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Missouri House Bill HB115

Missouri 2023 Regular Session

Missouri House Bill HB115 Compare Versions

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11 FIRSTREGULARSESSION
22 [TRULYAGREEDTOANDFINALLYPASSED]
33 SENATESUBSTITUTEFOR
44 HOUSECOMMITTEESUBSTITUTEFOR
55 HOUSEBILLNOS.115&99
66 102NDGENERALASSEMBLY
77 0039S.05T 2023
88 ANACT
99 Torepealsections195.070,334.036,334.100,334.104,334.506,334.613,335.016,335.019,
1010 335.036,335.046,335.051,335.056,335.076,335.086,335.175,337.510,and
1111 338.010,RSMo,andtoenactinlieuthereofnineteennewsectionsrelatingto
1212 licensingofhealthcareprofessionals.
1313 BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
1414 SectionA.Sections195.070,334.036,334.100,334.104,334.506,334.613,335.016,
1515 2335.019,335.036,335.046,335.051,335.056,335.076,335.086,335.175,337.510,and
1616 3338.010,RSMo,arerepealedandnineteennewsectionsenactedinlieuthereof,tobeknown
1717 4assections195.070,334.036,334.100,334.104,334.506,334.613,335.016,335.019,
1818 5335.036,335.046,335.051,335.056,335.076,335.086,335.175,337.510,337.550,338.010,
1919 6and338.012,toreadasfollows:
2020 195.070.1.Aphysician,podiatrist,dentist,aregisteredoptometristcertifiedto
2121 2administerpharmaceuticalagentsasprovidedinsection336.220,oranassistantphysicianin
2222 3accordancewithsection334.037oraphysicianassistantinaccordancewithsection334.747
2323 4ingoodfaithandinthecourseofhisorherprofessionalpracticeonly,mayprescribe,
2424 5administer,anddispensecontrolledsubstancesorheorshemaycausethesametobe
2525 6administeredordispensedbyanindividualasauthorizedbystatute.
2626 7 2.Anadvancedpracticeregisterednurse,asdefinedinsection335.016,butnota
2727 8certifiedregisterednurseanesthetistasdefinedinsubdivision(8)ofsection335.016,who
2828 9holdsacertificateofcontrolledsubstanceprescriptiveauthorityfromtheboardofnursing
2929 EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
3030 intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 10undersection335.019andwhoisdelegatedtheauthoritytoprescribecontrolledsubstances
3131 11underacollaborativepracticearrangementundersection334.104mayprescribeany
3232 12controlledsubstanceslistedinSchedulesIII,IV,andVofsection195.017,andmayhave
3333 13restrictedauthorityinScheduleII.PrescriptionsforScheduleIImedicationsprescribedbyan
3434 14advancedpracticeregisterednursewhohasacertificateofcontrolledsubstanceprescriptive
3535 15authorityarerestrictedtoonlythosemedicationscontaininghydrocodoneandScheduleII
3636 16controlledsubstancesforhospicepatientspursuanttotheprovisionsofsection334.104.
3737 17However,nosuchcertifiedadvancedpracticeregisterednurseshallprescribecontrolled
3838 18substanceforhisorherownselforfamily.ScheduleIIInarcoticcontrolledsubstanceand
3939 19ScheduleII-hydrocodoneprescriptionsshallbelimitedtoaonehundredtwenty-hoursupply
4040 20withoutrefill.
4141 21 3.Aveterinarian,ingoodfaithandinthecourseoftheveterinarian'sprofessional
4242 22practiceonly,andnotforusebyahumanbeing,mayprescribe,administer,anddispense
4343 23controlledsubstancesandtheveterinarianmaycausethemtobeadministeredbyanassistant
4444 24ororderlyunderhisorherdirectionandsupervision.
4545 25 4.Apractitionershallnotacceptanyportionofacontrolledsubstanceunusedbya
4646 26patient,foranyreason,ifsuchpractitionerdidnotoriginallydispensethedrug,except:
4747 27 (1)Whenthecontrolledsubstanceisdeliveredtothepractitionertoadministertothe
4848 28patientforwhomthemedicationisprescribedasauthorizedbyfederallaw.Practitioners
4949 29shallmaintainrecordsandsecurethemedicationasrequiredbythischapterandregulations
5050 30promulgatedpursuanttothischapter;or
5151 31 (2)Asprovidedinsection195.265.
5252 32 5.Anindividualpractitionershallnotprescribeordispenseacontrolledsubstancefor
5353 33suchpractitioner'spersonaluseexceptinamedicalemergency.
5454 334.036.1.Forpurposesofthissection,thefollowingtermsshallmean:
5555 2 (1)"Assistantphysician",anygraduateofamedicalschool[graduate] accredited
5656 3bytheLiaisonCommitteeonMedicalEducation,theCommissiononOsteopathic
5757 4CollegeAccreditation,oranorganizationaccreditedbytheEducationalCommission
5858 5forForeignMedicalGraduateswho:
5959 6 (a)IsaresidentandcitizenoftheUnitedStatesorisalegalresidentalien;
6060 7 (b)HassuccessfullycompletedStep2oftheUnitedStatesMedicalLicensing
6161 8Examinationortheequivalentofsuchstepofanyotherboard-approvedmedicallicensing
6262 9examinationwithinthethree-yearperiodimmediatelyprecedingapplicationforlicensureas
6363 10anassistantphysician,orwithinthreeyearsaftergraduationfromamedicalcollegeor
6464 11osteopathicmedicalcollege,whicheverislater;
6565 12 (c)Hasnotcompletedanapprovedpostgraduateresidencyandhassuccessfully
6666 13completedStep2oftheUnitedStatesMedicalLicensingExaminationortheequivalentof
6767 SSHCSHBs115&99 2 14suchstepofanyotherboard-approvedmedicallicensingexaminationwithintheimmediately
6868 15precedingthree-yearperiodunlesswhensuchthree-yearanniversaryoccurredheorshewas
6969 16servingasaresidentphysicianinanaccreditedresidencyintheUnitedStatesandcontinued
7070 17todosowithinthirtydayspriortoapplicationforlicensureasanassistantphysician;and
7171 18 (d)HasproficiencyintheEnglishlanguage.
7272 19
7373 20Anygraduateofamedicalschool[graduate] whocouldhaveappliedforlicensureand
7474 21compliedwiththeprovisionsofthissubdivisionatanytimebetweenAugust28,2014,and
7575 22August28,2017,mayapplyforlicensureandshallbedeemedincompliancewiththe
7676 23provisionsofthissubdivision;
7777 24 (2)"Assistantphysiciancollaborativepracticearrangement",anagreementbetweena
7878 25physicianandanassistantphysicianthatmeetstherequirementsofthissectionandsection
7979 26334.037[;
8080 27 (3)"Medicalschoolgraduate",anypersonwhohasgraduatedfromamedicalcollege
8181 28orosteopathicmedicalcollegedescribedinsection334.031].
8282 29 2.(1)Anassistantphysiciancollaborativepracticearrangementshalllimitthe
8383 30assistantphysiciantoprovidingonlyprimarycareservicesandonlyinmedicallyunderserved
8484 31ruralorurbanareasofthisstate[orinanypilotprojectareasestablishedinwhichassistant
8585 32physiciansmaypractice].
8686 33 (2)Foraphysician-assistantphysicianteamworkinginaruralhealthclinicunderthe
8787 34federalRuralHealthClinicServicesAct,P.L.95-210,asamended:
8888 35 (a)Anassistantphysicianshallbeconsideredaphysicianassistantforpurposesof
8989 36regulationsoftheCentersforMedicareandMedicaidServices(CMS);and
9090 37 (b)Nosupervisionrequirementsinadditiontotheminimumfederallawshallbe
9191 38required.
9292 39 3.(1)Forpurposesofthissection,thelicensureofassistantphysiciansshalltake
9393 40placewithinprocessesestablishedbyrulesofthestateboardofregistrationforthehealing
9494 41arts.Theboardofhealingartsisauthorizedtoestablishrulesunderchapter536establishing
9595 42licensureandrenewalprocedures,supervision,collaborativepracticearrangements,fees,and
9696 43addressingsuchothermattersasarenecessarytoprotectthepublicanddisciplinethe
9797 44profession.Nolicensurefeeforanassistantphysicianshallexceedtheamountofany
9898 45licensurefeeforaphysicianassistant.Anapplicationforlicensuremaybedeniedorthe
9999 46licensureofanassistantphysicianmaybesuspendedorrevokedbytheboardinthesame
100100 47mannerandforviolationofthestandardsassetforthbysection334.100,orsuchother
101101 48standardsofconductsetbytheboardbyrule.Noruleorregulationshallrequireanassistant
102102 49physiciantocompletemorehoursofcontinuingmedicaleducationthanthatofalicensed
103103 50physician.
104104 SSHCSHBs115&99 3 51 (2)Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis
105105 52createdundertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplies
106106 53withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.
107107 54Thissectionandchapter536arenonseverableandifanyofthepowersvestedwiththe
108108 55generalassemblyunderchapter536toreview,todelaytheeffectivedate,ortodisapprove
109109 56andannularulearesubsequentlyheldunconstitutional,thenthegrantofrulemaking
110110 57authorityandanyruleproposedoradoptedafterAugust28,2014,shallbeinvalidandvoid.
111111 58 (3)Anyrulesorregulationsregardingassistantphysiciansineffectasoftheeffective
112112 59dateofthissectionthatconflictwiththeprovisionsofthissectionandsection334.037shall
113113 60benullandvoidasoftheeffectivedateofthissection.
114114 61 4.Anassistantphysicianshallclearlyidentifyhimselforherselfasanassistant
115115 62physicianandshallbepermittedtousetheterms"doctor","Dr.",or"doc".Noassistant
116116 63physicianshallpracticeorattempttopracticewithoutanassistantphysiciancollaborative
117117 64practicearrangement,exceptasotherwiseprovidedinthissectionandinanemergency
118118 65situation.
119119 66 5.Thecollaboratingphysicianisresponsibleatalltimesfortheoversightofthe
120120 67activitiesofandacceptsresponsibilityforprimarycareservicesrenderedbytheassistant
121121 68physician.
122122 69 6.Theprovisionsofsection334.037shallapplytoallassistantphysician
123123 70collaborativepracticearrangements.Anyrenewaloflicensureunderthissectionshall
124124 71includeverificationofactualpracticeunderacollaborativepracticearrangementin
125125 72accordancewiththissubsectionduringtheimmediatelyprecedinglicensureperiod.
126126 73 7.Eachhealthcarrierorhealthbenefitplanthatoffersorissueshealthbenefitplans
127127 74thataredelivered,issuedfordelivery,continued,orrenewedinthisstateshallreimbursean
128128 75assistantphysicianforthediagnosis,consultation,ortreatmentofaninsuredorenrolleeon
129129 76thesamebasisthatthehealthcarrierorhealthbenefitplancoverstheservicewhenitis
130130 77deliveredbyanothercomparablemid-levelhealthcareproviderincluding,butnotlimitedto,
131131 78aphysicianassistant.
132132 334.100.1.Theboardmayrefusetoissueorrenewanycertificateofregistrationor
133133 2authority,permitorlicenserequiredpursuanttothischapterforoneoranycombinationof
134134 3causesstatedinsubsection2ofthissection.Theboardshallnotifytheapplicantinwritingof
135135 4thereasonsfortherefusalandshalladvisetheapplicantoftheapplicant'srighttofilea
136136 5complaintwiththeadministrativehearingcommissionasprovidedbychapter621.Asan
137137 6alternativetoarefusaltoissueorrenewanycertificate,registrationorauthority,theboard
138138 7may,atitsdiscretion,issuealicensewhichissubjecttoprobation,restrictionorlimitationto
139139 8anapplicantforlicensureforanyoneoranycombinationofcausesstatedinsubsection2of
140140 9thissection.Theboard'sorderofprobation,limitationorrestrictionshallcontainastatement
141141 SSHCSHBs115&99 4 10ofthedisciplineimposed,thebasistherefor,thedatesuchactionshallbecomeeffective,anda
142142 11statementthattheapplicanthasthirtydaystorequestinwritingahearingbeforethe
143143 12administrativehearingcommission.Iftheboardissuesaprobationary,limitedorrestricted
144144 13licensetoanapplicantforlicensure,eitherpartymayfileawrittenpetitionwiththe
145145 14administrativehearingcommissionwithinthirtydaysoftheeffectivedateoftheprobationary,
146146 15limitedorrestrictedlicenseseekingreviewoftheboard'sdetermination.Ifnowrittenrequest
147147 16forahearingisreceivedbytheadministrativehearingcommissionwithinthethirty-day
148148 17period,therighttoseekreviewoftheboard'sdecisionshallbeconsideredaswaived.
149149 18 2.Theboardmaycauseacomplainttobefiledwiththeadministrativehearing
150150 19commissionasprovidedbychapter621againstanyholderofanycertificateofregistrationor
151151 20authority,permitorlicenserequiredbythischapteroranypersonwhohasfailedtorenewor
152152 21hassurrenderedtheperson'scertificateofregistrationorauthority,permitorlicenseforany
153153 22oneoranycombinationofthefollowingcauses:
154154 23 (1)Useofanycontrolledsubstance,asdefinedinchapter195,oralcoholicbeverage
155155 24toanextentthatsuchuseimpairsaperson'sabilitytoperformtheworkofanyprofession
156156 25licensedorregulatedbythischapter;
157157 26 (2)Thepersonhasbeenfinallyadjudicatedandfoundguilty,orenteredapleaof
158158 27guiltyornolocontendere,inacriminalprosecutionunderthelawsofanystateorofthe
159159 28UnitedStates,foranyoffensereasonablyrelatedtothequalifications,functionsordutiesof
160160 29anyprofessionlicensedorregulatedpursuanttothischapter,foranyoffenseinvolvingfraud,
161161 30dishonestyoranactofviolence,orforanyoffenseinvolvingmoralturpitude,whetherornot
162162 31sentenceisimposed;
163163 32 (3)Useoffraud,deception,misrepresentationorbriberyinsecuringanycertificateof
164164 33registrationorauthority,permitorlicenseissuedpursuanttothischapterorinobtaining
165165 34permissiontotakeanyexaminationgivenorrequiredpursuanttothischapter;
166166 35 (4)Misconduct,fraud,misrepresentation,dishonesty,unethicalconductor
167167 36unprofessionalconductintheperformanceofthefunctionsordutiesofanyprofession
168168 37licensedorregulatedbythischapter,including,butnotlimitedto,thefollowing:
169169 38 (a)Obtainingorattemptingtoobtainanyfee,charge,tuitionorothercompensation
170170 39byfraud,deceptionormisrepresentation;willfullyandcontinuallyoverchargingor
171171 40overtreatingpatients;orchargingforvisitstothephysician'sofficewhichdidnotoccur
172172 41unlesstheserviceswerecontractedforinadvance,orforserviceswhichwerenotrenderedor
173173 42documentedinthepatient'srecords;
174174 43 (b)Attempting,directlyorindirectly,bywayofintimidation,coercionordeception,
175175 44toobtainorretainapatientordiscouragetheuseofasecondopinionorconsultation;
176176 45 (c)Willfullyandcontinuallyperforminginappropriateorunnecessarytreatment,
177177 46diagnostictestsormedicalorsurgicalservices;
178178 SSHCSHBs115&99 5 47 (d)Delegatingprofessionalresponsibilitiestoapersonwhoisnotqualifiedby
179179 48training,skill,competency,age,experienceorlicensuretoperformsuchresponsibilities;
180180 49 (e)Misrepresentingthatanydisease,ailmentorinfirmitycanbecuredbyamethod,
181181 50procedure,treatment,medicineordevice;
182182 51 (f)Performingorprescribingmedicalserviceswhichhavebeendeclaredbyboard
183183 52ruletobeofnomedicalorosteopathicvalue;
184184 53 (g)Finaldisciplinaryactionbyanyprofessionalmedicalorosteopathicassociationor
185185 54societyorlicensedhospitalormedicalstaffofsuchhospitalinthisoranyotherstateor
186186 55territory,whetheragreedtovoluntarilyornot,andincluding,butnotlimitedto,anyremoval,
187187 56suspension,limitation,orrestrictionoftheperson'slicenseorstafforhospitalprivileges,
188188 57failuretorenewsuchprivilegesorlicenseforcause,orotherfinaldisciplinaryaction,ifthe
189189 58actionwasinanywayrelatedtounprofessionalconduct,professionalincompetence,
190190 59malpracticeoranyotherviolationofanyprovisionofthischapter;
191191 60 (h)Signingablankprescriptionform;ordispensing,prescribing,administeringor
192192 61otherwisedistributinganydrug,controlledsubstanceorothertreatmentwithoutsufficient
193193 62examinationincludingfailingtoestablishavalidphysician-patientrelationshippursuantto
194194 63section334.108,orforotherthanmedicallyacceptedtherapeuticorexperimentalor
195195 64investigativepurposesdulyauthorizedbyastateorfederalagency,ornotinthecourseof
196196 65professionalpractice,ornotingoodfaithtorelievepainandsuffering,ornottocurean
197197 66ailment,physicalinfirmityordisease,exceptasauthorizedinsection334.104;
198198 67 (i)Exercisinginfluencewithinaphysician-patientrelationshipforpurposesof
199199 68engagingapatientinsexualactivity;
200200 69 (j)Beinglistedonanystateorfederalsexualoffenderregistry;
201201 70 (k)Terminatingthemedicalcareofapatientwithoutadequatenoticeorwithout
202202 71makingotherarrangementsforthecontinuedcareofthepatient;
203203 72 (l)Failingtofurnishdetailsofapatient'smedicalrecordstoothertreatingphysicians
204204 73orhospitalsuponproperrequest;orfailingtocomplywithanyotherlawrelatingtomedical
205205 74records;
206206 75 (m)Failureofanyapplicantorlicenseetocooperatewiththeboardduringany
207207 76investigation;
208208 77 (n)Failuretocomplywithanysubpoenaorsubpoenaducestecumfromtheboardor
209209 78anorderoftheboard;
210210 79 (o)Failuretotimelypaylicenserenewalfeesspecifiedinthischapter;
211211 80 (p)Violatingaprobationagreement,order,orothersettlementagreementwiththis
212212 81boardoranyotherlicensingagency;
213213 82 (q)Failingtoinformtheboardofthephysician'scurrentresidenceandbusiness
214214 83address;
215215 SSHCSHBs115&99 6 84 (r)Advertisingbyanapplicantorlicenseewhichisfalseormisleading,orwhich
216216 85violatesanyruleoftheboard,orwhichclaimswithoutsubstantiationthepositivecureofany
217217 86disease,orprofessionalsuperioritytoorgreaterskillthanthatpossessedbyanyother
218218 87physician.Anapplicantorlicenseeshallalsobeinviolationofthisprovisioniftheapplicant
219219 88orlicenseehasafinancialinterestinanyorganization,corporationorassociationwhichissues
220220 89orconductssuchadvertising;
221221 90 (s)Anyotherconductthatisunethicalorunprofessionalinvolvingaminor;
222222 91 (5)Anyconductorpracticewhichisormightbeharmfulordangeroustothemental
223223 92orphysicalhealthofapatientorthepublic;orincompetency,grossnegligenceorrepeated
224224 93negligenceintheperformanceofthefunctionsordutiesofanyprofessionlicensedor
225225 94regulatedbythischapter.Forthepurposesofthissubdivision,"repeatednegligence"means
226226 95thefailure,onmorethanoneoccasion,tousethatdegreeofskillandlearningordinarilyused
227227 96underthesameorsimilarcircumstancesbythememberoftheapplicant'sorlicensee's
228228 97profession;
229229 98 (6)Violationof,orattemptingtoviolate,directlyorindirectly,orassistingor
230230 99enablinganypersontoviolate,anyprovisionofthischapterorchapter324,orofanylawful
231231 100ruleorregulationadoptedpursuanttothischapterorchapter324;
232232 101 (7)Impersonationofanypersonholdingacertificateofregistrationorauthority,
233233 102permitorlicenseorallowinganypersontousehisorhercertificateofregistrationor
234234 103authority,permit,licenseordiplomafromanyschool;
235235 104 (8)Revocation,suspension,restriction,modification,limitation,reprimand,warning,
236236 105censure,probationorotherfinaldisciplinaryactionagainsttheholderoforapplicantfora
237237 106licenseorotherrighttopracticeanyprofessionregulatedbythischapterbyanotherstate,
238238 107territory,federalagencyorcountry,whetherornotvoluntarilyagreedtobythelicenseeor
239239 108applicant,including,butnotlimitedto,thedenialoflicensure,surrenderofthelicense,
240240 109allowingthelicensetoexpireorlapse,ordiscontinuingorlimitingthepracticeofmedicine
241241 110whilesubjecttoaninvestigationorwhileactuallyunderinvestigationbyanylicensing
242242 111authority,medicalfacility,branchoftheArmedForcesoftheUnitedStatesofAmerica,
243243 112insurancecompany,court,agencyofthestateorfederalgovernment,oremployer;
244244 113 (9)Apersonisfinallyadjudgedincapacitatedordisabledbyacourtofcompetent
245245 114jurisdiction;
246246 115 (10)Assistingorenablinganypersontopracticeoroffertopracticeanyprofession
247247 116licensedorregulatedbythischapterwhoisnotregisteredandcurrentlyeligibletopractice
248248 117pursuanttothischapter;orknowinglyperforminganyactwhichinanywayaids,assists,
249249 118procures,advises,orencouragesanypersontopracticemedicinewhoisnotregisteredand
250250 119currentlyeligibletopracticepursuanttothischapter.Aphysicianwhoworksinaccordance
251251 SSHCSHBs115&99 7 120withstandingordersorprotocolsorinaccordancewiththeprovisionsofsection334.104
252252 121shallnotbeinviolationofthissubdivision;
253253 122 (11)Issuanceofacertificateofregistrationorauthority,permitorlicensebasedupon
254254 123amaterialmistakeoffact;
255255 124 (12)Failuretodisplayavalidcertificateorlicenseifsorequiredbythischapteror
256256 125anyrulepromulgatedpursuanttothischapter;
257257 126 (13)Violationofthedruglawsorrulesandregulationsofthisstate,includingbutnot
258258 127limitedtoanyprovisionofchapter195,anyotherstate,orthefederalgovernment;
259259 128 (14)Knowinglymaking,orcausingtobemade,oraiding,orabettinginthemaking
260260 129of,afalsestatementinanybirth,deathorothercertificateordocumentexecutedin
261261 130connectionwiththepracticeoftheperson'sprofession;
262262 131 (15)Knowinglymakingafalsestatement,orallyorinwritingtotheboard;
263263 132 (16)Solicitingpatronageinpersonorbyagentsorrepresentatives,orbyanyother
264264 133meansormanner,undertheperson'sownnameorunderthenameofanotherpersonor
265265 134concern,actualorpretended,insuchamannerastoconfuse,deceive,ormisleadthepublicas
266266 135totheneedornecessityfororappropriatenessofhealthcareservicesforallpatients,orthe
267267 136qualificationsofanindividualpersonorpersonstodiagnose,render,orperformhealthcare
268268 137services;
269269 138 (17)Using,orpermittingtheuseof,theperson'snameunderthedesignationof
270270 139"Doctor","Dr.","M.D.",or"D.O.",oranysimilardesignationwithreferencetothe
271271 140commercialexploitationofanygoods,waresormerchandise;
272272 141 (18)Knowinglymakingorcausingtobemadeafalsestatementormisrepresentation
273273 142ofamaterialfact,withintenttodefraud,forpaymentpursuanttotheprovisionsofchapter
274274 143208orchapter630orforpaymentfromTitleXVIIIorTitleXIXoftheSocialSecurityAct;
275275 144 (19)Failureorrefusaltoproperlyguardagainstcontagious,infectiousor
276276 145communicablediseasesorthespreadthereof;maintaininganunsanitaryofficeor
277277 146performingprofessionalservicesunderunsanitaryconditions;orfailuretoreportthe
278278 147existenceofanunsanitaryconditionintheofficeofaphysicianorinanyhealthcarefacility
279279 148totheboard,inwriting,withinthirtydaysafterthediscoverythereof;
280280 149 (20)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist,
281281 150payingorofferingtopayareferralfeeor[,notwithstandingsection334.010tothecontrary,
282282 151practicingorofferingtopracticeprofessionalphysicaltherapyindependentoftheprescription
283283 152anddirectionofapersonlicensedandregisteredasaphysicianandsurgeonpursuanttothis
284284 153chapter,asadentistpursuanttochapter332,asapodiatristpursuanttochapter330,asan
285285 154advancedpracticeregisterednurseunderchapter335,oranylicensedandregistered
286286 155physician,dentist,podiatrist,oradvancedpracticeregisterednursepracticinginanother
287287 SSHCSHBs115&99 8 156jurisdiction,whoselicenseisingoodstanding] evaluatingortreatingapatientina
288288 157mannerinconsistentwithsection334.506;
289289 158 (21)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist,
290290 159treatingorattemptingtotreatailmentsorotherhealthconditionsofhumanbeingsotherthan
291291 160byprofessionalphysicaltherapyandasauthorizedbysections334.500to334.620;
292292 161 (22)Anypersonlicensedtopracticeasaphysicianorsurgeon,requiring,asa
293293 162conditionofthephysician-patientrelationship,thatthepatientreceiveprescribeddrugs,
294294 163devicesorotherprofessionalservicesdirectlyfromfacilitiesofthatphysician'sofficeorother
295295 164entitiesunderthatphysician'sownershiporcontrol.Aphysicianshallprovidethepatient
296296 165withaprescriptionwhichmaybetakentothefacilityselectedbythepatientandaphysician
297297 166knowinglyfailingtodisclosetoapatientonaformapprovedbytheadvisorycommissionfor
298298 167professionalphysicaltherapistsasestablishedbysection334.625whichisdatedandsigned
299299 168byapatientorguardianacknowledgingthatthepatientorguardianhasreadandunderstands
300300 169thatthephysicianhasapecuniaryinterestinaphysicaltherapyorrehabilitationservice
301301 170providingprescribedtreatmentandthattheprescribedtreatmentisavailableonacompetitive
302302 171basis.Thissubdivisionshallnotapplytoareferralbyonephysiciantoanotherphysician
303303 172withinagroupofphysicianspracticingtogether;
304304 173 (23)Apatternofpersonaluseorconsumptionofanycontrolledsubstanceunlessitis
305305 174prescribed,dispensedoradministeredbyanotherphysicianwhoisauthorizedbylawtodoso;
306306 175 (24)Habitualintoxicationordependenceonalcohol,evidenceofwhichmayinclude
307307 176morethanonealcohol-relatedenforcementcontactasdefinedbysection302.525;
308308 177 (25)Failuretocomplywithatreatmentprogramoranaftercareprogramenteredinto
309309 178aspartofaboardorder,settlementagreementorlicensee'sprofessionalhealthprogram;
310310 179 (26)Revocation,suspension,limitation,probation,orrestrictionofanykind
311311 180whatsoeverofanycontrolledsubstanceauthority,whetheragreedtovoluntarilyornot,or
312312 181voluntaryterminationofacontrolledsubstanceauthoritywhileunderinvestigation;
313313 182 (27)Foraphysiciantooperate,conduct,manage,orestablishanabortionfacility,or
314314 183foraphysiciantoperformanabortioninanabortionfacility,ifsuchfacilitycomesunderthe
315315 184definitionofanambulatorysurgicalcenterpursuanttosections197.200to197.240,andsuch
316316 185facilityhasfailedtoobtainorrenewalicenseasanambulatorysurgicalcenter.
