| 6 | 6 | | ANACT |
|---|
| 7 | 7 | | Torepealsections197.400,197.405,197.445,334.104,and335.175,RSMo,andtoenactin |
|---|
| 8 | 8 | | lieuthereoffivenewsectionsrelatingtohealthcareprofessionals,withanemergency |
|---|
| 9 | 9 | | clause. |
|---|
| 10 | 10 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
|---|
| 11 | 11 | | SectionA.Sections197.400,197.405,197.445,334.104,and335.175,RSMo,are |
|---|
| 12 | 12 | | 2repealedandfivenewsectionsenactedinlieuthereof,tobeknownassections197.400, |
|---|
| 13 | 13 | | 3197.405,197.445,334.104,and335.175,toreadasfollows: |
|---|
| 14 | 14 | | 197.400.Asusedinsections197.400to197.475,unlessthecontextotherwise |
|---|
| 15 | 15 | | 2requires,thefollowingtermsmean: |
|---|
| 16 | 16 | | 3 (1)"Advancedpracticeregisterednurse",thesamemeaninggiventothetermin |
|---|
| 17 | 17 | | 4section335.016; |
|---|
| 18 | 18 | | 5 (2)"Council",thehomehealthservicesadvisorycouncilcreatedbysections197.400 |
|---|
| 19 | 19 | | 6to197.475; |
|---|
| 20 | 20 | | 7 [(2)](3)"Department",thedepartmentofhealthandseniorservices; |
|---|
| 21 | 21 | | 8 [(3)](4)"Homehealthagency",apublicagencyorprivateorganizationora |
|---|
| 22 | 22 | | 9subdivisionorsubunitofanagencyororganizationthatprovidestwoormorehomehealth |
|---|
| 23 | 23 | | 10servicesattheresidenceofapatientaccordingtoa[physician's] written[andsigned] planof |
|---|
| 24 | 24 | | 11treatmentsignedbyaphysician,advancedpracticeregisterednurse,orphysician |
|---|
| 25 | 25 | | 12assistant; |
|---|
| 26 | 26 | | 13 [(4)](5)"Homehealthservices",anyofthefollowingitemsandservicesprovidedat |
|---|
| 27 | 27 | | 14theresidenceofthepatientonapart-timeorintermittentbasis:nursing,physicaltherapy, |
|---|
| 28 | 28 | | 15speechtherapy,occupationaltherapy,homehealthaid,ormedicalsocialservice; |
|---|
| 29 | 29 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
|---|
| 30 | 30 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 16 [(5)](6)"Part-timeorintermittentbasis",theprovidingofhomehealthservicesinan |
|---|
| 31 | 31 | | 17interruptedintervalsequenceontheaverageofnottoexceedthreehoursinanytwenty-four- |
|---|
| 32 | 32 | | 18hourperiod; |
|---|
| 33 | 33 | | 19 [(6)](7)"Patient'sresidence",theactualplaceofresidenceofthepersonreceiving |
|---|
| 34 | 34 | | 20homehealthservices,includinginstitutionalresidencesaswellasindividualdwellingunits; |
|---|
| 35 | 35 | | 21 [(7)](8)"Physician",apersonlicensedbythestateboardofregistrationforthe |
|---|
| 36 | 36 | | 22healingartspursuanttotheprovisionsofchapter334topracticeinthisstateasaphysician |
|---|
| 37 | 37 | | 23andsurgeon; |
|---|
| 38 | 38 | | 24 [(8)](9)"Physicianassistant",apersonlicensedbythestateboardof |
|---|
| 39 | 39 | | 25registrationforthehealingartsundertheprovisionsofchapter334topracticeinthis |
|---|
| 40 | 40 | | 26stateasaphysicianassistant; |
|---|
| 41 | 41 | | 27 (10)"Planoftreatment",aplanreviewedandsignedasoftenasmedicallynecessary |
|---|
| 42 | 42 | | 28byaphysician[or],podiatrist,advancedpracticeregisterednurse,orphysicianassistant, |
|---|
