HS HCS HB 564 -- PROFESSIONAL REGISTRATION (Behnen)

This substitute contains provisions relating to deaf
interpreters, occupational therapists, dietitians, tatooists,
interior designers, athlete agents, architects, barbers,
cosmetologists, dentists, physical therapists, anesthesiologist
assistants, athletic trainers, psychologists, social workers,
real estate professionals, and auctioneers.

DEAF INTERPRETERS

The substitute authorizes the Missouri Commission for the Deaf
and Hard of Hearing to issue a provisional certification as an
interpreter to a person nominated by a local public school
district if the school district certifies that it was unable to
locate and employ a certified and licensed deaf interpreter.

The substitute further expands the authority of the Division of
Professional Registration to deny license renewal of deaf
interpreters for failure to provide satisfactory evidence of
current certification with the Missouri Commission for the Deaf
and Hard of Hearing.

OCCUPATIONAL THERAPISTS

The Missouri Board of Occupational Therapy is given authority to
give licensing exams to qualified applicants upon demand and is
placed under the purview of the Administrative Hearing
Commission.

DIETITIANS

The substitute:

(1)  Creates the definitions for "dietetic practice" and
"registered dietitian";

(2)  Places the State Committee of Dietitians within the
division;

(3)  Authorizes the committee to assist the division in carrying
out the provisions of the Dietitians Practice Act;

(4)  Requires the committee to approve the licensing examination;

(5)  Exempts from licensure certain persons if they do not hold
themselves out as being licensed dietitians; and

(6)  Contains provisions regarding lapsed and inactive licenses.

INTERIOR DESIGNERS

Expired language relating to the grandfather provisions for
interior designer licenses is repealed.

TATTOOISTS

The substitute authorizes the division to issue temporary
licenses for persons entering the state for the sole purpose of
participating in a state or national convention where the
applicant will be practicing the profession of tattooing, body
piercing, and branding.  The temporary license will be valid for
14 days.

This provision contains an emergency clause.

ATHLETE AGENTS

All athlete agents operating in this state are required to be
registered and certified by the division.  Fees for registration
and renewal will be set by the division and deposited in the
Athlete Agent Fund, which is created by the substitute.
Registration and certification are valid for a two-year period
and may be renewed indefinitely.  The division director may
refuse to issue a certificate or may suspend or revoke a
certificate for reasons set out in the substitute:

All agent-athlete contracts must be written and contain certain
information, including the basis for the agent's fee and a notice
warning the student-athlete about possible loss of eligibility.

ARCHITECTS

The substitute establishes inactive licenses for architects.
Licensed architects may make application for an inactive license
with the Missouri Board for Architects, Professional Engineers,
Land Surveyors, and Landscape Architects.  After receiving their
inactive license, inactive licensees cannot practice architecture
in this state, but they may continue to hold themselves out as
being an architect.  Inactive licensees who fail to maintain a
current license in any state for a period exceeding five years
prior to requesting licensure reinstatement must take a licensing
examination deemed appropriate by the board.

BARBERS

The substitute allows for the licensing of barber apprentices and
certification of barber apprentice supervisors.  Prior to being
eligible to apply for a barber's license, barber apprentices must
work for no less than 2,000 hours under a licensed barber who is
certified by the State Board of Barber Examiners to act as a
barber apprentice supervisor.  Applicants for a barber apprentice
certificate must be at least 16 years old.

COSMETOLOGISTS

Manicurist apprentices are required to complete at least 800
hours of supervised training prior to making application for
licensure.  The course of study for all cosmetology apprentices
may not exceed 12 hours per day and 72 hours per week.

DENTISTS

The substitute:

(1)  Allows for the practice of dentistry across state lines, as
long as the person practicing across state lines is licensed to
practice dentistry in another state and the practice is limited
to the rendering of documented opinions concerning diagnosis and
treatment through electronic means.  When receiving consultations
across state lines, the ultimate authority and responsibility for
the diagnosis and treatment of the patient remains with the
primary care dentist licensed in this state;

(2)  Expands the definition of "practices dentistry" to include
the use of lasers;

(3)  Authorizes the Missouri Dental Board to issue specialist
licenses without examination to applicants who have been
certified in any specialty by an examining board recognized by
the American Dental Association or the Council on Dental
Accreditation;

(4)  Allows for issuance of specialized licenses for dentists who
hold specialty licenses in other states, as long as they are
licensed in this state and the educational requirements for their
specialized licenses are the same or exceed those in this state;