317317 186 3.Collaborativepracticearrangements,protocolsandstandingordersshallbein
318318 187writingandsignedanddatedbyaphysicianpriortotheirimplementation.
319319 188 4.Afterthefilingofsuchcomplaintbeforetheadministrativehearingcommission,
320320 189theproceedingsshallbeconductedinaccordancewiththeprovisionsofchapter621.Upona
321321 190findingbytheadministrativehearingcommissionthatthegrounds,providedinsubsection2
322322 191ofthissection,fordisciplinaryactionaremet,theboardmay,singlyorincombination,warn,
323323 192censureorplacethepersonnamedinthecomplaintonprobationonsuchtermsand
324324 SSHCSHBs115&99 9 193conditionsastheboarddeemsappropriateforaperiodnottoexceedtenyears,ormay
325325 194suspendtheperson'slicense,certificateorpermitforaperiodnottoexceedthreeyears,or
326326 195restrictorlimittheperson'slicense,certificateorpermitforanindefiniteperiodoftime,or
327327 196revoketheperson'slicense,certificate,orpermit,oradministerapublicorprivatereprimand,
328328 197ordenytheperson'sapplicationforalicense,orpermanentlywithholdissuanceofalicenseor
329329 198requirethepersontosubmittothecare,counselingortreatmentofphysiciansdesignatedby
330330 199theboardattheexpenseoftheindividualtobeexamined,orrequirethepersontoattendsuch
331331 200continuingeducationalcoursesandpasssuchexaminationsastheboardmaydirect.
332332 201 5.Inanyorderofrevocation,theboardmayprovidethatthepersonmaynotapplyfor
333333 202reinstatementoftheperson'slicenseforaperiodoftimerangingfromtwotosevenyears
334334 203followingthedateoftheorderofrevocation.Allstayordersshalltollthistimeperiod.
335335 204 6.Beforerestoringtogoodstandingalicense,certificateorpermitissuedpursuantto
336336 205thischapterwhichhasbeeninarevoked,suspendedorinactivestateforanycauseformore
337337 206thantwoyears,theboardmayrequiretheapplicanttoattendsuchcontinuingmedical
338338 207educationcoursesandpasssuchexaminationsastheboardmaydirect.
339339 208 7.Inanyinvestigation,hearingorotherproceedingtodeterminealicensee'sor
340340 209applicant'sfitnesstopractice,anyrecordrelatingtoanypatientofthelicenseeorapplicant
341341 210shallbediscoverablebytheboardandadmissibleintoevidence,regardlessofanystatutoryor
342342 211commonlawprivilegewhichsuchlicensee,applicant,recordcustodianorpatientmight
343343 212otherwiseinvoke.Inaddition,nosuchlicensee,applicant,orrecordcustodianmaywithhold
344344 213recordsortestimonybearinguponalicensee'sorapplicant'sfitnesstopracticeontheground
345345 214ofprivilegebetweensuchlicensee,applicantorrecordcustodianandapatient.
346346 215 8.Theactoflawfullydispensing,prescribing,administering,orotherwise
347347 216distributingivermectintabletsorhydroxychloroquinesulfatetabletsforhumanuseshall
348348 217notbegroundsfordenial,suspension,revocation,orotherdisciplinaryactionbytheboard.
349349 334.104.1.Aphysicianmayenterintocollaborativepracticearrangementswith
350350 2registeredprofessionalnurses.Collaborativepracticearrangementsshallbeintheformof
351351 3writtenagreements,jointlyagreed-uponprotocols,orstandingordersforthedeliveryof
352352 4healthcareservices.Collaborativepracticearrangements,whichshallbeinwriting,may
353353 5delegatetoaregisteredprofessionalnursetheauthoritytoadministerordispensedrugsand
354354 6providetreatmentaslongasthedeliveryofsuchhealthcareservicesiswithinthescopeof
355355 7practiceoftheregisteredprofessionalnurseandisconsistentwiththatnurse'sskill,training
356356 8andcompetence.
357357 9 2.(1)Collaborativepracticearrangements,whichshallbeinwriting,maydelegateto
358358 10aregisteredprofessionalnursetheauthoritytoadminister,dispenseorprescribedrugsand
359359 11providetreatmentiftheregisteredprofessionalnurseisanadvancedpracticeregisterednurse
360360 12asdefinedinsubdivision(2)ofsection335.016.Collaborativepracticearrangementsmay
361361 SSHCSHBs115&99 10 13delegatetoanadvancedpracticeregisterednurse,asdefinedinsection335.016,theauthority
362362 14toadminister,dispense,orprescribecontrolledsubstanceslistedinSchedulesIII,IV,andVof
363363 15section195.017,andScheduleII-hydrocodone;exceptthat,thecollaborativepractice
364364 16arrangementshallnotdelegatetheauthoritytoadministeranycontrolledsubstanceslistedin
365365 17SchedulesIII,IV,andVofsection195.017,orScheduleII-hydrocodoneforthepurposeof
366366 18inducingsedationorgeneralanesthesiafortherapeutic,diagnostic,orsurgicalprocedures.
367367 19ScheduleIIInarcoticcontrolledsubstanceandScheduleII-hydrocodoneprescriptionsshall
368368 20belimitedtoaonehundredtwenty-hoursupplywithoutrefill.
369369 21 (2)Notwithstandinganyotherprovisionofthissectiontothecontrary,a
370370 22collaborativepracticearrangementmaydelegatetoanadvancedpracticeregistered
371371 23nursetheauthoritytoadminister,dispense,orprescribeScheduleIIcontrolled
372372 24substancesforhospicepatients;provided,thattheadvancedpracticeregisterednurseis
373373 25employedbyahospiceprovidercertifiedpursuanttochapter197andtheadvanced
374374 26practiceregisterednurseisprovidingcaretohospicepatientspursuanttoa
375375 27collaborativepracticearrangementthatdesignatesthecertifiedhospiceasalocation
376376 28wheretheadvancedpracticeregisterednurseisauthorizedtopracticeandprescribe.
377377 29 (3)Suchcollaborativepracticearrangementsshallbeintheformofwritten
378378 30agreements,jointlyagreed-uponprotocolsorstandingordersforthedeliveryofhealthcare
379379 31services.
380380 32 (4)Anadvancedpracticeregisterednursemayprescribebuprenorphineforuptoa
381381 33thirty-daysupplywithoutrefillforpatientsreceivingmedication-assistedtreatmentfor
382382 34substanceusedisordersunderthedirectionofthecollaboratingphysician.
383383 35 3.Thewrittencollaborativepracticearrangementshallcontainatleastthefollowing
384384 36provisions:
385385 37 (1)Completenames,homeandbusinessaddresses,zipcodes,andtelephonenumbers
386386 38ofthecollaboratingphysicianandtheadvancedpracticeregisterednurse;
387387 39 (2)Alistofallotherofficesorlocationsbesidesthoselistedinsubdivision(1)ofthis
388388 40subsectionwherethecollaboratingphysicianauthorizedtheadvancedpracticeregistered
389389 41nursetoprescribe;
390390 42 (3)Arequirementthatthereshallbepostedateveryofficewheretheadvanced
391391 43practiceregisterednurseisauthorizedtoprescribe,incollaborationwithaphysician,a
392392 44prominentlydisplayeddisclosurestatementinformingpatientsthattheymaybeseenbyan
393393 45advancedpracticeregisterednurseandhavetherighttoseethecollaboratingphysician;
394394 46 (4)Allspecialtyorboardcertificationsofthecollaboratingphysicianandall
395395 47certificationsoftheadvancedpracticeregisterednurse;
396396 SSHCSHBs115&99 11 48 (5)Themannerofcollaborationbetweenthecollaboratingphysicianandthe
397397 49advancedpracticeregisterednurse,includinghowthecollaboratingphysicianandthe
398398 50advancedpracticeregisterednursewill:
399399 51 (a)Engageincollaborativepracticeconsistentwitheachprofessional'sskill,training,
400400 52education,andcompetence;
401401 53 (b)Maintaingeographicproximity,exceptasspecifiedinthisparagraph.The
402402 54followingprovisionsshallapplywithrespecttothisrequirement:
403403 55 a.UntilAugust28,2025,anadvancedpracticeregisterednurseproviding
404404 56servicesinacorrectionalcenter,asdefinedinsection217.010,andhisorher
405405 57collaboratingphysicianshallsatisfythegeographicproximityrequirementifthey
406406 58practicewithintwohundredmilesbyroadofoneanother.Anincarceratedpatientwho
407407 59requestsorrequiresaphysicianconsultationshallbetreatedbyaphysicianassoonas
408408 60appropriate;
409409 61 b.Thecollaborativepracticearrangementmayallowforgeographicproximitytobe
410410 62waivedforamaximumoftwenty-eightdayspercalendaryearforruralhealthclinicsas
411411 63definedbyP.L.95-210(42U.S.C.Section1395x,asamended), aslongasthecollaborative
412412 64practicearrangementincludesalternativeplansasrequiredinparagraph(c)ofthis
413413 65subdivision.Thisexceptiontogeographicproximityshallapplyonlytoindependentrural
414414 66healthclinics,provider-basedruralhealthclinicswheretheproviderisacriticalaccess
415415 67hospitalasprovidedin42U.S.C.Section1395i-4,andprovider-basedruralhealthclinics
416416 68wherethemainlocationofthehospitalsponsorisgreaterthanfiftymilesfromtheclinic[.];
417417 69 c.Thecollaborativepracticearrangementmayallowforgeographicproximity
418418 70tobewaivedwhenthearrangementoutlinestheuseoftelehealth,asdefinedinsection
419419 71191.1145;
420420 72 d.Inadditiontothewaiversandexemptionsprovidedinthissubsection,an
421421 73applicationforawaiverforanyotherreasonofanyapplicablegeographicproximity
422422 74shallbeavailableifaphysicianiscollaboratingwithanadvancedpracticeregistered
423423 75nurseinexcessofanygeographicproximitylimit.Theboardofnursingandthestate
424424 76boardofregistrationforthehealingartsshallrevieweachapplicationforawaiverof
425425 77geographicproximityandapprovetheapplicationiftheboardsdeterminethat
426426 78adequatesupervisionexistsbetweenthecollaboratingphysicianandtheadvanced
427427 79practiceregisterednurse.Theboardsshallhaveforty-fivecalendardaystoreviewthe
428428 80completedapplicationforthewaiverofgeographicproximity.Ifnoactionistakenby
429429 81theboardswithinforty-fivedaysafterthesubmissionoftheapplicationforawaiver,
430430 82thentheapplicationshallbedeemedapproved.Iftheapplicationisdeniedbythe
431431 83boards,theprovisionsofsection536.063forcontestedcasesshallapplyandgovern
432432 84proceedingsforappellatepurposes;and
433433 SSHCSHBs115&99 12 85 e.Thecollaboratingphysicianisrequiredtomaintaindocumentationrelatedtothis
434434 86requirementandtopresentittothestateboardofregistrationforthehealingartswhen
435435 87requested;and
436436 88 (c)Providecoverageduringabsence,incapacity,infirmity,oremergencybythe
437437 89collaboratingphysician;
438438 90 (6)Adescriptionoftheadvancedpracticeregisterednurse'scontrolledsubstance
439439 91prescriptiveauthorityincollaborationwiththephysician,includingalistofthecontrolled
440440 92substancesthephysicianauthorizesthenursetoprescribeanddocumentationthatitis
441441 93consistentwitheachprofessional'seducation,knowledge,skill,andcompetence;
442442 94 (7)Alistofallotherwrittenpracticeagreementsofthecollaboratingphysicianand
443443 95theadvancedpracticeregisterednurse;
444444 96 (8)Thedurationofthewrittenpracticeagreementbetweenthecollaborating
445445 97physicianandtheadvancedpracticeregisterednurse;
446446 98 (9)Adescriptionofthetimeandmannerofthecollaboratingphysician'sreviewof
447447 99theadvancedpracticeregisterednurse'sdeliveryofhealthcareservices.Thedescriptionshall
448448 100includeprovisionsthattheadvancedpracticeregisterednurseshallsubmitaminimumoften
449449 101percentofthechartsdocumentingtheadvancedpracticeregisterednurse'sdeliveryofhealth
450450 102careservicestothecollaboratingphysicianforreviewbythecollaboratingphysician,orany
451451 103otherphysiciandesignatedinthecollaborativepracticearrangement,everyfourteendays;
452452 104[and]
453453 105 (10)Thecollaboratingphysician,oranyotherphysiciandesignatedinthe
454454 106collaborativepracticearrangement,shallrevieweveryfourteendaysaminimumoftwenty
455455 107percentofthechartsinwhichtheadvancedpracticeregisterednurseprescribescontrolled
456456 108substances.Thechartsreviewedunderthissubdivisionmaybecountedinthenumberof
457457 109chartsrequiredtobereviewedundersubdivision(9)ofthissubsection; and
458458 110 (11)Ifacollaborativepracticearrangementisusedinclinicalsituationswherea
459459 111collaboratingadvancedpracticeregisterednurseprovideshealthcareservicesthat
460460 112includethediagnosisandinitiationoftreatmentforacutelyorchronicallyillorinjured
461461 113persons,thenthecollaboratingphysicianoranyotherphysiciandesignatedinthe
462462 114collaborativepracticearrangementshallbepresentforsufficientperiodsoftime,at
463463 115leastonceeverytwoweeks,exceptinextraordinarycircumstancesthatshallbe
464464 116documented,toparticipateinachartreviewandtoprovidenecessarymedicaldirection,
465465 117medicalservices,consultations,andsupervisionofthehealthcarestaff.
466466 118 4.Thestateboardofregistrationforthehealingartspursuanttosection334.125and
467467 119theboardofnursingpursuanttosection335.036mayjointlypromulgaterulesregulatingthe
468468 120useofcollaborativepracticearrangements.Suchrulesshallbelimitedto[specifying
469469 121geographicareastobecovered,] themethodsoftreatmentthatmaybecoveredby
470470 SSHCSHBs115&99 13 122collaborativepracticearrangementsandtherequirementsforreviewofservicesprovided
471471 123pursuanttocollaborativepracticearrangementsincludingdelegatingauthoritytoprescribe
472472 124controlledsubstances.Anyrulesrelatingtogeographicproximityshallallowa
473473 125collaboratingphysicianandacollaboratingadvancedpracticeregisterednurseto
474474 126practicewithintwohundredmilesbyroadofoneanotheruntilAugust28,2025,ifthe
475475 127nurseisprovidingservicesinacorrectionalcenter,asdefinedinsection217.010.Any
476476 128rulesrelatingtodispensingordistributionofmedicationsordevicesbyprescriptionor
477477 129prescriptiondrugordersunderthissectionshallbesubjecttotheapprovalofthestateboard
478478 130ofpharmacy.Anyrulesrelatingtodispensingordistributionofcontrolledsubstancesby
479479 131prescriptionorprescriptiondrugordersunderthissectionshallbesubjecttotheapprovalof
480480 132thedepartmentofhealthandseniorservicesandthestateboardofpharmacy.Inordertotake
481481 133effect,suchrulesshallbeapprovedbyamajorityvoteofaquorumofeachboard.Neitherthe
482482 134stateboardofregistrationforthehealingartsnortheboardofnursingmayseparately
483483 135promulgaterulesrelatingtocollaborativepracticearrangements.Suchjointlypromulgated
484484 136rulesshallbeconsistentwithguidelinesforfederallyfundedclinics.Therulemaking
485485 137authoritygrantedinthissubsectionshallnotextendtocollaborativepracticearrangementsof
486486 138hospitalemployeesprovidinginpatientcarewithinhospitalsasdefinedpursuanttochapter
487487 139197orpopulation-basedpublichealthservicesasdefinedby20CSR2150-5.100asofApril
488488 14030,2008.
489489 141 5.Thestateboardofregistrationforthehealingartsshallnotdeny,revoke,suspend
490490 142orotherwisetakedisciplinaryactionagainstaphysicianforhealthcareservicesdelegatedtoa
491491 143registeredprofessionalnurseprovidedtheprovisionsofthissectionandtherules
492492 144promulgatedthereunderaresatisfied.Uponthewrittenrequestofaphysiciansubjecttoa
493493 145disciplinaryactionimposedasaresultofanagreementbetweenaphysicianandaregistered
494494 146professionalnurseorregisteredphysicianassistant,whetherwrittenornot,priortoAugust
495495 14728,1993,allrecordsofsuchdisciplinarylicensureactionandallrecordspertainingtothe
496496 148filing,investigationorreviewofanallegedviolationofthischapterincurredasaresultof
497497 149suchanagreementshallberemovedfromtherecordsofthestateboardofregistrationforthe
498498 150healingartsandthedivisionofprofessionalregistrationandshallnotbedisclosedtoany
499499 151publicorprivateentityseekingsuchinformationfromtheboardorthedivision.Thestate
500500 152boardofregistrationforthehealingartsshalltakeactiontocorrectreportsofalleged
501501 153violationsanddisciplinaryactionsasdescribedinthissectionwhichhavebeensubmittedto
502502 154theNationalPractitionerDataBank.Insubsequentapplicationsorrepresentationsrelatingto
503503 155hisorhermedicalpractice,aphysiciancompletingformsordocumentsshallnotberequired
504504 156toreportanyactionsofthestateboardofregistrationforthehealingartsforwhichthe
505505 157recordsaresubjecttoremovalunderthissection.
506506 SSHCSHBs115&99 14 158 6.Withinthirtydaysofanychangeandoneachrenewal,thestateboardof
507507 159registrationforthehealingartsshallrequireeveryphysiciantoidentifywhetherthephysician
508508 160isengagedinanycollaborativepractice[agreement] arrangement, includingcollaborative
509509 161practice[agreements] arrangementsdelegatingtheauthoritytoprescribecontrolled
510510 162substances,orphysicianassistant[agreement] collaborativepracticearrangementand
511511 163alsoreporttotheboardthenameofeachlicensedprofessionalwithwhomthephysicianhas
512512 164enteredintosuch[agreement] arrangement. Theboard[may] shallmakethisinformation
513513 165availabletothepublic.Theboardshalltrackthereportedinformationandmayroutinely
514514 166conductrandomreviewsofsuch[agreements] arrangementstoensurethat[agreements]
515515 167arrangementsarecarriedoutforcomplianceunderthischapter.
516516 168 7.Notwithstandinganylawtothecontrary,acertifiedregisterednurseanesthetistas
517517 169definedinsubdivision(8)ofsection335.016shallbepermittedtoprovideanesthesiaservices
518518 170withoutacollaborativepracticearrangementprovidedthatheorsheisunderthesupervision
519519 171ofananesthesiologistorotherphysician,dentist,orpodiatristwhoisimmediatelyavailableif
520520 172needed.Nothinginthissubsectionshallbeconstruedtoprohibitorpreventacertified
521521 173registerednurseanesthetistasdefinedinsubdivision(8)ofsection335.016fromenteringinto
522522 174acollaborativepracticearrangementunderthissection,exceptthatthecollaborativepractice
523523 175arrangementmaynotdelegatetheauthoritytoprescribeanycontrolledsubstanceslistedin
524524 176SchedulesIII,IV,andVofsection195.017,orScheduleII-hydrocodone.
525525 177 8.Acollaboratingphysicianshallnotenterintoacollaborativepracticearrangement
526526 178withmorethansixfull-timeequivalentadvancedpracticeregisterednurses,full-time
527527 179equivalentlicensedphysicianassistants,orfull-timeequivalentassistantphysicians,orany
528528 180combinationthereof.Thislimitationshallnotapplytocollaborativearrangementsofhospital
529529 181employeesprovidinginpatientcareserviceinhospitalsasdefinedinchapter197or
530530 182population-basedpublichealthservicesasdefinedby20CSR2150-5.100asofApril30,
531531 1832008,ortoacertifiedregisterednurseanesthetistprovidinganesthesiaservicesunderthe
532532 184supervisionofananesthesiologistorotherphysician,dentist,orpodiatristwhoisimmediately
533533 185availableifneededassetoutinsubsection7ofthissection.
534534 186 9.Itistheresponsibilityofthecollaboratingphysiciantodetermineanddocument
535535 187thecompletionofatleastaone-monthperiodoftimeduringwhichtheadvancedpractice
536536 188registerednurseshallpracticewiththecollaboratingphysiciancontinuouslypresentbefore
537537 189practicinginasettingwherethecollaboratingphysicianisnotcontinuouslypresent.This
538538 190limitationshallnotapplytocollaborativearrangementsofprovidersofpopulation-based
539539 191publichealthservicesasdefinedby20CSR2150-5.100asofApril30,2008, orto
540540 192collaborativepracticearrangementsbetweenaprimarycarephysicianandaprimary
541541 193careadvancedpracticeregisterednurseorabehavioralhealthphysiciananda
542542 194behavioralhealthadvancedpracticeregisterednurse,wherethecollaboratingphysician
543543 SSHCSHBs115&99 15 195isnewtoapatientpopulationtowhichtheadvancedpracticeregisterednurseis
544544 196familiar.
545545 197 10.Noagreementmadeunderthissectionshallsupersedecurrenthospitallicensing
546546 198regulationsgoverninghospitalmedicationordersunderprotocolsorstandingordersforthe
547547 199purposeofdeliveringinpatientoremergencycarewithinahospitalasdefinedinsection
548548 200197.020ifsuchprotocolsorstandingordershavebeenapprovedbythehospital'smedical
549549 201staffandpharmaceuticaltherapeuticscommittee.
