MO
Missouri Senate Bill SB157

Missouri 2023 Regular Session

Missouri Senate Bill SB157 Compare Versions

OldNewDifferences
1-
2-EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
3-and is intended to be omitted in the law.
41 FIRSTREGULARSESSION
5-[TRULY AGREED TO AND FINALLY PASSED ]
6-CONFERENCE COMMITTEE SUBSTITUTE FOR
72 HOUSECOMMITTEESUBSTITUTEFOR
83 SENATESUBSTITUTEFOR
94 SENATECOMMITTEESUBSTITUTEFOR
105 SENATEBILLNO.157
116 102NDGENERALASSEMBLY
12-2023
13-0779S.09T
7+0779H.05C DANARADEMANMILLER,ChiefClerk
148 ANACT
15-To repeal sections 190.255, 191.500, 191.505, 191.510, 191.515, 191.520, 191.525, 191.530,
16-191.535, 191.540, 191.545, 191.550, 191.600, 191.828, 191.831, 193.145, 193.265,
17-195.070, 195.100, 195.206, 281.102, 324.520, 331.020, 331.060, 334.036, 334.043,
18-334.100, 334.104, 334.506, 334.613, 334.735, 334.747, 335.016, 335.019, 335.036,
19-335.046, 335.051, 335.056, 335.076, 335.086, 335.175, 335.203, 335.212, 335.215,
20-335.218, 335.221, 335.224, 335.227, 335.230, 335.233, 335.236, 335.239, 335.242,
21-335.245, 335.248, 335.251, 335.254, 335.257, 337.510, 337.615, 337.644, 337.665,
22-338.010, 340.200, 340.216, 340.218, and 340.222, RSMo, and section 192.530 as truly
23-agreed to and finally passed by senate substitute for house bill no. 402, one hundred
24-second general assembly, first regular session, and to enact in lieu thereof ninety-four
25-new sections relating to professions requiring licensure, with penalty provisions and an
26-emergency clause for a certain section.
27-
9+Torepealsections191.500,191.505,191.510,191.515,191.520,191.525,191.530,191.535,
10+191.540,191.545,191.550,191.600,191.828,191.831,195.070,195.100,324.520,
11+329.010,334.036,334.043,334.100,334.104,334.506,334.613,334.735,334.747,
12+335.016,335.019,335.036,335.046,335.051,335.056,335.076,335.086,335.175,
13+335.203,335.212,335.215,335.218,335.221,335.224,335.227,335.230,335.233,
14+335.236,335.239,335.242,335.245,335.248,335.251,335.254,335.257,337.510,
15+337.615,337.644,and337.665,RSMo,andtoenactinlieuthereofseventy-eightnew
16+sectionsrelatingtoprofessionsrequiringlicensure,withpenaltyprovisions.
2817 BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
29- Section A. Sections 190.255, 191.500, 191.505, 191.510, 1
30-191.515, 191.520, 191.525, 191.530, 191.535, 191.540, 191.545, 2
31-191.550, 191.600, 191.828, 191.831, 193.145, 193.265, 195.070, 3
32-195.100, 195.206, 281.102, 324.520, 331.020, 331.060, 334.036, 4
33-334.043, 334.100, 334.104, 334.506, 334.613, 334.735, 334.747, 5
34-335.016, 335.019, 335.036, 335.046, 335.051, 335.056, 335.076, 6 CCS HCS SS SCS SB 157 2
35-335.086, 335.175, 335.203, 335.212, 335.215, 335.218, 335.221, 7
36-335.224, 335.227, 335.230, 335.233, 335 .236, 335.239, 335.242, 8
37-335.245, 335.248, 335.251, 335.254, 335.257, 337.510, 337.615, 9
38-337.644, 337.665, 338.010, 340.200, 340.216, 340.218, and 10
39-340.222, RSMo, and section 192.530 as truly agreed to and 11
40-finally passed by senate substitute for house bill no . 402, one 12
41-hundred second general assembly, first regular session, are 13
42-repealed and ninety-four new sections enacted in lieu thereof, 14
43-to be known as sections 190.255, 191.430, 191.435, 191.440, 15
44-191.445, 191.450, 191.592, 191.600, 191.828, 191.831, 193.145, 16
45-193.265, 195.070, 195.100, 195.206, 281.102, 324.520, 331.020, 17
46-331.060, 334.036, 334.043, 334.100, 334.104, 334.506, 334.613, 18
47-334.735, 334.747, 334.1600, 334.1605, 334.1610, 334.1615, 19
48-334.1620, 334.1625, 334.1630, 334.1635, 334.1640, 334.1645, 20
49-334.1650, 334.1655, 334.1660, 334.1665, 334.1670, 334.1675, 21
50-334.1680, 334.1685, 334.1690, 334.1695, 334.1700, 334.1705, 22
51-334.1710, 334.1715, 334.1720, 335.016, 335.019, 335.036, 23
52-335.046, 335.051, 335.056, 335.076, 335.086, 335.175, 335.203, 24
53-335.205, 337.510, 337.550, 337.615, 337.644, 337.665, 337.1000, 25
54-337.1005, 337.1010, 337.1015, 337.1020, 337.1025, 337.1030, 26
55-337.1035, 337.1040, 337.1045, 337.1050, 337.1055, 337.1060, 27
56-337.1065, 337.1070, 337.1075, 338.010, 338.012, 340.200, 28
57-340.216, 340.218, 340.222, 344.045, 344.05 5, 344.102, and 1, to 29
58-read as follows:30
59- 190.255. 1. Any qualified first responder may obtain 1
60-and administer naloxone , or any other drug or device 2
61-approved by the United States Food and Drug Administration, 3
62-that blocks the effects of an opioid ove rdose and is 4
63-administered in a manner approved by the United States Food 5
64-and Drug Administration to a person suffering from an 6
65-apparent narcotic or opiate -related overdose in order to 7
66-revive the person. 8 CCS HCS SS SCS SB 157 3
67- 2. Any licensed drug distributor or pharmac y in 9
68-Missouri may sell naloxone , or any other drug or device 10
69-approved by the United States Food and Drug Administration, 11
70-that blocks the effects of an opioid overdose and is 12
71-administered in a manner approved by the United States Food 13
72-and Drug Administration to qualified first responder 14
73-agencies to allow the agency to stock naloxone or other such 15
74-drugs or devices for the administration of such drug or 16
75-device to persons suffering from an apparent narcotic or 17
76-opiate overdose in order to revive the per son. 18
77- 3. For the purposes of this section, "qualified first 19
78-responder" shall mean any [state and local law enforcement 20
79-agency staff,] fire department personnel, fire district 21
80-personnel, or licensed emergency medical technician who is 22
81-acting under the directives and established protocols of a 23
82-medical director of a local licensed ground ambulance 24
83-service licensed under section 190.109 , or any state or 25
84-local law enforcement agency staff member, who comes in 26
85-contact with a person suffering from an apparent narcotic or 27
86-opiate-related overdose and who has received training in 28
87-recognizing and responding to a narcotic or opiate overdose 29
88-and the administration of naloxone , or any other drug or 30
89-device approved by the United States Food and Drug 31
90-Administration, that blocks the effects of an opioid 32
91-overdose and is administered in a manner approved by the 33
92-United States Food and Drug Administration to a person 34
93-suffering from an apparent narcotic or opiate -related 35
94-overdose. "Qualified first responder agencies" shall mean 36
95-any state or local law enforcement agency, fire department, 37
96-or ambulance service that provides documented training to 38
97-its staff related to the administration of naloxone or other 39 CCS HCS SS SCS SB 157 4
98-such drugs or devices in an apparent narcotic or opi ate 40
99-overdose situation. 41
100- 4. A qualified first responder shall only administer 42
101-naloxone, or any other drug or device approved by the United 43
102-States Food and Drug Administration, that blocks the effects 44
103-of an opioid overdose and is administered in a manner 45
104-approved by the United States Food and Drug Administration 46
105-by such means as the qualified first responder has received 47
106-training for the administration of naloxone or other such 48
107-drugs or devices. 49
108- 191.430. 1. There is hereby established within the 1
109-department of health and senior services the "Health 2
110-Professional Loan Repayment Program" to provide forgivable 3
111-loans for the purpose of repaying existing loans related to 4
112-applicable educational expenses for health care, mental 5
113-health, and public health professionals. The department of 6
114-health and senior services shall be the administrative 7
115-agency for the implementation of the program established by 8
116-this section. 9
117- 2. The department of health and senior services shall 10
118-prescribe the form and the time and method of filing 11
119-applications and supervise the processing, including 12
120-oversight and monitoring of the program, and shall 13
121-promulgate rules to implement the provisions of sections 14
122-191.430 to 191.450. Any rule or portion o f a rule, as that 15
123-term is defined in section 536.010, that is created under 16
124-the authority delegated in this section shall become 17
125-effective only if it complies with and is subject to all of 18
126-the provisions of chapter 536 and, if applicable, section 19
127-536.028. This section and chapter 536 are nonseverable and 20
128-if any of the powers vested with the general assembly 21
129-pursuant to chapter 536 to review, to delay the effective 22 CCS HCS SS SCS SB 157 5
130-date, or to disapprove and annul a rule are subsequently 23
131-held unconstitutional, then the grant of rulemaking 24
132-authority and any rule proposed or adopted after August 28, 25
133-2023, shall be invalid and void. 26
134- 3. The director of the department of health and senior 27
135-services shall have the discretion to determine the health 28
136-professionals and practitioners who will receive forgivable 29
137-health professional loans from the department to pay their 30
138-existing loans. The director shall make such determinations 31
139-each fiscal year based on evidence associated with the 32
140-greatest needs in the best inte rests of the public. The 33
141-health care, mental health, and public health professionals 34
142-or disciplines funded in any given year shall be contingent 35
143-upon consultation with the office of workforce development 36
144-in the department of higher education and workf orce 37
145-development and the department of mental health, or their 38
146-successor agencies. 39
147- 4. The department of health and senior services shall 40
148-enter into a contract with each selected applicant who 41
149-receives a health professional loan under this section . 42
150-Each selected applicant shall apply the loan award to his or 43
151-her educational debt. The contract shall detail the methods 44
152-of forgiveness associated with a service obligation and the 45
153-terms associated with the principal and interest accruing on 46
154-the loan at the time of the award. The contract shall 47
155-contain details concerning how forgiveness is earned, 48
156-including when partial forgiveness is earned through a 49
157-service obligation, and the terms and conditions associated 50
158-with repayment of the loans for a ny obligation not served. 51
159- 5. All health professional loans shall be made from 52
160-funds appropriated by the general assembly to the health 53 CCS HCS SS SCS SB 157 6
161-professional loan incentive fund established in section 54
162-191.445. 55
163- 191.435. The department of health and senior services 1
164-shall designate counties, communities, or sections of areas 2
165-in the state as areas of defined need for health care, 3
166-mental health, and public health services. If a county, 4
167-community, or section of an area has been designated or 5
168-determined as a professional shortage area, a shortage area, 6
169-or a health care, mental health, or public health 7
170-professional shortage area by the federal Department of 8
171-Health and Human Services or its successor agency, the 9
172-department of health and s enior services shall designate it 10
173-as an area of defined need under this section. If the 11
174-director of the department of health and senior services 12
175-determines that a county, community, or section of an area 13
176-has an extraordinary need for health care profe ssional 14
177-services without a corresponding supply of such 15
178-professionals, the department of health and senior services 16
179-may designate it as an area of defined need under this 17
180-section. 18
181- 191.440. 1. The department of health and senior 1
182-services shall enter into a contract with each individual 2
183-qualifying for a forgivable loan under sections 191.430 to 3
184-191.450. The written contract between the department and 4
185-the individual shall contain, but not be limited to, the 5
186-following: 6
187- (1) An agreement that the state agrees to award a loan 7
188-and the individual agrees to serve for a period equal to two 8
189-years, or a longer period as the individual may agree to, in 9
190-an area of defined need as designated by the department, 10
191-with such service perio d to begin on the date identified on 11
192-the signed contract; 12 CCS HCS SS SCS SB 157 7
193- (2) A provision that any financial obligations arising 13
194-out of a contract entered into and any obligation of the 14
195-individual that is conditioned thereon is contingent upon 15
196-funds being appropriated for loans; 16
197- (3) The area of defined need where the person will 17
198-practice; 18
199- (4) A statement of the damages to which the state is 19
200-entitled for the individual's breach of the contract; and 20
201- (5) Such other statements of the rights and 21
202-liabilities of the department and of the individual not 22
203-inconsistent with sections 191.430 to 191.450. 23
204- 2. The department of health and senior services may 24
205-stipulate specific practice sites, contingent upon 25
206-department-generated health care, mental h ealth, and public 26
207-health professional need priorities, where applicants shall 27
208-agree to practice for the duration of their participation in 28
209-the program. 29
210- 191.445. There is hereby created in the state treasury 1
211-the "Health Professional Loan Incentive Fund", which shall 2
212-consist of any appropriations made by the general assembly, 3
213-all funds recovered from an individual under section 4
214-191.450, and all funds generated by loan repayments received 5
215-under sections 191.430 to 191.450. The state treasurer 6
216-shall be custodian of the fund. In accordance with sections 7
217-30.170 and 30.180, the state treasurer may approve 8
218-disbursements. The fund shall be a dedicated fund and, upon 9
219-appropriation, moneys in this fund shall be used solely by 10
220-the department of health and senior services to provide 11
221-loans under sections 191.430 to 191.450. Notwithstanding 12
222-the provisions of section 33.080 to the contrary, any moneys 13
223-remaining in the fund at the end of the biennium shall not 14
224-revert to the credit of t he general revenue fund. The state 15 CCS HCS SS SCS SB 157 8
225-treasurer shall invest moneys in the fund in the same manner 16
226-as other funds are invested. Any interest and moneys earned 17
227-on such investments shall be credited to the fund. 18
228- 191.450. 1. An individual who enters into a written 1
229-contract with the department of health and senior services, 2
230-as described in section 191.440, and who fails to maintain 3
231-an acceptable employment status shall be liable to the state 4
232-for any amount awarded as a loan by the dep artment directly 5
233-to the individual who entered into the contract that has not 6
234-yet been forgiven. 7
235- 2. An individual fails to maintain an acceptable 8
236-employment status under this section when the contracted 9
237-individual involuntarily or voluntarily ter minates 10
238-qualifying employment, is dismissed from such employment 11
239-before completion of the contractual service obligation 12
240-within the specific time frame outlined in the contract, or 13
241-fails to respond to requests made by the department. 14
242- 3. If an individual breaches the written contract of 15
243-the individual by failing to begin or complete such 16
244-individual's service obligation, the state shall be entitled 17
245-to recover from the individual an amount equal to the sum of: 18
246- (1) The total amount of the loa n awarded by the 19
247-department or, if the department had already awarded partial 20
248-forgiveness at the time of the breach, the amount of the 21
249-loan not yet forgiven; 22
250- (2) The interest on the amount that would be payable 23
251-if at the time the loan was awarded it was a loan bearing 24
252-interest at the maximum prevailing rate as determined by the 25
253-Treasurer of the United States; 26
254- (3) An amount equal to any damages incurred by the 27
255-department as a result of the breach; and 28 CCS HCS SS SCS SB 157 9
256- (4) Any legal fees or associated costs incurred by the 29
257-department or the state of Missouri in the collection of 30
258-damages. 31
259- 191.592. 1. For purposes of this section, the 1
260-following terms mean: 2
261- (1) "Department", the department of health and senior 3
262-services; 4
263- (2) "Eligible entity", an entity that operates a 5
264-physician medical residency program in this state and that 6
265-is accredited by the Accreditation Council for Graduate 7
266-Medical Education; 8
267- (3) "General primary care and psychiatry", family 9
268-medicine, general internal medicine, general pediatrics, 10
269-internal medicine-pediatrics, general obstetrics and 11
270-gynecology, or general psychiatry; 12
271- (4) "Grant-funded residency position", a position that 13
272-is accredited by the Accreditation Council for Graduate 14
273-Medical Education, that is established as a result of 15
274-funding awarded to an eligible entity for the purpose of 16
275-establishing an additional medical resident position beyond 17
276-the currently existing medical resident positions, and that 18
277-is within the fields o f general primary care and 19
278-psychiatry. Such position shall end when the medical 20
279-residency funding under this section is completed or when 21
280-the resident in the medical grant -funded residency position 22
281-is no longer employed by the eligible entity, whichev er is 23
282-earlier; 24
283- (5) "Participating medical resident", an individual 25
284-who is a medical school graduate with a doctor of medicine 26
285-degree or doctor of osteopathic medicine degree, who is 27
286-participating in a postgraduate training program at an 28 CCS HCS SS SCS SB 157 10
287-eligible entity, and who is filling a grant -funded residency 29
288-position. 30
289- 2. (1) Subject to appropriation, the department shall 31
290-establish a medical residency grant program to award grants 32
291-to eligible entities for the purpose of establishing and 33
292-funding new general primary care and psychiatry medical 34
293-residency positions in this state and continuing the funding 35
294-of such new residency positions for the duration of the 36
295-funded residency. 37
296- (2) (a) Funding shall be available for three years 38
297-for residency positions in family medicine, general internal 39
298-medicine, and general pediatrics. 40
299- (b) Funding shall be available for four years for 41
300-residency positions in general obstetrics and gynecology, 42
301-internal medicine-pediatrics, and general psychiatry. 43
302- 3. (1) There is hereby created in the state treasury 44
303-the "Medical Residency Grant Program Fund". Moneys in the 45
304-fund shall be used to implement and fund grants to eligible 46
305-entities. 47
306- (2) The medical residency grant program fund shall 48
307-include funds appropriated by the general assembly, 49
308-reimbursements from awarded eligible entities that were not 50
309-able to fill the residency position or positions with an 51
310-individual medical resident or residents, and any gifts, 52
311-contributions, grants, or bequests r eceived from federal, 53
312-private, or other sources. 54
313- (3) The state treasurer shall be custodian of the 55
314-fund. In accordance with sections 30.170 and 30.180, the 56
315-state treasurer may approve disbursements. The fund shall 57
316-be a dedicated fund and, upon appropriation, moneys in the 58
317-fund shall be used solely as provided in this section. 59 CCS HCS SS SCS SB 157 11
318- (4) Notwithstanding the provisions of section 33.080 60
319-to the contrary, any moneys remaining in the fund at the end 61
320-of the biennium shall not revert to the credit of the 62
321-general revenue fund. 63
322- (5) The state treasurer shall invest moneys in the 64
323-fund in the same manner as other funds are invested. Any 65
324-interest and moneys earned on such investments shall be 66
325-credited to the fund. 67
326- 4. Subject to appropriatio n, the department shall 68
327-expend moneys in the medical residency grant program fund in 69
328-the following order: 70
329- (1) Necessary costs of the department to implement 71
330-this section; 72
331- (2) Funding of grant-funded residency positions of 73
332-individuals in the fourth year of their residency, as 74
333-applicable to residents in general obstetrics and 75
334-gynecology, internal medicine -pediatrics, and general 76
335-psychiatry; 77
336- (3) Funding of grant-funded residency positions of 78
337-individuals in the third year of their resi dency; 79
338- (4) Funding of grant-funded residency positions of 80
339-individuals in the second year of their residency; 81
340- (5) Funding of grant-funded residency positions of 82
341-individuals in the first year of their residency; and 83
342- (6) The establishment of new grant-funded residency 84
343-positions at awarded eligible entities. 85
344- 5. The department shall establish criteria to evaluate 86
345-which eligible entities shall be awarded grants for new 87
346-grant-funded residency positions, criteria for determining 88
347-the amount and duration of grants, the contents of the grant 89
348-application, procedures and timelines by which eligible 90
349-entities may apply for grants, and all other rules needed to 91 CCS HCS SS SCS SB 157 12
350-implement the purposes of this section. Such criteria shall 92
351-include a preference for eligible entities located in areas 93
352-of highest need for general primary care and psychiatric 94
353-care physicians, as determined by the health professional 95
354-shortage area score. 96
355- 6. Eligible entities that receive grants under this 97
356-section shall: 98
357- (1) Agree to supplement awarded funds under this 99
358-section, if necessary, to establish or maintain a grant - 100
359-funded residency position for the duration of the funded 101
360-resident's medical residency; and 102
361- (2) Agree to abide by other requirements impose d by 103
362-rule. 104
363- 7. Annual funding per participating medical resident 105
364-shall be limited to: 106
365- (1) Direct graduate medical education costs including, 107
366-but not limited to: 108
367- (a) Salaries and benefits for residents, faculty, and 109
368-program staff; 110
369- (b) Malpractice insurance, licenses, and other 111
370-required fees; and 112
371- (c) Program administration and educational materials; 113
372-and 114
373- (2) Indirect costs of graduate medical education 115
374-necessary to meet the standards of the Accreditation Council 116
375-for Graduate Medical Education. 117
376- 8. No new grant-funded residency positions under this 118
377-section shall be established after the tenth fiscal year in 119
378-which grants are awarded. However, any residency positions 120
379-funded under this section may continue to be f unded until 121
380-the completion of the resident's medical residency. 122 CCS HCS SS SCS SB 157 13
381- 9. The department shall submit an annual report to the 123
382-general assembly regarding the implementation of the program 124
383-developed under this section. 125
384- 10. The department may promulga te all necessary rules 126
385-and regulations for the administration of this section. Any 127
386-rule or portion of a rule, as that term is defined in 128
387-section 536.010, that is created under the authority 129
388-delegated in this section shall become effective only if it 130
389-complies with and is subject to all of the provisions of 131
390-chapter 536 and, if applicable, section 536.028. This 132
391-section and chapter 536 are nonseverable and if any of the 133
392-powers vested with the general assembly pursuant to chapter 134
393-536 to review, to del ay the effective date, or to disapprove 135
394-and annul a rule are subsequently held unconstitutional, 136
395-then the grant of rulemaking authority and any rule proposed 137
396-or adopted after the effective date of this section shall be 138
397-invalid and void. 139
398- 11. The provisions of this section shall expire on 140
399-January 1, 2038. 141
400- 191.600. 1. Sections 191.600 to 191.615 establish a 1
401-loan repayment program for graduates of approved medical 2
402-schools, schools of osteopathic medicine, schools of 3
403-dentistry and accredited chiropractic colleges who practice 4
404-in areas of defined need and shall be known as the "Health 5
405-Professional Student Loan Repayment Program". Sections 6
406-191.600 to 191.615 shall apply to graduates of accredited 7
407-chiropractic colleges when fe deral guidelines for 8
408-chiropractic shortage areas are developed. 9
409- 2. The "Health Professional Student Loan and Loan 10
410-Repayment Program Fund" is hereby created in the state 11
411-treasury. All funds recovered from an individual pursuant 12
412-to section 191.614 and all funds generated by loan 13 CCS HCS SS SCS SB 157 14
413-repayments and penalties received pursuant to section 14
414-191.540 shall be credited to the fund. The moneys in the 15
415-fund shall be used by the department of health and senior 16
416-services to provide loan repayments pursuant to s ection 17
417-191.611 in accordance with sections 191.600 to 191.614 [and 18
418-to provide loans pursuant to sections 191.500 to 191.550 ]. 19
419- 191.828. 1. The following departments shall conduct 1
420-on-going evaluations of the effect of the initiatives 2
421-enacted by the following sections: 3
422- (1) The department of commerce and insurance shall 4
423-evaluate the effect of revising section 376.782 and sections 5
424-143.999, 208.178, 374.126, and 376.891 to 376.894; 6
425- (2) The department of health and senior ser vices shall 7
426-evaluate the effect of revising sections 105.711 and 8
427-[sections 191.520 and ] 191.600 and enacting section 191.411, 9
428-and sections 167.600 to 167.621, 191.231, 208.177, 431.064, 10
429-and 660.016. In collaboration with the state board of 11
430-registration for the healing arts, the state board of 12
431-nursing, and the state board of pharmacy, the department of 13
432-health and senior services shall also evaluate the effect of 14
433-revising section 195.070, section 334.100, and section 15
434-335.016, and of sections 334.104 and 334.112, and section 16
435-338.095 and 338.198; 17
436- (3) The department of social services shall evaluate 18
437-the effect of revising section 198.090, and sections 19
438-208.151, 208.152 and 208.215, and section 383.125, and of 20
439-sections 167.600 to 167.621, 208.17 7, 208.178, 208.179, 21
440-208.181, and 211.490; 22
441- (4) The office of administration shall evaluate the 23
442-effect of revising sections 105.711 and 105.721; 24
443- (5) The Missouri consolidated health care plan shall 25
444-evaluate the effect of section 103.178; and 26 CCS HCS SS SCS SB 157 15
445- (6) The department of mental health shall evaluate the 27
446-effect of section 191.831 as it relates to substance abuse 28
447-treatment and of section 191.835. 29
448- 2. The department of revenue and office of 30
449-administration shall make biannual reports to the general 31
450-assembly and the governor concerning the income received 32
451-into the health initiatives fund and the level of funding 33
452-required to operate the programs and initiatives funded by 34
453-the health initiatives fund at an optimal level. 35
454- 191.831. 1. There is hereby established in the state 1
455-treasury a "Health Initiatives Fund", to which shall be 2
456-deposited all revenues designated for the fund under 3
457-subsection 8 of section 149.015, and subsection 3 of section 4
458-149.160, and section 167.609, and all other funds donated to 5
459-the fund or otherwise deposited pursuant to law. The state 6
460-treasurer shall administer the fund. Money in the fund 7
461-shall be appropriated to provide funding for implementing 8
462-the new programs and initiatives established b y sections 9
463-105.711 and 105.721. The moneys in the fund may further be 10
464-used to fund those programs established by sections 11
465-191.411[, 191.520] and 191.600, sections 208.151 and 12
466-208.152, and sections 103.178, 143.999, 167.600 to 167.621, 13
467-188.230, 191.211, 191.231, 191.825 to 191.839, 192.013, 14
468-208.177, 208.178, 208.179 and 208.181, 211.490, 285.240, 15
469-337.093, 374.126, 376.891 to 376.894, 431.064, 660.016, 16
470-660.017 and 660.018; in addition, not less than fifteen 17
471-percent of the proceeds deposited to the h ealth initiative 18
472-fund pursuant to sections 149.015 and 149.160 shall be 19
473-appropriated annually to provide funding for the C -STAR 20
474-substance abuse rehabilitation program of the department of 21
475-mental health, or its successor program, and a C -STAR pilot 22
476-project developed by the director of the division of alcohol 23 CCS HCS SS SCS SB 157 16
477-and drug abuse and the director of the department of 24
478-corrections as an alternative to incarceration, as provided 25
479-in subsections 2, 3, and 4 of this section. Such pilot 26
480-project shall be known as the "Alt-care" program. In 27
481-addition, some of the proceeds deposited to the health 28
482-initiatives fund pursuant to sections 149.015 and 149.160 29
483-shall be appropriated annually to the division of alcohol 30
484-and drug abuse of the department of mental health to be used 31
485-for the administration and oversight of the substance abuse 32
486-traffic [offenders] offender program defined in section 33
487-302.010 [and section 577.001]. The provisions of section 34
488-33.080 to the contrary notwithstanding, money in the health 35
489-initiatives fund shall not be transferred at the close of 36
490-the biennium to the general revenue fund. 37
491- 2. The director of the division of alcohol and drug 38
492-abuse and the director of the department of corrections 39
493-shall develop and administer a pilot project to provide a 40
494-comprehensive substance abuse treatment and rehabilitation 41
495-program as an alternative to incarceration, hereinafter 42
496-referred to as "Alt-care". Alt-care shall be funded using 43
497-money provided under subsection 1 of this section through 44
498-the Missouri Medicaid program, the C -STAR program of the 45
499-department of mental health, and the division of alcohol and 46
500-drug abuse's purchase -of-service system. Alt-care shall 47
501-offer a flexible combination of clinical services and living 48
502-arrangements individuall y adapted to each client and her 49
503-children. Alt-care shall consist of the following 50
504-components: 51
505- (1) Assessment and treatment planning; 52
506- (2) Community support to provide continuity, 53
507-monitoring of progress and access to services and resources; 54
508- (3) Counseling from individual to family therapy; 55 CCS HCS SS SCS SB 157 17
509- (4) Day treatment services which include accessibility 56
510-seven days per week, transportation to and from the Alt -care 57
511-program, weekly drug testing, leisure activities, weekly 58
512-events for families and companions, job and education 59
513-preparedness training, peer support and self -help and daily 60
514-living skills; and 61
515- (5) Living arrangement options which are permanent, 62
516-substance-free and conducive to treatment and recovery. 63
517- 3. Any female who is pregnant or is the custodial 64
518-parent of a child or children under the age of twelve years, 65
519-and who has pleaded guilty to or found guilty of violating 66
520-the provisions of chapter 195, and whose controlled 67
521-substance abuse was a precipitating or contribut ing factor 68
522-in the commission of the offense, and who is placed on 69
523-probation may be required, as a condition of probation, to 70
524-participate in Alt-care, if space is available in the pilot 71
525-project area. Determinations of eligibility for the 72
526-program, placement, and continued participation shall be 73
527-made by the division of alcohol and drug abuse, in 74
528-consultation with the department of corrections. 75
529- 4. The availability of space in Alt -care shall be 76
530-determined by the director of the division of alcohol and 77
531-drug abuse in conjunction with the director of the 78
532-department of corrections. If the sentencing court is 79
533-advised that there is no space available, the court shall 80
534-consider other authorized dispositions. 81
535- [192.530. 1. As used in this section, the 1
536-following terms mean: 2
537- (1) "Department", the department of health 3
538-and senior services; 4
539- (2) "Health care provider", the same 5
540-meaning given to the term in section 376.1350; 6
541- (3) "Voluntary nonopioid directive form", 7
542-a form that may be used by a patient to deny or 8
543-refuse the administration or prescription of a 9 CCS HCS SS SCS SB 157 18
544-controlled substance containing an opioid by a 10
545-health care provider. 11
546- 2. In consultation with the board of 12
547-registration for the healing arts and the board 13
548-of pharmacy, the department shall develop and 14
549-publish a uniform voluntary nonopioid directive 15
550-form. 16
551- 3. The voluntary nonopioid directive form 17
552-developed by the department shall indicate to 18
553-all prescribing health care providers that the 19
554-named patient shall not be offered, prescribed, 20
555-supplied with, or otherwise administered a 21
556-controlled substance containing an opioid. 22
557- 4. The voluntary nonopioid directive form 23
558-shall be posted in a downloadable format on the 24
559-department's publicly accessib le website. 25
560- 5. (1) A patient may execute and file a 26
561-voluntary nonopioid directive form with a health 27
562-care provider. Each health care provider shall 28
563-sign and date the form in the presence of the 29
564-patient as evidence of acceptance and shall 30
565-provide a signed copy of the form to the patient. 31
566- (2) The patient executing and filing a 32
567-voluntary nonopioid directive form with a health 33
568-care provider shall sign and date the form in 34
569-the presence of the health care provider or a 35
570-designee of the healt h care provider. In the 36
571-case of a patient who is unable to execute and 37
572-file a voluntary nonopioid directive form, the 38
573-patient may designate a duly authorized guardian 39
574-or health care proxy to execute and file the 40
575-form in accordance with subdivision (1 ) of this 41
576-subsection. 42
577- (3) A patient may revoke the voluntary 43
578-nonopioid directive form for any reason and may 44
579-do so by written or oral means. 45
580- 6. The department shall promulgate 46
581-regulations for the implementation of the 47
582-voluntary nonopioid d irective form that shall 48
583-include, but not be limited to: 49
584- (1) A standard method for the recording 50
585-and transmission of the voluntary nonopioid 51
586-directive form, which shall include verification 52
587-by the patient's health care provider and shall 53
588-comply with the written consent requirements of 54
589-the Public Health Service Act, 42 U.S.C. Section 55
590-290dd-2(b), and 42 CFR Part 2, relating to 56
591-confidentiality of alcohol and drug abuse 57
592-patient records, provided that the voluntary 58
593-nonopioid directive form shall also provide the 59
594-basic procedures necessary to revoke the 60
595-voluntary nonopioid directive form; 61
596- (2) Procedures to record the voluntary 62
597-nonopioid directive form in the patient's 63
598-medical record or, if available, the patient's 64
599-interoperable electroni c medical record; 65 CCS HCS SS SCS SB 157 19
600- (3) Requirements and procedures for a 66
601-patient to appoint a duly authorized guardian or 67
602-health care proxy to override a previously filed 68
603-voluntary nonopioid directive form and 69
604-circumstances under which an attending health 70
605-care provider may override a previously filed 71
606-voluntary nonopioid directive form based on 72
607-documented medical judgment, which shall be 73
608-recorded in the patient's medical record; 74
609- (4) Procedures to ensure that any 75
610-recording, sharing, or distributing of dat a 76
611-relative to the voluntary nonopioid directive 77
612-form complies with all federal and state 78
613-confidentiality laws; and 79
614- (5) Appropriate exemptions for health care 80
615-providers and emergency medical personnel to 81
616-prescribe or administer a controlled subst ance 82
617-containing an opioid when, in their professional 83
618-medical judgment, a controlled substance 84
619-containing an opioid is necessary, or the 85
620-provider and medical personnel are acting in 86
621-good faith. 87
622-The department shall develop and publish 88
623-guidelines on its publicly accessible website 89
624-that shall address, at a minimum, the content of 90
625-the regulations promulgated under this 91
626-subsection. Any rule or portion of a rule, as 92
627-that term is defined in section 536.010, that is 93
628-created under the authority delegate d in this 94
629-section shall become effective only if it 95
630-complies with and is subject to all of the 96
631-provisions of chapter 536 and, if applicable, 97
632-section 536.028. This section and chapter 536 98
633-are nonseverable and if any of the powers vested 99
634-with the general assembly pursuant to chapter 100
635-536 to review, to delay the effective date, or 101
636-to disapprove and annul a rule are subsequently 102
637-held unconstitutional, then the grant of 103
638-rulemaking authority and any rule proposed or 104
639-adopted after August 28, 2023, shall be invalid 105
640-and void. 106
641- 7. A written prescription that is 107
642-presented at an outpatient pharmacy or a 108
643-prescription that is electronically transmitted 109
644-to an outpatient pharmacy is presumed to be 110
645-valid for the purposes of this section, and a 111
646-pharmacist in an outpatient setting shall not be 112
647-held in violation of this section for dispensing 113
648-a controlled substance in contradiction to a 114
649-voluntary nonopioid directive form, except upon 115
650-evidence that the pharmacist acted knowingly 116
651-against the voluntary no nopioid directive form. 117
652- 8. (1) A health care provider or an 118
653-employee of a health care provider acting in 119
654-good faith shall not be subject to criminal or 120
655-civil liability and shall not be considered to 121
656-have engaged in unprofessional conduct for 122 CCS HCS SS SCS SB 157 20
657-failing to offer or administer a prescription or 123
658-medication order for a controlled substance 124
659-containing an opioid under the voluntary 125
660-nonopioid directive form. 126
661- (2) A person acting as a representative or 127
662-an agent pursuant to a health care proxy shal l 128
663-not be subject to criminal or civil liability 129
664-for making a decision under subdivision (3) of 130
665-subsection 6 of this section in good faith. 131
666- (3) Notwithstanding any other provision of 132
667-law, a professional licensing board, at its 133
668-discretion, may limit, condition, or suspend the 134
669-license of, or assess fines against, a health 135
670-care provider who recklessly or negligently 136
671-fails to comply with a patient's voluntary 137
672-nonopioid directive form. ] 138
673- 193.145. 1. A certificate of death for ea ch death 1
674-which occurs in this state shall be filed with the local 2
675-registrar, or as otherwise directed by the state registrar, 3
676-within five days after death and shall be registered if such 4
677-certificate has been completed and filed pursuant to this 5
678-section. All data providers in the death registration 6
679-process, including, but not limited to, the state registrar, 7
680-local registrars, the state medical examiner, county medical 8
681-examiners, coroners, funeral directors or persons acting as 9
682-such, embalmers, sher iffs, attending physicians and resident 10
683-physicians, physician assistants, assistant physicians, 11
684-advanced practice registered nurses, and the chief medical 12
685-officers of licensed health care facilities, and other 13
686-public or private institutions providing m edical care, 14
687-treatment, or confinement to persons, shall be required to 15
688-use and utilize any electronic death registration system 16
689-required and adopted under subsection 1 of section 193.265 17
690-within six months of the system being certified by the 18
691-director of the department of health and senior services, or 19
692-the director's designee, to be operational and available to 20
693-all data providers in the death registration process. 21
694-[However, should the person or entity that certifies the 22 CCS HCS SS SCS SB 157 21
695-cause of death not be part of, or does not use, the 23
696-electronic death registration system, the funeral director 24
697-or person acting as such may enter the required personal 25
698-data into the electronic death registration system and then 26
699-complete the filing by presenting the signed cause of death 27
700-certification to the local registrar, in which case the 28
701-local registrar shall issue death certificates as set out in 29
702-subsection 2 of section 193.265. Nothing in this section 30
703-shall prevent the state registrar from adopting pilot 31
704-programs or voluntary electronic death registration programs 32
705-until such time as the system can be certified; however, no 33
706-such pilot or voluntary electronic death registration 34
707-program shall prevent the filing of a death certificate with 35
708-the local registrar or the ab ility to obtain certified 36
709-copies of death certificates under subsection 2 of section 37
710-193.265 until six months after such certification that the 38
711-system is operational. ] 39
712- 2. If the place of death is unknown but the dead body 40
713-is found in this state, the certificate of death shall be 41
714-completed and filed pursuant to the provisions of this 42
715-section. The place where the body is found shall be shown 43
716-as the place of death. The date of death shall be the date 44
717-on which the remains were found. 45
718- 3. When death occurs in a moving conveyance in the 46
719-United States and the body is first removed from the 47
720-conveyance in this state, the death shall be registered in 48
721-this state and the place where the body is first removed 49
722-shall be considered the place of deat h. When a death occurs 50
723-on a moving conveyance while in international waters or air 51
724-space or in a foreign country or its air space and the body 52
725-is first removed from the conveyance in this state, the 53
726-death shall be registered in this state but the cert ificate 54 CCS HCS SS SCS SB 157 22
727-shall show the actual place of death if such place may be 55
728-determined. 56
729- 4. The funeral director or person in charge of final 57
730-disposition of the dead body shall file the certificate of 58
731-death. The funeral director or person in charge of the 59
732-final disposition of the dead body shall obtain or verify 60
733-and enter into the electronic death registration system: 61
734- (1) The personal data from the next of kin or the best 62
735-qualified person or source available; 63
736- (2) The medical certification fro m the person 64
737-responsible for such certification if designated to do so 65
738-under subsection 5 of this section; and 66
739- (3) Any other information or data that may be required 67
740-to be placed on a death certificate or entered into the 68
741-electronic death certifi cate system including, but not 69
742-limited to, the name and license number of the embalmer. 70
743- 5. The medical certification shall be completed, 71
744-attested to its accuracy either by signature or an 72
745-electronic process approved by the department, and returned 73
746-to the funeral director or person in charge of final 74
747-disposition within seventy -two hours after death by the 75
748-physician, physician assistant, assistant physician, or 76
749-advanced practice registered nurse in charge of the 77
750-patient's care for the illness or condition which resulted 78
751-in death. In the absence of the physician, physician 79
752-assistant, assistant physician, or advanced practice 80
753-registered nurse or with the physician's, physician 81
754-assistant's, assistant physician's, or advanced practice 82
755-registered nurse's approval the certificate may be completed 83
756-and attested to its accuracy either by signature or an 84
757-approved electronic process by the physician's associate 85
758-physician, the chief medical officer of the institution in 86 CCS HCS SS SCS SB 157 23
759-which death occurred, or the physician who performed an 87
760-autopsy upon the decedent, provided such individual has 88
761-access to the medical history of the case, views the 89
762-deceased at or after death and death is due to natural 90
763-causes. The person authorized to complete the medical 91
764-certification may, in writing, designate any other person to 92
765-enter the medical certification information into the 93
766-electronic death registration system if the person 94
767-authorized to complete the medical certificate has 95
768-physically or by electronic process signe d a statement 96
769-stating the cause of death. Any persons completing the 97
770-medical certification or entering data into the electronic 98
771-death registration system shall be immune from civil 99
772-liability for such certification completion, data entry, or 100
773-determination of the cause of death, absent gross negligence 101
774-or willful misconduct. The state registrar may approve 102
775-alternate methods of obtaining and processing the medical 103
776-certification and filing the death certificate. The Social 104
777-Security number of any ind ividual who has died shall be 105
778-placed in the records relating to the death and recorded on 106
779-the death certificate. 107
780- 6. When death occurs from natural causes more than 108
781-thirty-six hours after the decedent was last treated by a 109
782-physician, physician ass istant, assistant physician, or 110
783-advanced practice registered nurse, the case shall be 111
784-referred to the county medical examiner or coroner or 112
785-physician or local registrar for investigation to determine 113
786-and certify the cause of death. If the death is determined 114
787-to be of a natural cause, the medical examiner or coroner or 115
788-local registrar shall refer the certificate of death to the 116
789-attending physician, physician assistant, assistant 117
790-physician, or advanced practice registered nurse for such 118 CCS HCS SS SCS SB 157 24
791-certification. If the attending physician, physician 119
792-assistant, assistant physician, or advanced practice 120
793-registered nurse refuses or is otherwise unavailable, the 121
794-medical examiner or coroner or local registrar shall attest 122
795-to the accuracy of the certificate of d eath either by 123
796-signature or an approved electronic process within thirty - 124
797-six hours. 125
798- 7. If the circumstances suggest that the death was 126
799-caused by other than natural causes, the medical examiner or 127
800-coroner shall determine the cause of death and sha ll, either 128
801-by signature or an approved electronic process, complete and 129
802-attest to the accuracy of the medical certification within 130
803-seventy-two hours after taking charge of the case. 131
804- 8. If the cause of death cannot be determined within 132
805-seventy-two hours after death, the attending medical 133
806-examiner, coroner, attending physician, physician assistant, 134
807-assistant physician, advanced practice registered nurse, or 135
808-local registrar shall give the funeral director, or person 136
809-in charge of final disposition of the dead body, notice of 137
810-the reason for the delay, and final disposition of the body 138
811-shall not be made until authorized by the medical examiner, 139
812-coroner, attending physician, physician assistant, assistant 140
813-physician, advanced practice registered nu rse, or local 141
814-registrar. 142
815- 9. When a death is presumed to have occurred within 143
816-this state but the body cannot be located, a death 144
817-certificate may be prepared by the state registrar upon 145
818-receipt of an order of a court of competent jurisdiction 146
819-which shall include the finding of facts required to 147
820-complete the death certificate. Such a death certificate 148
821-shall be marked "Presumptive", show on its face the date of 149
822-registration, and identify the court and the date of decree. 150 CCS HCS SS SCS SB 157 25
823- 10. (1) The department of health and senior services 151
824-shall notify all physicians, physician assistants, assistant 152
825-physicians, and advanced practice registered nurses licensed 153
826-under chapters 334 and 335 of the requirements regarding the 154
827-use of the electronic vital record s system provided for in 155
828-this section. 156
829- (2) On or before August 30, 2015, the department of 157
830-health and senior services, division of community and public 158
831-health shall create a working group comprised of 159
832-representation from the Missouri electronic v ital records 160
833-system users and recipients of death certificates used for 161
834-professional purposes to evaluate the Missouri electronic 162
835-vital records system, develop recommendations to improve the 163
836-efficiency and usability of the system, and to report such 164
837-findings and recommendations to the general assembly no 165
838-later than January 1, 2016. 166
839- 11. Notwithstanding any provision of law to the 167
840-contrary, if a coroner or deputy coroner is not current with 168
841-or is without the approved training under chapter 58, t he 169
842-department of health and senior services shall prohibit such 170
843-coroner from attesting to the accuracy of a certificate of 171
844-death. No person elected or appointed to the office of 172
845-coroner can assume such elected office until the training, 173
846-as established by the coroner standards and training 174
847-commission under the provisions of section 58.035, has been 175
848-completed and a certificate of completion has been issued. 176
849-In the event a coroner cannot fulfill his or her duties or 177
850-is no longer qualified to attest to the accuracy of a death 178
851-certificate, the sheriff of the county shall appoint a 179
852-medical professional to attest death certificates until such 180
853-time as the coroner can resume his or her duties or another 181
854-coroner is appointed or elected to the office. 182 CCS HCS SS SCS SB 157 26
855- 193.265. 1. For the issuance of a certification or 1
856-copy of a death record, the applicant shall pay a fee of 2
857-fourteen dollars for the first certification or copy and a 3
858-fee of eleven dollars for each additional copy ordered at 4
859-that time. For the issuance of a certification or copy of a 5
860-birth, marriage, divorce, or fetal death record, the 6
861-applicant shall pay a fee of fifteen dollars. No fee shall 7
862-be required or collected for a certification of birth, 8
863-death, or marriage if the re quest for certification is made 9
864-by the children's division, the division of youth services, 10
865-a guardian ad litem, or a juvenile officer on behalf of a 11
866-child or person under twenty -one years of age who has come 12
867-under the jurisdiction of the juvenile cour t under section 13
868-211.031. All fees collected under this subsection shall be 14
869-deposited to the state department of revenue. Beginning 15
870-August 28, 2004, for each vital records fee collected, the 16
871-director of revenue shall credit four dollars to the general 17
872-revenue fund, five dollars to the children's trust fund, one 18
873-dollar shall be credited to the endowed care cemetery audit 19
874-fund, one dollar for each certification or copy of death 20
875-records to the Missouri state coroners' training fund 21
876-established in section 58.208, and three dollars for the 22
877-first copy of death records and five dollars for birth, 23
878-marriage, divorce, and fetal death records shall be credited 24
879-to the Missouri public health services fund established in 25
880-section 192.900. Money in the endowed care cemetery audit 26
881-fund shall be available by appropriation to the division of 27
882-professional registration to pay its expenses in 28
883-administering sections 214.270 to 214.410. All interest 29
884-earned on money deposited in the endowed care cemetery audit 30
885-fund shall be credited to the endowed care cemetery fund. 31
886-Notwithstanding the provisions of section 33.080 to the 32 CCS HCS SS SCS SB 157 27
887-contrary, money placed in the endowed care cemetery audit 33
888-fund shall not be transferred and placed to the credit of 34
889-general revenue until t he amount in the fund at the end of 35
890-the biennium exceeds three times the amount of the 36
891-appropriation from the endowed care cemetery audit fund for 37
892-the preceding fiscal year. The money deposited in the 38
893-public health services fund under this section sha ll be 39
894-deposited in a separate account in the fund, and moneys in 40
895-such account, upon appropriation, shall be used to automate 41
896-and improve the state vital records system, and develop and 42
897-maintain an electronic birth and death registration system. 43
898-For any search of the files and records, when no record is 44
899-found, the state shall be entitled to a fee equal to the 45
900-amount for a certification of a vital record for a five -year 46
901-search to be paid by the applicant. For the processing of 47
902-each legitimation, ad option, court order or recording after 48
903-the registrant's twelfth birthday, the state shall be 49
904-entitled to a fee equal to the amount for a certification of 50
905-a vital record. Except whenever a certified copy or copies 51
906-of a vital record is required to perfe ct any claim of any 52
907-person on relief, or any dependent of any person who was on 53
908-relief for any claim upon the government of the state or 54
909-United States, the state registrar shall, upon request, 55
910-furnish a certified copy or so many certified copies as are 56
911-necessary, without any fee or compensation therefor. 57
912- 2. For the issuance of a certification of a death 58
913-record by the local registrar, the applicant shall pay a fee 59
914-of fourteen dollars for the first certification or copy and 60
915-a fee of eleven dolla rs for each additional copy ordered at 61
916-that time. For each fee collected under this subsection, 62
917-one dollar shall be deposited to the state department of 63
918-revenue and the remainder shall be deposited to the official 64 CCS HCS SS SCS SB 157 28
919-city or county health agency. The director of revenue shall 65
920-credit all fees deposited to the state department of revenue 66
921-under this subsection to the Missouri state coroners' 67
922-training fund established in section 58.208. 68
923- 3. For the issuance of a certification or copy of a 69
924-birth, marriage, divorce, or fetal death record, the 70
925-applicant shall pay a fee of fifteen dollars; except that, 71
926-in any county with a charter form of government and with 72
927-more than six hundred thousand but fewer than seven hundred 73
928-thousand inhabitants, a donation of one dollar may be 74
929-collected by the local registrar over and above any fees 75
930-required by law when a certification or copy of any marriage 76
931-license or birth certificate is provided, with such 77
932-donations collected to be forwarded monthly by the local 78
933-registrar to the county treasurer of such county and the 79
934-donations so forwarded to be deposited by the county 80
935-treasurer into the housing resource commission fund to 81
936-assist homeless families and provide financial assistance to 82
937-organizations addressing home lessness in such county. The 83
938-local registrar shall include a check -off box on the 84
939-application form for such copies. All fees collected under 85
940-this subsection, other than the donations collected in any 86
941-county with a charter form of government and with more than 87
942-six hundred thousand but fewer than seven hundred thousand 88
943-inhabitants for marriage licenses and birth certificates, 89
944-shall be deposited to the official city or county health 90
945-agency. 91
946- 4. A certified copy of a death record by the local 92
947-registrar can only be issued [within twenty-four hours of 93
948-receipt of the record by the local registrar. Computer- 94
949-generated certifications of death records may be issued by 95
950-the local registrar after twenty -four hours of receipt of 96 CCS HCS SS SCS SB 157 29
951-the records] after acceptance and registration with the 97
952-state registrar. The fees paid to the official county 98
953-health agency shall be retained by the local agency for 99
954-local public health purposes. 100
955- 5. No fee under this section shall be required or 101
956-collected from a paren t or guardian of a homeless child or 102
957-homeless youth, as defined in subsection 1 of section 103
958-167.020, or an unaccompanied youth, as defined in 42 U.S.C. 104
959-Section 11434a(6), for the issuance of a certification, or 105
960-copy of such certification, of birth of su ch child or 106
961-youth. An unaccompanied youth shall be eligible to receive 107
962-a certification or copy of his or her own birth record 108
963-without the consent or signature of his or her parent or 109
964-guardian; provided, that only one certificate under this 110
965-provision shall be provided without cost to the 111
966-unaccompanied or homeless youth. For the issuance of any 112
967-additional certificates, the statutory fee shall be paid. 113
968- 195.070. 1. A physician, podiatrist, dentist, a 1
969-registered optometrist certifi ed to administer 2
970-pharmaceutical agents as provided in section 336.220, or an 3
971-assistant physician in accordance with section 334.037 or a 4
972-physician assistant in accordance with section 334.747 in 5
973-good faith and in the course of his or her professional 6
974-practice only, may prescribe, administer, and dispense 7
975-controlled substances or he or she may cause the same to be 8
976-administered or dispensed by an individual as authorized by 9
977-statute. 10
978- 2. An advanced practice registered nurse, as defined 11
979-in section 335.016, but not a certified registered nurse 12
980-anesthetist as defined in subdivision (8) of section 13
981-335.016, who holds a certificate of controlled substance 14
982-prescriptive authority from the board of nursing under 15 CCS HCS SS SCS SB 157 30
983-section 335.019 and who is delegated th e authority to 16
984-prescribe controlled substances under a collaborative 17
985-practice arrangement under section 334.104 may prescribe any 18
986-controlled substances listed in Schedules III, IV, and V of 19
987-section 195.017, and may have restricted authority in 20
988-Schedule II. Prescriptions for Schedule II medications 21
989-prescribed by an advanced practice registered nurse who has 22
990-a certificate of controlled substance prescriptive authority 23
991-are restricted to only those medications containing 24
992-hydrocodone and Schedule II controlled substances for 25
993-hospice patients pursuant to the provisions of section 26
994-334.104. However, no such certified advanced practice 27
995-registered nurse shall prescribe controlled substance for 28
996-his or her own self or family. Schedule III narcotic 29
997-controlled substance and Schedule II - hydrocodone 30
998-prescriptions shall be limited to a one hundred twenty -hour 31
999-supply without refill. 32
1000- 3. A veterinarian, in good faith and in the course of 33
1001-the veterinarian's professional practice only, and not for 34
1002-use by a human being, may prescribe, administer, and 35
1003-dispense controlled substances and the veterinarian may 36
1004-cause them to be administered by an assistant or orderly 37
1005-under his or her direction and supervision. 38
1006- 4. A practitioner shall not accept any po rtion of a 39
1007-controlled substance unused by a patient, for any reason, if 40
1008-such practitioner did not originally dispense the drug, 41
1009-except: 42
1010- (1) When the controlled substance is delivered to the 43
1011-practitioner to administer to the patient for whom the 44
1012-medication is prescribed as authorized by federal law. 45
1013-Practitioners shall maintain records and secure the 46 CCS HCS SS SCS SB 157 31
1014-medication as required by this chapter and regulations 47
1015-promulgated pursuant to this chapter; or 48
1016- (2) As provided in section 195.265. 49
1017- 5. An individual practitioner shall not prescribe or 50
1018-dispense a controlled substance for such practitioner's 51
1019-personal use except in a medical emergency. 52
1020- 195.100. 1. It shall be unlawful to distribute any 1
1021-controlled substance in a com mercial container unless such 2
1022-container bears a label containing an identifying symbol for 3
1023-such substance in accordance with federal laws. 4
1024- 2. It shall be unlawful for any manufacturer of any 5
1025-controlled substance to distribute such substance unless the 6
1026-labeling thereof conforms to the requirements of federal law 7
1027-and contains the identifying symbol required in subsection 1 8
1028-of this section. 9
1029- 3. The label of a controlled substance in Schedule II, 10
1030-III or IV shall, when dispensed to or for a pat ient, contain 11
1031-a clear, concise warning that it is a criminal offense to 12
1032-transfer such narcotic or dangerous drug to any person other 13
1033-than the patient. 14
1034- 4. Whenever a manufacturer sells or dispenses a 15
1035-controlled substance and whenever a wholesaler sells or 16
1036-dispenses a controlled substance in a package prepared by 17
1037-him or her, the manufacturer or wholesaler shall securely 18
1038-affix to each package in which that drug is contained a 19
1039-label showing in legible English the name and address of the 20
1040-vendor and the quantity, kind, and form of controlled 21
1041-substance contained therein. No person except a pharmacist 22
1042-for the purpose of filling a prescription under this 23
1043-chapter, shall alter, deface, or remove any label so affixed. 24
1044- 5. Whenever a pharmacist or practitioner sells or 25
1045-dispenses any controlled substance on a prescription issued 26 CCS HCS SS SCS SB 157 32
1046-by a physician, physician assistant, dentist, podiatrist, 27
1047-veterinarian, or advanced practice registered nurse, the 28
1048-pharmacist or practitioner shall affix to the containe r in 29
1049-which such drug is sold or dispensed a label showing his or 30
1050-her own name and address of the pharmacy or practitioner for 31
1051-whom he or she is lawfully acting; the name of the patient 32
1052-or, if the patient is an animal, the name of the owner of 33
1053-the animal and the species of the animal; the name of the 34
1054-physician, physician assistant, dentist, podiatrist, 35
1055-advanced practice registered nurse, or veterinarian by whom 36
1056-the prescription was written; [the name of the collaborating 37
1057-physician if the prescriptio n is written by an advanced 38
1058-practice registered nurse or a physician assistant, ] and 39
1059-such directions as may be stated on the prescription. No 40
1060-person shall alter, deface, or remove any label so affixed. 41
1061- 195.206. 1. As used in this section, the following 1
1062-terms shall mean: 2
1063- (1) "Addiction mitigation medication", naltrexone 3
1064-hydrochloride that is administered in a manner approved by 4
1065-the United States Food and Drug Administration or any 5
1066-accepted medical practice method of adminis tering; 6
1067- (2) "Opioid antagonist", naloxone hydrochloride , or 7
1068-any other drug or device approved by the United States Food 8
1069-and Drug Administration, that blocks the effects of an 9
1070-opioid overdose [that] and is administered in a manner 10
1071-approved by the United States Food and Drug Administration 11
1072-or any accepted medical practice method of administering; 12
1073- (3) "Opioid-related drug overdose", a condition 13
1074-including, but not limited to, extreme physical illness, 14
1075-decreased level of consciousness, respira tory depression, 15
1076-coma, or death resulting from the consumption or use of an 16
1077-opioid or other substance with which an opioid was combined 17 CCS HCS SS SCS SB 157 33
1078-or a condition that a layperson would reasonably believe to 18
1079-be an opioid-related drug overdose that requires medical 19
1080-assistance. 20
1081- 2. Notwithstanding any other law or regulation to the 21
1082-contrary: 22
1083- (1) The director of the department of health and 23
1084-senior services, if a licensed physician, may issue a 24
1085-statewide standing order for an opioid antagonist or an 25
1086-addiction mitigation medication; 26
1087- (2) In the alternative, the department may employ or 27
1088-contract with a licensed physician who may issue a statewide 28
1089-standing order for an opioid antagonist or an addiction 29
1090-mitigation medication with the express written consent of 30
1091-the department director. 31
1092- 3. Notwithstanding any other law or regulation to the 32
1093-contrary, any licensed pharmacist in Missouri may sell and 33
1094-dispense an opioid antagonist or an addiction mitigation 34
1095-medication under physician protocol or u nder a statewide 35
1096-standing order issued under subsection 2 of this section. 36
1097- 4. A licensed pharmacist who, acting in good faith and 37
1098-with reasonable care, sells or dispenses an opioid 38
1099-antagonist or an addiction mitigation medication and an 39
1100-appropriate device to administer the drug, and the protocol 40
1101-physician, shall not be subject to any criminal or civil 41
1102-liability or any professional disciplinary action for 42
1103-prescribing or dispensing the opioid antagonist or an 43
1104-addiction mitigation medication or a ny outcome resulting 44
1105-from the administration of the opioid antagonist or an 45
1106-addiction mitigation medication. A physician issuing a 46
1107-statewide standing order under subsection 2 of this section 47
1108-shall not be subject to any criminal or civil liability or 48
1109-any professional disciplinary action for issuing the 49 CCS HCS SS SCS SB 157 34
1110-standing order or for any outcome related to the order or 50
1111-the administration of the opioid antagonist or an addiction 51
1112-mitigation medication. 52
1113- 5. Notwithstanding any other law or regulation to the 53
1114-contrary, it shall be permissible for any person to possess 54
1115-an opioid antagonist or an addiction mitigation medication. 55
1116- 6. Any person who administers an opioid antagonist to 56
1117-another person shall, immediately after administering the 57
1118-drug, contact emergency personnel. Any person who, acting 58
1119-in good faith and with reasonable care, administers an 59
1120-opioid antagonist to another person whom the person believes 60
1121-to be suffering an opioid -related drug overdose shall be 61
1122-immune from criminal prosecution, disciplinary actions from 62
1123-his or her professional licensing board, and civil liability 63
1124-due to the administration of the opioid antagonist. 64
1125- 281.102. The enactment of section 281.048 and the 1
1126-repeal and reenactment of sections 281.015, 281.020, 2
1127-281.025, 281.030, 281.035, 281.037, 281.038, 281.040, 3
1128-281.045, 281.050, 281.055, 281.060, 281.063, 281.065, 4
1129-281.070, 281.075, 281.085, and 281.101 of this act shall 5
1130-become effective on January 1, [2024] 2025. 6
1131- 324.520. 1. As used in sections 324.520 to 324.524, 1
1132-the following terms mean: 2
1133- (1) "Body piercing", the perforation of human tissue 3
1134-other than an ear for a nonmedical purpose; 4
1135- (2) "Branding", a permanent mark made on human tissue 5
1136-by burning with a hot ir on or other instrument; 6
1137- (3) "Controlled substance", any substance defined in 7
1138-section 195.010; 8
1139- (4) "Minor", a person under the age of eighteen; 9
1140- (5) "Tattoo", one or more of the following: 10 CCS HCS SS SCS SB 157 35
1141- (a) [An indelible] A mark made on the body o f another 11
1142-person by the insertion of a pigment , ink, or both pigment 12
1143-and ink under the skin with the aid of needles or blades 13
1144-using hand-held or machine-powered instruments; [or] 14
1145- (b) A mark made on the face or body of another person 15
1146-for cosmetic purposes or to any part of the body for scar 16
1147-coverage or other corrective purposes by the insertion of a 17
1148-pigment, ink, or both pigment and ink under the skin with 18
1149-the aid of needles; or 19
1150- (c) An indelible design made on the body of another 20
1151-person by production of scars other than by branding. 21
1152- 2. No person shall knowingly tattoo, brand or perform 22
1153-body piercing on a minor unless such person obtains the 23
1154-prior written informed consent of the minor's parent or 24
1155-legal guardian. The minor's parent or legal guardian shall 25
1156-execute the written informed consent required pursuant to 26
1157-this subsection in the presence of the person performing the 27
1158-tattooing, branding or body piercing on the minor, or in the 28
1159-presence of an employee or agent of such person . Any person 29
1160-who fraudulently misrepresents himself or herself as a 30
1161-parent is guilty of a class B misdemeanor. 31
1162- 3. A person shall not tattoo, brand or perform body 32
1163-piercing on another person if the other person is under the 33
1164-influence of intoxicat ing liquor or a controlled substance. 34
1165- 4. A person who violates any provisions of sections 35
1166-324.520 to 324.526 is guilty of a misdemeanor and shall be 36
1167-fined not more than five hundred dollars. If there is a 37
1168-subsequent violation within one year of t he initial 38
1169-violation, such person shall be fined not less than five 39
1170-hundred dollars or more than one thousand dollars. 40
1171- 5. No person under the age of eighteen shall tattoo, 41
1172-brand or perform body piercing on another person. 42 CCS HCS SS SCS SB 157 36
1173- 331.020. 1. Whenever in this chapter occurs the word 1
1174-"board", or "the board", such words shall be construed to 2
1175-mean the state board of chiropractic examiners. 3
1176- 2. For the purposes of this chapter, the following 4
1177-terms mean: 5
1178- (1) "Animal chiropractic", the examination and 6
1179-treatment of an animal through vertebral subluxation complex 7
1180-or spinal, joint, or musculoskeletal manipulation by an 8
1181-animal chiropractic practitioner. The term "animal 9
1182-chiropractic" shall not be construed to require supervision 10
1183-by a licensed veterinarian to practice or to allow the 11
1184-diagnosing of an animal; the performing of surgery; the 12
1185-dispensing, prescribing, or administering of medications, 13
1186-drugs, or biologics; or the performance of any other type of 14
1187-veterinary medicine when performed by an individual licensed 15
1188-by the state board of chiropractic examiners; 16
1189- (2) "Animal chiropractic practitioner": 17
1190- (a) A licensed veterinarian; or 18
1191- (b) An individual who is licensed by the state board 19
1192-of chiropractic examiner s to engage in the practice of 20
1193-chiropractic, as defined in section 331.010; who is 21
1194-certified by the AVCA or IVCA, as defined in section 22
1195-340.200, or other equivalent certifying body; who has 23
1196-graduated from a certification course in animal chiropractic 24
1197-with not less than two hundred ten hours of instruction; and 25
1198-whose practice of animal chiropractic shall be regulated by 26
1199-the state board of chiropractic examiners. 27
1200- 331.060. 1. The board may refuse to issue any 1
1201-certificate of registr ation or authority, permit or license 2
1202-required pursuant to this chapter for one or any combination 3
1203-of causes stated in subsection 2 of this section. The board 4
1204-shall notify the applicant in writing of the reasons for the 5 CCS HCS SS SCS SB 157 37
1205-refusal and shall advise the app licant of his right to file 6
1206-a complaint with the administrative hearing commission as 7
1207-provided by chapter 621. 8
1208- 2. The board may cause a complaint to be filed with 9
1209-the administrative hearing commission as provided by chapter 10
1210-621 against any holder of any certificate of registration or 11
1211-authority, permit or license required by this chapter or any 12
1212-person who has failed to renew or has surrendered his 13
1213-certificate of registration or authority, permit or license 14
1214-for any one or any combination of the following causes: 15
1215- (1) Use of any controlled substance, as defined in 16
1216-chapter 195, or alcoholic beverage to an extent that such 17
1217-use impairs a person's ability to perform the work of any 18
1218-profession licensed or regulated by this chapter; 19
1219- (2) The person has been finally adjudicated and found 20
1220-guilty, or entered a plea of guilty or nolo contendere, in a 21
1221-criminal prosecution under the laws of any state, of the 22
1222-United States, or of any country, for any offense directly 23
1223-related to the duties and r esponsibilities of the 24
1224-occupation, as set forth in section 324.012, regardless of 25
1225-whether or not sentence is imposed; 26
1226- (3) Use of fraud, deception, misrepresentation or 27
1227-bribery in securing any certificate of registration or 28
1228-authority, permit or li cense issued pursuant to this chapter 29
1229-or in obtaining permission to take any examination given or 30
1230-required pursuant to this chapter; 31
1231- (4) Obtaining or attempting to obtain any fee, charge, 32
1232-tuition or other compensation by fraud, deception or 33
1233-misrepresentation; 34
1234- (5) Incompetency, misconduct, gross negligence, fraud, 35
1235-misrepresentation or dishonesty in the performance of the 36 CCS HCS SS SCS SB 157 38
1236-functions or duties of any profession licensed or regulated 37
1237-by this chapter; 38
1238- (6) Violation of, or assisting or ena bling any person 39
1239-to violate, any provision of this chapter, or of any lawful 40
1240-rule or regulation adopted pursuant to this chapter; 41
1241- (7) Impersonation of any person holding a certificate 42
1242-of registration or authority, permit or license or allowing 43
1243-any person to use his or her certificate of registration or 44
1244-authority, permit, license or diploma from school; 45
1245- (8) Disciplinary action against the holder of a 46
1246-license or other right to practice any profession regulated 47
1247-by this chapter granted by ano ther state, territory, federal 48
1248-agency or country upon grounds for which revocation or 49
1249-suspension is authorized in this state; 50
1250- (9) A person is finally adjudged insane or incompetent 51
1251-by a court of competent jurisdiction; 52
1252- (10) Assisting or enabling any person to practice or 53
1253-offer to practice any profession licensed or regulated by 54
1254-this chapter who is not registered and currently eligible to 55
1255-practice under this chapter; 56
1256- (11) Issuance of a certificate of registration or 57
1257-authority, permit or license based upon a material mistake 58
1258-of fact; 59
1259- (12) Failure to display a valid certificate or license 60
1260-if so required by this chapter or any rule promulgated 61
1261-hereunder; 62
1262- (13) Violation of any professional trust or confidence; 63
1263- (14) Use of any advertisement or solicitation which is 64
1264-false, misleading or deceptive to the general public or 65
1265-persons to whom the advertisement or solicitation is 66
1266-primarily directed. False, misleading or deceptive 67 CCS HCS SS SCS SB 157 39
1267-advertisements or solicitations shall includ e, but not be 68
1268-limited to: 69
1269- (a) Promises of cure, relief from pain or other 70
1270-physical or mental condition, or improved physical or mental 71
1271-health; 72
1272- (b) Any self-laudatory statement; 73
1273- (c) Any misleading or deceptive statement offering or 74
1274-promising a free service. Nothing herein shall be construed 75
1275-to make it unlawful to offer a service for no charge if the 76
1276-offer is announced as part of a full disclosure of routine 77
1277-fees including consultation fees; 78
1278- (d) Any misleading or deceptive claim s of patient 79
1279-cure, relief or improved condition; superiority in service, 80
1280-treatment or materials; new or improved service, treatment 81
1281-or material, or reduced costs or greater savings. Nothing 82
1282-herein shall be construed to make it unlawful to use any 83
1283-such claim if it is readily verifiable by existing 84
1284-documentation, data or other substantial evidence. Any claim 85
1285-which exceeds or exaggerates the scope of its supporting 86
1286-documentation, data or evidence is misleading or deceptive; 87
1287- (e) Failure to use the term "chiropractor", "doctor of 88
1288-chiropractic", "chiropractic physician", or "D.C." in any 89
1289-advertisement, solicitation, sign, letterhead, or any other 90
1290-method of addressing the public; 91
1291- (f) Attempting to attract patronage in any manner 92
1292-which castigates, impugns, disparages, discredits or attacks 93
1293-other healing arts and sciences or other chiropractic 94
1294-physicians; 95
1295- (15) Violation of the drug laws or rules and 96
1296-regulations of this state, any other state or the federal 97
1297-government; 98 CCS HCS SS SCS SB 157 40
1298- (16) Failure or refusal to properly guard against 99
1299-contagious, infectious or communicable diseases or the 100
1300-spread thereof; 101
1301- (17) Fails to maintain a chiropractic office in a safe 102
1302-and sanitary condition; 103
1303- (18) Engaging in unprofessional or improper conduct in 104
1304-the practice of chiropractic; 105
1305- (19) Administering or prescribing any drug or medicine 106
1306-or attempting to practice medicine, surgery, or osteopathy 107
1307-within the meaning of chapter 334; 108
1308- (20) Engaging in the practice of animal chiropractic 109
1309-without a patient referral from a licensed veterinarian with 110
1310-a current veterinarian -client-patient relationship; 111
1311- (21) Being unable to practice as a chiropractic 112
1312-physician with reasonable skill and safety to patients 113
1313-because of one of the following: pr ofessional incompetency; 114
1314-illness, drunkenness, or excessive use of drugs, narcotics, 115
1315-or chemicals; any mental or physical condition. In enforcing 116
1316-this subdivision the board shall, after a hearing before the 117
1317-board, upon a finding of probable cause, requ ire the 118
1318-chiropractor for the purpose of establishing his competency 119
1319-to practice as a chiropractic physician to submit to a 120
1320-reexamination, which shall be conducted in accordance with 121
1321-rules adopted for this purpose by the board, including rules 122
1322-to allow the examination of the chiropractic physician's 123
1323-professional competence by at least three chiropractic 124
1324-physicians, or to submit to a mental or physical examination 125
1325-or combination thereof by at least three physicians. One 126
1326-examiner shall be selected by the chiropractic physician 127
1327-compelled to take the examination, one selected by the 128
1328-board, and one shall be selected by the two examiners so 129
1329-selected. Notice of the physical or mental examination shall 130 CCS HCS SS SCS SB 157 41
1330-be given by personal service or certified mail. Fail ure of 131
1331-the chiropractic physician to submit to an examination when 132
1332-directed shall constitute an admission of the allegations 133
1333-against him, unless the failure was due to circumstances 134
1334-beyond his control. A chiropractic physician whose right to 135
1335-practice has been affected under this subdivision shall, at 136
1336-reasonable intervals, be afforded an opportunity to 137
1337-demonstrate that he can resume competent practice with 138
1338-reasonable skill and safety to patients. 139
1339- (a) In any proceeding under this subdivision, ne ither 140
1340-the record of proceedings nor the orders entered by the 141
1341-board shall be used against a chiropractic physician in any 142
1342-other proceeding. Proceedings under this subdivision shall 143
1343-be conducted by the board without the filing of a complaint 144
1344-with the administrative hearing commission; 145
1345- (b) When the board finds any person unqualified 146
1346-because of any of the grounds set forth in this subdivision, 147
1347-it may enter an order imposing one or more of the following: 148
1348-denying his application for a license; perm anently 149
1349-withholding issuance of a license; administering a public or 150
1350-private reprimand; suspending or limiting or restricting his 151
1351-license to practice as a chiropractic physician for a period 152
1352-of not more than five years; revoking his license to 153
1353-practice as a chiropractic physician; requiring him to 154
1354-submit to the care, counseling or treatment of physicians 155
1355-designated by the chiropractic physician compelled to be 156
1356-treated. For the purpose of this subdivision, "license" 157
1357-includes the certificate of regis tration, or license, or 158
1358-both, issued by the board. 159
1359- 3. After the filing of such complaint, the proceedings 160
1360-shall be conducted in accordance with the provisions of 161
1361-chapter 621. Upon a finding by the administrative hearing 162 CCS HCS SS SCS SB 157 42
1362-commission that the ground s, provided in subsection 2 of 163
1363-this section, for disciplinary action are met, the board 164
1364-may, singly or in combination: 165
1365- (1) Censure or place the person named in the complaint 166
1366-on probation on such terms and conditions as the board deems 167
1367-appropriate for a period not to exceed five years; or 168
1368- (2) May suspend the license, certificate or permit for 169
1369-a period not to exceed three years; or 170
1370- (3) Revoke the license, certificate or permit. 171
1371- 4. If at any time after disciplinary sanctions have 172
1372-been imposed under this section or under any provision of 173
1373-this chapter, the licensee removes himself from the state of 174
1374-Missouri, ceases to be currently licensed under the 175
1375-provisions of this chapter, or fails to keep the Missouri 176
1376-state board of chiropra ctic examiners advised of his current 177
1377-place of business and residence, the time of his absence, or 178
1378-unlicensed status, or unknown whereabouts shall not be 179
1379-deemed or taken as any part of the time of discipline so 180
1380-imposed. 181
1381- 334.036. 1. For purposes of this section, the 1
1382-following terms shall mean: 2
1383- (1) "Assistant physician", any graduate of a medical 3
1384-school [graduate] accredited by the Liaison Committee on 4
1385-Medical Education, the Commission on Osteopathic College 5
1386-Accreditation, or an organization accredited by the 6
1387-Educational Commission for Foreign Medical Graduates who: 7
1388- (a) Is a resident and citizen of the United States or 8
1389-is a legal resident alien; 9
1390- (b) Has successfully completed Step 2 of the United 10
1391-States Medical Licensing Examination or the equivalent of 11
1392-such step of any other board -approved medical licensing 12
1393-examination within the three -year period immediately 13 CCS HCS SS SCS SB 157 43
1394-preceding application for licensure as an assistant 14
1395-physician, or within three years after graduati on from a 15
1396-medical college or osteopathic medical college, whichever is 16
1397-later; 17
1398- (c) Has not completed an approved postgraduate 18
1399-residency and has successfully completed Step 2 of the 19
1400-United States Medical Licensing Examination or the 20
1401-equivalent of such step of any other board -approved medical 21
1402-licensing examination within the immediately preceding three - 22
1403-year period unless when such three -year anniversary occurred 23
1404-he or she was serving as a resident physician in an 24
1405-accredited residency in the Unit ed States and continued to 25
1406-do so within thirty days prior to application for licensure 26
1407-as an assistant physician; and 27
1408- (d) Has proficiency in the English language. 28
1409-Any graduate of a medical school [graduate] who could have 29
1410-applied for licensure and complied with the provisions of 30
1411-this subdivision at any time between August 28, 2014, and 31
1412-August 28, 2017, may apply for licensure and shall be deemed 32
1413-in compliance with the provisions of this subdivision; 33
1414- (2) "Assistant physician collaborative p ractice 34
1415-arrangement", an agreement between a physician and an 35
1416-assistant physician that meets the requirements of this 36
1417-section and section 334.037 [; 37
1418- (3) "Medical school graduate", any person who has 38
1419-graduated from a medical college or osteopathic medical 39
1420-college described in section 334.031 ]. 40
1421- 2. (1) An assistant physician collaborative practice 41
1422-arrangement shall limit the assistant physician to providing 42
1423-only primary care services and only in medically underserved 43
1424-rural or urban areas of this state [or in any pilot project 44 CCS HCS SS SCS SB 157 44
1425-areas established in which assistant physicians may 45
1426-practice]. 46
1427- (2) For a physician-assistant physician team working 47
1428-in a rural health clinic under the federal Rural Health 48
1429-Clinic Services Act, P.L. 95 -210, as amended: 49
1430- (a) An assistant physician shall be considered a 50
1431-physician assistant for purposes of regulations of the 51
1432-Centers for Medicare and Medicaid Services (CMS); and 52
1433- (b) No supervision requirements in addition to the 53
1434-minimum federal law sha ll be required. 54
1435- 3. (1) For purposes of this section, the licensure of 55
1436-assistant physicians shall take place within processes 56
1437-established by rules of the state board of registration for 57
1438-the healing arts. The board of healing arts is authorized 58
1439-to establish rules under chapter 536 establishing licensure 59
1440-and renewal procedures, supervision, collaborative practice 60
1441-arrangements, fees, and addressing such other matters as are 61
1442-necessary to protect the public and discipline the 62
1443-profession. No licensure fee for an assistant physician 63
1444-shall exceed the amount of any licensure fee for a physician 64
1445-assistant. An application for licensure may be denied or 65
1446-the licensure of an assistant physician may be suspended or 66
1447-revoked by the board in the same mann er and for violation of 67
1448-the standards as set forth by section 334.100, or such other 68
1449-standards of conduct set by the board by rule. No rule or 69
1450-regulation shall require an assistant physician to complete 70
1451-more hours of continuing medical education than that of a 71
1452-licensed physician. 72
1453- (2) Any rule or portion of a rule, as that term is 73
1454-defined in section 536.010, that is created under the 74
1455-authority delegated in this section shall become effective 75
1456-only if it complies with and is subject to all of th e 76 CCS HCS SS SCS SB 157 45
1457-provisions of chapter 536 and, if applicable, section 77
1458-536.028. This section and chapter 536 are nonseverable and 78
1459-if any of the powers vested with the general assembly under 79
1460-chapter 536 to review, to delay the effective date, or to 80
1461-disapprove and annul a rule are subsequently held 81
1462-unconstitutional, then the grant of rulemaking authority and 82
1463-any rule proposed or adopted after August 28, 2014, shall be 83
1464-invalid and void. 84
1465- (3) Any rules or regulations regarding assistant 85
1466-physicians in effect as of the effective date of this 86
1467-section that conflict with the provisions of this section 87
1468-and section 334.037 shall be null and void as of the 88
1469-effective date of this section. 89
1470- 4. An assistant physician shall clearly identify 90
1471-himself or herself as an assistant physician and shall be 91
1472-permitted to use the terms "doctor", "Dr.", or "doc". No 92
1473-assistant physician shall practice or attempt to practice 93
1474-without an assistant physician collaborative practice 94
1475-arrangement, except as otherwise provided in thi s section 95
1476-and in an emergency situation. 96
1477- 5. The collaborating physician is responsible at all 97
1478-times for the oversight of the activities of and accepts 98
1479-responsibility for primary care services rendered by the 99
1480-assistant physician. 100
1481- 6. The provisions of section 334.037 shall apply to 101
1482-all assistant physician collaborative practice 102
1483-arrangements. Any renewal of licensure under this section 103
1484-shall include verification of actual practice under a 104
1485-collaborative practice arrangement in accordance wi th this 105
1486-subsection during the immediately preceding licensure period. 106
1487- 7. Each health carrier or health benefit plan that 107
1488-offers or issues health benefit plans that are delivered, 108 CCS HCS SS SCS SB 157 46
1489-issued for delivery, continued, or renewed in this state 109
1490-shall reimburse an assistant physician for the diagnosis, 110
1491-consultation, or treatment of an insured or enrollee on the 111
1492-same basis that the health carrier or health benefit plan 112
1493-covers the service when it is delivered by another 113
1494-comparable mid-level health care pr ovider including, but not 114
1495-limited to, a physician assistant. 115
1496- 334.043. [Upon the applicant paying a fee equivalent 1
1497-to the required examination fee and furnishing the board 2
1498-with all locations of previous practice and licensure in 3
1499-chronological order, the board shall, under regulations 4
1500-prescribed by it, admit without examination qualified 5
1501-persons who meet the requirements of this state including, 6
1502-but not limited to, sections 334.031, 334.035 and 334.040, 7
1503-and who hold certificates of licensure in any state or 8
1504-territory of the United States or the District of Columbia 9
1505-authorizing them to practice in the same manner and to the 10
1506-same extent as physicians and surgeons are authorized to 11
1507-practice by this chapter. Within the limits of th is 12
1508-section, the board is authorized and empowered to negotiate 13
1509-reciprocal compacts with licensing boards of other states 14
1510-for admission of licensed practitioners from Missouri in 15
1511-other states] 1. For purposes of this section, the 16
1512-following terms mean: 17
1513- (1) "Board", the state board of registration for the 18
1514-healing arts in the state of Missouri; 19
1515- (2) "License", a license, certificate, registration, 20
1516-permit, accreditation, or military occupational specialty 21
1517-that enables a person to legally prac tice an occupation or 22
1518-profession in a particular jurisdiction; 23
1519- (3) "Military", the Armed Forces of the United States, 24
1520-including the Air Force, Army, Coast Guard, Marine Corps, 25 CCS HCS SS SCS SB 157 47
1521-Navy, Space Force, National Guard, and any other military 26
1522-branch that is designated by Congress as part of the Armed 27
1523-Forces of the United States, and all reserve components and 28
1524-auxiliaries. The term "military" also includes the military 29
1525-reserves and militia of any United States territory or state; 30
1526- (4) "Nonresident military spouse", a nonresident 31
1527-spouse of an active duty member of the Armed Forces of the 32
1528-United States who has been transferred or is scheduled to be 33
1529-transferred to the state of Missouri, or who has been 34
1530-transferred or is scheduled to be transferred to an adjacent 35
1531-state and is or will be domiciled in the state of Missouri, 36
1532-or has moved to the state of Missouri on a permanent change - 37
1533-of-station basis; 38
1534- (5) "Oversight body", any board, department, agency, 39
1535-or office of a jurisdiction that issues licenses; 40
1536- (6) "Resident military spouse", a spouse of an active 41
1537-duty member of the Armed Forces of the United States who has 42
1538-been transferred or is scheduled to be transferred to the 43
1539-state of Missouri or an adjacent state and who is a 44
1540-permanent resident of the state of Missouri, who is 45
1541-domiciled in the state of Missouri, or who has Missouri as 46
1542-his or her home of record . 47
1543- 2. Any person who holds a valid current physician and 48
1544-surgeon license issued by another state, a branch or unit of 49
1545-the military, a territory of the United States, or the 50
1546-District of Columbia, and who has been licensed for at least 51
1547-one year in such other jurisdiction, may submit to the board 52
1548-an application for a physician and surgeon license in 53
1549-Missouri along with proof of current licensure and proof of 54
1550-licensure for at least one year in the other jurisdiction. 55
1551- 3. The board shall: 56 CCS HCS SS SCS SB 157 48
1552- (1) Within six months of receiving an application 57
1553-described in subsection 2 of this section, waive any 58
1554-examination, educational , or experience requirements for 59
1555-licensure in this state for the applicant if it determines 60
1556-that there were minimum education requirements and, if 61
1557-applicable, work experience and clinical supervision 62
1558-requirements in effect and the other jurisdiction ve rifies 63
1559-that the person met those requirements in order to be 64
1560-licensed or certified in that jurisdiction. The board may 65
1561-require an applicant to take and pass an examination 66
1562-specific to the laws of this state; or 67
1563- (2) Within thirty days of receivin g an application 68
1564-described in subsection 2 of this section from a nonresident 69
1565-military spouse or a resident military spouse, waive any 70
1566-examination, educational, or experience requirements for 71
1567-licensure in this state for the applicant and issue such 72
1568-applicant a license under this section if such applicant 73
1569-otherwise meets the requirements of this section. 74
1570- 4. (1) The board shall not waive any examination, 75
1571-educational, or experience requirements for any applicant 76
1572-who has had his or her license re voked by an oversight body 77
1573-outside the state; who is currently under investigation, who 78
1574-has a complaint pending, or who is currently under 79
1575-disciplinary action, except as provided in subdivision (2) 80
1576-of this subsection, with an oversight body outside the 81
1577-state; who does not hold a license in good standing with an 82
1578-oversight body outside the state; who has a criminal record 83
1579-that would disqualify him or her for licensure in Missouri; 84
1580-or who does not hold a valid current license in the other 85
1581-jurisdiction on the date the board receives his or her 86
1582-application under this section. 87 CCS HCS SS SCS SB 157 49
1583- (2) If another jurisdiction has taken disciplinary 88
1584-action against an applicant, the board shall determine if 89
1585-the cause for the action was corrected and the matter 90
1586-resolved. If the matter has not been resolved by that 91
1587-jurisdiction, the board may deny a license until the matter 92
1588-is resolved. 93
1589- 5. Nothing in this section shall prohibit the board 94
1590-from denying a license to an applicant under this section 95
1591-for any reason described in section 334.100. 96
1592- 6. Any person who is licensed under the provisions of 97
1593-this section shall be subject to the board's jurisdiction 98
1594-and all rules and regulations pertaining to the practice as 99
1595-a physician and surgeon in this state. 100
1596- 7. This section shall not be construed to waive any 101
1597-requirement for an applicant to pay any fees. 102
1598- 334.100. 1. The board may refuse to issue or renew 1
1599-any certificate of registration or authority, permit or 2
1600-license required pursuant to this chapter for one or any 3
1601-combination of causes stated in subsection 2 of this 4
1602-section. The board shall notify the applicant in writing of 5
1603-the reasons for the refusal and shall advise the applicant 6
1604-of the applicant's right to file a complaint with the 7
1605-administrative hearing commission as provided by chapter 8
1606-621. As an alternative to a refusal to issue or renew any 9
1607-certificate, registration or authority, the board may, at 10
1608-its discretion, issue a license which is subject to 11
1609-probation, restrictio n or limitation to an applicant for 12
1610-licensure for any one or any combination of causes stated in 13
1611-subsection 2 of this section. The board's order of 14
1612-probation, limitation or restriction shall contain a 15
1613-statement of the discipline imposed, the basis the refor, the 16
1614-date such action shall become effective, and a statement 17 CCS HCS SS SCS SB 157 50
1615-that the applicant has thirty days to request in writing a 18
1616-hearing before the administrative hearing commission. If 19
1617-the board issues a probationary, limited or restricted 20
1618-license to an applicant for licensure, either party may file 21
1619-a written petition with the administrative hearing 22
1620-commission within thirty days of the effective date of the 23
1621-probationary, limited or restricted license seeking review 24
1622-of the board's determination. If no written request for a 25
1623-hearing is received by the administrative hearing commission 26
1624-within the thirty-day period, the right to seek review of 27
1625-the board's decision shall be considered as waived. 28
1626- 2. The board may cause a complaint to be filed wit h 29
1627-the administrative hearing commission as provided by chapter 30
1628-621 against any holder of any certificate of registration or 31
1629-authority, permit or license required by this chapter or any 32
1630-person who has failed to renew or has surrendered the 33
1631-person's certificate of registration or authority, permit or 34
1632-license for any one or any combination of the following 35
1633-causes: 36
1634- (1) Use of any controlled substance, as defined in 37
1635-chapter 195, or alcoholic beverage to an extent that such 38
1636-use impairs a person's a bility to perform the work of any 39
1637-profession licensed or regulated by this chapter; 40
1638- (2) The person has been finally adjudicated and found 41
1639-guilty, or entered a plea of guilty or nolo contendere, in a 42
1640-criminal prosecution under the laws of any state or of the 43
1641-United States, for any offense reasonably related to the 44
1642-qualifications, functions or duties of any profession 45
1643-licensed or regulated pursuant to this chapter, for any 46
1644-offense involving fraud, dishonesty or an act of violence, 47
1645-or for any offense involving moral turpitude, whether or not 48
1646-sentence is imposed; 49 CCS HCS SS SCS SB 157 51
1647- (3) Use of fraud, deception, misrepresentation or 50
1648-bribery in securing any certificate of registration or 51
1649-authority, permit or license issued pursuant to this chapter 52
1650-or in obtaining permission to take any examination given or 53
1651-required pursuant to this chapter; 54
1652- (4) Misconduct, fraud, misrepresentation, dishonesty, 55
1653-unethical conduct or unprofessional conduct in the 56
1654-performance of the functions or duties of any profession 57
1655-licensed or regulated by this chapter, including, but not 58
1656-limited to, the following: 59
1657- (a) Obtaining or attempting to obtain any fee, charge, 60
1658-tuition or other compensation by fraud, deception or 61
1659-misrepresentation; willfully and continually overchargi ng or 62
1660-overtreating patients; or charging for visits to the 63
1661-physician's office which did not occur unless the services 64
1662-were contracted for in advance, or for services which were 65
1663-not rendered or documented in the patient's records; 66
1664- (b) Attempting, directly or indirectly, by way of 67
1665-intimidation, coercion or deception, to obtain or retain a 68
1666-patient or discourage the use of a second opinion or 69
1667-consultation; 70
1668- (c) Willfully and continually performing inappropriate 71
1669-or unnecessary treatment, diagn ostic tests or medical or 72
1670-surgical services; 73
1671- (d) Delegating professional responsibilities to a 74
1672-person who is not qualified by training, skill, competency, 75
1673-age, experience or licensure to perform such 76
1674-responsibilities; 77
1675- (e) Misrepresenting that any disease, ailment or 78
1676-infirmity can be cured by a method, procedure, treatment, 79
1677-medicine or device; 80 CCS HCS SS SCS SB 157 52
1678- (f) Performing or prescribing medical services which 81
1679-have been declared by board rule to be of no medical or 82
1680-osteopathic value; 83
1681- (g) Final disciplinary action by any professional 84
1682-medical or osteopathic association or society or licensed 85
1683-hospital or medical staff of such hospital in this or any 86
1684-other state or territory, whether agreed to voluntarily or 87
1685-not, and including, but not limite d to, any removal, 88
1686-suspension, limitation, or restriction of the person's 89
1687-license or staff or hospital privileges, failure to renew 90
1688-such privileges or license for cause, or other final 91
1689-disciplinary action, if the action was in any way related to 92
1690-unprofessional conduct, professional incompetence, 93
1691-malpractice or any other violation of any provision of this 94
1692-chapter; 95
1693- (h) Signing a blank prescription form; or dispensing, 96
1694-prescribing, administering or otherwise distributing any 97
1695-drug, controlled sub stance or other treatment without 98
1696-sufficient examination including failing to establish a 99
1697-valid physician-patient relationship pursuant to section 100
1698-334.108, or for other than medically accepted therapeutic or 101
1699-experimental or investigative purposes duly authorized by a 102
1700-state or federal agency, or not in the course of 103
1701-professional practice, or not in good faith to relieve pain 104
1702-and suffering, or not to cure an ailment, physical infirmity 105
1703-or disease, except as authorized in section 334.104; 106
1704- (i) Exercising influence within a physician -patient 107
1705-relationship for purposes of engaging a patient in sexual 108
1706-activity; 109
1707- (j) Being listed on any state or federal sexual 110
1708-offender registry; 111 CCS HCS SS SCS SB 157 53
1709- (k) Terminating the medical care of a patient without 112
1710-adequate notice or without making other arrangements for the 113
1711-continued care of the patient; 114
1712- (l) Failing to furnish details of a patient's medical 115
1713-records to other treating physicians or hospitals upon 116
1714-proper request; or failing to comply with any other law 117
1715-relating to medical records; 118
1716- (m) Failure of any applicant or licensee to cooperate 119
1717-with the board during any investigation; 120
1718- (n) Failure to comply with any subpoena or subpoena 121
1719-duces tecum from the board or an order of the board; 122
1720- (o) Failure to timely pay license renewal fees 123
1721-specified in this chapter; 124
1722- (p) Violating a probation agreement, order, or other 125
1723-settlement agreement with this board or any other licensing 126
1724-agency; 127
1725- (q) Failing to inform the board of the physician 's 128
1726-current residence and business address; 129
1727- (r) Advertising by an applicant or licensee which is 130
1728-false or misleading, or which violates any rule of the 131
1729-board, or which claims without substantiation the positive 132
1730-cure of any disease, or professional superiority to or 133
1731-greater skill than that possessed by any other physician. 134
1732-An applicant or licensee shall also be in violation of this 135
1733-provision if the applicant or licensee has a financial 136
1734-interest in any organization, corporation or association 137
1735-which issues or conducts such advertising; 138
1736- (s) Any other conduct that is unethical or 139
1737-unprofessional involving a minor; 140
1738- (5) Any conduct or practice which is or might be 141
1739-harmful or dangerous to the mental or physical health of a 142
1740-patient or the public; or incompetency, gross negligence or 143 CCS HCS SS SCS SB 157 54
1741-repeated negligence in the performance of the functions or 144
1742-duties of any profession licensed or regulated by this 145
1743-chapter. For the purposes of this subdivision, "repeated 146
1744-negligence" means the failure, on more than one occasion, to 147
1745-use that degree of skill and learning ordinarily used under 148
1746-the same or similar circumstances by the member of the 149
1747-applicant's or licensee's profession; 150
1748- (6) Violation of, or attempting to violate, directly 151
1749-or indirectly, or assisting or enabling any person to 152
1750-violate, any provision of this chapter or chapter 324, or of 153
1751-any lawful rule or regulation adopted pursuant to this 154
1752-chapter or chapter 324; 155
1753- (7) Impersonation of any person holding a certificate 156
1754-of registration or authority, permit or license or allowing 157
1755-any person to use his or her certificate of registration or 158
1756-authority, permit, license or diploma from any school; 159
1757- (8) Revocation, suspension, restriction, modification, 160
1758-limitation, reprimand, warni ng, censure, probation or other 161
1759-final disciplinary action against the holder of or applicant 162
1760-for a license or other right to practice any profession 163
1761-regulated by this chapter by another state, territory, 164
1762-federal agency or country, whether or not volunt arily agreed 165
1763-to by the licensee or applicant, including, but not limited 166
1764-to, the denial of licensure, surrender of the license, 167
1765-allowing the license to expire or lapse, or discontinuing or 168
1766-limiting the practice of medicine while subject to an 169
1767-investigation or while actually under investigation by any 170
1768-licensing authority, medical facility, branch of the Armed 171
1769-Forces of the United States of America, insurance company, 172
1770-court, agency of the state or federal government, or 173
1771-employer; 174 CCS HCS SS SCS SB 157 55
1772- (9) A person is finally adjudged incapacitated or 175
1773-disabled by a court of competent jurisdiction; 176
1774- (10) Assisting or enabling any person to practice or 177
1775-offer to practice any profession licensed or regulated by 178
1776-this chapter who is not registered and currently elig ible to 179
1777-practice pursuant to this chapter; or knowingly performing 180
1778-any act which in any way aids, assists, procures, advises, 181
1779-or encourages any person to practice medicine who is not 182
1780-registered and currently eligible to practice pursuant to 183
1781-this chapter. A physician who works in accordance with 184
1782-standing orders or protocols or in accordance with the 185
1783-provisions of section 334.104 shall not be in violation of 186
1784-this subdivision; 187
1785- (11) Issuance of a certificate of registration or 188
1786-authority, permit or license based upon a material mistake 189
1787-of fact; 190
1788- (12) Failure to display a valid certificate or license 191
1789-if so required by this chapter or any rule promulgated 192
1790-pursuant to this chapter; 193
1791- (13) Violation of the drug laws or rules and 194
1792-regulations of this state, including but not limited to any 195
1793-provision of chapter 195, any other state, or the federal 196
1794-government; 197
1795- (14) Knowingly making, or causing to be made, or 198
1796-aiding, or abetting in the making of, a false statement in 199
1797-any birth, death or other certificate or document executed 200
1798-in connection with the practice of the person's profession; 201
1799- (15) Knowingly making a false statement, orally or in 202
1800-writing to the board; 203
1801- (16) Soliciting patronage in person or by agents or 204
1802-representatives, or by any other means or manner, under the 205
1803-person's own name or under the name of another person or 206 CCS HCS SS SCS SB 157 56
1804-concern, actual or pretended, in such a manner as to 207
1805-confuse, deceive, or mislead the public as to the need or 208
1806-necessity for or appropriateness of health care services for 209
1807-all patients, or the qualifications of an individual person 210
1808-or persons to diagnose, render, or perform health care 211
1809-services; 212
1810- (17) Using, or permitting the use of, the person's 213
1811-name under the designation of "Doctor", "Dr. ", "M.D.", or 214
1812-"D.O.", or any similar designation with reference to the 215
1813-commercial exploitation of any goods, wares or merchandise; 216
1814- (18) Knowingly making or causing to be made a false 217
1815-statement or misrepresentation of a material fact, with 218
1816-intent to defraud, for payment pursuant to the provisions of 219
1817-chapter 208 or chapter 630 or for payment from Title XVIII 220
1818-or Title XIX of the Social Security Act; 221
1819- (19) Failure or refusal to properly guard against 222
1820-contagious, infectious or communicable dise ases or the 223
1821-spread thereof; maintaining an unsanitary office or 224
1822-performing professional services under unsanitary 225
1823-conditions; or failure to report the existence of an 226
1824-unsanitary condition in the office of a physician or in any 227
1825-health care facility to the board, in writing, within thirty 228
1826-days after the discovery thereof; 229
1827- (20) Any candidate for licensure or person licensed to 230
1828-practice as a physical therapist, paying or offering to pay 231
1829-a referral fee or[, notwithstanding section 334.010 to the 232
1830-contrary, practicing or offering to practice professional 233
1831-physical therapy independent of the prescription and 234
1832-direction of a person licensed and registered as a physician 235
1833-and surgeon pursuant to this chapter, as a dentist pursuant 236
1834-to chapter 332, as a podiatrist pursuant to chapter 330, as 237
1835-an advanced practice registered nurse under chapter 335, or 238 CCS HCS SS SCS SB 157 57
1836-any licensed and registered physician, dentist, podiatrist, 239
1837-or advanced practice registered nurse practicing in another 240
1838-jurisdiction, whose license is in good standing] evaluating 241
1839-or treating a patient in a manner inconsistent with section 242
1840-334.506; 243
1841- (21) Any candidate for licensure or person licensed to 244
1842-practice as a physical therapist, treating or attempting to 245
1843-treat ailments or other health cond itions of human beings 246
1844-other than by professional physical therapy and as 247
1845-authorized by sections 334.500 to 334.620; 248
1846- (22) Any person licensed to practice as a physician or 249
1847-surgeon, requiring, as a condition of the physician -patient 250
1848-relationship, that the patient receive prescribed drugs, 251
1849-devices or other professional services directly from 252
1850-facilities of that physician's office or other entities 253
1851-under that physician's ownership or control. A physician 254
1852-shall provide the patient with a prescript ion which may be 255
1853-taken to the facility selected by the patient and a 256
1854-physician knowingly failing to disclose to a patient on a 257
1855-form approved by the advisory commission for professional 258
1856-physical therapists as established by section 334.625 which 259
1857-is dated and signed by a patient or guardian acknowledging 260
1858-that the patient or guardian has read and understands that 261
1859-the physician has a pecuniary interest in a physical therapy 262
1860-or rehabilitation service providing prescribed treatment and 263
1861-that the prescribed treatment is available on a competitive 264
1862-basis. This subdivision shall not apply to a referral by 265
1863-one physician to another physician within a group of 266
1864-physicians practicing together; 267
1865- (23) A pattern of personal use or consumption of any 268
1866-controlled substance unless it is prescribed, dispensed or 269 CCS HCS SS SCS SB 157 58
1867-administered by another physician who is authorized by law 270
1868-to do so; 271
1869- (24) Habitual intoxication or dependence on alcohol, 272
1870-evidence of which may include more than one alcohol -related 273
1871-enforcement contact as defined by section 302.525; 274
1872- (25) Failure to comply with a treatment program or an 275
1873-aftercare program entered into as part of a board order, 276
1874-settlement agreement or licensee's professional health 277
1875-program; 278
1876- (26) Revocation, suspension, limitation, probation, or 279
1877-restriction of any kind whatsoever of any controlled 280
1878-substance authority, whether agreed to voluntarily or not, 281
1879-or voluntary termination of a controlled substance authority 282
1880-while under investigation; 283
1881- (27) For a physician to operate, conduct, manage, or 284
1882-establish an abortion facility, or for a physician to 285
1883-perform an abortion in an abortion facility, if such 286
1884-facility comes under the definition of an ambulatory 287
1885-surgical center pursuant to sections 197.200 to 197.240, a nd 288
1886-such facility has failed to obtain or renew a license as an 289
1887-ambulatory surgical center. 290
1888- 3. Collaborative practice arrangements, protocols and 291
1889-standing orders shall be in writing and signed and dated by 292
1890-a physician prior to their implementation . 293
1891- 4. After the filing of such complaint before the 294
1892-administrative hearing commission, the proceedings shall be 295
1893-conducted in accordance with the provisions of chapter 621. 296
1894-Upon a finding by the administrative hearing commission that 297
1895-the grounds, provided in subsection 2 of this section, for 298
1896-disciplinary action are met, the board may, singly or in 299
1897-combination, warn, censure or place the person named in the 300
1898-complaint on probation on such terms and conditions as the 301 CCS HCS SS SCS SB 157 59
1899-board deems appropriate for a period not to exceed ten 302
1900-years, or may suspend the person's license, certificate or 303
1901-permit for a period not to exceed three years, or restrict 304
1902-or limit the person's license, certificate or permit for an 305
1903-indefinite period of time, or revoke the person's license, 306
1904-certificate, or permit, or administer a public or private 307
1905-reprimand, or deny the person's application for a license, 308
1906-or permanently withhold issuance of a license or require the 309
1907-person to submit to the care, counseling or treatment of 310
1908-physicians designated by the board at the expense of the 311
1909-individual to be examined, or require the person to attend 312
1910-such continuing educational courses and pass such 313
1911-examinations as the board may direct. 314
1912- 5. In any order of revocation, the board may prov ide 315
1913-that the person may not apply for reinstatement of the 316
1914-person's license for a period of time ranging from two to 317
1915-seven years following the date of the order of revocation. 318
1916-All stay orders shall toll this time period. 319
1917- 6. Before restoring to g ood standing a license, 320
1918-certificate or permit issued pursuant to this chapter which 321
1919-has been in a revoked, suspended or inactive state for any 322
1920-cause for more than two years, the board may require the 323
1921-applicant to attend such continuing medical educatio n 324
1922-courses and pass such examinations as the board may direct. 325
1923- 7. In any investigation, hearing or other proceeding 326
1924-to determine a licensee's or applicant's fitness to 327
1925-practice, any record relating to any patient of the licensee 328
1926-or applicant shall be discoverable by the board and 329
1927-admissible into evidence, regardless of any statutory or 330
1928-common law privilege which such licensee, applicant, record 331
1929-custodian or patient might otherwise invoke. In addition, 332
1930-no such licensee, applicant, or record cus todian may 333 CCS HCS SS SCS SB 157 60
1931-withhold records or testimony bearing upon a licensee's or 334
1932-applicant's fitness to practice on the ground of privilege 335
1933-between such licensee, applicant or record custodian and a 336
1934-patient. 337
1935- 8. The act of lawfully dispensing, prescribing, 338
1936-administering, or otherwise distributing ivermectin tablets 339
1937-or hydroxychloroquine sulfate tablets for human use shall 340
1938-not be grounds for denial, suspension, revocation, or other 341
1939-disciplinary action by the board. 342
1940- 334.104. 1. A physician may enter into collaborative 1
1941-practice arrangements with registered professional nurses. 2
1942-Collaborative practice arrangements shall be in the form of 3
1943-written agreements, jointly agreed -upon protocols, or 4
1944-standing orders for the delivery of health ca re services. 5
1945-Collaborative practice arrangements, which shall be in 6
1946-writing, may delegate to a registered professional nurse the 7
1947-authority to administer or dispense drugs and provide 8
1948-treatment as long as the delivery of such health care 9
1949-services is within the scope of practice of the registered 10
1950-professional nurse and is consistent with that nurse's 11
1951-skill, training and competence. 12
1952- 2. (1) Collaborative practice arrangements, which 13
1953-shall be in writing, may delegate to a registered 14
1954-professional nurse the authority to administer, dispense or 15
1955-prescribe drugs and provide treatment if the registered 16
1956-professional nurse is an advanced practice registered nurse 17
1957-as defined in subdivision (2) of section 335.016. 18
1958-Collaborative practice arrangements m ay delegate to an 19
1959-advanced practice registered nurse, as defined in section 20
1960-335.016, the authority to administer, dispense, or prescribe 21
1961-controlled substances listed in Schedules III, IV, and V of 22
1962-section 195.017, and Schedule II - hydrocodone; except that, 23 CCS HCS SS SCS SB 157 61
1963-the collaborative practice arrangement shall not delegate 24
1964-the authority to administer any controlled substances listed 25
1965-in Schedules III, IV, and V of section 195.017, or Schedule 26
1966-II - hydrocodone for the purpose of inducing sedation or 27
1967-general anesthesia for therapeutic, diagnostic, or surgical 28
1968-procedures. Schedule III narcotic controlled substance and 29
1969-Schedule II - hydrocodone prescriptions shall be limited to 30
1970-a one hundred twenty -hour supply without refill. 31
1971- (2) Notwithstanding any oth er provision of this 32
1972-section to the contrary, a collaborative practice 33
1973-arrangement may delegate to an advanced practice registered 34
1974-nurse the authority to administer, dispense, or prescribe 35
1975-Schedule II controlled substances for hospice patients; 36
1976-provided, that the advanced practice registered nurse is 37
1977-employed by a hospice provider certified pursuant to chapter 38
1978-197 and the advanced practice registered nurse is providing 39
1979-care to hospice patients pursuant to a collaborative 40
1980-practice arrangement that d esignates the certified hospice 41
1981-as a location where the advanced practice registered nurse 42
1982-is authorized to practice and prescribe. 43
1983- (3) Such collaborative practice arrangements shall be 44
1984-in the form of written agreements, jointly agreed -upon 45
1985-protocols or standing orders for the delivery of health care 46
1986-services. 47
1987- (4) An advanced practice registered nurse may 48
1988-prescribe buprenorphine for up to a thirty -day supply 49
1989-without refill for patients receiving medication -assisted 50
1990-treatment for substanc e use disorders under the direction of 51
1991-the collaborating physician. 52
1992- 3. The written collaborative practice arrangement 53
1993-shall contain at least the following provisions: 54 CCS HCS SS SCS SB 157 62
1994- (1) Complete names, home and business addresses, zip 55
1995-codes, and telephone numbers of the collaborating physician 56
1996-and the advanced practice registered nurse; 57
1997- (2) A list of all other offices or locations besides 58
1998-those listed in subdivision (1) of this subsection where the 59
1999-collaborating physician authorized the advanced pr actice 60
2000-registered nurse to prescribe; 61
2001- (3) A requirement that there shall be posted at every 62
2002-office where the advanced practice registered nurse is 63
2003-authorized to prescribe, in collaboration with a physician, 64
2004-a prominently displayed disclosure stat ement informing 65
2005-patients that they may be seen by an advanced practice 66
2006-registered nurse and have the right to see the collaborating 67
2007-physician; 68
2008- (4) All specialty or board certifications of the 69
2009-collaborating physician and all certifications of the 70
2010-advanced practice registered nurse; 71
2011- (5) The manner of collaboration between the 72
2012-collaborating physician and the advanced practice registered 73
2013-nurse, including how the collaborating physician and the 74
2014-advanced practice registered nurse will: 75
2015- (a) Engage in collaborative practice consistent with 76
2016-each professional's skill, training, education, and 77
2017-competence; 78
2018- (b) Maintain geographic proximity, except as specified 79
2019-in this paragraph. The following provisions shall apply 80
2020-with respect to this requirement: 81
2021- a. Until August 28, 2025, an advanced practice 82
2022-registered nurse providing services in a correctional 83
2023-center, as defined in section 217.010, and his or her 84
2024-collaborating physician shall satisfy the geographic 85
2025-proximity requirement if they practice within two hundred 86 CCS HCS SS SCS SB 157 63
2026-miles by road of one another. An incarcerated patient who 87
2027-requests or requires a physician consultation shall be 88
2028-treated by a physician as soon as appropriate; 89
2029- b. The collaborative practice arrangement may all ow 90
2030-for geographic proximity to be waived for a maximum of 91
2031-twenty-eight days per calendar year for rural health clinics 92
2032-as defined by P.L. 95 -210 (42 U.S.C. Section 1395x, as 93
2033-amended), as long as the collaborative practice arrangement 94
2034-includes alternative plans as required in paragraph (c) of 95
2035-this subdivision. This exception to geographic proximity 96
2036-shall apply only to independent rural health clinics, 97
2037-provider-based rural health clinics where the provider is a 98
2038-critical access hospital as provided i n 42 U.S.C. Section 99
2039-1395i-4, and provider-based rural health clinics where the 100
2040-main location of the hospital sponsor is greater than fifty 101
2041-miles from the clinic [.]; 102
2042- c. The collaborative practice arrangement may allow 103
2043-for geographic proximity to b e waived when the arrangement 104
2044-outlines the use of telehealth, as defined in section 105
2045-191.1145; 106
2046- d. In addition to the waivers and exemptions provided 107
2047-in this subsection, an application for a waiver for any 108
2048-other reason of any applicable geographic proximity shall be 109
2049-available if a physician is collaborating with an advanced 110
2050-practice registered nurse in excess of any geographic 111
2051-proximity limit. The board of nursing and the state board 112
2052-of registration for the healing arts shall review each 113
2053-application for a waiver of geographic proximity and approve 114
2054-the application if the boards determine that adequate 115
2055-supervision exists between the collaborating physician and 116
2056-the advanced practice registered nurse. The boards shall 117
2057-have forty-five calendar days to review the completed 118 CCS HCS SS SCS SB 157 64
2058-application for the waiver of geographic proximity. If no 119
2059-action is taken by the boards within forty -five days after 120
2060-the submission of the application for a waiver, then the 121
2061-application shall be deemed approved. If the application is 122
2062-denied by the boards, the provisions of section 536.063 for 123
2063-contested cases shall apply and govern proceedings for 124
2064-appellate purposes; and 125
2065- e. The collaborating physician is required to maintain 126
2066-documentation related to this requireme nt and to present it 127
2067-to the state board of registration for the healing arts when 128
2068-requested; and 129
2069- (c) Provide coverage during absence, incapacity, 130
2070-infirmity, or emergency by the collaborating physician; 131
2071- (6) A description of the advanced pract ice registered 132
