MCQC tracked forty-one bills that were introduced during the 2026 session of the Missouri Senate and House of Representatives. Only one of the bills was passed by the House, HB 2292, which modifies abuse and neglect reporting to include reports of companion animal abuse. The bill was delivered to the Governor on May 28, 2026. If signed by the Governor it would become effective August 28, 2026.
MCQC had hopes that progress would be made on bipartisan legislation that would remove some of the restrictions on the practice of advanced practice registered nurses (APRNs). Three bills in the Senate and six bills in the House were introduced by Republicans and Democrats. The most promising bills for passage were SBs 979 and 1016, which would allow APRNs greater ability to prescribe controlled substances to patients. The bills passed unanimously in the Emerging Issues and Professional Registration Committee on March 31, 2026, however, the Speaker of the House (Jonathan Patterson), a physician, did not bring the bills up for a vote.
APRNs are registered nurses who have completed extensive training and have a master’s degree or a doctorate and are nationally certified. They provide primary and specialty care and operate under a collaborative practice arrangement with a licensed physician. In Missouri these arrangements restrict the geographic distance between the APRN and the physician, restrict the methods of treatment and authority to prescribe medications, and require consultation and frequent review by the collaborating physician. Many of these arrangements are costly for the APRN. Missouri is recognized as one of the most restrictive states in the country. The restrictions do not severely affect APRNs who practice in large hospital systems in metropolitan areas. The restrictions become much more unmanageable for APRNs who want to practice in clinics and long-term care facilities in Missouri’s rural counties.
MCQC has long supported lifting the restrictions on APRNs because research has shown that nursing homes that employ them have fewer emergency room visits for residents, lower staff turnover rates, fewer infection control citations and fewer complaints*. For many years, bills like SBs 979 and 1016 have been introduced by concerned legislators and have been supported by MCQC, the Missouri Nurses Association and numerous health care organizations serving Missouri long-term care facilities. Hopefully we will see real progress in the 2027 legislative session.
* Yang, B. K., Idzik, S., Nelson, H. W., & McSweeney-Feld, M. H. (2023). Nurse practitioner employment in relation to nursing staff turnover and resident care outcomes in U.S. nursing homes. Journal of the American Medical Directors Association, 24(11), 1767-1772. McHugh, M. D. (2021). Value of nurse practitioner inpatient hospital staffing. Medical Care, 59(10), 857.