2950S.03F
1
SENATE SUBSTITUTE
FOR
HOUSE BILL NO. 1713
AN ACT
To repeal sections 143.174, 143.175, 173.239,
191.480, and 301.3061, RSMo, and to enact in lieu
thereof twenty new sections relating to military
affairs.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Sections 143.174, 143.175, 173.239, 191.480, 1
and 301.3061, RSMo, are repealed and twenty new sections enacted 2
in lieu thereof, to be known as sections 41.092, 42.022, 42.312, 3
143.174, 143.175, 173.239, 191.479, 191.480, 191.2600, 4
191.2605, 191.2610, 191.2615, 191.2620, 191.2625, 191.2630, 5
301.3061, 301.3181, 301.3182, 620.3305, and 630.1170, to read 6
as follows:7
41.092. No member of the National Guard of this state 1
shall be required by the governor or the adjutant general to 2
receive a vaccination against COVID -19 as a condition of 3
active state duty service pursuant to section 41.480 or as a 4
condition for any other duty or training not in federal 5
service. 6
42.022. 1. In addition to any other duties imposed 1
under this chapter, the commission shall review the 2
provisions of the Commander John Scott Hannon Veterans 3
Mental Health Care Improvement Act of 2019, enacted by the 4
116th United States Congress (Pub. L. 116 -171), as amended, 5
and any regulations related thereto. After review, the 6
commission, in collaboration with the department of mental 7
health, shall provide recommendations and make efforts to 8
adopt procedures, programs, treatment options, additional 9
aid, and any other assistance deemed necessary by the 10
2
commission to assist in the efforts to prevent veteran 11
suicide, subject to appropriation. 12
2. Before July 1, 2025, and before every July first 13
thereafter the commission shall file a report with the 14
department of public safety and the general assembly on the 15
recommendations, implementation, and effectiveness of the 16
efforts by the commission to prevent veteran suicide. 17
3. The department of public safety may promulgate all 18
necessary rules and regulations for the administration of 19
this section. Any rule or portion of a rule, as that term 20
is defined in section 536.010, that is created under the 21
authority delegated in this section shall become effective 22
only if it complies with and is subject to all of the 23
provisions of chapter 536 and , if applicable, section 24
536.028. This section and chapter 536 are nonseverable and 25
if any of the powers vested with the general assembly 26
pursuant to chapter 536 to review, to delay the effective 27
date, or to disapprove and annul a rule are subsequentl y 28
held unconstitutional, then the grant of rulemaking 29
authority and any rule proposed or adopted after August 28, 30
2024, shall be invalid and void. 31
42.312. 1. There is hereby created within the state 1
adjutant general's office the "Operation Enduring Freedom, 2
Operation Freedom's Sentinel, and Operation Allies Refuge 3
Program". Every veteran who honorably served on active duty 4
in the United States military service at any time beginning 5
October 7, 2001, and ending August 30, 2021, shall be 6
entitled to receive an Operation Enduring Freedom, Operation 7
Freedom's Sentinel, and Operation Allies Refuge medallion, 8
medal, and certificate of appreciation under this section, 9
provided that: 10
(1) Such veteran is a legal resident of th is state or 11
was a legal resident of this state at the time he or she 12
3
entered or was discharged from military service or at the 13
time of his or her death, or such veteran served in a unit 14
of the Missouri National Guard regardless of whether such 15
veteran is or ever was a legal resident of this state; and 16
(2) Such veteran was honorably separated or discharged 17
from military service, is still in active service in an 18
honorable status, or was in active service in an honorable 19
status at the time of his or her death. 20
2. The Operation Enduring Freedom, Operation Freedom's 21
Sentinel, and Operation Allies Refuge medallion, medal, and 22
certificate shall be awarded regardless of whether such 23
veteran served within the United States or in a foreign 24
country. The medallion, medal, and certificate shall be 25
awarded regardless of whether such veteran was under 26
eighteen years of age at the time of enlistment. For 27
purposes of this section, "veteran" means any person defined 28
as a veteran by the United Stat es Department of Veterans 29
Affairs or its successor agency. 30
143.174. For all tax years beginning on or after 1
January 1, 2016, for purposes of calculating the Missouri 2
taxable income as required under section 143.011, one 3
hundred percent of the income received by any person as 4
salary or compensation in any form as a member of the active 5
duty component of the Armed Forces of the United States, and 6
to the extent that such income is included in the federal 7
adjusted gross income, may be deducted from the taxpayer's 8
Missouri adjusted gross income to determine such taxpayer's 9
Missouri taxable income. If such person files a combined 10
return with a spouse, any military income received while 11
engaging in the performance of active duty m ay be deducted 12
from their Missouri combined adjusted gross income. For the 13
purposes of this section, "salary or compensation" shall 14
include any signing bonus. 15
4
143.175. 1. For all tax years beginning on or after 1
January 1, 2020, for purposes of calculating the Missouri 2
taxable income as required under section 143.011, a 3
percentage of the income received by any person as salary or 4
compensation: 5
(1) In performance of inactive duty for training (IDT) 6
of the National Guard o r annual training status (AT) of the 7
National Guard; [or] 8
(2) In reserve components of the Armed Forces of the 9
United States; or 10
(3) For all tax years beginning on or after January 1, 11
2025, in the form of a bonus from the National Guard or a 12
reserve component of the United States Armed Forces for 13
joining, reenlisting, or for any other reason; 14
and to the extent that such income is included in the 15
federal adjusted gross income, may be deducted from the 16
taxpayer's Missouri adjusted gross inc ome to determine such 17
taxpayer's Missouri taxable income. If such person files a 18
combined return with a spouse, a percentage of any military 19
income received while engaging in the performance of 20
National Guard or reserve military duty may be deducted f rom 21
their Missouri combined adjusted gross income. Such 22
military income shall be deducted as follows: 23
(a) For the tax year beginning on or after January 1, 24
2020, twenty percent of such military income; 25
(b) For the tax year beginning on or a fter January 1, 26
2021, forty percent of such military income; 27
(c) For the tax year beginning on or after January 1, 28
2022, sixty percent of such income; 29
(d) For the tax year beginning on or after January 1, 30
2023, eighty percent of such income; 31
(e) For all tax years beginning on January 1, 2024, 32
and thereafter, one hundred percent of such income. 33
5
2. Notwithstanding the provisions of this section or 34
any other provision of law to the contrary, the deduction 35
authorized by this sectio n shall not apply to compensation 36
