***SB 400 Will Be Heard in the Senate Professional Registration & Licensing Committee on Monday 3/4/19 at 2PM. SB 400 Is An
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***SB 400 will be heard in the Senate Professional Registration & Licensing Committee on Monday 3/4/19 at 2PM. SB 400 is an APRN licensing bill with provisions similar to HB 301 but adds some additional language to define the APRN role in the health care delivery system. This is a priority bill for AMNP and was filed by Sen. Eric Burlison. SB 400 has the full support of AMNP, MONA, BJC, and a host of other organizations. We are excited about the continued movement on APRN priorities 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. If you would like to submit written testimony on this matter, please use the attached Senate Witness Form to send your written testimony to the Senate Committee on Professional Registration & Licensing. For questions or further instructions on how to do so, please email us at [email protected] *** Committee members are as follows: SENATE PROFESSIONAL REGISTRATION & LICENSING Chair Sen. Jeanie Riddle [email protected] Vice Chair Sen. Eric Burlison [email protected] Sen. Lauren Arthur [email protected] Sen. Mike Cunningham [email protected] Sen. David Sater [email protected] Sen. Scott Sifton [email protected] Sen. Paul Weiland [email protected] 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. It was a marathon week in the Missouri Capitol as legislators tackled a host of controversial subjects and committees began to pass significant numbers of bills out to the floor for debate. This week also saw the deadline to file new bills in both the House and Senate, and an abundant number of those new bills kept bill drafters overwhelmed through the week in the hurry to file legislation prior to the March 1st cut off. In the House, a total of 1255 bills were filed, along with 56 House Concurrent Resolutions, 58 House Joint Resolutions, and 30 House Resolutions. In the Senate, 518 Senate Bills were filed, along with 21 Senate Concurrent Resolutions, 30 Senate Joint Resolutions, and 5 Senate Resolutions. All totaled, that amounts to nearly 2,000 bills and resolutions. Attention will now turn towards drafting amendments and committee substitutes as committee hearings and the perfection of bills become a higher priority in the remaining weeks of session. Specific to Missouri’s nurse practitioners this week, two priority bills of interest were heard in committee in the House. HB 301, filed by Rep. Nick Schroer, establishes an APRN license for Missouri’s nurse practitioners, certified registered nurse anesthetists, certified nurse midwives, and clinical nurse specialists. The bill was heard in the House Professional Registration & Licensing Committee chaired by Rep. Robert Ross. Proponents testifying in support of the measure included AMNP, the president of medical practice and physician for BJC healthcare, APRN and former AMNP board member Tammy Bartholomew, Leading Age Missouri, St. Luke’s Health System, Missouri Hospital Association, Missouri Nurses Association, FQHC’s, Kids Win MO, SSM Health Care, and the Missouri Healthcare Association. Proponents testified that establishing an APRN license would streamline verification for Medicaid and insurance payments as well as align care provided by APRN’s in a way that is consistent with education and training. Moreover, proponents argued that any deviations from care that would require discipline currently require disciplinary action against the RN license rather than an APRN license. As such, the scope of practice for APRN’s is unnecessarily restrictive because of how they are currently licensed. Opponents to the measure included the Missouri State Medical Association, Missouri Association of Osteopathic Physicians and Surgeons, and the American College of Obstetricians and Gynecologists. Opposition was tempered from previous years, and instead suggested that if an APRN license was established, that it should be regulated by the Board of Healing Arts (BOHA) because the APRN scope of practice is substantially similar to that of physician assistants and assistant physicians, both of whom are regulated by BOHA. In addition to proponents and opponents, Lori Scheidt of the state Board of Nursing (BON) testified for informational purposes and provided clarity around how the BON would administer and discipline licenses for advanced practice nurses separate and distinct from RN’s. Outside of testimony, no further action was taken on the bill. We will keep you apprised of when it is scheduled for a vote in committee. In other APRN related activity, Rep. Hannah Kelly presented HB 420 to the House Committee on Children and Families this week. HB 420 is a bill proposed by pro-life groups that seeks to remove the geographic proximity barrier for APRN’s practicing in pregnancy resource centers providing maternal and neonatal care. The bill applies only to those types of facilities. Testifying in support of HB 420 was the executive director of Guiding Star Mid-Missouri, Sam Lee of the Campaign for Life, Association of Missouri Nurse Practitioners, Missouri Nurses Association, and Rep. Dale Wright. Testifying in opposition was the Missouri State Medical Association and for informational purposes was Planned Parenthood. The committee took no action on the bill. We will keep you apprised of when it is scheduled for a vote in committee as well. In other House activity, the chamber perfected 12 bills this week and sent 14 to the Senate. The primary focus of the House this week was on HB 126 which would prohibit abortions once a fetal heartbeat is detected. The bill would impose a $1,000 fine for violation and a physician’s license could be revoked if an abortion was performed after the heartbeat was detected. The bill became an omnibus abortion bill after several amendments were adopted including: a ban on abortions past 20 weeks, two-parent consent for minors, prohibition on abortions when tests reveal a Down Syndrome indication, and a trigger law stipulating that abortions would be banned altogether except in medical emergencies if the Supreme Court overturns Roe v. Wade. The House also tackled other measures of interest including HB 239 (dealing with controlled substances offenses), HB 441 (complaints against psychologists’ licenses), HB 138 (dealing with do not resuscitate orders on children in health care facilities), and HB 207(permitting medical alert notations on driver’s licenses). In House committee activity, in addition to the hearings on the aforementioned HB 301 and HB 420, Professional Registration passed HB 628 out of committee dealing with restrictions on the authority of dentists to prescribe certain opioids and HB 667 which places restrictions and prohibitions and drug importations for pharmacies. On the other side of the Capitol, the Senate saw its first protracted overnight filibuster of the session this week as Sen. Ed Emery brought SB 7 to the floor to modify provisions of law related to lawsuit joinder and venue reform as part of the effort to continue tort reform initiatives. The 14-hour filibuster ended at 6AM after parties reached compromise language that places limitations on joining other lawsuits and “venue shopping”. Since significant floor time was devoted to the filibuster, only 6 other bills were perfected this week with 6 sent to the House for consideration. Although Senate committees were very busy this past week, few measures were directly related to APRN’s. For the upcoming week, AMNP will be focused on generating momentum for Sen. Burlison’s SB 400 and encouraging committee votes on HB 301 and HB 420. UPCOMING HEARINGS HOUSE - Professional Registration – 3/5/19 @ 12:30PM (Hearing Room 7) Notice not yet posted HOUSE – Health & Mental Health – 3/4/19 @ 12PM (Hearing Room 7) HB 492 - This bill prohibits health carriers from only allowing health care providers to be reimbursed using methods requiring the health care provider to pay a fee or reduced reimbursement rate in order to receive such reimbursement. If a health carrier changes reimbursement methods they must notify the health care provider if any fee, discount or other remuneration required to redeem the reimbursement amount. For new or renewed contracts after August 28, 2019, health carriers must offer an alternative reimbursement method which has no such fees. HB 600 - This bill entitles any intermediate care facility or skilled nursing facility participating in MO HealthNet that incurs total capital expenditures in excess of $2,000 per bed to obtain a recalculation of its Medicaid per diem reimbursement rate based on its additional capital costs or all costs incurred during the fiscal year during which such capital expenditures were made. Senate – Professional Registration – 3/4/19 @ 2PM SB 400 – This bill establishes an APRN license under the Board of Nursing and defines the practice of advanced practice nursing. As always, if you have any questions or we can be of assistance, please don’t hesitate to contact us at [email protected] . .