Modifies provisions relating to clinical fellowships required for licensure as a speech-language pathologist

EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
and is intended to be omitted in the law.
SECOND REGULAR SESSION
SENATE COMMITTEE SUBSTITUTE FOR
HOUSE BILL NO. 2591
103RD GENERAL ASSEMBLY
4165S.03C KRISTINA MARTIN, Secretary
AN ACT
To repeal sections 198.073, 326.256, 326.277, 326.280, 326.283, 326.286, 326.289, 326.292,
332.081, 334.031, 334.870, 334.880, 335.081, 337.600, 338.012, and 345.050, RSMo,
and to enact in lieu thereof seventeen new sections relating to professional licens ure,
with penalty provisions.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Sections 198.073, 326.256, 326.277, 326.280, 1
326.283, 326.286, 326.289, 326.292, 332.081, 334.031, 334.870, 2
334.880, 335.081, 337.600, 338.012, and 345.050, RSMo, are 3
repealed and seventeen new sections enacted in lieu thereof, to 4
be known as sections 198.073, 326.256, 326.277, 326.280, 5
326.283, 326.286, 326.289, 326.292, 332.081, 334.031, 334.870, 6
334.880, 335.081, 337.600, 338.012, 338.206, and 345.050, to 7
read as follows:8
198.073. 1. A residential care facility shall admit 1
or retain only those persons who are capable mentally and 2
physically of negotiating a normal path to safety using 3
assistive devices or aids when necessary, and who may need 4
assisted personal care within the limitations of such 5
facilities, and who do not require hospitalization or 6
skilled nursing care. 7
2. Notwithstanding the provisions of subsection 1 of 8
this section, those persons previously qualified for 9
residence who may have a temporary period of incapacity due 10
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to illness, surgery, or injury, which period does not exceed 11
forty-five days, may be allowed to remain in a residential 12
care facility or assisted living facility if approved by a 13
physician. 14
3. Any facility licensed as a residential care 15
facility II on August 27, 2006, shall be granted a license 16
as an assisted living facility, as defined in section 17
198.006, on August 28, 2006, regardless of the laws, rules, 18
and regulations for licensure as an assisted living facility 19
as long as such facility continues to meet all laws, rules, 20
and regulations that were in place on August 27, 2006, for a 21
residential care facility II. At such time that the average 22
total reimbursement, not including residents' cost-of-living 23
increases in their benefits from the Social Security 24
Administration after August 28, 2006, for the care of 25
persons eligible for Medicaid in an assisted living facility 26
is equal to or exceeds forty-one dollars per day, all 27
facilities with a license as an assisted living facility 28
shall meet all laws, rules, and regulations for licensure as 29
an assisted living facility. Nothing in this section shall 30
be construed to allow any facility that has not met the 31
requirements of subsections 4 and 6 of this section to care 32
for any individual with a physical, cognitive, or other 33
impairment that prevents the individual from safely 34
evacuating the facility. 35
4. Any facility licensed as an assisted living 36
facility, as defined in section 198.006, except for 37
facilities licensed under subsection 3 of this section, may 38
admit or retain an individual for residency in an assisted 39
living facility only if the individual does not require 40
hospitalization or skilled nursing placement, and only if 41
the facility: 42
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(1) Provides for or coordinates oversight and services 43
to meet the needs of the resident as documented in a written 44
contract signed by the resident, or legal representative of 45
the resident; 46
(2) Has twenty-four-hour staff appropriate in numbers 47
and with appropriate skills to provide such services; 48
(3) Has a written plan for the protection of all 49
residents in the event of a disaster, including keeping 50
residents in place, evacuating residents to areas of refuge, 51
evacuating residents from the building if necessary, or 52
other methods of protection based on the disaster and the 53
individual building design; 54
(4) Completes a pre-move-in screening with 55
participation of the prospective resident; 56
(5) Completes for each resident a community-based 57
assessment, as defined in subdivision (7) of section 198.006: 58
(a) Upon admission; 59
(b) At least semiannually; and 60
(c) Whenever a significant change has occurred in the 61
resident's condition which may require a change in services; 62
(6) Based on the assessment in subsection 7 of this 63
section and subdivision (5) of this subsection, develops an 64
individualized service plan in partnership with the 65
resident, or legal representative of the resident, that 66
outlines the needs and preferences of the resident. The 67
individualized service plan will be reviewed with the 68
resident, or legal representative of the resident, at least 69
annually, or when there is a significant change in the 70
resident's condition which may require a change in 71
services. The signatures of an authorized representative of 72
the facility and the resident, or the resident's legal 73
representative, shall be contained on the individualized 74
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service plan to acknowledge that the service plan has been 75
reviewed and understood by the resident or legal 76
representative; 77
(7) Makes available and implements self-care, 78
productive and leisure activity programs which maximize and 79
encourage the resident's optimal functional ability; 80
(8) Ensures that the residence does not accept or 81
retain a resident who: 82
(a) Has exhibited behaviors that present a reasonable 83
likelihood of serious harm to himself or herself or others; 84
(b) Requires physical restraint; 85
(c) Requires chemical restraint. As used in this 86
paragraph, the following terms mean: 87
a. "Chemical restraint", a psychopharmacologic drug 88
that is used for discipline or convenience and not required 89
to treat medical symptoms; 90
b. "Convenience", any action taken by the facility to 91
control resident behavior or maintain residents with a 92
lesser amount of effort by the facility and not in the 93
resident's best interest; 94
c. "Discipline", any action taken by the facility for 95
the purpose of punishing or penalizing residents; 96
(d) Requires skilled nursing services as defined in 97
subdivision (23) of section 198.006 for which the facility 98
is not licensed or able to provide; 99
(e) Requires more than one person to simultaneously 100
physically assist the resident with any activity of daily 101
living, with the exception of bathing and transferring; 102
(f) Is bed-bound or similarly immobilized due to a 103
debilitating or chronic condition; and 104
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(9) Develops and implements a plan to protect the 105
rights, privacy, and safety of all residents and to protect 106
against the financial exploitation of all residents; 107
(10) Complies with the training requirements of 108
subsection 7 of section 192.2000. 109
5. Exceptions to paragraphs (d) to (f) of subdivision 110
(8) of subsection 4 of this section shall be made for 111
residents on hospice, provided the resident, designated 112
representative, or both, and the assisted living provider, 113
physician, and licensed hospice provider all agree that such 114
program of care is appropriate for the resident. 115
6. If an assisted living facility accepts or retains 116
any individual with a physical, cognitive, or other 117
impairment that prevents the individual from safely 118
evacuating the facility with minimal assistance, the 119
facility shall: 120
(1) Have sufficient staff present and awake twenty- 121
four hours a day to assist in the evacuation; 122
(2) Include an individualized evacuation plan in the 123
service plan of the resident; and 124
(3) Take necessary measures to provide residents with 125
the opportunity to explore the facility and, if appropriate, 126
its grounds; and 127
(4) Use a personal electronic monitoring device for 128
any resident whose physician recommends the use of such 129
device. 130
7. An individual admitted or readmitted to the 131
facility shall have an admission physical examination by a 132
licensed physician, advanced practice registered nurse, or 133
physician assistant. Documentation should be obtained prior 134
to admission but shall be on file not later than ten days 135
after admission and shall contain information regarding the 136
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individual's current medical status and any special orders 137
or procedures that should be followed. If the individual is 138
admitted directly from a hospital or another long-term care 139
facility and is accompanied on admission by a report that 140
reflects his or her current medical status, an admission 141
physical shall not be required. 142
8. Facilities licensed as an assisted living facility 143
shall disclose to a prospective resident, or legal 144
representative of the resident, information regarding the 145
services the facility is able to provide or coordinate, the 146
costs of such services to the resident, and the resident 147
conditions that will require discharge or transfer, 148
including the provisions of subdivision (8) of subsection 4 149
of this section. 150
9. After January 1, 2008, no entity shall hold itself 151
out as an assisted living facility or advertise itself as an 152
assisted living facility without obtaining a license from 153
the department to operate as an assisted living facility. 154
Any residential care facility II licensed under this chapter 155
that does not use the term assisted living in the name of 156
its licensed facility on or before May 1, 2006, shall be 157
prohibited from using such term after August 28, 2006, 158
unless such facility meets the requirements for an assisted 159
living facility in subsection 4 of this section. Any 160
facility licensed as an intermediate care facility prior to 161
August 28, 2006, that provides the services of an assisted 162
living facility, as described in paragraphs (a), (b), and 163
(c) of subdivision (6) of section 198.006, utilizing the 164
social model of care, may advertise itself as an assisted 165
living facility without obtaining a license from the 166
department to operate as an assisted living facility. 167
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10. The department of health and senior services shall 168
promulgate rules to ensure compliance with this section. 169
Any rule or portion of a rule, as that term is defined in 170
section 536.010, that is created under the authority 171
delegated in this section shall become effective only if it 172
complies with and is subject to all of the provisions of 173
chapter 536 and, if applicable, section 536.028. This 174
section and chapter 536 are nonseverable and if any of the 175
powers vested with the general assembly pursuant to chapter 176
536 to review, to delay the effective date, or to disapprove 177
and annul a rule are subsequently held unconstitutional, 178
then the grant of rulemaking authority and any rule proposed 179
or adopted after August 28, 2006, shall be invalid and void. 180
326.256. 1. As used in this chapter, the following 1
terms mean: 2
(1) "AICPA", the American Institute of Certified 3
Public Accountants; 4
(2) "Attest" or "attest services", providing the 5
following services: 6
(a) Any audit or other engagement to be performed in 7
accordance with the Statements on Auditing Standards (SAS); 8
(b) Any examination of prospective financial 9
information to be performed in accordance with the 10
Statements on Standards for Attestation Engagements (SSAE); 11
(c) Any engagement to be performed in accordance with 12
the auditing standards and rules of the Public Company 13
Accounting Oversight Board (PCAOB); 14
(d) Any review of a financial statement to be 15
performed in accordance with the Statements on Standards for 16
Accounting and Review Services (SSARS); or 17
(e) Any examination, review, or agreed upon procedures 18
engagement to be performed in accordance with the SSAE, 19
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other than an examination described in paragraph (b) of this 20
subdivision; 21
(3) "Board", the Missouri state board of accountancy 22
established under section 326.259 or its predecessor 23
pursuant to prior law; 24
(4) "Certificate", a certificate issued under section 25
326.060 prior to August 28, 2001; 26
(5) "Certified public accountant" or "CPA", the holder 27
of a certificate or license as defined in this section; 28
(6) "Certified public accounting firm", "CPA firm" or 29