2072-nurse's controlled substance prescriptive authority in 133
2073-collaboration with the physician, including a list of the 134
2074-controlled substances the physician authorizes the nurse to 135
2075-prescribe and documentation that it is consistent with each 136
2076-professional's education, knowledge, skill, and competence; 137
2077- (7) A list of all other written practice agreements of 138
2078-the collaborating physician and the advanced practice 139
2079-registered nurse; 140
2080- (8) The duration of the written practice agreement 141
2081-between the collaborating physician and the advanced 142
2082-practice registered nurse; 143
2083- (9) A description of the time and manner of the 144
2084-collaborating physician's review of the advanced practice 145
2085-registered nurse's delivery of health care services. The 146
2086-description shall include provisions that the advanced 147
2087-practice registered nurse shall submit a minimum of ten 148
2088-percent of the charts documenting the advanced practice 149
2089-registered nurse's delivery of health care services to the 150 CCS HCS SS SCS SB 157 65
2090-collaborating physician for review by the collaborating 151
2091-physician, or any other physician designated in the 152
2092-collaborative practice arrangement, every fourteen days; 153
2093-[and] 154
2094- (10) The collaborating physician, or any other 155
2095-physician designated in the collaborative practice 156
2096-arrangement, shall review every fourteen days a minimum of 157
2097-twenty percent of the charts in which the advanced practice 158
2098-registered nurse prescribes controlled substances. The 159
2099-charts reviewed under this subdivision may be counted in the 160
2100-number of charts required t o be reviewed under subdivision 161
2101-(9) of this subsection ; and 162
2102- (11) If a collaborative practice arrangement is used 163
2103-in clinical situations where a collaborating advanced 164
2104-practice registered nurse provides health care services that 165
2105-include the diagnosis and initiation of treatment for 166
2106-acutely or chronically ill or injured persons, then the 167
2107-collaborating physician or any other physician designated in 168
2108-the collaborative practice arrangement shall be present for 169
2109-sufficient periods of time, at least on ce every two weeks, 170
2110-except in extraordinary circumstances that shall be 171
2111-documented, to participate in a chart review and to provide 172
2112-necessary medical direction, medical services, 173
2113-consultations, and supervision of the health care staff . 174
2114- 4. The state board of registration for the healing 175
2115-arts pursuant to section 334.125 and the board of nursing 176
2116-pursuant to section 335.036 may jointly promulgate rules 177
2117-regulating the use of collaborative practice arrangements. 178
2118-Such rules shall be limited to [specifying geographic areas 179
2119-to be covered,] the methods of treatment that may be covered 180
2120-by collaborative practice arrangements and the requirements 181
2121-for review of services provided pursuant to collaborative 182 CCS HCS SS SCS SB 157 66
2122-practice arrangements including delegating author ity to 183
2123-prescribe controlled substances. Any rules relating to 184
2124-geographic proximity shall allow a collaborating physician 185
2125-and a collaborating advanced practice registered nurse to 186
2126-practice within two hundred miles by road of one another 187
2127-until August 28, 2025, if the nurse is providing services in 188
2128-a correctional center, as defined in section 217.010. Any 189
2129-rules relating to dispensing or distribution of medications 190
2130-or devices by prescription or prescription drug orders under 191
2131-this section shall be sub ject to the approval of the state 192
2132-board of pharmacy. Any rules relating to dispensing or 193
2133-distribution of controlled substances by prescription or 194
2134-prescription drug orders under this section shall be subject 195
2135-to the approval of the department of health and senior 196
2136-services and the state board of pharmacy. In order to take 197
2137-effect, such rules shall be approved by a majority vote of a 198
2138-quorum of each board. Neither the state board of 199
2139-registration for the healing arts nor the board of nursing 200
2140-may separately promulgate rules relating to collaborative 201
2141-practice arrangements. Such jointly promulgated rules shall 202
2142-be consistent with guidelines for federally funded clinics. 203
2143-The rulemaking authority granted in this subsection shall 204
2144-not extend to collaborat ive practice arrangements of 205
2145-hospital employees providing inpatient care within hospitals 206
2146-as defined pursuant to chapter 197 or population -based 207
2147-public health services as defined by 20 CSR 2150 -5.100 as of 208
2148-April 30, 2008. 209
2149- 5. The state board of re gistration for the healing 210
2150-arts shall not deny, revoke, suspend or otherwise take 211
2151-disciplinary action against a physician for health care 212
2152-services delegated to a registered professional nurse 213
2153-provided the provisions of this section and the rules 214 CCS HCS SS SCS SB 157 67
2154-promulgated thereunder are satisfied. Upon the written 215
2155-request of a physician subject to a disciplinary action 216
2156-imposed as a result of an agreement between a physician and 217
2157-a registered professional nurse or registered physician 218
2158-assistant, whether written or not, prior to August 28, 1993, 219
2159-all records of such disciplinary licensure action and all 220
2160-records pertaining to the filing, investigation or review of 221
2161-an alleged violation of this chapter incurred as a result of 222
2162-such an agreement shall be removed from the records of the 223
2163-state board of registration for the healing arts and the 224
2164-division of professional registration and shall not be 225
2165-disclosed to any public or private entity seeking such 226
2166-information from the board or the division. The state board 227
2167-of registration for the healing arts shall take action to 228
2168-correct reports of alleged violations and disciplinary 229
2169-actions as described in this section which have been 230
2170-submitted to the National Practitioner Data Bank. In 231
2171-subsequent applications or represent ations relating to his 232
2172-or her medical practice, a physician completing forms or 233
2173-documents shall not be required to report any actions of the 234
2174-state board of registration for the healing arts for which 235
2175-the records are subject to removal under this sectio n. 236
2176- 6. Within thirty days of any change and on each 237
2177-renewal, the state board of registration for the healing 238
2178-arts shall require every physician to identify whether the 239
2179-physician is engaged in any collaborative practice 240
2180-[agreement] arrangement, including collaborative practice 241
2181-[agreements] arrangements delegating the authority to 242
2182-prescribe controlled substances, or physician assistant 243
2183-[agreement] collaborative practice arrangement and also 244
2184-report to the board the name of each licensed profession al 245
2185-with whom the physician has entered into such [agreement] 246 CCS HCS SS SCS SB 157 68
2186-arrangement. The board [may] shall make this information 247
2187-available to the public. The board shall track the reported 248
2188-information and may routinely conduct random reviews of such 249
2189-[agreements] arrangements to ensure that [agreements] 250
2190-arrangements are carried out for compliance under this 251
2191-chapter. 252
2192- 7. Notwithstanding any law to the contrary, a 253
2193-certified registered nurse anesthetist as defined in 254
2194-subdivision (8) of section 335.016 shal l be permitted to 255
2195-provide anesthesia services without a collaborative practice 256
2196-arrangement provided that he or she is under the supervision 257
2197-of an anesthesiologist or other physician, dentist, or 258
2198-podiatrist who is immediately available if needed. Nothing 259
2199-in this subsection shall be construed to prohibit or prevent 260
2200-a certified registered nurse anesthetist as defined in 261
2201-subdivision (8) of section 335.016 from entering into a 262
2202-collaborative practice arrangement under this section, 263
2203-except that the colla borative practice arrangement may not 264
2204-delegate the authority to prescribe any controlled 265
2205-substances listed in Schedules III, IV, and V of section 266
2206-195.017, or Schedule II - hydrocodone. 267
2207- 8. A collaborating physician shall not enter into a 268
2208-collaborative practice arrangement with more than six full - 269
2209-time equivalent advanced practice registered nurses, full - 270
2210-time equivalent licensed physician assistants, or full -time 271
2211-equivalent assistant physicians, or any combination 272
2212-thereof. This limitation shall not apply to collaborative 273
2213-arrangements of hospital employees providing inpatient care 274
2214-service in hospitals as defined in chapter 197 or population - 275
2215-based public health services as defined by 20 CSR 2150 -5.100 276
2216-as of April 30, 2008, or to a certified reg istered nurse 277
2217-anesthetist providing anesthesia services under the 278 CCS HCS SS SCS SB 157 69
2218-supervision of an anesthesiologist or other physician, 279
2219-dentist, or podiatrist who is immediately available if 280
2220-needed as set out in subsection 7 of this section. 281
2221- 9. It is the responsibility of the collaborating 282
2222-physician to determine and document the completion of at 283
2223-least a one-month period of time during which the advanced 284
2224-practice registered nurse shall practice with the 285
2225-collaborating physician continuously present before 286
2226-practicing in a setting where the collaborating physician is 287
2227-not continuously present. This limitation shall not apply 288
2228-to collaborative arrangements of providers of population - 289
2229-based public health services , as defined by 20 CSR 2150 - 290
2230-5.100 as of April 30, 2008, or to collaborative practice 291
2231-arrangements between a primary care physician and a primary 292
2232-care advanced practice registered nurse or a behavioral 293
2233-health physician and a behavioral health advanced practice 294
2234-registered nurse, where the collaborating physician is new 295
2235-to a patient population to which the advanced practice 296
2236-registered nurse is familiar . 297
2237- 10. No agreement made under this section shall 298
2238-supersede current hospital licensing regulations governing 299
2239-hospital medication orders under proto cols or standing 300
2240-orders for the purpose of delivering inpatient or emergency 301
2241-care within a hospital as defined in section 197.020 if such 302
2242-protocols or standing orders have been approved by the 303
2243-hospital's medical staff and pharmaceutical therapeutics 304
2244-committee. 305
2245- 11. No contract or other [agreement] term of 306
2246-employment shall require a physician to act as a 307
2247-collaborating physician for an advanced practice registered 308
2248-nurse against the physician's will. A physician shall have 309
2249-the right to refuse to act as a collaborating physician, 310 CCS HCS SS SCS SB 157 70
2250-without penalty, for a particular advanced practice 311
2251-registered nurse. No contract or other agreement shall 312
2252-limit the collaborating physician's ultimate authority over 313
2253-any protocols or standing orders or in the delega tion of the 314
2254-physician's authority to any advanced practice registered 315
2255-nurse, but this requirement shall not authorize a physician 316
2256-in implementing such protocols, standing orders, or 317
2257-delegation to violate applicable standards for safe medical 318
2258-practice established by hospital's medical staff. 319
2259- 12. No contract or other [agreement] term of 320
2260-employment shall require any advanced practice registered 321
2261-nurse to serve as a collaborating advanced practice 322
2262-registered nurse for any collaborating physician ag ainst the 323
2263-advanced practice registered nurse's will. An advanced 324
2264-practice registered nurse shall have the right to refuse to 325
2265-collaborate, without penalty, with a particular physician. 326
2266- 334.506. 1. As used in this section, the following 1
2267-terms mean: 2
2268- (1) "Approved health care provider" [means], a person 3
2269-holding a current and active license as a physician and 4
2270-surgeon under this chapter, a chiropractor under chapter 5
2271-331, a dentist under chapter 332, a podiatrist under chapter 6
2272-330, a physician assistant under this chapter, an advanced 7
2273-practice registered nurse under chapter 335, or any licensed 8
2274-and registered physician, chiropractor, dentist, or 9
2275-podiatrist practicing in another jurisdiction whose license 10
2276-is in good standing; 11
2277- (2) "Consult" or "consultation", communication by 12
2278-telephone, by fax, in writing, or in person with the 13
2279-patient's personally approved licensed health care provider 14
2280-or a licensed health care provider of the patient's 15
2281-designation. 16 CCS HCS SS SCS SB 157 71
2282- 2. A physical therapist [shall not] may evaluate and 17
2283-initiate treatment [for a new injury or illness ] on a 18
2284-patient without a prescription or referral from an approved 19
2285-health care provider , provided that the physical therapist 20
2286-has a doctorate of physical therapy de gree or has five years 21
2287-of clinical practice as a physical therapist . 22
2288- 3. A physical therapist may provide educational 23
2289-resources and training, develop fitness or wellness programs 24
2290-[for asymptomatic persons ], or provide screening or 25
2291-consultative services within the scope of physical therapy 26
2292-practice without [the] a prescription [and direction of] or 27
2293-referral from an approved health care provider. 28
2294- 4. [A physical therapist may examine and treat without 29
2295-the prescription and direction of an appr oved health care 30
2296-provider any person with a recurring self -limited injury 31
2297-within one year of diagnosis by an approved health care 32
2298-provider or a chronic illness that has been previously 33
2299-diagnosed by an approved health care provider. The physical 34
2300-therapist shall:] 35
2301- (1) [Contact the patient's current approved health 36
2302-care provider within seven days of initiating physical 37
2303-therapy services under this subsection; ] A physical 38
2304-therapist shall refer to an approved health care provider 39
2305-any patient whose condition at the time of evaluation or 40
2306-treatment is determined to be beyond the scope of practice 41
2307-of physical therapy. The physical therapist shall not 42
2308-provide physical therapy services or treatment after this 43
2309-referral has been made. 44
2310- (2) [Not change an existing physical therapy referral 45
2311-available to the physical therapist without approval of the 46
2312-patient's current approved health care provider; ] A physical 47
2313-therapist shall refer to an approved health care provider 48 CCS HCS SS SCS SB 157 72
2314-any patient who does not demo nstrate measurable or 49
2315-functional improvement after ten visits or thirty days, 50
2316-whichever occurs first. The physical therapist shall not 51
2317-provide further therapy services or treatment after this 52
2318-referral has been made. 53
2319- (3) [Refer to an approved hea lth care provider any 54
2320-patient whose medical condition at the time of examination 55
2321-or treatment is determined to be beyond the scope of 56
2322-practice of physical therapy; 57
2323- (4) Refer to an approved health care provider any 58
2324-patient whose condition for whic h physical therapy services 59
2325-are rendered under this subsection has not been documented 60
2326-to be progressing toward documented treatment goals after 61
2327-six visits or fourteen days, whichever first occurs; 62
2328- (5) Notify the patient's current approved health care 63
2329-provider prior to the continuation of treatment if treatment 64
2330-rendered under this subsection is to continue beyond thirty 65
2331-days. The physical therapist shall provide such 66
2332-notification for each successive period of thirty days. ] 67
2333-(a) A physical therapist shall consult with an approved 68
2334-health care provider if, after every ten visits or thirty 69
2335-days, whichever occurs first, the patient has demonstrated 70
2336-measurable or functional improvement from the course of 71
2337-physical therapy services or treatment pr ovided and the 72
2338-physical therapist believes that continuation of the course 73
2339-of physical therapy services or treatment is reasonable and 74
2340-necessary based on the physical therapist's evaluation of 75
2341-the patient. The physical therapist shall not provide 76
2342-further physical therapy services or treatment until the 77
2343-consultation has occurred. 78
2344- (b) The consultation with the approved health care 79
2345-provider shall include information concerning: 80 CCS HCS SS SCS SB 157 73
2346- a. The patient's condition for which physical therapy 81
2347-services or treatments were provided; 82
2348- b. The basis for the course of services or treatment 83
2349-indicated, as determined from the physical therapy 84
2350-evaluation of the patient; 85
2351- c. The physical therapy services or treatment provided 86
2352-before the date of the co nsultation; 87
2353- d. The patient's demonstrated measurable or functional 88
2354-improvement from the services or treatment provided before 89
2355-the date of the consultation; 90
2356- e. The continuing physical therapy services or 91
2357-treatment proposed to be provided foll owing the 92
2358-consultation; and 93
2359- f. The professional physical therapy basis for the 94
2360-continued physical therapy services or treatment to be 95
2361-provided. 96
2362- (c) Continued physical therapy services or treatment 97
2363-following the consultation with and approva l by an approved 98
2364-health care provider shall proceed in accordance with any 99
2365-feedback, advice, opinion, or direction of the approved 100
2366-health care provider. The physical therapist shall notify 101
2367-the consulting approved health care provider of continuing 102
2368-physical therapy services or treatment and the patient's 103
2369-progress at least every ten visits or thirty days after the 104
2370-initial consultation unless the consulting approved health 105
2371-care provider directs otherwise. 106
2372- (d) The provisions of this subdivision s hall not apply 107
2373-to physical therapy services performed within a primary or 108
2374-secondary school for individuals within ages not in excess 109
2375-of twenty-one years. 110
2376- 5. The provision of physical therapy services of 111
2377-evaluation and screening pursuant to this s ection shall be 112 CCS HCS SS SCS SB 157 74
2378-limited to a physical therapist, and any authority for 113
2379-evaluation and screening granted within this section may not 114
2380-be delegated. Upon each reinitiation of physical therapy 115
2381-services, a physical therapist shall provide a full physical 116
2382-therapy evaluation prior to the reinitiation of physical 117
2383-therapy treatment. [Physical therapy treatment provided 118
2384-pursuant to the provisions of subsection 4 of this section 119
2385-may be delegated by physical therapists to physical 120
2386-therapist assistants only i f the patient's current approved 121
2387-health care provider has been so informed as part of the 122
2388-physical therapist's seven -day notification upon 123
2389-reinitiation of physical therapy services as required in 124
2390-subsection 4 of this section. ] Nothing in this subsecti on 125
2391-shall be construed as to limit the ability of physical 126
2392-therapists or physical therapist assistants to provide 127
2393-physical therapy services in accordance with the provisions 128
2394-of this chapter, and upon the referral of an approved health 129
2395-care provider. Nothing in this subsection shall prohibit an 130
2396-approved health care provider from acting within the scope 131
2397-of their practice as defined by the applicable chapters of 132
2398-RSMo. 133
2399- 6. No person licensed to practice, or applicant for 134
2400-licensure, as a physical t herapist or physical therapist 135
2401-assistant shall make a medical diagnosis. 136
2402- 7. A physical therapist shall only delegate physical 137
2403-therapy treatment to a physical therapist assistant or to a 138
2404-person in an entry level of a professional education program 139
2405-approved by the Commission on Accreditation in Physical 140
2406-Therapy Education (CAPTE) who satisfies supervised clinical 141
2407-education requirements related to the person's physical 142
2408-therapist or physical therapist assistant education. The 143 CCS HCS SS SCS SB 157 75
2409-entry-level person shall be under the supervision of a 144
2410-physical therapist. 145
2411- 334.613. 1. The board may refuse to issue or renew a 1
2412-license to practice as a physical therapist or physical 2
2413-therapist assistant for one or any combination of causes 3
2414-stated in subsection 2 of this section. The board shall 4
2415-notify the applicant in writing of the reasons for the 5
2416-refusal and shall advise the applicant of the applicant's 6
2417-right to file a complaint with the administrative hearing 7
2418-commission as provided by chapter 6 21. As an alternative to 8
2419-a refusal to issue or renew a license to practice as a 9
2420-physical therapist or physical therapist assistant, the 10
2421-board may, at its discretion, issue a license which is 11
2422-subject to probation, restriction, or limitation to an 12
2423-applicant for licensure for any one or any combination of 13
2424-causes stated in subsection 2 of this section. The board's 14
2425-order of probation, limitation, or restriction shall contain 15
2426-a statement of the discipline imposed, the basis therefor, 16
2427-the date such action shall become effective, and a statement 17
2428-that the applicant has thirty days to request in writing a 18
2429-hearing before the administrative hearing commission. If 19
2430-the board issues a probationary, limited, or restricted 20
2431-license to an applicant for licensur e, either party may file 21
2432-a written petition with the administrative hearing 22
2433-commission within thirty days of the effective date of the 23
2434-probationary, limited, or restricted license seeking review 24
2435-of the board's determination. If no written request for a 25
2436-hearing is received by the administrative hearing commission 26
2437-within the thirty-day period, the right to seek review of 27
2438-the board's decision shall be considered as waived. 28
2439- 2. The board may cause a complaint to be filed with 29
2440-the administrative he aring commission as provided by chapter 30 CCS HCS SS SCS SB 157 76
2441-621 against any holder of a license to practice as a 31
2442-physical therapist or physical therapist assistant who has 32
2443-failed to renew or has surrendered his or her license for 33
2444-any one or any combination of the followin g causes: 34
2445- (1) Use of any controlled substance, as defined in 35
2446-chapter 195, or alcoholic beverage to an extent that such 36
2447-use impairs a person's ability to perform the work of a 37
2448-physical therapist or physical therapist assistant; 38
2449- (2) The person has been finally adjudicated and found 39
2450-guilty, or entered a plea of guilty or nolo contendere, in a 40
2451-criminal prosecution under the laws of any state, of the 41
2452-United States, or of any country, for any offense directly 42
2453-related to the duties and responsib ilities of the 43
2454-occupation, as set forth in section 324.012, regardless of 44
2455-whether or not sentence is imposed; 45
2456- (3) Use of fraud, deception, misrepresentation, or 46
2457-bribery in securing any certificate of registration or 47
2458-authority, permit, or license issued under this chapter or 48
2459-in obtaining permission to take any examination given or 49
2460-required under this chapter; 50
2461- (4) Misconduct, fraud, misrepresentation, dishonesty, 51
2462-unethical conduct, or unprofessional conduct in the 52
2463-performance of the functi ons or duties of a physical 53
2464-therapist or physical therapist assistant, including but not 54
2465-limited to the following: 55
2466- (a) Obtaining or attempting to obtain any fee, charge, 56
2467-tuition, or other compensation by fraud, deception, or 57
2468-misrepresentation; wi llfully and continually overcharging or 58
2469-overtreating patients; or charging for sessions of physical 59
2470-therapy which did not occur unless the services were 60
2471-contracted for in advance, or for services which were not 61
2472-rendered or documented in the patient's r ecords; 62 CCS HCS SS SCS SB 157 77
2473- (b) Attempting, directly or indirectly, by way of 63
2474-intimidation, coercion, or deception, to obtain or retain a 64
2475-patient or discourage the use of a second opinion or 65
2476-consultation; 66
2477- (c) Willfully and continually performing inappropriate 67
2478-or unnecessary treatment or services; 68
2479- (d) Delegating professional responsibilities to a 69
2480-person who is not qualified by training, skill, competency, 70
2481-age, experience, or licensure to perform such 71
2482-responsibilities; 72
2483- (e) Misrepresenting that any disease, ailment, or 73
2484-infirmity can be cured by a method, procedure, treatment, 74
2485-medicine, or device; 75
2486- (f) Performing services which have been declared by 76
2487-board rule to be of no physical therapy value; 77
2488- (g) Final disciplinary action by any profe ssional 78
2489-association, professional society, licensed hospital or 79
2490-medical staff of the hospital, or physical therapy facility 80
2491-in this or any other state or territory, whether agreed to 81
2492-voluntarily or not, and including but not limited to any 82
2493-removal, suspension, limitation, or restriction of the 83
2494-person's professional employment, malpractice, or any other 84
2495-violation of any provision of this chapter; 85
2496- (h) Administering treatment without sufficient 86
2497-examination, or for other than medically accepted 87
2498-therapeutic or experimental or investigative purposes duly 88
2499-authorized by a state or federal agency, or not in the 89
2500-course of professional physical therapy practice; 90
2501- (i) Engaging in or soliciting sexual relationships, 91
2502-whether consensual or nonconsens ual, while a physical 92
2503-therapist or physical therapist assistant/patient 93
2504-relationship exists; making sexual advances, requesting 94 CCS HCS SS SCS SB 157 78
2505-sexual favors, or engaging in other verbal conduct or 95
2506-physical contact of a sexual nature with patients or clients; 96
2507- (j) Terminating the care of a patient without adequate 97
2508-notice or without making other arrangements for the 98
2509-continued care of the patient; 99
2510- (k) Failing to furnish details of a patient's physical 100
2511-therapy records to treating physicians, other physical 101
2512-therapists, or hospitals upon proper request; or failing to 102
2513-comply with any other law relating to physical therapy 103
2514-records; 104
2515- (l) Failure of any applicant or licensee, other than 105
2516-the licensee subject to the investigation, to cooperate with 106
2517-the board during any investigation; 107
2518- (m) Failure to comply with any subpoena or subpoena 108
2519-duces tecum from the board or an order of the board; 109
2520- (n) Failure to timely pay license renewal fees 110
2521-specified in this chapter; 111
2522- (o) Violating a probation agr eement with this board or 112
2523-any other licensing agency; 113
2524- (p) Failing to inform the board of the physical 114
2525-therapist's or physical therapist assistant's current 115
2526-telephone number, residence, and business address; 116
2527- (q) Advertising by an applicant or licensee which is 117
2528-false or misleading, or which violates any rule of the 118
2529-board, or which claims without substantiation the positive 119
2530-cure of any disease, or professional superiority to or 120
2531-greater skill than that possessed by any other physical 121
2532-therapist or physical therapist assistant. An applicant or 122
2533-licensee shall also be in violation of this provision if the 123
2534-applicant or licensee has a financial interest in any 124
2535-organization, corporation, or association which issues or 125
2536-conducts such advertising; 126 CCS HCS SS SCS SB 157 79
2537- (5) Any conduct or practice which is or might be 127
2538-harmful or dangerous to the mental or physical health of a 128
2539-patient or the public; or incompetency, gross negligence, or 129
2540-repeated negligence in the performance of the functions or 130
2541-duties of a physical therapist or physical therapist 131
2542-assistant. For the purposes of this subdivision, "repeated 132
2543-negligence" means the failure, on more than one occasion, to 133
2544-use that degree of skill and learning ordinarily used under 134
2545-the same or similar circumstances b y the member of the 135
2546-applicant's or licensee's profession; 136
2547- (6) Violation of, or attempting to violate, directly 137
2548-or indirectly, or assisting or enabling any person to 138
2549-violate, any provision of this chapter, or of any lawful 139
2550-rule adopted under this chapter; 140
2551- (7) Impersonation of any person licensed as a physical 141
2552-therapist or physical therapist assistant or allowing any 142
2553-person to use his or her license or diploma from any school; 143
2554- (8) Revocation, suspension, restriction, modification, 144
2555-limitation, reprimand, warning, censure, probation, or other 145
2556-final disciplinary action against a physical therapist or 146
2557-physical therapist assistant for a license or other right to 147
2558-practice as a physical therapist or physical therapist 148
2559-assistant by another state, territory, federal agency or 149
2560-country, whether or not voluntarily agreed to by the 150
2561-licensee or applicant, including but not limited to the 151
2562-denial of licensure, surrender of the license, allowing the 152
2563-license to expire or lapse, or discontinuing o r limiting the 153
2564-practice of physical therapy while subject to an 154
2565-investigation or while actually under investigation by any 155
2566-licensing authority, medical facility, branch of the Armed 156
2567-Forces of the United States of America, insurance company, 157 CCS HCS SS SCS SB 157 80
2568-court, agency of the state or federal government, or 158
2569-employer; 159
2570- (9) A person is finally adjudged incapacitated or 160
2571-disabled by a court of competent jurisdiction; 161
2572- (10) Assisting or enabling any person to practice or 162
2573-offer to practice who is not licensed and currently eligible 163
2574-to practice under this chapter; or knowingly performing any 164
2575-act which in any way aids, assists, procures, advises, or 165
2576-encourages any person to practice physical therapy who is 166
2577-not licensed and currently eligible to practice under this 167
2578-chapter; 168
2579- (11) Issuance of a license to practice as a physical 169
2580-therapist or physical therapist assistant based upon a 170
2581-material mistake of fact; 171
2582- (12) Failure to display a valid license pursuant to 172
2583-practice as a physical therapist or phy sical therapist 173
2584-assistant; 174
2585- (13) Knowingly making, or causing to be made, or 175
2586-aiding, or abetting in the making of, a false statement in 176
2587-any document executed in connection with the practice of 177
2588-physical therapy; 178
2589- (14) Soliciting patronage in p erson or by agents or 179
2590-representatives, or by any other means or manner, under the 180
2591-person's own name or under the name of another person or 181
2592-concern, actual or pretended, in such a manner as to 182
2593-confuse, deceive, or mislead the public as to the need or 183
2594-necessity for or appropriateness of physical therapy 184
2595-services for all patients, or the qualifications of an 185
2596-individual person or persons to render, or perform physical 186
2597-therapy services; 187
2598- (15) Using, or permitting the use of, the person's 188
2599-name under the designation of "physical therapist", 189 CCS HCS SS SCS SB 157 81
2600-"physiotherapist", "registered physical therapist", "P.T.", 190
2601-"Ph.T.", "P.T.T.", "D.P.T.", "M.P.T." or "R.P.T.", "physical 191
2602-therapist assistant", "P.T.A.", "L.P.T.A.", "C.P.T.A.", or 192
2603-any similar designation with r eference to the commercial 193
2604-exploitation of any goods, wares or merchandise; 194
2605- (16) Knowingly making or causing to be made a false 195
2606-statement or misrepresentation of a material fact, with 196
2607-intent to defraud, for payment under chapter 208 or chapter 197
2608-630 or for payment from Title XVIII or Title XIX of the 198
2609-Social Security Act; 199
2610- (17) Failure or refusal to properly guard against 200
2611-contagious, infectious, or communicable diseases or the 201
2612-spread thereof; maintaining an unsanitary facility or 202
2613-performing professional services under unsanitary 203
2614-conditions; or failure to report the existence of an 204
2615-unsanitary condition in any physical therapy facility to the 205
2616-board, in writing, within thirty days after the discovery 206
2617-thereof; 207
2618- (18) Any candidate for lic ensure or person licensed to 208
2619-practice as a physical therapist or physical therapist 209
2620-assistant paying or offering to pay a referral fee or [, 210
2621-notwithstanding section 334.010 to the contrary, practicing 211
2622-or offering to practice professional physical therap y 212
2623-independent of the prescription and direction of a person 213
2624-licensed and registered as a physician and surgeon under 214
2625-this chapter, as a physician assistant under this chapter, 215
2626-as a chiropractor under chapter 331, as a dentist under 216
2627-chapter 332, as a podiatrist under chapter 330, as an 217
2628-advanced practice registered nurse under chapter 335, or any 218
2629-licensed and registered physician, chiropractor, dentist, 219
2630-podiatrist, or advanced practice registered nurse practicing 220
2631-in another jurisdiction, whose licens e is in good standing ] 221 CCS HCS SS SCS SB 157 82
2632-evaluating or treating a patient in a manner inconsistent 222
2633-with section 334.506 ; 223
2634- (19) Any candidate for licensure or person licensed to 224
2635-practice as a physical therapist or physical therapist 225
2636-assistant treating or attempting to treat ailments or other 226
2637-health conditions of human beings other than by professional 227
2638-physical therapy and as authorized by sections 334.500 to 228
2639-334.685; 229
2640- (20) A pattern of personal use or consumption of any 230
2641-controlled substance unless it is pres cribed, dispensed, or 231
2642-administered by a physician who is authorized by law to do 232
2643-so; 233
2644- (21) Failing to maintain adequate patient records 234
2645-under section 334.602; 235
2646- (22) Attempting to engage in conduct that subverts or 236
2647-undermines the integrity of the licensing examination or the 237
2648-licensing examination process, including but not limited to 238
2649-utilizing in any manner recalled or memorized licensing 239
2650-examination questions from or with any person or entity, 240
2651-failing to comply with all test center securit y procedures, 241
2652-communicating or attempting to communicate with any other 242
2653-examinees during the test, or copying or sharing licensing 243
2654-examination questions or portions of questions; 244
2655- (23) Any candidate for licensure or person licensed to 245
2656-practice as a physical therapist or physical therapist 246
2657-assistant who requests, receives, participates or engages 247
2658-directly or indirectly in the division, transferring, 248
2659-assigning, rebating or refunding of fees received for 249
2660-professional services or profits by means o f a credit or 250
2661-other valuable consideration such as wages, an unearned 251
2662-commission, discount or gratuity with any person who 252 CCS HCS SS SCS SB 157 83
2663-referred a patient, or with any relative or business 253
2664-associate of the referring person; 254
2665- (24) Being unable to practice as a physical therapist 255
2666-or physical therapist assistant with reasonable skill and 256
2667-safety to patients by reasons of incompetency, or because of 257
2668-illness, drunkenness, excessive use of drugs, narcotics, 258
2669-chemicals, or as a result of any mental or physical 259
2670-condition. The following shall apply to this subdivision: 260
2671- (a) In enforcing this subdivision the board shall, 261
2672-after a hearing by the board, upon a finding of probable 262
2673-cause, require a physical therapist or physical therapist 263
2674-assistant to submit to a r eexamination for the purpose of 264
2675-establishing his or her competency to practice as a physical 265
2676-therapist or physical therapist assistant conducted in 266
2677-accordance with rules adopted for this purpose by the board, 267
2678-including rules to allow the examination of the pattern and 268
2679-practice of such physical therapist's or physical therapist 269
2680-assistant's professional conduct, or to submit to a mental 270
2681-or physical examination or combination thereof by a facility 271
2682-or professional approved by the board; 272
2683- (b) For the purpose of this subdivision, every 273
2684-physical therapist and physical therapist assistant licensed 274
2685-under this chapter is deemed to have consented to submit to 275
2686-a mental or physical examination when directed in writing by 276
2687-the board; 277
2688- (c) In addition to ordering a physical or mental 278
2689-examination to determine competency, the board may, 279
2690-notwithstanding any other law limiting access to medical or 280
2691-other health data, obtain medical data and health records 281
2692-relating to a physical therapist, physical therap ist 282
2693-assistant or applicant without the physical therapist's, 283
2694-physical therapist assistant's or applicant's consent; 284 CCS HCS SS SCS SB 157 84
2695- (d) Written notice of the reexamination or the 285
2696-physical or mental examination shall be sent to the physical 286
2697-therapist or physical therapist assistant, by registered 287
2698-mail, addressed to the physical therapist or physical 288
2699-therapist assistant at the physical therapist's or physical 289
2700-therapist assistant's last known address. Failure of a 290
2701-physical therapist or physical therapist assist ant to submit 291
2702-to the examination when directed shall constitute an 292
2703-admission of the allegations against the physical therapist 293
2704-or physical therapist assistant, in which case the board may 294
2705-enter a final order without the presentation of evidence, 295
2706-unless the failure was due to circumstances beyond the 296
2707-physical therapist's or physical therapist assistant's 297
2708-control. A physical therapist or physical therapist 298
2709-assistant whose right to practice has been affected under 299
2710-this subdivision shall, at reasonabl e intervals, be afforded 300
2711-an opportunity to demonstrate that the physical therapist or 301
2712-physical therapist assistant can resume the competent 302
2713-practice as a physical therapist or physical therapist 303
2714-assistant with reasonable skill and safety to patients; 304
2715- (e) In any proceeding under this subdivision neither 305
2716-the record of proceedings nor the orders entered by the 306
2717-board shall be used against a physical therapist or physical 307
2718-therapist assistant in any other proceeding. Proceedings 308
2719-under this subdivision shall be conducted by the board 309
2720-without the filing of a complaint with the administrative 310
2721-hearing commission; 311
2722- (f) When the board finds any person unqualified 312
2723-because of any of the grounds set forth in this subdivision, 313
2724-it may enter an order i mposing one or more of the 314
2725-disciplinary measures set forth in subsection 3 of this 315
2726-section. 316 CCS HCS SS SCS SB 157 85
2727- 3. After the filing of such complaint before the 317
2728-administrative hearing commission, the proceedings shall be 318
2729-conducted in accordance with the provisions o f chapter 621. 319
2730-Upon a finding by the administrative hearing commission that 320
2731-the grounds provided in subsection 2 of this section for 321
2732-disciplinary action are met, the board may, singly or in 322
2733-combination: 323
2734- (1) Warn, censure or place the physical th erapist or 324
2735-physical therapist assistant named in the complaint on 325
2736-probation on such terms and conditions as the board deems 326
2737-appropriate for a period not to exceed ten years; 327
2738- (2) Suspend the physical therapist's or physical 328
2739-therapist assistant's l icense for a period not to exceed 329
2740-three years; 330
2741- (3) Restrict or limit the physical therapist's or 331
2742-physical therapist assistant's license for an indefinite 332
2743-period of time; 333
2744- (4) Revoke the physical therapist's or physical 334
2745-therapist assistant's license; 335
2746- (5) Administer a public or private reprimand; 336
2747- (6) Deny the physical therapist's or physical 337
2748-therapist assistant's application for a license; 338
2749- (7) Permanently withhold issuance of a license; 339
2750- (8) Require the physical therapis t or physical 340
2751-therapist assistant to submit to the care, counseling or 341
2752-treatment of physicians designated by the board at the 342
2753-expense of the physical therapist or physical therapist 343
2754-assistant to be examined; 344
2755- (9) Require the physical therapist or physical 345
2756-therapist assistant to attend such continuing educational 346
2757-courses and pass such examinations as the board may direct. 347 CCS HCS SS SCS SB 157 86
2758- 4. In any order of revocation, the board may provide 348
2759-that the physical therapist or physical therapist assistant 349
2760-shall not apply for reinstatement of the physical 350
2761-therapist's or physical therapist assistant's license for a 351
2762-period of time ranging from two to seven years following the 352
2763-date of the order of revocation. All stay orders shall toll 353
2764-this time period. 354
2765- 5. Before restoring to good standing a license issued 355
2766-under this chapter which has been in a revoked, suspended, 356
2767-or inactive state for any cause for more than two years, the 357
2768-board may require the applicant to attend such continuing 358
2769-medical education cour ses and pass such examinations as the 359
2770-board may direct. 360
2771- 6. In any investigation, hearing or other proceeding 361
2772-to determine a physical therapist's, physical therapist 362
2773-assistant's or applicant's fitness to practice, any record 363
2774-relating to any patien t of the physical therapist, physical 364
2775-therapist assistant, or applicant shall be discoverable by 365
2776-the board and admissible into evidence, regardless of any 366
2777-statutory or common law privilege which such physical 367
2778-therapist, physical therapist assistant, ap plicant, record 368
2779-custodian, or patient might otherwise invoke. In addition, 369
2780-no such physical therapist, physical therapist assistant, 370
2781-applicant, or record custodian may withhold records or 371
2782-testimony bearing upon a physical therapist's, physical 372
2783-therapist assistant's, or applicant's fitness to practice on 373
2784-the grounds of privilege between such physical therapist, 374
2785-physical therapist assistant, applicant, or record custodian 375
2786-and a patient. 376
2787- 334.735. 1. As used in sections 334.735 to 334.749, 1
2788-the following terms mean: 2 CCS HCS SS SCS SB 157 87
2789- (1) "Applicant", any individual who seeks to become 3
2790-licensed as a physician assistant; 4
2791- (2) "Certification" or "registration", a process by a 5
2792-certifying entity that grants recognition to applicants 6
2793-meeting predetermined qualifications specified by such 7
2794-certifying entity; 8
2795- (3) "Certifying entity", the nongovernmental agency or 9
2796-association which certifies or registers individuals who 10
2797-have completed academic and training requirements; 11
2798- (4) "Collaborative practice arrangement", written 12
2799-agreements, jointly agreed upon protocols, or standing 13
2800-orders, all of which shall be in writing, for the delivery 14
2801-of health care services; 15
2802- (5) "Department", the department of commerce and 16
2803-insurance or a desig nated agency thereof; 17
2804- (6) "License", a document issued to an applicant by 18
2805-the board acknowledging that the applicant is entitled to 19
2806-practice as a physician assistant; 20
2807- (7) "Physician assistant", a person who has graduated 21
2808-from a physician ass istant program accredited by the 22
2809-Accreditation Review Commission on Education for the 23
2810-Physician Assistant or its successor agency, prior to 2001, 24
2811-or the Committee on Allied Health Education and 25
2812-Accreditation or the Commission on Accreditation of Allied 26
2813-Health Education Programs, who has passed the certifying 27
2814-examination administered by the National Commission on 28
2815-Certification of Physician Assistants and has active 29
2816-certification by the National Commission on Certification of 30
2817-Physician Assistants who provides health care services 31
2818-delegated by a licensed physician. A person who has been 32
2819-employed as a physician assistant for three years prior to 33
2820-August 28, 1989, who has passed the National Commission on 34 CCS HCS SS SCS SB 157 88
2821-Certification of Physician Assistants examina tion, and has 35
2822-active certification of the National Commission on 36
2823-Certification of Physician Assistants; 37
2824- (8) "Recognition", the formal process of becoming a 38
2825-certifying entity as required by the provisions of sections 39
2826-334.735 to 334.749. 40
2827- 2. The scope of practice of a physician assistant 41
2828-shall consist only of the following services and procedures: 42
2829- (1) Taking patient histories; 43
2830- (2) Performing physical examinations of a patient; 44
2831- (3) Performing or assisting in the performance of 45
2832-routine office laboratory and patient screening procedures; 46
2833- (4) Performing routine therapeutic procedures; 47
2834- (5) Recording diagnostic impressions and evaluating 48
2835-situations calling for attention of a physician to institute 49
2836-treatment procedures ; 50
2837- (6) Instructing and counseling patients regarding 51
2838-mental and physical health using procedures reviewed and 52
2839-approved by a collaborating physician; 53
2840- (7) Assisting the supervising physician in 54
2841-institutional settings, including reviewing of tre atment 55
2842-plans, ordering of tests and diagnostic laboratory and 56
2843-radiological services, and ordering of therapies, using 57
2844-procedures reviewed and approved by a licensed physician; 58
2845- (8) Assisting in surgery; and 59
2846- (9) Performing such other tasks not prohibited by law 60
2847-under the collaborative practice arrangement with a licensed 61
2848-physician as the physician assistant has been trained and is 62
2849-proficient to perform. 63
2850- 3. Physician assistants shall not perform or prescribe 64
2851-abortions. 65 CCS HCS SS SCS SB 157 89
2852- 4. Physician assistants shall not prescribe any drug, 66
2853-medicine, device or therapy unless pursuant to a 67
2854-collaborative practice arrangement in accordance with the 68
2855-law, nor prescribe lenses, prisms or contact lenses for the 69
2856-aid, relief or correction of vision or th e measurement of 70
2857-visual power or visual efficiency of the human eye, nor 71
2858-administer or monitor general or regional block anesthesia 72
2859-during diagnostic tests, surgery or obstetric procedures. 73
2860-Prescribing of drugs, medications, devices or therapies by a 74
2861-physician assistant shall be pursuant to a collaborative 75
2862-practice arrangement which is specific to the clinical 76
2863-conditions treated by the supervising physician and the 77
2864-physician assistant shall be subject to the following: 78
2865- (1) A physician assistant shall only prescribe 79
2866-controlled substances in accordance with section 334.747; 80
2867- (2) The types of drugs, medications, devices or 81
2868-therapies prescribed by a physician assistant shall be 82
2869-consistent with the scopes of practice of the physician 83
2870-assistant and the collaborating physician; 84
2871- (3) All prescriptions shall conform with state and 85
2872-federal laws and regulations and shall include the name, 86
2873-address and telephone number of the physician assistant [and 87
2874-the supervising physician ]; 88
2875- (4) A physician assistant, or advanced practice 89
2876-registered nurse as defined in section 335.016 may request, 90
2877-receive and sign for noncontrolled professional samples and 91
2878-may distribute professional samples to patients; and 92
2879- (5) A physician assistant shall not prescribe any 93
2880-drugs, medicines, devices or therapies the collaborating 94
2881-physician is not qualified or authorized to prescribe. 95
2882- 5. A physician assistant shall clearly identify 96
2883-himself or herself as a physician assistant and shall not 97 CCS HCS SS SCS SB 157 90
2884-use or permit to be used in the physician assistant's behalf 98
2885-the terms "doctor", "Dr." or "doc" nor hold himself or 99
2886-herself out in any way to be a physician or surgeon. No 100
2887-physician assistant shall practice or attempt to practice 101
2888-without physician collaboration or in any location where the 102
2889-collaborating physician is not immediately available for 103
2890-consultation, assistance and intervention, except as 104
2891-otherwise provided in this section, and in an emergency 105
2892-situation, nor shall any physician assistant bill a pati ent 106
2893-independently or directly for any services or procedure by 107
2894-the physician assistant; except that, nothing in this 108
2895-subsection shall be construed to prohibit a physician 109
2896-assistant from enrolling with a third -party plan or the 110
2897-department of social ser vices as a MO HealthNet or Medicaid 111
2898-provider while acting under a collaborative practice 112
2899-arrangement between the physician and physician assistant. 113
2900- 6. The licensing of physician assistants shall take 114
2901-place within processes established by the state board of 115
2902-registration for the healing arts through rule and 116
2903-regulation. The board of healing arts is authorized to 117
2904-establish rules pursuant to chapter 536 establishing 118
2905-licensing and renewal procedures, collaboration, 119
2906-collaborative practice arrangeme nts, fees, and addressing 120
2907-such other matters as are necessary to protect the public 121
2908-and discipline the profession. An application for licensing 122
2909-may be denied or the license of a physician assistant may be 123
2910-suspended or revoked by the board in the same manner and for 124
2911-violation of the standards as set forth by section 334.100, 125
2912-or such other standards of conduct set by the board by rule 126
2913-or regulation. Persons licensed pursuant to the provisions 127
2914-of chapter 335 shall not be required to be licensed as 128
2915-physician assistants. All applicants for physician 129 CCS HCS SS SCS SB 157 91
2916-assistant licensure who complete a physician assistant 130
2917-training program after January 1, 2008, shall have a 131
2918-master's degree from a physician assistant program. 132
2919- 7. At all times the physician is res ponsible for the 133
2920-oversight of the activities of, and accepts responsibility 134
2921-for, health care services rendered by the physician 135
2922-assistant. 136
2923- 8. (1) A physician may enter into collaborative 137
2924-practice arrangements with physician assistants. 138
2925-Collaborative practice arrangements, which shall be in 139
2926-writing, may delegate to a physician assistant the authority 140
2927-to prescribe, administer, or dispense drugs and provide 141
2928-treatment which is within the skill, training, and 142
2929-competence of the physician assistan t. Collaborative 143
2930-practice arrangements may delegate to a physician assistant, 144
2931-as defined in section 334.735, the authority to administer, 145
2932-dispense, or prescribe controlled substances listed in 146
2933-Schedules III, IV, and V of section 195.017, and Schedule 147
2934-II - hydrocodone. Schedule III narcotic controlled 148
2935-substances and Schedule II - hydrocodone prescriptions shall 149
2936-be limited to a one hundred twenty -hour supply without 150
2937-refill. Such collaborative practice arrangements shall be 151
2938-in the form of a written arrangement, jointly agreed -upon 152
2939-protocols, or standing orders for the delivery of health 153
2940-care services. 154
2941- (2) Notwithstanding any other provision of this 155
2942-section to the contrary, a collaborative practice 156
2943-arrangement may delegate to a physician as sistant the 157
2944-authority to administer, dispense, or prescribe Schedule II 158
2945-controlled substances for hospice patients; provided, that 159
2946-the physician assistant is employed by a hospice provider 160
2947-certified pursuant to chapter 197 and the physician 161 CCS HCS SS SCS SB 157 92
2948-assistant is providing care to hospice patients pursuant to 162
2949-a collaborative practice arrangement that designates the 163
2950-certified hospice as a location where the physician 164
2951-assistant is authorized to practice and prescribe. 165
2952- 9. The written collaborative practice arrangement 166
2953-shall contain at least the following provisions: 167
2954- (1) Complete names, home and business addresses, zip 168
2955-codes, and telephone numbers of the collaborating physician 169
2956-and the physician assistant; 170
2957- (2) A list of all other offices or lo cations, other 171
2958-than those listed in subdivision (1) of this subsection, 172
2959-where the collaborating physician has authorized the 173
2960-physician assistant to prescribe; 174
2961- (3) A requirement that there shall be posted at every 175
2962-office where the physician assist ant is authorized to 176
2963-prescribe, in collaboration with a physician, a prominently 177
2964-displayed disclosure statement informing patients that they 178
2965-may be seen by a physician assistant and have the right to 179
2966-see the collaborating physician; 180
2967- (4) All specialty or board certifications of the 181
2968-collaborating physician and all certifications of the 182
2969-physician assistant; 183
2970- (5) The manner of collaboration between the 184
2971-collaborating physician and the physician assistant, 185
2972-including how the collaborating physic ian and the physician 186
2973-assistant will: 187
2974- (a) Engage in collaborative practice consistent with 188
2975-each professional's skill, training, education, and 189
2976-competence; 190
2977- (b) Maintain geographic proximity, as determined by 191
2978-the board of registration for the healing arts; and 192 CCS HCS SS SCS SB 157 93
2979- (c) Provide coverage during absence, incapacity, 193
2980-infirmity, or emergency of the collaborating physician; 194
2981- (6) A list of all other written collaborative practice 195
2982-arrangements of the collaborating physician and the 196
2983-physician assistant; 197
2984- (7) The duration of the written practice arrangement 198
2985-between the collaborating physician and the physician 199
2986-assistant; 200
2987- (8) A description of the time and manner of the 201
2988-collaborating physician's review of the physician 202
2989-assistant's delivery of health care services. The 203
2990-description shall include provisions that the physician 204
2991-assistant shall submit a minimum of ten percent of the 205
2992-charts documenting the physician assistant's delivery of 206
2993-health care services to the collaborating phys ician for 207
2994-review by the collaborating physician, or any other 208
2995-physician designated in the collaborative practice 209
2996-arrangement, every fourteen days. Reviews may be conducted 210
2997-electronically; 211
2998- (9) The collaborating physician, or any other 212
2999-physician designated in the collaborative practice 213
3000-arrangement, shall review every fourteen days a minimum of 214
3001-twenty percent of the charts in which the physician 215
3002-assistant prescribes controlled substances. The charts 216
3003-reviewed under this subdivision may be count ed in the number 217
3004-of charts required to be reviewed under subdivision (8) of 218
3005-this subsection; [and] 219
3006- (10) A statement that no collaboration requirements in 220
3007-addition to the federal law shall be required for a 221
3008-physician-physician assistant team worki ng in a certified 222
3009-community behavioral health clinic as defined by Pub.L. 113 - 223
3010-93, or a rural health clinic under the federal Rural Health 224 CCS HCS SS SCS SB 157 94
3011-Services Act, Pub.L. 95 -210, as amended, or a federally 225
3012-qualified health center as defined in 42 U.S.C. Section 226
3013-[1395 of the Public Health Service Act ] 1395x, as amended; 227
3014-and 228
3015- (11) If a collaborative practice arrangement is used 229
3016-in clinical situations where a collaborating physician 230
3017-assistant provides health care services that include the 231
3018-diagnosis and initiation of treatment for acutely or 232
3019-chronically ill or injured persons, then the collaborating 233
3020-physician or any other physician designated in the 234
3021-collaborative practice arrangement shall be present for 235
3022-sufficient periods of time, at least once every two weeks, 236
3023-except in extraordinary circumstances that shall be 237
3024-documented, to participate in a chart review and to provide 238
3025-necessary medical direction, medical services, 239
3026-consultations, and supervision of the health care staff . 240
3027- 10. The state board of registration for the healing 241
3028-arts under section 334.125 may promulgate rules regulating 242
3029-the use of collaborative practice arrangements. 243
3030- 11. The state board of registration for the healing 244
3031-arts shall not deny, revoke, suspend, or otherwise take 245
3032-disciplinary action against a collaborating physician for 246
3033-health care services delegated to a physician assistant, 247
3034-provided that the provisions of this section and the rules 248
3035-promulgated thereunder are satisfied. 249
3036- 12. Within thirty days of any change and on each 250
3037-renewal, the state board of registration for the healing 251
3038-arts shall require every physician to identify whether the 252
3039-physician is engaged in any collaborative practice 253
3040-arrangement, including collaborative practice arrangements 254
3041-delegating the authority to prescribe controlled substances, 255
3042-and also report to the board the name of each physician 256 CCS HCS SS SCS SB 157 95
3043-assistant with whom the physician has entered into such 257
3044-arrangement. The board may make such information available 258
3045-to the public. The board shall track the reported 259
3046-information and may routinely conduct random reviews of such 260
3047-arrangements to ensure that the arrangements are carried out 261
3048-in compliance with this chapter. 262
3049- 13. The collaborating physician shall determine and 263
3050-document the complet ion of a period of time during which the 264
3051-physician assistant shall practice with the collaborating 265
3052-physician continuously present before practicing in a 266
3053-setting where the collaborating physician is not 267
3054-continuously present. This limitation shall not a pply to 268
3055-collaborative arrangements of providers of population -based 269
3056-public health services as defined by 20 CSR 2150 -5.100 as of 270
3057-April 30, 2009. 271
3058- 14. No contract or other arrangement shall require a 272
3059-physician to act as a collaborating physician fo r a 273
3060-physician assistant against the physician's will. A 274
3061-physician shall have the right to refuse to act as a 275
3062-supervising physician, without penalty, for a particular 276
3063-physician assistant. No contract or other agreement shall 277
3064-limit the collaborating p hysician's ultimate authority over 278
3065-any protocols or standing orders or in the delegation of the 279
3066-physician's authority to any physician assistant. No 280
3067-contract or other arrangement shall require any physician 281
3068-assistant to collaborate with any physician against the 282
3069-physician assistant's will. A physician assistant shall 283
3070-have the right to refuse to collaborate, without penalty, 284
3071-with a particular physician. 285
3072- 15. Physician assistants shall file with the board a 286
3073-copy of their collaborating physician form. 287 CCS HCS SS SCS SB 157 96
3074- 16. No physician shall be designated to serve as a 288
3075-collaborating physician for more than six full -time 289
3076-equivalent licensed physician assistants, full -time 290
3077-equivalent advanced practice registered nurses, or full -time 291
3078-equivalent assistant ph ysicians, or any combination 292
3079-thereof. This limitation shall not apply to physician 293
3080-assistant collaborative practice arrangements of hospital 294
3081-employees providing inpatient care service in hospitals as 295
3082-defined in chapter 197, or to a certified registere d nurse 296
3083-anesthetist providing anesthesia services under the 297
3084-supervision of an anesthesiologist or other physician, 298
3085-dentist, or podiatrist who is immediately available if 299
3086-needed as set out in subsection 7 of section 334.104. 300
3087- 17. No arrangement made under this section shall 301
3088-supercede current hospital licensing regulations governing 302
3089-hospital medication orders under protocols or standing 303
3090-orders for the purpose of delivering inpatient or emergency 304
3091-care within a hospital, as defined in section 197.0 20, if 305
3092-such protocols or standing orders have been approved by the 306
3093-hospital's medical staff and pharmaceutical therapeutics 307
3094-committee. 308
3095- 334.747. 1. (1) A physician assistant with a 1
3096-certificate of controlled substance prescriptive a uthority 2
3097-as provided in this section may prescribe any controlled 3
3098-substance listed in Schedule III, IV, or V of section 4
3099-195.017, and may have restricted authority in Schedule II, 5
3100-when delegated the authority to prescribe controlled 6
3101-substances in a collaborative practice arrangement. Such 7
3102-authority shall be listed on the collaborating physician 8
3103-form on file with the state board of healing arts. The 9
3104-collaborating physician shall maintain the right to limit a 10
3105-specific scheduled drug or scheduled dru g category that the 11 CCS HCS SS SCS SB 157 97
3106-physician assistant is permitted to prescribe. Any 12
3107-limitations shall be listed on the collaborating physician 13
3108-form. Prescriptions for Schedule II medications prescribed 14
3109-by a physician assistant with authority to prescribe 15
3110-delegated in a collaborative practice arrangement are 16
3111-restricted to only those medications containing 17
3112-hydrocodone. Physician assistants shall not prescribe 18
3113-controlled substances for themselves or members of their 19
3114-families. Schedule III narcotic controlled substances and 20
3115-Schedule II - hydrocodone prescriptions shall be limited to 21
3116-a five-day supply without refill, except that buprenorphine 22
3117-may be prescribed for up to a thirty -day supply without 23
3118-refill for patients receiving medication -assisted treatment 24
3119-for substance use disorders under the direction of the 25
3120-collaborating physician. Physician assistants who are 26
3121-authorized to prescribe controlled substances under this 27
3122-section shall register with the federal Drug Enforcement 28
3123-Administration and the state bureau of narcotics and 29
3124-dangerous drugs, and shall include the Drug Enforcement 30
3125-Administration registration number on prescriptions for 31
3126-controlled substances. 32
3127- (2) Notwithstanding any other provision of this 33
3128-section to the contrary, a collaborativ e practice 34
3129-arrangement may delegate to a physician assistant the 35
3130-authority to administer, dispense, or prescribe Schedule II 36
3131-controlled substances for hospice patients; provided, that 37
3132-the physician assistant is employed by a hospice provider 38
3133-certified pursuant to chapter 197 and the physician 39
3134-assistant is providing care to hospice patients pursuant to 40
3135-a collaborative practice arrangement that designates the 41
3136-certified hospice as a location where the physician 42
3137-assistant is authorized to practice and prescribe. 43 CCS HCS SS SCS SB 157 98
3138- 2. The collaborating physician shall be responsible to 44
3139-determine and document the completion of at least one 45
3140-hundred twenty hours in a four -month period by the physician 46
3141-assistant during which the physician assistant shall 47
3142-practice with the collaborating physician on -site prior to 48
3143-prescribing controlled substances when the collaborating 49
3144-physician is not on-site. Such limitation shall not apply 50
3145-to physician assistants of population -based public health 51
3146-services as defined in 20 CSR 2 150-5.100 as of April 30, 52
3147-2009. 53
3148- 3. A physician assistant shall receive a certificate 54
3149-of controlled substance prescriptive authority from the 55
3150-board of healing arts upon verification of the completion of 56
3151-the following educational requirements: 57
3152- (1) Successful completion of an advanced pharmacology 58
3153-course that includes clinical training in the prescription 59
3154-of drugs, medicines, and therapeutic devices. A course or 60
3155-courses with advanced pharmacological content in a physician 61
3156-assistant program accredited by the Accreditation Review 62
3157-Commission on Education for the Physician Assistant (ARC -PA) 63
3158-or its predecessor agency shall satisfy such requirement; 64
3159- (2) Completion of a minimum of three hundred clock 65
3160-hours of clinical training by the col laborating physician in 66
3161-the prescription of drugs, medicines, and therapeutic 67
3162-devices; 68
3163- (3) Completion of a minimum of one year of supervised 69
3164-clinical practice or supervised clinical rotations. One 70
3165-year of clinical rotations in a program accredit ed by the 71
3166-Accreditation Review Commission on Education for the 72
3167-Physician Assistant (ARC -PA) or its predecessor agency, 73
3168-which includes pharmacotherapeutics as a component of its 74
3169-clinical training, shall satisfy such requirement. Proof of 75 CCS HCS SS SCS SB 157 99
3170-such training shall serve to document experience in the 76
3171-prescribing of drugs, medicines, and therapeutic devices; 77
3172- (4) A physician assistant previously licensed in a 78
3173-jurisdiction where physician assistants are authorized to 79
3174-prescribe controlled substances may o btain a state bureau of 80
3175-narcotics and dangerous drugs registration if a 81
3176-collaborating physician can attest that the physician 82
3177-assistant has met the requirements of subdivisions (1) to 83
3178-(3) of this subsection and provides documentation of 84
3179-existing federal Drug Enforcement Agency registration. 85
3180- 334.1600. Sections 334.1600 to 334.1720 shall be known 1
3181-and may be cited as the "Interstate Medical Licensure 2
3182-Compact". 3
3183- 334.1605. In order to strengthen access to health 1
3184-care, and in recognition of the advances in the delivery of 2
3185-health care, the member states of the Interstate Medical 3
3186-Licensure Compact have allied in common purpose to develop a 4
3187-comprehensive process that complements the existing 5
3188-licensing and regulatory authority of state medical boards, 6
3189-provides a streamlined process that allows physicians to 7
3190-become licensed in multiple states, thereby enhancing the 8
3191-portability of a medical license and ensuring the safety of 9
3192-patients. The Compact creates another pat hway for licensure 10
3193-and does not otherwise change a state's existing Medical 11
3194-Practice Act. The Compact also adopts the prevailing 12
3195-standard for licensure and affirms that the practice of 13
3196-medicine occurs where the patient is located at the time of 14
3197-the physician-patient encounter, and therefore, requires the 15
3198-physician to be under the jurisdiction of the state medical 16
3199-board where the patient is located. State medical boards 17
3200-that participate in the Compact retain the jurisdiction to 18
3201-impose an adverse action against a license to practice 19 CCS HCS SS SCS SB 157 100
3202-medicine in that state issued to a physician through the 20
3203-procedures in the Compact. 21
3204- 334.1610. In this compact: 1
3205- (1) "Bylaws" means those bylaws established by the 2
3206-Interstate Commission pursuan t to section 334.1655. 3
3207- (2) "Commissioner" means the voting representative 4
3208-appointed by each member board pursuant to section 334.1655. 5
3209- (3) "Conviction" means a finding by a court that an 6
3210-individual is guilty of a criminal offense through 7
3211-adjudication, or entry of a plea of guilt or no contest to 8
3212-the charge by the offender. Evidence of an entry of a 9
3213-conviction of a criminal offense by the court shall be 10
3214-considered final for purposes of disciplinary action by a 11
3215-member board. 12
3216- (4) "Expedited License" means a full and unrestricted 13
3217-medical license granted by a member state to an eligible 14
3218-physician through the process set forth in the Compact. 15
3219- (5) "Interstate Commission" means the interstate 16
3220-commission created pursuant to section 334.1655. 17
3221- (6) "License" means authorization by a member state 18
3222-for a physician to engage in the practice of medicine, which 19
3223-would be unlawful without authorization. 20
3224- (7) "Medical Practice Act" means laws and regulations 21
3225-governing the practice of allopathic and osteopathic 22
3226-medicine within a member state. 23
3227- (8) "Member Board" means a state agency in a member 24
3228-state that acts in the sovereign interests of the state by 25
3229-protecting the public through licensure, regulation, and 26
3230-education of physicians as directed by the state government. 27
3231- (9) "Member State" means a state that has enacted the 28
3232-Compact. 29 CCS HCS SS SCS SB 157 101
3233- (10) "Practice of Medicine" means that clinical 30
3234-prevention, diagnosis, or treatment of human disease, 31
3235-injury, or condition requiring a physician to obtain and 32
3236-maintain a license in compliance with the Medical Practice 33
3237-Act of a member state. 34
3238- (11) "Physician" means any person who: 35
3239- (a) Is a graduate of a medical school accredited by 36
3240-the Liaison Committee on Medical Education , the Commission 37
3241-on Osteopathic College Accreditation, or a medical school 38
3242-listed in the International Medical Education Directory or 39
3243-its equivalent; 40
3244- (b) Passed each component of the United States Medical 41
3245-Licensing Examination (USMLE) or the Comp rehensive 42
3246-Osteopathic Medical Licensing Examination (COMLEX -USA) 43
3247-within three attempts, or any of its predecessor 44
3248-examinations accepted by a state medical board as an 45
3249-equivalent examination for licensure purposes; 46
3250- (c) Successfully completed gradu ate medical education 47
3251-approved by the Accreditation Council for Graduate Medical 48
3252-Education or the American Osteopathic Association; 49
3253- (d) Holds specialty certification or a time -unlimited 50
3254-specialty certificate recognized by the American Board of 51
3255-Medical Specialties or the American Osteopathic 52
3256-Association's Bureau of Osteopathic Specialists; 53
3257- (e) Possesses a full and unrestricted license to 54
3258-engage in the practice of medicine issued by a member board; 55
3259- (f) Has never been convicted, receive d adjudication, 56
3260-deferred adjudication, community supervision, or deferred 57
3261-disposition for any offense by a court of appropriate 58
3262-jurisdiction; 59
3263- (g) Has never held a license authorizing the practice 60
3264-of medicine subjected to discipline by a licensing agency in 61 CCS HCS SS SCS SB 157 102
3265-any state, federal, or foreign jurisdiction, excluding any 62
3266-action related to non -payment of fees related to a license; 63
3267- (h) Has never had a controlled substance license or 64
3268-permit suspended or revoked by a state or the United States 65
3269-Drug Enforcement Administration; and 66
3270- (i) Is not under active investigation by a licensing 67
3271-agency or law enforcement authority in any state, federal, 68
3272-or foreign jurisdiction. 69
3273- (12) "Offense" means a felony, gross misdemeanor, or 70
3274-crime of moral turpitude. 71
3275- (13) "Rule" means a written statement by the 72
3276-Interstate Commission promulgated pursuant to section 73
3277-334.1660 of the Compact that is of general applicability, 74
3278-implements, interprets, or prescribes a policy or provision 75
3279-of the Compact, or an organizational, procedural, or 76
3280-practice requirement of the Interstate Commission, and has 77
3281-the force and effect of statutory law in a member state, and 78
3282-includes the amendment, repeal, or suspension of an existing 79
3283-rule. 80
3284- (14) "State" means any stat e, commonwealth, district, 81
3285-or territory of the United States. 82
3286- (15) "State of Principal License" means a member state 83
3287-where a physician holds a license to practice medicine and 84
3288-which has been designated as such by the physician for 85
3289-purposes of registration and participation in the Compact. 86
3290- 334.1615. 1. A physician must meet the eligibility 1
3291-requirements as defined in subdivision (11) of section 2
3292-334.1610 to receive an expedited license under the terms and 3
3293-provisions of the Com pact. 4
3294- 2. A physician who does not meet the requirements of 5
3295-subdivision (11) of section 334.1610 may obtain a license to 6
3296-practice medicine in a member state if the individual 7 CCS HCS SS SCS SB 157 103
3297-complies with all laws and requirements, other than the 8
3298-Compact, relating to the issuance of a license to practice 9
3299-medicine in that state. 10
3300- 334.1620. 1. A physician shall designate a member 1
3301-state as the state of principal license for purposes of 2
3302-registration for expedited licensure through the Compact if 3
3303-the physician possesses a full and unrestricted license to 4
3304-practice medicine in that state, and the state is: 5
3305- (1) The state of principal residence for the 6
3306-physician, or 7
3307- (2) The state where at least 25% of the practice of 8
3308-medicine occurs, or 9
3309- (3) The location of the physician's employer, or 10
3310- (4) If no state qualifies under subdivision (1), (2), 11
3311-or (3) of this subsection, the state designated as state of 12
3312-residence for purpose of federal income tax. 13
3313- 2. A physician may redesig nate a member state as state 14
3314-of principal license at any time, as long as the state meets 15
3315-the requirements of subsection 1 of this section. 16
3316- 3. The Interstate Commission is authorized to develop 17
3317-rules to facilitate redesignation of another member s tate as 18
3318-the state of principal license. 19
3319- 334.1625. 1. A physician seeking licensure through 1
3320-the Compact shall file an application for an expedited 2
3321-license with the member board of the state selected by the 3
3322-physician as the state of principal license. 4
3323- 2. Upon receipt of an application for an expedited 5
3324-license, the member board within the state selected as the 6
3325-state of principal license shall evaluate whether the 7
3326-physician is eligible for expedited licensure and issue a 8
3327-letter of qualification, verifying or denying the 9
3328-physician's eligibility, to the Interstate Commission. 10 CCS HCS SS SCS SB 157 104
3329- (1) Static qualifications, which include verification 11
3330-of medical education, graduate medical education, results of 12
3331-any medical or licensing examina tion, and other 13
3332-qualifications as determined by the Interstate Commission 14
3333-through rule, shall not be subject to additional primary 15
3334-source verification where already primary source verified by 16
3335-the state of principal license. 17
3336- (2) The member board within the state selected as the 18
3337-state of principal license shall, in the course of verifying 19
3338-eligibility, perform a criminal background check of an 20
3339-applicant, including the use of the results of fingerprint 21
3340-or other biometric data checks compliant with the 22
3341-requirements of the Federal Bureau of Investigation, with 23
3342-the exception of federal employees who have suitability 24
3343-determination in accordance with 5 C.F.R. §731.202. 25
3344- (3) Appeal on the determination of eligibility shall 26
3345-be made to the member state where the application was filed 27
3346-and shall be subject to the law of that state. 28
3347- 3. Upon verification in subsection 2 of this section, 29
3348-physicians eligible for an expedited license shall complete 30
3349-the registration process established by the Inte rstate 31
3350-Commission to receive a license in a member state selected 32
3351-pursuant to subsection 1 of this section, including the 33
3352-payment of any applicable fees. 34
3353- 4. After receiving verification of eligibility under 35
3354-subsection 2 of this section and any fe es under subsection 3 36
3355-of this section, a member board shall issue an expedited 37
3356-license to the physician. This license shall authorize the 38
3357-physician to practice medicine in the issuing state 39
3358-consistent with the Medical Practice Act and all applicable 40
3359-laws and regulations of the issuing member board and member 41
3360-state. 42 CCS HCS SS SCS SB 157 105
3361- 5. An expedited license shall be valid for a period 43
3362-consistent with the licensure period in the member state and 44
3363-in the same manner as required for other physicians holding 45
3364-a full and unrestricted license within the member state. 46
3365- 6. An expedited license obtained through the Compact 47
3366-shall be terminated if a physician fails to maintain a 48
3367-license in the state of principal licensure for a non - 49
3368-disciplinary reason, without redes ignation of a new state of 50
3369-principal licensure. 51
3370- 7. The Interstate Commission is authorized to develop 52
3371-rules regarding the application process, including payment 53
3372-of any applicable fees, and the issuance of an expedited 54
3373-license. 55
3374- 334.1630. 1. A member state issuing an expedited 1
3375-license authorizing the practice of medicine in that state 2
3376-may impose a fee for a license issued or renewed through the 3
3377-Compact. 4
3378- 2. The Interstate Commission is authorized to develop 5
3379-rules regarding fees for expedited licenses. 6
3380- 334.1635. 1. A physician seeking to renew an 1
3381-expedited license granted in a member state shall complete a 2
3382-renewal process with the Interstate Commission if the 3
3383-physician: 4
3384- (1) Maintains a full and unrestricted license in a 5
3385-state of principal license; 6
3386- (2) Has not been convicted, received adjudication, 7
3387-deferred adjudication, community supervision, or deferred 8
3388-disposition for any offense by a court of appropriate 9
3389-jurisdiction; 10
3390- (3) Has not had a license authorizing the practice of 11
3391-medicine subject to discipline by a licensing agency in any 12
3392-state, federal, or foreign jurisdiction, excluding any 13 CCS HCS SS SCS SB 157 106
3393-action related to non -payment of fees related to a license; 14
3394-and 15
3395- (4) Has not had a controlled substance license or 16
3396-permit suspended or revoked by a state or the United States 17
3397-Drug Enforcement Administration. 18
3398- 2. Physicians shall comply with all continuing 19
3399-professional development or continuing medical education 20
3400-requirements for renewal of a license issued by a member 21
3401-state. 22
3402- 3. The Interstate Commission shall collect any renewal 23
3403-fees charged for the renewal of a license and distribute the 24
3404-fees to the applicable member board. 25
3405- 4. Upon receipt of any renewal fees collec ted in 26
3406-subsection 3 of this section, a member board shall renew the 27
3407-physician's license. 28
3408- 5. Physician information collected by the Interstate 29
3409-Commission during the renewal process will be distributed to 30
3410-all member boards. 31
3411- 6. The Interstate Commission is authorized to develop 32
3412-rules to address renewal of licenses obtained through the 33
3413-Compact. 34
3414- 334.1640. 1. The Interstate Commission shall 1
3415-establish a database of all physicians licensed, or who have 2
3416-applied for licensure, under section 334.1625. 3
3417- 2. Notwithstanding any other provision of law, member 4
3418-boards shall report to the Interstate Commission any public 5
3419-action or complaints against a licensed physician who has 6
3420-applied or received an expedited license through t he Compact. 7
3421- 3. Member boards shall report disciplinary or 8
3422-investigatory information determined as necessary and proper 9
3423-by rule of the Interstate Commission. 10 CCS HCS SS SCS SB 157 107
3424- 4. Member boards may report any non -public complaint, 11
3425-disciplinary, or investigatory information not required by 12
3426-subsection 3 of this section to the Interstate Commission. 13
3427- 5. Member boards shall share complaint or disciplinary 14
3428-information about a physician upon request of another member 15
3429-board. 16
3430- 6. All information provided to the Interstate 17
3431-Commission or distributed by member boards shall be 18
3432-confidential, filed under seal, and used only for 19
3433-investigatory or disciplinary matters. 20
3434- 7. The Interstate Commission is authorized to develop 21
3435-rules for mandated or discretionary sharing of information 22
3436-by member boards. 23
3437- 334.1645. 1. Licensure and disciplinary records of 1
3438-physicians are deemed investigative. 2
3439- 2. In addition to the authority granted to a member 3
3440-board by its respective Medical Practice Act or other 4
3441-applicable state law, a member board may participate with 5
3442-other member boards in joint investigations of physicians 6
3443-licensed by the member boards. 7
3444- 3. A subpoena issued by a member state shall be 8
3445-enforceable in other member states. 9
3446- 4. Member boards may share any investigative, 10
3447-litigation, or compliance materials in furtherance of any 11
3448-joint or individual investigation initiated under the 12
3449-Compact. 13
3450- 5. Any member state may investigate actual or alleged 14
3451-violations of the statut es authorizing the practice of 15
3452-medicine in any other member state in which a physician 16
3453-holds a license to practice medicine. 17
3454- 334.1650. 1. Any disciplinary action taken by any 1
3455-member board against a physician licensed through the 2 CCS HCS SS SCS SB 157 108
3456-Compact shall be deemed unprofessional conduct which may be 3
3457-subject to discipline by other member boards, in addition to 4
3458-any violation of the Medical Practice Act or regulations in 5
3459-that state. 6
3460- 2. If a license granted to a physician by the member 7
3461-board in the state of principal license is revoked, 8
3462-surrendered or relinquished in lieu of discipline, or 9
3463-suspended, then all licenses issued to the physician by 10
3464-member boards shall automatically be placed, without further 11
3465-action necessary by any member board, on the same status. 12
3466-If the member board in the state of principal license 13
3467-subsequently reinstates the physician's license, a license 14
3468-issued to the physician by any other member board shall 15
3469-remain encumbered until that respective member board ta kes 16
3470-action to reinstate the license in a manner consistent with 17
3471-the Medical Practice Act of that state. 18
3472- 3. If disciplinary action is taken against a physician 19
3473-by a member board not in the state of principal license, any 20
3474-other member board may dee m the action conclusive as to 21
3475-matter of law and fact decided, and: 22
3476- (1) Impose the same or lesser sanction(s) against the 23
3477-physician so long as such sanctions are consistent with the 24
3478-Medical Practice Act of that state; or 25
3479- (2) Pursue separate disciplinary action against the 26
3480-physician under its respective Medical Practice Act, 27
3481-regardless of the action taken in other member states. 28
3482- 4. If a license granted to a physician by a member 29
3483-board is revoked, surrendered or relinquished in lieu of 30
3484-discipline, or suspended, then any license(s) issued to the 31
3485-physician by any other member board(s) shall be suspended, 32
3486-automatically and immediately without further action 33
3487-necessary by the other member board(s), for ninety (90) days 34 CCS HCS SS SCS SB 157 109
3488-upon entry of the order by the disciplining board, to permit 35
3489-the member board(s) to investigate the basis for the action 36
3490-under the Medical Practice Act of that state. A member 37
3491-board may terminate the automatic suspension of the license 38
3492-it issued prior to the completion of the ninety (90) day 39
3493-suspension period in a manner consistent with the Medical 40
3494-Practice Act of that state. 41
3495- 334.1655. 1. The member states hereby create the 1
3496-"Interstate Medical Licensure Compact Commission". 2
3497- 2. The purpose of the Interstate Commission is the 3
3498-administration of the Interstate Medical Licensure Compact, 4
3499-which is a discretionary state function. 5
3500- 3. The Interstate Commission shall be a body corporate 6
3501-and joint agency of the member states and shall have all the 7
3502-responsibilities, powers, and duties set forth in the 8
3503-Compact, and such additional powers as may be conferred upon 9
3504-it by a subsequent concurrent action of the respective 10
3505-legislatures of the member states in accordance with the 11
3506-terms of the Compact. 12
3507- 4. The Interstate Commission shall consist of two 13
3508-voting representatives appointed by each member state who 14
3509-shall serve as Commissioners. In states where allopathic 15
3510-and osteopathic physicians are regulated by separate member 16
3511-boards, or if the licensing and disciplinary authority is 17
3512-split between separate member boards, or if the licensing 18
3513-and disciplinary authority is split between multiple member 19
3514-boards within a member state, the member state shall appoint 20
3515-one representative from each mem ber board. A Commissioner 21
3516-shall be a(n): 22
3517- (1) Allopathic or osteopathic physician appointed to a 23
3518-member board; 24 CCS HCS SS SCS SB 157 110
3519- (2) Executive director, executive secretary, or 25
3520-similar executive of a member board; or 26
3521- (3) Member of the public appointed t o a member board. 27
3522- 5. The Interstate Commission shall meet at least once 28
3523-each calendar year. A portion of this meeting shall be a 29
3524-business meeting to address such matters as may properly 30
3525-come before the Commission, including the election of 31
3526-officers. The chairperson may call additional meetings and 32
3527-shall call for a meeting upon the request of a majority of 33
3528-the member states. 34
3529- 6. The bylaws may provide for meetings of the 35
3530-Interstate Commission to be conducted by telecommunication 36
3531-or electronic communication. 37
3532- 7. Each Commissioner participating at a meeting of the 38
3533-Interstate Commission is entitled to one vote. A majority 39
3534-of Commissioners shall constitute a quorum for the 40
3535-transaction of business, unless a larger quorum is required 41
3536-by the bylaws of the Interstate Commission. A Commissioner 42
3537-shall not delegate a vote to another Commissioner. In the 43
3538-absence of its Commissioner, a member state may delegate 44
3539-voting authority for a specified meeting to another person 45
3540-from that state who shall meet the requirements of 46
3541-subsection 4 of this section. 47
3542- 8. The Interstate Commission shall provide public 48
3543-notice of all meetings and all meetings shall be open to the 49
3544-public. The Interstate Commission may close a meeting, in 50
3545-full or in portion, where it determines by a two -thirds vote 51
3546-of the Commissioners present that an open meeting would be 52
3547-likely to: 53
3548- (1) Relate solely to the internal personnel practice 54
3549-and procedures of the Interstate Commission; 55 CCS HCS SS SCS SB 157 111
3550- (2) Discuss matters spec ifically exempted from 56
3551-disclosure by federal statute; 57
3552- (3) Discuss trade secrets, commercial, or financial 58
3553-information that is privileged or confidential; 59
3554- (4) Involve accusing a person of a crime, or formally 60
3555-censuring a person; 61
3556- (5) Discuss information of a personal nature where 62
3557-disclosure would constitute a clearly unwarranted invasion 63
3558-of personal privacy; 64
3559- (6) Discuss investigative records compiled for law 65
3560-enforcement purposes; or 66
3561- (7) Specifically relate to the participat ion in a 67
3562-civil action or other legal proceeding. 68
3563- 9. The Interstate Commission shall keep minutes which 69
3564-shall fully describe all matters discussed in a meeting and 70
3565-shall provide a full and accurate summary of actions taken, 71
3566-including record of any roll call votes. 72
3567- 10. The Interstate Commission shall make its 73
3568-information and official records, to the extent not 74
3569-otherwise designated in the Compact or by its rules, 75
3570-available to the public for inspection. 76
3571- 11. The Interstate Commission sha ll establish an 77
3572-executive committee, which shall include officers, members, 78
3573-and others as determined by the bylaws. The executive 79
3574-committee shall have the power to act on behalf of the 80
3575-Interstate Commission, with the exception of rulemaking, 81
3576-during periods when the Interstate Commission is not in 82
3577-session. When acting on behalf of the Interstate 83
3578-Commission, the executive committee shall oversee the 84
3579-administration of the Compact including enforcement and 85
3580-compliance with the provisions of the Compac t, its bylaws 86
3581-and rules, and other such duties as necessary. 87 CCS HCS SS SCS SB 157 112
3582- 12. The Interstate Commission shall establish other 88
3583-committees for governance and administration of the Compact. 89
3584- 334.1660. The powers and duties of the Interstate 1
3585-Commission shall be to: 2
3586- (1) Oversee and maintain the administration of the 3
3587-Compact; 4
3588- (2) Promulgate rules which shall be binding to the 5
3589-extent and in the manner provided for in the Compact; 6
3590- (3) Issue, upon the request of a member state or 7
3591-member board, advisory opinions concerning the meaning or 8
3592-interpretation of the Compact, its bylaws, rules, and 9
3593-actions; 10
3594- (4) Enforce compliance with Compact provisions, the 11
3595-rules promulgated by the Interstate Commission, and the 12
3596-bylaws, using all necessary and proper means, including but 13
3597-not limited to the use of judicial process; 14
3598- (5) Establish and appoint committees including, but 15
3599-not limited to, an executive committee as required by 16
3600-section 334.1655, which shall have the power to act on 17
3601-behalf of the Interstate Commission in carrying out its 18
3602-powers and duties; 19
3603- (6) Pay, or provide for the payment of the expenses 20
3604-related to the establishment, organization, and ongoing 21
3605-activities of the Interstate Commission; 22
3606- (7) Establish and maintain one or more offices; 23
3607- (8) Borrow, accept, hire, or contract for services of 24
3608-personnel; 25
3609- (9) Purchase and maintain insurance and bonds; 26
3610- (10) Employ an executive director who shall have such 27
3611-powers to employ, select or appoint e mployees, agents, or 28
3612-consultants, and to determine their qualifications, define 29
3613-their duties, and fix their compensation; 30 CCS HCS SS SCS SB 157 113
3614- (11) Establish personnel policies and programs 31
3615-relating to conflicts of interest, rates of compensation, 32
3616-and qualifications of personnel; 33
3617- (12) Accept donations and grants of money, equipment, 34
3618-supplies, materials, and services and to receive, utilize, 35
3619-and dispose of it in a manner consistent with the conflict 36
3620-of interest policies established by the Interstate 37
3621-Commission; 38
3622- (13) Lease, purchase, accept contributions or 39
3623-donations of, or otherwise to own, hold, improve or use, any 40
3624-property, real, personal, or mixed; 41
3625- (14) Sell, convey, mortgage, pledge, lease, exchange, 42
3626-abandon, or otherwise dispose of any prop erty, real, 43
3627-personal, or mixed; 44
3628- (15) Establish a budget and make expenditures; 45
3629- (16) Adopt a seal and bylaws governing the management 46
3630-and operation of the Interstate Commission; 47
3631- (17) Report annually to the legislatures and governors 48
3632-of the member states concerning the activities of the 49
3633-Interstate Commission during the preceding year. Such 50
3634-reports shall also include reports of financial audits and 51
3635-any recommendations that may have been adopted by the 52
3636-Interstate Commission; 53
3637- (18) Coordinate education, training, and public 54
3638-awareness regarding the Compact, its implementation, and its 55
3639-operation; 56
3640- (19) Maintain records in accordance with the bylaws; 57
3641- (20) Seek and obtain trademarks, copyrights, and 58
3642-patents; and 59
3643- (21) Perform such functions as may be necessary or 60
3644-appropriate to achieve the purpose of the Compact. 61 CCS HCS SS SCS SB 157 114
3645- 334.1665. 1. The Interstate Commission may levy on 1
3646-and collect an annual assessment from each member state to 2
3647-cover the cost of the op erations and activities of the 3
3648-Interstate Commission and its staff. The total assessment 4
3649-must be sufficient to cover the annual budget approved each 5
3650-year for which revenue is not provided by other sources. 6
3651-The aggregate annual assessment amount shall be allocated 7
3652-upon a formula to be determined by the Interstate 8
3653-Commission, which shall promulgate a rule binding upon all 9
3654-member states. 10
3655- 2. The Interstate Commission shall not incur 11
3656-obligations of any kind prior to securing the funds adequate 12
3657-to meet the same. 13
3658- 3. The Interstate Commission shall not pledge the 14
3659-credit of any of the member states, except by, and with the 15
3660-authority of, the member state. 16
3661- 4. The Interstate Commission shall be subject to a 17
3662-yearly financial audit conducte d by a certified or licensed 18
3663-accountant and the report of the audit shall be included in 19
3664-the annual report of the Interstate Commission. 20
3665- 334.1670. 1. The Interstate Commission shall, by a 1
3666-majority of Commissioners present and voting , adopt bylaws 2
3667-to govern its conduct as may be necessary or appropriate to 3
3668-carry out the purposes of the Compact within twelve (12) 4
3669-months of the first Interstate Commission meeting. 5
3670- 2. The Interstate Commission shall elect or appoint 6
3671-annually from among its Commissioners a chairperson, a vice - 7
3672-chairperson, and a treasurer, each of whom shall have such 8
3673-authority and duties as may be specified in the bylaws. The 9
3674-chairperson, or in the chairperson's absence or disability, 10
3675-the vice-chairperson, shall preside at all meetings of the 11
3676-Interstate Commission. 12 CCS HCS SS SCS SB 157 115
3677- 3. Officers selected in subsection 2 of this section 13
3678-shall serve without remuneration for the Interstate 14
3679-Commission. 15
3680- 4. The officers and employees of the Interstate 16
3681-Commission shall be immune from suit and liability, either 17
3682-personally or in their official capacity, for a claim for 18
3683-damage to or loss of property or personal injury or other 19
3684-civil liability caused or arising out of, or relating to, an 20
3685-actual or alleged act, error, or omission that occurred, or 21
3686-that such person had a reasonable basis for believing 22
3687-occurred, within the scope of Interstate Commission 23
3688-employment, duties, or responsibilities; provided that such 24
3689-person shall not be protected from suit or liability for 25
3690-damage, loss, injury, or liability caused by the intentional 26
3691-or willful and wanton misconduct of such person. 27
3692- 5. The liability of the executive director and 28
3693-employees of the Interstate Commission or representatives of 29
3694-the Interstate Commission, ac ting within the scope of such 30
3695-person's employment or duties for acts, errors, or omissions 31
3696-occurring within such person's state, may not exceed the 32
3697-limits of liability set forth under the constitution and 33
3698-laws of that state for state officials, employe es, and 34
3699-agents. The Interstate Commission is considered to be an 35
3700-instrumentality of the states for the purpose of any such 36
3701-action. Nothing in this subsection shall be construed to 37
3702-protect such person from suit or liability for damage, loss, 38
3703-injury, or liability caused by the intentional or willful 39
3704-and wanton misconduct of such person. 40
3705- 6. The Interstate Commission shall defend the 41
3706-executive director, its employees, and subject to the 42
3707-approval of the attorney general or other appropriate legal 43
3708-counsel of the member state represented by an Interstate 44 CCS HCS SS SCS SB 157 116
3709-Commission representative, shall defend such Interstate 45
3710-Commission representative in any civil action seeking to 46
3711-impose liability arising out of an actual or alleged act, 47
3712-error or omission that occurred within the scope of 48
3713-Interstate Commission employment, duties or 49
3714-responsibilities, or that the defendant had a reasonable 50
3715-basis for believing occurred within the scope of Interstate 51
3716-Commission employment, duties, or responsibilities, provided 52
3717-that the actual or alleged act, error, or omission did not 53
3718-result from intentional or willful and wanton misconduct on 54
3719-the part of such person. 55
3720- 7. To the extent not covered by the state involved, 56
3721-member state, or the Interstate Commission, the 57
3722-representatives or employees of the Interstate Commission 58
3723-shall be held harmless in the amount of a settlement or 59
3724-judgement, including attorney's fees and costs, obtained 60
3725-against such persons arising out of an actual or alleged 61
3726-act, error, or omission t hat occurred within the scope of 62
3727-the Interstate Commission employment, duties, or 63
3728-responsibilities, or that such persons had a reasonable 64
3729-basis for believing occurred within the scope of Interstate 65
3730-Commission employment, duties, or responsibilities, pr ovided 66
3731-that the actual or alleged act, error, or omission did not 67
3732-result from intentional or willful and wanton misconduct on 68
3733-the part of such person. 69
3734- 334.1675. 1. The Interstate Commission shall 1
3735-promulgate reasonable rules in orde r to effectively and 2
3736-efficiently achieve the purpose of the Compact. 3
3737-Notwithstanding the foregoing, in the event the Interstate 4
3738-Commission exercises its rulemaking authority in a manner 5
3739-that is beyond the scope of the purposes of the Compact, or 6
3740-the powers granted hereunder, then such an action by the 7 CCS HCS SS SCS SB 157 117
3741-Interstate Commission shall be invalid and have no force or 8
3742-effect. 9
3743- 2. Rules deemed appropriate for the operations of the 10
3744-Interstate Commission shall be made pursuant to a rulemaking 11
3745-process that substantially conforms to the "Model State 12
3746-Administrative Procedure Act" of 2010, and subsequent 13
3747-amendments thereto. 14
3748- 3. Not later than thirty (30) days after a rule is 15
3749-promulgated, any person may file a petition for judicial 16
3750-review of the rule in the United States District Court for 17
3751-the District of Columbia or the federal district where the 18
3752-Interstate Commission has its principal offices, provided 19
3753-that the filing of such a petition shall not stay or 20
3754-otherwise prevent the rule from becoming effective unless 21
3755-the court finds that the petitioner has a substantial 22
3756-likelihood of success. The court shall give deference to 23
3757-the actions of the Interstate Commission consistent with 24
3758-applicable law and shall not find the rule to be unlawful if 25
3759-the rule represents a reasonable exercise of the authority 26
3760-granted to the Interstate Commission. 27
3761- 334.1680. 1. The executive, legislative, and judicial 1
3762-branches of state government in each member state shall 2
3763-enforce the Compact and shall take all actions necessary and 3
3764-appropriate to effectuate the Compact's purposes and 4
3765-intent. The provisions of the Compact and the rules 5
3766-promulgated hereunder shall have standing as statutory law 6
3767-but shall not override existing state authority to regu late 7
3768-the practice of medicine. 8
3769- 2. All courts shall take judicial notice of the 9
3770-Compact and the rules in any judicial or administrative 10
3771-proceeding in a member state pertaining to the subject 11 CCS HCS SS SCS SB 157 118
3772-matter of the Compact which may affect the powers, 12
3773-responsibilities or actions of the Interstate Commission. 13
3774- 3. The Interstate Commission shall be entitled to 14
3775-receive all services of process in any such proceeding, and 15
3776-shall have standing to intervene in the proceeding for all 16
3777-purposes. Failure to provide service of process to the 17
3778-Interstate Commission shall render a judgment or order void 18
3779-as to the Interstate Commission, the Compact, or promulgated 19
3780-rules. 20
3781- 334.1685. 1. The Interstate Commission, in the 1
3782-reasonable exercise of i ts discretion, shall enforce the 2
3783-provisions and rules of the Compact. 3
3784- 2. The Interstate Commission may, by majority vote of 4
3785-the Commissioners, initiate legal action in the United 5
3786-States District Court for the District of Columbia, or, at 6
3787-the discretion of the Interstate Commission, in the federal 7
3788-district where the Interstate Commission has its principal 8
3789-offices, to enforce compliance with the provisions of the 9
3790-Compact, and its promulgated rules and bylaws, against a 10
3791-member state in default. The relief sought may include both 11
3792-injunctive relief and damages. In the event judicial 12
3793-enforcement is necessary, the prevailing party shall be 13
3794-awarded all costs of such litigation including reasonable 14
3795-attorney's fees. 15
3796- 3. The remedies herein sha ll not be the exclusive 16
3797-remedies of the Interstate Commission. The Interstate 17
3798-Commission may avail itself of any other remedies available 18
3799-under state law or regulation of a profession. 19
3800- 334.1690. 1. The grounds for default include, but are 1
3801-not limited to, failure of a member state to perform such 2
3802-obligations or responsibilities imposed upon it by the 3 CCS HCS SS SCS SB 157 119
3803-Compact, or the rules and bylaws of the Interstate 4
3804-Commission promulgated under the Compact. 5
3805- 2. If the Interstate Commission determines that a 6
3806-member state has defaulted in the performance of its 7
3807-obligations or responsibilities under the Compact, or the 8
3808-bylaws or promulgated rules, the Interstate Commission shall: 9
3809- (1) Provide written notice to the defaulting state and 10
3810-other member states, of the nature of the default, the means 11
3811-of curing the default, and any action taken by the 12
3812-Interstate Commission. The Interstate Commission shall 13
3813-specify the conditions by which the defaulting state must 14
3814-cure its default; and 15
3815- (2) Provide remedial training and specific technical 16
3816-assistance regarding the default. 17
3817- 3. If the defaulting state fails to cure the default, 18
3818-the defaulting state shall be terminated from the Compact 19
3819-upon an affirmative vote of a majority of the Commissioners 20
3820-and all rights, privileges, and benefits conferred by the 21
3821-Compact shall terminate on the effective date of 22
3822-termination. A cure of the default does not relieve the 23
3823-offending state of obligations or liabilities incurred 24
3824-during the period of the default. 25
3825- 4. Termination of membership in the Compact shall be 26
3826-imposed only after all other means of securing compliance 27
3827-have been exhausted. Notice of intent to terminate shall be 28
3828-given by the Interstate Commission to the governor, the 29
3829-majority and minority leaders of the defaulting state's 30
3830-legislature, and each of the member states. 31
3831- 5. The Interstate Commission shall establish rules and 32
3832-procedures to address licenses and physicians that are 33
3833-materially impacted by the termination of a member state, or 34
3834-the withdrawal of a member state. 35 CCS HCS SS SCS SB 157 120
3835- 6. The member state which has been terminated is 36
3836-responsible for all dues, obligations, and liabilities 37
3837-incurred through the effective date of termination including 38
3838-obligations, the performa nce of which extends beyond the 39
3839-effective date of termination. 40
3840- 7. The Interstate Commission shall not bear any costs 41
3841-relating to any state that has been found to be in default 42
3842-or which has been terminated from the Compact, unless 43
3843-otherwise mutually agreed upon in writing between the 44
3844-Interstate Commission and the defaulting state. 45
3845- 8. The defaulting state may appeal the action of the 46
3846-Interstate Commission by petitioning the United States 47
3847-District Court for the District of Columbia or the fe deral 48
3848-district where the Interstate Commission has its principal 49
3849-offices. The prevailing party shall be awarded all costs of 50
3850-such litigation including reasonable attorney's fees. 51
3851- 334.1695. 1. The Interstate Commission shall attempt , 1
3852-upon the request of a member state, to resolve disputes 2
3853-which are subject to the Compact and which may arise among 3
3854-member states or member boards. 4
3855- 2. The Interstate Commission shall promulgate rules 5
3856-providing for both mediation and binding disp ute resolution 6
3857-as appropriate. 7
3858- 334.1700. 1. Any state is eligible to become a member 1
3859-of the Compact. 2
3860- 2. The Compact shall become effective and binding upon 3
3861-legislative enactment of the Compact into law by no less 4
3862-than seven (7) states. Thereafter, it shall become 5
3863-effective and binding on a state upon enactment of the 6
3864-Compact into law by that state. 7
3865- 3. The governors of non -member states, or their 8
3866-designees, shall be invited to participate in the activities 9 CCS HCS SS SCS SB 157 121
3867-of the Interstate Commission on a non -voting basis prior to 10
3868-adoption of the Compact by all states. 11
3869- 4. The Interstate Commission may propose amendments to 12
3870-the Compact for enactment by the member states. No 13
3871-amendment shall become effective and binding upon t he 14
3872-Interstate Commission and the member states unless and until 15
3873-it is enacted into law by unanimous consent of the member 16
3874-states. 17
3875- 334.1705. 1. Once effective, the Compact shall 1
3876-continue in force and remain binding upon each and eve ry 2
3877-member state; provided that a member state may withdraw from 3
3878-the Compact by specifically repealing the statute which 4
3879-enacted the Compact into law. 5
3880- 2. Withdrawal from the Compact shall be by the 6
3881-enactment of a statute repealing the same, but sh all not 7
3882-take effect until one (1) year after the effective date of 8
3883-such statute and until written notice of the withdrawal has 9
3884-been given by the withdrawing state to the governor of each 10
3885-other member state. 11
3886- 3. The withdrawing state shall immediat ely notify the 12
3887-chairperson of the Interstate Commission in writing upon the 13
3888-introduction of legislation repealing the Compact in the 14
3889-withdrawing state. 15
3890- 4. The Interstate Commission shall notify the other 16
3891-member states of the withdrawing state's i ntent to withdraw 17
3892-within sixty (60) days of its receipt of notice provided 18
3893-under subsection 3 of this section. 19
3894- 5. The withdrawing state is responsible for all dues, 20
3895-obligations and liabilities incurred through the effective 21
3896-date of withdrawal, in cluding obligations, the performance 22
3897-of which extend beyond the effective date of withdrawal. 23 CCS HCS SS SCS SB 157 122
3898- 6. Reinstatement following withdrawal of a member 24
3899-state shall occur upon the withdrawing state reenacting the 25
3900-Compact or upon such later date as determin ed by the 26
3901-Interstate Commission. 27
3902- 7. The Interstate Commission is authorized to develop 28
3903-rules to address the impact of the withdrawal of a member 29
3904-state on licenses granted in other member states to 30
3905-physicians who designated the withdrawing member state as 31
3906-the state of principal license. 32
3907- 334.1710. 1. The Compact shall dissolve effective 1
3908-upon the date of the withdrawal or default of the member 2
3909-state which reduces the membership of the Compact to one (1) 3
3910-member state. 4
3911- 2. Upon the dissolution of the Compact, the Compact 5
3912-becomes null and void and shall be of no further force or 6
3913-effect, and the business and affairs of the Interstate 7
3914-Commission shall be concluded, and surplus funds shall be 8
3915-distributed in accordance with the bylaws. 9
3916- 334.1715. 1. The provisions of the Compact shall be 1
3917-severable, and if any phrase, clause, sentence, or provision 2
3918-is deemed unenforceable, the remaining provisions of the 3
3919-Compact shall be enforceable. 4
3920- 2. The provisions of the Compact shall be liberally 5
3921-construed to effectuate its purposes. 6
3922- 3. Nothing in the Compact shall be construed to 7
3923-prohibit the applicability of other interstate compacts to 8
3924-which the member states are members. 9
3925- 334.1720. 1. Nothing herein prevents the enforcement 1
3926-of any other law of a member state that is not inconsistent 2
3927-with the Compact. 3
3928- 2. All laws in a member state in conflict with the 4
3929-Compact are superseded to the extent of the conflict. 5 CCS HCS SS SCS SB 157 123
3930- 3. All lawful actions of the Interstate Commission, 6
3931-including all rules and bylaws promulgated by the 7
3932-Commission, are binding upon the member states. 8
3933- 4. All agreements between the Interstate Commission 9
3934-and the member states are binding in accordance with the ir 10
3935-terms. 11
3936- 5. In the event any provision of the Compact exceeds 12
3937-the constitutional limits imposed on the legislature of any 13
3938-member state, such provision shall be ineffective to the 14
3939-extent of the conflict with the constitutional provision in 15
3940-question in that member state. 16
3941- 335.016. As used in this chapter, unless the context 1
3942-clearly requires otherwise, the following words and terms 2
3943-mean: 3
3944- (1) "Accredited", the official authorization or status 4
3945-granted by an agency for a pr ogram through a voluntary 5
3946-process; 6
3947- (2) "Advanced practice registered nurse" or "APRN", a 7
3948-[nurse who has education beyond the basic nursing education 8
3949-and is certified by a nationally recognized professional 9
3950-organization as a certified nurse practi tioner, certified 10
3951-nurse midwife, certified registered nurse anesthetist, or a 11
3952-certified clinical nurse specialist. The board shall 12
3953-promulgate rules specifying which nationally recognized 13
3954-professional organization certifications are to be 14
3955-recognized for the purposes of this section. Advanced 15
3956-practice nurses and only such individuals may use the title 16
3957-"Advanced Practice Registered Nurse" and the abbreviation 17
3958-"APRN"] person who is licensed under the provisions of this 18
3959-chapter to engage in the practi ce of advanced practice 19
3960-nursing as a certified clinical nurse specialist, certified 20 CCS HCS SS SCS SB 157 124
3961-nurse midwife, certified nurse practitioner, or certified 21
3962-registered nurse anesthetist ; 22
3963- (3) "Approval", official recognition of nursing 23
3964-education programs which m eet standards established by the 24
3965-board of nursing; 25
3966- (4) "Board" or "state board", the state board of 26
3967-nursing; 27
3968- (5) "Certified clinical nurse specialist", a 28
3969-registered nurse who is currently certified as a clinical 29
3970-nurse specialist by a nation ally recognized certifying board 30
3971-approved by the board of nursing; 31
3972- (6) "Certified nurse midwife", a registered nurse who 32
3973-is currently certified as a nurse midwife by the American 33
3974-[College of Nurse Midwives ] Midwifery Certification Board , 34
3975-or other nationally recognized certifying body approved by 35
3976-the board of nursing; 36
3977- (7) "Certified nurse practitioner", a registered nurse 37
3978-who is currently certified as a nurse practitioner by a 38
3979-nationally recognized certifying body approved by the board 39
3980-of nursing; 40
3981- (8) "Certified registered nurse anesthetist", a 41
3982-registered nurse who is currently certified as a nurse 42
3983-anesthetist by the Council on Certification of Nurse 43
3984-Anesthetists, the [Council on Recertification of Nurse 44
3985-Anesthetists] National Board of Certification and 45
3986-Recertification for Nurse Anesthetists , or other nationally 46
3987-recognized certifying body approved by the board of nursing; 47
3988- (9) "Executive director", a qualified individual 48
3989-employed by the board as executive secretary or othe rwise to 49
3990-administer the provisions of this chapter under the board's 50
3991-direction. Such person employed as executive director shall 51
3992-not be a member of the board; 52 CCS HCS SS SCS SB 157 125
3993- (10) "Inactive [nurse] license status", as defined by 53
3994-rule pursuant to section 335.061 ; 54
3995- (11) "Lapsed license status", as defined by rule under 55
3996-section 335.061; 56
3997- (12) "Licensed practical nurse" or "practical nurse", 57
3998-a person licensed pursuant to the provisions of this chapter 58
3999-to engage in the practice of practical nursing; 59
4000- (13) "Licensure", the issuing of a license [to 60
4001-practice professional or practical nursing ] to candidates 61
4002-who have met the [specified] requirements specified under 62
4003-this chapter, authorizing the person to engage in the 63
4004-practice of advanced practice, pr ofessional, or practical 64
4005-nursing, and the recording of the names of those persons as 65
4006-holders of a license to practice advanced practice, 66
4007-professional, or practical nursing; 67
4008- (14) "Practice of advanced practice nursing", the 68
4009-performance for compens ation of activities and services 69
4010-consistent with the required education, training, 70
4011-certification, demonstrated competencies, and experiences of 71
4012-an advanced practice registered nurse; 72
4013- (15) "Practice of practical nursing", the performance 73
4014-for compensation of selected acts for the promotion of 74
4015-health and in the care of persons who are ill, injured, or 75
4016-experiencing alterations in normal health processes. Such 76
4017-performance requires substantial specialized skill, judgment 77
4018-and knowledge. All such nursing care shall be given under 78
4019-the direction of a person licensed by a state regulatory 79
4020-board to prescribe medications and treatments or under the 80
4021-direction of a registered professional nurse. For the 81
4022-purposes of this chapter, the term "direction" sh all mean 82
4023-guidance or supervision provided by a person licensed by a 83
4024-state regulatory board to prescribe medications and 84 CCS HCS SS SCS SB 157 126
4025-treatments or a registered professional nurse, including, 85
4026-but not limited to, oral, written, or otherwise communicated 86
4027-orders or directives for patient care. When practical 87
4028-nursing care is delivered pursuant to the direction of a 88
4029-person licensed by a state regulatory board to prescribe 89
4030-medications and treatments or under the direction of a 90
4031-registered professional nurse, such care may be delivered by 91
4032-a licensed practical nurse without direct physical oversight; 92
4033- [(15)] (16) "Practice of professional nursing", the 93
4034-performance for compensation of any act or action which 94
4035-requires substantial specialized education, judgment and 95
4036-skill based on knowledge and application of principles 96
4037-derived from the biological, physical, social , behavioral, 97
4038-and nursing sciences, including, but not limited to: 98
4039- (a) Responsibility for the promotion and teaching of 99
4040-health care and the preve ntion of illness to the patient and 100
4041-his or her family; 101
4042- (b) Assessment, data collection, nursing diagnosis, 102
4043-nursing care, evaluation, and counsel of persons who are 103
4044-ill, injured, or experiencing alterations in normal health 104
4045-processes; 105
4046- (c) The administration of medications and treatments 106
4047-as prescribed by a person licensed by a state regulatory 107
4048-board to prescribe medications and treatments; 108
4049- (d) The coordination and assistance in the 109
4050-determination and delivery of a plan of health care w ith all 110
4051-members of a health team; 111
4052- (e) The teaching and supervision of other persons in 112
4053-the performance of any of the foregoing; 113
4054- [(16) A] (17) "Registered professional nurse" or 114
4055-"registered nurse", a person licensed pursuant to the 115 CCS HCS SS SCS SB 157 127
4056-provisions of this chapter to engage in the practice of 116
4057-professional nursing; 117
4058- [(17)] (18) "Retired license status", any person 118
4059-licensed in this state under this chapter who retires from 119
4060-such practice. Such person shall file with the board an 120
4061-affidavit, on a form to be furnished by the board, which 121
4062-states the date on which the licensee retired from such 122
4063-practice, an intent to retire from the practice for at least 123
4064-two years, and such other facts as tend to verify the 124
4065-retirement as the board may deem ne cessary; but if the 125
4066-licensee thereafter reengages in the practice, the licensee 126
4067-shall renew his or her license with the board as provided by 127
4068-this chapter and by rule and regulation. 128
4069- 335.019. 1. An advanced practice registered nurse' s 1
4070-prescriptive authority shall include authority to: 2
4071- (1) Prescribe, dispense, and administer medications 3
4072-and nonscheduled legend drugs, as defined in section 4
4073-338.330, within such APRN's practice and specialty; and 5
4074- (2) Notwithstanding any oth er provision of this 6
4075-chapter to the contrary, receive, prescribe, administer, and 7
4076-provide nonscheduled legend drug samples from pharmaceutical 8
4077-manufacturers to patients at no charge to the patient or any 9
4078-other party. 10
4079- 2. The board of nursing may g rant a certificate of 11
4080-controlled substance prescriptive authority to an advanced 12
4081-practice registered nurse who: 13
4082- (1) Submits proof of successful completion of an 14
4083-advanced pharmacology course that shall include preceptorial 15
4084-experience in the prescr iption of drugs, medicines , and 16
4085-therapeutic devices; and 17
4086- (2) Provides documentation of a minimum of three 18
4087-hundred clock hours preceptorial experience in the 19 CCS HCS SS SCS SB 157 128
4088-prescription of drugs, medicines, and therapeutic devices 20
4089-with a qualified preceptor; and 21
4090- (3) Provides evidence of a minimum of one thousand 22
4091-hours of practice in an advanced practice nursing category 23
4092-prior to application for a certificate of prescriptive 24
4093-authority. The one thousand hours shall not include 25
4094-clinical hours obtained in the advanced practice nursing 26
4095-education program. The one thousand hours of practice in an 27
4096-advanced practice nursing category may include transmitting 28
4097-a prescription order orally or telephonically or to an 29
4098-inpatient medical record from protocols develo ped in 30
4099-collaboration with and signed by a licensed physician; and 31
4100- (4) Has a controlled substance prescribing authority 32
4101-delegated in the collaborative practice arrangement under 33
4102-section 334.104 with a physician who has an unrestricted 34
4103-federal Drug Enforcement Administration registration number 35
4104-and who is actively engaged in a practice comparable in 36
4105-scope, specialty, or expertise to that of the advanced 37
4106-practice registered nurse. 38
4107- 335.036. 1. The board shall: 1
4108- (1) Elect for a one-year term a president and a 2
4109-secretary, who shall also be treasurer, and the board may 3
4110-appoint, employ and fix the compensation of a legal counsel 4
4111-and such board personnel as defined in subdivision (4) of 5
4112-subsection 11 of section 324.001 as are necessary to 6
4113-administer the provisions of sections 335.011 to [335.096] 7
4114-335.099; 8
4115- (2) Adopt and revise such rules and regulations as may 9
4116-be necessary to enable it to carry into effect the 10
4117-provisions of sections 335.011 to [335.096] 335.099; 11
4118- (3) Prescribe minimum standards for educational 12
4119-programs preparing persons for licensure as a registered 13 CCS HCS SS SCS SB 157 129
4120-professional nurse or licensed practical nurse pursuant to 14
4121-the provisions of sections 335.011 to [335.096] 335.099; 15
4122- (4) Provide for surveys o f such programs every five 16
4123-years and in addition at such times as it may deem necessary; 17
4124- (5) Designate as "approved" such programs as meet the 18
4125-requirements of sections 335.011 to [335.096] 335.099 and 19
4126-the rules and regulations enacted pursuant to such sections; 20
4127-and the board shall annually publish a list of such programs; 21
4128- (6) Deny or withdraw approval from educational 22
4129-programs for failure to meet prescribed minimum standards; 23
4130- (7) Examine, license, and cause to be renewed the 24
4131-licenses of duly qualified applicants; 25
4132- (8) Cause the prosecution of all persons violating 26
4133-provisions of sections 335.011 to [335.096] 335.099, and may 27
4134-incur such necessary expenses therefor; 28
4135- (9) Keep a record of all the proceedings; and make an 29
4136-annual report to the governor and to the director of the 30
4137-department of commerce and insurance. 31
4138- 2. The board shall set the amount of the fees which 32
4139-this chapter authorizes and requires by rules and 33
4140-regulations. The fees shall be set at a level to prod uce 34
4141-revenue which shall not substantially exceed the cost and 35
4142-expense of administering this chapter. 36
4143- 3. All fees received by the board pursuant to the 37
4144-provisions of sections 335.011 to [335.096] 335.099 shall be 38
4145-deposited in the state treasury an d be placed to the credit 39
