HCS SB 1124 -- PROFESSIONAL REGISTRATION

SPONSOR:  Shields (Behnen)

COMMITTEE ACTION:  Voted "do pass" by the Committee on
Professional Registration and Licensing by a vote of 15 to 0.

This substitute changes the laws regarding the licensing of
certain professions within the Division of Professional
Registration and the Department of Public Safety.

DEAF INTERPRETERS

Deaf interpreters are added to the list of professions which are
excused from certain provisions of the licensing laws while on
active military duty.

ATHLETIC CONTESTS (MIXED MARTIAL ARTS)

The substitute requires contestants participating in boxing,
kickboxing, wrestling, full-contact karate, or mixed martial arts
to sign a bout contract with the event promoter before each
contest which specifies their weight, how much they are being
paid, and the date and location of the event.

The substitute also defines "mixed martial arts."

MASSAGE THERAPY

The Board of Therapeutic Massage is authorized to promulgate
rules establishing requirements for granting licenses for
applicants from other states who have completed massage therapy
programs which are less than 500 hours.  Massage therapy
businesses are prohibited from employing an unlicensed person for
the purpose of performing massage therapy services.  The board is
required to send copies of all board survey inspections to the
business within 30 days of the inspection.  The board is allowed
to waive or extend the time requirements for completion of
continuing education requirements under certain circumstances as
determined by the board.  Nonresident licensed massage therapists
will be exempt from licensure if they are providing services or
instruction in conjunction with disaster relief or at special
events.

The board is also authorized to contract for legal services.

BLASTING

The substitute establishes the Missouri Blasting Safety Act and
the Missouri State Blasting Board.  Persons using explosives in
this state must register with the Division of Fire Safety within
the Department of Public Safety within 60 days of the effective
date of the substitute and file an annual report stating their
blasting activities from the previous year.  Certain criteria is
established that must be met by applicants prior to the issuance
of a license, and the division is authorized to suspend, revoke,
or deny licenses.  A person whose license has expired for more
than three years will be required to take the licensing exam and
complete the continuing education requirements prior to being
reissued a license.  The substitute allows for license
reciprocity and provides for certain licensing exemptions.  The
division is authorized to adopt rules creating a standardized
qualification examination, continuing education requirements, and
a fee structure.

The Missouri Explosives Safety Act Administration Fund is created
to be used by the State Fire Marshal for administration and
enforcement costs.

The substitute also requires any person using explosives in this
state to notify the division at least two business days in
advance before blasting at a new site.

PRIVATE INVESTIGATORS

The Board of Private Investigator Examiners is established within
the division.  No person can provide private investigative
services without first being licensed.  The substitute specifies
the membership and duties of the board; exemptions from
licensure; requirements for application and licensure; proof of
liability insurance; training and written examinations; fees;
background checks on applicants; appeal process for the denial,
suspension, or revocation of licenses; types and terms of
licenses; and the procedure for applicants seeking reciprocity.
Licensees are allowed to disclose to the board, any law
enforcement agency, a prosecutor, or the licensee's own
representative any information regarding a criminal offense or to
instruct their clients to do so if they are victims of a criminal
act.  Licensees are prohibited from making false reports,
presenting themselves as a state or federal officer, or
manufacturing false evidence.  Certain identifying evidence must
be filed with the board by licensees.  Private investigators or
investigator agencies are required to maintain complete records
of their business transactions.  Records may be confidentially
examined by the board under certain circumstances.

DENTAL RECORDS

Dentists are required to maintain complete and adequate patient
records.  Records must be retained for at least seven years from
the date of the last professional service.  Any addition or
change to a patient's record made more than 48 hours after the
final entry will be entered as an addendum and will specify the
time; date; name of person making the addition, correction, or
change; and the reason for the change.

Laboratory work orders are also required to be maintained for
seven years.

REVOCATION OF LICENSES

The State Board of Registration for the Healing Arts is
authorized to revoke the professional license of any person
licensed under Chapter 334, RSMo, who has been found guilty of a
felony.  Currently, it only applies to physicians.

COLLABORATIVE AGREEMENTS

The substitute prohibits physicians from entering into a
collaborative agreement with an advanced practice nurse who
directly employs a collaborating physician.