"firm", a sole proprietorship, a corporation, a partnership 30
or any other form of organization issued a permit or 31
otherwise authorized to practice under section 326.289; 32
(7) "Client", a person or entity that agrees with a 33
licensee or licensee's employer to receive any professional 34
service; 35
(8) "Compilation", providing a service to be performed 36
in accordance with Statements on Standards for Accounting 37
and Review Services (SSARS) that is presented in the form of 38
financial statements information that is the representation 39
of management (owners) without undertaking to express any 40
assurance on the statements; 41
(9) "License", a license issued under section 326.280, 42
or privilege to practice under section 326.283; or, in each 43
case, an individual license or permit issued pursuant to 44
corresponding provisions of prior law; 45
(10) "Licensee", the holder of a license as defined in 46
this section; 47
(11) "Manager", a manager of a limited liability 48
company; 49
(12) "Member", a member of a limited liability company; 50
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(13) "NASBA", the National Association of State Boards 51
of Accountancy; 52
(14) "PCAOB", the Public Company Accounting Oversight 53
Board; 54
(15) "Peer review", a study, appraisal or review of 55
one or more aspects of the professional work of a [licensee 56
or] certified public accounting firm that performs attest or 57
compilation services, by licensees who are not affiliated 58
either personally or through their certified public 59
accounting firm being reviewed pursuant to the Standards for 60
Performing and Reporting on Peer Reviews promulgated by the 61
AICPA or such other standard adopted by regulation of the 62
board which meets or exceeds the AICPA standards; 63
(16) "Permit", a permit to practice as a certified 64
public accounting firm issued under section 326.289 or 65
corresponding provisions of prior law or pursuant to 66
corresponding provisions of the laws of other states; 67
(17) "Principal place of business", the office 68
location designated by the licensee for purposes of 69
[substantial equivalency] mobility and reciprocity; 70
(18) "Professional", arising out of or related to the 71
specialized knowledge or skills associated with certified 72
public accountants; 73
(19) "Public accounting": 74
(a) Performing or offering to perform for an 75
enterprise, client or potential client one or more services 76
involving the use of accounting or auditing skills, or one 77
or more management advisory or consulting services, or the 78
preparation of tax returns or the furnishing of advice on 79
tax matters by a person, firm, limited liability company or 80
professional corporation using the title "C.P.A." or "P.A." 81
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in signs, advertising, directory listing, business cards, 82
letterheads or other public representations; 83
(b) Signing or affixing a name, with any wording 84
indicating the person or entity has expert knowledge in 85
accounting or auditing to any opinion or certificate 86
attesting to the reliability of any representation or 87
estimate in regard to any person or organization embracing 88
financial information or facts respecting compliance with 89
conditions established by law or contract, including but not 90
limited to statutes, ordinances, rules, grants, loans and 91
appropriations; or 92
(c) Offering to the public or to prospective clients 93
to perform, or actually performing on behalf of clients, 94
professional services that involve or require an audit or 95
examination of financial records leading to the expression 96
of a written attestation or opinion concerning these records; 97
(20) "Report", when used with reference to any attest 98
or compilation service, means an opinion, report or other 99
form of language that states or implies assurance as to the 100
reliability of the attested information or compiled 101
financial statements, and that also includes or is 102
accompanied by any statement or implication that the person 103
or firm issuing it has special knowledge or competence in 104
accounting or auditing. Such a statement or implication of 105
special knowledge or competence may arise from use by the 106
issuer of the report of names or titles indicating that the 107
person or firm is an accountant or auditor, or from the 108
language of the report itself. The term report includes any 109
form of language which disclaims an opinion when such form 110
of language is conventionally understood to imply any 111
positive assurance as to the reliability of the attested 112
information or compiled financial statements referred to or 113
SCS HB 2591 11
special competence on the part of the person or firm issuing 114
such language, and includes any other form of language that 115
is conventionally understood to imply such assurance or such 116
special knowledge or competence; 117
(21) "State", any state of the United States, the 118
District of Columbia, Puerto Rico, the U.S. Virgin Islands, 119
the Commonwealth of the Northern Mariana Islands, and Guam; 120
except that "this state" means the state of Missouri; 121
(22) ["Substantial equivalency" or "substantially 122
equivalent", a determination by the board of accountancy or 123
its designee that the education, examination and experience 124
requirements contained in the statutes and administrative 125
rules of another jurisdiction are comparable to or exceed 126
the education, examination and experience requirements 127
contained in this chapter or that an individual certified 128
public accountant's education, examination and experience 129
qualifications are comparable to or exceed the education, 130
examination and experience requirements contained in this 131
chapter; 132
(23)] "Transmittal", any transmission of information 133
in any form, including but not limited to any and all 134
documents, records, minutes, computer files, disks or 135
information. 136
2. The statements on standards specified in this 137
section shall be adopted by reference by the board pursuant 138
to rulemaking and shall be those developed for general 139
application by the AICPA or other recognized national 140
accountancy organization as prescribed by board rule. 141
326.277. 1. Prior to June 30, 2021, for an applicant 1
to be eligible to apply for the examination, the applicant 2
shall fulfill the education requirements of subdivision (4) 3
of subsection 1 of section 326.280. 4
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2. On or after June 30, 2021, for an applicant to be 5
eligible to apply for the examination, the applicant shall: 6
(1) Provide proof that the applicant has [completed at 7
least one hundred twenty semester hours of college 8
education] obtained a baccalaureate degree or a post- 9
baccalaureate degree at an accredited college or university 10
recognized by the board, with an accounting concentration or 11
equivalent as determined by the board, in either case by 12
rule; 13
(2) Be at least eighteen years of age; and 14
(3) Be of good moral character. 15
326.280. 1. A license shall be granted by the board 1
to any person who meets the requirements of this chapter and 2
who: 3
(1) Is a resident of this state or has a place of 4
business in this state or, as an employee, is regularly 5
employed in this state; 6
(2) Has attained the age of eighteen years; 7
(3) Is of good moral character; 8
(4) [Either] Meets one of the following educational 9
requirements: 10
(a) [Applied for the initial examination prior to June 11
30, 1999, and] Holds a baccalaureate degree conferred by an 12
accredited college or university recognized by the board, 13
with [a] the total educational program including an 14
accounting concentration [in accounting] or [the 15
substantial] equivalent [of a concentration in accounting] 16
as determined by [the] board rule to be appropriate; or 17
(b) [Applied for the initial examination on or after 18
June 30, 1999, and has at least one hundred fifty semester 19
hours of college education, including a baccalaureate or 20
higher degree] Has a baccalaureate degree plus an additional 21
SCS HB 2591 13
thirty semester hours of college education conferred by an 22
accredited college or university recognized by the board, 23
with the total educational program including an accounting 24
concentration or equivalent as determined by board rule to 25
be appropriate; or 26
(c) Has a post-baccalaureate degree conferred by an 27
accredited college or university recognized by the board, 28
with the total education program including an accounting 29
concentration or equivalent as determined by board rule to 30
be appropriate; 31
(5) Has passed an examination in accounting, auditing 32
and such other related subjects as the board shall determine 33
is appropriate; and 34
(6) (a) Either: 35
a. Has had one year of experience for an applicant who 36
is applying for licensure on the basis of the educational 37
requirement in paragraphs (b) or (c) of subdivision (4) of 38
subsection 1 of this section; or 39
b. Has had two years of experience for an applicant 40
who is applying for licensure on the basis of the 41
educational requirement in paragraph (a) of subdivision (4) 42
of subsection 1 of this section. 43
(b) Experience shall be verified by a licensee and 44
shall include any type of service or advice involving the 45
use of accounting, attest, compilation, management advisory, 46
financial advisory, tax or consulting skills including 47
governmental accounting, budgeting or auditing. The board 48
shall promulgate rules and regulations concerning the 49
verifying licensee's review of the applicant's experience. 50
2. The board may prescribe by rule the terms and 51
conditions for reexaminations and fees to be paid for 52
reexaminations. 53
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3. A person who, on August 28, 2001, holds an 54
individual permit issued pursuant to the laws of this state 55
shall not be required to obtain additional licenses pursuant 56
to sections 326.280 to 326.286, and the licenses issued 57
shall be considered licenses issued pursuant to sections 58
326.280 to 326.286. However, such persons shall be subject 59
to the provisions of section 326.286 for renewal of licenses. 60
4. Upon application, the board may issue a temporary 61
license to an applicant pursuant to this subsection for a 62
person who has made a prima facie showing that the applicant 63
meets all of the requirements for a license and possesses 64
the experience required. The temporary license shall be 65
effective only until the board has had the opportunity to 66
investigate the applicant's qualifications for licensure 67
pursuant to subsection 1 of this section and notify the 68
applicant that the applicant's application for a license has 69
been granted or rejected. In no event shall a temporary 70
license be in effect for more than twelve months after the 71
date of issuance nor shall a temporary license be reissued 72
to the same applicant. No fee shall be charged for a 73
temporary license. The holder of a temporary license which 74
has not expired, been suspended or revoked shall be deemed 75
to be the holder of a license issued pursuant to this 76
section until the temporary license expires, is terminated, 77
suspended or revoked. 78
[5. Prior to June 30, 2021, an applicant for an 79
examination who meets the educational requirements of 80
subdivision (4) of subsection 1 of this section or who 81
reasonably expects to meet those requirements within sixty 82
days after the examination shall be eligible for examination 83
if the applicant also meets the requirements of subdivisions 84
(2) and (3) of subsection 1 of this section. For an 85
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applicant admitted to examination on the reasonable 86
expectation that the applicant will meet the educational 87
requirements within sixty days, no license shall be issued 88
nor credit for the examination or any part thereof given 89
unless the educational requirement is in fact met within the 90
sixty-day period.] 91
326.283. 1. (1) (a) An individual whose principal 1
place of business, domicile, or residency is not in this 2
state and who holds a valid and unrestricted license in good 3
standing to practice public accounting from any state [which 4
the board or its designee has determined by rule to be in 5
substantial equivalence with the licensure requirements of 6
this chapter, or if the individual's qualifications are 7
substantially equivalent to the licensure requirements of 8
this chapter, shall be presumed to have qualifications 9
substantially equivalent to this state's requirements and] 10
shall have all the privileges of licensees of this state 11
without the need to obtain a license or to otherwise notify 12
