MO HJR187

Submits a constitutional amendment to Missouri voters in November 2026 allowing advanced practice registered nurses (except nurse anesthetists) to practice independently without a collaborative practice arrangement after completing 2,000 documented hours of supervised practice

Grants exempt APRNs full prescriptive authority including scheduled controlled substances, and prohibits collaborative practice arrangements from containing geographic proximity restrictions or requiring initial on-site supervision periods

Limits collaborating physicians to no more than 10 full-time equivalent advanced practice providers

Creates a state-accredited residency program pathway for physician licensure as an alternative to nationally accredited (ACGME) programs, with the State Board of Registration for the Healing Arts overseeing approval

Allows shortened residency programs in specialties with demonstrated workforce shortages if competency-based standards are met, and prohibits hospitals from denying staff privileges based solely on whether a physician completed a state or nationally accredited residency