PHYSICIAN ASSISTANTS

The substitute expands the definition of "supervision" of
physician assistants to allow supervising physicians to be
available through telecommunications for consultation,
assistance, or intervention.

Supervising physicians must be present a minimum of 55% of the
clinic's hours for practice supervision and collaboration when
utilizing physician assistants.  No physician will supervise more
than three physician assistants; however, this provision does not
apply to physician agreements with hospital employees.

Physician assistants must practice within 50 miles of the
supervising physician when practicing in federally designated
health professional shortage areas (HPSA).  Physician assistants
not practicing in an HPSA will be limited to off-site practice in
which the supervising physician is able to be physically present
at the location within 30 minutes to ensure effective
intervention and supervision of patient care.

The substitute requires, after January 1, 2007, that applicants
for a physician's assistant license have a master's degree in a
health or medical science related field.

PHYSICAL THERAPY ASSISTANTS

The substitute makes a technical change in the laws regarding
reciprocity for physical therapy assistants.

MEDICAL IMAGING

The Medical Imaging and Radiation Therapy Quality Assurance Act
of 2006 and the Medical Imaging and Radiation Therapy Board of
Examiners within the Division of Professional Registration are
established.  All persons administering medical imaging and
radiation therapy procedures are required to be licensed by the
board.  Physicians, veterinarians, dentists, chiropractors,
podiatrists, registered nurses, and certain qualified persons
currently practicing medical imaging and radiation therapy are
exempted from licensure.  The substitute establishes certain
criteria that must be met by applicants for licensure as
radiographers, radiation therapists, nuclear medicine
technologists, and dental radiographers.  The board is authorized
to certify programs for medical imaging and radiation therapy in
medical facilities, dental facilities, educational institutions,
or other public or private institutions.  The board is further
authorized to adopt rules; give examinations; waive examination
requirements; establish continuing education; issue temporary
permits; renew, revoke, and suspend licenses; investigate charges
and allegations brought against licensees; issue subpoenas; hold
hearings; render judgments; and hear appeals.

Beginning August 28, 2009, persons providing the technical
component of diagnostic ultrasound services (sonography or
vascular technology) are required to be credentialed or practice
in an accredited laboratory.

NURSES

The substitute authorizes the State Board of Nursing to file a
complaint with the Administrative Hearing Commission requesting
an expedited hearing for a restriction or suspension of a license
for certain activities which the board deems to be a danger to
the public health and safety.  Within 15 days of the receipt of
the complaint, the commission will conduct a preliminary hearing
to determine whether the activities of the licensee are a danger
to the public.  The commission will issue a decision immediately
after the hearing either granting the board the authority to
suspend or restrict a license or dismissing the action.

A hearing before the commission will be granted if the licensee
makes a formal request within 30 days of the preliminary hearing.
If no request is made, the commission's decision becomes final.
If the licensee is found to be in violation of any imposed
disciplinary action, the matter will be considered a default
case; and the board is authorized to take appropriate action.

The substitute also requires a board of trustees or similarly
empowered official of any home health agency, nursing facility,
or entity which employs or contracts with licensed health care
professionals to take disciplinary action if it finds that a
licensee is in violation of the licensing laws for his or her
profession.  When disciplinary action is taken against a
licensee, the entity taking action will report it to the proper
health care professional licensing authority.

The substitute adds the Division of Professional Registration to
the list of agencies which are authorized to review criminal
conviction records for screening purposes.

COUNSELORS AND THERAPISTS

The substitute abolishes the Committee for Professional
Counselors and the State Committee of Marital and Family
Therapists and combines the two committees to become the Board of
Counselors and Therapists.  The Board of Counselors and
Therapists Fund is created for the deposit of all moneys
collected by the board.

Professional counselors licensed in other states will be allowed
to apply for licensure in Missouri without examination if the
applicant has had no disciplinary action taken against his or her
license in the past five years and has met all eligibility
criteria established by the American Association of State
Counseling Boards or its successor organization.

SOCIAL WORKERS

The substitute allows clinical social workers licensed in other
states to obtain a Missouri license if they have had no
disciplinary action taken against their license in the preceding
five years and their current state license has substantially the
same licensing requirements as the State of Missouri.

The substitute also expands continuing education requirements for
social workers to include ethics, rules, and regulations.