or register with the board or pay any fee[. Provided, 13
however], provided that at the time of initial licensure, 14
the individual was required to show evidence of having 15
passed the Uniform Certified Public Accountant Examination 16
and having met one of the following requirements: 17
a. A baccalaureate degree conferred by an accredited 18
college or university, with the total educational program 19
including an accounting concentration or equivalent, and not 20
less than two years of experience, both as defined by board 21
rule; 22
b. A baccalaureate degree plus an additional thirty 23
semester hours of college education conferred by an 24
accredited college or university, with the total educational 25
program including an accounting concentration or equivalent, 26
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and not less than one year of experience, both as defined by 27
board rule; or 28
c. A post-baccalaureate degree conferred by an 29
accredited college or university, with the total educational 30
program including an accounting concentration or equivalent, 31
and not less than one year of experience, both as defined by 32
board rule. 33
(b) An individual, whose principal place of business, 34
domicile, or residency is not in this state and who holds a 35
valid and unrestricted license in good standing to practice 36
public accountancy from any state as of December 31, 2024, 37
and who, as of such date, has practice privileges in this 38
state under paragraph (a) of this subdivision, shall 39
continue to have all the privileges of licensees in this 40
state without the need to obtain a license or otherwise 41
notify or register with the board or pay any fee. 42
(c) The board may by rule require individuals with a 43
valid but restricted license to obtain a license. 44
(2) An individual who qualifies for the privilege to 45
practice under this section may offer or render professional 46
services in this state, whether in person, by mail, 47
telephone, or electronic means, and no notice or other 48
submission shall be required of any such individual. 49
(3) An individual licensee of another state exercising 50
the privilege afforded under this section and the firm which 51
employs such licensee hereby simultaneously consent, as a 52
condition of the grant of this privilege: 53
(a) To the personal and subject matter jurisdiction 54
and disciplinary authority of the board; 55
(b) To comply with this chapter and the board's rules; 56
(c) That in the event the license from any state is no 57
longer valid or unrestricted, the individual shall cease 58
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offering or rendering professional services in this state 59
individually and on behalf of a firm; and 60
(d) To the appointment of the state board that issued 61
the individual's license as his or her agent upon whom 62
process may be served in any action or proceeding by this 63
board against the individual. 64
(4) An individual who has been granted the privilege 65
to practice under this section who performs attest or 66
compilation services shall comply with the provisions of 67
section 326.289. 68
(5) Nothing in this chapter shall prohibit temporary 69
practice in this state for professional business incidental 70
to a CPA's regular practice outside this state. "Temporary 71
practice" means that practice related to the direct purpose 72
of an engagement for a client located outside this state, 73
which engagement began outside this state and extends into 74
this state through common ownership, existence of a 75
subsidiary, assets or other operations located within this 76
state. 77
2. A licensee of this state offering or rendering 78
services or using his or her certified public accountant 79
title in another state shall be subject to disciplinary 80
action in this state for an act committed in another state 81
for which the licensee would be subject to discipline for an 82
act committed in the other state. Notwithstanding the 83
provisions of section 326.274 to the contrary, the board may 84
investigate any complaint made by the board of accountancy 85
of another state. 86
326.286. 1. The board may grant or renew licenses to 1
persons who make application and demonstrate that their 2
qualifications, including the qualifications prescribed by 3
section 326.280, are in accordance with this section. 4
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2. Licenses shall be initially issued and renewed for 5
periods of not more than three years and shall expire on the 6
renewal date following issuance or renewal. Applications 7
for licenses shall be made in such form, and in the case of 8
applications for renewal, between such dates, as the board 9
by rule shall specify. Application and renewal fees shall 10
be determined by the board by rule. 11
3. With regard to applicants that do not qualify for 12
reciprocity pursuant to subsection 1 of this section, the 13
board may issue a license to an applicant upon a showing 14
that: 15
(1) The applicant passed the examination required for 16
issuance of the applicant's certificate with grades that 17
would have been passing grades at the time in this state; 18
(2) The applicant had four years of experience outside 19
of this state of the type described in subdivision (6) of 20
subsection 1 of section 326.280 or meets equivalent 21
requirements prescribed by the board by rule, after passing 22
the examination upon which the applicant's license was based 23
and within the ten years immediately preceding the 24
application; and 25
(3) If the applicant's certificate, license or permit 26
was issued more than four years prior to the application for 27
issuance of a license pursuant to this section, the 28
applicant has fulfilled the requirements of continuing 29
professional education that would have been applicable 30
pursuant to subsection [6] 5 of this section. 31
4. As an alternative to the requirements of subsection 32
3 of this section, a certified public accountant licensed by 33
another state who establishes a principal place of business 34
in this state shall request the issuance of a license from 35
the board prior to establishing the principal place of 36
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business. The board may issue a license to the person [who 37
obtains verification from the NASBA National Qualification 38
Appraisal Service that the individual's qualifications are 39
substantially equivalent to the licensure requirements of 40
sections 326.250 to 326.331] whose qualifications the board 41
verifies to be comparable to the initial licensure 42
requirements of section 326.280. 43
5. [An application pursuant to this section may be 44
made through the NASBA Qualification Appraisal Service. 45
6.] Each licensee shall participate in a program of 46
learning designed to maintain professional competency. The 47
program of learning shall comply with rules adopted by the 48
board. The board may create by rule an exception to such 49
requirement for licensees who do not perform or offer to 50
perform for the public one or more kinds of services 51
involving the use of accounting or auditing skills, 52
including issuance of reports on financial statements or of 53
one or more kinds of management advisory, financial advisory 54
or consulting services, or the preparation of tax returns or 55
the furnishing of advice on tax matters. Licensees granted 56
an exception by the board shall place the word "inactive" 57
adjacent to their certified public accountant title on any 58
business card, letterhead or any other document or device, 59
except their certified public accountant certificate, on 60
which their certified public accountant title appears. 61
[7.] 6. Applicants for initial issuance or renewal of 62
licenses pursuant to this section shall list all states in 63
which they have applied for or hold certificates, licenses 64
or permits and list any past denial, revocation or 65
suspension or any discipline of a certificate, license or 66
permit. Each holder of or applicant for a license shall 67
notify the board in writing within thirty days after its 68
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occurrence of any issuance, denial, revocation or suspension 69
or any discipline of a certificate, license or permit by 70
another state. 71
[8.] 7. The board may issue a license to a holder of a 72
substantially equivalent foreign designation, provided that: 73
(1) The foreign authority which granted the 74
designation makes similar provisions to allow a person who 75
holds a valid license issued by this state to obtain such 76
foreign authority's comparable designation; and 77
(2) The foreign designation: 78
(a) Was duly issued by a foreign authority that 79
regulates the practice of public accounting and the foreign 80
designation has not expired or been revoked or suspended; 81
(b) Entitles the holder to issue reports upon 82
financial statements; and 83
(c) Was issued upon the basis of educational, 84
examination and experience requirements established by the 85
foreign authority or by law; and 86
(3) The applicant: 87
(a) Received the designation based on educational and 88
examination standards substantially equivalent to those in 89
effect in this state at the time the foreign designation was 90
granted; 91
(b) Completed an experience requirement substantially 92
equivalent to the requirement set out in subdivision (6) of 93
subsection 1 of section 326.280 in the jurisdiction which 94
granted the foreign designation or has completed four years 95
of professional experience in this state, or meets 96
equivalent requirements prescribed by the board by rule 97
within the ten years immediately preceding the application; 98
and 99
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(c) Passed a uniform qualifying examination in 100
national standards and an examination on the laws, 101
regulations and code of ethical conduct in effect in this 102
state acceptable to the board. 103
[9.] 8. An applicant pursuant to subsection [8] 7 of 104
this section shall list all jurisdictions, foreign and 105
domestic, in which the applicant has applied for or holds a 106
designation to practice public accounting. Each holder of a 107
license issued pursuant to this subsection shall notify the 108
board in writing within thirty days after its occurrence of 109
any issuance, denial, revocation, suspension or any 110
discipline of a designation or commencement of a 111
disciplinary or enforcement action by any jurisdiction. 112
[10.] 9. The board has the sole authority to interpret 113
the application of the provisions of subsections 7 and 8 114
[and 9] of this section. 115
326.289. 1. The board may grant or renew permits to 1
practice as a certified public accounting firm to applicants 2
that demonstrate their qualifications in accordance with 3
this chapter. 4
(1) The following shall hold a permit issued under 5
this chapter: 6
(a) Any firm with an office in this state, as defined 7
by the board by rule, offering or performing attest or 8
compilation services; or 9
(b) Any firm with an office in this state that uses 10
the title "CPA" or "CPA firm". 11
(2) Any firm that does not have an office in this 12
state may offer or perform attest or compilation services in 13
this state without a valid permit only if it meets each of 14
the following requirements: 15
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(a) It complies with the qualifications described in 16
subdivision (1) of subsection 4 of this section; 17
(b) It complies with the requirements of peer review 18
as set forth in this chapter and the board's promulgated 19
regulations; 20
(c) It performs such services through an individual 21
with practice privileges under section 326.283; and 22
(d) It can lawfully do so in the state where said 23
individual with the privilege to practice has his or her 24
principal place of business. 25
(3) A firm which is not subject to the requirements of 26
subdivisions (1) or (2) of this subsection may perform other 27
nonattest or noncompilation services while using the title 28
"CPA" or "CPA firm" in this state without a permit issued 29
under this section only if it: 30
(a) Performs such services through an individual with 31
the privilege to practice under section 326.283; and 32
(b) Can lawfully do so in the state where said 33
individual with privilege to practice has his or her 34
principal place of business. 35
(4) (a) All firms practicing public accounting in 36
this state shall register with the secretary of state. 37
(b) Firms which may be exempt from this requirement 38
include: 39
a. Sole proprietorships; 40
b. Trusts created pursuant to revocable trust 41
agreements, of which the trustee is a natural person who 42
