Missouri

Missouri credentials three types of addiction counselors. A Substance Abuse Counselor (SAC) I requires a bachelor’s degree and 15 hours of approved education coursework. A SAC II requires a bachelor’s degree, 15 hours of approved education coursework and one year of experience. A SAC III requires a bachelor’s degree, completed 15 hours of approved education coursework and two years of experience. Mo. Rev. Stat. §631.005, Mo. Rev. Stat. §631.010 and 9 Mo. Code of State Reg. §30-3.110

A professional counselor may provide services to individuals, couples, groups, organizations, institutions, corporations, schools, government agencies, or the general public involving the application of counseling procedures to assist in achieving more effective intrapersonal or interpersonal, marital, decisional, social, educational, vocational, developmental or rehabilitative adjustments. Diagnostic ability is not outlined in statute. Mo. Rev. Stat. §337.500

As of August 2018, 42 NPs in Missouri have received a federal waiver to treat opioid dependency with buprenorphine-containing products. Consistent with their prescriptive authority and with proper training or appropriate experience can receive a federal waiver to dispense buprenorphine-containing products, as long as the supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Mo. Code of State Reg. §20-2200-4.200(3)

As of August 2018, 2 PAs in Missouri have received a federal waiver to treat opioid dependency with buprenorphine-containing products. A Missouri PA may prescribe Schedules III-V controlled substances if outlined in a supervision agreement with a supervising physician and after being certified to do so by the state. Missouri PAs with proper training or appropriate experience can receive a federal waiver to dispense buprenorphine-containing products, as long as the supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Mo. Rev. Stat. §334.747

The law requires the certification of peer recovery specialists to include minimum education levels and training and testing as required. The administration and process for the certification of peer recovery specialists is administered by a third-party, non-profit certification provider. Mo. Code Regs. tit.9, § 30-4.030(2)(H)

Missouri has not codified language around POLST. Only physicians may sign transportable physician orders for patient preference (TPOPP) forms. Please see the TPOPP website for more information.

Written collaborative practice agreements are required between a physician and an NP. The agreement must outline geographic practice areas for the physician and the NP and methods of treatment within an NP’s scope of practice. Mo. Code of State Reg. §20-2200-4.200

Prescriptive authority and privileges must be outlined in the written practice agreement. Drugs dispensed must be within the NP’s scope of practice. If outlined in the agreement, the NP may prescribe Schedules II-V controlled substances. Mo. Code of State Reg. §20-2200-4.200(3)

NPs are not explicitly recognized in state policy as primary care providers.

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. Mo. Rev. Stat. §336.010

Optometrists may not administer medication through injection but can administer the COVID-19 vaccine. Mo. Rev. Stat. §336.010(4) and Missouri Department of Health and Senior Services Standing Order

Optometrists may prescribe Schedule III-V controlled substances and also Schedule II hydrocodone or hydrocodone combination medications. Mo. Rev. Stat. §336.010, Mo. Rev. Stat. §336.220 and 20 Mo. Code of State Regs. 2210-2.080(6)

A dental hygienist who has practiced at least three years and practices in a public health setting may provide fluoride treatments, teeth cleaning and sealants to Medicaid-eligible children. These services may be performed without the supervision of a dentist and are subject to Medicaid reimbursement. Mo. Rev. Stat. §332.311.2

Statute does not identify dental therapists as an oral health provider.

Missouri allows for the practice of teledentistry. Medicaid allows for reimbursement of teledentistry services through live video and store-and-forward modalities. MO Health Net, Dental Manual, pg. 259

Missouri has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act does allow pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Missouri does not allow pharmacists to modify prescriptions.

Missouri does not allow pharmacists to prescribe hormonal contraceptives.

A pharmacist must complete a training course in the subject area of tobacco cessation drug therapy and must include instruction in specific content areas. A written protocol for tobacco cessation drug therapy must be approved by the Board of Pharmacy. Mo. Rev. Stat. §338.010

State regulations outline appropriate supervision between a PA and a physician. A written agreement jointly agreed upon by the supervising physician and the PA is required. These agreements may delegate to a physician assistant the authority to prescribe, administer, or dispense drugs and provide treatment which is within the skill, training, and competence of the physician assistant. Mo. Rev. Stat. §334.735

A PA may prescribe Schedules III-V controlled substances if outlined in the supervision agreement with a physician. Prescriptions for Schedule II medications prescribed by a physician assistant with authority to prescribe delegated in a collaborative practice arrangement are restricted to only those medications containing hydrocodone. The PA must receive a certificate of controlled substances prescriptive authority from the Board of Healing Arts. Mo. Rev. Stat. §334.747

Collaborative practice arrangements, which shall be in writing, may delegate to a physician assistant the authority to prescribe, administer, or dispense drugs and provide treatment which is within the skill, training, and competence of the physician assistant. Mo. Rev. Stat. §334.735