "Expanded Workforce Access Act of 2019".
Beginning on January 1,2020, each state licensing authority shall grant a license to any applicant who has successfully completed the eighth grade, completed an apprenticeship approved by the appropriate licensing authority or the U.S. Department of Labor, and has passed the required licensure examination, if one is deemed to be necessary under state law.
The Division shall establish a passing score for such examinations, which shall not exceed the passing score that is required for a non-apprenticeship license. If there is no examination requirement for a non-apprenticeship license, no examination shall be required for applicants who complete an apprenticeship.
The number of working hours required for an apprenticeship shall not exceed the number of educational hours otherwise required for a non-apprenticeship license.
This provision is identical to SCS/HB 470 (2019) and a provision in SCS/HB 705 (2019), and HCS/SB 204 (2019), and is substantially similar to SB 318 (2019) and similar to HB 472 (2019).
OCCUPATIONAL FEES (Section 324.035)
Under this act, no board, commission, or committee within the Division of Professional Registration shall utilize occupational fees, or any other fees associated with licensing requirements, or contract or partner with any outside vendor or agency for the purpose of offering continuing education classes.
This provision is identical to a provision contained in SCS/HB 705 (2019), HCS/SB 204 (2019), HCS/HB 66 (2019), and HCS/HB 472 (2019).
EMBALMING APPRENTICESHIPS (section 333.041)
This act permits an applicant for an embalmer's license to continue to be employed by a funeral establishment where the applicant successfully completed an embalming apprenticeship for up to six months pending the successful completion of all other licensure requirements, or until the applicant's embalmer's license is issued, whichever comes first.
An applicant shall not continue to practice as an embalmer apprentice without providing written notice to the State Board of Embalmers and Funeral Directors to extend his or her apprenticeship registration for up to six months. The Board shall grant the extension upon receipt of the written notice.
This provision is identical to HB 816 (2019) and a provision in SCS/HB 705 (2019), and is substantially similar to a provision in HCS/SB 204 (2019).
FRESH START ACT (256.477, 317.015, 324.012, 324.086, 324.217, 324.262, 324.265, 324.496, 324.523, 324.1112, 324.1118, 326.280, 326.289, 326.310, 327.131, 327.221, 327.312, 327.381, 327.441, 327.612, 328.075, 328.150, 329.140, 331.030, 331.060, 332.231, 332.251, 332.281, 332.291, 333.041, 333.151, 334.414, 334.530, 334.613, 334.616, 334.655, 334.715, 334.920, 335.046, 335.066, 336.030, 336.110, 337.020, 337.035, 337.330, 337.510, 337.525, 337.615, 337.630, 337.644, 337.645, 337.665, 337.715, 337.730, 338.030, 338.055, 338.065, 338.185, 339.040, 339.100, 339.511, 339.532, 340.228, 340.264, 340.274, 340.300, 344.030, 344.050, 345.015, 345.050, 345.065,346.055, 346.105, and 436.230)
This act creates the "Fresh Start Act of 2019".
Beginning January 1, 2020, no person shall be disqualified by a state licensing authority from pursuing or practicing in any occupation for which a license is required solely or in part because of a prior conviction of a crime in this state or another state, unless the crime is directly related to the duties and responsibilities for the licensed occupation.
Prior to January 1, 2020, all state licensing authorities shall revise existing licensing requirements to explicitly list the specific criminal convictions that could disqualify an applicant from receiving a license. Only criminal convictions that are specific and directly related to the duties and responsibilities for the licensed occupation shall be listed. Licensing authorities are prohibited from using vague or generic terms, and from considering arrests without a subsequent conviction. The licensing authority shall use the clear and convincing standard of proof to determine whether an applicant with a criminal conviction will be denied a license, and shall make its determination based on several factors set forth in the act.
Beginning August 28, 2019, applicants for licensure who have pleaded guilty to, entered a plea of nolo contendere to, or been found guilty of any offenses set forth in the act may be considered by licensing authorities to have committed a criminal offense that directly relates to the duties and responsibilities of a licensed profession.
If an individual has a valid criminal conviction for a crime that could disqualify the individual from receiving a license, the disqualification shall not last longer than 5 years from the date of conviction, provided the conviction is not for a crime that is set forth in the act, and the individual has not been convicted of any other crime directly related to the duties and responsibilities of the occupation during the 5 year disqualification period.
An individual with a criminal record may petition a licensing authority at any time for a determination of whether they will be disqualified from receiving a license. The licensing authority is required to inform the individual of his or her standing within 30 days of receiving the petition, and may charge a fee, no greater than $25, to recoup the costs.
If a licensing authority denies an individual a license solely or in part because of the individual's prior criminal conviction, the licensing authority shall notify the individual in writing of the reasons for the denial, that the individual has the right to a hearing to challenge the decision, the earliest date the person may reapply for a license, and that evidence of rehabilitation may be considered upon reapplication. If the licensing authority grants a license to an individual, such decision shall be binding unless such individual commits a subsequent crime that directly relates to the occupation for which the individual is licensed, or upon discovery that such person failed to disclose information regarding a prior conviction in the license petition process.
