SB 293 - This act modifies provisions relating to advanced practice registered nurses (APRNs). This act repeals all current requirements for a written collaborative practice arrangement between an APRN and a collaborating physician, including geographic proximity requirements, except for the requirements that the arrangement have the name, address, phone number, license numbers of the APRN and collaborating physician, and a description of the APRN's controlled substance prescriptive authority.
This act removes a limit on the number of APRNs with whom a physician may enter collaborative practice arrangements and also repeals an exception to this limit for certified registered nurse anesthetists providing anesthesia services under the supervision of a physician, dentist, or podiatrist.
(Sections 334.037, 334.104, and 334.735)
This act requires an advanced practice registered nurse to have been granted a certificate of controlled substance prescriptive authority in order to be delegated, as part of a collaborative practice arrangement, authority to administer, dispense, or prescribe certain controlled substances as defined in the act.
Any previously adopted rules regulating the use of collaborative practice arrangements, except rules delegating the authority to prescribe controlled substances, are null and void from the effective date of this act.
The State Board of Registration for the Healing Arts shall, rather than may, make available to the public information identifying physicians and licensed professionals in engaged in any collaborative practice arrangement or physician assistant agreement.
Under current law, no collaborative practice arrangement shall supersede certain hospital licensing regulations as defined in current law, and no contract or other agreement shall limit a collaborating physician's ultimate authority over protocols, standing orders, or delegation of the authority to an APRN, insofar as the exercise of authority does not violate applicable medical standards. This act repeals these provisions. (Section 334.104)
This act is similar to HB 2226 (2020), HB 1441 (2020), HB 301 (2019), HB 693 (2019), SCS/SB 400 (2019), SCS/HB 705 (2019), SB 460 (2019), and HB 1502 (2018).
MATT KIMMINAU
Statutes affected: Introduced (0848S.02):
334.037,
334.104,
334.735
Senate Committee Minutes: SENATE COMMITTEE MINUTES Bill No.: SB 293
Sponsor: Hoskins
Hearing Date: 3/22/2021
COMMITTEE: Professional Registration
CHAIRMAN: Riddle
DATE REFERRED: 2/4/2021 DATE HEARING REQUESTED: 3/11/2021
STAFF:
Lindsey Alexander
Mary Cottom
Matt kimminau
Rob Krosley
WITNESSES GIVING INFORMATION:
WITNESSES FOR:
Jeremy Cady - Americans for Prosperity
Derek Leffert - Association of Missouri Nurse Practitioners
Jennifer Bernstein - National Council of Jewish Women St. Louis
Nicholas Fleming
Elise Schaller
Laurie Sparr - AMNP, MONA
Shanna Chapman - Association of Missouri Nurse Practitioners
Laura Kuensting
Susan Klotz
Mandy Hagseth - Missouri Family Health Council, Inc.
Brandon Forester - Please find written testimony attached.
Deborah Blinzler - Deborah BLinzler APRN, FNP-BC
Carl Smith - Carl Smith
William Bates - LeadingAge Missouri
Richard AuBuchon - Missouri Association of Nurse Practitioners
Christine Corbett - Christine Corbett DNP and Assoc MO NPs
Bruce Fletcher - Individual
Sarah Thompson - UM School of Nursing
Elaine Briggs - Individual
Carla Moore Beckesle - APRN
Kim Anderson - MO Affiliate American College of Nurse- Midwives
Laurie Sparr - Assoc of MO Nurse Practitioners
Nathan Granatham - Individual
Heidi Lucas - MO Nurse Assoc
Kathi Harness - Natl Council of State Board of Nursing; St. Lukes Health Care Systems
Laura Kuensting - Individual
Justin Alferman - SSM Health
Derek Leffert - assoc
Jessica Petrie - BJC Healthcare; MO Assoc. of Rural Health Clinics
Nancy Giddens - United WE
Mary Beck
COMMITTEE: Professional Registration
CHAIRMAN: Riddle
DATE REFERRED: 2/4/2021 DATE HEARING REQUESTED: 3/11/2021
WITNESSES AGAINST:
Amanda Harris - Heidi B. Miller, MD, St. Louis Regional Health Commission
Stephen Nittler - MAOPS opposes SB 293, as we support APRN licensure only if under the Board of Healing Arts to
ensure
Arnie C. AC "Honest-Abe" DIENOFF - State Public Advocate-More Practice & Oversight Needed
Todd Shaffer - MD
George Hubble - MSMA
David Jackson - MO Society of Anesthesiologist; MO Dermatological Society; American College of Obstericians and
Gynecologists
Kathryn Gamble - MO College of Emergency Physicians; WashU