550550 202 11.Nocontractorother[agreement] termofemploymentshallrequireaphysician
551551 203toactasacollaboratingphysicianforanadvancedpracticeregisterednurseagainstthe
552552 204physician'swill.Aphysicianshallhavetherighttorefusetoactasacollaboratingphysician,
553553 205withoutpenalty,foraparticularadvancedpracticeregisterednurse.Nocontractorother
554554 206agreementshalllimitthecollaboratingphysician'sultimateauthorityoveranyprotocolsor
555555 207standingordersorinthedelegationofthephysician'sauthoritytoanyadvancedpractice
556556 208registerednurse,butthisrequirementshallnotauthorizeaphysicianinimplementingsuch
557557 209protocols,standingorders,ordelegationtoviolateapplicablestandardsforsafemedical
558558 210practiceestablishedbyhospital'smedicalstaff.
559559 211 12.Nocontractorother[agreement] termofemploymentshallrequireany
560560 212advancedpracticeregisterednursetoserveasacollaboratingadvancedpracticeregistered
561561 213nurseforanycollaboratingphysicianagainsttheadvancedpracticeregisterednurse'swill.
562562 214Anadvancedpracticeregisterednurseshallhavetherighttorefusetocollaborate,without
563563 215penalty,withaparticularphysician.
564564 334.506.1.Asusedinthissection,thefollowingtermsmean:
565565 2 (1)"Approvedhealthcareprovider"[means], apersonholdingacurrentandactive
566566 3licenseasaphysicianandsurgeonunderthischapter,achiropractorunderchapter331,a
567567 4dentistunderchapter332,apodiatristunderchapter330,aphysicianassistantunderthis
568568 5chapter,anadvancedpracticeregisterednurseunderchapter335,oranylicensedand
569569 6registeredphysician,chiropractor,dentist,orpodiatristpracticinginanotherjurisdiction
570570 7whoselicenseisingoodstanding;
571571 8 (2)"Consult"or"consultation",communicationbytelephone,byfax,in
572572 9writing,orinpersonwiththepatient'spersonallyapprovedlicensedhealthcare
573573 10provideroralicensedhealthcareproviderofthepatient'sdesignation.
574574 11 2.Aphysicaltherapist[shallnot]mayevaluateandinitiatetreatment[foranew
575575 12injuryorillness] onapatientwithoutaprescriptionorreferralfromanapprovedhealthcare
576576 13provider, providedthatthephysicaltherapisthasadoctorateofphysicaltherapydegree
577577 14orhasfiveyearsofclinicalpracticeasaphysicaltherapist.
578578 15 3.Aphysicaltherapistmayprovideeducationalresourcesandtraining,develop
579579 16fitnessorwellnessprograms[forasymptomaticpersons], orprovidescreeningorconsultative
580580 SSHCSHBs115&99 16 17serviceswithinthescopeofphysicaltherapypracticewithout[the]aprescription[and
581581 18directionof]orreferralfromanapprovedhealthcareprovider.
582582 19 4.[Aphysicaltherapistmayexamineandtreatwithouttheprescriptionanddirection
583583 20ofanapprovedhealthcareprovideranypersonwitharecurringself-limitedinjurywithinone
584584 21yearofdiagnosisbyanapprovedhealthcareproviderorachronicillnessthathasbeen
585585 22previouslydiagnosedbyanapprovedhealthcareprovider.Thephysicaltherapistshall:]
586586 23 (1)[Contactthepatient'scurrentapprovedhealthcareproviderwithinsevendaysof
587587 24initiatingphysicaltherapyservicesunderthissubsection;] Aphysicaltherapistshallrefer
588588 25toanapprovedhealthcareprovideranypatientwhoseconditionatthetimeof
589589 26evaluationortreatmentisdeterminedtobebeyondthescopeofpracticeofphysical
590590 27therapy.Thephysicaltherapistshallnotprovidephysicaltherapyservicesortreatment
591591 28afterthisreferralhasbeenmade.
592592 29 (2)[Notchangeanexistingphysicaltherapyreferralavailabletothephysical
593593 30therapistwithoutapprovalofthepatient'scurrentapprovedhealthcareprovider;] Aphysical
594594 31therapistshallrefertoanapprovedhealthcareprovideranypatientwhodoesnot
595595 32demonstratemeasurableorfunctionalimprovementaftertenvisitsorthirtydays,
596596 33whicheveroccursfirst.Thephysicaltherapistshallnotprovidefurthertherapyservices
597597 34ortreatmentafterthisreferralhasbeenmade.
598598 35 (3)[Refertoanapprovedhealthcareprovideranypatientwhosemedicalconditionat
599599 36thetimeofexaminationortreatmentisdeterminedtobebeyondthescopeofpracticeof
600600 37physicaltherapy;
601601 38 (4)Refertoanapprovedhealthcareprovideranypatientwhoseconditionforwhich
602602 39physicaltherapyservicesarerenderedunderthissubsectionhasnotbeendocumentedtobe
603603 40progressingtowarddocumentedtreatmentgoalsaftersixvisitsorfourteendays,whichever
604604 41firstoccurs;
605605 42 (5)Notifythepatient'scurrentapprovedhealthcareproviderpriortothecontinuation
606606 43oftreatmentiftreatmentrenderedunderthissubsectionistocontinuebeyondthirtydays.
607607 44Thephysicaltherapistshallprovidesuchnotificationforeachsuccessiveperiodofthirty
608608 45days.](a)Aphysicaltherapistshallconsultwithanapprovedhealthcareproviderif,
609609 46aftereverytenvisitsorthirtydays,whicheveroccursfirst,thepatienthasdemonstrated
610610 47measurableorfunctionalimprovementfromthecourseofphysicaltherapyservicesor
611611 48treatmentprovidedandthephysicaltherapistbelievesthatcontinuationofthecourseof
612612 49physicaltherapyservicesortreatmentisreasonableandnecessarybasedonthephysical
613613 50therapist'sevaluationofthepatient.Thephysicaltherapistshallnotprovidefurther
614614 51physicaltherapyservicesortreatmentuntiltheconsultationhasoccurred.
615615 52 (b)Theconsultationwiththeapprovedhealthcareprovidershallinclude
616616 53informationconcerning:
617617 SSHCSHBs115&99 17 54 a.Thepatient'sconditionforwhichphysicaltherapyservicesortreatmentswere
618618 55provided;
619619 56 b.Thebasisforthecourseofservicesortreatmentindicated,asdetermined
620620 57fromthephysicaltherapyevaluationofthepatient;
621621 58 c.Thephysicaltherapyservicesortreatmentprovidedbeforethedateofthe
622622 59consultation;
623623 60 d.Thepatient'sdemonstratedmeasurableorfunctionalimprovementfromthe
624624 61servicesortreatmentprovidedbeforethedateoftheconsultation;
625625 62 e.Thecontinuingphysicaltherapyservicesortreatmentproposedtobe
626626 63providedfollowingtheconsultation;and
627627 64 f.Theprofessionalphysicaltherapybasisforthecontinuedphysicaltherapy
628628 65servicesortreatmenttobeprovided.
629629 66 (c)Continuedphysicaltherapyservicesortreatmentfollowingtheconsultation
630630 67withandapprovalbyanapprovedhealthcareprovidershallproceedinaccordance
631631 68withanyfeedback,advice,opinion,ordirectionoftheapprovedhealthcareprovider.
632632 69Thephysicaltherapistshallnotifytheconsultingapprovedhealthcareproviderof
633633 70continuingphysicaltherapyservicesortreatmentandthepatient'sprogressatleast
634634 71everytenvisitsorthirtydaysaftertheinitialconsultationunlesstheconsulting
635635 72approvedhealthcareproviderdirectsotherwise.
636636 73 (d)Theprovisionsofthissubdivisionshallnotapplytophysicaltherapyservices
637637 74performedwithinaprimaryorsecondaryschoolforindividualswithinagesnotin
638638 75excessoftwenty-oneyears.
639639 76 5.Theprovisionofphysicaltherapyservicesofevaluationandscreeningpursuantto
640640 77thissectionshallbelimitedtoaphysicaltherapist,andanyauthorityforevaluationand
641641 78screeninggrantedwithinthissectionmaynotbedelegated.Uponeachreinitiationof
642642 79physicaltherapyservices,aphysicaltherapistshallprovideafullphysicaltherapyevaluation
643643 80priortothereinitiationofphysicaltherapytreatment.[Physicaltherapytreatmentprovided
644644 81pursuanttotheprovisionsofsubsection4ofthissectionmaybedelegatedbyphysical
645645 82therapiststophysicaltherapistassistantsonlyifthepatient'scurrentapprovedhealthcare
646646 83providerhasbeensoinformedaspartofthephysicaltherapist'sseven-daynotificationupon
647647 84reinitiationofphysicaltherapyservicesasrequiredinsubsection4ofthissection.] Nothing
648648 85inthissubsectionshallbeconstruedastolimittheabilityofphysicaltherapistsorphysical
649649 86therapistassistantstoprovidephysicaltherapyservicesinaccordancewiththeprovisionsof
650650 87thischapter,anduponthereferralofanapprovedhealthcareprovider.Nothinginthis
651651 88subsectionshallprohibitanapprovedhealthcareproviderfromactingwithinthescopeof
652652 89theirpracticeasdefinedbytheapplicablechaptersofRSMo.
653653 SSHCSHBs115&99 18 90 6.Nopersonlicensedtopractice,orapplicantforlicensure,asaphysicaltherapistor
654654 91physicaltherapistassistantshallmakeamedicaldiagnosis.
655655 92 7.Aphysicaltherapistshallonlydelegatephysicaltherapytreatmenttoaphysical
656656 93therapistassistantortoapersoninanentrylevelofaprofessionaleducationprogram
657657 94approvedbytheCommissiononAccreditationinPhysicalTherapyEducation(CAPTE)who
658658 95satisfiessupervisedclinicaleducationrequirementsrelatedtotheperson'sphysicaltherapist
659659 96orphysicaltherapistassistanteducation.Theentry-levelpersonshallbeunderthe
660660 97supervisionofaphysicaltherapist.
661661 334.613.1.Theboardmayrefusetoissueorrenewalicensetopracticeasaphysical
662662 2therapistorphysicaltherapistassistantforoneoranycombinationofcausesstatedin
663663 3subsection2ofthissection.Theboardshallnotifytheapplicantinwritingofthereasonsfor
664664 4therefusalandshalladvisetheapplicantoftheapplicant'srighttofileacomplaintwiththe
665665 5administrativehearingcommissionasprovidedbychapter621.Asanalternativetoarefusal
666666 6toissueorrenewalicensetopracticeasaphysicaltherapistorphysicaltherapistassistant,the
667667 7boardmay,atitsdiscretion,issuealicensewhichissubjecttoprobation,restriction,or
668668 8limitationtoanapplicantforlicensureforanyoneoranycombinationofcausesstatedin
669669 9subsection2ofthissection.Theboard'sorderofprobation,limitation,orrestrictionshall
670670 10containastatementofthedisciplineimposed,thebasistherefor,thedatesuchactionshall
671671 11becomeeffective,andastatementthattheapplicanthasthirtydaystorequestinwritinga
672672 12hearingbeforetheadministrativehearingcommission.Iftheboardissuesaprobationary,
673673 13limited,orrestrictedlicensetoanapplicantforlicensure,eitherpartymayfileawritten
674674 14petitionwiththeadministrativehearingcommissionwithinthirtydaysoftheeffectivedateof
675675 15theprobationary,limited,orrestrictedlicenseseekingreviewoftheboard'sdetermination.If
676676 16nowrittenrequestforahearingisreceivedbytheadministrativehearingcommissionwithin
677677 17thethirty-dayperiod,therighttoseekreviewoftheboard'sdecisionshallbeconsideredas
678678 18waived.
679679 19 2.Theboardmaycauseacomplainttobefiledwiththeadministrativehearing
680680 20commissionasprovidedbychapter621againstanyholderofalicensetopracticeasa
681681 21physicaltherapistorphysicaltherapistassistantwhohasfailedtoreneworhassurrendered
682682 22hisorherlicenseforanyoneoranycombinationofthefollowingcauses:
683683 23 (1)Useofanycontrolledsubstance,asdefinedinchapter195,oralcoholicbeverage
684684 24toanextentthatsuchuseimpairsaperson'sabilitytoperformtheworkofaphysicaltherapist
685685 25orphysicaltherapistassistant;
686686 26 (2)Thepersonhasbeenfinallyadjudicatedandfoundguilty,orenteredapleaof
687687 27guiltyornolocontendere,inacriminalprosecutionunderthelawsofanystate,oftheUnited
688688 28States,orofanycountry,foranyoffensedirectlyrelatedtothedutiesandresponsibilitiesof
689689 SSHCSHBs115&99 19 29theoccupation,assetforthinsection324.012,regardlessofwhetherornotsentenceis
690690 30imposed;
691691 31 (3)Useoffraud,deception,misrepresentation,orbriberyinsecuringanycertificate
692692 32ofregistrationorauthority,permit,orlicenseissuedunderthischapterorinobtaining
693693 33permissiontotakeanyexaminationgivenorrequiredunderthischapter;
694694 34 (4)Misconduct,fraud,misrepresentation,dishonesty,unethicalconduct,or
695695 35unprofessionalconductintheperformanceofthefunctionsordutiesofaphysicaltherapist
696696 36orphysicaltherapistassistant,includingbutnotlimitedtothefollowing:
697697 37 (a)Obtainingorattemptingtoobtainanyfee,charge,tuition,orothercompensation
698698 38byfraud,deception,ormisrepresentation;willfullyandcontinuallyoverchargingor
699699 39overtreatingpatients;orchargingforsessionsofphysicaltherapywhichdidnotoccur
700700 40unlesstheserviceswerecontractedforinadvance,orforserviceswhichwerenotrenderedor
701701 41documentedinthepatient'srecords;
702702 42 (b)Attempting,directlyorindirectly,bywayofintimidation,coercion,ordeception,
703703 43toobtainorretainapatientordiscouragetheuseofasecondopinionorconsultation;
704704 44 (c)Willfullyandcontinuallyperforminginappropriateorunnecessarytreatmentor
705705 45services;
706706 46 (d)Delegatingprofessionalresponsibilitiestoapersonwhoisnotqualifiedby
707707 47training,skill,competency,age,experience,orlicensuretoperformsuchresponsibilities;
708708 48 (e)Misrepresentingthatanydisease,ailment,orinfirmitycanbecuredbyamethod,
709709 49procedure,treatment,medicine,ordevice;
710710 50 (f)Performingserviceswhichhavebeendeclaredbyboardruletobeofnophysical
711711 51therapyvalue;
712712 52 (g)Finaldisciplinaryactionbyanyprofessionalassociation,professionalsociety,
713713 53licensedhospitalormedicalstaffofthehospital,orphysicaltherapyfacilityinthisorany
714714 54otherstateorterritory,whetheragreedtovoluntarilyornot,andincludingbutnotlimitedto
715715 55anyremoval,suspension,limitation,orrestrictionoftheperson'sprofessionalemployment,
716716 56malpractice,oranyotherviolationofanyprovisionofthischapter;
717717 57 (h)Administeringtreatmentwithoutsufficientexamination,orforotherthan
718718 58medicallyacceptedtherapeuticorexperimentalorinvestigativepurposesdulyauthorizedbya
719719 59stateorfederalagency,ornotinthecourseofprofessionalphysicaltherapypractice;
720720 60 (i)Engaginginorsolicitingsexualrelationships,whetherconsensualor
721721 61nonconsensual,whileaphysicaltherapistorphysicaltherapistassistant/patientrelationship
722722 62exists;makingsexualadvances,requestingsexualfavors,orengaginginotherverbalconduct
723723 63orphysicalcontactofasexualnaturewithpatientsorclients;
724724 64 (j)Terminatingthecareofapatientwithoutadequatenoticeorwithoutmakingother
725725 65arrangementsforthecontinuedcareofthepatient;
726726 SSHCSHBs115&99 20 66 (k)Failingtofurnishdetailsofapatient'sphysicaltherapyrecordstotreating
727727 67physicians,otherphysicaltherapists,orhospitalsuponproperrequest;orfailingtocomply
728728 68withanyotherlawrelatingtophysicaltherapyrecords;
729729 69 (l)Failureofanyapplicantorlicensee,otherthanthelicenseesubjecttothe
730730 70investigation,tocooperatewiththeboardduringanyinvestigation;
731731 71 (m)Failuretocomplywithanysubpoenaorsubpoenaducestecumfromtheboardor
732732 72anorderoftheboard;
733733 73 (n)Failuretotimelypaylicenserenewalfeesspecifiedinthischapter;
734734 74 (o)Violatingaprobationagreementwiththisboardoranyotherlicensingagency;
735735 75 (p)Failingtoinformtheboardofthephysicaltherapist'sorphysicaltherapist
736736 76assistant'scurrenttelephonenumber,residence,andbusinessaddress;
737737 77 (q)Advertisingbyanapplicantorlicenseewhichisfalseormisleading,orwhich
738738 78violatesanyruleoftheboard,orwhichclaimswithoutsubstantiationthepositivecureofany
739739 79disease,orprofessionalsuperioritytoorgreaterskillthanthatpossessedbyanyother
740740 80physicaltherapistorphysicaltherapistassistant.Anapplicantorlicenseeshallalsobein
741741 81violationofthisprovisioniftheapplicantorlicenseehasafinancialinterestinany
742742 82organization,corporation,orassociationwhichissuesorconductssuchadvertising;
743743 83 (5)Anyconductorpracticewhichisormightbeharmfulordangeroustothemental
744744 84orphysicalhealthofapatientorthepublic;orincompetency,grossnegligence,orrepeated
745745 85negligenceintheperformanceofthefunctionsordutiesofaphysicaltherapistorphysical
746746 86therapistassistant.Forthepurposesofthissubdivision,"repeatednegligence"meansthe
747747 87failure,onmorethanoneoccasion,tousethatdegreeofskillandlearningordinarilyused
748748 88underthesameorsimilarcircumstancesbythememberoftheapplicant'sorlicensee's
749749 89profession;
750750 90 (6)Violationof,orattemptingtoviolate,directlyorindirectly,orassistingor
751751 91enablinganypersontoviolate,anyprovisionofthischapter,orofanylawfulruleadopted
752752 92underthischapter;
753753 93 (7)Impersonationofanypersonlicensedasaphysicaltherapistorphysicaltherapist
754754 94assistantorallowinganypersontousehisorherlicenseordiplomafromanyschool;
755755 95 (8)Revocation,suspension,restriction,modification,limitation,reprimand,warning,
756756 96censure,probation,orotherfinaldisciplinaryactionagainstaphysicaltherapistorphysical
757757 97therapistassistantforalicenseorotherrighttopracticeasaphysicaltherapistorphysical
758758 98therapistassistantbyanotherstate,territory,federalagencyorcountry,whetherornot
759759 99voluntarilyagreedtobythelicenseeorapplicant,includingbutnotlimitedtothedenialof
760760 100licensure,surrenderofthelicense,allowingthelicensetoexpireorlapse,ordiscontinuingor
761761 101limitingthepracticeofphysicaltherapywhilesubjecttoaninvestigationorwhileactually
762762 102underinvestigationbyanylicensingauthority,medicalfacility,branchoftheArmedForces
763763 SSHCSHBs115&99 21 103oftheUnitedStatesofAmerica,insurancecompany,court,agencyofthestateorfederal
764764 104government,oremployer;
765765 105 (9)Apersonisfinallyadjudgedincapacitatedordisabledbyacourtofcompetent
766766 106jurisdiction;
767767 107 (10)Assistingorenablinganypersontopracticeoroffertopracticewhoisnot
768768 108licensedandcurrentlyeligibletopracticeunderthischapter;orknowinglyperforminganyact
769769 109whichinanywayaids,assists,procures,advises,orencouragesanypersontopractice
770770 110physicaltherapywhoisnotlicensedandcurrentlyeligibletopracticeunderthischapter;
771771 111 (11)Issuanceofalicensetopracticeasaphysicaltherapistorphysicaltherapist
772772 112assistantbaseduponamaterialmistakeoffact;
773773 113 (12)Failuretodisplayavalidlicensepursuanttopracticeasaphysicaltherapistor
774774 114physicaltherapistassistant;
775775 115 (13)Knowinglymaking,orcausingtobemade,oraiding,orabettinginthemaking
776776 116of,afalsestatementinanydocumentexecutedinconnectionwiththepracticeofphysical
777777 117therapy;
778778 118 (14)Solicitingpatronageinpersonorbyagentsorrepresentatives,orbyanyother
779779 119meansormanner,undertheperson'sownnameorunderthenameofanotherpersonor
780780 120concern,actualorpretended,insuchamannerastoconfuse,deceive,ormisleadthepublicas
781781 121totheneedornecessityfororappropriatenessofphysicaltherapyservicesforallpatients,or
782782 122thequalificationsofanindividualpersonorpersonstorender,orperformphysicaltherapy
783783 123services;
784784 124 (15)Using,orpermittingtheuseof,theperson'snameunderthedesignationof
785785 125"physicaltherapist","physiotherapist","registeredphysicaltherapist","P.T.","Ph.T.",
786786 126"P.T.T.","D.P.T.","M.P.T."or"R.P.T.","physicaltherapistassistant","P.T.A.","L.P.T.A.",
787787 127"C.P.T.A.",oranysimilardesignationwithreferencetothecommercialexploitationofany
788788 128goods,waresormerchandise;
789789 129 (16)Knowinglymakingorcausingtobemadeafalsestatementormisrepresentation
790790 130ofamaterialfact,withintenttodefraud,forpaymentunderchapter208orchapter630orfor
791791 131paymentfromTitleXVIIIorTitleXIXoftheSocialSecurityAct;
792792 132 (17)Failureorrefusaltoproperlyguardagainstcontagious,infectious,or
793793 133communicablediseasesorthespreadthereof;maintaininganunsanitaryfacilityor
794794 134performingprofessionalservicesunderunsanitaryconditions;orfailuretoreportthe
795795 135existenceofanunsanitaryconditioninanyphysicaltherapyfacilitytotheboard,inwriting,
796796 136withinthirtydaysafterthediscoverythereof;
797797 137 (18)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist
798798 138orphysicaltherapistassistantpayingorofferingtopayareferralfeeor[,notwithstanding
799799 139section334.010tothecontrary,practicingorofferingtopracticeprofessionalphysical
800800 SSHCSHBs115&99 22 140therapyindependentoftheprescriptionanddirectionofapersonlicensedandregisteredasa
801801 141physicianandsurgeonunderthischapter,asaphysicianassistantunderthischapter,asa
802802 142chiropractorunderchapter331,asadentistunderchapter332,asapodiatristunderchapter
803803 143330,asanadvancedpracticeregisterednurseunderchapter335,oranylicensedand
804804 144registeredphysician,chiropractor,dentist,podiatrist,oradvancedpracticeregisterednurse
805805 145practicinginanotherjurisdiction,whoselicenseisingoodstanding] evaluatingortreatinga
806806 146patientinamannerinconsistentwithsection334.506;
807807 147 (19)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist
808808 148orphysicaltherapistassistanttreatingorattemptingtotreatailmentsorotherhealth
809809 149conditionsofhumanbeingsotherthanbyprofessionalphysicaltherapyandasauthorizedby
810810 150sections334.500to334.685;
811811 151 (20)Apatternofpersonaluseorconsumptionofanycontrolledsubstanceunlessitis
812812 152prescribed,dispensed,oradministeredbyaphysicianwhoisauthorizedbylawtodoso;
813813 153 (21)Failingtomaintainadequatepatientrecordsundersection334.602;
814814 154 (22)Attemptingtoengageinconductthatsubvertsorunderminestheintegrityofthe
815815 155licensingexaminationorthelicensingexaminationprocess,includingbutnotlimitedto
816816 156utilizinginanymannerrecalledormemorizedlicensingexaminationquestionsfromorwith
817817 157anypersonorentity,failingtocomplywithalltestcentersecurityprocedures,communicating
818818 158orattemptingtocommunicatewithanyotherexamineesduringthetest,orcopyingorsharing
819819 159licensingexaminationquestionsorportionsofquestions;
820820 160 (23)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist
821821 161orphysicaltherapistassistantwhorequests,receives,participatesorengagesdirectlyor
822822 162indirectlyinthedivision,transferring,assigning,rebatingorrefundingoffeesreceivedfor
823823 163professionalservicesorprofitsbymeansofacreditorothervaluableconsiderationsuchas
824824 164wages,anunearnedcommission,discountorgratuitywithanypersonwhoreferredapatient,
825825 165orwithanyrelativeorbusinessassociateofthereferringperson;
826826 166 (24)Beingunabletopracticeasaphysicaltherapistorphysicaltherapistassistant
827827 167withreasonableskillandsafetytopatientsbyreasonsofincompetency,orbecauseofillness,
828828 168drunkenness,excessiveuseofdrugs,narcotics,chemicals,orasaresultofanymentalor
829829 169physicalcondition.Thefollowingshallapplytothissubdivision:
830830 170 (a)Inenforcingthissubdivisiontheboardshall,afterahearingbytheboard,upona
831831 171findingofprobablecause,requireaphysicaltherapistorphysicaltherapistassistanttosubmit
832832 172toareexaminationforthepurposeofestablishinghisorhercompetencytopracticeasa
833833 173physicaltherapistorphysicaltherapistassistantconductedinaccordancewithrulesadopted
834834 174forthispurposebytheboard,includingrulestoallowtheexaminationofthepatternand
835835 175practiceofsuchphysicaltherapist'sorphysicaltherapistassistant'sprofessionalconduct,orto
836836 SSHCSHBs115&99 23 176submittoamentalorphysicalexaminationorcombinationthereofbyafacilityor
837837 177professionalapprovedbytheboard;
838838 178 (b)Forthepurposeofthissubdivision,everyphysicaltherapistandphysicaltherapist
839839 179assistantlicensedunderthischapterisdeemedtohaveconsentedtosubmittoamentalor
840840 180physicalexaminationwhendirectedinwritingbytheboard;
841841 181 (c)Inadditiontoorderingaphysicalormentalexaminationtodeterminecompetency,
842842 182theboardmay,notwithstandinganyotherlawlimitingaccesstomedicalorotherhealthdata,
843843 183obtainmedicaldataandhealthrecordsrelatingtoaphysicaltherapist,physicaltherapist
844844 184assistantorapplicantwithoutthephysicaltherapist's,physicaltherapistassistant'sor
845845 185applicant'sconsent;
846846 186 (d)Writtennoticeofthereexaminationorthephysicalormentalexaminationshallbe
847847 187senttothephysicaltherapistorphysicaltherapistassistant,byregisteredmail,addressedto
848848 188thephysicaltherapistorphysicaltherapistassistantatthephysicaltherapist'sorphysical
849849 189therapistassistant'slastknownaddress.Failureofaphysicaltherapistorphysicaltherapist
850850 190assistanttosubmittotheexaminationwhendirectedshallconstituteanadmissionofthe
851851 191allegationsagainstthephysicaltherapistorphysicaltherapistassistant,inwhichcasethe
852852 192boardmayenterafinalorderwithoutthepresentationofevidence,unlessthefailurewasdue
853853 193tocircumstancesbeyondthephysicaltherapist'sorphysicaltherapistassistant'scontrol.A
854854 194physicaltherapistorphysicaltherapistassistantwhoserighttopracticehasbeenaffected
855855 195underthissubdivisionshall,atreasonableintervals,beaffordedanopportunityto
856856 196demonstratethatthephysicaltherapistorphysicaltherapistassistantcanresumethe
857857 197competentpracticeasaphysicaltherapistorphysicaltherapistassistantwithreasonableskill
858858 198andsafetytopatients;
859859 199 (e)Inanyproceedingunderthissubdivisionneithertherecordofproceedingsnorthe
860860 200ordersenteredbytheboardshallbeusedagainstaphysicaltherapistorphysicaltherapist
861861 201assistantinanyotherproceeding.Proceedingsunderthissubdivisionshallbeconductedby
862862 202theboardwithoutthefilingofacomplaintwiththeadministrativehearingcommission;
863863 203 (f)Whentheboardfindsanypersonunqualifiedbecauseofanyofthegroundsset
864864 204forthinthissubdivision,itmayenteranorderimposingoneormoreofthedisciplinary
865865 205measuressetforthinsubsection3ofthissection.