received while engaging in civilian federal service, 37
including civil service positions requiring the wearing of 38
military uniform and military affiliation. 39
173.239. 1. Any member of the Missouri Na tional Guard 1
who possesses the qualifications set forth in this section 2
may, while he or she is a member of the Missouri National 3
Guard, be awarded [an] educational assistance in the form of: 4
(1) A tuition and fee waiver for undergraduate courses 5
at a postsecondary institution of higher education located 6
in this state that directly receives funds appropriated by 7
the general assembly. This tuition and fee waiver shall not 8
be implemented prior to the 2025 -2026 academic year. The 9
tuition and fee waiver shall only be for tuition and fees 10
that remain after the application of all payments from a 11
tuition assistance program of the National Guard, the United 12
States Army, or the United States Air Force; additional 13
federal military tuition assistanc e; GI Bill educational 14
entitlements; awarded external scholarships; and federal 15
financial grants, including the federal Pell grant, that are 16
available to the member in the current semester. 17
(2) A grant to an [approved public institution or an 18
approved private] eligible institution[, as those terms are 19
defined in either section 173.205 or section 173.778, ] of 20
his or her choice [while he or she is a member of the 21
Missouri National Guard. Funding for educational assistance 22
pursuant to this secti on may be requested annually in the 23
budget of the Missouri National Guard. Educational 24
assistance provided pursuant to this section shall not 25
exceed funds appropriated for that purpose ]. For purposes 26
6
of this subdivision, the term "eligible institutio n" shall 27
mean: 28
(a) An approved public institution or an approved 29
private institution, as those terms are defined in section 30
173.1102; or 31
(b) Any institution of postsecondary education that is 32
required by law to be, and currently is, certifi ed to 33
operate by the coordinating board for higher education; that 34
is institutionally accredited by an accrediting commission 35
recognized by the United States Department of Education; 36
that has operated continuously in this state for five or 37
more years; that has no more than fifty percent of its 38
students in correspondence programs; and that offers a one - 39
year or two-year certificate, associate or baccalaureate 40
degree programs, or graduate or professional degree programs. 41
2. (1) Educational assistance provided under this 42
section shall not exceed the [least] lesser of the following: 43
[(1)] (a) The actual tuition, as defined in section 44
173.260, charged at an approved institution where the 45
[individual] member is enrolled or accepted for enrol lment; 46
or 47
[(2)] (b) The [amount] product of the number of credit 48
hours taken multiplied by the average tuition cost per 49
credit hour charged to a Missouri resident at the University 50
of Missouri for attendance [;], with such average cost 51
determined by the Missouri National Guard. 52
[(3)] (2) The grants provided under this section may 53
be prorated subject to appropriations in an amount no less 54
than fifty percent of the limits set forth in this [section] 55
subsection. 56
3. (1) For either type of educational assistance 57
described in this section, a member of the Missouri National 58
Guard [seeking educational assistance pursuant to this 59
7
section] may apply to the appropriate office of the Missouri 60
National Guard before each semester. The member shall: 61
(a) Provide a certificate of satisfactory service of 62
his or her Missouri National Guard duties from his or her 63
commanding officer [and shall]; 64
(b) Possess all other necessary entrance requirements 65
of the school of his or her choice [and shall maintain]; 66
(c) Provide proof of maintaining a cumulative grade 67
point average (GPA) of at least two point five on a [four 68
point] four-point scale, or the equivalent on another scale 69
approved by the program administrator, while attending t he 70
approved public or private institution ; 71
(e) Have not yet earned a baccalaureate degree; and 72
(d) Have completed and submitted a Free Application 73
for Federal Student Aid (FAFSA) for the academic term for 74
which educational assistance is requ ested. 75
(2) For the tuition and fee waiver, the waiver shall 76
be awarded if the member applies and is otherwise eligible 77
pursuant to this section and shall be awarded only after the 78
Missouri National Guard has distributed any moneys available 79
for the member through the state tuition assistance program . 80
4. If the grade point average of a member who is 81
receiving educational assistance pursuant to this section 82
falls below two point five on a [four point] four-point 83
scale, or the equivalent on another scale, such member shall 84
retain the educational assistance and shall be placed on 85
probation under the educational assistance program. Failure 86
to achieve a current grade point average of at least two 87
point five on a [four point] four-point scale or the 88
equivalent on another scale for future semesters or 89
equivalent academic terms shall result in termination of the 90
[scholarship] educational assistance effective as of the 91
next academic term. The member shall be removed from 92
8
probation status upon achieving a cumulative grade point 93
average of two point five on a [four point] four-point scale 94
or the equivalent on another scale. 95
5. For the tuition and fee waiver, an applicant shall 96
cease to be eligible if his or her total completed credit 97
hours exceeds one hundred twenty credit hours. This 98
limitation applies to credit hours earned either with the 99
educational assistance described in this section or credit 100
earned outside of the educational assistance described in 101
this section. 102
6. The tuition and fee waiver shall not be available 103
in fiscal years in which the percentage of the total program 104
costs covered by the state appropriation for the educational 105
assistance pursuant to this section has decreased compared 106
to the previous fisc al year. 107
7. If a recipient of either type of educational 108
assistance pursuant to this section ceases to maintain their 109
active military affiliation while enrolled in an academic 110
semester or term for any reason except death, disability, or 111
medical disqualification the educational assistance shall be 112
terminated and the recipient shall repay any amounts awarded 113
or waived for the academic semester or term. 114
[6. Applicants for educational assistance pursuant to 115
this section shall meet the qualifi cations established by 116
section 173.215, except the provisions of subdivisions (2) 117
and (4) of subsection 1 of section 173.215, and shall be 118
qualified, full-time or part-time students. 119
7.] 8. The educational assistance program established 120
pursuant to this section shall be administered by the office 121
of the adjutant general of the Missouri National Guard. The 122
Missouri National Guard shall establish guidelines for 123
