FIRSTREGULARSESSION
[TRULYAGREEDTOANDFINALLYPASSED]
SENATESUBSTITUTEFOR
HOUSECOMMITTEESUBSTITUTEFOR
HOUSEBILLNOS.115&99
102NDGENERALASSEMBLY
0039S.05T 2023
ANACT
Torepealsections195.070,334.036,334.100,334.104,334.506,334.613,335.016,335.019,
335.036,335.046,335.051,335.056,335.076,335.086,335.175,337.510,and
338.010,RSMo,andtoenactinlieuthereofnineteennewsectionsrelatingto
licensingofhealthcareprofessionals.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Sections195.070,334.036,334.100,334.104,334.506,334.613,335.016,
2335.019,335.036,335.046,335.051,335.056,335.076,335.086,335.175,337.510,and
3338.010,RSMo,arerepealedandnineteennewsectionsenactedinlieuthereof,tobeknown
4assections195.070,334.036,334.100,334.104,334.506,334.613,335.016,335.019,
5335.036,335.046,335.051,335.056,335.076,335.086,335.175,337.510,337.550,338.010,
6and338.012,toreadasfollows:
195.070.1.Aphysician,podiatrist,dentist,aregisteredoptometristcertifiedto
2administerpharmaceuticalagentsasprovidedinsection336.220,oranassistantphysicianin
3accordancewithsection334.037oraphysicianassistantinaccordancewithsection334.747
4ingoodfaithandinthecourseofhisorherprofessionalpracticeonly,mayprescribe,
5administer,anddispensecontrolledsubstancesorheorshemaycausethesametobe
6administeredordispensedbyanindividualasauthorizedbystatute.
7 2.Anadvancedpracticeregisterednurse,asdefinedinsection335.016,butnota
8certifiedregisterednurseanesthetistasdefinedinsubdivision(8)ofsection335.016,who
9holdsacertificateofcontrolledsubstanceprescriptiveauthorityfromtheboardofnursing
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 10undersection335.019andwhoisdelegatedtheauthoritytoprescribecontrolledsubstances
11underacollaborativepracticearrangementundersection334.104mayprescribeany
12controlledsubstanceslistedinSchedulesIII,IV,andVofsection195.017,andmayhave
13restrictedauthorityinScheduleII.PrescriptionsforScheduleIImedicationsprescribedbyan
14advancedpracticeregisterednursewhohasacertificateofcontrolledsubstanceprescriptive
15authorityarerestrictedtoonlythosemedicationscontaininghydrocodoneandScheduleII
16controlledsubstancesforhospicepatientspursuanttotheprovisionsofsection334.104.
17However,nosuchcertifiedadvancedpracticeregisterednurseshallprescribecontrolled
18substanceforhisorherownselforfamily.ScheduleIIInarcoticcontrolledsubstanceand
19ScheduleII-hydrocodoneprescriptionsshallbelimitedtoaonehundredtwenty-hoursupply
20withoutrefill.
21 3.Aveterinarian,ingoodfaithandinthecourseoftheveterinarian'sprofessional
22practiceonly,andnotforusebyahumanbeing,mayprescribe,administer,anddispense
23controlledsubstancesandtheveterinarianmaycausethemtobeadministeredbyanassistant
24ororderlyunderhisorherdirectionandsupervision.
25 4.Apractitionershallnotacceptanyportionofacontrolledsubstanceunusedbya
26patient,foranyreason,ifsuchpractitionerdidnotoriginallydispensethedrug,except:
27 (1)Whenthecontrolledsubstanceisdeliveredtothepractitionertoadministertothe
28patientforwhomthemedicationisprescribedasauthorizedbyfederallaw.Practitioners
29shallmaintainrecordsandsecurethemedicationasrequiredbythischapterandregulations
30promulgatedpursuanttothischapter;or
31 (2)Asprovidedinsection195.265.
32 5.Anindividualpractitionershallnotprescribeordispenseacontrolledsubstancefor
33suchpractitioner'spersonaluseexceptinamedicalemergency.
334.036.1.Forpurposesofthissection,thefollowingtermsshallmean:
2 (1)"Assistantphysician",anygraduateofamedicalschool[graduate] accredited
3bytheLiaisonCommitteeonMedicalEducation,theCommissiononOsteopathic
4CollegeAccreditation,oranorganizationaccreditedbytheEducationalCommission
5forForeignMedicalGraduateswho:
6 (a)IsaresidentandcitizenoftheUnitedStatesorisalegalresidentalien;
7 (b)HassuccessfullycompletedStep2oftheUnitedStatesMedicalLicensing
8Examinationortheequivalentofsuchstepofanyotherboard-approvedmedicallicensing
9examinationwithinthethree-yearperiodimmediatelyprecedingapplicationforlicensureas
10anassistantphysician,orwithinthreeyearsaftergraduationfromamedicalcollegeor
11osteopathicmedicalcollege,whicheverislater;
12 (c)Hasnotcompletedanapprovedpostgraduateresidencyandhassuccessfully
13completedStep2oftheUnitedStatesMedicalLicensingExaminationortheequivalentof
SSHCSHBs115&99 2 14suchstepofanyotherboard-approvedmedicallicensingexaminationwithintheimmediately
15precedingthree-yearperiodunlesswhensuchthree-yearanniversaryoccurredheorshewas
16servingasaresidentphysicianinanaccreditedresidencyintheUnitedStatesandcontinued
17todosowithinthirtydayspriortoapplicationforlicensureasanassistantphysician;and
18 (d)HasproficiencyintheEnglishlanguage.
19
20Anygraduateofamedicalschool[graduate] whocouldhaveappliedforlicensureand
21compliedwiththeprovisionsofthissubdivisionatanytimebetweenAugust28,2014,and
22August28,2017,mayapplyforlicensureandshallbedeemedincompliancewiththe
23provisionsofthissubdivision;
24 (2)"Assistantphysiciancollaborativepracticearrangement",anagreementbetweena
25physicianandanassistantphysicianthatmeetstherequirementsofthissectionandsection
26334.037[;
27 (3)"Medicalschoolgraduate",anypersonwhohasgraduatedfromamedicalcollege
28orosteopathicmedicalcollegedescribedinsection334.031].
29 2.(1)Anassistantphysiciancollaborativepracticearrangementshalllimitthe
30assistantphysiciantoprovidingonlyprimarycareservicesandonlyinmedicallyunderserved
31ruralorurbanareasofthisstate[orinanypilotprojectareasestablishedinwhichassistant
32physiciansmaypractice].
33 (2)Foraphysician-assistantphysicianteamworkinginaruralhealthclinicunderthe
34federalRuralHealthClinicServicesAct,P.L.95-210,asamended:
35 (a)Anassistantphysicianshallbeconsideredaphysicianassistantforpurposesof
36regulationsoftheCentersforMedicareandMedicaidServices(CMS);and
37 (b)Nosupervisionrequirementsinadditiontotheminimumfederallawshallbe
38required.
39 3.(1)Forpurposesofthissection,thelicensureofassistantphysiciansshalltake
40placewithinprocessesestablishedbyrulesofthestateboardofregistrationforthehealing
41arts.Theboardofhealingartsisauthorizedtoestablishrulesunderchapter536establishing
42licensureandrenewalprocedures,supervision,collaborativepracticearrangements,fees,and
43addressingsuchothermattersasarenecessarytoprotectthepublicanddisciplinethe
44profession.Nolicensurefeeforanassistantphysicianshallexceedtheamountofany
45licensurefeeforaphysicianassistant.Anapplicationforlicensuremaybedeniedorthe
46licensureofanassistantphysicianmaybesuspendedorrevokedbytheboardinthesame
47mannerandforviolationofthestandardsassetforthbysection334.100,orsuchother
48standardsofconductsetbytheboardbyrule.Noruleorregulationshallrequireanassistant
49physiciantocompletemorehoursofcontinuingmedicaleducationthanthatofalicensed
50physician.
SSHCSHBs115&99 3 51 (2)Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis
52createdundertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplies
53withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.
54Thissectionandchapter536arenonseverableandifanyofthepowersvestedwiththe
55generalassemblyunderchapter536toreview,todelaytheeffectivedate,ortodisapprove
56andannularulearesubsequentlyheldunconstitutional,thenthegrantofrulemaking
57authorityandanyruleproposedoradoptedafterAugust28,2014,shallbeinvalidandvoid.
58 (3)Anyrulesorregulationsregardingassistantphysiciansineffectasoftheeffective
59dateofthissectionthatconflictwiththeprovisionsofthissectionandsection334.037shall
60benullandvoidasoftheeffectivedateofthissection.
61 4.Anassistantphysicianshallclearlyidentifyhimselforherselfasanassistant
62physicianandshallbepermittedtousetheterms"doctor","Dr.",or"doc".Noassistant
63physicianshallpracticeorattempttopracticewithoutanassistantphysiciancollaborative
64practicearrangement,exceptasotherwiseprovidedinthissectionandinanemergency
65situation.
66 5.Thecollaboratingphysicianisresponsibleatalltimesfortheoversightofthe
67activitiesofandacceptsresponsibilityforprimarycareservicesrenderedbytheassistant
68physician.
69 6.Theprovisionsofsection334.037shallapplytoallassistantphysician
70collaborativepracticearrangements.Anyrenewaloflicensureunderthissectionshall
71includeverificationofactualpracticeunderacollaborativepracticearrangementin
72accordancewiththissubsectionduringtheimmediatelyprecedinglicensureperiod.
73 7.Eachhealthcarrierorhealthbenefitplanthatoffersorissueshealthbenefitplans
74thataredelivered,issuedfordelivery,continued,orrenewedinthisstateshallreimbursean
75assistantphysicianforthediagnosis,consultation,ortreatmentofaninsuredorenrolleeon
76thesamebasisthatthehealthcarrierorhealthbenefitplancoverstheservicewhenitis
77deliveredbyanothercomparablemid-levelhealthcareproviderincluding,butnotlimitedto,
78aphysicianassistant.
334.100.1.Theboardmayrefusetoissueorrenewanycertificateofregistrationor
2authority,permitorlicenserequiredpursuanttothischapterforoneoranycombinationof
3causesstatedinsubsection2ofthissection.Theboardshallnotifytheapplicantinwritingof
4thereasonsfortherefusalandshalladvisetheapplicantoftheapplicant'srighttofilea
5complaintwiththeadministrativehearingcommissionasprovidedbychapter621.Asan
6alternativetoarefusaltoissueorrenewanycertificate,registrationorauthority,theboard
7may,atitsdiscretion,issuealicensewhichissubjecttoprobation,restrictionorlimitationto
8anapplicantforlicensureforanyoneoranycombinationofcausesstatedinsubsection2of
9thissection.Theboard'sorderofprobation,limitationorrestrictionshallcontainastatement
SSHCSHBs115&99 4 10ofthedisciplineimposed,thebasistherefor,thedatesuchactionshallbecomeeffective,anda
11statementthattheapplicanthasthirtydaystorequestinwritingahearingbeforethe
12administrativehearingcommission.Iftheboardissuesaprobationary,limitedorrestricted
13licensetoanapplicantforlicensure,eitherpartymayfileawrittenpetitionwiththe
14administrativehearingcommissionwithinthirtydaysoftheeffectivedateoftheprobationary,
15limitedorrestrictedlicenseseekingreviewoftheboard'sdetermination.Ifnowrittenrequest
16forahearingisreceivedbytheadministrativehearingcommissionwithinthethirty-day
17period,therighttoseekreviewoftheboard'sdecisionshallbeconsideredaswaived.
18 2.Theboardmaycauseacomplainttobefiledwiththeadministrativehearing
19commissionasprovidedbychapter621againstanyholderofanycertificateofregistrationor
20authority,permitorlicenserequiredbythischapteroranypersonwhohasfailedtorenewor
21hassurrenderedtheperson'scertificateofregistrationorauthority,permitorlicenseforany
22oneoranycombinationofthefollowingcauses:
23 (1)Useofanycontrolledsubstance,asdefinedinchapter195,oralcoholicbeverage
24toanextentthatsuchuseimpairsaperson'sabilitytoperformtheworkofanyprofession
25licensedorregulatedbythischapter;
26 (2)Thepersonhasbeenfinallyadjudicatedandfoundguilty,orenteredapleaof
27guiltyornolocontendere,inacriminalprosecutionunderthelawsofanystateorofthe
28UnitedStates,foranyoffensereasonablyrelatedtothequalifications,functionsordutiesof
29anyprofessionlicensedorregulatedpursuanttothischapter,foranyoffenseinvolvingfraud,
30dishonestyoranactofviolence,orforanyoffenseinvolvingmoralturpitude,whetherornot
31sentenceisimposed;
32 (3)Useoffraud,deception,misrepresentationorbriberyinsecuringanycertificateof
33registrationorauthority,permitorlicenseissuedpursuanttothischapterorinobtaining
34permissiontotakeanyexaminationgivenorrequiredpursuanttothischapter;
35 (4)Misconduct,fraud,misrepresentation,dishonesty,unethicalconductor
36unprofessionalconductintheperformanceofthefunctionsordutiesofanyprofession
37licensedorregulatedbythischapter,including,butnotlimitedto,thefollowing:
38 (a)Obtainingorattemptingtoobtainanyfee,charge,tuitionorothercompensation
39byfraud,deceptionormisrepresentation;willfullyandcontinuallyoverchargingor
40overtreatingpatients;orchargingforvisitstothephysician'sofficewhichdidnotoccur
41unlesstheserviceswerecontractedforinadvance,orforserviceswhichwerenotrenderedor
42documentedinthepatient'srecords;
43 (b)Attempting,directlyorindirectly,bywayofintimidation,coercionordeception,
44toobtainorretainapatientordiscouragetheuseofasecondopinionorconsultation;
45 (c)Willfullyandcontinuallyperforminginappropriateorunnecessarytreatment,
46diagnostictestsormedicalorsurgicalservices;
SSHCSHBs115&99 5 47 (d)Delegatingprofessionalresponsibilitiestoapersonwhoisnotqualifiedby
48training,skill,competency,age,experienceorlicensuretoperformsuchresponsibilities;
49 (e)Misrepresentingthatanydisease,ailmentorinfirmitycanbecuredbyamethod,
50procedure,treatment,medicineordevice;
51 (f)Performingorprescribingmedicalserviceswhichhavebeendeclaredbyboard
52ruletobeofnomedicalorosteopathicvalue;
53 (g)Finaldisciplinaryactionbyanyprofessionalmedicalorosteopathicassociationor
54societyorlicensedhospitalormedicalstaffofsuchhospitalinthisoranyotherstateor
55territory,whetheragreedtovoluntarilyornot,andincluding,butnotlimitedto,anyremoval,
56suspension,limitation,orrestrictionoftheperson'slicenseorstafforhospitalprivileges,
57failuretorenewsuchprivilegesorlicenseforcause,orotherfinaldisciplinaryaction,ifthe
58actionwasinanywayrelatedtounprofessionalconduct,professionalincompetence,
59malpracticeoranyotherviolationofanyprovisionofthischapter;
60 (h)Signingablankprescriptionform;ordispensing,prescribing,administeringor
61otherwisedistributinganydrug,controlledsubstanceorothertreatmentwithoutsufficient
62examinationincludingfailingtoestablishavalidphysician-patientrelationshippursuantto
63section334.108,orforotherthanmedicallyacceptedtherapeuticorexperimentalor
64investigativepurposesdulyauthorizedbyastateorfederalagency,ornotinthecourseof
65professionalpractice,ornotingoodfaithtorelievepainandsuffering,ornottocurean
66ailment,physicalinfirmityordisease,exceptasauthorizedinsection334.104;
67 (i)Exercisinginfluencewithinaphysician-patientrelationshipforpurposesof
68engagingapatientinsexualactivity;
69 (j)Beinglistedonanystateorfederalsexualoffenderregistry;
70 (k)Terminatingthemedicalcareofapatientwithoutadequatenoticeorwithout
71makingotherarrangementsforthecontinuedcareofthepatient;
72 (l)Failingtofurnishdetailsofapatient'smedicalrecordstoothertreatingphysicians
73orhospitalsuponproperrequest;orfailingtocomplywithanyotherlawrelatingtomedical
74records;
75 (m)Failureofanyapplicantorlicenseetocooperatewiththeboardduringany
76investigation;
77 (n)Failuretocomplywithanysubpoenaorsubpoenaducestecumfromtheboardor
78anorderoftheboard;
79 (o)Failuretotimelypaylicenserenewalfeesspecifiedinthischapter;
80 (p)Violatingaprobationagreement,order,orothersettlementagreementwiththis
81boardoranyotherlicensingagency;
82 (q)Failingtoinformtheboardofthephysician'scurrentresidenceandbusiness
83address;
SSHCSHBs115&99 6 84 (r)Advertisingbyanapplicantorlicenseewhichisfalseormisleading,orwhich
85violatesanyruleoftheboard,orwhichclaimswithoutsubstantiationthepositivecureofany
86disease,orprofessionalsuperioritytoorgreaterskillthanthatpossessedbyanyother
87physician.Anapplicantorlicenseeshallalsobeinviolationofthisprovisioniftheapplicant
88orlicenseehasafinancialinterestinanyorganization,corporationorassociationwhichissues
89orconductssuchadvertising;
90 (s)Anyotherconductthatisunethicalorunprofessionalinvolvingaminor;
91 (5)Anyconductorpracticewhichisormightbeharmfulordangeroustothemental
92orphysicalhealthofapatientorthepublic;orincompetency,grossnegligenceorrepeated
93negligenceintheperformanceofthefunctionsordutiesofanyprofessionlicensedor
94regulatedbythischapter.Forthepurposesofthissubdivision,"repeatednegligence"means
95thefailure,onmorethanoneoccasion,tousethatdegreeofskillandlearningordinarilyused
96underthesameorsimilarcircumstancesbythememberoftheapplicant'sorlicensee's
97profession;
98 (6)Violationof,orattemptingtoviolate,directlyorindirectly,orassistingor
99enablinganypersontoviolate,anyprovisionofthischapterorchapter324,orofanylawful
100ruleorregulationadoptedpursuanttothischapterorchapter324;
101 (7)Impersonationofanypersonholdingacertificateofregistrationorauthority,
102permitorlicenseorallowinganypersontousehisorhercertificateofregistrationor
103authority,permit,licenseordiplomafromanyschool;
104 (8)Revocation,suspension,restriction,modification,limitation,reprimand,warning,
105censure,probationorotherfinaldisciplinaryactionagainsttheholderoforapplicantfora
106licenseorotherrighttopracticeanyprofessionregulatedbythischapterbyanotherstate,
107territory,federalagencyorcountry,whetherornotvoluntarilyagreedtobythelicenseeor
108applicant,including,butnotlimitedto,thedenialoflicensure,surrenderofthelicense,
109allowingthelicensetoexpireorlapse,ordiscontinuingorlimitingthepracticeofmedicine
110whilesubjecttoaninvestigationorwhileactuallyunderinvestigationbyanylicensing
111authority,medicalfacility,branchoftheArmedForcesoftheUnitedStatesofAmerica,
112insurancecompany,court,agencyofthestateorfederalgovernment,oremployer;
113 (9)Apersonisfinallyadjudgedincapacitatedordisabledbyacourtofcompetent
114jurisdiction;
115 (10)Assistingorenablinganypersontopracticeoroffertopracticeanyprofession
116licensedorregulatedbythischapterwhoisnotregisteredandcurrentlyeligibletopractice
117pursuanttothischapter;orknowinglyperforminganyactwhichinanywayaids,assists,
118procures,advises,orencouragesanypersontopracticemedicinewhoisnotregisteredand
119currentlyeligibletopracticepursuanttothischapter.Aphysicianwhoworksinaccordance
SSHCSHBs115&99 7 120withstandingordersorprotocolsorinaccordancewiththeprovisionsofsection334.104
121shallnotbeinviolationofthissubdivision;
122 (11)Issuanceofacertificateofregistrationorauthority,permitorlicensebasedupon
123amaterialmistakeoffact;
124 (12)Failuretodisplayavalidcertificateorlicenseifsorequiredbythischapteror
125anyrulepromulgatedpursuanttothischapter;
126 (13)Violationofthedruglawsorrulesandregulationsofthisstate,includingbutnot
127limitedtoanyprovisionofchapter195,anyotherstate,orthefederalgovernment;
128 (14)Knowinglymaking,orcausingtobemade,oraiding,orabettinginthemaking
129of,afalsestatementinanybirth,deathorothercertificateordocumentexecutedin
130connectionwiththepracticeoftheperson'sprofession;
131 (15)Knowinglymakingafalsestatement,orallyorinwritingtotheboard;
132 (16)Solicitingpatronageinpersonorbyagentsorrepresentatives,orbyanyother
133meansormanner,undertheperson'sownnameorunderthenameofanotherpersonor
134concern,actualorpretended,insuchamannerastoconfuse,deceive,ormisleadthepublicas
135totheneedornecessityfororappropriatenessofhealthcareservicesforallpatients,orthe
136qualificationsofanindividualpersonorpersonstodiagnose,render,orperformhealthcare
137services;
138 (17)Using,orpermittingtheuseof,theperson'snameunderthedesignationof
139"Doctor","Dr.","M.D.",or"D.O.",oranysimilardesignationwithreferencetothe
140commercialexploitationofanygoods,waresormerchandise;
141 (18)Knowinglymakingorcausingtobemadeafalsestatementormisrepresentation
142ofamaterialfact,withintenttodefraud,forpaymentpursuanttotheprovisionsofchapter
143208orchapter630orforpaymentfromTitleXVIIIorTitleXIXoftheSocialSecurityAct;
144 (19)Failureorrefusaltoproperlyguardagainstcontagious,infectiousor
145communicablediseasesorthespreadthereof;maintaininganunsanitaryofficeor
146performingprofessionalservicesunderunsanitaryconditions;orfailuretoreportthe
147existenceofanunsanitaryconditionintheofficeofaphysicianorinanyhealthcarefacility
148totheboard,inwriting,withinthirtydaysafterthediscoverythereof;
149 (20)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist,
150payingorofferingtopayareferralfeeor[,notwithstandingsection334.010tothecontrary,
151practicingorofferingtopracticeprofessionalphysicaltherapyindependentoftheprescription
152anddirectionofapersonlicensedandregisteredasaphysicianandsurgeonpursuanttothis
153chapter,asadentistpursuanttochapter332,asapodiatristpursuanttochapter330,asan
154advancedpracticeregisterednurseunderchapter335,oranylicensedandregistered
155physician,dentist,podiatrist,oradvancedpracticeregisterednursepracticinginanother
SSHCSHBs115&99 8 156jurisdiction,whoselicenseisingoodstanding] evaluatingortreatingapatientina
157mannerinconsistentwithsection334.506;
158 (21)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist,
159treatingorattemptingtotreatailmentsorotherhealthconditionsofhumanbeingsotherthan
160byprofessionalphysicaltherapyandasauthorizedbysections334.500to334.620;
161 (22)Anypersonlicensedtopracticeasaphysicianorsurgeon,requiring,asa
162conditionofthephysician-patientrelationship,thatthepatientreceiveprescribeddrugs,
163devicesorotherprofessionalservicesdirectlyfromfacilitiesofthatphysician'sofficeorother
164entitiesunderthatphysician'sownershiporcontrol.Aphysicianshallprovidethepatient
165withaprescriptionwhichmaybetakentothefacilityselectedbythepatientandaphysician
166knowinglyfailingtodisclosetoapatientonaformapprovedbytheadvisorycommissionfor
167professionalphysicaltherapistsasestablishedbysection334.625whichisdatedandsigned
168byapatientorguardianacknowledgingthatthepatientorguardianhasreadandunderstands
169thatthephysicianhasapecuniaryinterestinaphysicaltherapyorrehabilitationservice
170providingprescribedtreatmentandthattheprescribedtreatmentisavailableonacompetitive
171basis.Thissubdivisionshallnotapplytoareferralbyonephysiciantoanotherphysician
172withinagroupofphysicianspracticingtogether;
173 (23)Apatternofpersonaluseorconsumptionofanycontrolledsubstanceunlessitis
174prescribed,dispensedoradministeredbyanotherphysicianwhoisauthorizedbylawtodoso;
175 (24)Habitualintoxicationordependenceonalcohol,evidenceofwhichmayinclude
176morethanonealcohol-relatedenforcementcontactasdefinedbysection302.525;
177 (25)Failuretocomplywithatreatmentprogramoranaftercareprogramenteredinto
178aspartofaboardorder,settlementagreementorlicensee'sprofessionalhealthprogram;
179 (26)Revocation,suspension,limitation,probation,orrestrictionofanykind
180whatsoeverofanycontrolledsubstanceauthority,whetheragreedtovoluntarilyornot,or
181voluntaryterminationofacontrolledsubstanceauthoritywhileunderinvestigation;
182 (27)Foraphysiciantooperate,conduct,manage,orestablishanabortionfacility,or
183foraphysiciantoperformanabortioninanabortionfacility,ifsuchfacilitycomesunderthe
184definitionofanambulatorysurgicalcenterpursuanttosections197.200to197.240,andsuch
185facilityhasfailedtoobtainorrenewalicenseasanambulatorysurgicalcenter.