866866 206 3.Afterthefilingofsuchcomplaintbeforetheadministrativehearingcommission,
867867 207theproceedingsshallbeconductedinaccordancewiththeprovisionsofchapter621.Upona
868868 208findingbytheadministrativehearingcommissionthatthegroundsprovidedinsubsection2
869869 209ofthissectionfordisciplinaryactionaremet,theboardmay,singlyorincombination:
870870 210 (1)Warn,censureorplacethephysicaltherapistorphysicaltherapistassistantnamed
871871 211inthecomplaintonprobationonsuchtermsandconditionsastheboarddeemsappropriate
872872 212foraperiodnottoexceedtenyears;
873873 SSHCSHBs115&99 24 213 (2)Suspendthephysicaltherapist'sorphysicaltherapistassistant'slicensefora
874874 214periodnottoexceedthreeyears;
875875 215 (3)Restrictorlimitthephysicaltherapist'sorphysicaltherapistassistant'slicensefor
876876 216anindefiniteperiodoftime;
877877 217 (4)Revokethephysicaltherapist'sorphysicaltherapistassistant'slicense;
878878 218 (5)Administerapublicorprivatereprimand;
879879 219 (6)Denythephysicaltherapist'sorphysicaltherapistassistant'sapplicationfora
880880 220license;
881881 221 (7)Permanentlywithholdissuanceofalicense;
882882 222 (8)Requirethephysicaltherapistorphysicaltherapistassistanttosubmittothecare,
883883 223counselingortreatmentofphysiciansdesignatedbytheboardattheexpenseofthephysical
884884 224therapistorphysicaltherapistassistanttobeexamined;
885885 225 (9)Requirethephysicaltherapistorphysicaltherapistassistanttoattendsuch
886886 226continuingeducationalcoursesandpasssuchexaminationsastheboardmaydirect.
887887 227 4.Inanyorderofrevocation,theboardmayprovidethatthephysicaltherapistor
888888 228physicaltherapistassistantshallnotapplyforreinstatementofthephysicaltherapist'sor
889889 229physicaltherapistassistant'slicenseforaperiodoftimerangingfromtwotosevenyears
890890 230followingthedateoftheorderofrevocation.Allstayordersshalltollthistimeperiod.
891891 231 5.Beforerestoringtogoodstandingalicenseissuedunderthischapterwhichhas
892892 232beeninarevoked,suspended,orinactivestateforanycauseformorethantwoyears,the
893893 233boardmayrequiretheapplicanttoattendsuchcontinuingmedicaleducationcoursesandpass
894894 234suchexaminationsastheboardmaydirect.
895895 235 6.Inanyinvestigation,hearingorotherproceedingtodetermineaphysical
896896 236therapist's,physicaltherapistassistant'sorapplicant'sfitnesstopractice,anyrecordrelatingto
897897 237anypatientofthephysicaltherapist,physicaltherapistassistant,orapplicantshallbe
898898 238discoverablebytheboardandadmissibleintoevidence,regardlessofanystatutoryor
899899 239commonlawprivilegewhichsuchphysicaltherapist,physicaltherapistassistant,applicant,
900900 240recordcustodian,orpatientmightotherwiseinvoke.Inaddition,nosuchphysicaltherapist,
901901 241physicaltherapistassistant,applicant,orrecordcustodianmaywithholdrecordsortestimony
902902 242bearinguponaphysicaltherapist's,physicaltherapistassistant's,orapplicant'sfitnessto
903903 243practiceonthegroundsofprivilegebetweensuchphysicaltherapist,physicaltherapist
904904 244assistant,applicant,orrecordcustodianandapatient.
905905 335.016.Asusedinthischapter,unlessthecontextclearlyrequiresotherwise,the
906906 2followingwordsandtermsmean:
907907 3 (1)"Accredited",theofficialauthorizationorstatusgrantedbyanagencyfora
908908 4programthroughavoluntaryprocess;
909909 SSHCSHBs115&99 25 5 (2)"Advancedpracticeregisterednurse"or"APRN", a[nursewhohaseducation
910910 6beyondthebasicnursingeducationandiscertifiedbyanationallyrecognizedprofessional
911911 7organizationasacertifiednursepractitioner,certifiednursemidwife,certifiedregistered
912912 8nurseanesthetist,oracertifiedclinicalnursespecialist.Theboardshallpromulgaterules
913913 9specifyingwhichnationallyrecognizedprofessionalorganizationcertificationsaretobe
914914 10recognizedforthepurposesofthissection.Advancedpracticenursesandonlysuch
915915 11individualsmayusethetitle"AdvancedPracticeRegisteredNurse"andtheabbreviation
916916 12"APRN"] personwhoislicensedundertheprovisionsofthischaptertoengageinthe
917917 13practiceofadvancedpracticenursingasacertifiedclinicalnursespecialist,certified
918918 14nursemidwife,certifiednursepractitioner,orcertifiedregisterednurseanesthetist;
919919 15 (3)"Approval",officialrecognitionofnursingeducationprogramswhichmeet
920920 16standardsestablishedbytheboardofnursing;
921921 17 (4)"Board"or"stateboard",thestateboardofnursing;
922922 18 (5)"Certifiedclinicalnursespecialist",aregisterednursewhoiscurrentlycertifiedas
923923 19aclinicalnursespecialistbyanationallyrecognizedcertifyingboardapprovedbytheboard
924924 20ofnursing;
925925 21 (6)"Certifiednursemidwife",aregisterednursewhoiscurrentlycertifiedasanurse
926926 22midwifebytheAmerican[CollegeofNurseMidwives] MidwiferyCertificationBoard, or
927927 23othernationallyrecognizedcertifyingbodyapprovedbytheboardofnursing;
928928 24 (7)"Certifiednursepractitioner",aregisterednursewhoiscurrentlycertifiedasa
929929 25nursepractitionerbyanationallyrecognizedcertifyingbodyapprovedbytheboardof
930930 26nursing;
931931 27 (8)"Certifiedregisterednurseanesthetist",aregisterednursewhoiscurrently
932932 28certifiedasanurseanesthetistbytheCouncilonCertificationofNurseAnesthetists,the
933933 29[CouncilonRecertificationofNurseAnesthetists] NationalBoardofCertificationand
934934 30RecertificationforNurseAnesthetists, orothernationallyrecognizedcertifyingbody
935935 31approvedbytheboardofnursing;
936936 32 (9)"Executivedirector",aqualifiedindividualemployedbytheboardasexecutive
937937 33secretaryorotherwisetoadministertheprovisionsofthischapterundertheboard'sdirection.
938938 34Suchpersonemployedasexecutivedirectorshallnotbeamemberoftheboard;
939939 35 (10)"Inactive[nurse] licensestatus", asdefinedbyrulepursuanttosection335.061;
940940 36 (11)"Lapsedlicensestatus",asdefinedbyruleundersection335.061;
941941 37 (12)"Licensedpracticalnurse"or"practicalnurse",apersonlicensedpursuanttothe
942942 38provisionsofthischaptertoengageinthepracticeofpracticalnursing;
943943 39 (13)"Licensure",theissuingofalicense[topracticeprofessionalorpractical
944944 40nursing] tocandidateswhohavemetthe[specified] requirementsspecifiedunderthis
945945 41chapter,authorizingthepersontoengageinthepracticeofadvancedpractice,
946946 SSHCSHBs115&99 26 42professional,orpracticalnursing,andtherecordingofthenamesofthosepersonsas
947947 43holdersofalicensetopracticeadvancedpractice,professional, orpracticalnursing;
948948 44 (14)"Practiceofadvancedpracticenursing",theperformanceforcompensation
949949 45ofactivitiesandservicesconsistentwiththerequirededucation,training,certification,
950950 46demonstratedcompetencies,andexperiencesofanadvancedpracticeregisterednurse;
951951 47 (15)"Practiceofpracticalnursing",theperformanceforcompensationofselected
952952 48actsforthepromotionofhealthandinthecareofpersonswhoareill,injured,orexperiencing
953953 49alterationsinnormalhealthprocesses.Suchperformancerequiressubstantialspecialized
954954 50skill,judgmentandknowledge.Allsuchnursingcareshallbegivenunderthedirectionofa
955955 51personlicensedbyastateregulatoryboardtoprescribemedicationsandtreatmentsorunder
956956 52thedirectionofaregisteredprofessionalnurse.Forthepurposesofthischapter,theterm
957957 53"direction"shallmeanguidanceorsupervisionprovidedbyapersonlicensedbyastate
958958 54regulatoryboardtoprescribemedicationsandtreatmentsoraregisteredprofessionalnurse,
959959 55including,butnotlimitedto,oral,written,orotherwisecommunicatedordersordirectivesfor
960960 56patientcare.Whenpracticalnursingcareisdeliveredpursuanttothedirectionofaperson
961961 57licensedbyastateregulatoryboardtoprescribemedicationsandtreatmentsorunderthe
962962 58directionofaregisteredprofessionalnurse,suchcaremaybedeliveredbyalicensedpractical
963963 59nursewithoutdirectphysicaloversight;
964964 60 [(15)] (16)"Practiceofprofessionalnursing",theperformanceforcompensationof
965965 61anyactoractionwhichrequiressubstantialspecializededucation,judgmentandskillbased
966966 62onknowledgeandapplicationofprinciplesderivedfromthebiological,physical,social,
967967 63behavioral,andnursingsciences,including,butnotlimitedto:
968968 64 (a)Responsibilityforthepromotionandteachingofhealthcareandtheprevention
969969 65ofillnesstothepatientandhisorherfamily;
970970 66 (b)Assessment,datacollection,nursingdiagnosis,nursingcare,evaluation,and
971971 67counselofpersonswhoareill,injured, orexperiencingalterationsinnormalhealthprocesses;
972972 68 (c)Theadministrationofmedicationsandtreatmentsasprescribedbyaperson
973973 69licensedbyastateregulatoryboardtoprescribemedicationsandtreatments;
974974 70 (d)Thecoordinationandassistanceinthedeterminationanddeliveryofaplanof
975975 71healthcarewithallmembersofahealthteam;
976976 72 (e)Theteachingandsupervisionofotherpersonsintheperformanceofanyofthe
977977 73foregoing;
978978 74 [(16)A](17)"Registeredprofessionalnurse"or"registerednurse",apersonlicensed
979979 75pursuanttotheprovisionsofthischaptertoengageinthepracticeofprofessionalnursing;
980980 76 [(17)] (18)"Retiredlicensestatus",anypersonlicensedinthisstateunderthischapter
981981 77whoretiresfromsuchpractice.Suchpersonshallfilewiththeboardanaffidavit,onaform
982982 78tobefurnishedbytheboard,whichstatesthedateonwhichthelicenseeretiredfromsuch
983983 SSHCSHBs115&99 27 79practice,anintenttoretirefromthepracticeforatleasttwoyears,andsuchotherfactsastend
984984 80toverifytheretirementastheboardmaydeemnecessary;butifthelicenseethereafter
985985 81reengagesinthepractice,thelicenseeshallrenewhisorherlicensewiththeboardas
986986 82providedbythischapterandbyruleandregulation.
987987 335.019.1.Anadvancedpracticeregisterednurse'sprescriptiveauthorityshall
988988 2includeauthorityto:
989989 3 (1)Prescribe,dispense,andadministermedicationsandnonscheduledlegend
990990 4drugs,asdefinedinsection338.330,withinsuchAPRN'spracticeandspecialty;and
991991 5 (2)Notwithstandinganyotherprovisionofthischaptertothecontrary,receive,
992992 6prescribe,administer,andprovidenonscheduledlegenddrugsamplesfrom
993993 7pharmaceuticalmanufacturerstopatientsatnochargetothepatientoranyotherparty.
994994 8 2.Theboardofnursingmaygrantacertificateofcontrolledsubstanceprescriptive
995995 9authoritytoanadvancedpracticeregisterednursewho:
996996 10 (1)Submitsproofofsuccessfulcompletionofanadvancedpharmacologycoursethat
997997 11shallincludepreceptorialexperienceintheprescriptionofdrugs,medicines, andtherapeutic
998998 12devices;and
999999 13 (2)Providesdocumentationofaminimumofthreehundredclockhourspreceptorial
10001000 14experienceintheprescriptionofdrugs,medicines,andtherapeuticdeviceswithaqualified
10011001 15preceptor;and
10021002 16 (3)Providesevidenceofaminimumofonethousandhoursofpracticeinanadvanced
10031003 17practicenursingcategorypriortoapplicationforacertificateofprescriptiveauthority.The
10041004 18onethousandhoursshallnotincludeclinicalhoursobtainedintheadvancedpracticenursing
10051005 19educationprogram.Theonethousandhoursofpracticeinanadvancedpracticenursing
10061006 20categorymayincludetransmittingaprescriptionorderorallyortelephonicallyortoan
10071007 21inpatientmedicalrecordfromprotocolsdevelopedincollaborationwithandsignedbya
10081008 22licensedphysician;and
10091009 23 (4)Hasacontrolledsubstanceprescribingauthoritydelegatedinthecollaborative
10101010 24practicearrangementundersection334.104withaphysicianwhohasanunrestrictedfederal
10111011 25DrugEnforcementAdministrationregistrationnumberandwhoisactivelyengagedina
10121012 26practicecomparableinscope,specialty,orexpertisetothatoftheadvancedpractice
10131013 27registerednurse.
10141014 335.036.1.Theboardshall:
10151015 2 (1)Electforaone-yeartermapresidentandasecretary,whoshallalsobetreasurer,
10161016 3andtheboardmayappoint,employandfixthecompensationofalegalcounselandsuch
10171017 4boardpersonnelasdefinedinsubdivision(4)ofsubsection11ofsection324.001asare
10181018 5necessarytoadministertheprovisionsofsections335.011to[335.096] 335.099;
10191019 SSHCSHBs115&99 28 6 (2)Adoptandrevisesuchrulesandregulationsasmaybenecessarytoenableitto
10201020 7carryintoeffecttheprovisionsofsections335.011to[335.096] 335.099;
10211021 8 (3)Prescribeminimumstandardsforeducationalprogramspreparingpersonsfor
10221022 9licensureasaregisteredprofessionalnurseorlicensedpracticalnursepursuanttothe
10231023 10provisionsofsections335.011to[335.096] 335.099;
10241024 11 (4)Provideforsurveysofsuchprogramseveryfiveyearsandinadditionatsuch
10251025 12timesasitmaydeemnecessary;
10261026 13 (5)Designateas"approved"suchprogramsasmeettherequirementsofsections
10271027 14335.011to[335.096] 335.099andtherulesandregulationsenactedpursuanttosuchsections;
10281028 15andtheboardshallannuallypublishalistofsuchprograms;
10291029 16 (6)Denyorwithdrawapprovalfromeducationalprogramsforfailuretomeet
10301030 17prescribedminimumstandards;
10311031 18 (7)Examine,license,andcausetoberenewedthelicensesofdulyqualified
10321032 19applicants;
10331033 20 (8)Causetheprosecutionofallpersonsviolatingprovisionsofsections335.011to
10341034 21[335.096] 335.099, andmayincursuchnecessaryexpensestherefor;
10351035 22 (9)Keeparecordofalltheproceedings;andmakeanannualreporttothegovernor
10361036 23andtothedirectorofthedepartmentofcommerceandinsurance.
10371037 24 2.Theboardshallsettheamountofthefeeswhichthischapterauthorizesand
10381038 25requiresbyrulesandregulations.Thefeesshallbesetataleveltoproducerevenuewhich
10391039 26shallnotsubstantiallyexceedthecostandexpenseofadministeringthischapter.
10401040 27 3.Allfeesreceivedbytheboardpursuanttotheprovisionsofsections335.011to
10411041 28[335.096] 335.099shallbedepositedinthestatetreasuryandbeplacedtothecreditofthe
10421042 29stateboardofnursingfund.Alladministrativecostsandexpensesoftheboardshallbepaid
10431043 30fromappropriationsmadeforthosepurposes.Theboardisauthorizedtoprovidefundingfor
10441044 31thenursingeducationincentiveprogramestablishedinsections335.200to335.203.
10451045 32 4.Theprovisionsofsection33.080tothecontrarynotwithstanding,moneyinthis
10461046 33fundshallnotbetransferredandplacedtothecreditofgeneralrevenueuntiltheamountin
10471047 34thefundattheendofthebienniumexceedstwotimestheamountoftheappropriationfrom
10481048 35theboard'sfundsfortheprecedingfiscalyearor,iftheboardrequiresbyrule,permitrenewal
10491049 36lessfrequentlythanyearly,thenthreetimestheappropriationfromtheboard'sfundsforthe
10501050 37precedingfiscalyear.Theamount,ifany,inthefundwhichshalllapseisthatamountinthe
10511051 38fundwhichexceedstheappropriatemultipleoftheappropriationsfromtheboard'sfundsfor
10521052 39theprecedingfiscalyear.
10531053 40 5.Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis
10541054 41createdundertheauthoritydelegatedinthischaptershallbecomeeffectiveonlyifitcomplies
10551055 42withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.
10561056 SSHCSHBs115&99 29 43AllrulemakingauthoritydelegatedpriortoAugust28,1999,isofnoforceandeffectand
10571057 44repealed.Nothinginthissectionshallbeinterpretedtorepealoraffectthevalidityofany
10581058 45rulefiledoradoptedpriortoAugust28,1999,ifitfullycompliedwithallapplicable
10591059 46provisionsoflaw.Thissectionandchapter536arenonseverableandifanyofthepowers
10601060 47vestedwiththegeneralassemblypursuanttochapter536toreview,todelaytheeffectivedate
10611061 48ortodisapproveandannularulearesubsequentlyheldunconstitutional,thenthegrantof
10621062 49rulemakingauthorityandanyruleproposedoradoptedafterAugust28,1999,shallbeinvalid
10631063 50andvoid.
10641064 335.046.1.Anapplicantforalicensetopracticeasaregisteredprofessionalnurse
10651065 2shallsubmittotheboardawrittenapplicationonformsfurnishedtotheapplicant.The
10661066 3originalapplicationshallcontaintheapplicant'sstatementsshowingtheapplicant'seducation
10671067 4andothersuchpertinentinformationastheboardmayrequire.Theapplicantshallbeofgood
10681068 5moralcharacterandhavecompletedatleastthehighschoolcourseofstudy,ortheequivalent
10691069 6thereofasdeterminedbythestateboardofeducation,andhavesuccessfullycompletedthe
10701070 7basicprofessionalcurriculuminanaccreditedorapprovedschoolofnursingandearneda
10711071 8professionalnursingdegreeordiploma.Eachapplicationshallcontainastatementthatitis
10721072 9madeunderoathoraffirmationandthatitsrepresentationsaretrueandcorrecttothebest
10731073 10knowledgeandbeliefofthepersonsigningsame,subjecttothepenaltiesofmakingafalse
10741074 11affidavitordeclaration.Applicantsfromnon-English-speakinglandsshallberequiredto
10751075 12submitevidenceofproficiencyintheEnglishlanguage.Theapplicantmustbeapprovedby
10761076 13theboardandshallpassanexaminationasrequiredbytheboard.Theboardmayrequireby
10771077 14ruleasarequirementforlicensurethateachapplicantshallpassanoralorpractical
10781078 15examination.Uponsuccessfullypassingtheexamination,theboardmayissuetothe
10791079 16applicantalicensetopracticenursingasaregisteredprofessionalnurse.Theapplicantfora
10801080 17licensetopracticeregisteredprofessionalnursingshallpayalicensefeeinsuchamountasset
10811081 18bytheboard.Thefeeshallbeuniformforallapplicants.Applicantsfromforeigncountries
10821082 19shallbelicensedasprescribedbyrule.
10831083 20 2.Anapplicantforlicensetopracticeasalicensedpracticalnurseshallsubmittothe
10841084 21boardawrittenapplicationonformsfurnishedtotheapplicant.Theoriginalapplicationshall
10851085 22containtheapplicant'sstatementsshowingtheapplicant'seducationandothersuchpertinent
10861086 23informationastheboardmayrequire.Suchapplicantshallbeofgoodmoralcharacter,and
10871087 24havecompletedatleasttwoyearsofhighschool,oritsequivalentasestablishedbythestate
10881088 25boardofeducation,andhavesuccessfullycompletedabasicprescribedcurriculuminastate-
10891089 26accreditedorapprovedschoolofnursing,earnedanursingdegree,certificateordiplomaand
10901090 27completedacourseapprovedbytheboardontheroleofthepracticalnurse.Eachapplication
10911091 28shallcontainastatementthatitismadeunderoathoraffirmationandthatitsrepresentations
10921092 29aretrueandcorrecttothebestknowledgeandbeliefofthepersonsigningsame,subjecttothe
10931093 SSHCSHBs115&99 30 30penaltiesofmakingafalseaffidavitordeclaration.Applicantsfromnon-English-speaking
10941094 31countriesshallberequiredtosubmitevidenceoftheirproficiencyintheEnglishlanguage.