4146-of the state board of nursing fund. All administrative 40
4147-costs and expenses of the board shall be paid from 41
4148-appropriations made for those purposes. The board is 42
4149-authorized to provide funding for the nursing education 43
4150-incentive program established in sections 335.200 to 335.203. 44 CCS HCS SS SCS SB 157 130
4151- 4. The provisions of section 33.080 to the contrary 45
4152-notwithstanding, money in this fund shall not be transferred 46
4153-and placed to the credit of general revenue until the amount 47
4154-in the fund at the end of the biennium exceeds two times the 48
4155-amount of the appropriation from the board's funds for the 49
4156-preceding fiscal year or, if the board requires by rule, 50
4157-permit renewal less frequently than yearly, then three times 51
4158-the appropriation from the board' s funds for the preceding 52
4159-fiscal year. The amount, if any, in the fund which shall 53
4160-lapse is that amount in the fund which exceeds the 54
4161-appropriate multiple of the appropriations from the board's 55
4162-funds for the preceding fiscal year. 56
4163- 5. Any rule or portion of a rule, as that term is 57
4164-defined in section 536.010, that is created under the 58
4165-authority delegated in this chapter shall become effective 59
4166-only if it complies with and is subject to all of the 60
4167-provisions of chapter 536 and, if applicable, sec tion 61
4168-536.028. All rulemaking authority delegated prior to August 62
4169-28, 1999, is of no force and effect and repealed. Nothing 63
4170-in this section shall be interpreted to repeal or affect the 64
4171-validity of any rule filed or adopted prior to August 28, 65
4172-1999, if it fully complied with all applicable provisions of 66
4173-law. This section and chapter 536 are nonseverable and if 67
4174-any of the powers vested with the general assembly pursuant 68
4175-to chapter 536 to review, to delay the effective date or to 69
4176-disapprove and annul a rule are subsequently held 70
4177-unconstitutional, then the grant of rulemaking authority and 71
4178-any rule proposed or adopted after August 28, 1999, shall be 72
4179-invalid and void. 73
4180- 335.046. 1. An applicant for a license to practice as 1
4181-a registered professional nurse shall submit to the board a 2
4182-written application on forms furnished to the applicant. 3 CCS HCS SS SCS SB 157 131
4183-The original application shall contain the applicant's 4
4184-statements showing the applicant's education and other such 5
4185-pertinent information as the board may require. The 6
4186-applicant shall be of good moral character and have 7
4187-completed at least the high school course of study, or the 8
4188-equivalent thereof as determined by the state board of 9
4189-education, and have successfully completed the basic 10
4190-professional curriculum in an accredited or approved school 11
4191-of nursing and earned a professional nursing degree or 12
4192-diploma. Each application shall contain a statement that it 13
4193-is made under oath or affirmation and that its 14
4194-representations are true and corr ect to the best knowledge 15
4195-and belief of the person signing same, subject to the 16
4196-penalties of making a false affidavit or declaration. 17
4197-Applicants from non-English-speaking lands shall be required 18
4198-to submit evidence of proficiency in the English languag e. 19
4199-The applicant must be approved by the board and shall pass 20
4200-an examination as required by the board. The board may 21
4201-require by rule as a requirement for licensure that each 22
4202-applicant shall pass an oral or practical examination. Upon 23
4203-successfully passing the examination, the board may issue to 24
4204-the applicant a license to practice nursing as a registered 25
4205-professional nurse. The applicant for a license to practice 26
4206-registered professional nursing shall pay a license fee in 27
4207-such amount as set by the board. The fee shall be uniform 28
4208-for all applicants. Applicants from foreign countries shall 29
4209-be licensed as prescribed by rule. 30
4210- 2. An applicant for license to practice as a licensed 31
4211-practical nurse shall submit to the board a written 32
4212-application on forms furnished to the applicant. The 33
4213-original application shall contain the applicant's 34
4214-statements showing the applicant's education and other such 35 CCS HCS SS SCS SB 157 132
4215-pertinent information as the board may require. Such 36
4216-applicant shall be of good moral character, and have 37
4217-completed at least two years of high school, or its 38
4218-equivalent as established by the state board of education, 39
4219-and have successfully completed a basic prescribed 40
4220-curriculum in a state -accredited or approved school of 41
4221-nursing, earned a nursin g degree, certificate or diploma and 42
4222-completed a course approved by the board on the role of the 43
4223-practical nurse. Each application shall contain a statement 44
4224-that it is made under oath or affirmation and that its 45
4225-representations are true and correct to the best knowledge 46
4226-and belief of the person signing same, subject to the 47
4227-penalties of making a false affidavit or declaration. 48
4228-Applicants from non-English-speaking countries shall be 49
4229-required to submit evidence of their proficiency in the 50
4230-English language. The applicant must be approved by the 51
4231-board and shall pass an examination as required by the 52
4232-board. The board may require by rule as a requirement for 53
4233-licensure that each applicant shall pass an oral or 54
4234-practical examination. Upon successfully passing the 55
4235-examination, the board may issue to the applicant a license 56
4236-to practice as a licensed practical nurse. The applicant 57
4237-for a license to practice licensed practical nursing shall 58
4238-pay a fee in such amount as may be set by the board. The 59
4239-fee shall be uniform for all applicants. Applicants from 60
4240-foreign countries shall be licensed as prescribed by rule. 61
4241- 3. (1) An applicant for a license to practice as an 62
4242-advanced practice registered nurse shall submit to the board 63
4243-a written application on forms furnished to the applicant. 64
4244-The original application shall contain: 65 CCS HCS SS SCS SB 157 133
4245- (a) Statements showing the applicant's education and 66
4246-other such pertinent information as the board may require; 67
4247-and 68
4248- (b) A statement that it is made under oath or 69
4249-affirmation and that its representations are true and 70
4250-correct to the best knowledge and belief of the person 71
4251-signing same, subject to the penalties of making a false 72
4252-affidavit or declaration. 73
4253- (2) The applicant for a license to practice as an 74
4254-advanced practice registered nurse shall pay a fee in such 75
4255-amount as may be set by the board. The fee shall be uniform 76
4256-for all applicants. 77
4257- (3) An applicant shall: 78
4258- (a) Hold a current registered professional nurse 79
4259-license or privilege to pra ctice, shall not be currently 80
4260-subject to discipline or any restrictions, and shall not 81
4261-hold an encumbered license or privilege to practice as a 82
4262-registered professional nurse or advanced practice 83
4263-registered nurse in any state or territory; 84
4264- (b) Have completed an accredited graduate -level 85
4265-advanced practice registered nurse program and achieved at 86
4266-least one certification as a clinical nurse specialist, 87
4267-nurse midwife, nurse practitioner, or registered nurse 88
4268-anesthetist, with at least one population focus prescribed 89
4269-by rule of the board; 90
4270- (c) Be currently certified by a national certifying 91
4271-body recognized by the Missouri state board of nursing in 92
4272-the advanced practice registered nurse role; and 93
4273- (d) Have a population focus on his or her 94
4274-certification, corresponding with his or her educational 95
4275-advanced practice registered nurse program. 96 CCS HCS SS SCS SB 157 134
4276- (4) Any person holding a document of recognition to 97
4277-practice nursing as an advanced practice registered nurse in 98
4278-this state that is current on Au gust 28, 2023, shall be 99
4279-deemed to be licensed as an advanced practice registered 100
4280-nurse under the provisions of this section and shall be 101
4281-eligible for renewal of such license under the conditions 102
4282-and standards prescribed in this chapter and as prescribe d 103
4283-by rule. 104
4284- 4. Upon refusal of the board to allow any applicant to 105
4285-[sit for] take either the registered professional nurses' 106
4286-examination or the licensed practical nurses' examination, 107
4287-[as the case may be,] or upon refusal to issue an advanced 108
4288-practice registered nurse license, the board shall comply 109
4289-with the provisions of section 621.120 and advise the 110
4290-applicant of his or her right to have a hearing before the 111
4291-administrative hearing commission. The administrative 112
4292-hearing commission shall hear complaints taken pursuant to 113
4293-section 621.120. 114
4294- [4.] 5. The board shall not deny a license because of 115
4295-sex, religion, race, ethnic origin, age or political 116
4296-affiliation. 117
4297- 335.051. 1. The board shall issue a license to 1
4298-practice nursing as [either] an advanced practice registered 2
4299-nurse, a registered professional nurse , or a licensed 3
4300-practical nurse without examination to an applicant who has 4
4301-duly become licensed as [a] an advanced practice registered 5
4302-nurse, registered nurse, or licensed practical nurse 6
4303-pursuant to the laws of another state, territory, or foreign 7
4304-country if the applicant meets the qualifications required 8
4305-of advanced practice registered nurses, registered nurses, 9
4306-or licensed practical nurses in this state at th e time the 10 CCS HCS SS SCS SB 157 135
4307-applicant was originally licensed in the other state, 11
4308-territory, or foreign country. 12
4309- 2. Applicants from foreign countries shall be licensed 13
4310-as prescribed by rule. 14
4311- 3. Upon application, the board shall issue a temporary 15
4312-permit to an applicant pursuant to subsection 1 of this 16
4313-section for a license as [either] an advanced practice 17
4314-registered nurse, a registered professional nurse , or a 18
4315-licensed practical nurse who has made a prima facie showing 19
4316-that the applicant meets all of the requirements for such a 20
4317-license. The temporary permit shall be effective only until 21
4318-the board shall have had the opportunity to investigate his 22
4319-or her qualifications for licensure pursuant to subsection 1 23
4320-of this section and to notify the applicant th at his or her 24
4321-application for a license has been either granted or 25
4322-rejected. In no event shall such temporary permit be in 26
4323-effect for more than twelve months after the date of its 27
4324-issuance nor shall a permit be reissued to the same 28
4325-applicant. No fee shall be charged for such temporary 29
4326-permit. The holder of a temporary permit which has not 30
4327-expired, or been suspended or revoked, shall be deemed to be 31
4328-the holder of a license issued pursuant to section 335.046 32
4329-until such temporary permit expires, is terminated or is 33
4330-suspended or revoked. 34
4331- 335.056. 1. The license of every person licensed 1
4332-under the provisions of [sections 335.011 to 335.096 ] this 2
4333-chapter shall be renewed as provided. An application for 3
4334-renewal of license shall be mailed to every person to whom a 4
4335-license was issued or renewed during the current licensing 5
4336-period. The applicant shall complete the application and 6
4337-return it to the board by the renewal date with a renewal 7
4338-fee in an amount to be set by the board. The fee shall be 8 CCS HCS SS SCS SB 157 136
4339-uniform for all applicants. The certificates of renewal 9
4340-shall render the holder thereof a legal practitioner of 10
4341-nursing for the period stated in the certificate of 11
4342-renewal. Any person who practices nursing as an advanced 12
4343-practice registered nurse, a registered professional nurse , 13
4344-or [as] a licensed practical nurse during the time his or 14
4345-her license has lapsed shall be considered an illegal 15
4346-practitioner and shall be subject to the penalties provided 16
4347-for violation of the provision s of sections 335.011 to 17
4348-[335.096] 335.099. 18
4349- 2. The renewal of advanced practice registered nurse 19
4350-licenses and registered professional nurse licenses shall 20
4351-occur at the same time, as prescribed by rule. Failure to 21
4352-renew and maintain the registere d professional nurse license 22
4353-or privilege to practice or failure to provide the required 23
4354-fee and evidence of active certification or maintenance of 24
4355-certification as prescribed by rules and regulations shall 25
4356-result in expiration of the advanced practice registered 26
4357-nurse license. 27
4358- 3. A licensed nurse who holds an APRN license shall be 28
4359-disciplined on his or her APRN license for any violations of 29
4360-this chapter. 30
4361- 335.076. 1. Any person who holds a license to 1
4362-practice professional nursing in this state may use the 2
4363-title "Registered Professional Nurse" and the abbreviation 3
4364-["R.N."] "RN". No other person shall use the title 4
4365-"Registered Professional Nurse" or the abbreviation ["R.N."] 5
4366-"RN". No other person shall assume any title o r use any 6
4367-abbreviation or any other words, letters, signs, or devices 7
4368-to indicate that the person using the same is a registered 8
4369-professional nurse. 9 CCS HCS SS SCS SB 157 137
4370- 2. Any person who holds a license to practice 10
4371-practical nursing in this state may use the title " Licensed 11
4372-Practical Nurse" and the abbreviation ["L.P.N."] "LPN". No 12
4373-other person shall use the title "Licensed Practical Nurse" 13
4374-or the abbreviation ["L.P.N."] "LPN". No other person shall 14
4375-assume any title or use any abbreviation or any other words, 15
4376-letters, signs, or devices to indicate that the person using 16
4377-the same is a licensed practical nurse. 17
4378- 3. Any person who holds a license [or recognition] to 18
4379-practice advanced practice nursing in this state may use the 19
4380-title "Advanced Practice Regist ered Nurse", the designations 20
4381-of "certified registered nurse anesthetist", "certified 21
4382-nurse midwife", "certified clinical nurse specialist", and 22
4383-"certified nurse practitioner", and the [abbreviation] 23
4384-abbreviations "APRN", [and any other title designati ons 24
4385-appearing on his or her license ] "CRNA", "CNM", "CNS", and 25
4386-"NP", respectively. No other person shall use the title 26
4387-"Advanced Practice Registered Nurse" or the abbreviation 27
4388-"APRN". No other person shall assume any title or use any 28
4389-abbreviation or any other words, letters, signs, or devices 29
4390-to indicate that the person using the same is an advanced 30
4391-practice registered nurse. 31
4392- 4. No person shall practice or offer to practice 32
4393-professional nursing, practical nursing, or advanced 33
4394-practice nursing in this state or use any title, sign, 34
4395-abbreviation, card, or device to indicate that such person 35
4396-is a practicing professional nurse, practical nurse, or 36
4397-advanced practice nurse unless he or she has been duly 37
4398-licensed under the provisions of this cha pter. 38
4399- 5. In the interest of public safety and consumer 39
4400-awareness, it is unlawful for any person to use the title 40
4401-"nurse" in reference to himself or herself in any capacity, 41 CCS HCS SS SCS SB 157 138
4402-except individuals who are or have been licensed as a 42
4403-registered nurse, licensed practical nurse, or advanced 43
4404-practice registered nurse under this chapter. 44
4405- 6. Notwithstanding any law to the contrary, nothing in 45
4406-this chapter shall prohibit a Christian Science nurse from 46
4407-using the title "Christian Science nurse", so long as such 47
4408-person provides only religious nonmedical services when 48
4409-offering or providing such services to those who choose to 49
4410-rely upon healing by spiritual means alone and does not hold 50
4411-his or her own religious organization and does not hold 51
4412-himself or herself out as a registered nurse, advanced 52
4413-practice registered nurse, nurse practitioner, licensed 53
4414-practical nurse, nurse midwife, clinical nurse specialist, 54
4415-or nurse anesthetist, unless otherwise authorized by law to 55
4416-do so. 56
4417- 335.086. No person, firm, corporation or association 1
4418-shall: 2
4419- (1) Sell or attempt to sell or fraudulently obtain or 3
4420-furnish or attempt to furnish any nursing diploma, license, 4
4421-renewal or record or aid or abet therein; 5
4422- (2) Practice [professional or practical] nursing as 6
4423-defined by sections 335.011 to [335.096] 335.099 under cover 7
4424-of any diploma, license, or record illegally or fraudulently 8
4425-obtained or signed or issued unlawfully or under fraudulent 9
4426-representation; 10
4427- (3) Practice [professional nursing or practical ] 11
4428-nursing as defined by sections 335.011 to [335.096] 335.099 12
4429-unless duly licensed to do so under the provisions of 13
4430-sections 335.011 to [335.096] 335.099; 14
4431- (4) Use in connection with his or her name any 15
4432-designation tending to imply that he or she is a licensed 16
4433-advanced practice registered nurse, a licensed registered 17 CCS HCS SS SCS SB 157 139
4434-professional nurse, or a licensed practical nurse unless 18
4435-duly licensed so to practice under the provisions of 19
4436-sections 335.011 to [335.096] 335.099; 20
4437- (5) Practice [professional nursing or practical ] 21
4438-nursing during the time his or her license issued under the 22
4439-provisions of sections 335.011 to [335.096] 335.099 shall be 23
4440-suspended or revoked; or 24
4441- (6) Conduct a nursing education program for the 25
4442-preparation of professional or practical nurses unless the 26
4443-program has been accredited by the board. 27
4444- 335.175. 1. No later than January 1, 2014, there is 1
4445-hereby established within the state board of registration 2
4446-for the healing arts and the state board of nursing the 3
4447-"Utilization of Telehealth by Nurses". An advanced practice 4
4448-registered nurse (APRN) providing nursing services under a 5
4449-collaborative practice arrangement under section 334.104 may 6
4450-provide such services outside the geographi c proximity 7
4451-requirements of section 334.104 if the collaborating 8
4452-physician and advanced practice registered nurse utilize 9
4453-telehealth [in the care of the patient and if the services 10
4454-are provided in a rural area of need ]. Telehealth providers 11
4455-shall be required to obtain patient consent before 12
4456-telehealth services are initiated and ensure confidentiality 13
4457-of medical information. 14
4458- 2. As used in this section, "telehealth" shall have 15
4459-the same meaning as such term is defined in section 191.1145. 16
4460- [3. (1) The boards shall jointly promulgate rules 17
4461-governing the practice of telehealth under this section. 18
4462-Such rules shall address, but not be limited to, appropriate 19
4463-standards for the use of telehealth. 20
4464- (2) Any rule or portion of a rule, as th at term is 21
4465-defined in section 536.010, that is created under the 22 CCS HCS SS SCS SB 157 140
4466-authority delegated in this section shall become effective 23
4467-only if it complies with and is subject to all of the 24
4468-provisions of chapter 536 and, if applicable, section 25
4469-536.028. This section and chapter 536 are nonseverable and 26
4470-if any of the powers vested with the general assembly 27
4471-pursuant to chapter 536 to review, to delay the effective 28
4472-date, or to disapprove and annul a rule are subsequently 29
4473-held unconstitutional, then the grant of r ulemaking 30
4474-authority and any rule proposed or adopted after August 28, 31
4475-2013, shall be invalid and void. 32
4476- 4. For purposes of this section, "rural area of need" 33
4477-means any rural area of this state which is located in a 34
4478-health professional shortage are a as defined in section 35
4479-354.650.] 36
4480- 335.203. 1. There is hereby established the "Nursing 1
4481-Education Incentive Program" within the state board of 2
4482-nursing. 3
4483- 2. Subject to appropriation and board disbursement, 4
4484-grants shall be awarde d through the nursing education 5
4485-incentive program to eligible institutions of higher 6
4486-education based on criteria jointly determined by the board 7
4487-and the department of higher education and workforce 8
4488-development. [Grant award amounts shall not exceed on e 9
4489-hundred fifty thousand dollars. ] No campus shall receive 10
4490-more than one grant per year. 11
4491- 3. To be considered for a grant, an eligible 12
4492-institution of higher education shall offer a program of 13
4493-nursing that meets the predetermined category and area of 14
4494-need as established by the board and the department under 15
4495-subsection 4 of this section. 16
4496- 4. The board and the department shall determine 17
4497-categories and areas of need for designating grants to 18 CCS HCS SS SCS SB 157 141
4498-eligible institutions of higher education. In establishing 19
4499-categories and areas of need, the board and department may 20
4500-consider criteria including, but not limited to: 21
4501- (1) Data generated from licensure renewal data and the 22
4502-department of health and senior services; and 23
4503- (2) National nursing statistical data and trends that 24
4504-have identified nursing shortages. 25
4505- 5. The board shall be the administrative agency 26
4506-responsible for implementation of the program established 27
4507-under sections 335.200 to 335.203, and shall promulgate 28
4508-reasonable rules for the exercise of its functions and the 29
4509-effectuation of the purposes of sections 335.200 to 30
4510-335.203. The board shall, by rule, prescribe the form, 31
4511-time, and method of filing applications and shall supervise 32
4512-the processing of such applications. 33
4513- 6. Any rule or portion of a rule, as that term is 34
4514-defined in section 536.010, that is created under the 35
4515-authority delegated in this section shall become effective 36
4516-only if it complies with and is subject to all of the 37
4517-provisions of chapter 536 and, if a pplicable, section 38
4518-536.028. This section and chapter 536 are nonseverable and 39
4519-if any of the powers vested with the general assembly 40
4520-pursuant to chapter 536 to review, to delay the effective 41
4521-date, or to disapprove and annul a rule are subsequently 42
4522-held unconstitutional, then the grant of rulemaking 43
4523-authority and any rule proposed or adopted after August 28, 44
4524-2011, shall be invalid and void. 45
4525- 335.205. The board, in addition to any other duties it 1
4526-may have regarding licensure of nurs es, shall collect, at 2
4527-the time of any initial license application or license 3
4528-renewal application, a nursing education incentive program 4
4529-surcharge from each person licensed or relicensed under this 5 CCS HCS SS SCS SB 157 142
4530-chapter, in the amount of one dollar per year for pract ical 6
4531-nurses and five dollars per year for registered professional 7
4532-nurses. These funds shall be deposited in the state board 8
4533-of nursing fund described in section 335.036. 9
4534- 337.510. 1. As used in this section, the following 1
4535-terms mean: 2
4536- (1) "License", a license, certificate, registration, 3
4537-permit, accreditation, or military occupational specialty 4
4538-that enables a person to legally practice an occupation or 5
4539-profession in a particular jurisdiction; 6
4540- (2) "Military", the Armed F orces of the United States, 7
4541-including the Air Force, Army, Coast Guard, Marine Corps, 8
4542-Navy, Space Force, National Guard and any other military 9
4543-branch that is designated by Congress as part of the Armed 10
4544-Forces of the United States, and all reserve compo nents and 11
4545-auxiliaries. Such term also includes the military reserves 12
4546-and militia of any United States territory or state; 13
4547- (3) "Nonresident military spouse", a nonresident 14
4548-spouse of an active duty member of the Armed Forces of the 15
4549-United States who has been transferred or is scheduled to be 16
4550-transferred to the state of Missouri, or who has been 17
4551-transferred or is scheduled to be transferred to an adjacent 18
4552-state and is or will be domiciled in the state of Missouri, 19
4553-or has moved to the state of Mi ssouri on a permanent change - 20
4554-of-station basis; 21
4555- (4) "Resident military spouse", a spouse of an active 22
4556-duty member of the Armed Forces of the United States who has 23
4557-been transferred or is scheduled to be transferred to the 24
4558-state of Missouri or an ad jacent state and who is a 25
4559-permanent resident of the state of Missouri, who is 26
4560-domiciled in the state of Missouri, or who has Missouri as 27
4561-his or her home of record. 28 CCS HCS SS SCS SB 157 143
4562- 2. Each applicant for licensure as a professional 29
4563-counselor shall furnish evidence to the committee that the 30
4564-applicant is at least eighteen years of age, is a United 31
4565-States citizen or is legally present in the United States; 32
4566-and 33
4567- (1) The applicant has completed a course of study as 34
4568-defined by the board rule leading to a master' s, 35
4569-specialist's, or doctoral degree with a major in counseling, 36
4570-except any applicant who has held a license as a 37
4571-professional counselor in this state or currently holds a 38
4572-license as a professional counselor in another state shall 39
4573-not be required to ha ve completed any courses related to 40
4574-career development; and 41
4575- (2) The applicant has completed acceptable supervised 42
4576-counseling as defined by board rule. If the applicant has a 43
4577-master's degree with a major in counseling as defined by 44
4578-board rule, the applicant shall complete at least two years 45
4579-of acceptable supervised counseling experience subsequent to 46
4580-the receipt of the master's degree. The composition and 47
4581-number of hours comprising the acceptable supervised 48
4582-counseling experience shall be defi ned by board rule. An 49
4583-applicant may substitute thirty semester hours of post 50
4584-master's graduate study for one of the two required years of 51
4585-acceptable supervised counseling experience if such hours 52
4586-are clearly related to counseling; 53
4587- (3) After August 28, 2007, each applicant shall have 54
4588-completed a minimum of three hours of graduate level 55
4589-coursework in diagnostic systems either in the curriculum 56
4590-leading to a degree or as post master's graduate level 57
4591-course work; 58
4592- (4) Upon examination, the ap plicant is possessed of 59
4593-requisite knowledge of the profession, including techniques 60 CCS HCS SS SCS SB 157 144
4594-and applications, research and its interpretation, and 61
4595-professional affairs and ethics. 62
4596- [2. Any person holding a current license, certificate 63
4597-of registration, or permit from another state or territory 64
4598-of the United States to practice as a professional counselor 65
4599-who does not meet the requirements in section 324.009 and 66
4600-who is at least eighteen years of age, and is a United 67
4601-States citizen or is legally present in the United States 68
4602-may be granted a license without examination to engage in 69
4603-the practice of professional counseling in this state upon 70
4604-the application to the board, payment of the required fee as 71
4605-established by the board, and satisfying one of the 72
4606-following requirements: 73
4607- (1) Approval by the American Association of State 74
4608-Counseling Boards (AASCB) or its successor organization 75
4609-according to the eligibility criteria established by AASCB. 76
4610-The successor organization shall be defined by board rule; or 77
4611- (2) In good standing and currently certified by the 78
4612-National Board for Certified Counselors or its successor 79
4613-organization and has completed acceptable supervised 80
4614-counseling experience as defined by board rule. The 81
4615-successor organization shal l be defined by board rule. ] 82
4616- 3. (1) Any person who holds a valid current 83
4617-professional counselor license issued by another state, a 84
4618-branch or unit of the military, a territory of the United 85
4619-States, or the District of Columbia, and who has been 86
4620-licensed for at least one year in such other jurisdiction, 87
4621-may submit an application for a professional counselor 88
4622-license in Missouri along with proof of current licensure 89
4623-and proof of licensure for at least one year in the other 90
4624-jurisdiction, to the com mittee. 91
4625- (2) The committee shall: 92 CCS HCS SS SCS SB 157 145
4626- (a) Within six months of receiving an application 93
4627-described in subdivision (1) of this subsection, waive any 94
4628-examination, educational, or experience requirements for 95
4629-licensure in this state for the applicant if it determines 96
4630-that there were minimum education requirements and, if 97
4631-applicable, work experience and clinical supervision 98
4632-requirements in effect and the other jurisdiction verifies 99
4633-that the person met those requirements in order to be 100
4634-licensed or certified in that jurisdiction. The committee 101
4635-may require an applicant to take and pass an examination 102
4636-specific to the laws of this state; or 103
4637- (b) Within thirty days of receiving an application 104
4638-described in subdivision (1) of this subsection from a 105
4639-nonresident military spouse or a resident military spouse, 106
4640-waive any examination, educational, or experience 107
4641-requirements for licensure in this state for the applicant 108
4642-and issue such applicant a license under this subsection if 109
4643-such applicant otherwi se meets the requirements of this 110
4644-subsection. 111
4645- (3) (a) The committee shall not waive any 112
4646-examination, educational, or experience requirements for any 113
4647-applicant who has had his or her license revoked by a 114
4648-committee outside the state; who is curren tly under 115
4649-investigation, who has a complaint pending, or who is 116
4650-currently under disciplinary action, except as provided in 117
4651-paragraph (b) of this subdivision, with a committee outside 118
4652-the state; who does not hold a license in good standing with 119
4653-a committee outside the state; who has a criminal record 120
4654-that would disqualify him or her for licensure in Missouri; 121
4655-or who does not hold a valid current license in the other 122
4656-jurisdiction on the date the committee receives his or her 123
4657-application under this su bsection. 124 CCS HCS SS SCS SB 157 146
4658- (b) If another jurisdiction has taken disciplinary 125
4659-action against an applicant, the committee shall determine 126
4660-if the cause for the action was corrected and the matter 127
4661-resolved. If the matter has not been resolved by that 128
4662-jurisdiction, the committee may deny a license until the 129
4663-matter is resolved. 130
4664- (4) Nothing in this subsection shall prohibit the 131
4665-committee from denying a license to an applicant under this 132
4666-subsection for any reason described in section 337.525. 133
4667- (5) Any person who is licensed under the provisions of 134
4668-this subsection shall be subject to the committee's 135
4669-jurisdiction and all rules and regulations pertaining to the 136
4670-practice as a licensed professional counselor in this state. 137
4671- (6) This subsection shall not be construed to waive 138
4672-any requirement for an applicant to pay any fees. 139
4673- 4. The committee shall issue a license to each person 140
4674-who files an application and fee and who furnishes evidence 141
4675-satisfactory to the committee that the applicant has 142
4676-complied with the provisions of this act and has taken and 143
4677-passed a written, open -book examination on Missouri laws and 144
4678-regulations governing the practice of professional 145
4679-counseling as defined in section 337.500. The division 146
4680-shall issue a provisional profes sional counselor license to 147
4681-any applicant who meets all requirements of this section, 148
4682-but who has not completed the required acceptable supervised 149
4683-counseling experience and such applicant may reapply for 150
4684-licensure as a professional counselor upon compl etion of 151
4685-such acceptable supervised counseling experience. 152
4686- [4.] 5. All persons licensed to practice professional 153
4687-counseling in this state shall pay on or before the license 154
4688-renewal date a renewal license fee and shall furnish to the 155
4689-committee satisfactory evidence of the completion of the 156 CCS HCS SS SCS SB 157 147
4690-requisite number of hours of continuing education as 157
4691-required by rule, including two hours of suicide assessment, 158
4692-referral, treatment, and management training, which shall be 159
4693-no more than forty hours biennial ly. The continuing 160
4694-education requirements may be waived by the committee upon 161
4695-presentation to the committee of satisfactory evidence of 162
4696-the illness of the licensee or for other good cause. 163
4697- 337.550. SECTION 1: PURPOSE 1
4698- The purpose of this Compact is to facilitate interstate 2
4699-practice of Licensed Professional Counselors with the goal 3
4700-of improving public access to Professional Counseling 4
4701-services. The practice of Professional Counseling occurs in 5
4702-the State where the client is l ocated at the time of the 6
4703-counseling services. The Compact preserves the regulatory 7
4704-authority of States to protect public health and safety 8
4705-through the current system of State licensure. 9
4706- This Compact is designed to achieve the following 10
4707-objectives: 11
4708- A. Increase public access to Professional Counseling 12
4709-services by providing for the mutual recognition of other 13
4710-Member State licenses; 14
4711- B. Enhance the States' ability to protect the public's 15
4712-health and safety; 16
4713- C. Encourage the coopera tion of Member States in 17
4714-regulating multistate practice for Licensed Professional 18
4715-Counselors; 19
4716- D. Support spouses of relocating Active Duty Military 20
4717-personnel; 21
4718- E. Enhance the exchange of licensure, investigative, 22
4719-and disciplinary information among Member States; 23 CCS HCS SS SCS SB 157 148
4720- F. Allow for the use of Telehealth technology to 24
4721-facilitate increased access to Professional Counseling 25
4722-services; 26
4723- G. Support the uniformity of Professional Counseling 27
4724-licensure requirements throughout the States to prom ote 28
4725-public safety and public health benefits; 29
4726- H. Invest all Member States with the authority to hold 30
4727-a Licensed Professional Counselor accountable for meeting 31
4728-all State practice laws in the State in which the client is 32
4729-located at the time care is rendered through the mutual 33
4730-recognition of Member State licenses; 34
4731- I. Eliminate the necessity for licenses in multiple 35
4732-States; and 36
4733- J. Provide opportunities for interstate practice by 37
4734-Licensed Professional Counselors who meet uniform licensur e 38
4735-requirements. 39
4736- SECTION 2. DEFINITIONS 40
4737- As used in this Compact, and except as otherwise 41
4738-provided, the following definitions shall apply: 42
4739- A. "Active Duty Military" means full -time duty status 43
4740-in the active uniformed service of the United States, 44
4741-including members of the National Guard and Reserve on 45
4742-active duty orders pursuant to 10 U.S.C. Chapters 1209 and 46
4743-1211. 47
4744- B. "Adverse Action" means any administrative, civil, 48
4745-equitable or criminal action permitted by a State's laws 49
4746-which is imposed by a licensing board or other authority 50
4747-against a Licensed Professional Counselor, including actions 51
4748-against an individual's license or Privilege to Practice 52
4749-such as revocation, suspension, probation, monitoring of the 53
4750-licensee, limitation o n the licensee's practice, or any 54
4751-other Encumbrance on licensure affecting a Licensed 55 CCS HCS SS SCS SB 157 149
4752-Professional Counselor's authorization to practice, 56
4753-including issuance of a cease and desist action. 57
4754- C. "Alternative Program" means a non -disciplinary 58
4755-monitoring or practice remediation process approved by a 59
4756-Professional Counseling Licensing Board to address Impaired 60
4757-Practitioners. 61
4758- D. "Continuing Competence/Education" means a 62
4759-requirement, as a condition of license renewal, to provide 63
4760-evidence of participation in, and/or completion of, 64
4761-educational and professional activities relevant to practice 65
4762-or area of work. 66
4763- E. "Counseling Compact Commission" or "Commission" 67
4764-means the national administrative body whose membership 68
4765-consists of all States that have enacted the Compact. 69
4766- F. "Current Significant Investigative Information" 70
4767-means: 71
4768- 1. Investigative Information that a Licensing Board, 72
4769-after a preliminary inquiry that includes notification and 73
4770-an opportunity for the Licensed Professional Counselor to 74
4771-respond, if required by State law, has reason to believe is 75
4772-not groundless and, if proved true, would indicate more than 76
4773-a minor infraction; or 77
4774- 2. Investigative Information that indicates that the 78
4775-Licensed Professional Counselor repr esents an immediate 79
4776-threat to public health and safety regardless of whether the 80
4777-Licensed Professional Counselor has been notified and had an 81
4778-opportunity to respond. 82
4779- G. "Data System" means a repository of information 83
4780-about Licensees, including, b ut not limited to, continuing 84
4781-education, examination, licensure, investigative, Privilege 85
4782-to Practice and Adverse Action information. 86 CCS HCS SS SCS SB 157 150
4783- H. "Encumbered License" means a license in which an 87
4784-Adverse Action restricts the practice of licensed 88
4785-Professional Counseling by the Licensee and said Adverse 89
4786-Action has been reported to the National Practitioners Data 90
4787-Bank (NPDB). 91
4788- I. "Encumbrance" means a revocation or suspension of, 92
4789-or any limitation on, the full and unrestricted practice of 93
4790-Licensed Professional Counseling by a Licensing Board. 94
4791- J. "Executive Committee" means a group of directors 95
4792-elected or appointed to act on behalf of, and within the 96
4793-powers granted to them by, the Commission. 97
4794- K. "Home State" means the Member State that is the 98
4795-Licensee's primary State of residence. 99
4796- L. "Impaired Practitioner" means an individual who has 100
4797-a condition(s) that may impair their ability to practice as 101
4798-a Licensed Professional Counselor without some type of 102
4799-intervention and may include, but are not limited to, 103
4800-alcohol and drug dependence, mental health impairment, and 104
4801-neurological or physical impairments. 105
4802- M. "Investigative Information" means information, 106
4803-records, and documents received or generated by a 107
4804-Professional Counseling Lice nsing Board pursuant to an 108
4805-investigation. 109
4806- N. "Jurisprudence Requirement" if required by a Member 110
4807-State, means the assessment of an individual's knowledge of 111
4808-the laws and Rules governing the practice of Professional 112
4809-Counseling in a State. 113
4810- O. "Licensed Professional Counselor" means a counselor 114
4811-licensed by a Member State, regardless of the title used by 115
4812-that State, to independently assess, diagnose, and treat 116
4813-behavioral health conditions. 117 CCS HCS SS SCS SB 157 151
4814- P. "Licensee" means an individual who currently holds 118
4815-an authorization from the State to practice as a Licensed 119
4816-Professional Counselor. 120
4817- Q. "Licensing Board" means the agency of a State, or 121
4818-equivalent, that is responsible for the licensing and 122
4819-regulation of Licensed Professional Counselors. 123
4820- R. "Member State" means a State that has enacted the 124
4821-Compact. 125
4822- S. "Privilege to Practice" means a legal 126
4823-authorization, which is equivalent to a license, permitting 127
4824-the practice of Professional Counseling in a Remote State. 128
4825- T. "Professional Counseling" means the assessment, 129
4826-diagnosis, and treatment of behavioral health conditions by 130
4827-a Licensed Professional Counselor. 131
4828- U. "Remote State" means a Member State other than the 132
4829-Home State, where a Licensee is exercising or seeking to 133
4830-exercise the Privilege to Practice. 134
4831- V. "Rule" means a regulation promulgated by the 135
4832-Commission that has the force of law. 136
4833- W. "Single State License" means a Licensed 137
4834-Professional Counselor license issued by a Member State that 138
4835-authorizes practice only within the issuing State and does 139
4836-not include a Privilege to Practice in any other Member 140
4837-State. 141
4838- X. "State" means any state, commonwealth, district, or 142
4839-territory of the United States of America that regulates the 143
4840-practice of Professional Co unseling. 144
4841- Y. "Telehealth" means the application of 145
4842-telecommunication technology to deliver Professional 146
4843-Counseling services remotely to assess, diagnose, and treat 147
4844-behavioral health conditions. 148 CCS HCS SS SCS SB 157 152
4845- Z. "Unencumbered License" means a license that 149
4846-authorizes a Licensed Professional Counselor to engage in 150
4847-the full and unrestricted practice of Professional 151
4848-Counseling. 152
4849- SECTION 3. STATE PARTICIPATION IN THE COMPACT 153
4850- A. To Participate in the Compact, a State must 154
4851-currently: 155
4852- 1. License and regulate Licensed Professional 156
4853-Counselors; 157
4854- 2. Require Licensees to pass a nationally recognized 158
4855-exam approved by the Commission; 159
4856- 3. Require Licensees to have a 60 semester -hour (or 90 160
4857-quarter-hour) master's degree in counseling or 60 s emester- 161
4858-hours (or 90 quarter -hours) of graduate course work 162
4859-including the following topic areas: 163
4860- a. Professional Counseling Orientation and Ethical 164
4861-Practice; 165
4862- b. Social and Cultural Diversity; 166
4863- c. Human Growth and Development; 167
4864- d. Career Development; 168
4865- e. Counseling and Helping Relationships; 169
4866- f. Group Counseling and Group Work; 170
4867- g. Diagnosis and Treatment; Assessment and Testing; 171
4868- h. Research and Program Evaluation; and 172
4869- i. Other areas as determined by the Co mmission. 173
4870- 4. Require Licensees to complete a supervised 174
4871-postgraduate professional experience as defined by the 175
4872-Commission; 176
4873- 5. Have a mechanism in place for receiving and 177
4874-investigating complaints about Licensees. 178
4875- B. A Member State shall : 179 CCS HCS SS SCS SB 157 153
4876- 1. Participate fully in the Commission's Data System, 180
4877-including using the Commission's unique identifier as 181
4878-defined in Rules; 182
4879- 2. Notify the Commission, in compliance with the terms 183
4880-of the Compact and Rules, of any Adverse Action or the 184
4881-availability of Investigative Information regarding a 185
4882-Licensee; 186
4883- 3. Implement or utilize procedures for considering the 187
4884-criminal history records of applicants for an initial 188
4885-Privilege to Practice. These procedures shall include the 189
4886-submission of fingerprints or other biometric -based 190
4887-information by applicants for the purpose of obtaining an 191
4888-applicant's criminal history record information from the 192
4889-Federal Bureau of Investigation and the agency responsible 193
4890-for retaining that State's criminal record s; 194
4891- a. A member state must fully implement a criminal 195
4892-background check requirement, within a time frame 196
4893-established by rule, by receiving the results of the Federal 197
4894-Bureau of Investigation record search and shall use the 198
4895-results in making licensur e decisions. 199
4896- b. Communication between a Member State, the 200
4897-Commission and among Member States regarding the 201
4898-verification of eligibility for licensure through the 202
4899-Compact shall not include any information received from the 203
4900-Federal Bureau of Investi gation relating to a federal 204
4901-criminal records check performed by a Member State under 205
4902-Public Law 92-544. 206
4903- 4. Comply with the Rules of the Commission; 207
4904- 5. Require an applicant to obtain or retain a license 208
4905-in the Home State and meet the Home St ate's qualifications 209
4906-for licensure or renewal of licensure, as well as all other 210
4907-applicable State laws; 211 CCS HCS SS SCS SB 157 154
4908- 6. Grant the Privilege to Practice to a Licensee 212
4909-holding a valid Unencumbered License in another Member State 213
4910-in accordance with the terms of the Compact and Rules; and 214
4911- 7. Provide for the attendance of the State's 215
4912-commissioner to the Counseling Compact Commission meetings. 216
4913- C. Member States may charge a fee for granting the 217
4914-Privilege to Practice. 218
4915- D. Individuals not residing in a Member State shall 219
4916-continue to be able to apply for a Member State's Single 220
4917-State License as provided under the laws of each Member 221
4918-State. However, the Single State License granted to these 222
4919-individuals shall not be recognized as granting a Privileg e 223
4920-to Practice Professional Counseling in any other Member 224
4921-State. 225
4922- E. Nothing in this Compact shall affect the 226
4923-requirements established by a Member State for the issuance 227
4924-of a Single State License. 228
4925- F. A license issued to a Licensed Profession al 229
4926-Counselor by a Home State to a resident in that State shall 230
4927-be recognized by each Member State as authorizing a Licensed 231
4928-Professional Counselor to practice Professional Counseling, 232
4929-under a Privilege to Practice, in each Member State. 233
4930- SECTION 4. PRIVILEGE TO PRACTICE 234
4931- A. To exercise the Privilege to Practice under the 235
4932-terms and provisions of the Compact, the Licensee shall: 236
4933- 1. Hold a license in the Home State; 237
4934- 2. Have a valid United States Social Security Number 238
4935-or National Practitioner Identifier; 239
4936- 3. Be eligible for a Privilege to Practice in any 240
4937-Member State in accordance with Section 4(D), (G) and (H); 241 CCS HCS SS SCS SB 157 155
4938- 4. Have not had any Encumbrance or restriction against 242
4939-any license or Privilege to Practice within the previou s two 243
4940-(2) years; 244
4941- 5. Notify the Commission that the Licensee is seeking 245
4942-the Privilege to Practice within a Remote State(s); 246
4943- 6. Pay any applicable fees, including any State fee, 247
4944-for the Privilege to Practice; 248
4945- 7. Meet any Continuing Compe tence/Education 249
4946-requirements established by the Home State; 250
4947- 8. Meet any Jurisprudence Requirements established by 251
4948-the Remote State(s) in which the Licensee is seeking a 252
4949-Privilege to Practice; and 253
4950- 9. Report to the Commission any Adverse Actio n, 254
4951-Encumbrance, or restriction on license taken by any non - 255
4952-Member State within 30 days from the date the action is 256
4953-taken. 257
4954- B. The Privilege to Practice is valid until the 258
4955-expiration date of the Home State license. The Licensee 259
4956-must comply with the requirements of Section 4(A) to 260
4957-maintain the Privilege to Practice in the Remote State. 261
4958- C. A Licensee providing Professional Counseling in a 262
4959-Remote State under the Privilege to Practice shall adhere to 263
4960-the laws and regulations of the Remote Sta te. 264
4961- D. A Licensee providing Professional Counseling 265
4962-services in a Remote State is subject to that State's 266
4963-regulatory authority. A Remote State may, in accordance 267
4964-with due process and that State's laws, remove a Licensee's 268
4965-Privilege to Practice i n the Remote State for a specific 269
4966-period of time, impose fines, and/or take any other 270
4967-necessary actions to protect the health and safety of its 271
4968-citizens. The Licensee may be ineligible for a Privilege to 272 CCS HCS SS SCS SB 157 156
4969-Practice in any Member State until the specific time for 273
4970-removal has passed and all fines are paid. 274
4971- E. If a Home State license is encumbered, the Licensee 275
4972-shall lose the Privilege to Practice in any Remote State 276
4973-until the following occur: 277
4974- 1. The Home State license is no longer encumbered ; and 278
4975- 2. Have not had any Encumbrance or restriction against 279
4976-any license or Privilege to Practice within the previous two 280
4977-(2) years. 281
4978- F. Once an Encumbered License in the Home State is 282
4979-restored to good standing, the Licensee must meet the 283
4980-requirements of Section 4(A) to obtain a Privilege to 284
4981-Practice in any Remote State. 285
4982- G. If a Licensee's Privilege to Practice in any Remote 286
4983-State is removed, the individual may lose the Privilege to 287
4984-Practice in all other Remote States until the follo wing 288
4985-occur: 289
4986- 1. The specific period of time for which the Privilege 290
4987-to Practice was removed has ended; 291
4988- 2. All fines have been paid; and 292
4989- 3. Have not had any Encumbrance or restriction against 293
4990-any license or Privilege to Practice within t he previous two 294
4991-(2) years. 295
4992- H. Once the requirements of Section 4(G) have been 296
4993-met, the Licensee must meet the requirements in Section 4(A) 297
4994-to obtain a Privilege to Practice in a Remote State. 298
4995- SECTION 5: OBTAINING A NEW HOME STATE LICENSE BAS ED ON 299
4996-A PRIVILEGE TO PRACTICE 300
4997- A. A Licensed Professional Counselor may hold a Home 301
4998-State license, which allows for a Privilege to Practice in 302
4999-other Member States, in only one Member State at a time. 303 CCS HCS SS SCS SB 157 157
5000- B. If a Licensed Professional Counselor ch anges 304
5001-primary State of residence by moving between two Member 305
5002-States: 306
5003- 1. The Licensed Professional Counselor shall file an 307
5004-application for obtaining a new Home State license based on 308
5005-a Privilege to Practice, pay all applicable fees, and notify 309
5006-the current and new Home State in accordance with applicable 310
5007-Rules adopted by the Commission. 311
5008- 2. Upon receipt of an application for obtaining a new 312
5009-Home State license by virtue of a Privilege to Practice, the 313
5010-new Home State shall verify that the Li censed Professional 314
5011-Counselor meets the pertinent criteria outlined in Section 4 315
5012-via the Data System, without need for primary source 316
5013-verification except for: 317
5014- a. a Federal Bureau of Investigation fingerprint based 318
5015-criminal background check if not previously performed or 319
5016-updated pursuant to applicable rules adopted by the 320
5017-Commission in accordance with Public Law 92 -544; 321
5018- b. other criminal background check as required by the 322
5019-new Home State; and 323
5020- c. completion of any requisite Jurisprude nce 324
5021-Requirements of the new Home State. 325
5022- 3. The former Home State shall convert the former Home 326
5023-State license into a Privilege to Practice once the new Home 327
5024-State has activated the new Home State license in accordance 328
5025-with applicable Rules adopted by the Commission. 329
5026- 4. Notwithstanding any other provision of this 330
5027-Compact, if the Licensed Professional Counselor cannot meet 331
5028-the criteria in Section 4, the new Home State may apply its 332
5029-requirements for issuing a new Single State License. 333 CCS HCS SS SCS SB 157 158
5030- 5. The Licensed Professional Counselor shall pay all 334
5031-applicable fees to the new Home State in order to be issued 335
5032-a new Home State license. 336
5033- C. If a Licensed Professional Counselor changes 337
5034-Primary State of Residence by moving from a Member State to 338
5035-a non-Member State, or from a non -Member State to a Member 339
5036-State, the State criteria shall apply for issuance of a 340
5037-Single State License in the new State. 341
5038- D. Nothing in this Compact shall interfere with a 342
5039-Licensee's ability to hold a Single State L icense in 343
5040-multiple States, however for the purposes of this Compact, a 344
5041-Licensee shall have only one Home State license. 345
5042- E. Nothing in this Compact shall affect the 346
5043-requirements established by a Member State for the issuance 347
5044-of a Single State Lice nse. 348
5045- SECTION 6. ACTIVE DUTY MILITARY PERSONNEL OR THEIR 349
5046-SPOUSES 350
5047- Active Duty Military personnel, or their spouse, shall 351
5048-designate a Home State where the individual has a current 352
5049-license in good standing. The individual may retain the 353
5050-Home State designation during the period the service member 354
5051-is on active duty. Subsequent to designating a Home State, 355
5052-the individual shall only change their Home State through 356
5053-application for licensure in the new State, or through the 357
5054-process outlined in Se ction 5. 358
5055- SECTION 7. COMPACT PRIVILEGE TO PRACTICE TELEHEALTH 359
5056- A. Member States shall recognize the right of a 360
5057-Licensed Professional Counselor, licensed by a Home State in 361
5058-accordance with Section 3 and under Rules promulgated by the 362
5059-Commission, to practice Professional Counseling in any 363
5060-Member State via Telehealth under a Privilege to Practice as 364 CCS HCS SS SCS SB 157 159
5061-provided in the Compact and Rules promulgated by the 365
5062-Commission. 366
5063- B. A Licensee providing Professional Counseling 367
5064-services in a Remote State under the Privilege to Practice 368
5065-shall adhere to the laws and regulations of the Remote State. 369
5066- SECTION 8. ADVERSE ACTIONS 370
5067- A. In addition to the other powers conferred by State 371
5068-law, a Remote State shall have the authority, in accordance 372
5069-with existing State due process law, to: 373
5070- 1. Take Adverse Action against a Licensed Professional 374
5071-Counselor's Privilege to Practice within that Member State, 375
5072-and 376
5073- 2. Issue subpoenas for both hearings and 377
5074-investigations that require the attendance and testimony of 378
5075-witnesses as well as the production of evidence. Subpoenas 379
5076-issued by a Licensing Board in a Member State for the 380
5077-attendance and testimony of witnesses or the production of 381
5078-evidence from another Member State shall be enforced in the 382
5079-latter State by any court of competent jurisdiction, 383
5080-according to the practice and procedure of that court 384
5081-applicable to subpoenas issued in proceedings pending before 385
5082-it. The issuing authority shall pay any witness fees, 386
5083-travel expenses, mileage, and oth er fees required by the 387
5084-service statutes of the State in which the witnesses or 388
5085-evidence are located. 389
5086- 3. Only the Home State shall have the power to take 390
5087-Adverse Action against a Licensed Professional Counselor's 391
5088-license issued by the Home State. 392
5089- B. For purposes of taking Adverse Action, the Home 393
5090-State shall give the same priority and effect to reported 394
5091-conduct received from a Member State as it would if the 395
5092-conduct had occurred within the Home State. In so doing, 396 CCS HCS SS SCS SB 157 160
5093-the Home State shall a pply its own State laws to determine 397
5094-appropriate action. 398
5095- C. The Home State shall complete any pending 399
5096-investigations of a Licensed Professional Counselor who 400
5097-changes primary State of residence during the course of the 401
5098-investigations. The Home State shall also have the 402
5099-authority to take appropriate action(s) and shall promptly 403
5100-report the conclusions of the investigations to the 404
5101-administrator of the Data System. The administrator of the 405
5102-coordinated licensure information system shall promptly 406
5103-notify the new Home State of any Adverse Actions. 407
5104- D. A Member State, if otherwise permitted by State 408
5105-law, may recover from the affected Licensed Professional 409
5106-Counselor the costs of investigations and dispositions of 410
5107-cases resulting from any Advers e Action taken against that 411
5108-Licensed Professional Counselor. 412
5109- E. A Member State may take Adverse Action based on the 413
5110-factual findings of the Remote State, provided that the 414
5111-Member State follows its own procedures for taking the 415
5112-Adverse Action. 416
5113- F. Joint Investigations: 417
5114- 1. In addition to the authority granted to a Member 418
5115-State by its respective Professional Counseling practice act 419
5116-or other applicable State law, any Member State may 420
5117-participate with other Member States in joint investig ations 421
5118-of Licensees. 422
5119- 2. Member States shall share any investigative, 423
5120-litigation, or compliance materials in furtherance of any 424
5121-joint or individual investigation initiated under the 425
5122-Compact. 426
5123- G. If Adverse Action is taken by the Home State 427
5124-against the license of a Licensed Professional Counselor, 428 CCS HCS SS SCS SB 157 161
5125-the Licensed Professional Counselor's Privilege to Practice 429
5126-in all other Member States shall be deactivated until all 430
5127-Encumbrances have been removed from the State license. All 431
5128-Home State disciplinary orders that impose Adverse Action 432
5129-against the license of a Licensed Professional Counselor 433
5130-shall include a Statement that the Licensed Professional 434
5131-Counselor's Privilege to Practice is deactivated in all 435
5132-Member States during the pendency of the order. 436
5133- H. If a Member State takes Adverse Action, it shall 437
5134-promptly notify the administrator of the Data System. The 438
5135-administrator of the Data System shall promptly notify the 439
5136-Home State of any Adverse Actions by Remote States. 440
5137- I. Nothing in this Compact shall override a Member 441
5138-State's decision that participation in an Alternative 442
5139-Program may be used in lieu of Adverse Action. 443
5140- SECTION 9. ESTABLISHMENT OF COUNSELING COMPACT 444
5141-COMMISSION 445
5142- A. The Compact Member States hereby create and 446
5143-establish a joint public agency known as the Counseling 447
5144-Compact Commission: 448
5145- 1. The Commission is an instrumentality of the Compact 449
5146-States. 450
5147- 2. Venue is proper and judicial proceedings by or 451
5148-against the Commission shall be brought solely and 452
5149-exclusively in a court of competent jurisdiction where the 453
5150-principal office of the Commission is located. The 454
5151-Commission may waive venue and jurisdictional defenses to 455
5152-the extent it adopts or consents to participate in 456
5153-alternative dispute resolut ion proceedings. 457
5154- 3. Nothing in this Compact shall be construed to be a 458
5155-waiver of sovereign immunity. 459
5156- B. Membership, Voting, and Meetings 460 CCS HCS SS SCS SB 157 162
5157- 1. Each Member State shall have and be limited to one 461
5158-(1) delegate selected by that Member State's Licensing Board. 462
5159- 2. The delegate shall be either: 463
5160- a. A current member of the Licensing Board at the time 464
5161-of appointment, who is a Licensed Professional Counselor or 465
5162-public member; or 466
5163- b. An administrator of the Licensing Board. 467
5164- 3. Any delegate may be removed or suspended from 468
5165-office as provided by the law of the State from which the 469
5166-delegate is appointed. 470
5167- 4. The Member State Licensing Board shall fill any 471
5168-vacancy occurring on the Commission within 60 days. 472
5169- 5. Each delegate shall be entitled to one (1) vote 473
5170-with regard to the promulgation of Rules and creation of 474
5171-bylaws and shall otherwise have an opportunity to 475
5172-participate in the business and affairs of the Commission. 476
5173- 6. A delegate shall vote in person or by such other 477
5174-means as provided in the bylaws. The bylaws may provide for 478
5175-delegates' participation in meetings by telephone or other 479
5176-means of communication. 480
5177- 7. The Commission shall meet at least once during each 481
5178-calendar year. Additional meetings shall be held as set 482
5179-forth in the bylaws. 483
5180- 8. The Commission shall by Rule establish a term of 484
5181-office for delegates and may by Rule establish term limits. 485
5182- C. The Commission shall have the following powers and 486
5183-duties: 487
5184- 1. Establish the fiscal year of the Commission; 488
5185- 2. Establish bylaws; 489
5186- 3. Maintain its financial records in accordance with 490
5187-the bylaws; 491 CCS HCS SS SCS SB 157 163
5188- 4. Meet and take such actions as are consistent with 492
5189-the provisions of this Compact and the bylaws; 493
5190- 5. Promulgate Rules which shall be binding to the 494
5191-extent and in the manner provided for in the Compact; 495
5192- 6. Bring and prosecute legal proceedings or actions in 496
5193-the name of the Commission, provided that the standing of 497
5194-any State Licensing Board to sue or be sued u nder applicable 498
5195-law shall not be affected; 499
5196- 7. Purchase and maintain insurance and bonds; 500
5197- 8. Borrow, accept, or contract for services of 501
5198-personnel, including, but not limited to, employees of a 502
5199-Member State; 503
5200- 9. Hire employees, elect or appoint officers, fix 504
5201-compensation, define duties, grant such individuals 505
5202-appropriate authority to carry out the purposes of the 506
5203-Compact, and establish the Commission's personnel policies 507
5204-and programs relating to conflicts of interest, 508
5205-qualifications of personnel, and other related personnel 509
5206-matters; 510
5207- 10. Accept any and all appropriate donations and 511
5208-grants of money, equipment, supplies, materials, and 512
5209-services, and to receive, utilize, and dispose of the same; 513
5210-provided that at all times the Co mmission shall avoid any 514
5211-appearance of impropriety and/or conflict of interest; 515
5212- 11. Lease, purchase, accept appropriate gifts or 516
5213-donations of, or otherwise to own, hold, improve or use, any 517
5214-property, real, personal or mixed; provided that at all 518
5215-times the Commission shall avoid any appearance of 519
5216-impropriety; 520
5217- 12. Sell, convey, mortgage, pledge, lease, exchange, 521
5218-abandon, or otherwise dispose of any property real, 522
5219-personal, or mixed; 523 CCS HCS SS SCS SB 157 164
5220- 13. Establish a budget and make expenditures; 524
5221- 14. Borrow money; 525
5222- 15. Appoint committees, including standing committees 526
5223-composed of members, State regulators, State legislators or 527
5224-their representatives, and consumer representatives, and 528
5225-such other interested persons as may be designated in this 529
5226-Compact and the bylaws; 530
5227- 16. Provide and receive information from, and 531
5228-cooperate with, law enforcement agencies; 532
5229- 17. Establish and elect an Executive Committee; and 533
5230- 18. Perform such other functions as may be necessary 534
5231-or appropriate to achieve the purposes of this Compact 535
5232-consistent with the State regulation of Professional 536
5233-Counseling licensure and practice. 537
5234- D. The Executive Committee 538
5235- 1. The Executive Committee shall have the power to act 539
5236-on behalf of the Commission accor ding to the terms of this 540
5237-Compact. 541
5238- 2. The Executive Committee shall be composed of up to 542
5239-eleven (11) members: 543
5240- a. Seven voting members who are elected by the 544
5241-Commission from the current membership of the Commission; and 545
5242- b. Up to four (4) ex-officio, nonvoting members from 546
5243-four (4) recognized national professional counselor 547
5244-organizations. 548
5245- c. The ex-officio members will be selected by their 549
5246-respective organizations. 550
5247- 3. The Commission may remove any member of the 551
5248-Executive Committee as provided in bylaws. 552
5249- 4. The Executive Committee shall meet at least 553
5250-annually. 554 CCS HCS SS SCS SB 157 165
5251- 5. The Executive Committee shall have the following 555
5252-duties and responsibilities: 556
5253- a. Recommend to the entire Commission changes to the 557
5254-Rules or bylaws, changes to this Compact legislation, fees 558
5255-paid by Compact Member States such as annual dues, and any 559
5256-Commission Compact fee charged to Licensees for the 560
5257-Privilege to Practice; 561
5258- b. Ensure Compact administration services are 562
5259-appropriately provided, contractual or otherwise; 563
5260- c. Prepare and recommend the budget; 564
5261- d. Maintain financial records on behalf of the 565
5262-Commission; 566
5263- e. Monitor Compact compliance of Member States and 567
5264-provide compliance reports to the Commission; 568
5265- f. Establish additional committees as necessary; and 569
5266- g. Other duties as provided in Rules or bylaws. 570
5267- E. Meetings of the Commission 571
5268- 1. All meetings shall be open to the public, and 572
5269-public notice of meetings shall be given in the same manner 573
5270-as required under the Rulemaking provisions in Section 11. 574
5271- 2. The Commission or the Executive Committee or other 575
5272-committees of the Commission may convene in a closed, non - 576
5273-public meeting if the Commission or Executive Committee or 577
5274-other committees of the Commission must discuss: 578
5275- a. Non-compliance of a Member State with its 579
5276-obligations under the Compact; 580
5277- b. The employment, compensation, discipline or other 581
5278-matters, practices or procedures related to specific 582
5279-employees or other matters re lated to the Commission's 583
5280-internal personnel practices and procedures; 584
5281- c. Current, threatened, or reasonably anticipated 585
5282-litigation; 586 CCS HCS SS SCS SB 157 166
5283- d. Negotiation of contracts for the purchase, lease, 587
5284-or sale of goods, services, or real estate; 588
5285- e. Accusing any person of a crime or formally 589
5286-censuring any person; 590
5287- f. Disclosure of trade secrets or commercial or 591
5288-financial information that is privileged or confidential; 592
5289- g. Disclosure of information of a personal nature 593
5290-where disclosure would constitute a clearly unwarranted 594
5291-invasion of personal privacy; 595
5292- h. Disclosure of investigative records compiled for 596
5293-law enforcement purposes; 597
5294- i. Disclosure of information related to any 598
5295-investigative reports prepared by or on behalf of or fo r use 599
5296-of the Commission or other committee charged with 600
5297-responsibility of investigation or determination of 601
5298-compliance issues pursuant to the Compact; or 602
5299- j. Matters specifically exempted from disclosure by 603
5300-federal or Member State statute. 604
5301- 3. If a meeting, or portion of a meeting, is closed 605
5302-pursuant to this provision, the Commission's legal counsel 606
5303-or designee shall certify that the meeting may be closed and 607
5304-shall reference each relevant exempting provision. 608
5305- 4. The Commission shall k eep minutes that fully and 609
5306-clearly describe all matters discussed in a meeting and 610
5307-shall provide a full and accurate summary of actions taken, 611
5308-and the reasons therefore, including a description of the 612
5309-views expressed. All documents considered in conne ction 613
5310-with an action shall be identified in such minutes. All 614
5311-minutes and documents of a closed meeting shall remain under 615
5312-seal, subject to release by a majority vote of the 616
5313-Commission or order of a court of competent jurisdiction. 617
5314- F. Financing of the Commission 618 CCS HCS SS SCS SB 157 167
5315- 1. The Commission shall pay, or provide for the 619
5316-payment of, the reasonable expenses of its establishment, 620
5317-organization, and ongoing activities. 621
5318- 2. The Commission may accept any and all appropriate 622
5319-revenue sources, donations , and grants of money, equipment, 623
5320-supplies, materials, and services. 624
5321- 3. The Commission may levy on and collect an annual 625
5322-assessment from each Member State or impose fees on other 626
5323-parties to cover the cost of the operations and activities 627
5324-of the Commission and its staff, which must be in a total 628
5325-amount sufficient to cover its annual budget as approved 629
5326-each year for which revenue is not provided by other 630
5327-sources. The aggregate annual assessment amount shall be 631
5328-allocated based upon a formula to be determined by the 632
5329-Commission, which shall promulgate a Rule binding upon all 633
5330-Member States. 634
5331- 4. The Commission shall not incur obligations of any 635
5332-kind prior to securing the funds adequate to meet the same; 636
5333-nor shall the Commission pledge the cr edit of any of the 637
5334-Member States, except by and with the authority of the 638
5335-Member State. 639
5336- 5. The Commission shall keep accurate accounts of all 640
5337-receipts and disbursements. The receipts and disbursements 641
5338-of the Commission shall be subject to the au dit and 642
5339-accounting procedures established under its bylaws. 643
5340-However, all receipts and disbursements of funds handled by 644
5341-the Commission shall be audited yearly by a certified or 645
5342-licensed public accountant, and the report of the audit 646
5343-shall be included in and become part of the annual report of 647
5344-the Commission. 648
5345- G. Qualified Immunity, Defense, and Indemnification 649 CCS HCS SS SCS SB 157 168
5346- 1. The members, officers, executive director, 650
5347-employees and representatives of the Commission shall be 651
5348-immune from suit and liabi lity, either personally or in 652
5349-their official capacity, for any claim for damage to or loss 653
5350-of property or personal injury or other civil liability 654
5351-caused by or arising out of any actual or alleged act, error 655
5352-or omission that occurred, or that the perso n against whom 656
5353-the claim is made had a reasonable basis for believing 657
5354-occurred within the scope of Commission employment, duties 658
5355-or responsibilities; provided that nothing in this paragraph 659
5356-shall be construed to protect any such person from suit 660
5357-and/or liability for any damage, loss, injury, or liability 661
5358-caused by the intentional or willful or wanton misconduct of 662
5359-that person. 663
5360- 2. The Commission shall defend any member, officer, 664
5361-executive director, employee or representative of the 665
5362-Commission in any civil action seeking to impose liability 666
5363-arising out of any actual or alleged act, error, or omission 667
5364-that occurred within the scope of Commission employment, 668
5365-duties, or responsibilities, or that the person against whom 669
5366-the claim is made had a r easonable basis for believing 670
5367-occurred within the scope of Commission employment, duties, 671
5368-or responsibilities; provided that nothing herein shall be 672
5369-construed to prohibit that person from retaining his or her 673
5370-own counsel; and provided further, that the actual or 674
5371-alleged act, error, or omission did not result from that 675
5372-person's intentional or willful or wanton misconduct. 676
5373- 3. The Commission shall indemnify and hold harmless 677
5374-any member, officer, executive director, employee, or 678
5375-representative of the Commission for the amount of any 679
5376-settlement or judgment obtained against that person arising 680
5377-out of any actual or alleged act, error, or omission that 681 CCS HCS SS SCS SB 157 169
5378-occurred within the scope of Commission employment, duties, 682
5379-or responsibilities, or that such per son had a reasonable 683
5380-basis for believing occurred within the scope of Commission 684
5381-employment, duties, or responsibilities, provided that the 685
5382-actual or alleged act, error, or omission did not result 686
5383-from the intentional or willful or wanton misconduct of that 687
5384-person. 688
5385- SECTION 10. DATA SYSTEM 689
5386- A. The Commission shall provide for the development, 690
5387-maintenance, operation, and utilization of a coordinated 691
5388-database and reporting system containing licensure, Adverse 692
5389-Action, and Investigative Inform ation on all licensed 693
5390-individuals in Member States. 694
5391- B. Notwithstanding any other provision of State law to 695
5392-the contrary, a Member State shall submit a uniform data set 696
5393-to the Data System on all individuals to whom this Compact 697
5394-is applicable as required by the Rules of the Commission, 698
5395-including: 699
5396- 1. Identifying information; 700
5397- 2. Licensure data; 701
5398- 3. Adverse Actions against a license or Privilege to 702
5399-Practice; 703
5400- 4. Non-confidential information related to Alternative 704
5401-Program participation; 705
5402- 5. Any denial of application for licensure, and the 706
5403-reason(s) for such denial; 707
5404- 6. Current Significant Investigative Information; and 708
5405- 7. Other information that may facilitate the 709
5406-administration of this Compact, as determined by the Rules 710
5407-of the Commission. 711 CCS HCS SS SCS SB 157 170
5408- C. Investigative Information pertaining to a Licensee 712
5409-in any Member State will only be available to other Member 713
5410-States. 714
5411- D. The Commission shall promptly notify all Member 715
5412-States of any Adverse Action taken agai nst a Licensee or an 716
5413-individual applying for a license. Adverse Action 717
5414-information pertaining to a Licensee in any Member State 718
5415-will be available to any other Member State. 719
5416- E. Member States contributing information to the Data 720
5417-System may designate information that may not be shared with 721
5418-the public without the express permission of the 722
5419-contributing State. 723
5420- F. Any information submitted to the Data System that 724
5421-is subsequently required to be expunged by the laws of the 725
5422-Member State contribut ing the information shall be removed 726
5423-from the Data System. 727
5424- SECTION 11. RULEMAKING 728
5425- A. The Commission shall promulgate reasonable Rules in 729
5426-order to effectively and efficiently achieve the purpose of 730
5427-the Compact. Notwithstanding the foregoing, in the event 731
5428-the Commission exercises its Rulemaking authority in a 732
5429-manner that is beyond the scope of the purposes of the 733
5430-Compact, or the powers granted hereunder, then such an 734
5431-action by the Commission shall be invalid and have no force 735
5432-or effect. 736
5433- B. The Commission shall exercise its Rulemaking powers 737
5434-pursuant to the criteria set forth in this Section and the 738
5435-Rules adopted thereunder. Rules and amendments shall become 739
5436-binding as of the date specified in each Rule or amendment. 740
5437- C. If a majority of the legislatures of the Member 741
5438-States rejects a Rule, by enactment of a statute or 742
5439-resolution in the same manner used to adopt the Compact 743 CCS HCS SS SCS SB 157 171
5440-within four (4) years of the date of adoption of the Rule, 744
5441-then such Rule shall have no further forc e and effect in any 745
5442-Member State. 746
5443- D. Rules or amendments to the Rules shall be adopted 747
5444-at a regular or special meeting of the Commission. 748
5445- E. Prior to promulgation and adoption of a final Rule 749
5446-or Rules by the Commission, and at least thirty ( 30) days in 750
5447-advance of the meeting at which the Rule will be considered 751
5448-and voted upon, the Commission shall file a Notice of 752
5449-Proposed Rulemaking: 753
5450- 1. On the website of the Commission or other publicly 754
5451-accessible platform; and 755
5452- 2. On the website of each Member State Professional 756
5453-Counseling Licensing Board or other publicly accessible 757
5454-platform or the publication in which each State would 758
5455-otherwise publish proposed Rules. 759
5456- F. The Notice of Proposed Rulemaking shall include: 760
5457- 1. The proposed time, date, and location of the 761
5458-meeting in which the Rule will be considered and voted upon; 762
5459- 2. The text of the proposed Rule or amendment and the 763
5460-reason for the proposed Rule; 764
5461- 3. A request for comments on the proposed Rule from 765
5462-any interested person; and 766
5463- 4. The manner in which interested persons may submit 767
5464-notice to the Commission of their intention to attend the 768
5465-public hearing and any written comments. 769
5466- G. Prior to adoption of a proposed Rule, the 770
5467-Commission shall all ow persons to submit written data, 771
5468-facts, opinions, and arguments, which shall be made 772
5469-available to the public. 773 CCS HCS SS SCS SB 157 172
5470- H. The Commission shall grant an opportunity for a 774
5471-public hearing before it adopts a Rule or amendment if a 775
5472-hearing is requested by: 776
5473- 1. At least twenty-five (25) persons; 777
5474- 2. A State or federal governmental subdivision or 778
5475-agency; or 779
5476- 3. An association having at least twenty -five (25) 780
5477-members. 781
5478- I. If a hearing is held on the proposed Rule or 782
5479-amendment, the Commissi on shall publish the place, time, and 783
5480-date of the scheduled public hearing. If the hearing is 784
5481-held via electronic means, the Commission shall publish the 785
5482-mechanism for access to the electronic hearing. 786
5483- 1. All persons wishing to be heard at the he aring 787
5484-shall notify the executive director of the Commission or 788
5485-other designated member in writing of their desire to appear 789
5486-and testify at the hearing not less than five (5) business 790
5487-days before the scheduled date of the hearing. 791
5488- 2. Hearings shall be conducted in a manner providing 792
5489-each person who wishes to comment a fair and reasonable 793
5490-opportunity to comment orally or in writing. 794
5491- 3. All hearings will be recorded. A copy of the 795
5492-recording will be made available on request. 796
5493- 4. Nothing in this section shall be construed as 797
5494-requiring a separate hearing on each Rule. Rules may be 798
5495-grouped for the convenience of the Commission at hearings 799
5496-required by this section. 800
5497- J. Following the scheduled hearing date, or by the 801
5498-close of business on the scheduled hearing date if the 802
5499-hearing was not held, the Commission shall consider all 803
5500-written and oral comments received. 804 CCS HCS SS SCS SB 157 173
5501- K. If no written notice of intent to attend the public 805
5502-hearing by interested parties is received, the Commission 806
5503-may proceed with promulgation of the proposed Rule without a 807
5504-public hearing. 808
5505- L. The Commission shall, by majority vote of all 809
5506-members, take final action on the proposed Rule and shall 810
5507-determine the effective date of the Rule, if any, based on 811
5508-the Rulemaking record and the full text of the Rule. 812
5509- M. Upon determination that an emergency exists, the 813
5510-Commission may consider and adopt an emergency Rule without 814
5511-prior notice, opportunity for comment, or hearing, provided 815
5512-that the usual Rulemaking procedures provided in the Compact 816
5513-and in this section shall be retroactively applied to the 817
5514-Rule as soon as reasonably possible, in no event later than 818
5515-ninety (90) days after the effective date of the Rule. For 819
5516-the purposes of this provision, an eme rgency Rule is one 820
5517-that must be adopted immediately in order to: 821
5518- 1. Meet an imminent threat to public health, safety, 822
5519-or welfare; 823
5520- 2. Prevent a loss of Commission or Member State funds; 824
5521- 3. Meet a deadline for the promulgation of an 825
5522-administrative Rule that is established by federal law or 826
5523-Rule; or 827
5524- 4. Protect public health and safety. 828
5525- N. The Commission or an authorized committee of the 829
5526-Commission may direct revisions to a previously adopted Rule 830
5527-or amendment for purposes of correcting typographical 831
5528-errors, errors in format, errors in consistency, or 832
5529-grammatical errors. Public notice of any revisions shall be 833
5530-posted on the website of the Commission. The revision shall 834
5531-be subject to challenge by any person for a period o f thirty 835
5532-(30) days after posting. The revision may be challenged 836 CCS HCS SS SCS SB 157 174
5533-only on grounds that the revision results in a material 837
5534-change to a Rule. A challenge shall be made in writing and 838
5535-delivered to the chair of the Commission prior to the end of 839
5536-the notice period. If no challenge is made, the revision 840
5537-will take effect without further action. If the revision is 841
5538-challenged, the revision may not take effect without the 842
5539-approval of the Commission. 843
5540- SECTION 12. OVERSIGHT, DISPUTE RESOLUTION, AND 844
5541-ENFORCEMENT 845
5542- A. Oversight 846
5543- 1. The executive, legislative, and judicial branches 847
5544-of State government in each Member State shall enforce this 848
5545-Compact and take all actions necessary and appropriate to 849
5546-effectuate the Compact's purposes and intent. The 850
5547-provisions of this Compact and the Rules promulgated 851
5548-hereunder shall have standing as statutory law. 852
5549- 2. All courts shall take judicial notice of the 853
5550-Compact and the Rules in any judicial or administrative 854
5551-proceeding in a Member State pertaining to the subject 855
5552-matter of this Compact which may affect the powers, 856
5553-responsibilities, or actions of the Commission. 857
5554- 3. The Commission shall be entitled to receive service 858
5555-of process in any such proceeding and shall have standing to 859
5556-intervene in such a proceeding for all purposes. Failure to 860
5557-provide service of process to the Commission shall render a 861
5558-judgment or order void as to the Commission, this Compact, 862
5559-or promulgated Rules. 863
5560- B. Default, Technical Assistance, and Termination 864
5561- 1. If the Commission determines that a Member State 865
5562-has defaulted in the performance of its obligations or 866
5563-responsibilities under this Compact or the promulgated 867
5564-Rules, the Commission shall: 868 CCS HCS SS SCS SB 157 175
5565- a. Provide written notice to the defaulting State and 869
5566-other Member States of the nature of the default, the 870
5567-proposed means of curing the default and/or any other action 871
5568-to be taken by the Commission; and 872
5569- b. Provide remedial training and specific technical 873
5570-assistance regarding the default. 874
5571- C. If a State in default fails to cure the default, 875
5572-the defaulting State may be terminated from the Compact upon 876
5573-an affirmative vote of a majority of the Member States, and 877
5574-all rights, privileges and benefits conferred by this 878
5575-Compact may be terminated on the e ffective date of 879
5576-termination. A cure of the default does not relieve the 880
5577-offending State of obligations or liabilities incurred 881
5578-during the period of default. 882
5579- D. Termination of membership in the Compact shall be 883
5580-imposed only after all other means of securing compliance 884
5581-have been exhausted. Notice of intent to suspend or 885
5582-terminate shall be given by the Commission to the governor, 886
5583-the majority and minority leaders of the defaulting State's 887
5584-legislature, and each of the Member States. 888
5585- E. A State that has been terminated is responsible for 889
5586-all assessments, obligations, and liabilities incurred 890
5587-through the effective date of termination, including 891
5588-obligations that extend beyond the effective date of 892
5589-termination. 893
5590- F. The Commission shall not bear any costs related to 894
5591-a State that is found to be in default or that has been 895
5592-terminated from the Compact, unless agreed upon in writing 896
5593-between the Commission and the defaulting State. 897
5594- G. The defaulting State may appeal the action of th e 898
5595-Commission by petitioning the U.S. District Court for the 899
5596-District of Columbia or the federal district where the 900 CCS HCS SS SCS SB 157 176
5597-Commission has its principal offices. The prevailing member 901
5598-shall be awarded all costs of such litigation, including 902
5599-reasonable attorney's fees. 903
5600- H. Dispute Resolution 904
5601- 1. Upon request by a Member State, the Commission 905
5602-shall attempt to resolve disputes related to the Compact 906
5603-that arise among Member States and between member and non - 907
5604-Member States. 908
5605- 2. The Commission shall promulgate a Rule providing 909
5606-for both mediation and binding dispute resolution for 910
5607-disputes as appropriate. 911
5608- I. Enforcement 912
5609- 1. The Commission, in the reasonable exercise of its 913
5610-discretion, shall enforce the provisions and Rules of this 914
5611-Compact. 915
5612- 2. By majority vote, the Commission may initiate legal 916
5613-action in the United States District Court for the District 917
5614-of Columbia or the federal district where the Commission has 918
5615-its principal offices against a Member State in default to 919
5616-enforce compliance with the provisions of the Compact and 920
5617-its promulgated Rules and bylaws. The relief sought may 921
5618-include both injunctive relief and damages. In the event 922
5619-judicial enforcement is necessary, the prevailing member 923
5620-shall be awarded all costs of such litigation, including 924
5621-reasonable attorney's fees. 925
5622- 3. The remedies herein shall not be the exclusive 926
5623-remedies of the Commission. The Commission may pursue any 927
5624-other remedies available under federal or State law. 928
5625- SECTION 13. DATE OF IMPLEMENTATION OF THE COUNSELING 929
5626-COMPACT COMMISSION AND ASSOCIATED RULES, WITHDRAWAL, AND 930
5627-AMENDMENT 931 CCS HCS SS SCS SB 157 177
5628- A. The Compact shall come into effect on the date on 932
5629-which the Compact statute is enacted into law in the tenth 933
5630-Member State. The provisions, which become effective at 934
5631-that time, shall be limited to the powers granted to the 935
5632-Commission relating to assembly and the promulgation of 936
5633-Rules. Thereafter, the Commission shall meet and exercise 937
5634-Rulemaking powers necessary to the implementation and 938
5635-administration of the Compact. 939
5636- B. Any State that joins the Compact subsequent to the 940
5637-Commission's initial adoption of the Rules shall be subject 941
5638-to the Rules as they exist on the date on which the Compact 942
5639-becomes law in that State. Any Rule that has been 943
5640-previously adopted by the Commission shall have the full 944
5641-force and effect of law on the day the Compact becomes law 945
5642-in that State. 946
5643- C. Any Member State may withdraw from this Compact by 947
5644-enacting a statute repealing the same. 948
5645- 1. A Member State's withdrawal shall not take effect 949
5646-until six (6) months after enactment of the repealing 950
5647-statute. 951
5648- 2. Withdrawal shall not affect the continuing 952
5649-requirement of the withdrawing State's Professional 953
5650-Counseling Licensing Board to comply with th e investigative 954
5651-and Adverse Action reporting requirements of this act prior 955
5652-to the effective date of withdrawal. 956
5653- D. Nothing contained in this Compact shall be 957
5654-construed to invalidate or prevent any Professional 958
5655-Counseling licensure agreement or o ther cooperative 959
5656-arrangement between a Member State and a non -Member State 960
5657-that does not conflict with the provisions of this Compact. 961
5658- E. This Compact may be amended by the Member States. 962
5659-No amendment to this Compact shall become effective and 963 CCS HCS SS SCS SB 157 178
5660-binding upon any Member State until it is enacted into the 964
5661-laws of all Member States. 965
5662- SECTION 14. CONSTRUCTION AND SEVERABILITY 966
5663- This Compact shall be liberally construed so as to 967
5664-effectuate the purposes thereof. The provisions of this 968
5665-Compact shall be severable and if any phrase, clause, 969
5666-sentence or provision of this Compact is declared to be 970
5667-contrary to the constitution of any Member State or of the 971
5668-United States or the applicability thereof to any 972
5669-government, agency, person or circumstan ce is held invalid, 973
5670-the validity of the remainder of this Compact and the 974
5671-applicability thereof to any government, agency, person or 975
5672-circumstance shall not be affected thereby. If this Compact 976
5673-shall be held contrary to the constitution of any Member 977
5674-State, the Compact shall remain in full force and effect as 978
5675-to the remaining Member States and in full force and effect 979
5676-as to the Member State affected as to all severable matters. 980
5677- SECTION 15. BINDING EFFECT OF COMPACT AND OTHER LAWS 981
5678- A. A Licensee providing Professional Counseling 982
5679-services in a Remote State under the Privilege to Practice 983
5680-shall adhere to the laws and regulations, including scope of 984
5681-practice, of the Remote State. 985
5682- B. Nothing herein prevents the enforcement of any 986
5683-other law of a Member State that is not inconsistent with 987
5684-the Compact. 988
5685- C. Any laws in a Member State in conflict with the 989
5686-Compact are superseded to the extent of the conflict. 990
5687- D. Any lawful actions of the Commission, including all 991
5688-Rules and bylaws properly promulgated by the Commission, are 992
5689-binding upon the Member States. 993 CCS HCS SS SCS SB 157 179
5690- E. All permissible agreements between the Commission 994
5691-and the Member States are binding in accordance with their 995
5692-terms. 996
5693- F. In the event any provision of the Compact exceeds 997
5694-the constitutional limits imposed on the legislature of any 998
5695-Member State, the provision shall be ineffective to the 999
5696-extent of the conflict with the constitutional provision in 1000
5697-question in that Member State. 1001
5698- 337.615. 1. As used in this section, the following 1
5699-terms mean: 2
5700- (1) "License", a license, certificate, registration, 3
5701-permit, accreditation, or military occupational specialty 4
5702-that enables a person to legally practice an occupation or 5
5703-profession in a particular j urisdiction; 6
5704- (2) "Military", the Armed Forces of the United States, 7
5705-including the Air Force, Army, Coast Guard, Marine Corps, 8
5706-Navy, Space Force, National Guard, and any other military 9
5707-branch that is designated by Congress as part of the Armed 10
5708-Forces of the United States, and all reserve components and 11
5709-auxiliaries. The term "military" also includes the military 12
5710-reserves and militia of any United States territory or state; 13
5711- (3) "Nonresident military spouse", a nonresident 14
5712-spouse of an active-duty member of the Armed Forces of the 15
5713-United States who has been transferred or is scheduled to be 16
5714-transferred to the state of Missouri, or who has been 17
5715-transferred or is scheduled to be transferred to an adjacent 18
5716-state and is or will be domiciled i n the state of Missouri, 19
5717-or has moved to the state of Missouri on a permanent change - 20
5718-of-station basis; 21
5719- (4) "Oversight body", any board, department, agency, 22
5720-or office of a jurisdiction that issues licenses; 23 CCS HCS SS SCS SB 157 180
5721- (5) "Resident military spouse", a s pouse of an active- 24
5722-duty member of the Armed Forces of the United States who has 25
5723-been transferred or is scheduled to be transferred to the 26
5724-state of Missouri or an adjacent state and who is a 27
5725-permanent resident of the state of Missouri, who is 28
5726-domiciled in the state of Missouri, or who has Missouri as 29
5727-his or her home of record. 30
5728- 2. Each applicant for licensure as a clinical social 31
5729-worker shall furnish evidence to the committee that: 32
5730- (1) The applicant has a master's degree from a college 33
5731-or university program of social work accredited by the 34
5732-council of social work education or a doctorate degree from 35
5733-a school of social work acceptable to the committee; 36
5734- (2) The applicant has completed at least three 37
5735-thousand hours of supervised clinic al experience with a 38
5736-qualified clinical supervisor, as defined in section 39
5737-337.600, in no less than twenty -four months and no more than 40
5738-forty-eight consecutive calendar months. For any applicant 41
5739-who has successfully completed at least four thousand hou rs 42
5740-of supervised clinical experience with a qualified clinical 43
5741-supervisor, as defined in section 337.600, within the same 44
5742-time frame prescribed in this subsection, the applicant 45
5743-shall be eligible for application of licensure at three 46
5744-thousand hours and shall be furnished a certificate by the 47
5745-state committee for social workers acknowledging the 48
5746-completion of said additional hours; 49
5747- (3) The applicant has achieved a passing score, as 50
5748-defined by the committee, on an examination approved by the 51
5749-committee. The eligibility requirements for such 52
5750-examination shall be promulgated by rule of the committee; 53
5751-and 54 CCS HCS SS SCS SB 157 181
5752- (4) The applicant is at least eighteen years of age, 55
5753-is a United States citizen or has status as a legal resident 56
5754-alien, and has not bee n finally adjudicated and found 57
5755-guilty, or entered a plea of guilty or nolo contendere, in a 58
5756-criminal prosecution under the laws of any state, of the 59
5757-United States, or of any country, for any offense directly 60
5758-related to the duties and responsibilities of the 61
5759-occupation, as set forth in section 324.012, regardless of 62
5760-whether or not sentence has been imposed. 63
5761- [2. Any person holding a current license, certificate 64
5762-of registration, or permit from another state or territory 65
5763-of the United States or t he District of Columbia to practice 66
5764-clinical social work who does not meet the requirements of 67
5765-section 324.009 and who has had no disciplinary action taken 68
5766-against the license, certificate of registration, or permit 69
5767-for the preceding five years may be granted a license to 70
5768-practice clinical social work in this state if the person 71
5769-has received a masters or doctoral degree from a college or 72
5770-university program of social work accredited by the council 73
5771-of social work education and has been licensed to pra ctice 74
5772-clinical social work for the preceding five years. ] 75
5773- 3. (1) Any person who holds a valid current clinical 76
5774-social work license issued by another state, a branch or 77
5775-unit of the military, a territory of the United States, or 78
5776-the District of Columbia, and who has been licensed for at 79
5777-least one year in such other jurisdiction, may submit to the 80
5778-committee an application for a clinical social work license 81
5779-in Missouri along with proof of current licensure and proof 82
5780-of licensure for at least one year in the other jurisdiction. 83
5781- (2) The committee shall: 84
5782- (a) Within six months of receiving an application 85
5783-described in subdivision (1) of this subsection, waive any 86 CCS HCS SS SCS SB 157 182
5784-examination, educational, or experience requirements for 87
5785-licensure in this state for the applicant if it determines 88
5786-that there were minimum education requirements and, if 89
5787-applicable, work experience and clinical supervision 90
5788-requirements in effect and the other jurisdiction verifies 91
5789-that the person met those requirements in or der to be 92
5790-licensed or certified in that jurisdiction. The committee 93
5791-may require an applicant to take and pass an examination 94
5792-specific to the laws of this state; or 95
5793- (b) Within thirty days of receiving an application 96
5794-described in subdivision (1) o f this subsection from a 97
5795-nonresident military spouse or a resident military spouse, 98
5796-waive any examination, educational, or experience 99
5797-requirements for licensure in this state for the applicant 100
5798-and issue such applicant a license under this subsection if 101
5799-such applicant otherwise meets the requirements of this 102
5800-subsection. 103
5801- (3) (a) The committee shall not waive any 104
5802-examination, educational, or experience requirements for any 105
5803-applicant who has had his or her license revoked by an 106
5804-oversight body outside the state; who is currently under 107
5805-investigation, who has a complaint pending, or who is 108
5806-currently under disciplinary action, except as provided in 109
5807-paragraph (b) of this subdivision, with an oversight body 110
5808-outside the state; who does not hold a li cense in good 111
5809-standing with an oversight body outside the state; who has a 112
5810-criminal record that would disqualify him or her for 113
5811-licensure in Missouri; or who does not hold a valid current 114
5812-license in the other jurisdiction on the date the committee 115
5813-receives his or her application under this subsection. 116
5814- (b) If another jurisdiction has taken disciplinary 117
5815-action against an applicant, the committee shall determine 118 CCS HCS SS SCS SB 157 183
5816-if the cause for the action was corrected and the matter 119
5817-resolved. If the matter has not been resolved by that 120
5818-jurisdiction, the committee may deny a license until the 121
5819-matter is resolved. 122
5820- (4) Nothing in this subsection shall prohibit the 123
5821-committee from denying a license to an applicant under this 124
5822-subsection for any reason descri bed in section 337.630. 125
5823- (5) Any person who is licensed under the provisions of 126
5824-this subsection shall be subject to the committee's 127
5825-jurisdiction and all rules and regulations pertaining to the 128
5826-practice as a licensed clinical social worker in this s tate. 129
5827- (6) This subsection shall not be construed to waive 130
5828-any requirement for an applicant to pay any fees. 131
5829- 4. The committee shall issue a license to each person 132
5830-who files an application and fee as required by the 133
5831-provisions of sections 337. 600 to 337.689 and who furnishes 134
5832-evidence satisfactory to the committee that the applicant 135
5833-has complied with the provisions of subdivisions (1) to (4) 136
5834-of subsection [1] 2 of this section [or with the provisions 137
5835-of subsection 2 of this section ]. 138
5836- 337.644. 1. As used in this section, the following 1
5837-terms mean: 2
5838- (1) "License", a license, certificate, registration, 3
5839-permit, accreditation, or military occupational specialty 4
5840-that enables a person to legally practice an occupa tion or 5
5841-profession in a particular jurisdiction; 6
5842- (2) "Military", the Armed Forces of the United States, 7
5843-including the Air Force, Army, Coast Guard, Marine Corps, 8
5844-Navy, Space Force, National Guard, and any other military 9
5845-branch that is designated by Congress as part of the Armed 10
5846-Forces of the United States, and all reserve components and 11 CCS HCS SS SCS SB 157 184
5847-auxiliaries. The term "military" also includes the military 12
5848-reserves and militia of any United States territory or state; 13
5849- (3) "Nonresident military spous e", a nonresident 14
5850-spouse of an active-duty member of the Armed Forces of the 15
5851-United States who has been transferred or is scheduled to be 16
5852-transferred to the state of Missouri, or who has been 17
5853-transferred or is scheduled to be transferred to an adjacent 18
5854-state and is or will be domiciled in the state of Missouri, 19
5855-or has moved to the state of Missouri on a permanent change - 20
5856-of-station basis; 21
5857- (4) "Oversight body", any board, department, agency, 22
5858-or office of a jurisdiction that issues licenses; 23
5859- (5) "Resident military spouse", a spouse of an active - 24
5860-duty member of the Armed Forces of the United States who has 25
5861-been transferred or is scheduled to be transferred to the 26
5862-state of Missouri or an adjacent state and who is a 27
5863-permanent resident of the state of Missouri, who is 28
5864-domiciled in the state of Missouri, or who has Missouri as 29
5865-his or her home of record. 30
5866- 2. Each applicant for licensure as a master social 31
5867-worker shall furnish evidence to the committee that: 32
5868- (1) The applicant has a master's or doctorate degree 33
5869-in social work from an accredited social work degree program 34
5870-approved by the council of social work education; 35
5871- (2) The applicant has achieved a passing score, as 36
5872-defined by the committee, on an examination approved by the 37
5873-committee. The eligibility requirements for such 38
5874-examination shall be determined by the state committee for 39
5875-social workers; 40
5876- (3) The applicant is at least eighteen years of age, 41
5877-is a United States citizen or has status as a legal resident 42
5878-alien, and has not been finally adjudicated and found 43 CCS HCS SS SCS SB 157 185
5879-guilty, or entered a plea of guilty or nolo contendere, in a 44
5880-criminal prosecution under the laws of any state, of the 45
5881-United States, or of any country, for any offense directly 46
5882-related to the duties a nd responsibilities of the 47
5883-occupation, as set forth in section 324.012, regardless [or] 48
5884-of whether or not sentence is imposed; 49
5885- (4) The applicant has submitted a written application 50
5886-on forms prescribed by the state board; and 51
5887- (5) The applicant has submitted the required licensing 52
5888-fee, as determined by the committee. 53
5889- [2.] 3. Any applicant who answers in the affirmative 54
5890-to any question on the application that relates to possible 55
5891-grounds for denial of licensure under section 337.630 shal l 56
5892-submit a sworn affidavit setting forth in detail the facts 57
5893-which explain such answer and copies of appropriate 58
5894-documents related to such answer. 59
5895- [3.] 4. The committee shall issue a license to each 60
5896-person who files an application and fee as requ ired by the 61
5897-provisions of sections 337.600 to 337.689 and who furnishes 62
5898-evidence satisfactory to the committee that the applicant 63
5899-has complied with the provisions of subsection [1] 2 of this 64
5900-section. The license shall refer to the individual as a 65
5901-licensed master social worker and shall recognize that 66
5902-individual's right to practice licensed master social work 67
5903-as defined in section 337.600. 68
5904- 5. (1) Any person who holds a valid current master 69
5905-social work license issued by another state, a branch or 70
5906-unit of the military, a territory of the United States, or 71
5907-the District of Columbia, and who has been licensed for at 72
5908-least one year in such other jurisdiction, may submit to the 73
5909-committee an application for a master social work license in 74 CCS HCS SS SCS SB 157 186
5910-Missouri along with proof of current licensure and proof of 75
5911-licensure for at least one year in the other jurisdiction. 76
5912- (2) The committee shall: 77
5913- (a) Within six months of receiving an application 78
5914-described in subdivision (1) of this subsection, waive any 79
5915-examination, educational, or experience requirements for 80
5916-licensure in this state for the applicant if it determines 81
5917-that there were minimum education requirements and, if 82
5918-applicable, work experience and clinical supervision 83
5919-requirements in effect and the other jurisdiction verifies 84
5920-that the person met those requirements in order to be 85
5921-licensed or certified in that jurisdiction. The committee 86
5922-may require an applicant to take and pass an examination 87
5923-specific to the laws of this state; or 88
5924- (b) Within thirty days of receiving an application 89
5925-described in subdivision (1) of this subsection from a 90
5926-nonresident military spouse or a resident military spouse, 91
5927-waive any examination, educational, or experience 92
5928-requirements for licensure in this sta te for the applicant 93
5929-and issue such applicant a license under this subsection if 94
5930-such applicant otherwise meets the requirements of this 95
5931-subsection. 96
5932- (3) (a) The committee shall not waive any 97
5933-examination, educational, or experience requirements f or any 98
5934-applicant who has had his or her license revoked by an 99
5935-oversight body outside the state; who is currently under 100
5936-investigation, who has a complaint pending, or who is 101
5937-currently under disciplinary action, except as provided in 102
5938-paragraph (b) of this subdivision, with an oversight body 103
5939-outside the state; who does not hold a license in good 104
5940-standing with an oversight body outside the state; who has a 105
5941-criminal record that would disqualify him or her for 106 CCS HCS SS SCS SB 157 187
5942-licensure in Missouri; or who does not hold a valid current 107
5943-license in the other jurisdiction on the date the committee 108
5944-receives his or her application under this section. 109
5945- (b) If another jurisdiction has taken disciplinary 110
5946-action against an applicant, the committee shall determine 111
5947-if the cause for the action was corrected and the matter 112
5948-resolved. If the matter has not been resolved by that 113
5949-jurisdiction, the committee may deny a license until the 114
5950-matter is resolved. 115
5951- (4) Nothing in this subsection shall prohibit the 116
5952-committee from denying a license to an applicant under this 117
5953-subsection for any reason described in section 337.630. 118
5954- (5) Any person who is licensed under the provisions of 119
5955-this subsection shall be subject to the committee's 120
5956-jurisdiction and all rules and regulati ons pertaining to the 121
5957-practice as a licensed master social worker in this state. 122
5958- (6) This subsection shall not be construed to waive 123
5959-any requirement for an applicant to pay any fees. 124
5960- 337.665. 1. As used in this section, the fol lowing 1
5961-terms mean: 2
5962- (1) "License", a license, certificate, registration, 3
5963-permit, accreditation, or military occupational specialty 4
5964-that enables a person to legally practice an occupation or 5
5965-profession in a particular jurisdiction; 6
5966- (2) "Military", the Armed Forces of the United States, 7
5967-including the Air Force, Army, Coast Guard, Marine Corps, 8
5968-Navy, Space Force, National Guard, and any other military 9
5969-branch that is designated by Congress as part of the Armed 10
5970-Forces of the United States, and all reserve components and 11
5971-auxiliaries. The term "military" also includes the military 12
5972-reserves and militia of any United States territory or state; 13 CCS HCS SS SCS SB 157 188
5973- (3) "Nonresident military spouse", a nonresident 14
5974-spouse of an active-duty member of the Armed Fo rces of the 15
5975-United States who has been transferred or is scheduled to be 16
5976-transferred to the state of Missouri, or who has been 17
5977-transferred or is scheduled to be transferred to an adjacent 18
5978-state and is or will be domiciled in the state of Missouri, 19
5979-or has moved to the state of Missouri on a permanent change - 20
5980-of-station basis; 21
5981- (4) "Oversight body", any board, department, agency, 22
5982-or office of a jurisdiction that issues licenses; 23
5983- (5) "Resident military spouse", a spouse of an active - 24
5984-duty member of the Armed Forces of the United States who has 25
5985-been transferred or is scheduled to be transferred to the 26
5986-state of Missouri or an adjacent state and who is a 27
5987-permanent resident of the state of Missouri, who is 28
5988-domiciled in the state of Missouri, or who has Missouri as 29
5989-his or her home of record. 30
5990- 2. Each applicant for licensure as a baccalaureate 31
5991-social worker shall furnish evidence to the committee that: 32
5992- (1) The applicant has a baccalaureate degree in social 33
5993-work from an accredited soc ial work degree program approved 34
5994-by the council of social work education; 35
5995- (2) The applicant has achieved a passing score, as 36
5996-defined by the committee, on an examination approved by the 37
5997-committee. The eligibility requirements for such 38
5998-examination shall be determined by the state committee for 39
5999-social work; 40
6000- (3) The applicant is at least eighteen years of age, 41
6001-is a United States citizen or has status as a legal resident 42
6002-alien, and has not been finally adjudicated and found 43
6003-guilty, or entered a plea of guilty or nolo contendere, in a 44
6004-criminal prosecution under the laws of any state, of the 45 CCS HCS SS SCS SB 157 189
6005-United States, or of any country, for any offense directly 46
6006-related to the duties and responsibilities of the 47
6007-occupation, as set forth in section 324.01 2, regardless of 48
6008-whether or not sentence is imposed; 49
6009- (4) The applicant has submitted a written application 50
6010-on forms prescribed by the state board; and 51
6011- (5) The applicant has submitted the required licensing 52
6012-fee, as determined by the committee . 53
6013- [2.] 3. Any applicant who answers in the affirmative 54
6014-to any question on the application that relates to possible 55
6015-grounds for denial of licensure pursuant to section 337.630 56
6016-shall submit a sworn affidavit setting forth in detail the 57
6017-facts which explain such answer and copies of appropriate 58
6018-documents related to such answer. 59
6019- [3.] 4. The committee shall issue a license to each 60
6020-person who files an application and fee as required by the 61
6021-provisions of sections 337.600 to 337.689 and who furnis hes 62
6022-evidence satisfactory to the committee that the applicant 63
6023-has complied with the provisions of subsection [1] 2 of this 64
6024-section. 65
6025- [4.] 5. The committee shall issue a certificate to 66
6026-practice independently under subsection 3 of section 337.653 67
6027-to any licensed baccalaureate social worker who has 68
6028-satisfactorily completed three thousand hours of supervised 69
6029-experience with a qualified baccalaureate supervisor in no 70
6030-less than twenty-four months and no more than forty -eight 71
6031-consecutive calendar mon ths. 72
6032- 6. (1) Any person who holds a valid current 73
6033-baccalaureate social work license issued by another state, a 74
6034-branch or unit of the military, a territory of the United 75
6035-States, or the District of Columbia, and who has been 76
6036-licensed for at least o ne year in such other jurisdiction, 77 CCS HCS SS SCS SB 157 190
6037-may submit to the committee an application for a 78
6038-baccalaureate social work license in Missouri along with 79
6039-proof of current licensure and proof of licensure for at 80
6040-least one year in the other jurisdiction. 81
6041- (2) The committee shall: 82
6042- (a) Within six months of receiving an application 83
6043-described in subdivision (1) of this subsection, waive any 84
6044-examination, educational, or experience requirements for 85
6045-licensure in this state for the applicant if it determines 86
6046-that there were minimum education requirements and, if 87
6047-applicable, work experience and clinical supervision 88
6048-requirements in effect and the other jurisdiction verifies 89
6049-that the person met those requirements in order to be 90
6050-licensed or certified in that ju risdiction. The committee 91
6051-may require an applicant to take and pass an examination 92
6052-specific to the laws of this state; or 93
6053- (b) Within thirty days of receiving an application 94
6054-described in subdivision (1) of this subsection from a 95
6055-nonresident military spouse or a resident military spouse, 96
6056-waive any examination, educational, or experience 97
6057-requirements for licensure in this state for the applicant 98
6058-and issue such applicant a license under this subsection if 99
6059-such applicant otherwise meets the requir ements of this 100
6060-subsection. 101
6061- (3) (a) The committee shall not waive any 102
6062-examination, educational, or experience requirements for any 103
6063-applicant who has had his or her license revoked by an 104
6064-oversight body outside the state; who is currently under 105
6065-investigation, who has a complaint pending, or who is 106
6066-currently under disciplinary action, except as provided in 107
6067-paragraph (b) of this subdivision, with an oversight body 108
6068-outside the state; who does not hold a license in good 109 CCS HCS SS SCS SB 157 191
6069-standing with an oversight b ody outside the state; who has a 110
6070-criminal record that would disqualify him or her for 111
6071-licensure in Missouri; or who does not hold a valid current 112
6072-license in the other jurisdiction on the date the committee 113
6073-receives his or her application under this sub section. 114
6074- (b) If another jurisdiction has taken disciplinary 115
6075-action against an applicant, the committee shall determine 116
6076-if the cause for the action was corrected and the matter 117
6077-resolved. If the matter has not been resolved by that 118
6078-jurisdiction, the committee may deny a license until the 119
6079-matter is resolved. 120
6080- (4) Nothing in this subsection shall prohibit the 121
6081-committee from denying a license to an applicant under this 122
6082-subsection for any reason described in section 337.630. 123
6083- (5) Any person who is licensed under the provisions of 124
6084-this subsection shall be subject to the committee's 125
6085-jurisdiction and all rules and regulations pertaining to the 126
6086-practice as a licensed baccalaureate social worker in this 127
6087-state. 128
6088- (6) This subsection shall not be construed to waive 129
6089-any requirement for an applicant to pay any fees. 130
6090- 337.1000. 1. Sections 337.1000 to 337.1075 shall be 1
6091-known and may be cited as the "Social Work Licensure 2
6092-Compact". 3
6093- 2. The purpose of this Compact is to facilitate 4
6094-interstate practice of Regulated Social Workers by improving 5
6095-public access to competent Social Work Services. The 6
6096-Compact preserves the regulatory authority of States to 7
6097-protect public health and safety through the current system 8
6098-of State licensure. 9
6099- 3. This Compact is designed to achieve the following 10
6100-objectives: 11 CCS HCS SS SCS SB 157 192
6101- (1) Increase public access to Social Work Services; 12
6102- (2) Reduce overly burdensome and duplicative 13
6103-requirements associated with holding multiple licenses; 14
6104- (3) Enhance the Member States' ability to protect the 15
6105-public's health and safety; 16
6106- (4) Encourage the cooperation of Member States in 17
6107-regulating multistate practice; 18
6108- (5) Promote mobility and address workforce shortages 19
6109-by eliminating the nec essity for licenses in multiple States 20
6110-by providing for the mutual recognition of other Member 21
6111-State licenses; 22
6112- (6) Support military families; 23
6113- (7) Facilitate the exchange of licensure and 24
6114-disciplinary information among Member States; 25
6115- (8) Authorize all Member States to hold a Regulated 26
6116-Social Worker accountable for abiding by a Member State's 27
6117-laws, regulations, and applicable professional standards in 28
6118-the Member State in which the client is located at the time 29
6119-care is rendered; and 30
6120- (9) Allow for the use of telehealth to facilitate 31
6121-increased access to regulated Social Work Services. 32
6122- 337.1005. As used in this Compact, and except as 1
6123-otherwise provided, the following definitions shall apply: 2
6124- (1) "Active Military Member" means any individual with 3
6125-full-time duty status in the active armed forces of the 4
6126-United States including members of the National Guard and 5
6127-Reserve. 6
6128- (2) "Adverse Action" means any administrative, civil, 7
6129-equitable or criminal action permitted by a State's laws 8
6130-which is imposed by a Licensing Authority or other authority 9
6131-against a Regulated Social Worker, including actions against 10
6132-an individual's license or Multistate Authorization to 11 CCS HCS SS SCS SB 157 193
6133-Practice such as revocation, suspension, proba tion, 12
6134-monitoring of the Licensee, limitation on the Licensee's 13
6135-practice, or any other Encumbrance on licensure affecting a 14
6136-Regulated Social Worker's authorization to practice, 15
6137-including issuance of a cease and desist action. 16
6138- (3) "Alternative Program" means a non-disciplinary 17
6139-monitoring or practice remediation process approved by a 18
6140-Licensing Authority to address practitioners with an 19
6141-Impairment. 20
6142- (4) "Charter Member States" means Member States who 21
6143-have enacted legislation to adopt this Com pact where such 22
6144-legislation predates the effective date of this Compact as 23
6145-described in section 337.1065. 24
6146- (5) "Compact Commission" or "Commission" means the 25
6147-government agency whose membership consists of all States 26
6148-that have enacted this Compact, which is known as the Social 27
6149-Work Licensure Compact Commission, as described in section 28
6150-337.1045, and which shall operate as an instrumentality of 29
6151-the Member States. 30
6152- (6) "Current Significant Investigative Information" 31
6153-means: 32
6154- (a) Investigative information that a Licensing 33
6155-Authority, after a preliminary inquiry that includes 34
6156-notification and an opportunity for the Regulated Social 35
6157-Worker to respond has reason to believe is not groundless 36
6158-and, if proved true, would indicate more than a min or 37
6159-infraction as may be defined by the Commission; or 38
6160- (b) Investigative information that indicates that the 39
6161-Regulated Social Worker represents an immediate threat to 40
6162-public health and safety, as may be defined by the 41
6163-Commission, regardless of whe ther the Regulated Social 42 CCS HCS SS SCS SB 157 194
6164-Worker has been notified and has had an opportunity to 43
6165-respond. 44
6166- (7) "Data System" means a repository of information 45
6167-about Licensees, including, continuing education, 46
6168-examination, licensure, Current Significant Investigat ive 47
6169-Information, Disqualifying Event, Multistate License(s) and 48
6170-Adverse Action information or other information as required 49
6171-by the Commission. 50
6172- (8) "Domicile" means the jurisdiction in which the 51
6173-Licensee resides and intends to remain indefinitely. 52
6174- (9) "Disqualifying Event" means any Adverse Action or 53
6175-incident which results in an Encumbrance that disqualifies 54
6176-or makes the Licensee ineligible to either obtain, retain or 55
6177-renew a Multistate License. 56
6178- (10) "Encumbrance" means a revocation or suspension 57
6179-of, or any limitation on, the full and unrestricted practice 58
6180-of Social Work licensed and regulated by a Licensing 59
6181-Authority. 60
6182- (11) "Executive Committee" means a group of delegates 61
6183-elected or appointed to act on behalf of, and within the 62
6184-powers granted to them by, the compact and Commission. 63
6185- (12) "Home State" means the Member State that is the 64
6186-Licensee's primary Domicile. 65
6187- (13) "Impairment" means a condition(s) that may impair 66
6188-a practitioner's ability to engage in full an d unrestricted 67
6189-practice as a Regulated Social Worker without some type of 68
6190-intervention and may include alcohol and drug dependence, 69
6191-mental health impairment, and neurological or physical 70
6192-impairments. 71
6193- (14) "Licensee(s)" means an individual who cur rently 72
6194-holds a license from a State to practice as a Regulated 73
6195-Social Worker. 74 CCS HCS SS SCS SB 157 195
6196- (15) "Licensing Authority" means the board or agency 75
6197-of a Member State, or equivalent, that is responsible for 76
6198-the licensing and regulation of Regulated Social Workers. 77
6199- (16) "Member State" means a state, commonwealth, 78
6200-district, or territory of the United States of America that 79
6201-has enacted this Compact. 80
6202- (17) "Multistate Authorization to Practice" means a 81
6203-legally authorized privilege to practice, which is 82
6204-equivalent to a license, associated with a Multistate 83
6205-License permitting the practice of Social Work in a Remote 84
6206-State. 85
6207- (18) "Multistate License" means a license to practice 86
6208-as a Regulated Social Worker issued by a Home State 87
6209-Licensing Authority t hat authorizes the Regulated Social 88
6210-Worker to practice in all Member States under Multistate 89
6211-Authorization to Practice. 90
6212- (19) "Qualifying National Exam" means a national 91
6213-licensing examination approved by the Commission. 92
6214- (20) "Regulated Social Worker" means any clinical, 93
6215-master's or bachelor's Social Worker licensed by a Member 94
6216-State regardless of the title used by that Member State. 95
6217- (21) "Remote State" means a Member State other than 96
6218-the Licensee's Home State. 97
6219- (22) "Rule(s)" or "Rule(s) of the Commission" means a 98
6220-regulation or regulations duly promulgated by the 99
6221-Commission, as authorized by the Compact, that has the force 100
6222-of law. 101
6223- (23) "Single State License" means a Social Work 102
6224-license issued by any State that authorizes practice only 103
6225-within the issuing State and does not include Multistate 104
6226-Authorization to Practice in any Member State. 105 CCS HCS SS SCS SB 157 196
6227- (24) "Social Work" or "Social Work Services" means the 106
6228-application of social work theory, knowledge, methods, 107
6229-ethics, and the professional use of self to restore or 108
6230-enhance social, psychosocial, or biopsychosocial functioning 109
6231-of individuals, couples, families, groups, organizations, 110
6232-and communities through the care and services provided by a 111
6233-Regulated Social Worker as set fort h in the Member State's 112
6234-statutes and regulations in the State where the services are 113
6235-being provided. 114
6236- (25) "State" means any state, commonwealth, district, 115
6237-or territory of the United States of America that regulates 116
6238-the practice of Social Work. 117
6239- (26) "Unencumbered License" means a license that 118
6240-authorizes a Regulated Social Worker to engage in the full 119
6241-and unrestricted practice of Social Work. 120
6242- 337.1010. 1. To be eligible to participate in the 1
6243-compact, a potential Member State must currently meet all of 2
6244-the following criteria: 3
6245- (1) License and regulate the practice of Social Work 4
6246-at either the clinical, master's, or bachelor's category. 5
6247- (2) Require applicants for licensure to graduate from 6
6248-a program that is: 7
6249- (a) Operated by a college or university recognized by 8
6250-the Licensing Authority; 9
6251- (b) Accredited, or in candidacy by an institution that 10
6252-subsequently becomes accredited, by an accrediting agency 11
6253-recognized by either: 12
6254- a. the Council for Higher Education Accreditation, or 13