Any written determination by the licensing authority that an applicant's criminal conviction is a specifically listed disqualifying conviction and is directly related to the duties and responsibilities for the licensed occupation shall be documented with written findings for each reason by clear and convincing evidence sufficient for a reviewing court. In any administrative hearing or civil litigation, the licensing authority shall carry the burden of proof on the question of whether the applicant's criminal conviction directly relates to the occupation for which the license was sought.
This act shall apply to any profession for which an occupational license is issued in this state, excluding peace officers or other law enforcement personnel, podiatrists, dentists, physicians and surgeons, pharmacists, or any persons under the supervision or jurisdiction of the Director of Finance, and including any new occupational license created by a state licensing authority after August 28, 2019. Political subdivisions are prohibited from creating any new occupational licenses after August 28, 2019.
Provisions of law relating to the denial of licensure, denial of license renewal, or revocation of a certificate of registration for any offense reasonably related to the qualifications, functions or duties of the occupation, an essential element of which is fraud, dishonesty, an act of violence or moral turpitude are repealed for the following occupations and professions, and a requirement that no person applying for such licensure have committed an offense directly related to the duties and responsibilities of the occupation as set forth in the act, is added for:
1. Accountants;
2. Acupuncturists;
3. Anesthesiologist assistants;
4. Architects, engineers, land surveyors, landscape architects;
5. Athletic trainers;
6. Athlete agents;
7. Baccalaureate social workers;
8. Barbers;
9. Behavior analysts;
10. Boxing and Wrestling;
11. Chiropractors;
12. Cosmetologists;
13. Dental hygienists;
14. Dieticians;
15. Endowed care cemetery operators;
16. Geologists;
17. Hearing aid fitters and dealers;
18. Marital and Family therapists;
19. Massage Therapists;
20. Nurses;
21. Occupational therapists;
22. Optometrists;
23. Physical therapists;
24. Psychologists;
25. Private Investigators;
26. Professional counselors;
27. Real estate agents, brokers, appraisers, and escrow agents;
28. Respiratory care therapists;
29. Social workers;
30. Speech pathologists and audiologists;
31. Tattooing, branding, and body piercing;
32. Veterinarians.
Provisions of law relating to the initial granting of a certificate of registration based on good moral character are repealed for the following occupations and professions, and a requirement that no person applying for such licensure have committed any crime set forth in the act is added for:
33. Accountants;
34. Architects, engineers, land surveyors, landscape architects;
35. Athletic trainers;
36. Baccalaureate social workers;
37. Barbers;
38. Chiropractors;
39. Dentists;
40. Dental hygienists;
41. Funeral directors;
42. Hearing aid fitters and dealers;
43. Marital and family therapists;
44. Massage therapists;
45. Nurses;
46. Nursing home administrators;
47. Optometrists;
48. Physical therapists;
49. Physical therapist assistants;
50. Psychologists;
51. Professional counselors;
52. Real estate agents, brokers, appraisers, and escrow agents;
53. Real estate appraisers and appraisal management;
54. Social workers;
55. Speech pathologists and audiologists;
56. Speech language pathology assistants;
57. Veterinarians;
58. Veterinarian technicians.
These provisions are substantially similar to SS/SCS/HCS/HB 564 (2019) and SB 251 (2019), and is similar to HCS/HB 472 (2019).
LICENSING OF PHYSICAL THERAPISTS (Section 334.506 and 334.613)
This act modifies provisions relating to the scope of practice for physical therapists.
Under current law, a physical therapist is prohibited from initiating treatment for a new injury or illness without a prescription from an approved health care provider. This act allows a physical therapist to evaluate and initiate treatment on a patient without a prescription or referral from an approved provider provided that the physical therapist has a Doctorate of Physical Therapy degree or has completed five years of clinical practice as a physical therapist.
Current law allows a physical therapist to examine and treat any person with a recurring self-limited injury within one year of diagnosis by an approved health care provider, or a chronic illness that has been previously diagnosed, without the prescription and direction of an approved health care provider. Physical therapists are required to contact the patient's provider within 7 days of initiating services, not change an existing referral available without approval of the patient's provider, refer an approved health care provider to any patient whose medical condition is determined to be beyond the scope of practice of the physical therapist, refer a health care provider to any patient whose condition for which the services have not been improving after 6 visits, or 14 days, and notify the patient's provider prior to the continuation of treatment.
This act repeals such provisions, and requires a physical therapist to refer to an approved health care provider any patient whose condition is determined to be beyond the scope of practice, or any patient who does not demonstrate measurable or functional improvement after 10 visits or 21 business days, or consult with a provider if, after such time, the patient has demonstrated measurable or functional improvement and the therapist believes that continuation of physical therapy or treatment is reasonable and necessary. The physical therapist, however, is prohibited from providing further services after such time period until a consultation with the health care provider has occurred. Continued physical therapy services or treatment following the consultation with a provider shall proceed in accordance with the direction of the provider, and the physical therapist shall notify the provider of continuing physical therapy services every 30 days after the initial consultation, unless otherwise directed.
This act repeals the provision of current law providing that certain physical therapy treatments may be delegated by physical therapists to physical therapist assistants if the patient's provider has been informed.
