HCS/SS#2/SB 1233 - This act modifies provisions relating to the licensing of certain professionals. INTERIOR DESIGNERS (SECTIONS 324.001, 324.028, 327.011, 327.031, 327.041, 327.081, 327.381, 327.411, 327.441, 327.442, 327.451, 327.700, 327.705, 327.710, 327.720, 327.725, 327.730, 327.735, 327.740, 327.745, 327.750, 537.033 & 621.045 AND THE REPEAL OF SECTIONS 324.406, 324.412, 324.421, 324.424 & 324.436) This act modifies the registration of interior designers from the Division of Professional Registration with advice and recommendations by the Interior Design Council to the licensing of interior designers from the Missouri Board for Architects, Professional Engineers, Professional Land Surveyors, Professional Landscape Architects, and Licensed Interior Designers ("Board"). The Board shall increase from fifteen members to seventeen members with the two new members being licensed interior designers. The Interior Design Council and the Interior Design Council Fund shall be abolished upon the appointment by the Governor and confirmation by the Senate of the licensed interior designer members of the Board. The rules of the Interior Design Council shall be deemed adopted by the Board until revised, amended, or repealed, of which such action shall be taken on or before January 1, 2027. The funds in the Interior Design Council Fund shall be transferred to the State Board of Architects, Professional Engineers, Professional Land Surveyors, Professional Landscape Architects, and Licensed Interior Designers Fund. Additionally, this act defines the practice of licensed interior design and provides that a licensed interior designer shall undertake to perform licensed interior design services only when he or she is qualified by education, training, and experience in the specific technical areas involved. Furthermore, licensed interior designers shall be in responsible charge of interior design technical submissions that can affect the health, safety, and welfare of the public within their scope of practice. Licensed interior designers shall not take responsible charge over interior technical submissions prepared by another person unless the licensed interior designer actually exercises personal supervision and direct control over such interior technical submissions. This act modifies the educational and training requirements for licensed interior designers by repealing the qualification of at least three years of an interior design curriculum from an accredited institution with three years of experience. Additionally, an applicant shall be exempt from providing substantial evidence of certain educational and training qualifications if his or her curriculum or transcript has been approved by the Board. Nothing in this act shall be construed as precluding an architect from performing any of the services within the practice of licensed interior design. Current law provides that a renewal or reinstatement application for registration as an interior designer shall be accompanied by proof of completion of continuing education in the fields of either interior design or architecture. This act repeals such provision and provides that the Board shall establish the continuing education requirements for interior designers which shall be substantially equivalent to the continuing education requirements for architects. Finally, this act includes licensed interior designers in the definition of "design professional" for immunity from civil liability for participation in a peer review process. This act contains a delayed effective date for the repeal of the Interior Design Council and the Interior Design Fund, which shall become effective upon notification to the Revisor of the appointment of the interior designer members of the Board by the Director of the Division of Professional Regulation. These provisions are identical to SS/SCS/SB 991 (2026) and is similar to HB 2353 (2026), SB 287 (2025), HB 566 (2025), SB 1325 (2024), and HB 2158 (2024). LICENSE RECIPROCITY - APEPLSPLA (SECTION 324.009) For reciprocity of licensure from another jurisdiction, the Missouri Board for Architects, Professional Engineers, Professional Land Surveyors and Professional Landscape Architects may deny a license or decline to grant a temporary or probationary license to an applicant if the Board determines the applicant's qualifications are not comparable to those established by the Board. This provision is identical to HB 1813 (2026). LICENSE RECIPROCITY - TELEHEALTH (SECTION 324.009) Those health care providers, who hold a current license issued by another jurisdiction and are licensed in Missouri with a waiver of examination, educational, or experience requirements, shall be deemed to be fully licensed to practice within the profession's scope of practice in Missouri and may provide telehealth services to the same extent and manner as health care providers who receive a license without a waiver. This provision is identical to SB 1691 (2026), a provision in HCS/HB 2300 (2026), in HCS/HB 2372 (2026), and HCS/HB 2974 (2026). NONRENEWABLE TEMPORARY LICENSES FOR DIETITIANS (SECTION 324.218) This act establishes a temporary license for dietitians. Under the act, an applicant who has not previously taken or passed an examination recognized by the State Committee of Dietitians ("Committee") and who meets the qualifications for licensure as a dietitian may obtain without examination a nonrenewable temporary license by paying a temporary license fee and submitting to the Committee an agreement-to-supervise