holds a license or privilege to practice as set forth in 43
section 326.280, 326.283, or 326.286; 44
c. General partnerships not operating as a limited 45
liability partnership; or 46
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d. Foreign professional corporations which do not meet 47
criteria of chapter 356 due to name or ownership, shall 48
obtain a certificate of authority as a general corporation. 49
Notwithstanding the provisions of chapter 356, the secretary 50
of state may issue a certificate of authority to a foreign 51
professional corporation which does not meet the criteria of 52
chapter 356 due to name or ownership, if the corporation 53
meets the requirements of this section and the rules of the 54
board. 55
(5) A sole practitioner or single member limited 56
liability company (LLC) using the title of "certified public 57
accountant(s)", "CPA", or similar abbreviation in their 58
business name may request exemption from the firm permit 59
requirements of paragraph (b) of subdivision (1) of this 60
subsection by submitting a written request to the board that 61
affirms the business does not offer nor perform attest 62
services nor other services subject to peer review. 63
2. Permits shall be initially issued and renewed for 64
periods of not more than three years or for a specific 65
period as prescribed by board rule following issuance or 66
renewal. 67
3. The board shall determine by rule the form for 68
application and renewal of permits and shall annually 69
determine the fees for permits and their renewals. 70
4. An applicant for initial issuance or renewal of a 71
permit to practice under this section shall be required to 72
show that: 73
(1) A simple majority of the ownership of the firm, in 74
terms of financial interests and voting rights of all 75
partners, officers, principals, shareholders, members or 76
managers, belongs to licensees who are licensed in some 77
state, and the partners, officers, principals, shareholders, 78
SCS HB 2591 24
members or managers, whose principal place of business is in 79
this state and who perform professional services in this 80
state are licensees under section 326.280 or the 81
corresponding provision of prior law. Although firms may 82
include nonlicensee owners, the firm and its ownership shall 83
comply with rules promulgated by the board; 84
(2) Any certified public accounting firm may include 85
owners who are not licensees provided that: 86
(a) The firm designates a licensee of this state, or 87
in the case of a firm which must have a permit under this 88
section designates a licensee of another state who meets the 89
requirements of section 326.283, who is responsible for the 90
proper registration of the firm and identifies that 91
individual to the board; 92
(b) All nonlicensee owners are active individual 93
participants in the certified public accounting firm or 94
affiliated entities; 95
(c) All owners are of good moral character; and 96
(d) The firm complies with other requirements as the 97
board may impose by rule; 98
(3) Any licensee who is responsible for supervising 99
attest services, or signs or authorizes someone to sign the 100
licensee's report on the financial statements on behalf of 101
the firm, shall meet competency requirements as determined 102
by the board by rule which shall include one year of 103
experience in addition to the experience required under 104
subdivision (6) of subsection 1 of section 326.280 and shall 105
be verified by a licensee. The additional experience 106
required by this subsection shall include experience in 107
attest work supervised by a licensee. 108
5. An applicant for initial issuance or renewal of a 109
permit to practice shall register each office of the firm 110
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within this state with the board and show that all attest 111
and compilation services rendered in this state are under 112
the charge of a licensee. 113
6. No licensee or firm holding a permit under this 114
chapter shall use a professional or firm name or designation 115
that is misleading as to: 116
(1) The legal form of the firm; 117
(2) The persons who are partners, officers, members, 118
managers or shareholders of the firm; or 119
(3) Any other matter. 120
The names of one or more former partners, members or 121
shareholders may be included in the name of a firm or its 122
successor unless the firm becomes a sole proprietorship 123
because of the death or withdrawal of all other partners, 124
officers, members or shareholders. A firm may use a 125
fictitious name if the fictitious name is registered with 126
the board and is not otherwise misleading. The name of a 127
firm shall not include the name or initials of an individual 128
who is not a present or a past partner, member or 129
shareholder of the firm or its predecessor. The name of the 130
firm shall not include the name of an individual who is not 131
a licensee. 132
7. Applicants for initial issuance or renewal of 133
permits shall list in their application all states in which 134
they have applied for or hold permits as certified public 135
accounting firms and list any past denial, revocation, 136
suspension or any discipline of a permit by any other 137
state. Each holder of or applicant for a permit under this 138
section shall notify the board in writing within thirty days 139
after its occurrence of any change in the identities of 140
partners, principals, officers, shareholders, members or 141
SCS HB 2591 26
managers whose principal place of business is in this state; 142
any change in the number or location of offices within this 143
state; any change in the identity of the persons in charge 144
of such offices; and any issuance, denial, revocation, 145
suspension or any discipline of a permit by any other state. 146
8. Firms which fall out of compliance with the 147
provisions of this section due to changes in firm ownership 148
or personnel after receiving or renewing a permit shall take 149
corrective action to bring the firm back into compliance as 150
quickly as possible. The board may grant a reasonable 151
period of time for a firm to take such corrective action. 152
Failure to bring the firm back into compliance within a 153
reasonable period as defined by the board may result in the 154
suspension or revocation of the firm permit. 155
9. The board shall require by rule, as a condition to 156
the renewal of permits, that firms undergo, no more 157
frequently than once every three years, peer reviews 158
conducted in a manner as the board shall specify. The 159
review shall include a verification that individuals in the 160
firm who are responsible for supervising attest and 161
compilation services or sign or authorize someone to sign 162
the accountant's report on the financial statements on 163
behalf of the firm meet the competency requirements set out 164
in the professional standards for such services, provided 165
that any such rule: 166
(1) Shall include reasonable provision for compliance 167
by a firm showing that it has within the preceding three 168
years undergone a peer review that is [a satisfactory 169
equivalent] comparable to peer review generally required 170
under this subsection; 171
(2) May require, with respect to peer reviews, that 172
peer reviews be subject to oversight by an oversight body 173
SCS HB 2591 27
established or sanctioned by board rule, which shall 174
periodically report to the board on the effectiveness of the 175
review program under its charge and provide to the board a 176
listing of firms that have participated in a peer review 177
program that is satisfactory to the board; and 178
(3) Shall require, with respect to peer reviews, that 179
the peer review processes be operated and documents 180
maintained in a manner designed to preserve confidentiality, 181
and that the board or any third party other than the 182
oversight body shall not have access to documents furnished 183
or generated in the course of the peer review of the firm 184
except as provided in subdivision (2) of this subsection. 185
10. The board may, by rule, charge a fee for oversight 186
of peer reviews, provided that the fee charged shall be 187
[substantially equivalent] comparable to the cost of 188
oversight. 189
11. Notwithstanding any other provision in this 190
section, the board may obtain the following information 191
regarding peer review from any approved American Institute 192
for Certified Public Accountants peer review program: 193
(1) The firm's name and address; 194
(2) The firm's dates of enrollment in the program; 195
(3) The date of acceptance and the period covered by 196
the firm's most recently accepted peer review; and 197
(4) If applicable, whether the firm's enrollment in 198
the program has been dropped or terminated. 199
12. In connection with proceedings before the board or 200
upon receipt of a complaint involving the licensee 201
performing peer reviews, the board shall not have access to 202
any documents furnished or generated in the course of the 203
performance of the peer reviews except for peer review 204
reports, letters of comment and summary review memoranda. 205
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The documents shall be furnished to the board only in a 206
redacted manner that does not specifically identify any firm 207
or licensee being peer reviewed or any of their clients. 208
13. The peer review processes shall be operated and 209
the documents generated thereby be maintained in a manner 210
designed to preserve their confidentiality. No third party, 211
other than the oversight body, the board, subject to the 212
provisions of subsection 12 of this section, or the 213
organization performing peer review shall have access to 214
documents furnished or generated in the course of the 215
review. All documents shall be privileged and closed 216
records for all purposes and all meetings at which the 217
documents are discussed shall be considered closed meetings 218
under subdivision (1) of section 610.021. The proceedings, 219
records and workpapers of the board and any peer review 220
subjected to the board process shall be privileged and shall 221
not be subject to discovery, subpoena or other means of 222
legal process or introduction into evidence at any civil 223
action, arbitration, administrative proceeding or board 224
proceeding. No member of the board or person who is 225
involved in the peer review process shall be permitted or 226
required to testify in any civil action, arbitration, 227
administrative proceeding or board proceeding as to any 228
matters produced, presented, disclosed or discussed during 229
or in connection with the peer review process or as to any 230
findings, recommendations, evaluations, opinions or other 231
actions of such committees or any of its members; provided, 232
however, that information, documents or records that are 233
publicly available shall not be subject to discovery or use 234
in any civil action, arbitration, administrative proceeding 235
or board proceeding merely because they were presented or 236
considered in connection with the peer review process. 237
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326.292. 1. Only licensees may issue a report on 1
financial statements of any person, firm, organization or 2
governmental unit or offer to render or render any attest 3
service. Such restriction shall not prohibit any act of a 4
public official or public employee in the performance of the 5
person's duties as such; nor prohibit the performance by any 6
nonlicensee of other services involving the use of 7
accounting skills, including the preparation of tax returns, 8
management advisory services and the preparation of 9
nonattest financial statements. Nonlicensees may prepare 10
financial statements and issue nonattest transmittals or 11
information thereon which do not purport to be in compliance 12
with the Statements on Standards for Accounting and Review 13
Services (SSARS). 14
2. Only certified public accountants shall use or 15
assume the title certified public accountant, or the 16
abbreviation CPA or any other title, designation, words, 17
letters, abbreviation, sign, card or device tending to 18
indicate that such person is a certified public accountant. 19
Nothing in this section shall prohibit: 20
(1) A certified public accountant whose certificate 21
was in full force and effect, issued pursuant to the laws of 22
this state prior to August 28, 2001, and who does not engage 23
in the practice of public accounting, auditing, bookkeeping 24
or any similar occupation, from using the title certified 25
public accountant or abbreviation CPA; 26
(2) A person who holds a certificate, then in force 27
and effect, issued pursuant to the laws of this state prior 28
to August 28, 2001, and who is regularly employed by or is a 29