equitable administrative distribution of educational 124
assistance. 125
9
9. For purposes of this section, the terms "fee" and 126
"fees" mean any mandatory fees charged by an institution to 127
all full-time students as a condition of enrollment. 128
191.479. 1. For the purpose of this section, a "bona 1
fide physician-patient relationship" means a relationship 2
between a physician and a patient in which the physician: 3
(1) Has completed an assessment of the patient's 4
medical history and current medical condition, including an 5
in-person examination of the patient; 6
(2) Has consulted with the patient with respect to the 7
patient's medical condition; and 8
(3) Is available to provide follow -up care and 9
treatment to the patient. 10
2. Notwithstanding the provisions of chapter 195 or 11
579 or any other provision of law to the contrary, any 12
person who acquires, uses, produces, possesses, transfers, 13
or administers psilocybin for the person's own therapeutic 14
use shall not be in violation of state or local law and 15
shall not be subject to a civil fine, penalty, or san ction 16
so long as the following conditions are met: 17
(1) The person is a veteran, as defined in section 18
42.002, who resides in Missouri; 19
(2) The person is twenty -one years of age or older; 20
(3) The person suffers from posttraumatic stress 21
disorder, major depressive disorder, or a substance use 22
disorder or requires end -of-life care; 23
(4) The person has enrolled in a study regarding the 24
use of psilocybin to treat posttraumatic stress disorder, 25
major depressive disorder, or substance use disorders or for 26
end-of-life care; 27
(5) The person informs the department of mental health 28
that the person plans to acquire, use, produce, possess, 29
10
transfer, or administer psilocybin in accordance with this 30
section; 31
(6) The person provides the department with: 32
(a) Documentation from a physician with whom the 33
patient has a bona fide physician -patient relationship that 34
the person suffers from posttraumatic stress disorder, major 35
depressive disorder, or a substance use disorder or r equires 36
end-of-life care; 37
(b) The name of the facilitator who will be present 38
with the person when they use psilocybin, who is one of the 39
following: 40
a. A physician licensed under chapter 334; 41
b. A psychologist licensed under chapter 33 7; 42
c. A master's-level mental health therapist with full 43
clinical experience such as a licensed clinical social 44
worker, marital and family therapist, or professional 45
counselor, as such professions are licensed under chapter 46
337, or a registered a rt therapist; 47
d. A nurse licensed under chapter 335 with a doctor of 48
nursing practice degree; 49
e. A physician assistant licensed under chapter 334; or 50
f. An advanced practice registered nurse licensed 51
under chapter 335, including, but no t limited to, a 52
psychiatric-mental health nurse practitioner; 53
(c) The address of the location where the use of 54
psilocybin will take place; and 55
(d) The time period, not to exceed twelve months, 56
during which the person will use psilocybin; 57
(7) The person ensures that a laboratory licensed by 58
the state to test controlled substances tests the psilocybin 59
the person intends to ingest; and 60
(8) The person limits the use of psilocybin to no more 61
than one hundred and fifty milligrams of psilocybin analyte 62
11
(4-phosphoryloxy-N, N-dimethyltryptamine) during any twelve - 63
month period. 64
3. (1) A facilitator described under subsection 2 of 65
this section, in order to serve as a facilitator, shall have 66
completed a training program specific to psilocybin 67
consistent with the most current American Psychedelic 68
Practitioners Association Professional Practice Guidelines 69
for Psychedelic-Assisted Therapy and shall comply with such 70
guidelines. The curriculum of a training program under this 71
subsection shall cover all content areas set forth in the 72
guidelines and shall consist of no less than thirty hours of 73
synchronous learning. Facilitators, excluding those who are 74
psychologists, psychiatrists, or psychiatric -mental health 75
nurse practitioners, shall complete one and one half 76
continuing education hours of training on the most current 77
version of the Diagnostic and Statistical Manual of Mental 78
Disorders within the facilitator's respective licensure 79
renewal period and prior to facilitating a psilocybin 80
session. 81
(2) An individual shall have training in posttraumatic 82
stress disorder, complex posttraumatic stress disorder, 83
major depressive disorder, substance use disorder, or end -of- 84
life care in order to serve as a facilitator for a p erson 85
seeking psilocybin-assisted psychotherapy to treat such 86
conditions. 87
4. Notwithstanding the provisions of chapter 195 or 88
579 or any other provision of law to the contrary: 89
(1) Any person twenty-one years of age or older who 90
assists another person in any of the acts allowed under 91
subsection 2 of this section shall not be in violation of 92
state or local law and shall not be subject to a civil fine, 93
penalty, or sanction; and 94
12
(2) Any laboratory licensed by the state to test 95
controlled substances or cannabis that tests psilocybin for 96
a person engaged in acts allowed under subsection 2 of this 97
section shall not be in violation of state or local law and 98
shall not be subject to a civil fine, penalty, or sanction. 99
5. Subject to appropriation, the department shall 100
provide grants totaling three million dollars for research 101
on the use and efficacy of psilocybin for persons described 102
in subsection 2 of this section. 103
6. The department shall prepare and submit to the 104
governor, lieutenant governor, and the general assembly 105
annual reports on any information collected by the 106
department on the implementation and outcomes of the use of 107
psilocybin as described in subsection 2 of this section. 108
7. The department shall maintai n the confidentiality 109
of any personally identifiable protected information 110
collected from any persons who provide information to the 111
department under subsection 2 of this section. 112
8. Notwithstanding any other provision of law to the 113
contrary, the department, any health care providers, and any 114
other person involved in the acts described in subsection 2 115
of this section shall not be subject to criminal or civil 116
liability or sanction under the laws of this state for 117
providing care to a person enga ged in acts allowed under 118
subsection 2 of this section, except in cases of gross 119
negligence or willful misconduct. No health care provider 120
shall be subject to discipline against his or her 121
professional license for providing care to a person engaged 122
in acts allowed under subsection 2 of this section. 123
9. Notwithstanding any other provision of law to the 124
contrary, a physician shall not be subject to criminal or 125
civil liability or sanction under the laws of this state for 126
providing documentation that a person suffers from 127
13
posttraumatic stress disorder, major depressive disorder, or 128
a substance use disorder or requires end -of-life care, and 129