| 43 | 43 | | 29nottoexceedsixtydaysinduration,prescribingitemsandservicesforanindividualpatient's |
|---|
| 44 | 44 | | 30condition; |
|---|
| 45 | 45 | | 31 [(9)](11)"Podiatrist",apersonlicensedbythestateboardofpodiatrypursuanttothe |
|---|
| 46 | 46 | | 32provisionsofchapter330topracticeinthisstateasapodiatrist; |
|---|
| 47 | 47 | | 33 [(10)] (12)"Subunit"or"subdivision",anyorganizationalunitofalarger |
|---|
| 48 | 48 | | 34organizationwhichcanbeclearlydefinedasaseparateentitywithinthelargerstructure, |
|---|
| 49 | 49 | | 35whichcanmeetalloftherequirementsofsections197.400to197.475independentofthe |
|---|
| 50 | 50 | | 36largerorganization,whichcanbeheldaccountableforthecareofpatientsitisserving,and |
|---|
| 51 | 51 | | 37whichprovidestoallpatientscareandservicesmeetingthestandardsandrequirementsof |
|---|
| 52 | 52 | | 38sections197.400to197.475. |
|---|
| 53 | 53 | | 197.405.Nohomehealthagency,includingMedicareandMedicaidproviders,shall |
|---|
| 54 | 54 | | 2providetwoormoreofthehomehealthservicescoveredbysubdivision[(4)](5)ofsection |
|---|
| 55 | 55 | | 3197.400orshallholditselfoutasprovidingsuchhomehealthservicesorasahomehealth |
|---|
| 56 | 56 | | 4agencyunlessitislicensedandregisteredinaccordancewiththeprovisionsofsections |
|---|
| 57 | 57 | | 5197.400to197.475. |
|---|
| 58 | 58 | | 197.445.1.Thedepartmentmayadoptreasonablerulesandstandardsnecessaryto |
|---|
| 59 | 59 | | 2carryouttheprovisionsofsections197.400to197.477.Therulesandstandardsadopted |
|---|
| 60 | 60 | | 3shallnotbelessthanthestandardsestablishedbythefederalgovernmentforhomehealth |
|---|
| 61 | 61 | | 4agenciesunderTitleXVIIIoftheFederalSocialSecurityAct.Thereasonablerulesand |
|---|
| 62 | 62 | | 5standardsshallbeinitiallypromulgatedwithinoneyearofSeptember28,1983. |
|---|
| 63 | 63 | | 6 2.Therulesandstandardsadoptedbythedepartmentpursuanttotheprovisionsof |
|---|
| 64 | 64 | | 7sections197.400to197.477shallapplytoallhealthservicescoveredbysections197.400to |
|---|
| 65 | 65 | | 8197.477renderedtoanypatientbeingservedbyahomehealthagencyregardlessofsourceof |
|---|
| 66 | 66 | | 9paymentfortheservice,patient'scondition,orplaceofresidence,atwhichthehomehealth |
|---|
| 135 | | - | 65theadvancedpracticeregisterednurse'sdeliveryofhealthcareservices.Thedescriptionshall |
|---|
| 136 | | - | 66includeprovisionsthattheadvancedpracticeregisterednurseshallsubmitaminimumoften |
|---|
| 137 | | - | 67percentofthechartsdocumentingtheadvancedpracticeregisterednurse'sdeliveryofhealth |
|---|
| 138 | | - | 68careservicestothecollaboratingphysicianforreviewbythecollaboratingphysician,orany |
|---|
| 139 | | - | 69otherphysiciandesignatedinthecollaborativepracticearrangement,everyfourteendays;and |
|---|
| 140 | | - | HCSHB2434 4 70 (10)Thecollaboratingphysician,oranyotherphysiciandesignatedinthe |
|---|
| 141 | | - | 71collaborativepracticearrangement,shallrevieweveryfourteendaysaminimumoftwenty |
|---|
| 142 | | - | 72percentofthechartsinwhichtheadvancedpracticeregisterednurseprescribescontrolled |
|---|
| 143 | | - | 73substances.Thechartsreviewedunderthissubdivisionmaybecountedinthenumberof |
