Missouri Dental Board pilot projects; (21) physical therapists; (22) audiologists and speech-language pathologists; (23) dentistry; (24) medical retainer agreements; (25) syringe access programs; (26) services for foster children and clients of the Department of Mental Health; (27) civil detentions; and (28) the repeal of certain Department of Health and Senior Services statutes.

SICKLE CELL (Sections 9.236 and 208.184)

This act establishes the third full week in September each year as "Sickle Cell Awareness Week".

This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS#2/SB 710 (2022), the truly agreed to and finally passed SS/SCS/HCS/HB 2627 (2022), the truly agreed to and finally passed SS/SCS/HB 1738 (2022), SB 1145 (2022), HCS/HB 2462 (2022), HB 2559 (2022), HB 2653 (2022), HCS/HB 2658 (2022), HCS/SS/SCS/SB 46 (2021), and CCS#2/HCS/SS/SB 64 (2021).

Under this act, the Advisory Council on Rare Diseases and Personalized Medicine within the MO HealthNet Division shall annually review specified issues relating to sickle cell disease, including medications and treatment options. After each annual review, the Division may develop a report of the review to be made available to the public.

This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS#2/SB 710 (2022), HCS/HB 2658 (2022), and HB 2653 (2022) and similar to a provision in SB 1147 (2022) and HB 2559 (2022).

SUBSTANCE ABUSE AWARENESS AND PREVENTION MONTH (Section 9.347)

This act establishes October as "Substance Abuse Awareness and Prevention Month".

This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HB 1738 (2022), HCS/HB 2463 (2022), and HB 1838 (2022).

BLACK MATERNAL HEALTH WEEK (Section 9.364)

This act establishes the week of April 11 through April 17 of each year as "Black Maternal Health Week".

This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS#2/SB 710 (2022).

MINORITY HEALTH MONTH (Section 9.365)

This act establishes April as "Minority Health Month".

MEDICAL PRECEPTORSHIP TAX CREDIT (Section 135.690)

For all tax years beginning on or after January 1, 2023, this act authorizes a taxpayer to claim a tax credit for serving as a community-based faculty preceptor for a medical student core preceptorship or a physician assistant student core preceptorship, as such terms are defined in the act. The tax credit shall be equal to $1,000 for each preceptorship, but not to exceed $3,000 in any tax year. Tax credits authorized by the act shall not be refundable or transferable, and shall not be carried forward or backward to any other tax year. The total amount of tax credits authorized in a given year shall not exceed $200,000. Additional tax credits may be authorized provided in amount not to exceed the excess funds available in the Medical Preceptor Fund, as created by the act.

Beginning January 1, 2023, the Division of Professional Registration of the Missouri Department of Commerce and Insurance shall increase the license fees for physicians and surgeons by $7 and for physician assistants by $3, with such revenues to be deposited in the Medical Preceptor Fund. At the end of each tax year, an amount equal to the total dollar amount of tax credits claimed during the tax year shall be transferred to the General Revenue Fund.

This provision is substantially similar to provisions in the truly agreed to and finally passed SS/SCS/HB 2331 (2022), SCS/SB 801 (2022), SS/HB 502 (2021), HCS/SCS/SB 403 (2021), HCS/SS/SB 580 (2020), and HB 2036 (2020).

WILL'S LAW (Sections 167.625 and B)

This act establishes "Will's Law," requiring individualized health care plans to be developed by school nurses in public schools and charter schools. Such plans shall be developed in consultation with a student's parent or guardian and appropriate medical professionals that address procedural guidelines and specific directions for particular emergency situations relating to the student's epilepsy or seizure disorder. Plans are to be updated at the beginning of each school year and as necessary. Notice must be given to any school employee that may interact with the student, including symptoms of the epilepsy or seizure disorder and any medical and treatment issues that may affect the educational process.

All school employees shall be trained every two years in the care of students with epilepsy and seizure disorders. Training shall include an online or in-person course of instruction approved by the Department of Health and Senior Services. School personnel shall obtain a release from a student   s parent to authorize the sharing of medical information with other school employees as necessary.

This act protects school employees from being held liable for any good faith act or omission while performing their duties.

This provision contains an emergency clause.

This provision is identical to provisions in the truly agreed to and finally passed CCS/HCS#2/SB 710 (2022), the truly agreed to and finally passed CCS#2/HCS/SS/SCS/SBs 681 & 662 (2022), SCS/SB 187 (2021), and provisions in HCS/SS/SCS 152 (2021) and is substantially similar to HB 2588 (2020).

SUICIDE AWARENESS AND PREVENTION (Sections 170.047, 170.048, 173.1200, and 338.061)

This act establishes the "Jason Flatt/Avery Reine Cantor Act", which provides that beginning in the 2023-2024 school year, each school district may offer at least 2 hours of suicide prevention training for all practicing teachers. All teachers, principals, and licensed educators may attend such a training or complete training on suicide prevention through self-review of suicide prevention materials. The Department of Elementary and Secondary Education may develop materials to be used for such training or may offer districts materials developed by a third party.