form that is signed by a licensed dietitian who has agreed to supervise the applicant and has active dietetics practice in this state for a minimum of one year. The temporary license shall expire the date the Committee is notified by the supervising dietitian that the temporary licensee's employment has ceased or within one hundred eighty days of its issuance, whichever occurs first. This act further provides that the supervising dietitian shall not be an immediate family member of the temporary licensee. Additionally, the act requires the supervising dietitian to submit a signed and notarized form attesting that the applicant shall begin employment at a location in this state within seven days of issuance of the temporary license. If the temporary licensee's employment ceases, the supervising dietitian shall notify the Committee within three days. Finally, this act provides that a supervising dietitian shall not supervise more than one temporary licensee at a time. This provision is identical to a provision in HB 1961 (2026), in the perfected HCS/HB 268 (2025), and in HB 397 (2025), and is substantially similar to a provision in SB 1339 (2026) SB 412 (2025), in SB 1053 (2024), HB 1666 (2024), in SCS/HB 2280 (2024), HB 845 (2023), and HB 873 (2023). EMERGENCY SUSPENSIONS - MASSAGE THERAPY & CHIROPRACTIC (SECTIONS 324.263 & 331.084) This act provides that the Board of Therapeutic Massage and the Board of Chiropractic Examiners can apply to the Administrative Hearing Commission ("AHC") for an emergency suspension or restriction of a license if the licensee is the subject of a pending criminal indictment, information, or other charge related to the duties and responsibilities of the licensed occupation, and there is reasonable cause to believe that the public health, safety, or welfare is at imminent risk of harm. Within one business day of receiving the complaint, the AHC shall return a service packet, as described in the act, to the board, which shall then serve the licensee within twenty-four hours. Within five days of receipt of the complaint, the AHC shall conduct a review and, if the AHC determines there is reasonable cause for the board's complaint, the AHC shall enter an order of suspension or restriction. The order will be effective upon personal service or delivery of a copy at all of the licensee's addresses on file. The AHC shall then hold an evidentiary hearing on the record within forty-five days of the board's filing, or upon final adjudication of the criminal charges, to determine if the initial order entered by the AHC will continue in effect and whether a cause for discipline exists. If no cause for discipline is found, the AHC shall issue findings and terminate the order for suspension or restriction. If the AHC finds cause for discipline, the AHC shall issue findings and order the suspension or restriction to remain in effect until a disciplinary hearing before the board, which may impose discipline otherwise authorized by state law. Furthermore, this act provides that if the AHC does not grant an initial order, the board shall remove all reference to such emergency suspension or restriction from public records. These provisions are identical to HB 1623 (2026), SB 1647 (2026), provisions in HCS/HB 2300 (2026), HB 58 (2025), in the perfected HCS/HB 268 (2025), in the perfected HB 478 (2025), and in SCS/HB 834 (2025) and contains a provision similar to HB 1549 (2024), a provision in SCS/HCS/HB 2280 (2024), HCS/HB 175 (2023), and HB 1610 (2022). DIETITIAN LICENSURE COMPACT (SECTIONS 324.1800 TO 324.1865) This act establishes the Dietitian Licensure Compact ("Compact"), which facilitates the interstate practice of dietetics and authorizes dietitians licensed in a participating state to practice in other participating states. The Compact sets forth the requirements to be met in order for a state to join and the requirements for a dietitian to obtain and exercise the ability to practice in other participating states. The Compact further provides that a dietitian with compact privilege shall function within the scope of practice authorized by the participating state in which they seek to practice and shall be subject to that state's regulatory authority. A dietitian whose privilege in a participating state is encumbered or removed is not eligible for compact privilege in other participating states until the encumbrance or removal has passed and all requirements are met. Additionally, the Compact creates the Dietitian Licensure Compact Commission ("Commission"), which is a joint government agency of the participating states tasked with administering and implementing the Compact. The Compact provides for its powers and duties, including the development and maintenance of a coordinated database and reporting system containing licensure, adverse actions, and investigative information on all licensees and applicants. Each participating state shall have one Commissioner, who shall be selected within sixty days by the licensing authority of the participating state. Additionally, there shall be an Executive Committee of the Commission, composed of nine members, to act on behalf of the Commission. Upon enactment, the Compact shall be reviewed by the Commission to determine if it is materially different from the Model Compact and whether the state qualifies for participation in the Compact. Any state that adopts the Compact subsequent to the Commission’s initial adoption of the rules and bylaws shall be subject to the rules and bylaws