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.

Lori Scheidt
Executive Director
Missouri Board of Nursing

THANK YOU to

• Association of Missouri Nurse Practitioners (AMNP) and Derek Leffert (lobbyist)
• Missouri Nurses Association (MONA) and Kyna Iman (lobbyist)
• National Council of the State Boards of Nursing (NCSBN) and Kathi Harness (lobbyist)
• Sen. Nick Schroer
• Sen. Rusty Black
• Rep. Alex Riley
• Other Senators and Representatives who were supportive of this change
• ALL MISSOURI APRNs, especially those who wrote, attended, spoke and supported the elimination of this rule!