(5)  Gives the board the authority to create specialization
committees for each specialty recognized by the American Dental
Association.  The committees will assist the board in
establishing criteria and evaluating applicants for specialty
licenses;

(6)  Provides that all specialty licenses be subject to sanctions
and that licensees pay fees as set forth by the board;

(7)  Requires all dentists and dental hygienists to complete all
continuing education requirements prior to license renewal.
Failing to do so, without reasonable cause, will result in the
license being sanctioned by the board;

(8)  Requires all dentists and dental hygienists who have allowed
their licenses to lapse for more than four years to make
application and take all licensing examinations required by the
board;

(9)  Contains provisions pertaining to the disposition of
complaints brought before the Administrative Hearing Commission
by the board regarding licensees who present a clear and present
danger to the health and safety of the public at large; and

(10)  Allows the board to disclose confidential records and
information to the board's Committee on Well-Being for the
purpose of assisting in the rehabilitation of impaired licensees.
All information disclosed to the committee is still considered
confidential and closed to the public.

COLLABORATIVE PRACTICE

The substitute allows physicians to collaborate and share
responsibilities with qualified health care practitioners
practicing independent of the physician with respect to
preoperative and postoperative care for surgical patients, with
the consent of patients.

The substitute also provides the fees be divided based on the
relative value of services provided and that no demands or
threats regarding collaboration or referrals be made by either
party.

PHYSICAL THERAPISTS

The substitute:

(1)  Provides for reciprocal, provisional, and temporary
licenses;

(2)  Allows additional examination sittings for individuals who
meet criteria established in the substitute;

(3)  Requires provisional licensed physical therapists to
practice under the direct supervision of a licensed physical
therapist;

(4)  Permits issuance of temporary licenses to those failing the
licensing exam.  The duration of the first temporary license will
be six months and can only be renewed once.  This renewal may
only be issued if the licensee, after showing good cause, fails
to sit for the next scheduled examination.  Temporary licenses
may be issued to students in their last semester of physical
therapy school; and

(5)  Allows applicants to sit for the licensing exam no more than
three times.  Upon failing the state exam for the second time, an
applicant must complete a program of remediation before sitting
for the third exam.

ANESTHESIOLOGIST ASSISTANTS

The substitute:

(1)  Establishes registration for anesthesiologist assistants
under the State Board of Registration for the Healing Arts;

(2)  Allows anesthesiologist assistants to assist a supervising
anesthesiologist in formulating and executing an anesthesia care
plan for patients.  Anesthesiologist assistants are given
authority to obtain patient history, perform relevant physical
exams, pretest and calibrate anesthesia delivery systems,
interpret information while in consultation with an
anesthesiologist, establish airway intervention, administer
vasoactive and other anesthetic drugs, adjust vasoactive
infusions, and provide tasks not prohibited by law while under
the supervision of an anesthesiologist;

(3)  Requires an anesthesiologist to be responsible for the
oversight of the health care services rendered by an
anesthesiologist assistant;

(4)  Prohibits anesthesiologist assistants from prescribing
medications and controlled substances, conducting activities
which are beyond the scope of practice of the supervising
anesthesiologist, practicing without the supervision of an
anesthesiologist, and holding themselves out as being a
physician;

(5)  Prohibits anesthesiologists from billing for services
performed by an anesthesiologist assistant;

(6)  Requires applicants for licensure to apply to the board and
pay the required fees;

(7)  Allows the board to issue temporary and inactive licenses;

(8)  Requires retiring anesthesiologist assistants to file an
affidavit with the board stating their intentions and the date of
their retirement;

(9)  Gives the board authority to negotiate reciprocal compacts
with other states and to license qualified applicants from other
states;

(10)  Requires the board to promulgate rules pertaining to
application forms, certification, registration, and fees;

(11)  Grants the board the authority to refuse to issue, suspend,
or renew licenses and describes the allowable causes for the
board to file complaints with the Administrative Hearing
Commission;

(12)  Prohibits any person from practicing as an anesthesiologist
assistant without a license, unless the person is in a certified
program under direct supervision of an anesthesiologist or is in
a hospital residency program to become an anesthesiologist;

(13)  Requires that all continuing education requirements be met
prior to license renewal;

(14)  Requires all fees collected by the division to be deposited
to the credit of the Board of Registration for the Healing Arts
Fund;

(15)  Requires all supervising anesthesiologists to adopt
protocols that delineate the services provided and the manner of
supervision;

(16)  Gives the governing boards of hospitals the authority to
limit the functions and activities of anesthesiologist
assistants;

(17)  Prohibits persons from holding themselves out as being
anesthesiologist assistants without being duly licensed by the
board; and

(18)  Establishes the Advisory Commission for Anesthesiologist
Assistants.

