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), HCS/SB 164 (2019), HCS/SB 204 (2019), and is substantially similar to SB 318 (2019), HCS/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 HCS/HB 66 (2019), HCS/HB 472 (2019), HCS/SB 164 (2019), and HCS/SB 204 (2019).

STATEWIDE MECHANICAL CONTRACTOR LICENSES (Sections 324.950, 324.953, 324.956, 324.959, 324.962, 324.965, 324.968, 324.971, 324.977, 324.980, and 324.983)

This act shall be known as the Missouri Statewide Mechanical Contractor Licensing Act.

Under this act, the statewide mechanical license for mechanical contractors shall be regulated by the Division of Professional Registration, within the Department of Insurance, Financial Institutions and Professional Registration. This act creates the Office of Mechanical Contractors within the Division, to carry out the provisions of this act.

Applicants for a statewide mechanical license must meet certain criteria set forth in the act. A corporation, firm, institution, organization, company, or representative seeking to engage in mechanical contracting, is required to employ at least one license holder. A statewide licensed mechanical contractor may represent only one entity at a time. (Section 324.959)

Political subdivisions may establish their own local mechanical contractor's license, but must recognize a statewide license in lieu of a local license for the purposes of performing contracting work or obtaining permits to perform work within such political subdivision. No political subdivision may require the employees of a statewide licensed mechanical contractor or its subcontractors or manufacturers' representatives to obtain journeymen licenses, apprenticeship licenses, or occupational licenses that require passing any examination or any special requirements to assess proficiency.

If a political subdivision does not recognize a statewide license in lieu of a local license, a statewide mechanical contractor licensee may file a complaint with the Division, which may investigate such complaint. If the Division finds that the political subdivision failed to recognize a statewide license, the Division shall notify the political subdivision of such violation and grant them 30 days to comply. If after 30 days the political subdivision does not comply, the Division shall notify the director of the Department of Revenue, who shall withhold any moneys the political subdivision would otherwise be entitled to from local sales tax until the political subdivision is in compliance. (Section 324.962)

This act establishes the Missouri Mechanical Contractor Licensing Fund in the state treasury, which shall be expended for the administration of this act. (Section 324.965)

Mechanical contractor licenses shall expire on a renewal date established by the Division. The Division shall, prior to the renewal date, mail a renewal notice to the last known address of each person licensed under this act. Failure to provide the Division with the information required for renewal or to pay the required fee shall result in the license being declared inactive. The license shall remain inactive until the licensee applies for reinstatement and pays the required fees, so long as the application for reinstatement is received within two years of the renewal date. (Section 324.968)

Any person operating as a mechanical contractor in a political subdivision shall not be required to possess a statewide license to operate as a mechanical contractor in such political subdivision. (Section 324.971)

The Division may refuse to issue any certificate of registration or license, and may cause a complaint to be filed with the Administrative Hearing Commission against any holder of a certificate of registration or license for causes set forth in the act. Upon a finding by the Administrative Hearing Commission that grounds for disciplinary action are met, the Division may censure or place such a person on probation for a period not to exceed five years, or may suspend, for a period not to exceed three years, or revoke any license. Upon a judicial or administrative finding of a violation of this act, the Division may assess fines up to $5,000.(Section 324.980)

Any person who knowingly violates the provisions of this act is guilty of a Class B misdemeanor. (Section 324.983)

These provisions are identical to SB 376 (2019), are substantially similar to HCS/HB 326 (2019), and are similar to HB 2673 (2018).

ISSUANCE AND RENEWAL OF CPA PERMITS (Section 326.289)

Under this act, the Missouri State Board of Accountancy may obtain information regarding peer review from any approved American Institute for Certified Public Accountants peer review program.

The Board may obtain the name and address of the public accounting firm, the firm's dates of enrollment in the program, the date of acceptance and the period covered by the firm's most recently accepted peer review, and if applicable, whether the firm's enrollment in the program has been dropped or terminated. act.

This provision is identical to SS/SB 219 (2019) and is substantially similar to HB 585 (2019), HB 943 (2019).