10951095 32Theapplicantmustbeapprovedbytheboardandshallpassanexaminationasrequiredbythe
10961096 33board.Theboardmayrequirebyruleasarequirementforlicensurethateachapplicantshall
10971097 34passanoralorpracticalexamination.Uponsuccessfullypassingtheexamination,theboard
10981098 35mayissuetotheapplicantalicensetopracticeasalicensedpracticalnurse.Theapplicantfor
10991099 36alicensetopracticelicensedpracticalnursingshallpayafeeinsuchamountasmaybesetby
11001100 37theboard.Thefeeshallbeuniformforallapplicants.Applicantsfromforeigncountriesshall
11011101 38belicensedasprescribedbyrule.
11021102 39 3.(1)Anapplicantforalicensetopracticeasanadvancedpracticeregistered
11031103 40nurseshallsubmittotheboardawrittenapplicationonformsfurnishedtothe
11041104 41applicant.Theoriginalapplicationshallcontain:
11051105 42 (a)Statementsshowingtheapplicant'seducationandothersuchpertinent
11061106 43informationastheboardmayrequire;and
11071107 44 (b)Astatementthatitismadeunderoathoraffirmationandthatits
11081108 45representationsaretrueandcorrecttothebestknowledgeandbeliefoftheperson
11091109 46signingsame,subjecttothepenaltiesofmakingafalseaffidavitordeclaration.
11101110 47 (2)Theapplicantforalicensetopracticeasanadvancedpracticeregistered
11111111 48nurseshallpayafeeinsuchamountasmaybesetbytheboard.Thefeeshallbe
11121112 49uniformforallapplicants.
11131113 50 (3)Anapplicantshall:
11141114 51 (a)Holdacurrentregisteredprofessionalnurselicenseorprivilegetopractice,
11151115 52shallnotbecurrentlysubjecttodisciplineoranyrestrictions,andshallnotholdan
11161116 53encumberedlicenseorprivilegetopracticeasaregisteredprofessionalnurseor
11171117 54advancedpracticeregisterednurseinanystateorterritory;
11181118 55 (b)Havecompletedanaccreditedgraduate-leveladvancedpracticeregistered
11191119 56nurseprogramandachievedatleastonecertificationasaclinicalnursespecialist,nurse
11201120 57midwife,nursepractitioner,orregisterednurseanesthetist,withatleastonepopulation
11211121 58focusprescribedbyruleoftheboard;
11221122 59 (c)Becurrentlycertifiedbyanationalcertifyingbodyrecognizedbythe
11231123 60Missouristateboardofnursingintheadvancedpracticeregisterednurserole;and
11241124 61 (d)Haveapopulationfocusonhisorhercertification,correspondingwithhisor
11251125 62hereducationaladvancedpracticeregisterednurseprogram.
11261126 63 (4)Anypersonholdingadocumentofrecognitiontopracticenursingasan
11271127 64advancedpracticeregisterednurseinthisstatethatiscurrentonAugust28,2023,shall
11281128 65bedeemedtobelicensedasanadvancedpracticeregisterednurseundertheprovisions
11291129 SSHCSHBs115&99 31 66ofthissectionandshallbeeligibleforrenewalofsuchlicenseundertheconditionsand
11301130 67standardsprescribedinthischapterandasprescribedbyrule.
11311131 68 4.Uponrefusaloftheboardtoallowanyapplicantto[sitfor]takeeitherthe
11321132 69registeredprofessionalnurses'examinationorthelicensedpracticalnurses'examination,[as
11331133 70thecasemaybe,]oruponrefusaltoissueanadvancedpracticeregisterednurselicense,
11341134 71theboardshallcomplywiththeprovisionsofsection621.120andadvisetheapplicantofhis
11351135 72orherrighttohaveahearingbeforetheadministrativehearingcommission.The
11361136 73administrativehearingcommissionshallhearcomplaintstakenpursuanttosection621.120.
11371137 74 [4.]5.Theboardshallnotdenyalicensebecauseofsex,religion,race,ethnicorigin,
11381138 75ageorpoliticalaffiliation.
11391139 335.051.1.Theboardshallissuealicensetopracticenursingas[either] an
11401140 2advancedpracticeregisterednurse,aregisteredprofessionalnurse, oralicensedpractical
11411141 3nursewithoutexaminationtoanapplicantwhohasdulybecomelicensedas[a]anadvanced
11421142 4practiceregisterednurse,registerednurse, orlicensedpracticalnursepursuanttothelaws
11431143 5ofanotherstate,territory,orforeigncountryiftheapplicantmeetsthequalificationsrequired
11441144 6ofadvancedpracticeregisterednurses,registerednurses, orlicensedpracticalnursesinthis
11451145 7stateatthetimetheapplicantwasoriginallylicensedintheotherstate,territory,orforeign
11461146 8country.
11471147 9 2.Applicantsfromforeigncountriesshallbelicensedasprescribedbyrule.
11481148 10 3.Uponapplication,theboardshallissueatemporarypermittoanapplicantpursuant
11491149 11tosubsection1ofthissectionforalicenseas[either] anadvancedpracticeregistered
11501150 12nurse,aregisteredprofessionalnurse, oralicensedpracticalnursewhohasmadeaprima
11511151 13facieshowingthattheapplicantmeetsalloftherequirementsforsuchalicense.The
11521152 14temporarypermitshallbeeffectiveonlyuntiltheboardshallhavehadtheopportunityto
11531153 15investigatehisorherqualificationsforlicensurepursuanttosubsection1ofthissectionand
11541154 16tonotifytheapplicantthathisorherapplicationforalicensehasbeeneithergrantedor
11551155 17rejected.Innoeventshallsuchtemporarypermitbeineffectformorethantwelvemonths
11561156 18afterthedateofitsissuancenorshallapermitbereissuedtothesameapplicant.Nofeeshall
11571157 19bechargedforsuchtemporarypermit.Theholderofatemporarypermitwhichhasnot
11581158 20expired,orbeensuspendedorrevoked,shallbedeemedtobetheholderofalicenseissued
11591159 21pursuanttosection335.046untilsuchtemporarypermitexpires,isterminatedorissuspended
11601160 22orrevoked.
11611161 335.056.1.Thelicenseofeverypersonlicensedundertheprovisionsof[sections
11621162 2335.011to335.096] thischaptershallberenewedasprovided.Anapplicationforrenewal
11631163 3oflicenseshallbemailedtoeverypersontowhomalicensewasissuedorrenewedduringthe
11641164 4currentlicensingperiod.Theapplicantshallcompletetheapplicationandreturnittothe
11651165 5boardbytherenewaldatewitharenewalfeeinanamounttobesetbytheboard.Thefee
11661166 SSHCSHBs115&99 32 6shallbeuniformforallapplicants.Thecertificatesofrenewalshallrendertheholderthereof
11671167 7alegalpractitionerofnursingfortheperiodstatedinthecertificateofrenewal.Anyperson
11681168 8whopracticesnursingasanadvancedpracticeregisterednurse,aregisteredprofessional
11691169 9nurse, or[as]alicensedpracticalnurseduringthetimehisorherlicensehaslapsedshallbe
11701170 10consideredanillegalpractitionerandshallbesubjecttothepenaltiesprovidedforviolationof
11711171 11theprovisionsofsections335.011to[335.096] 335.099.
11721172 12 2.Therenewalofadvancedpracticeregisterednurselicensesandregistered
11731173 13professionalnurselicensesshalloccuratthesametime,asprescribedbyrule.Failure
11741174 14torenewandmaintaintheregisteredprofessionalnurselicenseorprivilegetopractice
11751175 15orfailuretoprovidetherequiredfeeandevidenceofactivecertificationormaintenance
11761176 16ofcertificationasprescribedbyrulesandregulationsshallresultinexpirationofthe
11771177 17advancedpracticeregisterednurselicense.
11781178 18 3.AlicensednursewhoholdsanAPRNlicenseshallbedisciplinedontheir
11791179 19APRNlicenseforanyviolationsofthischapter.
11801180 335.076.1.Anypersonwhoholdsalicensetopracticeprofessionalnursinginthis
11811181 2statemayusethetitle"RegisteredProfessionalNurse"andtheabbreviation["R.N."] "RN".
11821182 3Nootherpersonshallusethetitle"RegisteredProfessionalNurse"ortheabbreviation
11831183 4["R.N."] "RN". Nootherpersonshallassumeanytitleoruseanyabbreviationoranyother
11841184 5words,letters,signs,ordevicestoindicatethatthepersonusingthesameisaregistered
11851185 6professionalnurse.
11861186 7 2.Anypersonwhoholdsalicensetopracticepracticalnursinginthisstatemayuse
11871187 8thetitle"LicensedPracticalNurse"andtheabbreviation["L.P.N."]"LPN". Nootherperson
11881188 9shallusethetitle"LicensedPracticalNurse"ortheabbreviation["L.P.N."]"LPN". Noother
11891189 10personshallassumeanytitleoruseanyabbreviationoranyotherwords,letters,signs,or
11901190 11devicestoindicatethatthepersonusingthesameisalicensedpracticalnurse.
11911191 12 3.Anypersonwhoholdsalicense[orrecognition] topracticeadvancedpractice
11921192 13nursinginthisstatemayusethetitle"AdvancedPracticeRegisteredNurse",the
11931193 14designationsof"certifiedregisterednurseanesthetist","certifiednursemidwife",
11941194 15"certifiedclinicalnursespecialist",and"certifiednursepractitioner",andthe
11951195 16[abbreviation] abbreviations"APRN",[andanyothertitledesignationsappearingonhis
11961196 17orherlicense] "CRNA","CNM","CNS",and"NP",respectively. Nootherpersonshall
11971197 18usethetitle"AdvancedPracticeRegisteredNurse"ortheabbreviation"APRN".Noother
11981198 19personshallassumeanytitleoruseanyabbreviationoranyotherwords,letters,signs,or
11991199 20devicestoindicatethatthepersonusingthesameisanadvancedpracticeregisterednurse.
12001200 21 4.Nopersonshallpracticeoroffertopracticeprofessionalnursing,practicalnursing,
12011201 22oradvancedpracticenursinginthisstateoruseanytitle,sign,abbreviation,card,ordeviceto
12021202 SSHCSHBs115&99 33 23indicatethatsuchpersonisapracticingprofessionalnurse,practicalnurse,oradvanced
12031203 24practicenurseunlessheorshehasbeendulylicensedundertheprovisionsofthischapter.
12041204 25 5.Intheinterestofpublicsafetyandconsumerawareness,itisunlawfulforany
12051205 26persontousethetitle"nurse"inreferencetohimselforherselfinanycapacity,except
12061206 27individualswhoareorhavebeenlicensedasaregisterednurse,licensedpracticalnurse,or
12071207 28advancedpracticeregisterednurseunderthischapter.
12081208 29 6.Notwithstandinganylawtothecontrary,nothinginthischaptershallprohibita
12091209 30ChristianSciencenursefromusingthetitle"ChristianSciencenurse",solongassuchperson
12101210 31providesonlyreligiousnonmedicalserviceswhenofferingorprovidingsuchservicestothose
12111211 32whochoosetorelyuponhealingbyspiritualmeansaloneanddoesnotholdhisorherown
12121212 33religiousorganizationanddoesnotholdhimselforherselfoutasaregisterednurse,advanced
12131213 34practiceregisterednurse,nursepractitioner,licensedpracticalnurse,nursemidwife,clinical
12141214 35nursespecialist,ornurseanesthetist,unlessotherwiseauthorizedbylawtodoso.
12151215 335.086.Noperson,firm,corporationorassociationshall:
12161216 2 (1)Sellorattempttosellorfraudulentlyobtainorfurnishorattempttofurnishany
12171217 3nursingdiploma,license,renewalorrecordoraidorabettherein;
12181218 4 (2)Practice[professionalorpractical] nursingasdefinedbysections335.011to
12191219 5[335.096] 335.099undercoverofanydiploma,license,orrecordillegallyorfraudulently
12201220 6obtainedorsignedorissuedunlawfullyorunderfraudulentrepresentation;
12211221 7 (3)Practice[professionalnursingorpractical] nursingasdefinedbysections335.011
12221222 8to[335.096] 335.099unlessdulylicensedtodosoundertheprovisionsofsections335.011to
12231223 9[335.096] 335.099;
12241224 10 (4)Useinconnectionwithhisorhernameanydesignationtendingtoimplythathe
12251225 11orsheisalicensedadvancedpracticeregisterednurse,alicensedregisteredprofessional
12261226 12nurse, oralicensedpracticalnurseunlessdulylicensedsotopracticeundertheprovisionsof
12271227 13sections335.011to[335.096] 335.099;
12281228 14 (5)Practice[professionalnursingorpractical] nursingduringthetimehisorher
12291229 15licenseissuedundertheprovisionsofsections335.011to[335.096] 335.099shallbe
12301230 16suspendedorrevoked;or
12311231 17 (6)Conductanursingeducationprogramforthepreparationofprofessionalor
12321232 18practicalnursesunlesstheprogramhasbeenaccreditedbytheboard.
12331233 335.175.1.NolaterthanJanuary1,2014,thereisherebyestablishedwithinthestate
12341234 2boardofregistrationforthehealingartsandthestateboardofnursingthe"Utilizationof
12351235 3TelehealthbyNurses".Anadvancedpracticeregisterednurse(APRN)providingnursing
12361236 4servicesunderacollaborativepracticearrangementundersection334.104mayprovidesuch
12371237 5servicesoutsidethegeographicproximityrequirementsofsection334.104ifthe
12381238 6collaboratingphysicianandadvancedpracticeregisterednurseutilizetelehealth[inthe
12391239 SSHCSHBs115&99 34 7careofthepatientandiftheservicesareprovidedinaruralareaofneed.] Telehealth
12401240 8providersshallberequiredtoobtainpatientconsentbeforetelehealthservicesareinitiated
12411241 9andensureconfidentialityofmedicalinformation.
12421242 10 2.Asusedinthissection,"telehealth"shallhavethesamemeaningassuchtermis
12431243 11definedinsection191.1145.
12441244 12 [3.(1)Theboardsshalljointlypromulgaterulesgoverningthepracticeoftelehealth
12451245 13underthissection.Suchrulesshalladdress,butnotbelimitedto,appropriatestandardsfor
12461246 14theuseoftelehealth.
12471247 15 (2)Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis
12481248 16createdundertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplies
12491249 17withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.
12501250 18Thissectionandchapter536arenonseverableandifanyofthepowersvestedwiththe
12511251 19generalassemblypursuanttochapter536toreview,todelaytheeffectivedate,orto
12521252 20disapproveandannularulearesubsequentlyheldunconstitutional,thenthegrantof
12531253 21rulemakingauthorityandanyruleproposedoradoptedafterAugust28,2013,shallbeinvalid
12541254 22andvoid.
12551255 23 4.Forpurposesofthissection,"ruralareaofneed"meansanyruralareaofthisstate
12561256 24whichislocatedinahealthprofessionalshortageareaasdefinedinsection354.650.]
12571257 337.510.1.Asusedinthissection,thefollowingtermsmean:
12581258 2 (1)"License",license,certificate,registration,permit,accreditation,ormilitary
12591259 3occupationalspecialtythatenablesapersontolegallypracticeanoccupationor
12601260 4professioninaparticularjurisdiction;
12611261 5 (2)"Military",theArmedForcesoftheUnitedStates,includingtheAirForce,
12621262 6Army,CoastGuard,MarineCorps,Navy,SpaceForce,NationalGuardandanyother
12631263 7militarybranchthatisdesignatedbyCongressaspartoftheArmedForcesofthe
12641264 8UnitedStates,andallreservecomponentsandauxiliaries.Suchtermalsoincludesthe
12651265 9militaryreservesandmilitiaofanyUnitedStatesterritoryorstate;
12661266 10 (3)"Nonresidentmilitaryspouse",anonresidentspouseofanactiveduty
12671267 11memberoftheArmedForcesoftheUnitedStateswhohasbeentransferredoris
12681268 12scheduledtobetransferredtothestateofMissouri,orwhohasbeentransferredoris
12691269 13scheduledtobetransferredtoanadjacentstateandisorwillbedomiciledinthestateof
12701270 14Missouri,orhasmovedtothestateofMissourionapermanentchange-of-stationbasis;
12711271 15 (4)"Residentmilitaryspouse",aspouseofanactivedutymemberoftheArmed
12721272 16ForcesoftheUnitedStateswhohasbeentransferredorisscheduledtobetransferredto
12731273 17thestateofMissourioranadjacentstateandwhoisapermanentresidentofthestateof
12741274 18Missouri,whoisdomiciledinthestateofMissouri,orwhohasMissouriashisorher
12751275 19homeofrecord.
12761276 SSHCSHBs115&99 35 20 2.Eachapplicantforlicensureasaprofessionalcounselorshallfurnishevidenceto
12771277 21thecommitteethattheapplicantisatleasteighteenyearsofage,isaUnitedStatescitizenor
12781278 22islegallypresentintheUnitedStates;and
12791279 23 (1)Theapplicanthascompletedacourseofstudyasdefinedbytheboardruleleading
12801280 24toamaster's,specialist's,ordoctoraldegreewithamajorincounseling,exceptanyapplicant
12811281 25whohasheldalicenseasaprofessionalcounselorinthisstateorcurrentlyholdsalicenseasa
12821282 26professionalcounselorinanotherstateshallnotberequiredtohavecompletedanycourses
12831283 27relatedtocareerdevelopment;and
12841284 28 (2)Theapplicanthascompletedacceptablesupervisedcounselingasdefinedby
12851285 29boardrule.Iftheapplicanthasamaster'sdegreewithamajorincounselingasdefinedby
12861286 30boardrule,theapplicantshallcompleteatleasttwoyearsofacceptablesupervisedcounseling
12871287 31experiencesubsequenttothereceiptofthemaster'sdegree.Thecompositionandnumberof
12881288 32hourscomprisingtheacceptablesupervisedcounselingexperienceshallbedefinedbyboard
12891289 33rule.Anapplicantmaysubstitutethirtysemesterhoursofpostmaster'sgraduatestudyfor
12901290 34oneofthetworequiredyearsofacceptablesupervisedcounselingexperienceifsuchhours
12911291 35areclearlyrelatedtocounseling;
12921292 36 (3)AfterAugust28,2007,eachapplicantshallhavecompletedaminimumofthree
12931293 37hoursofgraduatelevelcourseworkindiagnosticsystemseitherinthecurriculumleadingtoa
12941294 38degreeoraspostmaster'sgraduatelevelcoursework;
12951295 39 (4)Uponexamination,theapplicantispossessedofrequisiteknowledgeofthe
12961296 40profession,includingtechniquesandapplications,researchanditsinterpretation,and
12971297 41professionalaffairsandethics.
12981298 42 [2.Anypersonholdingacurrentlicense,certificateofregistration,orpermitfrom
12991299 43anotherstateorterritoryoftheUnitedStatestopracticeasaprofessionalcounselorwhodoes
13001300 44notmeettherequirementsinsection324.009andwhoisatleasteighteenyearsofage,andis
13011301 45aUnitedStatescitizenorislegallypresentintheUnitedStatesmaybegrantedalicense
13021302 46withoutexaminationtoengageinthepracticeofprofessionalcounselinginthisstateuponthe
13031303 47applicationtotheboard,paymentoftherequiredfeeasestablishedbytheboard,and
13041304 48satisfyingoneofthefollowingrequirements:
13051305 49 (1)ApprovalbytheAmericanAssociationofStateCounselingBoards(AASCB)or
13061306 50itssuccessororganizationaccordingtotheeligibilitycriteriaestablishedbyAASCB.The
13071307 51successororganizationshallbedefinedbyboardrule;or
13081308 52 (2)IngoodstandingandcurrentlycertifiedbytheNationalBoardforCertified
13091309 53Counselorsoritssuccessororganizationandhascompletedacceptablesupervisedcounseling
13101310 54experienceasdefinedbyboardrule.Thesuccessororganizationshallbedefinedbyboard
13111311 55rule.]
13121312 SSHCSHBs115&99 36 56 3.(1)Anypersonwhoholdsavalidcurrentprofessionalcounselorlicenseissued
13131313 57byanotherstate,abranchorunitofthemilitary,aterritoryoftheUnitedStates,orthe
13141314 58DistrictofColumbia,andwhohasbeenlicensedforatleastoneyearinsuchother
13151315 59jurisdiction,maysubmitanapplicationforaprofessionalcounselorlicenseinMissouri
13161316 60alongwithproofofcurrentlicensureandproofoflicensureforatleastoneyearinthe
13171317 61otherjurisdiction,tothecommittee.
13181318 62 (2)Thecommitteeshall:
13191319 63 (a)Withinsixmonthsofreceivinganapplicationdescribedinsubdivision(1)of
13201320 64thissubsection,waiveanyexamination,educational,orexperiencerequirementsfor
13211321 65licensureinthisstatefortheapplicantifitdeterminesthattherewereminimum
13221322 66educationrequirementsand,ifapplicable,workexperienceandclinicalsupervision
13231323 67requirementsineffectandtheotherstateverifiesthatthepersonmetthose
13241324 68requirementsinordertobelicensedorcertifiedinthatstate.Thecommitteemay
13251325 69requireanapplicanttotakeandpassanexaminationspecifictothelawsofthisstate;or
13261326 70 (b)Withinthirtydaysofreceivinganapplicationdescribedinsubdivision(1)of
13271327 71thissubsectionfromanonresidentmilitaryspouseoraresidentmilitaryspouse,waive
13281328 72anyexamination,educational,orexperiencerequirementsforlicensureinthisstatefor
13291329 73theapplicantandissuesuchapplicantalicenseunderthissubsectionifsuchapplicant
13301330 74otherwisemeetstherequirementsofthissection.
13311331 75 (3)(a)Thecommitteeshallnotwaiveanyexamination,educational,or
13321332 76experiencerequirementsforanyapplicantwhohashadhisorherlicenserevokedbya
13331333 77committeeoutsidethestate;whoiscurrentlyunderinvestigation,whohasacomplaint
13341334 78pending,orwhoiscurrentlyunderdisciplinaryaction,exceptasprovidedinparagraph
13351335 79(b)ofthissubdivision,withacommitteeoutsidethestate;whodoesnotholdalicensein
13361336 80goodstandingwithacommitteeoutsidethestate;whohasacriminalrecordthatwould
13371337 81disqualifyhimorherforlicensureinMissouri;orwhodoesnotholdavalidcurrent
13381338 82licenseintheotherjurisdictiononthedatethecommitteereceiveshisorherapplication
13391339 83underthissection.
13401340 84 (b)Ifanotherjurisdictionhastakendisciplinaryactionagainstanapplicant,the
13411341 85committeeshalldetermineifthecausefortheactionwascorrectedandthematter
13421342 86resolved.Ifthematterhasnotbeenresolvedbythatjurisdiction,thecommitteemay
13431343 87denyalicenseuntilthematterisresolved.
13441344 88 (4)Nothinginthissubsectionshallprohibitthecommitteefromdenyinga
13451345 89licensetoanapplicantunderthissubsectionforanyreasondescribedinsection337.525.
13461346 90 (5)Anypersonwhoislicensedundertheprovisionsofthissubsectionshallbe
13471347 91subjecttothecommittee'sjurisdictionandallrulesandregulationspertainingtothe
13481348 92practiceasalicensedprofessionalcounselorinthisstate.
13491349 SSHCSHBs115&99 37 93 (6)Thissubsectionshallnotbeconstruedtowaiveanyrequirementforan
13501350 94applicanttopayanyfees.
13511351 95 4.Thecommitteeshallissuealicensetoeachpersonwhofilesanapplicationandfee
13521352 96andwhofurnishesevidencesatisfactorytothecommitteethattheapplicanthascompliedwith
13531353 97theprovisionsofthisactandhastakenandpassedawritten,open-bookexaminationon
13541354 98Missourilawsandregulationsgoverningthepracticeofprofessionalcounselingasdefinedin
13551355 99section337.500.Thedivisionshallissueaprovisionalprofessionalcounselorlicensetoany
13561356 100applicantwhomeetsallrequirementsofthissection,butwhohasnotcompletedtherequired
13571357 101acceptablesupervisedcounselingexperienceandsuchapplicantmayreapplyforlicensureas
13581358 102aprofessionalcounseloruponcompletionofsuchacceptablesupervisedcounseling
13591359 103experience.
13601360 104 [4.]5.Allpersonslicensedtopracticeprofessionalcounselinginthisstateshallpay
13611361 105onorbeforethelicenserenewaldatearenewallicensefeeandshallfurnishtothecommittee
13621362 106satisfactoryevidenceofthecompletionoftherequisitenumberofhoursofcontinuing
13631363 107educationasrequiredbyrule,includingtwohoursofsuicideassessment,referral,treatment,
13641364 108andmanagementtraining,whichshallbenomorethanfortyhoursbiennially.Thecontinuing
13651365 109educationrequirementsmaybewaivedbythecommitteeuponpresentationtothecommittee
13661366 110ofsatisfactoryevidenceoftheillnessofthelicenseeorforothergoodcause.