|---|
| 144 | | - | 74chartsrequiredtobereviewedundersubdivision(9)ofthissubsection. |
|---|
| 145 | | - | 75 4.Thestateboardofregistrationforthehealingartspursuanttosection334.125and |
|---|
| 146 | | - | 76theboardofnursingpursuanttosection335.036mayjointlypromulgaterulesregulatingthe |
|---|
| 147 | | - | 77useofcollaborativepracticearrangements.Suchrulesshallbelimitedto[specifying |
|---|
| 148 | | - | 78geographicareastobecovered,] themethodsoftreatmentthatmaybecoveredby |
|---|
| 149 | | - | 79collaborativepracticearrangementsandtherequirementsforreviewofservicesprovided |
|---|
| 150 | | - | 80pursuanttocollaborativepracticearrangementsincludingdelegatingauthoritytoprescribe |
|---|
| 151 | | - | 81controlledsubstances.Anyrulesrelatingtodispensingordistributionofmedicationsor |
|---|
| 152 | | - | 82devicesbyprescriptionorprescriptiondrugordersunderthissectionshallbesubjecttothe |
|---|
| 153 | | - | 83approvalofthestateboardofpharmacy.Anyrulesrelatingtodispensingordistributionof |
|---|
| 154 | | - | 84controlledsubstancesbyprescriptionorprescriptiondrugordersunderthissectionshallbe |
|---|
| 155 | | - | 85subjecttotheapprovalofthedepartmentofhealthandseniorservicesandthestateboardof |
|---|
| 156 | | - | 86pharmacy.Inordertotakeeffect,suchrulesshallbeapprovedbyamajorityvoteofa |
|---|
| 157 | | - | 87quorumofeachboard.Neitherthestateboardofregistrationforthehealingartsnorthe |
|---|
| 158 | | - | 88boardofnursingmayseparatelypromulgaterulesrelatingtocollaborativepractice |
|---|
| 159 | | - | 89arrangements.Suchjointlypromulgatedrulesshallbeconsistentwithguidelinesfor |
|---|
| 160 | | - | 90federallyfundedclinics.Therulemakingauthoritygrantedinthissubsectionshallnotextend |
|---|
| 161 | | - | 91tocollaborativepracticearrangementsofhospitalemployeesprovidinginpatientcarewithin |
|---|
| 162 | | - | 92hospitalsasdefinedpursuanttochapter197orpopulation-basedpublichealthservicesas |
|---|
| 163 | | - | 93definedby20CSR2150-5.100asofApril30,2008. |
|---|
| 164 | | - | 94 5.Thestateboardofregistrationforthehealingartsshallnotdeny,revoke,suspend |
|---|
| 165 | | - | 95orotherwisetakedisciplinaryactionagainstaphysicianforhealthcareservicesdelegatedtoa |
|---|
| 166 | | - | 96registeredprofessionalnurseprovidedtheprovisionsofthissectionandtherules |
|---|
| 167 | | - | 97promulgatedthereunderaresatisfied.Uponthewrittenrequestofaphysiciansubjecttoa |
|---|
| 168 | | - | 98disciplinaryactionimposedasaresultofanagreementbetweenaphysicianandaregistered |
|---|
| 169 | | - | 99professionalnurseorregisteredphysicianassistant,whetherwrittenornot,priortoAugust |
|---|
| 170 | | - | 10028,1993,allrecordsofsuchdisciplinarylicensureactionandallrecordspertainingtothe |
|---|
| 171 | | - | 101filing,investigationorreviewofanallegedviolationofthischapterincurredasaresultof |
|---|
| 172 | | - | 102suchanagreementshallberemovedfromtherecordsofthestateboardofregistrationforthe |
|---|
| 173 | | - | 103healingartsandthedivisionofprofessionalregistrationandshallnotbedisclosedtoany |
|---|
| 174 | | - | 104publicorprivateentityseekingsuchinformationfromtheboardorthedivision.Thestate |