186 3.Collaborativepracticearrangements,protocolsandstandingordersshallbein
187writingandsignedanddatedbyaphysicianpriortotheirimplementation.
188 4.Afterthefilingofsuchcomplaintbeforetheadministrativehearingcommission,
189theproceedingsshallbeconductedinaccordancewiththeprovisionsofchapter621.Upona
190findingbytheadministrativehearingcommissionthatthegrounds,providedinsubsection2
191ofthissection,fordisciplinaryactionaremet,theboardmay,singlyorincombination,warn,
192censureorplacethepersonnamedinthecomplaintonprobationonsuchtermsand
SSHCSHBs115&99 9 193conditionsastheboarddeemsappropriateforaperiodnottoexceedtenyears,ormay
194suspendtheperson'slicense,certificateorpermitforaperiodnottoexceedthreeyears,or
195restrictorlimittheperson'slicense,certificateorpermitforanindefiniteperiodoftime,or
196revoketheperson'slicense,certificate,orpermit,oradministerapublicorprivatereprimand,
197ordenytheperson'sapplicationforalicense,orpermanentlywithholdissuanceofalicenseor
198requirethepersontosubmittothecare,counselingortreatmentofphysiciansdesignatedby
199theboardattheexpenseoftheindividualtobeexamined,orrequirethepersontoattendsuch
200continuingeducationalcoursesandpasssuchexaminationsastheboardmaydirect.
201 5.Inanyorderofrevocation,theboardmayprovidethatthepersonmaynotapplyfor
202reinstatementoftheperson'slicenseforaperiodoftimerangingfromtwotosevenyears
203followingthedateoftheorderofrevocation.Allstayordersshalltollthistimeperiod.
204 6.Beforerestoringtogoodstandingalicense,certificateorpermitissuedpursuantto
205thischapterwhichhasbeeninarevoked,suspendedorinactivestateforanycauseformore
206thantwoyears,theboardmayrequiretheapplicanttoattendsuchcontinuingmedical
207educationcoursesandpasssuchexaminationsastheboardmaydirect.
208 7.Inanyinvestigation,hearingorotherproceedingtodeterminealicensee'sor
209applicant'sfitnesstopractice,anyrecordrelatingtoanypatientofthelicenseeorapplicant
210shallbediscoverablebytheboardandadmissibleintoevidence,regardlessofanystatutoryor
211commonlawprivilegewhichsuchlicensee,applicant,recordcustodianorpatientmight
212otherwiseinvoke.Inaddition,nosuchlicensee,applicant,orrecordcustodianmaywithhold
213recordsortestimonybearinguponalicensee'sorapplicant'sfitnesstopracticeontheground
214ofprivilegebetweensuchlicensee,applicantorrecordcustodianandapatient.
215 8.Theactoflawfullydispensing,prescribing,administering,orotherwise
216distributingivermectintabletsorhydroxychloroquinesulfatetabletsforhumanuseshall
217notbegroundsfordenial,suspension,revocation,orotherdisciplinaryactionbytheboard.
334.104.1.Aphysicianmayenterintocollaborativepracticearrangementswith
2registeredprofessionalnurses.Collaborativepracticearrangementsshallbeintheformof
3writtenagreements,jointlyagreed-uponprotocols,orstandingordersforthedeliveryof
4healthcareservices.Collaborativepracticearrangements,whichshallbeinwriting,may
5delegatetoaregisteredprofessionalnursetheauthoritytoadministerordispensedrugsand
6providetreatmentaslongasthedeliveryofsuchhealthcareservicesiswithinthescopeof
7practiceoftheregisteredprofessionalnurseandisconsistentwiththatnurse'sskill,training
8andcompetence.
9 2.(1)Collaborativepracticearrangements,whichshallbeinwriting,maydelegateto
10aregisteredprofessionalnursetheauthoritytoadminister,dispenseorprescribedrugsand
11providetreatmentiftheregisteredprofessionalnurseisanadvancedpracticeregisterednurse
12asdefinedinsubdivision(2)ofsection335.016.Collaborativepracticearrangementsmay
SSHCSHBs115&99 10 13delegatetoanadvancedpracticeregisterednurse,asdefinedinsection335.016,theauthority
14toadminister,dispense,orprescribecontrolledsubstanceslistedinSchedulesIII,IV,andVof
15section195.017,andScheduleII-hydrocodone;exceptthat,thecollaborativepractice
16arrangementshallnotdelegatetheauthoritytoadministeranycontrolledsubstanceslistedin
17SchedulesIII,IV,andVofsection195.017,orScheduleII-hydrocodoneforthepurposeof
18inducingsedationorgeneralanesthesiafortherapeutic,diagnostic,orsurgicalprocedures.
19ScheduleIIInarcoticcontrolledsubstanceandScheduleII-hydrocodoneprescriptionsshall
20belimitedtoaonehundredtwenty-hoursupplywithoutrefill.
21 (2)Notwithstandinganyotherprovisionofthissectiontothecontrary,a
22collaborativepracticearrangementmaydelegatetoanadvancedpracticeregistered
23nursetheauthoritytoadminister,dispense,orprescribeScheduleIIcontrolled
24substancesforhospicepatients;provided,thattheadvancedpracticeregisterednurseis
25employedbyahospiceprovidercertifiedpursuanttochapter197andtheadvanced
26practiceregisterednurseisprovidingcaretohospicepatientspursuanttoa
27collaborativepracticearrangementthatdesignatesthecertifiedhospiceasalocation
28wheretheadvancedpracticeregisterednurseisauthorizedtopracticeandprescribe.
29 (3)Suchcollaborativepracticearrangementsshallbeintheformofwritten
30agreements,jointlyagreed-uponprotocolsorstandingordersforthedeliveryofhealthcare
31services.
32 (4)Anadvancedpracticeregisterednursemayprescribebuprenorphineforuptoa
33thirty-daysupplywithoutrefillforpatientsreceivingmedication-assistedtreatmentfor
34substanceusedisordersunderthedirectionofthecollaboratingphysician.
35 3.Thewrittencollaborativepracticearrangementshallcontainatleastthefollowing
36provisions:
37 (1)Completenames,homeandbusinessaddresses,zipcodes,andtelephonenumbers
38ofthecollaboratingphysicianandtheadvancedpracticeregisterednurse;
39 (2)Alistofallotherofficesorlocationsbesidesthoselistedinsubdivision(1)ofthis
40subsectionwherethecollaboratingphysicianauthorizedtheadvancedpracticeregistered
41nursetoprescribe;
42 (3)Arequirementthatthereshallbepostedateveryofficewheretheadvanced
43practiceregisterednurseisauthorizedtoprescribe,incollaborationwithaphysician,a
44prominentlydisplayeddisclosurestatementinformingpatientsthattheymaybeseenbyan
45advancedpracticeregisterednurseandhavetherighttoseethecollaboratingphysician;
46 (4)Allspecialtyorboardcertificationsofthecollaboratingphysicianandall
47certificationsoftheadvancedpracticeregisterednurse;
SSHCSHBs115&99 11 48 (5)Themannerofcollaborationbetweenthecollaboratingphysicianandthe
49advancedpracticeregisterednurse,includinghowthecollaboratingphysicianandthe
50advancedpracticeregisterednursewill:
51 (a)Engageincollaborativepracticeconsistentwitheachprofessional'sskill,training,
52education,andcompetence;
53 (b)Maintaingeographicproximity,exceptasspecifiedinthisparagraph.The
54followingprovisionsshallapplywithrespecttothisrequirement:
55 a.UntilAugust28,2025,anadvancedpracticeregisterednurseproviding
56servicesinacorrectionalcenter,asdefinedinsection217.010,andhisorher
57collaboratingphysicianshallsatisfythegeographicproximityrequirementifthey
58practicewithintwohundredmilesbyroadofoneanother.Anincarceratedpatientwho
59requestsorrequiresaphysicianconsultationshallbetreatedbyaphysicianassoonas
60appropriate;
61 b.Thecollaborativepracticearrangementmayallowforgeographicproximitytobe
62waivedforamaximumoftwenty-eightdayspercalendaryearforruralhealthclinicsas
63definedbyP.L.95-210(42U.S.C.Section1395x,asamended), aslongasthecollaborative
64practicearrangementincludesalternativeplansasrequiredinparagraph(c)ofthis
65subdivision.Thisexceptiontogeographicproximityshallapplyonlytoindependentrural
66healthclinics,provider-basedruralhealthclinicswheretheproviderisacriticalaccess
67hospitalasprovidedin42U.S.C.Section1395i-4,andprovider-basedruralhealthclinics
68wherethemainlocationofthehospitalsponsorisgreaterthanfiftymilesfromtheclinic[.];
69 c.Thecollaborativepracticearrangementmayallowforgeographicproximity
70tobewaivedwhenthearrangementoutlinestheuseoftelehealth,asdefinedinsection
71191.1145;
72 d.Inadditiontothewaiversandexemptionsprovidedinthissubsection,an
73applicationforawaiverforanyotherreasonofanyapplicablegeographicproximity
74shallbeavailableifaphysicianiscollaboratingwithanadvancedpracticeregistered
75nurseinexcessofanygeographicproximitylimit.Theboardofnursingandthestate
76boardofregistrationforthehealingartsshallrevieweachapplicationforawaiverof
77geographicproximityandapprovetheapplicationiftheboardsdeterminethat
78adequatesupervisionexistsbetweenthecollaboratingphysicianandtheadvanced
79practiceregisterednurse.Theboardsshallhaveforty-fivecalendardaystoreviewthe
80completedapplicationforthewaiverofgeographicproximity.Ifnoactionistakenby
81theboardswithinforty-fivedaysafterthesubmissionoftheapplicationforawaiver,
82thentheapplicationshallbedeemedapproved.Iftheapplicationisdeniedbythe
83boards,theprovisionsofsection536.063forcontestedcasesshallapplyandgovern
84proceedingsforappellatepurposes;and
SSHCSHBs115&99 12 85 e.Thecollaboratingphysicianisrequiredtomaintaindocumentationrelatedtothis
86requirementandtopresentittothestateboardofregistrationforthehealingartswhen
87requested;and
88 (c)Providecoverageduringabsence,incapacity,infirmity,oremergencybythe
89collaboratingphysician;
90 (6)Adescriptionoftheadvancedpracticeregisterednurse'scontrolledsubstance
91prescriptiveauthorityincollaborationwiththephysician,includingalistofthecontrolled
92substancesthephysicianauthorizesthenursetoprescribeanddocumentationthatitis
93consistentwitheachprofessional'seducation,knowledge,skill,andcompetence;
94 (7)Alistofallotherwrittenpracticeagreementsofthecollaboratingphysicianand
95theadvancedpracticeregisterednurse;
96 (8)Thedurationofthewrittenpracticeagreementbetweenthecollaborating
97physicianandtheadvancedpracticeregisterednurse;
98 (9)Adescriptionofthetimeandmannerofthecollaboratingphysician'sreviewof
99theadvancedpracticeregisterednurse'sdeliveryofhealthcareservices.Thedescriptionshall
100includeprovisionsthattheadvancedpracticeregisterednurseshallsubmitaminimumoften
101percentofthechartsdocumentingtheadvancedpracticeregisterednurse'sdeliveryofhealth
102careservicestothecollaboratingphysicianforreviewbythecollaboratingphysician,orany
103otherphysiciandesignatedinthecollaborativepracticearrangement,everyfourteendays;
104[and]
105 (10)Thecollaboratingphysician,oranyotherphysiciandesignatedinthe
106collaborativepracticearrangement,shallrevieweveryfourteendaysaminimumoftwenty
107percentofthechartsinwhichtheadvancedpracticeregisterednurseprescribescontrolled
108substances.Thechartsreviewedunderthissubdivisionmaybecountedinthenumberof
109chartsrequiredtobereviewedundersubdivision(9)ofthissubsection; and
110 (11)Ifacollaborativepracticearrangementisusedinclinicalsituationswherea
111collaboratingadvancedpracticeregisterednurseprovideshealthcareservicesthat
112includethediagnosisandinitiationoftreatmentforacutelyorchronicallyillorinjured
113persons,thenthecollaboratingphysicianoranyotherphysiciandesignatedinthe
114collaborativepracticearrangementshallbepresentforsufficientperiodsoftime,at
115leastonceeverytwoweeks,exceptinextraordinarycircumstancesthatshallbe
116documented,toparticipateinachartreviewandtoprovidenecessarymedicaldirection,
117medicalservices,consultations,andsupervisionofthehealthcarestaff.
118 4.Thestateboardofregistrationforthehealingartspursuanttosection334.125and
119theboardofnursingpursuanttosection335.036mayjointlypromulgaterulesregulatingthe
120useofcollaborativepracticearrangements.Suchrulesshallbelimitedto[specifying
121geographicareastobecovered,] themethodsoftreatmentthatmaybecoveredby
SSHCSHBs115&99 13 122collaborativepracticearrangementsandtherequirementsforreviewofservicesprovided
123pursuanttocollaborativepracticearrangementsincludingdelegatingauthoritytoprescribe
124controlledsubstances.Anyrulesrelatingtogeographicproximityshallallowa
125collaboratingphysicianandacollaboratingadvancedpracticeregisterednurseto
126practicewithintwohundredmilesbyroadofoneanotheruntilAugust28,2025,ifthe
127nurseisprovidingservicesinacorrectionalcenter,asdefinedinsection217.010.Any
128rulesrelatingtodispensingordistributionofmedicationsordevicesbyprescriptionor
129prescriptiondrugordersunderthissectionshallbesubjecttotheapprovalofthestateboard
130ofpharmacy.Anyrulesrelatingtodispensingordistributionofcontrolledsubstancesby
131prescriptionorprescriptiondrugordersunderthissectionshallbesubjecttotheapprovalof
132thedepartmentofhealthandseniorservicesandthestateboardofpharmacy.Inordertotake
133effect,suchrulesshallbeapprovedbyamajorityvoteofaquorumofeachboard.Neitherthe
134stateboardofregistrationforthehealingartsnortheboardofnursingmayseparately
135promulgaterulesrelatingtocollaborativepracticearrangements.Suchjointlypromulgated
136rulesshallbeconsistentwithguidelinesforfederallyfundedclinics.Therulemaking
137authoritygrantedinthissubsectionshallnotextendtocollaborativepracticearrangementsof
138hospitalemployeesprovidinginpatientcarewithinhospitalsasdefinedpursuanttochapter
139197orpopulation-basedpublichealthservicesasdefinedby20CSR2150-5.100asofApril
14030,2008.
141 5.Thestateboardofregistrationforthehealingartsshallnotdeny,revoke,suspend
142orotherwisetakedisciplinaryactionagainstaphysicianforhealthcareservicesdelegatedtoa
143registeredprofessionalnurseprovidedtheprovisionsofthissectionandtherules
144promulgatedthereunderaresatisfied.Uponthewrittenrequestofaphysiciansubjecttoa
145disciplinaryactionimposedasaresultofanagreementbetweenaphysicianandaregistered
146professionalnurseorregisteredphysicianassistant,whetherwrittenornot,priortoAugust
14728,1993,allrecordsofsuchdisciplinarylicensureactionandallrecordspertainingtothe
148filing,investigationorreviewofanallegedviolationofthischapterincurredasaresultof
149suchanagreementshallberemovedfromtherecordsofthestateboardofregistrationforthe
150healingartsandthedivisionofprofessionalregistrationandshallnotbedisclosedtoany
151publicorprivateentityseekingsuchinformationfromtheboardorthedivision.Thestate
152boardofregistrationforthehealingartsshalltakeactiontocorrectreportsofalleged
153violationsanddisciplinaryactionsasdescribedinthissectionwhichhavebeensubmittedto
154theNationalPractitionerDataBank.Insubsequentapplicationsorrepresentationsrelatingto
155hisorhermedicalpractice,aphysiciancompletingformsordocumentsshallnotberequired
156toreportanyactionsofthestateboardofregistrationforthehealingartsforwhichthe
157recordsaresubjecttoremovalunderthissection.
SSHCSHBs115&99 14 158 6.Withinthirtydaysofanychangeandoneachrenewal,thestateboardof
159registrationforthehealingartsshallrequireeveryphysiciantoidentifywhetherthephysician
160isengagedinanycollaborativepractice[agreement] arrangement, includingcollaborative
161practice[agreements] arrangementsdelegatingtheauthoritytoprescribecontrolled
162substances,orphysicianassistant[agreement] collaborativepracticearrangementand
163alsoreporttotheboardthenameofeachlicensedprofessionalwithwhomthephysicianhas
164enteredintosuch[agreement] arrangement. Theboard[may] shallmakethisinformation
165availabletothepublic.Theboardshalltrackthereportedinformationandmayroutinely
166conductrandomreviewsofsuch[agreements] arrangementstoensurethat[agreements]
167arrangementsarecarriedoutforcomplianceunderthischapter.
168 7.Notwithstandinganylawtothecontrary,acertifiedregisterednurseanesthetistas
169definedinsubdivision(8)ofsection335.016shallbepermittedtoprovideanesthesiaservices
170withoutacollaborativepracticearrangementprovidedthatheorsheisunderthesupervision
171ofananesthesiologistorotherphysician,dentist,orpodiatristwhoisimmediatelyavailableif
172needed.Nothinginthissubsectionshallbeconstruedtoprohibitorpreventacertified
173registerednurseanesthetistasdefinedinsubdivision(8)ofsection335.016fromenteringinto
174acollaborativepracticearrangementunderthissection,exceptthatthecollaborativepractice
175arrangementmaynotdelegatetheauthoritytoprescribeanycontrolledsubstanceslistedin
176SchedulesIII,IV,andVofsection195.017,orScheduleII-hydrocodone.
177 8.Acollaboratingphysicianshallnotenterintoacollaborativepracticearrangement
178withmorethansixfull-timeequivalentadvancedpracticeregisterednurses,full-time
179equivalentlicensedphysicianassistants,orfull-timeequivalentassistantphysicians,orany
180combinationthereof.Thislimitationshallnotapplytocollaborativearrangementsofhospital
181employeesprovidinginpatientcareserviceinhospitalsasdefinedinchapter197or
182population-basedpublichealthservicesasdefinedby20CSR2150-5.100asofApril30,
1832008,ortoacertifiedregisterednurseanesthetistprovidinganesthesiaservicesunderthe
184supervisionofananesthesiologistorotherphysician,dentist,orpodiatristwhoisimmediately
185availableifneededassetoutinsubsection7ofthissection.
186 9.Itistheresponsibilityofthecollaboratingphysiciantodetermineanddocument
187thecompletionofatleastaone-monthperiodoftimeduringwhichtheadvancedpractice
188registerednurseshallpracticewiththecollaboratingphysiciancontinuouslypresentbefore
189practicinginasettingwherethecollaboratingphysicianisnotcontinuouslypresent.This
190limitationshallnotapplytocollaborativearrangementsofprovidersofpopulation-based
191publichealthservicesasdefinedby20CSR2150-5.100asofApril30,2008, orto
192collaborativepracticearrangementsbetweenaprimarycarephysicianandaprimary
193careadvancedpracticeregisterednurseorabehavioralhealthphysiciananda
194behavioralhealthadvancedpracticeregisterednurse,wherethecollaboratingphysician
SSHCSHBs115&99 15 195isnewtoapatientpopulationtowhichtheadvancedpracticeregisterednurseis
196familiar.
