CCS HCS SB 296 -- PROFESSIONAL REGISTRATION

This bill changes the laws regarding the licensure of certain
professionals by 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 (Section 105.711, RSMo)

Licensed or registered physicians, nurses, physician assistants,
dental hygienists, or dentists 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 (Sections 214.270, 214.280, 214.330,
214.385, and 214.387)

The bill:

(1)  Prohibits the principal from an endowed care trust fund from
being distributed except to the extent that a unitrust election
is in effect with respect to the trust under the provisions of
Section 469.411;

(2)  Requires cemetery operators who sell prearranged burial
merchandise and services to deposit a portion of the purchase
price in an escrow or trust account within 60 days of receipt.
These funds must be maintained in the account until delivery of
the property, performance of the services, or the contract is
canceled; and

(3)  Requires cemetery operators, which have been paid in full
for merchandise and the performance of services, to deposit 80%
of the published retail price from their own funds into a
trusteed account.  Currently, 40% of the published retail price
must be deposited.

HEALTH CARE INFORMATION COLLECTION (Section 324.001)

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 required to support
workforce planning and policy development.  This information must
not be publicly disclosed so as to identify a specific health
care provider.

DIVISION OF PROFESSIONAL REGISTRATION (Chapters 324, 334, 337,
and 346)

The duties for the regulation of certain professionals 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 bill:

(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 gave 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 its forms and licenses;

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

(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; and

(6)  Repeals conflicting and obsolete provisions of law regarding
the licensure of barbers and cosmetologists.

ARCHITECTS, ENGINEERS, LAND SURVEYORS, AND LANDSCAPE ARCHITECTS
(Section 327.442)

The bill authorizes the Board for Architects, Professional
Engineers, Professional Land Surveyors and Landscape Architects
within the Department of Insurance, Financial Institutions and
Professional Registration to conduct disciplinary hearings for
licensees convicted of certain felonies and to automatically deny
licenses to anyone who has had a license revoked or denied in
another state.  The board may establish other qualifications by
which the person may be licensed.

VOLUNTEER LICENSES FOR RETIRED DENTISTS AND DENTAL HYGIENISTS
(Sections 332.112 and 332.113)

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.  An
individual seeking a volunteer license is required to file an
affidavit stating that he or she has been licensed for at least
10 years and has not allowed that license to lapse or expire for
at least four years prior to his or her application for a
volunteer license, is retired, his or her license was in good
standing at retirement, and that he or she has passed the
examination and met other requirements.

Beginning December 1, 2010, dentists and dental hygienists with
volunteer licenses must renew their license every two years and
must submit evidence of current certification in specified life
support programs 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.

PHYSICIAN ASSISTANTS (Sections 195.070, 195.100, 334.735, and
334.747)

A physician assistant who works in a rural health clinic and
receives a waiver of the minimum on-site supervision requirement
and maximum distance requirement from a supervising physician
does not need to receive any additional waiver as long as the
clinic maintains its status as a rural health clinic and the
physician assistant and supervising physician comply with federal
supervision requirements.  Physician assistants receiving waivers
will only be required to renew their waiver every five years,
when their supervising physician changes from the physician
listed on their application, or when they move their primary
practice location more than 10 miles from the location listed on
the waiver application.

A physician assistant with a certificate of controlled substance
prescriptive authority is 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 a drug category that a physician
assistant may prescribe.  Physician assistants are prohibited
from prescribing controlled substances to themselves or family
members and are limited to prescribing a five-day 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 state Bureau of Narcotics and
Dangerous Drugs.  Pharmacists are required to list the name of
the physician assistant and the supervising physician on the
prescription label.

NURSE LICENSURE COMPACT (Sections 335.300 - 335.355)

The bill adopts the Nurse Licensure Compact which allows licensed
registered nurses and licensed practical/vocational nurses to
practice in any state which adopts the compact.  All states
wishing to participate must adopt the compact's articles of
authorization.

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

PHARMACIES AND PHARMACISTS (Sections 338.010, 338.013, 338.057,
338.220, and 338.337)

The bill:

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

(2)  Removes the provision of the 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 a pharmacy technician certificate of registration 30
days after the expiration date;

(4)  Allows licensed pharmacists to perform certain nondispensing
activities and administer drugs and vaccines by protocol, as
permitted by law, outside of a pharmacy without a pharmacy
permit;

(5)  Specifies that, under certain conditions, an out-of-state
wholesale drug distributor that is a drug manufacturer which
produces and distributes from a facility inspected and approved
by the federal Food and Drug Administration and is licensed by
the state in which the facility is located will not be required
to be licensed but must register its business name and address
with the Board of Pharmacy within the Department of Insurance,
Financial Institutions and Professional Registration and pay a
filing fee as established by the department.  This also applies
to a wholesale drug distributor located in a foreign country if
it is authorized and in good standing to operate as a drug
manufacturer within its jurisdiction; 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 (Section 376.811)

Insurance companies, health services corporations, and health
maintenance organizations are required, subject to contractual
provisions, to provide coverage for mental health care benefits
by licensed marital and family therapists for up to two visits a
year.

TEETH WHITENING SERVICES (Section 1)

The bill specifies that any person providing teeth whitening
services to another person by the use of products not readily
available to the public through over-the-counter purchase will be
deemed to be engaging in the practice of dentistry.  Application
of whitening formulations may be done by licensed dental
hygienists and registered dental assistants, but only under the
appropriate level of supervision of a licensed dentist.  Any
person who takes dental impressions or performs any part of the
teeth whitening process without being under the appropriate level
of supervision of a licensed dentist will be deemed to be
engaging in the practice of dentistry.

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