CERTIFICATES OF AUTHORITY (Section 327.401)

This act exempts any electrical cooperative, or any electrical corporation operating under a cooperative business plan, from provisions relating to the right to practice as an architect, professional engineer, professional land surveyor, or professional landscape architect.

This provision is identical to SCS/SB 509 (2019), SCS/HB 705 (2019), and is similar to SCS/HB 355 (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), SCS/HB 705 (2019), HCS/SB 204 (2019), and is substantially similar to HCS/SB 164 (2019).

COLLABORATIVE PRACTICE ARRANGEMENTS (Sections 334.108 and 334.735)

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.

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.

These provisions are identical to SS/HB 219 (2019), SCS/HB 758 (2019), and CS/HB 840 (2019), and are substantially similar to HCS/SB 164 (2019), and HCS/SB 204 (2019).

ATHLETIC TRAINERS (Sections 334.702, 334.704, 334.706, 334.708, 334.710, 334.712, 334.715, 334.717, 334.721, 334.725, and 334.726)

This act modifies provisions relating to athletic trainers, including a number of definitions. (Section 334.702)

Under this act, an athletic trainer is required to refer any individual whose medical condition is beyond the scope of their education, training, and competence to a licensed physician. (Section 334.703)

No person shall hold himself or herself out as an athletic trainer or to be practicing athletic training, by title or description, unless such person has been licensed. (Section 334.704)

Under this act, the State Board of Registration for the Healing Arts may issue a temporary license to any person who is licensed as an athletic trainer in any other state, who has attested that no professional license issued to him or her has ever been disciplined, and who meets any other requirements established by the Board. A temporary license issued by the Board is valid for six months from the date of issuance, or until a permanent license is issued or denied.

Currently, the Board is required to make available a roster of the name and business addresses of all athletic trainers licensed in the state. This act removes the requirement that such information be annually prepared, and that copies be made available to any person upon request. In addition, this act removes the requirement that the Board set the fee for the roster, and adopt an official seal. (Section 334.706)

Under current law, any person seeking licensure after August 28, 2006, must be a resident, or in the process of establishing residency in the state, and have passed the National Athletic Trainers Association Board of Certification examination. Under this act, any person seeking licensure is required only to have passed the Board of Certification, Inc.'s examination.

Currently, the Board shall grant licensure to any qualified nonresident athletic trainer holding a license or licensure in another state if such other state recognizes licenses or licensure of the state of Missouri. This act repeals this provision. (Section 334.708)

All applications for initial licensure shall, under current law, be accompanied by an initial licensure fee which shall be paid to the Director of Revenue and deposited by the State Treasurer. Under this act, all fees charged by the Board shall be collected and deposited into the Board of Registration for the Healing Arts Fund. (Section 334.710)

All licenses issued under current law shall expire on January 30 of each year. Under this act, all licenses shall expire pursuant to a schedule established by rule. (Section 334.712)

This act adds a provision allowing the Board to deny a license or seek discipline if any person has practiced in the state of Missouri while no longer certified as an athletic trainer by the Board of Certification, Inc.

Current law sets forth disciplinary actions the Board may take after the filing of a complaint before the Administrative Commission, and a finding by the Commission that the grounds for disciplinary action are met. This act removes such disciplinary actions, and instead allows the Board to impose any of the disciplines currently authorized by the Board against other Board licensees. (Section 334.715)

Under this act, the Missouri Athletic Trainer Advisory Committee is to be composed of 6 members, rather than 5, to be appointed by the Board. Each member of the Committee shall be a resident of the state of Missouri for five years immediately preceding appointment, and remain a resident of Missouri throughout the term. The additional member shall be a member of the Board.

Current law exempts dentists licensed by the Missouri Dental Board, and optometrists licensed by the State Board of Optometry. Under this act, dentists and optometrists are not exempt from athletic training licensing provisions.

