SB 1233: Modifies provisions relating to activities requiring licensure

HCS/SS#2/SB 1233 - This act modifies provisions relating to activities requiring licensure. INTERIOR DESIGNERS (SECTIONS 324.001, 324.028, 327.011, 327.031, 327.041, 327.081, 327.381, 327.411, 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 The rules of the Interior Design Council shall be deemed adopted by the Board until revised, amended, or repealed, of which such action shall be taken on or before January 1, 2027.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 provisions in the perfected SS/SB 895 (2026), SS/SCS/SB 991 (2026), in HCS/SS/SB 1083 (2026), HCS/HB 2353 (2026), and are similar to provisions in SB 287 (2025), HB 566 (2025), SB 1325 (2024), and HB 2158 (2024). NONRENEWABLE TEMPORARY LICENSES (SECTION 324.004) Under this act, any person who has at least three years of work experience in an occupation or profession in another state or the District of Columbia that does not use a license to regulate that occupation or profession may submit an application for a non-renewable, two-year temporary license in Missouri to the relevant oversight body. A person shall submit proof of experience in the occupation or profession and proof of citizenship or lawful presence in the United States, except as provided. Within 45 days of receiving the application, the oversight body shall make a determination of qualification. The oversight body shall require an applicant to take and pass a profession-specific examination and may require an examination specific to Missouri laws. If the applicant is not residing in Missouri, the oversight body shall conditionally approve the application. If an applicant fails to provide proof of domicile in Missouri within 60 days of receipt of temporary license, the oversight body may terminate the temporary license and the applicant may reapply for the temporary license. Upon expiration of the temporary license, individuals shall be required to apply for a permanent license, consistent with the licensure and application requirements of that license as set forth in statute and rule. A license issued under this act shall not be qualified for reciprocity with another state or as part of an interstate compact. The provisions of this act shall not apply to certain specified professions. This provision is identical to a provision in SS/SB 895 (2026), in HCS/SS/SB 1083 (2026), and in HCS/SB 1092 (2026) and is similar to a provision in HCS/HB 2300 (2026), in SS/SB 61 (2025) and in the perfected HB 478 (2025), SB 817 (2024), in HCS/SS#2/SCS/SB 88 (2023), and HB 1900 (2022). 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 a provision in HCS/SB 1019 (2026), in HCS/SB 1092 (2026), SB 1691 (2026), in HCS/HB 2300 (2026), in SCS/HCS/HB 2372 (2026), and in the truly agreed to and finally passed SS/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 HCS/SB 1092 (2026), in SCS/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), in 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). 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 HCS/HB 1797 (2026), provisions in HCS/HB 2300 (2026), and in SCS/HB 2591 (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), in HCS/SB 1092 (2026), HB 1710 (2026), in HB 1847 (2026), in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), in SCS/HB 2591 (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). RESPIRATORY CARE LICENSES (SECTIONS 334.870 & 334.880) Currently, an applicant for a respiratory care license is required to submit written evidence of credentials from the cognitive competency testing organization authorized by the Missouri Board for Respiratory Care or current licensure or registration as a respiratory care practitioner in another jurisdiction that meets or exceeds Missouri licensure standards. This act instead provides that the applicant shall submit: (1) An active credential as a registered respiratory therapist through the National Board for Respiratory Care (NBRC); (2) Current licensure or registration with an active credential as a respiratory care practitioner in another jurisdiction that meets or exceeds Missouri licensure standards; or (3) An active credential as a certified respiratory therapist earned prior to January 1, 2027, through the NBRC. Additionally, this act provides that license renewals shall be subject to random audits to ensure the licensee has an active credential through the NBRC. These provisions are identical to provisions in HCS/SS/SB 1083 (2026) and in SCS/HB 2591 (2026), and are similar to provisions in HCS/HB 2957 (2026). 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) in HB 2413 (2026), and in SCS/HB 2591 (2026) and is similar to a provision in SCS/SB 841 (2026) and in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026). LENGTH OF SUPERVISION FOR SOCIAL WORKERS (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 a provision in the perfected SS/SB 895 (2026), in HCS/SS/SB 1083 (2026), in HCS/SB 1092 (2026), SB 1417 (2026), HB 1963 (2026), in HCS/HB 2300 (2026), in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), in SCS/HB 2591 (2026), SB 479 (2025), and SB 563 (2025), and is substantially similar to HB 886 (2025). PRACTICE OF PHARMACY - VACCINES (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 vaccines approved by the FDA after January 1, 2026, 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 substantially similar to a provision in the truly agreed to and finally passed HCS/SS/SCS/SB 878 (2026) and in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and is similar to a provision in SS/SCS/SB 841 (2026), HB 1976 (2026), and in SCS/HCS/HB 3009 (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 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 the truly agreed to and finally passed HCS/SS/SCS/SB 878 (2026), HCS/HB 2300 (2026), in SCS/HCS/HB 2372 (2026), and in HCS/HB 3009 (2026), and is similar to 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 SS/SCS/SB 841 (2026), in HCS/HBs 1945 & 2570 (2026), in the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026), in SCS/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 SS/SCS/SB 841 (2026), HB 1978 (2026), in the truly agreed to and finally passed SS/SCS/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/SB 1019 (2026), in HCS/SS/SB 1083 (2026), in HCS/SB 1092 (2026), in HCS/HB 2300 (2026), and in SCS/HB 2591 (2026) and is substantially similar to a provision in the perfected SS/SB 895 (2026), SB 1405 (2026), in the truly agreed to and finally passed SS/SCS/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