13671367 337.550.SECTION1:PURPOSE
13681368 2 ThepurposeofthisCompactistofacilitateinterstatepracticeofLicensed
13691369 3ProfessionalCounselorswiththegoalofimprovingpublicaccesstoProfessional
13701370 4Counselingservices.ThepracticeofProfessionalCounselingoccursintheStatewhere
13711371 5theclientislocatedatthetimeofthecounselingservices.TheCompactpreservesthe
13721372 6regulatoryauthorityofStatestoprotectpublichealthandsafetythroughthecurrent
13731373 7systemofStatelicensure.
13741374 8 ThisCompactisdesignedtoachievethefollowingobjectives:
13751375 9 A.IncreasepublicaccesstoProfessionalCounselingservicesbyprovidingfor
13761376 10themutualrecognitionofotherMemberStatelicenses;
13771377 11 B.EnhancetheStates'abilitytoprotectthepublic'shealthandsafety;
13781378 12 C.EncouragethecooperationofMemberStatesinregulatingmultistate
13791379 13practiceforLicensedProfessionalCounselors;
13801380 14 D.SupportspousesofrelocatingActiveDutyMilitarypersonnel;
13811381 15 E.Enhancetheexchangeoflicensure,investigative,anddisciplinary
13821382 16informationamongMemberStates;
13831383 17 F.AllowfortheuseofTelehealthtechnologytofacilitateincreasedaccessto
13841384 18ProfessionalCounselingservices;
13851385 SSHCSHBs115&99 38 19 G.SupporttheuniformityofProfessionalCounselinglicensurerequirements
13861386 20throughouttheStatestopromotepublicsafetyandpublichealthbenefits;
13871387 21 H.InvestallMemberStateswiththeauthoritytoholdaLicensedProfessional
13881388 22CounseloraccountableformeetingallStatepracticelawsintheStateinwhichtheclient
13891389 23islocatedatthetimecareisrenderedthroughthemutualrecognitionofMemberState
13901390 24licenses;
13911391 25 I.EliminatethenecessityforlicensesinmultipleStates;and
13921392 26 J.ProvideopportunitiesforinterstatepracticebyLicensedProfessional
13931393 27Counselorswhomeetuniformlicensurerequirements.
13941394 28 SECTION2.DEFINITIONS
13951395 29 AsusedinthisCompact,andexceptasotherwiseprovided,thefollowing
13961396 30definitionsshallapply:
13971397 31 A."ActiveDutyMilitary"meansfull-timedutystatusintheactiveuniformed
13981398 32serviceoftheUnitedStates,includingmembersoftheNationalGuardandReserveon
13991399 33activedutyorderspursuantto10U.S.C.Chapters1209and1211.
14001400 34 B."AdverseAction"meansanyadministrative,civil,equitableorcriminal
14011401 35actionpermittedbyaState'slawswhichisimposedbyalicensingboardorother
14021402 36authorityagainstaLicensedProfessionalCounselor,includingactionsagainstan
14031403 37individual'slicenseorPrivilegetoPracticesuchasrevocation,suspension,probation,
14041404 38monitoringofthelicensee,limitationonthelicensee'spractice,oranyother
14051405 39EncumbranceonlicensureaffectingaLicensedProfessionalCounselor's
14061406 40authorizationtopractice,includingissuanceofaceaseanddesistaction.
14071407 41 C."AlternativeProgram"meansanon-disciplinarymonitoringorpractice
14081408 42remediationprocessapprovedbyaProfessionalCounselingLicensingBoardtoaddress
14091409 43ImpairedPractitioners.
14101410 44 D."ContinuingCompetence/Education"meansarequirement,asaconditionof
14111411 45licenserenewal,toprovideevidenceofparticipationin,and/orcompletionof,
14121412 46educationalandprofessionalactivitiesrelevanttopracticeorareaofwork.
14131413 47 E."CounselingCompactCommission"or"Commission"meansthenational
14141414 48administrativebodywhosemembershipconsistsofallStatesthathaveenactedthe
14151415 49Compact.
14161416 50 F."CurrentSignificantInvestigativeInformation"means:
14171417 51 1.InvestigativeInformationthataLicensingBoard,afterapreliminaryinquiry
14181418 52thatincludesnotificationandanopportunityfortheLicensedProfessionalCounselorto
14191419 53respond,ifrequiredbyStatelaw,hasreasontobelieveisnotgroundlessand,ifproved
14201420 54true,wouldindicatemorethanaminorinfraction;or
14211421 SSHCSHBs115&99 39 55 2.InvestigativeInformationthatindicatesthattheLicensedProfessional
14221422 56Counselorrepresentsanimmediatethreattopublichealthandsafetyregardlessof
14231423 57whethertheLicensedProfessionalCounselorhasbeennotifiedandhadanopportunity
14241424 58torespond.
14251425 59 G."DataSystem"meansarepositoryofinformationaboutLicensees,including,
14261426 60butnotlimitedto,continuingeducation,examination,licensure,investigative,Privilege
14271427 61toPracticeandAdverseActioninformation.
14281428 62 H."EncumberedLicense"meansalicenseinwhichanAdverseActionrestricts
14291429 63thepracticeoflicensedProfessionalCounselingbytheLicenseeandsaidAdverse
14301430 64ActionhasbeenreportedtotheNationalPractitionersDataBank(NPDB).
14311431 65 I."Encumbrance"meansarevocationorsuspensionof,oranylimitationon,the
14321432 66fullandunrestrictedpracticeofLicensedProfessionalCounselingbyaLicensingBoard.
14331433 67 J."ExecutiveCommittee"meansagroupofdirectorselectedorappointedtoact
14341434 68onbehalfof,andwithinthepowersgrantedtothemby,theCommission.
14351435 69 K."HomeState"meanstheMemberStatethatistheLicensee'sprimaryState
14361436 70ofresidence.
14371437 71 L."ImpairedPractitioner"meansanindividualwhohasacondition(s)thatmay
14381438 72impairtheirabilitytopracticeasaLicensedProfessionalCounselorwithoutsometype
14391439 73ofinterventionandmayinclude,butarenotlimitedto,alcoholanddrugdependence,
14401440 74mentalhealthimpairment,andneurologicalorphysicalimpairments.
14411441 75 M."InvestigativeInformation"meansinformation,records,anddocuments
14421442 76receivedorgeneratedbyaProfessionalCounselingLicensingBoardpursuanttoan
14431443 77investigation.
14441444 78 N."JurisprudenceRequirement"ifrequiredbyaMemberState,meansthe
14451445 79assessmentofanindividual'sknowledgeofthelawsandRulesgoverningthepracticeof
14461446 80ProfessionalCounselinginaState.
14471447 81 O."LicensedProfessionalCounselor"meansacounselorlicensedbyaMember
14481448 82State,regardlessofthetitleusedbythatState,toindependentlyassess,diagnose,and
14491449 83treatbehavioralhealthconditions.
14501450 84 P."Licensee"meansanindividualwhocurrentlyholdsanauthorizationfrom
14511451 85theStatetopracticeasaLicensedProfessionalCounselor.
14521452 86 Q."LicensingBoard"meanstheagencyofaState,orequivalent,thatis
14531453 87responsibleforthelicensingandregulationofLicensedProfessionalCounselors.
14541454 88 R."MemberState"meansaStatethathasenactedtheCompact.
14551455 89 S."PrivilegetoPractice"meansalegalauthorization,whichisequivalenttoa
14561456 90license,permittingthepracticeofProfessionalCounselinginaRemoteState.
14571457 SSHCSHBs115&99 40 91 T."ProfessionalCounseling"meanstheassessment,diagnosis,andtreatmentof
14581458 92behavioralhealthconditionsbyaLicensedProfessionalCounselor.
14591459 93 U."RemoteState"meansaMemberStateotherthantheHomeState,wherea
14601460 94LicenseeisexercisingorseekingtoexercisethePrivilegetoPractice.
14611461 95 V."Rule"meansaregulationpromulgatedbytheCommissionthathastheforce
14621462 96oflaw.
14631463 97 W."SingleStateLicense"meansaLicensedProfessionalCounselorlicense
14641464 98issuedbyaMemberStatethatauthorizespracticeonlywithintheissuingStateanddoes
14651465 99notincludeaPrivilegetoPracticeinanyotherMemberState.
14661466 100 X."State"meansanystate,commonwealth,district,orterritoryoftheUnited
14671467 101StatesofAmericathatregulatesthepracticeofProfessionalCounseling.
14681468 102 Y."Telehealth"meanstheapplicationoftelecommunicationtechnologyto
14691469 103deliverProfessionalCounselingservicesremotelytoassess,diagnose,andtreat
14701470 104behavioralhealthconditions.
14711471 105 Z."UnencumberedLicense"meansalicensethatauthorizesaLicensed
14721472 106ProfessionalCounselortoengageinthefullandunrestrictedpracticeofProfessional
14731473 107Counseling.
14741474 108 SECTION3.STATEPARTICIPATIONINTHECOMPACT
14751475 109 A.ToParticipateintheCompact,aStatemustcurrently:
14761476 110 1.LicenseandregulateLicensedProfessionalCounselors;
14771477 111 2.RequireLicenseestopassanationallyrecognizedexamapprovedbythe
14781478 112Commission;
14791479 113 3.RequireLicenseestohavea60semester-hour(or90quarter-hour)master's
14801480 114degreeincounselingor60semester-hours(or90quarter-hours)ofgraduatecourse
14811481 115workincludingthefollowingtopicareas:
14821482 116 a.ProfessionalCounselingOrientationandEthicalPractice;
14831483 117 b.SocialandCulturalDiversity;
14841484 118 c.HumanGrowthandDevelopment;
14851485 119 d.CareerDevelopment;
14861486 120 e.CounselingandHelpingRelationships;
14871487 121 f.GroupCounselingandGroupWork;
14881488 122 g.DiagnosisandTreatment;AssessmentandTesting;
14891489 123 h.ResearchandProgramEvaluation;and
14901490 124 i.OtherareasasdeterminedbytheCommission.
14911491 125 4.RequireLicenseestocompleteasupervisedpostgraduateprofessional
14921492 126experienceasdefinedbytheCommission;
14931493 SSHCSHBs115&99 41 127 5.Haveamechanisminplaceforreceivingandinvestigatingcomplaintsabout
14941494 128Licensees.
14951495 129 B.AMemberStateshall:
14961496 130 1.ParticipatefullyintheCommission'sDataSystem,includingusingthe
14971497 131Commission'suniqueidentifierasdefinedinRules;
14981498 132 2.NotifytheCommission,incompliancewiththetermsoftheCompactand
14991499 133Rules,ofanyAdverseActionortheavailabilityofInvestigativeInformationregardinga
15001500 134Licensee;
15011501 135 3.Implementorutilizeproceduresforconsideringthecriminalhistoryrecords
15021502 136ofapplicantsforaninitialPrivilegetoPractice.Theseproceduresshallincludethe
15031503 137submissionoffingerprintsorotherbiometric-basedinformationbyapplicantsforthe
15041504 138purposeofobtaininganapplicant'scriminalhistoryrecordinformationfromthe
15051505 139FederalBureauofInvestigationandtheagencyresponsibleforretainingthatState's
15061506 140criminalrecords;
15071507 141 a.Amemberstatemustfullyimplementacriminalbackgroundcheck
15081508 142requirement,withinatimeframeestablishedbyrule,byreceivingtheresultsofthe
15091509 143FederalBureauofInvestigationrecordsearchandshallusetheresultsinmaking
15101510 144licensuredecisions.
15111511 145 b.CommunicationbetweenaMemberState,theCommissionandamong
15121512 146MemberStatesregardingtheverificationofeligibilityforlicensurethroughthe
15131513 147CompactshallnotincludeanyinformationreceivedfromtheFederalBureauof
15141514 148InvestigationrelatingtoafederalcriminalrecordscheckperformedbyaMemberState
15151515 149underPublicLaw92-544.
15161516 150 4.ComplywiththeRulesoftheCommission;
15171517 151 5.RequireanapplicanttoobtainorretainalicenseintheHomeStateandmeet
15181518 152theHomeState'squalificationsforlicensureorrenewaloflicensure,aswellasallother
15191519 153applicableStatelaws;
15201520 154 6.GrantthePrivilegetoPracticetoaLicenseeholdingavalidUnencumbered
15211521 155LicenseinanotherMemberStateinaccordancewiththetermsoftheCompactand
15221522 156Rules;and
15231523 157 7.ProvidefortheattendanceoftheState'scommissionertotheCounseling
15241524 158CompactCommissionmeetings.
15251525 159 C.MemberStatesmaychargeafeeforgrantingthePrivilegetoPractice.
15261526 160 D.IndividualsnotresidinginaMemberStateshallcontinuetobeabletoapply
15271527 161foraMemberState'sSingleStateLicenseasprovidedunderthelawsofeachMember
15281528 162State.However,theSingleStateLicensegrantedtotheseindividualsshallnotbe
15291529 SSHCSHBs115&99 42 163recognizedasgrantingaPrivilegetoPracticeProfessionalCounselinginanyother
15301530 164MemberState.
15311531 165 E.NothinginthisCompactshallaffecttherequirementsestablishedbya
15321532 166MemberStatefortheissuanceofaSingleStateLicense.
15331533 167 F.AlicenseissuedtoaLicensedProfessionalCounselorbyaHomeStatetoa
15341534 168residentinthatStateshallberecognizedbyeachMemberStateasauthorizinga
15351535 169LicensedProfessionalCounselortopracticeProfessionalCounseling,underaPrivilege
15361536 170toPractice,ineachMemberState.
15371537 171 SECTION4.PRIVILEGETOPRACTICE
15381538 172 A.ToexercisethePrivilegetoPracticeunderthetermsandprovisionsofthe
15391539 173Compact,theLicenseeshall:
15401540 174 1.HoldalicenseintheHomeState;
15411541 175 2.HaveavalidUnitedStatesSocialSecurityNumberorNationalPractitioner
15421542 176Identifier;
15431543 177 3.BeeligibleforaPrivilegetoPracticeinanyMemberStateinaccordancewith
15441544 178Section4(D),(G)and(H);
15451545 179 4.HavenothadanyEncumbranceorrestrictionagainstanylicenseorPrivilege
15461546 180toPracticewithintheprevioustwo(2)years;
15471547 181 5.NotifytheCommissionthattheLicenseeisseekingthePrivilegetoPractice
15481548 182withinaRemoteState(s);
15491549 183 6.Payanyapplicablefees,includinganyStatefee,forthePrivilegetoPractice;
15501550 184 7.MeetanyContinuingCompetence/Educationrequirementsestablishedbythe
15511551 185HomeState;
15521552 186 8.MeetanyJurisprudenceRequirementsestablishedbytheRemoteState(s)in
15531553 187whichtheLicenseeisseekingaPrivilegetoPractice;and
15541554 188 9.ReporttotheCommissionanyAdverseAction,Encumbrance,orrestriction
15551555 189onlicensetakenbyanynon-MemberStatewithin30daysfromthedatetheactionis
15561556 190taken.
15571557 191 B.ThePrivilegetoPracticeisvaliduntiltheexpirationdateoftheHomeState
15581558 192license.TheLicenseemustcomplywiththerequirementsofSection4(A)tomaintain
15591559 193thePrivilegetoPracticeintheRemoteState.
15601560 194 C.ALicenseeprovidingProfessionalCounselinginaRemoteStateunderthe
15611561 195PrivilegetoPracticeshalladheretothelawsandregulationsoftheRemoteState.
15621562 196 D.ALicenseeprovidingProfessionalCounselingservicesinaRemoteStateis
15631563 197subjecttothatState'sregulatoryauthority.ARemoteStatemay,inaccordancewith
15641564 198dueprocessandthatState'slaws,removeaLicensee'sPrivilegetoPracticeinthe
15651565 199RemoteStateforaspecificperiodoftime,imposefines,and/ortakeanyothernecessary
15661566 SSHCSHBs115&99 43 200actionstoprotectthehealthandsafetyofitscitizens.TheLicenseemaybeineligiblefor
15671567 201aPrivilegetoPracticeinanyMemberStateuntilthespecifictimeforremovalhas
15681568 202passedandallfinesarepaid.
15691569 203 E.IfaHomeStatelicenseisencumbered,theLicenseeshalllosethePrivilegeto
15701570 204PracticeinanyRemoteStateuntilthefollowingoccur:
15711571 205 1.TheHomeStatelicenseisnolongerencumbered;and
15721572 206 2.HavenothadanyEncumbranceorrestrictionagainstanylicenseorPrivilege
15731573 207toPracticewithintheprevioustwo(2)years.
15741574 208 F.OnceanEncumberedLicenseintheHomeStateisrestoredtogoodstanding,
15751575 209theLicenseemustmeettherequirementsofSection4(A)toobtainaPrivilegetoPractice
15761576 210inanyRemoteState.
15771577 211 G.IfaLicensee'sPrivilegetoPracticeinanyRemoteStateisremoved,the
15781578 212individualmaylosethePrivilegetoPracticeinallotherRemoteStatesuntilthe
15791579 213followingoccur:
15801580 214 1.ThespecificperiodoftimeforwhichthePrivilegetoPracticewasremoved
15811581 215hasended;
15821582 216 2.Allfineshavebeenpaid;and
15831583 217 3.HavenothadanyEncumbranceorrestrictionagainstanylicenseorPrivilege
15841584 218toPracticewithintheprevioustwo(2)years.
15851585 219 H.OncetherequirementsofSection4(G)havebeenmet,theLicenseemustmeet
15861586 220therequirementsinSection4(A)toobtainaPrivilegetoPracticeinaRemoteState.
15871587 221 SECTION5:OBTAININGANEWHOMESTATELICENSEBASEDONA
15881588 222PRIVILEGETOPRACTICE
15891589 223 A.ALicensedProfessionalCounselormayholdaHomeStatelicense,which
15901590 224allowsforaPrivilegetoPracticeinotherMemberStates,inonlyoneMemberStateata
15911591 225time.
15921592 226 B.IfaLicensedProfessionalCounselorchangesprimaryStateofresidenceby
15931593 227movingbetweentwoMemberStates:
15941594 228 1.TheLicensedProfessionalCounselorshallfileanapplicationforobtaininga
15951595 229newHomeStatelicensebasedonaPrivilegetoPractice,payallapplicablefees,and
15961596 230notifythecurrentandnewHomeStateinaccordancewithapplicableRulesadoptedby
15971597 231theCommission.
15981598 232 2.UponreceiptofanapplicationforobtaininganewHomeStatelicenseby
15991599 233virtueofaPrivilegetoPractice,thenewHomeStateshallverifythattheLicensed
16001600 234ProfessionalCounselormeetsthepertinentcriteriaoutlinedinSection4viatheData
16011601 235System,withoutneedforprimarysourceverificationexceptfor:
16021602 SSHCSHBs115&99 44 236 a.aFederalBureauofInvestigationfingerprintbasedcriminalbackground
16031603 237checkifnotpreviouslyperformedorupdatedpursuanttoapplicablerulesadoptedby
16041604 238theCommissioninaccordancewithPublicLaw92-544;
16051605 239 b.othercriminalbackgroundcheckasrequiredbythenewHomeState;and
16061606 240 c.completionofanyrequisiteJurisprudenceRequirementsofthenewHome
16071607 241State.
16081608 242 3.TheformerHomeStateshallconverttheformerHomeStatelicenseintoa
16091609 243PrivilegetoPracticeoncethenewHomeStatehasactivatedthenewHomeStatelicense
16101610 244inaccordancewithapplicableRulesadoptedbytheCommission.
16111611 245 4.NotwithstandinganyotherprovisionofthisCompact,iftheLicensed
16121612 246ProfessionalCounselorcannotmeetthecriteriainSection4,thenewHomeStatemay
16131613 247applyitsrequirementsforissuinganewSingleStateLicense.
16141614 248 5.TheLicensedProfessionalCounselorshallpayallapplicablefeestothenew
16151615 249HomeStateinordertobeissuedanewHomeStatelicense.
16161616 250 C.IfaLicensedProfessionalCounselorchangesPrimaryStateofResidenceby
16171617 251movingfromaMemberStatetoanon-MemberState,orfromanon-MemberStatetoa
16181618 252MemberState,theStatecriteriashallapplyforissuanceofaSingleStateLicenseinthe
16191619 253newState.
16201620 254 D.NothinginthisCompactshallinterferewithaLicensee'sabilitytoholda
16211621 255SingleStateLicenseinmultipleStates,howeverforthepurposesofthisCompact,a
16221622 256LicenseeshallhaveonlyoneHomeStatelicense.
16231623 257 E.NothinginthisCompactshallaffecttherequirementsestablishedbya
16241624 258MemberStatefortheissuanceofaSingleStateLicense.
16251625 259 SECTION6.ACTIVEDUTYMILITARYPERSONNELORTHEIRSPOUSES
16261626 260 ActiveDutyMilitarypersonnel,ortheirspouse,shalldesignateaHomeState
16271627 261wheretheindividualhasacurrentlicenseingoodstanding.Theindividualmayretain
16281628 262theHomeStatedesignationduringtheperiodtheservicememberisonactiveduty.
16291629 263SubsequenttodesignatingaHomeState,theindividualshallonlychangetheirHome
16301630 264StatethroughapplicationforlicensureinthenewState,orthroughtheprocessoutlined
16311631 265inSection5.
16321632 266 SECTION7.COMPACTPRIVILEGETOPRACTICETELEHEALTH
16331633 267 A.MemberStatesshallrecognizetherightofaLicensedProfessionalCounselor,
16341634 268licensedbyaHomeStateinaccordancewithSection3andunderRulespromulgatedby
16351635 269theCommission,topracticeProfessionalCounselinginanyMemberStatevia
16361636 270TelehealthunderaPrivilegetoPracticeasprovidedintheCompactandRules
16371637 271promulgatedbytheCommission.
16381638 SSHCSHBs115&99 45 272 B.ALicenseeprovidingProfessionalCounselingservicesinaRemoteState
16391639 273underthePrivilegetoPracticeshalladheretothelawsandregulationsoftheRemote
16401640 274State.
16411641 275 SECTION8.ADVERSEACTIONS
16421642 276 A.InadditiontotheotherpowersconferredbyStatelaw,aRemoteStateshall
16431643 277havetheauthority,inaccordancewithexistingStatedueprocesslaw,to:
16441644 278 1.TakeAdverseActionagainstaLicensedProfessionalCounselor'sPrivilegeto
16451645 279PracticewithinthatMemberState,and
16461646 280 2.Issuesubpoenasforbothhearingsandinvestigationsthatrequirethe
16471647 281attendanceandtestimonyofwitnessesaswellastheproductionofevidence.Subpoenas
16481648 282issuedbyaLicensingBoardinaMemberStatefortheattendanceandtestimonyof
16491649 283witnessesortheproductionofevidencefromanotherMemberStateshallbeenforcedin
16501650 284thelatterStatebyanycourtofcompetentjurisdiction,accordingtothepracticeand
16511651 285procedureofthatcourtapplicabletosubpoenasissuedinproceedingspendingbeforeit.
16521652 286Theissuingauthorityshallpayanywitnessfees,travelexpenses,mileage,andotherfees
16531653 287requiredbytheservicestatutesoftheStateinwhichthewitnessesorevidenceare
16541654 288located.
16551655 289 3.OnlytheHomeStateshallhavethepowertotakeAdverseActionagainsta
16561656 290LicensedProfessionalCounselor'slicenseissuedbytheHomeState.
16571657 291 B.ForpurposesoftakingAdverseAction,theHomeStateshallgivethesame
16581658 292priorityandeffecttoreportedconductreceivedfromaMemberStateasitwouldifthe
16591659 293conducthadoccurredwithintheHomeState.Insodoing,theHomeStateshallapply
16601660 294itsownStatelawstodetermineappropriateaction.
16611661 295 C.TheHomeStateshallcompleteanypendinginvestigationsofaLicensed
16621662 296ProfessionalCounselorwhochangesprimaryStateofresidenceduringthecourseofthe
16631663 297investigations.TheHomeStateshallalsohavetheauthoritytotakeappropriateaction
16641664 298(s)andshallpromptlyreporttheconclusionsoftheinvestigationstotheadministrator
16651665 299oftheDataSystem.Theadministratorofthecoordinatedlicensureinformationsystem
16661666 300shallpromptlynotifythenewHomeStateofanyAdverseActions.