197 10.Noagreementmadeunderthissectionshallsupersedecurrenthospitallicensing
198regulationsgoverninghospitalmedicationordersunderprotocolsorstandingordersforthe
199purposeofdeliveringinpatientoremergencycarewithinahospitalasdefinedinsection
200197.020ifsuchprotocolsorstandingordershavebeenapprovedbythehospital'smedical
201staffandpharmaceuticaltherapeuticscommittee.
202 11.Nocontractorother[agreement] termofemploymentshallrequireaphysician
203toactasacollaboratingphysicianforanadvancedpracticeregisterednurseagainstthe
204physician'swill.Aphysicianshallhavetherighttorefusetoactasacollaboratingphysician,
205withoutpenalty,foraparticularadvancedpracticeregisterednurse.Nocontractorother
206agreementshalllimitthecollaboratingphysician'sultimateauthorityoveranyprotocolsor
207standingordersorinthedelegationofthephysician'sauthoritytoanyadvancedpractice
208registerednurse,butthisrequirementshallnotauthorizeaphysicianinimplementingsuch
209protocols,standingorders,ordelegationtoviolateapplicablestandardsforsafemedical
210practiceestablishedbyhospital'smedicalstaff.
211 12.Nocontractorother[agreement] termofemploymentshallrequireany
212advancedpracticeregisterednursetoserveasacollaboratingadvancedpracticeregistered
213nurseforanycollaboratingphysicianagainsttheadvancedpracticeregisterednurse'swill.
214Anadvancedpracticeregisterednurseshallhavetherighttorefusetocollaborate,without
215penalty,withaparticularphysician.
334.506.1.Asusedinthissection,thefollowingtermsmean:
2 (1)"Approvedhealthcareprovider"[means], apersonholdingacurrentandactive
3licenseasaphysicianandsurgeonunderthischapter,achiropractorunderchapter331,a
4dentistunderchapter332,apodiatristunderchapter330,aphysicianassistantunderthis
5chapter,anadvancedpracticeregisterednurseunderchapter335,oranylicensedand
6registeredphysician,chiropractor,dentist,orpodiatristpracticinginanotherjurisdiction
7whoselicenseisingoodstanding;
8 (2)"Consult"or"consultation",communicationbytelephone,byfax,in
9writing,orinpersonwiththepatient'spersonallyapprovedlicensedhealthcare
10provideroralicensedhealthcareproviderofthepatient'sdesignation.
11 2.Aphysicaltherapist[shallnot]mayevaluateandinitiatetreatment[foranew
12injuryorillness] onapatientwithoutaprescriptionorreferralfromanapprovedhealthcare
13provider, providedthatthephysicaltherapisthasadoctorateofphysicaltherapydegree
14orhasfiveyearsofclinicalpracticeasaphysicaltherapist.
15 3.Aphysicaltherapistmayprovideeducationalresourcesandtraining,develop
16fitnessorwellnessprograms[forasymptomaticpersons], orprovidescreeningorconsultative
SSHCSHBs115&99 16 17serviceswithinthescopeofphysicaltherapypracticewithout[the]aprescription[and
18directionof]orreferralfromanapprovedhealthcareprovider.
19 4.[Aphysicaltherapistmayexamineandtreatwithouttheprescriptionanddirection
20ofanapprovedhealthcareprovideranypersonwitharecurringself-limitedinjurywithinone
21yearofdiagnosisbyanapprovedhealthcareproviderorachronicillnessthathasbeen
22previouslydiagnosedbyanapprovedhealthcareprovider.Thephysicaltherapistshall:]
23 (1)[Contactthepatient'scurrentapprovedhealthcareproviderwithinsevendaysof
24initiatingphysicaltherapyservicesunderthissubsection;] Aphysicaltherapistshallrefer
25toanapprovedhealthcareprovideranypatientwhoseconditionatthetimeof
26evaluationortreatmentisdeterminedtobebeyondthescopeofpracticeofphysical
27therapy.Thephysicaltherapistshallnotprovidephysicaltherapyservicesortreatment
28afterthisreferralhasbeenmade.
29 (2)[Notchangeanexistingphysicaltherapyreferralavailabletothephysical
30therapistwithoutapprovalofthepatient'scurrentapprovedhealthcareprovider;] Aphysical
31therapistshallrefertoanapprovedhealthcareprovideranypatientwhodoesnot
32demonstratemeasurableorfunctionalimprovementaftertenvisitsorthirtydays,
33whicheveroccursfirst.Thephysicaltherapistshallnotprovidefurthertherapyservices
34ortreatmentafterthisreferralhasbeenmade.
35 (3)[Refertoanapprovedhealthcareprovideranypatientwhosemedicalconditionat
36thetimeofexaminationortreatmentisdeterminedtobebeyondthescopeofpracticeof
37physicaltherapy;
38 (4)Refertoanapprovedhealthcareprovideranypatientwhoseconditionforwhich
39physicaltherapyservicesarerenderedunderthissubsectionhasnotbeendocumentedtobe
40progressingtowarddocumentedtreatmentgoalsaftersixvisitsorfourteendays,whichever
41firstoccurs;
42 (5)Notifythepatient'scurrentapprovedhealthcareproviderpriortothecontinuation
43oftreatmentiftreatmentrenderedunderthissubsectionistocontinuebeyondthirtydays.
44Thephysicaltherapistshallprovidesuchnotificationforeachsuccessiveperiodofthirty
45days.](a)Aphysicaltherapistshallconsultwithanapprovedhealthcareproviderif,
46aftereverytenvisitsorthirtydays,whicheveroccursfirst,thepatienthasdemonstrated
47measurableorfunctionalimprovementfromthecourseofphysicaltherapyservicesor
48treatmentprovidedandthephysicaltherapistbelievesthatcontinuationofthecourseof
49physicaltherapyservicesortreatmentisreasonableandnecessarybasedonthephysical
50therapist'sevaluationofthepatient.Thephysicaltherapistshallnotprovidefurther
51physicaltherapyservicesortreatmentuntiltheconsultationhasoccurred.
52 (b)Theconsultationwiththeapprovedhealthcareprovidershallinclude
53informationconcerning:
SSHCSHBs115&99 17 54 a.Thepatient'sconditionforwhichphysicaltherapyservicesortreatmentswere
55provided;
56 b.Thebasisforthecourseofservicesortreatmentindicated,asdetermined
57fromthephysicaltherapyevaluationofthepatient;
58 c.Thephysicaltherapyservicesortreatmentprovidedbeforethedateofthe
59consultation;
60 d.Thepatient'sdemonstratedmeasurableorfunctionalimprovementfromthe
61servicesortreatmentprovidedbeforethedateoftheconsultation;
62 e.Thecontinuingphysicaltherapyservicesortreatmentproposedtobe
63providedfollowingtheconsultation;and
64 f.Theprofessionalphysicaltherapybasisforthecontinuedphysicaltherapy
65servicesortreatmenttobeprovided.
66 (c)Continuedphysicaltherapyservicesortreatmentfollowingtheconsultation
67withandapprovalbyanapprovedhealthcareprovidershallproceedinaccordance
68withanyfeedback,advice,opinion,ordirectionoftheapprovedhealthcareprovider.
69Thephysicaltherapistshallnotifytheconsultingapprovedhealthcareproviderof
70continuingphysicaltherapyservicesortreatmentandthepatient'sprogressatleast
71everytenvisitsorthirtydaysaftertheinitialconsultationunlesstheconsulting
72approvedhealthcareproviderdirectsotherwise.
73 (d)Theprovisionsofthissubdivisionshallnotapplytophysicaltherapyservices
74performedwithinaprimaryorsecondaryschoolforindividualswithinagesnotin
75excessoftwenty-oneyears.
76 5.Theprovisionofphysicaltherapyservicesofevaluationandscreeningpursuantto
77thissectionshallbelimitedtoaphysicaltherapist,andanyauthorityforevaluationand
78screeninggrantedwithinthissectionmaynotbedelegated.Uponeachreinitiationof
79physicaltherapyservices,aphysicaltherapistshallprovideafullphysicaltherapyevaluation
80priortothereinitiationofphysicaltherapytreatment.[Physicaltherapytreatmentprovided
81pursuanttotheprovisionsofsubsection4ofthissectionmaybedelegatedbyphysical
82therapiststophysicaltherapistassistantsonlyifthepatient'scurrentapprovedhealthcare
83providerhasbeensoinformedaspartofthephysicaltherapist'sseven-daynotificationupon
84reinitiationofphysicaltherapyservicesasrequiredinsubsection4ofthissection.] Nothing
85inthissubsectionshallbeconstruedastolimittheabilityofphysicaltherapistsorphysical
86therapistassistantstoprovidephysicaltherapyservicesinaccordancewiththeprovisionsof
87thischapter,anduponthereferralofanapprovedhealthcareprovider.Nothinginthis
88subsectionshallprohibitanapprovedhealthcareproviderfromactingwithinthescopeof
89theirpracticeasdefinedbytheapplicablechaptersofRSMo.
SSHCSHBs115&99 18 90 6.Nopersonlicensedtopractice,orapplicantforlicensure,asaphysicaltherapistor
91physicaltherapistassistantshallmakeamedicaldiagnosis.
92 7.Aphysicaltherapistshallonlydelegatephysicaltherapytreatmenttoaphysical
93therapistassistantortoapersoninanentrylevelofaprofessionaleducationprogram
94approvedbytheCommissiononAccreditationinPhysicalTherapyEducation(CAPTE)who
95satisfiessupervisedclinicaleducationrequirementsrelatedtotheperson'sphysicaltherapist
96orphysicaltherapistassistanteducation.Theentry-levelpersonshallbeunderthe
97supervisionofaphysicaltherapist.
334.613.1.Theboardmayrefusetoissueorrenewalicensetopracticeasaphysical
2therapistorphysicaltherapistassistantforoneoranycombinationofcausesstatedin
3subsection2ofthissection.Theboardshallnotifytheapplicantinwritingofthereasonsfor
4therefusalandshalladvisetheapplicantoftheapplicant'srighttofileacomplaintwiththe
5administrativehearingcommissionasprovidedbychapter621.Asanalternativetoarefusal
6toissueorrenewalicensetopracticeasaphysicaltherapistorphysicaltherapistassistant,the
7boardmay,atitsdiscretion,issuealicensewhichissubjecttoprobation,restriction,or
8limitationtoanapplicantforlicensureforanyoneoranycombinationofcausesstatedin
9subsection2ofthissection.Theboard'sorderofprobation,limitation,orrestrictionshall
10containastatementofthedisciplineimposed,thebasistherefor,thedatesuchactionshall
11becomeeffective,andastatementthattheapplicanthasthirtydaystorequestinwritinga
12hearingbeforetheadministrativehearingcommission.Iftheboardissuesaprobationary,
13limited,orrestrictedlicensetoanapplicantforlicensure,eitherpartymayfileawritten
14petitionwiththeadministrativehearingcommissionwithinthirtydaysoftheeffectivedateof
15theprobationary,limited,orrestrictedlicenseseekingreviewoftheboard'sdetermination.If
16nowrittenrequestforahearingisreceivedbytheadministrativehearingcommissionwithin
17thethirty-dayperiod,therighttoseekreviewoftheboard'sdecisionshallbeconsideredas
18waived.
19 2.Theboardmaycauseacomplainttobefiledwiththeadministrativehearing
20commissionasprovidedbychapter621againstanyholderofalicensetopracticeasa
21physicaltherapistorphysicaltherapistassistantwhohasfailedtoreneworhassurrendered
22hisorherlicenseforanyoneoranycombinationofthefollowingcauses:
23 (1)Useofanycontrolledsubstance,asdefinedinchapter195,oralcoholicbeverage
24toanextentthatsuchuseimpairsaperson'sabilitytoperformtheworkofaphysicaltherapist
25orphysicaltherapistassistant;
26 (2)Thepersonhasbeenfinallyadjudicatedandfoundguilty,orenteredapleaof
27guiltyornolocontendere,inacriminalprosecutionunderthelawsofanystate,oftheUnited
28States,orofanycountry,foranyoffensedirectlyrelatedtothedutiesandresponsibilitiesof
SSHCSHBs115&99 19 29theoccupation,assetforthinsection324.012,regardlessofwhetherornotsentenceis
30imposed;
31 (3)Useoffraud,deception,misrepresentation,orbriberyinsecuringanycertificate
32ofregistrationorauthority,permit,orlicenseissuedunderthischapterorinobtaining
33permissiontotakeanyexaminationgivenorrequiredunderthischapter;
34 (4)Misconduct,fraud,misrepresentation,dishonesty,unethicalconduct,or
35unprofessionalconductintheperformanceofthefunctionsordutiesofaphysicaltherapist
36orphysicaltherapistassistant,includingbutnotlimitedtothefollowing:
37 (a)Obtainingorattemptingtoobtainanyfee,charge,tuition,orothercompensation
38byfraud,deception,ormisrepresentation;willfullyandcontinuallyoverchargingor
39overtreatingpatients;orchargingforsessionsofphysicaltherapywhichdidnotoccur
40unlesstheserviceswerecontractedforinadvance,orforserviceswhichwerenotrenderedor
41documentedinthepatient'srecords;
42 (b)Attempting,directlyorindirectly,bywayofintimidation,coercion,ordeception,
43toobtainorretainapatientordiscouragetheuseofasecondopinionorconsultation;
44 (c)Willfullyandcontinuallyperforminginappropriateorunnecessarytreatmentor
45services;
46 (d)Delegatingprofessionalresponsibilitiestoapersonwhoisnotqualifiedby
47training,skill,competency,age,experience,orlicensuretoperformsuchresponsibilities;
48 (e)Misrepresentingthatanydisease,ailment,orinfirmitycanbecuredbyamethod,
49procedure,treatment,medicine,ordevice;
50 (f)Performingserviceswhichhavebeendeclaredbyboardruletobeofnophysical
51therapyvalue;
52 (g)Finaldisciplinaryactionbyanyprofessionalassociation,professionalsociety,
53licensedhospitalormedicalstaffofthehospital,orphysicaltherapyfacilityinthisorany
54otherstateorterritory,whetheragreedtovoluntarilyornot,andincludingbutnotlimitedto
55anyremoval,suspension,limitation,orrestrictionoftheperson'sprofessionalemployment,
56malpractice,oranyotherviolationofanyprovisionofthischapter;
57 (h)Administeringtreatmentwithoutsufficientexamination,orforotherthan
58medicallyacceptedtherapeuticorexperimentalorinvestigativepurposesdulyauthorizedbya
59stateorfederalagency,ornotinthecourseofprofessionalphysicaltherapypractice;
60 (i)Engaginginorsolicitingsexualrelationships,whetherconsensualor
61nonconsensual,whileaphysicaltherapistorphysicaltherapistassistant/patientrelationship
62exists;makingsexualadvances,requestingsexualfavors,orengaginginotherverbalconduct
63orphysicalcontactofasexualnaturewithpatientsorclients;
64 (j)Terminatingthecareofapatientwithoutadequatenoticeorwithoutmakingother
65arrangementsforthecontinuedcareofthepatient;
SSHCSHBs115&99 20 66 (k)Failingtofurnishdetailsofapatient'sphysicaltherapyrecordstotreating
67physicians,otherphysicaltherapists,orhospitalsuponproperrequest;orfailingtocomply
68withanyotherlawrelatingtophysicaltherapyrecords;
69 (l)Failureofanyapplicantorlicensee,otherthanthelicenseesubjecttothe
70investigation,tocooperatewiththeboardduringanyinvestigation;
71 (m)Failuretocomplywithanysubpoenaorsubpoenaducestecumfromtheboardor
72anorderoftheboard;
73 (n)Failuretotimelypaylicenserenewalfeesspecifiedinthischapter;
74 (o)Violatingaprobationagreementwiththisboardoranyotherlicensingagency;
75 (p)Failingtoinformtheboardofthephysicaltherapist'sorphysicaltherapist
76assistant'scurrenttelephonenumber,residence,andbusinessaddress;
77 (q)Advertisingbyanapplicantorlicenseewhichisfalseormisleading,orwhich
78violatesanyruleoftheboard,orwhichclaimswithoutsubstantiationthepositivecureofany
79disease,orprofessionalsuperioritytoorgreaterskillthanthatpossessedbyanyother
80physicaltherapistorphysicaltherapistassistant.Anapplicantorlicenseeshallalsobein
81violationofthisprovisioniftheapplicantorlicenseehasafinancialinterestinany
82organization,corporation,orassociationwhichissuesorconductssuchadvertising;
83 (5)Anyconductorpracticewhichisormightbeharmfulordangeroustothemental
84orphysicalhealthofapatientorthepublic;orincompetency,grossnegligence,orrepeated
85negligenceintheperformanceofthefunctionsordutiesofaphysicaltherapistorphysical
86therapistassistant.Forthepurposesofthissubdivision,"repeatednegligence"meansthe
87failure,onmorethanoneoccasion,tousethatdegreeofskillandlearningordinarilyused
88underthesameorsimilarcircumstancesbythememberoftheapplicant'sorlicensee's
89profession;
90 (6)Violationof,orattemptingtoviolate,directlyorindirectly,orassistingor
91enablinganypersontoviolate,anyprovisionofthischapter,orofanylawfulruleadopted
92underthischapter;
93 (7)Impersonationofanypersonlicensedasaphysicaltherapistorphysicaltherapist
94assistantorallowinganypersontousehisorherlicenseordiplomafromanyschool;
95 (8)Revocation,suspension,restriction,modification,limitation,reprimand,warning,
96censure,probation,orotherfinaldisciplinaryactionagainstaphysicaltherapistorphysical
97therapistassistantforalicenseorotherrighttopracticeasaphysicaltherapistorphysical
98therapistassistantbyanotherstate,territory,federalagencyorcountry,whetherornot
99voluntarilyagreedtobythelicenseeorapplicant,includingbutnotlimitedtothedenialof
100licensure,surrenderofthelicense,allowingthelicensetoexpireorlapse,ordiscontinuingor
101limitingthepracticeofphysicaltherapywhilesubjecttoaninvestigationorwhileactually
102underinvestigationbyanylicensingauthority,medicalfacility,branchoftheArmedForces
SSHCSHBs115&99 21 103oftheUnitedStatesofAmerica,insurancecompany,court,agencyofthestateorfederal
104government,oremployer;
105 (9)Apersonisfinallyadjudgedincapacitatedordisabledbyacourtofcompetent
106jurisdiction;
107 (10)Assistingorenablinganypersontopracticeoroffertopracticewhoisnot
108licensedandcurrentlyeligibletopracticeunderthischapter;orknowinglyperforminganyact
109whichinanywayaids,assists,procures,advises,orencouragesanypersontopractice
110physicaltherapywhoisnotlicensedandcurrentlyeligibletopracticeunderthischapter;
111 (11)Issuanceofalicensetopracticeasaphysicaltherapistorphysicaltherapist
112assistantbaseduponamaterialmistakeoffact;
113 (12)Failuretodisplayavalidlicensepursuanttopracticeasaphysicaltherapistor
114physicaltherapistassistant;
115 (13)Knowinglymaking,orcausingtobemade,oraiding,orabettinginthemaking
116of,afalsestatementinanydocumentexecutedinconnectionwiththepracticeofphysical
117therapy;
118 (14)Solicitingpatronageinpersonorbyagentsorrepresentatives,orbyanyother
119meansormanner,undertheperson'sownnameorunderthenameofanotherpersonor
120concern,actualorpretended,insuchamannerastoconfuse,deceive,ormisleadthepublicas
121totheneedornecessityfororappropriatenessofphysicaltherapyservicesforallpatients,or
122thequalificationsofanindividualpersonorpersonstorender,orperformphysicaltherapy
123services;
124 (15)Using,orpermittingtheuseof,theperson'snameunderthedesignationof
125"physicaltherapist","physiotherapist","registeredphysicaltherapist","P.T.","Ph.T.",
126"P.T.T.","D.P.T.","M.P.T."or"R.P.T.","physicaltherapistassistant","P.T.A.","L.P.T.A.",
127"C.P.T.A.",oranysimilardesignationwithreferencetothecommercialexploitationofany
128goods,waresormerchandise;
129 (16)Knowinglymakingorcausingtobemadeafalsestatementormisrepresentation
130ofamaterialfact,withintenttodefraud,forpaymentunderchapter208orchapter630orfor
131paymentfromTitleXVIIIorTitleXIXoftheSocialSecurityAct;
132 (17)Failureorrefusaltoproperlyguardagainstcontagious,infectious,or
133communicablediseasesorthespreadthereof;maintaininganunsanitaryfacilityor
134performingprofessionalservicesunderunsanitaryconditions;orfailuretoreportthe
135existenceofanunsanitaryconditioninanyphysicaltherapyfacilitytotheboard,inwriting,
136withinthirtydaysafterthediscoverythereof;
137 (18)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist
138orphysicaltherapistassistantpayingorofferingtopayareferralfeeor[,notwithstanding
139section334.010tothecontrary,practicingorofferingtopracticeprofessionalphysical
SSHCSHBs115&99 22 140therapyindependentoftheprescriptionanddirectionofapersonlicensedandregisteredasa
141physicianandsurgeonunderthischapter,asaphysicianassistantunderthischapter,asa
142chiropractorunderchapter331,asadentistunderchapter332,asapodiatristunderchapter
143330,asanadvancedpracticeregisterednurseunderchapter335,oranylicensedand
144registeredphysician,chiropractor,dentist,podiatrist,oradvancedpracticeregisterednurse
145practicinginanotherjurisdiction,whoselicenseisingoodstanding] evaluatingortreatinga
146patientinamannerinconsistentwithsection334.506;
147 (19)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist
148orphysicaltherapistassistanttreatingorattemptingtotreatailmentsorotherhealth
149conditionsofhumanbeingsotherthanbyprofessionalphysicaltherapyandasauthorizedby
150sections334.500to334.685;
151 (20)Apatternofpersonaluseorconsumptionofanycontrolledsubstanceunlessitis
152prescribed,dispensed,oradministeredbyaphysicianwhoisauthorizedbylawtodoso;
153 (21)Failingtomaintainadequatepatientrecordsundersection334.602;
154 (22)Attemptingtoengageinconductthatsubvertsorunderminestheintegrityofthe
155licensingexaminationorthelicensingexaminationprocess,includingbutnotlimitedto
156utilizinginanymannerrecalledormemorizedlicensingexaminationquestionsfromorwith
157anypersonorentity,failingtocomplywithalltestcentersecurityprocedures,communicating
158orattemptingtocommunicatewithanyotherexamineesduringthetest,orcopyingorsharing
159licensingexaminationquestionsorportionsofquestions;
160 (23)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist
161orphysicaltherapistassistantwhorequests,receives,participatesorengagesdirectlyor
162indirectlyinthedivision,transferring,assigning,rebatingorrefundingoffeesreceivedfor
163professionalservicesorprofitsbymeansofacreditorothervaluableconsiderationsuchas
164wages,anunearnedcommission,discountorgratuitywithanypersonwhoreferredapatient,
165orwithanyrelativeorbusinessassociateofthereferringperson;
166 (24)Beingunabletopracticeasaphysicaltherapistorphysicaltherapistassistant
167withreasonableskillandsafetytopatientsbyreasonsofincompetency,orbecauseofillness,
168drunkenness,excessiveuseofdrugs,narcotics,chemicals,orasaresultofanymentalor
169physicalcondition.Thefollowingshallapplytothissubdivision:
170 (a)Inenforcingthissubdivisiontheboardshall,afterahearingbytheboard,upona
171findingofprobablecause,requireaphysicaltherapistorphysicaltherapistassistanttosubmit
172toareexaminationforthepurposeofestablishinghisorhercompetencytopracticeasa
173physicaltherapistorphysicaltherapistassistantconductedinaccordancewithrulesadopted
174forthispurposebytheboard,includingrulestoallowtheexaminationofthepatternand
175practiceofsuchphysicaltherapist'sorphysicaltherapistassistant'sprofessionalconduct,orto
SSHCSHBs115&99 23 176submittoamentalorphysicalexaminationorcombinationthereofbyafacilityor
177professionalapprovedbytheboard;
178 (b)Forthepurposeofthissubdivision,everyphysicaltherapistandphysicaltherapist
179assistantlicensedunderthischapterisdeemedtohaveconsentedtosubmittoamentalor
180physicalexaminationwhendirectedinwritingbytheboard;
181 (c)Inadditiontoorderingaphysicalormentalexaminationtodeterminecompetency,
182theboardmay,notwithstandinganyotherlawlimitingaccesstomedicalorotherhealthdata,
183obtainmedicaldataandhealthrecordsrelatingtoaphysicaltherapist,physicaltherapist
184assistantorapplicantwithoutthephysicaltherapist's,physicaltherapistassistant'sor
185applicant'sconsent;
186 (d)Writtennoticeofthereexaminationorthephysicalormentalexaminationshallbe
187senttothephysicaltherapistorphysicaltherapistassistant,byregisteredmail,addressedto
188thephysicaltherapistorphysicaltherapistassistantatthephysicaltherapist'sorphysical
189therapistassistant'slastknownaddress.Failureofaphysicaltherapistorphysicaltherapist
190assistanttosubmittotheexaminationwhendirectedshallconstituteanadmissionofthe
191allegationsagainstthephysicaltherapistorphysicaltherapistassistant,inwhichcasethe
192boardmayenterafinalorderwithoutthepresentationofevidence,unlessthefailurewasdue
193tocircumstancesbeyondthephysicaltherapist'sorphysicaltherapistassistant'scontrol.A
194physicaltherapistorphysicaltherapistassistantwhoserighttopracticehasbeenaffected
195underthissubdivisionshall,atreasonableintervals,beaffordedanopportunityto
196demonstratethatthephysicaltherapistorphysicaltherapistassistantcanresumethe
197competentpracticeasaphysicaltherapistorphysicaltherapistassistantwithreasonableskill
198andsafetytopatients;
199 (e)Inanyproceedingunderthissubdivisionneithertherecordofproceedingsnorthe
200ordersenteredbytheboardshallbeusedagainstaphysicaltherapistorphysicaltherapist
201assistantinanyotherproceeding.Proceedingsunderthissubdivisionshallbeconductedby
202theboardwithoutthefilingofacomplaintwiththeadministrativehearingcommission;
203 (f)Whentheboardfindsanypersonunqualifiedbecauseofanyofthegroundsset
204forthinthissubdivision,itmayenteranorderimposingoneormoreofthedisciplinary
205measuressetforthinsubsection3ofthissection.