existing on the date on which the Compact becomes law. Any participating state may withdraw from the Compact by repealing the Compact, but such withdrawal shall not take effect until 180 days after the enactment of the repeal. Finally, the Compact shall be binding upon participating states and shall supersede any conflict with state law. These provisions are identical to provisions in HB 1961 (2026), in the perfected HCS/HB 268 (2025), in HB 397 (2025), and in HB 2477 (2024), and are substantially similar to a provision in SB 1339 (2026) and in SB 412 (2025). ACCOUNTANTS (SECTIONS 326.256 TO 326.292) This act modifies the requirements for licensing of accountants. This act provides that an applicant for examination shall provide proof that the applicant has obtained a baccalaureate degree or a post-baccalaureate degree, instead of proof of completion of at least 120 semester hours of college education. Additionally, for licensure, the applicant shall either hold a baccalaureate degree, a baccalaureate degree and 30 additional semester hours of college education, or a post-baccalaureate degree from an accredited college or university recognized by the Missouri State Board of Accountancy ("Board") with the total educational program including a Board-appropriate accounting concentration or equivalent. If the applicant has a baccalaureate degree, the applicant shall have two years of experience. If the applicant has a baccalaureate degree and 30 additional semester hours of college education or a post-baccalaureate degree, the applicant shall have at least one year of experience. This act also repeals the eligibility for examination if the applicant expects to meet the educational requirements within 60 days. This act changes the educational and examination requirements for reciprocity of those individuals whose principal place of business, domicile, or residency is not in this state and who hold a valid and unrestricted public accounting license in another state. Current law provides that such non-Missouri individuals shall have all the privileges of licensees without the need to obtain a license, notify or register with the Board, or pay a fee if the license has been determined by the Board to be in substantial equivalence with the Missouri licensure requirements or if the individual's qualifications are substantially equivalent to Missouri licensure requirements. This act provides that a non-Missouri individual, whose license is in good standing, shall have all the privileges of a licensee without the need to obtain a license, notify or register with the Board, or pay a fee if the individual was required to show proof of passage of the Uniform Certified Public Accountant Examination and the educational and experience requirements of Missouri licensees. Additionally, non-Missouri individuals, whose licenses are in good standing to practice public accountancy from any state as of December 31, 2024, and who has practice privileges in this state as of December 31, 2024, shall continue to have such privileges. Rather than receiving verification on substantial equivalence of an individual's qualifications from the NASBA National Qualification Appraisal Service, the Board may license a person whose qualifications the Board verifies to be comparable to the Missouri licensure requirements. Sole practitioners or single member LLCs that use "certified public accountant," "CPA," or other abbreviations, but that do not offer nor perform attest services or other services subject to peer review may request exemption from the Board for the firm permit requirements. This act provides that the rules regarding peer review shall include reasonable provision for compliance by a firm showing that it has undergone a peer review that is comparable, rather than satisfactory equivalent, to peer review generally required under current law within three years. Lastly, the Board may charge a fee for oversight of peer reviews, provided that the fee charged shall be comparable, rather than substantially equivalent, to the cost of oversight. These provisions are identical to provisions in the perfected HCS/HB 1797 (2026). PRACTICE OF DENTISTRY IN CORRECTIONAL CENTERS (SECTION 332.081) Current law provides that no corporation shall practice dentistry unless that corporation is a nonprofit corporation or a professional corporation under Missouri law. This act provides that such provision shall not apply to entities contracted with the state to provide care in correctional centers. This provision is identical to a provision in SCS/SB 841 (2026), HB 1710 (2026), HB 1847 (2026), in HCS/HB 2372 (2026), in HCS/SS/SB 7 (2025), in the perfected HB 56 (2025), HB 122 (2025), SB 143 (2025), in the perfected HCS/HB 268 (2025), in SCS/SB 317 (2025), SB 548 (2025), in SCS/HCS/HB 943 (2025), in HCS/HB 1505 (2025), in SS/SCS/HCS/HB 1659 (2024), SB 1287 (2024), and HB 2280 (2024). DENTIST AND DENTAL HYGIENIST COMPACT (SECTIONS 332.700 TO 332.760) This act establishes the Dentist and Dental Hygienist Compact ("Compact"), which facilitates the interstate practice of dentistry and dental hygiene and provides for dentists and dental hygienists licensed in a participating state the ability to practice in other participating states. The Compact sets forth the requirements to be met in order for a state to join and the requirements for a dentist or dental hygienist to obtain and exercise the ability to practice in other participating states. The Compact further provides that a dentist or dental hygienist