6255-its successor; or 14
6256- b. the United States Department of Education; and 15
6257- (c) Corresponds to the licensure sought as outlined in 16
6258-section 337.1015. 17 CCS HCS SS SCS SB 157 197
6259- (3) Require applicants for clinical licensure to 18
6260-complete a period of supervised practice. 19
6261- (4) Have a mechanism in place for receiving, 20
6262-investigating, and adjudicating complaints about Licensees. 21
6263- 2. To maintain membership in the Compact a Member 22
6264-State shall: 23
6265- (1) Require that applicants for a Mult istate License 24
6266-pass a Qualifying National Exam for the corresponding 25
6267-category of Multistate License sought as outlined in section 26
6268-337.1015; 27
6269- (2) Participate fully in the Commission's Data System, 28
6270-including using the Commission's unique identifier as 29
6271-defined in Rules; 30
6272- (3) Notify the Commission, in compliance with the 31
6273-terms of the Compact and Rules, of any Adverse Action or the 32
6274-availability of Current Significant Investigative 33
6275-Information regarding a Licensee; 34
6276- (4) Implement procedures for considering the criminal 35
6277-history records of applicants for a Multistate License. 36
6278-Such procedures shall include the submission of fingerprints 37
6279-or other biometric-based information by applicants for the 38
6280-purpose of obtaining an applicant's criminal history record 39
6281-information from the Federal Bureau of Investigation and the 40
6282-agency responsible for retaining that State's criminal 41
6283-records; 42
6284- (5) Comply with the Rules of the Commission; 43
6285- (6) Require an applicant to obtain or retain a license 44
6286-in the Home State and meet the Home State's qualifications 45
6287-for licensure or renewal of licensure, as well as all other 46
6288-applicable Home State laws; 47 CCS HCS SS SCS SB 157 198
6289- (7) Authorize a Licensee holding a Multistate License 48
6290-in any Member State to practice in accordance with the terms 49
6291-of the Compact and Rules of the Commission; and 50
6292- (8) Designate a delegate to participate in the 51
6293-Commission meetings. 52
6294- 3. A Member State meeting the requirements of 53
6295-subsections 1 and 2 of this section shall designate the 54
6296-categories of Social Work licensure that are eligible for 55
6297-issuance of a Multistate License for applicants in such 56
6298-Member State. To the extent that any Member State does not 57
6299-meet the requirements for participation in the Compact at 58
6300-any particular category of Social Work licensure, such 59
6301-Member State may choose, but is not obligated to, issue a 60
6302-Multistate License to applicants that otherwise meet the 61
6303-requirements of section 337.1015 for issuance of a 62
6304-Multistate License in such category or categories of 63
6305-licensure. 64
6306- 4. The Home State may charge a fee for granting the 65
6307-Multistate License. 66
6308- 337.1015. 1. To be eligible for a Multistate License 1
6309-under the terms and provisions of the Compact, an applicant, 2
6310-regardless of category must: 3
6311- (1) Hold or be eligible for an active, Unencumbered 4
6312-License in the Home State; 5
6313- (2) Pay any applicable fees, including any State fee, 6
6314-for the Multistate License; 7
6315- (3) Submit, in connection with an application for a 8
6316-Multistate License, finger prints or other biometric data for 9
6317-the purpose of obtaining criminal history record information 10
6318-from the Federal Bureau of Investigation and the agency 11
6319-responsible for retaining that State's criminal records; 12 CCS HCS SS SCS SB 157 199
6320- (4) Notify the Home State of any Adver se Action, 13
6321-Encumbrance, or restriction on any professional license 14
6322-taken by any Member State or non -Member State within 30 days 15
6323-from the date the action is taken; 16
6324- (5) Meet any continuing competence requirements 17
6325-established by the Home State; 18
6326- (6) Abide by the laws, regulations, and applicable 19
6327-standards in the Member State where the client is located at 20
6328-the time care is rendered. 21
6329- 2. An applicant for a clinical -category Multistate 22
6330-License must meet all of the following requirements: 23
6331- (1) Fulfill a competency requirement, which shall be 24
6332-satisfied by either: 25
6333- (a) Passage of a clinical -category Qualifying National 26
6334-Exam; or 27
6335- (b) Licensure of the applicant in their Home State at 28
6336-the clinical category, beginning prior to suc h time as a 29
6337-Qualifying National Exam was required by the Home State and 30
6338-accompanied by a period of continuous Social Work licensure 31
6339-thereafter, all of which may be further governed by the 32
6340-Rules of the Commission; or 33
6341- (c) The substantial equivalenc y of the foregoing 34
6342-competency requirements which the Commission may determine 35
6343-by Rule. 36
6344- (2) Attain at least a master's degree in Social Work 37
6345-from a program that is: 38
6346- (a) Operated by a college or university recognized by 39
6347-the Licensing Authorit y; and 40
6348- (b) Accredited, or in candidacy that subsequently 41
6349-becomes accredited, by an accrediting agency recognized by 42
6350-either: 43 CCS HCS SS SCS SB 157 200
6351- a. the Council for Higher Education Accreditation or 44
6352-its successor; or 45
6353- b. the United States Department of Educa tion. 46
6354- (3) Fulfill a practice requirement, which shall be 47
6355-satisfied by demonstrating completion of either: 48
6356- (a) A period of postgraduate supervised clinical 49
6357-practice equal to a minimum of three thousand hours; or 50
6358- (b) A minimum of two year s of full-time postgraduate 51
6359-supervised clinical practice; or 52
6360- (c) The substantial equivalency of the foregoing 53
6361-practice requirements which the Commission may determine by 54
6362-Rule. 55
6363- 3. An applicant for a master's -category Multistate 56
6364-License must meet all of the following requirements: 57
6365- (1) Fulfill a competency requirement, which shall be 58
6366-satisfied by either: 59
6367- (a) Passage of a masters -category Qualifying National 60
6368-Exam; 61
6369- (b) Licensure of the applicant in their Home State at 62
6370-the master's category, beginning prior to such time as a 63
6371-Qualifying National Exam was required by the Home State at 64
6372-the master's category and accompanied by a continuous period 65
6373-of Social Work licensure thereafter, all of which may be 66
6374-further governed by the R ules of the Commission; or 67
6375- (c) The substantial equivalency of the foregoing 68
6376-competency requirements which the Commission may determine 69
6377-by Rule. 70
6378- (2) Attain at least a master's degree in Social Work 71
6379-from a program that is: 72
6380- (a) Operated by a college or university recognized by 73
6381-the Licensing Authority; and 74 CCS HCS SS SCS SB 157 201
6382- (b) Accredited, or in candidacy that subsequently 75
6383-becomes accredited, by an accrediting agency recognized by 76
6384-either: 77
6385- a. the Council for Higher Education Accreditation or 78
6386-its successor; or 79
6387- b. the United States Department of Education. 80
6388- 4. An applicant for a bachelor's -category Multistate 81
6389-License must meet all of the following requirements: 82
6390- (1) Fulfill a competency requirement, which shall be 83
6391-satisfied by either: 84
6392- (a) Passage of a bachelor's -category Qualifying 85
6393-National Exam; 86
6394- (b) Licensure of the applicant in their Home State at 87
6395-the bachelor's category, beginning prior to such time as a 88
6396-Qualifying National Exam was required by the Home State an d 89
6397-accompanied by a period of continuous Social Work licensure 90
6398-thereafter, all of which may be further governed by the 91
6399-Rules of the Commission; or 92
6400- (c) The substantial equivalency of the foregoing 93
6401-competency requirements which the Commission may de termine 94
6402-by Rule. 95
6403- (2) Attain at least a bachelor's degree in Social Work 96
6404-from a program that is: 97
6405- (a) Operated by a college or university recognized by 98
6406-the Licensing Authority; and 99
6407- (b) Accredited, or in candidacy that subsequently 100
6408-becomes accredited, by an accrediting agency recognized by 101
6409-either: 102
6410- a. the Council for Higher Education Accreditation or 103
6411-its successor; or 104
6412- b. the United States Department of Education. 105 CCS HCS SS SCS SB 157 202
6413- 5. The Multistate License for a Regulated Social 106
6414-Worker is subject to the renewal requirements of the Home 107
6415-State. The Regulated Social Worker must maintain compliance 108
6416-with the requirements of subsection 1 of this section to be 109
6417-eligible to renew a Multistate License. 110
6418- 6. The Regulated Social Worker's se rvices in a Remote 111
6419-State are subject to that Member State's regulatory 112
6420-authority. A Remote State may, in accordance with due 113
6421-process and that Member State's laws, remove a Regulated 114
6422-Social Worker's Multistate Authorization to Practice in the 115
6423-Remote State for a specific period of time, impose fines, 116
6424-and take any other necessary actions to protect the health 117
6425-and safety of its citizens. 118
6426- 7. If a Multistate License is encumbered, the 119
6427-Regulated Social Worker's Multistate Authorization to 120
6428-Practice shall be deactivated in all Remote States until the 121
6429-Multistate License is no longer encumbered. 122
6430- 8. If a Multistate Authorization to Practice is 123
6431-encumbered in a Remote State, the regulated Social Worker's 124
6432-Multistate Authorization to Practice may be deactivated in 125
6433-that State until the Multistate Authorization to Practice is 126
6434-no longer encumbered. 127
6435- 337.1020. 1. Upon receipt of an application for a 1
6436-Multistate License, the Home State Licensing Authority shall 2
6437-determine the applica nt's eligibility for a Multistate 3
6438-License in accordance with section 337.1015 of this Compact. 4
6439- 2. If such applicant is eligible pursuant to section 5
6440-337.1015 of this Compact, the Home State Licensing Authority 6
6441-shall issue a Multistate License that authorizes the 7
6442-applicant or Regulated Social Worker to practice in all 8
6443-Member States under a Multistate Authorization to Practice. 9 CCS HCS SS SCS SB 157 203
6444- 3. Upon issuance of a Multistate License, the Home 10
6445-State Licensing Authority shall designate whether the 11
6446-Regulated Social Worker holds a Multistate License in the 12
6447-Bachelors, Masters, or Clinical category of Social Work. 13
6448- 4. A Multistate License issued by a Home State to a 14
6449-resident in that State shall be recognized by all Compact 15
6450-Member States as authorizing Soc ial Work Practice under a 16
6451-Multistate Authorization to Practice corresponding to each 17
6452-category of licensure regulated in each Member State. 18
6453- 337.1025. 1. Nothing in this Compact, nor any Rule of 1
6454-the Commission, shall be construed to l imit, restrict, or in 2
6455-any way reduce the ability of a Member State to enact and 3
6456-enforce laws, regulations, or other rules related to the 4
6457-practice of Social Work in that State, where those laws, 5
6458-regulations, or other rules are not inconsistent with the 6
6459-provisions of this Compact. 7
6460- 2. Nothing in this Compact shall affect the 8
6461-requirements established by a Member State for the issuance 9
6462-of a Single State License. 10
6463- 3. Nothing in this Compact, nor any Rule of the 11
6464-Commission, shall be construed to limit, restrict, or in any 12
6465-way reduce the ability of a Member State to take Adverse 13
6466-Action against a Licensee's Single State License to practice 14
6467-Social Work in that State. 15
6468- 4. Nothing in this Compact, nor any Rule of the 16
6469-Commission, shall be cons trued to limit, restrict, or in any 17
6470-way reduce the ability of a Remote State to take Adverse 18
6471-Action against a Licensee's Multistate Authorization to 19
6472-Practice in that State. 20
6473- 5. Nothing in this Compact, nor any Rule of the 21
6474-Commission, shall be cons trued to limit, restrict, or in any 22
6475-way reduce the ability of a Licensee's Home State to take 23 CCS HCS SS SCS SB 157 204
6476-Adverse Action against a Licensee's Multistate License based 24
6477-upon information provided by a Remote State. 25
6478- 337.1030. 1. A Licensee can hold a Multistate 1
6479-License, issued by their Home State, in only one Member 2
6480-State at any given time. 3
6481- 2. If a Licensee changes their Home State by moving 4
6482-between two Member States: 5
6483- (1) The Licensee shall immediately apply for the 6
6484-reissuance of their Multistate License in their new Home 7
6485-State. The Licensee shall pay all applicable fees and 8
6486-notify the prior Home State in accordance with the Rules of 9
6487-the Commission. 10
6488- (2) Upon receipt of an application to reissue a 11
6489-Multistate License, the new Home State shall verify that the 12
6490-Multistate License is active, unencumbered and eligible for 13
6491-reissuance under the terms of the Compact and the Rules of 14
6492-the Commission. The Multistate License issued by the prior 15
6493-Home State will be deactivated and all Member States 16
6494-notified in accordance with the applicable Rules adopted by 17
6495-the Commission. 18
6496- (3) Prior to the reissuance of the Multistate License, 19
6497-the new Home State shall conduct procedures for considering 20
6498-the criminal history records of the Licen see. Such 21
6499-procedures shall include the submission of fingerprints or 22
6500-other biometric-based information by applicants for the 23
6501-purpose of obtaining an applicant's criminal history record 24
6502-information from the Federal Bureau of Investigation and the 25
6503-agency responsible for retaining that State's criminal 26
6504-records. 27
6505- (4) If required for initial licensure, the new Home 28
6506-State may require completion of jurisprudence requirements 29
6507-in the new Home State. 30 CCS HCS SS SCS SB 157 205
6508- (5) Notwithstanding any other provision of this 31
6509-Compact, if a Licensee does not meet the requirements set 32
6510-forth in this Compact for the reissuance of a Multistate 33
6511-License by the new Home State, then the Licensee shall be 34
6512-subject to the new Home State requirements for the issuance 35
6513-of a Single State License in that State. 36
6514- 3. If a Licensee changes their primary State of 37
6515-residence by moving from a Member State to a non -Member 38
6516-State, or from a non -Member State to a Member State, then 39
6517-the Licensee shall be subject to the State requirements for 40
6518-the issuance of a Single State License in the new Home State. 41
6519- 4. Nothing in this Compact shall interfere with a 42
6520-Licensee's ability to hold a Single State License in 43
6521-multiple States; however, for the purposes of this Compact, 44
6522-a Licensee shall have only one Home State, and only one 45
6523-Multistate License. 46
6524- 5. Nothing in this Compact shall interfere with the 47
6525-requirements established by a Member State for the issuance 48
6526-of a Single State License. 49
6527- 337.1035. An Active Military Membe r or their spouse 1
6528-shall designate a Home State where the individual has a 2
6529-Multistate License. The individual may retain their Home 3
6530-State designation during the period the service member is on 4
6531-active duty. 5
6532- 337.1040. 1. In addition to the other powers 1
6533-conferred by State law, a Remote State shall have the 2
6534-authority, in accordance with existing State due process 3
6535-law, to: 4
6536- (1) Take Adverse Action against a Regulated Social 5
6537-Worker's Multistate Authorization to Practice only with in 6
6538-that Member State, and issue subpoenas for both hearings and 7
6539-investigations that require the attendance and testimony of 8 CCS HCS SS SCS SB 157 206
6540-witnesses as well as the production of evidence. Subpoenas 9
6541-issued by a Licensing Authority in a Member State for the 10
6542-attendance and testimony of witnesses or the production of 11
6543-evidence from another Member State shall be enforced in the 12
6544-latter State by any court of competent jurisdiction, 13
6545-according to the practice and procedure of that court 14
6546-applicable to subpoenas issued in p roceedings pending before 15
6547-it. The issuing Licensing Authority shall pay any witness 16
6548-fees, travel expenses, mileage, and other fees required by 17
6549-the service statutes of the State in which the witnesses or 18
6550-evidence are located. 19
6551- (2) Only the Home State shall have the power to take 20
6552-Adverse Action against a Regulated Social Worker's 21
6553-Multistate License. 22
6554- 2. For purposes of taking Adverse Action, the Home 23
6555-State shall give the same priority and effect to reported 24
6556-conduct received from a Member St ate as it would if the 25
6557-conduct had occurred within the Home State. In so doing, 26
6558-the Home State shall apply its own State laws to determine 27
6559-appropriate action. 28
6560- 3. The Home State shall complete any pending 29
6561-investigations of a Regulated Social Work er who changes 30
6562-their Home State during the course of the investigations. 31
6563-The Home State shall also have the authority to take 32
6564-appropriate action(s) and shall promptly report the 33
6565-conclusions of the investigations to the administrator of 34
6566-the Data System. The administrator of the Data System shall 35
6567-promptly notify the new Home State of any Adverse Actions. 36
6568- 4. A Member State, if otherwise permitted by State 37
6569-law, may recover from the affected Regulated Social Worker 38
6570-the costs of investigations and dispositions of cases 39 CCS HCS SS SCS SB 157 207
6571-resulting from any Adverse Action taken against that 40
6572-Regulated Social Worker. 41
6573- 5. A Member State may take Adverse Action based on the 42
6574-factual findings of another Member State, provided that the 43
6575-Member State follows its own p rocedures for taking the 44
6576-Adverse Action. 45
6577- 6. (1) In addition to the authority granted to a 46
6578-Member State by its respective Social Work practice act or 47
6579-other applicable State law, any Member State may participate 48
6580-with other Member States in joint i nvestigations of 49
6581-Licensees. 50
6582- (2) Member States shall share any investigative, 51
6583-litigation, or compliance materials in furtherance of any 52
6584-joint or individual investigation initiated under the 53
6585-Compact. 54
6586- 7. If Adverse Action is taken by the Home State 55
6587-against the Multistate License of a Regulated Social Worker, 56
6588-the Regulated Social Worker's Multistate Authorization to 57
6589-Practice in all other Member States shall be deactivated 58
6590-until all Encumbrances have been removed from the Multistate 59
6591-License. All Home State disciplinary orders that impose 60
6592-Adverse Action against the license of a Regulated Social 61
6593-Worker shall include a statement that the Regulated Social 62
6594-Worker's Multistate Authorization to Practice is deactivated 63
6595-in all Member States until all conditions of the decision, 64
6596-order or agreement are satisfied. 65
6597- 8. If a Member State takes Adverse Action, it shall 66
6598-promptly notify the administrator of the Data System. The 67
6599-administrator of the Data System shall promptly notify the 68
6600-Home State and all other Member States of any Adverse 69
6601-Actions by Remote States. 70 CCS HCS SS SCS SB 157 208
6602- 9. Nothing in this Compact shall override a Member 71
6603-State's decision that participation in an Alternative 72
6604-Program may be used in lieu of Adverse Action. 73
6605- 10. Nothing in this Compact shall authorize a Member 74
6606-State to demand the issuance of subpoenas for attendance and 75
6607-testimony of witnesses or the production of evidence from 76
6608-another Member State for lawful actions within that Member 77
6609-State. 78
6610- 11. Nothing in this Compac t shall authorize a Member 79
6611-State to impose discipline against a Regulated Social Worker 80
6612-who holds a Multistate Authorization to Practice for lawful 81
6613-actions within another Member State. 82
6614- 337.1045. 1. The Compact Member States hereby c reate 1
6615-and establish a joint government agency whose membership 2
6616-consists of all Member States that have enacted the compact 3
6617-known as the Social Work Licensure Compact Commission. The 4
6618-Commission is an instrumentality of the Compact States 5
6619-acting jointly and not an instrumentality of any one State. 6
6620-The Commission shall come into existence on or after the 7
6621-effective date of the Compact as set forth in section 8
6622-337.1065. 9
6623- 2. (1) Each Member State shall have and be limited to 10
6624-one (1) delegate selec ted by that Member State's State 11
6625-Licensing Authority. 12
6626- (2) The delegate shall be either: 13
6627- (a) A current member of the State Licensing Authority 14
6628-at the time of appointment, who is a Regulated Social Worker 15
6629-or public member of the State Licensin g Authority; or 16
6630- (b) An administrator of the State Licensing Authority 17
6631-or their designee. 18 CCS HCS SS SCS SB 157 209
6632- (3) The Commission shall by Rule or bylaw establish a 19
6633-term of office for delegates and may by Rule or bylaw 20
6634-establish term limits. 21
6635- (4) The Commission may recommend removal or suspension 22
6636-of any delegate from office. 23
6637- (5) A Member State's State Licensing Authority shall 24
6638-fill any vacancy of its delegate occurring on the Commission 25
6639-within 60 days of the vacancy. 26
6640- (6) Each delegate shall be entitled to one vote on all 27
6641-matters before the Commission requiring a vote by Commission 28
6642-delegates. 29
6643- (7) A delegate shall vote in person or by such other 30
6644-means as provided in the bylaws. The bylaws may provide for 31
6645-delegates to meet by telecommuni cation, videoconference, or 32
6646-other means of communication. 33
6647- (8) The Commission shall meet at least once during 34
6648-each calendar year. Additional meetings may be held as set 35
6649-forth in the bylaws. The Commission may meet by 36
6650-telecommunication, video con ference or other similar 37
6651-electronic means. 38
6652- 3. The Commission shall have the following powers: 39
6653- (1) Establish the fiscal year of the Commission; 40
6654- (2) Establish code of conduct and conflict of interest 41
6655-policies; 42
6656- (3) Establish and amend Rules and bylaws; 43
6657- (4) Maintain its financial records in accordance with 44
6658-the bylaws; 45
6659- (5) Meet and take such actions as are consistent with 46
6660-the provisions of this Compact, the Commission's Rules, and 47
6661-the bylaws; 48
6662- (6) Initiate and conclude legal proceedings or actions 49
6663-in the name of the Commission, provided that the standing of 50 CCS HCS SS SCS SB 157 210
6664-any State Licensing Board to sue or be sued under applicable 51
6665-law shall not be affected; 52
6666- (7) Maintain and certify records and information 53
6667-provided to a Member State as the authenticated business 54
6668-records of the Commission, and designate an agent to do so 55
6669-on the Commission's behalf; 56
6670- (8) Purchase and maintain insurance and bonds; 57
6671- (9) Borrow, accept, or contract for services of 58
6672-personnel, including, but not limited to, employees of a 59
6673-Member State; 60
6674- (10) Conduct an annual financial review; 61
6675- (11) Hire employees, elect or appoint officers, fix 62
6676-compensation, define duties, grant such individuals 63
6677-appropriate authority to carry out the purp oses of the 64
6678-Compact, and establish the Commission's personnel policies 65
6679-and programs relating to conflicts of interest, 66
6680-qualifications of personnel, and other related personnel 67
6681-matters; 68
6682- (12) Assess and collect fees; 69
6683- (13) Accept any and all a ppropriate gifts, donations, 70
6684-grants of money, other sources of revenue, equipment, 71
6685-supplies, materials, and services, and receive, utilize, and 72
6686-dispose of the same; provided that at all times the 73
6687-Commission shall avoid any appearance of impropriety or 74
6688-conflict of interest; 75
6689- (14) Lease, purchase, retain, own, hold, improve, or 76
6690-use any property, real, personal, or mixed, or any undivided 77
6691-interest therein; 78
6692- (15) Sell, convey, mortgage, pledge, lease, exchange, 79
6693-abandon, or otherwise dispose of any property real, 80
6694-personal, or mixed; 81
6695- (16) Establish a budget and make expenditures; 82 CCS HCS SS SCS SB 157 211
6696- (17) Borrow money; 83
6697- (18) Appoint committees, including standing 84
6698-committees, composed of members, State regulators, State 85
6699-legislators or their represe ntatives, and consumer 86
6700-representatives, and such other interested persons as may be 87
6701-designated in this Compact and the bylaws; 88
6702- (19) Provide and receive information from, and 89
6703-cooperate with, law enforcement agencies; 90
6704- (20) Establish and elect an Executive Committee, 91
6705-including a chair and a vice chair; 92
6706- (21) Determine whether a State's adopted language is 93
6707-materially different from the model compact language such 94
6708-that the State would not qualify for participation in the 95
6709-Compact; and 96
6710- (22) Perform such other functions as may be necessary 97
6711-or appropriate to achieve the purposes of this Compact. 98
6712- 4. (1) The Executive Committee shall have the power 99
6713-to act on behalf of the Commission according to the terms of 100
6714-this Compact. The powers, duties, and responsibilities of 101
6715-the Executive Committee shall include: 102
6716- (a) Oversee the day-to-day activities of the 103
6717-administration of the compact including enforcement and 104
6718-compliance with the provisions of the compact, its Rules and 105
6719-bylaws, and other such duties as deemed necessary; 106
6720- (b) Recommend to the Commission changes to the Rules 107
6721-or bylaws, changes to this Compact legislation, fees charged 108
6722-to Compact Member States, fees charged to Licensees, and 109
6723-other fees; 110
6724- (c) Ensure Compact administration services are 111
6725-appropriately provided, including by contract; 112
6726- (d) Prepare and recommend the budget; 113 CCS HCS SS SCS SB 157 212
6727- (e) Maintain financial records on behalf of the 114
6728-Commission; 115
6729- (f) Monitor Compact compliance of Member States and 116
6730-provide compliance reports to the Commission; 117
6731- (g) Establish additional committees as necessary; 118
6732- (h) Exercise the powers and duties of the Commission 119
6733-during the interim between Commission meetings, except for 120
6734-adopting or amending Rules, adopting or amending bylaws, and 121
6735-exercising any other powers and duties expressly reserved to 122
6736-the Commission by Rule or bylaw; and 123
6737- (i) Other duties as provided in the Rules or bylaws of 124
6738-the Commission. 125
6739- (2) The Executive Committee shall be composed of u p to 126
6740-eleven (11) members: 127
6741- (a) The chair and vice chair of the Commission shall 128
6742-be voting members of the Executive Committee; and 129
6743- (b) The Commission shall elect five voting members 130
6744-from the current membership of the Commission. 131
6745- (c) Up to four (4) ex-officio, nonvoting members from 132
6746-four (4) recognized national Social Work organizations. 133
6747- (d) The ex-officio members will be selected by their 134
6748-respective organizations. 135
6749- (3) The Commission may remove any member of the 136
6750-Executive Committee as provided in the Commission's bylaws. 137
6751- (4) The Executive Committee shall meet at least 138
6752-annually. 139
6753- (a) Executive Committee meetings shall be open to the 140
6754-public, except that the Executive Committee may meet in a 141
6755-closed, non-public meeting as provided in subdivision (2) of 142
6756-subsection 6 of this section. 143
6757- (b) The Executive Committee shall give seven (7) days' 144
6758-notice of its meetings, posted on its website and as 145 CCS HCS SS SCS SB 157 213
6759-determined to provide notice to persons with an interest in 146
6760-the business of the Commission. 147
6761- (c) The Executive Committee may hold a special meeting 148
6762-in accordance with paragraph (b) of subdivision (1) of 149
6763-subsection 6 of this section. 150
6764- 5. The Commission shall adopt and provide to the 151
6765-Member States an annual report . 152
6766- 6. (1) All meetings shall be open to the public, 153
6767-except that the Commission may meet in a closed, non -public 154
6768-meeting as provided in subdivision (2) of this subsection. 155
6769- (a) Public notice for all meetings of the full 156
6770-Commission of meetings shall be given in the same manner as 157
6771-required under the Rulemaking provisions in section 158
6772-337.1055, except that the Commission may hold a special 159
6773-meeting as provided in paragraph (b) of this subdivision. 160
6774- (b) The Commission may hold a special meetin g when it 161
6775-must meet to conduct emergency business by giving 48 hours' 162
6776-notice to all commissioners, on the Commission's website, 163
6777-and other means as provided in the Commission's Rules. The 164
6778-Commission's legal counsel shall certify that the 165
6779-Commission's need to meet qualifies as an emergency. 166
6780- (2) The Commission or the Executive Committee or other 167
6781-committees of the Commission may convene in a closed, non - 168
6782-public meeting for the Commission or Executive Committee or 169
6783-other committees of the Commission to receive legal advice 170
6784-or to discuss: 171
6785- (a) Non-compliance of a Member State with its 172
6786-obligations under the Compact; 173
6787- (b) The employment, compensation, discipline or other 174
6788-matters, practices or procedures related to specific 175
6789-employees; 176 CCS HCS SS SCS SB 157 214
6790- (c) Current or threatened discipline of a Licensee by 177
6791-the Commission or by a Member State's Licensing Authority; 178
6792- (d) Current, threatened, or reasonably anticipated 179
6793-litigation; 180
6794- (e) Negotiation of contracts for the purchase, lease, 181
6795-or sale of goods, services, or real estate; 182
6796- (f) Accusing any person of a crime or formally 183
6797-censuring any person; 184
6798- (g) Trade secrets or commercial or financial 185
6799-information that is privileged or confidential; 186
6800- (h) Information of a personal nature whe re disclosure 187
6801-would constitute a clearly unwarranted invasion of personal 188
6802-privacy; 189
6803- (i) Investigative records compiled for law enforcement 190
6804-purposes; 191
6805- (j) Information related to any investigative reports 192
6806-prepared by or on behalf of or for use of the Commission or 193
6807-other committee charged with responsibility of investigation 194
6808-or determination of compliance issues pursuant to the 195
6809-Compact; 196
6810- (k) Matters specifically exempted from disclosure by 197
6811-federal or Member State law; or 198
6812- (l) Other matters as promulgated by the Commission by 199
6813-Rule. 200
6814- (3) If a meeting, or portion of a meeting, is closed, 201
6815-the presiding officer shall state that the meeting will be 202
6816-closed and reference each relevant exempting provision, and 203
6817-such reference shall be recorded in the minutes. 204
6818- (4) The Commission shall keep minutes that fully and 205
6819-clearly describe all matters discussed in a meeting and 206
6820-shall provide a full and accurate summary of actions taken, 207
6821-and the reasons therefor, including a description of the 208 CCS HCS SS SCS SB 157 215
6822-views expressed. All documents considered in connection 209
6823-with an action shall be identified in such minutes. All 210
6824-minutes and documents of a closed meeting shall remain under 211
6825-seal, subject to release only by a majority vote of the 212
6826-Commission or order of a court of competent jurisdiction. 213
6827- 7. (1) The Commission shall pay, or provide for the 214
6828-payment of, the reasonable expenses of its establishment, 215
6829-organization, and ongoing activities. 216
6830- (2) The Commission may accept any and all appropri ate 217
6831-revenue sources as provided in subdivision (13) of 218
6832-subsection 3 of this section. 219
6833- (3) The Commission may levy on and collect an annual 220
6834-assessment from each Member State and impose fees on 221
6835-Licensees of Member States to whom it grants a Multista te 222
6836-License to cover the cost of the operations and activities 223
6837-of the Commission and its staff, which must be in a total 224
6838-amount sufficient to cover its annual budget as approved 225
6839-each year for which revenue is not provided by other 226
6840-sources. The aggregate annual assessment amount for Member 227
6841-States shall be allocated based upon a formula that the 228
6842-Commission shall promulgate by Rule. 229
6843- (4) The Commission shall not incur obligations of any 230
6844-kind prior to securing the funds adequate to meet the same; 231
6845-nor shall the Commission pledge the credit of any of the 232
6846-Member States, except by and with the authority of the 233
6847-Member State. 234
6848- (5) The Commission shall keep accurate accounts of all 235
6849-receipts and disbursements. The receipts and disbursements 236
6850-of the Commission shall be subject to the financial review 237
6851-and accounting procedures established under its bylaws. 238
6852-However, all receipts and disbursements of funds handled by 239
6853-the Commission shall be subject to an annual financial 240 CCS HCS SS SCS SB 157 216
6854-review by a certified or l icensed public accountant, and the 241
6855-report of the financial review shall be included in and 242
6856-become part of the annual report of the Commission. 243
6857- 8. (1) The members, officers, executive director, 244
6858-employees and representatives of the Commission shall be 245
6859-immune from suit and liability, both personally and in their 246
6860-official capacity, for any claim for damage to or loss of 247
6861-property or personal injury or other civil liability caused 248
6862-by or arising out of any actual or alleged act, error, or 249
6863-omission that occurred, or that the person against whom the 250
6864-claim is made had a reasonable basis for believing occurred 251
6865-within the scope of Commission employment, duties or 252
6866-responsibilities; provided that nothing in this subdivision 253
6867-shall be construed to protect any such person from suit or 254
6868-liability for any damage, loss, injury, or liability caused 255
6869-by the intentional or willful or wanton misconduct of that 256
6870-person. The procurement of insurance of any type by the 257
6871-Commission shall not in any way compromise or limit the 258
6872-immunity granted hereunder. 259
6873- (2) The Commission shall defend any member, officer, 260
6874-executive director, employee, and representative of the 261
6875-Commission in any civil action seeking to impose liability 262
6876-arising out of any actual or alleged act , error, or omission 263
6877-that occurred within the scope of Commission employment, 264
6878-duties, or responsibilities, or as determined by the 265
6879-Commission that the person against whom the claim is made 266
6880-had a reasonable basis for believing occurred within the 267
6881-scope of Commission employment, duties, or responsibilities; 268
6882-provided that nothing herein shall be construed to prohibit 269
6883-that person from retaining their own counsel at their own 270
6884-expense; and provided further, that the actual or alleged 271 CCS HCS SS SCS SB 157 217
6885-act, error, or omiss ion did not result from that person's 272
6886-intentional or willful or wanton misconduct. 273
6887- (3) The Commission shall indemnify and hold harmless 274
6888-any member, officer, executive director, employee, and 275
6889-representative of the Commission for the amount of any 276
6890-settlement or judgment obtained against that person arising 277
6891-out of any actual or alleged act, error, or omission that 278
6892-occurred within the scope of Commission employment, duties, 279
6893-or responsibilities, or that such person had a reasonable 280
6894-basis for believing occurred within the scope of Commission 281
6895-employment, duties, or responsibilities, provided that the 282
6896-actual or alleged act, error, or omission did not result 283
6897-from the intentional or willful or wanton misconduct of that 284
6898-person. 285
6899- (4) Nothing herein shall be construed as a limitation 286
6900-on the liability of any Licensee for professional 287
6901-malpractice or misconduct, which shall be governed solely by 288
6902-any other applicable State laws. 289
6903- (5) Nothing in this Compact shall be interpreted to 290
6904-waive or otherwise abrogate a Member State's state action 291
6905-immunity or state action affirmative defense with respect to 292
6906-antitrust claims under the Sherman Act, Clayton Act, or any 293
6907-other State or federal antitrust or anticompetitive law or 294
6908-regulation. 295
6909- (6) Nothing in this Compact shall be construed to be a 296
6910-waiver of sovereign immunity by the Member States or by the 297
6911-Commission. 298
6912- 337.1050. 1. The Commission shall provide for the 1
6913-development, maintenance, operation, and utilization of a 2
6914-coordinated Data System. 3 CCS HCS SS SCS SB 157 218
6915- 2. The Commission shall assign each applicant for a 4
6916-Multistate License a unique identifier, as determined by the 5
6917-Rules of the Commission. 6
6918- 3. Notwithstanding any other provision of State law to 7
6919-the contrary, a Member State shall submit a uniform data set 8
6920-to the Data System on all individuals to whom this Compact 9
6921-is applicable as required by the Rules of the Commission, 10
6922-including: 11
6923- (1) Identifying information; 12
6924- (2) Licensure data; 13
6925- (3) Adverse Actions again st a license and information 14
6926-related thereto; 15
6927- (4) Non-confidential information related to 16
6928-Alternative Program participation, the beginning and ending 17
6929-dates of such participation, and other information related 18
6930-to such participation not made confid ential under Member 19
6931-State law; 20
6932- (5) Any denial of application for licensure, and the 21
6933-reason or reasons for such denial; 22
6934- (6) The presence of Current Significant Investigative 23
6935-Information; and 24
6936- (7) Other information that may facilitate the 25
6937-administration of this Compact or the protection of the 26
6938-public, as determined by the Rules of the Commission. 27
6939- 4. The records and information provided to a Member 28
6940-State pursuant to this Compact or through the Data System, 29
6941-when certified by the Co mmission or an agent thereof, shall 30
6942-constitute the authenticated business records of the 31
6943-Commission, and shall be entitled to any associated hearsay 32
6944-exception in any relevant judicial, quasi -judicial or 33
6945-administrative proceedings in a Member State. 34 CCS HCS SS SCS SB 157 219
6946- 5. (1) Current Significant Investigative Information 35
6947-pertaining to a Licensee in any Member State will only be 36
6948-available to other Member States. 37
6949- (2) It is the responsibility of the Member States to 38
6950-report any Adverse Action against a Licensee and to monitor 39
6951-the database to determine whether Adverse Action has been 40
6952-taken against a Licensee. Adverse Action information 41
6953-pertaining to a Licensee in any Member State will be 42
6954-available to any other Member State. 43
6955- 6. Member States contributing information to the Data 44
6956-System may designate information that may not be shared with 45
6957-the public without the express permission of the 46
6958-contributing State. 47
6959- 7. Any information submitted to the Data System that 48
6960-is subsequently expunged pursuant to f ederal law or the laws 49
6961-of the Member State contributing the information shall be 50
6962-removed from the Data System. 51
6963- 337.1055. 1. The Commission shall promulgate 1
6964-reasonable Rules in order to effectively and efficiently 2
6965-implement and administer the purposes and provisions of the 3
6966-Compact. A Rule shall be invalid and have no force or 4
6967-effect only if a court of competent jurisdiction holds that 5
6968-the Rule is invalid because the Commission exercised its 6
6969-rulemaking authority in a manner that is beyond the scope 7
6970-and purposes of the Compact, or the powers granted 8
6971-hereunder, or based upon another applicable standard of 9
6972-review. 10
6973- 2. The Rules of the Commission shall have the force of 11
6974-law in each Member State, provided however that where th e 12
6975-Rules of the Commission conflict with the laws of the Member 13
6976-State that establish the Member State's laws, regulations, 14
6977-and applicable standards that govern the practice of Social 15 CCS HCS SS SCS SB 157 220
6978-Work as held by a court of competent jurisdiction, the Rules 16
6979-of the Commission shall be ineffective in that State to the 17
6980-extent of the conflict. 18
6981- 3. The Commission shall exercise its Rulemaking powers 19
6982-pursuant to the criteria set forth in this Section and the 20
6983-Rules adopted thereunder. Rules shall become binding on the 21
6984-day following adoption or the date specified in the rule or 22
6985-amendment, whichever is later. 23
6986- 4. If a majority of the legislatures of the Member 24
6987-States rejects a Rule or portion of a Rule, by enactment of 25
6988-a statute or resolution in the same mann er used to adopt the 26
6989-Compact within four (4) years of the date of adoption of the 27
6990-Rule, then such Rule shall have no further force and effect 28
6991-in any Member State. 29
6992- 5. Rules shall be adopted at a regular or special 30
6993-meeting of the Commission. 31
6994- 6. Prior to adoption of a proposed Rule, the 32
6995-Commission shall hold a public hearing and allow persons to 33
6996-provide oral and written comments, data, facts, opinions, 34
6997-and arguments. 35
6998- 7. Prior to adoption of a proposed Rule by the 36
6999-Commission, and at le ast thirty (30) days in advance of the 37
7000-meeting at which the Commission will hold a public hearing 38
7001-on the proposed Rule, the Commission shall provide a Notice 39
7002-of Proposed Rulemaking: 40
7003- (1) On the website of the Commission or other publicly 41
7004-accessible platform; 42
7005- (2) To persons who have requested notice of the 43
7006-Commission's notices of proposed rulemaking; and 44
7007- (3) In such other way(s) as the Commission may by Rule 45
7008-specify. 46
7009- 8. The Notice of Proposed Rulemaking shall include: 47 CCS HCS SS SCS SB 157 221
7010- (1) The time, date, and location of the public hearing 48
7011-at which the Commission will hear public comments on the 49
7012-proposed Rule and, if different, the time, date, and 50
7013-location of the meeting where the Commission will consider 51
7014-and vote on the proposed Rule; 52
7015- (2) If the hearing is held via telecommunication, 53
7016-video conference, or other electronic means, the Commission 54
7017-shall include the mechanism for access to the hearing in the 55
7018-Notice of Proposed Rulemaking; 56
7019- (3) The text of the proposed Rule and the reason 57
7020-therefor; 58
7021- (4) A request for comments on the proposed Rule from 59
7022-any interested person; and 60
7023- (5) The manner in which interested persons may submit 61
7024-written comments. 62
7025- 9. All hearings will be recorded. A copy of the 63
7026-recording and all written comments and documents received by 64
7027-the Commission in response to the proposed Rule shall be 65
7028-available to the public. 66
7029- 10. Nothing in this section shall be construed as 67
7030-requiring a separate hearing on each Rule. Rules may be 68
7031-grouped for the convenience of the Commission at hearings 69
7032-required by this section. 70
7033- 11. The Commission shall, by majority vote of all 71
7034-members, take final action on the proposed Rule based on the 72
7035-Rulemaking record and the full text of the Rule. 73
7036- (1) The Commission may adopt changes to the proposed 74
7037-Rule provided the changes do not enlarge the original 75
7038-purpose of the proposed Rule. 76
7039- (2) The Commission shall provide an explanation of the 77
7040-reasons for substantive changes made to the proposed Rule as 78 CCS HCS SS SCS SB 157 222
7041-well as reasons for substantive changes not made that were 79
7042-recommended by commenters. 80
7043- (3) The Commission shall determine a reasonable 81
7044-effective date for the Rule. Except for an emergency as 82
7045-provided in subsection 12 of this section, the effective 83
7046-date of the rule shall be no sooner than 30 days after 84
7047-issuing the notice that it adopted or amended the Rule. 85
7048- 12. Upon determination that an emergency exists, the 86
7049-Commission may consider and adopt an emergency Rule with 48 87
7050-hours' notice, with op portunity to comment, provided that 88
7051-the usual Rulemaking procedures provided in the Compact and 89
7052-in this section shall be retroactively applied to the Rule 90
7053-as soon as reasonably possible, in no event later than 91
7054-ninety (90) days after the effective date of the Rule. For 92
7055-the purposes of this provision, an emergency Rule is one 93
7056-that must be adopted immediately in order to: 94
7057- (1) Meet an imminent threat to public health, safety, 95
7058-or welfare; 96
7059- (2) Prevent a loss of Commission or Member State funds ; 97
7060- (3) Meet a deadline for the promulgation of a Rule 98
7061-that is established by federal law or rule; or 99
7062- (4) Protect public health and safety. 100
7063- 13. The Commission or an authorized committee of the 101
7064-Commission may direct revisions to a previous ly adopted Rule 102
7065-for purposes of correcting typographical errors, errors in 103
7066-format, errors in consistency, or grammatical errors. 104
7067-Public notice of any revisions shall be posted on the 105
7068-website of the Commission. The revision shall be subject to 106
7069-challenge by any person for a period of thirty (30) days 107
7070-after posting. The revision may be challenged only on 108
7071-grounds that the revision results in a material change to a 109
7072-Rule. A challenge shall be made in writing and delivered to 110 CCS HCS SS SCS SB 157 223
7073-the Commission prior to t he end of the notice period. If no 111
7074-challenge is made, the revision will take effect without 112
7075-further action. If the revision is challenged, the revision 113
7076-may not take effect without the approval of the Commission. 114
7077- 14. No Member State's rulemaking requirements shall 115
7078-apply under this compact. 116
7079- 337.1060. 1. (1) The executive and judicial branches 1
7080-of State government in each Member State shall enforce this 2
7081-Compact and take all actions necessary and appropriate to 3
7082-implement the Compact. 4
7083- (2) Except as otherwise provided in this Compact, 5
7084-venue is proper and judicial proceedings by or against the 6
7085-Commission shall be brought solely and exclusively in a 7
7086-court of competent jurisdiction where the principal office 8
7087-of the Commission is located. The Commission may waive 9
7088-venue and jurisdictional defenses to the extent it adopts or 10
7089-consents to participate in alternative dispute resolution 11
7090-proceedings. Nothing herein shall affect or limit the 12
7091-selection or propriety of venue in any action against a 13
7092-Licensee for professional malpractice, misconduct or any 14
7093-such similar matter. 15
7094- (3) The Commission shall be entitled to receive 16
7095-service of process in any proceeding regarding the 17
7096-enforcement or interpretation of the Compact and shall have 18
7097-standing to intervene in such a proceeding for all 19
7098-purposes. Failure to provide the Commission service of 20
7099-process shall render a judgment or order void as to the 21
7100-Commission, this Compact, or promulgated Rules. 22
7101- 2. (1) If the Commission determines that a Member 23
7102-State has defaulted in the performance of its obligations or 24
7103-responsibilities under this Compact or the promulgated 25
7104-Rules, the Commission shall provide written notice to the 26 CCS HCS SS SCS SB 157 224
7105-defaulting State. The notice of default shall des cribe the 27
7106-default, the proposed means of curing the default, and any 28
7107-other action that the Commission may take, and shall offer 29
7108-training and specific technical assistance regarding the 30
7109-default. 31
7110- (2) The Commission shall provide a copy of the notic e 32
7111-of default to the other Member States. 33
7112- 3. If a State in default fails to cure the default, 34
7113-the defaulting State may be terminated from the Compact upon 35
7114-an affirmative vote of a majority of the delegates of the 36
7115-Member States, and all rights, pri vileges and benefits 37
7116-conferred on that State by this Compact may be terminated on 38
7117-the effective date of termination. A cure of the default 39
7118-does not relieve the offending State of obligations or 40
7119-liabilities incurred during the period of default. 41
7120- 4. Termination of membership in the Compact shall be 42
7121-imposed only after all other means of securing compliance 43
7122-have been exhausted. Notice of intent to suspend or 44
7123-terminate shall be given by the Commission to the governor, 45
7124-the majority and minority le aders of the defaulting State's 46
7125-legislature, the defaulting State's State Licensing 47
7126-Authority and each of the Member States' State Licensing 48
7127-Authority. 49
7128- 5. A State that has been terminated is responsible for 50
7129-all assessments, obligations, and liabi lities incurred 51
7130-through the effective date of termination, including 52
7131-obligations that extend beyond the effective date of 53
7132-termination. 54
7133- 6. Upon the termination of a State's membership from 55
7134-this Compact, that State shall immediately provide notice to 56
7135-all Licensees within that State of such termination. The 57
7136-terminated State shall continue to recognize all licenses 58 CCS HCS SS SCS SB 157 225
7137-granted pursuant to this Compact for a minimum of six (6) 59
7138-months after the date of said notice of termination. 60
7139- 7. The Commission shall not bear any costs related to 61
7140-a State that is found to be in default or that has been 62
7141-terminated from the Compact, unless agreed upon in writing 63
7142-between the Commission and the defaulting State. 64
7143- 8. The defaulting State may appeal the action of the 65
7144-Commission by petitioning the U.S. District Court for the 66
7145-District of Columbia or the federal district where the 67
7146-Commission has its principal offices. The prevailing party 68
7147-shall be awarded all costs of such litigation, including 69
7148-reasonable attorney's fees. 70
7149- 9. (1) Upon request by a Member State, the Commission 71
7150-shall attempt to resolve disputes related to the Compact 72
7151-that arise among Member States and between Member and non - 73
7152-Member States. 74
7153- (2) The Commission shall promulgate a Rul e providing 75
7154-for both mediation and binding dispute resolution for 76
7155-disputes as appropriate. 77
7156- 10. (1) By majority vote as provided by Rule, the 78
7157-Commission may initiate legal action against a Member State 79
7158-in default in the United States District Cou rt for the 80
7159-District of Columbia or the federal district where the 81
7160-Commission has its principal offices to enforce compliance 82
7161-with the provisions of the Compact and its promulgated 83
7162-Rules. The relief sought may include both injunctive relief 84
7163-and damages. In the event judicial enforcement is 85
7164-necessary, the prevailing party shall be awarded all costs 86
7165-of such litigation, including reasonable attorney's fees. 87
7166-The remedies herein shall not be the exclusive remedies of 88
7167-the Commission. The Commission may pursue any other 89 CCS HCS SS SCS SB 157 226
7168-remedies available under federal or the defaulting Member 90
7169-State's law. 91
7170- (2) A Member State may initiate legal action against 92
7171-the Commission in the U.S. District Court for the District 93
7172-of Columbia or the federal district where th e Commission has 94
7173-its principal offices to enforce compliance with the 95
7174-provisions of the Compact and its promulgated Rules. The 96
7175-relief sought may include both injunctive relief and 97
7176-damages. In the event judicial enforcement is necessary, 98
7177-the prevailing party shall be awarded all costs of such 99
7178-litigation, including reasonable attorney's fees. 100
7179- (3) No person other than a Member State shall enforce 101
7180-this compact against the Commission. 102
7181- 337.1065. 1. The Compact shall come into e ffect on 1
7182-the date on which the Compact statute is enacted into law in 2
7183-the seventh Member State. 3
7184- (1) On or after the effective date of the Compact, the 4
7185-Commission shall convene and review the enactment of each of 5
7186-the first seven Member States ("Ch arter Member States") to 6
7187-determine if the statute enacted by each such Charter Member 7
7188-State is materially different than the model Compact statute. 8
7189- (a) A Charter Member State whose enactment is found to 9
7190-be materially different from the model Compa ct statute shall 10
7191-be entitled to the default process set forth in section 11
7192-337.1060. 12
7193- (b) If any Member State is later found to be in 13
7194-default, or is terminated or withdraws from the Compact, the 14
7195-Commission shall remain in existence and the Compact s hall 15
7196-remain in effect even if the number of Member States should 16
7197-be less than seven. 17
7198- (2) Member States enacting the Compact subsequent to 18
7199-the seven initial Charter Member States shall be subject to 19 CCS HCS SS SCS SB 157 227
7200-the process set forth in subdivision (21) of sub section 3 of 20
7201-section 337.1045 to determine if their enactments are 21
7202-materially different from the model Compact statute and 22
7203-whether they qualify for participation in the Compact. 23
7204- (3) All actions taken for the benefit of the 24
7205-Commission or in furthe rance of the purposes of the 25
7206-administration of the Compact prior to the effective date of 26
7207-the Compact or the Commission coming into existence shall be 27
7208-considered to be actions of the Commission unless 28
7209-specifically repudiated by the Commission. 29
7210- (4) Any State that joins the Compact subsequent to the 30
7211-Commission's initial adoption of the Rules and bylaws shall 31
7212-be subject to the Rules and bylaws as they exist on the date 32
7213-on which the Compact becomes law in that State. Any Rule 33
7214-that has been previo usly adopted by the Commission shall 34
7215-have the full force and effect of law on the day the Compact 35
7216-becomes law in that State. 36
7217- 2. Any Member State may withdraw from this Compact by 37
7218-enacting a statute repealing the same. 38
7219- (1) A Member State's withdrawal shall not take effect 39
7220-until 180 days after enactment of the repealing statute. 40
7221- (2) Withdrawal shall not affect the continuing 41
7222-requirement of the withdrawing State's Licensing Authority 42
7223-to comply with the investigative and Adverse Action 43
7224-reporting requirements of this Compact prior to the 44
7225-effective date of withdrawal. 45
7226- (3) Upon the enactment of a statute withdrawing from 46
7227-this compact, a State shall immediately provide notice of 47
7228-such withdrawal to all Licensees within that State. 48
7229-Notwithstanding any subsequent statutory enactment to the 49
7230-contrary, such withdrawing State shall continue to recognize 50 CCS HCS SS SCS SB 157 228
7231-all licenses granted pursuant to this compact for a minimum 51
7232-of 180 days after the date of such notice of withdrawal. 52
7233- 3. Nothing contained in this Compact shall be 53
7234-construed to invalidate or prevent any licensure agreement 54
7235-or other cooperative arrangement between a Member State and 55
7236-a non-Member State that does not conflict with the 56
7237-provisions of this Compact. 57
7238- 4. This Compact may be amended by the Member States. 58
7239-No amendment to this Compact shall become effective and 59
7240-binding upon any Member State until it is enacted into the 60
7241-laws of all Member States. 61
7242- 337.1070. 1. This Compact and the Commission's 1
7243-rulemaking authority shall be liberally construed so as to 2
7244-effectuate the purposes, and the implementation and 3
7245-administration of the Compact. Provisions of the Compact 4
7246-expressly authorizing or requiring the promulgation of Rules 5
7247-shall not be construed to limit the Commission's rulemaking 6
7248-authority solely for those purposes. 7
7249- 2. The provisions of this Compact shall be severable 8
7250-and if any phrase, clause, sentence or provision of this 9
7251-Compact is held by a court of competent jurisdiction to be 10
7252-contrary to the constitution of any Member State, a State 11
7253-seeking participation in the Compact, or of the United 12
7254-States, or the applicability thereof to any government, 13
7255-agency, person or circumstance is held to be 14
7256-unconstitutional by a court of competent jurisdiction, the 15
7257-validity of the remainder of this Compact and the 16
7258-applicability thereof to any other government, agency, 17
7259-person or circumstance shall not be affected thereby. 18
7260- 3. Notwithstanding subsection 2 of this section, the 19
7261-Commission may deny a State's participation in the Compact 20
7262-or, in accordance with the requirements of subsection 2 of 21 CCS HCS SS SCS SB 157 229
7263-section 337.1060, terminate a Member State's participation 22
7264-in the Compact, if it determines that a constitutional 23
7265-requirement of a Member State is a m aterial departure from 24
7266-the Compact. Otherwise, if this Compact shall be held to be 25
7267-contrary to the constitution of any Member State, the 26
7268-Compact shall remain in full force and effect as to the 27
7269-remaining Member States and in full force and effect as to 28
7270-the Member State affected as to all severable matters. 29
7271- 337.1075. 1. A Licensee providing services in a 1
7272-Remote State under a Multistate Authorization to Practice 2
7273-shall adhere to the laws and regulations, including laws, 3
7274-regulations, and applicable standards, of the Remote State 4
7275-where the client is located at the time care is rendered. 5
7276- 2. Nothing herein shall prevent or inhibit the 6
7277-enforcement of any other law of a Member State that is not 7
7278-inconsistent with the Compact. 8
7279- 3. Any laws, statutes, regulations, or other legal 9
7280-requirements in a Member State in conflict with the Compact 10
7281-are superseded to the extent of the conflict. 11
7282- 4. All permissible agreements between the Commission 12
7283-and the Member States are binding i n accordance with their 13
7284-terms. 14
7285- 338.010. 1. The "practice of pharmacy" [means] 1
7286-includes: 2
7287- (1) The interpretation, implementation, and evaluation 3
7288-of medical prescription orders, including any legend drugs 4
7289-under 21 U.S.C. Section 353[;], and the receipt, 5
7290-transmission, or handling of such orders or facilitating the 6
7291-dispensing of such orders; 7
7292- (2) The designing, initiating, implementing, and 8
7293-monitoring of a medication therapeutic plan [as defined by 9
7294-the prescription order s o long as the prescription order is 10 CCS HCS SS SCS SB 157 230
7295-specific to each patient for care by a pharmacist ] in 11
7296-accordance with the provisions of this section ; 12
7297- (3) The compounding, dispensing, labeling, and 13
7298-administration of drugs and devices pursuant to medical 14
7299-prescription orders [and administration of viral influenza, 15
7300-pneumonia, shingles, hepatitis A, hepatitis B, diphtheria, 16
7301-tetanus, pertussis, and meningitis vaccines by written 17
7302-protocol authorized by a physician for persons at least 18
7303-seven years of age or the a ge recommended by the Centers for 19
7304-Disease Control and Prevention, whichever is higher, or the 20
7305-administration of pneumonia, shingles, hepatitis A, 21
7306-hepatitis B, diphtheria, tetanus, pertussis, meningitis, and 22
7307-viral influenza vaccines by written protocol authorized by a 23
7308-physician for a specific patient as authorized by rule ]; 24
7309- (4) The ordering and administration of vaccines 25
7310-approved or authorized by the U.S. Food and Drug 26
7311-Administration, excluding vaccines for cholera, monkeypox, 27
7312-Japanese encephalitis, typhoid, rabies, yellow fever, tick - 28
7313-borne encephalitis, anthrax, tuberculosis, dengue, Hib, 29
7314-polio, rotavirus, smallpox, and any vaccine approved after 30
7315-January 1, 2023, to persons at least seven years of age or 31
7316-the age recommended by the Centers f or Disease Control and 32
7317-Prevention, whichever is older, pursuant to joint 33
7318-promulgation of rules established by the board of pharmacy 34
7319-and the state board of registration for the healing arts 35
7320-unless rules are established under a state of emergency as 36
7321-described in section 44.100; 37
7322- (5) The participation in drug selection according to 38
7323-state law and participation in drug utilization reviews; 39
7324- (6) The proper and safe storage of drugs and devices 40
7325-and the maintenance of proper records thereof; 41 CCS HCS SS SCS SB 157 231
7326- (7) Consultation with patients and other health care 42
7327-practitioners, and veterinarians and their clients about 43
7328-legend drugs, about the safe and effective use of drugs and 44
7329-devices; 45
7330- (8) The prescribing and dispensing of any nicotine 46
7331-replacement therapy product under section 338.665; 47
7332- (9) The dispensing of HIV postexposure prophylaxis 48
7333-pursuant to section 338.730; and 49
7334- (10) The offering or performing of those acts, 50
7335-services, operations, or transactions necessary in the 51
7336-conduct, operation, management and control of a pharmacy. 52
7337- 2. No person shall engage in the practice of pharmacy 53
7338-unless he or she is licensed under the provisions of this 54
7339-chapter. 55
7340- 3. This chapter shall not be construed to prohibit the 56
7341-use of auxiliary personnel under the direct supervision of a 57
7342-pharmacist from assisting the pharmacist in any of his or 58
7343-her duties. This assistance in no way is intended to 59
7344-relieve the pharmacist from his or her responsibilities for 60
7345-compliance with this chapter and he or she wil l be 61
7346-responsible for the actions of the auxiliary personnel 62
7347-acting in his or her assistance. 63
7348- 4. This chapter shall [also] not be construed to 64
7349-prohibit or interfere with any legally registered 65
7350-practitioner of medicine, dentistry, or podiatry, or 66
7351-veterinary medicine only for use in animals, or the practice 67
7352-of optometry in accordance with and as provided in sections 68
7353-195.070 and 336.220 in the compounding, administering, 69
7354-prescribing, or dispensing of his or her own prescriptions. 70
7355- [2. Any pharmacist who accepts a prescription order 71
7356-for a medication therapeutic plan shall have a written 72 CCS HCS SS SCS SB 157 232
7357-protocol from the physician who refers the patient for 73
7358-medication therapy services. ] 74
7359- 5. A pharmacist with a certificate of medication 75
7360-therapeutic plan authority may provide medication therapy 76
7361-services pursuant to a written protocol from a physician 77
7362-licensed under chapter 334 to patients who have established 78
7363-a physician-patient relationship, as described in 79
7364-subdivision (1) of subsection 1 of section 191.1146, with 80
7365-the protocol physician. The written protocol [and the 81
7366-prescription order for a medication therapeutic plan ] 82
7367-authorized by this section shall come only from the 83
7368-physician [only,] and shall not come from a nurse engaged in 84
7369-a collaborative practice arrangement under section 334.104, 85
7370-or from a physician assistant engaged in a collaborative 86
7371-practice arrangement under section 334.735. 87
7372- [3.] 6. Nothing in this section shall be construed as 88
7373-to prevent any person, firm or corporation fr om owning a 89
7374-pharmacy regulated by sections 338.210 to 338.315, provided 90
7375-that a licensed pharmacist is in charge of such pharmacy. 91
7376- [4.] 7. Nothing in this section shall be construed to 92
7377-apply to or interfere with the sale of nonprescription drugs 93
7378-and the ordinary household remedies and such drugs or 94
7379-medicines as are normally sold by those engaged in the sale 95
7380-of general merchandise. 96
7381- [5.] 8. No health carrier as defined in chapter 376 97
7382-shall require any physician with which they contract to 98
7383-enter into a written protocol with a pharmacist for 99
7384-medication therapeutic services. 100
7385- [6.] 9. This section shall not be construed to allow a 101
7386-pharmacist to diagnose or independently prescribe 102
7387-pharmaceuticals. 103 CCS HCS SS SCS SB 157 233
7388- [7.] 10. The state board of registr ation for the 104
7389-healing arts, under section 334.125, and the state board of 105
7390-pharmacy, under section 338.140, shall jointly promulgate 106
7391-rules regulating the use of protocols [for prescription 107
7392-orders] for medication therapy services [and administration 108
7393-of viral influenza vaccines ]. Such rules shall require 109
7394-protocols to include provisions allowing for timely 110
7395-communication between the pharmacist and the [referring] 111
7396-protocol physician or similar body authorized by this 112
7397-section, and any other patient prote ction provisions deemed 113
7398-appropriate by both boards. In order to take effect, such 114
7399-rules shall be approved by a majority vote of a quorum of 115
7400-each board. Neither board shall separately promulgate rules 116
7401-regulating the use of protocols for [prescription orders 117
7402-for] medication therapy services [and administration of 118
7403-viral influenza vaccines ]. Any rule or portion of a rule, 119
7404-as that term is defined in section 536.010, that is created 120
7405-under the authority delegated in this section shall become 121
7406-effective only if it complies with and is subject to all of 122
7407-the provisions of chapter 536 and, if applicable, section 123
7408-536.028. This section and chapter 536 are nonseverable and 124
7409-if any of the powers vested with the general assembly 125
7410-pursuant to chapter 536 to rev iew, to delay the effective 126
7411-date, or to disapprove and annul a rule are subsequently 127
7412-held unconstitutional, then the grant of rulemaking 128
7413-authority and any rule proposed or adopted after August 28, 129
7414-2007, shall be invalid and void. 130
7415- [8.] 11. The state board of pharmacy may grant a 131
7416-certificate of medication therapeutic plan authority to a 132
7417-licensed pharmacist who submits proof of successful 133
7418-completion of a board -approved course of academic clinical 134
7419-study beyond a bachelor of science in pharmacy, in cluding 135 CCS HCS SS SCS SB 157 234
7420-but not limited to clinical assessment skills, from a 136
7421-nationally accredited college or university, or a 137
7422-certification of equivalence issued by a nationally 138
7423-recognized professional organization and approved by the 139
7424-board of pharmacy. 140
7425- [9.] 12. Any pharmacist who has received a certificate 141
7426-of medication therapeutic plan authority may engage in the 142
7427-designing, initiating, implementing, and monitoring of a 143
7428-medication therapeutic plan as defined by a [prescription 144
7429-order] written protocol from a physician that [is] may be 145
7430-specific to each patient for care by a pharmacist. 146
7431- [10.] 13. Nothing in this section shall be construed 147
7432-to allow a pharmacist to make a therapeutic substitution of 148
7433-a pharmaceutical prescribed by a physician unless aut horized 149
7434-by the written protocol or the physician's prescription 150
7435-order. 151
7436- [11.] 14. "Veterinarian", "doctor of veterinary 152
7437-medicine", "practitioner of veterinary medicine", "DVM", 153
7438-"VMD", "BVSe", "BVMS", "BSe (Vet Science)", "VMB", "MRCVS", 154
7439-or an equivalent title means a person who has received a 155
7440-doctor's degree in veterinary medicine from an accredited 156
7441-school of veterinary medicine or holds an Educational 157
7442-Commission for Foreign Veterinary Graduates (EDFVG) 158
7443-certificate issued by the American Veter inary Medical 159
7444-Association (AVMA). 160
7445- [12.] 15. In addition to other requirements 161
7446-established by the joint promulgation of rules by the board 162
7447-of pharmacy and the state board of registration for the 163
7448-healing arts: 164
7449- (1) A pharmacist shall administe r vaccines by protocol 165
7450-in accordance with treatment guidelines established by the 166
7451-Centers for Disease Control and Prevention (CDC); 167 CCS HCS SS SCS SB 157 235
7452- (2) A pharmacist who is administering a vaccine shall 168
7453-request a patient to remain in the pharmacy a safe amount of 169
7454-time after administering the vaccine to observe any adverse 170
7455-reactions. Such pharmacist shall have adopted emergency 171
7456-treatment protocols[;]. 172
7457- [(3)] 16. In addition to other requirements by the 173
7458-board, a pharmacist shall receive additional training as 174
7459-required by the board and evidenced by receiving a 175
7460-certificate from the board upon completion, and shall 176
7461-display the certification in his or her pharmacy where 177
7462-vaccines are delivered. 178
7463- [13.] 17. A pharmacist shall inform the patient that 179
7464-the administration of [the] a vaccine will be entered into 180
7465-the ShowMeVax system, as administered by the department of 181
7466-health and senior services. The patient shall attest to the 182
7467-inclusion of such information in the system by signing a 183
7468-form provided by the pharmacist. If the patient indicates 184
7469-that he or she does not want such information entered into 185
7470-the ShowMeVax system, the pharmacist shall provide a written 186
7471-report within fourteen days of administration of a vaccine 187
7472-to the patient's health care provid er, if provided by the 188
7473-patient, containing: 189
7474- (1) The identity of the patient; 190
7475- (2) The identity of the vaccine or vaccines 191
7476-administered; 192
7477- (3) The route of administration; 193
7478- (4) The anatomic site of the administration; 194
7479- (5) The dose administered; and 195
7480- (6) The date of administration. 196
7481- 18. A pharmacist licensed under this chapter may order 197
7482-and administer vaccines approved or authorized by the U.S. 198
7483-Food and Drug Administration to address a public health 199 CCS HCS SS SCS SB 157 236
7484-need, as lawfully authorized by the state or federal 200
7485-government, or a department or agency thereof, during a 201
7486-state or federally declared public health emergency. 202
7487- 338.012. 1. A pharmacist with a certificate of 1
7488-medication therapeutic plan authority may provide influenza, 2
7489-group A streptococcus, and COVID -19 medication therapy 3
7490-services pursuant to a statewide standing order issued by 4
7491-the director or chief medical officer of the department of 5
7492-health and senior services if that person is a licensed 6
7493-physician, or a licensed physician designated by the 7
7494-department of health and senior services. 8
7495- 2. The state board of registration for the healing 9
7496-arts, pursuant to section 334.125, and the state board of 10
7497-pharmacy, pursuant to section 338.140, shall jo intly 11
7498-promulgate rules to implement the provisions of this 12
7499-section. Any rule or portion of a rule, as that term is 13
7500-defined in section 536.010, that is created under the 14
7501-authority delegated in this section shall become effective 15
7502-only if it complies wi th and is subject to all of the 16
7503-provisions of chapter 536 and, if applicable, section 17
7504-536.028. This section and chapter 536 are nonseverable and 18
7505-if any of the powers vested with the general assembly 19
7506-pursuant to chapter 536 to review, to delay the effe ctive 20
7507-date, or to disapprove and annul a rule are subsequently 21
7508-held unconstitutional, then the grant of rulemaking 22
7509-authority and any rule proposed or adopted after August 28, 23
7510-2023, shall be invalid and void. 24
7511- 340.200. When used in sections 340.200 to 340.330, the 1
7512-following terms mean: 2
7513- (1) "Accredited school of veterinary medicine", any 3
7514-veterinary college or division of a university or college 4
7515-that offers the degree of doctor of veterinary medicine or 5 CCS HCS SS SCS SB 157 237
7516-its equivalent and is a ccredited by the American Veterinary 6
7517-Medical Association (AVMA); 7
7518- (2) "Animal", any wild, exotic or domestic, living or 8
7519-dead animal or mammal other than man, including birds, fish 9
7520-and reptiles; 10
7521- (3) "Animal chiropractic", the examination and 11
7522-treatment of an animal through vertebral subluxation complex 12
7523-or spinal, joint, or musculoskeletal manipulation by an 13
7524-animal chiropractic practitioner. The term "animal 14
7525-chiropractic" shall not be construed to require supervision 15
7526-by a licensed veterin arian to practice or to allow the 16
7527-diagnosing of an animal; the performing of surgery; the 17
7528-dispensing, prescribing, or administering of medications, 18
7529-drugs, or biologics; or the performance of any other type of 19
7530-veterinary medicine when performed by an in dividual licensed 20
7531-by the state board of chiropractic examiners; 21
7532- (4) "Animal chiropractic practitioner": 22
7533- (a) A licensed veterinarian; or 23
7534- (b) An individual who is licensed by the state board 24
7535-of chiropractic examiners to engage in the prac tice of 25
7536-chiropractic, as defined in section 331.010; who is 26
7537-certified by the AVCA, IVCA, or other equivalent certifying 27
7538-body; who has graduated from a certification course in 28
7539-animal chiropractic with not less than two hundred ten hours 29
7540-of instruction; and whose practice of animal chiropractic 30
7541-shall be regulated by the state board of chiropractic 31
7542-examiners under chapter 331; 32
7543- (5) "Applicant", an individual who files an 33
7544-application to be licensed to practice veterinary medicine 34
7545-or to be registered as a veterinary technician; 35
7546- [(4)] (6) "Appointed member of the board", regularly 36
7547-appointed members of the Missouri veterinary medical board, 37 CCS HCS SS SCS SB 157 238
7548-not including the state veterinarian who serves on the board 38
7549-ex officio; 39
7550- [(5)] (7) "AVCA", the American Veterinary Chiropractic 40
7551-Association or its successor organization; 41
7552- (8) "Board", the Missouri veterinary medical board; 42
7553- [(6)] (9) "Consulting veterinarian", a veterinarian 43
7554-licensed in another state, country or territory who gives 44
7555-advice or demonstrates techniques to a licensed Missouri 45
7556-veterinarian or group of licensed Missouri veterinarians; 46
7557- [(7)] (10) "ECFVG certificate", a certificate issued 47
7558-by the American Veterinary Medical Association Educational 48
7559-Commission for Foreig n Veterinary Graduates or its 49
7560-successor. The certificate must indicate that the holder of 50
7561-the certificate has demonstrated knowledge and skill 51
7562-equivalent to that possessed by a graduate of an accredited 52
7563-school of veterinary medicine; 53
7564- [(8)] (11) "Emergency", when an animal has been placed 54
7565-in a life-threatening condition and immediate treatment is 55
7566-necessary to sustain life or where death is imminent and 56
7567-action is necessary to relieve pain or suffering; 57
7568- [(9)] (12) "Faculty member", full p rofessors, 58
7569-assistant professors, associate professors, clinical 59
7570-instructors and residents but does not include interns or 60
7571-adjunct appointments; 61
7572- [(10)] (13) "Foreign veterinary graduate", any person, 62
7573-including foreign nationals and American citize ns, who has 63
7574-received a professional veterinary medical degree from an 64
7575-AVMA listed veterinary college located outside the 65
7576-boundaries of the United States, its territories or Canada, 66
7577-that is not accredited by the AVMA; 67
7578- [(11)] (14) "IVCA", the International Veterinary 68
7579-Chiropractic Association or its successor organization; 69 CCS HCS SS SCS SB 157 239
7580- (15) "License", any permit, approval, registration or 70
7581-certificate issued or renewed by the board; 71
7582- [(12)] (16) "Licensed veterinarian", an individual who 72
7583-is validly and currently licensed to practice veterinary 73
7584-medicine in Missouri as determined by the board in 74
7585-accordance with the requirements and provisions of sections 75
7586-340.200 to 340.330; 76
7587- [(13)] (17) "Minimum standards", standards as set by 77
7588-board rule and which establish the minimum requirements for 78
7589-the practice of veterinary medicine in the state of Missouri 79
7590-as are consistent with the intent and purpose of sections 80
7591-340.200 to 340.330; 81
7592- [(14)] (18) "Person", any individual, firm, 82
7593-partnership, associa tion, joint venture, cooperative or 83
7594-corporation or any other group or combination acting in 84
7595-concert; whether or not acting as principal, trustee, 85
7596-fiduciary, receiver, or as any kind of legal or personal 86
7597-representative or as the successor in interest, a ssigning 87
7598-agent, factor, servant, employee, director, officer or any 88
7599-other representative of such person; 89
7600- [(15)] (19) "Practice of veterinary medicine", to 90
7601-represent directly, indirectly, publicly or privately an 91
7602-ability and willingness to do any act described in 92
7603-subdivision [(28)] (32) of this section; 93
7604- [(16)] (20) "Provisional license", a license issued to 94
7605-a person while that person is engaged in a veterinary 95
7606-candidacy program; 96
7607- [(17)] (21) "Registered veterinary technician", a 97
7608-person who is formally trained for the specific purpose of 98
7609-assisting a licensed veterinarian with technical services 99
7610-under the appropriate level of supervision as is consistent 100
7611-with the particular delegated animal health care task; 101 CCS HCS SS SCS SB 157 240
7612- [(18)] (22) "Supervision": 102
7613- (a) "Immediate supervision", the licensed veterinarian 103
7614-is in the immediate area and within audible and visual range 104
7615-of the animal patient and the person treating the patient; 105
7616- (b) "Direct supervision", the licensed veterinarian is 106
7617-on the premises where the animal is being treated and is 107
7618-quickly and easily available and the animal has been 108
7619-examined by a licensed veterinarian at such times as 109
7620-acceptable veterinary medical practice requires consistent 110
7621-with the particular delegated a nimal health care task; 111
7622- (c) "Indirect supervision", the licensed veterinarian 112
7623-need not be on the premises but has given either written or 113
7624-oral instructions for the treatment of the animal patient or 114
7625-treatment protocol has been established and the animal has 115
7626-been examined by a licensed veterinarian at such times as 116
7627-acceptable veterinary medical practice requires consistent 117
7628-with the particular delegated health care task; provided 118
7629-that the patient is not in a surgical plane of anesthesia 119
7630-and the licensed veterinarian is available for consultation 120
7631-on at least a daily basis; 121
7632- [(19)] (23) "Supervisor", a licensed veterinarian 122
7633-employing or utilizing the services of a registered 123
7634-veterinary technician, veterinary intern, temporary 124
7635-provisional licensee, veterinary medical student, 125
7636-unregistered assistant or any other individual working under 126
7637-that veterinarian's supervision; 127
7638- [(20)] (24) "Temporary license", any temporary 128
7639-permission to practice veterinary medicine issued by the 129
7640-board pursuant to section 340.248; 130
7641- [(21)] (25) "Unregistered assistant", any individual 131
7642-who is not a registered veterinary technician or licensed 132
7643-veterinarian and is employed by a licensed veterinarian; 133 CCS HCS SS SCS SB 157 241
7644- [(22)] (26) "Veterinarian", "doctor of veterinary 134
7645-medicine", "DVM", "VMD", or equivalent title, a person who 135
7646-has received a doctor's degree in veterinary medicine from 136
7647-an accredited school of veterinary medicine or holds a ECFVG 137
7648-certificate issued by the AVMA; 138
7649- [(23)] (27) "Veterinarian-client-patient 139
7650-relationship", the veterinarian has assumed the 140
7651-responsibility for making medical judgments regarding the 141
7652-health of the animal and the need for medical treatment, and 142
7653-the client, owner or owner's agent has agreed to follow the 143
7654-instructions of the veterinarian. There is sufficient 144
7655-knowledge of the animal by the veterinarian to initiate at 145
7656-least a general or preliminary diagnosis of the medical 146
7657-condition of the animal. Veterinarian-client-patient 147
7658-relationship means that the veterinarian has recently seen 148
7659-and is personally acquainted with the keeping and care of 149
7660-the animal by virtue of an examination or by medically 150
7661-appropriate and timely visits to the premises where the 151
7662-animal is kept. The practicing veterinarian is readily 152
7663-available for follow-up care in case of adverse reactions or 153
7664-failure of the prescribed course of therapy; 154
7665- [(24)] (28) "Veterinary candidacy program", a program 155
7666-by which a person who has received a doctor of veterinary 156
7667-medicine or equivalent degree from an acc redited school of 157
7668-veterinary medicine can obtain the practical experience 158
7669-required for licensing in Missouri pursuant to sections 159
7670-340.200 to 340.330; 160
7671- [(25)] (29) "Veterinary facility", any place or unit 161
7672-from which the practice of veterinary medic ine is conducted, 162
7673-including but not limited to the following: 163
7674- (a) "Veterinary or animal hospital or clinic", a 164
7675-facility that meets or exceeds all physical requirements and 165 CCS HCS SS SCS SB 157 242
7676-minimum standards as established by board rule for 166
7677-veterinary facilities; provides quality examination, 167
7678-diagnostic and health maintenance services for medical and 168
7679-surgical treatment of animals and is equipped to provide 169
7680-housing and nursing care for animals during illness or 170
7681-convalescence; 171
7682- (b) "Specialty practice or c linic", a facility that 172
7683-provides complete specialty service by a licensed 173
7684-veterinarian who has advanced training in a specialty and is 174
7685-a diplomate of an approved specialty board. A specialty 175
7686-practice or clinic shall meet all minimum standards which 176
7687-are applicable to a specialty as established by board rule; 177
7688- (c) "Central hospital", a facility that meets all 178
7689-requirements of a veterinary or animal hospital or clinic as 179
7690-defined in paragraph (a) of this subdivision and other 180
7691-requirements as estab lished by board rule, and which 181
7692-provides specialized care, including but not limited to 182
7693-twenty-four-hour nursing care and specialty consultation on 183
7694-permanent or on-call basis. A central hospital shall be 184
7695-utilized primarily on referral from area veteri nary 185
7696-hospitals or clinics; 186
7697- (d) "Satellite, outpatient or mobile small animal 187
7698-clinic", a supportive facility owned by or associated with 188
7699-and has ready access to a full -service veterinary hospital 189
7700-or clinic or a central hospital providing all manda tory 190
7701-services and meeting all physical requirements and minimum 191
7702-standards as established by sections 340.200 to 340.330 or 192
7703-by board rule; 193
7704- (e) "Large animal mobile clinic", a facility that 194
7705-provides examination, diagnostic and preventive medicine and 195
7706-minor surgical services for large animals not requiring 196
7707-confinement or hospitalization; 197 CCS HCS SS SCS SB 157 243
7708- (f) "Emergency clinic", a facility established to 198
7709-receive patients and to treat illnesses and injuries of an 199
7710-emergency nature; 200
7711- [(26)] (30) "Veterinary candidate", a person who has 201
7712-received a doctor of veterinary medicine or equivalent 202
7713-degree from an accredited school or college of veterinary 203
7714-medicine and who is working under the supervision of a board - 204
7715-approved licensed veterinarian; 205
7716- [(27)] (31) "Veterinary intern", a person who has 206
7717-received a doctor of veterinary medicine or equivalent 207
7718-degree from an accredited school or college of veterinary 208
7719-medicine and who is participating in additional clinical 209
7720-training in veterinary medicine to prep are for AVMA- 210
7721-recognized certification or specialization; 211
7722- [(28)] (32) "Veterinary medicine", the science of 212
7723-diagnosing, treating, changing, alleviating, rectifying, 213
7724-curing or preventing any animal disease, deformity, defect, 214
7725-injury or other physic al or mental condition, including, but 215
7726-not limited to, the prescription or administration of any 216
7727-drug, medicine, biologic, apparatus, application, anesthesia 217
7728-or other therapeutic or diagnostic substance or technique on 218
7729-any animal, including, but not li mited to, acupuncture, 219
7730-dentistry, animal psychology, animal chiropractic, 220
7731-theriogenology, surgery, both general and cosmetic surgery, 221
7732-any manual, mechanical, biological or chemical procedure for 222
7733-testing for pregnancy or for correcting sterility or 223
7734-infertility or to render service or recommendations with 224
7735-regard to any of the procedures in this [paragraph] 225
7736-subdivision; 226
7737- [(29)] (33) "Veterinary student preceptee", a person 227
7738-who is pursuing a veterinary degree in an accredited school 228 CCS HCS SS SCS SB 157 244
7739-of veterinary medicine which has a preceptor program and who 229
7740-has completed the academic requirements of such program. 230
7741- 340.216. 1. It is unlawful for any person not 1
7742-licensed as a veterinarian under the provisions of sections 2
7743-340.200 to 340.330 to practice veterinary medicine or to do 3
7744-any act which requires knowledge of veterinary medicine for 4
7745-valuable consideration, or for any person not so licensed to 5
7746-hold himself or herself out to the public as a practitioner 6
7747-of veterinary medicine by adverti sement, the use of any 7
7748-title or abbreviation with the person's name, or otherwise; 8
7749-except that nothing in sections 340.200 to 340.330 shall be 9
7750-construed as prohibiting: 10
7751- (1) Any person from gratuitously providing emergency 11
7752-treatment, aid or assist ance to animals where a licensed 12
7753-veterinarian is not available within a reasonable length of 13
7754-time if the person does not represent himself or herself to 14
7755-be a veterinarian or use any title or degree appertaining to 15
7756-the practice thereof; 16
7757- (2) Acts of a person who is a student in good standing 17
7758-in a school or college of veterinary medicine or while 18
7759-working as a student preceptee, in performing duties or 19
7760-functions assigned by the student's instructors, or while 20
7761-working under the appropriate level of supervision of a 21
7762-licensed veterinarian as is consistent with the particular 22
7763-delegated animal health care task as established by board 23
7764-rule, and acts performed by a student in a school or college 24
7765-of veterinary medicine recognized by the board and perfo rmed 25
7766-as part of the education and training curriculum of the 26
7767-school under the supervision of the faculty. The 27
7768-unsupervised or unauthorized practice of veterinary 28
7769-medicine, even though on the premises of a school or college 29
7770-of veterinary medicine, is prohibited; 30 CCS HCS SS SCS SB 157 245
7771- (3) Personnel employed by the United States Department 31
7772-of Agriculture or the Missouri department of agriculture 32
7773-from engaging in animal disease, parasite control or 33
7774-eradication programs, or other functions specifically 34
7775-required and authorized to be performed by unlicensed 35
7776-federal or state officials under any lawful act or statute, 36
7777-except that this exemption shall not apply to such persons 37
7778-not actively engaged in performing or fulfilling their 38
7779-official duties and responsibilities; 39
7780- (4) Any merchant or manufacturer from selling drugs, 40
7781-medicine, appliances or other products used in the 41
7782-prevention or treatment of animal diseases if such drug, 42
7783-medicine, appliance or other product is not marked by the 43
7784-appropriate federal label. Such merchants or manufacturers 44
7785-shall not, either directly or indirectly, attempt to 45
7786-diagnose a symptom or disease in order to advise treatment, 46
7787-use of drugs, medicine, appliances or other products; 47
7788- (5) The owner of any animal or animals and the o wner's 48
7789-full-time employees from caring for and treating any animals 49
7790-belonging to such owner, with or without the advice and 50
7791-consultation of a licensed veterinarian, provided that the 51
7792-ownership of the animal or animals is not transferred, or 52
7793-employment changed, to avoid the provisions of sections 53
7794-340.200 to 340.330; however, only a licensed veterinarian 54
7795-may immunize or treat an animal for diseases which are 55
7796-communicable to humans and which are of public health 56
7797-significance, except as otherwise provi ded for by board rule; 57
7798- (6) Any graduate of any accredited school of 58
7799-veterinary medicine while engaged in a veterinary candidacy 59
7800-program or foreign graduate from a nonaccredited school or 60
7801-college of veterinary medicine while engaged in a veterinary 61
7802-candidacy program or clinical evaluation program, and while 62 CCS HCS SS SCS SB 157 246
7803-under the appropriate level of supervision of a licensed 63
7804-veterinarian performing acts which are consistent with the 64
7805-particular delegated animal health care task; 65
7806- (7) State agencies, accredited schools, institutions, 66
7807-foundations, business corporations or associations, 67
7808-physicians licensed to practice medicine and surgery in all 68
7809-its branches, graduate doctors of veterinary medicine, or 69
7810-persons under the direct supervision thereof from c onducting 70
7811-experiments and scientific research on animals in the 71
7812-development of pharmaceuticals, biologicals, serums, or 72
7813-methods of treatment, or techniques for the diagnosis or 73
7814-treatment of human ailments, or when engaged in the study 74
7815-and development of methods and techniques directly or 75
7816-indirectly applicable to the problems of the practice of 76
7817-veterinary medicine; 77
7818- (8) Any veterinary technician, duly registered by, and 78
7819-in good standing with, the board from administering 79
7820-medication, appliances or other products for the treatment 80
7821-of animals while under the appropriate level of supervision 81
7822-as is consistent with the delegated animal health care task; 82
7823-[and] 83
7824- (9) A consulting veterinarian while working in a 84
7825-consulting capacity in Missouri wh ile under the immediate 85
7826-supervision of a veterinarian licensed and in good standing 86
7827-under sections 340.200 to 340.330 ; and 87
7828- (10) Any animal chiropractic practitioner from 88
7829-engaging in the practice of animal chiropractic if the 89
7830-animal chiropractic p ractitioner has received a referral of 90
7831-the animal from a licensed veterinarian with a current 91
7832-veterinarian-client-patient relationship, as defined in 92
7833-section 340.200. The referring veterinarian may limit the 93
7834-number of visits or length of treatment at the time of 94 CCS HCS SS SCS SB 157 247
7835-referral or after consultation with the animal chiropractic 95
7836-practitioner. 96
7837- 2. Nothing in sections 340.200 to 340.330 shall be 97
7838-construed as limiting the board's authority to provide other 98
7839-exemptions or exceptions to the requirements of licensing as 99
7840-the board may find necessary or appropriate under its 100
7841-rulemaking authority. 101
7842- 340.218. The use of any title, words, abbreviations, 1
7843-letters or symbol in a manner or under circumstances which 2
7844-induce the reasonable belief th at the person using them is 3
7845-qualified to do any act described in subdivision [(24)] (32) 4
7846-of section 340.200 is prima facie evidence of the intention 5
7847-to represent such person as engaged in the practice of 6
7848-veterinary medicine under sections 340.200 to 34 0.330. 7
7849- 340.222. 1. A supervisor, as defined in subdivision 1
7850-[(19)] (23) of section 340.200, is individually and 2
7851-separately responsible and liable for the performance of the 3
7852-acts delegated to and the omissions of the veterinary 4
7853-technician, veterinary medical candidate, temporary 5
7854-licensee, veterinary medical preceptee, unregistered 6
7855-assistant or any other individual working under his or her 7
7856-supervision. 8
7857- 2. Nothing in this section shall be construed to 9
7858-relieve veterinary tech nicians, veterinary medical 10
7859-candidates, provisional licensees, temporary licensees, 11
7860-veterinary medical preceptees or unregistered assistants of 12
7861-any responsibility or liability for any of their own acts or 13
7862-omissions. 14
7863- 344.045. 1. The board shall receive complaints 1
7864-concerning its licensees' professional practices. The board 2
7865-shall establish by rule a procedure for the handling of such 3
7866-complaints prior to the filing of formal complaints before 4 CCS HCS SS SCS SB 157 248
7867-the administrative hearing commission. The rule shall 5
7868-provide, at a minimum, for the logging of each complaint 6
7869-received, the recording of the licensee's name, the name of 7
7870-the complaining party, the date of the complaint, and a 8
7871-brief statement of the complaint and its ultimate 9
7872-disposition. The rule shall provide for informing the 10
7873-complaining party of the progress of the investigation, the 11
7874-dismissal of the charges, or the filing of a complaint 12
7875-before the administrative hearing commission. 13
7876- 2. Notwithstanding any other provision of l aw, no 14
7877-complaint, investigatory report, or information received 15
7878-from any source shall be disclosed prior to its review by 16
7879-the board. 17
7880- 3. At its discretion, the board may disclose 18
7881-complaints, completed investigatory reports, and information 19
7882-obtained from state administrative and law enforcement 20
7883-agencies to a licensee or license applicant in order to 21
7884-further an investigation or to facilitate settlement 22
7885-negotiations. 23
7886- 4. Information obtained from a federal administrative 24
7887-or law enforcement a gency shall be disclosed only upon 25
7888-receipt of written consent to the disclosure from the 26
7889-federal administrative or law enforcement agency. 27
7890- 5. At its discretion, the board may disclose 28
7891-complaints and investigatory reports if any such disclosure 29
7892-is: 30
7893- (1) In the course of voluntary interstate exchange of 31
7894-information; 32
7895- (2) In accordance with a lawful request; or 33
7896- (3) To other state or federal administrative or law 34
7897-enforcement agencies acting within the scope of their 35
7898-statutory authority. 36 CCS HCS SS SCS SB 157 249
7899- 6. Except where disclosure is specifically authorized 37
7900-in this section and as described in section 610.021, 38
7901-deliberations, votes, or minutes of closed proceedings shall 39
7902-not be subject to disclosure or discovery. Once a final 40
7903-disposition is rendered, that decision shall be made 41
7904-available to the parties and the public. 42
7905- 344.055. 1. All educational transcripts, test scores, 1
7906-complaints, investigatory reports, and information 2
7907-pertaining to any person who is an applicant or l icensee of 3
7908-the board are confidential and shall not be disclosed to the 4
7909-public or any member of the public, except with the written 5
7910-consent of the person whose records are involved. The board 6
7911-shall disclose the records or information if the person 7
7912-whose records or information is involved has consented to 8
7913-the disclosure. The board is entitled to the attorney - 9
7914-client privilege and work -product privilege to the same 10
7915-extent as any other person. 11
7916- 2. Notwithstanding the provisions of subsection 1 of 12
7917-this section, the board may disclose confidential 13
7918-information without the consent of the person involved if 14
7919-the disclosure is: 15
7920- (1) In the course of voluntary interstate exchange of 16
7921-information; 17
7922- (2) In accordance with a lawful request; or 18
7923- (3) To other administrative or law enforcement 19
7924-agencies acting within the scope of their statutory 20
7925-authority. 21
7926- 3. Information regarding identity, including names and 22
7927-addresses, registration, and currency of the license of the 23
7928-persons possessing nursing home administrator licenses and 24
7929-the names and addresses of applicants for nursing home 25
7930-administrator licenses, is not confidential information. 26 CCS HCS SS SCS SB 157 250
7931- 344.102. No person shall practice as a nursing home 1
7932-administrator in this stat e or hold himself or herself out 2
7933-as a nursing home administrator if his or her license is 3
7934-expired or is revoked. Expired licenses shall remain 4
7935-subject to disciplinary action for violations of this 5
7936-chapter and the rules promulgated thereunder. 6
7937- Section 1. The department of health and senior 1
7938-services shall include on its website an advance health care 2
7939-directive form and directions for completing such form as 3
7940-described in section 459.015. The department shall include 4
7941-a listing of possible uses for an advance health care 5
7942-directive, including to limit pain control to nonopioid 6
7943-measures. 7
7944- [191.500. As used in sections 191.500 to 1
7945-191.550, unless the context clearly indicates 2
7946-otherwise, the following terms mean: 3
7947- (1) "Area of defined need", a community or 4
7948-section of an urban area of this state which is 5
7949-certified by the department of health and senior 6
7950-services as being in need of the services of a 7
7951-physician to improve the patient -doctor ratio in 8
7952-the area, to contribute professional physician 9
7953-services to an area of economic impact, or to 10
7954-contribute professional physician services to an 11
7955-area suffering from the effects of a natural 12
7956-disaster; 13
7957- (2) "Department", the department of health 14
7958-and senior services; 15
7959- (3) "Eligible student", a full -time 16
7960-student accepted and enrolled in a formal course 17
7961-of instruction leading to a degree of doctor of 18
7962-medicine or doctor of osteopathy, including 19
7963-psychiatry, at a participating school, or a 20
7964-doctor of dental surgery, doctor of dental 21
7965-medicine, or a bachelor of science degree in 22
7966-dental hygiene; 23
7967- (4) "Financial assistance", an amount of 24
7968-money paid by the state of Missouri to a 25
7969-qualified applicant pursuant to sections 191.500 26
7970-to 191.550; 27
7971- (5) "Participating school", an institution 28
7972-of higher learning within this state which 29
7973-grants the degrees of doctor of medicine or 30
7974-doctor of osteopathy, and which is accredited in 31
7975-the appropriate degree program by the American 32
7976-Medical Association or the American Osteopathic 33 CCS HCS SS SCS SB 157 251
7977-Association, or a degree program by the American 34
7978-Dental Association or the American Psychiatric 35
7979-Association, and applicable residency programs 36
7980-for each degree type and discipline; 37
7981- (6) "Primary care", general or family 38
7982-practice, internal medicine, pediatric , 39
7983-psychiatric, obstetric and gynecological care as 40
7984-provided to the general public by physicians 41
7985-licensed and registered pursuant to chapter 334, 42
7986-dental practice, or a dental hygienist licensed 43
7987-and registered pursuant t o chapter 332; 44
7988- (7) "Resident", any natural person who has 45
7989-lived in this state for one or more years for 46
7990-any purpose other than the attending of an 47
7991-educational institution located within this 48
7992-state; 49
7993- (8) "Rural area", a town or community 50
7994-within this state which is not within a standard 51
7995-metropolitan statistical area, and has a 52
7996-population of six thousand or fewer inhabitants 53
7997-as determined by the last preceding federal 54
7998-decennial census or any unincorporated area not 55
7999-within a standard metrop olitan statistical area. ] 56
8000- [191.505. The department of health and 1
8001-senior services shall be the administrative 2
8002-agency for the implementation of the program 3
8003-established by sections 191.500 to 191.550. The 4
8004-department shall promulgate r easonable rules and 5
8005-regulations for the exercise of its functions in 6
8006-the effectuation of the purposes of sections 7
8007-191.500 to 191.550. It shall prescribe the form 8
8008-and the time and method of filing applications 9
8009-and supervise the processing thereof. ] 10
8010- [191.510. The department shall enter into 1
8011-a contract with each applicant receiving a state 2
8012-loan under sections 191.500 to 191.550 for 3
8013-repayment of the principal and interest and for 4
8014-forgiveness of a portion thereof for 5
8015-participation in the service areas as provided 6
8016-in sections 191.500 to 191.550. ] 7
8017- [191.515. An eligible student may apply to 1
8018-the department for a loan under sections 191.500 2
8019-to 191.550 only if, at the time of his 3
8020-application and throughout the p eriod during 4
8021-which he receives the loan, he has been formally 5
8022-accepted as a student in a participating school 6
8023-in a course of study leading to the degree of 7
8024-doctor of medicine or doctor of osteopathy, 8
8025-including psychiatry, or a doctor of dental 9
8026-surgery, a doctor of dental medicine, or a 10
8027-bachelor of science degree in dental hygiene, 11
8028-and is a resident of this state. ] 12
8029- [191.520. No loan to any eligible student 1
8030-shall exceed twenty-five thousand dollars for 2
8031-each academic year, which s hall run from August 3 CCS HCS SS SCS SB 157 252
8032-first of any year through July thirty -first of 4
8033-the following year. All loans shall be made 5
8034-from funds appropriated to the medical school 6
8035-loan and loan repayment program fund created by 7
8036-section 191.600, by the general assembly. ] 8
8037- [191.525. No more than twenty-five loans 1
8038-shall be made to eligible students during the 2
8039-first academic year this program is in effect. 3
8040-Twenty-five new loans may be made for the next 4
8041-three academic years until a total of one 5
8042-hundred loans are available. At least one-half 6
8043-of the loans shall be made to students from 7
8044-rural areas as defined in section 191.500. An 8
8045-eligible student may receive loans for each 9
8046-academic year he is pursuing a course of study 10
8047-directly leading to a degre e of doctor of 11
8048-medicine or doctor of osteopathy, doctor of 12
8049-dental surgery, or doctor of dental medicine, or 13
8050-a bachelor of science degree in dental hygiene. ] 14
8051- [191.530. Interest at the rate of nine and 1
8052-one-half percent per year shall be charged on 2
8053-all loans made under sections 191.500 to 191.550 3
8054-but one-fourth of the interest and principal of 4
8055-the total loan at the time of the awarding of 5
8056-the degree shall be forgiven for each year of 6
8057-participation by an applicant in the practice of 7
8058-his profession in a rural area or an area of 8
8059-defined need. The department shall grant a 9
8060-deferral of interest and principal payments to a 10
8061-loan recipient who is pursuing an internship or 11
8062-a residency in primary care. The deferral shall 12
8063-not exceed three years. The status of each loan 13
8064-recipient receiving a deferral shall be reviewed 14
8065-annually by the department to ensure compliance 15
8066-with the intent of this provision. The loan 16
8067-recipient will repay the loan beginning with the 17
8068-calendar year following c ompletion of his 18
8069-internship or his primary care residency in 19
8070-accordance with the loan contract. ] 20
8071- [191.535. If a student ceases his study 1
8072-prior to receiving a degree, interest at the 2
8073-rate specified in section 191.530 shall be 3
8074-charged on the amount received from the state 4
8075-under the provisions of sections 191.500 to 5
8076-191.550.] 6
8077- [191.540. 1. The department shall 1
8078-establish schedules and procedures for repayment 2
8079-of the principal and interest of any loan made 3
8080-under the provisions of sections 191.500 to 4
8081-191.550 and not forgiven as provided in section 5
8082-191.530. 6
8083- 2. A penalty shall be levied against a 7
8084-person in breach of contract. Such penalty shall 8
8085-be twice the sum of the principal and the 9
8086-accrued interest.] 10 CCS HCS SS SCS SB 157 253
8087- [191.545. When necessary to protect the 1
8088-interest of the state in any loan transaction 2
8089-under sections 191.500 to 191.550, the board may 3
8090-institute any action to recover any amount due. ] 4
8091- [191.550. The contracts made with the 1
8092-participating students shall be approved by the 2
8093-attorney general.] 3
8094- [335.212. As used in sections 335.212 to 1
8095-335.242, the following terms mean: 2
8096- (1) "Board", the Missouri state board of 3
8097-nursing; 4
8098- (2) "Department", the Missouri department 5
8099-of health and senior services; 6
8100- (3) "Director", director of the Missouri 7
8101-department of health and senior services; 8
8102- (4) "Eligible student", a resident who has 9
8103-been accepted as a full -time student in a formal 10
8104-course of instruction leading to an associate 11
8105-degree, a diploma, a bachelor of science, a 12
8106-master of science in nursing (M.S.N.), a 13
8107-doctorate in nursing (Ph.D. or D.N.P.), or a 14
8108-student with a master of science in nursing 15
8109-seeking a doctorate in education (Ed.D.) , or 16
8110-leading to the completion of educational 17
8111-requirements for a licensed practical nurse. 18
8112-The doctoral applicant may be a part -time 19
8113-student; 20
8114- (5) "Participating school", an institution 21
8115-within this state which is approved by the board 22
8116-for participation in the professional and 23
8117-practical nursing student loan program 24
8118-established by sections 335.212 to 335.242, 25
8119-having a nursing department and offering a 26
8120-course of instruction based on nursing theory 27
8121-and clinical nursing experience; 28
8122- (6) "Qualified applicant", an eligible 29
8123-student approved by the board for participation 30
8124-in the professional and practical nursing 31
8125-student loan program established by sections 32
8126-335.212 to 335.242; 33
8127- (7) "Qualified employment", employment on 34
8128-a full-time basis in Missouri in a position 35
8129-requiring licensure as a licensed practical 36
8130-nurse or registered professional nurse in any 37
8131-hospital as defined in section 197.020 or in any 38
8132-agency, institution, or organization located in 39
8133-an area of need as determined by the department 40
8134-of health and senior services. Any forgiveness 41
8135-of such principal and interest for any qualified 42
8136-applicant engaged in qualified employment on a 43
8137-less than full-time basis may be prorated to 44
8138-reflect the amounts provided in this section; 45
8139- (8) "Resident", any person who has lived 46
8140-in this state for one or more years for any 47
8141-purpose other than the attending of an 48 CCS HCS SS SCS SB 157 254
8142-educational institution located within this 49
8143-state.] 50
8144- [335.215. 1. The department of health and 1
8145-senior services shall be the administrative 2
8146-agency for the implementation of the 3
8147-professional and practical nursing student loan 4
8148-program established under sections 335.212 to 5
8149-335.242, and the nursing student loan repayment 6
8150-program established under sections 335 .245 to 7
8151-335.259. 8
8152- 2. An advisory panel of nurses shall be 9
8153-appointed by the director. It shall be composed 10
8154-of not more than eleven members representing 11
8155-practical, associate degree, diploma, 12
8156-baccalaureate and graduate nursing education, 13
8157-community health, primary care, hospital, long - 14
8158-term care, a consumer, and the Missouri state 15
8159-board of nursing. The panel shall make 16
8160-recommendations to the director on the content 17
8161-of any rules, regulations or guidelines prior to 18
8162-their promulgation. The panel may make 19
8163-recommendations to the director regarding fund 20
8164-allocations for loans and loan repayment based 21
8165-on current nursing shortage needs. 22
8166- 3. The department of health and senior 23
8167-services shall promulgate reasonable rules and 24
8168-regulations for the e xercise of its function 25
8169-pursuant to sections 335.212 to 335.259. It 26
8170-shall prescribe the form, the time and method of 27
8171-filing applications and supervise the 28
8172-proceedings thereof. No rule or portion of a 29
8173-rule promulgated under the authority of sections 30
8174-335.212 to 335.257 shall become effective unless 31
8175-it has been promulgated pursuant to the 32
8176-provisions of section 536.024. 33
8177- 4. Ninety-five percent of funds loaned 34
8178-pursuant to sections 335.212 to 335.242 shall be 35
8179-loaned to qualified applicants who are enrolled 36
8180-in professional nursing programs in 37
8181-participating schools and five percent of the 38
8182-funds loaned pursuant to sections 335.212 to 39
8183-335.242 shall be loaned to qualified applicants 40
8184-who are enrolled in practical nursing programs. 41
8185-Priority shall be given to eligible students who 42
8186-have established financial need. All loan 43
8187-repayment funds pursuant to sections 335.245 to 44
8188-335.259 shall be used to reimburse successful 45
8189-associate, diploma, baccalaureate or graduate 46
8190-professional nurse applicants' educ ational loans 47
8191-who agree to serve in areas of defined need as 48
8192-determined by the department. ] 49
8193- [335.218. There is hereby established the 1
8194-"Professional and Practical Nursing Student Loan 2
8195-and Nurse Loan Repayment Fund". All fees 3
8196-pursuant to section 335.221, general revenue 4
8197-appropriations to the student loan or loan 5 CCS HCS SS SCS SB 157 255
8198-repayment program, voluntary contributions to 6
8199-support or match the student loan and loan 7
8200-repayment program activities, funds collected 8
8201-from repayment and penalties, and funds received 9
8202-from the federal government shall be deposited 10
8203-in the state treasury and be placed to the 11
8204-credit of the professional and practical nursing 12
8205-student loan and nurse loan repayment fund. The 13
8206-fund shall be managed by the department of 14
8207-health and senior services and all 15
8208-administrative costs and expenses incurred as a 16
8209-result of the effectuation of sections 335.212 17
8210-to 335.259 shall be paid from this fund. ] 18
8211- [335.221. The board, in addition to any 1
8212-other duties it may have regarding licensure of 2
8213-nurses, shall collect, at the time of licensure 3
8214-or licensure renewal, an education surcharge 4
8215-from each person licensed or relicensed pursuant 5
8216-to sections 335.011 to 335.096, in the amount of 6
8217-one dollar per year for practical nu rses and 7
8218-five dollars per year for professional nurses. 8
8219-These funds shall be deposited in the 9
8220-professional and practical nursing student loan 10
8221-and nurse loan repayment fund. All expenditures 11
8222-authorized by sections 335.212 to 335.259 shall 12
8223-be paid from funds appropriated by the general 13
8224-assembly from the professional and practical 14
8225-nursing student loan and nurse loan repayment 15
8226-fund. The provisions of section 33.080 to the 16
8227-contrary notwithstanding, money in this fund 17
8228-shall not be transferred and pl aced to the 18
8229-credit of general revenue. ] 19
8230- [335.224. The department of health and 1
8231-senior services shall enter into a contract with 2
8232-each qualified applicant receiving financial 3
8233-assistance under the provisions of sections 4
8234-335.212 to 335.242 for repayment of the 5
8235-principal and interest. ] 6
8236- [335.227. An eligible student may apply to 1
8237-the department for financial assistance under 2
8238-the provisions of sections 335.212 to 335.242 3
8239-if, at the time of his application for a loan, 4
8240-the eligible student has formally applied for 5
8241-acceptance at a participating school. Receipt 6
8242-of financial assistance is contingent upon 7
8243-acceptance and continued enrollment at a 8
8244-participating school. ] 9
8245- [335.230. Financial assistance to any 1
8246-qualified applicant shall not exceed ten 2
8247-thousand dollars for each academic year for a 3
8248-professional nursing program and shall not 4
8249-exceed five thousand dollars for each academic 5
8250-year for a practical nursing program. All 6
8251-financial assistance s hall be made from funds 7
8252-credited to the professional and practical 8 CCS HCS SS SCS SB 157 256
8253-nursing student loan and nurse loan repayment 9
8254-fund. A qualified applicant may receive 10
8255-financial assistance for each academic year he 11
8256-remains a student in good standing at a 12
8257-participating school.] 13
8258- [335.233. The department shall establish 1
8259-schedules for repayment of the principal and 2
8260-interest on any financial assistance made under 3
8261-the provisions of sections 335.212 to 335.242. 4
8262-Interest at the rate of nine and one -half 5
8263-percent per annum shall be charged on all 6
8264-financial assistance made under the provisions 7
8265-of sections 335.212 to 335.242, but the interest 8
8266-and principal of the total financial assistance 9
8267-granted to a qualified applicant at the time of 10
8268-the successful completion of a nursing degree, 11
8269-diploma program or a practical nursing program 12
8270-shall be forgiven through qualified employment. ] 13
8271- [335.236. The financial assistance 1
8272-recipient shall repay the financial assistance 2
8273-principal and interest beginning not more than 3
8274-six months after completion of the degree for 4
8275-which the financial assistance was made in 5
8276-accordance with the repayment contract. If an 6
8277-eligible student ceases his study prior to 7
8278-successful completion of a degree or gradu ation 8
8279-at a participating school, interest at the rate 9
8280-specified in section 335.233 shall be charged on 10
8281-the amount of financial assistance received from 11
8282-the state under the provisions of sections 12
8283-335.212 to 335.242, and repayment, in accordance 13
8284-with the repayment contract, shall begin within 14
8285-ninety days of the date the financial aid 15
8286-recipient ceased to be an eligible student. All 16
8287-funds repaid by recipients of financial 17
8288-assistance to the department shall be deposited 18
8289-in the professional and practi cal nursing 19
8290-student loan and nurse loan repayment fund for 20
8291-use pursuant to sections 335.212 to 335.259. ] 21
8292- [335.239. The department shall grant a 1
8293-deferral of interest and principal payments to a 2
8294-financial assistance recipient who is p ursuing 3
8295-an advanced degree, special nursing program, or 4
8296-upon special conditions established by the 5
8297-department. The deferral shall not exceed four 6
8298-years. The status of each deferral shall be 7
8299-reviewed annually by the department of health 8
8300-and senior services to ensure compliance with 9
8301-the intent of this section. ] 10
8302- [335.242. When necessary to protect the 1
8303-interest of the state in any financial 2
8304-assistance transaction under sections 335.212 to 3
8305-335.259, the department of health and sen ior 4
8306-services may institute any action to recover any 5
8307-amount due.] 6 CCS HCS SS SCS SB 157 257
8308- [335.245. As used in sections 335.245 to 1
8309-335.259, the following terms mean: 2
8310- (1) "Department", the Missouri department 3
8311-of health and senior services; 4
8312- (2) "Eligible applicant", a Missouri 5
8313-licensed nurse who has attained either an 6
8314-associate degree, a diploma, a bachelor of 7
8315-science, or graduate degree in nursing from an 8
8316-accredited institution approved by the board of 9
8317-nursing or a student nurse in the final year of 10
8318-a full-time baccalaureate school of nursing 11
8319-leading to a baccalaureate degree or graduate 12
8320-nursing program leading to a master's degree in 13
8321-nursing and has agreed to serve in an area of 14
8322-defined need as established by the department; 15
8323- (3) "Participating school", an institution 16
8324-within this state which grants an associate 17
8325-degree in nursing, grants a bachelor or master 18
8326-of science degree in nursing or provides a 19
8327-diploma nursing program which is accredited by 20
8328-the state board of nursing, or a regionally 21
8329-accredited institution in this state which 22
8330-provides a bachelor of science completion 23
8331-program for registered professional nurses; 24
8332- (4) "Qualified employment", employment on 25
8333-a full-time basis in Missouri in a position 26
8334-requiring licensure as a licensed practical 27
8335-nurse or registered professional nurse in any 28
8336-hospital as defined in section 197.020 or public 29
8337-or nonprofit agency, institution, or 30
8338-organization located in an area of need as 31
8339-determined by the department of health and 32
8340-senior services. Any forgiveness of such 33
8341-principal and interest for any qualified 34
8342-applicant engaged in qualified employment on a 35
8343-less than full-time basis may be prorated to 36
8344-reflect the amounts provided in this section. ] 37
8345- [335.248. Sections 335.245 to 335.259 1
8346-shall be known as the "Nursing Student Loan 2
8347-Repayment Program". The department of health 3
8348-and senior services shall be the administrative 4
8349-agency for the implementation of the authority 5
8350-established by sections 335.245 to 335.259. The 6
8351-department shall promulgate reasonable rules and 7
8352-regulations necessary to implement sections 8
8353-335.245 to 335.259. Promulgated rules shall 9
8354-include, but not be limited to, applicant 10
8355-eligibility, selection criteria, prioritization 11
8356-of service obligation sites and the content of 12
8357-loan repayment contracts, including repayment 13
8358-schedules for those in default and penalties. 14
8359-The department shall promulgate rules regarding 15
8360-recruitment opportunities for minority students 16
8361-into nursing schools. Priority for student loan 17
8362-repayment shall be given to eligible applicants 18
8363-who have demonstrated financial need. All funds 19 CCS HCS SS SCS SB 157 258
8364-collected by the department from participants 20
8365-not meeting their contractual obligations to the 21
8366-state shall be deposited in the profession al and 22
8367-practical nursing student loan and nurse loan 23
8368-repayment fund for use pursuant to sections 24
8369-335.212 to 335.259.] 25
8370- [335.251. Upon proper verification to the 1
8371-department by the eligible applicant of securing 2
8372-qualified employment i n this state, the 3
8373-department shall enter into a loan repayment 4
8374-contract with the eligible applicant to repay 5
8375-the interest and principal on the educational 6
8376-loans of the applicant to the limit of the 7
8377-contract, which contract shall provide for 8
8378-instances of less than full-time qualified 9
8379-employment consistent with the provisions of 10
8380-section 335.233, out of any appropriation made 11
8381-to the professional and practical nursing 12
8382-student loan and nurse loan repayment fund. If 13
8383-the applicant breaches the contract by failing 14
8384-to begin or complete the qualified employment, 15
8385-the department is entitled to recover the total 16
8386-of the loan repayment paid by the department 17
8387-plus interest on the repaid amount at the rate 18
8388-of nine and one-half percent per annum. ] 19
8389- [335.254. Sections 335.212 to 335.259 1
8390-shall not be construed to require the department 2
8391-to enter into contracts with individuals who 3
8392-qualify for nursing education loans or nursing 4
8393-loan repayment programs when federal, state and 5
8394-local funds are not available for such purposes. ] 6
8395- [335.257. Successful applicants for whom 1
8396-loan payments are made under the provisions of 2
8397-sections 335.245 to 335.259 shall verify to the 3
8398-department twice each year in the manner 4
8399-prescribed by the de partment that qualified 5
8400-employment in this state is being maintained. ] 6
8401- Section B. Because immediate action is necessary to 1
8402-address the shortage of health care providers in this state, 2
8403-the enactment of section 191.592 of this act is d eemed 3
8404-necessary for the immediate preservation of the public 4
8405-health, welfare, peace, and safety, and is hereby declared 5
8406-to be an emergency act within the meaning of the 6
8407-constitution, and the enactment of section 191.592 of this 7
8408-act shall be in full fo rce and effect upon its passage and 8
8409-approval. 9
8410-
18+SectionA.Sections191.500,191.505,191.510,191.515,191.520,191.525,191.530,
19+2191.535,191.540,191.545,191.550,191.600,191.828,191.831,195.070,195.100,324.520,
20+3329.010,334.036,334.043,334.100,334.104,334.506,334.613,334.735,334.747,335.016,
21+4335.019,335.036,335.046,335.051,335.056,335.076,335.086,335.175,335.203,335.212,
22+5335.215,335.218,335.221,335.224,335.227,335.230,335.233,335.236,335.239,335.242,
23+6335.245,335.248,335.251,335.254,335.257,337.510,337.615,337.644,and337.665,
24+7RSMo,arerepealedandseventy-eightnewsectionsenactedinlieuthereof,tobeknownas
25+8sections191.430,191.435,191.440,191.445,191.450,191.600,191.828,191.831,195.070,
26+9195.100,324.520,329.010,329.280,334.036,334.043,334.100,334.104,334.506,334.613,
27+10334.735,334.747,334.1600,334.1605,334.1610,334.1615,334.1620,334.1625,334.1630,
28+11334.1635,334.1640,334.1645,334.1650,334.1655,334.1660,334.1665,334.1670,
29+12334.1675,334.1680,334.1685,334.1690,334.1695,334.1700,334.1705,334.1710,
30+EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
31+intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 13334.1715,334.1720,335.016,335.019,335.036,335.046,335.051,335.056,335.076,
32+14335.086,335.175,335.203,335.205,337.510,337.550,337.615,337.644,337.665,
33+15337.1000,337.1005,337.1010,337.1015,337.1020,337.1025,337.1030,337.1035,
34+16337.1040,337.1045,337.1050,337.1055,337.1060,337.1065,337.1070,and337.1075,to
35+17readasfollows:
36+191.430.1.Thereisherebyestablishedwithinthedepartmentofhealthand
37+2seniorservicesthe"HealthProfessionalLoanRepaymentProgram"toprovide
38+3forgivableloansforthepurposeofrepayingexistingloansrelatedtoapplicable
39+4educationalexpensesforhealthcare,mentalhealth,andpublichealthprofessionals.