16671667 301 D.AMemberState,ifotherwisepermittedbyStatelaw,mayrecoverfromthe
16681668 302affectedLicensedProfessionalCounselorthecostsofinvestigationsanddispositionsof
16691669 303casesresultingfromanyAdverseActiontakenagainstthatLicensedProfessional
16701670 304Counselor.
16711671 305 E.AMemberStatemaytakeAdverseActionbasedonthefactualfindingsofthe
16721672 306RemoteState,providedthattheMemberStatefollowsitsownproceduresfortakingthe
16731673 307AdverseAction.
16741674 308 F.JointInvestigations:
16751675 SSHCSHBs115&99 46 309 1.InadditiontotheauthoritygrantedtoaMemberStatebyitsrespective
16761676 310ProfessionalCounselingpracticeactorotherapplicableStatelaw,anyMemberState
16771677 311mayparticipatewithotherMemberStatesinjointinvestigationsofLicensees.
16781678 312 2.MemberStatesshallshareanyinvestigative,litigation,orcompliance
16791679 313materialsinfurtheranceofanyjointorindividualinvestigationinitiatedunderthe
16801680 314Compact.
16811681 315 G.IfAdverseActionistakenbytheHomeStateagainstthelicenseofaLicensed
16821682 316ProfessionalCounselor,theLicensedProfessionalCounselor'sPrivilegetoPracticeinall
16831683 317otherMemberStatesshallbedeactivateduntilallEncumbranceshavebeenremoved
16841684 318fromtheStatelicense.AllHomeStatedisciplinaryordersthatimposeAdverseAction
16851685 319againstthelicenseofaLicensedProfessionalCounselorshallincludeaStatementthat
16861686 320theLicensedProfessionalCounselor'sPrivilegetoPracticeisdeactivatedinallMember
16871687 321Statesduringthependencyoftheorder.
16881688 322 H.IfaMemberStatetakesAdverseAction,itshallpromptlynotifythe
16891689 323administratoroftheDataSystem.TheadministratoroftheDataSystemshallpromptly
16901690 324notifytheHomeStateofanyAdverseActionsbyRemoteStates.
16911691 325 I.NothinginthisCompactshalloverrideaMemberState'sdecisionthat
16921692 326participationinanAlternativeProgrammaybeusedinlieuofAdverseAction.
16931693 327 SECTION 9.ESTABLISHMENT OFCOUNSELING COMPACT
16941694 328COMMISSION
16951695 329 A.TheCompactMemberStatesherebycreateandestablishajointpublic
16961696 330agencyknownastheCounselingCompactCommission:
16971697 331 1.TheCommissionisaninstrumentalityoftheCompactStates.
16981698 332 2.VenueisproperandjudicialproceedingsbyoragainsttheCommissionshall
16991699 333bebroughtsolelyandexclusivelyinacourtofcompetentjurisdictionwherethe
17001700 334principalofficeoftheCommissionislocated.TheCommissionmaywaivevenueand
17011701 335jurisdictionaldefensestotheextentitadoptsorconsentstoparticipateinalternative
17021702 336disputeresolutionproceedings.
17031703 337 3.NothinginthisCompactshallbeconstruedtobeawaiverofsovereign
17041704 338immunity.
17051705 339 B.Membership,Voting,andMeetings
17061706 340 1.EachMemberStateshallhaveandbelimitedtoone(1)delegateselectedby
17071707 341thatMemberState'sLicensingBoard.
17081708 342 2.Thedelegateshallbeeither:
17091709 343 a.AcurrentmemberoftheLicensingBoardatthetimeofappointment,whoisa
17101710 344LicensedProfessionalCounselororpublicmember;or
17111711 345 b.AnadministratoroftheLicensingBoard.
17121712 SSHCSHBs115&99 47 346 3.Anydelegatemayberemovedorsuspendedfromofficeasprovidedbythelaw
17131713 347oftheStatefromwhichthedelegateisappointed.
17141714 348 4.TheMemberStateLicensingBoardshallfillanyvacancyoccurringonthe
17151715 349Commissionwithin60days.
17161716 350 5.Eachdelegateshallbeentitledtoone(1)votewithregardtothepromulgation
17171717 351ofRulesandcreationofbylawsandshallotherwisehaveanopportunitytoparticipate
17181718 352inthebusinessandaffairsoftheCommission.
17191719 353 6.Adelegateshallvoteinpersonorbysuchothermeansasprovidedinthe
17201720 354bylaws.Thebylawsmayprovidefordelegates'participationinmeetingsbytelephone
17211721 355orothermeansofcommunication.
17221722 356 7.TheCommissionshallmeetatleastonceduringeachcalendaryear.
17231723 357Additionalmeetingsshallbeheldassetforthinthebylaws.
17241724 358 8.TheCommissionshallbyRuleestablishatermofofficefordelegatesandmay
17251725 359byRuleestablishtermlimits.
17261726 360 C.TheCommissionshallhavethefollowingpowersandduties:
17271727 361 1.EstablishthefiscalyearoftheCommission;
17281728 362 2.Establishbylaws;
17291729 363 3.Maintainitsfinancialrecordsinaccordancewiththebylaws;
17301730 364 4.Meetandtakesuchactionsasareconsistentwiththeprovisionsofthis
17311731 365Compactandthebylaws;
17321732 366 5.PromulgateRuleswhichshallbebindingtotheextentandinthemanner
17331733 367providedforintheCompact;
17341734 368 6.Bringandprosecutelegalproceedingsoractionsinthenameofthe
17351735 369Commission,providedthatthestandingofanyStateLicensingBoardtosueorbesued
17361736 370underapplicablelawshallnotbeaffected;
17371737 371 7.Purchaseandmaintaininsuranceandbonds;
17381738 372 8.Borrow,accept,orcontractforservicesofpersonnel,including,butnot
17391739 373limitedto,employeesofaMemberState;
17401740 374 9.Hireemployees,electorappointofficers,fixcompensation,defineduties,
17411741 375grantsuchindividualsappropriateauthoritytocarryoutthepurposesoftheCompact,
17421742 376andestablishtheCommission'spersonnelpoliciesandprogramsrelatingtoconflictsof
17431743 377interest,qualificationsofpersonnel,andotherrelatedpersonnelmatters;
17441744 378 10.Acceptanyandallappropriatedonationsandgrantsofmoney,equipment,
17451745 379supplies,materials,andservices,andtoreceive,utilize,anddisposeofthesame;
17461746 380providedthatatalltimestheCommissionshallavoidanyappearanceofimpropriety
17471747 381and/orconflictofinterest;
17481748 SSHCSHBs115&99 48 382 11.Lease,purchase,acceptappropriategiftsordonationsof,orotherwiseto
17491749 383own,hold,improveoruse,anyproperty,real,personalormixed;providedthatatall
17501750 384timestheCommissionshallavoidanyappearanceofimpropriety;
17511751 385 12.Sell,convey,mortgage,pledge,lease,exchange,abandon,orotherwise
17521752 386disposeofanypropertyreal,personal,ormixed;
17531753 387 13.Establishabudgetandmakeexpenditures;
17541754 388 14.Borrowmoney;
17551755 389 15.Appointcommittees,includingstandingcommitteescomposedofmembers,
17561756 390Stateregulators,Statelegislatorsortheirrepresentatives,andconsumer
17571757 391representatives,andsuchotherinterestedpersonsasmaybedesignatedinthis
17581758 392Compactandthebylaws;
17591759 393 16.Provideandreceiveinformationfrom,andcooperatewith,lawenforcement
17601760 394agencies;
17611761 395 17.EstablishandelectanExecutiveCommittee;and
17621762 396 18.Performsuchotherfunctionsasmaybenecessaryorappropriatetoachieve
17631763 397thepurposesofthisCompactconsistentwiththeStateregulationofProfessional
17641764 398Counselinglicensureandpractice.
17651765 399 D.TheExecutiveCommittee
17661766 400 1.TheExecutiveCommitteeshallhavethepowertoactonbehalfofthe
17671767 401CommissionaccordingtothetermsofthisCompact.
17681768 402 2.TheExecutiveCommitteeshallbecomposedofuptoeleven(11)members:
17691769 403 a.SevenvotingmemberswhoareelectedbytheCommissionfromthecurrent
17701770 404membershipoftheCommission;and
17711771 405 b.Uptofour(4)ex-officio,nonvotingmembersfromfour(4)recognized
17721772 406nationalprofessionalcounselororganizations.
17731773 407 c.Theex-officiomemberswillbeselectedbytheirrespectiveorganizations.
17741774 408 3.TheCommissionmayremoveanymemberoftheExecutiveCommitteeas
17751775 409providedinbylaws.
17761776 410 4.TheExecutiveCommitteeshallmeetatleastannually.
17771777 411 5.TheExecutiveCommitteeshallhavethefollowingdutiesandresponsibilities:
17781778 412 a.RecommendtotheentireCommissionchangestotheRulesorbylaws,
17791779 413changestothisCompactlegislation,feespaidbyCompactMemberStatessuchas
17801780 414annualdues,andanyCommissionCompactfeechargedtoLicenseesforthePrivilegeto
17811781 415Practice;
17821782 416 b.EnsureCompactadministrationservicesareappropriatelyprovided,
17831783 417contractualorotherwise;
17841784 418 c.Prepareandrecommendthebudget;
17851785 SSHCSHBs115&99 49 419 d.MaintainfinancialrecordsonbehalfoftheCommission;
17861786 420 e.MonitorCompactcomplianceofMemberStatesandprovidecompliance
17871787 421reportstotheCommission;
17881788 422 f.Establishadditionalcommitteesasnecessary;and
17891789 423 g.OtherdutiesasprovidedinRulesorbylaws.
17901790 424 E.MeetingsoftheCommission
17911791 425 1.Allmeetingsshallbeopentothepublic,andpublicnoticeofmeetingsshallbe
17921792 426giveninthesamemannerasrequiredundertheRulemakingprovisionsinSection11.
17931793 427 2.TheCommissionortheExecutiveCommitteeorothercommitteesofthe
17941794 428Commissionmayconveneinaclosed,non-publicmeetingiftheCommissionor
17951795 429ExecutiveCommitteeorothercommitteesoftheCommissionmustdiscuss:
17961796 430 a.Non-complianceofaMemberStatewithitsobligationsundertheCompact;
17971797 431 b.Theemployment,compensation,disciplineorothermatters,practicesor
17981798 432proceduresrelatedtospecificemployeesorothermattersrelatedtotheCommission's
17991799 433internalpersonnelpracticesandprocedures;
18001800 434 c.Current,threatened,orreasonablyanticipatedlitigation;
18011801 435 d.Negotiationofcontractsforthepurchase,lease,orsaleofgoods,services,or
18021802 436realestate;
18031803 437 e.Accusinganypersonofacrimeorformallycensuringanyperson;
18041804 438 f.Disclosureoftradesecretsorcommercialorfinancialinformationthatis
18051805 439privilegedorconfidential;
18061806 440 g.Disclosureofinformationofapersonalnaturewheredisclosurewould
18071807 441constituteaclearlyunwarrantedinvasionofpersonalprivacy;
18081808 442 h.Disclosureofinvestigativerecordscompiledforlawenforcementpurposes;
18091809 443 i.Disclosureofinformationrelatedtoanyinvestigativereportspreparedbyor
18101810 444onbehalfoforforuseoftheCommissionorothercommitteechargedwith
18111811 445responsibilityofinvestigationordeterminationofcomplianceissuespursuanttothe
18121812 446Compact;or
18131813 447 j.MattersspecificallyexemptedfromdisclosurebyfederalorMemberState
18141814 448statute.
18151815 449 3.Ifameeting,orportionofameeting,isclosedpursuanttothisprovision,the
18161816 450Commission'slegalcounselordesigneeshallcertifythatthemeetingmaybeclosedand
18171817 451shallreferenceeachrelevantexemptingprovision.
18181818 452 4.TheCommissionshallkeepminutesthatfullyandclearlydescribeallmatters
18191819 453discussedinameetingandshallprovideafullandaccuratesummaryofactionstaken,
18201820 454andthereasonstherefore,includingadescriptionoftheviewsexpressed.Alldocuments
18211821 455consideredinconnectionwithanactionshallbeidentifiedinsuchminutes.Allminutes
18221822 SSHCSHBs115&99 50 456anddocumentsofaclosedmeetingshallremainunderseal,subjecttoreleasebya
18231823 457majorityvoteoftheCommissionororderofacourtofcompetentjurisdiction.
18241824 458 F.FinancingoftheCommission
18251825 459 1.TheCommissionshallpay,orprovideforthepaymentof,thereasonable
18261826 460expensesofitsestablishment,organization,andongoingactivities.
18271827 461 2.TheCommissionmayacceptanyandallappropriaterevenuesources,
18281828 462donations,andgrantsofmoney,equipment,supplies,materials,andservices.
18291829 463 3.TheCommissionmaylevyonandcollectanannualassessmentfromeach
18301830 464MemberStateorimposefeesonotherpartiestocoverthecostoftheoperationsand
18311831 465activitiesoftheCommissionanditsstaff,whichmustbeinatotalamountsufficientto
18321832 466coveritsannualbudgetasapprovedeachyearforwhichrevenueisnotprovidedby
18331833 467othersources.Theaggregateannualassessmentamountshallbeallocatedbasedupona
18341834 468formulatobedeterminedbytheCommission,whichshallpromulgateaRulebinding
18351835 469uponallMemberStates.
18361836 470 4.TheCommissionshallnotincurobligationsofanykindpriortosecuringthe
18371837 471fundsadequatetomeetthesame;norshalltheCommissionpledgethecreditofanyof
18381838 472theMemberStates,exceptbyandwiththeauthorityoftheMemberState.
18391839 473 5.TheCommissionshallkeepaccurateaccountsofallreceiptsand
18401840 474disbursements.ThereceiptsanddisbursementsoftheCommissionshallbesubject
18411841 475totheauditandaccountingproceduresestablishedunderitsbylaws.However,all
18421842 476receiptsanddisbursementsoffundshandledbytheCommissionshallbeauditedyearly
18431843 477byacertifiedorlicensedpublicaccountant,andthereportoftheauditshallbeincluded
18441844 478inandbecomepartoftheannualreportoftheCommission.
18451845 479 G.QualifiedImmunity,Defense,andIndemnification
18461846 480 1.Themembers,officers,executivedirector,employeesandrepresentativesof
18471847 481theCommissionshallbeimmunefromsuitandliability,eitherpersonallyorintheir
18481848 482officialcapacity,foranyclaimfordamagetoorlossofpropertyorpersonalinjuryor
18491849 483othercivilliabilitycausedbyorarisingoutofanyactualorallegedact,erroror
18501850 484omissionthatoccurred,orthatthepersonagainstwhomtheclaimismadehada
18511851 485reasonablebasisforbelievingoccurredwithinthescopeofCommissionemployment,
18521852 486dutiesorresponsibilities;providedthatnothinginthisparagraphshallbeconstruedto
18531853 487protectanysuchpersonfromsuitand/orliabilityforanydamage,loss,injury,or
18541854 488liabilitycausedbytheintentionalorwillfulorwantonmisconductofthatperson.
18551855 489 2.TheCommissionshalldefendanymember,officer,executivedirector,
18561856 490employeeorrepresentativeoftheCommissioninanycivilactionseekingtoimpose
18571857 491liabilityarisingoutofanyactualorallegedact,error,oromissionthatoccurredwithin
18581858 492thescopeofCommissionemployment,duties,orresponsibilities,orthattheperson
18591859 SSHCSHBs115&99 51 493againstwhomtheclaimismadehadareasonablebasisforbelievingoccurredwithinthe
18601860 494scopeofCommissionemployment,duties,orresponsibilities;providedthatnothing
18611861 495hereinshallbeconstruedtoprohibitthatpersonfromretaininghisorherowncounsel;
18621862 496andprovidedfurther,thattheactualorallegedact,error,oromissiondidnotresult
18631863 497fromthatperson'sintentionalorwillfulorwantonmisconduct.
18641864 498 3.TheCommissionshallindemnifyandholdharmlessanymember,officer,
18651865 499executivedirector,employee,orrepresentativeoftheCommissionfortheamountofany
18661866 500settlementorjudgmentobtainedagainstthatpersonarisingoutofanyactualoralleged
18671867 501act,error,oromissionthatoccurredwithinthescopeofCommissionemployment,
18681868 502duties,orresponsibilities,orthatsuchpersonhadareasonablebasisforbelieving
18691869 503occurredwithinthescopeofCommissionemployment,duties,orresponsibilities,
18701870 504providedthattheactualorallegedact,error,oromissiondidnotresultfromthe
18711871 505intentionalorwillfulorwantonmisconductofthatperson.
18721872 506 SECTION10.DATASYSTEM
18731873 507 A.TheCommissionshallprovideforthedevelopment,maintenance,operation,
18741874 508andutilizationofacoordinateddatabaseandreportingsystemcontaininglicensure,
18751875 509AdverseAction,andInvestigativeInformationonalllicensedindividualsinMember
18761876 510States.
18771877 511 B.NotwithstandinganyotherprovisionofStatelawtothecontrary,aMember
18781878 512StateshallsubmitauniformdatasettotheDataSystemonallindividualstowhomthis
18791879 513CompactisapplicableasrequiredbytheRulesoftheCommission,including:
18801880 514 1.Identifyinginformation;
18811881 515 2.Licensuredata;
18821882 516 3.AdverseActionsagainstalicenseorPrivilegetoPractice;
18831883 517 4.Non-confidentialinformationrelatedtoAlternativeProgramparticipation;
18841884 518 5.Anydenialofapplicationforlicensure,andthereason(s)forsuchdenial;
18851885 519 6.CurrentSignificantInvestigativeInformation;and
18861886 520 7.OtherinformationthatmayfacilitatetheadministrationofthisCompact,as
18871887 521determinedbytheRulesoftheCommission.
18881888 522 C.InvestigativeInformationpertainingtoaLicenseeinanyMemberStatewill
18891889 523onlybeavailabletootherMemberStates.
18901890 524 D.TheCommissionshallpromptlynotifyallMemberStatesofanyAdverse
18911891 525ActiontakenagainstaLicenseeoranindividualapplyingforalicense.AdverseAction
18921892 526informationpertainingtoaLicenseeinanyMemberStatewillbeavailabletoanyother
18931893 527MemberState.
18941894 SSHCSHBs115&99 52 528 E.MemberStatescontributinginformationtotheDataSystemmaydesignate
18951895 529informationthatmaynotbesharedwiththepublicwithouttheexpresspermissionof
18961896 530thecontributingState.
18971897 531 F.AnyinformationsubmittedtotheDataSystemthatissubsequentlyrequired
18981898 532tobeexpungedbythelawsoftheMemberStatecontributingtheinformationshallbe
18991899 533removedfromtheDataSystem.
19001900 534 SECTION11.RULEMAKING
19011901 535 A.TheCommissionshallpromulgatereasonableRulesinordertoeffectively
19021902 536andefficientlyachievethepurposeoftheCompact.Notwithstandingtheforegoing,in
19031903 537theeventtheCommissionexercisesitsRulemakingauthorityinamannerthatisbeyond
19041904 538thescopeofthepurposesoftheCompact,orthepowersgrantedhereunder,thensuch
19051905 539anactionbytheCommissionshallbeinvalidandhavenoforceoreffect.
19061906 540 B.TheCommissionshallexerciseitsRulemakingpowerspursuanttothe
19071907 541criteriasetforthinthisSectionandtheRulesadoptedthereunder.Rulesand
19081908 542amendmentsshallbecomebindingasofthedatespecifiedineachRuleoramendment.
19091909 543 C.IfamajorityofthelegislaturesoftheMemberStatesrejectsaRule,by
19101910 544enactmentofastatuteorresolutioninthesamemannerusedtoadopttheCompact
19111911 545withinfour(4)yearsofthedateofadoptionoftheRule,thensuchRuleshallhaveno
19121912 546furtherforceandeffectinanyMemberState.
19131913 547 D.RulesoramendmentstotheRulesshallbeadoptedataregularorspecial
19141914 548meetingoftheCommission.
19151915 549 E.PriortopromulgationandadoptionofafinalRuleorRulesbythe
19161916 550Commission,andatleastthirty(30)daysinadvanceofthemeetingatwhichtheRule
19171917 551willbeconsideredandvotedupon,theCommissionshallfileaNoticeofProposed
19181918 552Rulemaking:
19191919 553 1.OnthewebsiteoftheCommissionorotherpubliclyaccessibleplatform;and
19201920 554 2.OnthewebsiteofeachMemberStateProfessionalCounselingLicensing
19211921 555BoardorotherpubliclyaccessibleplatformorthepublicationinwhicheachState
19221922 556wouldotherwisepublishproposedRules.
19231923 557 F.TheNoticeofProposedRulemakingshallinclude:
19241924 558 1.Theproposedtime,date,andlocationofthemeetinginwhichtheRulewillbe
19251925 559consideredandvotedupon;
19261926 560 2.ThetextoftheproposedRuleoramendmentandthereasonfortheproposed
19271927 561Rule;
19281928 562 3.ArequestforcommentsontheproposedRulefromanyinterestedperson;
19291929 563and
19301930 SSHCSHBs115&99 53 564 4.ThemannerinwhichinterestedpersonsmaysubmitnoticetotheCommission
19311931 565oftheirintentiontoattendthepublichearingandanywrittencomments.
19321932 566 G.PriortoadoptionofaproposedRule,theCommissionshallallowpersonsto
19331933 567submitwrittendata,facts,opinions,andarguments,whichshallbemadeavailableto
19341934 568thepublic.
19351935 569 H.TheCommissionshallgrantanopportunityforapublichearingbeforeit
19361936 570adoptsaRuleoramendmentifahearingisrequestedby:
19371937 571 1.Atleasttwenty-five(25)persons;
19381938 572 2.AStateorfederalgovernmentalsubdivisionoragency;or
19391939 573 3.Anassociationhavingatleasttwenty-five(25)members.
19401940 574 I.IfahearingisheldontheproposedRuleoramendment,theCommissionshall
19411941 575publishtheplace,time,anddateofthescheduledpublichearing.Ifthehearingisheld
19421942 576viaelectronicmeans,theCommissionshallpublishthemechanismforaccesstothe
19431943 577electronichearing.
19441944 578 1.Allpersonswishingtobeheardatthehearingshallnotifytheexecutive
19451945 579directoroftheCommissionorotherdesignatedmemberinwritingoftheirdesireto
19461946 580appearandtestifyatthehearingnotlessthanfive(5)businessdaysbeforethescheduled
19471947 581dateofthehearing.
19481948 582 2.Hearingsshallbeconductedinamannerprovidingeachpersonwhowishesto
19491949 583commentafairandreasonableopportunitytocommentorallyorinwriting.
19501950 584 3.Allhearingswillberecorded.Acopyoftherecordingwillbemadeavailable
19511951 585onrequest.
19521952 586 4.Nothinginthissectionshallbeconstruedasrequiringaseparatehearingon
19531953 587eachRule.RulesmaybegroupedfortheconvenienceoftheCommissionathearings
19541954 588requiredbythissection.
19551955 589 J.Followingthescheduledhearingdate,orbythecloseofbusinessonthe
19561956 590scheduledhearingdateifthehearingwasnotheld,theCommissionshallconsiderall
19571957 591writtenandoralcommentsreceived.
19581958 592 K.Ifnowrittennoticeofintenttoattendthepublichearingbyinterestedparties
19591959 593isreceived,theCommissionmayproceedwithpromulgationoftheproposedRule
19601960 594withoutapublichearing.
19611961 595 L.TheCommissionshall,bymajorityvoteofallmembers,takefinalactionon
19621962 596theproposedRuleandshalldeterminetheeffectivedateoftheRule,ifany,basedonthe
19631963 597RulemakingrecordandthefulltextoftheRule.
19641964 598 M.Upondeterminationthatanemergencyexists,theCommissionmayconsider
19651965 599andadoptanemergencyRulewithoutpriornotice,opportunityforcomment,or
19661966 600hearing,providedthattheusualRulemakingproceduresprovidedintheCompactand
19671967 SSHCSHBs115&99 54 601inthissectionshallberetroactivelyappliedtotheRuleassoonasreasonablypossible,in
19681968 602noeventlaterthanninety(90)daysaftertheeffectivedateoftheRule.Forthepurposes
19691969 603ofthisprovision,anemergencyRuleisonethatmustbeadoptedimmediatelyinorder
19701970 604to:
19711971 605 1.Meetanimminentthreattopublichealth,safety,orwelfare;
19721972 606 2.PreventalossofCommissionorMemberStatefunds;
19731973 607 3.MeetadeadlineforthepromulgationofanadministrativeRulethatis
19741974 608establishedbyfederallaworRule;or
19751975 609 4.Protectpublichealthandsafety.