no state agency or regulatory board shall revoke, fail to 130
renew, or take any other action against a physi cian's 131
license issued under chapter 334 based solely on the 132
physician's provision of documentation that a person suffers 133
from posttraumatic stress disorder, major depressive 134
disorder, or a substance use disorder or requires end -of- 135
life care. 136
10. Notwithstanding any other provision of law to the 137
contrary, no state agency, including employees therein, 138
shall disclose to the federal government, any federal 139
government employee, or any unauthorized third party the 140
statewide list or any individual i nformation of persons who 141
meet the requirements of this section. 142
191.480. 1. For purposes of this section, the 1
following terms shall mean: 2
(1) "Eligible patient", a person who meets all of the 3
following: 4
(a) Has a terminal, life-threatening, or severely 5
debilitating condition or illness; 6
(b) Has considered all other treatment options 7
currently approved by the United States Food and Drug 8
Administration and all relevant clinical trials conducted in 9
this state; 10
(c) Has received a prescription or recommendation from 11
the person's physician for an investigational drug, 12
biological product, or device; 13
(d) Has given written informed consent which shall be 14
at least as comprehensive as the consent used in c linical 15
trials for the use of the investigational drug, biological 16
product, or device or, if the patient is a minor or lacks 17
the mental capacity to provide informed consent, a parent or 18
14
legal guardian has given written informed consent on the 19
patient's behalf; and 20
(e) Has documentation from the person's physician that 21
the person has met the requirements of this subdivision; 22
(2) "Investigational drug, biological product, or 23
device", a drug, biological product, or device, any of which 24
are used to treat the patient's terminal illness, that has 25
successfully completed phase one of a clinical trial but has 26
not been approved for general use by the United States Food 27
and Drug Administration and remains under investigation in a 28
clinical trial[. The term shall not include Schedule I 29
controlled substances ]; 30
(3) "Life-threatening", diseases or conditions: 31
(a) Where the likelihood of death is high unless the 32
course of the disease is interrupted; and 33
(b) With potentially fatal o utcomes, where the end 34
point of clinical trial analysis is survival; 35
(4) "Severely debilitating", diseases or conditions 36
that cause major irreversible morbidity; 37
(5) "Terminal illness", a disease that without life - 38
sustaining procedures will result in death in the near 39
future or a state of permanent unconsciousness from which 40
recovery is unlikely. 41
2. A manufacturer of an investigational drug, 42
biological product, or device may make available the 43
manufacturer's investigational drug, bi ological product, or 44
device to eligible patients under this section. This 45
section does not require that a manufacturer make available 46
an investigational drug, biological product, or device to an 47
eligible patient. A manufacturer may: 48
(1) Provide an investigational drug, biological 49
product, or device to an eligible patient without receiving 50
compensation; or 51
15
(2) Require an eligible patient to pay the costs of or 52
associated with the manufacture of the investigational drug, 53
biological product, or device. 54
3. This section does not require a health care insurer 55
to provide coverage for the cost of any investigational 56
drug, biological product, or device. A health care insurer 57
may provide coverage for an investigational drug, biological 58
product, or device. 59
4. This section does not require the department of 60
corrections to provide coverage for the cost of any 61
investigational drug, biological product, or device. 62
5. Notwithstanding any other provision of law to the 63
contrary, no state agency or regulatory board shall revoke, 64
fail to renew, or take any other action against a 65
physician's license issued under chapter 334 based solely on 66
the physician's recommendation to an eligible patient 67
regarding prescription for or treatmen t with an 68
investigational drug, biological product, or device. Action 69
against a health care provider's Medicare certification 70
based solely on the health care provider's recommendation 71
that a patient have access to an investigational drug, 72
biological product, or device is prohibited. 73
6. If a provision of this section or its application 74
to any person or circumstance is held invalid, the 75
invalidity does not affect other provisions or applications 76
of this section that can be given effect without the invalid 77
provision or application, and to this end the provisions of 78
this section are severable. 79
7. If the clinical trial is closed due to lack of 80
efficacy or toxicity, the drug shall not be offered. If 81
notice is given on a drug, product, or device taken by a 82
patient outside of a clinical trial, the pharmaceutical 83
company or patient's physician shall notify the patient of 84
16
the information from the safety committee of the clinical 85
trial. 86
8. Except in the case of gross negligence or wil lful 87
misconduct, any person who manufactures, imports, 88
distributes, prescribes, dispenses, or administers an 89
investigational drug or device to an eligible patient with a 90
terminal illness in accordance with this section shall not 91
be liable in any actio n under state law for any loss, 92
damage, or injury arising out of, relating to, or resulting 93
from: 94
(1) The design, development, clinical testing and 95
investigation, manufacturing, labeling, distribution, sale, 96
purchase, donation, dispensing, prescr iption, 97
administration, or use of the drug or device; or 98
(2) The safety or effectiveness of the drug or device. 99
191.2600. Sections 191.2600 to 191.2630 shall be known 1
and may be cited as the "Veterans Traumatic Brain Injury 2
Treatment and Recovery Act". 3
191.2605. As used in sections 191.2600 to 191.2630, 1
unless the context indicates otherwise, the following terms 2
mean: 3
(1) "Alternative therapies", any therapies for a 4
condition that are not conside red the standard or 5
conventional therapies for that condition including, but not 6
limited to, hyperbaric oxygen therapy; 7
(2) "Commission", the Missouri veterans commission; 8
(3) "Facility", a public or private health clinic, 9
outpatient health clinic, community health center, hospital, 10
or other facility authorized under rules of the department 11
of health and senior services to provide hyperbaric oxygen 12
therapy under sections 191.2600 to 191.2630; 13
(4) "Fund", the veterans traumatic brain injury 14
treatment and recovery fund established in section 191.2615; 15
17
(5) "Health care practitioner", a person who is 16
licensed to provide medical or other health care in this 17
state and who has prescriptive authority including, but not 18
limited to, a physician; 19
(6) "Hyperbaric oxygen therapy" or "therapy", 20
treatment for posttraumatic stress disorder or traumatic 21