with compact privilege shall function within the scope of practice authorized by the participating state in which they seek to practice and shall be subject to that state's regulatory authority. A dentist or dental hygienist whose privilege in a participating state is encumbered or removed is not eligible for compact privilege in other participating states until the encumbrance or removal has passed and all requirements are met. Additionally, the Compact creates the Dentist and Dental Hygienist Compact Commission ("Commission"), which is a joint government agency of the participating states tasked with administering and implementing the Compact. Each participating state shall have one Commissioner, who shall be selected within sixty days by the licensing authority of the participating state. Additionally, there shall be an Executive Board of the Commission, composed of seven Commissioners, to act on behalf of the Commission. The act provides for the powers and duties of the Commission, including the development and maintenance of a coordinated database and reporting system containing licensure, adverse actions, and investigative information on all licensees and applicants. The Commission may levy on and collect an annual assessment from each participating state and impose fees on licensees for the compact privilege in order to cover the cost of the operations and activities of the Commission and its staff. Upon enactment, the Compact shall be reviewed by the Commission to determine if it is materially different from the Model Compact and whether the state qualifies for participation in the Compact. Any state that adopts the Compact subsequent to the Commission’s initial adoption of the rules and bylaws shall be subject to the rules and bylaws existing on the date on which the Compact becomes law. Any participating state may withdraw from the Compact by repealing the Compact, but such withdrawal shall not take effect until 180 days after the enactment of the repeal. Finally, the Compact shall be binding upon participating states and shall supersede any conflict with state law. These provisions are identical to HB 1847 (2026), HCS/SS/SB 7 (2025), provisions in HB 56 (2025), provisions in HCS/SS/SB 61 (2025), a provision in SB 327 (2025), a provision in SCS/HCS/HB 943 (2025), provisions in HB 1031 (2025), a provision in SS/SB 778 (2024), HB 2075 (2024), and is similar to SCS/SB 988 (2026). PA LICENSURE COMPACT (SECTIONS 334.1800 TO 334.1860) This act establishes the PA Licensure Compact ("Compact"), which allows for the interstate licensure of physician assistants. The Compact sets forth the requirements to be met in order for a state to join and maintain membership in the Compact. Additionally, the Compact provides the requirements for a physician assistant to obtain and exercise the ability to practice in the remote participating states. A compact privilege expires when the licensee's qualifying license in the participating state from which the licensee applied for the compact privilege expires. A participating state in which a licensee is licensed shall have exclusive power to impose adverse actions against the license issued by that state. A remote state shall have the authority to take adverse action to remove the compact privilege within that state for a physician assistant. Participating states may also conduct joint investigations with other participating states. Participating states shall report licensure data along with any adverse action and significant investigative information to the data system established in the Compact. Additionally, the Compact creates the PA Licensure Compact Commission ("Commission"), which is a joint government agency of participating states with the power to administer and implement the Compact. Each participating state shall be entitled to one delegate, who shall be selected by the state's licensing authority for physician assistants and who shall either be a current physician assistant, physician, or member or administrator of the licensing board. The Commission shall meet at least once a year. Additionally, there shall be an Executive Committee to act on behalf of the Commission, including on day-to-day activities related to the administration of the Compact. The Executive Committee shall be composed of seven members from the current Commission and two of members from national professional and certification organizations. The Commission may levy and collect an annual assessment from each participating state and impose fees on licensees to whom it grants compact privileges to cover the costs of the operations and activities of the Commission and its staff. Commissioners, officers, executive directors, employees, and agents of the Commission shall be immune from liability, both personally and in their official capacity, for any claim for damages arising out of any acts or omissions that occurred within the scope of the Commission's employment, duties, or responsibilities, except for those damages caused by intentional or willful or wanton misconduct. The procurement of insurance by the Commission shall not limit such immunity. For any actions by or against the Commission, venue is proper in a court of competent jurisdiction where the principal office of the Commission is located. Upon enactment, the Compact shall be reviewed by the Commission to determine if it is materially different from the Model Compact and whether the state qualifies for participation in the Compact. Any state that adopts the Compact