director or officer of a corporation, partnership, 30
association or business trust, in his or her capacity as 31
such, from signing, delivering or issuing any financial, 32
SCS HB 2591 30
accounting or related statement, or report thereon relating 33
to such corporation, partnership, association or business 34
trust provided the capacity is so designated, and provided 35
in the signature line the title CPA or certified public 36
accountant is not designated. 37
3. No firm shall provide attest or compilation 38
services or assume or use the title certified public 39
accountants or the abbreviation CPAs, or any other title, 40
designation, words, letters, abbreviation, sign, card or 41
device tending to indicate that such firm is a certified 42
public accounting firm unless: 43
(1) The firm holds a valid permit [issued under 44
section 326.289] or is a firm exempt from the permit 45
requirement under [subdivisions (2) and (3) of subsection 1 46
of] section 326.289 and complies with all other applicable 47
provisions of that section; and 48
(2) Ownership of the firm is in accord with section 49
326.289 and rules promulgated by the board. 50
4. Only persons holding a valid license or permit 51
issued under section 326.280 or 326.289, or persons 52
qualifying for the privilege to practice under section 53
326.283, and firms exempt from the permit requirement under 54
subsection 1 of section 326.289, shall assume or use the 55
title certified accountant, chartered accountant, enrolled 56
accountant, licensed accountant, registered accountant, 57
accredited accountant or any other title or designation 58
likely to be confused with the titles certified public 59
accountant or public accountant, or use any of the 60
abbreviations CA, LA, RA, AA or similar abbreviation likely 61
to be confused with the abbreviation CPA or PA. The title 62
enrolled agent or EA shall only be used by individuals so 63
designated by the Internal Revenue Service. Nothing in this 64
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section shall prohibit the use or issuance of a title for 65
nonattest services provided that the organization and the 66
title issued by the organization existed prior to August 28, 67
2001. 68
5. (1) Nonlicensees shall not use language in any 69
statement relating to the financial affairs of a person or 70
entity that is conventionally used by certified public 71
accountants in reports on financial statements. 72
Nonlicensees may use the following safe harbor language: 73
(a) For compilations: 74
"I (We) have prepared the accompanying 75
(financial statements) of (name of entity) as of 76
(time period) for the (period) then ended. This 77
presentation is limited to preparing in the form 78
of a financial statement information that is the 79
representation of management (owners). I (We) 80
have not audited or reviewed the accompanying 81
financial statements and accordingly do not 82
express an opinion or any other form of 83
assurance on them." 84
(b) For reviews: 85
"I (We) reviewed the accompanying 86
(financial statements) of (name of entity) as of 87
(time period) for the (period) then ended. 88
These financial statements (information) are 89
(is) the responsibility of the company's 90
management. I (We) have not audited the 91
accompanying financial statements and 92
accordingly do not express an opinion or any 93
other form of assurance on them.". 94
(2) Only persons or firms holding a valid license or 95
permit issued under section 326.280 or 326.289 shall assume 96
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or use any title or designation that includes the words 97
accountant or accounting in connection with any other 98
language, including the language of a report, that implies 99
that the person or firm holds a license or permit or has 100
special competence as an accountant or auditor; provided, 101
however, that this subsection shall not prohibit any 102
officer, partner, principal, member, manager or employee of 103
any firm or organization from affixing such person's own 104
signature to any statement in reference to the financial 105
affairs of the firm or organization with any wording 106
designating the position, title or office that the person 107
holds therein nor prohibit any act of a public official or 108
employee in the performance of the person's duties as such. 109
Nothing in this subsection shall prohibit the singular use 110
of "accountant" or "accounting" for nonattest purposes. 111
6. Licensees signing or authorizing someone to sign 112
reports on financial statements when performing attest or 113
compilation services shall provide those services in 114
accordance with professional standards as determined by the 115
board by rule. 116
7. No licensee or firm holding a permit under sections 117
326.280 to 326.289 shall use a professional or firm name or 118
designation that is misleading about the legal form of the 119
firm, or about the persons who are partners, principals, 120
officers, members, managers or shareholders of the firm, or 121
about any other matter. 122
8. None of the foregoing provisions of this section 123
shall apply to a person or firm holding a certification, 124
designation, degree or license granted in a foreign country 125
entitling the holder to engage in the practice of public 126
accounting or its equivalent in the country whose activities 127
in this state are limited to the provision of professional 128
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services to persons or firms who are residents of, 129
governments of, or business entities of the country in which 130
the person holds the entitlement, who performs no attest or 131
compilation services and who issues no reports with respect 132
to the financial statements of any other persons, firms or 133
governmental units in this state, and who does not use in 134
this state any title or designation other than the one under 135
which the person practices in such country, followed by a 136
translation of such title or designation into the English 137
language, if it is in a different language, and by the name 138
of such country. 139
9. No licensee shall perform attest or compilation 140
services through any certified public accounting firm that 141
does not hold a valid permit issued under section 326.289. 142
10. Nothing herein shall prohibit a practicing 143
attorney or firm of attorneys from preparing or presenting 144
records or documents customarily prepared by an attorney or 145
firm of attorneys in connection with the attorney's 146
professional work in the practice of law. 147
11. Nothing herein shall prohibit any trustee, 148
executor, administrator, referee or commissioner from 149
signing and certifying financial reports incident to his or 150
her duties in that capacity. 151
12. Nothing herein shall prohibit any director or 152
officer of a corporation, partner or a partnership, sole 153
proprietor of a business enterprise, member of a joint 154
venture, member of a committee appointed by stockholders, 155
creditors or courts, or an employee of any of the foregoing, 156
in his or her capacity as such, from signing, delivering or 157
issuing any financial, accounting or related statement, or 158
report thereon, relating to the corporation, partnership, 159
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business enterprise, joint venture or committee, provided 160
the capacity is designated on the statement or report. 161
13. (1) A licensee shall not for a commission 162
recommend or refer to a client any product or service, or 163
for a commission recommend or refer any product or service 164
to be supplied by a client, or receive a commission, when 165
the licensee also performs for that client: 166
(a) Attest services; or 167
(b) A compilation of a financial statement when the 168
licensee expects, or reasonably may expect, that a third 169
party will use the financial statement and the licensee's 170
compilation report does not disclose a lack of independence; 171
or 172
(c) An examination of prospective financial 173
information. 174
Such prohibition applies during the period in which the 175
licensee is engaged to perform any of the services listed 176
above and the period covered by any historical financial 177
statements involved in such listed services. 178
(2) A licensee who is not prohibited by this section 179
from performing services for or receiving a commission and 180
who is paid or expects to be paid a commission shall 181
disclose in writing that fact to any person or entity to 182
whom the licensee recommends or refers a product or service 183
to which the commission relates. 184
(3) Any licensee who accepts a referral fee for 185
recommending or referring any service of a licensee to any 186
person or entity or who pays a referral fee to obtain a 187
client shall disclose in writing the acceptance or payment 188
to the client. 189
14. (1) A licensee shall not: 190
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(a) Perform for a contingent fee any professional 191
services for, or receive a fee from, a client for whom the 192
licensee or the licensees's firm performs: 193
a. Attest services; 194
b. A compilation of a financial statement when the 195
licensee expects, or reasonably might expect, that a third 196
party will use the financial statement and the licensee's 197
compilation report does not disclose a lack of independence; 198
or 199
c. An examination of prospective financial information; 200
(b) Prepare an original tax return or claim for a tax 201
refund for a contingent fee for any client; or 202
(c) Prepare an amended tax return or claim for a tax 203
refund for a contingent fee for any client, unless permitted 204
by board rule. 205
(2) The prohibition in subdivision (1) of this 206
subsection applies during the period in which the licensee 207
is engaged to perform any of those services and the period 208
covered by any historical financial statements involved in 209
any services. 210
(3) A contingent fee is a fee established for the 211
performance of any service pursuant to an arrangement in 212
which no fee will be charged unless a specified finding or 213
result is attained, or in which the amount of the fee is 214
otherwise dependent upon the finding or result of the 215
service. Solely for purposes of this section, fees are not 216
regarded as being contingent if fixed by courts or other 217
public authorities, or, in tax matters, if determined based 218
on the results of judicial proceedings or the findings of 219
governmental agencies. A licensee's fees may vary 220
depending, for example, on the complexity of services 221
rendered. 222
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15. Any person who violates any provision of 223
subsections 1 to 5 of this section shall be guilty of a 224
class A misdemeanor. Whenever the board has reason to 225
believe that any person has violated this section it may 226
certify the facts to the attorney general of this state or 227
bring other appropriate proceedings. 228
332.081. 1. Notwithstanding any other provision of 1
law to the contrary, hospitals licensed under chapter 197 2
shall be authorized to employ any or all of the following 3
oral health providers: 4
(1) A dentist licensed under this chapter for the 5
purpose of treating on hospital premises those patients who 6
present with a dental condition and such treatment is 7
necessary to ameliorate the condition for which they 8
presented such as severe pain or tooth abscesses; 9
(2) An oral and maxillofacial surgeon licensed under 10
this chapter for the purpose of treating oral conditions 11
that need to be ameliorated as part of treating the 12
underlying cause of the patient's medical needs including, 13
but not limited to, head and neck cancer, HIV or AIDS, 14
severe trauma resulting in admission to the hospital, organ 15
transplant, diabetes, or seizure disorders. It shall be a 16
condition of treatment that such patients are admitted to 17
the hospital on either an in- or out-patient basis; and 18
(3) A maxillofacial prosthodontist licensed under this 19
chapter for the purpose of treating and supporting patients 20
of a head and neck cancer team or other complex care or 21
surgical team for the fabrication of appliances following 22
ablative surgery, surgery to correct birth anomalies, 23
extensive radiation treatment of the head or neck, or trauma- 24
related surgery. 25
SCS HB 2591 37
2. No person or other entity shall practice dentistry 26
in Missouri or provide dental services as [defined] 27
described in section 332.071 unless and until the board has 28
issued to the person a certificate certifying that the 29
person has been duly registered as a dentist in Missouri or 30
the board has issued such certificate to an entity that has 31