|---|
| 175 | | - | 105boardofregistrationforthehealingartsshalltakeactiontocorrectreportsofalleged |
|---|
| 176 | | - | 106violationsanddisciplinaryactionsasdescribedinthissectionwhichhavebeensubmittedto |
|---|
| 177 | | - | HCSHB2434 5 107theNationalPractitionerDataBank.Insubsequentapplicationsorrepresentationsrelatingto |
|---|
| 178 | | - | 108hisorhermedicalpractice,aphysiciancompletingformsordocumentsshallnotberequired |
|---|
| 179 | | - | 109toreportanyactionsofthestateboardofregistrationforthehealingartsforwhichthe |
|---|
| 180 | | - | 110recordsaresubjecttoremovalunderthissection. |
|---|
| 181 | | - | 111 6.Withinthirtydaysofanychangeandoneachrenewal,thestateboardof |
|---|
| 182 | | - | 112registrationforthehealingartsshallrequireeveryphysiciantoidentifywhetherthephysician |
|---|
| 183 | | - | 113isengagedinanycollaborativepracticeagreement,includingcollaborativepractice |
|---|
| 184 | | - | 114agreementsdelegatingtheauthoritytoprescribecontrolledsubstances,orphysician |
|---|
| 185 | | - | 115assistantagreementandalsoreporttotheboardthenameofeachlicensedprofessional |
|---|
| 186 | | - | 116withwhomthephysicianhasenteredintosuchagreement.Theboardmaymakethis |
|---|
| 187 | | - | 117informationavailabletothepublic.Theboardshalltrackthereportedinformationandmay |
|---|
| 188 | | - | 118routinelyconductrandomreviewsofsuchagreementstoensurethatagreementsarecarried |
|---|
| 189 | | - | 119outforcomplianceunderthischapter. |
|---|
| 190 | | - | 120 7.Notwithstandinganylawtothecontrary,acertifiedregisterednurseanesthetistas |
|---|
| 191 | | - | 121definedinsubdivision(8)ofsection335.016shallbepermittedtoprovideanesthesiaservices |
|---|
| 192 | | - | 122withoutacollaborativepracticearrangementprovidedthatheorsheisunderthesupervision |
|---|
| 193 | | - | 123ofananesthesiologistorotherphysician,dentist,orpodiatristwhoisimmediatelyavailableif |
|---|
| 194 | | - | 124needed.Nothinginthissubsectionshallbeconstruedtoprohibitorpreventacertified |
|---|
| 195 | | - | 125registerednurseanesthetistasdefinedinsubdivision(8)ofsection335.016fromenteringinto |
|---|
| 196 | | - | 126acollaborativepracticearrangementunderthissection,exceptthatthecollaborativepractice |
|---|
| 197 | | - | 127arrangementmaynotdelegatetheauthoritytoprescribeanycontrolledsubstanceslistedin |
|---|
| 198 | | - | 128SchedulesIII,IV,andVofsection195.017,orScheduleII-hydrocodone. |
|---|
| 199 | | - | 129 8.Acollaboratingphysicianshallnotenterintoacollaborativepracticearrangement |
|---|
| 200 | | - | 130withmorethansixfull-timeequivalentadvancedpracticeregisterednurses,full-time |
|---|
| 201 | | - | 131equivalentlicensedphysicianassistants,orfull-timeequivalentassistantphysicians,orany |
|---|
| 202 | | - | 132combinationthereof.Thislimitationshallnotapplytocollaborativearrangementsofhospital |
|---|
| 203 | | - | 133employeesprovidinginpatientcareserviceinhospitalsasdefinedinchapter197or |
|---|
| 204 | | - | 134population-basedpublichealthservicesasdefinedby20CSR2150-5.100asofApril30, |
|---|