Under this act, athletic trainers holding a valid credential from other nations, states, or territories performing their duties for their respective teams or organizations if they restrict their duties only to their teams or organizations and only during the course of their teams' or organizations' visit, not to exceed 30 days in one calendar year, in this state are exempt from athletic training licensing provisions. (Section 334.721)

The provisions of this act become effective 30 days after the effective date of this act. (Section 334.726)

This act is identical to SCS/SB 247 (2019), and is similar to SB 454 (2017), HB 882 (2017), and HB 2375 (2016).

RADIOLOGIC IMAGING AND RADIATION THERAPY LICENSES (Sections 334.1000, 334.1005, 334.1010, 334.1015, 334.1020, 334,1025, 334.1030, 334.1035, 334.1040, 334.1045, 334.1050, 334.1055, 334,1060, 334.1065, and 334.1070)

This act creates the Missouri Radiologic Imaging and Radiation Therapy Advisory Commission to guide, advise, and make recommendations to the State Board of Registration for the Healing Arts.

The Commission shall consist of five members appointed by the Director of the Division of Professional Registration, and shall include a nuclear medicine technologist, a radiation therapist, a radiographer, a physician specializing in the practice area of diagnostic radiology, and a physician specializing in the practice area of radiation oncology.

The initial commission members shall not be required to be licensed, but are required to obtain a license within 180 days after the effective date of the initial rules promulgated by the Board. Additionally, each member is required to be a citizen of the United States, a resident of Missouri for at least one year, and actively engaged in the practice of radiology for the past five years.

Each member of the Commission shall be appointed for a five-year term, except that for the first Commission, three members shall be appointed for five years, and two members shall be appointed for three years. Any vacancy on the Commission shall be filled for the unexpected term of the member.

No member of the Commission shall receive more than $70 per day for Commission business, except for actual and necessary expenses incurred in performing the duties of the Commission.

The Board, based on the recommendations, guidance, and advice of the Commission, shall meet certain requirements as set forth in the act, including the ongoing examination of the scope of practice for limited x-ray machine operators, nuclear medicine technologists, nuclear medicine advanced associates, radiation therapists, radiographers, and radiologist assistants.

(Section 334.1005)

Under this act, 180 days after the effective date of the rules promulgated by the Board, only a person licensed under the act may perform radiologic imaging or radiation therapy procedures on humans for diagnostic or therapeutic purposes.

Dental hygienists and dental assistants, resident physicians or students enrolled in and attending a school or college of medicine, chiropractic, podiatry, dentistry, radiologic imaging, or radiation therapy who performs radiologic imaging or radiation therapy procedures on humans while under the direct supervision of a licensed practitioner, persons employed by the United States government when performing radiologic imaging or radiation therapy associated with that employment, persons performing radiologic procedures on nonhuman subject or cadavers, or certified registered nurse anesthetists are exempt from the act.

(Section 334.1015)

An applicant applying for licensure as a radiographer or radiation therapist, nuclear medicine technologist or nuclear medicine advanced associate, radiologist assistant, or limited x-ray machine operator shall meet certain requirements set forth in the act. (Sections 334.1020-334.1035)

Every person licensed under this act shall, on or before the licensing renewal date, apply to the Board for licensure for the next licensing period. A notice shall be made available to each person licensed in the state, and failure to receive such notice shall not relieve a person of the duty to renew such person's license and pay the renewal fee, nor shall it exempt such person from penalties set forth in the act.

If a person fails to renew such license for two consecutive renewal periods, such license shall be deemed expired.

(Section 334.1040)

A person who has been engaged in the practice of radiologic imaging and radiation therapy, other than a radiologist assistant, and who does not hold a current certification and registration by a certification organization may continue to practice in such occupation provided such person meets certain conditions set forth in the act.

Any person violating the provisions of the act shall be subject to discipline by his or her respective licensing board.

(Section 334.1045)

The Board may issue a temporary license to any person whose certification and registration is pending and who meets the requirements as defined by Board rule. A temporary license shall expire 90 days after the date of the next examination if such applicant is required to take an examination. If the applicant does not take the examination on the next scheduled date, the temporary license shall expire. If no examination is required, a temporary license shall expire upon the granting or denial of a license. A temporary license shall not be issued for a period of more than 180 days, except that new graduates awaiting national certification and registration may be issued a temporary license for up to one year.