been duly registered to provide dental services by licensed 32
dentists and dental hygienists and unless and until the 33
board has issued to the person a license, to be renewed each 34
period, as provided in this chapter, to practice dentistry 35
or as a dental hygienist, or has issued to the person or 36
entity a permit, to be renewed each period, to provide 37
dental services in Missouri. Nothing in this chapter shall 38
be so construed as to make it unlawful for: 39
(1) A legally qualified physician or surgeon, who does 40
not practice dentistry as a specialty, from extracting teeth; 41
(2) A dentist licensed in a state other than Missouri 42
from making a clinical demonstration before a meeting of 43
dentists in Missouri; 44
(3) Dental students in any accredited dental school to 45
practice dentistry under the personal direction of 46
instructors; 47
(4) Dental hygiene students in any accredited dental 48
hygiene school to practice dental hygiene under the personal 49
direction of instructors; 50
(5) A duly registered and licensed dental hygienist in 51
Missouri to practice dental hygiene as defined in section 52
332.091; 53
(6) A dental assistant, certified dental assistant, or 54
expanded functions dental assistant to be delegated duties 55
as defined in section 332.093; 56
SCS HB 2591 38
(7) A duly registered dentist or dental hygienist to 57
teach in an accredited dental or dental hygiene school; 58
(8) A person who has been granted a dental faculty 59
permit under section 332.183 to practice dentistry in the 60
scope of his or her employment at an accredited dental 61
school, college, or program in Missouri; 62
(9) A duly qualified anesthesiologist or nurse 63
anesthetist to administer an anesthetic in connection with 64
dental services or dental surgery; 65
(10) A person to practice dentistry in or for: 66
(a) The United States Armed Forces; 67
(b) The United States Public Health Service; 68
(c) Migrant, community, or health care for the 69
homeless health centers provided in Section 330 of the 70
Public Health Service Act (42 U.S.C. Section 254b); 71
(d) Federally qualified health centers as defined in 72
Section 1905(l) (42 U.S.C. Section 1396d(l)) of the Social 73
Security Act; 74
(e) Governmental entities, including county health 75
departments; or 76
(f) The United States Veterans Bureau; or 77
(11) A dentist licensed in a state other than Missouri 78
to evaluate a patient or render an oral, written, or 79
otherwise documented dental opinion when providing testimony 80
or records for the purpose of a civil or criminal action 81
before any judicial or administrative proceeding of this 82
state or other forum in this state. 83
3. No corporation shall practice dentistry as defined 84
in section 332.071 unless that corporation is organized 85
under the provisions of chapter 355 or 356 provided that a 86
corporation organized under the provisions of chapter 355 87
and qualifying as an organization under 26 U.S.C. Section 88
SCS HB 2591 39
501(c)(3) may only employ dentists and dental hygienists 89
licensed in this state to render dental services to Medicaid 90
recipients, low-income individuals who have available income 91
below two hundred percent of the federal poverty level, and 92
all participants in the SCHIP program, unless such 93
limitation is contrary to or inconsistent with federal or 94
state law or regulation. This subsection shall not apply to: 95
(1) A hospital licensed under chapter 197 that 96
provides care and treatment only to children under the age 97
of eighteen at which a person regulated under this chapter 98
provides dental care within the scope of his or her license 99
or registration; 100
(2) A federally qualified health center as defined in 101
Section 1905(l) of the Social Security Act (42 U.S.C. 102
Section 1396d(l)), or a migrant, community, or health care 103
for the homeless health center provided for in Section 330 104
of the Public Health Services Act (42 U.S.C. Section 254b) 105
at which a person regulated under this chapter provides 106
dental care within the scope of his or her license or 107
registration; 108
(3) A city or county health department organized under 109
chapter 192 or chapter 205 at which a person regulated under 110
this chapter provides dental care within the scope of his or 111
her license or registration; 112
(4) A social welfare board organized under section 113
205.770, a city health department operating under a city 114
charter, or a city-county health department at which a 115
person regulated under this chapter provides dental care 116
within the scope of his or her license or registration; 117
(5) Any entity that has received a permit from the 118
dental board and does not receive compensation from the 119
patient or from any third party on the patient's behalf at 120
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which a person regulated under this chapter provides dental 121
care within the scope of his or her license or registration; 122
or 123
(6) Any hospital nonprofit corporation exempt from 124
taxation under Section 501(c)(3) of the Internal Revenue 125
Code, as amended, that engages in its operations and 126
provides dental services at facilities owned by a city, 127
county, or other political subdivision of the state, or any 128
entity contracted with the state to provide care in a 129
correctional center, as such term is defined in section 130
217.010, at which a person regulated under this chapter 131
provides dental care within the scope of his or her license 132
or registration. 133
If any of the entities exempted from the requirements of 134
this subsection are unable to provide services to a patient 135
due to the lack of a qualified provider and a referral to 136
another entity is made, the exemption shall extend to the 137
person or entity that subsequently provides services to the 138
patient. 139
4. No unincorporated organization shall practice 140
dentistry as defined in section 332.071 unless such 141
organization is exempt from federal taxation under Section 142
501(c)(3) of the Internal Revenue Code of 1986, as amended, 143
and provides dental treatment without compensation from the 144
patient or any third party on their behalf as a part of a 145
broader program of social services including food 146
distribution. Nothing in this chapter shall prohibit 147
organizations under this subsection from employing any 148
person regulated by this chapter. 149
5. A dentist shall not enter into a contract that 150
allows a person who is not a dentist to influence or 151
SCS HB 2591 41
interfere with the exercise of the dentist's independent 152
professional judgment. 153
6. A not-for-profit corporation organized under the 154
provisions of chapter 355 and qualifying as an organization 155
under 26 U.S.C. Section 501(c)(3), an unincorporated 156
organization operating pursuant to subsection 4 of this 157
section, or any other person should not direct or interfere 158
or attempt to direct or interfere with a licensed dentist's 159
professional judgment and competent practice of dentistry. 160
Nothing in this subsection shall be so construed as to make 161
it unlawful for not-for-profit organizations to enforce 162
employment contracts, corporate policy and procedure 163
manuals, or quality improvement or assurance requirements. 164
7. All entities defined in subsection 3 of this 165
section and those exempted under subsection 4 of this 166
section shall apply for a permit to employ dentists and 167
dental hygienists licensed in this state to render dental 168
services, and the entity shall apply for the permit in 169
writing on forms provided by the Missouri dental board. The 170
board shall not charge a fee of any kind for the issuance or 171
renewal of such permit. The provisions of this subsection 172
shall not apply to a federally qualified health center as 173
defined in Section 1905(l) of the Social Security Act (42 174
U.S.C. Section 1396d(l)). 175
8. Any entity that obtains a permit to render dental 176
services in this state is subject to discipline pursuant to 177
section 332.321. If the board concludes that the person or 178
entity has committed an act or is engaging in a course of 179
conduct that would be grounds for disciplinary action, the 180
board may file a complaint before the administrative hearing 181
commission. The board may refuse to issue or renew the 182
permit of any entity for one or any combination of causes 183
SCS HB 2591 42
stated in subsection 2 of section 332.321. The board shall 184
notify the applicant in writing of the reasons for the 185
refusal and shall advise the applicant of his or her right 186
to file a complaint with the administrative hearing 187
commission as provided by chapter 621. 188
9. A federally qualified health center as defined in 189
Section 1905(l) of the Social Security Act (42 U.S.C. 190
Section 1396d(l)) shall register with the board. The 191
information provided to the board as part of the 192
registration shall include the name of the health center, 193
the nonprofit status of the health center, sites where 194
dental services will be provided, and the names of all 195
persons employed by, or contracting with, the health center 196
who are required to hold a license pursuant to this 197
chapter. The registration shall be renewed every twenty- 198
four months. The board shall not charge a fee of any kind 199
for the issuance or renewal of the registration. The 200
registration of the health center shall not be subject to 201
discipline pursuant to section 332.321. Nothing in this 202
subsection shall prohibit disciplinary action against a 203
licensee of this chapter who is employed by, or contracts 204
with, such health center for the actions of the licensee in 205
connection with such employment or contract. 206
10. The board may promulgate rules and regulations to 207
ensure not-for-profit corporations are rendering care to the 208
patient populations as set forth herein, including 209
requirements for covered not-for-profit corporations to 210
report patient census data to the board. The provisions of 211
this subsection shall not apply to a federally qualified 212
health center as defined in Section 1905(l) of the Social 213
Security Act (42 U.S.C. Section 1396d(l)). 214
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11. All not-for-profit corporations organized or 215
operated pursuant to the provisions of chapter 355 and 216
qualifying as an organization under 26 U.S.C. Section 217
501(c)(3), or the requirements relating to migrant, 218
community, or health care for the homeless health centers 219
provided in Section 330 of the Public Health Service Act (42 220
U.S.C. Section 254b) and federally qualified health centers 221
as defined in Section 1905(l) (42 U.S.C. Section 1396d(l)) 222
of the Social Security Act, that employ persons who practice 223
dentistry or dental hygiene in this state shall do so in 224
accordance with the relevant laws of this state except to 225
the extent that such laws are contrary to, or inconsistent 226
with, federal statute or regulation. 227
334.031. 1. (1) Candidates for licenses as 1
physicians and surgeons shall furnish [satisfactory evidence 2
of their good moral character, and their preliminary 3
qualifications, to wit: a certificate of graduation from an 4
accredited high school or its equivalent, and satisfactory 5
evidence of completion of preprofessional education 6
consisting of a minimum of sixty semester hours of college 7
credits in acceptable subjects leading towards the degree of 8
bachelor of arts or bachelor of science from an accredited 9
college or university. They shall also furnish satisfactory 10
evidence of having attended throughout at least four terms 11
of thirty-two weeks of actual instructions in each term and 12
of having received a diploma from some reputable medical 13
college or osteopathic college that enforces requirements of 14
four terms of thirty-two weeks for actual instruction in 15
each term, including, in addition to class work, such 16
experience in operative and hospital work during the last 17
two years of instruction as is required by the American 18
Medical Association and the American Osteopathic Association 19
SCS HB 2591 44
before the college is approved and accredited as reputable. 20
Any medical college approved and accredited as reputable by 21
the American Medical Association or the Liaison Committee on 22
Medical Education and any osteopathic college approved and 23
accredited as reputable by the American Osteopathic 24
Association is deemed to have complied with the requirements 25
of this subsection]: 26
(a) Evidence of good moral character by submitting to 27
a criminal background check as provided in section 43.540; 28
(b) Either: 29
