SB 1233: Relating to activities requiring licensure
Sponsor: Curtis Trent
OPPOSE
Structural problems require major surgery, not minor amendments.
SB 1233 modifies many areas of Missouri professional licensing law. It changes CPA pathways, creates or adopts interstate compacts for dietitians, dentists, and physician assistants, folds licensed interior designers into the architects board structure, expands health-care workforce data collection, and removes the expiration for the Rx Cares program. While it includes some provisions that reduce licensing barriers, these positives are outweighed by major structural defects including single-subject problems, new interstate commissions, data privacy issues, and new General Revenue costs.
What Does This Bill Do?
- Multi-State Compact Commissions: Enacts the Dietitian, Dentist and Dental Hygienist, and Physician Assistant Licensure Compacts, delegating authority to multistate bodies and requiring participation in commission data systems.
- Health-Care Workforce Data Pipeline: Allows health-related boards to contract with DHSS or nonprofits to collect and analyze workforce data, permitting identifying data to be released to contractors without affirmative opt-in consent.
- Ongoing Rx Cares Spending & Bureaucracy: Removes the August 28, 2026 expiration for the Rx Cares for Missouri Program and creates new long-term-care medication rules requiring additional DHSS staffing and rulemaking.
Constitutional or Critical Context
This bill suffers from a serious single-subject and fair-notice problem. Under the generic catch-all title "relating to activities requiring licensure," the House Committee Substitute repeals dozens of sections and enacts 83 new sections. Senators openly discussed on the floor whether the bill had shifted from the "licensing of accountants" to a broad omnibus vehicle. Furthermore, the interstate compact commissions created in this bill can bind Missouri through rules, fees, data systems, and governance requirements, violating state sovereignty.
Red Flags & Recommended Amendments
Data Collection Is Not Opt-In
Authorizes workforce data collection, identifying-data transfer to contractors, and biometric background checks for compacts without requiring affirmative opt-in consent from professionals.
Interstate Compact Governance
Creates external governing structures that operate outside direct Missouri voter control with rulemaking, fees, disciplinary sharing, and enforcement mechanisms.
Act for Missouri Recommendation:
Act for Missouri OPPOSES SB 1233. There are useful licensure-reform pieces buried inside the bill, but the current version fails Act4MO's process, privacy, sovereignty, and limited-government tests. The structural problems require major surgery, not minor amendments.