206 3.Afterthefilingofsuchcomplaintbeforetheadministrativehearingcommission,
207theproceedingsshallbeconductedinaccordancewiththeprovisionsofchapter621.Upona
208findingbytheadministrativehearingcommissionthatthegroundsprovidedinsubsection2
209ofthissectionfordisciplinaryactionaremet,theboardmay,singlyorincombination:
210 (1)Warn,censureorplacethephysicaltherapistorphysicaltherapistassistantnamed
211inthecomplaintonprobationonsuchtermsandconditionsastheboarddeemsappropriate
212foraperiodnottoexceedtenyears;
SSHCSHBs115&99 24 213 (2)Suspendthephysicaltherapist'sorphysicaltherapistassistant'slicensefora
214periodnottoexceedthreeyears;
215 (3)Restrictorlimitthephysicaltherapist'sorphysicaltherapistassistant'slicensefor
216anindefiniteperiodoftime;
217 (4)Revokethephysicaltherapist'sorphysicaltherapistassistant'slicense;
218 (5)Administerapublicorprivatereprimand;
219 (6)Denythephysicaltherapist'sorphysicaltherapistassistant'sapplicationfora
220license;
221 (7)Permanentlywithholdissuanceofalicense;
222 (8)Requirethephysicaltherapistorphysicaltherapistassistanttosubmittothecare,
223counselingortreatmentofphysiciansdesignatedbytheboardattheexpenseofthephysical
224therapistorphysicaltherapistassistanttobeexamined;
225 (9)Requirethephysicaltherapistorphysicaltherapistassistanttoattendsuch
226continuingeducationalcoursesandpasssuchexaminationsastheboardmaydirect.
227 4.Inanyorderofrevocation,theboardmayprovidethatthephysicaltherapistor
228physicaltherapistassistantshallnotapplyforreinstatementofthephysicaltherapist'sor
229physicaltherapistassistant'slicenseforaperiodoftimerangingfromtwotosevenyears
230followingthedateoftheorderofrevocation.Allstayordersshalltollthistimeperiod.
231 5.Beforerestoringtogoodstandingalicenseissuedunderthischapterwhichhas
232beeninarevoked,suspended,orinactivestateforanycauseformorethantwoyears,the
233boardmayrequiretheapplicanttoattendsuchcontinuingmedicaleducationcoursesandpass
234suchexaminationsastheboardmaydirect.
235 6.Inanyinvestigation,hearingorotherproceedingtodetermineaphysical
236therapist's,physicaltherapistassistant'sorapplicant'sfitnesstopractice,anyrecordrelatingto
237anypatientofthephysicaltherapist,physicaltherapistassistant,orapplicantshallbe
238discoverablebytheboardandadmissibleintoevidence,regardlessofanystatutoryor
239commonlawprivilegewhichsuchphysicaltherapist,physicaltherapistassistant,applicant,
240recordcustodian,orpatientmightotherwiseinvoke.Inaddition,nosuchphysicaltherapist,
241physicaltherapistassistant,applicant,orrecordcustodianmaywithholdrecordsortestimony
242bearinguponaphysicaltherapist's,physicaltherapistassistant's,orapplicant'sfitnessto
243practiceonthegroundsofprivilegebetweensuchphysicaltherapist,physicaltherapist
244assistant,applicant,orrecordcustodianandapatient.
335.016.Asusedinthischapter,unlessthecontextclearlyrequiresotherwise,the
2followingwordsandtermsmean:
3 (1)"Accredited",theofficialauthorizationorstatusgrantedbyanagencyfora
4programthroughavoluntaryprocess;
SSHCSHBs115&99 25 5 (2)"Advancedpracticeregisterednurse"or"APRN", a[nursewhohaseducation
6beyondthebasicnursingeducationandiscertifiedbyanationallyrecognizedprofessional
7organizationasacertifiednursepractitioner,certifiednursemidwife,certifiedregistered
8nurseanesthetist,oracertifiedclinicalnursespecialist.Theboardshallpromulgaterules
9specifyingwhichnationallyrecognizedprofessionalorganizationcertificationsaretobe
10recognizedforthepurposesofthissection.Advancedpracticenursesandonlysuch
11individualsmayusethetitle"AdvancedPracticeRegisteredNurse"andtheabbreviation
12"APRN"] personwhoislicensedundertheprovisionsofthischaptertoengageinthe
13practiceofadvancedpracticenursingasacertifiedclinicalnursespecialist,certified
14nursemidwife,certifiednursepractitioner,orcertifiedregisterednurseanesthetist;
15 (3)"Approval",officialrecognitionofnursingeducationprogramswhichmeet
16standardsestablishedbytheboardofnursing;
17 (4)"Board"or"stateboard",thestateboardofnursing;
18 (5)"Certifiedclinicalnursespecialist",aregisterednursewhoiscurrentlycertifiedas
19aclinicalnursespecialistbyanationallyrecognizedcertifyingboardapprovedbytheboard
20ofnursing;
21 (6)"Certifiednursemidwife",aregisterednursewhoiscurrentlycertifiedasanurse
22midwifebytheAmerican[CollegeofNurseMidwives] MidwiferyCertificationBoard, or
23othernationallyrecognizedcertifyingbodyapprovedbytheboardofnursing;
24 (7)"Certifiednursepractitioner",aregisterednursewhoiscurrentlycertifiedasa
25nursepractitionerbyanationallyrecognizedcertifyingbodyapprovedbytheboardof
26nursing;
27 (8)"Certifiedregisterednurseanesthetist",aregisterednursewhoiscurrently
28certifiedasanurseanesthetistbytheCouncilonCertificationofNurseAnesthetists,the
29[CouncilonRecertificationofNurseAnesthetists] NationalBoardofCertificationand
30RecertificationforNurseAnesthetists, orothernationallyrecognizedcertifyingbody
31approvedbytheboardofnursing;
32 (9)"Executivedirector",aqualifiedindividualemployedbytheboardasexecutive
33secretaryorotherwisetoadministertheprovisionsofthischapterundertheboard'sdirection.
34Suchpersonemployedasexecutivedirectorshallnotbeamemberoftheboard;
35 (10)"Inactive[nurse] licensestatus", asdefinedbyrulepursuanttosection335.061;
36 (11)"Lapsedlicensestatus",asdefinedbyruleundersection335.061;
37 (12)"Licensedpracticalnurse"or"practicalnurse",apersonlicensedpursuanttothe
38provisionsofthischaptertoengageinthepracticeofpracticalnursing;
39 (13)"Licensure",theissuingofalicense[topracticeprofessionalorpractical
40nursing] tocandidateswhohavemetthe[specified] requirementsspecifiedunderthis
41chapter,authorizingthepersontoengageinthepracticeofadvancedpractice,
SSHCSHBs115&99 26 42professional,orpracticalnursing,andtherecordingofthenamesofthosepersonsas
43holdersofalicensetopracticeadvancedpractice,professional, orpracticalnursing;
44 (14)"Practiceofadvancedpracticenursing",theperformanceforcompensation
45ofactivitiesandservicesconsistentwiththerequirededucation,training,certification,
46demonstratedcompetencies,andexperiencesofanadvancedpracticeregisterednurse;
47 (15)"Practiceofpracticalnursing",theperformanceforcompensationofselected
48actsforthepromotionofhealthandinthecareofpersonswhoareill,injured,orexperiencing
49alterationsinnormalhealthprocesses.Suchperformancerequiressubstantialspecialized
50skill,judgmentandknowledge.Allsuchnursingcareshallbegivenunderthedirectionofa
51personlicensedbyastateregulatoryboardtoprescribemedicationsandtreatmentsorunder
52thedirectionofaregisteredprofessionalnurse.Forthepurposesofthischapter,theterm
53"direction"shallmeanguidanceorsupervisionprovidedbyapersonlicensedbyastate
54regulatoryboardtoprescribemedicationsandtreatmentsoraregisteredprofessionalnurse,
55including,butnotlimitedto,oral,written,orotherwisecommunicatedordersordirectivesfor
56patientcare.Whenpracticalnursingcareisdeliveredpursuanttothedirectionofaperson
57licensedbyastateregulatoryboardtoprescribemedicationsandtreatmentsorunderthe
58directionofaregisteredprofessionalnurse,suchcaremaybedeliveredbyalicensedpractical
59nursewithoutdirectphysicaloversight;
60 [(15)] (16)"Practiceofprofessionalnursing",theperformanceforcompensationof
61anyactoractionwhichrequiressubstantialspecializededucation,judgmentandskillbased
62onknowledgeandapplicationofprinciplesderivedfromthebiological,physical,social,
63behavioral,andnursingsciences,including,butnotlimitedto:
64 (a)Responsibilityforthepromotionandteachingofhealthcareandtheprevention
65ofillnesstothepatientandhisorherfamily;
66 (b)Assessment,datacollection,nursingdiagnosis,nursingcare,evaluation,and
67counselofpersonswhoareill,injured, orexperiencingalterationsinnormalhealthprocesses;
68 (c)Theadministrationofmedicationsandtreatmentsasprescribedbyaperson
69licensedbyastateregulatoryboardtoprescribemedicationsandtreatments;
70 (d)Thecoordinationandassistanceinthedeterminationanddeliveryofaplanof
71healthcarewithallmembersofahealthteam;
72 (e)Theteachingandsupervisionofotherpersonsintheperformanceofanyofthe
73foregoing;
74 [(16)A](17)"Registeredprofessionalnurse"or"registerednurse",apersonlicensed
75pursuanttotheprovisionsofthischaptertoengageinthepracticeofprofessionalnursing;
76 [(17)] (18)"Retiredlicensestatus",anypersonlicensedinthisstateunderthischapter
77whoretiresfromsuchpractice.Suchpersonshallfilewiththeboardanaffidavit,onaform
78tobefurnishedbytheboard,whichstatesthedateonwhichthelicenseeretiredfromsuch
SSHCSHBs115&99 27 79practice,anintenttoretirefromthepracticeforatleasttwoyears,andsuchotherfactsastend
80toverifytheretirementastheboardmaydeemnecessary;butifthelicenseethereafter
81reengagesinthepractice,thelicenseeshallrenewhisorherlicensewiththeboardas
82providedbythischapterandbyruleandregulation.
335.019.1.Anadvancedpracticeregisterednurse'sprescriptiveauthorityshall
2includeauthorityto:
3 (1)Prescribe,dispense,andadministermedicationsandnonscheduledlegend
4drugs,asdefinedinsection338.330,withinsuchAPRN'spracticeandspecialty;and
5 (2)Notwithstandinganyotherprovisionofthischaptertothecontrary,receive,
6prescribe,administer,andprovidenonscheduledlegenddrugsamplesfrom
7pharmaceuticalmanufacturerstopatientsatnochargetothepatientoranyotherparty.
8 2.Theboardofnursingmaygrantacertificateofcontrolledsubstanceprescriptive
9authoritytoanadvancedpracticeregisterednursewho:
10 (1)Submitsproofofsuccessfulcompletionofanadvancedpharmacologycoursethat
11shallincludepreceptorialexperienceintheprescriptionofdrugs,medicines, andtherapeutic
12devices;and
13 (2)Providesdocumentationofaminimumofthreehundredclockhourspreceptorial
14experienceintheprescriptionofdrugs,medicines,andtherapeuticdeviceswithaqualified
15preceptor;and
16 (3)Providesevidenceofaminimumofonethousandhoursofpracticeinanadvanced
17practicenursingcategorypriortoapplicationforacertificateofprescriptiveauthority.The
18onethousandhoursshallnotincludeclinicalhoursobtainedintheadvancedpracticenursing
19educationprogram.Theonethousandhoursofpracticeinanadvancedpracticenursing
20categorymayincludetransmittingaprescriptionorderorallyortelephonicallyortoan
21inpatientmedicalrecordfromprotocolsdevelopedincollaborationwithandsignedbya
22licensedphysician;and
23 (4)Hasacontrolledsubstanceprescribingauthoritydelegatedinthecollaborative
24practicearrangementundersection334.104withaphysicianwhohasanunrestrictedfederal
25DrugEnforcementAdministrationregistrationnumberandwhoisactivelyengagedina
26practicecomparableinscope,specialty,orexpertisetothatoftheadvancedpractice
27registerednurse.
335.036.1.Theboardshall:
2 (1)Electforaone-yeartermapresidentandasecretary,whoshallalsobetreasurer,
3andtheboardmayappoint,employandfixthecompensationofalegalcounselandsuch
4boardpersonnelasdefinedinsubdivision(4)ofsubsection11ofsection324.001asare
5necessarytoadministertheprovisionsofsections335.011to[335.096] 335.099;
SSHCSHBs115&99 28 6 (2)Adoptandrevisesuchrulesandregulationsasmaybenecessarytoenableitto
7carryintoeffecttheprovisionsofsections335.011to[335.096] 335.099;
8 (3)Prescribeminimumstandardsforeducationalprogramspreparingpersonsfor
9licensureasaregisteredprofessionalnurseorlicensedpracticalnursepursuanttothe
10provisionsofsections335.011to[335.096] 335.099;
11 (4)Provideforsurveysofsuchprogramseveryfiveyearsandinadditionatsuch
12timesasitmaydeemnecessary;
13 (5)Designateas"approved"suchprogramsasmeettherequirementsofsections
14335.011to[335.096] 335.099andtherulesandregulationsenactedpursuanttosuchsections;
15andtheboardshallannuallypublishalistofsuchprograms;
16 (6)Denyorwithdrawapprovalfromeducationalprogramsforfailuretomeet
17prescribedminimumstandards;
18 (7)Examine,license,andcausetoberenewedthelicensesofdulyqualified
19applicants;
20 (8)Causetheprosecutionofallpersonsviolatingprovisionsofsections335.011to
21[335.096] 335.099, andmayincursuchnecessaryexpensestherefor;
22 (9)Keeparecordofalltheproceedings;andmakeanannualreporttothegovernor
23andtothedirectorofthedepartmentofcommerceandinsurance.
24 2.Theboardshallsettheamountofthefeeswhichthischapterauthorizesand
25requiresbyrulesandregulations.Thefeesshallbesetataleveltoproducerevenuewhich
26shallnotsubstantiallyexceedthecostandexpenseofadministeringthischapter.
27 3.Allfeesreceivedbytheboardpursuanttotheprovisionsofsections335.011to
28[335.096] 335.099shallbedepositedinthestatetreasuryandbeplacedtothecreditofthe
29stateboardofnursingfund.Alladministrativecostsandexpensesoftheboardshallbepaid
30fromappropriationsmadeforthosepurposes.Theboardisauthorizedtoprovidefundingfor
31thenursingeducationincentiveprogramestablishedinsections335.200to335.203.
32 4.Theprovisionsofsection33.080tothecontrarynotwithstanding,moneyinthis
33fundshallnotbetransferredandplacedtothecreditofgeneralrevenueuntiltheamountin
34thefundattheendofthebienniumexceedstwotimestheamountoftheappropriationfrom
35theboard'sfundsfortheprecedingfiscalyearor,iftheboardrequiresbyrule,permitrenewal
36lessfrequentlythanyearly,thenthreetimestheappropriationfromtheboard'sfundsforthe
37precedingfiscalyear.Theamount,ifany,inthefundwhichshalllapseisthatamountinthe
38fundwhichexceedstheappropriatemultipleoftheappropriationsfromtheboard'sfundsfor
39theprecedingfiscalyear.
40 5.Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis
41createdundertheauthoritydelegatedinthischaptershallbecomeeffectiveonlyifitcomplies
42withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.
SSHCSHBs115&99 29 43AllrulemakingauthoritydelegatedpriortoAugust28,1999,isofnoforceandeffectand
44repealed.Nothinginthissectionshallbeinterpretedtorepealoraffectthevalidityofany
45rulefiledoradoptedpriortoAugust28,1999,ifitfullycompliedwithallapplicable
46provisionsoflaw.Thissectionandchapter536arenonseverableandifanyofthepowers
47vestedwiththegeneralassemblypursuanttochapter536toreview,todelaytheeffectivedate
48ortodisapproveandannularulearesubsequentlyheldunconstitutional,thenthegrantof
49rulemakingauthorityandanyruleproposedoradoptedafterAugust28,1999,shallbeinvalid
50andvoid.
335.046.1.Anapplicantforalicensetopracticeasaregisteredprofessionalnurse
2shallsubmittotheboardawrittenapplicationonformsfurnishedtotheapplicant.The
3originalapplicationshallcontaintheapplicant'sstatementsshowingtheapplicant'seducation
4andothersuchpertinentinformationastheboardmayrequire.Theapplicantshallbeofgood
5moralcharacterandhavecompletedatleastthehighschoolcourseofstudy,ortheequivalent
6thereofasdeterminedbythestateboardofeducation,andhavesuccessfullycompletedthe
7basicprofessionalcurriculuminanaccreditedorapprovedschoolofnursingandearneda
8professionalnursingdegreeordiploma.Eachapplicationshallcontainastatementthatitis
9madeunderoathoraffirmationandthatitsrepresentationsaretrueandcorrecttothebest
10knowledgeandbeliefofthepersonsigningsame,subjecttothepenaltiesofmakingafalse
11affidavitordeclaration.Applicantsfromnon-English-speakinglandsshallberequiredto
12submitevidenceofproficiencyintheEnglishlanguage.Theapplicantmustbeapprovedby
13theboardandshallpassanexaminationasrequiredbytheboard.Theboardmayrequireby
14ruleasarequirementforlicensurethateachapplicantshallpassanoralorpractical
15examination.Uponsuccessfullypassingtheexamination,theboardmayissuetothe
16applicantalicensetopracticenursingasaregisteredprofessionalnurse.Theapplicantfora
17licensetopracticeregisteredprofessionalnursingshallpayalicensefeeinsuchamountasset
18bytheboard.Thefeeshallbeuniformforallapplicants.Applicantsfromforeigncountries
19shallbelicensedasprescribedbyrule.