brain injury that is based on a valid prescription from a 22
health care practitioner and that is delivered through: 23
(a) A hyperbaric chamber approved by the United States 24
Food and Drug Administration; or 25
(b) A hyperbaric oxygen device that is approved by the 26
United States Food and Drug Administration; 27
(7) "Physician", a person licensed to practice 28
medicine in this state under chapter 334; 29
(8) "Posttraumatic stress disorder", a mental health 30
condition that is triggered by a terrifying event, such as 31
by either experiencing or witnessing a life -threatening 32
event, including, but not limited to, military sexual 33
trauma, or as a secondary sequela to body trauma; 34
(9) "Traumatic brain injury", an acquired injury to 35
the brain. The term "traumatic brain injury" does not 36
include brain dysfunction caused by a congenital or 37
degenerative disorder or birth trauma; 38
(10) "Veteran", an individual who has served: 39
(a) In an active or reserve component of the Army, 40
Navy, Air Force, Marine Corps, Space Force, or Coast Guard 41
of the United States; 42
(b) In the National Guard of any state; or 43
(c) On active duty, other than for training, in any 44
component of the Armed Forces of the United States for a 45
period of one hundred eighty days or more, unless released 46
earlier because of service -connected disability, and who was 47
18
discharged or released from the Armed Forces of the United 48
States under other than dishonorable conditions. 49
191.2610. Any facility in this state that provides 1
hyperbaric oxygen therapy to a veteran shall be eligible for 2
reimbursement for such therapy from the com mission if the 3
following conditions are satisfied: 4
(1) The veteran receiving the therapy has been 5
diagnosed, by a health care practitioner, with posttraumatic 6
stress disorder or a traumatic brain injury and has 7
demonstrated that he or she previou sly sought services for 8
posttraumatic stress disorder or a traumatic brain injury 9
through the Veterans Health Administration service delivery 10
system or, if available to the veteran, through the private 11
health insurance system; 12
(2) The veteran receiving the therapy voluntarily 13
agreed to the therapy; 14
(3) The facility complies with applicable fire codes, 15
oversight requirements, and any treatment protocols required 16
under sections 191.2600 to 191.2630; 17
(4) The veteran receiving the thera py resides within 18
this state; 19
(5) Any hyperbaric chamber used to treat the veteran 20
meets the minimum standards for patients established by the 21
United States Food and Drug Administration; 22
(6) The facility complies with the federal Health 23
Insurance and Portability Accountability Act of 1996 for the 24
veteran receiving the therapy; 25
(7) The facility's treatment protocols for hyperbaric 26
oxygen therapy are aligned with the medical standards 27
demonstrated in published clinical trials for hype rbaric 28
oxygen therapy that occurred under the direction of an 29
institutional review board; 30
19
(8) The hyperbaric oxygen therapy is delivered solely 31
by health care practitioners in accordance with federal and 32
state law; 33
(9) Before providing hype rbaric oxygen therapy to the 34
veteran, the facility established a treatment plan 35
consistent with the requirements of sections 191.2600 to 36
191.2630; 37
(10) A prescription order for hyperbaric oxygen 38
therapy was issued by a health care practitioner be fore the 39
facility provided the therapy; 40
(11) The facility verified that both the facility and 41
the veteran met the requirements under sections 191.2600 to 42
191.2630 for reimbursement before proceeding with the 43
therapy; 44
(12) Before providing the therapy, the facility 45
estimated the costs of the therapy, including the costs of 46
cognitive testing to be conducted before and after the 47
therapy; 48
(13) The facility retains in the veteran's health care 49
file information on the type of cognitive t esting performed 50
as well as the results of the cognitive testing; 51
(14) The veteran is not charged or billed for the 52
therapy by the facility or any other entity and is not 53
liable for the costs of the therapy or any expenses incurred 54
in accordance with sections 191.2600 to 191.2630; 55
(15) The facility and any health care practitioners 56
involved in the hyperbaric oxygen therapy agree to cooperate 57
with the commission to provide an annual data summary 58
treatment report sufficient to assess the ef ficacy of 59
alternative treatment modalities for treating veterans with 60
posttraumatic stress disorder and traumatic brain injuries; 61
and 62
20
(16) The facility receives advance approval from the 63
commission as described in section 191.2615. 64
191.2615. 1. (1) There is hereby created in the 1
state treasury the "Veterans Traumatic Brain Injury 2
Treatment and Recovery Fund". The fund shall consist of any 3
appropriations, gifts, bequests, or public or private 4
donations to such fund. The state treasurer shall be 5
custodian of the fund. In accordance with sections 30.170 6
and 30.180, the state treasurer may approve disbursements. 7
The fund shall be a dedicated fund and, upon appropriation, 8
moneys in this fund shall be used solely for r eimbursements 9
to facilities for hyperbaric oxygen therapy provided to 10
veterans, for administrative expenses incurred by the 11
commission in distributing such reimbursements, and for 12
studies on the use of alternative therapies to treat 13
veterans with posttraumatic stress disorder and traumatic 14
brain injuries. 15
(2) Notwithstanding the provisions of section 33.080 16
to the contrary, any moneys remaining in the fund at the end 17
of the biennium shall not revert to the credit of the 18
general revenue fund. 19
(3) The state treasurer shall invest moneys in the 20
fund in the same manner as other funds are invested. Any 21
interest and moneys earned on such investments shall be 22
credited to the fund. 23
2. Any facility that intends to seek reimbursement 24
from the fund for hyperbaric oxygen therapy provided to a 25
veteran shall request advance approval from the commission 26
for reimbursement before providing such therapy. Upon 27
approval by the commission, the commission shall set aside 28
the appropriate amount of funds to ensure full payment for 29
the veteran's therapy. If moneys remaining in the fund are 30
21
insufficient to ensure full payment, the commission shall 31
deny the facility's request for advance approval. 32
3. If at the end of the six -month period immediately 33
following the date the commission approved the facility's 34
request for advance approval the facility has not submitted 35
any bills to the commission for the veteran or provided any 36
therapy for the veteran, the commission shall notify the 37
veteran and the facility that the funding reserved for the 38
veteran shall expire within thirty days if the facility 39
fails to notify the commission that therapy is scheduled or 40
continued. If the facility fails to notify the commission 41
that therapy is schedule d or continued within thirty days, 42
the commission shall release the funds reserved for the 43
