Legislative Update from the President: Missouri

Please review all the info below regarding APRN Practice in Missouri.  Pay particular attention to the highlighted areas…..this was just defeated in Kansas but at least in Kansas we are licensed as APRNs and it has been that way for years….in Missouri we really don’t have a lot of “requirements” to prove our value, education and oversite/regulation as APRNs.

MORE TO COME….be watching for “Calls to Action”

Committee Action of Interest:

APRN LEGISLATION: The Senate Professional Registration Committee held a hearing on Senate Bill 42, sponsored by Senator Wayne Wallingford, R-Cape Girardeau. This is the legislation to allow APRNs to work to their full extent of their education and training and allows the Board of Nursing to write a license for APRNs. A summary of the legislation is below.

Those testifying in support of the legislation were a number of APRNs:  Julie Long, JoAnn Franklin, Kathy Ayers, Elizabeth Cook, Jessica Christian, Keith Williston, Jessica Henmann and Theresa Hasting.  Associations testifying in support of the legislation were: Marcia Flesner with the Better Access Better Care Coalition, MO Association of Behavioral Healthcare, Missouri Association of Rural Health Clinics, BJC Hospital, SSM Hospital, MO Children’s Leadership Council, Leading Age Long-Term Care, and Jill Kliethermes with Missouri Nurses Association.

Those testifying in opposition were:  Missouri State Medical Society, Washington University School of Medicine, Missouri Pharmacy Association, Missouri Association of Emergency Room Physicians, OB/Gyn Association, Anesthesiologists, Signature Group, Dermatologists Association, Psychiatric Association, Missouri Association of Family Physicians, and Missouri Association of Osteopaths, Physicians & Surgeons.

On Wednesday, the House Professional Registration Committee heard the house version, HB165, sponsored by Rep. Tila Hubrecht, R-Dexter.  In the House, it was much of the same people testifying.  However, in the House, CEO of Clark Community Health Center in Monnet, Missouri, and Christy Henley, an APRN who works at the Health Center, testified and made a huge impact on just how important the need is to remove several of these barriers that are preventing them from helping patients.

The House Committee had many questions which required the committee hearing to be continued to late in the night and Thursday morning.  There was no action taken by either committee.

The House Professional Registration Committee also heard Rep. Lyle Rowland’s House Bill

244, which is also an APRN bill, but it just removes the mileage barrier and changes the ratio from three to five APRNs to a collaborator in a collaborative practice arrangement.

Prior to the House Professional Registration Committee hearing, the House Subcommittee on Scope of Practice met to deliver a very disappointing subcommittee report on the scope of practice for APRNs.  However, the committee did make some adjustments/amendments to the report at the request of MONA.

Committee Recommendations

The Subcommittee on Scope of Practice recommends that the Committee on Professional Registration and Licensing consider transferring all APRN oversight to the sole authority of the Board of Healing Arts should it be agreed that APRNs may practice without a collaborative relationship. Otherwise, the subcommittee recommends that the collaborative relationship between physicians and APRNs be maintained but with an additional focus on how such collaboration can better meet the needs of patients. The subcommittee also recommends a continued investigation into how the new telehealth statutes will affect the future of health care in Missouri. 

Since this is the first year for subcommittee reports, it is unclear what becomes of their recommendation. Hopefully, this will be the last we will see of the recommendation; although, the physician lobbying groups are recommending all APRNs be put under the Board of Healing Arts, so stay tuned…