| 205 | | - | 1352008,ortoacertifiedregisterednurseanesthetistprovidinganesthesiaservicesunderthe |
|---|
| 206 | | - | 136supervisionofananesthesiologistorotherphysician,dentist,orpodiatristwhoisimmediately |
|---|
| 207 | | - | 137availableifneededassetoutinsubsection7ofthissection. |
|---|
| 208 | | - | 138 9.Itistheresponsibilityofthecollaboratingphysiciantodetermineanddocument |
|---|
| 209 | | - | 139thecompletionofatleastaone-monthperiodoftimeduringwhichtheadvancedpractice |
|---|
| 210 | | - | 140registerednurseshallpracticewiththecollaboratingphysiciancontinuouslypresentbefore |
|---|
| 211 | | - | 141practicinginasettingwherethecollaboratingphysicianisnotcontinuouslypresent.This |
|---|
| 212 | | - | 142limitationshallnotapplytocollaborativearrangementsofprovidersofpopulation-based |
|---|
| 213 | | - | 143publichealthservicesasdefinedby20CSR2150-5.100asofApril30,2008. |
|---|
| 214 | | - | HCSHB2434 6 144 10.Noagreementmadeunderthissectionshallsupersedecurrenthospitallicensing |
|---|
| 215 | | - | 145regulationsgoverninghospitalmedicationordersunderprotocolsorstandingordersforthe |
|---|
| 216 | | - | 146purposeofdeliveringinpatientoremergencycarewithinahospitalasdefinedinsection |
|---|
| 217 | | - | 147197.020ifsuchprotocolsorstandingordershavebeenapprovedbythehospital'smedical |
|---|
| 218 | | - | 148staffandpharmaceuticaltherapeuticscommittee. |
|---|
| 219 | | - | 149 11.Nocontractorotheragreementshallrequireaphysiciantoactasacollaborating |
|---|
| 220 | | - | 150physicianforanadvancedpracticeregisterednurseagainstthephysician'swill.Aphysician |
|---|
| 221 | | - | 151shallhavetherighttorefusetoactasacollaboratingphysician,withoutpenalty,fora |
|---|
| 222 | | - | 152particularadvancedpracticeregisterednurse.Nocontractorotheragreementshalllimitthe |
|---|
| 223 | | - | 153collaboratingphysician'sultimateauthorityoveranyprotocolsorstandingordersorinthe |
|---|
| 224 | | - | 154delegationofthephysician'sauthoritytoanyadvancedpracticeregisterednurse,butthis |
|---|
| 225 | | - | 155requirementshallnotauthorizeaphysicianinimplementingsuchprotocols,standingorders, |
|---|
| 226 | | - | 156ordelegationtoviolateapplicablestandardsforsafemedicalpracticeestablishedbyhospital's |
|---|
| 227 | | - | 157medicalstaff. |
|---|
| 228 | | - | 158 12.Nocontractorotheragreementshallrequireanyadvancedpracticeregistered |
|---|
| 229 | | - | 159nursetoserveasacollaboratingadvancedpracticeregisterednurseforanycollaborating |
|---|
| 230 | | - | 160physicianagainsttheadvancedpracticeregisterednurse'swill.Anadvancedpractice |
|---|
| 231 | | - | 161registerednurseshallhavetherighttorefusetocollaborate,withoutpenalty,withaparticular |
|---|
| 232 | | - | 162physician. |
|---|
| 135 | + | 65theadvancedpracticeregisterednurse'sdeliveryofhealthcareservices[. Thedescription |
|---|
| 136 | + | 66shallincludeprovisionsthattheadvancedpracticeregisterednurseshallsubmitaminimum |
|---|
| 137 | + | 67oftenpercentofthechartsdocumentingtheadvancedpracticeregisterednurse'sdeliveryof |
|---|
| 138 | + | 68healthcareservicestothecollaboratingphysicianforreviewbythecollaboratingphysician, |