veteran and make them available for another veteran's 44
therapy under sections 191.2600 to 191.2630. 45
4. After receiving advance approval from the 46
commission and providing hyperbaric oxygen therapy to a 47
veteran in accordance with sections 191.2600 to 191.2630, 48
the facility shall not bill the veteran for the therapy but 49
shall submit the bill for the therapy to the commission. 50
5. The commission shall pay the bill for the therapy 51
received in accordance with subsection 4 of this section 52
from the fund within forty -five days of receipt. If the 53
costs of the therapy exceed the availability of moneys 54
remaining in the fund, the facility shall not hold the 55
veteran responsible for any payment, and the commission 56
shall not have any obligation to make payments to the 57
facility in an amount that exceeds the amount that was set 58
aside upon advance approval as described in subsection 2 of 59
this section. 60
6. The commission shall seek reimbursement for 61
payments made to facilities for treating veterans with 62
hyperbaric oxygen therapy from any of the following entities 63
22
based on the efficacy of treatments as demonstrated in the 64
healing of traumatic brain injurie s through hyperbaric 65
oxygen therapy by cognitive testing, brain scans, or other 66
assessment protocols medically accepted by the United States 67
Food and Drug Administration or the United States Department 68
of Defense under the War Risk Insurance Act, as am ended: 69
(1) The Tricare program of the United States 70
Department of Defense; 71
(2) Appropriate federal agencies, including the 72
Veterans Health Administration; and 73
(3) Any other responsible third -party payer. 74
7. The department of healt h and senior services shall 75
award funds to entities to study the use of alternative 76
therapies to treat veterans with posttraumatic stress 77
disorder and traumatic brain injuries. 78
191.2620. 1. Any facility may approve hyperbaric 1
oxygen therapy for a veteran in accordance with sections 2
191.2600 to 191.2630. 3
2. A licensing board shall not revoke, fail to renew, 4
suspend, or take any action against a health care 5
practitioner based solely on the health care practitioner's 6
recommendations to a veteran regarding access to or 7
treatment with hyperbaric oxygen therapy. 8
3. No state agency shall take any action, or assist in 9
any action, against a health care practitioner's Medicare or 10
Medicaid certification based solely on the health care 11
practitioner's recommendation that a veteran have access to 12
hyperbaric oxygen therapy. 13
4. No official employee or agent of the state shall 14
block or attempt to block access to hyperbaric oxygen 15
therapy by a veteran who meets all requir ements to receive 16
such therapy under sections 191.2600 to 191.2630. 17
23
5. Counseling, advice, or recommendations provided by 18
a health care practitioner consistent with the medical 19
standards of care shall not be considered a violation of 20
sections 191.2600 to 191.2630. 21
6. Hyperbaric oxygen therapy may be used under the 22
direction of an institutional review board with a national 23
clinical trial number for the purpose of collecting clinical 24
trial data. 25
191.2625. 1. Any facility that receives reimbursement 1
from the fund shall: 2
(1) Provide reports on individual veterans and groups 3
of veterans to the commission on measured health 4
improvements from accepted and approved cognitive testing 5
protocols, brain imaging, or oth er medical assessments 6
approved by the industry, the United States Food and Drug 7
Administration, the United States Department of Defense, 8
Tricare, or the Centers for Medicare and Medicaid Services 9
conducted before and after therapy; and 10
(2) Submit an annual report to the commission with the 11
following information: 12
(a) The number of veterans who received hyperbaric 13
oxygen therapy at the facility; 14
(b) The demographics of the veterans who received 15
hyperbaric oxygen therapy at the facili ty; 16
(c) The number of actual hyperbaric oxygen therapy 17
dives by veterans completed at the facility; 18
(d) Cognitive test results of veterans who received 19
hyperbaric oxygen therapy at the facility; and 20
(e) Any testimonials provided by vete rans voluntarily. 21
2. (1) Before January first each year, the commission 22
shall prepare a report detailing each treatment of 23
hyperbaric oxygen therapy provided to a veteran in 24
accordance with sections 191.2600 to 191.2630, the provider 25
24
type for each treatment provided, the number of veterans 26
treated or served, the treatment outcomes for the veterans 27
treated or served, and a detailed accounting of the moneys 28
used in the fund during the immediately preceding fiscal 29
year. 30
(2) The commission shall submit the report prepared 31
under subdivision (1) of this subsection to the governor, 32
the president pro tempore of the senate, the speaker of the 33
house of representatives, and the director of the department 34
of health and senior services. 35
3. Before January thirtieth each year, the department 36
of health and senior services shall submit to the governor a 37
report containing: 38
(1) Findings and recommendations related to the 39
administration of sections 191.2600 to 191.2630; 40
(2) Findings and recommendations from any studies 41
funded under section 191.2615 regarding the efficacy of 42
alternative therapies to treat posttraumatic stress disorder 43
and traumatic brain injuries; and 44
(3) Recommendations on budgetary, legislative, or 45
regulatory changes needed to expand access to alternative 46
therapies for veterans with posttraumatic stress disorder 47
and traumatic brain injuries. 48
191.2630. The commission and the department of health 1
and senior services shall jointly promu lgate all necessary 2
rules and regulations for the administration of sections 3
191.2600 to 191.2630. Any rule or portion of a rule, as 4
that term is defined in section 536.010, that is created 5
under the authority delegated in this section shall become 6
effective only if it complies with and is subject to all of 7
the provisions of chapter 536 and, if applicable, section 8
536.028. This section and chapter 536 are nonseverable and 9
if any of the powers vested with the general assembly 10
25
pursuant to chapter 5 36 to review, to delay the effective 11
date, or to disapprove and annul a rule are subsequently 12
held unconstitutional, then the grant of rulemaking 13
authority and any rule proposed or adopted after August 28, 14
2024, shall be invalid and void. 15
301.3061. 1. Any person eligible for membership in 1
the Disabled American Veterans and who possesses a valid 2
membership card issued by the Disabled American Veterans may 3
apply for Missouri Disabled American Veterans license plates 4
for any motor vehicle the person owns, either solely or 5
jointly, other than an apportioned motor vehicle or a 6
commercial motor vehicle licensed in excess of twenty -four 7
thousand pounds gross weight. The Missouri Disabled 8
American Veterans hereby authorizes the us e of its official 9
emblem to be affixed on multiyear personalized license 10
plates as provided in this section. 11
2. Upon presentation of a current photo 12