This provision is identical to provision in the truly agreed to and finally passed CCS#2/HCS/SS/SCS/SBs 681 & 662 (2022) and HCS/HB 2136 (2022) and substantially similar to SCS/SB 1142 (2022).

Beginning July 1, 2023, this act requires a public school or charter school with pupils in grades seven to twelve, as well as a public institution of higher education, that issues pupil or student identification cards to print the 3-digit dialing code that directs calls and routes text messages to the Suicide and Crisis Lifeline, 988.

These provisions are identical to provisions in the truly agreed to and finally passed HCS/HB 718 (2022), SCS/SB 1142 (2022), and HCS/HB 2136 (2022) and similar to HB 2238 (2022).

This act also establishes the "Tricia Leann Tharp Act" and states that the Board of Pharmacy shall recommend 2 hours of continuing education in suicide awareness and prevention for all licensed pharmacists. The 2 hours of suicide awareness and prevention education would count toward the total continuing education requirement for license renewal for every pharmacist. The Board of Pharmacy is authorized to develop guidelines suitable for training materials.

This provision is identical to provisions in HB 1644 (2022), HCS/HB 2136 (2022), HCS/HB 1677 (2022), HB 2316 (2022), and HCS/HB 2452 (2022).

EMERGENCY HEALTH CARE SERVICES (Sections 190.100, 190.101, 190.103, 190.176, 190.200, 190.241, 190.243, 190.245, and 190.257)

Under this act, the state EMS medical director shall serve as an ex officio member of the State Advisory Council on Emergency Medical Services. The Council shall consult with the Time-Critical Diagnosis Advisory Committee established under this act regarding time-critical diagnosis, defined as trauma care, stroke care, and STEMI care occurring either outside of a hospital or in a designated center.

The State EMS Medical Director's Advisory Committee shall review and make recommendations regarding all proposed community and regional time-critical diagnosis plans.

This act repeals the requirement under current law that hospitals disclose data elements under the Missouri Brain and Spinal Cord Injury Registry to the Department of Health and Senior Services' uniform data collection system on all ambulance runs and injured patients.

The Department shall cooperate with hospitals to provide public and professional information related to emergency medical services systems. The Department may provide public information of hospital designations as trauma, stroke, or STEMI centers. The Department shall make publicly available research and guidelines recommended by the Time-Critical Diagnosis Advisory Committee for recommended treatment standards. Currently, the Department makes recommendations for treatment standards, establishes protocols for transport of patients, and approves the development of regional or community-based plans for transporting STEMI or stroke patients. This act includes trauma patients.

Currently, the Department shall conduct a site review of a hospital to determine the applicable level of trauma center, STEMI, or stroke center criteria. Under this act, the site review may occur onsite or by any reasonable means of communication or combination thereof. In developing trauma, STEMI, or stroke center designation criteria, the Department shall use, as practicable, peer-reviewed and evidence-based clinical research and guidelines.

Currently, the Department shall conduct an onsite review of every trauma, STEMI, or stroke center every 5 years. Under this act, a site review shall be conducted every 3 years. The Department may deny, place on probation, suspend, or revoke a center's designation if it has determined there has been a substantial failure to comply with certain regulations. Centers that are placed on probationary status shall show compliance with these regulations within 12 months, unless otherwise provided by a settlement agreement with a maximum duration of 18 months.

This act modifies provisions governing alternative trauma, stroke, and STEMI center designations by repealing current law establishing various designation levels and requiring the Department to designate hospitals seeking alternative designation in manner that corresponds to a similar national designation. A hospital receiving a center designation under this provision may have such designation removed upon the request of the hospital or upon a determination by the Department that the organization certifying or verifying the alternative designation has suspended or revoked its designation. This act requires centers receiving alternative designations under this provision to submit to the Department proof of certification or verification and to participate in local and regional emergency services systems for training, sharing educational resources, and collaboration on improving patient outcomes.

This act modifies data submission requirements for designated centers to require submission to either a state or national registry. Additionally, this act repeals requirements that the data collections system meet certain standards.

This act repeals provisions of current law granting the Board of Registration for the Healing Arts the sole authority to establish education requirements for physicians practicing in an emergency department in a trauma, STEMI, or stroke center. Instead, the Department shall not have authority to establish additional education requirements for emergency medicine board-certified or board-eligible physicians, either through the American Board of Emergency Medicine or American Osteopathic Board of Emergency Medicine, who are practicing in the emergency department of a designated center. The Department shall deem the education requirements of such entities to meet the standards for designation. Education requirements for other physicians, nurses, and other providers who provide care at the designated center shall equal, but not exceed, those established by national designating or verifying bodies of trauma, stroke, or STEMI centers.

Under this act, the Department may only establish appropriate fees to offset the costs of center surveys.