|---|
| 139 | + | HB2434 4 69oranyotherphysiciandesignatedinthecollaborativepracticearrangement,everyfourteen |
|---|
| 140 | + | 70days]; and |
|---|
| 141 | + | 71 (10)Thecollaboratingphysician,oranyotherphysiciandesignatedinthe |
|---|
| 142 | + | 72collaborativepracticearrangement,shallrevieweveryfourteendaysaminimumoftwenty |
|---|
| 143 | + | 73percentofthechartsinwhichtheadvancedpracticeregisterednurseprescribescontrolled |
|---|
| 144 | + | 74substances.[Thechartsreviewedunderthissubdivisionmaybecountedinthenumberof |
|---|
| 145 | + | 75chartsrequiredtobereviewedundersubdivision(9)ofthissubsection.] |
|---|
| 146 | + | 76 4.Thestateboardofregistrationforthehealingartspursuanttosection334.125and |
|---|
| 147 | + | 77theboardofnursingpursuanttosection335.036mayjointlypromulgaterulesregulatingthe |
|---|
| 148 | + | 78useofcollaborativepracticearrangements.Suchrulesshallbelimitedto[specifying |
|---|
| 149 | + | 79geographicareastobecovered,] themethodsoftreatmentthatmaybecoveredby |
|---|
| 150 | + | 80collaborativepracticearrangementsandtherequirementsforreviewofservicesprovided |
|---|
| 151 | + | 81pursuanttocollaborativepracticearrangementsincludingdelegatingauthoritytoprescribe |
|---|
| 152 | + | 82controlledsubstances.Anyrulesrelatingtodispensingordistributionofmedicationsor |
|---|
| 153 | + | 83devicesbyprescriptionorprescriptiondrugordersunderthissectionshallbesubjecttothe |
|---|
| 154 | + | 84approvalofthestateboardofpharmacy.Anyrulesrelatingtodispensingordistributionof |
|---|
| 155 | + | 85controlledsubstancesbyprescriptionorprescriptiondrugordersunderthissectionshallbe |
|---|
| 156 | + | 86subjecttotheapprovalofthedepartmentofhealthandseniorservicesandthestateboardof |
|---|
| 157 | + | 87pharmacy.Inordertotakeeffect,suchrulesshallbeapprovedbyamajorityvoteofa |
|---|
| 158 | + | 88quorumofeachboard.Neitherthestateboardofregistrationforthehealingartsnorthe |
|---|
| 159 | + | 89boardofnursingmayseparatelypromulgaterulesrelatingtocollaborativepractice |
|---|
| 160 | + | 90arrangements.Suchjointlypromulgatedrulesshallbeconsistentwithguidelinesfor |
|---|
| 161 | + | 91federallyfundedclinics.Therulemakingauthoritygrantedinthissubsectionshallnotextend |
|---|
| 162 | + | 92tocollaborativepracticearrangementsofhospitalemployeesprovidinginpatientcarewithin |
|---|
| 163 | + | 93hospitalsasdefinedpursuanttochapter197orpopulation-basedpublichealthservicesas |
|---|
| 164 | + | 94definedby20CSR2150-5.100asofApril30,2008. |
|---|
| 165 | + | 95 5.Thestateboardofregistrationforthehealingartsshallnotdeny,revoke,suspend |
|---|
| 166 | + | 96orotherwisetakedisciplinaryactionagainstaphysicianforhealthcareservicesdelegatedtoa |
|---|
| 167 | + | 97registeredprofessionalnurseprovidedtheprovisionsofthissectionandtherules |
|---|
| 168 | + | 98promulgatedthereunderaresatisfied.Uponthewrittenrequestofaphysiciansubjecttoa |
|---|
| 169 | + | 99disciplinaryactionimposedasaresultofanagreementbetweenaphysicianandaregistered |
|---|
| 170 | + | 100professionalnurseorregisteredphysicianassistant,whetherwrittenornot,priortoAugust |