40+5Thedepartmentofhealthandseniorservicesshallbetheadministrativeagencyforthe
41+6implementationoftheprogramestablishedbythissection.
42+7 2.Thedepartmentofhealthandseniorservicesshallprescribetheformandthe
43+8timeandmethodoffilingapplicationsandsupervisetheprocessing,includingoversight
44+9andmonitoringoftheprogram,andshallpromulgaterulestoimplementtheprovisions
45+10ofsections191.430to191.450.Anyruleorportionofarule,asthattermisdefinedin
46+11section536.010,thatiscreatedundertheauthoritydelegatedinthissectionshall
47+12becomeeffectiveonlyifitcomplieswithandissubjecttoalloftheprovisionsofchapter
48+13536and,ifapplicable,section536.028.Thissectionandchapter536arenonseverable
49+14andifanyofthepowersvestedwiththegeneralassemblypursuanttochapter536to
50+15review,todelaytheeffectivedate,ortodisapproveandannularulearesubsequently
51+16heldunconstitutional,thenthegrantofrulemakingauthorityandanyruleproposedor
52+17adoptedafterAugust28,2023,shallbeinvalidandvoid.
53+18 3.Thedirectorofthedepartmentofhealthandseniorservicesshallhavethe
54+19discretiontodeterminethehealthprofessionalsandpractitionerswhowillreceive
55+20forgivablehealthprofessionalloansfromthedepartmenttopaytheirexistingloans.
56+21Thedirectorshallmakesuchdeterminationseachfiscalyearbasedonevidence
57+22associatedwiththegreatestneedsinthebestinterestsofthepublic.Thehealthcare,
58+23mentalhealth,andpublichealthprofessionalsordisciplinesfundedinanygivenyear
59+24shallbecontingentuponconsultationwiththeofficeofworkforcedevelopmentinthe
60+25departmentofhighereducationandworkforcedevelopmentandthedepartmentof
61+26mentalhealth,ortheirsuccessoragencies.
62+27 4.Thedepartmentofhealthandseniorservicesshallenterintoacontractwith
63+28eachselectedapplicantwhoreceivesahealthprofessionalloanunderthissection.Each
64+29selectedapplicantshallapplytheloanawardtohisorhereducationaldebt.The
65+30contractshalldetailthemethodsofforgivenessassociatedwithaserviceobligationand
66+31thetermsassociatedwiththeprincipalandinterestaccruingontheloanatthetimeof
67+32theaward.Thecontractshallcontaindetailsconcerninghowforgivenessisearned,
68+HCSSSSCSSB157 2 33includingwhenpartialforgivenessisearnedthroughaserviceobligation,andtheterms
69+34andconditionsassociatedwithrepaymentoftheloansforanyobligationnotserved.
70+35 5.Allhealthprofessionalloansshallbemadefromfundsappropriatedbythe
71+36generalassemblytothehealthprofessionalloanincentivefundestablishedinsection
72+37191.445.
73+191.435.Thedepartmentofhealthandseniorservicesshalldesignatecounties,
74+2communities,orsectionsofareasinthestateasareasofdefinedneedforhealthcare,
75+3mentalhealth,andpublichealthservices.Ifacounty,community,orsectionofanarea
76+4hasbeendesignatedordeterminedasaprofessionalshortagearea,ashortagearea,ora
77+5healthcare,mentalhealth,orpublichealthprofessionalshortageareabythefederal
78+6DepartmentofHealthandHumanServicesoritssuccessoragency,thedepartmentof
79+7healthandseniorservicesshalldesignateitasanareaofdefinedneedunderthissection.
80+8Ifthedirectorofthedepartmentofhealthandseniorservicesdeterminesthatacounty,
81+9community,orsectionofanareahasanextraordinaryneedforhealthcareprofessional
82+10serviceswithoutacorrespondingsupplyofsuchprofessionals,thedepartmentofhealth
83+11andseniorservicesmaydesignateitasanareaofdefinedneedunderthissection.
84+191.440.1.Thedepartmentofhealthandseniorservicesshallenterintoa
85+2contractwitheachindividualqualifyingforaforgivableloanundersections191.430to
86+3191.450.Thewrittencontractbetweenthedepartmentandtheindividualshallcontain,
87+4butnotbelimitedto,thefollowing:
88+5 (1)Anagreementthatthestateagreestoawardaloanandtheindividualagrees
89+6toserveforaperiodequaltotwoyears,oralongerperiodastheindividualmayagree
90+7to,inanareaofdefinedneedasdesignatedbythedepartment,withsuchserviceperiod
91+8tobeginonthedateidentifiedonthesignedcontract;
92+9 (2)Aprovisionthatanyfinancialobligationsarisingoutofacontractentered
93+10intoandanyobligationoftheindividualthatisconditionedthereoniscontingentupon
94+11fundsbeingappropriatedforloans;
95+12 (3)Theareaofdefinedneedwherethepersonwillpractice;
96+13 (4)Astatementofthedamagestowhichthestateisentitledfortheindividual's
97+14breachofthecontract;and
98+15 (5)Suchotherstatementsoftherightsandliabilitiesofthedepartmentandof
99+16theindividualnotinconsistentwithsections191.430to191.450.
100+17 2.Thedepartmentofhealthandseniorservicesmaystipulatespecificpractice
101+18sites,contingentupondepartment-generatedhealthcare,mentalhealth,andpublic
102+19healthprofessionalneedpriorities,whereapplicantsshallagreetopracticeforthe
103+20durationoftheirparticipationintheprogram.
104+HCSSSSCSSB157 3 191.445.Thereisherebycreatedinthestatetreasurythe"HealthProfessional
105+2LoanIncentiveFund",whichshallconsistofanyappropriationsmadebythegeneral
106+3assembly,allfundsrecoveredfromanindividualundersection191.450,andallfunds
107+4generatedbyloanrepaymentsreceivedundersections191.430to191.450.Thestate
108+5treasurershallbecustodianofthefund.Inaccordancewithsections30.170and30.180,
109+6thestatetreasurermayapprovedisbursements.Thefundshallbeadedicatedfundand,
110+7uponappropriation,moneysinthisfundshallbeusedsolelybythedepartmentof
111+8healthandseniorservicestoprovideloansundersections191.430to191.450.
112+9Notwithstandingtheprovisionsofsection33.080tothecontrary,anymoneys
113+10remaininginthefundattheendofthebienniumshallnotreverttothecreditofthe
114+11generalrevenuefund.Thestatetreasurershallinvestmoneysinthefundinthesame
115+12mannerasotherfundsareinvested.Anyinterestandmoneysearnedonsuch
116+13investmentsshallbecreditedtothefund.
117+191.450.1.Anindividualwhoentersintoawrittencontractwiththe
118+2departmentofhealthandseniorservices,asdescribedinsection191.440,andwhofails
119+3tomaintainanacceptableemploymentstatusshallbeliabletothestateforanyamount
120+4awardedasaloanbythedepartmentdirectlytotheindividualwhoenteredintothe
121+5contractthathasnotyetbeenforgiven.
122+6 2.Anindividualfailstomaintainanacceptableemploymentstatusunderthis
123+7sectionwhenthecontractedindividualinvoluntarilyorvoluntarilyterminates
124+8qualifyingemployment,isdismissedfromsuchemploymentbeforecompletionofthe
125+9contractualserviceobligationwithinthespecifictimeframeoutlinedinthecontract,or
126+10failstorespondtorequestsmadebythedepartment.
127+11 3.Ifanindividualbreachesthewrittencontractoftheindividualbyfailingto
128+12beginorcompletesuchindividual'sserviceobligation,thestateshallbeentitledto
129+13recoverfromtheindividualanamountequaltothesumof:
130+14 (1)Thetotalamountoftheloanawardedbythedepartmentor,ifthe
131+15departmenthadalreadyawardedpartialforgivenessatthetimeofthebreach,the
132+16amountoftheloannotyetforgiven;
133+17 (2)Theinterestontheamountthatwouldbepayableifatthetimetheloanwas
134+18awardeditwasaloanbearinginterestatthemaximumprevailingrateasdeterminedby
135+19theTreasureroftheUnitedStates;
136+20 (3)Anamountequaltoanydamagesincurredbythedepartmentasaresultof
137+21thebreach;and
138+22 (4)Anylegalfeesorassociatedcostsincurredbythedepartmentorthestateof
139+23Missouriinthecollectionofdamages.
140+HCSSSSCSSB157 4 191.600.1.Sections191.600to191.615establishaloanrepaymentprogramfor
141+2graduatesofapprovedmedicalschools,schoolsofosteopathicmedicine,schoolsofdentistry
142+3andaccreditedchiropracticcollegeswhopracticeinareasofdefinedneedandshallbeknown
143+4asthe"HealthProfessionalStudentLoanRepaymentProgram".Sections191.600to191.615
144+5shallapplytograduatesofaccreditedchiropracticcollegeswhenfederalguidelinesfor
145+6chiropracticshortageareasaredeveloped.
146+7 2.The"HealthProfessionalStudentLoanandLoanRepaymentProgramFund"is
147+8herebycreatedinthestatetreasury.Allfundsrecoveredfromanindividualpursuantto
148+9section191.614andallfundsgeneratedbyloanrepaymentsandpenaltiesreceivedpursuant
149+10tosection191.540shallbecreditedtothefund.Themoneysinthefundshallbeusedbythe
150+11departmentofhealthandseniorservicestoprovideloanrepaymentspursuanttosection
151+12191.611inaccordancewithsections191.600to191.614[andtoprovideloanspursuantto
152+13sections191.500to191.550].
153+191.828.1.Thefollowingdepartmentsshallconducton-goingevaluationsofthe
154+2effectoftheinitiativesenactedbythefollowingsections:
155+3 (1)Thedepartmentofcommerceandinsuranceshallevaluatetheeffectofrevising
156+4section376.782andsections143.999,208.178,374.126,and376.891to376.894;
157+5 (2)Thedepartmentofhealthandseniorservicesshallevaluatetheeffectofrevising
158+6sections105.711and[sections191.520and]191.600andenactingsection191.411,and
159+7sections167.600to167.621,191.231,208.177,431.064,and660.016.Incollaborationwith
160+8thestateboardofregistrationforthehealingarts,thestateboardofnursing,andthestate
161+9boardofpharmacy,thedepartmentofhealthandseniorservicesshallalsoevaluatetheeffect
162+10ofrevisingsection195.070,section334.100,andsection335.016,andofsections334.104
163+11and334.112,andsection338.095and338.198;
164+12 (3)Thedepartmentofsocialservicesshallevaluatetheeffectofrevisingsection
165+13198.090,andsections208.151,208.152and208.215,andsection383.125,andofsections
166+14167.600to167.621,208.177,208.178,208.179,208.181,and211.490;
167+15 (4)Theofficeofadministrationshallevaluatetheeffectofrevisingsections105.711
168+16and105.721;
169+17 (5)TheMissouriconsolidatedhealthcareplanshallevaluatetheeffectofsection
170+18103.178;and
171+19 (6)Thedepartmentofmentalhealthshallevaluatetheeffectofsection191.831asit
172+20relatestosubstanceabusetreatmentandofsection191.835.
173+21 2.Thedepartmentofrevenueandofficeofadministrationshallmakebiannualreports
174+22tothegeneralassemblyandthegovernorconcerningtheincomereceivedintothehealth
175+23initiativesfundandtheleveloffundingrequiredtooperatetheprogramsandinitiatives
176+24fundedbythehealthinitiativesfundatanoptimallevel.
177+HCSSSSCSSB157 5 191.831.1.Thereisherebyestablishedinthestatetreasurya"HealthInitiatives
178+2Fund",towhichshallbedepositedallrevenuesdesignatedforthefundundersubsection8of
179+3section149.015,andsubsection3ofsection149.160,andsection167.609,andallotherfunds
180+4donatedtothefundorotherwisedepositedpursuanttolaw.Thestatetreasurershall
181+5administerthefund.Moneyinthefundshallbeappropriatedtoprovidefundingfor
182+6implementingthenewprogramsandinitiativesestablishedbysections105.711and105.721.
183+7Themoneysinthefundmayfurtherbeusedtofundthoseprogramsestablishedbysections
184+8191.411[,191.520] and191.600,sections208.151and208.152,andsections103.178,
185+9143.999,167.600to167.621,188.230,191.211,191.231,191.825to191.839,192.013,
186+10208.177,208.178,208.179and208.181,211.490,285.240,337.093,374.126,376.891to
187+11376.894,431.064,660.016,660.017and660.018;inaddition,notlessthanfifteenpercentof
188+12theproceedsdepositedtothehealthinitiativefundpursuanttosections149.015and149.160
189+13shallbeappropriatedannuallytoprovidefundingfortheC-STARsubstanceabuse
190+14rehabilitationprogramofthedepartmentofmentalhealth,oritssuccessorprogram,andaC-
191+15STARpilotprojectdevelopedbythedirectorofthedivisionofalcoholanddrugabuseand
192+16thedirectorofthedepartmentofcorrectionsasanalternativetoincarceration,asprovidedin
193+17subsections2,3,and4ofthissection.Suchpilotprojectshallbeknownasthe"Alt-care"
194+18program.Inaddition,someoftheproceedsdepositedtothehealthinitiativesfundpursuantto
195+19sections149.015and149.160shallbeappropriatedannuallytothedivisionofalcoholand
196+20drugabuseofthedepartmentofmentalhealthtobeusedfortheadministrationandoversight
197+21ofthesubstanceabusetraffic[offenders] offenderprogramdefinedinsection302.010[and
198+22section577.001]. Theprovisionsofsection33.080tothecontrarynotwithstanding,moneyin
199+23thehealthinitiativesfundshallnotbetransferredatthecloseofthebienniumtothegeneral
200+24revenuefund.
201+25 2.Thedirectorofthedivisionofalcoholanddrugabuseandthedirectorofthe
202+26departmentofcorrectionsshalldevelopandadministerapilotprojecttoprovidea
203+27comprehensivesubstanceabusetreatmentandrehabilitationprogramasanalternativeto
204+28incarceration,hereinafterreferredtoas"Alt-care".Alt-careshallbefundedusingmoney
205+29providedundersubsection1ofthissectionthroughtheMissouriMedicaidprogram,theC-
206+30STARprogramofthedepartmentofmentalhealth,andthedivisionofalcoholanddrug
207+31abuse'spurchase-of-servicesystem.Alt-careshallofferaflexiblecombinationofclinical
208+32servicesandlivingarrangementsindividuallyadaptedtoeachclientandherchildren.Alt-
209+33careshallconsistofthefollowingcomponents:
210+34 (1)Assessmentandtreatmentplanning;
211+35 (2)Communitysupporttoprovidecontinuity,monitoringofprogressandaccessto
212+36servicesandresources;
213+37 (3)Counselingfromindividualtofamilytherapy;
214+HCSSSSCSSB157 6 38 (4)Daytreatmentserviceswhichincludeaccessibilitysevendaysperweek,
215+39transportationtoandfromtheAlt-careprogram,weeklydrugtesting,leisureactivities,
216+40weeklyeventsforfamiliesandcompanions,jobandeducationpreparednesstraining,peer
217+41supportandself-helpanddailylivingskills;and
218+42 (5)Livingarrangementoptionswhicharepermanent,substance-freeandconducive
219+43totreatmentandrecovery.
220+44 3.Anyfemalewhoispregnantoristhecustodialparentofachildorchildrenunder
221+45theageoftwelveyears,andwhohaspleadedguiltytoorfoundguiltyofviolatingthe
222+46provisionsofchapter195,andwhosecontrolledsubstanceabusewasaprecipitatingor
223+47contributingfactorinthecommissionoftheoffense,andwhoisplacedonprobationmaybe
224+48required,asaconditionofprobation,toparticipateinAlt-care,ifspaceisavailableinthe
225+49pilotprojectarea.Determinationsofeligibilityfortheprogram,placement,andcontinued
226+50participationshallbemadebythedivisionofalcoholanddrugabuse,inconsultationwiththe
227+51departmentofcorrections.
228+52 4.TheavailabilityofspaceinAlt-careshallbedeterminedbythedirectorofthe
229+53divisionofalcoholanddrugabuseinconjunctionwiththedirectorofthedepartmentof
230+54corrections.Ifthesentencingcourtisadvisedthatthereisnospaceavailable,thecourtshall
231+55considerotherauthorizeddispositions.
232+195.070.1.Aphysician,podiatrist,dentist,aregisteredoptometristcertifiedto
233+2administerpharmaceuticalagentsasprovidedinsection336.220,oranassistantphysicianin
234+3accordancewithsection334.037oraphysicianassistantinaccordancewithsection334.747
235+4ingoodfaithandinthecourseofhisorherprofessionalpracticeonly,mayprescribe,
236+5administer,anddispensecontrolledsubstancesorheorshemaycausethesametobe
237+6administeredordispensedbyanindividualasauthorizedbystatute.
238+7 2.Anadvancedpracticeregisterednurse,asdefinedinsection335.016,butnota
239+8certifiedregisterednurseanesthetistasdefinedinsubdivision(8)ofsection335.016,who
240+9holdsacertificateofcontrolledsubstanceprescriptiveauthorityfromtheboardofnursing
241+10undersection335.019andwhoisdelegatedtheauthoritytoprescribecontrolledsubstances
242+11underacollaborativepracticearrangementundersection334.104mayprescribeany
243+12controlledsubstanceslistedinSchedulesIII,IV,andVofsection195.017,andmayhave
244+13restrictedauthorityinScheduleII.PrescriptionsforScheduleIImedicationsprescribedbyan
245+14advancedpracticeregisterednursewhohasacertificateofcontrolledsubstanceprescriptive
246+15authorityarerestrictedtoonlythosemedicationscontaininghydrocodoneandScheduleII
247+16controlledsubstancesforhospicepatientspursuanttotheprovisionsofsection334.104.
248+17However,nosuchcertifiedadvancedpracticeregisterednurseshallprescribecontrolled
249+18substanceforhisorherownselforfamily.ScheduleIIInarcoticcontrolledsubstanceand
250+HCSSSSCSSB157 7 19ScheduleII-hydrocodoneprescriptionsshallbelimitedtoaonehundredtwenty-hoursupply
251+20withoutrefill.
252+21 3.Aveterinarian,ingoodfaithandinthecourseoftheveterinarian'sprofessional
253+22practiceonly,andnotforusebyahumanbeing,mayprescribe,administer,anddispense
254+23controlledsubstancesandtheveterinarianmaycausethemtobeadministeredbyanassistant
255+24ororderlyunderhisorherdirectionandsupervision.
256+25 4.Apractitionershallnotacceptanyportionofacontrolledsubstanceunusedbya
257+26patient,foranyreason,ifsuchpractitionerdidnotoriginallydispensethedrug,except:
258+27 (1)Whenthecontrolledsubstanceisdeliveredtothepractitionertoadministertothe
259+28patientforwhomthemedicationisprescribedasauthorizedbyfederallaw.Practitioners
260+29shallmaintainrecordsandsecurethemedicationasrequiredbythischapterandregulations
261+30promulgatedpursuanttothischapter;or
262+31 (2)Asprovidedinsection195.265.
263+32 5.Anindividualpractitionershallnotprescribeordispenseacontrolledsubstancefor
264+33suchpractitioner'spersonaluseexceptinamedicalemergency.
265+195.100.1.Itshallbeunlawfultodistributeanycontrolledsubstanceina
266+2commercialcontainerunlesssuchcontainerbearsalabelcontaininganidentifyingsymbolfor
267+3suchsubstanceinaccordancewithfederallaws.
268+4 2.Itshallbeunlawfulforanymanufacturerofanycontrolledsubstancetodistribute
269+5suchsubstanceunlessthelabelingthereofconformstotherequirementsoffederallawand
270+6containstheidentifyingsymbolrequiredinsubsection1ofthissection.
271+7 3.ThelabelofacontrolledsubstanceinScheduleII,IIIorIVshall,whendispensed
272+8toorforapatient,containaclear,concisewarningthatitisacriminaloffensetotransfersuch
273+9narcoticordangerousdrugtoanypersonotherthanthepatient.
274+10 4.Wheneveramanufacturersellsordispensesacontrolledsubstanceandwhenevera
275+11wholesalersellsordispensesacontrolledsubstanceinapackagepreparedbyhimorher,the
276+12manufacturerorwholesalershallsecurelyaffixtoeachpackageinwhichthatdrugis
277+13containedalabelshowinginlegibleEnglishthenameandaddressofthevendorandthe
278+14quantity,kind,andformofcontrolledsubstancecontainedtherein.Nopersonexcepta
279+15pharmacistforthepurposeoffillingaprescriptionunderthischapter,shallalter,deface,or
280+16removeanylabelsoaffixed.
281+17 5.Wheneverapharmacistorpractitionersellsordispensesanycontrolledsubstance
282+18onaprescriptionissuedbyaphysician,physicianassistant,dentist,podiatrist,veterinarian,or
283+19advancedpracticeregisterednurse,thepharmacistorpractitionershallaffixtothecontainer
284+20inwhichsuchdrugissoldordispensedalabelshowinghisorherownnameandaddressof
285+21thepharmacyorpractitionerforwhomheorsheislawfullyacting;thenameofthepatientor,
286+22ifthepatientisananimal,thenameoftheowneroftheanimalandthespeciesoftheanimal;
287+HCSSSSCSSB157 8 23thenameofthephysician,physicianassistant,dentist,podiatrist,advancedpracticeregistered
288+24nurse,orveterinarianbywhomtheprescriptionwaswritten;[thenameofthecollaborating
289+25physicianiftheprescriptioniswrittenbyanadvancedpracticeregisterednurseoraphysician
290+26assistant,] andsuchdirectionsasmaybestatedontheprescription.Nopersonshallalter,
291+27deface,orremoveanylabelsoaffixed.
292+324.520.1.Asusedinsections324.520to324.524,thefollowingtermsmean:
293+2 (1)"Bodypiercing",theperforationofhumantissueotherthananearfora
294+3nonmedicalpurpose;
295+4 (2)"Branding",apermanentmarkmadeonhumantissuebyburningwithahotiron
296+5orotherinstrument;
297+6 (3)"Controlledsubstance",anysubstancedefinedinsection195.010;
298+7 (4)"Minor",apersonundertheageofeighteen;
299+8 (5)"Tattoo",oneormoreofthefollowing:
300+9 (a)[Anindelible] Amarkmadeonthebodyofanotherpersonbytheinsertionofa
301+10pigment, ink,orbothpigmentandinkundertheskinwiththeaidofneedlesorblades
302+11usinghand-heldormachine-poweredinstruments; [or]
303+12 (b)Amarkmadeonthefaceorbodyofanotherpersonforcosmeticpurposesor
304+13toanypartofthebodyforscarcoverageorothercorrectivepurposesbytheinsertionof
305+14apigment,ink,orbothpigmentandinkundertheskinwiththeaidofneedles;or
306+15 (c)Anindelibledesignmadeonthebodyofanotherpersonbyproductionofscars
307+16otherthanbybranding.
308+17 2.Nopersonshallknowinglytattoo,brandorperformbodypiercingonaminor
309+18unlesssuchpersonobtainsthepriorwritteninformedconsentoftheminor'sparentorlegal
310+19guardian.Theminor'sparentorlegalguardianshallexecutethewritteninformedconsent
311+20requiredpursuanttothissubsectioninthepresenceofthepersonperformingthetattooing,
312+21brandingorbodypiercingontheminor,orinthepresenceofanemployeeoragentofsuch
313+22person.Anypersonwhofraudulentlymisrepresentshimselforherselfasaparentisguiltyof
314+23aclassBmisdemeanor.
315+24 3.Apersonshallnottattoo,brandorperformbodypiercingonanotherpersonifthe
316+25otherpersonisundertheinfluenceofintoxicatingliquororacontrolledsubstance.
317+26 4.Apersonwhoviolatesanyprovisionsofsections324.520to324.526isguiltyofa
318+27misdemeanorandshallbefinednotmorethanfivehundreddollars.Ifthereisasubsequent
319+28violationwithinoneyearoftheinitialviolation,suchpersonshallbefinednotlessthanfive
320+29hundreddollarsormorethanonethousanddollars.
321+30 5.Nopersonundertheageofeighteenshalltattoo,brandorperformbodypiercing
322+31onanotherperson.
323+HCSSSSCSSB157 9 329.010.Asusedinthischapter,unlessthecontextclearlyindicatesotherwise,the
324+2followingwordsandtermsmean:
325+3 (1)"Accreditedschoolofcosmetologyorschoolofmanicuring",anestablishment
326+4operatedforthepurposeofteachingcosmetologyasdefinedinthissectionandmeetingthe
327+5criteriasetforthunder34C.F.R.Part600,Sections600.1and600.2;
328+6 (2)"Apprentice"or"student",apersonwhoisengagedintrainingwithina
329+7cosmetologyestablishmentorschool,andwhilesotrainingperformsanyofthepracticesof
330+8theclassifiedoccupationswithinthischapterundertheimmediatedirectionandsupervision
331+9ofalicensedcosmetologistorinstructor;
332+10 (3)"Board",thestateboardofcosmetologyandbarberexaminers;
333+11 (4)"Cosmetologist",anypersonwho,forcompensation,engagesinthepracticeof
334+12cosmetology,asdefinedinsubdivision(5)ofthissection;
335+13 (5)"Cosmetology"includesperformingorofferingtoengageinanyactsofthe
336+14classifiedoccupationsofcosmetologyforcompensation,whichshallinclude:
337+15 (a)"ClassCH-hairdresser"includesarranging,dressing,curling,singeing,waving,
338+16permanentwaving,cleansing,cutting,bleaching,tinting,coloringorsimilarworkuponthe
339+17hairofanypersonbyanymeans;orremovingsuperfluoushairfromthebodyofanyperson
340+18bymeansotherthanelectricity,oranyothermeansofarchingortintingeyebrowsortinting
341+19eyelashes.ClassCH-hairdresseralsoincludesanypersonwhoeitherwiththeperson'shands
342+20orwithmechanicalorelectricalapparatusesorappliances,orbytheuseofcosmetic
343+21preparations,antiseptics,tonics,lotionsorcreamsengagesforcompensationinanyoneor
344+22anycombinationofthefollowing:massaging,cleaning,stimulating,manipulating,
345+23exercising,beautifyingorsimilarworkuponthescalp,face,neck,armsorbust;
346+24 (b)"ClassMO-manicurist"includescutting,trimming,polishing,coloring,tinting,
347+25cleaningorotherwisebeautifyingaperson'sfingernails,applyingartificialfingernails,
348+26massaging,cleaningaperson'shandsandarms;pedicuring,whichincludescutting,trimming,
349+27polishing,coloring,tinting,cleaningorotherwisebeautifyingaperson'stoenails,applying
350+28artificialtoenails,massagingandcleaningaperson'slegsandfeet;
351+29 (c)"ClassCA-hairdressingandmanicuring"includesallpracticesofcosmetology,
352+30asdefinedinparagraphs(a)and(b)ofthissubdivision;
353+31 (d)"ClassE-estheticians"includestheuseofmechanical,electricalapparatusesor
354+32appliances,orbytheuseofcosmeticpreparations,antiseptics,tonics,lotionsorcreams,not
355+33toexceedtenpercentphenol,engagesforcompensation,eitherdirectlyorindirectly,inany
356+34one,oranycombination,ofthefollowingpractices:massaging,cleansing,stimulating,
357+35manipulating,exercising,beautifyingorsimilarworkuponthescalp,face,neck,ears,arms,
358+36hands,bust,torso,legsorfeetandremovingsuperfluoushairbymeansotherthanelectric
359+HCSSSSCSSB157 10 37needleoranyothermeansofarchingortintingeyebrowsortintingeyelashes,ofanyperson;
360+38and
361+39 (e)"Personalserviceregistration",aregistrationobtainedfromtheboardto
362+40provideservicestoplaceboundclients;
363+41 (6)"Cosmetologyestablishment",thatpartofanybuildingwhereinorwhereuponany
364+42oftheclassifiedoccupationsarepracticedincludinganyspacerentedwithinalicensed
365+43establishmentbyapersonlicensedunderthischapter,forthepurposeofrendering
366+44cosmetologyservices;
367+45 (7)"Cross-overlicense",alicensethatisissuedtoanypersonwhohasmetthe
368+46licensureandexaminationrequirementsforbothbarberingandcosmetology;
369+47 (8)"Hairbraider",anypersonwho,forcompensation,engagesinthepracticeofhair
370+48braiding;
371+49 (9)"Hairbraiding",inaccordancewiththerequirementsofsection329.275,theuse
372+50oftechniquesthatresultintensiononhairstrandsorrootsbytwisting,wrapping,waving,
373+51extending,locking,orbraidingofthehairbyhandormechanicaldevice,butdoesnotinclude
374+52theapplicationofdyes,reactivechemicals,orotherpreparationstoalterthecolorofthehair
375+53ortostraighten,curl,oralterthestructureofthehair;
376+54 (10)"Hairdresser",anypersonwho,forcompensation,engagesinthepracticeof
377+55cosmetologyasdefinedinparagraph(a)ofsubdivision(5)ofthissection;
378+56 (11)"Instructor",anypersonwhoislicensedtoteachcosmetologyoranypracticesof
379+57cosmetologypursuanttothischapter;
380+58 (12)"Manicurist",anypersonwho,forcompensation,engagesinanyorallofthe
381+59practicesinparagraph(b)ofsubdivision(5)ofthissection;
382+60 (13)"Parentalconsent",thewritteninformedconsentofaminor'sparentorlegal
383+61guardianthatmustbeobtainedpriortoprovidingbodywaxingonornearthegenitalia;
384+62 (14)"Placeboundclient",aclientwhoisill,disabled,orotherwiseunableto
385+63traveltoacosmetologyestablishment;
386+64 (15)"Schoolofcosmetology"or"schoolofmanicuring",anestablishmentoperated
387+65forthepurposeofteachingcosmetologyasdefinedinsubdivision(5)ofthissection.
388+329.280.1.Anycosmetologistholdingacurrentandactivelicensetopractice
389+2thecategoriesofcosmetologydescribedinparagraphs(a)to(d)ofsubdivision(5)of
390+3section329.010mayregisterwiththeboardforapersonalserviceregistrationto
391+4provideservicestoplaceboundclientsoutsideofacosmetologyestablishment.An
392+5applicantforapersonalserviceregistrationshallsubmittotheboardanapplication,a
393+6feeassetbytheboard,andacopyoftheapplicant'scurrentandactivelicense.An
394+7applicantforapersonalserviceregistrationmaybedeniedsuchregistrationifthe
395+HCSSSSCSSB157 11 8applicanthaspledguiltyto,enteredapleaofnolocontendereto,orbeenfoundguiltyof
396+9anyoftheoffensessetforthinsubsection5ofsection329.050.
397+10 2.Apersonalserviceregistrantshallkeephisorherinformationthattheboard
398+11requiresintheinitialregistrationcurrentanduptodatewiththeboard.
399+12 3.Apersonalserviceregistrantshallprovidetotheclientorcustomeracopyof
400+13thepersonalserviceregistrationandlicenseuponrequest.
401+14 4.Theboardmay:
402+15 (1)Inspectthetools,equipment,andimplementsofanypersonalservice
403+16registrantonetimeeachyeartoensurethattheregistrantisfollowingallsanitation
404+17standardssetbytheboardbyrule;
405+18 (2)Inspectthetools,equipment,andimplementsofanypersonalservice
406+19registrantifacustomerorclientsubmitsacomplainttotheboardabouttheregistrant;
407+20and
408+21 (3)Followingallrequirementssetforthinsection329.140,revokethepersonal
409+22serviceregistrationofaregistrant,disciplinearegistrant'slicense,orrevokethe
410+23registrationanddisciplinethelicenseofaregistrantforanyviolationsetforthinsection
411+24329.140orforfailuretofollowtherequirementsofthissection.
412+25 5.Theboardmaypromulgateregulationsnecessaryfortheadministrationof
413+26thissection.Anyruleorportionofarule,asthattermisdefinedinsection536.010,that
414+27iscreatedundertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifit
415+28complieswithandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,
416+29section536.028.Thissectionandchapter536arenonseverableandifanyofthepowers
417+30vestedwiththegeneralassemblypursuanttochapter536toreview,todelaythe
418+31effectivedate,ortodisapproveandannularulearesubsequentlyheldunconstitutional,
419+32thenthegrantofrulemakingauthorityandanyruleproposedoradoptedafterAugust
420+3328,2023,shallbeinvalidandvoid.
421+334.036.1.Forpurposesofthissection,thefollowingtermsshallmean:
422+2 (1)"Assistantphysician",anygraduateofamedicalschool[graduate] accredited
423+3bytheLiaisonCommitteeonMedicalEducation,theCommissiononOsteopathic
424+4CollegeAccreditation,oranorganizationaccreditedbytheEducationalCommission
425+5forForeignMedicalGraduateswho:
426+6 (a)IsaresidentandcitizenoftheUnitedStatesorisalegalresidentalien;
427+7 (b)HassuccessfullycompletedStep2oftheUnitedStatesMedicalLicensing
428+8Examinationortheequivalentofsuchstepofanyotherboard-approvedmedicallicensing
429+9examinationwithinthethree-yearperiodimmediatelyprecedingapplicationforlicensureas
430+10anassistantphysician,orwithinthreeyearsaftergraduationfromamedicalcollegeor
431+11osteopathicmedicalcollege,whicheverislater;
432+HCSSSSCSSB157 12 12 (c)Hasnotcompletedanapprovedpostgraduateresidencyandhassuccessfully
433+13completedStep2oftheUnitedStatesMedicalLicensingExaminationortheequivalentof
434+14suchstepofanyotherboard-approvedmedicallicensingexaminationwithintheimmediately
435+15precedingthree-yearperiodunlesswhensuchthree-yearanniversaryoccurredheorshewas
436+16servingasaresidentphysicianinanaccreditedresidencyintheUnitedStatesandcontinued
437+17todosowithinthirtydayspriortoapplicationforlicensureasanassistantphysician;and
438+18 (d)HasproficiencyintheEnglishlanguage.
439+19
440+20Anygraduateofamedicalschool[graduate] whocouldhaveappliedforlicensureand
441+21compliedwiththeprovisionsofthissubdivisionatanytimebetweenAugust28,2014,and
442+22August28,2017,mayapplyforlicensureandshallbedeemedincompliancewiththe
443+23provisionsofthissubdivision;
444+24 (2)"Assistantphysiciancollaborativepracticearrangement",anagreementbetweena
445+25physicianandanassistantphysicianthatmeetstherequirementsofthissectionandsection
446+26334.037[;
447+27 (3)"Medicalschoolgraduate",anypersonwhohasgraduatedfromamedicalcollege
448+28orosteopathicmedicalcollegedescribedinsection334.031].
449+29 2.(1)Anassistantphysiciancollaborativepracticearrangementshalllimitthe
450+30assistantphysiciantoprovidingonlyprimarycareservicesandonlyinmedicallyunderserved
451+31ruralorurbanareasofthisstate[orinanypilotprojectareasestablishedinwhichassistant
452+32physiciansmaypractice].
453+33 (2)Foraphysician-assistantphysicianteamworkinginaruralhealthclinicunderthe
454+34federalRuralHealthClinicServicesAct,P.L.95-210,asamended:
455+35 (a)Anassistantphysicianshallbeconsideredaphysicianassistantforpurposesof
456+36regulationsoftheCentersforMedicareandMedicaidServices(CMS);and
457+37 (b)Nosupervisionrequirementsinadditiontotheminimumfederallawshallbe
458+38required.
459+39 3.(1)Forpurposesofthissection,thelicensureofassistantphysiciansshalltake
460+40placewithinprocessesestablishedbyrulesofthestateboardofregistrationforthehealing
461+41arts.Theboardofhealingartsisauthorizedtoestablishrulesunderchapter536establishing
462+42licensureandrenewalprocedures,supervision,collaborativepracticearrangements,fees,and
463+43addressingsuchothermattersasarenecessarytoprotectthepublicanddisciplinethe
464+44profession.Nolicensurefeeforanassistantphysicianshallexceedtheamountofany
465+45licensurefeeforaphysicianassistant.Anapplicationforlicensuremaybedeniedorthe
466+46licensureofanassistantphysicianmaybesuspendedorrevokedbytheboardinthesame
467+47mannerandforviolationofthestandardsassetforthbysection334.100,orsuchother
468+48standardsofconductsetbytheboardbyrule.Noruleorregulationshallrequireanassistant
469+HCSSSSCSSB157 13 49physiciantocompletemorehoursofcontinuingmedicaleducationthanthatofalicensed
470+50physician.
471+51 (2)Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis
472+52createdundertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplies
473+53withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.
474+54Thissectionandchapter536arenonseverableandifanyofthepowersvestedwiththe
475+55generalassemblyunderchapter536toreview,todelaytheeffectivedate,ortodisapprove
476+56andannularulearesubsequentlyheldunconstitutional,thenthegrantofrulemaking
477+57authorityandanyruleproposedoradoptedafterAugust28,2014,shallbeinvalidandvoid.
478+58 (3)Anyrulesorregulationsregardingassistantphysiciansineffectasoftheeffective
479+59dateofthissectionthatconflictwiththeprovisionsofthissectionandsection334.037shall
480+60benullandvoidasoftheeffectivedateofthissection.
481+61 4.Anassistantphysicianshallclearlyidentifyhimselforherselfasanassistant
482+62physicianandshallbepermittedtousetheterms"doctor","Dr.",or"doc".Noassistant
483+63physicianshallpracticeorattempttopracticewithoutanassistantphysiciancollaborative
484+64practicearrangement,exceptasotherwiseprovidedinthissectionandinanemergency
485+65situation.
486+66 5.Thecollaboratingphysicianisresponsibleatalltimesfortheoversightofthe
487+67activitiesofandacceptsresponsibilityforprimarycareservicesrenderedbytheassistant
488+68physician.
489+69 6.Theprovisionsofsection334.037shallapplytoallassistantphysician
490+70collaborativepracticearrangements.Anyrenewaloflicensureunderthissectionshall
491+71includeverificationofactualpracticeunderacollaborativepracticearrangementin
492+72accordancewiththissubsectionduringtheimmediatelyprecedinglicensureperiod.
493+73 7.Eachhealthcarrierorhealthbenefitplanthatoffersorissueshealthbenefitplans
494+74thataredelivered,issuedfordelivery,continued,orrenewedinthisstateshallreimbursean
495+75assistantphysicianforthediagnosis,consultation,ortreatmentofaninsuredorenrolleeon
496+76thesamebasisthatthehealthcarrierorhealthbenefitplancoverstheservicewhenitis
497+77deliveredbyanothercomparablemid-levelhealthcareproviderincluding,butnotlimitedto,
498+78aphysicianassistant.
499+334.043.[Upontheapplicantpayingafeeequivalenttotherequiredexaminationfee
500+2andfurnishingtheboardwithalllocationsofpreviouspracticeandlicensureinchronological
501+3order,theboardshall,underregulationsprescribedbyit,admitwithoutexaminationqualified
502+4personswhomeettherequirementsofthisstateincluding,butnotlimitedto,sections
503+5334.031,334.035and334.040,andwhoholdcertificatesoflicensureinanystateorterritory
504+6oftheUnitedStatesortheDistrictofColumbiaauthorizingthemtopracticeinthesame
505+7mannerandtothesameextentasphysiciansandsurgeonsareauthorizedtopracticebythis
506+HCSSSSCSSB157 14 8chapter.Withinthelimitsofthissection,theboardisauthorizedandempoweredtonegotiate
507+9reciprocalcompactswithlicensingboardsofotherstatesforadmissionoflicensed
508+10practitionersfromMissouriinotherstates] 1.Forpurposesofthissection,thefollowing
509+11termsmean:
510+12 (1)"Board",thestateboardofregistrationforthehealingartsinthestateof
511+13Missouri;
512+14 (2)"License",alicense,certificate,registration,permit,accreditation,or
513+15militaryoccupationalspecialtythatenablesapersontolegallypracticeanoccupationor
514+16professioninaparticularjurisdiction;
515+17 (3)"Military",theArmedForcesoftheUnitedStates,includingtheAirForce,
516+18Army,CoastGuard,MarineCorps,Navy,SpaceForce,NationalGuard,andanyother
517+19militarybranchthatisdesignatedbyCongressaspartoftheArmedForcesofthe
518+20UnitedStates,andallreservecomponentsandauxiliaries.Theterm"military"also
519+21includesthemilitaryreservesandmilitiaofanyUnitedStatesterritoryorstate;
520+22 (4)"Nonresidentmilitaryspouse",anonresidentspouseofanactiveduty
521+23memberoftheArmedForcesoftheUnitedStateswhohasbeentransferredoris
522+24scheduledtobetransferredtothestateofMissouri,orwhohasbeentransferredoris
523+25scheduledtobetransferredtoanadjacentstateandisorwillbedomiciledinthestateof
524+26Missouri,orhasmovedtothestateofMissourionapermanentchange-of-stationbasis;
525+27 (5)"Oversightbody",anyboard,department,agency,orofficeofajurisdiction
526+28thatissueslicenses;
527+29 (6)"Residentmilitaryspouse",aspouseofanactivedutymemberoftheArmed
528+30ForcesoftheUnitedStateswhohasbeentransferredorisscheduledtobetransferredto
529+31thestateofMissourioranadjacentstateandwhoisapermanentresidentofthestateof
530+32Missouri,whoisdomiciledinthestateofMissouri,orwhohasMissouriashisorher
531+33homeofrecord.
532+34 2.Anypersonwhoholdsavalidcurrentphysicianandsurgeonlicenseissuedby
533+35anotherstate,abranchorunitofthemilitary,aterritoryoftheUnitedStates,orthe
534+36DistrictofColumbia,andwhohasbeenlicensedforatleastoneyearinsuchother
535+37jurisdiction,maysubmittotheboardanapplicationforaphysicianandsurgeonlicense
536+38inMissourialongwithproofofcurrentlicensureandproofoflicensureforatleastone
537+39yearintheotherjurisdiction.
538+40 3.Theboardshall:
539+41 (1)Withinsixmonthsofreceivinganapplicationdescribedinsubsection2of
540+42thissection,waiveanyexamination,educational,orexperiencerequirementsfor
541+43licensureinthisstatefortheapplicantifitdeterminesthattherewereminimum
542+44educationrequirementsand,ifapplicable,workexperienceandclinicalsupervision
543+HCSSSSCSSB157 15 45requirementsineffectandtheotherjurisdictionverifiesthatthepersonmetthose
544+46requirementsinordertobelicensedorcertifiedinthatjurisdiction.Theboardmay
545+47requireanapplicanttotakeandpassanexaminationspecifictothelawsofthisstate;or
546+48 (2)Withinthirtydaysofreceivinganapplicationdescribedinsubsection2of
547+49thissectionfromanonresidentmilitaryspouseoraresidentmilitaryspouse,waiveany
548+50examination,educational,orexperiencerequirementsforlicensureinthisstateforthe
549+51applicantandissuesuchapplicantalicenseunderthissectionifsuchapplicant
550+52otherwisemeetstherequirementsofthissection.
551+53 4.(1)Theboardshallnotwaiveanyexamination,educational,orexperience
552+54requirementsforanyapplicantwhohashadhisorherlicenserevokedbyanoversight
553+55bodyoutsidethestate;whoiscurrentlyunderinvestigation,whohasacomplaint
554+56pending,orwhoiscurrentlyunderdisciplinaryaction,exceptasprovidedinsubdivision
555+57(2)ofthissubsection,withanoversightbodyoutsidethestate;whodoesnotholda
556+58licenseingoodstandingwithanoversightbodyoutsidethestate;whohasacriminal
557+59recordthatwoulddisqualifyhimorherforlicensureinMissouri;orwhodoesnothold
558+60avalidcurrentlicenseintheotherjurisdictiononthedatetheboardreceiveshisorher
559+61applicationunderthissection.
560+62 (2)Ifanotherjurisdictionhastakendisciplinaryactionagainstanapplicant,the
561+63boardshalldetermineifthecausefortheactionwascorrectedandthematterresolved.
562+64Ifthematterhasnotbeenresolvedbythatjurisdiction,theboardmaydenyalicense
563+65untilthematterisresolved.
564+66 5.Nothinginthissectionshallprohibittheboardfromdenyingalicensetoan
565+67applicantunderthissectionforanyreasondescribedinsection334.100.
566+68 6.Anypersonwhoislicensedundertheprovisionsofthissectionshallbesubject
567+69totheboard'sjurisdictionandallrulesandregulationspertainingtothepracticeasa
568+70physicianandsurgeoninthisstate.
569+71 7.Thissectionshallnotbeconstruedtowaiveanyrequirementforanapplicant
570+72topayanyfees.
571+334.100.1.Theboardmayrefusetoissueorrenewanycertificateofregistrationor
572+2authority,permitorlicenserequiredpursuanttothischapterforoneoranycombinationof
573+3causesstatedinsubsection2ofthissection.Theboardshallnotifytheapplicantinwritingof
574+4thereasonsfortherefusalandshalladvisetheapplicantoftheapplicant'srighttofilea
575+5complaintwiththeadministrativehearingcommissionasprovidedbychapter621.Asan
576+6alternativetoarefusaltoissueorrenewanycertificate,registrationorauthority,theboard
577+7may,atitsdiscretion,issuealicensewhichissubjecttoprobation,restrictionorlimitationto
578+8anapplicantforlicensureforanyoneoranycombinationofcausesstatedinsubsection2of
579+9thissection.Theboard'sorderofprobation,limitationorrestrictionshallcontainastatement
580+HCSSSSCSSB157 16 10ofthedisciplineimposed,thebasistherefor,thedatesuchactionshallbecomeeffective,anda
581+11statementthattheapplicanthasthirtydaystorequestinwritingahearingbeforethe
582+12administrativehearingcommission.Iftheboardissuesaprobationary,limitedorrestricted
583+13licensetoanapplicantforlicensure,eitherpartymayfileawrittenpetitionwiththe
584+14administrativehearingcommissionwithinthirtydaysoftheeffectivedateoftheprobationary,
585+15limitedorrestrictedlicenseseekingreviewoftheboard'sdetermination.Ifnowrittenrequest
586+16forahearingisreceivedbytheadministrativehearingcommissionwithinthethirty-day
587+17period,therighttoseekreviewoftheboard'sdecisionshallbeconsideredaswaived.
588+18 2.Theboardmaycauseacomplainttobefiledwiththeadministrativehearing
589+19commissionasprovidedbychapter621againstanyholderofanycertificateofregistrationor
590+20authority,permitorlicenserequiredbythischapteroranypersonwhohasfailedtorenewor
591+21hassurrenderedtheperson'scertificateofregistrationorauthority,permitorlicenseforany
592+22oneoranycombinationofthefollowingcauses:
593+23 (1)Useofanycontrolledsubstance,asdefinedinchapter195,oralcoholicbeverage
594+24toanextentthatsuchuseimpairsaperson'sabilitytoperformtheworkofanyprofession
595+25licensedorregulatedbythischapter;
596+26 (2)Thepersonhasbeenfinallyadjudicatedandfoundguilty,orenteredapleaof
597+27guiltyornolocontendere,inacriminalprosecutionunderthelawsofanystateorofthe
598+28UnitedStates,foranyoffensereasonablyrelatedtothequalifications,functionsordutiesof
599+29anyprofessionlicensedorregulatedpursuanttothischapter,foranyoffenseinvolvingfraud,
600+30dishonestyoranactofviolence,orforanyoffenseinvolvingmoralturpitude,whetherornot
601+31sentenceisimposed;
602+32 (3)Useoffraud,deception,misrepresentationorbriberyinsecuringanycertificateof
603+33registrationorauthority,permitorlicenseissuedpursuanttothischapterorinobtaining
604+34permissiontotakeanyexaminationgivenorrequiredpursuanttothischapter;
605+35 (4)Misconduct,fraud,misrepresentation,dishonesty,unethicalconductor
606+36unprofessionalconductintheperformanceofthefunctionsordutiesofanyprofession
607+37licensedorregulatedbythischapter,including,butnotlimitedto,thefollowing:
608+38 (a)Obtainingorattemptingtoobtainanyfee,charge,tuitionorothercompensation
609+39byfraud,deceptionormisrepresentation;willfullyandcontinuallyoverchargingor
610+40overtreatingpatients;orchargingforvisitstothephysician'sofficewhichdidnotoccur
611+41unlesstheserviceswerecontractedforinadvance,orforserviceswhichwerenotrenderedor
612+42documentedinthepatient'srecords;
613+43 (b)Attempting,directlyorindirectly,bywayofintimidation,coercionordeception,
614+44toobtainorretainapatientordiscouragetheuseofasecondopinionorconsultation;
615+45 (c)Willfullyandcontinuallyperforminginappropriateorunnecessarytreatment,
616+46diagnostictestsormedicalorsurgicalservices;
617+HCSSSSCSSB157 17 47 (d)Delegatingprofessionalresponsibilitiestoapersonwhoisnotqualifiedby
618+48training,skill,competency,age,experienceorlicensuretoperformsuchresponsibilities;
619+49 (e)Misrepresentingthatanydisease,ailmentorinfirmitycanbecuredbyamethod,
620+50procedure,treatment,medicineordevice;
621+51 (f)Performingorprescribingmedicalserviceswhichhavebeendeclaredbyboard
622+52ruletobeofnomedicalorosteopathicvalue;
623+53 (g)Finaldisciplinaryactionbyanyprofessionalmedicalorosteopathicassociationor
624+54societyorlicensedhospitalormedicalstaffofsuchhospitalinthisoranyotherstateor
625+55territory,whetheragreedtovoluntarilyornot,andincluding,butnotlimitedto,anyremoval,
626+56suspension,limitation,orrestrictionoftheperson'slicenseorstafforhospitalprivileges,
627+57failuretorenewsuchprivilegesorlicenseforcause,orotherfinaldisciplinaryaction,ifthe
628+58actionwasinanywayrelatedtounprofessionalconduct,professionalincompetence,
629+59malpracticeoranyotherviolationofanyprovisionofthischapter;
630+60 (h)Signingablankprescriptionform;ordispensing,prescribing,administeringor
631+61otherwisedistributinganydrug,controlledsubstanceorothertreatmentwithoutsufficient
632+62examinationincludingfailingtoestablishavalidphysician-patientrelationshippursuantto
633+63section334.108,orforotherthanmedicallyacceptedtherapeuticorexperimentalor
634+64investigativepurposesdulyauthorizedbyastateorfederalagency,ornotinthecourseof
635+65professionalpractice,ornotingoodfaithtorelievepainandsuffering,ornottocurean
636+66ailment,physicalinfirmityordisease,exceptasauthorizedinsection334.104;
637+67 (i)Exercisinginfluencewithinaphysician-patientrelationshipforpurposesof
638+68engagingapatientinsexualactivity;
639+69 (j)Beinglistedonanystateorfederalsexualoffenderregistry;
640+70 (k)Terminatingthemedicalcareofapatientwithoutadequatenoticeorwithout
641+71makingotherarrangementsforthecontinuedcareofthepatient;
642+72 (l)Failingtofurnishdetailsofapatient'smedicalrecordstoothertreatingphysicians
643+73orhospitalsuponproperrequest;orfailingtocomplywithanyotherlawrelatingtomedical
644+74records;
645+75 (m)Failureofanyapplicantorlicenseetocooperatewiththeboardduringany
646+76investigation;
647+77 (n)Failuretocomplywithanysubpoenaorsubpoenaducestecumfromtheboardor
648+78anorderoftheboard;
649+79 (o)Failuretotimelypaylicenserenewalfeesspecifiedinthischapter;
650+80 (p)Violatingaprobationagreement,order,orothersettlementagreementwiththis
651+81boardoranyotherlicensingagency;
652+82 (q)Failingtoinformtheboardofthephysician'scurrentresidenceandbusiness
653+83address;
654+HCSSSSCSSB157 18 84 (r)Advertisingbyanapplicantorlicenseewhichisfalseormisleading,orwhich
655+85violatesanyruleoftheboard,orwhichclaimswithoutsubstantiationthepositivecureofany
656+86disease,orprofessionalsuperioritytoorgreaterskillthanthatpossessedbyanyother
657+87physician.Anapplicantorlicenseeshallalsobeinviolationofthisprovisioniftheapplicant
658+88orlicenseehasafinancialinterestinanyorganization,corporationorassociationwhichissues
659+89orconductssuchadvertising;
660+90 (s)Anyotherconductthatisunethicalorunprofessionalinvolvingaminor;
661+91 (5)Anyconductorpracticewhichisormightbeharmfulordangeroustothemental
662+92orphysicalhealthofapatientorthepublic;orincompetency,grossnegligenceorrepeated
663+93negligenceintheperformanceofthefunctionsordutiesofanyprofessionlicensedor
664+94regulatedbythischapter.Forthepurposesofthissubdivision,"repeatednegligence"means
665+95thefailure,onmorethanoneoccasion,tousethatdegreeofskillandlearningordinarilyused
666+96underthesameorsimilarcircumstancesbythememberoftheapplicant'sorlicensee's
667+97profession;
668+98 (6)Violationof,orattemptingtoviolate,directlyorindirectly,orassistingor
669+99enablinganypersontoviolate,anyprovisionofthischapterorchapter324,orofanylawful
670+100ruleorregulationadoptedpursuanttothischapterorchapter324;
671+101 (7)Impersonationofanypersonholdingacertificateofregistrationorauthority,
672+102permitorlicenseorallowinganypersontousehisorhercertificateofregistrationor
673+103authority,permit,licenseordiplomafromanyschool;
674+104 (8)Revocation,suspension,restriction,modification,limitation,reprimand,warning,
675+105censure,probationorotherfinaldisciplinaryactionagainsttheholderoforapplicantfora
676+106licenseorotherrighttopracticeanyprofessionregulatedbythischapterbyanotherstate,
677+107territory,federalagencyorcountry,whetherornotvoluntarilyagreedtobythelicenseeor
678+108applicant,including,butnotlimitedto,thedenialoflicensure,surrenderofthelicense,
679+109allowingthelicensetoexpireorlapse,ordiscontinuingorlimitingthepracticeofmedicine
680+110whilesubjecttoaninvestigationorwhileactuallyunderinvestigationbyanylicensing
681+111authority,medicalfacility,branchoftheArmedForcesoftheUnitedStatesofAmerica,
682+112insurancecompany,court,agencyofthestateorfederalgovernment,oremployer;
683+113 (9)Apersonisfinallyadjudgedincapacitatedordisabledbyacourtofcompetent
684+114jurisdiction;
685+115 (10)Assistingorenablinganypersontopracticeoroffertopracticeanyprofession
686+116licensedorregulatedbythischapterwhoisnotregisteredandcurrentlyeligibletopractice
687+117pursuanttothischapter;orknowinglyperforminganyactwhichinanywayaids,assists,
688+118procures,advises,orencouragesanypersontopracticemedicinewhoisnotregisteredand
689+119currentlyeligibletopracticepursuanttothischapter.Aphysicianwhoworksinaccordance
690+HCSSSSCSSB157 19 120withstandingordersorprotocolsorinaccordancewiththeprovisionsofsection334.104
691+121shallnotbeinviolationofthissubdivision;
692+122 (11)Issuanceofacertificateofregistrationorauthority,permitorlicensebasedupon
693+123amaterialmistakeoffact;
694+124 (12)Failuretodisplayavalidcertificateorlicenseifsorequiredbythischapteror
695+125anyrulepromulgatedpursuanttothischapter;
696+126 (13)Violationofthedruglawsorrulesandregulationsofthisstate,includingbutnot
697+127limitedtoanyprovisionofchapter195,anyotherstate,orthefederalgovernment;
698+128 (14)Knowinglymaking,orcausingtobemade,oraiding,orabettinginthemaking
699+129of,afalsestatementinanybirth,deathorothercertificateordocumentexecutedin
700+130connectionwiththepracticeoftheperson'sprofession;
701+131 (15)Knowinglymakingafalsestatement,orallyorinwritingtotheboard;
702+132 (16)Solicitingpatronageinpersonorbyagentsorrepresentatives,orbyanyother
703+133meansormanner,undertheperson'sownnameorunderthenameofanotherpersonor
704+134concern,actualorpretended,insuchamannerastoconfuse,deceive,ormisleadthepublicas
705+135totheneedornecessityfororappropriatenessofhealthcareservicesforallpatients,orthe
706+136qualificationsofanindividualpersonorpersonstodiagnose,render,orperformhealthcare
707+137services;
708+138 (17)Using,orpermittingtheuseof,theperson'snameunderthedesignationof
709+139"Doctor","Dr.","M.D.",or"D.O.",oranysimilardesignationwithreferencetothe
710+140commercialexploitationofanygoods,waresormerchandise;
711+141 (18)Knowinglymakingorcausingtobemadeafalsestatementormisrepresentation
712+142ofamaterialfact,withintenttodefraud,forpaymentpursuanttotheprovisionsofchapter
713+143208orchapter630orforpaymentfromTitleXVIIIorTitleXIXoftheSocialSecurityAct;
714+144 (19)Failureorrefusaltoproperlyguardagainstcontagious,infectiousor
715+145communicablediseasesorthespreadthereof;maintaininganunsanitaryofficeor
716+146performingprofessionalservicesunderunsanitaryconditions;orfailuretoreportthe
717+147existenceofanunsanitaryconditionintheofficeofaphysicianorinanyhealthcarefacility
718+148totheboard,inwriting,withinthirtydaysafterthediscoverythereof;
719+149 (20)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist,
720+150payingorofferingtopayareferralfeeor[,notwithstandingsection334.010tothecontrary,
721+151practicingorofferingtopracticeprofessionalphysicaltherapyindependentoftheprescription
722+152anddirectionofapersonlicensedandregisteredasaphysicianandsurgeonpursuanttothis
723+153chapter,asadentistpursuanttochapter332,asapodiatristpursuanttochapter330,asan
724+154advancedpracticeregisterednurseunderchapter335,oranylicensedandregistered
725+155physician,dentist,podiatrist,oradvancedpracticeregisterednursepracticinginanother
726+HCSSSSCSSB157 20 156jurisdiction,whoselicenseisingoodstanding] evaluatingortreatingapatientina
727+157mannerinconsistentwithsection334.506;
728+158 (21)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist,
729+159treatingorattemptingtotreatailmentsorotherhealthconditionsofhumanbeingsotherthan
730+160byprofessionalphysicaltherapyandasauthorizedbysections334.500to334.620;
731+161 (22)Anypersonlicensedtopracticeasaphysicianorsurgeon,requiring,asa
732+162conditionofthephysician-patientrelationship,thatthepatientreceiveprescribeddrugs,
733+163devicesorotherprofessionalservicesdirectlyfromfacilitiesofthatphysician'sofficeorother
734+164entitiesunderthatphysician'sownershiporcontrol.Aphysicianshallprovidethepatient
735+165withaprescriptionwhichmaybetakentothefacilityselectedbythepatientandaphysician
736+166knowinglyfailingtodisclosetoapatientonaformapprovedbytheadvisorycommissionfor
737+167professionalphysicaltherapistsasestablishedbysection334.625whichisdatedandsigned
738+168byapatientorguardianacknowledgingthatthepatientorguardianhasreadandunderstands
739+169thatthephysicianhasapecuniaryinterestinaphysicaltherapyorrehabilitationservice
740+170providingprescribedtreatmentandthattheprescribedtreatmentisavailableonacompetitive
741+171basis.Thissubdivisionshallnotapplytoareferralbyonephysiciantoanotherphysician
742+172withinagroupofphysicianspracticingtogether;
743+173 (23)Apatternofpersonaluseorconsumptionofanycontrolledsubstanceunlessitis
744+174prescribed,dispensedoradministeredbyanotherphysicianwhoisauthorizedbylawtodoso;
745+175 (24)Habitualintoxicationordependenceonalcohol,evidenceofwhichmayinclude
746+176morethanonealcohol-relatedenforcementcontactasdefinedbysection302.525;
747+177 (25)Failuretocomplywithatreatmentprogramoranaftercareprogramenteredinto
748+178aspartofaboardorder,settlementagreementorlicensee'sprofessionalhealthprogram;
749+179 (26)Revocation,suspension,limitation,probation,orrestrictionofanykind
750+180whatsoeverofanycontrolledsubstanceauthority,whetheragreedtovoluntarilyornot,or
751+181voluntaryterminationofacontrolledsubstanceauthoritywhileunderinvestigation;
752+182 (27)Foraphysiciantooperate,conduct,manage,orestablishanabortionfacility,or
753+183foraphysiciantoperformanabortioninanabortionfacility,ifsuchfacilitycomesunderthe
754+184definitionofanambulatorysurgicalcenterpursuanttosections197.200to197.240,andsuch
755+185facilityhasfailedtoobtainorrenewalicenseasanambulatorysurgicalcenter.
756+186 3.Collaborativepracticearrangements,protocolsandstandingordersshallbein
757+187writingandsignedanddatedbyaphysicianpriortotheirimplementation.
758+188 4.Afterthefilingofsuchcomplaintbeforetheadministrativehearingcommission,
759+189theproceedingsshallbeconductedinaccordancewiththeprovisionsofchapter621.Upona
760+190findingbytheadministrativehearingcommissionthatthegrounds,providedinsubsection2
761+191ofthissection,fordisciplinaryactionaremet,theboardmay,singlyorincombination,warn,
762+192censureorplacethepersonnamedinthecomplaintonprobationonsuchtermsand
763+HCSSSSCSSB157 21 193conditionsastheboarddeemsappropriateforaperiodnottoexceedtenyears,ormay
764+194suspendtheperson'slicense,certificateorpermitforaperiodnottoexceedthreeyears,or
765+195restrictorlimittheperson'slicense,certificateorpermitforanindefiniteperiodoftime,or
766+196revoketheperson'slicense,certificate,orpermit,oradministerapublicorprivatereprimand,
767+197ordenytheperson'sapplicationforalicense,orpermanentlywithholdissuanceofalicenseor
768+198requirethepersontosubmittothecare,counselingortreatmentofphysiciansdesignatedby
769+199theboardattheexpenseoftheindividualtobeexamined,orrequirethepersontoattendsuch
770+200continuingeducationalcoursesandpasssuchexaminationsastheboardmaydirect.
771+201 5.Inanyorderofrevocation,theboardmayprovidethatthepersonmaynotapplyfor
772+202reinstatementoftheperson'slicenseforaperiodoftimerangingfromtwotosevenyears
773+203followingthedateoftheorderofrevocation.Allstayordersshalltollthistimeperiod.
774+204 6.Beforerestoringtogoodstandingalicense,certificateorpermitissuedpursuantto
775+205thischapterwhichhasbeeninarevoked,suspendedorinactivestateforanycauseformore
776+206thantwoyears,theboardmayrequiretheapplicanttoattendsuchcontinuingmedical
777+207educationcoursesandpasssuchexaminationsastheboardmaydirect.
778+208 7.Inanyinvestigation,hearingorotherproceedingtodeterminealicensee'sor
779+209applicant'sfitnesstopractice,anyrecordrelatingtoanypatientofthelicenseeorapplicant
780+210shallbediscoverablebytheboardandadmissibleintoevidence,regardlessofanystatutoryor
781+211commonlawprivilegewhichsuchlicensee,applicant,recordcustodianorpatientmight
782+212otherwiseinvoke.Inaddition,nosuchlicensee,applicant,orrecordcustodianmaywithhold
783+213recordsortestimonybearinguponalicensee'sorapplicant'sfitnesstopracticeontheground
784+214ofprivilegebetweensuchlicensee,applicantorrecordcustodianandapatient.
785+215 8.Theactoflawfullydispensing,prescribing,administering,orotherwise
786+216distributingivermectintabletsorhydroxychloroquinesulfatetabletsforhumanuseshall
787+217notbegroundsfordenial,suspension,revocation,orotherdisciplinaryactionbytheboard.
788+334.104.1.Aphysicianmayenterintocollaborativepracticearrangementswith
789+2registeredprofessionalnurses.Collaborativepracticearrangementsshallbeintheformof
790+3writtenagreements,jointlyagreed-uponprotocols,orstandingordersforthedeliveryof
791+4healthcareservices.Collaborativepracticearrangements,whichshallbeinwriting,may
792+5delegatetoaregisteredprofessionalnursetheauthoritytoadministerordispensedrugsand
793+6providetreatmentaslongasthedeliveryofsuchhealthcareservicesiswithinthescopeof
794+7practiceoftheregisteredprofessionalnurseandisconsistentwiththatnurse'sskill,training
795+8andcompetence.
796+9 2.(1)Collaborativepracticearrangements,whichshallbeinwriting,maydelegateto
797+10aregisteredprofessionalnursetheauthoritytoadminister,dispenseorprescribedrugsand
798+11providetreatmentiftheregisteredprofessionalnurseisanadvancedpracticeregisterednurse
799+12asdefinedinsubdivision(2)ofsection335.016.Collaborativepracticearrangementsmay
800+HCSSSSCSSB157 22 13delegatetoanadvancedpracticeregisterednurse,asdefinedinsection335.016,theauthority
801+14toadminister,dispense,orprescribecontrolledsubstanceslistedinSchedulesIII,IV,andVof
802+15section195.017,andScheduleII-hydrocodone;exceptthat,thecollaborativepractice
803+16arrangementshallnotdelegatetheauthoritytoadministeranycontrolledsubstanceslistedin
804+17SchedulesIII,IV,andVofsection195.017,orScheduleII-hydrocodoneforthepurposeof
805+18inducingsedationorgeneralanesthesiafortherapeutic,diagnostic,orsurgicalprocedures.
806+19ScheduleIIInarcoticcontrolledsubstanceandScheduleII-hydrocodoneprescriptionsshall
807+20belimitedtoaonehundredtwenty-hoursupplywithoutrefill.
808+21 (2)Notwithstandinganyotherprovisionofthissectiontothecontrary,a
809+22collaborativepracticearrangementmaydelegatetoanadvancedpracticeregistered
810+23nursetheauthoritytoadminister,dispense,orprescribeScheduleIIcontrolled
811+24substancesforhospicepatients;provided,thattheadvancedpracticeregisterednurseis
812+25employedbyahospiceprovidercertifiedpursuanttochapter197andtheadvanced
813+26practiceregisterednurseisprovidingcaretohospicepatientspursuanttoa
814+27collaborativepracticearrangementthatdesignatesthecertifiedhospiceasalocation
815+28wheretheadvancedpracticeregisterednurseisauthorizedtopracticeandprescribe.
816+29 (3)Suchcollaborativepracticearrangementsshallbeintheformofwritten
817+30agreements,jointlyagreed-uponprotocolsorstandingordersforthedeliveryofhealthcare
818+31services.
819+32 (4)Anadvancedpracticeregisterednursemayprescribebuprenorphineforuptoa
820+33thirty-daysupplywithoutrefillforpatientsreceivingmedication-assistedtreatmentfor
821+34substanceusedisordersunderthedirectionofthecollaboratingphysician.
822+35 3.Thewrittencollaborativepracticearrangementshallcontainatleastthefollowing
823+36provisions:
824+37 (1)Completenames,homeandbusinessaddresses,zipcodes,andtelephonenumbers
825+38ofthecollaboratingphysicianandtheadvancedpracticeregisterednurse;
826+39 (2)Alistofallotherofficesorlocationsbesidesthoselistedinsubdivision(1)ofthis
827+40subsectionwherethecollaboratingphysicianauthorizedtheadvancedpracticeregistered
828+41nursetoprescribe;
829+42 (3)Arequirementthatthereshallbepostedateveryofficewheretheadvanced
830+43practiceregisterednurseisauthorizedtoprescribe,incollaborationwithaphysician,a
831+44prominentlydisplayeddisclosurestatementinformingpatientsthattheymaybeseenbyan
832+45advancedpracticeregisterednurseandhavetherighttoseethecollaboratingphysician;
833+46 (4)Allspecialtyorboardcertificationsofthecollaboratingphysicianandall
834+47certificationsoftheadvancedpracticeregisterednurse;
835+HCSSSSCSSB157 23 48 (5)Themannerofcollaborationbetweenthecollaboratingphysicianandthe
836+49advancedpracticeregisterednurse,includinghowthecollaboratingphysicianandthe
837+50advancedpracticeregisterednursewill:
838+51 (a)Engageincollaborativepracticeconsistentwitheachprofessional'sskill,training,
839+52education,andcompetence;
840+53 (b)Maintaingeographicproximity,exceptasspecifiedinthisparagraph.The
841+54followingprovisionsshallapplywithrespecttothisrequirement:
842+55 a.UntilAugust28,2025,anadvancedpracticeregisterednurseproviding
843+56servicesinacorrectionalcenter,asdefinedinsection217.010,andhisorher
844+57collaboratingphysicianshallsatisfythegeographicproximityrequirementifthey
845+58practicewithintwohundredmilesbyroadofoneanother.Anincarceratedpatientwho
846+59requestsorrequiresaphysicianconsultationshallbetreatedbyaphysicianassoonas
847+60appropriate;
848+61 b.Thecollaborativepracticearrangementmayallowforgeographicproximitytobe
849+62waivedforamaximumoftwenty-eightdayspercalendaryearforruralhealthclinicsas
850+63definedbyP.L.95-210(42U.S.C.Section1395x,asamended), aslongasthecollaborative
851+64practicearrangementincludesalternativeplansasrequiredinparagraph(c)ofthis
852+65subdivision.Thisexceptiontogeographicproximityshallapplyonlytoindependentrural
853+66healthclinics,provider-basedruralhealthclinicswheretheproviderisacriticalaccess
854+67hospitalasprovidedin42U.S.C.Section1395i-4,andprovider-basedruralhealthclinics
855+68wherethemainlocationofthehospitalsponsorisgreaterthanfiftymilesfromtheclinic[.];
856+69 c.Thecollaborativepracticearrangementmayallowforgeographicproximity
857+70tobewaivedwhenthearrangementoutlinestheuseoftelehealth,asdefinedinsection
858+71191.1145;
859+72 d.Inadditiontothewaiversandexemptionsprovidedinthissubsection,an
860+73applicationforawaiverforanyotherreasonofanyapplicablegeographicproximity
861+74shallbeavailableifaphysicianiscollaboratingwithanadvancedpracticeregistered
862+75nurseinexcessofanygeographicproximitylimit.Theboardofnursingandthestate
863+76boardofregistrationforthehealingartsshallrevieweachapplicationforawaiverof
864+77geographicproximityandapprovetheapplicationiftheboardsdeterminethat
865+78adequatesupervisionexistsbetweenthecollaboratingphysicianandtheadvanced
866+79practiceregisterednurse.Theboardsshallhaveforty-fivecalendardaystoreviewthe
867+80completedapplicationforthewaiverofgeographicproximity.Ifnoactionistakenby
868+81theboardswithinforty-fivedaysafterthesubmissionoftheapplicationforawaiver,
869+82thentheapplicationshallbedeemedapproved.Iftheapplicationisdeniedbythe
870+83boards,theprovisionsofsection536.063forcontestedcasesshallapplyandgovern
871+84proceedingsforappellatepurposes;and
872+HCSSSSCSSB157 24 85 e.Thecollaboratingphysicianisrequiredtomaintaindocumentationrelatedtothis
873+86requirementandtopresentittothestateboardofregistrationforthehealingartswhen
874+87requested;and
875+88 (c)Providecoverageduringabsence,incapacity,infirmity,oremergencybythe
876+89collaboratingphysician;
877+90 (6)Adescriptionoftheadvancedpracticeregisterednurse'scontrolledsubstance
878+91prescriptiveauthorityincollaborationwiththephysician,includingalistofthecontrolled
879+92substancesthephysicianauthorizesthenursetoprescribeanddocumentationthatitis
880+93consistentwitheachprofessional'seducation,knowledge,skill,andcompetence;
881+94 (7)Alistofallotherwrittenpracticeagreementsofthecollaboratingphysicianand
882+95theadvancedpracticeregisterednurse;
883+96 (8)Thedurationofthewrittenpracticeagreementbetweenthecollaborating
884+97physicianandtheadvancedpracticeregisterednurse;
885+98 (9)Adescriptionofthetimeandmannerofthecollaboratingphysician'sreviewof
886+99theadvancedpracticeregisterednurse'sdeliveryofhealthcareservices.Thedescriptionshall
887+100includeprovisionsthattheadvancedpracticeregisterednurseshallsubmitaminimumoften
888+101percentofthechartsdocumentingtheadvancedpracticeregisterednurse'sdeliveryofhealth
889+102careservicestothecollaboratingphysicianforreviewbythecollaboratingphysician,orany
890+103otherphysiciandesignatedinthecollaborativepracticearrangement,everyfourteendays;
891+104[and]
892+105 (10)Thecollaboratingphysician,oranyotherphysiciandesignatedinthe
893+106collaborativepracticearrangement,shallrevieweveryfourteendaysaminimumoftwenty
894+107percentofthechartsinwhichtheadvancedpracticeregisterednurseprescribescontrolled
895+108substances.Thechartsreviewedunderthissubdivisionmaybecountedinthenumberof
896+109chartsrequiredtobereviewedundersubdivision(9)ofthissubsection; and
897+110 (11)Ifacollaborativepracticearrangementisusedinclinicalsituationswherea
898+111collaboratingadvancedpracticeregisterednurseprovideshealthcareservicesthat
899+112includethediagnosisandinitiationoftreatmentforacutelyorchronicallyillorinjured
900+113persons,thenthecollaboratingphysicianoranyotherphysiciandesignatedinthe
901+114collaborativepracticearrangementshallbepresentforsufficientperiodsoftime,at
902+115leastonceeverytwoweeks,exceptinextraordinarycircumstancesthatshallbe
903+116documented,toparticipateinachartreviewandtoprovidenecessarymedicaldirection,
904+117medicalservices,consultations,andsupervisionofthehealthcarestaff.
905+118 4.Thestateboardofregistrationforthehealingartspursuanttosection334.125and
906+119theboardofnursingpursuanttosection335.036mayjointlypromulgaterulesregulatingthe
907+120useofcollaborativepracticearrangements.Suchrulesshallbelimitedto[specifying
908+121geographicareastobecovered,] themethodsoftreatmentthatmaybecoveredby
909+HCSSSSCSSB157 25 122collaborativepracticearrangementsandtherequirementsforreviewofservicesprovided
910+123pursuanttocollaborativepracticearrangementsincludingdelegatingauthoritytoprescribe
911+124controlledsubstances.Anyrulesrelatingtogeographicproximityshallallowa
912+125collaboratingphysicianandacollaboratingadvancedpracticeregisterednurseto
913+126practicewithintwohundredmilesbyroadofoneanotheruntilAugust28,2025,ifthe
914+127nurseisprovidingservicesinacorrectionalcenter,asdefinedinsection217.010.Any
915+128rulesrelatingtodispensingordistributionofmedicationsordevicesbyprescriptionor
916+129prescriptiondrugordersunderthissectionshallbesubjecttotheapprovalofthestateboard
917+130ofpharmacy.Anyrulesrelatingtodispensingordistributionofcontrolledsubstancesby
918+131prescriptionorprescriptiondrugordersunderthissectionshallbesubjecttotheapprovalof
919+132thedepartmentofhealthandseniorservicesandthestateboardofpharmacy.Inordertotake
920+133effect,suchrulesshallbeapprovedbyamajorityvoteofaquorumofeachboard.Neitherthe
921+134stateboardofregistrationforthehealingartsnortheboardofnursingmayseparately
922+135promulgaterulesrelatingtocollaborativepracticearrangements.Suchjointlypromulgated
923+136rulesshallbeconsistentwithguidelinesforfederallyfundedclinics.Therulemaking
924+137authoritygrantedinthissubsectionshallnotextendtocollaborativepracticearrangementsof
925+138hospitalemployeesprovidinginpatientcarewithinhospitalsasdefinedpursuanttochapter
926+139197orpopulation-basedpublichealthservicesasdefinedby20CSR2150-5.100asofApril
927+14030,2008.
928+141 5.Thestateboardofregistrationforthehealingartsshallnotdeny,revoke,suspend
929+142orotherwisetakedisciplinaryactionagainstaphysicianforhealthcareservicesdelegatedtoa
930+143registeredprofessionalnurseprovidedtheprovisionsofthissectionandtherules
931+144promulgatedthereunderaresatisfied.Uponthewrittenrequestofaphysiciansubjecttoa
932+145disciplinaryactionimposedasaresultofanagreementbetweenaphysicianandaregistered
933+146professionalnurseorregisteredphysicianassistant,whetherwrittenornot,priortoAugust
934+14728,1993,allrecordsofsuchdisciplinarylicensureactionandallrecordspertainingtothe
935+148filing,investigationorreviewofanallegedviolationofthischapterincurredasaresultof
936+149suchanagreementshallberemovedfromtherecordsofthestateboardofregistrationforthe
937+150healingartsandthedivisionofprofessionalregistrationandshallnotbedisclosedtoany
938+151publicorprivateentityseekingsuchinformationfromtheboardorthedivision.Thestate
939+152boardofregistrationforthehealingartsshalltakeactiontocorrectreportsofalleged
940+153violationsanddisciplinaryactionsasdescribedinthissectionwhichhavebeensubmittedto
941+154theNationalPractitionerDataBank.Insubsequentapplicationsorrepresentationsrelatingto
942+155hisorhermedicalpractice,aphysiciancompletingformsordocumentsshallnotberequired
943+156toreportanyactionsofthestateboardofregistrationforthehealingartsforwhichthe
944+157recordsaresubjecttoremovalunderthissection.
945+HCSSSSCSSB157 26 158 6.Withinthirtydaysofanychangeandoneachrenewal,thestateboardof
946+159registrationforthehealingartsshallrequireeveryphysiciantoidentifywhetherthephysician
947+160isengagedinanycollaborativepractice[agreement] arrangement, includingcollaborative
948+161practice[agreements] arrangementsdelegatingtheauthoritytoprescribecontrolled
949+162substances,orphysicianassistant[agreement] collaborativepracticearrangementand
950+163alsoreporttotheboardthenameofeachlicensedprofessionalwithwhomthephysicianhas
951+164enteredintosuch[agreement] arrangement. Theboard[may] shallmakethisinformation
952+165availabletothepublic.Theboardshalltrackthereportedinformationandmayroutinely
953+166conductrandomreviewsofsuch[agreements] arrangementstoensurethat[agreements]
954+167arrangementsarecarriedoutforcomplianceunderthischapter.
955+168 7.Notwithstandinganylawtothecontrary,acertifiedregisterednurseanesthetistas
956+169definedinsubdivision(8)ofsection335.016shallbepermittedtoprovideanesthesiaservices
957+170withoutacollaborativepracticearrangementprovidedthatheorsheisunderthesupervision
958+171ofananesthesiologistorotherphysician,dentist,orpodiatristwhoisimmediatelyavailableif
959+172needed.Nothinginthissubsectionshallbeconstruedtoprohibitorpreventacertified
960+173registerednurseanesthetistasdefinedinsubdivision(8)ofsection335.016fromenteringinto
961+174acollaborativepracticearrangementunderthissection,exceptthatthecollaborativepractice
962+175arrangementmaynotdelegatetheauthoritytoprescribeanycontrolledsubstanceslistedin
963+176SchedulesIII,IV,andVofsection195.017,orScheduleII-hydrocodone.
964+177 8.Acollaboratingphysicianshallnotenterintoacollaborativepracticearrangement
965+178withmorethansixfull-timeequivalentadvancedpracticeregisterednurses,full-time
966+179equivalentlicensedphysicianassistants,orfull-timeequivalentassistantphysicians,orany
967+180combinationthereof.Thislimitationshallnotapplytocollaborativearrangementsofhospital
968+181employeesprovidinginpatientcareserviceinhospitalsasdefinedinchapter197or
969+182population-basedpublichealthservicesasdefinedby20CSR2150-5.100asofApril30,
970+1832008,ortoacertifiedregisterednurseanesthetistprovidinganesthesiaservicesunderthe
971+184supervisionofananesthesiologistorotherphysician,dentist,orpodiatristwhoisimmediately
972+185availableifneededassetoutinsubsection7ofthissection.
973+186 9.Itistheresponsibilityofthecollaboratingphysiciantodetermineanddocument
974+187thecompletionofatleastaone-monthperiodoftimeduringwhichtheadvancedpractice
975+188registerednurseshallpracticewiththecollaboratingphysiciancontinuouslypresentbefore
976+189practicinginasettingwherethecollaboratingphysicianisnotcontinuouslypresent.This
977+190limitationshallnotapplytocollaborativearrangementsofprovidersofpopulation-based
978+191publichealthservicesasdefinedby20CSR2150-5.100asofApril30,2008, orto
979+192collaborativepracticearrangementsbetweenaprimarycarephysicianandaprimary
980+193careadvancedpracticeregisterednurseorabehavioralhealthphysiciananda
981+194behavioralhealthadvancedpracticeregisterednurse,wherethecollaboratingphysician
982+HCSSSSCSSB157 27 195isnewtoapatientpopulationtowhichtheadvancedpracticeregisterednurseis
983+196familiar.
984+197 10.Noagreementmadeunderthissectionshallsupersedecurrenthospitallicensing
985+198regulationsgoverninghospitalmedicationordersunderprotocolsorstandingordersforthe
986+199purposeofdeliveringinpatientoremergencycarewithinahospitalasdefinedinsection
987+200197.020ifsuchprotocolsorstandingordershavebeenapprovedbythehospital'smedical
988+201staffandpharmaceuticaltherapeuticscommittee.