This act adds physician assistants to the list of providers who shall instruct ambulance personnel to transport a severely ill patient to a trauma, STEMI, or stroke center.

Failure of a hospital to provide all medical records and quality improvement documentation necessary for the Department to implement the provisions of this act shall result in the revocation of the hospital's designation as a trauma, STEMI, or stroke center.

This act repeals a provision of law relating to peer review systems for trauma, STEMI, and stroke cases.

Finally, this act establishes the "Time-Critical Diagnosis Advisory Committee" within the Department for the purpose of advising and making recommendations to the Department on improving public and professional education related to time-critical diagnosis; cooperative research endeavors; developing standards and policies relating to time-critical diagnosis; and reviewing and recommending community and regional time-critical diagnosis plans. The Director of the Department shall appoint 14 members to the committee, as specified in the act.

These provisions are identical to provisions in the truly agreed to and finally passed SS/SCS/HB 2331 (2022) and HB 2355 (2022), substantially similar to SB 1020 (2022), and similar to SB 541 (2021).

Under this act, any emergency medical services provider licensed under certain provisions of state law shall be considered a health care professional for purposes of liability and disclosure of materials produced by a peer review committee. Any quality improvement or quality assurance activity required by such licensed individuals shall be considered an activity of a peer review committee.

This provision is identical to HB 2109 (2022) and SB 1059 (2022).

MEDICAL STUDENT LOAN PROGRAMS (Sections 191.500, 191.515, 191.520, 191.525, 335.230, and 335.257)

This act modifies provisions of current law relating to the medical student loan program administered by the Department of Health and Senior Services by adding psychiatry, dental surgery, dental medicine, or dental hygiene students to the list of eligible students in the program, as well as adding psychiatric care, dental practice, and dental hygienists to the definition of "primary care". Additionally, this act modifies the loan amount students may be eligible to receive from $7,500 each academic year to $25,000 each academic year.

This act also modifies the Nursing Student Loan Program by modifying the amount of financial assistance available to students from $5,000 each academic year for professional nursing programs to $10,000 each academic year and from $2,500 each academic year for practical nursing programs to $5,000 each academic year.

Finally, this act modifies the Nursing Student Loan Repayment Program by removing the June and December deadlines for qualified employment verification while retaining the requirement that such employment be verified twice each year.

These provisions are identical to provisions in the truly agreed to and finally passed CCS/HCS#2/SB 710 (2022), the truly agreed to and finally passed SS/SCS/HB 2331 (2022), SCS/SB 1045 (2022), and SB 757 (2022) and substantially similar to provisions in HCS/HB 2133 (2022) and HB 2881 (2022).

HEALTH CARE FACILITY VISITATION (Sections 191.1400, 191.2290, and 630.202)

This act establishes the "Compassionate Care Visitation Act". Under this act, a health care facility, defined as a hospital, hospice, or long-term care facility, shall allow a resident, patient, or guardian of such, to permit in-person contact with a compassionate care visitor during visiting hours. A compassionate care visitor may be the patient's or resident's friend, family member, or other person requested by the patient or resident. The compassionate care visitation is a visit necessary to meet the physical or mental needs of the patient or resident, including end-of-life care, assistance with hearing and speaking, emotional support, assistance with eating or drinking, or social support.

A health care facility shall allow a resident to permit at least 2 compassionate care visitors simultaneously to have in-person contact with the resident during visitation hours. Visitation hours shall include evenings, weekends, and holidays, and shall be no less than 6 hours daily. 24-hour visitation may be allowed when reasonably appropriate. Visitors may leave and return during visitor hours. Visitors may be restricted within the facility to the patient or resident's room or common areas and may be restricted entirely for reasons specified in the act.

By January 1, 2023, the Department of Health and Senior Services shall develop informational materials for patients, residents, and their legal guardians regarding the provisions of this act. Health care facilities shall make these informational materials accessible upon admission or registration and on the primary website of the facility.

A compassionate care visitor may report any violation of the Compassionate Care Visitation Act by a health care facility to the Department of Health and Senior Services, as specified in the act. The Department shall investigate any such complaint within thirty-six hours of receipt.

No health care facility shall be held liable for damages in an action involving a liability claim against the facility arising from compliance with the provisions of this act; provided no recklessness or willful misconduct on the part of the facility, employees, or contractors has occurred.

The provisions of this act shall not be terminated, suspended, or waived except by a declaration by the Governor of a state of emergency, in which case the provisions of the "Essential Caregiver Program Act" shall apply.

Additionally, this act establishes the "Essential Caregiver Program Act". During a governor-declared state of emergency, a hospital, long-term care facility, or facility operated, licensed, or certified by the Department of Mental Health shall allow a resident of such facility, or the resident's guardian or legal representative, to designate an essential caregiver for in-person contact with the resident in accordance with the standards and guidelines developed under this act. An "essential caregiver" is defined as a family member, friend, guardian, or other individual selected by a resident, or the guardian or legal repres