a. A diploma and academic transcripts from a school 30
accredited by the Liaison Committee on Medical Education, 31
the Commission on Osteopathic College Accreditation, or a 32
similar accrediting agency or from some reputable medical 33
college or osteopathic college; or 34
b. A valid certificate from the Educational Commission 35
for Foreign Medical Graduates (ECFMG); and 36
(c) A certificate demonstrating that the applicant has 37
satisfied the requirements of section 334.035 relating to 38
postgraduate training. An applicant who holds a valid 39
certificate issued by the ECFMG shall submit satisfactory 40
evidence of successful completion of two years of such 41
training. 42
(2) Except as provided in subsection 3 of this 43
section, the board shall not require applicants to provide 44
information in addition to the information the applicant is 45
required to furnish under this subsection. 46
2. In determining the qualifications necessary for 47
licensure as a qualified physician and surgeon, the board, 48
by rule and regulation, may accept the certificate of the 49
National Board of Medical Examiners of the United States, 50
chartered pursuant to the laws of the District of Columbia, 51
SCS HB 2591 45
of the National Board of Examiners for Osteopathic 52
Physicians and Surgeons chartered pursuant to the laws of 53
the state of Indiana, or of the Licentiate of the Medical 54
Counsel of Canada (LMCC) in lieu of and as equivalent to its 55
own professional examination. Every applicant for a license 56
on the basis of such certificate, upon making application 57
showing necessary qualifications as provided in subsection 1 58
of this section, shall be required to pay the same fee 59
required of applicants to take the examination before the 60
board. 61
3. The board may require applicants to list all 62
licenses to practice as a physician currently or previously 63
held in any other state, territory, or country and to 64
disclose any past or pending investigations, discipline, or 65
sanctions against each such license. 66
4. In addition to the criminal background screening 67
required by this section, the board may obtain a report on 68
the applicant from the National Practitioner Data Bank or 69
the Federation of State Medical Boards. 70
334.870. An applicant for a license to practice 1
respiratory care may be issued a license which is valid 2
until the expiration date as determined by the board after 3
the following requirements have been met: 4
(1) The applicant submits to the board: 5
(a) A completed application for licensure; 6
(b) Written evidence of: 7
a. [Credentials from the certifying entity; or] An 8
active credential as a registered respiratory therapist 9
through the National Board for Respiratory Care, or a 10
successor credentialing organization; 11
b. Current licensure or registration with an active 12
credential as a registered respiratory [care practitioner] 13
SCS HB 2591 46
therapist practicing in another state, the District of 14
Columbia or territory of the United States which requires 15
standards for licensure or registration determined by the 16
board to be equivalent to, or exceed, the requirements for 17
licensure under sections 334.800 to 334.930; or 18
c. An active credential as a certified respiratory 19
therapist earned prior to January 1, 2027, through the 20
National Board for Respiratory Care; 21
(c) Payment of any required fees; 22
(2) The board requests and receives a complete 23
background check and other information as may be deemed 24
necessary to fulfill sections 334.800 to 334.910; 25
(3) An applicant who has completed the requirements of 26
subdivision (1) of this section and has submitted the 27
necessary information for the background check pursuant to 28
subdivision (2) of this section may obtain a conditional 29
license to practice as a respiratory care practitioner 30
pending the outcome of the background check subject to the 31
following restrictions: 32
(a) The conditional license shall only be issued if 33
the applicant has made a prima facie showing that he or she 34
meets all of the requirements for full licensure; 35
(b) The conditional license shall only be effective 36
until the board has had an opportunity to investigate the 37
applicant's qualifications for licensure pursuant to 38
subdivisions (1) and (2) of this section and to notify the 39
applicant that his or her application for licensure has been 40
granted or denied; 41
(c) If the applicant provides false or misleading 42
information to the board, the board may automatically 43
terminate the conditional license. If the board 44
automatically terminates a conditional license, the board 45
SCS HB 2591 47
shall notify the holder of the board's decision by certified 46
mail or personal service; 47
(d) In no event shall such conditional license be in 48
effect for more than twelve months after the date of its 49
issuance; 50
(e) A conditional license shall not be eligible for 51
renewal; and 52
(f) No fee shall be charged for issuing a conditional 53
license. 54
334.880. 1. A license issued pursuant to sections 1
334.800 to 334.930 shall be renewed biennially, except as 2
provided in sections 334.800 to 334.930. The board shall 3
mail a notice to each person licensed during the preceding 4
licensing period at least thirty calendar days prior to the 5
expiration date of the license. The board shall not renew 6
any license unless the licensee shall provide satisfactory 7
evidence of having complied with the board's minimum 8
requirements for continuing education. 9
2. Failure of a licensee to renew his or her license 10
prior to the expiration of the license shall result in the 11
lapse of the license. A lapsed license may be reinstated by 12
the board as provided by rule. 13
3. Any license renewal is subject to a random audit to 14
ensure the licensee has an active credential through the 15
National Board for Respiratory Care, or a successor 16
credentialing organization. If audited, proof of active 17
credential shall be submitted directly to the board by the 18
National Board for Respiratory Care, or the successor 19
credentialing organization. 20
4. Each licensee may, in lieu of submitting proof of 21
the completion of the required continuing education course, 22
apply for an inactive license at the time of renewal and pay 23
SCS HB 2591 48
the required inactive fee. An inactive license shall be 24
renewed biennially. An inactive license may be reactivated 25
by the board as provided by rule. 26
[4.] 5. Any person who practices as a respiratory care 27
practitioner during the time his or her license is inactive 28
or lapsed shall be considered an illegal practitioner and 29
shall be subject to the penalties for violation of the 30
respiratory care practice act. 31
335.081. So long as the person involved does not 1
represent or hold himself or herself out as a nurse licensed 2
to practice in this state, no provision of sections 335.011 3
to 335.096 shall be construed as prohibiting: 4
(1) The practice of any profession for which a license 5
is required and issued pursuant to the laws of this state by 6
a person duly licensed to practice that profession; 7
(2) The services rendered by technicians, nurses' 8
aides or their equivalent trained and employed in public or 9
private hospitals and licensed long-term care facilities 10
except the services rendered in licensed long-term care 11
facilities shall be limited to administering medication, 12
excluding the administration of medication by an injectable 13
route other than: 14
(a) Insulin; and 15
(b) Subcutaneous injectable medications, provided that 16
any such medication was prescribed by the physician for the 17
long-term care facility resident who receives the medication; 18
(3) The providing of nursing care by friends or 19
members of the family of the person receiving such care; 20
(4) The incidental care of the sick, aged, or infirm 21
by domestic servants or persons primarily employed as 22
housekeepers; 23
SCS HB 2591 49
(5) The furnishing of nursing assistance in the case 24
of an emergency situation; 25
(6) The practice of nursing under proper supervision: 26
(a) As a part of the course of study by students 27
enrolled in approved schools of professional nursing or in 28
schools of practical nursing; 29
(b) By graduates of accredited nursing programs 30
pending the results of the first licensing examination or 31
ninety days after graduation, whichever first occurs; 32
(c) A graduate nurse who is prevented from attending 33
the first licensing examination following graduation by 34
reason of active duty in the military may practice as a 35
graduate nurse pending the results of the first licensing 36
examination scheduled by the board following the release of 37
such graduate nurse from active military duty or pending the 38
results of the first licensing examination taken by the 39
graduate nurse while involved in active military service 40
whichever comes first; 41
(7) The practice of nursing in this state by any 42
legally qualified nurse duly licensed to practice in another 43
state whose engagement requires such nurse to accompany and 44
care for a patient temporarily residing in this state for a 45
period not to exceed six months; 46
(8) The practice of any legally qualified nurse who is 47
employed by the government of the United States or any 48
bureau, division or agency thereof, while in the discharge 49
of his or her official duties or to the practice of any 50
legally qualified nurse serving in the Armed Forces of the 51
United States while stationed within this state; 52
(9) Nonmedical nursing care of the sick with or 53
without compensation when done in connection with the 54
practice of the religious tenets of any church by adherents 55
SCS HB 2591 50
thereof, as long as they do not engage in the practice of 56
nursing as defined in sections 335.011 to 335.096; 57
(10) The practice of any legally qualified and 58
licensed nurse of another state, territory, or foreign 59
country whose responsibilities include transporting patients 60
into, out of, or through this state while actively engaged 61
in patient transport that does not exceed forty-eight hours 62
in this state. 63
337.600. As used in sections 337.600 to 337.689, the 1
following terms mean: 2
(1) "Advanced macro social worker", the applications 3
of social work theory, knowledge, methods, principles, 4
values, and ethics; and the professional use of self to 5
community and organizational systems, systemic and macrocosm 6
issues, and other indirect nonclinical services; specialized 7
knowledge and advanced practice skills in case management, 8
information and referral, nonclinical assessments, 9
counseling, outcome evaluation, mediation, nonclinical 10
supervision, nonclinical consultation, expert testimony, 11
education, outcome evaluation, research, advocacy, social 12
planning and policy development, community organization, and 13
the development, implementation and administration of 14
policies, programs, and activities. A licensed advanced 15
macro social worker may not treat mental or emotional 16
disorders or provide psychotherapy without the direct 17
supervision of a licensed clinical social worker, or 18
diagnose a mental disorder; 19
(2) "Clinical social work", the application of social 20
work theory, knowledge, values, methods, principles, and 21
techniques of case work, group work, client-centered 22
advocacy, community organization, administration, planning, 23
evaluation, consultation, research, psychotherapy and 24
SCS HB 2591 51
counseling methods and techniques to persons, families and 25
groups in assessment, diagnosis, treatment, prevention and 26
amelioration of mental and emotional conditions; 27
(3) "Committee", the state committee for social 28
workers established in section 337.622; 29
(4) "Department", the Missouri department of commerce 30
and insurance; 31
(5) "Director", the director of the division of 32
professional registration; 33
(6) "Division", the division of professional 34
registration; 35
(7) "Independent practice", any practice of social 36
workers outside of an organized setting such as a social, 37
medical, or governmental agency in which a social worker 38
assumes responsibility and accountability for services 39
required; 40
(8) "Licensed advanced macro social worker", any 41
person who offers to render services to individuals, groups, 42
families, couples, organizations, institutions, communities, 43
government agencies, corporations, or the general public for 44
a fee, monetary or otherwise, implying that the person is 45
trained, experienced, and licensed as an advanced macro 46
social worker, and who holds a current valid license to 47
practice as an advanced macro social worker; 48
(9) "Licensed baccalaureate social worker", any person 49
