***Two priority bills for ’s nurse practitioners will be heard in committee on Tuesday, 2/26.

HB 301 will be heard on 2/26/19 at 12:30 in the House Professional Registration & Licensing committee. This bill would establish an APRN license regulated by the Missouri Board of Nursing and is long overdue.

HB 420 will be heard on 2/26/19 at 8AM in the House Children & Families committee. This bill would remove the requirement for geographic proximity in collaborative practice arrangements when an APRN was providing care at an alternatives to abortion agency.***

Both bills are a step in the right direction towards loosening restrictions on Missouri NP’s and we encourage you if you are a constituent of a committee member to email them to express your support and ask that they support the measure. Committee members are as follows:

HOUSE PROFESSIONAL REGISTRATION & LICENSING

Rep. Robert Ross Rep. Steve Helms Rep. Rep. Richard Brown Rep. Jeff Coleman Rep. Rep. Derek Grier Rep. DaRon McGee Rep. Rep. Rep. Rep. Jeff Shawan Rep.

HOUSE CHILDREN & FAMILIES

Rep. Rep. Jim Neely Rep. Rep. Dottie Bailey Rep. Rep. Rep. Rep. Rep. Rep. Rachel Proudie Rep. Rep. Rep.

Your consistent contact with your elected officials is an integral part of our overall legislative efforts, and we encourage you to visit with them in district, in the Capitol, and by phone or email whenever possible. If you’d like information on who to contact, how to effectively communicate with your official, or questions about the various bills, please don’t hesitate to contact us.

In addition to the scheduling of hearings on HB 301 and HB 420, Sen. Eric Burlison filed SB 400 on Monday as a result of working with AMNP, MONA, and BJC Health Care. SB 400 is similar to HB 301 in that it creates an APRN license, but goes further than HB 301 by adding definitions of practice (while still leaving a CPA for controlled substances). Although not a full practice bill, AMNP strongly supports SB 400 and is grateful to Sen. Burlison for his willingness to file the measure. We will keep you apprised of the progress on this bill as it begins to move.

In addition to movement on several APRN measures, the seventh week of session saw a flurry of activity on both sides of the Capitol as the House and Senate debated a number of measures across a wide range of issues during both floor debate and committee.

The House approved several measures and sent quite a few to the Senate. The list of bills on the perfection calendar continues to grow despite the House working through a variety of issues. And with the last day for bill filing on Friday, March 1, legislators file a copious number of bills in the final 2 weeks of filing.

Perfected House bills include HB 70 (2-way communication devices in correctional facilities), HB 138 (DNR in health care facilities), HB 207 (medical alert on driver licenses), HB 239 (Drug trafficking), HB 242 (death investigations), HB 303 (prison canteen funds), HB 324 (drones near correctional facilities), HB 352 (parole eligibility), HB 354 (financial protection of seniors), HB 441 (prisoner complaints against psychologists licenses), HB 451 (vehicle inspection fees), HB 461 (disposition of human remains), and HB 499 (drivers license revocations).

In addition to crafting the aforementioned bills during floor debate, the House sent the following bills to the Senate for consideration: HB 77 (PSPRS), HB 113 (minimum terms of imprisonment), HB 214 (Competitive bidding), HB 242 (death investigations), HB 243 (domestic violence lease agreements), HB 255 (Missouri Works), HB 283 (geologic resources fee), HB 321 (limited liability companies), HB 324 (drones near correctional facilities), HB 402 (left on red), & HB 447 (coroner standards). Of these bills, HB 242 dealing with death investigations, contained a clarifying provision dealing with advanced practice registered nurses. The provision requires referral to a coroner if the patient dies within 36-hours of being treated by a physician, physician assistant, assistant physician, or advanced practice nurse.

In House committee activity, several bills of interest to Missouri’s NP’s were heard. In the Special Committee on Aging, HB 466 was passed out of committee. The bill provides that structured family caregiving for Alzheimer patients is permissible under Medicaid with a waiver and is subject to home visits and case management provisions dictated by the Department of Social Services. Also related to long term care, HB 675 was heard in the same committee. HB 675 permits electronic monitoring in long term care facilities as long as the devices comply with the facility’s policies. Supporters believe that this bill would help with patient safety and free up resources that could be better utilized elsewhere.

In Senate activity, the Conservative Caucus flexed their muscle during floor debate on a variety of bills, forcing Senate leadership to lay bills over that weren’t consistent with their conservative philosophies. This could be a signal of a rocky April and May, as there are a sufficient number of members to make things difficult if they so choose.

In floor activity, the Senate spent time on SB 56 (Missouri Works Program), SB 16 (Fast Track Workforce Incentive), and SB 154 (Arbitration agreements) before those bills were laid over to work out the differences among the stakeholders. The Senate did manage to perfect several bills this week, including SB 21 (Public safety sales tax), SB 36 (Real Estate License Immunity), SB 90 (unemployment reforms), and SB 197 (intoxicating liquor). Several bills were also third read and sent to the House this week, including the highly controversial SB 28 (Low Income Housing Tax Credits). It is expected that tort reform will be teed up for floor debate when lawmakers return to Jefferson City.

In Senate committee activity this week, several bills relevant to Missouri NP’s were heard or voted out. Senate Appropriations heard testimony on SB 11 which specifies that long term care facilities that spend more than $2,000 per bed in capital improvements can obtain a recalculation of its Medicaid reimbursement rate. Additionally, the committee heard testimony on SB 29, which extends the sunset on the federal reimbursement allowance for nursing facilities, Medicaid managed care, hospitals, pharmacy, and intermediate care facilities. The Senate Health & Mental Health also heard testimony on reimbursement measures this week as they listened to extensive testimony on SB 298 which prohibits health carriers from restricting methods of reimbursement to a method requiring health care providers to pay a fee to redeem the amount of their claim for reimbursement. A host of health care organizations testified in support of the measure while insurance organizations stood in opposition.

For both chambers, there will be continued significant activity in the 3 weeks prior to Spring Break. With many APRN and health care matters still in play, continued engagement by NP’s all across Missouri will be crucial for success.

For the week of 2/25/19 – 3/1/19, the following hearings will be held that are of interest to Missouri NP’s.

UPCOMING HEARINGS HOUSE - Professional Registration – 2/26/19 @ 12:30PM (Hearing Room 7) HB 301 – Establishes an APRN license.

HOUSE – Children & Families – 2/26/19 @ 8AM (Hearing Room 1) HB 420 – Waives geographic proximity for APRN’s working in alternatives to abortion agencies.

HOUSE – Health & Mental Health – 2/25/19 @ 1PM (Hearing Room 7) HB 492 – Changes provisions relating to health carrier reimbursements

As always, if you have any questions or we can be of assistance, please don’t hesitate to contact us at [email protected] .