Government Relations

UM Legislative Update Newsletter

May 22, 2007

Overview of health-related legislation passed by General Assembly

The 2007 legislative session closed with the passage of a number of health care-related bills, including the MO HealthNet bill to reform Medicaid, SB577. These bills now await the governor´s signature or veto. If the governor chooses not to veto or sign the bills by July 14, 2007, they will automatically become law as of Aug. 28, 2007.

SB 3: Modifies various provisions regarding mental health. Fire safety standards, abuse and neglect investigation, and sex offender notification procedures are modified and the term "vulnerable persons" is defined. A mental health fatality review panel is also created to review suspicious deaths of mental health clients.

SB 4: This act extends the sunsets for the Medicaid Managed Care Organization reimbursement allowance and the Pharmacy Tax to June 30, 2009. The sunset for the Federal Reimbursement Allowance assessment and the Nursing Facility Reimbursement Allowance sunsets are extended to September 30, 2011.

SB 16: Beginning July 1, 2008, this act allows every child enrolling in kindergarten or first grade to receive a comprehensive vision examination from an optometrist or physician. The act also requires public schools to conduct eye screenings before a child leaves first grade and third grade. A Children´s Vision Commission is created to oversee the requirements.

SB 25: Modifies various provisions relating to children´s services. Child abuse and neglect investigations and child support enforcement procedures are modified. Prior authorization will not be required under MO HealthNet for psychological or counseling services for children under six or any child in the custody of or adopted from the state.

SB 46: This act requires the Director of the Department of Social Services to designate liaisons to faith-based organizations in each region of the state. The liaison will communicate with and promote faith-based organizations to provide private community services for persons in need who otherwise would require public services.

SB 112: Modifies provisions related to special education for children. The Missouri Sunset Act will not apply to the early intervention program for infants and toddlers (First Steps Program). It also removes statutory references to "handicapped" as related to children and replaces it with "children with disabilities".

SB 195: This act allows pharmacists to receive a certificate of medication therapeutic plan authority in order to accept and administer a patient´s order for a medication therapeutic plan. The act also changes the "practice of pharmacy" to allow the administration of vaccines. A Well-Being Committee is created for pharmacists requiring intervention, treatment, or rehabilitation.

SB 272: A variety of changes are made to professional registration and licensing of professionals, including physical therapists and pharmacists. The makeup of the Advisory Commission for Physical Therapists is modified to include a physical therapist assistant. The definition of "physical therapist" is also modified. A multi-year license for pharmacy interns will now be allowed and the Board may issue and enforce cease and desist orders to stop unauthorized practices and it may issue veterinary permits to pharmacies. The act also allows Schools of Nursing and Schools of Medicine to access the state´s employee disqualification list.

SB 308: Modifies laws relating to the practice of licensed professionals. Every child enrolling in kindergarten or first grade and again before third grade will receive a comprehensive vision examination from an optometrist or physician. The makeup of the Board of Registration for the Healing Arts is modified to require at least 5 members to be graduates of professional schools accredited by the LCME or recognized by the Educational Commission for Foreign Medical Graduates. The supervision of Physician Assistants is modified (similar to HB497 description below). Definitions are created for terms relating to lapsed or temporary licenses for nurses. The State Board of Nursing is also allowed to create an impaired nurse program and provisions are modified relating to disciplinary actions against nurses. The definition of "practice of optometry" is modified and reciprocity will be allowed for out-of-state optometrists. In addition, continuing education requirements will be raised within a 2-year period from 8 hours to 32 hours. Licensing for clinical and baccalaureate social workers is expanded and 3000 hours of supervised clinical experience will be required. Audiologists may fit, program, and dispense assistive listening devices and retailers may employ audiologists in lieu of the current requirements for a licensed hearing aid specialist. The definition of "health care professional" is modified as it relates to who is subject to peer review to include physical therapists, emergency medical technicians, and emergency medical dispatchers.

SB 397: Provisions for applications for long-term care facilities are modified to no longer require affidavits under oath or certified copies of documents. Applicants must attest by signature that documents are true.

SB 513:: Nurses working in any institution within an area of need in Missouri will qualify for the Professional and Practical Nursing Student Loan Program.

SCR 5: Recognizes November 21, 2007, as Chronic Obstructive Pulmonary Disease Awareness Day and November as COPD month.

HB 98: Allows area agencies on aging to establish volunteer transportation programs to take elderly clients to and from health-related appointments.

HB 182: Allows for recognition of Outside the Hospital Do-Not-Resuscitate orders by emergency medical providers for patients receiving treatment outside the hospital. Any DNR order must be included as the first page of a patient´s medical record.