identification, the person's valid membership card issued by 13
the Disabled American Veterans, and payment of a fifteen 14
dollar fee in addition to the regular registration fees and 15
presentation of other documents which may be required by 16
law, the department of revenue shall issue a personalized 17
license plate to the vehicle owner, which shall bear the 18
emblem of the Disabled American Veterans organization, [an 19
emblem consisting exclusively of a red letter "D", followed 20
by a white letter "A" and a blue letter "V" in modified 21
block letters, with each letter having a black shaded 22
edging, and shall eng rave the words "WARTIME DISABLED" in 23
red letters centered ] and shall have an authorized Disabled 24
American Veterans' slogan near the bottom of the plate. 25
Such license plates shall be made with fully reflective 26
material with a common color scheme and de sign, shall be 27
clearly visible at night, and shall be aesthetically 28
26
attractive, as prescribed by section 301.130. A fee for the 29
issuance of personalized license plates issued under section 30
301.144 shall not be required for plates issued under this 31
section. 32
3. Any person who applies for a Disabled American 33
Veterans license plate under this section to be used on a 34
vehicle commonly known and referred to as a pickup truck may 35
be issued a Disabled American Veterans license plate with 36
the designation "beyond local" indicated in the upper right 37
corner of the plate. 38
4. There shall be no limit on the number of license 39
plates any person qualified under this section may obtain so 40
long as each set of license plates issued under this section 41
is issued for vehicles owned solely or jointly by such 42
person. License plates issued under this section shall not 43
be transferable to any other person except that any 44
registered co-owner of the motor vehicle may operate the 45
motor vehicle for the duration of the year licensed in the 46
event of the death of the qualified person. 47
5. The director shall promulgate rules to implement 48
the provisions of this section. Any rule or portion of a 49
rule, as that term is defined in section 536.010, that is 50
created under the authority delegated in this section shall 51
become effective only if it complies with and is subject to 52
all of the provisions of chapter 536 and, if applicable, 53
section 536.028. This section and chapter 536 are 54
nonseverable and if any of the powers vested with the 55
general assembly pursuant to chapter 536 to review, to delay 56
the effective date, or to disapprove and annul a rule are 57
subsequently held unconstitutional, then the grant of 58
rulemaking authority and any rule proposed or adopted a fter 59
August 28, 2006, shall be invalid and void. 60
27
301.3181. Any person who served as a member of the 1
Armed Forces of the United States in Afghanistan and Iraq, 2
who was awarded the Afghanistan Campaign medal and the Iraq 3
Campaign medal, may apply for Afghanistan and Iraq Veteran 4
vehicle license plates, for any motor vehicle the person 5
owns, either solely or jointly, other than an apportioned 6
motor vehicle or a commercial motor vehicle licensed in 7
excess of twenty-four thousand pounds gross weight. Any 8
such person shall make application for the license plates 9
authorized by this section on a form provided by the 10
director of revenue and furnish such proof of service in 11
Afghanistan and Iraq, the awarding of the Afghanistan 12
Campaign medal and the Iraq Campaign medal, and status as 13
currently serving in a branch of the Armed Forces of the 14
United States or as an honorably discharged veteran as the 15
director may require. Upon presentation of the proof of 16
eligibility, payment of a fifteen-dollar fee in addition to 17
the regular registration fees, and presentation of documents 18
that may be required by law, the director shall then issue 19
license plates bearing letters or numbers or a combination 20
thereof as determined by the director, with the words 21
"AFGHANISTAN & IRAQ VETERAN" in place of the words "SHOW -ME 22
STATE". Such plates shall bear the Afghanistan Campaign 23
medal and the Iraq Campaign medal on the left side, with the 24
Afghanistan Campaign medal appearing farthest to the left 25
and the Iraq Campaign medal appearing immediately to the 26
right of the Afghanistan Campaign medal. Notwithstanding 27
the provisions of section 301.144, no additional fee shall 28
be charged for the personalization of license plates issued 29
pursuant to this section. The plates shall be clearly 30
visible at night and shall be aesthetically attractive, as 31
prescribed by section 301.130. There shall be no limit on 32
the number of license plates any person qualified pursuant 33
28
to this section may obtain so long as each set of license 34
plates issued pursuant to this section is issued for a 35
vehicle owned solely or jointly by such person. License 36
plates issued pursuant to this section shall not be 37
transferable to any other person except that any registered 38
co-owner of the motor vehicle may operate the motor vehicle 39
for the duration of the year licensed in the event of the 40
death of the qualified person. 41
301.3182. Any person who served as a member of the 1
Armed Forces of the United States in A fghanistan, who was 2
awarded the Afghanistan Campaign medal, may apply for 3
Afghanistan Veteran vehicle license plates, for any motor 4
vehicle the person owns, either solely or jointly, other 5
than an apportioned motor vehicle or a commercial motor 6
vehicle licensed in excess of twenty -four thousand pounds 7
gross weight. Any such person shall make application for 8
the license plates authorized by this section on a form 9
provided by the director of revenue and furnish such proof 10
of service in Afghanistan, the awarding of the Afghanistan 11
Campaign medal, and status as currently serving in a branch 12
of the Armed Forces of the United States or as an honorably 13
discharged veteran as the director may require. Upon 14
presentation of the proof of eligibility, paym ent of a 15
fifteen-dollar fee in addition to the regular registration 16
fees, and presentation of documents that may be required by 17
law, the director shall then issue license plates bearing 18
letters or numbers or a combination thereof as determined by 19
the director, with the words "AFGHANISTAN VETERAN" in place 20
of the words "SHOW-ME STATE". Such plates shall bear the 21
Afghanistan Campaign medal on the left side. 22
Notwithstanding the provisions of section 301.144, no 23
additional fee shall be charged for th e personalization of 24
license plates issued pursuant to this section. The plates 25
29
shall be clearly visible at night and shall be aesthetically 26
attractive, as prescribed by section 301.130. There shall 27
be no limit on the number of license plates any per son 28
qualified pursuant to this section may obtain so long as 29
each set of license plates issued pursuant to this section 30
is issued for a vehicle owned solely or jointly by such 31
person. License plates issued pursuant to this section 32
shall not be transferable to any other person except that 33