BOARD OF PHARMACY

The one-year time limit for an intern pharmacist license is
removed and language is repealed authorizing the State Board of
Pharmacy to promulgate rules restricting the practice of intern
pharmacists.  The board is also authorized to issue cease and
desist orders to persons engaged in the unauthorized practice of
pharmacy and enforce orders by applying to a court of competent
jurisdiction.  The board is further authorized to waive licensure
if a state of emergency is declared when the safety and welfare
of the inhabitants of the state are in jeopardy.

The substitute also creates a veterinary class for pharmacy
permits or licenses.

REAL ESTATE

Internet advertising communications of real estate will be
allowed if the advertising is incidental to the licensee's
operation.

Any notice of appeal for the revocation of a license is required
to be sent to the Administrative Hearing Commission by certified
mail.

REAL ESTATE APPRAISERS

The substitute repeals the requirement that members of the
Missouri Real Estate Appraisers Commission be members in good
standing of a nationally recognized real estate appraisal
organization, repeals the provision regarding the term of office
of initial members of the commission, and repeals the provision
authorizing the commission to decide the location of future
quarterly meetings.

The daily per diem for commission members is increased from $50
to $70.  The commission is authorized to administer oaths and
issue and enforce subpoenas.  The provision authorizing the
commission to waive continuing education requirements for retired
or disabled appraisers is repealed.

The substitute authorizes the commission to issue inactive
licenses and allows persons to renew expired licenses within a
one-year period if evidence of the completion of all continuing
education requirements is provided.

VETERINARIANS

The Missouri Veterinary Medical Board is authorized to promulgate
rules determining when applicants are required to submit an
application for the licensing examination.  Currently, applicants
are required to make application 60 days prior to taking the
examination.

NURSING HOME ADMINISTRATORS

Nursing home administrators are required to pay licensing fees
to the Department of Health and Senior Services.  Applicants for
licensure who have failed the examination administered by the
Missouri Board of Nursing Home Administrators three times are
prohibited from being licensed unless they have successfully
completed the board-prescribed course of instruction and passed
the examination.  Temporary emergency licenses may be issued to
an applicant whose licensing examination results have not been
received by the board, and the board may issue probationary
licenses.  The board is authorized to file complaints with the
Administrative Hearing Commission for violations of any
provisions of Chapter 198 or rules promulgated by the board.
Members of the board must be citizens of the United States and
reside in Missouri for at least one year prior to being
appointed.

The substitute authorizes the board to establish an inactive
license.

HEALTH CARE PROFESSIONAL PEER REVIEW

The substitute authorizes licensed ambulance services, emergency
medical response agencies, and not-for-profit organizations which
contract for ambulance services to establish peer review
committees.

CONTRACT FOR SERVICES

The substitute authorizes the Director of the Division of
Professional Registration to retain personnel necessary to render
services to the division.

ADMINISTRATIVE HEARING COMMISSION

The Administrative Hearing Commission is authorized to publish in
a local newspaper of general circulation notifications of
licensing cases to be heard before the commission if notification
cannot be accomplished in person or by certified mail.

DISQUALIFICATION LIST

The Department of Health and Senior Services is required to
provide the employee disqualification list to any school of
nursing, school of medicine, or school of any other health
profession in order to determine whether students participating
in patient care services are on the disqualification list.  The
list identifies individuals who have been determined by the
department to have recklessly, knowingly, or purposely abused or
neglected an in-home services or home health patient while
employed by an in-home services provider or home health agency.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of $0 to
$505,668 in FY 2007, $4,500 to $611,301 in FY 2008, and $2,250 to
$609,051 in FY 2009.  Estimated Effect on Other State Funds of a
Cost of Unknown less than $332,229 in FY 2007, an Income of
Unknown exceeding $909,180 in FY 2008, and a Cost of Unknown less
than $447,885 in FY 2009.

PROPONENTS:  Supporters say that along with some technical
changes the bill allows license reciprocity for physical therapy
assistants, professional counselors, and social workers.

Testifying for the bill was Representative Behnen.

OPPONENTS:  There was no opposition voiced to the committee.

Bob Dominique, Legislative Analyst

Missouri House of Representatives
93rd General Assembly, 2nd Regular Session
Last Updated November 29, 2006 at 9:47 am