|---|
| 171 | + | 10128,1993,allrecordsofsuchdisciplinarylicensureactionandallrecordspertainingtothe |
|---|
| 172 | + | 102filing,investigationorreviewofanallegedviolationofthischapterincurredasaresultof |
|---|
| 173 | + | 103suchanagreementshallberemovedfromtherecordsofthestateboardofregistrationforthe |
|---|
| 174 | + | 104healingartsandthedivisionofprofessionalregistrationandshallnotbedisclosedtoany |
|---|
| 175 | + | 105publicorprivateentityseekingsuchinformationfromtheboardorthedivision.Thestate |
|---|
| 176 | + | HB2434 5 106boardofregistrationforthehealingartsshalltakeactiontocorrectreportsofalleged |
|---|
| 177 | + | 107violationsanddisciplinaryactionsasdescribedinthissectionwhichhavebeensubmittedto |
|---|
| 178 | + | 108theNationalPractitionerDataBank.Insubsequentapplicationsorrepresentationsrelatingto |
|---|
| 179 | + | 109hisorhermedicalpractice,aphysiciancompletingformsordocumentsshallnotberequired |
|---|
| 180 | + | 110toreportanyactionsofthestateboardofregistrationforthehealingartsforwhichthe |
|---|
| 181 | + | 111recordsaresubjecttoremovalunderthissection. |
|---|
| 182 | + | 112 6.Withinthirtydaysofanychangeandoneachrenewal,thestateboardof |
|---|
| 183 | + | 113registrationforthehealingartsshallrequireeveryphysiciantoidentifywhetherthephysician |
|---|
| 184 | + | 114isengagedinanycollaborativepracticeagreement,includingcollaborativepractice |
|---|
| 185 | + | 115agreementsdelegatingtheauthoritytoprescribecontrolledsubstances,orphysician |
|---|
| 186 | + | 116assistantagreementandalsoreporttotheboardthenameofeachlicensedprofessional |
|---|
| 187 | + | 117withwhomthephysicianhasenteredintosuchagreement.Theboardmaymakethis |
|---|
| 188 | + | 118informationavailabletothepublic.Theboardshalltrackthereportedinformationandmay |
|---|
| 189 | + | 119routinelyconductrandomreviewsofsuchagreementstoensurethatagreementsarecarried |
|---|
| 190 | + | 120outforcomplianceunderthischapter. |
|---|
| 191 | + | 121 7.Notwithstandinganylawtothecontrary,acertifiedregisterednurseanesthetistas |
|---|
| 192 | + | 122definedinsubdivision(8)ofsection335.016shallbepermittedtoprovideanesthesiaservices |
|---|
| 193 | + | 123withoutacollaborativepracticearrangementprovidedthatheorsheisunderthesupervision |
|---|
| 194 | + | 124ofananesthesiologistorotherphysician,dentist,orpodiatristwhoisimmediatelyavailableif |
|---|
| 195 | + | 125needed.Nothinginthissubsectionshallbeconstruedtoprohibitorpreventacertified |
|---|
| 196 | + | 126registerednurseanesthetistasdefinedinsubdivision(8)ofsection335.016fromenteringinto |
|---|
| 197 | + | 127acollaborativepracticearrangementunderthissection,exceptthatthecollaborativepractice |
|---|
| 198 | + | 128arrangementmaynotdelegatetheauthoritytoprescribeanycontrolledsubstanceslistedin |
|---|
| 199 | + | 129SchedulesIII,IV,andVofsection195.017,orScheduleII-hydrocodone. |
|---|
| 200 | + | 130 8.Acollaboratingphysicianshallnotenterintoacollaborativepracticearrangement |
|---|
| 201 | + | 131withmorethansixfull-timeequivalentadvancedpracticeregisterednurses,full-time |