989+202 11.Nocontractorother[agreement] termofemploymentshallrequireaphysician
990+203toactasacollaboratingphysicianforanadvancedpracticeregisterednurseagainstthe
991+204physician'swill.Aphysicianshallhavetherighttorefusetoactasacollaboratingphysician,
992+205withoutpenalty,foraparticularadvancedpracticeregisterednurse.Nocontractorother
993+206agreementshalllimitthecollaboratingphysician'sultimateauthorityoveranyprotocolsor
994+207standingordersorinthedelegationofthephysician'sauthoritytoanyadvancedpractice
995+208registerednurse,butthisrequirementshallnotauthorizeaphysicianinimplementingsuch
996+209protocols,standingorders,ordelegationtoviolateapplicablestandardsforsafemedical
997+210practiceestablishedbyhospital'smedicalstaff.
998+211 12.Nocontractorother[agreement] termofemploymentshallrequireany
999+212advancedpracticeregisterednursetoserveasacollaboratingadvancedpracticeregistered
1000+213nurseforanycollaboratingphysicianagainsttheadvancedpracticeregisterednurse'swill.
1001+214Anadvancedpracticeregisterednurseshallhavetherighttorefusetocollaborate,without
1002+215penalty,withaparticularphysician.
1003+334.506.1.Asusedinthissection,thefollowingtermsmean:
1004+2 (1)"Approvedhealthcareprovider"[means], apersonholdingacurrentandactive
1005+3licenseasaphysicianandsurgeonunderthischapter,achiropractorunderchapter331,a
1006+4dentistunderchapter332,apodiatristunderchapter330,aphysicianassistantunderthis
1007+5chapter,anadvancedpracticeregisterednurseunderchapter335,oranylicensedand
1008+6registeredphysician,chiropractor,dentist,orpodiatristpracticinginanotherjurisdiction
1009+7whoselicenseisingoodstanding;
1010+8 (2)"Consult"or"consultation",communicationbytelephone,byfax,in
1011+9writing,orinpersonwiththepatient'spersonallyapprovedlicensedhealthcare
1012+10provideroralicensedhealthcareproviderofthepatient'sdesignation.
1013+11 2.Aphysicaltherapist[shallnot]mayevaluateandinitiatetreatment[foranew
1014+12injuryorillness] onapatientwithoutaprescriptionorreferralfromanapprovedhealthcare
1015+13provider, providedthatthephysicaltherapisthasadoctorateofphysicaltherapydegree
1016+14orhasfiveyearsofclinicalpracticeasaphysicaltherapist.
1017+15 3.Aphysicaltherapistmayprovideeducationalresourcesandtraining,develop
1018+16fitnessorwellnessprograms[forasymptomaticpersons], orprovidescreeningorconsultative
1019+HCSSSSCSSB157 28 17serviceswithinthescopeofphysicaltherapypracticewithout[the]aprescription[and
1020+18directionof]orreferralfromanapprovedhealthcareprovider.
1021+19 4.[Aphysicaltherapistmayexamineandtreatwithouttheprescriptionanddirection
1022+20ofanapprovedhealthcareprovideranypersonwitharecurringself-limitedinjurywithinone
1023+21yearofdiagnosisbyanapprovedhealthcareproviderorachronicillnessthathasbeen
1024+22previouslydiagnosedbyanapprovedhealthcareprovider.Thephysicaltherapistshall:]
1025+23 (1)[Contactthepatient'scurrentapprovedhealthcareproviderwithinsevendaysof
1026+24initiatingphysicaltherapyservicesunderthissubsection;] Aphysicaltherapistshallrefer
1027+25toanapprovedhealthcareprovideranypatientwhoseconditionatthetimeof
1028+26evaluationortreatmentisdeterminedtobebeyondthescopeofpracticeofphysical
1029+27therapy.Thephysicaltherapistshallnotprovidephysicaltherapyservicesortreatment
1030+28afterthisreferralhasbeenmade.
1031+29 (2)[Notchangeanexistingphysicaltherapyreferralavailabletothephysical
1032+30therapistwithoutapprovalofthepatient'scurrentapprovedhealthcareprovider;] Aphysical
1033+31therapistshallrefertoanapprovedhealthcareprovideranypatientwhodoesnot
1034+32demonstratemeasurableorfunctionalimprovementaftertenvisitsorthirtydays,
1035+33whicheveroccursfirst.Thephysicaltherapistshallnotprovidefurthertherapyservices
1036+34ortreatmentafterthisreferralhasbeenmade.
1037+35 (3)[Refertoanapprovedhealthcareprovideranypatientwhosemedicalconditionat
1038+36thetimeofexaminationortreatmentisdeterminedtobebeyondthescopeofpracticeof
1039+37physicaltherapy;
1040+38 (4)Refertoanapprovedhealthcareprovideranypatientwhoseconditionforwhich
1041+39physicaltherapyservicesarerenderedunderthissubsectionhasnotbeendocumentedtobe
1042+40progressingtowarddocumentedtreatmentgoalsaftersixvisitsorfourteendays,whichever
1043+41firstoccurs;
1044+42 (5)Notifythepatient'scurrentapprovedhealthcareproviderpriortothecontinuation
1045+43oftreatmentiftreatmentrenderedunderthissubsectionistocontinuebeyondthirtydays.
1046+44Thephysicaltherapistshallprovidesuchnotificationforeachsuccessiveperiodofthirty
1047+45days.] (a)Aphysicaltherapistshallconsultwithanapprovedhealthcareproviderif,
1048+46aftereverytenvisitsorthirtydays,whicheveroccursfirst,thepatienthasdemonstrated
1049+47measurableorfunctionalimprovementfromthecourseofphysicaltherapyservicesor
1050+48treatmentprovidedandthephysicaltherapistbelievesthatcontinuationofthecourseof
1051+49physicaltherapyservicesortreatmentisreasonableandnecessarybasedonthephysical
1052+50therapist'sevaluationofthepatient.Thephysicaltherapistshallnotprovidefurther
1053+51physicaltherapyservicesortreatmentuntiltheconsultationhasoccurred.
1054+52 (b)Theconsultationwiththeapprovedhealthcareprovidershallinclude
1055+53informationconcerning:
1056+HCSSSSCSSB157 29 54 a.Thepatient'sconditionforwhichphysicaltherapyservicesortreatmentswere
1057+55provided;
1058+56 b.Thebasisforthecourseofservicesortreatmentindicated,asdetermined
1059+57fromthephysicaltherapyevaluationofthepatient;
1060+58 c.Thephysicaltherapyservicesortreatmentprovidedbeforethedateofthe
1061+59consultation;
1062+60 d.Thepatient'sdemonstratedmeasurableorfunctionalimprovementfromthe
1063+61servicesortreatmentprovidedbeforethedateoftheconsultation;
1064+62 e.Thecontinuingphysicaltherapyservicesortreatmentproposedtobe
1065+63providedfollowingtheconsultation;and
1066+64 f.Theprofessionalphysicaltherapybasisforthecontinuedphysicaltherapy
1067+65servicesortreatmenttobeprovided.
1068+66 (c)Continuedphysicaltherapyservicesortreatmentfollowingtheconsultation
1069+67withandapprovalbyanapprovedhealthcareprovidershallproceedinaccordance
1070+68withanyfeedback,advice,opinion,ordirectionoftheapprovedhealthcareprovider.
1071+69Thephysicaltherapistshallnotifytheconsultingapprovedhealthcareproviderof
1072+70continuingphysicaltherapyservicesortreatmentandthepatient'sprogressatleast
1073+71everytenvisitsorthirtydaysaftertheinitialconsultationunlesstheconsulting
1074+72approvedhealthcareproviderdirectsotherwise.
1075+73 (d)Theprovisionsofthissubdivisionshallnotapplytophysicaltherapyservices
1076+74performedwithinaprimaryorsecondaryschoolforindividualswithinagesnotin
1077+75excessoftwenty-oneyears.
1078+76 5.Theprovisionofphysicaltherapyservicesofevaluationandscreeningpursuantto
1079+77thissectionshallbelimitedtoaphysicaltherapist,andanyauthorityforevaluationand
1080+78screeninggrantedwithinthissectionmaynotbedelegated.Uponeachreinitiationof
1081+79physicaltherapyservices,aphysicaltherapistshallprovideafullphysicaltherapyevaluation
1082+80priortothereinitiationofphysicaltherapytreatment.[Physicaltherapytreatmentprovided
1083+81pursuanttotheprovisionsofsubsection4ofthissectionmaybedelegatedbyphysical
1084+82therapiststophysicaltherapistassistantsonlyifthepatient'scurrentapprovedhealthcare
1085+83providerhasbeensoinformedaspartofthephysicaltherapist'sseven-daynotificationupon
1086+84reinitiationofphysicaltherapyservicesasrequiredinsubsection4ofthissection.] Nothing
1087+85inthissubsectionshallbeconstruedastolimittheabilityofphysicaltherapistsorphysical
1088+86therapistassistantstoprovidephysicaltherapyservicesinaccordancewiththeprovisionsof
1089+87thischapter,anduponthereferralofanapprovedhealthcareprovider.Nothinginthis
1090+88subsectionshallprohibitanapprovedhealthcareproviderfromactingwithinthescopeof
1091+89theirpracticeasdefinedbytheapplicablechaptersofRSMo.
1092+HCSSSSCSSB157 30 90 6.Nopersonlicensedtopractice,orapplicantforlicensure,asaphysicaltherapistor
1093+91physicaltherapistassistantshallmakeamedicaldiagnosis.
1094+92 7.Aphysicaltherapistshallonlydelegatephysicaltherapytreatmenttoaphysical
1095+93therapistassistantortoapersoninanentrylevelofaprofessionaleducationprogram
1096+94approvedbytheCommissiononAccreditationinPhysicalTherapyEducation(CAPTE)who
1097+95satisfiessupervisedclinicaleducationrequirementsrelatedtotheperson'sphysicaltherapist
1098+96orphysicaltherapistassistanteducation.Theentry-levelpersonshallbeunderthe
1099+97supervisionofaphysicaltherapist.
1100+334.613.1.Theboardmayrefusetoissueorrenewalicensetopracticeasaphysical
1101+2therapistorphysicaltherapistassistantforoneoranycombinationofcausesstatedin
1102+3subsection2ofthissection.Theboardshallnotifytheapplicantinwritingofthereasonsfor
1103+4therefusalandshalladvisetheapplicantoftheapplicant'srighttofileacomplaintwiththe
1104+5administrativehearingcommissionasprovidedbychapter621.Asanalternativetoarefusal
1105+6toissueorrenewalicensetopracticeasaphysicaltherapistorphysicaltherapistassistant,the
1106+7boardmay,atitsdiscretion,issuealicensewhichissubjecttoprobation,restriction,or
1107+8limitationtoanapplicantforlicensureforanyoneoranycombinationofcausesstatedin
1108+9subsection2ofthissection.Theboard'sorderofprobation,limitation,orrestrictionshall
1109+10containastatementofthedisciplineimposed,thebasistherefor,thedatesuchactionshall
1110+11becomeeffective,andastatementthattheapplicanthasthirtydaystorequestinwritinga
1111+12hearingbeforetheadministrativehearingcommission.Iftheboardissuesaprobationary,
1112+13limited,orrestrictedlicensetoanapplicantforlicensure,eitherpartymayfileawritten
1113+14petitionwiththeadministrativehearingcommissionwithinthirtydaysoftheeffectivedateof
1114+15theprobationary,limited,orrestrictedlicenseseekingreviewoftheboard'sdetermination.If
1115+16nowrittenrequestforahearingisreceivedbytheadministrativehearingcommissionwithin
1116+17thethirty-dayperiod,therighttoseekreviewoftheboard'sdecisionshallbeconsideredas
1117+18waived.
1118+19 2.Theboardmaycauseacomplainttobefiledwiththeadministrativehearing
1119+20commissionasprovidedbychapter621againstanyholderofalicensetopracticeasa
1120+21physicaltherapistorphysicaltherapistassistantwhohasfailedtoreneworhassurrendered
1121+22hisorherlicenseforanyoneoranycombinationofthefollowingcauses:
1122+23 (1)Useofanycontrolledsubstance,asdefinedinchapter195,oralcoholicbeverage
1123+24toanextentthatsuchuseimpairsaperson'sabilitytoperformtheworkofaphysicaltherapist
1124+25orphysicaltherapistassistant;
1125+26 (2)Thepersonhasbeenfinallyadjudicatedandfoundguilty,orenteredapleaof
1126+27guiltyornolocontendere,inacriminalprosecutionunderthelawsofanystate,oftheUnited
1127+28States,orofanycountry,foranyoffensedirectlyrelatedtothedutiesandresponsibilitiesof
1128+HCSSSSCSSB157 31 29theoccupation,assetforthinsection324.012,regardlessofwhetherornotsentenceis
1129+30imposed;
1130+31 (3)Useoffraud,deception,misrepresentation,orbriberyinsecuringanycertificate
1131+32ofregistrationorauthority,permit,orlicenseissuedunderthischapterorinobtaining
1132+33permissiontotakeanyexaminationgivenorrequiredunderthischapter;
1133+34 (4)Misconduct,fraud,misrepresentation,dishonesty,unethicalconduct,or
1134+35unprofessionalconductintheperformanceofthefunctionsordutiesofaphysicaltherapist
1135+36orphysicaltherapistassistant,includingbutnotlimitedtothefollowing:
1136+37 (a)Obtainingorattemptingtoobtainanyfee,charge,tuition,orothercompensation
1137+38byfraud,deception,ormisrepresentation;willfullyandcontinuallyoverchargingor
1138+39overtreatingpatients;orchargingforsessionsofphysicaltherapywhichdidnotoccur
1139+40unlesstheserviceswerecontractedforinadvance,orforserviceswhichwerenotrenderedor
1140+41documentedinthepatient'srecords;
1141+42 (b)Attempting,directlyorindirectly,bywayofintimidation,coercion,ordeception,
1142+43toobtainorretainapatientordiscouragetheuseofasecondopinionorconsultation;
1143+44 (c)Willfullyandcontinuallyperforminginappropriateorunnecessarytreatmentor
1144+45services;
1145+46 (d)Delegatingprofessionalresponsibilitiestoapersonwhoisnotqualifiedby
1146+47training,skill,competency,age,experience,orlicensuretoperformsuchresponsibilities;
1147+48 (e)Misrepresentingthatanydisease,ailment,orinfirmitycanbecuredbyamethod,
1148+49procedure,treatment,medicine,ordevice;
1149+50 (f)Performingserviceswhichhavebeendeclaredbyboardruletobeofnophysical
1150+51therapyvalue;
1151+52 (g)Finaldisciplinaryactionbyanyprofessionalassociation,professionalsociety,
1152+53licensedhospitalormedicalstaffofthehospital,orphysicaltherapyfacilityinthisorany
1153+54otherstateorterritory,whetheragreedtovoluntarilyornot,andincludingbutnotlimitedto
1154+55anyremoval,suspension,limitation,orrestrictionoftheperson'sprofessionalemployment,
1155+56malpractice,oranyotherviolationofanyprovisionofthischapter;
1156+57 (h)Administeringtreatmentwithoutsufficientexamination,orforotherthan
1157+58medicallyacceptedtherapeuticorexperimentalorinvestigativepurposesdulyauthorizedbya
1158+59stateorfederalagency,ornotinthecourseofprofessionalphysicaltherapypractice;
1159+60 (i)Engaginginorsolicitingsexualrelationships,whetherconsensualor
1160+61nonconsensual,whileaphysicaltherapistorphysicaltherapistassistant/patientrelationship
1161+62exists;makingsexualadvances,requestingsexualfavors,orengaginginotherverbalconduct
1162+63orphysicalcontactofasexualnaturewithpatientsorclients;
1163+64 (j)Terminatingthecareofapatientwithoutadequatenoticeorwithoutmakingother
1164+65arrangementsforthecontinuedcareofthepatient;
1165+HCSSSSCSSB157 32 66 (k)Failingtofurnishdetailsofapatient'sphysicaltherapyrecordstotreating
1166+67physicians,otherphysicaltherapists,orhospitalsuponproperrequest;orfailingtocomply
1167+68withanyotherlawrelatingtophysicaltherapyrecords;
1168+69 (l)Failureofanyapplicantorlicensee,otherthanthelicenseesubjecttothe
1169+70investigation,tocooperatewiththeboardduringanyinvestigation;
1170+71 (m)Failuretocomplywithanysubpoenaorsubpoenaducestecumfromtheboardor
1171+72anorderoftheboard;
1172+73 (n)Failuretotimelypaylicenserenewalfeesspecifiedinthischapter;
1173+74 (o)Violatingaprobationagreementwiththisboardoranyotherlicensingagency;
1174+75 (p)Failingtoinformtheboardofthephysicaltherapist'sorphysicaltherapist
1175+76assistant'scurrenttelephonenumber,residence,andbusinessaddress;
1176+77 (q)Advertisingbyanapplicantorlicenseewhichisfalseormisleading,orwhich
1177+78violatesanyruleoftheboard,orwhichclaimswithoutsubstantiationthepositivecureofany
1178+79disease,orprofessionalsuperioritytoorgreaterskillthanthatpossessedbyanyother
1179+80physicaltherapistorphysicaltherapistassistant.Anapplicantorlicenseeshallalsobein
1180+81violationofthisprovisioniftheapplicantorlicenseehasafinancialinterestinany
1181+82organization,corporation,orassociationwhichissuesorconductssuchadvertising;
1182+83 (5)Anyconductorpracticewhichisormightbeharmfulordangeroustothemental
1183+84orphysicalhealthofapatientorthepublic;orincompetency,grossnegligence,orrepeated
1184+85negligenceintheperformanceofthefunctionsordutiesofaphysicaltherapistorphysical
1185+86therapistassistant.Forthepurposesofthissubdivision,"repeatednegligence"meansthe
1186+87failure,onmorethanoneoccasion,tousethatdegreeofskillandlearningordinarilyused
1187+88underthesameorsimilarcircumstancesbythememberoftheapplicant'sorlicensee's
1188+89profession;
1189+90 (6)Violationof,orattemptingtoviolate,directlyorindirectly,orassistingor
1190+91enablinganypersontoviolate,anyprovisionofthischapter,orofanylawfulruleadopted
1191+92underthischapter;
1192+93 (7)Impersonationofanypersonlicensedasaphysicaltherapistorphysicaltherapist
1193+94assistantorallowinganypersontousehisorherlicenseordiplomafromanyschool;
1194+95 (8)Revocation,suspension,restriction,modification,limitation,reprimand,warning,
1195+96censure,probation,orotherfinaldisciplinaryactionagainstaphysicaltherapistorphysical
1196+97therapistassistantforalicenseorotherrighttopracticeasaphysicaltherapistorphysical
1197+98therapistassistantbyanotherstate,territory,federalagencyorcountry,whetherornot
1198+99voluntarilyagreedtobythelicenseeorapplicant,includingbutnotlimitedtothedenialof
1199+100licensure,surrenderofthelicense,allowingthelicensetoexpireorlapse,ordiscontinuingor
1200+101limitingthepracticeofphysicaltherapywhilesubjecttoaninvestigationorwhileactually
1201+102underinvestigationbyanylicensingauthority,medicalfacility,branchoftheArmedForces
1202+HCSSSSCSSB157 33 103oftheUnitedStatesofAmerica,insurancecompany,court,agencyofthestateorfederal
1203+104government,oremployer;
1204+105 (9)Apersonisfinallyadjudgedincapacitatedordisabledbyacourtofcompetent
1205+106jurisdiction;
1206+107 (10)Assistingorenablinganypersontopracticeoroffertopracticewhoisnot
1207+108licensedandcurrentlyeligibletopracticeunderthischapter;orknowinglyperforminganyact
1208+109whichinanywayaids,assists,procures,advises,orencouragesanypersontopractice
1209+110physicaltherapywhoisnotlicensedandcurrentlyeligibletopracticeunderthischapter;
1210+111 (11)Issuanceofalicensetopracticeasaphysicaltherapistorphysicaltherapist
1211+112assistantbaseduponamaterialmistakeoffact;
1212+113 (12)Failuretodisplayavalidlicensepursuanttopracticeasaphysicaltherapistor
1213+114physicaltherapistassistant;
1214+115 (13)Knowinglymaking,orcausingtobemade,oraiding,orabettinginthemaking
1215+116of,afalsestatementinanydocumentexecutedinconnectionwiththepracticeofphysical
1216+117therapy;
1217+118 (14)Solicitingpatronageinpersonorbyagentsorrepresentatives,orbyanyother
1218+119meansormanner,undertheperson'sownnameorunderthenameofanotherpersonor
1219+120concern,actualorpretended,insuchamannerastoconfuse,deceive,ormisleadthepublicas
1220+121totheneedornecessityfororappropriatenessofphysicaltherapyservicesforallpatients,or
1221+122thequalificationsofanindividualpersonorpersonstorender,orperformphysicaltherapy
1222+123services;
1223+124 (15)Using,orpermittingtheuseof,theperson'snameunderthedesignationof
1224+125"physicaltherapist","physiotherapist","registeredphysicaltherapist","P.T.","Ph.T.",
1225+126"P.T.T.","D.P.T.","M.P.T."or"R.P.T.","physicaltherapistassistant","P.T.A.","L.P.T.A.",
1226+127"C.P.T.A.",oranysimilardesignationwithreferencetothecommercialexploitationofany
1227+128goods,waresormerchandise;
1228+129 (16)Knowinglymakingorcausingtobemadeafalsestatementormisrepresentation
1229+130ofamaterialfact,withintenttodefraud,forpaymentunderchapter208orchapter630orfor
1230+131paymentfromTitleXVIIIorTitleXIXoftheSocialSecurityAct;
1231+132 (17)Failureorrefusaltoproperlyguardagainstcontagious,infectious,or
1232+133communicablediseasesorthespreadthereof;maintaininganunsanitaryfacilityor
1233+134performingprofessionalservicesunderunsanitaryconditions;orfailuretoreportthe
1234+135existenceofanunsanitaryconditioninanyphysicaltherapyfacilitytotheboard,inwriting,
1235+136withinthirtydaysafterthediscoverythereof;
1236+137 (18)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist
1237+138orphysicaltherapistassistantpayingorofferingtopayareferralfeeor[,notwithstanding
1238+139section334.010tothecontrary,practicingorofferingtopracticeprofessionalphysical
1239+HCSSSSCSSB157 34 140therapyindependentoftheprescriptionanddirectionofapersonlicensedandregisteredasa
1240+141physicianandsurgeonunderthischapter,asaphysicianassistantunderthischapter,asa
1241+142chiropractorunderchapter331,asadentistunderchapter332,asapodiatristunderchapter
1242+143330,asanadvancedpracticeregisterednurseunderchapter335,oranylicensedand
1243+144registeredphysician,chiropractor,dentist,podiatrist,oradvancedpracticeregisterednurse
1244+145practicinginanotherjurisdiction,whoselicenseisingoodstanding] evaluatingortreatinga
1245+146patientinamannerinconsistentwithsection334.506;
1246+147 (19)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist
1247+148orphysicaltherapistassistanttreatingorattemptingtotreatailmentsorotherhealth
1248+149conditionsofhumanbeingsotherthanbyprofessionalphysicaltherapyandasauthorizedby
1249+150sections334.500to334.685;
1250+151 (20)Apatternofpersonaluseorconsumptionofanycontrolledsubstanceunlessitis
1251+152prescribed,dispensed,oradministeredbyaphysicianwhoisauthorizedbylawtodoso;
1252+153 (21)Failingtomaintainadequatepatientrecordsundersection334.602;
1253+154 (22)Attemptingtoengageinconductthatsubvertsorunderminestheintegrityofthe
1254+155licensingexaminationorthelicensingexaminationprocess,includingbutnotlimitedto
1255+156utilizinginanymannerrecalledormemorizedlicensingexaminationquestionsfromorwith
1256+157anypersonorentity,failingtocomplywithalltestcentersecurityprocedures,communicating
1257+158orattemptingtocommunicatewithanyotherexamineesduringthetest,orcopyingorsharing
1258+159licensingexaminationquestionsorportionsofquestions;
1259+160 (23)Anycandidateforlicensureorpersonlicensedtopracticeasaphysicaltherapist
1260+161orphysicaltherapistassistantwhorequests,receives,participatesorengagesdirectlyor
1261+162indirectlyinthedivision,transferring,assigning,rebatingorrefundingoffeesreceivedfor
1262+163professionalservicesorprofitsbymeansofacreditorothervaluableconsiderationsuchas
1263+164wages,anunearnedcommission,discountorgratuitywithanypersonwhoreferredapatient,
1264+165orwithanyrelativeorbusinessassociateofthereferringperson;
1265+166 (24)Beingunabletopracticeasaphysicaltherapistorphysicaltherapistassistant
1266+167withreasonableskillandsafetytopatientsbyreasonsofincompetency,orbecauseofillness,
1267+168drunkenness,excessiveuseofdrugs,narcotics,chemicals,orasaresultofanymentalor
1268+169physicalcondition.Thefollowingshallapplytothissubdivision:
1269+170 (a)Inenforcingthissubdivisiontheboardshall,afterahearingbytheboard,upona
1270+171findingofprobablecause,requireaphysicaltherapistorphysicaltherapistassistanttosubmit
1271+172toareexaminationforthepurposeofestablishinghisorhercompetencytopracticeasa
1272+173physicaltherapistorphysicaltherapistassistantconductedinaccordancewithrulesadopted
1273+174forthispurposebytheboard,includingrulestoallowtheexaminationofthepatternand
1274+175practiceofsuchphysicaltherapist'sorphysicaltherapistassistant'sprofessionalconduct,orto
1275+HCSSSSCSSB157 35 176submittoamentalorphysicalexaminationorcombinationthereofbyafacilityor
1276+177professionalapprovedbytheboard;
1277+178 (b)Forthepurposeofthissubdivision,everyphysicaltherapistandphysicaltherapist
1278+179assistantlicensedunderthischapterisdeemedtohaveconsentedtosubmittoamentalor
1279+180physicalexaminationwhendirectedinwritingbytheboard;
1280+181 (c)Inadditiontoorderingaphysicalormentalexaminationtodeterminecompetency,
1281+182theboardmay,notwithstandinganyotherlawlimitingaccesstomedicalorotherhealthdata,
1282+183obtainmedicaldataandhealthrecordsrelatingtoaphysicaltherapist,physicaltherapist
1283+184assistantorapplicantwithoutthephysicaltherapist's,physicaltherapistassistant'sor
1284+185applicant'sconsent;
1285+186 (d)Writtennoticeofthereexaminationorthephysicalormentalexaminationshallbe
1286+187senttothephysicaltherapistorphysicaltherapistassistant,byregisteredmail,addressedto
1287+188thephysicaltherapistorphysicaltherapistassistantatthephysicaltherapist'sorphysical
1288+189therapistassistant'slastknownaddress.Failureofaphysicaltherapistorphysicaltherapist
1289+190assistanttosubmittotheexaminationwhendirectedshallconstituteanadmissionofthe
1290+191allegationsagainstthephysicaltherapistorphysicaltherapistassistant,inwhichcasethe
1291+192boardmayenterafinalorderwithoutthepresentationofevidence,unlessthefailurewasdue
1292+193tocircumstancesbeyondthephysicaltherapist'sorphysicaltherapistassistant'scontrol.A
1293+194physicaltherapistorphysicaltherapistassistantwhoserighttopracticehasbeenaffected
1294+195underthissubdivisionshall,atreasonableintervals,beaffordedanopportunityto
1295+196demonstratethatthephysicaltherapistorphysicaltherapistassistantcanresumethe
1296+197competentpracticeasaphysicaltherapistorphysicaltherapistassistantwithreasonableskill
1297+198andsafetytopatients;
1298+199 (e)Inanyproceedingunderthissubdivisionneithertherecordofproceedingsnorthe
1299+200ordersenteredbytheboardshallbeusedagainstaphysicaltherapistorphysicaltherapist
1300+201assistantinanyotherproceeding.Proceedingsunderthissubdivisionshallbeconductedby
1301+202theboardwithoutthefilingofacomplaintwiththeadministrativehearingcommission;
1302+203 (f)Whentheboardfindsanypersonunqualifiedbecauseofanyofthegroundsset
1303+204forthinthissubdivision,itmayenteranorderimposingoneormoreofthedisciplinary
1304+205measuressetforthinsubsection3ofthissection.
1305+206 3.Afterthefilingofsuchcomplaintbeforetheadministrativehearingcommission,
1306+207theproceedingsshallbeconductedinaccordancewiththeprovisionsofchapter621.Upona
1307+208findingbytheadministrativehearingcommissionthatthegroundsprovidedinsubsection2
1308+209ofthissectionfordisciplinaryactionaremet,theboardmay,singlyorincombination:
1309+210 (1)Warn,censureorplacethephysicaltherapistorphysicaltherapistassistantnamed
1310+211inthecomplaintonprobationonsuchtermsandconditionsastheboarddeemsappropriate
1311+212foraperiodnottoexceedtenyears;
1312+HCSSSSCSSB157 36 213 (2)Suspendthephysicaltherapist'sorphysicaltherapistassistant'slicensefora
1313+214periodnottoexceedthreeyears;
1314+215 (3)Restrictorlimitthephysicaltherapist'sorphysicaltherapistassistant'slicensefor
1315+216anindefiniteperiodoftime;
1316+217 (4)Revokethephysicaltherapist'sorphysicaltherapistassistant'slicense;
1317+218 (5)Administerapublicorprivatereprimand;
1318+219 (6)Denythephysicaltherapist'sorphysicaltherapistassistant'sapplicationfora
1319+220license;
1320+221 (7)Permanentlywithholdissuanceofalicense;
1321+222 (8)Requirethephysicaltherapistorphysicaltherapistassistanttosubmittothecare,
1322+223counselingortreatmentofphysiciansdesignatedbytheboardattheexpenseofthephysical
1323+224therapistorphysicaltherapistassistanttobeexamined;
1324+225 (9)Requirethephysicaltherapistorphysicaltherapistassistanttoattendsuch
1325+226continuingeducationalcoursesandpasssuchexaminationsastheboardmaydirect.
1326+227 4.Inanyorderofrevocation,theboardmayprovidethatthephysicaltherapistor
1327+228physicaltherapistassistantshallnotapplyforreinstatementofthephysicaltherapist'sor
1328+229physicaltherapistassistant'slicenseforaperiodoftimerangingfromtwotosevenyears
1329+230followingthedateoftheorderofrevocation.Allstayordersshalltollthistimeperiod.
1330+231 5.Beforerestoringtogoodstandingalicenseissuedunderthischapterwhichhas
1331+232beeninarevoked,suspended,orinactivestateforanycauseformorethantwoyears,the
1332+233boardmayrequiretheapplicanttoattendsuchcontinuingmedicaleducationcoursesandpass
1333+234suchexaminationsastheboardmaydirect.
1334+235 6.Inanyinvestigation,hearingorotherproceedingtodetermineaphysical
1335+236therapist's,physicaltherapistassistant'sorapplicant'sfitnesstopractice,anyrecordrelatingto
1336+237anypatientofthephysicaltherapist,physicaltherapistassistant,orapplicantshallbe
1337+238discoverablebytheboardandadmissibleintoevidence,regardlessofanystatutoryor
1338+239commonlawprivilegewhichsuchphysicaltherapist,physicaltherapistassistant,applicant,
1339+240recordcustodian,orpatientmightotherwiseinvoke.Inaddition,nosuchphysicaltherapist,
1340+241physicaltherapistassistant,applicant,orrecordcustodianmaywithholdrecordsortestimony
1341+242bearinguponaphysicaltherapist's,physicaltherapistassistant's,orapplicant'sfitnessto
1342+243practiceonthegroundsofprivilegebetweensuchphysicaltherapist,physicaltherapist
1343+244assistant,applicant,orrecordcustodianandapatient.
1344+334.735.1.Asusedinsections334.735to334.749,thefollowingtermsmean:
1345+2 (1)"Applicant",anyindividualwhoseekstobecomelicensedasaphysician
1346+3assistant;
1347+HCSSSSCSSB157 37 4 (2)"Certification"or"registration",aprocessbyacertifyingentitythatgrants
1348+5recognitiontoapplicantsmeetingpredeterminedqualificationsspecifiedbysuchcertifying
1349+6entity;
1350+7 (3)"Certifyingentity",thenongovernmentalagencyorassociationwhichcertifiesor
1351+8registersindividualswhohavecompletedacademicandtrainingrequirements;
1352+9 (4)"Collaborativepracticearrangement",writtenagreements,jointlyagreedupon
1353+10protocols,orstandingorders,allofwhichshallbeinwriting,forthedeliveryofhealthcare
1354+11services;
1355+12 (5)"Department",thedepartmentofcommerceandinsuranceoradesignatedagency
1356+13thereof;
1357+14 (6)"License",adocumentissuedtoanapplicantbytheboardacknowledgingthatthe
1358+15applicantisentitledtopracticeasaphysicianassistant;
1359+16 (7)"Physicianassistant",apersonwhohasgraduatedfromaphysicianassistant
1360+17programaccreditedbytheAccreditationReviewCommissiononEducationforthePhysician
1361+18Assistantoritssuccessoragency,priorto2001,ortheCommitteeonAlliedHealthEducation
1362+19andAccreditationortheCommissiononAccreditationofAlliedHealthEducationPrograms,
1363+20whohaspassedthecertifyingexaminationadministeredbytheNationalCommissionon
1364+21CertificationofPhysicianAssistantsandhasactivecertificationbytheNationalCommission
1365+22onCertificationofPhysicianAssistantswhoprovideshealthcareservicesdelegatedbya
1366+23licensedphysician.Apersonwhohasbeenemployedasaphysicianassistantforthreeyears
1367+24priortoAugust28,1989,whohaspassedtheNationalCommissiononCertificationof
1368+25PhysicianAssistantsexamination,andhasactivecertificationoftheNationalCommissionon
1369+26CertificationofPhysicianAssistants;
1370+27 (8)"Recognition",theformalprocessofbecomingacertifyingentityasrequiredby
1371+28theprovisionsofsections334.735to334.749.
1372+29 2.Thescopeofpracticeofaphysicianassistantshallconsistonlyofthefollowing
1373+30servicesandprocedures:
1374+31 (1)Takingpatienthistories;
1375+32 (2)Performingphysicalexaminationsofapatient;
1376+33 (3)Performingorassistingintheperformanceofroutineofficelaboratoryandpatient
1377+34screeningprocedures;
1378+35 (4)Performingroutinetherapeuticprocedures;
1379+36 (5)Recordingdiagnosticimpressionsandevaluatingsituationscallingforattentionof
1380+37aphysiciantoinstitutetreatmentprocedures;
1381+38 (6)Instructingandcounselingpatientsregardingmentalandphysicalhealthusing
1382+39proceduresreviewedandapprovedbyacollaboratingphysician;
1383+HCSSSSCSSB157 38 40 (7)Assistingthesupervisingphysicianininstitutionalsettings,includingreviewing
1384+41oftreatmentplans,orderingoftestsanddiagnosticlaboratoryandradiologicalservices,and
1385+42orderingoftherapies,usingproceduresreviewedandapprovedbyalicensedphysician;
1386+43 (8)Assistinginsurgery;and
1387+44 (9)Performingsuchothertasksnotprohibitedbylawunderthecollaborativepractice
1388+45arrangementwithalicensedphysicianasthephysicianassistanthasbeentrainedandis
1389+46proficienttoperform.
1390+47 3.Physicianassistantsshallnotperformorprescribeabortions.
1391+48 4.Physicianassistantsshallnotprescribeanydrug,medicine,deviceortherapy
1392+49unlesspursuanttoacollaborativepracticearrangementinaccordancewiththelaw,nor
1393+50prescribelenses,prismsorcontactlensesfortheaid,relieforcorrectionofvisionorthe
1394+51measurementofvisualpowerorvisualefficiencyofthehumaneye,noradministerormonitor
1395+52generalorregionalblockanesthesiaduringdiagnostictests,surgeryorobstetricprocedures.
1396+53Prescribingofdrugs,medications,devicesortherapiesbyaphysicianassistantshallbe
1397+54pursuanttoacollaborativepracticearrangementwhichisspecifictotheclinicalconditions
1398+55treatedbythesupervisingphysicianandthephysicianassistantshallbesubjecttothe
1399+56following:
1400+57 (1)Aphysicianassistantshallonlyprescribecontrolledsubstancesinaccordance
1401+58withsection334.747;
1402+59 (2)Thetypesofdrugs,medications,devicesortherapiesprescribedbyaphysician
1403+60assistantshallbeconsistentwiththescopesofpracticeofthephysicianassistantandthe
1404+61collaboratingphysician;
1405+62 (3)Allprescriptionsshallconformwithstateandfederallawsandregulationsand
1406+63shallincludethename,addressandtelephonenumberofthephysicianassistant[andthe
1407+64supervisingphysician];
1408+65 (4)Aphysicianassistant,oradvancedpracticeregisterednurseasdefinedinsection
1409+66335.016mayrequest,receiveandsignfornoncontrolledprofessionalsamplesandmay
1410+67distributeprofessionalsamplestopatients;and
1411+68 (5)Aphysicianassistantshallnotprescribeanydrugs,medicines,devicesor
1412+69therapiesthecollaboratingphysicianisnotqualifiedorauthorizedtoprescribe.
1413+70 5.Aphysicianassistantshallclearlyidentifyhimselforherselfasaphysician
1414+71assistantandshallnotuseorpermittobeusedinthephysicianassistant'sbehalftheterms
1415+72"doctor","Dr."or"doc"norholdhimselforherselfoutinanywaytobeaphysicianor
1416+73surgeon.Nophysicianassistantshallpracticeorattempttopracticewithoutphysician
1417+74collaborationorinanylocationwherethecollaboratingphysicianisnotimmediately
1418+75availableforconsultation,assistanceandintervention,exceptasotherwiseprovidedinthis
1419+76section,andinanemergencysituation,norshallanyphysicianassistantbillapatient
1420+HCSSSSCSSB157 39 77independentlyordirectlyforanyservicesorprocedurebythephysicianassistant;exceptthat,
1421+78nothinginthissubsectionshallbeconstruedtoprohibitaphysicianassistantfromenrolling
1422+79withathird-partyplanorthedepartmentofsocialservicesasaMOHealthNetorMedicaid
1423+80providerwhileactingunderacollaborativepracticearrangementbetweenthephysicianand
1424+81physicianassistant.
1425+82 6.Thelicensingofphysicianassistantsshalltakeplacewithinprocessesestablished
1426+83bythestateboardofregistrationforthehealingartsthroughruleandregulation.Theboard
1427+84ofhealingartsisauthorizedtoestablishrulespursuanttochapter536establishinglicensing
1428+85andrenewalprocedures,collaboration,collaborativepracticearrangements,fees,and
1429+86addressingsuchothermattersasarenecessarytoprotectthepublicanddisciplinethe
1430+87profession.Anapplicationforlicensingmaybedeniedorthelicenseofaphysicianassistant
1431+88maybesuspendedorrevokedbytheboardinthesamemannerandforviolationofthe
1432+89standardsassetforthbysection334.100,orsuchotherstandardsofconductsetbytheboard
1433+90byruleorregulation.Personslicensedpursuanttotheprovisionsofchapter335shallnotbe
1434+91requiredtobelicensedasphysicianassistants.Allapplicantsforphysicianassistantlicensure
1435+92whocompleteaphysicianassistanttrainingprogramafterJanuary1,2008,shallhavea
1436+93master'sdegreefromaphysicianassistantprogram.
1437+94 7.Atalltimesthephysicianisresponsiblefortheoversightoftheactivitiesof,and
1438+95acceptsresponsibilityfor,healthcareservicesrenderedbythephysicianassistant.
1439+96 8.(1)Aphysicianmayenterintocollaborativepracticearrangementswithphysician
1440+97assistants.Collaborativepracticearrangements,whichshallbeinwriting,maydelegatetoa
1441+98physicianassistanttheauthoritytoprescribe,administer,ordispensedrugsandprovide
1442+99treatmentwhichiswithintheskill,training,andcompetenceofthephysicianassistant.
1443+100Collaborativepracticearrangementsmaydelegatetoaphysicianassistant,asdefinedin
1444+101section334.735,theauthoritytoadminister,dispense,orprescribecontrolledsubstances
1445+102listedinSchedulesIII,IV,andVofsection195.017,andScheduleII-hydrocodone.
1446+103ScheduleIIInarcoticcontrolledsubstancesandScheduleII-hydrocodoneprescriptionsshall
1447+104belimitedtoaonehundredtwenty-hoursupplywithoutrefill.Suchcollaborativepractice
1448+105arrangementsshallbeintheformofawrittenarrangement,jointlyagreed-uponprotocols,or
1449+106standingordersforthedeliveryofhealthcareservices.
1450+107 (2)Notwithstandinganyotherprovisionofthissectiontothecontrary,a
1451+108collaborativepracticearrangementmaydelegatetoaphysicianassistanttheauthority
1452+109toadminister,dispense,orprescribeScheduleIIcontrolledsubstancesforhospice
1453+110patients;provided,thatthephysicianassistantisemployedbyahospiceprovider
1454+111certifiedpursuanttochapter197andthephysicianassistantisprovidingcaretohospice
1455+112patientspursuanttoacollaborativepracticearrangementthatdesignatesthecertified
1456+HCSSSSCSSB157 40 113hospiceasalocationwherethephysicianassistantisauthorizedtopracticeand
1457+114prescribe.
1458+115 9.Thewrittencollaborativepracticearrangementshallcontainatleastthefollowing
1459+116provisions:
1460+117 (1)Completenames,homeandbusinessaddresses,zipcodes,andtelephonenumbers
1461+118ofthecollaboratingphysicianandthephysicianassistant;
1462+119 (2)Alistofallotherofficesorlocations,otherthanthoselistedinsubdivision(1)of
1463+120thissubsection,wherethecollaboratingphysicianhasauthorizedthephysicianassistantto
1464+121prescribe;
1465+122 (3)Arequirementthatthereshallbepostedateveryofficewherethephysician
1466+123assistantisauthorizedtoprescribe,incollaborationwithaphysician,aprominentlydisplayed
1467+124disclosurestatementinformingpatientsthattheymaybeseenbyaphysicianassistantand
1468+125havetherighttoseethecollaboratingphysician;
1469+126 (4)Allspecialtyorboardcertificationsofthecollaboratingphysicianandall
1470+127certificationsofthephysicianassistant;
1471+128 (5)Themannerofcollaborationbetweenthecollaboratingphysicianandthe
1472+129physicianassistant,includinghowthecollaboratingphysicianandthephysicianassistant
1473+130will:
1474+131 (a)Engageincollaborativepracticeconsistentwitheachprofessional'sskill,training,
1475+132education,andcompetence;
1476+133 (b)Maintaingeographicproximity,asdeterminedbytheboardofregistrationforthe
1477+134healingarts;and
1478+135 (c)Providecoverageduringabsence,incapacity,infirmity,oremergencyofthe
1479+136collaboratingphysician;
1480+137 (6)Alistofallotherwrittencollaborativepracticearrangementsofthecollaborating
1481+138physicianandthephysicianassistant;
1482+139 (7)Thedurationofthewrittenpracticearrangementbetweenthecollaborating
1483+140physicianandthephysicianassistant;
1484+141 (8)Adescriptionofthetimeandmannerofthecollaboratingphysician'sreviewof
1485+142thephysicianassistant'sdeliveryofhealthcareservices.Thedescriptionshallinclude
1486+143provisionsthatthephysicianassistantshallsubmitaminimumoftenpercentofthecharts
1487+144documentingthephysicianassistant'sdeliveryofhealthcareservicestothecollaborating
1488+145physicianforreviewbythecollaboratingphysician,oranyotherphysiciandesignatedinthe
1489+146collaborativepracticearrangement,everyfourteendays.Reviewsmaybeconducted
1490+147electronically;
1491+148 (9)Thecollaboratingphysician,oranyotherphysiciandesignatedinthe
1492+149collaborativepracticearrangement,shallrevieweveryfourteendaysaminimumoftwenty
1493+HCSSSSCSSB157 41 150percentofthechartsinwhichthephysicianassistantprescribescontrolledsubstances.The
1494+151chartsreviewedunderthissubdivisionmaybecountedinthenumberofchartsrequiredtobe
1495+152reviewedundersubdivision(8)ofthissubsection;and
1496+153 (10)Astatementthatnocollaborationrequirementsinadditiontothefederallaw
1497+154shallberequiredforaphysician-physicianassistantteamworkinginacertifiedcommunity
1498+155behavioralhealthclinicasdefinedbyPub.L.113-93,oraruralhealthclinicunderthefederal
1499+156RuralHealthServicesAct,Pub.L.95-210,asamended,orafederallyqualifiedhealthcenter
1500+157asdefinedin42U.S.C.Section[1395ofthePublicHealthServiceAct]1395x, asamended.
1501+158 10.Thestateboardofregistrationforthehealingartsundersection334.125may
1502+159promulgaterulesregulatingtheuseofcollaborativepracticearrangements.
1503+160 11.Thestateboardofregistrationforthehealingartsshallnotdeny,revoke,suspend,
1504+161orotherwisetakedisciplinaryactionagainstacollaboratingphysicianforhealthcareservices
1505+162delegatedtoaphysicianassistant,providedthattheprovisionsofthissectionandtherules
1506+163promulgatedthereunderaresatisfied.
1507+164 12.Withinthirtydaysofanychangeandoneachrenewal,thestateboardof
1508+165registrationforthehealingartsshallrequireeveryphysiciantoidentifywhetherthephysician
1509+166isengagedinanycollaborativepracticearrangement,includingcollaborativepractice
1510+167arrangementsdelegatingtheauthoritytoprescribecontrolledsubstances,andalsoreportto
1511+168theboardthenameofeachphysicianassistantwithwhomthephysicianhasenteredintosuch
1512+169arrangement.Theboardmaymakesuchinformationavailabletothepublic.Theboardshall
1513+170trackthereportedinformationandmayroutinelyconductrandomreviewsofsuch
1514+171arrangementstoensurethatthearrangementsarecarriedoutincompliancewiththischapter.
1515+172 13.Thecollaboratingphysicianshalldetermineanddocumentthecompletionofa
1516+173periodoftimeduringwhichthephysicianassistantshallpracticewiththecollaborating
1517+174physiciancontinuouslypresentbeforepracticinginasettingwherethecollaborating
1518+175physicianisnotcontinuouslypresent.Thislimitationshallnotapplytocollaborative
1519+176arrangementsofprovidersofpopulation-basedpublichealthservicesasdefinedby20CSR
1520+1772150-5.100asofApril30,2009.
1521+178 14.Nocontractorotherarrangementshallrequireaphysiciantoactasa
1522+179collaboratingphysicianforaphysicianassistantagainstthephysician'swill.Aphysician
1523+180shallhavetherighttorefusetoactasasupervisingphysician,withoutpenalty,foraparticular
1524+181physicianassistant.Nocontractorotheragreementshalllimitthecollaboratingphysician's
1525+182ultimateauthorityoveranyprotocolsorstandingordersorinthedelegationofthephysician's
1526+183authoritytoanyphysicianassistant.Nocontractorotherarrangementshallrequireany
1527+184physicianassistanttocollaboratewithanyphysicianagainstthephysicianassistant'swill.A
1528+185physicianassistantshallhavetherighttorefusetocollaborate,withoutpenalty,witha
1529+186particularphysician.
1530+HCSSSSCSSB157 42 187 15.Physicianassistantsshallfilewiththeboardacopyoftheircollaborating
1531+188physicianform.
1532+189 16.Nophysicianshallbedesignatedtoserveasacollaboratingphysicianformore
1533+190thansixfull-timeequivalentlicensedphysicianassistants,full-timeequivalentadvanced
1534+191practiceregisterednurses,orfull-timeequivalentassistantphysicians,oranycombination
1535+192thereof.Thislimitationshallnotapplytophysicianassistantcollaborativepractice
1536+193arrangementsofhospitalemployeesprovidinginpatientcareserviceinhospitalsasdefinedin
1537+194chapter197,ortoacertifiedregisterednurseanesthetistprovidinganesthesiaservicesunder
1538+195thesupervisionofananesthesiologistorotherphysician,dentist,orpodiatristwhois
1539+196immediatelyavailableifneededassetoutinsubsection7ofsection334.104.
1540+197 17.Noarrangementmadeunderthissectionshallsupercedecurrenthospitallicensing
1541+198regulationsgoverninghospitalmedicationordersunderprotocolsorstandingordersforthe
1542+199purposeofdeliveringinpatientoremergencycarewithinahospital,asdefinedinsection
1543+200197.020,ifsuchprotocolsorstandingordershavebeenapprovedbythehospital'smedical
1544+201staffandpharmaceuticaltherapeuticscommittee.
1545+334.747.1.(1)Aphysicianassistantwithacertificateofcontrolledsubstance
1546+2prescriptiveauthorityasprovidedinthissectionmayprescribeanycontrolledsubstance
1547+3listedinScheduleIII,IV,orVofsection195.017,andmayhaverestrictedauthorityin
1548+4ScheduleII,whendelegatedtheauthoritytoprescribecontrolledsubstancesinacollaborative
1549+5practicearrangement.Suchauthorityshallbelistedonthecollaboratingphysicianformon
1550+6filewiththestateboardofhealingarts.Thecollaboratingphysicianshallmaintaintheright
1551+7tolimitaspecificscheduleddrugorscheduleddrugcategorythatthephysicianassistantis
1552+8permittedtoprescribe.Anylimitationsshallbelistedonthecollaboratingphysicianform.
1553+9PrescriptionsforScheduleIImedicationsprescribedbyaphysicianassistantwithauthorityto
1554+10prescribedelegatedinacollaborativepracticearrangementarerestrictedtoonlythose
1555+11medicationscontaininghydrocodone.Physicianassistantsshallnotprescribecontrolled
1556+12substancesforthemselvesormembersoftheirfamilies.ScheduleIIInarcoticcontrolled
1557+13substancesandScheduleII-hydrocodoneprescriptionsshallbelimitedtoafive-daysupply
1558+14withoutrefill,exceptthatbuprenorphinemaybeprescribedforuptoathirty-daysupply
1559+15withoutrefillforpatientsreceivingmedication-assistedtreatmentforsubstanceusedisorders
1560+16underthedirectionofthecollaboratingphysician.Physicianassistantswhoareauthorizedto
1561+17prescribecontrolledsubstancesunderthissectionshallregisterwiththefederalDrug
1562+18EnforcementAdministrationandthestatebureauofnarcoticsanddangerousdrugs,andshall
1563+19includetheDrugEnforcementAdministrationregistrationnumberonprescriptionsfor
1564+20controlledsubstances.
1565+21 (2)Notwithstandinganyotherprovisionofthissectiontothecontrary,a
1566+22collaborativepracticearrangementmaydelegatetoaphysicianassistanttheauthority
1567+HCSSSSCSSB157 43 23toadminister,dispense,orprescribeScheduleIIcontrolledsubstancesforhospice
1568+24patients;provided,thatthephysicianassistantisemployedbyahospiceprovider
1569+25certifiedpursuanttochapter197andthephysicianassistantisprovidingcaretohospice
1570+26patientspursuanttoacollaborativepracticearrangementthatdesignatesthecertified
1571+27hospiceasalocationwherethephysicianassistantisauthorizedtopracticeand
1572+28prescribe.
1573+29 2.Thecollaboratingphysicianshallberesponsibletodetermineanddocumentthe
1574+30completionofatleastonehundredtwentyhoursinafour-monthperiodbythephysician
1575+31assistantduringwhichthephysicianassistantshallpracticewiththecollaboratingphysician
1576+32on-sitepriortoprescribingcontrolledsubstanceswhenthecollaboratingphysicianisnoton-
1577+33site.Suchlimitationshallnotapplytophysicianassistantsofpopulation-basedpublichealth
1578+34servicesasdefinedin20CSR2150-5.100asofApril30,2009.
1579+35 3.Aphysicianassistantshallreceiveacertificateofcontrolledsubstanceprescriptive
1580+36authorityfromtheboardofhealingartsuponverificationofthecompletionofthefollowing
1581+37educationalrequirements:
1582+38 (1)Successfulcompletionofanadvancedpharmacologycoursethatincludesclinical
1583+39trainingintheprescriptionofdrugs,medicines,andtherapeuticdevices.Acourseorcourses
1584+40withadvancedpharmacologicalcontentinaphysicianassistantprogramaccreditedbythe
1585+41AccreditationReviewCommissiononEducationforthePhysicianAssistant(ARC-PA)orits
1586+42predecessoragencyshallsatisfysuchrequirement;
1587+43 (2)Completionofaminimumofthreehundredclockhoursofclinicaltrainingbythe
1588+44collaboratingphysicianintheprescriptionofdrugs,medicines,andtherapeuticdevices;
1589+45 (3)Completionofaminimumofoneyearofsupervisedclinicalpracticeor
1590+46supervisedclinicalrotations.Oneyearofclinicalrotationsinaprogramaccreditedbythe
1591+47AccreditationReviewCommissiononEducationforthePhysicianAssistant(ARC-PA)orits
1592+48predecessoragency,whichincludespharmacotherapeuticsasacomponentofitsclinical
1593+49training,shallsatisfysuchrequirement.Proofofsuchtrainingshallservetodocument
1594+50experienceintheprescribingofdrugs,medicines,andtherapeuticdevices;
1595+51 (4)Aphysicianassistantpreviouslylicensedinajurisdictionwherephysician
1596+52assistantsareauthorizedtoprescribecontrolledsubstancesmayobtainastatebureauof
1597+53narcoticsanddangerousdrugsregistrationifacollaboratingphysiciancanattestthatthe
1598+54physicianassistanthasmettherequirementsofsubdivisions(1)to(3)ofthissubsectionand
1599+55providesdocumentationofexistingfederalDrugEnforcementAgencyregistration.
1600+334.1600.Sections334.1600to334.1720shallbeknownandmaybecitedasthe
1601+2"InterstateMedicalLicensureCompact".
1602+334.1605.Inordertostrengthenaccesstohealthcare,andinrecognitionofthe
1603+2advancesinthedeliveryofhealthcare,thememberstatesoftheInterstateMedical
1604+HCSSSSCSSB157 44 3LicensureCompacthavealliedincommonpurposetodevelopacomprehensiveprocess
1605+4thatcomplementstheexistinglicensingandregulatoryauthorityofstatemedical
1606+5boards,providesastreamlinedprocessthatallowsphysicianstobecomelicensedin
1607+6multiplestates,therebyenhancingtheportabilityofamedicallicenseandensuringthe
1608+7safetyofpatients.TheCompactcreatesanotherpathwayforlicensureanddoesnot
1609+8otherwisechangeastate'sexistingMedicalPracticeAct.TheCompactalsoadoptsthe
1610+9prevailingstandardforlicensureandaffirmsthatthepracticeofmedicineoccurswhere
1611+10thepatientislocatedatthetimeofthephysician-patientencounter,andtherefore,
1612+11requiresthephysiciantobeunderthejurisdictionofthestatemedicalboardwherethe
1613+12patientislocated.StatemedicalboardsthatparticipateintheCompactretainthe
1614+13jurisdictiontoimposeanadverseactionagainstalicensetopracticemedicineinthat
1615+14stateissuedtoaphysicianthroughtheproceduresintheCompact.
1616+334.1610.Inthiscompact:
1617+2 (1)"Bylaws"meansthosebylawsestablishedbytheInterstateCommission
1618+3pursuanttosection334.1655.
1619+4 (2)"Commissioner"meansthevotingrepresentativeappointedbyeachmember
1620+5boardpursuanttosection334.1655.
1621+6 (3)"Conviction"meansafindingbyacourtthatanindividualisguiltyofa
1622+7criminaloffensethroughadjudication,orentryofapleaofguiltornocontesttothe
1623+8chargebytheoffender.Evidenceofanentryofaconvictionofacriminaloffensebythe
1624+9courtshallbeconsideredfinalforpurposesofdisciplinaryactionbyamemberboard.
1625+10 (4)"ExpeditedLicense"meansafullandunrestrictedmedicallicensegranted
1626+11byamemberstatetoaneligiblephysicianthroughtheprocesssetforthintheCompact.
1627+12 (5)"InterstateCommission"meanstheinterstatecommissioncreatedpursuant
1628+13tosection334.1655.
1629+14 (6)"License"meansauthorizationbyamemberstateforaphysiciantoengage
1630+15inthepracticeofmedicine,whichwouldbeunlawfulwithoutauthorization.
1631+16 (7)"MedicalPracticeAct"meanslawsandregulationsgoverningthepracticeof
1632+17allopathicandosteopathicmedicinewithinamemberstate.
1633+18 (8)"MemberBoard"meansastateagencyinamemberstatethatactsinthe
1634+19sovereigninterestsofthestatebyprotectingthepublicthroughlicensure,regulation,
1635+20andeducationofphysiciansasdirectedbythestategovernment.
1636+21 (9)"MemberState"meansastatethathasenactedtheCompact.
1637+22 (10)"PracticeofMedicine"meansthatclinicalprevention,diagnosis,or
1638+23treatmentofhumandisease,injury,orconditionrequiringaphysiciantoobtainand
1639+24maintainalicenseincompliancewiththeMedicalPracticeActofamemberstate.
1640+25 (11)"Physician"meansanypersonwho:
1641+HCSSSSCSSB157 45 26 (a)IsagraduateofamedicalschoolaccreditedbytheLiaisonCommitteeon
1642+27MedicalEducation,theCommissiononOsteopathicCollegeAccreditation,oramedical
1643+28schoollistedintheInternationalMedicalEducationDirectoryoritsequivalent;
1644+29 (b)PassedeachcomponentoftheUnitedStatesMedicalLicensingExamination
1645+30(USMLE)ortheComprehensiveOsteopathicMedicalLicensingExamination
1646+31(COMLEX-USA) withinthreeattempts,oranyofitspredecessorexaminations
1647+32acceptedbyastatemedicalboardasanequivalentexaminationforlicensurepurposes;
1648+33 (c)Successfullycompletedgraduatemedicaleducationapprovedbythe
1649+34AccreditationCouncilforGraduateMedicalEducationortheAmericanOsteopathic
1650+35Association;
1651+36 (d)Holdsspecialtycertificationoratime-unlimitedspecialtycertificate
1652+37recognizedbytheAmericanBoardofMedicalSpecialtiesortheAmerican
1653+38OsteopathicAssociation'sBureauofOsteopathicSpecialists;
1654+39 (e)Possessesafullandunrestrictedlicensetoengageinthepracticeofmedicine
1655+40issuedbyamemberboard;
1656+41 (f)Hasneverbeenconvicted,receivedadjudication,deferredadjudication,
1657+42communitysupervision,ordeferreddispositionforanyoffensebyacourtof
1658+43appropriatejurisdiction;
1659+44 (g)Hasneverheldalicenseauthorizingthepracticeofmedicinesubjectedto
1660+45disciplinebyalicensingagencyinanystate,federal,orforeignjurisdiction,excluding
1661+46anyactionrelatedtonon-paymentoffeesrelatedtoalicense;
1662+47 (h)Hasneverhadacontrolledsubstancelicenseorpermitsuspendedorrevoked
1663+48byastateortheUnitedStatesDrugEnforcementAdministration;and
1664+49 (i)Isnotunderactiveinvestigationbyalicensingagencyorlawenforcement
1665+50authorityinanystate,federal,orforeignjurisdiction.
1666+51 (12)"Offense"meansafelony,grossmisdemeanor,orcrimeofmoralturpitude.
1667+52 (13)"Rule"meansawrittenstatementbytheInterstateCommission
1668+53promulgatedpursuanttosection334.1660oftheCompactthatisofgeneral
1669+54applicability,implements,interprets,orprescribesapolicyorprovisionofthe
1670+55Compact,oranorganizational,procedural,orpracticerequirementoftheInterstate
1671+56Commission,andhastheforceandeffectofstatutorylawinamemberstate,and
1672+57includestheamendment,repeal,orsuspensionofanexistingrule.
1673+58 (14)"State"meansanystate,commonwealth,district,orterritoryoftheUnited
1674+59States.
1675+60 (15)"StateofPrincipalLicense"meansamemberstatewhereaphysicianholds
1676+61alicensetopracticemedicineandwhichhasbeendesignatedassuchbythephysician
1677+62forpurposesofregistrationandparticipationintheCompact.
1678+HCSSSSCSSB157 46 334.1615.1.Aphysicianmustmeettheeligibilityrequirementsasdefinedin
1679+2subdivision(11)ofsection334.1610toreceiveanexpeditedlicenseunderthetermsand
1680+3provisionsoftheCompact.
1681+4 2.Aphysicianwhodoesnotmeettherequirementsofsubdivision(11)ofsection
1682+5334.1610mayobtainalicensetopracticemedicineinamemberstateiftheindividual
1683+6complieswithalllawsandrequirements,otherthantheCompact,relatingtothe
1684+7issuanceofalicensetopracticemedicineinthatstate.
1685+334.1620.1.Aphysicianshalldesignateamemberstateasthestateofprincipal
1686+2licenseforpurposesofregistrationforexpeditedlicensurethroughtheCompactifthe
1687+3physicianpossessesafullandunrestrictedlicensetopracticemedicineinthatstate,and
1688+4thestateis:
1689+5 (1)Thestateofprincipalresidenceforthephysician,or
1690+6 (2)Thestatewhereatleast25%ofthepracticeofmedicineoccurs,or
1691+7 (3)Thelocationofthephysician'semployer,or
1692+8 (4)Ifnostatequalifiesundersubdivision(1),(2),or(3)ofthissubsection,the
1693+9statedesignatedasstateofresidenceforpurposeoffederalincometax.
1694+10 2.Aphysicianmayredesignateamemberstateasstateofprincipallicenseat
1695+11anytime,aslongasthestatemeetstherequirementsofsubsection1ofthissection.
1696+12 3.TheInterstateCommissionisauthorizedtodeveloprulestofacilitate
1697+13redesignationofanothermemberstateasthestateofprincipallicense.
1698+334.1625.1.AphysicianseekinglicensurethroughtheCompactshallfilean
1699+2applicationforanexpeditedlicensewiththememberboardofthestateselectedbythe
1700+3physicianasthestateofprincipallicense.
1701+4 2.Uponreceiptofanapplicationforanexpeditedlicense,thememberboard
1702+5withinthestateselectedasthestateofprincipallicenseshallevaluatewhetherthe
1703+6physicianiseligibleforexpeditedlicensureandissuealetterofqualification,verifying
1704+7ordenyingthephysician'seligibility,totheInterstateCommission.
1705+8 (1)Staticqualifications,whichincludeverificationofmedicaleducation,
1706+9graduatemedicaleducation,resultsofanymedicalorlicensingexamination,andother
1707+10qualificationsasdeterminedbytheInterstateCommissionthroughrule,shallnotbe
1708+11subjecttoadditionalprimarysourceverificationwherealreadyprimarysourceverified
1709+12bythestateofprincipallicense.
1710+13 (2)Thememberboardwithinthestateselectedasthestateofprincipallicense
1711+14shall,inthecourseofverifyingeligibility,performacriminalbackgroundcheckofan
1712+15applicant,includingtheuseoftheresultsoffingerprintorotherbiometricdatachecks
1713+16compliantwiththerequirementsoftheFederalBureauofInvestigation,withthe
1714+HCSSSSCSSB157 47 17exceptionoffederalemployeeswhohavesuitabilitydeterminationinaccordancewith5
1715+18C.F.R.§731.202.
1716+19 (3)Appealonthedeterminationofeligibilityshallbemadetothememberstate
1717+20wheretheapplicationwasfiledandshallbesubjecttothelawofthatstate.
1718+21 3.Uponverificationinsubsection2ofthissection,physicianseligibleforan
1719+22expeditedlicenseshallcompletetheregistrationprocessestablishedbytheInterstate
1720+23Commissiontoreceivealicenseinamemberstateselectedpursuanttosubsection1of
1721+24thissection,includingthepaymentofanyapplicablefees.
1722+25 4.Afterreceivingverificationofeligibilityundersubsection2ofthissectionand
1723+26anyfeesundersubsection3ofthissection,amemberboardshallissueanexpedited
1724+27licensetothephysician.Thislicenseshallauthorizethephysiciantopracticemedicine
1725+28intheissuingstateconsistentwiththeMedicalPracticeActandallapplicablelawsand
1726+29regulationsoftheissuingmemberboardandmemberstate.
1727+30 5.Anexpeditedlicenseshallbevalidforaperiodconsistentwiththelicensure
1728+31periodinthememberstateandinthesamemannerasrequiredforotherphysicians
1729+32holdingafullandunrestrictedlicensewithinthememberstate.
1730+33 6.AnexpeditedlicenseobtainedthroughtheCompactshallbeterminatedifa
1731+34physicianfailstomaintainalicenseinthestateofprincipallicensureforanon-
1732+35disciplinaryreason,withoutredesignationofanewstateofprincipallicensure.
1733+36 7.TheInterstateCommissionisauthorizedtodeveloprulesregardingthe
1734+37applicationprocess,includingpaymentofanyapplicablefees,andtheissuanceofan
1735+38expeditedlicense.
1736+334.1630.1.Amemberstateissuinganexpeditedlicenseauthorizingthe
1737+2practiceofmedicineinthatstatemayimposeafeeforalicenseissuedorrenewed
1738+3throughtheCompact.
1739+4 2.TheInterstateCommissionisauthorizedtodeveloprulesregardingfeesfor
1740+5expeditedlicenses.
1741+334.1635.1.Aphysicianseekingtorenewanexpeditedlicensegrantedina
1742+2memberstateshallcompletearenewalprocesswiththeInterstateCommissionifthe
1743+3physician:
1744+4 (1)Maintainsafullandunrestrictedlicenseinastateofprincipallicense;
1745+5 (2)Hasnotbeenconvicted,receivedadjudication,deferredadjudication,
1746+6communitysupervision,ordeferreddispositionforanyoffensebyacourtof
1747+7appropriatejurisdiction;
1748+8 (3)Hasnothadalicenseauthorizingthepracticeofmedicinesubjectto
1749+9disciplinebyalicensingagencyinanystate,federal,orforeignjurisdiction,excluding
1750+10anyactionrelatedtonon-paymentoffeesrelatedtoalicense;and
1751+HCSSSSCSSB157 48 11 (4)Hasnothadacontrolledsubstancelicenseorpermitsuspendedorrevoked
1752+12byastateortheUnitedStatesDrugEnforcementAdministration.
1753+13 2.Physiciansshallcomplywithallcontinuingprofessionaldevelopmentor
1754+14continuingmedicaleducationrequirementsforrenewalofalicenseissuedbyamember
1755+15state.
1756+16 3.TheInterstateCommissionshallcollectanyrenewalfeeschargedforthe
1757+17renewalofalicenseanddistributethefeestotheapplicablememberboard.
1758+18 4.Uponreceiptofanyrenewalfeescollectedinsubsection3ofthissection,a
1759+19memberboardshallrenewthephysician'slicense.
1760+20 5.PhysicianinformationcollectedbytheInterstateCommissionduringthe
1761+21renewalprocesswillbedistributedtoallmemberboards.
1762+22 6.TheInterstateCommissionisauthorizedtodeveloprulestoaddressrenewal
1763+23oflicensesobtainedthroughtheCompact.
1764+334.1640.1.TheInterstateCommissionshallestablishadatabaseofall
1765+2physicianslicensed,orwhohaveappliedforlicensure,undersection334.1625.
1766+3 2.Notwithstandinganyotherprovisionoflaw,memberboardsshallreportto
1767+4theInterstateCommissionanypublicactionorcomplaintsagainstalicensedphysician
1768+5whohasappliedorreceivedanexpeditedlicensethroughtheCompact.
1769+6 3.Memberboardsshallreportdisciplinaryorinvestigatoryinformation
1770+7determinedasnecessaryandproperbyruleoftheInterstateCommission.
1771+8 4.Memberboardsmayreportanynon-publiccomplaint,disciplinary,or
1772+9investigatoryinformationnotrequiredbysubsection3ofthissectiontotheInterstate
1773+10Commission.
1774+11 5.Memberboardsshallsharecomplaintordisciplinaryinformationabouta
1775+12physicianuponrequestofanothermemberboard.
1776+13 6.AllinformationprovidedtotheInterstateCommissionordistributedby
1777+14memberboardsshallbeconfidential,filedunderseal,andusedonlyforinvestigatoryor
1778+15disciplinarymatters.
1779+16 7.TheInterstateCommissionisauthorizedtodeveloprulesformandatedor
1780+17discretionarysharingofinformationbymemberboards.
1781+334.1645.1.Licensureanddisciplinaryrecordsofphysiciansaredeemed
1782+2investigative.
1783+3 2.Inadditiontotheauthoritygrantedtoamemberboardbyitsrespective
1784+4MedicalPracticeActorotherapplicablestatelaw,amemberboardmayparticipate
1785+5withothermemberboardsinjointinvestigationsofphysicianslicensedbythemember
1786+6boards.
1787+HCSSSSCSSB157 49 7 3.Asubpoenaissuedbyamemberstateshallbeenforceableinothermember
1788+8states.
1789+9 4.Memberboardsmayshareanyinvestigative,litigation,orcompliance
1790+10materialsinfurtheranceofanyjointorindividualinvestigationinitiatedunderthe
1791+11Compact.
1792+12 5.Anymemberstatemayinvestigateactualorallegedviolationsofthestatutes
1793+13authorizingthepracticeofmedicineinanyothermemberstateinwhichaphysician
1794+14holdsalicensetopracticemedicine.
1795+334.1650.1.Anydisciplinaryactiontakenbyanymemberboardagainsta
1796+2physicianlicensedthroughtheCompactshallbedeemedunprofessionalconductwhich
1797+3maybesubjecttodisciplinebyothermemberboards,inadditiontoanyviolationofthe
1798+4MedicalPracticeActorregulationsinthatstate.
1799+5 2.Ifalicensegrantedtoaphysicianbythememberboardinthestateof
1800+6principallicenseisrevoked,surrenderedorrelinquishedinlieuofdiscipline,or
1801+7suspended,thenalllicensesissuedtothephysicianbymemberboardsshall
1802+8automaticallybeplaced,withoutfurtheractionnecessarybyanymemberboard,on
1803+9thesamestatus.Ifthememberboardinthestateofprincipallicensesubsequently
1804+10reinstatesthephysician'slicense,alicenseissuedtothephysicianbyanyothermember
1805+11boardshallremainencumbereduntilthatrespectivememberboardtakesactionto
1806+12reinstatethelicenseinamannerconsistentwiththeMedicalPracticeActofthatstate.
1807+13 3.Ifdisciplinaryactionistakenagainstaphysicianbyamemberboardnotin
1808+14thestateofprincipallicense,anyothermemberboardmaydeemtheactionconclusive
1809+15astomatteroflawandfactdecided,and:
1810+16 (1)Imposethesameorlessersanction(s)againstthephysiciansolongassuch
1811+17sanctionsareconsistentwiththeMedicalPracticeActofthatstate;or
1812+18 (2)Pursueseparatedisciplinaryactionagainstthephysicianunderitsrespective
1813+19MedicalPracticeAct,regardlessoftheactiontakeninothermemberstates.
1814+20 4.Ifalicensegrantedtoaphysicianbyamemberboardisrevoked,surrendered
1815+21orrelinquishedinlieuofdiscipline,orsuspended,thenanylicense(s)issuedtothe
1816+22physicianbyanyothermemberboard(s)shallbesuspended,automaticallyand
1817+23immediatelywithoutfurtheractionnecessarybytheothermemberboard(s),forninety
1818+24(90)daysuponentryoftheorderbythediscipliningboard,topermitthememberboard
1819+25(s)toinvestigatethebasisfortheactionundertheMedicalPracticeActofthatstate.A
1820+26memberboardmayterminatetheautomaticsuspensionofthelicenseitissuedpriorto
1821+27thecompletionoftheninety(90)daysuspensionperiodinamannerconsistentwiththe
1822+28MedicalPracticeActofthatstate.
1823+HCSSSSCSSB157 50 334.1655.1.Thememberstatesherebycreatethe"InterstateMedicalLicensure
1824+2CompactCommission".
1825+3 2.ThepurposeoftheInterstateCommissionistheadministrationofthe
1826+4InterstateMedicalLicensureCompact,whichisadiscretionarystatefunction.
1827+5 3.TheInterstateCommissionshallbeabodycorporateandjointagencyofthe
1828+6memberstatesandshallhavealltheresponsibilities,powers,anddutiessetforthinthe
1829+7Compact,andsuchadditionalpowersasmaybeconferreduponitbyasubsequent
1830+8concurrentactionoftherespectivelegislaturesofthememberstatesinaccordancewith
1831+9thetermsoftheCompact.
1832+10 4.TheInterstateCommissionshallconsistoftwovotingrepresentatives
1833+11appointedbyeachmemberstatewhoshallserveasCommissioners.Instateswhere
1834+12allopathicandosteopathicphysiciansareregulatedbyseparatememberboards,orif
1835+13thelicensinganddisciplinaryauthorityissplitbetweenseparatememberboards,orif
1836+14thelicensinganddisciplinaryauthorityissplitbetweenmultiplememberboardswithin
1837+15amemberstate,thememberstateshallappointonerepresentativefromeachmember
1838+16board.ACommissionershallbea(n):
1839+17 (1)Allopathicorosteopathicphysicianappointedtoamemberboard;
1840+18 (2)Executivedirector,executivesecretary,orsimilarexecutiveofamember
1841+19board;or
1842+20 (3)Memberofthepublicappointedtoamemberboard.
1843+21 5.TheInterstateCommissionshallmeetatleastonceeachcalendaryear.A
1844+22portionofthismeetingshallbeabusinessmeetingtoaddresssuchmattersasmay
1845+23properlycomebeforetheCommission,includingtheelectionofofficers.The
1846+24chairpersonmaycalladditionalmeetingsandshallcallforameetinguponthe
1847+25requestofamajorityofthememberstates.
1848+26 6.ThebylawsmayprovideformeetingsoftheInterstateCommissiontobe
1849+27conductedbytelecommunicationorelectroniccommunication.
1850+28 7.EachCommissionerparticipatingatameetingoftheInterstateCommissionis
1851+29entitledtoonevote.AmajorityofCommissionersshallconstituteaquorumforthe
1852+30transactionofbusiness,unlessalargerquorumisrequiredbythebylawsofthe
1853+31InterstateCommission.ACommissionershallnotdelegateavotetoanother
1854+32Commissioner.IntheabsenceofitsCommissioner,amemberstatemaydelegate
1855+33votingauthorityforaspecifiedmeetingtoanotherpersonfromthatstatewhoshall
1856+34meettherequirementsofsubsection4ofthissection.
1857+35 8.TheInterstateCommissionshallprovidepublicnoticeofallmeetingsandall
1858+36meetingsshallbeopentothepublic.TheInterstateCommissionmaycloseameeting,in
1859+HCSSSSCSSB157 51 37fullorinportion,whereitdeterminesbyatwo-thirdsvoteoftheCommissionerspresent
1860+38thatanopenmeetingwouldbelikelyto:
1861+39 (1)Relatesolelytotheinternalpersonnelpracticeandproceduresofthe
1862+40InterstateCommission;
1863+41 (2)Discussmattersspecificallyexemptedfromdisclosurebyfederalstatute;
1864+42 (3)Discusstradesecrets,commercial,orfinancialinformationthatisprivileged
1865+43orconfidential;
1866+44 (4)Involveaccusingapersonofacrime,orformallycensuringaperson;
1867+45 (5)Discussinformationofapersonalnaturewheredisclosurewouldconstitutea
1868+46clearlyunwarrantedinvasionofpersonalprivacy;
1869+47 (6)Discussinvestigativerecordscompiledforlawenforcementpurposes;or
1870+48 (7)Specificallyrelatetotheparticipationinacivilactionorotherlegal
1871+49proceeding.
1872+50 9.TheInterstateCommissionshallkeepminuteswhichshallfullydescribeall
1873+51mattersdiscussedinameetingandshallprovideafullandaccuratesummaryofactions
1874+52taken,includingrecordofanyrollcallvotes.
1875+53 10.TheInterstateCommissionshallmakeitsinformationandofficialrecords,to
1876+54theextentnototherwisedesignatedintheCompactorbyitsrules,availabletothe
1877+55publicforinspection.
1878+56 11.TheInterstateCommissionshallestablishanexecutivecommittee,which
1879+57shallincludeofficers,members,andothersasdeterminedbythebylaws.Theexecutive
1880+58committeeshallhavethepowertoactonbehalfoftheInterstateCommission,withthe
1881+59exceptionofrulemaking,duringperiodswhentheInterstateCommissionisnotin
1882+60session.WhenactingonbehalfoftheInterstateCommission,theexecutivecommittee
1883+61shalloverseetheadministrationoftheCompactincludingenforcementandcompliance
1884+62withtheprovisionsoftheCompact,itsbylawsandrules,andothersuchdutiesas
1885+63necessary.
1886+64 12.TheInterstateCommissionshallestablishothercommitteesforgovernance
1887+65andadministrationoftheCompact.
1888+334.1660.ThepowersanddutiesoftheInterstateCommissionshallbeto:
1889+2 (1)OverseeandmaintaintheadministrationoftheCompact;
1890+3 (2)Promulgateruleswhichshallbebindingtotheextentandinthemanner
1891+4providedforintheCompact;
1892+5 (3)Issue,upontherequestofamemberstateormemberboard,advisory
1893+6opinionsconcerningthemeaningorinterpretationoftheCompact,itsbylaws,rules,
1894+7andactions;
1895+HCSSSSCSSB157 52 8 (4)EnforcecompliancewithCompactprovisions,therulespromulgatedbythe
1896+9InterstateCommission,andthebylaws,usingallnecessaryandpropermeans,including
1897+10butnotlimitedtotheuseofjudicialprocess;
1898+11 (5)Establishandappointcommitteesincluding,butnotlimitedto,anexecutive
1899+12committeeasrequiredbysection334.1655,whichshallhavethepowertoactonbehalf
1900+13oftheInterstateCommissionincarryingoutitspowersandduties;
1901+14 (6)Pay,orprovideforthepaymentoftheexpensesrelatedtotheestablishment,
1902+15organization,andongoingactivitiesoftheInterstateCommission;
1903+16 (7)Establishandmaintainoneormoreoffices;
1904+17 (8)Borrow,accept,hire,orcontractforservicesofpersonnel;
1905+18 (9)Purchaseandmaintaininsuranceandbonds;
1906+19 (10)Employanexecutivedirectorwhoshallhavesuchpowerstoemploy,select
1907+20orappointemployees,agents,orconsultants,andtodeterminetheirqualifications,
1908+21definetheirduties,andfixtheircompensation;
1909+22 (11)Establishpersonnelpoliciesandprogramsrelatingtoconflictsofinterest,
1910+23ratesofcompensation,andqualificationsofpersonnel;
1911+24 (12)Acceptdonationsandgrantsofmoney,equipment,supplies,materials,and
1912+25servicesandtoreceive,utilize,anddisposeofitinamannerconsistentwiththeconflict
1913+26ofinterestpoliciesestablishedbytheInterstateCommission;
1914+27 (13)Lease,purchase,acceptcontributionsordonationsof,orotherwisetoown,
1915+28hold,improveoruse,anyproperty,real,personal,ormixed;
1916+29 (14)Sell,convey,mortgage,pledge,lease,exchange,abandon,orotherwise
1917+30disposeofanyproperty,real,personal,ormixed;
1918+31 (15)Establishabudgetandmakeexpenditures;
1919+32 (16)Adoptasealandbylawsgoverningthemanagementandoperationofthe
1920+33InterstateCommission;
1921+34 (17)Reportannuallytothelegislaturesandgovernorsofthememberstates
1922+35concerningtheactivitiesoftheInterstateCommissionduringtheprecedingyear.Such
1923+36reportsshallalsoincludereportsoffinancialauditsandanyrecommendationsthatmay
1924+37havebeenadoptedbytheInterstateCommission;
1925+38 (18)Coordinateeducation,training,andpublicawarenessregardingthe
1926+39Compact,itsimplementation,anditsoperation;
1927+40 (19)Maintainrecordsinaccordancewiththebylaws;
1928+41 (20)Seekandobtaintrademarks,copyrights,andpatents;and
1929+42 (21)Performsuchfunctionsasmaybenecessaryorappropriatetoachievethe
1930+43purposeoftheCompact.
1931+HCSSSSCSSB157 53 334.1665.1.TheInterstateCommissionmaylevyonandcollectanannual
1932+2assessmentfromeachmemberstatetocoverthecostoftheoperationsandactivitiesof
1933+3theInterstateCommissionanditsstaff.Thetotalassessmentmustbesufficienttocover
1934+4theannualbudgetapprovedeachyearforwhichrevenueisnotprovidedbyother
1935+5sources.Theaggregateannualassessmentamountshallbeallocateduponaformulato
1936+6bedeterminedbytheInterstateCommission,whichshallpromulgatearulebinding
1937+7uponallmemberstates.
1938+8 2.TheInterstateCommissionshallnotincurobligationsofanykindpriorto
1939+9securingthefundsadequatetomeetthesame.
1940+10 3.TheInterstateCommissionshallnotpledgethecreditofanyofthemember
1941+11states,exceptby,andwiththeauthorityof,thememberstate.
1942+12 4.TheInterstateCommissionshallbesubjecttoayearlyfinancialaudit
1943+13conductedbyacertifiedorlicensedaccountantandthereportoftheauditshallbe
1944+14includedintheannualreportoftheInterstateCommission.
1945+334.1670.1.TheInterstateCommissionshall,byamajorityofCommissioners
1946+2presentandvoting,adoptbylawstogovernitsconductasmaybenecessaryor
1947+3appropriatetocarryoutthepurposesoftheCompactwithintwelve(12)monthsofthe
1948+4firstInterstateCommissionmeeting.
1949+5 2.TheInterstateCommissionshallelectorappointannuallyfromamongits
1950+6Commissionersachairperson,avice-chairperson,andatreasurer,eachofwhomshall
1951+7havesuchauthorityanddutiesasmaybespecifiedinthebylaws.Thechairperson,orin
1952+8thechairperson'sabsenceordisability,thevice-chairperson,shallpresideatall
1953+9meetingsoftheInterstateCommission.
1954+10 3.Officersselectedinsubsection2ofthissectionshallservewithout
1955+11remunerationfortheInterstateCommission.
1956+12 4.TheofficersandemployeesoftheInterstateCommissionshallbeimmune
1957+13fromsuitandliability,eitherpersonallyorintheirofficialcapacity,foraclaimfor
1958+14damagetoorlossofpropertyorpersonalinjuryorothercivilliabilitycausedorarising
1959+15outof,orrelatingto,anactualorallegedact,error,oromissionthatoccurred,orthat
1960+16suchpersonhadareasonablebasisforbelievingoccurred,withinthescopeofInterstate
1961+17Commissionemployment,duties,orresponsibilities;providedthatsuchpersonshallnot
1962+18beprotectedfromsuitorliabilityfordamage,loss,injury,orliabilitycausedbythe
1963+19intentionalorwillfulandwantonmisconductofsuchperson.
1964+20 5.TheliabilityoftheexecutivedirectorandemployeesoftheInterstate
1965+21CommissionorrepresentativesoftheInterstateCommission,actingwithinthescopeof
1966+22suchperson'semploymentordutiesforacts,errors,oromissionsoccurringwithinsuch
1967+23person'sstate,maynotexceedthelimitsofliabilitysetforthundertheconstitutionand
1968+HCSSSSCSSB157 54 24lawsofthatstateforstateofficials,employees,andagents.TheInterstateCommission
1969+25isconsideredtobeaninstrumentalityofthestatesforthepurposeofanysuchaction.
1970+26Nothinginthissubsectionshallbeconstruedtoprotectsuchpersonfromsuitorliability
1971+27fordamage,loss,injury,orliabilitycausedbytheintentionalorwillfulandwanton
1972+28misconductofsuchperson.
1973+29 6.TheInterstateCommissionshalldefendtheexecutivedirector,itsemployees,
1974+30andsubjecttotheapprovaloftheattorneygeneralorotherappropriatelegalcounselof
1975+31thememberstaterepresentedbyanInterstateCommissionrepresentative,shalldefend
1976+32suchInterstateCommissionrepresentativeinanycivilactionseekingtoimposeliability
1977+33arisingoutofanactualorallegedact,errororomissionthatoccurredwithinthescope
1978+34ofInterstateCommissionemployment,dutiesorresponsibilities,orthatthedefendant
1979+35hadareasonablebasisforbelievingoccurredwithinthescopeofInterstateCommission
1980+36employment,duties,orresponsibilities,providedthattheactualorallegedact,error,or
1981+37omissiondidnotresultfromintentionalorwillfulandwantonmisconductonthepartof
1982+38suchperson.
1983+39 7.Totheextentnotcoveredbythestateinvolved,memberstate,ortheInterstate
1984+40Commission,therepresentativesoremployeesoftheInterstateCommissionshallbe
1985+41heldharmlessintheamountofasettlementorjudgement,includingattorney'sfeesand
1986+42costs,obtainedagainstsuchpersonsarisingoutofanactualorallegedact,error,or
1987+43omissionthatoccurredwithinthescopeoftheInterstateCommissionemployment,
1988+44duties,orresponsibilities,orthatsuchpersonshadareasonablebasisforbelieving
1989+45occurredwithinthescopeofInterstateCommissionemployment,duties,or
1990+46responsibilities,providedthattheactualorallegedact,error,oromissiondidnot
1991+47resultfromintentionalorwillfulandwantonmisconductonthepartofsuchperson.
1992+334.1675.1.TheInterstateCommissionshallpromulgatereasonablerulesin
1993+2ordertoeffectivelyandefficientlyachievethepurposeoftheCompact.
1994+3Notwithstandingtheforegoing,intheeventtheInterstateCommissionexercisesits
1995+4rulemakingauthorityinamannerthatisbeyondthescopeofthepurposesofthe
1996+5Compact,orthepowersgrantedhereunder,thensuchanactionbytheInterstate
1997+6Commissionshallbeinvalidandhavenoforceoreffect.
1998+7 2.RulesdeemedappropriatefortheoperationsoftheInterstateCommission
1999+8shallbemadepursuanttoarulemakingprocessthatsubstantiallyconformstothe
2000+9"ModelStateAdministrativeProcedureAct"of2010,andsubsequentamendments
2001+10thereto.
2002+11 3.Notlaterthanthirty(30)daysafteraruleispromulgated,anypersonmayfile
2003+12apetitionforjudicialreviewoftheruleintheUnitedStatesDistrictCourtforthe
2004+13DistrictofColumbiaorthefederaldistrictwheretheInterstateCommissionhasits
2005+HCSSSSCSSB157 55 14principaloffices,providedthatthefilingofsuchapetitionshallnotstayorotherwise
2006+15preventtherulefrombecomingeffectiveunlessthecourtfindsthatthepetitionerhasa
2007+16substantiallikelihoodofsuccess.Thecourtshallgivedeferencetotheactionsofthe
2008+17InterstateCommissionconsistentwithapplicablelawandshallnotfindtheruletobe
2009+18unlawfuliftherulerepresentsareasonableexerciseoftheauthoritygrantedtothe
2010+19InterstateCommission.
2011+334.1680.1.Theexecutive,legislative,andjudicialbranchesofstate
2012+2governmentineachmemberstateshallenforcetheCompactandshalltakeall
2013+3actionsnecessaryandappropriatetoeffectuatetheCompact'spurposesandintent.The
2014+4provisionsoftheCompactandtherulespromulgatedhereundershallhavestandingas
2015+5statutorylawbutshallnotoverrideexistingstateauthoritytoregulatethepracticeof
2016+6medicine.
2017+7 2.AllcourtsshalltakejudicialnoticeoftheCompactandtherulesinany
2018+8judicialoradministrativeproceedinginamemberstatepertainingtothesubjectmatter
2019+9oftheCompactwhichmayaffectthepowers,responsibilitiesoractionsoftheInterstate
2020+10Commission.
2021+11 3.TheInterstateCommissionshallbeentitledtoreceiveallservicesofprocessin
2022+12anysuchproceeding,andshallhavestandingtointerveneintheproceedingforall
2023+13purposes.FailuretoprovideserviceofprocesstotheInterstateCommissionshall
2024+14renderajudgmentorordervoidastotheInterstateCommission,theCompact,or
2025+15promulgatedrules.
2026+334.1685.1.TheInterstateCommission,inthereasonableexerciseofits
2027+2discretion,shallenforcetheprovisionsandrulesoftheCompact.
2028+3 2.TheInterstateCommissionmay,bymajorityvoteoftheCommissioners,
2029+4initiatelegalactionintheUnitedStatesDistrictCourtfortheDistrictofColumbia,or,
2030+5atthediscretionoftheInterstateCommission,inthefederaldistrictwherethe
2031+6InterstateCommissionhasitsprincipaloffices,toenforcecompliancewiththe
2032+7provisionsoftheCompact,anditspromulgatedrulesandbylaws,againstamember
2033+8stateindefault.Thereliefsoughtmayincludebothinjunctivereliefanddamages.In
2034+9theeventjudicialenforcementisnecessary,theprevailingpartyshallbeawardedall
2035+10costsofsuchlitigationincludingreasonableattorney'sfees.
2036+11 3.TheremedieshereinshallnotbetheexclusiveremediesoftheInterstate
2037+12Commission.TheInterstateCommissionmayavailitselfofanyotherremedies
2038+13availableunderstatelaworregulationofaprofession.
2039+334.1690.1.Thegroundsfordefaultinclude,butarenotlimitedto,failureofa
2040+2memberstatetoperformsuchobligationsorresponsibilitiesimposeduponitbythe
2041+HCSSSSCSSB157 56 3Compact,ortherulesandbylawsoftheInterstateCommissionpromulgatedunderthe
2042+4Compact.
2043+5 2.IftheInterstateCommissiondeterminesthatamemberstatehasdefaultedin
2044+6theperformanceofitsobligationsorresponsibilitiesundertheCompact,orthebylaws
2045+7orpromulgatedrules,theInterstateCommissionshall:
2046+8 (1)Providewrittennoticetothedefaultingstateandothermemberstates,ofthe
2047+9natureofthedefault,themeansofcuringthedefault,andanyactiontakenbythe
2048+10InterstateCommission.TheInterstateCommissionshallspecifytheconditionsby
2049+11whichthedefaultingstatemustcureitsdefault;and
2050+12 (2)Provideremedialtrainingandspecifictechnicalassistanceregardingthe
2051+13default.
2052+14 3.Ifthedefaultingstatefailstocurethedefault,thedefaultingstateshallbe
2053+15terminatedfromtheCompactuponanaffirmativevoteofamajorityofthe
2054+16Commissionersandallrights,privileges,andbenefitsconferredbytheCompactshall
2055+17terminateontheeffectivedateoftermination.Acureofthedefaultdoesnotrelievethe
2056+18offendingstateofobligationsorliabilitiesincurredduringtheperiodofthedefault.
2057+19 4.TerminationofmembershipintheCompactshallbeimposedonlyafterall
2058+20othermeansofsecuringcompliancehavebeenexhausted.Noticeofintenttoterminate
2059+21shallbegivenbytheInterstateCommissiontothegovernor,themajorityandminority
2060+22leadersofthedefaultingstate'slegislature,andeachofthememberstates.
2061+23 5.TheInterstateCommissionshallestablishrulesandprocedurestoaddress
2062+24licensesandphysiciansthataremateriallyimpactedbytheterminationofamember
2063+25state,orthewithdrawalofamemberstate.
2064+26 6.Thememberstatewhichhasbeenterminatedisresponsibleforalldues,
2065+27obligations,andliabilitiesincurredthroughtheeffectivedateofterminationincluding
2066+28obligations,theperformanceofwhichextendsbeyondtheeffectivedateoftermination.
2067+29 7.TheInterstateCommissionshallnotbearanycostsrelatingtoanystatethat
2068+30hasbeenfoundtobeindefaultorwhichhasbeenterminatedfromtheCompact,unless
2069+31otherwisemutuallyagreeduponinwritingbetweentheInterstateCommissionandthe
2070+32defaultingstate.
2071+33 8.ThedefaultingstatemayappealtheactionoftheInterstateCommissionby
2072+34petitioningtheUnitedStatesDistrictCourtfortheDistrictofColumbiaorthefederal
2073+35districtwheretheInterstateCommissionhasitsprincipaloffices.Theprevailingparty
2074+36shallbeawardedallcostsofsuchlitigationincludingreasonableattorney'sfees.
2075+334.1695.1.TheInterstateCommissionshallattempt,upontherequestofa
2076+2memberstate,toresolvedisputeswhicharesubjecttotheCompactandwhichmayarise
2077+3amongmemberstatesormemberboards.
2078+HCSSSSCSSB157 57 4 2.TheInterstateCommissionshallpromulgaterulesprovidingforboth
2079+5mediationandbindingdisputeresolutionasappropriate.
2080+334.1700.1.AnystateiseligibletobecomeamemberoftheCompact.
2081+2 2.TheCompactshallbecomeeffectiveandbindinguponlegislativeenactmentof
2082+3theCompactintolawbynolessthanseven(7)states.Thereafter,itshallbecome
2083+4effectiveandbindingonastateuponenactmentoftheCompactintolawbythatstate.
2084+5 3.Thegovernorsofnon-memberstates,ortheirdesignees,shallbeinvitedto
2085+6participateintheactivitiesoftheInterstateCommissiononanon-votingbasispriorto
2086+7adoptionoftheCompactbyallstates.
2087+8 4.TheInterstateCommissionmayproposeamendmentstotheCompactfor
2088+9enactmentbythememberstates.Noamendmentshallbecomeeffectiveandbinding
2089+10upontheInterstateCommissionandthememberstatesunlessanduntilitisenacted
2090+11intolawbyunanimousconsentofthememberstates.
2091+334.1705.1.Onceeffective,theCompactshallcontinueinforceandremain
2092+2bindinguponeachandeverymemberstate;providedthatamemberstatemay
2093+3withdrawfromtheCompactbyspecificallyrepealingthestatutewhichenactedthe
2094+4Compactintolaw.
2095+5 2.WithdrawalfromtheCompactshallbebytheenactmentofastatute
2096+6repealingthesame,butshallnottakeeffectuntilone(1)yearaftertheeffectivedateof
2097+7suchstatuteanduntilwrittennoticeofthewithdrawalhasbeengivenbythe
2098+8withdrawingstatetothegovernorofeachothermemberstate.
2099+9 3.Thewithdrawingstateshallimmediatelynotifythechairpersonofthe
2100+10InterstateCommissioninwritingupontheintroductionoflegislationrepealingthe
2101+11Compactinthewithdrawingstate.
2102+12 4.TheInterstateCommissionshallnotifytheothermemberstatesofthe
2103+13withdrawingstate'sintenttowithdrawwithinsixty(60)daysofitsreceiptofnotice
2104+14providedundersubsection3ofthissection.
2105+15 5.Thewithdrawingstateisresponsibleforalldues,obligationsandliabilities
2106+16incurredthroughtheeffectivedateofwithdrawal,includingobligations,the
2107+17performanceofwhichextendbeyondtheeffectivedateofwithdrawal.
2108+18 6.Reinstatementfollowingwithdrawalofamemberstateshalloccuruponthe
2109+19withdrawingstatereenactingtheCompactoruponsuchlaterdateasdeterminedbythe
2110+20InterstateCommission.
2111+21 7.TheInterstateCommissionisauthorizedtodeveloprulestoaddressthe
2112+22impactofthewithdrawalofamemberstateonlicensesgrantedinothermemberstates
2113+23tophysicianswhodesignatedthewithdrawingmemberstateasthestateofprincipal
2114+24license.
2115+HCSSSSCSSB157 58 334.1710.1.TheCompactshalldissolveeffectiveuponthedateofthe
2116+2withdrawalordefaultofthememberstatewhichreducesthemembershipofthe
2117+3Compacttoone(1)memberstate.
2118+4 2.UponthedissolutionoftheCompact,theCompactbecomesnullandvoidand
2119+5shallbeofnofurtherforceoreffect,andthebusinessandaffairsoftheInterstate
2120+6Commissionshallbeconcluded,andsurplusfundsshallbedistributedinaccordance
2121+7withthebylaws.
2122+334.1715.1.TheprovisionsoftheCompactshallbeseverable,andifany
2123+2phrase,clause,sentence,orprovisionisdeemedunenforceable,theremainingprovisions
2124+3oftheCompactshallbeenforceable.
2125+4 2.TheprovisionsoftheCompactshallbeliberallyconstruedtoeffectuateits
2126+5purposes.
2127+6 3.NothingintheCompactshallbeconstruedtoprohibittheapplicabilityof
2128+7otherinterstatecompactstowhichthememberstatesaremembers.
2129+334.1720.1.Nothinghereinpreventstheenforcementofanyotherlawofa
2130+2memberstatethatisnotinconsistentwiththeCompact.
2131+3 2.AlllawsinamemberstateinconflictwiththeCompactaresupersededtothe
2132+4extentoftheconflict.
2133+5 3.AlllawfulactionsoftheInterstateCommission,includingallrulesandbylaws
2134+6promulgatedbytheCommission,arebindinguponthememberstates.
2135+7 4.AllagreementsbetweentheInterstateCommissionandthememberstatesare
2136+8bindinginaccordancewiththeirterms.
2137+9 5.IntheeventanyprovisionoftheCompactexceedstheconstitutionallimits
2138+10imposedonthelegislatureofanymemberstate,suchprovisionshallbeineffectivetothe
2139+11extentoftheconflictwiththeconstitutionalprovisioninquestioninthatmemberstate.
2140+335.016.Asusedinthischapter,unlessthecontextclearlyrequiresotherwise,the
2141+2followingwordsandtermsmean:
2142+3 (1)"Accredited",theofficialauthorizationorstatusgrantedbyanagencyfora
2143+4programthroughavoluntaryprocess;
2144+5 (2)"Advancedpracticeregisterednurse"or"APRN", a[nursewhohaseducation
2145+6beyondthebasicnursingeducationandiscertifiedbyanationallyrecognizedprofessional
2146+7organizationasacertifiednursepractitioner,certifiednursemidwife,certifiedregistered
2147+8nurseanesthetist,oracertifiedclinicalnursespecialist.Theboardshallpromulgaterules
2148+9specifyingwhichnationallyrecognizedprofessionalorganizationcertificationsaretobe
2149+10recognizedforthepurposesofthissection.Advancedpracticenursesandonlysuch
2150+11individualsmayusethetitle"AdvancedPracticeRegisteredNurse"andtheabbreviation
2151+12"APRN"] personwhoislicensedundertheprovisionsofthischaptertoengageinthe
2152+HCSSSSCSSB157 59 13practiceofadvancedpracticenursingasacertifiedclinicalnursespecialist,certified
2153+14nursemidwife,certifiednursepractitioner,orcertifiedregisterednurseanesthetist;
2154+15 (3)"Approval",officialrecognitionofnursingeducationprogramswhichmeet
2155+16standardsestablishedbytheboardofnursing;
2156+17 (4)"Board"or"stateboard",thestateboardofnursing;
2157+18 (5)"Certifiedclinicalnursespecialist",aregisterednursewhoiscurrentlycertifiedas
2158+19aclinicalnursespecialistbyanationallyrecognizedcertifyingboardapprovedbytheboard
2159+20ofnursing;
2160+21 (6)"Certifiednursemidwife",aregisterednursewhoiscurrentlycertifiedasanurse
2161+22midwifebytheAmerican[CollegeofNurseMidwives] MidwiferyCertificationBoard, or
2162+23othernationallyrecognizedcertifyingbodyapprovedbytheboardofnursing;
2163+24 (7)"Certifiednursepractitioner",aregisterednursewhoiscurrentlycertifiedasa
2164+25nursepractitionerbyanationallyrecognizedcertifyingbodyapprovedbytheboardof
2165+26nursing;
2166+27 (8)"Certifiedregisterednurseanesthetist",aregisterednursewhoiscurrently
2167+28certifiedasanurseanesthetistbytheCouncilonCertificationofNurseAnesthetists,the
2168+29[CouncilonRecertificationofNurseAnesthetists] NationalBoardofCertificationand
2169+30RecertificationforNurseAnesthetists, orothernationallyrecognizedcertifyingbody
2170+31approvedbytheboardofnursing;
2171+32 (9)"Executivedirector",aqualifiedindividualemployedbytheboardasexecutive
2172+33secretaryorotherwisetoadministertheprovisionsofthischapterundertheboard'sdirection.
2173+34Suchpersonemployedasexecutivedirectorshallnotbeamemberoftheboard;
2174+35 (10)"Inactive[nurse] licensestatus", asdefinedbyrulepursuanttosection335.061;
2175+36 (11)"Lapsedlicensestatus",asdefinedbyruleundersection335.061;
2176+37 (12)"Licensedpracticalnurse"or"practicalnurse",apersonlicensedpursuanttothe
2177+38provisionsofthischaptertoengageinthepracticeofpracticalnursing;
2178+39 (13)"Licensure",theissuingofalicense[topracticeprofessionalorpractical
2179+40nursing] tocandidateswhohavemetthe[specified] requirementsspecifiedunderthis
2180+41chapter,authorizingthepersontoengageinthepracticeofadvancedpractice,
2181+42professional,orpracticalnursing,andtherecordingofthenamesofthosepersonsas
2182+43holdersofalicensetopracticeadvancedpractice,professional, orpracticalnursing;
2183+44 (14)"Practiceofadvancedpracticenursing",theperformanceforcompensation
2184+45ofactivitiesandservicesconsistentwiththerequirededucation,training,certification,
2185+46demonstratedcompetencies,andexperiencesofanadvancedpracticeregisterednurse;
2186+47 (15)"Practiceofpracticalnursing",theperformanceforcompensationofselected
2187+48actsforthepromotionofhealthandinthecareofpersonswhoareill,injured,orexperiencing
2188+49alterationsinnormalhealthprocesses.Suchperformancerequiressubstantialspecialized
2189+HCSSSSCSSB157 60 50skill,judgmentandknowledge.Allsuchnursingcareshallbegivenunderthedirectionofa
2190+51personlicensedbyastateregulatoryboardtoprescribemedicationsandtreatmentsorunder
2191+52thedirectionofaregisteredprofessionalnurse.Forthepurposesofthischapter,theterm
2192+53"direction"shallmeanguidanceorsupervisionprovidedbyapersonlicensedbyastate
2193+54regulatoryboardtoprescribemedicationsandtreatmentsoraregisteredprofessionalnurse,
2194+55including,butnotlimitedto,oral,written,orotherwisecommunicatedordersordirectivesfor
2195+56patientcare.Whenpracticalnursingcareisdeliveredpursuanttothedirectionofaperson
2196+57licensedbyastateregulatoryboardtoprescribemedicationsandtreatmentsorunderthe
2197+58directionofaregisteredprofessionalnurse,suchcaremaybedeliveredbyalicensedpractical
2198+59nursewithoutdirectphysicaloversight;
2199+60 [(15)] (16)"Practiceofprofessionalnursing",theperformanceforcompensationof
2200+61anyactoractionwhichrequiressubstantialspecializededucation,judgmentandskillbased
2201+62onknowledgeandapplicationofprinciplesderivedfromthebiological,physical,social,
2202+63behavioral,andnursingsciences,including,butnotlimitedto:
2203+64 (a)Responsibilityforthepromotionandteachingofhealthcareandtheprevention
2204+65ofillnesstothepatientandhisorherfamily;
2205+66 (b)Assessment,datacollection,nursingdiagnosis,nursingcare,evaluation,and
2206+67counselofpersonswhoareill,injured, orexperiencingalterationsinnormalhealthprocesses;
2207+68 (c)Theadministrationofmedicationsandtreatmentsasprescribedbyaperson
2208+69licensedbyastateregulatoryboardtoprescribemedicationsandtreatments;
2209+70 (d)Thecoordinationandassistanceinthedeterminationanddeliveryofaplanof
2210+71healthcarewithallmembersofahealthteam;
2211+72 (e)Theteachingandsupervisionofotherpersonsintheperformanceofanyofthe
2212+73foregoing;
2213+74 [(16)A](17)"Registeredprofessionalnurse"or"registerednurse",apersonlicensed
2214+75pursuanttotheprovisionsofthischaptertoengageinthepracticeofprofessionalnursing;
2215+76 [(17)] (18)"Retiredlicensestatus",anypersonlicensedinthisstateunderthischapter
2216+77whoretiresfromsuchpractice.Suchpersonshallfilewiththeboardanaffidavit,onaform
2217+78tobefurnishedbytheboard,whichstatesthedateonwhichthelicenseeretiredfromsuch
2218+79practice,anintenttoretirefromthepracticeforatleasttwoyears,andsuchotherfactsastend
2219+80toverifytheretirementastheboardmaydeemnecessary;butifthelicenseethereafter
2220+81reengagesinthepractice,thelicenseeshallrenewhisorherlicensewiththeboardas
2221+82providedbythischapterandbyruleandregulation.
