HCS HB 1660 & 1269 -- PROFESSIONAL REGISTRATION

SPONSOR:  Behnen

COMMITTEE ACTION:  Voted "do pass" by the Committee on
Professional Registration and Licensing by a vote of 16 to 0.

This substitute changes the laws regarding the licensing of
certain professions within the Division of Professional
Registration in the Department of Economic Development and
establishes requirements for eye screening examinations for
children enrolled in public schools.

DEAF INTERPRETERS

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

EYE SCREENING EXAMS

Beginning July 1, 2007, all public schools are required to
conduct eye screening exams for each student prior to the
completion of the first grade.  When a student fails the eye
screening, the school district must notify the parent of the
results of the screening and require the student to receive a
complete eye exam from an optometrist or ophthalmologist.  The
substitute also establishes the Children's Vision Commission,
which will sunset on December 31, 2010.  The commission will
develop standardized screening tests, reporting forms,
appropriate training programs, design a brochure outlining the
benefits of ongoing eye care for children, and conduct a
three-year pilot project tracking the results of eye screenings.
The commission must submit a report to the General Assembly prior
to October 1, 2010, detailing the results and findings of the
study.

A student will be excused from the eye screening examination if
his or her parent or legal guardian objects to the examination
and submits that in writing to the appropriate school
administrator.

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.

PRIVATE INVESTIGATORS

The Board of Private Investigator Examiners is established within
the Division of Professional Registration.  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.

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 is established.  The substitute establishes the Medical
Imaging and Radiation Therapy Board of Examiners within the
Division of Professional Registration.  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 to 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 on 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
within the Department of Economic Development to the list of
agencies which are authorized to review criminal conviction
records for screening purposes.

PROFESSIONAL COUNSELORS

Professional counselors licensed in other states are 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 or has met all eligibility
criteria established by the American Association of State
Counseling Boards or its successor organization.

SOCIAL WORKERS

Clinical social workers licensed in other states are allowed 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.

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.

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, RSMo, 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.

ADMINISTRATIVE HEARING COMMISSION

The Administrative Hearing Commission is authorized to publish
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 $444,322
to $949,990 in FY 2007, $455,041 to exceeding $1,061,842 in
FY 2008, and $464,106 to exceeding $1,070,904 in FY 2009.
Estimated Effect on Other State Funds of a Cost of Unknown less
than $298,249 in FY 2007, an Income of $461,078 in FY 2008, and a
Cost of $576,578 in FY 2009.

PROPONENTS:  Supporters of HB 1660 say that it gives the Division
of Professional Registration more access to legal counsel,
establishes temporary licenses, and grants grace periods for
licensees on active military duty.

Supporters of HB 1269 say that many kids are falling through the
cracks when it comes to eye care.  If eye problems aren't
detected and treated at an early age, there can be permanent
damage to a child's sight.  The bill is vital to providing the
early intervention needed to protect the vision of Missouri's
children.

Testifying for HB 1660 were Representative Behnen; and Division
of Professional Registration, Department of Economic Development.
Testify for HB 1269 were Representatives Jetton and Tilley;
Missouri Coalition of Children's Agencies; and Missouri Nurses
Association.

OPPONENTS:  There was no opposition voiced to the committee.

OTHERS:  Others testifying on HB 1269 say that there have been
meetings going on since last year to try to reach a compromise
between the interested parties.  In order to get this program
moving forward, there will be compromise language submitted, even
with the objection of the optometric community.  Others feel that
there needs to be some accountability.  Nothing in the bill
mandates parents to get the proper recommended treatment.

Others testifying on HB 1269 were Representative Behnen; Missouri
Society of Eye Physicians and Surgeons; Missouri Optometric
Association; Missouri Association of School Nurses; Missouri
State Medical Association; Missouri Association of Osteopathic
Physicians and Surgeons; and Missouri Academy of Family
Physicians.

Bob Dominique, Legislative Analyst

Missouri House of Representatives
93rd General Assembly, 2nd Regular Session
Last Updated November 29, 2006 at 9:44 am