HB 352: Increases the rates paid to disabled employees by sheltered workshops.

HB 444: Authorizes an income tax deduction to be phased in over six years for social security benefits and benefits received from a public retirement system for those 62 years of age or older. A deduction is also allowed for 100 percent of the qualified health insurance premiums paid if premiums are not already deducted from federal taxable income.

HB 497: This act expands the definition of "supervision of physician assistants" to include supervision by a physician via telecommunication. Supervising physicians must be present a minimum of 66 percent of the clinic´s hours. PAs must practice within 30 miles of the supervising physician. The Advisory Commission on Physician Assistants may grant a waiver to individual physicians and PAs for an alternate amount of on-site supervision. Upon granting a waiver, a PA may practice unsupervised up to 50 miles from a physician if in a designated health professional shortage area. After Jan. 1, 2008, a PA applicant will be required to have a master´s degree in a health- or medical-science related field.

HB 554: Prohibits discrimination between licensed professional counselors when establishing rules and requiring or recommending services.

HB 555: Modifies procedures when an inmate files a complaint against a licensed professional counselor or a social worker. Unsubstantiated claims do not need to be disclosed.

HB 579: Allows any health care professional licensed in Missouri or in any other state to volunteer for deployment during an emergency declared by the Governor. Such volunteers will receive immunity from civil liability. The Department of Health and Senior Services may recruit, train and accept the services of citizen volunteers to dispense medication in a public health emergency.

HB 780: Modified various provisions related to professional licensing. Certain professionals on active military duty are allowed to extend their license renewal deadline until 60 days after completing military service. (Provisions are substantially similar to SB308). Establishes the Chronic Kidney Disease Task Force. Allows a graduate of a foreign medical school to be a member of the Board of Registration for the Healing Arts. Modifies provisions relating to the licensing of nurses, optometrists, and social workers. The definition of the practice of audiology is expanded. The Department of Health and Senior Services must provide the employee disqualification list to any school of nursing, medicine or other health profession in order to verify whether any student engaging in patient care is on the list.

HB 818: Establishes the Missouri Health Insurance Portability and Accountability Act to modify laws regarding health insurance carriers and assist in providing health insurance coverage to the currently uninsured. The Missouri Consolidated Health Care Plan must offer all qualified state employees and retirees the option of a high-deductible health insurance plan combined with a health savings account. One hundred percent of qualified health insurance premiums may be deducted from Missouri taxable income. A process is established for hospitals and other health care providers to intercept a person´s tax refund or lottery winnings to cover an existing debt. Requires health care providers to give certain information to anyone receiving a positive result on a prenatal test for Down´s syndrome or other condition. Health insurance providers must allow coverage of certain employee dependents up to 25 years of age and must notify enrollees of additions or deletions in prescription drug coverage. Allows anyone with a current certification as a minister of religion or a certification in the science of childbirth, midwifery, or obstetrics by an organization accredited by the National Organization for Competency Assurance to provide services related to pregnancy, including prenatal, delivery, and post-partum services.

HB 948: Requires newborn screening test specimens to be kept by the Department of Health and Senior Services for five years and then destroyed, unless otherwise directed. A specimen released for anonymous study must omit any identifying information of the donor. The department may charge a fee for the use of specimens for public health research. Children between six and 18 who are at 300 percent of poverty or below or individuals who are 19 and meet income requirements may apply for the Metabolic Formula Distribution Plan.

HB 1055: Modifies laws regarding sexual education in public schools and abortions. Allows schools to present information regarding contraception and STDs in a manner consistent with federal abstinence laws. Public schools and charter schools may not provide abortion services or allow anyone who provides abortion services to give any information regarding sexuality or STDs. Defines a "medical emergency" justifying an abortion as a condition that would cause death or a serious risk of substantial and irreversible impairment of a major bodily function to the mother. Penalties may apply to anyone who induces or knowingly aids in the inducement of an abortion (current law limits penalties to knowingly performing or aiding). Provides for an affirmative medical emergency defense for abortion provision violations. Establishes the Missouri Alternatives to Abortion Program to provide services or counseling to pregnant women or mothers. Federal, public, and private funds must be prioritized for use in this Program first. Public or private agencies participating in the program are not required to provide services or counseling regarding contraception, birth control, or services for pregnancies. Such agencies are prohibited from providing abortion referrals. Changes the definition of "ambulatory surgical center" to include any establishment operated for the purpose of performing or inducing any second or third trimester abortion or which performs at least five or more first trimester abortions per month.

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