any registered co-owner of the motor vehicle may operate the 34
motor vehicle for the duration of the year licensed in the 35
event of the death of the qualified person. 36
620.3305. 1. Subject to appropriations, the 1
department of economic development shall establish the 2
"Missouri Veterans and Job Opportunity Grant Program". 3
2. As used in this section, the following terms mean: 4
(1) "Eligible employer", any employer registered to do 5
business in Missouri that has paid wages to an individual in 6
a targeted group as defined in 26 U.S.C. Section 51, as 7
amended; 8
(2) "Grant", financial support provided by the state 9
to eligible employers, calculated as a percentage of the 10
federal work opportunity tax credit claimed for eligible 11
hires as allowed under 26 U.S.C. Section 51, as amended; 12
(3) "Targeted groups", has the same meaning as defined 13
under 26 U.S.C. Section 51, relating to the federal Work 14
Opportunity Tax Credit (WOTC); and 15
3. (1) There is hereby created in the state treasury 16
the "Missouri Veterans and Job Opportunity Grant Program 17
Fund". The fund shall consist of any appropriations to such 18
fund and any gifts, contributions, grants, or bequests 19
received from privat e or other sources. The state treasurer 20
shall be custodian of the fund. In accordance with sections 21
30.170 and 30.180, the state treasurer may approve 22
30
disbursements of public moneys in accordance with 23
distribution requirements and procedures develope d by the 24
department of economic development. The fund shall be a 25
dedicated fund and, upon appropriation, moneys in the fund 26
shall be used solely for the administration of this section. 27
(2) Notwithstanding the provisions of section 33.080 28
to the contrary, any moneys remaining in the fund at the end 29
of the biennium shall not revert to the credit of the 30
general revenue fund. 31
(3) The state treasurer shall invest moneys in the 32
fund in the same manner as other funds are invested. Any 33
interest and moneys earned on such investments shall be 34
credited to the fund. 35
4. The department of economic development shall 36
administer the grant, disbursing funds to eligible employers 37
based on applications received. 38
(1) (a) The department shall determine the grant 39
percentage annually, which shall be a portion of the federal 40
WOTC claimed by the employer for each eligible hire. This 41
percentage shall be contingent upon the available funds in 42
the Missouri veterans and job opportunity grant prog ram fund. 43
(b) At least fifty percent of the funds available 44
during a fiscal year to provide grants pursuant to this 45
section shall be reserved for eligible employers paying 46
wages to a qualified veteran, as such term is used in 26 47
U.S.C. Section 51(d). Any amount of such reserved funds 48
that is not claimed may be disbursed for wages paid to a 49
member of any other targeted group. 50
(2) Eligible employers must submit an application in a 51
form prescribed by the department, including detailed 52
information on the federal WOTC claimed and the impact of 53
such hires. 54
31
(3) Employers shall provide proof of eligibility for 55
the federal WOTC and documentation of the continued 56
employment of individuals from targeted groups. 57
5. The department of economic development shall 58
promulgate all necessary rules and regulations for the 59
administration of this section. Any rule or portion of a 60
rule, as that term is defined in section 536.010, that is 61
created under the authority delegated in this section s hall 62
become effective only if it complies with and is subject to 63
all of the provisions of chapter 536 and, if applicable, 64
section 536.028. This section and chapter 536 are 65
nonseverable and if any of the powers vested with the 66
general assembly pursuan t to chapter 536 to review, to delay 67
the effective date, or to disapprove and annul a rule are 68
subsequently held unconstitutional, then the grant of 69
rulemaking authority and any rule proposed or adopted after 70
August 28, 2024, shall be invalid and void. 71
630.1170. 1. Notwithstanding the provisions of 1
chapter 195 or 579 to the contrary, the department of mental 2
health, in collaboration with a hospital operated by an 3
institution of higher education in this state or contract 4
research organizations conducting trials approved by the 5
United States Food and Drug Administration, shall conduct a 6
study on the efficacy of using alternative medicine and 7
therapies, including, the use of psilocybin, in the 8
treatment of patients who suffer from posttraumatic stress 9
disorder, major depressive disorder, or substance abuse 10
disorders or who require end -of-life care. 11
2. (1) In conducting this study, the department, in 12
collaboration with the hospitals or research organizations 13
described in subsection 1 of this section and subject to 14
appropriation, shall: 15
32
(a) Perform a study on the therapeutic efficacy of 16
using psilocybin in the treatment of patients who suffer 17
from posttraumatic stress disorder, major depressive 18
disorder, or substance use disorders or who require end -of- 19
life care; and 20
(b) Review current literature regarding: 21
a. The safety and efficacy of psilocybin in the 22
treatment of patients who suffer from posttraumatic stress 23
disorder, major depressive disorde r, or substance use 24
disorders or who require end -of-life care; and 25
b. The access that patients have to psilocybin for 26
such treatment. 27
(2) The department shall prepare and submit to the 28
governor, lieutenant governor, and the general assembly the 29
following: 30
(a) Quarterly reports on the progress of the study; and 31
(b) A written report, submitted one year following the 32
commencement of the study, which shall: 33
a. Contain the results of the study and any 34
recommendations for legis lative or regulatory action; and 35
b. Highlight those clinical practices that appear to 36
be most successful as well as any safety or health concerns. 37
3. The department shall maintain the confidentiality 38
of any personally identifiable protected i nformation 39
collected during the study described in this section. 40
4. Notwithstanding any other provision of law to the 41
contrary, the department, any health care providers, and any 42
other person involved in the study described in this section 43
shall not be subject to criminal or civil liability or 44
sanction under the laws of this state for participating in 45
the study, except in cases of gross negligence or willful 46
misconduct. No health care provider shall be subject to 47
33
discipline against his or her professional license for 48
participation in the study. 49
5. Notwithstanding any other provision of law to the 50
contrary, a physician shall not be subject to criminal or 51
civil liability or sanction under the laws of this state for 52
referring a patient to the study described in this section, 53
and no state agency or regulatory board shall revoke, fail 54
to renew, or take any other action against a physician's 55
license issued under chapter 334 based solely on the 56
physician's referral of a patient to the st udy described in 57
this section. 58