20 2.Anapplicantforlicensetopracticeasalicensedpracticalnurseshallsubmittothe
21boardawrittenapplicationonformsfurnishedtotheapplicant.Theoriginalapplicationshall
22containtheapplicant'sstatementsshowingtheapplicant'seducationandothersuchpertinent
23informationastheboardmayrequire.Suchapplicantshallbeofgoodmoralcharacter,and
24havecompletedatleasttwoyearsofhighschool,oritsequivalentasestablishedbythestate
25boardofeducation,andhavesuccessfullycompletedabasicprescribedcurriculuminastate-
26accreditedorapprovedschoolofnursing,earnedanursingdegree,certificateordiplomaand
27completedacourseapprovedbytheboardontheroleofthepracticalnurse.Eachapplication
28shallcontainastatementthatitismadeunderoathoraffirmationandthatitsrepresentations
29aretrueandcorrecttothebestknowledgeandbeliefofthepersonsigningsame,subjecttothe
SSHCSHBs115&99 30 30penaltiesofmakingafalseaffidavitordeclaration.Applicantsfromnon-English-speaking
31countriesshallberequiredtosubmitevidenceoftheirproficiencyintheEnglishlanguage.
32Theapplicantmustbeapprovedbytheboardandshallpassanexaminationasrequiredbythe
33board.Theboardmayrequirebyruleasarequirementforlicensurethateachapplicantshall
34passanoralorpracticalexamination.Uponsuccessfullypassingtheexamination,theboard
35mayissuetotheapplicantalicensetopracticeasalicensedpracticalnurse.Theapplicantfor
36alicensetopracticelicensedpracticalnursingshallpayafeeinsuchamountasmaybesetby
37theboard.Thefeeshallbeuniformforallapplicants.Applicantsfromforeigncountriesshall
38belicensedasprescribedbyrule.
39 3.(1)Anapplicantforalicensetopracticeasanadvancedpracticeregistered
40nurseshallsubmittotheboardawrittenapplicationonformsfurnishedtothe
41applicant.Theoriginalapplicationshallcontain:
42 (a)Statementsshowingtheapplicant'seducationandothersuchpertinent
43informationastheboardmayrequire;and
44 (b)Astatementthatitismadeunderoathoraffirmationandthatits
45representationsaretrueandcorrecttothebestknowledgeandbeliefoftheperson
46signingsame,subjecttothepenaltiesofmakingafalseaffidavitordeclaration.
47 (2)Theapplicantforalicensetopracticeasanadvancedpracticeregistered
48nurseshallpayafeeinsuchamountasmaybesetbytheboard.Thefeeshallbe
49uniformforallapplicants.
50 (3)Anapplicantshall:
51 (a)Holdacurrentregisteredprofessionalnurselicenseorprivilegetopractice,
52shallnotbecurrentlysubjecttodisciplineoranyrestrictions,andshallnotholdan
53encumberedlicenseorprivilegetopracticeasaregisteredprofessionalnurseor
54advancedpracticeregisterednurseinanystateorterritory;
55 (b)Havecompletedanaccreditedgraduate-leveladvancedpracticeregistered
56nurseprogramandachievedatleastonecertificationasaclinicalnursespecialist,nurse
57midwife,nursepractitioner,orregisterednurseanesthetist,withatleastonepopulation
58focusprescribedbyruleoftheboard;
59 (c)Becurrentlycertifiedbyanationalcertifyingbodyrecognizedbythe
60Missouristateboardofnursingintheadvancedpracticeregisterednurserole;and
61 (d)Haveapopulationfocusonhisorhercertification,correspondingwithhisor
62hereducationaladvancedpracticeregisterednurseprogram.
63 (4)Anypersonholdingadocumentofrecognitiontopracticenursingasan
64advancedpracticeregisterednurseinthisstatethatiscurrentonAugust28,2023,shall
65bedeemedtobelicensedasanadvancedpracticeregisterednurseundertheprovisions
SSHCSHBs115&99 31 66ofthissectionandshallbeeligibleforrenewalofsuchlicenseundertheconditionsand
67standardsprescribedinthischapterandasprescribedbyrule.
68 4.Uponrefusaloftheboardtoallowanyapplicantto[sitfor]takeeitherthe
69registeredprofessionalnurses'examinationorthelicensedpracticalnurses'examination,[as
70thecasemaybe,]oruponrefusaltoissueanadvancedpracticeregisterednurselicense,
71theboardshallcomplywiththeprovisionsofsection621.120andadvisetheapplicantofhis
72orherrighttohaveahearingbeforetheadministrativehearingcommission.The
73administrativehearingcommissionshallhearcomplaintstakenpursuanttosection621.120.
74 [4.]5.Theboardshallnotdenyalicensebecauseofsex,religion,race,ethnicorigin,
75ageorpoliticalaffiliation.
335.051.1.Theboardshallissuealicensetopracticenursingas[either] an
2advancedpracticeregisterednurse,aregisteredprofessionalnurse, oralicensedpractical
3nursewithoutexaminationtoanapplicantwhohasdulybecomelicensedas[a]anadvanced
4practiceregisterednurse,registerednurse, orlicensedpracticalnursepursuanttothelaws
5ofanotherstate,territory,orforeigncountryiftheapplicantmeetsthequalificationsrequired
6ofadvancedpracticeregisterednurses,registerednurses, orlicensedpracticalnursesinthis
7stateatthetimetheapplicantwasoriginallylicensedintheotherstate,territory,orforeign
8country.
9 2.Applicantsfromforeigncountriesshallbelicensedasprescribedbyrule.
10 3.Uponapplication,theboardshallissueatemporarypermittoanapplicantpursuant
11tosubsection1ofthissectionforalicenseas[either] anadvancedpracticeregistered
12nurse,aregisteredprofessionalnurse, oralicensedpracticalnursewhohasmadeaprima
13facieshowingthattheapplicantmeetsalloftherequirementsforsuchalicense.The
14temporarypermitshallbeeffectiveonlyuntiltheboardshallhavehadtheopportunityto
15investigatehisorherqualificationsforlicensurepursuanttosubsection1ofthissectionand
16tonotifytheapplicantthathisorherapplicationforalicensehasbeeneithergrantedor
17rejected.Innoeventshallsuchtemporarypermitbeineffectformorethantwelvemonths
18afterthedateofitsissuancenorshallapermitbereissuedtothesameapplicant.Nofeeshall
19bechargedforsuchtemporarypermit.Theholderofatemporarypermitwhichhasnot
20expired,orbeensuspendedorrevoked,shallbedeemedtobetheholderofalicenseissued
21pursuanttosection335.046untilsuchtemporarypermitexpires,isterminatedorissuspended
22orrevoked.
335.056.1.Thelicenseofeverypersonlicensedundertheprovisionsof[sections
2335.011to335.096] thischaptershallberenewedasprovided.Anapplicationforrenewal
3oflicenseshallbemailedtoeverypersontowhomalicensewasissuedorrenewedduringthe
4currentlicensingperiod.Theapplicantshallcompletetheapplicationandreturnittothe
5boardbytherenewaldatewitharenewalfeeinanamounttobesetbytheboard.Thefee
SSHCSHBs115&99 32 6shallbeuniformforallapplicants.Thecertificatesofrenewalshallrendertheholderthereof
7alegalpractitionerofnursingfortheperiodstatedinthecertificateofrenewal.Anyperson
8whopracticesnursingasanadvancedpracticeregisterednurse,aregisteredprofessional
9nurse, or[as]alicensedpracticalnurseduringthetimehisorherlicensehaslapsedshallbe
10consideredanillegalpractitionerandshallbesubjecttothepenaltiesprovidedforviolationof
11theprovisionsofsections335.011to[335.096] 335.099.
12 2.Therenewalofadvancedpracticeregisterednurselicensesandregistered
13professionalnurselicensesshalloccuratthesametime,asprescribedbyrule.Failure
14torenewandmaintaintheregisteredprofessionalnurselicenseorprivilegetopractice
15orfailuretoprovidetherequiredfeeandevidenceofactivecertificationormaintenance
16ofcertificationasprescribedbyrulesandregulationsshallresultinexpirationofthe
17advancedpracticeregisterednurselicense.
18 3.AlicensednursewhoholdsanAPRNlicenseshallbedisciplinedontheir
19APRNlicenseforanyviolationsofthischapter.
335.076.1.Anypersonwhoholdsalicensetopracticeprofessionalnursinginthis
2statemayusethetitle"RegisteredProfessionalNurse"andtheabbreviation["R.N."] "RN".
3Nootherpersonshallusethetitle"RegisteredProfessionalNurse"ortheabbreviation
4["R.N."] "RN". Nootherpersonshallassumeanytitleoruseanyabbreviationoranyother
5words,letters,signs,ordevicestoindicatethatthepersonusingthesameisaregistered
6professionalnurse.
7 2.Anypersonwhoholdsalicensetopracticepracticalnursinginthisstatemayuse
8thetitle"LicensedPracticalNurse"andtheabbreviation["L.P.N."]"LPN". Nootherperson
9shallusethetitle"LicensedPracticalNurse"ortheabbreviation["L.P.N."]"LPN". Noother
10personshallassumeanytitleoruseanyabbreviationoranyotherwords,letters,signs,or
11devicestoindicatethatthepersonusingthesameisalicensedpracticalnurse.
12 3.Anypersonwhoholdsalicense[orrecognition] topracticeadvancedpractice
13nursinginthisstatemayusethetitle"AdvancedPracticeRegisteredNurse",the
14designationsof"certifiedregisterednurseanesthetist","certifiednursemidwife",
15"certifiedclinicalnursespecialist",and"certifiednursepractitioner",andthe
16[abbreviation] abbreviations"APRN",[andanyothertitledesignationsappearingonhis
17orherlicense] "CRNA","CNM","CNS",and"NP",respectively. Nootherpersonshall
18usethetitle"AdvancedPracticeRegisteredNurse"ortheabbreviation"APRN".Noother
19personshallassumeanytitleoruseanyabbreviationoranyotherwords,letters,signs,or
20devicestoindicatethatthepersonusingthesameisanadvancedpracticeregisterednurse.
21 4.Nopersonshallpracticeoroffertopracticeprofessionalnursing,practicalnursing,
22oradvancedpracticenursinginthisstateoruseanytitle,sign,abbreviation,card,ordeviceto
SSHCSHBs115&99 33 23indicatethatsuchpersonisapracticingprofessionalnurse,practicalnurse,oradvanced
24practicenurseunlessheorshehasbeendulylicensedundertheprovisionsofthischapter.
25 5.Intheinterestofpublicsafetyandconsumerawareness,itisunlawfulforany
26persontousethetitle"nurse"inreferencetohimselforherselfinanycapacity,except
27individualswhoareorhavebeenlicensedasaregisterednurse,licensedpracticalnurse,or
28advancedpracticeregisterednurseunderthischapter.
29 6.Notwithstandinganylawtothecontrary,nothinginthischaptershallprohibita
30ChristianSciencenursefromusingthetitle"ChristianSciencenurse",solongassuchperson
31providesonlyreligiousnonmedicalserviceswhenofferingorprovidingsuchservicestothose
32whochoosetorelyuponhealingbyspiritualmeansaloneanddoesnotholdhisorherown
33religiousorganizationanddoesnotholdhimselforherselfoutasaregisterednurse,advanced
34practiceregisterednurse,nursepractitioner,licensedpracticalnurse,nursemidwife,clinical
35nursespecialist,ornurseanesthetist,unlessotherwiseauthorizedbylawtodoso.
335.086.Noperson,firm,corporationorassociationshall:
2 (1)Sellorattempttosellorfraudulentlyobtainorfurnishorattempttofurnishany
3nursingdiploma,license,renewalorrecordoraidorabettherein;
4 (2)Practice[professionalorpractical] nursingasdefinedbysections335.011to
5[335.096] 335.099undercoverofanydiploma,license,orrecordillegallyorfraudulently
6obtainedorsignedorissuedunlawfullyorunderfraudulentrepresentation;
7 (3)Practice[professionalnursingorpractical] nursingasdefinedbysections335.011
8to[335.096] 335.099unlessdulylicensedtodosoundertheprovisionsofsections335.011to
9[335.096] 335.099;
10 (4)Useinconnectionwithhisorhernameanydesignationtendingtoimplythathe
11orsheisalicensedadvancedpracticeregisterednurse,alicensedregisteredprofessional
12nurse, oralicensedpracticalnurseunlessdulylicensedsotopracticeundertheprovisionsof
13sections335.011to[335.096] 335.099;
14 (5)Practice[professionalnursingorpractical] nursingduringthetimehisorher
15licenseissuedundertheprovisionsofsections335.011to[335.096] 335.099shallbe
16suspendedorrevoked;or
17 (6)Conductanursingeducationprogramforthepreparationofprofessionalor
18practicalnursesunlesstheprogramhasbeenaccreditedbytheboard.
335.175.1.NolaterthanJanuary1,2014,thereisherebyestablishedwithinthestate
2boardofregistrationforthehealingartsandthestateboardofnursingthe"Utilizationof
3TelehealthbyNurses".Anadvancedpracticeregisterednurse(APRN)providingnursing
4servicesunderacollaborativepracticearrangementundersection334.104mayprovidesuch
5servicesoutsidethegeographicproximityrequirementsofsection334.104ifthe
6collaboratingphysicianandadvancedpracticeregisterednurseutilizetelehealth[inthe
SSHCSHBs115&99 34 7careofthepatientandiftheservicesareprovidedinaruralareaofneed.] Telehealth
8providersshallberequiredtoobtainpatientconsentbeforetelehealthservicesareinitiated
9andensureconfidentialityofmedicalinformation.
10 2.Asusedinthissection,"telehealth"shallhavethesamemeaningassuchtermis
11definedinsection191.1145.
12 [3.(1)Theboardsshalljointlypromulgaterulesgoverningthepracticeoftelehealth
13underthissection.Suchrulesshalladdress,butnotbelimitedto,appropriatestandardsfor
14theuseoftelehealth.
15 (2)Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis
16createdundertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplies
17withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.
18Thissectionandchapter536arenonseverableandifanyofthepowersvestedwiththe
19generalassemblypursuanttochapter536toreview,todelaytheeffectivedate,orto
20disapproveandannularulearesubsequentlyheldunconstitutional,thenthegrantof
21rulemakingauthorityandanyruleproposedoradoptedafterAugust28,2013,shallbeinvalid
22andvoid.
23 4.Forpurposesofthissection,"ruralareaofneed"meansanyruralareaofthisstate
24whichislocatedinahealthprofessionalshortageareaasdefinedinsection354.650.]
337.510.1.Asusedinthissection,thefollowingtermsmean:
2 (1)"License",license,certificate,registration,permit,accreditation,ormilitary
3occupationalspecialtythatenablesapersontolegallypracticeanoccupationor
4professioninaparticularjurisdiction;
5 (2)"Military",theArmedForcesoftheUnitedStates,includingtheAirForce,
6Army,CoastGuard,MarineCorps,Navy,SpaceForce,NationalGuardandanyother
7militarybranchthatisdesignatedbyCongressaspartoftheArmedForcesofthe
8UnitedStates,andallreservecomponentsandauxiliaries.Suchtermalsoincludesthe
9militaryreservesandmilitiaofanyUnitedStatesterritoryorstate;
10 (3)"Nonresidentmilitaryspouse",anonresidentspouseofanactiveduty
11memberoftheArmedForcesoftheUnitedStateswhohasbeentransferredoris
12scheduledtobetransferredtothestateofMissouri,orwhohasbeentransferredoris
13scheduledtobetransferredtoanadjacentstateandisorwillbedomiciledinthestateof
14Missouri,orhasmovedtothestateofMissourionapermanentchange-of-stationbasis;
15 (4)"Residentmilitaryspouse",aspouseofanactivedutymemberoftheArmed
16ForcesoftheUnitedStateswhohasbeentransferredorisscheduledtobetransferredto
17thestateofMissourioranadjacentstateandwhoisapermanentresidentofthestateof
18Missouri,whoisdomiciledinthestateofMissouri,orwhohasMissouriashisorher
19homeofrecord.
SSHCSHBs115&99 35 20 2.Eachapplicantforlicensureasaprofessionalcounselorshallfurnishevidenceto
21thecommitteethattheapplicantisatleasteighteenyearsofage,isaUnitedStatescitizenor
22islegallypresentintheUnitedStates;and
23 (1)Theapplicanthascompletedacourseofstudyasdefinedbytheboardruleleading
24toamaster's,specialist's,ordoctoraldegreewithamajorincounseling,exceptanyapplicant
25whohasheldalicenseasaprofessionalcounselorinthisstateorcurrentlyholdsalicenseasa
26professionalcounselorinanotherstateshallnotberequiredtohavecompletedanycourses
27relatedtocareerdevelopment;and
28 (2)Theapplicanthascompletedacceptablesupervisedcounselingasdefinedby
29boardrule.Iftheapplicanthasamaster'sdegreewithamajorincounselingasdefinedby
30boardrule,theapplicantshallcompleteatleasttwoyearsofacceptablesupervisedcounseling
31experiencesubsequenttothereceiptofthemaster'sdegree.Thecompositionandnumberof
32hourscomprisingtheacceptablesupervisedcounselingexperienceshallbedefinedbyboard
33rule.Anapplicantmaysubstitutethirtysemesterhoursofpostmaster'sgraduatestudyfor
34oneofthetworequiredyearsofacceptablesupervisedcounselingexperienceifsuchhours
35areclearlyrelatedtocounseling;
36 (3)AfterAugust28,2007,eachapplicantshallhavecompletedaminimumofthree
37hoursofgraduatelevelcourseworkindiagnosticsystemseitherinthecurriculumleadingtoa
38degreeoraspostmaster'sgraduatelevelcoursework;
39 (4)Uponexamination,theapplicantispossessedofrequisiteknowledgeofthe
40profession,includingtechniquesandapplications,researchanditsinterpretation,and
41professionalaffairsandethics.
42 [2.Anypersonholdingacurrentlicense,certificateofregistration,orpermitfrom
43anotherstateorterritoryoftheUnitedStatestopracticeasaprofessionalcounselorwhodoes
44notmeettherequirementsinsection324.009andwhoisatleasteighteenyearsofage,andis
45aUnitedStatescitizenorislegallypresentintheUnitedStatesmaybegrantedalicense
46withoutexaminationtoengageinthepracticeofprofessionalcounselinginthisstateuponthe
47applicationtotheboard,paymentoftherequiredfeeasestablishedbytheboard,and
48satisfyingoneofthefollowingrequirements:
49 (1)ApprovalbytheAmericanAssociationofStateCounselingBoards(AASCB)or
50itssuccessororganizationaccordingtotheeligibilitycriteriaestablishedbyAASCB.The
51successororganizationshallbedefinedbyboardrule;or
52 (2)IngoodstandingandcurrentlycertifiedbytheNationalBoardforCertified
53Counselorsoritssuccessororganizationandhascompletedacceptablesupervisedcounseling
54experienceasdefinedbyboardrule.Thesuccessororganizationshallbedefinedbyboard
55rule.]
SSHCSHBs115&99 36 56 3.(1)Anypersonwhoholdsavalidcurrentprofessionalcounselorlicenseissued
57byanotherstate,abranchorunitofthemilitary,aterritoryoftheUnitedStates,orthe
58DistrictofColumbia,andwhohasbeenlicensedforatleastoneyearinsuchother
59jurisdiction,maysubmitanapplicationforaprofessionalcounselorlicenseinMissouri
60alongwithproofofcurrentlicensureandproofoflicensureforatleastoneyearinthe
61otherjurisdiction,tothecommittee.
62 (2)Thecommitteeshall:
63 (a)Withinsixmonthsofreceivinganapplicationdescribedinsubdivision(1)of
64thissubsection,waiveanyexamination,educational,orexperiencerequirementsfor
65licensureinthisstatefortheapplicantifitdeterminesthattherewereminimum
66educationrequirementsand,ifapplicable,workexperienceandclinicalsupervision
67requirementsineffectandtheotherstateverifiesthatthepersonmetthose
68requirementsinordertobelicensedorcertifiedinthatstate.Thecommitteemay
69requireanapplicanttotakeandpassanexaminationspecifictothelawsofthisstate;or
70 (b)Withinthirtydaysofreceivinganapplicationdescribedinsubdivision(1)of
71thissubsectionfromanonresidentmilitaryspouseoraresidentmilitaryspouse,waive
72anyexamination,educational,orexperiencerequirementsforlicensureinthisstatefor
73theapplicantandissuesuchapplicantalicenseunderthissubsectionifsuchapplicant
74otherwisemeetstherequirementsofthissection.
75 (3)(a)Thecommitteeshallnotwaiveanyexamination,educational,or
76experiencerequirementsforanyapplicantwhohashadhisorherlicenserevokedbya
77committeeoutsidethestate;whoiscurrentlyunderinvestigation,whohasacomplaint
78pending,orwhoiscurrentlyunderdisciplinaryaction,exceptasprovidedinparagraph
79(b)ofthissubdivision,withacommitteeoutsidethestate;whodoesnotholdalicensein
80goodstandingwithacommitteeoutsidethestate;whohasacriminalrecordthatwould
81disqualifyhimorherforlicensureinMissouri;orwhodoesnotholdavalidcurrent
82licenseintheotherjurisdictiononthedatethecommitteereceiveshisorherapplication
83underthissection.
84 (b)Ifanotherjurisdictionhastakendisciplinaryactionagainstanapplicant,the
85committeeshalldetermineifthecausefortheactionwascorrectedandthematter
86resolved.Ifthematterhasnotbeenresolvedbythatjurisdiction,thecommitteemay
87denyalicenseuntilthematterisresolved.
88 (4)Nothinginthissubsectionshallprohibitthecommitteefromdenyinga
89licensetoanapplicantunderthissubsectionforanyreasondescribedinsection337.525.
90 (5)Anypersonwhoislicensedundertheprovisionsofthissubsectionshallbe
91subjecttothecommittee'sjurisdictionandallrulesandregulationspertainingtothe
92practiceasalicensedprofessionalcounselorinthisstate.
