HCS HB 945 -- PROFESSIONAL REGISTRATION

SPONSOR:  Wasson (Wells)

COMMITTEE ACTION:  Voted "do pass" by the Special Committee on
Professional Registration and Licensing by a vote of 11 to 1.

This substitute changes the laws regarding the licensure of
certain professions in the Division of Professional Registration
within the Department of Insurance, Financial Institutions and
Professional Registration; the State Legal Expense Fund; endowed
care cemeteries; health care information collection; prescriptive
authority for physician assistants; and marital and family
therapists and adopts the Nurse Licensure Compact.

STATE LEGAL EXPENSE FUND

Medical practitioners providing services without compensation to
students at a summer camp are added to the list of health care
providers for whom the State Legal Expense Fund is available for
payment of certain claims filed against a provider.

ENDOWED CARE CEMETERIES

The substitute:

(1)  Allows the Division of Professional Registration within the
Department of Insurance, Financial Institutions and Professional
Registration to bring suit in Cole County against cemetery
operators;

(2)  Requires all contracts sold by cemetery operators for
cemetery services or for graves, cemetery markers, and crypts to
meet certain requirements;

(3)  Requires any person or entity with real property used for
the burial of human remains, excluding family burial grounds, to
notify the Office of Endowed Care Cemeteries within the
department of the name, location, and address of the real estate
before October 1, 2009, or within 30 days of acquiring the land;

(4)  Exempts cemetery operators from the provisions of
Chapter 436, RSMo, relating to prearranged funeral contracts but
prohibits them from adjusting or establishing prices for items
with the intent of evading the trust or escrow provisions of the
chapter;

(5)  Removes the provisions requiring a financial institution
serving as the trustee of an endowed care trust to be located in
Missouri.  All activities of the trust must be controlled by
Missouri law, and all funds held in trust must remain in
Missouri;

(6)  Requires cemetery operators to notify the division in
writing at least 30 days prior to ceasing to do business and
selling a majority of their assets.  Operators are required to
place 15% of the purchased amount in escrow for at least six
months in order to determine whether there are any financial
deficiencies;

(7)  Allows cemetery prearranged merchandise products contracts
to be canceled and fully refunded within 30 days after the
contract has been executed;

(8)  Allows the division to direct trustees to suspend the
distribution of money from endowed care trust funds if the
cemetery operator is not licensed, has failed to file annual
reports, doesn't respond to inquires, or has failed to file a
corrective action plan; and

(9)  Specifies that anyone who knowingly and unlawfully destroys,
mutilates, disfigures, defaces, or removes without authorization
any human remains from a cemetery or burial ground or other place
of interment, entombment, or inurnment will be guilty of a class
A misdemeanor.

HEALTH CARE INFORMATION COLLECTION

Any data or other information collected from health maintenance
organizations and community-based health maintenance
organizations by the Department of Health and Senior Services
regarding quality of care, access to care, member satisfaction,
and member health status that does not contain identifiable
information will be considered public information.

Each board or commission established under the Division of
Professional Registration within the Department of Insurance,
Financial Institutions and Professional Registration is
authorized to collect and analyze information needed to support
workforce planning and policy development.  This information will
be considered confidential so as to not identify a specific
health care provider.

DIVISION OF PROFESSIONAL REGISTRATION

The duties for the regulation of certain professions are
transferred from the Division of Professional Registration within
the Department of Insurance, Financial Institutions and
Professional Registration to the specific governing body for the
profession.  The substitute:

(1)  Authorizes the Board of Occupational Therapy to change its
licensing and renewal fee structure without the collaboration of
the division and to approve or disapprove certifying entities;

(2)  Repeals obsolete provisions which give the division more
authority to regulate its boards;

(3)  Authorizes the Board of Chiropractic Examiners, in
conjunction with the Acupuncturist Advisory Committee, to
prescribe the design of all forms and licenses it uses;

(4)  Repeals obsolete provisions regarding marital and family
therapists; and

(5)  Authorizes, without the collaboration of the division, the
Board of Examiners for Hearing Instrument Specialists to issue
and renew permits, licenses, and certificates; issue licenses to
applicants who are qualified to engage in the practice of fitting
hearing instruments; make recommendations for the prosecution of
violators of Chapter 346; make and publish rules necessary to
carry out the provisions of Chapter 346; and establish licensing
and renewal fees.