19761976 610 N.TheCommissionoranauthorizedcommitteeoftheCommissionmaydirect
19771977 611revisionstoapreviouslyadoptedRuleoramendmentforpurposesofcorrecting
19781978 612typographicalerrors,errorsinformat,errorsinconsistency,orgrammaticalerrors.
19791979 613PublicnoticeofanyrevisionsshallbepostedonthewebsiteoftheCommission.The
19801980 614revisionshallbesubjecttochallengebyanypersonforaperiodofthirty(30)daysafter
19811981 615posting.Therevisionmaybechallengedonlyongroundsthattherevisionresultsina
19821982 616materialchangetoaRule.Achallengeshallbemadeinwritinganddeliveredtothe
19831983 617chairoftheCommissionpriortotheendofthenoticeperiod.Ifnochallengeismade,
19841984 618therevisionwilltakeeffectwithoutfurtheraction.Iftherevisionischallenged,the
19851985 619revisionmaynottakeeffectwithouttheapprovaloftheCommission.
19861986 620 SECTION 12.OVERSIGHT ,DISPUTE RESOLUTION, AND
19871987 621ENFORCEMENT
19881988 622 A.Oversight
19891989 623 1.Theexecutive,legislative,andjudicialbranchesofStategovernmentineach
19901990 624MemberStateshallenforcethisCompactandtakeallactionsnecessaryand
19911991 625appropriatetoeffectuatetheCompact'spurposesandintent.Theprovisionsofthis
19921992 626CompactandtheRulespromulgatedhereundershallhavestandingasstatutorylaw.
19931993 627 2.AllcourtsshalltakejudicialnoticeoftheCompactandtheRulesinany
19941994 628judicialoradministrativeproceedinginaMemberStatepertainingtothesubject
19951995 629matterofthisCompactwhichmayaffectthepowers,responsibilities,oractionsofthe
19961996 630Commission.
19971997 631 3.TheCommissionshallbeentitledtoreceiveserviceofprocessinanysuch
19981998 632proceedingandshallhavestandingtointerveneinsuchaproceedingforallpurposes.
19991999 633FailuretoprovideserviceofprocesstotheCommissionshallrenderajudgmentor
20002000 634ordervoidastotheCommission,thisCompact,orpromulgatedRules.
20012001 635 B.Default,TechnicalAssistance,andTermination
20022002 SSHCSHBs115&99 55 636 1.IftheCommissiondeterminesthataMemberStatehasdefaultedinthe
20032003 637performanceofitsobligationsorresponsibilitiesunderthisCompactorthe
20042004 638promulgatedRules,theCommissionshall:
20052005 639 a.ProvidewrittennoticetothedefaultingStateandotherMemberStatesofthe
20062006 640natureofthedefault,theproposedmeansofcuringthedefaultand/oranyotheraction
20072007 641tobetakenbytheCommission;and
20082008 642 b.Provideremedialtrainingandspecifictechnicalassistanceregardingthe
20092009 643default.
20102010 644 C.IfaStateindefaultfailstocurethedefault,thedefaultingStatemaybe
20112011 645terminatedfromtheCompactuponanaffirmativevoteofamajorityoftheMember
20122012 646States,andallrights,privilegesandbenefitsconferredbythisCompactmaybe
20132013 647terminatedontheeffectivedateoftermination.Acureofthedefaultdoesnotrelieve
20142014 648theoffendingStateofobligationsorliabilitiesincurredduringtheperiodofdefault.
20152015 649 D.TerminationofmembershipintheCompactshallbeimposedonlyafterall
20162016 650othermeansofsecuringcompliancehavebeenexhausted.Noticeofintenttosuspendor
20172017 651terminateshallbegivenbytheCommissiontothegovernor,themajorityandminority
20182018 652leadersofthedefaultingState'slegislature,andeachoftheMemberStates.
20192019 653 E.AStatethathasbeenterminatedisresponsibleforallassessments,
20202020 654obligations,andliabilitiesincurredthroughtheeffectivedateoftermination,including
20212021 655obligationsthatextendbeyondtheeffectivedateoftermination.
20222022 656 F.TheCommissionshallnotbearanycostsrelatedtoaStatethatisfoundtobe
20232023 657indefaultorthathasbeenterminatedfromtheCompact,unlessagreeduponinwriting
20242024 658betweentheCommissionandthedefaultingState.
20252025 659 G.ThedefaultingStatemayappealtheactionoftheCommissionbypetitioning
20262026 660theU.S.DistrictCourtfortheDistrictofColumbiaorthefederaldistrictwherethe
20272027 661Commissionhasitsprincipaloffices.Theprevailingmembershallbeawardedallcosts
20282028 662ofsuchlitigation,includingreasonableattorney'sfees.
20292029 663 H.DisputeResolution
20302030 664 1.UponrequestbyaMemberState,theCommissionshallattempttoresolve
20312031 665disputesrelatedtotheCompactthatariseamongMemberStatesandbetweenmember
20322032 666andnon-MemberStates.
20332033 667 2.TheCommissionshallpromulgateaRuleprovidingforbothmediationand
20342034 668bindingdisputeresolutionfordisputesasappropriate.
20352035 669 I.Enforcement
20362036 670 1.TheCommission,inthereasonableexerciseofitsdiscretion,shallenforcethe
20372037 671provisionsandRulesofthisCompact.
20382038 SSHCSHBs115&99 56 672 2.Bymajorityvote,theCommissionmayinitiatelegalactionintheUnited
20392039 673StatesDistrictCourtfortheDistrictofColumbiaorthefederaldistrictwherethe
20402040 674CommissionhasitsprincipalofficesagainstaMemberStateindefaulttoenforce
20412041 675compliancewiththeprovisionsoftheCompactanditspromulgatedRulesandbylaws.
20422042 676Thereliefsoughtmayincludebothinjunctivereliefanddamages.Intheeventjudicial
20432043 677enforcementisnecessary,theprevailingmembershallbeawardedallcostsofsuch
20442044 678litigation,includingreasonableattorney'sfees.
20452045 679 3.TheremedieshereinshallnotbetheexclusiveremediesoftheCommission.
20462046 680TheCommissionmaypursueanyotherremediesavailableunderfederalorStatelaw.
20472047 681 SECTION13.DATEOFIMPLEMENTATIONOFTHECOUNSELING
20482048 682COMPACTCOMMISSION ANDASSOCIATEDRULES,WITHDRAWAL,AND
20492049 683AMENDMENT
20502050 684 A.TheCompactshallcomeintoeffectonthedateonwhichtheCompactstatute
20512051 685isenactedintolawinthetenthMemberState.Theprovisions,whichbecomeeffective
20522052 686atthattime,shallbelimitedtothepowersgrantedtotheCommissionrelatingto
20532053 687assemblyandthepromulgationofRules.Thereafter,theCommissionshallmeetand
20542054 688exerciseRulemakingpowersnecessarytotheimplementationandadministrationofthe
20552055 689Compact.
20562056 690 B.AnyStatethatjoinstheCompactsubsequenttotheCommission'sinitial
20572057 691adoptionoftheRulesshallbesubjecttotheRulesastheyexistonthedateonwhichthe
20582058 692CompactbecomeslawinthatState.AnyRulethathasbeenpreviouslyadoptedbythe
20592059 693CommissionshallhavethefullforceandeffectoflawonthedaytheCompactbecomes
20602060 694lawinthatState.
20612061 695 C.AnyMemberStatemaywithdrawfromthisCompactbyenactingastatute
20622062 696repealingthesame.
20632063 697 1.AMemberState'swithdrawalshallnottakeeffectuntilsix(6)monthsafter
20642064 698enactmentoftherepealingstatute.
20652065 699 2.Withdrawalshallnotaffectthecontinuingrequirementofthewithdrawing
20662066 700State'sProfessionalCounselingLicensingBoardtocomplywiththeinvestigativeand
20672067 701AdverseActionreportingrequirementsofthisactpriortotheeffectivedateof
20682068 702withdrawal.
20692069 703 D.NothingcontainedinthisCompactshallbeconstruedtoinvalidateorprevent
20702070 704anyProfessionalCounselinglicensureagreementorothercooperativearrangement
20712071 705betweenaMemberStateandanon-MemberStatethatdoesnotconflictwiththe
20722072 706provisionsofthisCompact.
20732073 SSHCSHBs115&99 57 707 E.ThisCompactmaybeamendedbytheMemberStates.Noamendmenttothis
20742074 708CompactshallbecomeeffectiveandbindinguponanyMemberStateuntilitisenacted
20752075 709intothelawsofallMemberStates.
20762076 710 SECTION14.CONSTRUCTION ANDSEVERABILITY
20772077 711 ThisCompactshallbeliberallyconstruedsoastoeffectuatethepurposes
20782078 712thereof.TheprovisionsofthisCompactshallbeseverableandifanyphrase,clause,
20792079 713sentenceorprovisionofthisCompactisdeclaredtobecontrarytotheconstitutionof
20802080 714anyMemberStateoroftheUnitedStatesortheapplicabilitythereoftoany
20812081 715government,agency,personorcircumstanceisheldinvalid,thevalidityofthe
20822082 716remainderofthisCompactandtheapplicabilitythereoftoanygovernment,agency,
20832083 717personorcircumstanceshallnotbeaffectedthereby.IfthisCompactshallbeheld
20842084 718contrarytotheconstitutionofanyMemberState,theCompactshallremaininfullforce
20852085 719andeffectastotheremainingMemberStatesandinfullforceandeffectastothe
20862086 720MemberStateaffectedastoallseverablematters.
20872087 721 SECTION15.BINDINGEFFECTOFCOMPACTANDOTHERLAWS
20882088 722 A.ALicenseeprovidingProfessionalCounselingservicesinaRemoteState
20892089 723underthePrivilegetoPracticeshalladheretothelawsandregulations,includingscope
20902090 724ofpractice,oftheRemoteState.
20912091 725 B.NothinghereinpreventstheenforcementofanyotherlawofaMemberState
20922092 726thatisnotinconsistentwiththeCompact.
20932093 727 C.AnylawsinaMemberStateinconflictwiththeCompactaresupersededto
20942094 728theextentoftheconflict.
20952095 729 D.AnylawfulactionsoftheCommission,includingallRulesandbylaws
20962096 730properlypromulgatedbytheCommission,arebindingupontheMemberStates.
20972097 731 E.AllpermissibleagreementsbetweentheCommissionandtheMemberStates
20982098 732arebindinginaccordancewiththeirterms.
20992099 733 F.IntheeventanyprovisionoftheCompactexceedstheconstitutionallimits
21002100 734imposedonthelegislatureofanyMemberState,theprovisionshallbeineffectivetothe
21012101 735extentoftheconflictwiththeconstitutionalprovisioninquestioninthatMemberState.
21022102 338.010.1.The"practiceofpharmacy"[means] includes:
21032103 2 (1)Theinterpretation,implementation,andevaluationofmedicalprescriptionorders,
21042104 3includinganylegenddrugsunder21U.S.C.Section353[;],andthereceipt,transmission,or
21052105 4handlingofsuchordersorfacilitatingthedispensingofsuchorders;
21062106 5 (2)Thedesigning,initiating,implementing,andmonitoringofamedication
21072107 6therapeuticplan[asdefinedbytheprescriptionordersolongastheprescriptionorderis
21082108 7specifictoeachpatientforcarebyapharmacist] inaccordancewiththeprovisionsofthis
21092109 8section;
21102110 SSHCSHBs115&99 58 9 (3)Thecompounding,dispensing,labeling,andadministrationofdrugsanddevices
21112111 10pursuanttomedicalprescriptionorders[andadministrationofviralinfluenza,pneumonia,
21122112 11shingles,hepatitisA,hepatitisB,diphtheria,tetanus,pertussis,andmeningitisvaccinesby
21132113 12writtenprotocolauthorizedbyaphysicianforpersonsatleastsevenyearsofageortheage
21142114 13recommendedbytheCentersforDiseaseControlandPrevention,whicheverishigher,orthe
21152115 14administrationofpneumonia,shingles,hepatitisA,hepatitisB,diphtheria,tetanus,pertussis,
21162116 15meningitis,andviralinfluenzavaccinesbywrittenprotocolauthorizedbyaphysicianfora
21172117 16specificpatientasauthorizedbyrule];
21182118 17 (4)Theorderingandadministrationofvaccinesapprovedorauthorizedbythe
21192119 18U.S.FoodandDrugAdministration,excludingvaccinesforcholera,monkeypox,
21202120 19Japaneseencephalitis,typhoid,rabies,yellowfever,tick-borneencephalitis,anthrax,
21212121 20tuberculosis,dengue,Hib,polio,rotavirus,smallpox,andanyvaccineapprovedafter
21222122 21January1,2023,topersonsatleastsevenyearsofageortheagerecommendedbythe
21232123 22CentersforDiseaseControlandPrevention,whicheverisolder,pursuanttojoint
21242124 23promulgationofrulesestablishedbytheboardofpharmacyandthestateboardof
21252125 24registrationforthehealingartsunlessrulesareestablishedunderastateofemergency
21262126 25asdescribedinsection44.100;
21272127 26 (5)Theparticipationindrugselectionaccordingtostatelawandparticipationindrug
21282128 27utilizationreviews;
21292129 28 (6)Theproperandsafestorageofdrugsanddevicesandthemaintenanceofproper
21302130 29recordsthereof;
21312131 30 (7)Consultationwithpatientsandotherhealthcarepractitioners,andveterinarians
21322132 31andtheirclientsaboutlegenddrugs,aboutthesafeandeffectiveuseofdrugsanddevices;
21332133 32 (8)Theprescribinganddispensingofanynicotinereplacementtherapyproductunder
21342134 33section338.665;
21352135 34 (9)ThedispensingofHIVpostexposureprophylaxispursuanttosection338.730;and
21362136 35 (10)Theofferingorperformingofthoseacts,services,operations,ortransactions
21372137 36necessaryintheconduct,operation,managementandcontrolofapharmacy.
21382138 37 2.Nopersonshallengageinthepracticeofpharmacyunlessheorsheislicensed
21392139 38undertheprovisionsofthischapter.
21402140 39 3.Thischaptershallnotbeconstruedtoprohibittheuseofauxiliarypersonnelunder
21412141 40thedirectsupervisionofapharmacistfromassistingthepharmacistinanyofhisorherduties.
21422142 41Thisassistanceinnowayisintendedtorelievethepharmacistfromhisorherresponsibilities
21432143 42forcompliancewiththischapterandheorshewillberesponsiblefortheactionsofthe
21442144 43auxiliarypersonnelactinginhisorherassistance.
21452145 44 4.Thischaptershall[also] notbeconstruedtoprohibitorinterferewithanylegally
21462146 45registeredpractitionerofmedicine,dentistry,orpodiatry,orveterinarymedicineonlyforuse
21472147 SSHCSHBs115&99 59 46inanimals,orthepracticeofoptometryinaccordancewithandasprovidedinsections
21482148 47195.070and336.220inthecompounding,administering,prescribing,ordispensingofhisor
21492149 48herownprescriptions.
21502150 49 [2.Anypharmacistwhoacceptsaprescriptionorderforamedicationtherapeuticplan
21512151 50shallhaveawrittenprotocolfromthephysicianwhorefersthepatientformedicationtherapy
21522152 51services.] 5.Apharmacistwithacertificateofmedicationtherapeuticplanauthority
21532153 52mayprovidemedicationtherapyservicespursuanttoawrittenprotocolfroma
21542154 53physicianlicensedunderchapter334topatientswhohaveestablishedaphysician-
21552155 54patientrelationship,asdescribedinsubdivision(1)ofsubsection1ofsection191.1146,
21562156 55withtheprotocolphysician.Thewrittenprotocol[andtheprescriptionorderfora
21572157 56medicationtherapeuticplan]authorizedbythissectionshallcomeonlyfromthephysician
21582158 57[only,]andshallnotcomefromanurseengagedinacollaborativepracticearrangementunder
21592159 58section334.104,orfromaphysicianassistantengagedinacollaborativepractice
21602160 59arrangementundersection334.735.
21612161 60 [3.]6.Nothinginthissectionshallbeconstruedastopreventanyperson,firmor
21622162 61corporationfromowningapharmacyregulatedbysections338.210to338.315,providedthat
21632163 62alicensedpharmacistisinchargeofsuchpharmacy.
21642164 63 [4.]7.Nothinginthissectionshallbeconstruedtoapplytoorinterferewiththesale
21652165 64ofnonprescriptiondrugsandtheordinaryhouseholdremediesandsuchdrugsormedicinesas
21662166 65arenormallysoldbythoseengagedinthesaleofgeneralmerchandise.
21672167 66 [5.]8.Nohealthcarrierasdefinedinchapter376shallrequireanyphysicianwith
21682168 67whichtheycontracttoenterintoawrittenprotocolwithapharmacistformedication
21692169 68therapeuticservices.
21702170 69 [6.]9.Thissectionshallnotbeconstruedtoallowapharmacisttodiagnoseor
21712171 70independentlyprescribepharmaceuticals.
21722172 71 [7.]10.Thestateboardofregistrationforthehealingarts,undersection334.125,and
21732173 72thestateboardofpharmacy,undersection338.140,shalljointlypromulgaterulesregulating
21742174 73theuseofprotocols[forprescriptionorders] formedicationtherapyservices[and
21752175 74administrationofviralinfluenzavaccines]. Suchrulesshallrequireprotocolstoinclude
21762176 75provisionsallowingfortimelycommunicationbetweenthepharmacistandthe[referring]
21772177 76protocolphysicianorsimilarbodyauthorizedbythissection, andanyotherpatient
21782178 77protectionprovisionsdeemedappropriatebybothboards.Inordertotakeeffect,suchrules
21792179 78shallbeapprovedbyamajorityvoteofaquorumofeachboard.Neitherboardshall
21802180 79separatelypromulgaterulesregulatingtheuseofprotocolsfor[prescriptionordersfor]
21812181 80medicationtherapyservices[andadministrationofviralinfluenzavaccines]. Anyruleor
21822182 81portionofarule,asthattermisdefinedinsection536.010,thatiscreatedundertheauthority
21832183 82delegatedinthissectionshallbecomeeffectiveonlyifitcomplieswithandissubjecttoallof
21842184 SSHCSHBs115&99 60 83theprovisionsofchapter536and,ifapplicable,section536.028.Thissectionandchapter
21852185 84536arenonseverableandifanyofthepowersvestedwiththegeneralassemblypursuantto
21862186 85chapter536toreview,todelaytheeffectivedate,ortodisapproveandannularuleare
21872187 86subsequentlyheldunconstitutional,thenthegrantofrulemakingauthorityandanyrule
21882188 87proposedoradoptedafterAugust28,2007,shallbeinvalidandvoid.
21892189 88 [8.]11.Thestateboardofpharmacymaygrantacertificateofmedicationtherapeutic
21902190 89planauthoritytoalicensedpharmacistwhosubmitsproofofsuccessfulcompletionofa
21912191 90board-approvedcourseofacademicclinicalstudybeyondabachelorofscienceinpharmacy,
21922192 91includingbutnotlimitedtoclinicalassessmentskills,fromanationallyaccreditedcollegeor
21932193 92university,oracertificationofequivalenceissuedbyanationallyrecognizedprofessional
21942194 93organizationandapprovedbytheboardofpharmacy.
21952195 94 [9.]12.Anypharmacistwhohasreceivedacertificateofmedicationtherapeuticplan
21962196 95authoritymayengageinthedesigning,initiating,implementing,andmonitoringofa
21972197 96medicationtherapeuticplanasdefinedbya[prescriptionorder] writtenprotocolfroma
21982198 97physicianthat[is]maybespecifictoeachpatientforcarebyapharmacist.
21992199 98 [10.]13.Nothinginthissectionshallbeconstruedtoallowapharmacisttomakea
22002200 99therapeuticsubstitutionofapharmaceuticalprescribedbyaphysicianunlessauthorizedby
22012201 100thewrittenprotocolorthephysician'sprescriptionorder.
22022202 101 [11.]14."Veterinarian","doctorofveterinarymedicine","practitionerofveterinary
22032203 102medicine","DVM","VMD","BVSe","BVMS","BSe(VetScience)","VMB","MRCVS",or
22042204 103anequivalenttitlemeansapersonwhohasreceivedadoctor'sdegreeinveterinarymedicine
22052205 104fromanaccreditedschoolofveterinarymedicineorholdsanEducationalCommissionfor
22062206 105ForeignVeterinaryGraduates(EDFVG)certificateissuedbytheAmericanVeterinary
22072207 106MedicalAssociation(AVMA).
22082208 107 [12.]15.Inadditiontootherrequirementsestablishedbythejointpromulgationof
22092209 108rulesbytheboardofpharmacyandthestateboardofregistrationforthehealingarts:
22102210 109 (1)Apharmacistshalladministervaccinesbyprotocolinaccordancewithtreatment
22112211 110guidelinesestablishedbytheCentersforDiseaseControlandPrevention(CDC);
22122212 111 (2)Apharmacistwhoisadministeringavaccineshallrequestapatienttoremainin
22132213 112thepharmacyasafeamountoftimeafteradministeringthevaccinetoobserveanyadverse
22142214 113reactions.Suchpharmacistshallhaveadoptedemergencytreatmentprotocols;
22152215 114 [(3)]16.Inadditiontootherrequirementsbytheboard,apharmacistshallreceive
22162216 115additionaltrainingasrequiredbytheboardandevidencedbyreceivingacertificatefromthe
22172217 116boarduponcompletion,andshalldisplaythecertificationinhisorherpharmacywhere
22182218 117vaccinesaredelivered.
22192219 118 [13.]17.Apharmacistshallinformthepatientthattheadministrationof[the]a
22202220 119vaccinewillbeenteredintotheShowMeVaxsystem,asadministeredbythedepartmentof
22212221 SSHCSHBs115&99 61 120healthandseniorservices.Thepatientshallattesttotheinclusionofsuchinformationinthe
22222222 121systembysigningaformprovidedbythepharmacist.Ifthepatientindicatesthatheorshe
22232223 122doesnotwantsuchinformationenteredintotheShowMeVaxsystem,thepharmacistshall
22242224 123provideawrittenreportwithinfourteendaysofadministrationofavaccinetothepatient's
22252225 124healthcareprovider,ifprovidedbythepatient,containing:
22262226 125 (1)Theidentityofthepatient;
22272227 126 (2)Theidentityofthevaccineorvaccinesadministered;
22282228 127 (3)Therouteofadministration;
22292229 128 (4)Theanatomicsiteoftheadministration;
22302230 129 (5)Thedoseadministered;and
22312231 130 (6)Thedateofadministration.
22322232 131 18.Apharmacistlicensedunderthischaptermayorderandadministervaccines
22332233 132approvedorauthorizedbytheU.S.FoodandDrugAdministrationtoaddressapublic
22342234 133healthneed,aslawfullyauthorizedbythestateorfederalgovernment,oradepartment
22352235 134oragencythereof,duringastateorfederallydeclaredpublichealthemergency.
22362236 338.012.1.Apharmacistwithacertificateofmedicationtherapeuticplan
22372237 2authoritymayprovideinfluenza,groupAstreptococcus,andCOVID-19medication
22382238 3therapyservicespursuanttoastatewidestandingorderissuedbythedirectororchief
22392239 4medicalofficerofthedepartmentofhealthandseniorservicesifthatpersonisa
22402240 5licensedphysician,oralicensedphysiciandesignatedbythedepartmentofhealthand
22412241 6seniorservices.
22422242 7 2.Thestateboardofregistrationforthehealingarts,pursuanttosection
22432243 8334.125,andthestateboardofpharmacy,pursuanttosection338.140,shalljointly
22442244 9promulgaterulestoimplementtheprovisionsofthissection.Anyruleorportionofa
22452245 10rule,asthattermisdefinedinsection536.010,thatiscreatedundertheauthority
22462246 11delegatedinthissectionshallbecomeeffectiveonlyifitcomplieswithandissubjectto
22472247 12alloftheprovisionsofchapter536and,ifapplicable,section536.028.Thissectionand
22482248 13chapter536arenonseverableandifanyofthepowersvestedwiththegeneralassembly
22492249 14pursuanttochapter536toreview,todelaytheeffectivedate,ortodisapproveandannul
22502250 15arulearesubsequentlyheldunconstitutional,thenthegrantofrulemakingauthority
22512251 16andanyruleproposedoradoptedafterAugust28,2023,shallbeinvalidandvoid.
22522252 âś”
22532253 SSHCSHBs115&99 62