SSHCSHBs115&99 37 93 (6)Thissubsectionshallnotbeconstruedtowaiveanyrequirementforan
94applicanttopayanyfees.
95 4.Thecommitteeshallissuealicensetoeachpersonwhofilesanapplicationandfee
96andwhofurnishesevidencesatisfactorytothecommitteethattheapplicanthascompliedwith
97theprovisionsofthisactandhastakenandpassedawritten,open-bookexaminationon
98Missourilawsandregulationsgoverningthepracticeofprofessionalcounselingasdefinedin
99section337.500.Thedivisionshallissueaprovisionalprofessionalcounselorlicensetoany
100applicantwhomeetsallrequirementsofthissection,butwhohasnotcompletedtherequired
101acceptablesupervisedcounselingexperienceandsuchapplicantmayreapplyforlicensureas
102aprofessionalcounseloruponcompletionofsuchacceptablesupervisedcounseling
103experience.
104 [4.]5.Allpersonslicensedtopracticeprofessionalcounselinginthisstateshallpay
105onorbeforethelicenserenewaldatearenewallicensefeeandshallfurnishtothecommittee
106satisfactoryevidenceofthecompletionoftherequisitenumberofhoursofcontinuing
107educationasrequiredbyrule,includingtwohoursofsuicideassessment,referral,treatment,
108andmanagementtraining,whichshallbenomorethanfortyhoursbiennially.Thecontinuing
109educationrequirementsmaybewaivedbythecommitteeuponpresentationtothecommittee
110ofsatisfactoryevidenceoftheillnessofthelicenseeorforothergoodcause.
337.550.SECTION1:PURPOSE
2 ThepurposeofthisCompactistofacilitateinterstatepracticeofLicensed
3ProfessionalCounselorswiththegoalofimprovingpublicaccesstoProfessional
4Counselingservices.ThepracticeofProfessionalCounselingoccursintheStatewhere
5theclientislocatedatthetimeofthecounselingservices.TheCompactpreservesthe
6regulatoryauthorityofStatestoprotectpublichealthandsafetythroughthecurrent
7systemofStatelicensure.
8 ThisCompactisdesignedtoachievethefollowingobjectives:
9 A.IncreasepublicaccesstoProfessionalCounselingservicesbyprovidingfor
10themutualrecognitionofotherMemberStatelicenses;
11 B.EnhancetheStates'abilitytoprotectthepublic'shealthandsafety;
12 C.EncouragethecooperationofMemberStatesinregulatingmultistate
13practiceforLicensedProfessionalCounselors;
14 D.SupportspousesofrelocatingActiveDutyMilitarypersonnel;
15 E.Enhancetheexchangeoflicensure,investigative,anddisciplinary
16informationamongMemberStates;
17 F.AllowfortheuseofTelehealthtechnologytofacilitateincreasedaccessto
18ProfessionalCounselingservices;
SSHCSHBs115&99 38 19 G.SupporttheuniformityofProfessionalCounselinglicensurerequirements
20throughouttheStatestopromotepublicsafetyandpublichealthbenefits;
21 H.InvestallMemberStateswiththeauthoritytoholdaLicensedProfessional
22CounseloraccountableformeetingallStatepracticelawsintheStateinwhichtheclient
23islocatedatthetimecareisrenderedthroughthemutualrecognitionofMemberState
24licenses;
25 I.EliminatethenecessityforlicensesinmultipleStates;and
26 J.ProvideopportunitiesforinterstatepracticebyLicensedProfessional
27Counselorswhomeetuniformlicensurerequirements.
28 SECTION2.DEFINITIONS
29 AsusedinthisCompact,andexceptasotherwiseprovided,thefollowing
30definitionsshallapply:
31 A."ActiveDutyMilitary"meansfull-timedutystatusintheactiveuniformed
32serviceoftheUnitedStates,includingmembersoftheNationalGuardandReserveon
33activedutyorderspursuantto10U.S.C.Chapters1209and1211.
34 B."AdverseAction"meansanyadministrative,civil,equitableorcriminal
35actionpermittedbyaState'slawswhichisimposedbyalicensingboardorother
36authorityagainstaLicensedProfessionalCounselor,includingactionsagainstan
37individual'slicenseorPrivilegetoPracticesuchasrevocation,suspension,probation,
38monitoringofthelicensee,limitationonthelicensee'spractice,oranyother
39EncumbranceonlicensureaffectingaLicensedProfessionalCounselor's
40authorizationtopractice,includingissuanceofaceaseanddesistaction.
41 C."AlternativeProgram"meansanon-disciplinarymonitoringorpractice
42remediationprocessapprovedbyaProfessionalCounselingLicensingBoardtoaddress
43ImpairedPractitioners.
44 D."ContinuingCompetence/Education"meansarequirement,asaconditionof
45licenserenewal,toprovideevidenceofparticipationin,and/orcompletionof,
46educationalandprofessionalactivitiesrelevanttopracticeorareaofwork.
47 E."CounselingCompactCommission"or"Commission"meansthenational
48administrativebodywhosemembershipconsistsofallStatesthathaveenactedthe
49Compact.
50 F."CurrentSignificantInvestigativeInformation"means:
51 1.InvestigativeInformationthataLicensingBoard,afterapreliminaryinquiry
52thatincludesnotificationandanopportunityfortheLicensedProfessionalCounselorto
53respond,ifrequiredbyStatelaw,hasreasontobelieveisnotgroundlessand,ifproved
54true,wouldindicatemorethanaminorinfraction;or
SSHCSHBs115&99 39 55 2.InvestigativeInformationthatindicatesthattheLicensedProfessional
56Counselorrepresentsanimmediatethreattopublichealthandsafetyregardlessof
57whethertheLicensedProfessionalCounselorhasbeennotifiedandhadanopportunity
58torespond.
59 G."DataSystem"meansarepositoryofinformationaboutLicensees,including,
60butnotlimitedto,continuingeducation,examination,licensure,investigative,Privilege
61toPracticeandAdverseActioninformation.
62 H."EncumberedLicense"meansalicenseinwhichanAdverseActionrestricts
63thepracticeoflicensedProfessionalCounselingbytheLicenseeandsaidAdverse
64ActionhasbeenreportedtotheNationalPractitionersDataBank(NPDB).
65 I."Encumbrance"meansarevocationorsuspensionof,oranylimitationon,the
66fullandunrestrictedpracticeofLicensedProfessionalCounselingbyaLicensingBoard.
67 J."ExecutiveCommittee"meansagroupofdirectorselectedorappointedtoact
68onbehalfof,andwithinthepowersgrantedtothemby,theCommission.
69 K."HomeState"meanstheMemberStatethatistheLicensee'sprimaryState
70ofresidence.
71 L."ImpairedPractitioner"meansanindividualwhohasacondition(s)thatmay
72impairtheirabilitytopracticeasaLicensedProfessionalCounselorwithoutsometype
73ofinterventionandmayinclude,butarenotlimitedto,alcoholanddrugdependence,
74mentalhealthimpairment,andneurologicalorphysicalimpairments.
75 M."InvestigativeInformation"meansinformation,records,anddocuments
76receivedorgeneratedbyaProfessionalCounselingLicensingBoardpursuanttoan
77investigation.
78 N."JurisprudenceRequirement"ifrequiredbyaMemberState,meansthe
79assessmentofanindividual'sknowledgeofthelawsandRulesgoverningthepracticeof
80ProfessionalCounselinginaState.
81 O."LicensedProfessionalCounselor"meansacounselorlicensedbyaMember
82State,regardlessofthetitleusedbythatState,toindependentlyassess,diagnose,and
83treatbehavioralhealthconditions.
84 P."Licensee"meansanindividualwhocurrentlyholdsanauthorizationfrom
85theStatetopracticeasaLicensedProfessionalCounselor.
86 Q."LicensingBoard"meanstheagencyofaState,orequivalent,thatis
87responsibleforthelicensingandregulationofLicensedProfessionalCounselors.
88 R."MemberState"meansaStatethathasenactedtheCompact.
89 S."PrivilegetoPractice"meansalegalauthorization,whichisequivalenttoa
90license,permittingthepracticeofProfessionalCounselinginaRemoteState.
SSHCSHBs115&99 40 91 T."ProfessionalCounseling"meanstheassessment,diagnosis,andtreatmentof
92behavioralhealthconditionsbyaLicensedProfessionalCounselor.
93 U."RemoteState"meansaMemberStateotherthantheHomeState,wherea
94LicenseeisexercisingorseekingtoexercisethePrivilegetoPractice.
95 V."Rule"meansaregulationpromulgatedbytheCommissionthathastheforce
96oflaw.
97 W."SingleStateLicense"meansaLicensedProfessionalCounselorlicense
98issuedbyaMemberStatethatauthorizespracticeonlywithintheissuingStateanddoes
99notincludeaPrivilegetoPracticeinanyotherMemberState.
100 X."State"meansanystate,commonwealth,district,orterritoryoftheUnited
101StatesofAmericathatregulatesthepracticeofProfessionalCounseling.
102 Y."Telehealth"meanstheapplicationoftelecommunicationtechnologyto
103deliverProfessionalCounselingservicesremotelytoassess,diagnose,andtreat
104behavioralhealthconditions.
105 Z."UnencumberedLicense"meansalicensethatauthorizesaLicensed
106ProfessionalCounselortoengageinthefullandunrestrictedpracticeofProfessional
107Counseling.
108 SECTION3.STATEPARTICIPATIONINTHECOMPACT
109 A.ToParticipateintheCompact,aStatemustcurrently:
110 1.LicenseandregulateLicensedProfessionalCounselors;
111 2.RequireLicenseestopassanationallyrecognizedexamapprovedbythe
112Commission;
113 3.RequireLicenseestohavea60semester-hour(or90quarter-hour)master's
114degreeincounselingor60semester-hours(or90quarter-hours)ofgraduatecourse
115workincludingthefollowingtopicareas:
116 a.ProfessionalCounselingOrientationandEthicalPractice;
117 b.SocialandCulturalDiversity;
118 c.HumanGrowthandDevelopment;
119 d.CareerDevelopment;
120 e.CounselingandHelpingRelationships;
121 f.GroupCounselingandGroupWork;
122 g.DiagnosisandTreatment;AssessmentandTesting;
123 h.ResearchandProgramEvaluation;and
124 i.OtherareasasdeterminedbytheCommission.
125 4.RequireLicenseestocompleteasupervisedpostgraduateprofessional
126experienceasdefinedbytheCommission;
SSHCSHBs115&99 41 127 5.Haveamechanisminplaceforreceivingandinvestigatingcomplaintsabout
128Licensees.
129 B.AMemberStateshall:
130 1.ParticipatefullyintheCommission'sDataSystem,includingusingthe
131Commission'suniqueidentifierasdefinedinRules;
132 2.NotifytheCommission,incompliancewiththetermsoftheCompactand
133Rules,ofanyAdverseActionortheavailabilityofInvestigativeInformationregardinga
134Licensee;
135 3.Implementorutilizeproceduresforconsideringthecriminalhistoryrecords
136ofapplicantsforaninitialPrivilegetoPractice.Theseproceduresshallincludethe
137submissionoffingerprintsorotherbiometric-basedinformationbyapplicantsforthe
138purposeofobtaininganapplicant'scriminalhistoryrecordinformationfromthe
139FederalBureauofInvestigationandtheagencyresponsibleforretainingthatState's
140criminalrecords;
141 a.Amemberstatemustfullyimplementacriminalbackgroundcheck
142requirement,withinatimeframeestablishedbyrule,byreceivingtheresultsofthe
143FederalBureauofInvestigationrecordsearchandshallusetheresultsinmaking
144licensuredecisions.
145 b.CommunicationbetweenaMemberState,theCommissionandamong
146MemberStatesregardingtheverificationofeligibilityforlicensurethroughthe
147CompactshallnotincludeanyinformationreceivedfromtheFederalBureauof
148InvestigationrelatingtoafederalcriminalrecordscheckperformedbyaMemberState
149underPublicLaw92-544.
150 4.ComplywiththeRulesoftheCommission;
151 5.RequireanapplicanttoobtainorretainalicenseintheHomeStateandmeet
152theHomeState'squalificationsforlicensureorrenewaloflicensure,aswellasallother
153applicableStatelaws;
154 6.GrantthePrivilegetoPracticetoaLicenseeholdingavalidUnencumbered
155LicenseinanotherMemberStateinaccordancewiththetermsoftheCompactand
156Rules;and
157 7.ProvidefortheattendanceoftheState'scommissionertotheCounseling
158CompactCommissionmeetings.
159 C.MemberStatesmaychargeafeeforgrantingthePrivilegetoPractice.
160 D.IndividualsnotresidinginaMemberStateshallcontinuetobeabletoapply
161foraMemberState'sSingleStateLicenseasprovidedunderthelawsofeachMember
162State.However,theSingleStateLicensegrantedtotheseindividualsshallnotbe
SSHCSHBs115&99 42 163recognizedasgrantingaPrivilegetoPracticeProfessionalCounselinginanyother
164MemberState.
165 E.NothinginthisCompactshallaffecttherequirementsestablishedbya
166MemberStatefortheissuanceofaSingleStateLicense.
167 F.AlicenseissuedtoaLicensedProfessionalCounselorbyaHomeStatetoa
168residentinthatStateshallberecognizedbyeachMemberStateasauthorizinga
169LicensedProfessionalCounselortopracticeProfessionalCounseling,underaPrivilege
170toPractice,ineachMemberState.
171 SECTION4.PRIVILEGETOPRACTICE
172 A.ToexercisethePrivilegetoPracticeunderthetermsandprovisionsofthe
173Compact,theLicenseeshall:
174 1.HoldalicenseintheHomeState;
175 2.HaveavalidUnitedStatesSocialSecurityNumberorNationalPractitioner
176Identifier;
177 3.BeeligibleforaPrivilegetoPracticeinanyMemberStateinaccordancewith
178Section4(D),(G)and(H);
179 4.HavenothadanyEncumbranceorrestrictionagainstanylicenseorPrivilege
180toPracticewithintheprevioustwo(2)years;
181 5.NotifytheCommissionthattheLicenseeisseekingthePrivilegetoPractice
182withinaRemoteState(s);
183 6.Payanyapplicablefees,includinganyStatefee,forthePrivilegetoPractice;
184 7.MeetanyContinuingCompetence/Educationrequirementsestablishedbythe
185HomeState;
186 8.MeetanyJurisprudenceRequirementsestablishedbytheRemoteState(s)in
187whichtheLicenseeisseekingaPrivilegetoPractice;and
188 9.ReporttotheCommissionanyAdverseAction,Encumbrance,orrestriction
189onlicensetakenbyanynon-MemberStatewithin30daysfromthedatetheactionis
190taken.
191 B.ThePrivilegetoPracticeisvaliduntiltheexpirationdateoftheHomeState
192license.TheLicenseemustcomplywiththerequirementsofSection4(A)tomaintain
193thePrivilegetoPracticeintheRemoteState.
194 C.ALicenseeprovidingProfessionalCounselinginaRemoteStateunderthe
195PrivilegetoPracticeshalladheretothelawsandregulationsoftheRemoteState.
196 D.ALicenseeprovidingProfessionalCounselingservicesinaRemoteStateis
197subjecttothatState'sregulatoryauthority.ARemoteStatemay,inaccordancewith
198dueprocessandthatState'slaws,removeaLicensee'sPrivilegetoPracticeinthe
199RemoteStateforaspecificperiodoftime,imposefines,and/ortakeanyothernecessary
SSHCSHBs115&99 43 200actionstoprotectthehealthandsafetyofitscitizens.TheLicenseemaybeineligiblefor
201aPrivilegetoPracticeinanyMemberStateuntilthespecifictimeforremovalhas
202passedandallfinesarepaid.
203 E.IfaHomeStatelicenseisencumbered,theLicenseeshalllosethePrivilegeto
204PracticeinanyRemoteStateuntilthefollowingoccur:
205 1.TheHomeStatelicenseisnolongerencumbered;and
206 2.HavenothadanyEncumbranceorrestrictionagainstanylicenseorPrivilege
207toPracticewithintheprevioustwo(2)years.
208 F.OnceanEncumberedLicenseintheHomeStateisrestoredtogoodstanding,
209theLicenseemustmeettherequirementsofSection4(A)toobtainaPrivilegetoPractice
210inanyRemoteState.
211 G.IfaLicensee'sPrivilegetoPracticeinanyRemoteStateisremoved,the
212individualmaylosethePrivilegetoPracticeinallotherRemoteStatesuntilthe
213followingoccur:
214 1.ThespecificperiodoftimeforwhichthePrivilegetoPracticewasremoved
215hasended;
216 2.Allfineshavebeenpaid;and
217 3.HavenothadanyEncumbranceorrestrictionagainstanylicenseorPrivilege
218toPracticewithintheprevioustwo(2)years.
219 H.OncetherequirementsofSection4(G)havebeenmet,theLicenseemustmeet
220therequirementsinSection4(A)toobtainaPrivilegetoPracticeinaRemoteState.
221 SECTION5:OBTAININGANEWHOMESTATELICENSEBASEDONA
222PRIVILEGETOPRACTICE
223 A.ALicensedProfessionalCounselormayholdaHomeStatelicense,which
224allowsforaPrivilegetoPracticeinotherMemberStates,inonlyoneMemberStateata
225time.
226 B.IfaLicensedProfessionalCounselorchangesprimaryStateofresidenceby
227movingbetweentwoMemberStates:
228 1.TheLicensedProfessionalCounselorshallfileanapplicationforobtaininga
229newHomeStatelicensebasedonaPrivilegetoPractice,payallapplicablefees,and
230notifythecurrentandnewHomeStateinaccordancewithapplicableRulesadoptedby
231theCommission.
232 2.UponreceiptofanapplicationforobtaininganewHomeStatelicenseby
233virtueofaPrivilegetoPractice,thenewHomeStateshallverifythattheLicensed
234ProfessionalCounselormeetsthepertinentcriteriaoutlinedinSection4viatheData
235System,withoutneedforprimarysourceverificationexceptfor:
SSHCSHBs115&99 44 236 a.aFederalBureauofInvestigationfingerprintbasedcriminalbackground
237checkifnotpreviouslyperformedorupdatedpursuanttoapplicablerulesadoptedby
238theCommissioninaccordancewithPublicLaw92-544;
239 b.othercriminalbackgroundcheckasrequiredbythenewHomeState;and
240 c.completionofanyrequisiteJurisprudenceRequirementsofthenewHome
241State.
242 3.TheformerHomeStateshallconverttheformerHomeStatelicenseintoa
243PrivilegetoPracticeoncethenewHomeStatehasactivatedthenewHomeStatelicense
244inaccordancewithapplicableRulesadoptedbytheCommission.
245 4.NotwithstandinganyotherprovisionofthisCompact,iftheLicensed
246ProfessionalCounselorcannotmeetthecriteriainSection4,thenewHomeStatemay
247applyitsrequirementsforissuinganewSingleStateLicense.
248 5.TheLicensedProfessionalCounselorshallpayallapplicablefeestothenew
249HomeStateinordertobeissuedanewHomeStatelicense.
250 C.IfaLicensedProfessionalCounselorchangesPrimaryStateofResidenceby
251movingfromaMemberStatetoanon-MemberState,orfromanon-MemberStatetoa
252MemberState,theStatecriteriashallapplyforissuanceofaSingleStateLicenseinthe
253newState.
254 D.NothinginthisCompactshallinterferewithaLicensee'sabilitytoholda
255SingleStateLicenseinmultipleStates,howeverforthepurposesofthisCompact,a
256LicenseeshallhaveonlyoneHomeStatelicense.
257 E.NothinginthisCompactshallaffecttherequirementsestablishedbya
258MemberStatefortheissuanceofaSingleStateLicense.
259 SECTION6.ACTIVEDUTYMILITARYPERSONNELORTHEIRSPOUSES
260 ActiveDutyMilitarypersonnel,ortheirspouse,shalldesignateaHomeState
261wheretheindividualhasacurrentlicenseingoodstanding.Theindividualmayretain
262theHomeStatedesignationduringtheperiodtheservicememberisonactiveduty.
263SubsequenttodesignatingaHomeState,theindividualshallonlychangetheirHome
264StatethroughapplicationforlicensureinthenewState,orthroughtheprocessoutlined
265inSection5.
266 SECTION7.COMPACTPRIVILEGETOPRACTICETELEHEALTH
267 A.MemberStatesshallrecognizetherightofaLicensedProfessionalCounselor,
268licensedbyaHomeStateinaccordancewithSection3andunderRulespromulgatedby
269theCommission,topracticeProfessionalCounselinginanyMemberStatevia
270TelehealthunderaPrivilegetoPracticeasprovidedintheCompactandRules
271promulgatedbytheCommission.
SSHCSHBs115&99 45 272 B.ALicenseeprovidingProfessionalCounselingservicesinaRemoteState
273underthePrivilegetoPracticeshalladheretothelawsandregulationsoftheRemote
274State.
275 SECTION8.ADVERSEACTIONS
276 A.InadditiontotheotherpowersconferredbyStatelaw,aRemoteStateshall
277havetheauthority,inaccordancewithexistingStatedueprocesslaw,to:
278 1.TakeAdverseActionagainstaLicensedProfessionalCounselor'sPrivilegeto
279PracticewithinthatMemberState,and
280 2.Issuesubpoenasforbothhearingsandinvestigationsthatrequirethe
281attendanceandtestimonyofwitnessesaswellastheproductionofevidence.Subpoenas
282issuedbyaLicensingBoardinaMemberStatefortheattendanceandtestimonyof
283witnessesortheproductionofevidencefromanotherMemberStateshallbeenforcedin
284thelatterStatebyanycourtofcompetentjurisdiction,accordingtothepracticeand
285procedureofthatcourtapplicabletosubpoenasissuedinproceedingspendingbeforeit.
286Theissuingauthorityshallpayanywitnessfees,travelexpenses,mileage,andotherfees
287requiredbytheservicestatutesoftheStateinwhichthewitnessesorevidenceare
288located.
289 3.OnlytheHomeStateshallhavethepowertotakeAdverseActionagainsta
290LicensedProfessionalCounselor'slicenseissuedbytheHomeState.