VOLUNTEER LICENSES FOR RETIRED DENTISTS AND DENTAL HYGIENISTS

The Dental Board within the Department of Insurance, Financial
Institutions and Professional Registration is allowed to grant
volunteer licenses to retired dentists and dental hygienists.
Individuals seeking volunteer licenses are required to file an
affidavit stating that they have been licensed for at least 10
years, their license has not been lapsed for the four years prior
to their application for a volunteer license, they are retired,
their license was in good standing at retirement, and they have
met examination and other requirements.

Beginning December 1, 2010, dentists and dental hygienists with
volunteer licenses must renew the license every two years and
must submit evidence of current certification in life support and
complete certain continuing education requirements.

Dentists with volunteer licenses may only provide dental and
preventative care without compensation to family members and at
certain facilities.  Dental hygienists with volunteer licenses
may only provide dental hygiene and preventative care without
compensation to family members and at certain facilities.

A dentist or dental hygienist is not required to pay any fee for
a volunteer license.

PRESCRIPTIVE AUTHORITY FOR PHYSICIAN ASSISTANTS

Physician assistants are allowed when delegated through a
physician supervision agreement to prescribe Schedule III, IV,
and V controlled substances.  Supervising physicians retain the
right to limit specific drugs or schedules a physician assistant
may prescribe.  Physician assistants are prohibited from
prescribing controlled substances to themselves or family members
and are limited to prescribing a 124-hour supply of Schedule III
drugs without a refill.  Physician assistants who are authorized
to prescribe must register with the federal Drug Enforcement
Administration and the federal Bureau of Narcotics and Dangerous
Drugs.

NURSE LICENSURE COMPACT

The substitute adopts the Nurse Licensure Compact which allows
licensed registered nurses to practice in any state which adopts
the compact.  All states wishing to participate must adopt the
following articles of authorization:

(1)  Article I - Finding and Declaration of Purpose;

(2)  Article II - Definitions;

(3)  Article III - General Provisions and Jurisdiction;

(4)  Article IV - Applications for Licensure in a Party State;

(5)  Article V - Adverse Actions;

(6)  Article VI - Additional Authorities Invested in Party State
Nurse Licensing Boards;

(7)  Article VII - Coordinated Licensure Information Systems;

(8)  Article VIII - Compact Administration and Interchange of
Information;

(9)  Article IX - Immunity;

(10)  Article X - Entry into Force, Withdrawal and Amendment; and

(11)  Article XI - Construction and Severability.

The compact is designed to facilitate the regulation of nurses,
and does not relieve employers from complying with state laws and
the compact does not supercede existing state labor laws.

PHARMACIES AND PHARMACISTS

The substitute:

(1)  Expands the definition of "practice of pharmacy" to include
the compounding, dispensing, labeling, and administration of
drugs and devices for pneumonia and shingles vaccines by written
protocol authorized by a physician;

(2)  Removes the provision of law which authorizes an applicant
for a pharmacy technician license to practice for a period of up
to 90 days prior to the issuance of his or her certificate of
registration;

(3)  Voids and nulls all pharmacy technician certificates of
registration 30 days after the expiration date;

(4)  Allows licensed pharmacists to perform certain nondispensing
activities and the administration of drugs and vaccines by
protocol outside of a pharmacy without a pharmacy permit subject
to rules established by the Board of Pharmacy within the
Department of Insurance, Financial Institutions and Professional
Registration;

(5)  Authorizes the board to establish the licensing filing fee
amount for out-of-state wholesale drug distributors.  Currently,
the filing fee is $10; and

(6)  Repeals the provisions which require the board to publish a
list of drugs which are not allowed to be substituted.

MARITAL AND FAMILY THERAPISTS

Marital and family therapists are added to the list of mental
health care professions in which insurance companies, health
service corporations, and health maintenance organizations are
required to provide coverage for mental health care benefits.
These benefits will include up to two visits a year.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of Unknown
exceeding $71,659 in FY 2010, Unknown exceeding $9,090 in FY
2011, and Unknown exceeding $43,210 in FY 2012.  Estimated Income
on Other State Funds of $0 in FY 2010, $18,500 in FY 2011, and
$250 in FY 2012.

PROPONENTS:  Supporters say that the bill provides a better
definition of capital gains, establishes 80% trusting, and
tightens the rules on income regarding endowed care cemeteries.

Testifying for the bill were Representative Wells; Associated
Cemeteries of Missouri; and Division of Professional
Registration, Department of Insurance, Financial Institutions and
Professional Registration.

OPPONENTS:  There was no opposition voiced to the committee.

Missouri House of Representatives
95th General Assembly, 1st Regular Session
Last Updated November 17, 2009 at 9:26 am