ATHLETIC TRAINERS

The substitute provides for the licensing of athletic trainers.
Currently, athletic trainers are registered by the State Board of
Registration for the Healing Arts.

PSYCHOLOGISTS

The State Committee of Psychologists is allowed to issue inactive
licenses.

SOCIAL WORKERS

The substitute prohibits any person from holding themselves out
as being a social worker or using the title of social worker
unless the person holds a current license in baccalaureate or
clinical social work issued by the State Committee for Social
Workers or holds a degree from an accredited social work program
approved by the Council on Social Work Education.

Beginning January 1, 2004, no entity, public or private, may use
the title of social worker for volunteer or employment positions
within contracts for services, documents, manuals, or reference
material unless those persons being referred to have met all
educational requirements set forth by the substitute.

REAL ESTATE PROFESSIONALS

The substitute:

(1)  Adds Internet web sites to the licensing exemption, when in
the case of advertising real estate, the advertising is
incidental to their normal business operations;

(2)  Removes the requirement of land developers selling their own
property from having on file with the Missouri Real Estate
Commission a certified copy of a currently effective statement of
record from the Office of Interstate Land Sales;

(3)  Allows the commission to issue temporary work permits to
individuals who have satisfied all licensing requirements prior
to the final review and printing of their licenses;

(4)  Grants entities providing continuing education the authority
to do so through the means of distance delivery;

(5)  Gives the commission authority, when conducting
investigations of complaints involving affiliated licensees, to
forward copies of the information regarding the complaint to the
affiliated licensee's broker;

(6)  Gives the commission authority, when a licensee fails to
renew or surrender his or her license and the commission finds
the licensee to be in violation of certain provisions, to cause
complaints to be filed with the Administrative Hearing
Commission;

(7)  Requires real estate brokers holding funds belonging to
another party in a real estate transaction to maintain the funds
in a separate account designated as an escrow or trust account.
Brokers may not commingle their own personal funds or any other
moneys in this account with the exception that a broker may
deposit an amount not to exceed $1,000 specifically identified
for the purpose of covering service charges related to the
account.  When brokers decide not to maintain an escrow account,
they must notify the commission.  If they decide to open an
escrow account, they must notify the commission within 10
business days of doing so.  In the case of disputes regarding
ownership of escrow moneys, the funds must be deposited with the
State Treasurer within 180 days of the original deposit.  The
funds will be held in trust until the dispute can be resolved;

(8)  Increases the amount of compensation which each member of
the commission receives from $50 to $75;

(9)  Requires designated brokers who have affiliated licensees to
adopt a written policy describing their relationships in regard
to their real estate activities; and

(10)  Repeals the provisions relating to escrow agents.

The provisions relating to real estate will become effective
January 1, 2004.

AUCTIONEERS

Requires the Speaker of the House of Representatives and the
President Pro Tem of the Senate to appoint a joint interim
committee to review the practice of auctioneering.  The joint
committee will complete its review and report its findings to the
General Assembly no later than December 31, 2004.

This provision expires January 1, 2005.

The substitute contains an effective date, expiration date, and
emergency clause for certain sections.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of Up to
$11,481 in FY 2004, $0 in FY 2005, and $0 in FY 2006.  Estimated
Net Income to Dietitian Fund of $115,800 in FY 2004, $3,474 in FY
2005, and $116,841 in FY 2006.  Estimated Net Effect on Athlete
Agent Fund of $0 in FY 2004, FY 2005, and FY 2006.  Estimated Net
Income to Barber Fund of $0 in FY 2004, $2,250 in FY 2005, and
$500 in FY 2006.  Estimated Net Effect to Board of Registration
for Healing Arts Fund of $0 in FY 2004, an income of $19,839 in
FY 2005, and a cost of $10,146 in FY 2006.  Estimated Net Cost to
Missouri Real State Commission Fund of $18,229 in FY 2004,
$21,875 in FY 2005, and $21,875 in FY 2006.

Missouri House of Representatives
Last Updated July 25, 2003 at 10:12 am