who offers to render services to individuals, groups, 50
organizations, institutions, corporations, government 51
agencies, or the general public for a fee, monetary or 52
otherwise, implying that the person is trained, experienced, 53
and licensed as a baccalaureate social worker, and who holds 54
a current valid license to practice as a baccalaureate 55
social worker; 56
SCS HB 2591 52
(10) "Licensed clinical social worker", any person who 57
offers to render services to individuals, groups, 58
organizations, institutions, corporations, government 59
agencies, or the general public for a fee, monetary or 60
otherwise, implying that the person is trained, experienced, 61
and licensed as a clinical social worker, and who holds a 62
current, valid license to practice as a clinical social 63
worker; 64
(11) "Licensed master social worker", any person who 65
offers to render services to individuals, groups, families, 66
couples, organizations, institutions, communities, 67
government agencies, corporations, or the general public for 68
a fee, monetary or otherwise, implying that the person is 69
trained, experienced, and licensed as a master social 70
worker, and who holds a current valid license to practice as 71
a master social worker. A licensed master social worker may 72
not treat mental or emotional disorders, provide 73
psychotherapy without the direct supervision of a licensed 74
clinical social worker, or diagnose a mental disorder; 75
(12) "Master social work", the application of social 76
work theory, knowledge, methods, and ethics and the 77
professional use of self to restore or enhance social, 78
psychosocial, or biopsychosocial functioning of individuals, 79
couples, families, groups, organizations, communities, 80
institutions, government agencies, or corporations. The 81
practice includes the applications of specialized knowledge 82
and advanced practice skills in the areas of assessment, 83
treatment planning, implementation and evaluation, case 84
management, mediation, information and referral, counseling, 85
client education, supervision, consultation, education, 86
research, advocacy, community organization and development, 87
planning, evaluation, implementation and administration of 88
SCS HB 2591 53
policies, programs, and activities. Under supervision as 89
provided in this section, the practice of master social work 90
may include the practices reserved to clinical social 91
workers or advanced macro social workers for no more than 92
forty-eight consecutive calendar months for the purpose of 93
obtaining licensure under section 337.615 or 337.645; 94
(13) "Practice of advanced macro social work", 95
rendering, offering to render, or supervising those who 96
render to individuals, couples, families, groups, 97
organizations, institutions, corporations, government 98
agencies, communities, or the general public any service 99
involving the application of methods, principles, and 100
techniques of advanced practice macro social work; 101
(14) "Practice of baccalaureate social work", 102
rendering, offering to render, or supervising those who 103
render to individuals, families, groups, organizations, 104
institutions, corporations, or the general public any 105
service involving the application of methods, principles, 106
and techniques of baccalaureate social work; 107
(15) "Practice of clinical social work", rendering, 108
offering to render, or supervising those who render to 109
individuals, couples, groups, organizations, institutions, 110
corporations, or the general public any service involving 111
the application of methods, principles, and techniques of 112
clinical social work; 113
(16) "Practice of master social work", rendering, 114
offering to render, or supervising those who render to 115
individuals, couples, families, groups, organizations, 116
institutions, corporations, government agencies, 117
communities, or the general public any service involving the 118
application of methods, principles, and techniques of master 119
social work; 120
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(17) "Qualified advanced macro supervisor", any 121
licensed social worker who meets the qualifications of a 122
qualified clinical supervisor or a licensed advanced macro 123
social worker who has: 124
(a) Practiced in the field of social work as a 125
licensed social worker for which he or she is supervising 126
the applicant for a minimum of [five] three years; 127
(b) Successfully completed a minimum of sixteen hours 128
of supervisory training from the Association of Social Work 129
Boards, the National Association of Social Workers, an 130
accredited university, or a program approved by the state 131
committee for social workers. All organizations providing 132
the supervisory training shall adhere to the basic content 133
and quality standards outlined by the state committee on 134
social work; and 135
(c) Met all the requirements of sections 337.600 to 136
337.689, and as defined by rule by the state committee for 137
social workers; 138
(18) "Qualified baccalaureate supervisor", any 139
licensed social worker who meets the qualifications of a 140
qualified clinical supervisor, qualified master supervisor, 141
qualified advanced macro supervisor, or a licensed 142
baccalaureate social worker who has: 143
(a) Practiced in the field of social work as a 144
licensed social worker for which he or she is supervising 145
the applicant for a minimum of [five] three years; 146
(b) Successfully completed a minimum of sixteen hours 147
of supervisory training from the Association of Social Work 148
Boards, the National Association of Social Workers, an 149
accredited university, or a program approved by the state 150
committee for social workers. All organizations providing 151
the supervisory training shall adhere to the basic content 152
SCS HB 2591 55
and quality standards outlined by the state committee on 153
social workers; and 154
(c) Met all the requirements of sections 337.600 to 155
337.689, and as defined by rule by the state committee for 156
social workers; 157
(19) "Qualified clinical supervisor", any licensed 158
clinical social worker who has: 159
(a) Practiced in the field of social work as a 160
licensed social worker for which he or she is supervising 161
the applicant for a minimum of [five] three years; 162
(b) Successfully completed a minimum of sixteen hours 163
of supervisory training from the Association of Social Work 164
Boards, the National Association of Social Workers, an 165
accredited university, or a program approved by the state 166
committee for social workers. All organizations providing 167
the supervisory training shall adhere to the basic content 168
and quality standards outlined by the state committee on 169
social work; and 170
(c) Met all the requirements of sections 337.600 to 171
337.689, and as defined by rule by the state committee for 172
social workers; 173
(20) "Social worker", any individual that has: 174
(a) Received a baccalaureate degree in social work 175
from an accredited social work program approved by the 176
Council on Social Work Education; 177
(b) Received a master's degree in social work from a 178
social work program: 179
a. Accredited by the Council on Social Work Education; 180
or 181
b. Recognized and approved by the committee in 182
accordance with rules adopted by the committee under section 183
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337.627 and in accordance with the procedure set forth in 184
section 337.628; 185
(c) Received a doctorate or Ph.D. in social work; or 186
(d) A current social worker license as set forth in 187
sections 337.600 to 337.689. 188
338.012. 1. A pharmacist with a certificate of 1
medication therapeutic plan authority may provide influenza, 2
group A streptococcus, and COVID-19 medication therapy 3
services pursuant to [a statewide standing order issued by 4
the director or chief medical officer of the department of 5
health and senior services if that person is a licensed 6
physician, or a licensed physician designated by the 7
department of health and senior services] rules established 8
by the board of pharmacy and the state board of registration 9
for the healing arts, as described in this section. 10
2. This section shall not be construed to allow a 11
pharmacist to diagnose or independently prescribe 12
pharmaceuticals. 13
3. The state board of registration for the healing 14
arts, pursuant to section 334.125, and the state board of 15
pharmacy, pursuant to section 338.140, shall jointly 16
promulgate rules to implement the provisions of this 17
section. Any rule or portion of a rule, as that term is 18
defined in section 536.010, that is created under the 19
authority delegated in this section shall become effective 20
only if it complies with and is subject to all of the 21
provisions of chapter 536 and, if applicable, section 22
536.028. This section and chapter 536 are nonseverable and 23
if any of the powers vested with the general assembly 24
pursuant to chapter 536 to review, to delay the effective 25
date, or to disapprove and annul a rule are subsequently 26
held unconstitutional, then the grant of rulemaking 27
SCS HB 2591 57
authority and any rule proposed or adopted after August 28, 28
2023, shall be invalid and void. 29
338.206. 1. As used in this section, the term 1
"medical device" shall mean equipment that is furnished by a 2
supplier or a home health agency and meets the following 3
conditions: 4
(1) Is a device classified by the United States Food 5
and Drug Administration as a Class I or Class II under 21 6
U.S.C. Section 360 and its implementing regulations under 21 7
CFR Parts 860 to 892; 8
(2) Is primarily and customarily used to serve a 9
medical purpose; 10
(3) Generally is not useful to an individual in the 11
absence of an illness or injury; and 12
(4) Is appropriate for use in the home. 13
2. Notwithstanding any provision of this chapter to 14
the contrary, pharmacists may prescribe any medical devices 15
authorized by rule promulgated jointly by the state board of 16
registration for the healing arts and the board of pharmacy 17
in accordance with subsection 3 of this section. 18
3. The state board of registration for the healing 19
arts, pursuant to section 334.125, and the board of 20
pharmacy, pursuant to section 338.140, shall jointly 21
promulgate rules to implement the provisions of this 22
section. Such rules shall be written and effective within 23
six months of the effective date of this act. 24
4. Any rule or portion of a rule, as that term is 25
defined in section 536.010, that is created under the 26
authority delegated in this section shall become effective 27
only if it complies with and is subject to all of the 28
provisions of chapter 536 and, if applicable, section 29
536.028. This section and chapter 536 are nonseverable and 30
SCS HB 2591 58
if any of the powers vested with the general assembly 31
pursuant to chapter 536 to review, to delay the effective 32
date, or to disapprove and annul a rule are subsequently 33
held unconstitutional, then the grant of rulemaking 34
authority and any rule proposed or adopted after August 28, 35
2026, shall be invalid and void. 36
345.050. To be eligible for licensure by the board by 1
examination, each applicant shall submit the application fee 2
and shall furnish evidence of such person's current 3
competence and shall: 4
(1) Hold a master's or a doctoral degree from a 5
program that was awarded "accreditation candidate" status or 6
is accredited by the Council on Academic Accreditation of 7
the American Speech-Language-Hearing Association or other 8
accrediting agency approved by the board in the area in 9
which licensure is sought; 10
(2) Submit official transcripts from one or more 11
accredited colleges or universities presenting evidence of 12
the completion of course work and clinical practicum 13
requirements equivalent to that required by the Council on 14
Academic Accreditation of the American Speech-Language- 15
Hearing Association or other accrediting agency approved by 16
the board; 17
(3) Present written evidence of completion of a 18
clinical fellowship from supervisors. The experience 19
required by this subdivision shall follow the completion of 20
the requirements of subdivisions (1) and (2) of this 21
section. This period of employment shall be under the 22
direct supervision of a [person who is licensed by the state 23
of Missouri in the profession in which the applicant seeks 24
to be] licensed speech-language pathologist in good standing 25
SCS HB 2591 59
in any state. Persons applying with an audiology clinical 26
doctoral degree are exempt from this provision; and 27
(4) Pass an examination promulgated or approved by the 28
board. The board shall determine the subject and scope of 29
the examinations. 30
✓