(Section 334.1050)

Any person licensed under the act may apply to the Board for an inactive license status. Upon receipt of the application, and the Board's determination that the licensee meets the requirements established by the Board, the licensee shall be declared inactive, and shall be placed on an inactive status list. A person who has been deemed inactive or who has discontinued practice due to retirement shall not practice within the state. However, such person may continue to use the title of his or her profession, or the initials of his or her profession.

An inactive licensee may return to active status by notifying the Board in advance of his or her intention, paying the appropriate fees, and meeting all requirements of the Board.

(Section 334.1055)

A person licensed under this act may use radioactive substances, or equipment emitting ionizing radiation for medical imaging or radiation therapy procedures on humans for diagnostic or therapeutic purposes only by prescription of an individual authorized by the state to prescribe such therapy procedures under the supervision of a licensed practitioner. Such person shall only use such procedures within the scope of his or her license.

(Section 334.1060)

The Board may refuse to issue or renew any license for any one or combination of causes set forth in the act. The Board shall notify the applicant in writing of the reasons for refusal, and shall advise the applicant of the applicant's right to file a complaint with the Administrative Hearing Commission. As an alternative, the Board may issue a license which is subject to reprimand, probation, restriction, or limitation for any reason set forth in the act, provided the Board takes certain steps set forth in the act.

A person who violates any provision of the act shall be guilty of a Class A misdemeanor.

(Section 334.1065)

Any authority to promulgate rules to implement the provisions of this act, to issue interpretation of the provisions of the act, or to establish the scope of practice for licenses issued under the act, shall not include the authority to define, regulate, or interpret the scope of practice of certified nurse anesthetists. (Section 334.1070)

These provisions are similar to SCS/SB 303 (2019).

ADVANCED PRACTICE REGISTERED NURSES (Sections 335.046, 335.047, 335.051 335.056, 335.076, and 335.086)

This act modifies provisions relating to advanced practice registered nurses.

Under this act, the Missouri State Board of Nursing may establish rules setting forth the licensing and renewal procedures, fees, and the discipline of advanced practice registered nurses.

(Section 335.047)

The Board may issue a license by endorsement to an APRN licensed in another state if the applicant meets the qualifications for licensure in Missouri, and such APRN shall practice in accordance with the laws of this state.

(Section 335.051)

A licensee's APRN license and his or her professional nursing license shall be treated as one license for the purpose of discipline, and renewal and assessment of renewal fees.

(Section 335.056)

Under current law, any person who holds a license to practice advanced practice nursing in the state may use the title "advanced practice registered nurse". Under this act, such person may use the designations of "certified registered nurse anesthetist", "certified nurse midwife", "certified clinical nurse specialist", and "certified nurse practitioner".

(Section 335.076)

These provisions are substantially similar to SCS/SB 400 (2019), SCS/HCS/HB 301 (2019), and are similar to HB 693 (2019), HCS/SB 164 (2019), and HB 1502 (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 HCS/SB 164 (2019), and HCS/SB 204 (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 are substantially similar to HCS/HB 66 (2019), HCS/SB 164 (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 HCS/SB 164 (2019) and HCS/SB 204 (2019).

SCOPE OF DISCIPLINARY PROCEDURE OF THE BOARD OF PHARMACY (Section 338.140)

This act authorizes the Board of Pharmacy to enter into a voluntary compliance agreement with pharmacists to ensure or promote compliance with current law and the rules of the Board, in lieu of disciplinary action. Such agreement shall be a public record, and the time limitation set forth under current law for commencing a disciplinary proceeding shall be tolled while such agreement is in effect.

This provision is identical to SB 253 (2019) and HB 257(2019), and is substantially similar to SS/HB 219 (2019).

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 source other than the real estate licensee or the seller 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 substantially similar to HCS/SB 36 (2019), SS/SB 920 (2018), HCS/HB 106 (2019), HCS/SB 164 (2019), and is similar to HB 1954 (2018).

JOSIE BUTLER