|---|
| 202 | + | 132equivalentlicensedphysicianassistants,orfull-timeequivalentassistantphysicians,orany |
|---|
| 203 | + | 133combinationthereof.Thislimitationshallnotapplytocollaborativearrangementsofhospital |
|---|
| 204 | + | 134employeesprovidinginpatientcareserviceinhospitalsasdefinedinchapter197or |
|---|
| 205 | + | 135population-basedpublichealthservicesasdefinedby20CSR2150-5.100asofApril30, |
|---|
| 206 | + | 1362008,ortoacertifiedregisterednurseanesthetistprovidinganesthesiaservicesunderthe |
|---|
| 207 | + | 137supervisionofananesthesiologistorotherphysician,dentist,orpodiatristwhoisimmediately |
|---|
| 208 | + | 138availableifneededassetoutinsubsection7ofthissection. |
|---|
| 209 | + | 139 9.Itistheresponsibilityofthecollaboratingphysiciantodetermineanddocument |
|---|
| 210 | + | 140thecompletionof[atleastaone-month] aperiodoftimeduringwhichtheadvancedpractice |
|---|
| 211 | + | 141registerednurseshallpracticewiththecollaboratingphysiciancontinuouslypresentbefore |
|---|
| 212 | + | 142practicinginasettingwherethecollaboratingphysicianisnotcontinuouslypresent.This |
|---|
| 213 | + | HB2434 6 143limitationshallnotapplytocollaborativearrangementsofprovidersofpopulation-based |
|---|
| 214 | + | 144publichealthservicesasdefinedby20CSR2150-5.100asofApril30,2008. |
|---|
| 215 | + | 145 10.Noagreementmadeunderthissectionshallsupersedecurrenthospitallicensing |
|---|
| 216 | + | 146regulationsgoverninghospitalmedicationordersunderprotocolsorstandingordersforthe |
|---|
| 217 | + | 147purposeofdeliveringinpatientoremergencycarewithinahospitalasdefinedinsection |
|---|
| 218 | + | 148197.020ifsuchprotocolsorstandingordershavebeenapprovedbythehospital'smedical |
|---|
| 219 | + | 149staffandpharmaceuticaltherapeuticscommittee. |
|---|
| 220 | + | 150 11.Nocontractorotheragreementshallrequireaphysiciantoactasacollaborating |
|---|
| 221 | + | 151physicianforanadvancedpracticeregisterednurseagainstthephysician'swill.Aphysician |
|---|
| 222 | + | 152shallhavetherighttorefusetoactasacollaboratingphysician,withoutpenalty,fora |
|---|
| 223 | + | 153particularadvancedpracticeregisterednurse.Nocontractorotheragreementshalllimitthe |
|---|
| 224 | + | 154collaboratingphysician'sultimateauthorityoveranyprotocolsorstandingordersorinthe |
|---|
| 225 | + | 155delegationofthephysician'sauthoritytoanyadvancedpracticeregisterednurse,butthis |
|---|
| 226 | + | 156requirementshallnotauthorizeaphysicianinimplementingsuchprotocols,standingorders, |
|---|
| 227 | + | 157ordelegationtoviolateapplicablestandardsforsafemedicalpracticeestablishedbyhospital's |
|---|
| 228 | + | 158medicalstaff. |
|---|
| 229 | + | 159 12.Nocontractorotheragreementshallrequireanyadvancedpracticeregistered |
|---|
| 230 | + | 160nursetoserveasacollaboratingadvancedpracticeregisterednurseforanycollaborating |
|---|
| 231 | + | 161physicianagainsttheadvancedpracticeregisterednurse'swill.Anadvancedpractice |
|---|
| 232 | + | 162registerednurseshallhavetherighttorefusetocollaborate,withoutpenalty,withaparticular |
|---|
| 233 | + | 163physician. |
|---|