subsequent to the Commission’s initial adoption of the rules and bylaws shall be subject to the rules and bylaws existing on the date on which the Compact becomes law. Finally, the Compact shall be binding upon participating states and shall supersede any conflict with state law. These provisions are identical to a provision in SCS/SB 1492 (2026) and HB 3129 (2026) and is similar to HB 1388 (2025). ADMINISTRATION OF CERTAIN INJECTIONS BY NURSE TECHNICIANS OR AIDES (SECTION 335.081) This act provides that licensing laws relating to nursing shall not prohibit the administration of subcutaneous injectable medications by a technician, nurses' aide, or their equivalent, provided the medications are prescribed by a physician for a long-term care resident. This provision is identical to a provision in SB 1528 (2026) and in HB 2413 (2026). SOCIAL WORK SUPERVISORS (SECTION 337.600) This act modifies the definitions of a "qualified advanced macro supervisor," "qualified baccalaureate supervisor," and "qualified clinical supervisor" to provide that such person is a licensed social worker who has practiced social work for which he or she is supervising the applicant for a minimum of three, instead of five, years. This provision is identical to SB 1092 (2026), SB 1417 (2026), HB 1963 (2026), provision in HCS/HB 2300 (2026), SB 479 (2025), and SB 563 (2025) and is substantially similar to HB 886 (2025). PRACTICE OF PHARMACY (SECTION 338.010) Currently, the practice of pharmacy includes the ordering and administration of vaccines approved or authorized by the FDA, but excludes certain vaccines and those vaccines approved after January 1, 2023. This act instead provides that the practice of pharmacy includes the ordering and administration of certain vaccines approved or authorized by the FDA as of January 1, 2026, but excludes certain vaccines and those that are not included by joint rules promulgated by the Board of Pharmacy and the State Board of Registration for the Healing Arts. This provision is identical to a provision in SS/SCS/SB 878 (2026), in the perfected HCS/HB 2372 (2026), and in the perfected HCS/HB 3009 (2026), and is substantially similar to HB 1976 (2026). PHARMACY EMERGENCY RULE WAIVERS (SECTION 338.312) The Board of Pharmacy shall have the authority to waive compliance with any Missouri rule or regulation for pharmacies dispensing, shipping, or delivering prescription drugs into another state or United States territory that is experiencing a declared state disaster or emergency, provided that: (1) The pharmacy is a licensed pharmacy in good standing and is authorized to ship prescription drugs into such state or territory; (2) The pharmacy is responding to a declared state disaster or emergency; (3) The pharmacy complies with all emergency rules and regulations for pharmacies and nonprofit pharmacies established by the state or territory for the duration of the disaster period; (4) The pharmacy complies with all applicable federal laws and regulations; and (5) The waiver applies only to prescription drugs dispensed, shipped, or delivered to residents or health care facilities located within the geographic area specified in the declared state disaster or emergency. This provision is identical to a provision in HCS/HB 2300 (2026), in the perfected HCS/HB 2372 (2026), and in HCS/HB 3009 (2026), and is similar to provision in SS/SCS/SB 878 (2026) and SB 1640 (2026). LICENSURE OF WHOLESALE DRUG DISTRIBUTORS (SECTION 338.333) Under this act, the Board of Pharmacy may permit an out-of-state wholesale drug distributor or third-party logistics provider to be licensed in this state despite not having a license issued by the distributor's or provider's resident state if the distributor or provider has a current and valid drug distributor accreditation from the National Association of Boards of Pharmacy. This provision is identical to a provision in SCS/SB 841 (2026), in HCS/HBs 1945 & 2570 (2026), in HCS/HB 2372 (2026), in the perfected HCS/HB 3009 (2026), in SCS/HCS/HB 943 (2025), in HCS/SB 94 (2025), and HB 1465 (2025). RX CARES FOR MISSOURI PROGRAM (Section 338.710) This act removes the expiration date of August 28, 2026, from the "RX Cares for Missouri Program". This provision is identical to a provision in SCS/SB 841 (2026), HB 1978 (2026), in HCS/HB 2372 (2026), and HB 1445 (2025). SPEECH PATHOLOGISTS AND AUDIOLOGISTS (SECTION 345.050) This act modifies the requirements for licensure as a speech pathologist or audiologist by providing for completion of a clinical fellowship under the direct supervision of a licensed speech-language pathologist in good standing in any state, rather than under the direct supervision of a person licensed by the state of Missouri in the profession in which the applicant seeks to be licensed. This provision is identical to a provision in HCS/HB 2300 (2026) and HB 2591 (2026), and is substantially similar to a provision in SB 1405 (2026), in HCS/HB 2372 (2026), in HCS/SS/SB 7 (2025), in the perfected SS/SB 61 (2025), in the perfected HCS/HB 268 (2025), SB 431 (2025), in the perfected HB 478 (2025), in HB 765 (2025), and in SCS/HB 834 (2025). SEVERABILITY (SECTION 1) In the event that any section, provision, clause, phrase, or word of this act or the application of the act is declared invalid under the Constitution of the United States or the Constitution of the State of Missouri, the General Assembly intends for the severability of this act. KATIE O'BRIEN

Modifies provisions relating to licensing of certain professionals