This act repeals the provision of current law permitting the State Board of Registration for the Healing Arts to file a complaint with the Administrative Hearing Commission against any physical therapist who is practicing or offering to practice professional physical therapy independent of the prescription and direction of a person licensed and registered as a physician and surgeon, physician's assistant, chiropractor, dentist, podiatrist, or advanced practice registered nurse, and instead allows such a complaint to be filed against any candidate for licensure or any licensed physical therapist who evaluates or treats a patient in a manner inconsistent with the act.
These provisions are identical to provisions contained in HCS/SB 204 (2019), and are substantially similar to HCS/HB 410 (2019), and are similar to HB 2090 (2018).
CONTINUING EDUCATION REQUIREMENTS FOR OPTOMETRISTS (Section 336.080)
This act adds a provision requiring a licensed optometrist to obtain two hours, out of the required 32 hours of continuing education, in the area of Missouri jurisprudence.
This provision is identical to a provision contained in SCS/HB 705 (2019).
PSYCHOLOGIST LICENSE (Section 337.020 and 337.029)
Under current law, any person seeking to obtain a license as a psychologist shall make an application to the Committee of Psychologists and shall pay the required application fee. The Committee is not permitted to charge an application fee until such time as the application has been approved, and if an application is denied, no application fee shall be charged. This act repeals such provision.
Current law permits a psychologist licensed in another jurisdiction to receive a license in Missouri, provided the psychologist passes a written exam on Missouri law and regulations governing the practice of psychology. Such person must also meet one of several listed criteria set forth under current law. This act removes one listed criteria allowing a psychologist who is currently licensed or certified as a psychologist in another jurisdiction that is then a signatory to the Association of State and Provincial Psychology Board's reciprocity agreement to be eligible for a license in Missouri.
These provisions are identical to HCS/SB 204 (2019) and provisions contained in SCS/HB 705 (2019).
PSYCHOLOGIST LICENSE RENEWAL (Section 337.050)
When applying for a renewal of a license, a psychologist shall submit proof of the completion of at least 40 hours of continuing education credit within the two-year period immediately preceding the date of the application for renewal of the license, with a minimum of three out of the 40 hours of continuing education dedicated to professional ethics.
This provision is identical to provisions in SCS/HB 705 (2019), HCS/SB 204 (2019), and is similar to HB 307 (2019) and SB 352 (2019).
PRISONER COMPLAINTS AGAINST PSYCHOLOGIST LICENSE (Section 337.068)
Under current law, if the Board finds merit to a complaint made by a prisoner under the care and control of the Department of Corrections or who has been ordered to be taken into custody, detained, or held as a sexually violent predator, and takes further investigative action, no documentation may appear on file nor may any disciplinary action be taken in regards to the licensee's license unless there are grounds for the denial, revocation, or suspension of a license.
This act includes complaints made by individuals who have been ordered to be evaluated in a criminal proceeding involving mental illness.
Under this act, a psychologist subject to the complaint by an individual who has been ordered to be evaluated in a criminal proceeding involving mental illness prior to August 28, 2019, may submit a written request to destroy all documentation regarding the complaint, and notify any other licensing board in another state, or any national registry who had been notified of the complaint, that the Board found the complaint to be unsubstantiated.
This act is identical to a provision contained in SS/SCS/HB 113 (2019), and HB 441 (2019), and is substantially similar to SB 451 (2019), and HB 2709 (2018).
MARITAL AND FAMILY THERAPISTS SUICIDE TRAINING (Section 337.712)
This act requires marital and family therapists to complete two hours of suicide assessment, referral, treatment, and management training as a condition of initial licensure and as a condition of license renewal.
This provision is identical to a provision contained in HB 307 (2019), HRB 1 (2019), SB 352 (2019), and HCS/SCS/SB 846 (2018).
IMMUNITY OF REAL ESTATE LICENSEES (Section 339.190)
This act expands the immunity of real estate licensees to include information about the size or area of a property or of improvements to property if the information was from a third party and the source is disclosed by the licensee. However, such licensee shall not have immunity if he or she knew the information was false, or acted with reckless disregard as to whether such information was true or false.
This act is identical to HCS/HB 106 (2019), SS/SB 920 (2018), and substantially similar to SB 36 (2019), a provision in SCS/HB 705 (2019), HB 1183 (2019) and similar to HB 1954 (2018).
LICENSING OF PLUMBERS (Section 341.170)
This act removes the age requirement for applicants for licensure to become master plumbers, journeyman plumbers, and master drainlayers.
This provision is identical to a provision contained in HCS/HB 472 (2019) and HCS/SB 204 (2019).
PROPERTY DESCRIPTIONS (Section 442.135)
Under this act, if a property is subdivided and a new property description is created, such description shall include the name and professional license number of the person that created the property description.
This act prohibits any person from submitting for recording, a conveyance of any property unless the property description receives such information.
This provision is identical to HCS/HB 770 (2019) and a provision contained in SCS/HB 705 (2019), HCS/SB 204 (2019), CCS/HCS/SB 36 (2019).
JOSIE BUTLER