2222+335.019.1.Anadvancedpracticeregisterednurse'sprescriptiveauthorityshall
2223+2includeauthorityto:
2224+3 (1)Prescribe,dispense,andadministermedicationsandnonscheduledlegend
2225+4drugs,asdefinedinsection338.330,withinsuchAPRN'spracticeandspecialty;and
2226+HCSSSSCSSB157 61 5 (2)Notwithstandinganyotherprovisionofthischaptertothecontrary,receive,
2227+6prescribe,administer,andprovidenonscheduledlegenddrugsamplesfrom
2228+7pharmaceuticalmanufacturerstopatientsatnochargetothepatientoranyotherparty.
2229+8 2.Theboardofnursingmaygrantacertificateofcontrolledsubstanceprescriptive
2230+9authoritytoanadvancedpracticeregisterednursewho:
2231+10 (1)Submitsproofofsuccessfulcompletionofanadvancedpharmacologycoursethat
2232+11shallincludepreceptorialexperienceintheprescriptionofdrugs,medicines, andtherapeutic
2233+12devices;and
2234+13 (2)Providesdocumentationofaminimumofthreehundredclockhourspreceptorial
2235+14experienceintheprescriptionofdrugs,medicines,andtherapeuticdeviceswithaqualified
2236+15preceptor;and
2237+16 (3)Providesevidenceofaminimumofonethousandhoursofpracticeinanadvanced
2238+17practicenursingcategorypriortoapplicationforacertificateofprescriptiveauthority.The
2239+18onethousandhoursshallnotincludeclinicalhoursobtainedintheadvancedpracticenursing
2240+19educationprogram.Theonethousandhoursofpracticeinanadvancedpracticenursing
2241+20categorymayincludetransmittingaprescriptionorderorallyortelephonicallyortoan
2242+21inpatientmedicalrecordfromprotocolsdevelopedincollaborationwithandsignedbya
2243+22licensedphysician;and
2244+23 (4)Hasacontrolledsubstanceprescribingauthoritydelegatedinthecollaborative
2245+24practicearrangementundersection334.104withaphysicianwhohasanunrestrictedfederal
2246+25DrugEnforcementAdministrationregistrationnumberandwhoisactivelyengagedina
2247+26practicecomparableinscope,specialty,orexpertisetothatoftheadvancedpractice
2248+27registerednurse.
2249+335.036.1.Theboardshall:
2250+2 (1)Electforaone-yeartermapresidentandasecretary,whoshallalsobetreasurer,
2251+3andtheboardmayappoint,employandfixthecompensationofalegalcounselandsuch
2252+4boardpersonnelasdefinedinsubdivision(4)ofsubsection11ofsection324.001asare
2253+5necessarytoadministertheprovisionsofsections335.011to[335.096] 335.099;
2254+6 (2)Adoptandrevisesuchrulesandregulationsasmaybenecessarytoenableitto
2255+7carryintoeffecttheprovisionsofsections335.011to[335.096] 335.099;
2256+8 (3)Prescribeminimumstandardsforeducationalprogramspreparingpersonsfor
2257+9licensureasaregisteredprofessionalnurseorlicensedpracticalnursepursuanttothe
2258+10provisionsofsections335.011to[335.096] 335.099;
2259+11 (4)Provideforsurveysofsuchprogramseveryfiveyearsandinadditionatsuch
2260+12timesasitmaydeemnecessary;
2261+HCSSSSCSSB157 62 13 (5)Designateas"approved"suchprogramsasmeettherequirementsofsections
2262+14335.011to[335.096] 335.099andtherulesandregulationsenactedpursuanttosuchsections;
2263+15andtheboardshallannuallypublishalistofsuchprograms;
2264+16 (6)Denyorwithdrawapprovalfromeducationalprogramsforfailuretomeet
2265+17prescribedminimumstandards;
2266+18 (7)Examine,license,andcausetoberenewedthelicensesofdulyqualified
2267+19applicants;
2268+20 (8)Causetheprosecutionofallpersonsviolatingprovisionsofsections335.011to
2269+21[335.096] 335.099, andmayincursuchnecessaryexpensestherefor;
2270+22 (9)Keeparecordofalltheproceedings;andmakeanannualreporttothegovernor
2271+23andtothedirectorofthedepartmentofcommerceandinsurance.
2272+24 2.Theboardshallsettheamountofthefeeswhichthischapterauthorizesand
2273+25requiresbyrulesandregulations.Thefeesshallbesetataleveltoproducerevenuewhich
2274+26shallnotsubstantiallyexceedthecostandexpenseofadministeringthischapter.
2275+27 3.Allfeesreceivedbytheboardpursuanttotheprovisionsofsections335.011to
2276+28[335.096] 335.099shallbedepositedinthestatetreasuryandbeplacedtothecreditofthe
2277+29stateboardofnursingfund.Alladministrativecostsandexpensesoftheboardshallbepaid
2278+30fromappropriationsmadeforthosepurposes.Theboardisauthorizedtoprovidefundingfor
2279+31thenursingeducationincentiveprogramestablishedinsections335.200to335.203.
2280+32 4.Theprovisionsofsection33.080tothecontrarynotwithstanding,moneyinthis
2281+33fundshallnotbetransferredandplacedtothecreditofgeneralrevenueuntiltheamountin
2282+34thefundattheendofthebienniumexceedstwotimestheamountoftheappropriationfrom
2283+35theboard'sfundsfortheprecedingfiscalyearor,iftheboardrequiresbyrule,permitrenewal
2284+36lessfrequentlythanyearly,thenthreetimestheappropriationfromtheboard'sfundsforthe
2285+37precedingfiscalyear.Theamount,ifany,inthefundwhichshalllapseisthatamountinthe
2286+38fundwhichexceedstheappropriatemultipleoftheappropriationsfromtheboard'sfundsfor
2287+39theprecedingfiscalyear.
2288+40 5.Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis
2289+41createdundertheauthoritydelegatedinthischaptershallbecomeeffectiveonlyifitcomplies
2290+42withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.
2291+43AllrulemakingauthoritydelegatedpriortoAugust28,1999,isofnoforceandeffectand
2292+44repealed.Nothinginthissectionshallbeinterpretedtorepealoraffectthevalidityofany
2293+45rulefiledoradoptedpriortoAugust28,1999,ifitfullycompliedwithallapplicable
2294+46provisionsoflaw.Thissectionandchapter536arenonseverableandifanyofthepowers
2295+47vestedwiththegeneralassemblypursuanttochapter536toreview,todelaytheeffectivedate
2296+48ortodisapproveandannularulearesubsequentlyheldunconstitutional,thenthegrantof
2297+HCSSSSCSSB157 63 49rulemakingauthorityandanyruleproposedoradoptedafterAugust28,1999,shallbeinvalid
2298+50andvoid.
2299+335.046.1.Anapplicantforalicensetopracticeasaregisteredprofessionalnurse
2300+2shallsubmittotheboardawrittenapplicationonformsfurnishedtotheapplicant.The
2301+3originalapplicationshallcontaintheapplicant'sstatementsshowingtheapplicant'seducation
2302+4andothersuchpertinentinformationastheboardmayrequire.Theapplicantshallbeofgood
2303+5moralcharacterandhavecompletedatleastthehighschoolcourseofstudy,ortheequivalent
2304+6thereofasdeterminedbythestateboardofeducation,andhavesuccessfullycompletedthe
2305+7basicprofessionalcurriculuminanaccreditedorapprovedschoolofnursingandearneda
2306+8professionalnursingdegreeordiploma.Eachapplicationshallcontainastatementthatitis
2307+9madeunderoathoraffirmationandthatitsrepresentationsaretrueandcorrecttothebest
2308+10knowledgeandbeliefofthepersonsigningsame,subjecttothepenaltiesofmakingafalse
2309+11affidavitordeclaration.Applicantsfromnon-English-speakinglandsshallberequiredto
2310+12submitevidenceofproficiencyintheEnglishlanguage.Theapplicantmustbeapprovedby
2311+13theboardandshallpassanexaminationasrequiredbytheboard.Theboardmayrequireby
2312+14ruleasarequirementforlicensurethateachapplicantshallpassanoralorpractical
2313+15examination.Uponsuccessfullypassingtheexamination,theboardmayissuetothe
2314+16applicantalicensetopracticenursingasaregisteredprofessionalnurse.Theapplicantfora
2315+17licensetopracticeregisteredprofessionalnursingshallpayalicensefeeinsuchamountasset
2316+18bytheboard.Thefeeshallbeuniformforallapplicants.Applicantsfromforeigncountries
2317+19shallbelicensedasprescribedbyrule.
2318+20 2.Anapplicantforlicensetopracticeasalicensedpracticalnurseshallsubmittothe
2319+21boardawrittenapplicationonformsfurnishedtotheapplicant.Theoriginalapplicationshall
2320+22containtheapplicant'sstatementsshowingtheapplicant'seducationandothersuchpertinent
2321+23informationastheboardmayrequire.Suchapplicantshallbeofgoodmoralcharacter,and
2322+24havecompletedatleasttwoyearsofhighschool,oritsequivalentasestablishedbythestate
2323+25boardofeducation,andhavesuccessfullycompletedabasicprescribedcurriculuminastate-
2324+26accreditedorapprovedschoolofnursing,earnedanursingdegree,certificateordiplomaand
2325+27completedacourseapprovedbytheboardontheroleofthepracticalnurse.Eachapplication
2326+28shallcontainastatementthatitismadeunderoathoraffirmationandthatitsrepresentations
2327+29aretrueandcorrecttothebestknowledgeandbeliefofthepersonsigningsame,subjecttothe
2328+30penaltiesofmakingafalseaffidavitordeclaration.Applicantsfromnon-English-speaking
2329+31countriesshallberequiredtosubmitevidenceoftheirproficiencyintheEnglishlanguage.
2330+32Theapplicantmustbeapprovedbytheboardandshallpassanexaminationasrequiredbythe
2331+33board.Theboardmayrequirebyruleasarequirementforlicensurethateachapplicantshall
2332+34passanoralorpracticalexamination.Uponsuccessfullypassingtheexamination,theboard
2333+35mayissuetotheapplicantalicensetopracticeasalicensedpracticalnurse.Theapplicantfor
2334+HCSSSSCSSB157 64 36alicensetopracticelicensedpracticalnursingshallpayafeeinsuchamountasmaybesetby
2335+37theboard.Thefeeshallbeuniformforallapplicants.Applicantsfromforeigncountriesshall
2336+38belicensedasprescribedbyrule.
2337+39 3.(1)Anapplicantforalicensetopracticeasanadvancedpracticeregistered
2338+40nurseshallsubmittotheboardawrittenapplicationonformsfurnishedtothe
2339+41applicant.Theoriginalapplicationshallcontain:
2340+42 (a)Statementsshowingtheapplicant'seducationandothersuchpertinent
2341+43informationastheboardmayrequire;and
2342+44 (b)Astatementthatitismadeunderoathoraffirmationandthatits
2343+45representationsaretrueandcorrecttothebestknowledgeandbeliefoftheperson
2344+46signingsame,subjecttothepenaltiesofmakingafalseaffidavitordeclaration.
2345+47 (2)Theapplicantforalicensetopracticeasanadvancedpracticeregistered
2346+48nurseshallpayafeeinsuchamountasmaybesetbytheboard.Thefeeshallbe
2347+49uniformforallapplicants.
2348+50 (3)Anapplicantshall:
2349+51 (a)Holdacurrentregisteredprofessionalnurselicenseorprivilegetopractice,
2350+52shallnotbecurrentlysubjecttodisciplineoranyrestrictions,andshallnotholdan
2351+53encumberedlicenseorprivilegetopracticeasaregisteredprofessionalnurseor
2352+54advancedpracticeregisterednurseinanystateorterritory;
2353+55 (b)Havecompletedanaccreditedgraduate-leveladvancedpracticeregistered
2354+56nurseprogramandachievedatleastonecertificationasaclinicalnursespecialist,nurse
2355+57midwife,nursepractitioner,orregisterednurseanesthetist,withatleastonepopulation
2356+58focusprescribedbyruleoftheboard;
2357+59 (c)Becurrentlycertifiedbyanationalcertifyingbodyrecognizedbythe
2358+60Missouristateboardofnursingintheadvancedpracticeregisterednurserole;and
2359+61 (d)Haveapopulationfocusonhisorhercertification,correspondingwithhisor
2360+62hereducationaladvancedpracticeregisterednurseprogram.
2361+63 (4)Anypersonholdingadocumentofrecognitiontopracticenursingasan
2362+64advancedpracticeregisterednurseinthisstatethatiscurrentonAugust28,2023,shall
2363+65bedeemedtobelicensedasanadvancedpracticeregisterednurseundertheprovisions
2364+66ofthissectionandshallbeeligibleforrenewalofsuchlicenseundertheconditionsand
2365+67standardsprescribedinthischapterandasprescribedbyrule.
2366+68 4.Uponrefusaloftheboardtoallowanyapplicantto[sitfor]takeeitherthe
2367+69registeredprofessionalnurses'examinationorthelicensedpracticalnurses'examination,[as
2368+70thecasemaybe,]oruponrefusaltoissueanadvancedpracticeregisterednurselicense,
2369+71theboardshallcomplywiththeprovisionsofsection621.120andadvisetheapplicantofhis
2370+HCSSSSCSSB157 65 72orherrighttohaveahearingbeforetheadministrativehearingcommission.The
2371+73administrativehearingcommissionshallhearcomplaintstakenpursuanttosection621.120.
2372+74 [4.]5.Theboardshallnotdenyalicensebecauseofsex,religion,race,ethnicorigin,
2373+75ageorpoliticalaffiliation.
2374+335.051.1.Theboardshallissuealicensetopracticenursingas[either] an
2375+2advancedpracticeregisterednurse,aregisteredprofessionalnurse, oralicensedpractical
2376+3nursewithoutexaminationtoanapplicantwhohasdulybecomelicensedas[a]anadvanced
2377+4practiceregisterednurse,registerednurse, orlicensedpracticalnursepursuanttothelaws
2378+5ofanotherstate,territory,orforeigncountryiftheapplicantmeetsthequalificationsrequired
2379+6ofadvancedpracticeregisterednurses,registerednurses, orlicensedpracticalnursesinthis
2380+7stateatthetimetheapplicantwasoriginallylicensedintheotherstate,territory,orforeign
2381+8country.
2382+9 2.Applicantsfromforeigncountriesshallbelicensedasprescribedbyrule.
2383+10 3.Uponapplication,theboardshallissueatemporarypermittoanapplicantpursuant
2384+11tosubsection1ofthissectionforalicenseas[either] anadvancedpracticeregistered
2385+12nurse,aregisteredprofessionalnurse, oralicensedpracticalnursewhohasmadeaprima
2386+13facieshowingthattheapplicantmeetsalloftherequirementsforsuchalicense.The
2387+14temporarypermitshallbeeffectiveonlyuntiltheboardshallhavehadtheopportunityto
2388+15investigatehisorherqualificationsforlicensurepursuanttosubsection1ofthissectionand
2389+16tonotifytheapplicantthathisorherapplicationforalicensehasbeeneithergrantedor
2390+17rejected.Innoeventshallsuchtemporarypermitbeineffectformorethantwelvemonths
2391+18afterthedateofitsissuancenorshallapermitbereissuedtothesameapplicant.Nofeeshall
2392+19bechargedforsuchtemporarypermit.Theholderofatemporarypermitwhichhasnot
2393+20expired,orbeensuspendedorrevoked,shallbedeemedtobetheholderofalicenseissued
2394+21pursuanttosection335.046untilsuchtemporarypermitexpires,isterminatedorissuspended
2395+22orrevoked.
2396+335.056.1.Thelicenseofeverypersonlicensedundertheprovisionsof[sections
2397+2335.011to335.096] thischaptershallberenewedasprovided.Anapplicationforrenewal
2398+3oflicenseshallbemailedtoeverypersontowhomalicensewasissuedorrenewedduringthe
2399+4currentlicensingperiod.Theapplicantshallcompletetheapplicationandreturnittothe
2400+5boardbytherenewaldatewitharenewalfeeinanamounttobesetbytheboard.Thefee
2401+6shallbeuniformforallapplicants.Thecertificatesofrenewalshallrendertheholderthereof
2402+7alegalpractitionerofnursingfortheperiodstatedinthecertificateofrenewal.Anyperson
2403+8whopracticesnursingasanadvancedpracticeregisterednurse,aregisteredprofessional
2404+9nurse, or[as]alicensedpracticalnurseduringthetimehisorherlicensehaslapsedshallbe
2405+10consideredanillegalpractitionerandshallbesubjecttothepenaltiesprovidedforviolationof
2406+11theprovisionsofsections335.011to[335.096] 335.099.
2407+HCSSSSCSSB157 66 12 2.Therenewalofadvancedpracticeregisterednurselicensesandregistered
2408+13professionalnurselicensesshalloccuratthesametime,asprescribedbyrule.Failure
2409+14torenewandmaintaintheregisteredprofessionalnurselicenseorprivilegetopractice
2410+15orfailuretoprovidetherequiredfeeandevidenceofactivecertificationormaintenance
2411+16ofcertificationasprescribedbyrulesandregulationsshallresultinexpirationofthe
2412+17advancedpracticeregisterednurselicense.
2413+18 3.AlicensednursewhoholdsanAPRNlicenseshallbedisciplinedontheir
2414+19APRNlicenseforanyviolationsofthischapter.
2415+335.076.1.Anypersonwhoholdsalicensetopracticeprofessionalnursinginthis
2416+2statemayusethetitle"RegisteredProfessionalNurse"andtheabbreviation["R.N."] "RN".
2417+3Nootherpersonshallusethetitle"RegisteredProfessionalNurse"ortheabbreviation
2418+4["R.N."] "RN". Nootherpersonshallassumeanytitleoruseanyabbreviationoranyother
2419+5words,letters,signs,ordevicestoindicatethatthepersonusingthesameisaregistered
2420+6professionalnurse.
2421+7 2.Anypersonwhoholdsalicensetopracticepracticalnursinginthisstatemayuse
2422+8thetitle"LicensedPracticalNurse"andtheabbreviation["L.P.N."]"LPN". Nootherperson
2423+9shallusethetitle"LicensedPracticalNurse"ortheabbreviation["L.P.N."]"LPN". Noother
2424+10personshallassumeanytitleoruseanyabbreviationoranyotherwords,letters,signs,or
2425+11devicestoindicatethatthepersonusingthesameisalicensedpracticalnurse.
2426+12 3.Anypersonwhoholdsalicense[orrecognition] topracticeadvancedpractice
2427+13nursinginthisstatemayusethetitle"AdvancedPracticeRegisteredNurse",the
2428+14designationsof"certifiedregisterednurseanesthetist","certifiednursemidwife",
2429+15"certifiedclinicalnursespecialist",and"certifiednursepractitioner",andthe
2430+16[abbreviation] abbreviations"APRN",[andanyothertitledesignationsappearingonhis
2431+17orherlicense] "CRNA","CNM","CNS",and"NP",respectively. Nootherpersonshall
2432+18usethetitle"AdvancedPracticeRegisteredNurse"ortheabbreviation"APRN".Noother
2433+19personshallassumeanytitleoruseanyabbreviationoranyotherwords,letters,signs,or
2434+20devicestoindicatethatthepersonusingthesameisanadvancedpracticeregisterednurse.
2435+21 4.Nopersonshallpracticeoroffertopracticeprofessionalnursing,practicalnursing,
2436+22oradvancedpracticenursinginthisstateoruseanytitle,sign,abbreviation,card,ordeviceto
2437+23indicatethatsuchpersonisapracticingprofessionalnurse,practicalnurse,oradvanced
2438+24practicenurseunlessheorshehasbeendulylicensedundertheprovisionsofthischapter.
2439+25 5.Intheinterestofpublicsafetyandconsumerawareness,itisunlawfulforany
2440+26persontousethetitle"nurse"inreferencetohimselforherselfinanycapacity,except
2441+27individualswhoareorhavebeenlicensedasaregisterednurse,licensedpracticalnurse,or
2442+28advancedpracticeregisterednurseunderthischapter.
2443+HCSSSSCSSB157 67 29 6.Notwithstandinganylawtothecontrary,nothinginthischaptershallprohibita
2444+30ChristianSciencenursefromusingthetitle"ChristianSciencenurse",solongassuchperson
2445+31providesonlyreligiousnonmedicalserviceswhenofferingorprovidingsuchservicestothose
2446+32whochoosetorelyuponhealingbyspiritualmeansaloneanddoesnotholdhisorherown
2447+33religiousorganizationanddoesnotholdhimselforherselfoutasaregisterednurse,advanced
2448+34practiceregisterednurse,nursepractitioner,licensedpracticalnurse,nursemidwife,clinical
2449+35nursespecialist,ornurseanesthetist,unlessotherwiseauthorizedbylawtodoso.
2450+335.086.Noperson,firm,corporationorassociationshall:
2451+2 (1)Sellorattempttosellorfraudulentlyobtainorfurnishorattempttofurnishany
2452+3nursingdiploma,license,renewalorrecordoraidorabettherein;
2453+4 (2)Practice[professionalorpractical] nursingasdefinedbysections335.011to
2454+5[335.096] 335.099undercoverofanydiploma,license,orrecordillegallyorfraudulently
2455+6obtainedorsignedorissuedunlawfullyorunderfraudulentrepresentation;
2456+7 (3)Practice[professionalnursingorpractical] nursingasdefinedbysections335.011
2457+8to[335.096] 335.099unlessdulylicensedtodosoundertheprovisionsofsections335.011to
2458+9[335.096] 335.099;
2459+10 (4)Useinconnectionwithhisorhernameanydesignationtendingtoimplythathe
2460+11orsheisalicensedadvancedpracticeregisterednurse,alicensedregisteredprofessional
2461+12nurse, oralicensedpracticalnurseunlessdulylicensedsotopracticeundertheprovisionsof
2462+13sections335.011to[335.096] 335.099;
2463+14 (5)Practice[professionalnursingorpractical] nursingduringthetimehisorher
2464+15licenseissuedundertheprovisionsofsections335.011to[335.096] 335.099shallbe
2465+16suspendedorrevoked;or
2466+17 (6)Conductanursingeducationprogramforthepreparationofprofessionalor
2467+18practicalnursesunlesstheprogramhasbeenaccreditedbytheboard.
2468+335.175.1.NolaterthanJanuary1,2014,thereisherebyestablishedwithinthestate
2469+2boardofregistrationforthehealingartsandthestateboardofnursingthe"Utilizationof
2470+3TelehealthbyNurses".Anadvancedpracticeregisterednurse(APRN)providingnursing
2471+4servicesunderacollaborativepracticearrangementundersection334.104mayprovidesuch
2472+5servicesoutsidethegeographicproximityrequirementsofsection334.104ifthe
2473+6collaboratingphysicianandadvancedpracticeregisterednurseutilizetelehealth[inthe
2474+7careofthepatientandiftheservicesareprovidedinaruralareaofneed]. Telehealth
2475+8providersshallberequiredtoobtainpatientconsentbeforetelehealthservicesareinitiated
2476+9andensureconfidentialityofmedicalinformation.
2477+10 2.Asusedinthissection,"telehealth"shallhavethesamemeaningassuchtermis
2478+11definedinsection191.1145.
2479+HCSSSSCSSB157 68 12 [3.(1)Theboardsshalljointlypromulgaterulesgoverningthepracticeoftelehealth
2480+13underthissection.Suchrulesshalladdress,butnotbelimitedto,appropriatestandardsfor
2481+14theuseoftelehealth.
2482+15 (2)Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis
2483+16createdundertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplies
2484+17withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.
2485+18Thissectionandchapter536arenonseverableandifanyofthepowersvestedwiththe
2486+19generalassemblypursuanttochapter536toreview,todelaytheeffectivedate,orto
2487+20disapproveandannularulearesubsequentlyheldunconstitutional,thenthegrantof
2488+21rulemakingauthorityandanyruleproposedoradoptedafterAugust28,2013,shallbeinvalid
2489+22andvoid.
2490+23 4.Forpurposesofthissection,"ruralareaofneed"meansanyruralareaofthisstate
2491+24whichislocatedinahealthprofessionalshortageareaasdefinedinsection354.650.]
2492+335.203.1.Thereisherebyestablishedthe"NursingEducationIncentiveProgram"
2493+2withinthestateboardofnursing.
2494+3 2.Subjecttoappropriationandboarddisbursement,grantsshallbeawardedthrough
2495+4thenursingeducationincentiveprogramtoeligibleinstitutionsofhighereducationbasedon
2496+5criteriajointlydeterminedbytheboardandthedepartmentofhighereducationandworkforce
2497+6development.[Grantawardamountsshallnotexceedonehundredfiftythousanddollars.]
2498+7Nocampusshallreceivemorethanonegrantperyear.
2499+8 3.Tobeconsideredforagrant,aneligibleinstitutionofhighereducationshalloffera
2500+9programofnursingthatmeetsthepredeterminedcategoryandareaofneedasestablishedby
2501+10theboardandthedepartmentundersubsection4ofthissection.
2502+11 4.Theboardandthedepartmentshalldeterminecategoriesandareasofneedfor
2503+12designatinggrantstoeligibleinstitutionsofhighereducation.Inestablishingcategoriesand
2504+13areasofneed,theboardanddepartmentmayconsidercriteriaincluding,butnotlimitedto:
2505+14 (1)Datageneratedfromlicensurerenewaldataandthedepartmentofhealthand
2506+15seniorservices;and
2507+16 (2)Nationalnursingstatisticaldataandtrendsthathaveidentifiednursingshortages.
2508+17 5.Theboardshallbetheadministrativeagencyresponsibleforimplementationofthe
2509+18programestablishedundersections335.200to335.203,andshallpromulgatereasonable
2510+19rulesfortheexerciseofitsfunctionsandtheeffectuationofthepurposesofsections335.200
2511+20to335.203.Theboardshall,byrule,prescribetheform,time,andmethodoffiling
2512+21applicationsandshallsupervisetheprocessingofsuchapplications.
2513+22 6.Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatis
2514+23createdundertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplies
2515+24withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.
2516+HCSSSSCSSB157 69 25Thissectionandchapter536arenonseverableandifanyofthepowersvestedwiththe
2517+26generalassemblypursuanttochapter536toreview,todelaytheeffectivedate,orto
2518+27disapproveandannularulearesubsequentlyheldunconstitutional,thenthegrantof
2519+28rulemakingauthorityandanyruleproposedoradoptedafterAugust28,2011,shallbeinvalid
2520+29andvoid.
2521+335.205.Theboard,inadditiontoanyotherdutiesitmayhaveregarding
2522+2licensureofnurses,shallcollect,atthetimeofanyinitiallicenseapplicationorlicense
2523+3renewalapplication,anursingeducationincentiveprogramsurchargefromeachperson
2524+4licensedorrelicensedunderchapter335,intheamountofonedollarperyearfor
2525+5practicalnursesandfivedollarsperyearforregisteredprofessionalnurses.These
2526+6fundsshallbedepositedinthestateboardofnursingfunddescribedinsection335.036.
2527+337.510.1.Asusedinthissection,thefollowingtermsmean:
2528+2 (1)"License",alicense,certificate,registration,permit,accreditation,or
2529+3militaryoccupationalspecialtythatenablesapersontolegallypracticeanoccupationor
2530+4professioninaparticularjurisdiction;
2531+5 (2)"Military",theArmedForcesoftheUnitedStates,includingtheAirForce,
2532+6Army,CoastGuard,MarineCorps,Navy,SpaceForce,NationalGuardandanyother
2533+7militarybranchthatisdesignatedbyCongressaspartoftheArmedForcesofthe
2534+8UnitedStates,andallreservecomponentsandauxiliaries.Suchtermalsoincludesthe
2535+9militaryreservesandmilitiaofanyUnitedStatesterritoryorstate;
2536+10 (3)"Nonresidentmilitaryspouse",anonresidentspouseofanactiveduty
2537+11memberoftheArmedForcesoftheUnitedStateswhohasbeentransferredoris
2538+12scheduledtobetransferredtothestateofMissouri,orwhohasbeentransferredoris
2539+13scheduledtobetransferredtoanadjacentstateandisorwillbedomiciledinthestateof
2540+14Missouri,orhasmovedtothestateofMissourionapermanentchange-of-stationbasis;
2541+15 (4)"Residentmilitaryspouse",aspouseofanactivedutymemberoftheArmed
2542+16ForcesoftheUnitedStateswhohasbeentransferredorisscheduledtobetransferredto
2543+17thestateofMissourioranadjacentstateandwhoisapermanentresidentofthestateof
2544+18Missouri,whoisdomiciledinthestateofMissouri,orwhohasMissouriashisorher
2545+19homeofrecord.
2546+20 2.Eachapplicantforlicensureasaprofessionalcounselorshallfurnishevidenceto
2547+21thecommitteethattheapplicantisatleasteighteenyearsofage,isaUnitedStatescitizenor
2548+22islegallypresentintheUnitedStates;and
2549+23 (1)Theapplicanthascompletedacourseofstudyasdefinedbytheboardruleleading
2550+24toamaster's,specialist's,ordoctoraldegreewithamajorincounseling,exceptanyapplicant
2551+25whohasheldalicenseasaprofessionalcounselorinthisstateorcurrentlyholdsalicenseasa
2552+HCSSSSCSSB157 70 26professionalcounselorinanotherstateshallnotberequiredtohavecompletedanycourses
2553+27relatedtocareerdevelopment;and
2554+28 (2)Theapplicanthascompletedacceptablesupervisedcounselingasdefinedby
2555+29boardrule.Iftheapplicanthasamaster'sdegreewithamajorincounselingasdefinedby
2556+30boardrule,theapplicantshallcompleteatleasttwoyearsofacceptablesupervisedcounseling
2557+31experiencesubsequenttothereceiptofthemaster'sdegree.Thecompositionandnumberof
2558+32hourscomprisingtheacceptablesupervisedcounselingexperienceshallbedefinedbyboard
2559+33rule.Anapplicantmaysubstitutethirtysemesterhoursofpostmaster'sgraduatestudyfor
2560+34oneofthetworequiredyearsofacceptablesupervisedcounselingexperienceifsuchhours
2561+35areclearlyrelatedtocounseling;
2562+36 (3)AfterAugust28,2007,eachapplicantshallhavecompletedaminimumofthree
2563+37hoursofgraduatelevelcourseworkindiagnosticsystemseitherinthecurriculumleadingtoa
2564+38degreeoraspostmaster'sgraduatelevelcoursework;
2565+39 (4)Uponexamination,theapplicantispossessedofrequisiteknowledgeofthe
2566+40profession,includingtechniquesandapplications,researchanditsinterpretation,and
2567+41professionalaffairsandethics.
2568+42 [2.Anypersonholdingacurrentlicense,certificateofregistration,orpermitfrom
2569+43anotherstateorterritoryoftheUnitedStatestopracticeasaprofessionalcounselorwhodoes
2570+44notmeettherequirementsinsection324.009andwhoisatleasteighteenyearsofage,andis
2571+45aUnitedStatescitizenorislegallypresentintheUnitedStatesmaybegrantedalicense
2572+46withoutexaminationtoengageinthepracticeofprofessionalcounselinginthisstateuponthe
2573+47applicationtotheboard,paymentoftherequiredfeeasestablishedbytheboard,and
2574+48satisfyingoneofthefollowingrequirements:
2575+49 (1)ApprovalbytheAmericanAssociationofStateCounselingBoards(AASCB)or
2576+50itssuccessororganizationaccordingtotheeligibilitycriteriaestablishedbyAASCB.The
2577+51successororganizationshallbedefinedbyboardrule;or
2578+52 (2)IngoodstandingandcurrentlycertifiedbytheNationalBoardforCertified
2579+53Counselorsoritssuccessororganizationandhascompletedacceptablesupervisedcounseling
2580+54experienceasdefinedbyboardrule.Thesuccessororganizationshallbedefinedbyboard
2581+55rule.]
2582+56 3.(1)Anypersonwhoholdsavalidcurrentprofessionalcounselorlicenseissued
2583+57byanotherstate,abranchorunitofthemilitary,aterritoryoftheUnitedStates,orthe
2584+58DistrictofColumbia,andwhohasbeenlicensedforatleastoneyearinsuchother
2585+59jurisdiction,maysubmitanapplicationforaprofessionalcounselorlicenseinMissouri
2586+60alongwithproofofcurrentlicensureandproofoflicensureforatleastoneyearinthe
2587+61otherjurisdiction,tothecommittee.
2588+62 (2)Thecommitteeshall:
2589+HCSSSSCSSB157 71 63 (a)Withinsixmonthsofreceivinganapplicationdescribedinsubdivision(1)of
2590+64thissubsection,waiveanyexamination,educational,orexperiencerequirementsfor
2591+65licensureinthisstatefortheapplicantifitdeterminesthattherewereminimum
2592+66educationrequirementsand,ifapplicable,workexperienceandclinicalsupervision
2593+67requirementsineffectandtheotherstateverifiesthatthepersonmetthose
2594+68requirementsinordertobelicensedorcertifiedinthatstate.Thecommitteemay
2595+69requireanapplicanttotakeandpassanexaminationspecifictothelawsofthisstate;or
2596+70 (b)Withinthirtydaysofreceivinganapplicationdescribedinsubdivision(1)of
2597+71thissubsectionfromanonresidentmilitaryspouseoraresidentmilitaryspouse,waive
2598+72anyexamination,educational,orexperiencerequirementsforlicensureinthisstatefor
2599+73theapplicantandissuesuchapplicantalicenseunderthissubsectionifsuchapplicant
2600+74otherwisemeetstherequirementsofthissection.
2601+75 (3)(a)Thecommitteeshallnotwaiveanyexamination,educational,or
2602+76experiencerequirementsforanyapplicantwhohashadhisorherlicenserevokedbya
2603+77committeeoutsidethestate;whoiscurrentlyunderinvestigation,whohasacomplaint
2604+78pending,orwhoiscurrentlyunderdisciplinaryaction,exceptasprovidedinparagraph
2605+79(b)ofthissubdivision,withacommitteeoutsidethestate;whodoesnotholdalicensein
2606+80goodstandingwithacommitteeoutsidethestate;whohasacriminalrecordthatwould
2607+81disqualifyhimorherforlicensureinMissouri;orwhodoesnotholdavalidcurrent
2608+82licenseintheotherjurisdictiononthedatethecommitteereceiveshisorherapplication
2609+83underthissection.
2610+84 (b)Ifanotherjurisdictionhastakendisciplinaryactionagainstanapplicant,the
2611+85committeeshalldetermineifthecausefortheactionwascorrectedandthematter
2612+86resolved.Ifthematterhasnotbeenresolvedbythatjurisdiction,thecommitteemay
2613+87denyalicenseuntilthematterisresolved.
2614+88 (4)Nothinginthissubsectionshallprohibitthecommitteefromdenyinga
2615+89licensetoanapplicantunderthissubsectionforanyreasondescribedinsection337.525.
2616+90 (5)Anypersonwhoislicensedundertheprovisionsofthissubsectionshallbe
2617+91subjecttothecommittee'sjurisdictionandallrulesandregulationspertainingtothe
2618+92practiceasalicensedprofessionalcounselorinthisstate.
2619+93 (6)Thissubsectionshallnotbeconstruedtowaiveanyrequirementforan
2620+94applicanttopayanyfees.
2621+95 4.Thecommitteeshallissuealicensetoeachpersonwhofilesanapplicationandfee
2622+96andwhofurnishesevidencesatisfactorytothecommitteethattheapplicanthascompliedwith
2623+97theprovisionsofthisactandhastakenandpassedawritten,open-bookexaminationon
2624+98Missourilawsandregulationsgoverningthepracticeofprofessionalcounselingasdefinedin
2625+99section337.500.Thedivisionshallissueaprovisionalprofessionalcounselorlicensetoany
2626+HCSSSSCSSB157 72 100applicantwhomeetsallrequirementsofthissection,butwhohasnotcompletedtherequired
2627+101acceptablesupervisedcounselingexperienceandsuchapplicantmayreapplyforlicensureas
2628+102aprofessionalcounseloruponcompletionofsuchacceptablesupervisedcounseling
2629+103experience.
2630+104 [4.]5.Allpersonslicensedtopracticeprofessionalcounselinginthisstateshallpay
2631+105onorbeforethelicenserenewaldatearenewallicensefeeandshallfurnishtothecommittee
2632+106satisfactoryevidenceofthecompletionoftherequisitenumberofhoursofcontinuing
2633+107educationasrequiredbyrule,includingtwohoursofsuicideassessment,referral,treatment,
2634+108andmanagementtraining,whichshallbenomorethanfortyhoursbiennially.Thecontinuing
2635+109educationrequirementsmaybewaivedbythecommitteeuponpresentationtothecommittee
2636+110ofsatisfactoryevidenceoftheillnessofthelicenseeorforothergoodcause.
2637+337.550.SECTION1:PURPOSE
2638+2 ThepurposeofthisCompactistofacilitateinterstatepracticeofLicensed
2639+3ProfessionalCounselorswiththegoalofimprovingpublicaccesstoProfessional
2640+4Counselingservices.ThepracticeofProfessionalCounselingoccursintheStatewhere
2641+5theclientislocatedatthetimeofthecounselingservices.TheCompactpreservesthe
2642+6regulatoryauthorityofStatestoprotectpublichealthandsafetythroughthecurrent
2643+7systemofStatelicensure.
2644+8 ThisCompactisdesignedtoachievethefollowingobjectives:
2645+9 A.IncreasepublicaccesstoProfessionalCounselingservicesbyprovidingfor
2646+10themutualrecognitionofotherMemberStatelicenses;
2647+11 B.EnhancetheStates'abilitytoprotectthepublic'shealthandsafety;
2648+12 C.EncouragethecooperationofMemberStatesinregulatingmultistate
2649+13practiceforLicensedProfessionalCounselors;
2650+14 D.SupportspousesofrelocatingActiveDutyMilitarypersonnel;
2651+15 E.Enhancetheexchangeoflicensure,investigative,anddisciplinary
2652+16informationamongMemberStates;
2653+17 F.AllowfortheuseofTelehealthtechnologytofacilitateincreasedaccessto
2654+18ProfessionalCounselingservices;
2655+19 G.SupporttheuniformityofProfessionalCounselinglicensurerequirements
2656+20throughouttheStatestopromotepublicsafetyandpublichealthbenefits;
2657+21 H.InvestallMemberStateswiththeauthoritytoholdaLicensedProfessional
2658+22CounseloraccountableformeetingallStatepracticelawsintheStateinwhichtheclient
2659+23islocatedatthetimecareisrenderedthroughthemutualrecognitionofMemberState
2660+24licenses;
2661+25 I.EliminatethenecessityforlicensesinmultipleStates;and
2662+HCSSSSCSSB157 73 26 J.ProvideopportunitiesforinterstatepracticebyLicensedProfessional
2663+27Counselorswhomeetuniformlicensurerequirements.
2664+28 SECTION2.DEFINITIONS
2665+29 AsusedinthisCompact,andexceptasotherwiseprovided,thefollowing
2666+30definitionsshallapply:
2667+31 A."ActiveDutyMilitary"meansfull-timedutystatusintheactiveuniformed
2668+32serviceoftheUnitedStates,includingmembersoftheNationalGuardandReserveon
2669+33activedutyorderspursuantto10U.S.C.Chapters1209and1211.
2670+34 B."AdverseAction"meansanyadministrative,civil,equitableorcriminal
2671+35actionpermittedbyaState'slawswhichisimposedbyalicensingboardorother
2672+36authorityagainstaLicensedProfessionalCounselor,includingactionsagainstan
2673+37individual'slicenseorPrivilegetoPracticesuchasrevocation,suspension,probation,
2674+38monitoringofthelicensee,limitationonthelicensee'spractice,oranyother
2675+39EncumbranceonlicensureaffectingaLicensedProfessionalCounselor's
2676+40authorizationtopractice,includingissuanceofaceaseanddesistaction.
2677+41 C."AlternativeProgram"meansanon-disciplinarymonitoringorpractice
2678+42remediationprocessapprovedbyaProfessionalCounselingLicensingBoardtoaddress
2679+43ImpairedPractitioners.
2680+44 D."ContinuingCompetence/Education"meansarequirement,asaconditionof
2681+45licenserenewal,toprovideevidenceofparticipationin,and/orcompletionof,
2682+46educationalandprofessionalactivitiesrelevanttopracticeorareaofwork.
2683+47 E."CounselingCompactCommission"or"Commission"meansthenational
2684+48administrativebodywhosemembershipconsistsofallStatesthathaveenactedthe
2685+49Compact.
2686+50 F."CurrentSignificantInvestigativeInformation"means:
2687+51 1.InvestigativeInformationthataLicensingBoard,afterapreliminaryinquiry
2688+52thatincludesnotificationandanopportunityfortheLicensedProfessionalCounselorto
2689+53respond,ifrequiredbyStatelaw,hasreasontobelieveisnotgroundlessand,ifproved
2690+54true,wouldindicatemorethanaminorinfraction;or
2691+55 2.InvestigativeInformationthatindicatesthattheLicensedProfessional
2692+56Counselorrepresentsanimmediatethreattopublichealthandsafetyregardlessof
2693+57whethertheLicensedProfessionalCounselorhasbeennotifiedandhadanopportunity
2694+58torespond.
2695+59 G."DataSystem"meansarepositoryofinformationaboutLicensees,including,
2696+60butnotlimitedto,continuingeducation,examination,licensure,investigative,Privilege
2697+61toPracticeandAdverseActioninformation.
2698+HCSSSSCSSB157 74 62 H."EncumberedLicense"meansalicenseinwhichanAdverseActionrestricts
2699+63thepracticeoflicensedProfessionalCounselingbytheLicenseeandsaidAdverse
2700+64ActionhasbeenreportedtotheNationalPractitionersDataBank(NPDB).
2701+65 I."Encumbrance"meansarevocationorsuspensionof,oranylimitationon,the
2702+66fullandunrestrictedpracticeofLicensedProfessionalCounselingbyaLicensingBoard.
2703+67 J."ExecutiveCommittee"meansagroupofdirectorselectedorappointedtoact
2704+68onbehalfof,andwithinthepowersgrantedtothemby,theCommission.
2705+69 K."HomeState"meanstheMemberStatethatistheLicensee'sprimaryState
2706+70ofresidence.
2707+71 L."ImpairedPractitioner"meansanindividualwhohasacondition(s)thatmay
2708+72impairtheirabilitytopracticeasaLicensedProfessionalCounselorwithoutsometype
2709+73ofinterventionandmayinclude,butarenotlimitedto,alcoholanddrugdependence,
2710+74mentalhealthimpairment,andneurologicalorphysicalimpairments.
2711+75 M."InvestigativeInformation"meansinformation,records,anddocuments
2712+76receivedorgeneratedbyaProfessionalCounselingLicensingBoardpursuanttoan
2713+77investigation.
2714+78 N."JurisprudenceRequirement"ifrequiredbyaMemberState,meansthe
2715+79assessmentofanindividual'sknowledgeofthelawsandRulesgoverningthepracticeof
2716+80ProfessionalCounselinginaState.
2717+81 O."LicensedProfessionalCounselor"meansacounselorlicensedbyaMember
2718+82State,regardlessofthetitleusedbythatState,toindependentlyassess,diagnose,and
2719+83treatbehavioralhealthconditions.
2720+84 P."Licensee"meansanindividualwhocurrentlyholdsanauthorizationfrom
2721+85theStatetopracticeasaLicensedProfessionalCounselor.
2722+86 Q."LicensingBoard"meanstheagencyofaState,orequivalent,thatis
2723+87responsibleforthelicensingandregulationofLicensedProfessionalCounselors.
2724+88 R."MemberState"meansaStatethathasenactedtheCompact.
2725+89 S."PrivilegetoPractice"meansalegalauthorization,whichisequivalenttoa
2726+90license,permittingthepracticeofProfessionalCounselinginaRemoteState.
2727+91 T."ProfessionalCounseling"meanstheassessment,diagnosis,andtreatmentof
2728+92behavioralhealthconditionsbyaLicensedProfessionalCounselor.
2729+93 U."RemoteState"meansaMemberStateotherthantheHomeState,wherea
2730+94LicenseeisexercisingorseekingtoexercisethePrivilegetoPractice.
2731+95 V."Rule"meansaregulationpromulgatedbytheCommissionthathastheforce
2732+96oflaw.
2733+HCSSSSCSSB157 75 97 W."SingleStateLicense"meansaLicensedProfessionalCounselorlicense
2734+98issuedbyaMemberStatethatauthorizespracticeonlywithintheissuingStateanddoes
2735+99notincludeaPrivilegetoPracticeinanyotherMemberState.
2736+100 X."State"meansanystate,commonwealth,district,orterritoryoftheUnited
2737+101StatesofAmericathatregulatesthepracticeofProfessionalCounseling.
2738+102 Y."Telehealth"meanstheapplicationoftelecommunicationtechnologyto
2739+103deliverProfessionalCounselingservicesremotelytoassess,diagnose,andtreat
2740+104behavioralhealthconditions.
2741+105 Z."UnencumberedLicense"meansalicensethatauthorizesaLicensed
2742+106ProfessionalCounselortoengageinthefullandunrestrictedpracticeofProfessional
2743+107Counseling.
2744+108 SECTION3.STATEPARTICIPATIONINTHECOMPACT
2745+109 A.ToParticipateintheCompact,aStatemustcurrently:
2746+110 1.LicenseandregulateLicensedProfessionalCounselors;
2747+111 2.RequireLicenseestopassanationallyrecognizedexamapprovedbythe
2748+112Commission;
2749+113 3.RequireLicenseestohavea60semester-hour(or90quarter-hour)master's
2750+114degreeincounselingor60semester-hours(or90quarter-hours)ofgraduatecourse
2751+115workincludingthefollowingtopicareas:
2752+116 a.ProfessionalCounselingOrientationandEthicalPractice;
2753+117 b.SocialandCulturalDiversity;
2754+118 c.HumanGrowthandDevelopment;
2755+119 d.CareerDevelopment;
2756+120 e.CounselingandHelpingRelationships;
2757+121 f.GroupCounselingandGroupWork;
2758+122 g.DiagnosisandTreatment;AssessmentandTesting;
2759+123 h.ResearchandProgramEvaluation;and
2760+124 i.OtherareasasdeterminedbytheCommission.
2761+125 4.RequireLicenseestocompleteasupervisedpostgraduateprofessional
2762+126experienceasdefinedbytheCommission;
2763+127 5.Haveamechanisminplaceforreceivingandinvestigatingcomplaintsabout
2764+128Licensees.
2765+129 B.AMemberStateshall:
2766+130 1.ParticipatefullyintheCommission'sDataSystem,includingusingthe
2767+131Commission'suniqueidentifierasdefinedinRules;
2768+HCSSSSCSSB157 76 132 2.NotifytheCommission,incompliancewiththetermsoftheCompactand
2769+133Rules,ofanyAdverseActionortheavailabilityofInvestigativeInformationregardinga
2770+134Licensee;
2771+135 3.Implementorutilizeproceduresforconsideringthecriminalhistoryrecords
2772+136ofapplicantsforaninitialPrivilegetoPractice.Theseproceduresshallincludethe
2773+137submissionoffingerprintsorotherbiometric-basedinformationbyapplicantsforthe
2774+138purposeofobtaininganapplicant'scriminalhistoryrecordinformationfromthe
2775+139FederalBureauofInvestigationandtheagencyresponsibleforretainingthatState's
2776+140criminalrecords;
2777+141 a.Amemberstatemustfullyimplementacriminalbackgroundcheck
2778+142requirement,withinatimeframeestablishedbyrule,byreceivingtheresultsofthe
2779+143FederalBureauofInvestigationrecordsearchandshallusetheresultsinmaking
2780+144licensuredecisions.
2781+145 b.CommunicationbetweenaMemberState,theCommissionandamong
2782+146MemberStatesregardingtheverificationofeligibilityforlicensurethroughthe
2783+147CompactshallnotincludeanyinformationreceivedfromtheFederalBureauof
2784+148InvestigationrelatingtoafederalcriminalrecordscheckperformedbyaMemberState
2785+149underPublicLaw92-544.
2786+150 4.ComplywiththeRulesoftheCommission;
2787+151 5.RequireanapplicanttoobtainorretainalicenseintheHomeStateandmeet
2788+152theHomeState'squalificationsforlicensureorrenewaloflicensure,aswellasallother
2789+153applicableStatelaws;
2790+154 6.GrantthePrivilegetoPracticetoaLicenseeholdingavalidUnencumbered
2791+155LicenseinanotherMemberStateinaccordancewiththetermsoftheCompactand
2792+156Rules;and
2793+157 7.ProvidefortheattendanceoftheState'scommissionertotheCounseling
2794+158CompactCommissionmeetings.
2795+159 C.MemberStatesmaychargeafeeforgrantingthePrivilegetoPractice.
2796+160 D.IndividualsnotresidinginaMemberStateshallcontinuetobeabletoapply
2797+161foraMemberState'sSingleStateLicenseasprovidedunderthelawsofeachMember
2798+162State.However,theSingleStateLicensegrantedtotheseindividualsshallnotbe
2799+163recognizedasgrantingaPrivilegetoPracticeProfessionalCounselinginanyother
2800+164MemberState.
2801+165 E.NothinginthisCompactshallaffecttherequirementsestablishedbya
2802+166MemberStatefortheissuanceofaSingleStateLicense.
2803+167 F.AlicenseissuedtoaLicensedProfessionalCounselorbyaHomeStatetoa
2804+168residentinthatStateshallberecognizedbyeachMemberStateasauthorizinga
2805+HCSSSSCSSB157 77 169LicensedProfessionalCounselortopracticeProfessionalCounseling,underaPrivilege
2806+170toPractice,ineachMemberState.
2807+171 SECTION4.PRIVILEGETOPRACTICE
2808+172 A.ToexercisethePrivilegetoPracticeunderthetermsandprovisionsofthe
2809+173Compact,theLicenseeshall:
2810+174 1.HoldalicenseintheHomeState;
2811+175 2.HaveavalidUnitedStatesSocialSecurityNumberorNationalPractitioner
2812+176Identifier;
2813+177 3.BeeligibleforaPrivilegetoPracticeinanyMemberStateinaccordancewith
2814+178Section4(D),(G)and(H);
2815+179 4.HavenothadanyEncumbranceorrestrictionagainstanylicenseorPrivilege
2816+180toPracticewithintheprevioustwo(2)years;
2817+181 5.NotifytheCommissionthattheLicenseeisseekingthePrivilegetoPractice
2818+182withinaRemoteState(s);
2819+183 6.Payanyapplicablefees,includinganyStatefee,forthePrivilegetoPractice;
2820+184 7.MeetanyContinuingCompetence/Educationrequirementsestablishedbythe
2821+185HomeState;
2822+186 8.MeetanyJurisprudenceRequirementsestablishedbytheRemoteState(s)in
2823+187whichtheLicenseeisseekingaPrivilegetoPractice;and
2824+188 9.ReporttotheCommissionanyAdverseAction,Encumbrance,orrestriction
2825+189onlicensetakenbyanynon-MemberStatewithin30daysfromthedatetheactionis
2826+190taken.
2827+191 B.ThePrivilegetoPracticeisvaliduntiltheexpirationdateoftheHomeState
2828+192license.TheLicenseemustcomplywiththerequirementsofSection4(A)tomaintain
2829+193thePrivilegetoPracticeintheRemoteState.
2830+194 C.ALicenseeprovidingProfessionalCounselinginaRemoteStateunderthe
2831+195PrivilegetoPracticeshalladheretothelawsandregulationsoftheRemoteState.
2832+196 D.ALicenseeprovidingProfessionalCounselingservicesinaRemoteStateis
2833+197subjecttothatState'sregulatoryauthority.ARemoteStatemay,inaccordancewith
2834+198dueprocessandthatState'slaws,removeaLicensee'sPrivilegetoPracticeinthe
2835+199RemoteStateforaspecificperiodoftime,imposefines,and/ortakeanyothernecessary
2836+200actionstoprotectthehealthandsafetyofitscitizens.TheLicenseemaybeineligiblefor
2837+201aPrivilegetoPracticeinanyMemberStateuntilthespecifictimeforremovalhas
2838+202passedandallfinesarepaid.
2839+203 E.IfaHomeStatelicenseisencumbered,theLicenseeshalllosethePrivilegeto
2840+204PracticeinanyRemoteStateuntilthefollowingoccur:
2841+205 1.TheHomeStatelicenseisnolongerencumbered;and
2842+HCSSSSCSSB157 78 206 2.HavenothadanyEncumbranceorrestrictionagainstanylicenseorPrivilege
2843+207toPracticewithintheprevioustwo(2)years.
2844+208 F.OnceanEncumberedLicenseintheHomeStateisrestoredtogoodstanding,
2845+209theLicenseemustmeettherequirementsofSection4(A)toobtainaPrivilegetoPractice
2846+210inanyRemoteState.
2847+211 G.IfaLicensee'sPrivilegetoPracticeinanyRemoteStateisremoved,the
2848+212individualmaylosethePrivilegetoPracticeinallotherRemoteStatesuntilthe
2849+213followingoccur:
2850+214 1.ThespecificperiodoftimeforwhichthePrivilegetoPracticewasremoved
2851+215hasended;
2852+216 2.Allfineshavebeenpaid;and
2853+217 3.HavenothadanyEncumbranceorrestrictionagainstanylicenseorPrivilege
2854+218toPracticewithintheprevioustwo(2)years.
2855+219 H.OncetherequirementsofSection4(G)havebeenmet,theLicenseemustmeet
2856+220therequirementsinSection4(A)toobtainaPrivilegetoPracticeinaRemoteState.
2857+221 SECTION5:OBTAININGANEWHOMESTATELICENSEBASEDONA
2858+222PRIVILEGETOPRACTICE
2859+223 A.ALicensedProfessionalCounselormayholdaHomeStatelicense,which
2860+224allowsforaPrivilegetoPracticeinotherMemberStates,inonlyoneMemberStateata
2861+225time.
2862+226 B.IfaLicensedProfessionalCounselorchangesprimaryStateofresidenceby
2863+227movingbetweentwoMemberStates:
2864+228 1.TheLicensedProfessionalCounselorshallfileanapplicationforobtaininga
2865+229newHomeStatelicensebasedonaPrivilegetoPractice,payallapplicablefees,and
2866+230notifythecurrentandnewHomeStateinaccordancewithapplicableRulesadoptedby
2867+231theCommission.
2868+232 2.UponreceiptofanapplicationforobtaininganewHomeStatelicenseby
2869+233virtueofaPrivilegetoPractice,thenewHomeStateshallverifythattheLicensed
2870+234ProfessionalCounselormeetsthepertinentcriteriaoutlinedinSection4viatheData
2871+235System,withoutneedforprimarysourceverificationexceptfor:
2872+236 a.aFederalBureauofInvestigationfingerprintbasedcriminalbackground
2873+237checkifnotpreviouslyperformedorupdatedpursuanttoapplicablerulesadoptedby
2874+238theCommissioninaccordancewithPublicLaw92-544;
2875+239 b.othercriminalbackgroundcheckasrequiredbythenewHomeState;and
2876+240 c.completionofanyrequisiteJurisprudenceRequirementsofthenewHome
2877+241State.
2878+HCSSSSCSSB157 79 242 3.TheformerHomeStateshallconverttheformerHomeStatelicenseintoa
2879+243PrivilegetoPracticeoncethenewHomeStatehasactivatedthenewHomeStatelicense
2880+244inaccordancewithapplicableRulesadoptedbytheCommission.
2881+245 4.NotwithstandinganyotherprovisionofthisCompact,iftheLicensed
2882+246ProfessionalCounselorcannotmeetthecriteriainSection4,thenewHomeStatemay
2883+247applyitsrequirementsforissuinganewSingleStateLicense.
2884+248 5.TheLicensedProfessionalCounselorshallpayallapplicablefeestothenew
2885+249HomeStateinordertobeissuedanewHomeStatelicense.
2886+250 C.IfaLicensedProfessionalCounselorchangesPrimaryStateofResidenceby
2887+251movingfromaMemberStatetoanon-MemberState,orfromanon-MemberStatetoa
2888+252MemberState,theStatecriteriashallapplyforissuanceofaSingleStateLicenseinthe
2889+253newState.
2890+254 D.NothinginthisCompactshallinterferewithaLicensee'sabilitytoholda
2891+255SingleStateLicenseinmultipleStates,howeverforthepurposesofthisCompact,a
2892+256LicenseeshallhaveonlyoneHomeStatelicense.
2893+257 E.NothinginthisCompactshallaffecttherequirementsestablishedbya
2894+258MemberStatefortheissuanceofaSingleStateLicense.
2895+259 SECTION6.ACTIVEDUTYMILITARYPERSONNELORTHEIRSPOUSES
2896+260 ActiveDutyMilitarypersonnel,ortheirspouse,shalldesignateaHomeState
2897+261wheretheindividualhasacurrentlicenseingoodstanding.Theindividualmayretain
2898+262theHomeStatedesignationduringtheperiodtheservicememberisonactiveduty.
2899+263SubsequenttodesignatingaHomeState,theindividualshallonlychangetheirHome
2900+264StatethroughapplicationforlicensureinthenewState,orthroughtheprocessoutlined
2901+265inSection5.
2902+266 SECTION7.COMPACTPRIVILEGETOPRACTICETELEHEALTH
2903+267 A.MemberStatesshallrecognizetherightofaLicensedProfessionalCounselor,
2904+268licensedbyaHomeStateinaccordancewithSection3andunderRulespromulgatedby
2905+269theCommission,topracticeProfessionalCounselinginanyMemberStatevia
2906+270TelehealthunderaPrivilegetoPracticeasprovidedintheCompactandRules
2907+271promulgatedbytheCommission.
2908+272 B.ALicenseeprovidingProfessionalCounselingservicesinaRemoteState
2909+273underthePrivilegetoPracticeshalladheretothelawsandregulationsoftheRemote
2910+274State.
2911+275 SECTION8.ADVERSEACTIONS
2912+276 A.InadditiontotheotherpowersconferredbyStatelaw,aRemoteStateshall
2913+277havetheauthority,inaccordancewithexistingStatedueprocesslaw,to:
2914+HCSSSSCSSB157 80 278 1.TakeAdverseActionagainstaLicensedProfessionalCounselor'sPrivilegeto
2915+279PracticewithinthatMemberState,and
2916+280 2.Issuesubpoenasforbothhearingsandinvestigationsthatrequirethe
2917+281attendanceandtestimonyofwitnessesaswellastheproductionofevidence.Subpoenas
2918+282issuedbyaLicensingBoardinaMemberStatefortheattendanceandtestimonyof
2919+283witnessesortheproductionofevidencefromanotherMemberStateshallbeenforcedin
2920+284thelatterStatebyanycourtofcompetentjurisdiction,accordingtothepracticeand
2921+285procedureofthatcourtapplicabletosubpoenasissuedinproceedingspendingbeforeit.
2922+286Theissuingauthorityshallpayanywitnessfees,travelexpenses,mileage,andotherfees
2923+287requiredbytheservicestatutesoftheStateinwhichthewitnessesorevidenceare
2924+288located.
2925+289 3.OnlytheHomeStateshallhavethepowertotakeAdverseActionagainsta
2926+290LicensedProfessionalCounselor'slicenseissuedbytheHomeState.
2927+291 B.ForpurposesoftakingAdverseAction,theHomeStateshallgivethesame
2928+292priorityandeffecttoreportedconductreceivedfromaMemberStateasitwouldifthe
2929+293conducthadoccurredwithintheHomeState.Insodoing,theHomeStateshallapply
2930+294itsownStatelawstodetermineappropriateaction.
2931+295 C.TheHomeStateshallcompleteanypendinginvestigationsofaLicensed
2932+296ProfessionalCounselorwhochangesprimaryStateofresidenceduringthecourseofthe
2933+297investigations.TheHomeStateshallalsohavetheauthoritytotakeappropriateaction
2934+298(s)andshallpromptlyreporttheconclusionsoftheinvestigationstotheadministrator
2935+299oftheDataSystem.Theadministratorofthecoordinatedlicensureinformationsystem
2936+300shallpromptlynotifythenewHomeStateofanyAdverseActions.
2937+301 D.AMemberState,ifotherwisepermittedbyStatelaw,mayrecoverfromthe
2938+302affectedLicensedProfessionalCounselorthecostsofinvestigationsanddispositionsof
2939+303casesresultingfromanyAdverseActiontakenagainstthatLicensedProfessional
2940+304Counselor.
2941+305 E.AMemberStatemaytakeAdverseActionbasedonthefactualfindingsofthe
2942+306RemoteState,providedthattheMemberStatefollowsitsownproceduresfortakingthe
2943+307AdverseAction.
2944+308 F.JointInvestigations:
2945+309 1.InadditiontotheauthoritygrantedtoaMemberStatebyitsrespective
2946+310ProfessionalCounselingpracticeactorotherapplicableStatelaw,anyMemberState
2947+311mayparticipatewithotherMemberStatesinjointinvestigationsofLicensees.
2948+312 2.MemberStatesshallshareanyinvestigative,litigation,orcompliance
2949+313materialsinfurtheranceofanyjointorindividualinvestigationinitiatedunderthe
2950+314Compact.
2951+HCSSSSCSSB157 81 315 G.IfAdverseActionistakenbytheHomeStateagainstthelicenseofaLicensed
2952+316ProfessionalCounselor,theLicensedProfessionalCounselor'sPrivilegetoPracticeinall
2953+317otherMemberStatesshallbedeactivateduntilallEncumbranceshavebeenremoved
2954+318fromtheStatelicense.AllHomeStatedisciplinaryordersthatimposeAdverseAction
2955+319againstthelicenseofaLicensedProfessionalCounselorshallincludeaStatementthat
2956+320theLicensedProfessionalCounselor'sPrivilegetoPracticeisdeactivatedinallMember
2957+321Statesduringthependencyoftheorder.
2958+322 H.IfaMemberStatetakesAdverseAction,itshallpromptlynotifythe
2959+323administratoroftheDataSystem.TheadministratoroftheDataSystemshallpromptly
2960+324notifytheHomeStateofanyAdverseActionsbyRemoteStates.
2961+325 I.NothinginthisCompactshalloverrideaMemberState'sdecisionthat
2962+326participationinanAlternativeProgrammaybeusedinlieuofAdverseAction.
2963+327 SECTION 9.ESTABLISHMENT OFCOUNSELING COMPACT
2964+328COMMISSION
2965+329 A.TheCompactMemberStatesherebycreateandestablishajointpublic
2966+330agencyknownastheCounselingCompactCommission:
2967+331 1.TheCommissionisaninstrumentalityoftheCompactStates.
2968+332 2.VenueisproperandjudicialproceedingsbyoragainsttheCommissionshall
2969+333bebroughtsolelyandexclusivelyinacourtofcompetentjurisdictionwherethe
2970+334principalofficeoftheCommissionislocated.TheCommissionmaywaivevenueand
2971+335jurisdictionaldefensestotheextentitadoptsorconsentstoparticipateinalternative
2972+336disputeresolutionproceedings.
2973+337 3.NothinginthisCompactshallbeconstruedtobeawaiverofsovereign
2974+338immunity.
2975+339 B.Membership,Voting,andMeetings
2976+340 1.EachMemberStateshallhaveandbelimitedtoone(1)delegateselectedby
2977+341thatMemberState'sLicensingBoard.
2978+342 2.Thedelegateshallbeeither:
2979+343 a.AcurrentmemberoftheLicensingBoardatthetimeofappointment,whoisa
2980+344LicensedProfessionalCounselororpublicmember;or
2981+345 b.AnadministratoroftheLicensingBoard.
2982+346 3.Anydelegatemayberemovedorsuspendedfromofficeasprovidedbythelaw
2983+347oftheStatefromwhichthedelegateisappointed.
2984+348 4.TheMemberStateLicensingBoardshallfillanyvacancyoccurringonthe
2985+349Commissionwithin60days.
2986+HCSSSSCSSB157 82 350 5.Eachdelegateshallbeentitledtoone(1)votewithregardtothepromulgation
2987+351ofRulesandcreationofbylawsandshallotherwisehaveanopportunitytoparticipate
2988+352inthebusinessandaffairsoftheCommission.
2989+353 6.Adelegateshallvoteinpersonorbysuchothermeansasprovidedinthe
2990+354bylaws.Thebylawsmayprovidefordelegates'participationinmeetingsbytelephone
2991+355orothermeansofcommunication.
2992+356 7.TheCommissionshallmeetatleastonceduringeachcalendaryear.
2993+357Additionalmeetingsshallbeheldassetforthinthebylaws.
2994+358 8.TheCommissionshallbyRuleestablishatermofofficefordelegatesandmay
2995+359byRuleestablishtermlimits.
2996+360 C.TheCommissionshallhavethefollowingpowersandduties:
2997+361 1.EstablishthefiscalyearoftheCommission;
2998+362 2.Establishbylaws;
2999+363 3.Maintainitsfinancialrecordsinaccordancewiththebylaws;
3000+364 4.Meetandtakesuchactionsasareconsistentwiththeprovisionsofthis
3001+365Compactandthebylaws;
3002+366 5.PromulgateRuleswhichshallbebindingtotheextentandinthemanner
3003+367providedforintheCompact;
3004+368 6.Bringandprosecutelegalproceedingsoractionsinthenameofthe
3005+369Commission,providedthatthestandingofanyStateLicensingBoardtosueorbesued
3006+370underapplicablelawshallnotbeaffected;
3007+371 7.Purchaseandmaintaininsuranceandbonds;
3008+372 8.Borrow,accept,orcontractforservicesofpersonnel,including,butnot
3009+373limitedto,employeesofaMemberState;
3010+374 9.Hireemployees,electorappointofficers,fixcompensation,defineduties,
3011+375grantsuchindividualsappropriateauthoritytocarryoutthepurposesoftheCompact,
3012+376andestablishtheCommission'spersonnelpoliciesandprogramsrelatingtoconflictsof
3013+377interest,qualificationsofpersonnel,andotherrelatedpersonnelmatters;
3014+378 10.Acceptanyandallappropriatedonationsandgrantsofmoney,equipment,
3015+379supplies,materials,andservices,andtoreceive,utilize,anddisposeofthesame;
3016+380providedthatatalltimestheCommissionshallavoidanyappearanceofimpropriety
3017+381and/orconflictofinterest;
3018+382 11.Lease,purchase,acceptappropriategiftsordonationsof,orotherwiseto
3019+383own,hold,improveoruse,anyproperty,real,personalormixed;providedthatatall
3020+384timestheCommissionshallavoidanyappearanceofimpropriety;
3021+385 12.Sell,convey,mortgage,pledge,lease,exchange,abandon,orotherwise
3022+386disposeofanypropertyreal,personal,ormixed;
3023+HCSSSSCSSB157 83 387 13.Establishabudgetandmakeexpenditures;
3024+388 14.Borrowmoney;
3025+389 15.Appointcommittees,includingstandingcommitteescomposedofmembers,
3026+390Stateregulators,Statelegislatorsortheirrepresentatives,andconsumer
3027+391representatives,andsuchotherinterestedpersonsasmaybedesignatedinthis
3028+392Compactandthebylaws;
3029+393 16.Provideandreceiveinformationfrom,andcooperatewith,lawenforcement
3030+394agencies;
3031+395 17.EstablishandelectanExecutiveCommittee;and
3032+396 18.Performsuchotherfunctionsasmaybenecessaryorappropriatetoachieve
3033+397thepurposesofthisCompactconsistentwiththeStateregulationofProfessional
3034+398Counselinglicensureandpractice.
3035+399 D.TheExecutiveCommittee
3036+400 1.TheExecutiveCommitteeshallhavethepowertoactonbehalfofthe
3037+401CommissionaccordingtothetermsofthisCompact.
3038+402 2.TheExecutiveCommitteeshallbecomposedofuptoeleven(11)members:
3039+403 a.SevenvotingmemberswhoareelectedbytheCommissionfromthecurrent
3040+404membershipoftheCommission;and
3041+405 b.Uptofour(4)ex-officio,nonvotingmembersfromfour(4)recognized
3042+406nationalprofessionalcounselororganizations.
3043+407 c.Theex-officiomemberswillbeselectedbytheirrespectiveorganizations.
3044+408 3.TheCommissionmayremoveanymemberoftheExecutiveCommitteeas
3045+409providedinbylaws.
3046+410 4.TheExecutiveCommitteeshallmeetatleastannually.
3047+411 5.TheExecutiveCommitteeshallhavethefollowingdutiesandresponsibilities:
3048+412 a.RecommendtotheentireCommissionchangestotheRulesorbylaws,
3049+413changestothisCompactlegislation,feespaidbyCompactMemberStatessuchas
3050+414annualdues,andanyCommissionCompactfeechargedtoLicenseesforthePrivilegeto
3051+415Practice;
3052+416 b.EnsureCompactadministrationservicesareappropriatelyprovided,
3053+417contractualorotherwise;
3054+418 c.Prepareandrecommendthebudget;
3055+419 d.MaintainfinancialrecordsonbehalfoftheCommission;
3056+420 e.MonitorCompactcomplianceofMemberStatesandprovidecompliance
3057+421reportstotheCommission;
3058+422 f.Establishadditionalcommitteesasnecessary;and
3059+423 g.OtherdutiesasprovidedinRulesorbylaws.
3060+HCSSSSCSSB157 84 424 E.MeetingsoftheCommission
3061+425 1.Allmeetingsshallbeopentothepublic,andpublicnoticeofmeetingsshallbe
3062+426giveninthesamemannerasrequiredundertheRulemakingprovisionsinSection11.
3063+427 2.TheCommissionortheExecutiveCommitteeorothercommitteesofthe
3064+428Commissionmayconveneinaclosed,non-publicmeetingiftheCommissionor
3065+429ExecutiveCommitteeorothercommitteesoftheCommissionmustdiscuss:
3066+430 a.Non-complianceofaMemberStatewithitsobligationsundertheCompact;
3067+431 b.Theemployment,compensation,disciplineorothermatters,practicesor
3068+432proceduresrelatedtospecificemployeesorothermattersrelatedtotheCommission's
3069+433internalpersonnelpracticesandprocedures;
3070+434 c.Current,threatened,orreasonablyanticipatedlitigation;
3071+435 d.Negotiationofcontractsforthepurchase,lease,orsaleofgoods,services,or
3072+436realestate;
3073+437 e.Accusinganypersonofacrimeorformallycensuringanyperson;
3074+438 f.Disclosureoftradesecretsorcommercialorfinancialinformationthatis
3075+439privilegedorconfidential;
3076+440 g.Disclosureofinformationofapersonalnaturewheredisclosurewould
3077+441constituteaclearlyunwarrantedinvasionofpersonalprivacy;
3078+442 h.Disclosureofinvestigativerecordscompiledforlawenforcementpurposes;
3079+443 i.Disclosureofinformationrelatedtoanyinvestigativereportspreparedbyor
3080+444onbehalfoforforuseoftheCommissionorothercommitteechargedwith
3081+445responsibilityofinvestigationordeterminationofcomplianceissuespursuanttothe
3082+446Compact;or
3083+447 j.MattersspecificallyexemptedfromdisclosurebyfederalorMemberState
3084+448statute.
3085+449 3.Ifameeting,orportionofameeting,isclosedpursuanttothisprovision,the
3086+450Commission'slegalcounselordesigneeshallcertifythatthemeetingmaybeclosedand
3087+451shallreferenceeachrelevantexemptingprovision.
3088+452 4.TheCommissionshallkeepminutesthatfullyandclearlydescribeallmatters
3089+453discussedinameetingandshallprovideafullandaccuratesummaryofactionstaken,
3090+454andthereasonstherefore,includingadescriptionoftheviewsexpressed.Alldocuments
3091+455consideredinconnectionwithanactionshallbeidentifiedinsuchminutes.Allminutes
3092+456anddocumentsofaclosedmeetingshallremainunderseal,subjecttoreleasebya
3093+457majorityvoteoftheCommissionororderofacourtofcompetentjurisdiction.
3094+458 F.FinancingoftheCommission
3095+459 1.TheCommissionshallpay,orprovideforthepaymentof,thereasonable
3096+460expensesofitsestablishment,organization,andongoingactivities.
3097+HCSSSSCSSB157 85 461 2.TheCommissionmayacceptanyandallappropriaterevenuesources,
3098+462donations,andgrantsofmoney,equipment,supplies,materials,andservices.
3099+463 3.TheCommissionmaylevyonandcollectanannualassessmentfromeach
3100+464MemberStateorimposefeesonotherpartiestocoverthecostoftheoperationsand
3101+465activitiesoftheCommissionanditsstaff,whichmustbeinatotalamountsufficientto
3102+466coveritsannualbudgetasapprovedeachyearforwhichrevenueisnotprovidedby
3103+467othersources.Theaggregateannualassessmentamountshallbeallocatedbasedupona
3104+468formulatobedeterminedbytheCommission,whichshallpromulgateaRulebinding
3105+469uponallMemberStates.
3106+470 4.TheCommissionshallnotincurobligationsofanykindpriortosecuringthe
3107+471fundsadequatetomeetthesame;norshalltheCommissionpledgethecreditofanyof
3108+472theMemberStates,exceptbyandwiththeauthorityoftheMemberState.
3109+473 5.TheCommissionshallkeepaccurateaccountsofallreceiptsand
3110+474disbursements.ThereceiptsanddisbursementsoftheCommissionshallbesubject
3111+475totheauditandaccountingproceduresestablishedunderitsbylaws.However,all
3112+476receiptsanddisbursementsoffundshandledbytheCommissionshallbeauditedyearly
3113+477byacertifiedorlicensedpublicaccountant,andthereportoftheauditshallbeincluded
3114+478inandbecomepartoftheannualreportoftheCommission.
3115+479 G.QualifiedImmunity,Defense,andIndemnification
3116+480 1.Themembers,officers,executivedirector,employeesandrepresentativesof
3117+481theCommissionshallbeimmunefromsuitandliability,eitherpersonallyorintheir
3118+482officialcapacity,foranyclaimfordamagetoorlossofpropertyorpersonalinjuryor
3119+483othercivilliabilitycausedbyorarisingoutofanyactualorallegedact,erroror
3120+484omissionthatoccurred,orthatthepersonagainstwhomtheclaimismadehada
3121+485reasonablebasisforbelievingoccurredwithinthescopeofCommissionemployment,
3122+486dutiesorresponsibilities;providedthatnothinginthisparagraphshallbeconstruedto
3123+487protectanysuchpersonfromsuitand/orliabilityforanydamage,loss,injury,or
3124+488liabilitycausedbytheintentionalorwillfulorwantonmisconductofthatperson.
3125+489 2.TheCommissionshalldefendanymember,officer,executivedirector,
3126+490employeeorrepresentativeoftheCommissioninanycivilactionseekingtoimpose
3127+491liabilityarisingoutofanyactualorallegedact,error,oromissionthatoccurredwithin
3128+492thescopeofCommissionemployment,duties,orresponsibilities,orthattheperson
3129+493againstwhomtheclaimismadehadareasonablebasisforbelievingoccurredwithinthe
3130+494scopeofCommissionemployment,duties,orresponsibilities;providedthatnothing
3131+495hereinshallbeconstruedtoprohibitthatpersonfromretaininghisorherowncounsel;
3132+496andprovidedfurther,thattheactualorallegedact,error,oromissiondidnotresult
3133+497fromthatperson'sintentionalorwillfulorwantonmisconduct.
3134+HCSSSSCSSB157 86 498 3.TheCommissionshallindemnifyandholdharmlessanymember,officer,
3135+499executivedirector,employee,orrepresentativeoftheCommissionfortheamountofany
3136+500settlementorjudgmentobtainedagainstthatpersonarisingoutofanyactualoralleged
3137+501act,error,oromissionthatoccurredwithinthescopeofCommissionemployment,
3138+502duties,orresponsibilities,orthatsuchpersonhadareasonablebasisforbelieving
3139+503occurredwithinthescopeofCommissionemployment,duties,orresponsibilities,
3140+504providedthattheactualorallegedact,error,oromissiondidnotresultfromthe
3141+505intentionalorwillfulorwantonmisconductofthatperson.
3142+506 SECTION10.DATASYSTEM
3143+507 A.TheCommissionshallprovideforthedevelopment,maintenance,operation,
3144+508andutilizationofacoordinateddatabaseandreportingsystemcontaininglicensure,
3145+509AdverseAction,andInvestigativeInformationonalllicensedindividualsinMember
3146+510States.
3147+511 B.NotwithstandinganyotherprovisionofStatelawtothecontrary,aMember
3148+512StateshallsubmitauniformdatasettotheDataSystemonallindividualstowhomthis
3149+513CompactisapplicableasrequiredbytheRulesoftheCommission,including:
3150+514 1.Identifyinginformation;
3151+515 2.Licensuredata;
3152+516 3.AdverseActionsagainstalicenseorPrivilegetoPractice;
3153+517 4.Non-confidentialinformationrelatedtoAlternativeProgramparticipation;
3154+518 5.Anydenialofapplicationforlicensure,andthereason(s)forsuchdenial;
3155+519 6.CurrentSignificantInvestigativeInformation;and
3156+520 7.OtherinformationthatmayfacilitatetheadministrationofthisCompact,as
3157+521determinedbytheRulesoftheCommission.
3158+522 C.InvestigativeInformationpertainingtoaLicenseeinanyMemberStatewill
3159+523onlybeavailabletootherMemberStates.
3160+524 D.TheCommissionshallpromptlynotifyallMemberStatesofanyAdverse
3161+525ActiontakenagainstaLicenseeoranindividualapplyingforalicense.AdverseAction
3162+526informationpertainingtoaLicenseeinanyMemberStatewillbeavailabletoanyother
3163+527MemberState.
3164+528 E.MemberStatescontributinginformationtotheDataSystemmaydesignate
3165+529informationthatmaynotbesharedwiththepublicwithouttheexpresspermissionof
3166+530thecontributingState.
3167+531 F.AnyinformationsubmittedtotheDataSystemthatissubsequentlyrequired
3168+532tobeexpungedbythelawsoftheMemberStatecontributingtheinformationshallbe
3169+533removedfromtheDataSystem.
3170+534 SECTION11.RULEMAKING
3171+HCSSSSCSSB157 87 535 A.TheCommissionshallpromulgatereasonableRulesinordertoeffectively
3172+536andefficientlyachievethepurposeoftheCompact.Notwithstandingtheforegoing,in
3173+537theeventtheCommissionexercisesitsRulemakingauthorityinamannerthatisbeyond
3174+538thescopeofthepurposesoftheCompact,orthepowersgrantedhereunder,thensuch
3175+539anactionbytheCommissionshallbeinvalidandhavenoforceoreffect.
3176+540 B.TheCommissionshallexerciseitsRulemakingpowerspursuanttothe
3177+541criteriasetforthinthisSectionandtheRulesadoptedthereunder.Rulesand
3178+542amendmentsshallbecomebindingasofthedatespecifiedineachRuleoramendment.
3179+543 C.IfamajorityofthelegislaturesoftheMemberStatesrejectsaRule,by
3180+544enactmentofastatuteorresolutioninthesamemannerusedtoadopttheCompact
3181+545withinfour(4)yearsofthedateofadoptionoftheRule,thensuchRuleshallhaveno
3182+546furtherforceandeffectinanyMemberState.
3183+547 D.RulesoramendmentstotheRulesshallbeadoptedataregularorspecial
3184+548meetingoftheCommission.
3185+549 E.PriortopromulgationandadoptionofafinalRuleorRulesbythe
3186+550Commission,andatleastthirty(30)daysinadvanceofthemeetingatwhichtheRule
3187+551willbeconsideredandvotedupon,theCommissionshallfileaNoticeofProposed
3188+552Rulemaking:
3189+553 1.OnthewebsiteoftheCommissionorotherpubliclyaccessibleplatform;and
3190+554 2.OnthewebsiteofeachMemberStateProfessionalCounselingLicensing
3191+555BoardorotherpubliclyaccessibleplatformorthepublicationinwhicheachState
3192+556wouldotherwisepublishproposedRules.
3193+557 F.TheNoticeofProposedRulemakingshallinclude:
3194+558 1.Theproposedtime,date,andlocationofthemeetinginwhichtheRulewillbe
3195+559consideredandvotedupon;
3196+560 2.ThetextoftheproposedRuleoramendmentandthereasonfortheproposed
3197+561Rule;
3198+562 3.ArequestforcommentsontheproposedRulefromanyinterestedperson;
3199+563and
3200+564 4.ThemannerinwhichinterestedpersonsmaysubmitnoticetotheCommission
3201+565oftheirintentiontoattendthepublichearingandanywrittencomments.
3202+566 G.PriortoadoptionofaproposedRule,theCommissionshallallowpersonsto
3203+567submitwrittendata,facts,opinions,andarguments,whichshallbemadeavailableto
3204+568thepublic.
3205+569 H.TheCommissionshallgrantanopportunityforapublichearingbeforeit
3206+570adoptsaRuleoramendmentifahearingisrequestedby:
3207+571 1.Atleasttwenty-five(25)persons;
3208+HCSSSSCSSB157 88 572 2.AStateorfederalgovernmentalsubdivisionoragency;or
3209+573 3.Anassociationhavingatleasttwenty-five(25)members.
3210+574 I.IfahearingisheldontheproposedRuleoramendment,theCommissionshall
3211+575publishtheplace,time,anddateofthescheduledpublichearing.Ifthehearingisheld
3212+576viaelectronicmeans,theCommissionshallpublishthemechanismforaccesstothe
3213+577electronichearing.
3214+578 1.Allpersonswishingtobeheardatthehearingshallnotifytheexecutive
3215+579directoroftheCommissionorotherdesignatedmemberinwritingoftheirdesireto
3216+580appearandtestifyatthehearingnotlessthanfive(5)businessdaysbeforethescheduled
3217+581dateofthehearing.
3218+582 2.Hearingsshallbeconductedinamannerprovidingeachpersonwhowishesto
3219+583commentafairandreasonableopportunitytocommentorallyorinwriting.
3220+584 3.Allhearingswillberecorded.Acopyoftherecordingwillbemadeavailable
3221+585onrequest.
3222+586 4.Nothinginthissectionshallbeconstruedasrequiringaseparatehearingon
3223+587eachRule.RulesmaybegroupedfortheconvenienceoftheCommissionathearings
3224+588requiredbythissection.
3225+589 J.Followingthescheduledhearingdate,orbythecloseofbusinessonthe
3226+590scheduledhearingdateifthehearingwasnotheld,theCommissionshallconsiderall
3227+591writtenandoralcommentsreceived.
3228+592 K.Ifnowrittennoticeofintenttoattendthepublichearingbyinterestedparties
3229+593isreceived,theCommissionmayproceedwithpromulgationoftheproposedRule
3230+594withoutapublichearing.
3231+595 L.TheCommissionshall,bymajorityvoteofallmembers,takefinalactionon
3232+596theproposedRuleandshalldeterminetheeffectivedateoftheRule,ifany,basedonthe
3233+597RulemakingrecordandthefulltextoftheRule.
3234+598 M.Upondeterminationthatanemergencyexists,theCommissionmayconsider
3235+599andadoptanemergencyRulewithoutpriornotice,opportunityforcomment,or
3236+600hearing,providedthattheusualRulemakingproceduresprovidedintheCompactand
3237+601inthissectionshallberetroactivelyappliedtotheRuleassoonasreasonablypossible,in
3238+602noeventlaterthanninety(90)daysaftertheeffectivedateoftheRule.Forthepurposes
3239+603ofthisprovision,anemergencyRuleisonethatmustbeadoptedimmediatelyinorder
3240+604to:
3241+605 1.Meetanimminentthreattopublichealth,safety,orwelfare;
3242+606 2.PreventalossofCommissionorMemberStatefunds;
3243+607 3.MeetadeadlineforthepromulgationofanadministrativeRulethatis
3244+608establishedbyfederallaworRule;or
3245+HCSSSSCSSB157 89 609 4.Protectpublichealthandsafety.
3246+610 N.TheCommissionoranauthorizedcommitteeoftheCommissionmaydirect
3247+611revisionstoapreviouslyadoptedRuleoramendmentforpurposesofcorrecting
3248+612typographicalerrors,errorsinformat,errorsinconsistency,orgrammaticalerrors.
3249+613PublicnoticeofanyrevisionsshallbepostedonthewebsiteoftheCommission.The
3250+614revisionshallbesubjecttochallengebyanypersonforaperiodofthirty(30)daysafter
3251+615posting.Therevisionmaybechallengedonlyongroundsthattherevisionresultsina
3252+616materialchangetoaRule.Achallengeshallbemadeinwritinganddeliveredtothe
3253+617chairoftheCommissionpriortotheendofthenoticeperiod.Ifnochallengeismade,
3254+618therevisionwilltakeeffectwithoutfurtheraction.Iftherevisionischallenged,the
3255+619revisionmaynottakeeffectwithouttheapprovaloftheCommission.
3256+620 SECTION 12.OVERSIGHT ,DISPUTE RESOLUTION, AND
3257+621ENFORCEMENT
3258+622 A.Oversight
3259+623 1.Theexecutive,legislative,andjudicialbranchesofStategovernmentineach
3260+624MemberStateshallenforcethisCompactandtakeallactionsnecessaryand
3261+625appropriatetoeffectuatetheCompact'spurposesandintent.Theprovisionsofthis
3262+626CompactandtheRulespromulgatedhereundershallhavestandingasstatutorylaw.
3263+627 2.AllcourtsshalltakejudicialnoticeoftheCompactandtheRulesinany
3264+628judicialoradministrativeproceedinginaMemberStatepertainingtothesubject
3265+629matterofthisCompactwhichmayaffectthepowers,responsibilities,oractionsofthe
3266+630Commission.
3267+631 3.TheCommissionshallbeentitledtoreceiveserviceofprocessinanysuch
3268+632proceedingandshallhavestandingtointerveneinsuchaproceedingforallpurposes.
3269+633FailuretoprovideserviceofprocesstotheCommissionshallrenderajudgmentor
3270+634ordervoidastotheCommission,thisCompact,orpromulgatedRules.
3271+635 B.Default,TechnicalAssistance,andTermination
3272+636 1.IftheCommissiondeterminesthataMemberStatehasdefaultedinthe
3273+637performanceofitsobligationsorresponsibilitiesunderthisCompactorthe
3274+638promulgatedRules,theCommissionshall:
3275+639 a.ProvidewrittennoticetothedefaultingStateandotherMemberStatesofthe
3276+640natureofthedefault,theproposedmeansofcuringthedefaultand/oranyotheraction
3277+641tobetakenbytheCommission;and
3278+642 b.Provideremedialtrainingandspecifictechnicalassistanceregardingthe
3279+643default.
3280+644 C.IfaStateindefaultfailstocurethedefault,thedefaultingStatemaybe
3281+645terminatedfromtheCompactuponanaffirmativevoteofamajorityoftheMember
3282+HCSSSSCSSB157 90 646States,andallrights,privilegesandbenefitsconferredbythisCompactmaybe
3283+647terminatedontheeffectivedateoftermination.Acureofthedefaultdoesnotrelieve
3284+648theoffendingStateofobligationsorliabilitiesincurredduringtheperiodofdefault.
3285+649 D.TerminationofmembershipintheCompactshallbeimposedonlyafterall
3286+650othermeansofsecuringcompliancehavebeenexhausted.Noticeofintenttosuspendor
3287+651terminateshallbegivenbytheCommissiontothegovernor,themajorityandminority
3288+652leadersofthedefaultingState'slegislature,andeachoftheMemberStates.
3289+653 E.AStatethathasbeenterminatedisresponsibleforallassessments,
3290+654obligations,andliabilitiesincurredthroughtheeffectivedateoftermination,including
3291+655obligationsthatextendbeyondtheeffectivedateoftermination.
3292+656 F.TheCommissionshallnotbearanycostsrelatedtoaStatethatisfoundtobe
3293+657indefaultorthathasbeenterminatedfromtheCompact,unlessagreeduponinwriting
3294+658betweentheCommissionandthedefaultingState.
3295+659 G.ThedefaultingStatemayappealtheactionoftheCommissionbypetitioning
3296+660theU.S.DistrictCourtfortheDistrictofColumbiaorthefederaldistrictwherethe
3297+661Commissionhasitsprincipaloffices.Theprevailingmembershallbeawardedallcosts
3298+662ofsuchlitigation,includingreasonableattorney'sfees.
3299+663 H.DisputeResolution
3300+664 1.UponrequestbyaMemberState,theCommissionshallattempttoresolve
3301+665disputesrelatedtotheCompactthatariseamongMemberStatesandbetweenmember
3302+666andnon-MemberStates.
3303+667 2.TheCommissionshallpromulgateaRuleprovidingforbothmediationand
3304+668bindingdisputeresolutionfordisputesasappropriate.
3305+669 I.Enforcement
3306+670 1.TheCommission,inthereasonableexerciseofitsdiscretion,shallenforcethe
3307+671provisionsandRulesofthisCompact.
3308+672 2.Bymajorityvote,theCommissionmayinitiatelegalactionintheUnited
3309+673StatesDistrictCourtfortheDistrictofColumbiaorthefederaldistrictwherethe
3310+674CommissionhasitsprincipalofficesagainstaMemberStateindefaulttoenforce
3311+675compliancewiththeprovisionsoftheCompactanditspromulgatedRulesandbylaws.
3312+676Thereliefsoughtmayincludebothinjunctivereliefanddamages.Intheeventjudicial
3313+677enforcementisnecessary,theprevailingmembershallbeawardedallcostsofsuch
3314+678litigation,includingreasonableattorney'sfees.
3315+679 3.TheremedieshereinshallnotbetheexclusiveremediesoftheCommission.
3316+680TheCommissionmaypursueanyotherremediesavailableunderfederalorStatelaw.
3317+HCSSSSCSSB157 91 681 SECTION13.DATEOFIMPLEMENTATIONOFTHECOUNSELING
3318+682COMPACTCOMMISSION ANDASSOCIATEDRULES,WITHDRAWAL,AND
3319+683AMENDMENT
3320+684 A.TheCompactshallcomeintoeffectonthedateonwhichtheCompactstatute
3321+685isenactedintolawinthetenthMemberState.Theprovisions,whichbecomeeffective
3322+686atthattime,shallbelimitedtothepowersgrantedtotheCommissionrelatingto
3323+687assemblyandthepromulgationofRules.Thereafter,theCommissionshallmeetand
3324+688exerciseRulemakingpowersnecessarytotheimplementationandadministrationofthe
3325+689Compact.
3326+690 B.AnyStatethatjoinstheCompactsubsequenttotheCommission'sinitial
3327+691adoptionoftheRulesshallbesubjecttotheRulesastheyexistonthedateonwhichthe
3328+692CompactbecomeslawinthatState.AnyRulethathasbeenpreviouslyadoptedbythe
3329+693CommissionshallhavethefullforceandeffectoflawonthedaytheCompactbecomes
3330+694lawinthatState.
3331+695 C.AnyMemberStatemaywithdrawfromthisCompactbyenactingastatute
3332+696repealingthesame.
3333+697 1.AMemberState'swithdrawalshallnottakeeffectuntilsix(6)monthsafter
3334+698enactmentoftherepealingstatute.
3335+699 2.Withdrawalshallnotaffectthecontinuingrequirementofthewithdrawing
3336+700State'sProfessionalCounselingLicensingBoardtocomplywiththeinvestigativeand
3337+701AdverseActionreportingrequirementsofthisactpriortotheeffectivedateof
3338+702withdrawal.
3339+703 D.NothingcontainedinthisCompactshallbeconstruedtoinvalidateorprevent
3340+704anyProfessionalCounselinglicensureagreementorothercooperativearrangement
3341+705betweenaMemberStateandanon-MemberStatethatdoesnotconflictwiththe
3342+706provisionsofthisCompact.
3343+707 E.ThisCompactmaybeamendedbytheMemberStates.Noamendmenttothis
3344+708CompactshallbecomeeffectiveandbindinguponanyMemberStateuntilitisenacted
3345+709intothelawsofallMemberStates.
3346+710 SECTION14.CONSTRUCTION ANDSEVERABILITY
3347+711 ThisCompactshallbeliberallyconstruedsoastoeffectuatethepurposes
3348+712thereof.TheprovisionsofthisCompactshallbeseverableandifanyphrase,clause,
3349+713sentenceorprovisionofthisCompactisdeclaredtobecontrarytotheconstitutionof
3350+714anyMemberStateoroftheUnitedStatesortheapplicabilitythereoftoany
3351+715government,agency,personorcircumstanceisheldinvalid,thevalidityofthe
3352+716remainderofthisCompactandtheapplicabilitythereoftoanygovernment,agency,
3353+717personorcircumstanceshallnotbeaffectedthereby.IfthisCompactshallbeheld
3354+HCSSSSCSSB157 92 718contrarytotheconstitutionofanyMemberState,theCompactshallremaininfullforce
3355+719andeffectastotheremainingMemberStatesandinfullforceandeffectastothe
3356+720MemberStateaffectedastoallseverablematters.
3357+721 SECTION15.BINDINGEFFECTOFCOMPACTANDOTHERLAWS
3358+722 A.ALicenseeprovidingProfessionalCounselingservicesinaRemoteState
3359+723underthePrivilegetoPracticeshalladheretothelawsandregulations,includingscope
3360+724ofpractice,oftheRemoteState.
3361+725 B.NothinghereinpreventstheenforcementofanyotherlawofaMemberState
3362+726thatisnotinconsistentwiththeCompact.
3363+727 C.AnylawsinaMemberStateinconflictwiththeCompactaresupersededto
3364+728theextentoftheconflict.
3365+729 D.AnylawfulactionsoftheCommission,includingallRulesandbylaws
3366+730properlypromulgatedbytheCommission,arebindingupontheMemberStates.
3367+731 E.AllpermissibleagreementsbetweentheCommissionandtheMemberStates
3368+732arebindinginaccordancewiththeirterms.
3369+733 F.IntheeventanyprovisionoftheCompactexceedstheconstitutionallimits
3370+734imposedonthelegislatureofanyMemberState,theprovisionshallbeineffectivetothe
3371+735extentoftheconflictwiththeconstitutionalprovisioninquestioninthatMemberState.
3372+337.615.1.Asusedinthissection,thefollowingtermsmean:
3373+2 (1)"License",alicense,certificate,registration,permit,accreditation,or
3374+3militaryoccupationalspecialtythatenablesapersontolegallypracticeanoccupationor
3375+4professioninaparticularjurisdiction;
3376+5 (2)"Military",theArmedForcesoftheUnitedStates,includingtheAirForce,
3377+6Army,CoastGuard,MarineCorps,Navy,SpaceForce,NationalGuard,andanyother
3378+7militarybranchthatisdesignatedbyCongressaspartoftheArmedForcesofthe
3379+8UnitedStates,andallreservecomponentsandauxiliaries.Theterm"military"also
3380+9includesthemilitaryreservesandmilitiaofanyUnitedStatesterritoryorstate;
3381+10 (3)"Nonresidentmilitaryspouse",anonresidentspouseofanactive-duty
3382+11memberoftheArmedForcesoftheUnitedStateswhohasbeentransferredoris
3383+12scheduledtobetransferredtothestateofMissouri,orwhohasbeentransferredoris
3384+13scheduledtobetransferredtoanadjacentstateandisorwillbedomiciledinthestateof
3385+14Missouri,orhasmovedtothestateofMissourionapermanentchange-of-stationbasis;
3386+15 (4)"Oversightbody",anyboard,department,agency,orofficeofajurisdiction
3387+16thatissueslicenses;
3388+17 (5)"Residentmilitaryspouse",aspouseofanactive-dutymemberoftheArmed
3389+18ForcesoftheUnitedStateswhohasbeentransferredorisscheduledtobetransferredto
3390+19thestateofMissourioranadjacentstateandwhoisapermanentresidentofthestateof
3391+HCSSSSCSSB157 93 20Missouri,whoisdomiciledinthestateofMissouri,orwhohasMissouriashisorher
3392+21homeofrecord.
3393+22 2.Eachapplicantforlicensureasaclinicalsocialworkershallfurnishevidencetothe
3394+23committeethat:
3395+24 (1)Theapplicanthasamaster'sdegreefromacollegeoruniversityprogramofsocial
3396+25workaccreditedbythecouncilofsocialworkeducationoradoctoratedegreefromaschool
3397+26ofsocialworkacceptabletothecommittee;
3398+27 (2)Theapplicanthascompletedatleastthreethousandhoursofsupervisedclinical
3399+28experiencewithaqualifiedclinicalsupervisor,asdefinedinsection337.600,innolessthan
3400+29twenty-fourmonthsandnomorethanforty-eightconsecutivecalendarmonths.Forany
3401+30applicantwhohassuccessfullycompletedatleastfourthousandhoursofsupervisedclinical
3402+31experiencewithaqualifiedclinicalsupervisor,asdefinedinsection337.600,withinthesame
3403+32timeframeprescribedinthissubsection,theapplicantshallbeeligibleforapplicationof
3404+33licensureatthreethousandhoursandshallbefurnishedacertificatebythestatecommittee
3405+34forsocialworkersacknowledgingthecompletionofsaidadditionalhours;
3406+35 (3)Theapplicanthasachievedapassingscore,asdefinedbythecommittee,onan
3407+36examinationapprovedbythecommittee.Theeligibilityrequirementsforsuchexamination
3408+37shallbepromulgatedbyruleofthecommittee;and
3409+38 (4)Theapplicantisatleasteighteenyearsofage,isaUnitedStatescitizenorhas
3410+39statusasalegalresidentalien,andhasnotbeenfinallyadjudicatedandfoundguilty,or
3411+40enteredapleaofguiltyornolocontendere,inacriminalprosecutionunderthelawsofany
3412+41state,oftheUnitedStates,orofanycountry,foranyoffensedirectlyrelatedtothedutiesand
3413+42responsibilitiesoftheoccupation,assetforthinsection324.012,regardlessofwhetherornot
3414+43sentencehasbeenimposed.
3415+44 [2.Anypersonholdingacurrentlicense,certificateofregistration,orpermitfrom
3416+45anotherstateorterritoryoftheUnitedStatesortheDistrictofColumbiatopracticeclinical
3417+46socialworkwhodoesnotmeettherequirementsofsection324.009andwhohashadno
3418+47disciplinaryactiontakenagainstthelicense,certificateofregistration,orpermitforthe
3419+48precedingfiveyearsmaybegrantedalicensetopracticeclinicalsocialworkinthisstateif
3420+49thepersonhasreceivedamastersordoctoraldegreefromacollegeoruniversityprogramof
3421+50socialworkaccreditedbythecouncilofsocialworkeducationandhasbeenlicensedto
3422+51practiceclinicalsocialworkfortheprecedingfiveyears.]
3423+52 3.(1)Anypersonwhoholdsavalidcurrentclinicalsocialworklicenseissuedby
3424+53anotherstate,abranchorunitofthemilitary,aterritoryoftheUnitedStates,orthe
3425+54DistrictofColumbia,andwhohasbeenlicensedforatleastoneyearinsuchother
3426+55jurisdiction,maysubmittothecommitteeanapplicationforaclinicalsocialwork
3427+HCSSSSCSSB157 94 56licenseinMissourialongwithproofofcurrentlicensureandproofoflicensureforat
3428+57leastoneyearintheotherjurisdiction.
3429+58 (2)Thecommitteeshall:
3430+59 (a)Withinsixmonthsofreceivinganapplicationdescribedinsubdivision(1)of
3431+60thissubsection,waiveanyexamination,educational,orexperiencerequirementsfor
3432+61licensureinthisstatefortheapplicantifitdeterminesthattherewereminimum
3433+62educationrequirementsand,ifapplicable,workexperienceandclinicalsupervision
3434+63requirementsineffectandtheotherjurisdictionverifiesthatthepersonmetthose
3435+64requirementsinordertobelicensedorcertifiedinthatjurisdiction.Thecommittee
3436+65mayrequireanapplicanttotakeandpassanexaminationspecifictothelawsofthis
3437+66state;or
3438+67 (b)Withinthirtydaysofreceivinganapplicationdescribedinsubdivision(1)of
3439+68thissubsectionfromanonresidentmilitaryspouseoraresidentmilitaryspouse,waive
3440+69anyexamination,educational,orexperiencerequirementsforlicensureinthisstatefor
3441+70theapplicantandissuesuchapplicantalicenseunderthissubsectionifsuchapplicant
3442+71otherwisemeetstherequirementsofthissubsection.
3443+72 (3)(a)Thecommitteeshallnotwaiveanyexamination,educational,or
3444+73experiencerequirementsforanyapplicantwhohashadhisorherlicenserevokedbyan
3445+74oversightbodyoutsidethestate;whoiscurrentlyunderinvestigation,whohasa
3446+75complaintpending,orwhoiscurrentlyunderdisciplinaryaction,exceptasprovidedin
3447+76paragraph(b)ofthissubdivision,withanoversightbodyoutsidethestate;whodoesnot
3448+77holdalicenseingoodstandingwithanoversightbodyoutsidethestate;whohasa
3449+78criminalrecordthatwoulddisqualifyhimorherforlicensureinMissouri;orwhodoes
3450+79notholdavalidcurrentlicenseintheotherjurisdictiononthedatethecommittee
3451+80receiveshisorherapplicationunderthissection.
3452+81 (b)Ifanotherjurisdictionhastakendisciplinaryactionagainstanapplicant,the
3453+82committeeshalldetermineifthecausefortheactionwascorrectedandthematter
3454+83resolved.Ifthematterhasnotbeenresolvedbythatjurisdiction,thecommitteemay
3455+84denyalicenseuntilthematterisresolved.
3456+85 (4)Nothinginthissubsectionshallprohibitthecommitteefromdenyinga
3457+86licensetoanapplicantunderthissubsectionforanyreasondescribedinsection337.630.
3458+87 (5)Anypersonwhoislicensedundertheprovisionsofthissubsectionshallbe
3459+88subjecttothecommittee'sjurisdictionandallrulesandregulationspertainingtothe
3460+89practiceasalicensedclinicalsocialworkerinthisstate.
3461+90 (6)Thissubsectionshallnotbeconstruedtowaiveanyrequirementforan
3462+91applicanttopayanyfees.
3463+HCSSSSCSSB157 95 92 4.Thecommitteeshallissuealicensetoeachpersonwhofilesanapplicationandfee
3464+93asrequiredbytheprovisionsofsections337.600to337.689andwhofurnishesevidence
3465+94satisfactorytothecommitteethattheapplicanthascompliedwiththeprovisionsof
3466+95subdivisions(1)to(4)ofsubsection[1]2ofthissection[orwiththeprovisionsofsubsection
3467+962ofthissection].
3468+337.644.1.Asusedinthissection,thefollowingtermsmean:
3469+2 (1)"License",alicense,certificate,registration,permit,accreditation,or
3470+3militaryoccupationalspecialtythatenablesapersontolegallypracticeanoccupationor
3471+4professioninaparticularjurisdiction;
3472+5 (2)"Military",theArmedForcesoftheUnitedStates,includingtheAirForce,
3473+6Army,CoastGuard,MarineCorps,Navy,SpaceForce,NationalGuard,andanyother
3474+7militarybranchthatisdesignatedbyCongressaspartoftheArmedForcesofthe
3475+8UnitedStates,andallreservecomponentsandauxiliaries.Theterm"military"also
3476+9includesthemilitaryreservesandmilitiaofanyUnitedStatesterritoryorstate;
3477+10 (3)"Nonresidentmilitaryspouse",anonresidentspouseofanactive-duty
3478+11memberoftheArmedForcesoftheUnitedStateswhohasbeentransferredoris
3479+12scheduledtobetransferredtothestateofMissouri,orwhohasbeentransferredoris
3480+13scheduledtobetransferredtoanadjacentstateandisorwillbedomiciledinthestateof
3481+14Missouri,orhasmovedtothestateofMissourionapermanentchange-of-stationbasis;
3482+15 (4)"Oversightbody",anyboard,department,agency,orofficeofajurisdiction
3483+16thatissueslicenses;
3484+17 (5)"Residentmilitaryspouse",aspouseofanactive-dutymemberoftheArmed
3485+18ForcesoftheUnitedStateswhohasbeentransferredorisscheduledtobetransferredto
3486+19thestateofMissourioranadjacentstateandwhoisapermanentresidentofthestateof
3487+20Missouri,whoisdomiciledinthestateofMissouri,orwhohasMissouriashisorher
3488+21homeofrecord.
