Clarification of Geographic Proximity

Changes were made to 334.104 RSMo effective August 28, 2023. Specifically, the law was amended to limit the joint promulgation of rules between the Board of Nursing and the Board of Registration for the Healing Arts (BOHA) regarding collaborative practice to two areas - methods of treatment that may be covered by a collaborative practice arrangement and requirements for the review of services.

PRIOR to August 28, 2023, both boards had rulemaking authority on geographic proximity. There was a rule that defined geographic proximity as 75 miles. The Board of Nursing had a full board meeting on September 1, 2023 and voted to eliminate the 75-mile definition of geographic proximity from the joint rules. BOHA disagreed. The Board of Nursing could not file a rule to eliminate the rule that defines geographic proximity as 75 miles because it was a JOINT rule so both boards had to agree. The BOHA had a full board meeting January 21, 2024 and voted to file the joint rule to eliminate the 75-mile definition. Accordingly, the boards are jointly filing rules rescinding section (2) of each of their rules to be consistent with the statutory language. The Board of Nursing rule number is 20 CSR 2200-4.200 Collaborative Practice. Because the rule conflicts with statute, the Board of Nursing WILL NOT enforce the 75 mile definition of geographic proximity.

Emergency Rule Issued Regarding LPN IV Medication Administration

The Missouri State Board of Nursing has issued an emergency rule allowing graduate practical nurses, IV-Certified licensed practical nurses, and licensed practical nurses who hold a multi-state license and are IV-certified to administer IV push or bolus medications under certain circumstances. The individual must receive additional individualized education and experience with documented competency verification by the employer before being allowed to engage in these activities. There are certain limitations. Be sure to read the rule in its entirety and pay special attention to the function/duties that cannot be performed under any circumstances. The emergency rule is effective January 22, 2024, and expires July 19, 2024. You may view the rule at A proposed rule has also been filed and is slated to be published in the February 15, Missouri Register. The public will have an opportunity to submit comments on the proposed rule.

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