291 B.ForpurposesoftakingAdverseAction,theHomeStateshallgivethesame
292priorityandeffecttoreportedconductreceivedfromaMemberStateasitwouldifthe
293conducthadoccurredwithintheHomeState.Insodoing,theHomeStateshallapply
294itsownStatelawstodetermineappropriateaction.
295 C.TheHomeStateshallcompleteanypendinginvestigationsofaLicensed
296ProfessionalCounselorwhochangesprimaryStateofresidenceduringthecourseofthe
297investigations.TheHomeStateshallalsohavetheauthoritytotakeappropriateaction
298(s)andshallpromptlyreporttheconclusionsoftheinvestigationstotheadministrator
299oftheDataSystem.Theadministratorofthecoordinatedlicensureinformationsystem
300shallpromptlynotifythenewHomeStateofanyAdverseActions.
301 D.AMemberState,ifotherwisepermittedbyStatelaw,mayrecoverfromthe
302affectedLicensedProfessionalCounselorthecostsofinvestigationsanddispositionsof
303casesresultingfromanyAdverseActiontakenagainstthatLicensedProfessional
304Counselor.
305 E.AMemberStatemaytakeAdverseActionbasedonthefactualfindingsofthe
306RemoteState,providedthattheMemberStatefollowsitsownproceduresfortakingthe
307AdverseAction.
308 F.JointInvestigations:
SSHCSHBs115&99 46 309 1.InadditiontotheauthoritygrantedtoaMemberStatebyitsrespective
310ProfessionalCounselingpracticeactorotherapplicableStatelaw,anyMemberState
311mayparticipatewithotherMemberStatesinjointinvestigationsofLicensees.
312 2.MemberStatesshallshareanyinvestigative,litigation,orcompliance
313materialsinfurtheranceofanyjointorindividualinvestigationinitiatedunderthe
314Compact.
315 G.IfAdverseActionistakenbytheHomeStateagainstthelicenseofaLicensed
316ProfessionalCounselor,theLicensedProfessionalCounselor'sPrivilegetoPracticeinall
317otherMemberStatesshallbedeactivateduntilallEncumbranceshavebeenremoved
318fromtheStatelicense.AllHomeStatedisciplinaryordersthatimposeAdverseAction
319againstthelicenseofaLicensedProfessionalCounselorshallincludeaStatementthat
320theLicensedProfessionalCounselor'sPrivilegetoPracticeisdeactivatedinallMember
321Statesduringthependencyoftheorder.
322 H.IfaMemberStatetakesAdverseAction,itshallpromptlynotifythe
323administratoroftheDataSystem.TheadministratoroftheDataSystemshallpromptly
324notifytheHomeStateofanyAdverseActionsbyRemoteStates.
325 I.NothinginthisCompactshalloverrideaMemberState'sdecisionthat
326participationinanAlternativeProgrammaybeusedinlieuofAdverseAction.
327 SECTION 9.ESTABLISHMENT OFCOUNSELING COMPACT
328COMMISSION
329 A.TheCompactMemberStatesherebycreateandestablishajointpublic
330agencyknownastheCounselingCompactCommission:
331 1.TheCommissionisaninstrumentalityoftheCompactStates.
332 2.VenueisproperandjudicialproceedingsbyoragainsttheCommissionshall
333bebroughtsolelyandexclusivelyinacourtofcompetentjurisdictionwherethe
334principalofficeoftheCommissionislocated.TheCommissionmaywaivevenueand
335jurisdictionaldefensestotheextentitadoptsorconsentstoparticipateinalternative
336disputeresolutionproceedings.
337 3.NothinginthisCompactshallbeconstruedtobeawaiverofsovereign
338immunity.
339 B.Membership,Voting,andMeetings
340 1.EachMemberStateshallhaveandbelimitedtoone(1)delegateselectedby
341thatMemberState'sLicensingBoard.
342 2.Thedelegateshallbeeither:
343 a.AcurrentmemberoftheLicensingBoardatthetimeofappointment,whoisa
344LicensedProfessionalCounselororpublicmember;or
345 b.AnadministratoroftheLicensingBoard.
SSHCSHBs115&99 47 346 3.Anydelegatemayberemovedorsuspendedfromofficeasprovidedbythelaw
347oftheStatefromwhichthedelegateisappointed.
348 4.TheMemberStateLicensingBoardshallfillanyvacancyoccurringonthe
349Commissionwithin60days.
350 5.Eachdelegateshallbeentitledtoone(1)votewithregardtothepromulgation
351ofRulesandcreationofbylawsandshallotherwisehaveanopportunitytoparticipate
352inthebusinessandaffairsoftheCommission.
353 6.Adelegateshallvoteinpersonorbysuchothermeansasprovidedinthe
354bylaws.Thebylawsmayprovidefordelegates'participationinmeetingsbytelephone
355orothermeansofcommunication.
356 7.TheCommissionshallmeetatleastonceduringeachcalendaryear.
357Additionalmeetingsshallbeheldassetforthinthebylaws.
358 8.TheCommissionshallbyRuleestablishatermofofficefordelegatesandmay
359byRuleestablishtermlimits.
360 C.TheCommissionshallhavethefollowingpowersandduties:
361 1.EstablishthefiscalyearoftheCommission;
362 2.Establishbylaws;
363 3.Maintainitsfinancialrecordsinaccordancewiththebylaws;
364 4.Meetandtakesuchactionsasareconsistentwiththeprovisionsofthis
365Compactandthebylaws;
366 5.PromulgateRuleswhichshallbebindingtotheextentandinthemanner
367providedforintheCompact;
368 6.Bringandprosecutelegalproceedingsoractionsinthenameofthe
369Commission,providedthatthestandingofanyStateLicensingBoardtosueorbesued
370underapplicablelawshallnotbeaffected;
371 7.Purchaseandmaintaininsuranceandbonds;
372 8.Borrow,accept,orcontractforservicesofpersonnel,including,butnot
373limitedto,employeesofaMemberState;
374 9.Hireemployees,electorappointofficers,fixcompensation,defineduties,
375grantsuchindividualsappropriateauthoritytocarryoutthepurposesoftheCompact,
376andestablishtheCommission'spersonnelpoliciesandprogramsrelatingtoconflictsof
377interest,qualificationsofpersonnel,andotherrelatedpersonnelmatters;
378 10.Acceptanyandallappropriatedonationsandgrantsofmoney,equipment,
379supplies,materials,andservices,andtoreceive,utilize,anddisposeofthesame;
380providedthatatalltimestheCommissionshallavoidanyappearanceofimpropriety
381and/orconflictofinterest;
SSHCSHBs115&99 48 382 11.Lease,purchase,acceptappropriategiftsordonationsof,orotherwiseto
383own,hold,improveoruse,anyproperty,real,personalormixed;providedthatatall
384timestheCommissionshallavoidanyappearanceofimpropriety;
385 12.Sell,convey,mortgage,pledge,lease,exchange,abandon,orotherwise
386disposeofanypropertyreal,personal,ormixed;
387 13.Establishabudgetandmakeexpenditures;
388 14.Borrowmoney;
389 15.Appointcommittees,includingstandingcommitteescomposedofmembers,
390Stateregulators,Statelegislatorsortheirrepresentatives,andconsumer
391representatives,andsuchotherinterestedpersonsasmaybedesignatedinthis
392Compactandthebylaws;
393 16.Provideandreceiveinformationfrom,andcooperatewith,lawenforcement
394agencies;
395 17.EstablishandelectanExecutiveCommittee;and
396 18.Performsuchotherfunctionsasmaybenecessaryorappropriatetoachieve
397thepurposesofthisCompactconsistentwiththeStateregulationofProfessional
398Counselinglicensureandpractice.
399 D.TheExecutiveCommittee
400 1.TheExecutiveCommitteeshallhavethepowertoactonbehalfofthe
401CommissionaccordingtothetermsofthisCompact.
402 2.TheExecutiveCommitteeshallbecomposedofuptoeleven(11)members:
403 a.SevenvotingmemberswhoareelectedbytheCommissionfromthecurrent
404membershipoftheCommission;and
405 b.Uptofour(4)ex-officio,nonvotingmembersfromfour(4)recognized
406nationalprofessionalcounselororganizations.
407 c.Theex-officiomemberswillbeselectedbytheirrespectiveorganizations.
408 3.TheCommissionmayremoveanymemberoftheExecutiveCommitteeas
409providedinbylaws.
410 4.TheExecutiveCommitteeshallmeetatleastannually.
411 5.TheExecutiveCommitteeshallhavethefollowingdutiesandresponsibilities:
412 a.RecommendtotheentireCommissionchangestotheRulesorbylaws,
413changestothisCompactlegislation,feespaidbyCompactMemberStatessuchas
414annualdues,andanyCommissionCompactfeechargedtoLicenseesforthePrivilegeto
415Practice;
416 b.EnsureCompactadministrationservicesareappropriatelyprovided,
417contractualorotherwise;
418 c.Prepareandrecommendthebudget;
SSHCSHBs115&99 49 419 d.MaintainfinancialrecordsonbehalfoftheCommission;
420 e.MonitorCompactcomplianceofMemberStatesandprovidecompliance
421reportstotheCommission;
422 f.Establishadditionalcommitteesasnecessary;and
423 g.OtherdutiesasprovidedinRulesorbylaws.
424 E.MeetingsoftheCommission
425 1.Allmeetingsshallbeopentothepublic,andpublicnoticeofmeetingsshallbe
426giveninthesamemannerasrequiredundertheRulemakingprovisionsinSection11.
427 2.TheCommissionortheExecutiveCommitteeorothercommitteesofthe
428Commissionmayconveneinaclosed,non-publicmeetingiftheCommissionor
429ExecutiveCommitteeorothercommitteesoftheCommissionmustdiscuss:
430 a.Non-complianceofaMemberStatewithitsobligationsundertheCompact;
431 b.Theemployment,compensation,disciplineorothermatters,practicesor
432proceduresrelatedtospecificemployeesorothermattersrelatedtotheCommission's
433internalpersonnelpracticesandprocedures;
434 c.Current,threatened,orreasonablyanticipatedlitigation;
435 d.Negotiationofcontractsforthepurchase,lease,orsaleofgoods,services,or
436realestate;
437 e.Accusinganypersonofacrimeorformallycensuringanyperson;
438 f.Disclosureoftradesecretsorcommercialorfinancialinformationthatis
439privilegedorconfidential;
440 g.Disclosureofinformationofapersonalnaturewheredisclosurewould
441constituteaclearlyunwarrantedinvasionofpersonalprivacy;
442 h.Disclosureofinvestigativerecordscompiledforlawenforcementpurposes;
443 i.Disclosureofinformationrelatedtoanyinvestigativereportspreparedbyor
444onbehalfoforforuseoftheCommissionorothercommitteechargedwith
445responsibilityofinvestigationordeterminationofcomplianceissuespursuanttothe
446Compact;or
447 j.MattersspecificallyexemptedfromdisclosurebyfederalorMemberState
448statute.
449 3.Ifameeting,orportionofameeting,isclosedpursuanttothisprovision,the
450Commission'slegalcounselordesigneeshallcertifythatthemeetingmaybeclosedand
451shallreferenceeachrelevantexemptingprovision.
452 4.TheCommissionshallkeepminutesthatfullyandclearlydescribeallmatters
453discussedinameetingandshallprovideafullandaccuratesummaryofactionstaken,
454andthereasonstherefore,includingadescriptionoftheviewsexpressed.Alldocuments
455consideredinconnectionwithanactionshallbeidentifiedinsuchminutes.Allminutes
SSHCSHBs115&99 50 456anddocumentsofaclosedmeetingshallremainunderseal,subjecttoreleasebya
457majorityvoteoftheCommissionororderofacourtofcompetentjurisdiction.
458 F.FinancingoftheCommission
459 1.TheCommissionshallpay,orprovideforthepaymentof,thereasonable
460expensesofitsestablishment,organization,andongoingactivities.
461 2.TheCommissionmayacceptanyandallappropriaterevenuesources,
462donations,andgrantsofmoney,equipment,supplies,materials,andservices.
463 3.TheCommissionmaylevyonandcollectanannualassessmentfromeach
464MemberStateorimposefeesonotherpartiestocoverthecostoftheoperationsand
465activitiesoftheCommissionanditsstaff,whichmustbeinatotalamountsufficientto
466coveritsannualbudgetasapprovedeachyearforwhichrevenueisnotprovidedby
467othersources.Theaggregateannualassessmentamountshallbeallocatedbasedupona
468formulatobedeterminedbytheCommission,whichshallpromulgateaRulebinding
469uponallMemberStates.
470 4.TheCommissionshallnotincurobligationsofanykindpriortosecuringthe
471fundsadequatetomeetthesame;norshalltheCommissionpledgethecreditofanyof
472theMemberStates,exceptbyandwiththeauthorityoftheMemberState.
473 5.TheCommissionshallkeepaccurateaccountsofallreceiptsand
474disbursements.ThereceiptsanddisbursementsoftheCommissionshallbesubject
475totheauditandaccountingproceduresestablishedunderitsbylaws.However,all
476receiptsanddisbursementsoffundshandledbytheCommissionshallbeauditedyearly
477byacertifiedorlicensedpublicaccountant,andthereportoftheauditshallbeincluded
478inandbecomepartoftheannualreportoftheCommission.
479 G.QualifiedImmunity,Defense,andIndemnification
480 1.Themembers,officers,executivedirector,employeesandrepresentativesof
481theCommissionshallbeimmunefromsuitandliability,eitherpersonallyorintheir
482officialcapacity,foranyclaimfordamagetoorlossofpropertyorpersonalinjuryor
483othercivilliabilitycausedbyorarisingoutofanyactualorallegedact,erroror
484omissionthatoccurred,orthatthepersonagainstwhomtheclaimismadehada
485reasonablebasisforbelievingoccurredwithinthescopeofCommissionemployment,
486dutiesorresponsibilities;providedthatnothinginthisparagraphshallbeconstruedto
487protectanysuchpersonfromsuitand/orliabilityforanydamage,loss,injury,or
488liabilitycausedbytheintentionalorwillfulorwantonmisconductofthatperson.
489 2.TheCommissionshalldefendanymember,officer,executivedirector,
490employeeorrepresentativeoftheCommissioninanycivilactionseekingtoimpose
491liabilityarisingoutofanyactualorallegedact,error,oromissionthatoccurredwithin
492thescopeofCommissionemployment,duties,orresponsibilities,orthattheperson
SSHCSHBs115&99 51 493againstwhomtheclaimismadehadareasonablebasisforbelievingoccurredwithinthe
494scopeofCommissionemployment,duties,orresponsibilities;providedthatnothing
495hereinshallbeconstruedtoprohibitthatpersonfromretaininghisorherowncounsel;
496andprovidedfurther,thattheactualorallegedact,error,oromissiondidnotresult
497fromthatperson'sintentionalorwillfulorwantonmisconduct.
498 3.TheCommissionshallindemnifyandholdharmlessanymember,officer,
499executivedirector,employee,orrepresentativeoftheCommissionfortheamountofany
500settlementorjudgmentobtainedagainstthatpersonarisingoutofanyactualoralleged
501act,error,oromissionthatoccurredwithinthescopeofCommissionemployment,
502duties,orresponsibilities,orthatsuchpersonhadareasonablebasisforbelieving
503occurredwithinthescopeofCommissionemployment,duties,orresponsibilities,
504providedthattheactualorallegedact,error,oromissiondidnotresultfromthe
505intentionalorwillfulorwantonmisconductofthatperson.
506 SECTION10.DATASYSTEM
507 A.TheCommissionshallprovideforthedevelopment,maintenance,operation,
508andutilizationofacoordinateddatabaseandreportingsystemcontaininglicensure,
509AdverseAction,andInvestigativeInformationonalllicensedindividualsinMember
510States.
511 B.NotwithstandinganyotherprovisionofStatelawtothecontrary,aMember
512StateshallsubmitauniformdatasettotheDataSystemonallindividualstowhomthis
513CompactisapplicableasrequiredbytheRulesoftheCommission,including:
514 1.Identifyinginformation;
515 2.Licensuredata;
516 3.AdverseActionsagainstalicenseorPrivilegetoPractice;
517 4.Non-confidentialinformationrelatedtoAlternativeProgramparticipation;
518 5.Anydenialofapplicationforlicensure,andthereason(s)forsuchdenial;
519 6.CurrentSignificantInvestigativeInformation;and
520 7.OtherinformationthatmayfacilitatetheadministrationofthisCompact,as
521determinedbytheRulesoftheCommission.
522 C.InvestigativeInformationpertainingtoaLicenseeinanyMemberStatewill
523onlybeavailabletootherMemberStates.
524 D.TheCommissionshallpromptlynotifyallMemberStatesofanyAdverse
525ActiontakenagainstaLicenseeoranindividualapplyingforalicense.AdverseAction
526informationpertainingtoaLicenseeinanyMemberStatewillbeavailabletoanyother
527MemberState.
SSHCSHBs115&99 52 528 E.MemberStatescontributinginformationtotheDataSystemmaydesignate
529informationthatmaynotbesharedwiththepublicwithouttheexpresspermissionof
530thecontributingState.
531 F.AnyinformationsubmittedtotheDataSystemthatissubsequentlyrequired
532tobeexpungedbythelawsoftheMemberStatecontributingtheinformationshallbe
533removedfromtheDataSystem.
534 SECTION11.RULEMAKING
535 A.TheCommissionshallpromulgatereasonableRulesinordertoeffectively
536andefficientlyachievethepurposeoftheCompact.Notwithstandingtheforegoing,in
537theeventtheCommissionexercisesitsRulemakingauthorityinamannerthatisbeyond
538thescopeofthepurposesoftheCompact,orthepowersgrantedhereunder,thensuch
539anactionbytheCommissionshallbeinvalidandhavenoforceoreffect.
540 B.TheCommissionshallexerciseitsRulemakingpowerspursuanttothe
541criteriasetforthinthisSectionandtheRulesadoptedthereunder.Rulesand
542amendmentsshallbecomebindingasofthedatespecifiedineachRuleoramendment.
543 C.IfamajorityofthelegislaturesoftheMemberStatesrejectsaRule,by
544enactmentofastatuteorresolutioninthesamemannerusedtoadopttheCompact
545withinfour(4)yearsofthedateofadoptionoftheRule,thensuchRuleshallhaveno
546furtherforceandeffectinanyMemberState.
547 D.RulesoramendmentstotheRulesshallbeadoptedataregularorspecial
548meetingoftheCommission.
549 E.PriortopromulgationandadoptionofafinalRuleorRulesbythe
550Commission,andatleastthirty(30)daysinadvanceofthemeetingatwhichtheRule
551willbeconsideredandvotedupon,theCommissionshallfileaNoticeofProposed
552Rulemaking:
553 1.OnthewebsiteoftheCommissionorotherpubliclyaccessibleplatform;and
554 2.OnthewebsiteofeachMemberStateProfessionalCounselingLicensing
555BoardorotherpubliclyaccessibleplatformorthepublicationinwhicheachState
556wouldotherwisepublishproposedRules.
557 F.TheNoticeofProposedRulemakingshallinclude:
558 1.Theproposedtime,date,andlocationofthemeetinginwhichtheRulewillbe
559consideredandvotedupon;
560 2.ThetextoftheproposedRuleoramendmentandthereasonfortheproposed
561Rule;
562 3.ArequestforcommentsontheproposedRulefromanyinterestedperson;
563and
SSHCSHBs115&99 53 564 4.ThemannerinwhichinterestedpersonsmaysubmitnoticetotheCommission
565oftheirintentiontoattendthepublichearingandanywrittencomments.
566 G.PriortoadoptionofaproposedRule,theCommissionshallallowpersonsto
567submitwrittendata,facts,opinions,andarguments,whichshallbemadeavailableto
568thepublic.
569 H.TheCommissionshallgrantanopportunityforapublichearingbeforeit
570adoptsaRuleoramendmentifahearingisrequestedby:
571 1.Atleasttwenty-five(25)persons;
572 2.AStateorfederalgovernmentalsubdivisionoragency;or
573 3.Anassociationhavingatleasttwenty-five(25)members.
574 I.IfahearingisheldontheproposedRuleoramendment,theCommissionshall
575publishtheplace,time,anddateofthescheduledpublichearing.Ifthehearingisheld
576viaelectronicmeans,theCommissionshallpublishthemechanismforaccesstothe
577electronichearing.
578 1.Allpersonswishingtobeheardatthehearingshallnotifytheexecutive
579directoroftheCommissionorotherdesignatedmemberinwritingoftheirdesireto
580appearandtestifyatthehearingnotlessthanfive(5)businessdaysbeforethescheduled
581dateofthehearing.
582 2.Hearingsshallbeconductedinamannerprovidingeachpersonwhowishesto
583commentafairandreasonableopportunitytocommentorallyorinwriting.
584 3.Allhearingswillberecorded.Acopyoftherecordingwillbemadeavailable
585onrequest.
586 4.Nothinginthissectionshallbeconstruedasrequiringaseparatehearingon
587eachRule.RulesmaybegroupedfortheconvenienceoftheCommissionathearings
588requiredbythissection.
589 J.Followingthescheduledhearingdate,orbythecloseofbusinessonthe
590scheduledhearingdateifthehearingwasnotheld,theCommissionshallconsiderall
591writtenandoralcommentsreceived.
592 K.Ifnowrittennoticeofintenttoattendthepublichearingbyinterestedparties
593isreceived,theCommissionmayproceedwithpromulgationoftheproposedRule
594withoutapublichearing.
595 L.TheCommissionshall,bymajorityvoteofallmembers,takefinalactionon
596theproposedRuleandshalldeterminetheeffectivedateoftheRule,ifany,basedonthe
597RulemakingrecordandthefulltextoftheRule.
598 M.Upondeterminationthatanemergencyexists,theCommissionmayconsider
599andadoptanemergencyRulewithoutpriornotice,opportunityforcomment,or
600hearing,providedthattheusualRulemakingproceduresprovidedintheCompactand
SSHCSHBs115&99 54 601inthissectionshallberetroactivelyappliedtotheRuleassoonasreasonablypossible,in
602noeventlaterthanninety(90)daysaftertheeffectivedateoftheRule.Forthepurposes
603ofthisprovision,anemergencyRuleisonethatmustbeadoptedimmediatelyinorder
604to:
605 1.Meetanimminentthreattopublichealth,safety,orwelfare;
606 2.PreventalossofCommissionorMemberStatefunds;
607 3.MeetadeadlineforthepromulgationofanadministrativeRulethatis
608establishedbyfederallaworRule;or
609 4.Protectpublichealthandsafety.