3489+22 2.Eachapplicantforlicensureasamastersocialworkershallfurnishevidencetothe
3490+23committeethat:
3491+24 (1)Theapplicanthasamaster'sordoctoratedegreeinsocialworkfromanaccredited
3492+25socialworkdegreeprogramapprovedbythecouncilofsocialworkeducation;
3493+26 (2)Theapplicanthasachievedapassingscore,asdefinedbythecommittee,onan
3494+27examinationapprovedbythecommittee.Theeligibilityrequirementsforsuchexamination
3495+28shallbedeterminedbythestatecommitteeforsocialworkers;
3496+29 (3)Theapplicantisatleasteighteenyearsofage,isaUnitedStatescitizenorhas
3497+30statusasalegalresidentalien,andhasnotbeenfinallyadjudicatedandfoundguilty,or
3498+31enteredapleaofguiltyornolocontendere,inacriminalprosecutionunderthelawsofany
3499+32state,oftheUnitedStates,orofanycountry,foranyoffensedirectlyrelatedtothedutiesand
3500+HCSSSSCSSB157 96 33responsibilitiesoftheoccupation,assetforthinsection324.012,regardless[or]ofwhetheror
3501+34notsentenceisimposed;
3502+35 (4)Theapplicanthassubmittedawrittenapplicationonformsprescribedbythestate
3503+36board;and
3504+37 (5)Theapplicanthassubmittedtherequiredlicensingfee,asdeterminedbythe
3505+38committee.
3506+39 [2.]3.Anyapplicantwhoanswersintheaffirmativetoanyquestiononthe
3507+40applicationthatrelatestopossiblegroundsfordenialoflicensureundersection337.630shall
3508+41submitaswornaffidavitsettingforthindetailthefactswhichexplainsuchanswerandcopies
3509+42ofappropriatedocumentsrelatedtosuchanswer.
3510+43 [3.]4.Thecommitteeshallissuealicensetoeachpersonwhofilesanapplicationand
3511+44feeasrequiredbytheprovisionsofsections337.600to337.689andwhofurnishesevidence
3512+45satisfactorytothecommitteethattheapplicanthascompliedwiththeprovisionsof
3513+46subsection[1]2ofthissection.Thelicenseshallrefertotheindividualasalicensedmaster
3514+47socialworkerandshallrecognizethatindividual'srighttopracticelicensedmastersocial
3515+48workasdefinedinsection337.600.
3516+49 5.(1)Anypersonwhoholdsavalidcurrentmastersocialworklicenseissuedby
3517+50anotherstate,abranchorunitofthemilitary,aterritoryoftheUnitedStates,orthe
3518+51DistrictofColumbia,andwhohasbeenlicensedforatleastoneyearinsuchother
3519+52jurisdiction,maysubmittothecommitteeanapplicationforamastersocialwork
3520+53licenseinMissourialongwithproofofcurrentlicensureandproofoflicensureforat
3521+54leastoneyearintheotherjurisdiction.
3522+55 (2)Thecommitteeshall:
3523+56 (a)Withinsixmonthsofreceivinganapplicationdescribedinsubdivision(1)of
3524+57thissubsection,waiveanyexamination,educational,orexperiencerequirementsfor
3525+58licensureinthisstatefortheapplicantifitdeterminesthattherewereminimum
3526+59educationrequirementsand,ifapplicable,workexperienceandclinicalsupervision
3527+60requirementsineffectandtheotherjurisdictionverifiesthatthepersonmetthose
3528+61requirementsinordertobelicensedorcertifiedinthatjurisdiction.Thecommittee
3529+62mayrequireanapplicanttotakeandpassanexaminationspecifictothelawsofthis
3530+63state;or
3531+64 (b)Withinthirtydaysofreceivinganapplicationdescribedinsubdivision(1)of
3532+65thissubsectionfromanonresidentmilitaryspouseoraresidentmilitaryspouse,waive
3533+66anyexamination,educational,orexperiencerequirementsforlicensureinthisstatefor
3534+67theapplicantandissuesuchapplicantalicenseunderthissubsectionifsuchapplicant
3535+68otherwisemeetstherequirementsofthissubsection.
3536+HCSSSSCSSB157 97 69 (3)(a)Thecommitteeshallnotwaiveanyexamination,educational,or
3537+70experiencerequirementsforanyapplicantwhohashadhisorherlicenserevokedbyan
3538+71oversightbodyoutsidethestate;whoiscurrentlyunderinvestigation,whohasa
3539+72complaintpending,orwhoiscurrentlyunderdisciplinaryaction,exceptasprovidedin
3540+73paragraph(b)ofthissubdivision,withanoversightbodyoutsidethestate;whodoesnot
3541+74holdalicenseingoodstandingwithanoversightbodyoutsidethestate;whohasa
3542+75criminalrecordthatwoulddisqualifyhimorherforlicensureinMissouri;orwhodoes
3543+76notholdavalidcurrentlicenseintheotherjurisdictiononthedatethecommittee
3544+77receiveshisorherapplicationunderthissection.
3545+78 (b)Ifanotherjurisdictionhastakendisciplinaryactionagainstanapplicant,the
3546+79committeeshalldetermineifthecausefortheactionwascorrectedandthematter
3547+80resolved.Ifthematterhasnotbeenresolvedbythatjurisdiction,thecommitteemay
3548+81denyalicenseuntilthematterisresolved.
3549+82 (4)Nothinginthissubsectionshallprohibitthecommitteefromdenyinga
3550+83licensetoanapplicantunderthissubsectionforanyreasondescribedinsection337.630.
3551+84 (5)Anypersonwhoislicensedundertheprovisionsofthissubsectionshallbe
3552+85subjecttothecommittee'sjurisdictionandallrulesandregulationspertainingtothe
3553+86practiceasalicensedmastersocialworkerinthisstate.
3554+87 (6)Thissubsectionshallnotbeconstruedtowaiveanyrequirementforan
3555+88applicanttopayanyfees.
3556+337.665.1.Asusedinthissection,thefollowingtermsmean:
3557+2 (1)"License",alicense,certificate,registration,permit,accreditation,or
3558+3militaryoccupationalspecialtythatenablesapersontolegallypracticeanoccupationor
3559+4professioninaparticularjurisdiction;
3560+5 (2)"Military",theArmedForcesoftheUnitedStates,includingtheAirForce,
3561+6Army,CoastGuard,MarineCorps,Navy,SpaceForce,NationalGuard,andanyother
3562+7militarybranchthatisdesignatedbyCongressaspartoftheArmedForcesofthe
3563+8UnitedStates,andallreservecomponentsandauxiliaries.Theterm"military"also
3564+9includesthemilitaryreservesandmilitiaofanyUnitedStatesterritoryorstate;
3565+10 (3)"Nonresidentmilitaryspouse",anonresidentspouseofanactive-duty
3566+11memberoftheArmedForcesoftheUnitedStateswhohasbeentransferredoris
3567+12scheduledtobetransferredtothestateofMissouri,orwhohasbeentransferredoris
3568+13scheduledtobetransferredtoanadjacentstateandisorwillbedomiciledinthestateof
3569+14Missouri,orhasmovedtothestateofMissourionapermanentchange-of-stationbasis;
3570+15 (4)"Oversightbody",anyboard,department,agency,orofficeofajurisdiction
3571+16thatissueslicenses;
3572+HCSSSSCSSB157 98 17 (5)"Residentmilitaryspouse",aspouseofanactive-dutymemberoftheArmed
3573+18ForcesoftheUnitedStateswhohasbeentransferredorisscheduledtobetransferredto
3574+19thestateofMissourioranadjacentstateandwhoisapermanentresidentofthestateof
3575+20Missouri,whoisdomiciledinthestateofMissouri,orwhohasMissouriashisorher
3576+21homeofrecord.
3577+22 2.Eachapplicantforlicensureasabaccalaureatesocialworkershallfurnishevidence
3578+23tothecommitteethat:
3579+24 (1)Theapplicanthasabaccalaureatedegreeinsocialworkfromanaccreditedsocial
3580+25workdegreeprogramapprovedbythecouncilofsocialworkeducation;
3581+26 (2)Theapplicanthasachievedapassingscore,asdefinedbythecommittee,onan
3582+27examinationapprovedbythecommittee.Theeligibilityrequirementsforsuchexamination
3583+28shallbedeterminedbythestatecommitteeforsocialwork;
3584+29 (3)Theapplicantisatleasteighteenyearsofage,isaUnitedStatescitizenorhas
3585+30statusasalegalresidentalien,andhasnotbeenfinallyadjudicatedandfoundguilty,or
3586+31enteredapleaofguiltyornolocontendere,inacriminalprosecutionunderthelawsofany
3587+32state,oftheUnitedStates,orofanycountry,foranyoffensedirectlyrelatedtothedutiesand
3588+33responsibilitiesoftheoccupation,assetforthinsection324.012,regardlessofwhetherornot
3589+34sentenceisimposed;
3590+35 (4)Theapplicanthassubmittedawrittenapplicationonformsprescribedbythestate
3591+36board;and
3592+37 (5)Theapplicanthassubmittedtherequiredlicensingfee,asdeterminedbythe
3593+38committee.
3594+39 [2.]3.Anyapplicantwhoanswersintheaffirmativetoanyquestiononthe
3595+40applicationthatrelatestopossiblegroundsfordenialoflicensurepursuanttosection337.630
3596+41shallsubmitaswornaffidavitsettingforthindetailthefactswhichexplainsuchanswerand
3597+42copiesofappropriatedocumentsrelatedtosuchanswer.
3598+43 [3.]4.Thecommitteeshallissuealicensetoeachpersonwhofilesanapplicationand
3599+44feeasrequiredbytheprovisionsofsections337.600to337.689andwhofurnishesevidence
3600+45satisfactorytothecommitteethattheapplicanthascompliedwiththeprovisionsof
3601+46subsection[1]2ofthissection.
3602+47 [4.]5.Thecommitteeshallissueacertificatetopracticeindependentlyunder
3603+48subsection3ofsection337.653toanylicensedbaccalaureatesocialworkerwhohas
3604+49satisfactorilycompletedthreethousandhoursofsupervisedexperiencewithaqualified
3605+50baccalaureatesupervisorinnolessthantwenty-fourmonthsandnomorethanforty-eight
3606+51consecutivecalendarmonths.
3607+52 6.(1)Anypersonwhoholdsavalidcurrentbaccalaureatesocialworklicense
3608+53issuedbyanotherstate,abranchorunitofthemilitary,aterritoryoftheUnitedStates,
3609+HCSSSSCSSB157 99 54ortheDistrictofColumbia,andwhohasbeenlicensedforatleastoneyearinsuchother
3610+55jurisdiction,maysubmittothecommitteeanapplicationforabaccalaureatesocial
3611+56worklicenseinMissourialongwithproofofcurrentlicensureandproofoflicensurefor
3612+57atleastoneyearintheotherjurisdiction.
3613+58 (2)Thecommitteeshall:
3614+59 (a)Withinsixmonthsofreceivinganapplicationdescribedinsubdivision(1)of
3615+60thissubsection,waiveanyexamination,educational,orexperiencerequirementsfor
3616+61licensureinthisstatefortheapplicantifitdeterminesthattherewereminimum
3617+62educationrequirementsand,ifapplicable,workexperienceandclinicalsupervision
3618+63requirementsineffectandtheotherjurisdictionverifiesthatthepersonmetthose
3619+64requirementsinordertobelicensedorcertifiedinthatjurisdiction.Thecommittee
3620+65mayrequireanapplicanttotakeandpassanexaminationspecifictothelawsofthis
3621+66state;or
3622+67 (b)Withinthirtydaysofreceivinganapplicationdescribedinsubdivision(1)of
3623+68thissubsectionfromanonresidentmilitaryspouseoraresidentmilitaryspouse,waive
3624+69anyexamination,educational,orexperiencerequirementsforlicensureinthisstatefor
3625+70theapplicantandissuesuchapplicantalicenseunderthissubsectionifsuchapplicant
3626+71otherwisemeetstherequirementsofthissubsection.
3627+72 (3)(a)Thecommitteeshallnotwaiveanyexamination,educational,or
3628+73experiencerequirementsforanyapplicantwhohashadhisorherlicenserevokedbyan
3629+74oversightbodyoutsidethestate;whoiscurrentlyunderinvestigation,whohasa
3630+75complaintpending,orwhoiscurrentlyunderdisciplinaryaction,exceptasprovidedin
3631+76paragraph(b)ofthissubdivision,withanoversightbodyoutsidethestate;whodoesnot
3632+77holdalicenseingoodstandingwithanoversightbodyoutsidethestate;whohasa
3633+78criminalrecordthatwoulddisqualifyhimorherforlicensureinMissouri;orwhodoes
3634+79notholdavalidcurrentlicenseintheotherjurisdictiononthedatethecommittee
3635+80receiveshisorherapplicationunderthissection.
3636+81 (b)Ifanotherjurisdictionhastakendisciplinaryactionagainstanapplicant,the
3637+82committeeshalldetermineifthecausefortheactionwascorrectedandthematter
3638+83resolved.Ifthematterhasnotbeenresolvedbythatjurisdiction,thecommitteemay
3639+84denyalicenseuntilthematterisresolved.
3640+85 (4)Nothinginthissubsectionshallprohibitthecommitteefromdenyinga
3641+86licensetoanapplicantunderthissubsectionforanyreasondescribedinsection337.630.
3642+87 (5)Anypersonwhoislicensedundertheprovisionsofthissubsectionshallbe
3643+88subjecttothecommittee'sjurisdictionandallrulesandregulationspertainingtothe
3644+89practiceasalicensedbaccalaureatesocialworkerinthisstate.
3645+HCSSSSCSSB157 100 90 (6)Thissubsectionshallnotbeconstruedtowaiveanyrequirementforan
3646+91applicanttopayanyfees.
3647+337.1000.1.Sections337.1000to337.1075shallbeknownandmaybecitedas
3648+2the"SocialWorkLicensureCompact".
3649+3 2.ThepurposeofthisCompactistofacilitateinterstatepracticeofRegulated
3650+4SocialWorkersbyimprovingpublicaccesstocompetentSocialWorkServices.The
3651+5CompactpreservestheregulatoryauthorityofStatestoprotectpublichealthandsafety
3652+6throughthecurrentsystemofStatelicensure.
3653+7 3.ThisCompactisdesignedtoachievethefollowingobjectives:
3654+8 (1)IncreasepublicaccesstoSocialWorkServices;
3655+9 (2)Reduceoverlyburdensomeandduplicativerequirementsassociatedwith
3656+10holdingmultiplelicenses;
3657+11 (3)EnhancetheMemberStates'abilitytoprotectthepublic'shealthandsafety;
3658+12 (4)EncouragethecooperationofMemberStatesinregulatingmultistate
3659+13practice;
3660+14 (5)Promotemobilityandaddressworkforceshortagesbyeliminatingthe
3661+15necessityforlicensesinmultipleStatesbyprovidingforthemutualrecognitionofother
3662+16MemberStatelicenses;
3663+17 (6)Supportmilitaryfamilies;
3664+18 (7)Facilitatetheexchangeoflicensureanddisciplinaryinformationamong
3665+19MemberStates;
3666+20 (8)AuthorizeallMemberStatestoholdaRegulatedSocialWorkeraccountable
3667+21forabidingbyaMemberState'slaws,regulations,andapplicableprofessional
3668+22standardsintheMemberStateinwhichtheclientislocatedatthetimecareisrendered;
3669+23and
3670+24 (9)Allowfortheuseoftelehealthtofacilitateincreasedaccesstoregulated
3671+25SocialWorkServices.
3672+337.1005.AsusedinthisCompact,andexceptasotherwiseprovided,the
3673+2followingdefinitionsshallapply:
3674+3 (1)"ActiveMilitaryMember"meansanyindividualwithfull-timedutystatusin
3675+4theactivearmedforcesoftheUnitedStatesincludingmembersoftheNationalGuard
3676+5andReserve.
3677+6 (2)"AdverseAction"meansanyadministrative,civil,equitableorcriminal
3678+7actionpermittedbyaState'slawswhichisimposedbyaLicensingAuthorityorother
3679+8authorityagainstaRegulatedSocialWorker,includingactionsagainstanindividual's
3680+9licenseorMultistateAuthorizationtoPracticesuchasrevocation,suspension,
3681+10probation,monitoringoftheLicensee,limitationontheLicensee'spractice,orany
3682+HCSSSSCSSB157 101 11otherEncumbranceonlicensureaffectingaRegulatedSocialWorker'sauthorizationto
3683+12practice,includingissuanceofaceaseanddesistaction.
3684+13 (3)"AlternativeProgram"meansanon-disciplinarymonitoringorpractice
3685+14remediationprocessapprovedbyaLicensingAuthoritytoaddresspractitionerswithan
3686+15Impairment.
3687+16 (4)"CharterMemberStates"meansMemberStateswhohaveenacted
3688+17legislationtoadoptthisCompactwheresuchlegislationpredatestheeffectivedateof
3689+18thisCompactasdescribedinsection337.1065.
3690+19 (5)"CompactCommission"or"Commission"meansthegovernmentagency
3691+20whosemembershipconsistsofallStatesthathaveenactedthisCompact,whichis
3692+21knownastheSocialWorkLicensureCompactCommission,asdescribedinsection
3693+22337.1045,andwhichshalloperateasaninstrumentalityoftheMemberStates.
3694+23 (6)"CurrentSignificantInvestigativeInformation"means:
3695+24 (a)InvestigativeinformationthataLicensingAuthority,afterapreliminary
3696+25inquirythatincludesnotificationandanopportunityfortheRegulatedSocialWorker
3697+26torespondhasreasontobelieveisnotgroundlessand,ifprovedtrue,wouldindicate
3698+27morethanaminorinfractionasmaybedefinedbytheCommission;or
3699+28 (b)InvestigativeinformationthatindicatesthattheRegulatedSocialWorker
3700+29representsanimmediatethreattopublichealthandsafety,asmaybedefinedbythe
3701+30Commission,regardlessofwhethertheRegulatedSocialWorkerhasbeennotifiedand
3702+31hashadanopportunitytorespond.
3703+32 (7)"DataSystem"meansarepositoryofinformationaboutLicensees,including,
3704+33continuingeducation,examination,licensure,CurrentSignificantInvestigative
3705+34Information,DisqualifyingEvent,MultistateLicense(s)andAdverseAction
3706+35informationorotherinformationasrequiredbytheCommission.
3707+36 (8)"Domicile"meansthejurisdictioninwhichtheLicenseeresidesandintends
3708+37toremainindefinitely.
3709+38 (9)"DisqualifyingEvent"meansanyAdverseActionorincidentwhichresults
3710+39inanEncumbrancethatdisqualifiesormakestheLicenseeineligibletoeitherobtain,
3711+40retainorrenewaMultistateLicense.
3712+41 (10)"Encumbrance"meansarevocationorsuspensionof,oranylimitationon,
3713+42thefullandunrestrictedpracticeofSocialWorklicensedandregulatedbyaLicensing
3714+43Authority.
3715+44 (11)"ExecutiveCommittee"meansagroupofdelegateselectedorappointedto
3716+45actonbehalfof,andwithinthepowersgrantedtothemby,thecompactand
3717+46Commission.
3718+HCSSSSCSSB157 102 47 (12)"HomeState"meanstheMemberStatethatistheLicensee'sprimary
3719+48Domicile.
3720+49 (13)"Impairment"meansacondition(s)thatmayimpairapractitioner'sability
3721+50toengageinfullandunrestrictedpracticeasaRegulatedSocialWorkerwithoutsome
3722+51typeofinterventionandmayincludealcoholanddrugdependence,mentalhealth
3723+52impairment,andneurologicalorphysicalimpairments.
3724+53 (14)"Licensee(s)"meansanindividualwhocurrentlyholdsalicensefroma
3725+54StatetopracticeasaRegulatedSocialWorker.
3726+55 (15)"LicensingAuthority"meanstheboardoragencyofaMemberState,or
3727+56equivalent,thatisresponsibleforthelicensingandregulationofRegulatedSocial
3728+57Workers.
3729+58 (16)"MemberState"meansastate,commonwealth,district,orterritoryofthe
3730+59UnitedStatesofAmericathathasenactedthisCompact.
3731+60 (17)"MultistateAuthorizationtoPractice"meansalegallyauthorizedprivilege
3732+61topractice,whichisequivalenttoalicense,associatedwithaMultistateLicense
3733+62permittingthepracticeofSocialWorkinaRemoteState.
3734+63 (18)"MultistateLicense"meansalicensetopracticeasaRegulatedSocial
3735+64WorkerissuedbyaHomeStateLicensingAuthoritythatauthorizestheRegulated
3736+65SocialWorkertopracticeinallMemberStatesunderMultistateAuthorizationto
3737+66Practice.
3738+67 (19)"QualifyingNationalExam"meansanationallicensingexamination
3739+68approvedbytheCommission.
3740+69 (20)"RegulatedSocialWorker"meansanyclinical,master'sorbachelor's
3741+70SocialWorkerlicensedbyaMemberStateregardlessofthetitleusedbythatMember
3742+71State.
3743+72 (21)"RemoteState"meansaMemberStateotherthantheLicensee'sHome
3744+73State.
3745+74 (22)"Rule(s)"or"Rule(s)oftheCommission"meansaregulationorregulations
3746+75dulypromulgatedbytheCommission,asauthorizedbytheCompact,thathastheforce
3747+76oflaw.
3748+77 (23)"SingleStateLicense"meansaSocialWorklicenseissuedbyanyStatethat
3749+78authorizespracticeonlywithintheissuingStateanddoesnotincludeMultistate
3750+79AuthorizationtoPracticeinanyMemberState.
3751+80 (24)"SocialWork"or"SocialWorkServices"meanstheapplicationofsocial
3752+81worktheory,knowledge,methods,ethics,andtheprofessionaluseofselftorestoreor
3753+82enhancesocial,psychosocial,orbiopsychosocialfunctioningofindividuals,couples,
3754+83families,groups,organizations,andcommunitiesthroughthecareandservices
3755+HCSSSSCSSB157 103 84providedbyaRegulatedSocialWorkerassetforthintheMemberState'sstatutesand
3756+85regulationsintheStatewheretheservicesarebeingprovided.
3757+86 (25)"State"meansanystate,commonwealth,district,orterritoryoftheUnited
3758+87StatesofAmericathatregulatesthepracticeofSocialWork.
3759+88 (26)"UnencumberedLicense"meansalicensethatauthorizesaRegulated
3760+89SocialWorkertoengageinthefullandunrestrictedpracticeofSocialWork.
3761+337.1010.1.Tobeeligibletoparticipateinthecompact,apotentialMember
3762+2Statemustcurrentlymeetallofthefollowingcriteria:
3763+3 (1)LicenseandregulatethepracticeofSocialWorkateithertheclinical,
3764+4master's,orbachelor'scategory.
3765+5 (2)Requireapplicantsforlicensuretograduatefromaprogramthatis:
3766+6 (a)OperatedbyacollegeoruniversityrecognizedbytheLicensingAuthority;
3767+7 (b)Accredited,orincandidacybyaninstitutionthatsubsequentlybecomes
3768+8accredited,byanaccreditingagencyrecognizedbyeither:
3769+9 a.theCouncilforHigherEducationAccreditation,oritssuccessor;or
3770+10 b.theUnitedStatesDepartmentofEducation;and
3771+11 (c)Correspondstothelicensuresoughtasoutlinedinsection337.1015.
3772+12 (3)Requireapplicantsforclinicallicensuretocompleteaperiodofsupervised
3773+13practice.
3774+14 (4)Haveamechanisminplaceforreceiving,investigating,andadjudicating
3775+15complaintsaboutLicensees.
3776+16 2.TomaintainmembershipintheCompactaMemberStateshall:
3777+17 (1)RequirethatapplicantsforaMultistateLicensepassaQualifyingNational
3778+18ExamforthecorrespondingcategoryofMultistateLicensesoughtasoutlinedinsection
3779+19337.1015;
3780+20 (2)ParticipatefullyintheCommission'sDataSystem,includingusingthe
3781+21Commission'suniqueidentifierasdefinedinRules;
3782+22 (3)NotifytheCommission,incompliancewiththetermsoftheCompactand
3783+23Rules,ofanyAdverseActionortheavailabilityofCurrentSignificantInvestigative
3784+24InformationregardingaLicensee;
3785+25 (4)Implementproceduresforconsideringthecriminalhistoryrecordsof
3786+26applicantsforaMultistateLicense.Suchproceduresshallincludethesubmissionof
3787+27fingerprintsorotherbiometric-basedinformationbyapplicantsforthepurposeof
3788+28obtaininganapplicant'scriminalhistoryrecordinformationfromtheFederalBureau
3789+29ofInvestigationandtheagencyresponsibleforretainingthatState'scriminalrecords;
3790+30 (5)ComplywiththeRulesoftheCommission;
3791+HCSSSSCSSB157 104 31 (6)RequireanapplicanttoobtainorretainalicenseintheHomeStateandmeet
3792+32theHomeState'squalificationsforlicensureorrenewaloflicensure,aswellasallother
3793+33applicableHomeStatelaws;
3794+34 (7)AuthorizeaLicenseeholdingaMultistateLicenseinanyMemberStateto
3795+35practiceinaccordancewiththetermsoftheCompactandRulesoftheCommission;and
3796+36 (8)DesignateadelegatetoparticipateintheCommissionmeetings.
3797+37 3.AMemberStatemeetingtherequirementsofsubsections1and2ofthis
3798+38sectionshalldesignatethecategoriesofSocialWorklicensurethatareeligiblefor
3799+39issuanceofaMultistateLicenseforapplicantsinsuchMemberState.Totheextentthat
3800+40anyMemberStatedoesnotmeettherequirementsforparticipationintheCompactat
3801+41anyparticularcategoryofSocialWorklicensure,suchMemberStatemaychoose,butis
3802+42notobligatedto,issueaMultistateLicensetoapplicantsthatotherwisemeetthe
3803+43requirementsofsection337.1015forissuanceofaMultistateLicenseinsuchcategoryor
3804+44categoriesoflicensure.
3805+45 4.TheHomeStatemaychargeafeeforgrantingtheMultistateLicense.
3806+337.1015.1.TobeeligibleforaMultistateLicenseunderthetermsand
3807+2provisionsoftheCompact,anapplicant,regardlessofcategorymust:
3808+3 (1)Holdorbeeligibleforanactive,UnencumberedLicenseintheHomeState;
3809+4 (2)Payanyapplicablefees,includinganyStatefee,fortheMultistateLicense;
3810+5 (3)Submit,inconnectionwithanapplicationforaMultistateLicense,
3811+6fingerprintsorotherbiometricdataforthepurposeofobtainingcriminalhistoryrecord
3812+7informationfromtheFederalBureauofInvestigationandtheagencyresponsiblefor
3813+8retainingthatState'scriminalrecords;
3814+9 (4)NotifytheHomeStateofanyAdverseAction,Encumbrance,orrestriction
3815+10onanyprofessionallicensetakenbyanyMemberStateornon-MemberStatewithin30
3816+11daysfromthedatetheactionistaken;
3817+12 (5)MeetanycontinuingcompetencerequirementsestablishedbytheHome
3818+13State;
3819+14 (6)Abidebythelaws,regulations,andapplicablestandardsintheMember
3820+15Statewheretheclientislocatedatthetimecareisrendered.
3821+16 2.Anapplicantforaclinical-categoryMultistateLicensemustmeetallofthe
3822+17followingrequirements:
3823+18 (1)Fulfillacompetencyrequirement,whichshallbesatisfiedbyeither:
3824+19 (a)Passageofaclinical-categoryQualifyingNationalExam;or
3825+20 (b)LicensureoftheapplicantintheirHomeStateattheclinicalcategory,
3826+21beginningpriortosuchtimeasaQualifyingNationalExamwasrequiredbytheHome
3827+HCSSSSCSSB157 105 22StateandaccompaniedbyaperiodofcontinuousSocialWorklicensurethereafter,allof
3828+23whichmaybefurthergovernedbytheRulesoftheCommission;or
3829+24 (c)Thesubstantialequivalencyoftheforegoingcompetencyrequirementswhich
3830+25theCommissionmaydeterminebyRule.
3831+26 (2)Attainatleastamaster'sdegreeinSocialWorkfromaprogramthatis:
3832+27 (a)OperatedbyacollegeoruniversityrecognizedbytheLicensingAuthority;
3833+28and
3834+29 (b)Accredited,orincandidacythatsubsequentlybecomesaccredited,byan
3835+30accreditingagencyrecognizedbyeither:
3836+31 a.theCouncilforHigherEducationAccreditationoritssuccessor;or
3837+32 b.theUnitedStatesDepartmentofEducation.
3838+33 (3)Fulfillapracticerequirement,whichshallbesatisfiedbydemonstrating
3839+34completionofeither:
3840+35 (a)Aperiodofpostgraduatesupervisedclinicalpracticeequaltoaminimumof
3841+36threethousandhours;or
3842+37 (b)Aminimumoftwoyearsoffull-timepostgraduatesupervisedclinical
3843+38practice;or
3844+39 (c)Thesubstantialequivalencyoftheforegoingpracticerequirementswhichthe
3845+40CommissionmaydeterminebyRule.
3846+41 3.Anapplicantforamaster's-categoryMultistateLicensemustmeetallofthe
3847+42followingrequirements:
3848+43 (1)Fulfillacompetencyrequirement,whichshallbesatisfiedbyeither:
3849+44 (a)Passageofamasters-categoryQualifyingNationalExam;
3850+45 (b)LicensureoftheapplicantintheirHomeStateatthemaster'scategory,
3851+46beginningpriortosuchtimeasaQualifyingNationalExamwasrequiredbytheHome
3852+47Stateatthemaster'scategoryandaccompaniedbyacontinuousperiodofSocialWork
3853+48licensurethereafter,allofwhichmaybefurthergovernedbytheRulesofthe
3854+49Commission;or
3855+50 (c)Thesubstantialequivalencyoftheforegoingcompetencyrequirementswhich
3856+51theCommissionmaydeterminebyRule.
3857+52 (2)Attainatleastamaster'sdegreeinSocialWorkfromaprogramthatis:
3858+53 (a)OperatedbyacollegeoruniversityrecognizedbytheLicensingAuthority;
3859+54and
3860+55 (b)Accredited,orincandidacythatsubsequentlybecomesaccredited,byan
3861+56accreditingagencyrecognizedbyeither:
3862+57 a.theCouncilforHigherEducationAccreditationoritssuccessor;or
3863+58 b.theUnitedStatesDepartmentofEducation.
3864+HCSSSSCSSB157 106 59 4.Anapplicantforabachelor's-categoryMultistateLicensemustmeetallofthe
3865+60followingrequirements:
3866+61 (1)Fulfillacompetencyrequirement,whichshallbesatisfiedbyeither:
3867+62 (a)Passageofabachelor's-categoryQualifyingNationalExam;
3868+63 (b)LicensureoftheapplicantintheirHomeStateatthebachelor'scategory,
3869+64beginningpriortosuchtimeasaQualifyingNationalExamwasrequiredbytheHome
3870+65StateandaccompaniedbyaperiodofcontinuousSocialWorklicensurethereafter,allof
3871+66whichmaybefurthergovernedbytheRulesoftheCommission;or
3872+67 (c)Thesubstantialequivalencyoftheforegoingcompetencyrequirementswhich
3873+68theCommissionmaydeterminebyRule.
3874+69 (2)Attainatleastabachelor'sdegreeinSocialWorkfromaprogramthatis:
3875+70 (a)OperatedbyacollegeoruniversityrecognizedbytheLicensingAuthority;
3876+71and
3877+72 (b)Accredited,orincandidacythatsubsequentlybecomesaccredited,byan
3878+73accreditingagencyrecognizedbyeither:
3879+74 a.theCouncilforHigherEducationAccreditationoritssuccessor;or
3880+75 b.theUnitedStatesDepartmentofEducation.
3881+76 5.TheMultistateLicenseforaRegulatedSocialWorkerissubjecttothe
3882+77renewalrequirementsoftheHomeState.TheRegulatedSocialWorkermustmaintain
3883+78compliancewiththerequirementsofsubsection1ofthissectiontobeeligibletorenewa
3884+79MultistateLicense.
3885+80 6.TheRegulatedSocialWorker'sservicesinaRemoteStatearesubjecttothat
3886+81MemberState'sregulatoryauthority.ARemoteStatemay,inaccordancewithdue
3887+82processandthatMemberState'slaws,removeaRegulatedSocialWorker'sMultistate
3888+83AuthorizationtoPracticeintheRemoteStateforaspecificperiodoftime,imposefines,
3889+84andtakeanyothernecessaryactionstoprotectthehealthandsafetyofitscitizens.
3890+85 7.IfaMultistateLicenseisencumbered,theRegulatedSocialWorker's
3891+86MultistateAuthorizationtoPracticeshallbedeactivatedinallRemoteStatesuntilthe
3892+87MultistateLicenseisnolongerencumbered.
3893+88 8.IfaMultistateAuthorizationtoPracticeisencumberedinaRemoteState,the
3894+89regulatedSocialWorker'sMultistateAuthorizationtoPracticemaybedeactivatedin
3895+90thatStateuntiltheMultistateAuthorizationtoPracticeisnolongerencumbered.
3896+337.1020.1.UponreceiptofanapplicationforaMultistateLicense,theHome
3897+2StateLicensingAuthorityshalldeterminetheapplicant'seligibilityforaMultistate
3898+3Licenseinaccordancewithsection337.1015ofthisCompact.
3899+4 2.Ifsuchapplicantiseligiblepursuanttosection337.1015ofthisCompact,the
3900+5HomeStateLicensingAuthorityshallissueaMultistateLicensethatauthorizesthe
3901+HCSSSSCSSB157 107 6applicantorRegulatedSocialWorkertopracticeinallMemberStatesundera
3902+7MultistateAuthorizationtoPractice.
3903+8 3.UponissuanceofaMultistateLicense,theHomeStateLicensingAuthority
3904+9shalldesignatewhethertheRegulatedSocialWorkerholdsaMultistateLicenseinthe
3905+10Bachelors,Masters,orClinicalcategoryofSocialWork.
3906+11 4.AMultistateLicenseissuedbyaHomeStatetoaresidentinthatStateshallbe
3907+12recognizedbyallCompactMemberStatesasauthorizingSocialWorkPracticeundera
3908+13MultistateAuthorizationtoPracticecorrespondingtoeachcategoryoflicensure
3909+14regulatedineachMemberState.
3910+337.1025.1.NothinginthisCompact,noranyRuleoftheCommission,shallbe
3911+2construedtolimit,restrict,orinanywayreducetheabilityofaMemberStatetoenact
3912+3andenforcelaws,regulations,orotherrulesrelatedtothepracticeofSocialWorkin
3913+4thatState,wherethoselaws,regulations,orotherrulesarenotinconsistentwiththe
3914+5provisionsofthisCompact.
3915+6 2.NothinginthisCompactshallaffecttherequirementsestablishedbya
3916+7MemberStatefortheissuanceofaSingleStateLicense.
3917+8 3.NothinginthisCompact,noranyRuleoftheCommission,shallbeconstrued
3918+9tolimit,restrict,orinanywayreducetheabilityofaMemberStatetotakeAdverse
3919+10ActionagainstaLicensee'sSingleStateLicensetopracticeSocialWorkinthatState.
3920+11 4.NothinginthisCompact,noranyRuleoftheCommission,shallbeconstrued
3921+12tolimit,restrict,orinanywayreducetheabilityofaRemoteStatetotakeAdverse
3922+13ActionagainstaLicensee'sMultistateAuthorizationtoPracticeinthatState.
3923+14 5.NothinginthisCompact,noranyRuleoftheCommission,shallbeconstrued
3924+15tolimit,restrict,orinanywayreducetheabilityofaLicensee'sHomeStatetotake
3925+16AdverseActionagainstaLicensee'sMultistateLicensebaseduponinformation
3926+17providedbyaRemoteState.
3927+337.1030.1.ALicenseecanholdaMultistateLicense,issuedbytheirHome
3928+2State,inonlyoneMemberStateatanygiventime.
3929+3 2.IfaLicenseechangestheirHomeStatebymovingbetweentwoMember
3930+4States:
3931+5 (1)TheLicenseeshallimmediatelyapplyforthereissuanceoftheirMultistate
3932+6LicenseintheirnewHomeState.TheLicenseeshallpayallapplicablefeesandnotify
3933+7thepriorHomeStateinaccordancewiththeRulesoftheCommission.
3934+8 (2)UponreceiptofanapplicationtoreissueaMultistateLicense,thenewHome
3935+9StateshallverifythattheMultistateLicenseisactive,unencumberedandeligiblefor
3936+10reissuanceunderthetermsoftheCompactandtheRulesoftheCommission.The
3937+HCSSSSCSSB157 108 11MultistateLicenseissuedbythepriorHomeStatewillbedeactivatedandallMember
3938+12StatesnotifiedinaccordancewiththeapplicableRulesadoptedbytheCommission.
3939+13 (3)PriortothereissuanceoftheMultistateLicense,thenewHomeStateshall
3940+14conductproceduresforconsideringthecriminalhistoryrecordsoftheLicensee.Such
3941+15proceduresshallincludethesubmissionoffingerprintsorotherbiometric-based
3942+16informationbyapplicantsforthepurposeofobtaininganapplicant'scriminalhistory
3943+17recordinformationfromtheFederalBureauofInvestigationandtheagencyresponsible
3944+18forretainingthatState'scriminalrecords.
3945+19 (4)Ifrequiredforinitiallicensure,thenewHomeStatemayrequirecompletion
3946+20ofjurisprudencerequirementsinthenewHomeState.
3947+21 (5)NotwithstandinganyotherprovisionofthisCompact,ifaLicenseedoesnot
3948+22meettherequirementssetforthinthisCompactforthereissuanceofaMultistate
3949+23LicensebythenewHomeState,thentheLicenseeshallbesubjecttothenewHome
3950+24StaterequirementsfortheissuanceofaSingleStateLicenseinthatState.
3951+25 3.IfaLicenseechangestheirprimaryStateofresidencebymovingfroma
3952+26MemberStatetoanon-MemberState,orfromanon-MemberStatetoaMemberState,
3953+27thentheLicenseeshallbesubjecttotheStaterequirementsfortheissuanceofaSingle
3954+28StateLicenseinthenewHomeState.
3955+29 4.NothinginthisCompactshallinterferewithaLicensee'sabilitytoholda
3956+30SingleStateLicenseinmultipleStates;however,forthepurposesofthisCompact,a
3957+31LicenseeshallhaveonlyoneHomeState,andonlyoneMultistateLicense.
3958+32 5.NothinginthisCompactshallinterferewiththerequirementsestablishedbya
3959+33MemberStatefortheissuanceofaSingleStateLicense.
3960+337.1035.AnActiveMilitaryMemberortheirspouseshalldesignateaHome
3961+2StatewheretheindividualhasaMultistateLicense.Theindividualmayretaintheir
3962+3HomeStatedesignationduringtheperiodtheservicememberisonactiveduty.
3963+337.1040.1.InadditiontotheotherpowersconferredbyStatelaw,aRemote
3964+2Stateshallhavetheauthority,inaccordancewithexistingStatedueprocesslaw,to:
3965+3 (1)TakeAdverseActionagainstaRegulatedSocialWorker'sMultistate
3966+4AuthorizationtoPracticeonlywithinthatMemberState,andissuesubpoenasforboth
3967+5hearingsandinvestigationsthatrequiretheattendanceandtestimonyofwitnessesas
3968+6wellastheproductionofevidence.SubpoenasissuedbyaLicensingAuthorityina
3969+7MemberStatefortheattendanceandtestimonyofwitnessesortheproductionof
3970+8evidencefromanotherMemberStateshallbeenforcedinthelatterStatebyanycourt
3971+9ofcompetentjurisdiction,accordingtothepracticeandprocedureofthatcourt
3972+10applicabletosubpoenasissuedinproceedingspendingbeforeit.TheissuingLicensing
3973+HCSSSSCSSB157 109 11Authorityshallpayanywitnessfees,travelexpenses,mileage,andotherfeesrequired
3974+12bytheservicestatutesoftheStateinwhichthewitnessesorevidencearelocated.
3975+13 (2)OnlytheHomeStateshallhavethepowertotakeAdverseActionagainsta
3976+14RegulatedSocialWorker'sMultistateLicense.
3977+15 2.ForpurposesoftakingAdverseAction,theHomeStateshallgivethesame
3978+16priorityandeffecttoreportedconductreceivedfromaMemberStateasitwouldifthe
3979+17conducthadoccurredwithintheHomeState.Insodoing,theHomeStateshallapply
3980+18itsownStatelawstodetermineappropriateaction.
3981+19 3.TheHomeStateshallcompleteanypendinginvestigationsofaRegulated
3982+20SocialWorkerwhochangestheirHomeStateduringthecourseoftheinvestigations.
3983+21TheHomeStateshallalsohavetheauthoritytotakeappropriateaction(s)andshall
3984+22promptlyreporttheconclusionsoftheinvestigationstotheadministratoroftheData
3985+23System.TheadministratoroftheDataSystemshallpromptlynotifythenewHome
3986+24StateofanyAdverseActions.
3987+25 4.AMemberState,ifotherwisepermittedbyStatelaw,mayrecoverfromthe
3988+26affectedRegulatedSocialWorkerthecostsofinvestigationsanddispositionsofcases
3989+27resultingfromanyAdverseActiontakenagainstthatRegulatedSocialWorker.
3990+28 5.AMemberStatemaytakeAdverseActionbasedonthefactualfindingsof
3991+29anotherMemberState,providedthattheMemberStatefollowsitsownproceduresfor
3992+30takingtheAdverseAction.
3993+31 6.(1)InadditiontotheauthoritygrantedtoaMemberStatebyitsrespective
3994+32SocialWorkpracticeactorotherapplicableStatelaw,anyMemberStatemay
3995+33participatewithotherMemberStatesinjointinvestigationsofLicensees.
3996+34 (2)MemberStatesshallshareanyinvestigative,litigation,orcompliance
3997+35materialsinfurtheranceofanyjointorindividualinvestigationinitiatedunderthe
3998+36Compact.
3999+37 7.IfAdverseActionistakenbytheHomeStateagainsttheMultistateLicenseof
4000+38aRegulatedSocialWorker,theRegulatedSocialWorker'sMultistateAuthorizationto
4001+39PracticeinallotherMemberStatesshallbedeactivateduntilallEncumbranceshave
4002+40beenremovedfromtheMultistateLicense.AllHomeStatedisciplinaryordersthat
4003+41imposeAdverseActionagainstthelicenseofaRegulatedSocialWorkershallincludea
4004+42statementthattheRegulatedSocialWorker'sMultistateAuthorizationtoPracticeis
4005+43deactivatedinallMemberStatesuntilallconditionsofthedecision,orderoragreement
4006+44aresatisfied.
4007+45 8.IfaMemberStatetakesAdverseAction,itshallpromptlynotifythe
4008+46administratoroftheDataSystem.TheadministratoroftheDataSystemshallpromptly
4009+HCSSSSCSSB157 110 47notifytheHomeStateandallotherMemberStatesofanyAdverseActionsbyRemote
4010+48States.
4011+49 9.NothinginthisCompactshalloverrideaMemberState'sdecisionthat
4012+50participationinanAlternativeProgrammaybeusedinlieuofAdverseAction.
4013+51 10.NothinginthisCompactshallauthorizeaMemberStatetodemandthe
4014+52issuanceofsubpoenasforattendanceandtestimonyofwitnessesortheproductionof
4015+53evidencefromanotherMemberStateforlawfulactionswithinthatMemberState.
4016+54 11.NothinginthisCompactshallauthorizeaMemberStatetoimposediscipline
4017+55againstaRegulatedSocialWorkerwhoholdsaMultistateAuthorizationtoPracticefor
4018+56lawfulactionswithinanotherMemberState.
4019+337.1045.1.TheCompactMemberStatesherebycreateandestablishajoint
4020+2governmentagencywhosemembershipconsistsofallMemberStatesthathaveenacted
4021+3thecompactknownastheSocialWorkLicensureCompactCommission.The
4022+4CommissionisaninstrumentalityoftheCompactStatesactingjointlyandnotan
4023+5instrumentalityofanyoneState.TheCommissionshallcomeintoexistenceonorafter
4024+6theeffectivedateoftheCompactassetforthinsection337.1065.
4025+7 2.(1)EachMemberStateshallhaveandbelimitedtoone(1)delegateselected
4026+8bythatMemberState'sStateLicensingAuthority.
4027+9 (2)Thedelegateshallbeeither:
4028+10 (a)AcurrentmemberoftheStateLicensingAuthorityatthetimeof
4029+11appointment,whoisaRegulatedSocialWorkerorpublicmemberoftheStateLicensing
4030+12Authority;or
4031+13 (b)AnadministratoroftheStateLicensingAuthorityortheirdesignee.
4032+14 (3)TheCommissionshallbyRuleorbylawestablishatermofofficefor
4033+15delegatesandmaybyRuleorbylawestablishtermlimits.
4034+16 (4)TheCommissionmayrecommendremovalorsuspensionofanydelegate
4035+17fromoffice.
4036+18 (5)AMemberState'sStateLicensingAuthorityshallfillanyvacancyofits
4037+19delegateoccurringontheCommissionwithin60daysofthevacancy.
4038+20 (6)Eachdelegateshallbeentitledtoonevoteonallmattersbeforethe
4039+21CommissionrequiringavotebyCommissiondelegates.
4040+22 (7)Adelegateshallvoteinpersonorbysuchothermeansasprovidedinthe
4041+23bylaws.Thebylawsmayprovidefordelegatestomeetbytelecommunication,
4042+24videoconference,orothermeansofcommunication.
4043+25 (8)TheCommissionshallmeetatleastonceduringeachcalendaryear.
4044+26Additionalmeetingsmaybeheldassetforthinthebylaws.TheCommissionmaymeet
4045+27bytelecommunication,videoconferenceorothersimilarelectronicmeans.
4046+HCSSSSCSSB157 111 28 3.TheCommissionshallhavethefollowingpowers:
4047+29 (1)EstablishthefiscalyearoftheCommission;
4048+30 (2)Establishcodeofconductandconflictofinterestpolicies;
4049+31 (3)EstablishandamendRulesandbylaws;
4050+32 (4)Maintainitsfinancialrecordsinaccordancewiththebylaws;
4051+33 (5)Meetandtakesuchactionsasareconsistentwiththeprovisionsofthis
4052+34Compact,theCommission'sRules,andthebylaws;
4053+35 (6)Initiateandconcludelegalproceedingsoractionsinthenameofthe
4054+36Commission,providedthatthestandingofanyStateLicensingBoardtosueorbesued
4055+37underapplicablelawshallnotbeaffected;
4056+38 (7)MaintainandcertifyrecordsandinformationprovidedtoaMemberStateas
4057+39theauthenticatedbusinessrecordsoftheCommission,anddesignateanagenttodoso
4058+40ontheCommission'sbehalf;
4059+41 (8)Purchaseandmaintaininsuranceandbonds;
4060+42 (9)Borrow,accept,orcontractforservicesofpersonnel,including,butnot
4061+43limitedto,employeesofaMemberState;
4062+44 (10)Conductanannualfinancialreview;
4063+45 (11)Hireemployees,electorappointofficers,fixcompensation,defineduties,
4064+46grantsuchindividualsappropriateauthoritytocarryoutthepurposesoftheCompact,
4065+47andestablishtheCommission'spersonnelpoliciesandprogramsrelatingtoconflictsof
4066+48interest,qualificationsofpersonnel,andotherrelatedpersonnelmatters;
4067+49 (12)Assessandcollectfees;
4068+50 (13)Acceptanyandallappropriategifts,donations,grantsofmoney,other
4069+51sourcesofrevenue,equipment,supplies,materials,andservices,andreceive,utilize,and
4070+52disposeofthesame;providedthatatalltimestheCommissionshallavoidany
4071+53appearanceofimproprietyorconflictofinterest;
4072+54 (14)Lease,purchase,retain,own,hold,improve,oruseanyproperty,real,
4073+55personal,ormixed,oranyundividedinteresttherein;
4074+56 (15)Sell,convey,mortgage,pledge,lease,exchange,abandon,orotherwise
4075+57disposeofanypropertyreal,personal,ormixed;
4076+58 (16)Establishabudgetandmakeexpenditures;
4077+59 (17)Borrowmoney;
4078+60 (18)Appointcommittees,includingstandingcommittees,composedofmembers,
4079+61Stateregulators,Statelegislatorsortheirrepresentatives,andconsumer
4080+62representatives,andsuchotherinterestedpersonsasmaybedesignatedinthis
4081+63Compactandthebylaws;
4082+HCSSSSCSSB157 112 64 (19)Provideandreceiveinformationfrom,andcooperatewith,lawenforcement
4083+65agencies;
4084+66 (20)EstablishandelectanExecutiveCommittee,includingachairandavice
4085+67chair;
4086+68 (21)DeterminewhetheraState'sadoptedlanguageismateriallydifferentfrom
4087+69themodelcompactlanguagesuchthattheStatewouldnotqualifyforparticipationin
4088+70theCompact;and
4089+71 (22)Performsuchotherfunctionsasmaybenecessaryorappropriatetoachieve
4090+72thepurposesofthisCompact.
4091+73 4.(1)TheExecutiveCommitteeshallhavethepowertoactonbehalfofthe
4092+74CommissionaccordingtothetermsofthisCompact.Thepowers,duties,and
4093+75responsibilitiesoftheExecutiveCommitteeshallinclude:
4094+76 (a)Overseetheday-to-dayactivitiesoftheadministrationofthecompact
4095+77includingenforcementandcompliancewiththeprovisionsofthecompact,itsRulesand
4096+78bylaws,andothersuchdutiesasdeemednecessary;
4097+79 (b)RecommendtotheCommissionchangestotheRulesorbylaws,changesto
4098+80thisCompactlegislation,feeschargedtoCompactMemberStates,feeschargedto
4099+81Licensees,andotherfees;
4100+82 (c)EnsureCompactadministrationservicesareappropriatelyprovided,
4101+83includingbycontract;
4102+84 (d)Prepareandrecommendthebudget;
4103+85 (e)MaintainfinancialrecordsonbehalfoftheCommission;
4104+86 (f)MonitorCompactcomplianceofMemberStatesandprovidecompliance
4105+87reportstotheCommission;
4106+88 (g)Establishadditionalcommitteesasnecessary;
4107+89 (h)ExercisethepowersanddutiesoftheCommissionduringtheinterim
4108+90betweenCommissionmeetings,exceptforadoptingoramendingRules,adoptingor
4109+91amendingbylaws,andexercisinganyotherpowersanddutiesexpresslyreservedtothe
4110+92CommissionbyRuleorbylaw;and
4111+93 (i)OtherdutiesasprovidedintheRulesorbylawsoftheCommission.
4112+94 (2)TheExecutiveCommitteeshallbecomposedofuptoeleven(11)members:
4113+95 (a)ThechairandvicechairoftheCommissionshallbevotingmembersofthe
4114+96ExecutiveCommittee;and
4115+97 (b)TheCommissionshallelectfivevotingmembersfromthecurrent
4116+98membershipoftheCommission.
4117+99 (c)Uptofour(4)ex-officio,nonvotingmembersfromfour(4)recognized
4118+100nationalSocialWorkorganizations.
4119+HCSSSSCSSB157 113 101 (d)Theex-officiomemberswillbeselectedbytheirrespectiveorganizations.
4120+102 (3)TheCommissionmayremoveanymemberoftheExecutiveCommitteeas
4121+103providedintheCommission'sbylaws.
4122+104 (4)TheExecutiveCommitteeshallmeetatleastannually.
4123+105 (a)ExecutiveCommitteemeetingsshallbeopentothepublic,exceptthatthe
4124+106ExecutiveCommitteemaymeetinaclosed,non-publicmeetingasprovidedin
4125+107subdivision(2)ofsubsection6ofthissection.
4126+108 (b)TheExecutiveCommitteeshallgiveseven(7)days'noticeofitsmeetings,
4127+109postedonitswebsiteandasdeterminedtoprovidenoticetopersonswithaninterestin
4128+110thebusinessoftheCommission.
4129+111 (c)TheExecutiveCommitteemayholdaspecialmeetinginaccordancewith
4130+112paragraph(b)ofsubdivision(1)ofsubsection6ofthissection.
4131+113 5.TheCommissionshalladoptandprovidetotheMemberStatesanannual
4132+114report.
4133+115 6.(1)Allmeetingsshallbeopentothepublic,exceptthattheCommissionmay
4134+116meetinaclosed,non-publicmeetingasprovidedinsubdivision(2)ofthissubsection.
4135+117 (a)PublicnoticeforallmeetingsofthefullCommissionofmeetingsshallbe
4136+118giveninthesamemannerasrequiredundertheRulemakingprovisionsinsection
4137+119337.1055,exceptthattheCommissionmayholdaspecialmeetingasprovidedin
4138+120paragraph(b)ofthissubdivision.
4139+121 (b)TheCommissionmayholdaspecialmeetingwhenitmustmeettoconduct
4140+122emergencybusinessbygiving48hours'noticetoallcommissioners,onthe
4141+123Commission'swebsite,andothermeansasprovidedintheCommission'sRules.The
4142+124Commission'slegalcounselshallcertifythattheCommission'sneedtomeetqualifiesas
4143+125anemergency.
4144+126 (2)TheCommissionortheExecutiveCommitteeorothercommitteesofthe
4145+127Commissionmayconveneinaclosed,non-publicmeetingfortheCommissionor
4146+128ExecutiveCommitteeorothercommitteesoftheCommissiontoreceivelegaladviceor
4147+129todiscuss:
4148+130 (a)Non-complianceofaMemberStatewithitsobligationsundertheCompact;
4149+131 (b)Theemployment,compensation,disciplineorothermatters,practicesor
4150+132proceduresrelatedtospecificemployees;
4151+133 (c)CurrentorthreateneddisciplineofaLicenseebytheCommissionorbya
4152+134MemberState'sLicensingAuthority;
4153+135 (d)Current,threatened,orreasonablyanticipatedlitigation;
4154+136 (e)Negotiationofcontractsforthepurchase,lease,orsaleofgoods,services,or
4155+137realestate;
4156+HCSSSSCSSB157 114 138 (f)Accusinganypersonofacrimeorformallycensuringanyperson;
4157+139 (g)Tradesecretsorcommercialorfinancialinformationthatisprivilegedor
4158+140confidential;
4159+141 (h)Informationofapersonalnaturewheredisclosurewouldconstituteaclearly
4160+142unwarrantedinvasionofpersonalprivacy;
4161+143 (i)Investigativerecordscompiledforlawenforcementpurposes;
4162+144 (j)Informationrelatedtoanyinvestigativereportspreparedbyoronbehalfof
4163+145orforuseoftheCommissionorothercommitteechargedwithresponsibilityof
4164+146investigationordeterminationofcomplianceissuespursuanttotheCompact;
4165+147 (k)MattersspecificallyexemptedfromdisclosurebyfederalorMemberState
4166+148law;or
4167+149 (l)OthermattersaspromulgatedbytheCommissionbyRule.
4168+150 (3)Ifameeting,orportionofameeting,isclosed,thepresidingofficershallstate
4169+151thatthemeetingwillbeclosedandreferenceeachrelevantexemptingprovision,and
4170+152suchreferenceshallberecordedintheminutes.
4171+153 (4)TheCommissionshallkeepminutesthatfullyandclearlydescribeall
4172+154mattersdiscussedinameetingandshallprovideafullandaccuratesummaryofactions
4173+155taken,andthereasonstherefor,includingadescriptionoftheviewsexpressed.All
4174+156documentsconsideredinconnectionwithanactionshallbeidentifiedinsuchminutes.
4175+157Allminutesanddocumentsofaclosedmeetingshallremainunderseal,subjectto
4176+158releaseonlybyamajorityvoteoftheCommissionororderofacourtofcompetent
4177+159jurisdiction.
4178+160 7.(1)TheCommissionshallpay,orprovideforthepaymentof,thereasonable
4179+161expensesofitsestablishment,organization,andongoingactivities.
4180+162 (2)TheCommissionmayacceptanyandallappropriaterevenuesourcesas
4181+163providedinsubdivision(13)ofsubsection3ofthissection.
4182+164 (3)TheCommissionmaylevyonandcollectanannualassessmentfromeach
4183+165MemberStateandimposefeesonLicenseesofMemberStatestowhomitgrantsa
4184+166MultistateLicensetocoverthecostoftheoperationsandactivitiesoftheCommission
4185+167anditsstaff,whichmustbeinatotalamountsufficienttocoveritsannualbudgetas
4186+168approvedeachyearforwhichrevenueisnotprovidedbyothersources.Theaggregate
4187+169annualassessmentamountforMemberStatesshallbeallocatedbaseduponaformula
4188+170thattheCommissionshallpromulgatebyRule.
4189+171 (4)TheCommissionshallnotincurobligationsofanykindpriortosecuringthe
4190+172fundsadequatetomeetthesame;norshalltheCommissionpledgethecreditofanyof
4191+173theMemberStates,exceptbyandwiththeauthorityoftheMemberState.
4192+HCSSSSCSSB157 115 174 (5)TheCommissionshallkeepaccurateaccountsofallreceiptsand
4193+175disbursements.ThereceiptsanddisbursementsoftheCommissionshallbesubject
4194+176tothefinancialreviewandaccountingproceduresestablishedunderitsbylaws.
4195+177However,allreceiptsanddisbursementsoffundshandledbytheCommissionshallbe
4196+178subjecttoanannualfinancialreviewbyacertifiedorlicensedpublicaccountant,and
4197+179thereportofthefinancialreviewshallbeincludedinandbecomepartoftheannual
4198+180reportoftheCommission.
4199+181 8.(1)Themembers,officers,executivedirector,employeesandrepresentatives
4200+182oftheCommissionshallbeimmunefromsuitandliability,bothpersonallyandintheir
4201+183officialcapacity,foranyclaimfordamagetoorlossofpropertyorpersonalinjuryor
4202+184othercivilliabilitycausedbyorarisingoutofanyactualorallegedact,error,or
4203+185omissionthatoccurred,orthatthepersonagainstwhomtheclaimismadehada
4204+186reasonablebasisforbelievingoccurredwithinthescopeofCommissionemployment,
4205+187dutiesorresponsibilities;providedthatnothinginthissubdivisionshallbeconstruedto
4206+188protectanysuchpersonfromsuitorliabilityforanydamage,loss,injury,orliability
4207+189causedbytheintentionalorwillfulorwantonmisconductofthatperson.The
4208+190procurementofinsuranceofanytypebytheCommissionshallnotinanyway
4209+191compromiseorlimittheimmunitygrantedhereunder.
4210+192 (2)TheCommissionshalldefendanymember,officer,executivedirector,
4211+193employee,andrepresentativeoftheCommissioninanycivilactionseekingtoimpose
4212+194liabilityarisingoutofanyactualorallegedact,error,oromissionthatoccurredwithin
4213+195thescopeofCommissionemployment,duties,orresponsibilities,orasdeterminedby
4214+196theCommissionthatthepersonagainstwhomtheclaimismadehadareasonablebasis
4215+197forbelievingoccurredwithinthescopeofCommissionemployment,duties,or
4216+198responsibilities;providedthatnothinghereinshallbeconstruedtoprohibitthat
4217+199personfromretainingtheirowncounselattheirownexpense;andprovidedfurther,
4218+200thattheactualorallegedact,error,oromissiondidnotresultfromthatperson's
4219+201intentionalorwillfulorwantonmisconduct.
4220+202 (3)TheCommissionshallindemnifyandholdharmlessanymember,officer,
4221+203executivedirector,employee,andrepresentativeoftheCommissionfortheamountof
4222+204anysettlementorjudgmentobtainedagainstthatpersonarisingoutofanyactualor
4223+205allegedact,error,oromissionthatoccurredwithinthescopeofCommission
4224+206employment,duties,orresponsibilities,orthatsuchpersonhadareasonablebasis
4225+207forbelievingoccurredwithinthescopeofCommissionemployment,duties,or
4226+208responsibilities,providedthattheactualorallegedact,error,oromissiondidnot
4227+209resultfromtheintentionalorwillfulorwantonmisconductofthatperson.
4228+HCSSSSCSSB157 116 210 (4)Nothinghereinshallbeconstruedasalimitationontheliabilityofany
4229+211Licenseeforprofessionalmalpracticeormisconduct,whichshallbegovernedsolelyby
4230+212anyotherapplicableStatelaws.
4231+213 (5)NothinginthisCompactshallbeinterpretedtowaiveorotherwiseabrogate
4232+214aMemberState'sstateactionimmunityorstateactionaffirmativedefensewithrespect
4233+215toantitrustclaimsundertheShermanAct,ClaytonAct,oranyotherStateorfederal
4234+216antitrustoranticompetitivelaworregulation.
4235+217 (6)NothinginthisCompactshallbeconstruedtobeawaiverofsovereign
4236+218immunitybytheMemberStatesorbytheCommission.
4237+337.1050.1.TheCommissionshallprovideforthedevelopment,maintenance,
4238+2operation,andutilizationofacoordinatedDataSystem.
4239+3 2.TheCommissionshallassigneachapplicantforaMultistateLicenseaunique
4240+4identifier,asdeterminedbytheRulesoftheCommission.
4241+5 3.NotwithstandinganyotherprovisionofStatelawtothecontrary,aMember
4242+6StateshallsubmitauniformdatasettotheDataSystemonallindividualstowhomthis
4243+7CompactisapplicableasrequiredbytheRulesoftheCommission,including:
4244+8 (1)Identifyinginformation;
4245+9 (2)Licensuredata;
4246+10 (3)AdverseActionsagainstalicenseandinformationrelatedthereto;
4247+11 (4)Non-confidentialinformationrelatedtoAlternativeProgramparticipation,
4248+12thebeginningandendingdatesofsuchparticipation,andotherinformationrelatedto
4249+13suchparticipationnotmadeconfidentialunderMemberStatelaw;
4250+14 (5)Anydenialofapplicationforlicensure,andthereasonorreasonsforsuch
4251+15denial;
4252+16 (6)ThepresenceofCurrentSignificantInvestigativeInformation;and
4253+17 (7)OtherinformationthatmayfacilitatetheadministrationofthisCompactor
4254+18theprotectionofthepublic,asdeterminedbytheRulesoftheCommission.
4255+19 4.TherecordsandinformationprovidedtoaMemberStatepursuanttothis
4256+20CompactorthroughtheDataSystem,whencertifiedbytheCommissionoranagent
4257+21thereof,shallconstitutetheauthenticatedbusinessrecordsoftheCommission,andshall
4258+22beentitledtoanyassociatedhearsayexceptioninanyrelevantjudicial,quasi-judicialor
4259+23administrativeproceedingsinaMemberState.
4260+24 5.(1)CurrentSignificantInvestigativeInformationpertainingtoaLicenseein
4261+25anyMemberStatewillonlybeavailabletootherMemberStates.
4262+26 (2)ItistheresponsibilityoftheMemberStatestoreportanyAdverseAction
4263+27againstaLicenseeandtomonitorthedatabasetodeterminewhetherAdverseAction
4264+HCSSSSCSSB157 117 28hasbeentakenagainstaLicensee.AdverseActioninformationpertainingtoaLicensee
4265+29inanyMemberStatewillbeavailabletoanyotherMemberState.
4266+30 6.MemberStatescontributinginformationtotheDataSystemmaydesignate
4267+31informationthatmaynotbesharedwiththepublicwithouttheexpresspermissionof
4268+32thecontributingState.
4269+33 7.AnyinformationsubmittedtotheDataSystemthatissubsequentlyexpunged
4270+34pursuanttofederallaworthelawsoftheMemberStatecontributingtheinformation
4271+35shallberemovedfromtheDataSystem.
4272+337.1055.1.TheCommissionshallpromulgatereasonableRulesinorderto
4273+2effectivelyandefficientlyimplementandadministerthepurposesandprovisionsofthe
4274+3Compact.ARuleshallbeinvalidandhavenoforceoreffectonlyifacourtof
4275+4competentjurisdictionholdsthattheRuleisinvalidbecausetheCommissionexercised
4276+5itsrulemakingauthorityinamannerthatisbeyondthescopeandpurposesofthe
4277+6Compact,orthepowersgrantedhereunder,orbaseduponanotherapplicablestandard
4278+7ofreview.
4279+8 2.TheRulesoftheCommissionshallhavetheforceoflawineachMember
4280+9State,providedhoweverthatwheretheRulesoftheCommissionconflictwiththelaws
4281+10oftheMemberStatethatestablishtheMemberState'slaws,regulations,andapplicable
4282+11standardsthatgovernthepracticeofSocialWorkasheldbyacourtofcompetent
4283+12jurisdiction,theRulesoftheCommissionshallbeineffectiveinthatStatetotheextent
4284+13oftheconflict.
4285+14 3.TheCommissionshallexerciseitsRulemakingpowerspursuanttothecriteria
4286+15setforthinthisSectionandtheRulesadoptedthereunder.Rulesshallbecomebinding
4287+16onthedayfollowingadoptionorthedatespecifiedintheruleoramendment,whichever
4288+17islater.
4289+18 4.IfamajorityofthelegislaturesoftheMemberStatesrejectsaRuleorportion
4290+19ofaRule,byenactmentofastatuteorresolutioninthesamemannerusedtoadoptthe
4291+20Compactwithinfour(4)yearsofthedateofadoptionoftheRule,thensuchRuleshall
4292+21havenofurtherforceandeffectinanyMemberState.
4293+22 5.RulesshallbeadoptedataregularorspecialmeetingoftheCommission.
4294+23 6.PriortoadoptionofaproposedRule,theCommissionshallholdapublic
4295+24hearingandallowpersonstoprovideoralandwrittencomments,data,facts,opinions,
4296+25andarguments.
4297+26 7.PriortoadoptionofaproposedRulebytheCommission,andatleastthirty
4298+27(30)daysinadvanceofthemeetingatwhichtheCommissionwillholdapublichearing
4299+28ontheproposedRule,theCommissionshallprovideaNoticeofProposedRulemaking:
4300+29 (1)OnthewebsiteoftheCommissionorotherpubliclyaccessibleplatform;
4301+HCSSSSCSSB157 118 30 (2)TopersonswhohaverequestednoticeoftheCommission'snoticesof
4302+31proposedrulemaking;and
4303+32 (3)Insuchotherway(s)astheCommissionmaybyRulespecify.
4304+33 8.TheNoticeofProposedRulemakingshallinclude:
4305+34 (1)Thetime,date,andlocationofthepublichearingatwhichtheCommission
4306+35willhearpubliccommentsontheproposedRuleand,ifdifferent,thetime,date,and
4307+36locationofthemeetingwheretheCommissionwillconsiderandvoteontheproposed
4308+37Rule;
4309+38 (2)Ifthehearingisheldviatelecommunication,videoconference,orother
4310+39electronicmeans,theCommissionshallincludethemechanismforaccesstothehearing
4311+40intheNoticeofProposedRulemaking;
4312+41 (3)ThetextoftheproposedRuleandthereasontherefor;
4313+42 (4)ArequestforcommentsontheproposedRulefromanyinterestedperson;
4314+43and
4315+44 (5)Themannerinwhichinterestedpersonsmaysubmitwrittencomments.
4316+45 9.Allhearingswillberecorded.Acopyoftherecordingandallwritten
4317+46commentsanddocumentsreceivedbytheCommissioninresponsetotheproposedRule
4318+47shallbeavailabletothepublic.
4319+48 10.Nothinginthissectionshallbeconstruedasrequiringaseparatehearingon
4320+49eachRule.RulesmaybegroupedfortheconvenienceoftheCommissionathearings
4321+50requiredbythissection.
4322+51 11.TheCommissionshall,bymajorityvoteofallmembers,takefinalactionon
4323+52theproposedRulebasedontheRulemakingrecordandthefulltextoftheRule.
4324+53 (1)TheCommissionmayadoptchangestotheproposedRuleprovidedthe
4325+54changesdonotenlargetheoriginalpurposeoftheproposedRule.
4326+55 (2)TheCommissionshallprovideanexplanationofthereasonsforsubstantive
4327+56changesmadetotheproposedRuleaswellasreasonsforsubstantivechangesnotmade
4328+57thatwererecommendedbycommenters.
4329+58 (3)TheCommissionshalldetermineareasonableeffectivedatefortheRule.
4330+59Exceptforanemergencyasprovidedinsubsection12ofthissection,theeffectivedate
4331+60oftheruleshallbenosoonerthan30daysafterissuingthenoticethatitadoptedor
4332+61amendedtheRule.
4333+62 12.Upondeterminationthatanemergencyexists,theCommissionmayconsider
4334+63andadoptanemergencyRulewith48hours'notice,withopportunitytocomment,
4335+64providedthattheusualRulemakingproceduresprovidedintheCompactandinthis
4336+65sectionshallberetroactivelyappliedtotheRuleassoonasreasonablypossible,inno
4337+HCSSSSCSSB157 119 66eventlaterthanninety(90)daysaftertheeffectivedateoftheRule.Forthepurposesof
4338+67thisprovision,anemergencyRuleisonethatmustbeadoptedimmediatelyinorderto:
4339+68 (1)Meetanimminentthreattopublichealth,safety,orwelfare;
4340+69 (2)PreventalossofCommissionorMemberStatefunds;
4341+70 (3)MeetadeadlineforthepromulgationofaRulethatisestablishedbyfederal
4342+71laworrule;or
4343+72 (4)Protectpublichealthandsafety.
4344+73 13.TheCommissionoranauthorizedcommitteeoftheCommissionmaydirect
4345+74revisionstoapreviouslyadoptedRuleforpurposesofcorrectingtypographicalerrors,
4346+75errorsinformat,errorsinconsistency,orgrammaticalerrors.Publicnoticeofany
4347+76revisionsshallbepostedonthewebsiteoftheCommission.Therevisionshallbesubject
4348+77tochallengebyanypersonforaperiodofthirty(30)daysafterposting.Therevision
4349+78maybechallengedonlyongroundsthattherevisionresultsinamaterialchangetoa
4350+79Rule.AchallengeshallbemadeinwritinganddeliveredtotheCommissionpriortothe
4351+80endofthenoticeperiod.Ifnochallengeismade,therevisionwilltakeeffectwithout
4352+81furtheraction.Iftherevisionischallenged,therevisionmaynottakeeffectwithoutthe
4353+82approvaloftheCommission.
4354+83 14.NoMemberState'srulemakingrequirementsshallapplyunderthis
4355+84compact.
4356+337.1060.1.(1)TheexecutiveandjudicialbranchesofStategovernmentin
4357+2eachMemberStateshallenforcethisCompactandtakeallactionsnecessaryand
4358+3appropriatetoimplementtheCompact.
4359+4 (2)ExceptasotherwiseprovidedinthisCompact,venueisproperandjudicial
4360+5proceedingsbyoragainsttheCommissionshallbebroughtsolelyandexclusivelyina
4361+6courtofcompetentjurisdictionwheretheprincipalofficeoftheCommissionislocated.
4362+7TheCommissionmaywaivevenueandjurisdictionaldefensestotheextentitadoptsor
4363+8consentstoparticipateinalternativedisputeresolutionproceedings.Nothingherein
4364+9shallaffectorlimittheselectionorproprietyofvenueinanyactionagainstaLicensee
4365+10forprofessionalmalpractice,misconductoranysuchsimilarmatter.
4366+11 (3)TheCommissionshallbeentitledtoreceiveserviceofprocessinany
4367+12proceedingregardingtheenforcementorinterpretationoftheCompactandshallhave
4368+13standingtointerveneinsuchaproceedingforallpurposes.Failuretoprovidethe
4369+14Commissionserviceofprocessshallrenderajudgmentorordervoidastothe
4370+15Commission,thisCompact,orpromulgatedRules.
4371+16 2.(1)IftheCommissiondeterminesthataMemberStatehasdefaultedinthe
4372+17performanceofitsobligationsorresponsibilitiesunderthisCompactorthe
4373+18promulgatedRules,theCommissionshallprovidewrittennoticetothedefaulting
4374+HCSSSSCSSB157 120 19State.Thenoticeofdefaultshalldescribethedefault,theproposedmeansofcuringthe
4375+20default,andanyotheractionthattheCommissionmaytake,andshalloffertraining
4376+21andspecifictechnicalassistanceregardingthedefault.
4377+22 (2)TheCommissionshallprovideacopyofthenoticeofdefaulttotheother
4378+23MemberStates.
4379+24 3.IfaStateindefaultfailstocurethedefault,thedefaultingStatemaybe
4380+25terminatedfromtheCompactuponanaffirmativevoteofamajorityofthedelegatesof
4381+26theMemberStates,andallrights,privilegesandbenefitsconferredonthatStatebythis
4382+27Compactmaybeterminatedontheeffectivedateoftermination.Acureofthedefault
4383+28doesnotrelievetheoffendingStateofobligationsorliabilitiesincurredduringthe
4384+29periodofdefault.
4385+30 4.TerminationofmembershipintheCompactshallbeimposedonlyafterall
4386+31othermeansofsecuringcompliancehavebeenexhausted.Noticeofintenttosuspendor
4387+32terminateshallbegivenbytheCommissiontothegovernor,themajorityandminority
4388+33leadersofthedefaultingState'slegislature,thedefaultingState'sStateLicensing
4389+34AuthorityandeachoftheMemberStates'StateLicensingAuthority.
4390+35 5.AStatethathasbeenterminatedisresponsibleforallassessments,
4391+36obligations,andliabilitiesincurredthroughtheeffectivedateoftermination,including
4392+37obligationsthatextendbeyondtheeffectivedateoftermination.
4393+38 6.UpontheterminationofaState'smembershipfromthisCompact,thatState
4394+39shallimmediatelyprovidenoticetoallLicenseeswithinthatStateofsuchtermination.
4395+40TheterminatedStateshallcontinuetorecognizealllicensesgrantedpursuanttothis
4396+41Compactforaminimumofsix(6)monthsafterthedateofsaidnoticeoftermination.
4397+42 7.TheCommissionshallnotbearanycostsrelatedtoaStatethatisfoundtobe
4398+43indefaultorthathasbeenterminatedfromtheCompact,unlessagreeduponinwriting
4399+44betweentheCommissionandthedefaultingState.
4400+45 8.ThedefaultingStatemayappealtheactionoftheCommissionbypetitioning
4401+46theU.S.DistrictCourtfortheDistrictofColumbiaorthefederaldistrictwherethe
4402+47Commissionhasitsprincipaloffices.Theprevailingpartyshallbeawardedallcostsof
4403+48suchlitigation,includingreasonableattorney'sfees.
4404+49 9.(1)UponrequestbyaMemberState,theCommissionshallattempttoresolve
4405+50disputesrelatedtotheCompactthatariseamongMemberStatesandbetweenMember
4406+51andnon-MemberStates.
4407+52 (2)TheCommissionshallpromulgateaRuleprovidingforbothmediationand
4408+53bindingdisputeresolutionfordisputesasappropriate.
4409+54 10.(1)BymajorityvoteasprovidedbyRule,theCommissionmayinitiatelegal
4410+55actionagainstaMemberStateindefaultintheUnitedStatesDistrictCourtforthe
4411+HCSSSSCSSB157 121 56DistrictofColumbiaorthefederaldistrictwheretheCommissionhasitsprincipal
4412+57officestoenforcecompliancewiththeprovisionsoftheCompactanditspromulgated
4413+58Rules.Thereliefsoughtmayincludebothinjunctivereliefanddamages.Intheevent
4414+59judicialenforcementisnecessary,theprevailingpartyshallbeawardedallcostsofsuch
4415+60litigation,includingreasonableattorney'sfees.Theremedieshereinshallnotbethe
4416+61exclusiveremediesoftheCommission.TheCommissionmaypursueanyother
4417+62remediesavailableunderfederalorthedefaultingMemberState'slaw.
4418+63 (2)AMemberStatemayinitiatelegalactionagainsttheCommissionintheU.S.
4419+64DistrictCourtfortheDistrictofColumbiaorthefederaldistrictwheretheCommission
4420+65hasitsprincipalofficestoenforcecompliancewiththeprovisionsoftheCompactandits
4421+66promulgatedRules.Thereliefsoughtmayincludebothinjunctivereliefanddamages.
4422+67Intheeventjudicialenforcementisnecessary,theprevailingpartyshallbeawardedall
4423+68costsofsuchlitigation,includingreasonableattorney'sfees.
4424+69 (3)NopersonotherthanaMemberStateshallenforcethiscompactagainstthe
4425+70Commission.
4426+337.1065.1.TheCompactshallcomeintoeffectonthedateonwhichthe
4427+2CompactstatuteisenactedintolawintheseventhMemberState.
4428+3 (1)OnoraftertheeffectivedateoftheCompact,theCommissionshallconvene
4429+4andreviewtheenactmentofeachofthefirstsevenMemberStates("CharterMember
4430+5States")todetermineifthestatuteenactedbyeachsuchCharterMemberStateis
4431+6materiallydifferentthanthemodelCompactstatute.
4432+7 (a)ACharterMemberStatewhoseenactmentisfoundtobemateriallydifferent
4433+8fromthemodelCompactstatuteshallbeentitledtothedefaultprocesssetforthin
4434+9section337.1060.
4435+10 (b)IfanyMemberStateislaterfoundtobeindefault,oristerminatedor
4436+11withdrawsfromtheCompact,theCommissionshallremaininexistenceandthe
4437+12CompactshallremainineffectevenifthenumberofMemberStatesshouldbelessthan
4438+13seven.
4439+14 (2)MemberStatesenactingtheCompactsubsequenttotheseveninitialCharter
4440+15MemberStatesshallbesubjecttotheprocesssetforthinsubdivision(21)ofsubsection
4441+163ofsection337.1045todetermineiftheirenactmentsaremateriallydifferentfromthe
4442+17modelCompactstatuteandwhethertheyqualifyforparticipationintheCompact.
4443+18 (3)AllactionstakenforthebenefitoftheCommissionorinfurtheranceofthe
4444+19purposesoftheadministrationoftheCompactpriortotheeffectivedateoftheCompact
4445+20ortheCommissioncomingintoexistenceshallbeconsideredtobeactionsofthe
4446+21CommissionunlessspecificallyrepudiatedbytheCommission.
4447+HCSSSSCSSB157 122 22 (4)AnyStatethatjoinstheCompactsubsequenttotheCommission'sinitial
4448+23adoptionoftheRulesandbylawsshallbesubjecttotheRulesandbylawsastheyexist
4449+24onthedateonwhichtheCompactbecomeslawinthatState.AnyRulethathasbeen
4450+25previouslyadoptedbytheCommissionshallhavethefullforceandeffectoflawonthe
4451+26daytheCompactbecomeslawinthatState.
4452+27 2.AnyMemberStatemaywithdrawfromthisCompactbyenactingastatute
4453+28repealingthesame.
4454+29 (1)AMemberState'swithdrawalshallnottakeeffectuntil180daysafter
4455+30enactmentoftherepealingstatute.
4456+31 (2)Withdrawalshallnotaffectthecontinuingrequirementofthewithdrawing
4457+32State'sLicensingAuthoritytocomplywiththeinvestigativeandAdverseAction
4458+33reportingrequirementsofthisCompactpriortotheeffectivedateofwithdrawal.
4459+34 (3)Upontheenactmentofastatutewithdrawingfromthiscompact,aStateshall
4460+35immediatelyprovidenoticeofsuchwithdrawaltoallLicenseeswithinthatState.
4461+36Notwithstandinganysubsequentstatutoryenactmenttothecontrary,suchwithdrawing
4462+37Stateshallcontinuetorecognizealllicensesgrantedpursuanttothiscompactfora
4463+38minimumof180daysafterthedateofsuchnoticeofwithdrawal.
4464+39 3.NothingcontainedinthisCompactshallbeconstruedtoinvalidateorprevent
4465+40anylicensureagreementorothercooperativearrangementbetweenaMemberState
4466+41andanon-MemberStatethatdoesnotconflictwiththeprovisionsofthisCompact.
4467+42 4.ThisCompactmaybeamendedbytheMemberStates.Noamendmenttothis
4468+43CompactshallbecomeeffectiveandbindinguponanyMemberStateuntilitisenacted
4469+44intothelawsofallMemberStates.
4470+337.1070.1.ThisCompactandtheCommission'srulemakingauthorityshallbe
4471+2liberallyconstruedsoastoeffectuatethepurposes,andtheimplementationand
4472+3administrationoftheCompact.ProvisionsoftheCompactexpresslyauthorizingor
4473+4requiringthepromulgationofRulesshallnotbeconstruedtolimittheCommission's
4474+5rulemakingauthoritysolelyforthosepurposes.
4475+6 2.TheprovisionsofthisCompactshallbeseverableandifanyphrase,clause,
4476+7sentenceorprovisionofthisCompactisheldbyacourtofcompetentjurisdictiontobe
4477+8contrarytotheconstitutionofanyMemberState,aStateseekingparticipationinthe
4478+9Compact,oroftheUnitedStates,ortheapplicabilitythereoftoanygovernment,
4479+10agency,personorcircumstanceisheldtobeunconstitutionalbyacourtofcompetent
4480+11jurisdiction,thevalidityoftheremainderofthisCompactandtheapplicabilitythereof
4481+12toanyothergovernment,agency,personorcircumstanceshallnotbeaffectedthereby.
4482+13 3.Notwithstandingsubsection2ofthissection,theCommissionmaydenya
4483+14State'sparticipationintheCompactor,inaccordancewiththerequirementsof
4484+HCSSSSCSSB157 123 15subsection2ofsection337.1060,terminateaMemberState'sparticipationinthe
4485+16Compact,ifitdeterminesthataconstitutionalrequirementofaMemberStateisa
4486+17materialdeparturefromtheCompact.Otherwise,ifthisCompactshallbeheldtobe
4487+18contrarytotheconstitutionofanyMemberState,theCompactshallremaininfullforce
4488+19andeffectastotheremainingMemberStatesandinfullforceandeffectastothe
4489+20MemberStateaffectedastoallseverablematters.
4490+337.1075.1.ALicenseeprovidingservicesinaRemoteStateunderaMultistate
4491+2AuthorizationtoPracticeshalladheretothelawsandregulations,includinglaws,
4492+3regulations,andapplicablestandards,oftheRemoteStatewheretheclientislocatedat
4493+4thetimecareisrendered.
4494+5 2.Nothinghereinshallpreventorinhibittheenforcementofanyotherlawofa
4495+6MemberStatethatisnotinconsistentwiththeCompact.
4496+7 3.Anylaws,statutes,regulations,orotherlegalrequirementsinaMemberState
4497+8inconflictwiththeCompactaresupersededtotheextentoftheconflict.
4498+9 4.AllpermissibleagreementsbetweentheCommissionandtheMemberStates
4499+10arebindinginaccordancewiththeirterms.
4500+[191.500.Asusedinsections191.500to191.550,unlessthecontext
4501+2 clearlyindicatesotherwise,thefollowingtermsmean:
4502+3 (1)"Areaofdefinedneed",acommunityorsectionofanurbanareaof
4503+4 thisstatewhichiscertifiedbythedepartmentofhealthandseniorservicesas
4504+5 beinginneedoftheservicesofaphysiciantoimprovethepatient-doctorratio
4505+6 inthearea,tocontributeprofessionalphysicianservicestoanareaof
4506+7 economicimpact,ortocontributeprofessionalphysicianservicestoanarea
4507+8 sufferingfromtheeffectsofanaturaldisaster;
4508+9 (2)"Department",thedepartmentofhealthandseniorservices;
4509+10 (3)"Eligiblestudent",afull-timestudentacceptedandenrolledina
4510+11 formalcourseofinstructionleadingtoadegreeofdoctorofmedicineor
4511+12 doctorofosteopathy,includingpsychiatry,ataparticipatingschool,ora
4512+13 doctorofdentalsurgery,doctorofdentalmedicine,orabachelorofscience
4513+14 degreeindentalhygiene;
4514+15 (4)"Financialassistance",anamountofmoneypaidbythestateof
4515+16 Missouritoaqualifiedapplicantpursuanttosections191.500to191.550;
4516+17 (5)"Participatingschool",aninstitutionofhigherlearningwithinthis
4517+18 statewhichgrantsthedegreesofdoctorofmedicineordoctorofosteopathy,
4518+19 andwhichisaccreditedintheappropriatedegreeprogrambytheAmerican
4519+20 MedicalAssociationortheAmericanOsteopathicAssociation,oradegree
4520+21 programbytheAmericanDentalAssociationortheAmericanPsychiatric
4521+22 Association,andapplicableresidencyprogramsforeachdegreetypeand
4522+23 discipline;
4523+24 (6)"Primarycare",generalorfamilypractice,internalmedicine,
4524+25 pediatric,psychiatric,obstetricandgynecologicalcareasprovidedtothe
4525+26 generalpublicbyphysicianslicensedandregisteredpursuanttochapter334,
4526+HCSSSSCSSB157 124 27 dentalpractice,oradentalhygienistlicensedandregisteredpursuantto
4527+28 chapter332;
4528+29 (7)"Resident",anynaturalpersonwhohaslivedinthisstateforoneor
4529+30 moreyearsforanypurposeotherthantheattendingofaneducational
4530+31 institutionlocatedwithinthisstate;
4531+32 (8)"Ruralarea",atownorcommunitywithinthisstatewhichisnot
4532+33 withinastandardmetropolitanstatisticalarea,andhasapopulationofsix
4533+34 thousandorfewerinhabitantsasdeterminedbythelastprecedingfederal
4534+35 decennialcensusoranyunincorporatedareanotwithinastandard
4535+36 metropolitanstatisticalarea.]
4536+[191.505.Thedepartmentofhealthandseniorservicesshallbethe
4537+2 administrativeagencyfortheimplementationoftheprogramestablishedby
4538+3 sections191.500to191.550.Thedepartmentshallpromulgatereasonable
4539+4 rulesandregulationsfortheexerciseofitsfunctionsintheeffectuationofthe
4540+5 purposesofsections191.500to191.550.Itshallprescribetheformandthe
4541+6 timeandmethodoffilingapplicationsandsupervisetheprocessingthereof.]
4542+[191.510.Thedepartmentshallenterintoacontractwitheach
4543+2 applicantreceivingastateloanundersections191.500to191.550for
4544+3 repaymentoftheprincipalandinterestandforforgivenessofaportionthereof
4545+4 forparticipationintheserviceareasasprovidedinsections191.500to
4546+5 191.550.]
4547+[191.515.Aneligiblestudentmayapplytothedepartmentforaloan
4548+2 undersections191.500to191.550onlyif,atthetimeofhisapplicationand
4549+3 throughouttheperiodduringwhichhereceivestheloan,hehasbeenformally
4550+4 acceptedasastudentinaparticipatingschoolinacourseofstudyleadingto
4551+5 thedegreeofdoctorofmedicineordoctorofosteopathy,includingpsychiatry,
4552+6 oradoctorofdentalsurgery,adoctorofdentalmedicine,orabachelorof
4553+7 sciencedegreeindentalhygiene,andisaresidentofthisstate.]
4554+[191.520.Noloantoanyeligiblestudentshallexceedtwenty-five
4555+2 thousanddollarsforeachacademicyear,whichshallrunfromAugustfirstof
4556+3 anyyearthroughJulythirty-firstofthefollowingyear.Allloansshallbe
4557+4 madefromfundsappropriatedtothemedicalschoolloanandloanrepayment
4558+5 programfundcreatedbysection191.600,bythegeneralassembly.]
4559+[191.525.Nomorethantwenty-fiveloansshallbemadetoeligible
4560+2 studentsduringthefirstacademicyearthisprogramisineffect.Twenty-five
4561+3 newloansmaybemadeforthenextthreeacademicyearsuntilatotalofone
4562+4 hundredloansareavailable.Atleastone-halfoftheloansshallbemadeto
4563+5 studentsfromruralareasasdefinedinsection191.500.Aneligiblestudent
4564+6 mayreceiveloansforeachacademicyearheispursuingacourseofstudy
4565+7 directlyleadingtoadegreeofdoctorofmedicineordoctorofosteopathy,
4566+8 doctorofdentalsurgery,ordoctorofdentalmedicine,orabachelorofscience
4567+9 degreeindentalhygiene.]
4568+HCSSSSCSSB157 125 [191.530.Interestattherateofnineandone-halfpercentperyearshall
4569+2 bechargedonallloansmadeundersections191.500to191.550butone-fourth
4570+3 oftheinterestandprincipalofthetotalloanatthetimeoftheawardingofthe
4571+4 degreeshallbeforgivenforeachyearofparticipationbyanapplicantinthe
4572+5 practiceofhisprofessioninaruralareaoranareaofdefinedneed.The
4573+6 departmentshallgrantadeferralofinterestandprincipalpaymentstoaloan
4574+7 recipientwhoispursuinganinternshiporaresidencyinprimarycare.The
4575+8 deferralshallnotexceedthreeyears.Thestatusofeachloanrecipient
4576+9 receivingadeferralshallbereviewedannuallybythedepartmenttoensure
4577+10 compliancewiththeintentofthisprovision.Theloanrecipientwillrepaythe
4578+11 loanbeginningwiththecalendaryearfollowingcompletionofhisinternship
4579+12 orhisprimarycareresidencyinaccordancewiththeloancontract.]
4580+[191.535.Ifastudentceaseshisstudypriortoreceivingadegree,
4581+2 interestattheratespecifiedinsection191.530shallbechargedontheamount
4582+3 receivedfromthestateundertheprovisionsofsections191.500to191.550.]
4583+[191.540.1.Thedepartmentshallestablishschedulesandprocedures
4584+2 forrepaymentoftheprincipalandinterestofanyloanmadeunderthe
4585+3 provisionsofsections191.500to191.550andnotforgivenasprovidedin
4586+4 section191.530.
4587+5 2.Apenaltyshallbeleviedagainstapersoninbreachofcontract.
4588+6 Suchpenaltyshallbetwicethesumoftheprincipalandtheaccruedinterest.]
4589+[191.545.Whennecessarytoprotecttheinterestofthestateinany
4590+2 loantransactionundersections191.500to191.550,theboardmayinstitute
4591+3 anyactiontorecoveranyamountdue.]
4592+[191.550.Thecontractsmadewiththeparticipatingstudentsshallbe
4593+2 approvedbytheattorneygeneral.]
4594+[335.212.Asusedinsections335.212to335.242,thefollowingterms
4595+2 mean:
4596+3 (1)"Board",theMissouristateboardofnursing;
4597+4 (2)"Department",theMissouridepartmentofhealthandsenior
4598+5 services;
4599+6 (3)"Director",directoroftheMissouridepartmentofhealthand
4600+7 seniorservices;
4601+8 (4)"Eligiblestudent",aresidentwhohasbeenacceptedasafull-time
4602+9 studentinaformalcourseofinstructionleadingtoanassociatedegree,a
4603+10 diploma,abachelorofscience,amasterofscienceinnursing(M.S.N.),a
4604+11 doctorateinnursing(Ph.D.orD.N.P.),orastudentwithamasterofsciencein
4605+12 nursingseekingadoctorateineducation(Ed.D.),orleadingtothecompletion
4606+13 ofeducationalrequirementsforalicensedpracticalnurse.Thedoctoral
4607+14 applicantmaybeapart-timestudent;
4608+15 (5)"Participatingschool",aninstitutionwithinthisstatewhichis
4609+16 approvedbytheboardforparticipationintheprofessionalandpractical
4610+17 nursingstudentloanprogramestablishedbysections335.212to335.242,
4611+HCSSSSCSSB157 126 18 havinganursingdepartmentandofferingacourseofinstructionbasedon
4612+19 nursingtheoryandclinicalnursingexperience;
4613+20 (6)"Qualifiedapplicant",aneligiblestudentapprovedbytheboardfor
4614+21 participationintheprofessionalandpracticalnursingstudentloanprogram
4615+22 establishedbysections335.212to335.242;
4616+23 (7)"Qualifiedemployment",employmentonafull-timebasisin
4617+24 Missouriinapositionrequiringlicensureasalicensedpracticalnurseor
4618+25 registeredprofessionalnurseinanyhospitalasdefinedinsection197.020orin
4619+26 anyagency,institution,ororganizationlocatedinanareaofneedas
4620+27 determinedbythedepartmentofhealthandseniorservices.Anyforgiveness
4621+28 ofsuchprincipalandinterestforanyqualifiedapplicantengagedinqualified
4622+29 employmentonalessthanfull-timebasismaybeproratedtoreflectthe
4623+30 amountsprovidedinthissection;
4624+31 (8)"Resident",anypersonwhohaslivedinthisstateforoneormore
4625+32 yearsforanypurposeotherthantheattendingofaneducationalinstitution
4626+33 locatedwithinthisstate.]
4627+[335.215.1.Thedepartmentofhealthandseniorservicesshallbethe
4628+2 administrativeagencyfortheimplementationoftheprofessionalandpractical
4629+3 nursingstudentloanprogramestablishedundersections335.212to335.242,
4630+4 andthenursingstudentloanrepaymentprogramestablishedundersections
4631+5 335.245to335.259.
4632+6 2.Anadvisorypanelofnursesshallbeappointedbythedirector.It
4633+7 shallbecomposedofnotmorethanelevenmembersrepresentingpractical,
4634+8 associatedegree,diploma,baccalaureateandgraduatenursingeducation,
4635+9 communityhealth,primarycare,hospital,long-termcare,aconsumer,andthe
4636+10 Missouristateboardofnursing.Thepanelshallmakerecommendationstothe
4637+11 directoronthecontentofanyrules,regulationsorguidelinespriortotheir
4638+12 promulgation.Thepanelmaymakerecommendationstothedirector
4639+13 regardingfundallocationsforloansandloanrepaymentbasedoncurrent
4640+14 nursingshortageneeds.
4641+15 3.Thedepartmentofhealthandseniorservicesshallpromulgate
4642+16 reasonablerulesandregulationsfortheexerciseofitsfunctionpursuantto
4643+17 sections335.212to335.259.Itshallprescribetheform,thetimeandmethod
4644+18 offilingapplicationsandsupervisetheproceedingsthereof.Noruleorportion
4645+19 ofarulepromulgatedundertheauthorityofsections335.212to335.257shall
4646+20 becomeeffectiveunlessithasbeenpromulgatedpursuanttotheprovisionsof
4647+21 section536.024.
4648+22 4.Ninety-fivepercentoffundsloanedpursuanttosections335.212to
4649+23 335.242shallbeloanedtoqualifiedapplicantswhoareenrolledin
4650+24 professionalnursingprogramsinparticipatingschoolsandfivepercentof
4651+25 thefundsloanedpursuanttosections335.212to335.242shallbeloanedto
4652+26 qualifiedapplicantswhoareenrolledinpracticalnursingprograms.Priority
4653+27 shallbegiventoeligiblestudentswhohaveestablishedfinancialneed.All
4654+28 loanrepaymentfundspursuanttosections335.245to335.259shallbeusedto
4655+29 reimbursesuccessfulassociate,diploma,baccalaureateorgraduate
4656+30 professionalnurseapplicants'educationalloanswhoagreetoserveinareas
4657+31 ofdefinedneedasdeterminedbythedepartment.]
4658+HCSSSSCSSB157 127 [335.218.Thereisherebyestablishedthe"ProfessionalandPractical
4659+2 NursingStudentLoanandNurseLoanRepaymentFund".Allfeespursuantto
4660+3 section335.221,generalrevenueappropriationstothestudentloanorloan
4661+4 repaymentprogram,voluntarycontributionstosupportormatchthestudent
4662+5 loanandloanrepaymentprogramactivities,fundscollectedfromrepayment
4663+6 andpenalties,andfundsreceivedfromthefederalgovernmentshallbe
4664+7 depositedinthestatetreasuryandbeplacedtothecreditoftheprofessional
4665+8 andpracticalnursingstudentloanandnurseloanrepaymentfund.Thefund
4666+9 shallbemanagedbythedepartmentofhealthandseniorservicesandall
4667+10 administrativecostsandexpensesincurredasaresultoftheeffectuationof
4668+11 sections335.212to335.259shallbepaidfromthisfund.]
4669+[335.221.Theboard,inadditiontoanyotherdutiesitmayhave
4670+2 regardinglicensureofnurses,shallcollect,atthetimeoflicensureorlicensure
4671+3 renewal,aneducationsurchargefromeachpersonlicensedorrelicensed
4672+4 pursuanttosections335.011to335.096,intheamountofonedollarperyear
4673+5 forpracticalnursesandfivedollarsperyearforprofessionalnurses.These
4674+6 fundsshallbedepositedintheprofessionalandpracticalnursingstudentloan
4675+7 andnurseloanrepaymentfund.Allexpendituresauthorizedbysections
4676+8 335.212to335.259shallbepaidfromfundsappropriatedbythegeneral
4677+9 assemblyfromtheprofessionalandpracticalnursingstudentloanandnurse
4678+10 loanrepaymentfund.Theprovisionsofsection33.080tothecontrary
4679+11 notwithstanding,moneyinthisfundshallnotbetransferredandplacedtothe
4680+12 creditofgeneralrevenue.]
4681+[335.224.Thedepartmentofhealthandseniorservicesshallenterinto
4682+2 acontractwitheachqualifiedapplicantreceivingfinancialassistanceunder
4683+3 theprovisionsofsections335.212to335.242forrepaymentoftheprincipal
4684+4 andinterest.]
4685+[335.227.Aneligiblestudentmayapplytothedepartmentfor
4686+2 financialassistanceundertheprovisionsofsections335.212to335.242if,at
4687+3 thetimeofhisapplicationforaloan,theeligiblestudenthasformallyapplied
4688+4 foracceptanceataparticipatingschool.Receiptoffinancialassistanceis
4689+5 contingentuponacceptanceandcontinuedenrollmentataparticipating
4690+6 school.]
4691+[335.230.Financialassistancetoanyqualifiedapplicantshallnot
4692+2 exceedtenthousanddollarsforeachacademicyearforaprofessionalnursing
4693+3 programandshallnotexceedfivethousanddollarsforeachacademicyearfor
4694+4 apracticalnursingprogram.Allfinancialassistanceshallbemadefromfunds
4695+5 creditedtotheprofessionalandpracticalnursingstudentloanandnurseloan
4696+6 repaymentfund.Aqualifiedapplicantmayreceivefinancialassistancefor
4697+7 eachacademicyearheremainsastudentingoodstandingataparticipating
4698+8 school.]
4699+HCSSSSCSSB157 128 [335.233.Thedepartmentshallestablishschedulesforrepaymentof
4700+2 theprincipalandinterestonanyfinancialassistancemadeunderthe
4701+3 provisionsofsections335.212to335.242.Interestattherateofnineand
4702+4 one-halfpercentperannumshallbechargedonallfinancialassistancemade
4703+5 undertheprovisionsofsections335.212to335.242,buttheinterestand
4704+6 principalofthetotalfinancialassistancegrantedtoaqualifiedapplicantatthe
4705+7 timeofthesuccessfulcompletionofanursingdegree,diplomaprogramora
4706+8 practicalnursingprogramshallbeforgiventhroughqualifiedemployment.]
4707+[335.236.Thefinancialassistancerecipientshallrepaythefinancial
4708+2 assistanceprincipalandinterestbeginningnotmorethansixmonthsafter
4709+3 completionofthedegreeforwhichthefinancialassistancewasmadein
4710+4 accordancewiththerepaymentcontract.Ifaneligiblestudentceaseshisstudy
4711+5 priortosuccessfulcompletionofadegreeorgraduationataparticipating
4712+6 school,interestattheratespecifiedinsection335.233shallbechargedonthe
4713+7 amountoffinancialassistancereceivedfromthestateundertheprovisionsof
4714+8 sections335.212to335.242,andrepayment,inaccordancewiththerepayment
4715+9 contract,shallbeginwithinninetydaysofthedatethefinancialaidrecipient
4716+10 ceasedtobeaneligiblestudent.Allfundsrepaidbyrecipientsoffinancial
4717+11 assistancetothedepartmentshallbedepositedintheprofessionalandpractical
4718+12 nursingstudentloanandnurseloanrepaymentfundforusepursuantto
4719+13 sections335.212to335.259.]
4720+[335.239.Thedepartmentshallgrantadeferralofinterestand
4721+2 principalpaymentstoafinancialassistancerecipientwhoispursuingan
4722+3 advanceddegree,specialnursingprogram,oruponspecialconditions
4723+4 establishedbythedepartment.Thedeferralshallnotexceedfouryears.
4724+5 Thestatusofeachdeferralshallbereviewedannuallybythedepartmentof
4725+6 healthandseniorservicestoensurecompliancewiththeintentofthissection.]
4726+[335.242.Whennecessarytoprotecttheinterestofthestateinany
4727+2 financialassistancetransactionundersections335.212to335.259,the
4728+3 departmentofhealthandseniorservicesmayinstituteanyactiontorecover
4729+4 anyamountdue.]
4730+[335.245.Asusedinsections335.245to335.259,thefollowingterms
4731+2 mean:
4732+3 (1)"Department",theMissouridepartmentofhealthandsenior
4733+4 services;
4734+5 (2)"Eligibleapplicant",aMissourilicensednursewhohasattained
4735+6 eitheranassociatedegree,adiploma,abachelorofscience,orgraduatedegree
4736+7 innursingfromanaccreditedinstitutionapprovedbytheboardofnursingora
4737+8 studentnurseinthefinalyearofafull-timebaccalaureateschoolofnursing
4738+9 leadingtoabaccalaureatedegreeorgraduatenursingprogramleadingtoa
4739+10 master'sdegreeinnursingandhasagreedtoserveinanareaofdefinedneedas
4740+11 establishedbythedepartment;
4741+12 (3)"Participatingschool",aninstitutionwithinthisstatewhichgrants
4742+13 anassociatedegreeinnursing,grantsabachelorormasterofsciencedegreein
4743+HCSSSSCSSB157 129 14 nursingorprovidesadiplomanursingprogramwhichisaccreditedbythestate
4744+15 boardofnursing,oraregionallyaccreditedinstitutioninthisstatewhich
4745+16 providesabachelorofsciencecompletionprogramforregisteredprofessional
4746+17 nurses;
4747+18 (4)"Qualifiedemployment",employmentonafull-timebasisin
4748+19 Missouriinapositionrequiringlicensureasalicensedpracticalnurseor
4749+20 registeredprofessionalnurseinanyhospitalasdefinedinsection197.020or
4750+21 publicornonprofitagency,institution,ororganizationlocatedinanareaof
4751+22 needasdeterminedbythedepartmentofhealthandseniorservices.Any
4752+23 forgivenessofsuchprincipalandinterestforanyqualifiedapplicantengaged
4753+24 inqualifiedemploymentonalessthanfull-timebasismaybeproratedto
4754+25 reflecttheamountsprovidedinthissection.]
4755+[335.248.Sections335.245to335.259shallbeknownasthe"Nursing
4756+2 StudentLoanRepaymentProgram".Thedepartmentofhealthandsenior
4757+3 servicesshallbetheadministrativeagencyfortheimplementationofthe
4758+4 authorityestablishedbysections335.245to335.259.Thedepartmentshall
4759+5 promulgatereasonablerulesandregulationsnecessarytoimplementsections
4760+6 335.245to335.259.Promulgatedrulesshallinclude,butnotbelimitedto,
4761+7 applicanteligibility,selectioncriteria,prioritizationofserviceobligationsites
4762+8 andthecontentofloanrepaymentcontracts,includingrepaymentschedules
4763+9 forthoseindefaultandpenalties.Thedepartmentshallpromulgaterules
4764+10 regardingrecruitmentopportunitiesforminoritystudentsintonursingschools.
4765+11 Priorityforstudentloanrepaymentshallbegiventoeligibleapplicantswho
4766+12 havedemonstratedfinancialneed.Allfundscollectedbythedepartmentfrom
4767+13 participantsnotmeetingtheircontractualobligationstothestateshallbe
4768+14 depositedintheprofessionalandpracticalnursingstudentloanandnurseloan
4769+15 repaymentfundforusepursuanttosections335.212to335.259.]
4770+[335.251.Uponproperverificationtothedepartmentbytheeligible
4771+2 applicantofsecuringqualifiedemploymentinthisstate,thedepartmentshall
4772+3 enterintoaloanrepaymentcontractwiththeeligibleapplicanttorepaythe
4773+4 interestandprincipalontheeducationalloansoftheapplicanttothelimitof
4774+5 thecontract,whichcontractshallprovideforinstancesoflessthanfull-time
4775+6 qualifiedemploymentconsistentwiththeprovisionsofsection335.233,outof
4776+7 anyappropriationmadetotheprofessionalandpracticalnursingstudentloan
4777+8 andnurseloanrepaymentfund.Iftheapplicantbreachesthecontractby
4778+9 failingtobeginorcompletethequalifiedemployment,thedepartmentis
4779+10 entitledtorecoverthetotaloftheloanrepaymentpaidbythedepartmentplus
4780+11 interestontherepaidamountattherateofnineandone-halfpercentper
4781+12 annum.]
4782+[335.254.Sections335.212to335.259shallnotbeconstruedto
4783+2 requirethedepartmenttoenterintocontractswithindividualswhoqualifyfor
4784+3 nursingeducationloansornursingloanrepaymentprogramswhenfederal,
4785+4 stateandlocalfundsarenotavailableforsuchpurposes.]
4786+HCSSSSCSSB157 130 [335.257.Successfulapplicantsforwhomloanpaymentsaremade
4787+2 undertheprovisionsofsections335.245to335.259shallverifytothe
4788+3 departmenttwiceeachyearinthemannerprescribedbythedepartmentthat
4789+4 qualifiedemploymentinthisstateisbeingmaintained.]
4790+✔
4791+HCSSSSCSSB157 131