610 N.TheCommissionoranauthorizedcommitteeoftheCommissionmaydirect
611revisionstoapreviouslyadoptedRuleoramendmentforpurposesofcorrecting
612typographicalerrors,errorsinformat,errorsinconsistency,orgrammaticalerrors.
613PublicnoticeofanyrevisionsshallbepostedonthewebsiteoftheCommission.The
614revisionshallbesubjecttochallengebyanypersonforaperiodofthirty(30)daysafter
615posting.Therevisionmaybechallengedonlyongroundsthattherevisionresultsina
616materialchangetoaRule.Achallengeshallbemadeinwritinganddeliveredtothe
617chairoftheCommissionpriortotheendofthenoticeperiod.Ifnochallengeismade,
618therevisionwilltakeeffectwithoutfurtheraction.Iftherevisionischallenged,the
619revisionmaynottakeeffectwithouttheapprovaloftheCommission.
620 SECTION 12.OVERSIGHT ,DISPUTE RESOLUTION, AND
621ENFORCEMENT
622 A.Oversight
623 1.Theexecutive,legislative,andjudicialbranchesofStategovernmentineach
624MemberStateshallenforcethisCompactandtakeallactionsnecessaryand
625appropriatetoeffectuatetheCompact'spurposesandintent.Theprovisionsofthis
626CompactandtheRulespromulgatedhereundershallhavestandingasstatutorylaw.
627 2.AllcourtsshalltakejudicialnoticeoftheCompactandtheRulesinany
628judicialoradministrativeproceedinginaMemberStatepertainingtothesubject
629matterofthisCompactwhichmayaffectthepowers,responsibilities,oractionsofthe
630Commission.
631 3.TheCommissionshallbeentitledtoreceiveserviceofprocessinanysuch
632proceedingandshallhavestandingtointerveneinsuchaproceedingforallpurposes.
633FailuretoprovideserviceofprocesstotheCommissionshallrenderajudgmentor
634ordervoidastotheCommission,thisCompact,orpromulgatedRules.
635 B.Default,TechnicalAssistance,andTermination
SSHCSHBs115&99 55 636 1.IftheCommissiondeterminesthataMemberStatehasdefaultedinthe
637performanceofitsobligationsorresponsibilitiesunderthisCompactorthe
638promulgatedRules,theCommissionshall:
639 a.ProvidewrittennoticetothedefaultingStateandotherMemberStatesofthe
640natureofthedefault,theproposedmeansofcuringthedefaultand/oranyotheraction
641tobetakenbytheCommission;and
642 b.Provideremedialtrainingandspecifictechnicalassistanceregardingthe
643default.
644 C.IfaStateindefaultfailstocurethedefault,thedefaultingStatemaybe
645terminatedfromtheCompactuponanaffirmativevoteofamajorityoftheMember
646States,andallrights,privilegesandbenefitsconferredbythisCompactmaybe
647terminatedontheeffectivedateoftermination.Acureofthedefaultdoesnotrelieve
648theoffendingStateofobligationsorliabilitiesincurredduringtheperiodofdefault.
649 D.TerminationofmembershipintheCompactshallbeimposedonlyafterall
650othermeansofsecuringcompliancehavebeenexhausted.Noticeofintenttosuspendor
651terminateshallbegivenbytheCommissiontothegovernor,themajorityandminority
652leadersofthedefaultingState'slegislature,andeachoftheMemberStates.
653 E.AStatethathasbeenterminatedisresponsibleforallassessments,
654obligations,andliabilitiesincurredthroughtheeffectivedateoftermination,including
655obligationsthatextendbeyondtheeffectivedateoftermination.
656 F.TheCommissionshallnotbearanycostsrelatedtoaStatethatisfoundtobe
657indefaultorthathasbeenterminatedfromtheCompact,unlessagreeduponinwriting
658betweentheCommissionandthedefaultingState.
659 G.ThedefaultingStatemayappealtheactionoftheCommissionbypetitioning
660theU.S.DistrictCourtfortheDistrictofColumbiaorthefederaldistrictwherethe
661Commissionhasitsprincipaloffices.Theprevailingmembershallbeawardedallcosts
662ofsuchlitigation,includingreasonableattorney'sfees.
663 H.DisputeResolution
664 1.UponrequestbyaMemberState,theCommissionshallattempttoresolve
665disputesrelatedtotheCompactthatariseamongMemberStatesandbetweenmember
666andnon-MemberStates.
667 2.TheCommissionshallpromulgateaRuleprovidingforbothmediationand
668bindingdisputeresolutionfordisputesasappropriate.
669 I.Enforcement
670 1.TheCommission,inthereasonableexerciseofitsdiscretion,shallenforcethe
671provisionsandRulesofthisCompact.
SSHCSHBs115&99 56 672 2.Bymajorityvote,theCommissionmayinitiatelegalactionintheUnited
673StatesDistrictCourtfortheDistrictofColumbiaorthefederaldistrictwherethe
674CommissionhasitsprincipalofficesagainstaMemberStateindefaulttoenforce
675compliancewiththeprovisionsoftheCompactanditspromulgatedRulesandbylaws.
676Thereliefsoughtmayincludebothinjunctivereliefanddamages.Intheeventjudicial
677enforcementisnecessary,theprevailingmembershallbeawardedallcostsofsuch
678litigation,includingreasonableattorney'sfees.
679 3.TheremedieshereinshallnotbetheexclusiveremediesoftheCommission.
680TheCommissionmaypursueanyotherremediesavailableunderfederalorStatelaw.
681 SECTION13.DATEOFIMPLEMENTATIONOFTHECOUNSELING
682COMPACTCOMMISSION ANDASSOCIATEDRULES,WITHDRAWAL,AND
683AMENDMENT
684 A.TheCompactshallcomeintoeffectonthedateonwhichtheCompactstatute
685isenactedintolawinthetenthMemberState.Theprovisions,whichbecomeeffective
686atthattime,shallbelimitedtothepowersgrantedtotheCommissionrelatingto
687assemblyandthepromulgationofRules.Thereafter,theCommissionshallmeetand
688exerciseRulemakingpowersnecessarytotheimplementationandadministrationofthe
689Compact.
690 B.AnyStatethatjoinstheCompactsubsequenttotheCommission'sinitial
691adoptionoftheRulesshallbesubjecttotheRulesastheyexistonthedateonwhichthe
692CompactbecomeslawinthatState.AnyRulethathasbeenpreviouslyadoptedbythe
693CommissionshallhavethefullforceandeffectoflawonthedaytheCompactbecomes
694lawinthatState.
695 C.AnyMemberStatemaywithdrawfromthisCompactbyenactingastatute
696repealingthesame.
697 1.AMemberState'swithdrawalshallnottakeeffectuntilsix(6)monthsafter
698enactmentoftherepealingstatute.
699 2.Withdrawalshallnotaffectthecontinuingrequirementofthewithdrawing
700State'sProfessionalCounselingLicensingBoardtocomplywiththeinvestigativeand
701AdverseActionreportingrequirementsofthisactpriortotheeffectivedateof
702withdrawal.
703 D.NothingcontainedinthisCompactshallbeconstruedtoinvalidateorprevent
704anyProfessionalCounselinglicensureagreementorothercooperativearrangement
705betweenaMemberStateandanon-MemberStatethatdoesnotconflictwiththe
706provisionsofthisCompact.
SSHCSHBs115&99 57 707 E.ThisCompactmaybeamendedbytheMemberStates.Noamendmenttothis
708CompactshallbecomeeffectiveandbindinguponanyMemberStateuntilitisenacted
709intothelawsofallMemberStates.
710 SECTION14.CONSTRUCTION ANDSEVERABILITY
711 ThisCompactshallbeliberallyconstruedsoastoeffectuatethepurposes
712thereof.TheprovisionsofthisCompactshallbeseverableandifanyphrase,clause,
713sentenceorprovisionofthisCompactisdeclaredtobecontrarytotheconstitutionof
714anyMemberStateoroftheUnitedStatesortheapplicabilitythereoftoany
715government,agency,personorcircumstanceisheldinvalid,thevalidityofthe
716remainderofthisCompactandtheapplicabilitythereoftoanygovernment,agency,
717personorcircumstanceshallnotbeaffectedthereby.IfthisCompactshallbeheld
718contrarytotheconstitutionofanyMemberState,theCompactshallremaininfullforce
719andeffectastotheremainingMemberStatesandinfullforceandeffectastothe
720MemberStateaffectedastoallseverablematters.
721 SECTION15.BINDINGEFFECTOFCOMPACTANDOTHERLAWS
722 A.ALicenseeprovidingProfessionalCounselingservicesinaRemoteState
723underthePrivilegetoPracticeshalladheretothelawsandregulations,includingscope
724ofpractice,oftheRemoteState.
725 B.NothinghereinpreventstheenforcementofanyotherlawofaMemberState
726thatisnotinconsistentwiththeCompact.
727 C.AnylawsinaMemberStateinconflictwiththeCompactaresupersededto
728theextentoftheconflict.
729 D.AnylawfulactionsoftheCommission,includingallRulesandbylaws
730properlypromulgatedbytheCommission,arebindingupontheMemberStates.
731 E.AllpermissibleagreementsbetweentheCommissionandtheMemberStates
732arebindinginaccordancewiththeirterms.
733 F.IntheeventanyprovisionoftheCompactexceedstheconstitutionallimits
734imposedonthelegislatureofanyMemberState,theprovisionshallbeineffectivetothe
735extentoftheconflictwiththeconstitutionalprovisioninquestioninthatMemberState.
338.010.1.The"practiceofpharmacy"[means] includes:
2 (1)Theinterpretation,implementation,andevaluationofmedicalprescriptionorders,
3includinganylegenddrugsunder21U.S.C.Section353[;],andthereceipt,transmission,or
4handlingofsuchordersorfacilitatingthedispensingofsuchorders;
5 (2)Thedesigning,initiating,implementing,andmonitoringofamedication
6therapeuticplan[asdefinedbytheprescriptionordersolongastheprescriptionorderis
7specifictoeachpatientforcarebyapharmacist] inaccordancewiththeprovisionsofthis
8section;
SSHCSHBs115&99 58 9 (3)Thecompounding,dispensing,labeling,andadministrationofdrugsanddevices
10pursuanttomedicalprescriptionorders[andadministrationofviralinfluenza,pneumonia,
11shingles,hepatitisA,hepatitisB,diphtheria,tetanus,pertussis,andmeningitisvaccinesby
12writtenprotocolauthorizedbyaphysicianforpersonsatleastsevenyearsofageortheage
13recommendedbytheCentersforDiseaseControlandPrevention,whicheverishigher,orthe
14administrationofpneumonia,shingles,hepatitisA,hepatitisB,diphtheria,tetanus,pertussis,
15meningitis,andviralinfluenzavaccinesbywrittenprotocolauthorizedbyaphysicianfora
16specificpatientasauthorizedbyrule];
17 (4)Theorderingandadministrationofvaccinesapprovedorauthorizedbythe
18U.S.FoodandDrugAdministration,excludingvaccinesforcholera,monkeypox,
19Japaneseencephalitis,typhoid,rabies,yellowfever,tick-borneencephalitis,anthrax,
20tuberculosis,dengue,Hib,polio,rotavirus,smallpox,andanyvaccineapprovedafter
21January1,2023,topersonsatleastsevenyearsofageortheagerecommendedbythe
22CentersforDiseaseControlandPrevention,whicheverisolder,pursuanttojoint
23promulgationofrulesestablishedbytheboardofpharmacyandthestateboardof
24registrationforthehealingartsunlessrulesareestablishedunderastateofemergency
25asdescribedinsection44.100;
26 (5)Theparticipationindrugselectionaccordingtostatelawandparticipationindrug
27utilizationreviews;
28 (6)Theproperandsafestorageofdrugsanddevicesandthemaintenanceofproper
29recordsthereof;
30 (7)Consultationwithpatientsandotherhealthcarepractitioners,andveterinarians
31andtheirclientsaboutlegenddrugs,aboutthesafeandeffectiveuseofdrugsanddevices;
32 (8)Theprescribinganddispensingofanynicotinereplacementtherapyproductunder
33section338.665;
34 (9)ThedispensingofHIVpostexposureprophylaxispursuanttosection338.730;and
35 (10)Theofferingorperformingofthoseacts,services,operations,ortransactions
36necessaryintheconduct,operation,managementandcontrolofapharmacy.
37 2.Nopersonshallengageinthepracticeofpharmacyunlessheorsheislicensed
38undertheprovisionsofthischapter.
39 3.Thischaptershallnotbeconstruedtoprohibittheuseofauxiliarypersonnelunder
40thedirectsupervisionofapharmacistfromassistingthepharmacistinanyofhisorherduties.
41Thisassistanceinnowayisintendedtorelievethepharmacistfromhisorherresponsibilities
42forcompliancewiththischapterandheorshewillberesponsiblefortheactionsofthe
43auxiliarypersonnelactinginhisorherassistance.
44 4.Thischaptershall[also] notbeconstruedtoprohibitorinterferewithanylegally
45registeredpractitionerofmedicine,dentistry,orpodiatry,orveterinarymedicineonlyforuse
SSHCSHBs115&99 59 46inanimals,orthepracticeofoptometryinaccordancewithandasprovidedinsections
47195.070and336.220inthecompounding,administering,prescribing,ordispensingofhisor
48herownprescriptions.
49 [2.Anypharmacistwhoacceptsaprescriptionorderforamedicationtherapeuticplan
50shallhaveawrittenprotocolfromthephysicianwhorefersthepatientformedicationtherapy
51services.] 5.Apharmacistwithacertificateofmedicationtherapeuticplanauthority
52mayprovidemedicationtherapyservicespursuanttoawrittenprotocolfroma
53physicianlicensedunderchapter334topatientswhohaveestablishedaphysician-
54patientrelationship,asdescribedinsubdivision(1)ofsubsection1ofsection191.1146,
55withtheprotocolphysician.Thewrittenprotocol[andtheprescriptionorderfora
56medicationtherapeuticplan]authorizedbythissectionshallcomeonlyfromthephysician
57[only,]andshallnotcomefromanurseengagedinacollaborativepracticearrangementunder
58section334.104,orfromaphysicianassistantengagedinacollaborativepractice
59arrangementundersection334.735.
60 [3.]6.Nothinginthissectionshallbeconstruedastopreventanyperson,firmor
61corporationfromowningapharmacyregulatedbysections338.210to338.315,providedthat
62alicensedpharmacistisinchargeofsuchpharmacy.
63 [4.]7.Nothinginthissectionshallbeconstruedtoapplytoorinterferewiththesale
64ofnonprescriptiondrugsandtheordinaryhouseholdremediesandsuchdrugsormedicinesas
65arenormallysoldbythoseengagedinthesaleofgeneralmerchandise.
66 [5.]8.Nohealthcarrierasdefinedinchapter376shallrequireanyphysicianwith
67whichtheycontracttoenterintoawrittenprotocolwithapharmacistformedication
68therapeuticservices.
69 [6.]9.Thissectionshallnotbeconstruedtoallowapharmacisttodiagnoseor
70independentlyprescribepharmaceuticals.
71 [7.]10.Thestateboardofregistrationforthehealingarts,undersection334.125,and
72thestateboardofpharmacy,undersection338.140,shalljointlypromulgaterulesregulating
73theuseofprotocols[forprescriptionorders] formedicationtherapyservices[and
74administrationofviralinfluenzavaccines]. Suchrulesshallrequireprotocolstoinclude
75provisionsallowingfortimelycommunicationbetweenthepharmacistandthe[referring]
76protocolphysicianorsimilarbodyauthorizedbythissection, andanyotherpatient
77protectionprovisionsdeemedappropriatebybothboards.Inordertotakeeffect,suchrules
78shallbeapprovedbyamajorityvoteofaquorumofeachboard.Neitherboardshall
79separatelypromulgaterulesregulatingtheuseofprotocolsfor[prescriptionordersfor]
80medicationtherapyservices[andadministrationofviralinfluenzavaccines]. Anyruleor
81portionofarule,asthattermisdefinedinsection536.010,thatiscreatedundertheauthority
82delegatedinthissectionshallbecomeeffectiveonlyifitcomplieswithandissubjecttoallof
SSHCSHBs115&99 60 83theprovisionsofchapter536and,ifapplicable,section536.028.Thissectionandchapter
84536arenonseverableandifanyofthepowersvestedwiththegeneralassemblypursuantto
85chapter536toreview,todelaytheeffectivedate,ortodisapproveandannularuleare
86subsequentlyheldunconstitutional,thenthegrantofrulemakingauthorityandanyrule
87proposedoradoptedafterAugust28,2007,shallbeinvalidandvoid.
88 [8.]11.Thestateboardofpharmacymaygrantacertificateofmedicationtherapeutic
89planauthoritytoalicensedpharmacistwhosubmitsproofofsuccessfulcompletionofa
90board-approvedcourseofacademicclinicalstudybeyondabachelorofscienceinpharmacy,
91includingbutnotlimitedtoclinicalassessmentskills,fromanationallyaccreditedcollegeor
92university,oracertificationofequivalenceissuedbyanationallyrecognizedprofessional
93organizationandapprovedbytheboardofpharmacy.
94 [9.]12.Anypharmacistwhohasreceivedacertificateofmedicationtherapeuticplan
95authoritymayengageinthedesigning,initiating,implementing,andmonitoringofa
96medicationtherapeuticplanasdefinedbya[prescriptionorder] writtenprotocolfroma
97physicianthat[is]maybespecifictoeachpatientforcarebyapharmacist.
98 [10.]13.Nothinginthissectionshallbeconstruedtoallowapharmacisttomakea
99therapeuticsubstitutionofapharmaceuticalprescribedbyaphysicianunlessauthorizedby
100thewrittenprotocolorthephysician'sprescriptionorder.
101 [11.]14."Veterinarian","doctorofveterinarymedicine","practitionerofveterinary
102medicine","DVM","VMD","BVSe","BVMS","BSe(VetScience)","VMB","MRCVS",or
103anequivalenttitlemeansapersonwhohasreceivedadoctor'sdegreeinveterinarymedicine
104fromanaccreditedschoolofveterinarymedicineorholdsanEducationalCommissionfor
105ForeignVeterinaryGraduates(EDFVG)certificateissuedbytheAmericanVeterinary
106MedicalAssociation(AVMA).
107 [12.]15.Inadditiontootherrequirementsestablishedbythejointpromulgationof
108rulesbytheboardofpharmacyandthestateboardofregistrationforthehealingarts:
109 (1)Apharmacistshalladministervaccinesbyprotocolinaccordancewithtreatment
110guidelinesestablishedbytheCentersforDiseaseControlandPrevention(CDC);
111 (2)Apharmacistwhoisadministeringavaccineshallrequestapatienttoremainin
112thepharmacyasafeamountoftimeafteradministeringthevaccinetoobserveanyadverse
113reactions.Suchpharmacistshallhaveadoptedemergencytreatmentprotocols;
114 [(3)]16.Inadditiontootherrequirementsbytheboard,apharmacistshallreceive
115additionaltrainingasrequiredbytheboardandevidencedbyreceivingacertificatefromthe
116boarduponcompletion,andshalldisplaythecertificationinhisorherpharmacywhere
117vaccinesaredelivered.
118 [13.]17.Apharmacistshallinformthepatientthattheadministrationof[the]a
119vaccinewillbeenteredintotheShowMeVaxsystem,asadministeredbythedepartmentof
SSHCSHBs115&99 61 120healthandseniorservices.Thepatientshallattesttotheinclusionofsuchinformationinthe
121systembysigningaformprovidedbythepharmacist.Ifthepatientindicatesthatheorshe
122doesnotwantsuchinformationenteredintotheShowMeVaxsystem,thepharmacistshall
123provideawrittenreportwithinfourteendaysofadministrationofavaccinetothepatient's
124healthcareprovider,ifprovidedbythepatient,containing:
125 (1)Theidentityofthepatient;
126 (2)Theidentityofthevaccineorvaccinesadministered;
127 (3)Therouteofadministration;
128 (4)Theanatomicsiteoftheadministration;
129 (5)Thedoseadministered;and
130 (6)Thedateofadministration.
131 18.Apharmacistlicensedunderthischaptermayorderandadministervaccines
132approvedorauthorizedbytheU.S.FoodandDrugAdministrationtoaddressapublic
133healthneed,aslawfullyauthorizedbythestateorfederalgovernment,oradepartment
134oragencythereof,duringastateorfederallydeclaredpublichealthemergency.
338.012.1.Apharmacistwithacertificateofmedicationtherapeuticplan
2authoritymayprovideinfluenza,groupAstreptococcus,andCOVID-19medication
3therapyservicespursuanttoastatewidestandingorderissuedbythedirectororchief
4medicalofficerofthedepartmentofhealthandseniorservicesifthatpersonisa
5licensedphysician,oralicensedphysiciandesignatedbythedepartmentofhealthand
6seniorservices.
7 2.Thestateboardofregistrationforthehealingarts,pursuanttosection
8334.125,andthestateboardofpharmacy,pursuanttosection338.140,shalljointly
9promulgaterulestoimplementtheprovisionsofthissection.Anyruleorportionofa
10rule,asthattermisdefinedinsection536.010,thatiscreatedundertheauthority
11delegatedinthissectionshallbecomeeffectiveonlyifitcomplieswithandissubjectto
12alloftheprovisionsofchapter536and,ifapplicable,section536.028.Thissectionand
13chapter536arenonseverableandifanyofthepowersvestedwiththegeneralassembly
14pursuanttochapter536toreview,todelaytheeffectivedate,ortodisapproveandannul
15arulearesubsequentlyheldunconstitutional,thenthegrantofrulemakingauthority
16andanyruleproposedoradoptedafterAugust28,2023,shallbeinvalidandvoid.
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SSHCSHBs115&99 62