COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:0908S.05P Bill No.:Perfected SS for SCS for SB 271 Subject:Boards, Commissions, Committees, and Councils; Counties; Fire Protection;
Political Subdivisions
Type:Original Date:April 15, 2025Bill Summary:This proposal modifies provisions relating to fire protection ordinances.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2026FY 2027FY 2028
General Revenue
Unknown
Unknown or
(Unknown)
Unknown or
(Unknown)
Total Estimated Net
Effect on General
RevenueUnknown
Unknown or
(Unknown)
Unknown or
(Unknown)
*Without additional information, Oversight cannot estimate the net effect. Oversight assumes the
unknown savings and the unknown cost will not exceed $250,000.
ESTIMATED NET EFFECT ON OTHER STATE FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028University Of
Missouri Healthcare*Up to $60,000Up to $60,000Up to $60,000
Total Estimated Net
Effect on Other State
FundsUp to $60,000Up to $60,000Up to $60,000
*Estimated net impact based on University Of Missouri Healthcare’s response.
Numbers within parentheses: () indicate costs or losses. L.R. No. 0908S.05P
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ESTIMATED NET EFFECT ON FEDERAL FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on All Federal
Funds $0$0$0
ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)FUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on FTE 000
☐ Estimated Net Effect (expenditures or reduced revenues) expected to exceed $250,000 in any
of the three fiscal years after implementation of the act or at full implementation of the act.
☐ Estimated Net Effect (savings or increased revenues) expected to exceed $250,000 in any of
the three fiscal years after implementation of the act or at full implementation of the act.
ESTIMATED NET EFFECT ON LOCAL FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Local Government$0$0 or Unknown$0 or Unknown L.R. No. 0908S.05P
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FISCAL ANALYSIS
ASSUMPTION
Oversight was unable to receive some of the agency responses in a timely manner due to the
short fiscal note request time. Oversight has presented this fiscal note on the best current
information that we have or on prior year information regarding a similar bill. Upon the receipt
of agency responses, Oversight will review to determine if an updated fiscal note should be
prepared and seek the necessary approval to publish a new fiscal note.
§§64.003 & 321.220 – Fire Protection District Boards Enacting Ordinances for Agricultural
Buildings
In response to a previous version, officials from Kansas City assumed the proposal will have no
fiscal impact on their organization. Oversight does not have any information to the contrary.
Therefore, Oversight will reflect a zero impact in the fiscal note.
Oversight notes the Florissant Valley Fire Protection District responded to a previous version
of the proposal but did not provide a fiscal impact statement for this proposal.
In response to similar legislation from this year, HB 533, officials from the City of O’Fallon
assumed the proposal will have no fiscal impact on their organization. Oversight does not have
any information to the contrary. Therefore, Oversight will reflect a zero impact in the fiscal note.
Oversight received a limited number of responses from cities, counties and fire protection
districts related to the fiscal impact of this proposal. Oversight has presented this fiscal note on
the best current information available. Upon receipt of additional responses, Oversight will
review to determine if an updated fiscal note should be prepared and seek the necessary approval
to publish a new fiscal note.
§190.101 – State Advisory Council on Emergency Medical Services
Oversight notes in response to similar legislation from this year, Perfected HCS for HB 943,
officials from the Department of Health and Senior Services stated this section increases the
number of members on the State Advisory Council on Emergency Medical Services from 16 to
no more than 23, outlines membership requirements and changes member appointment
responsibility from the Governor to the Director of the Department of Health and Senior
Services. Oversight assumes this section will not have a direct fiscal impact on the proposal.
§144.757 – Local Use Tax
In response to similar legislation from this year, HCS for HB 641, officials from the Office of
Administration - Budget and Planning (B&P) stated this bill defines the term “taxing
jurisdiction” to include any county, municipality, or any other political subdivision authorized to L.R. No. 0908S.05P
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impose a local sales tax as defined in any sales tax statute. The references to the governing body
of the “county or municipality” is replaced with the new term “taxing jurisdiction”. There is no
impact on TSR or the 18(e) calculation.
Officials from the Department of Revenue (DOR) state currently, in statute, cities, counties and
several other designated districts are allowed to collect a sale or use tax if adopted by their
voters. This proposal intends to allow any jurisdiction authorized to collect a sales tax for
emergency service districts to also put before the voters the question of whether to collect a use
tax for those districts.
DOR records note there are only 8 emergency districts in the state allowed to collect sales tax
currently. However, DOR’s interpretation of “emergency services” districts includes ambulance
districts (69 districts), fire protection districts (21 districts), and hospital districts (1 district).
It is unclear how many of these districts would want to collect a use tax and to get their citizens
to support a use tax. Should any of these districts succeed in adopting a use tax then DOR will
collect that money in its normal course of business. It should be noted that DOR is allowed to
retain 1% of all sales or use tax money remitted to reimburse our collection costs.
This proposal could result in an unknown revenue to districts that adopt the use tax and
therefore, DOR would also benefit by an unknown amount.
Oversight will show the potential fiscal impact to locals as $0 (not approved by voters) to an
unknown positive impact (local use tax approved by voters).
Oversight notes if a county approves the proposed use tax, DOR is allowed to retain 1% of
collections which is deposited into general revenue. Oversight will show the potential fiscal
impact to general revenue as $0 (not approved by voters) to an unknown positive impact (local
use tax approved by voters).
In response to similar legislation from this year, HCS for HB 641, officials from Kansas City
assumed the proposal will have no fiscal impact on their organization. Oversight does not have
any information to the contrary. Therefore, Oversight will reflect a zero impact in the fiscal note
for these agencies.
§§321.552, 321.554, 321.556 – Taxes for Emergency Services
In response to similar legislation from this year, HCS for HB 1268, officials from Office of
Administration - Budget and Planning (B&P) assumed these sections remove demographic
language from the bill that excludes specific counties in the state from imposing ambulance and
fire protection district sales taxes to support emergency services. DOR’s retained collection fee
will increase TSR because DOR will be able to collect its 1% administration fee for handling the
collection of the tax. B&P defers to DOR for more specific estimates of actual collection costs. L.R. No. 0908S.05P
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Officials from the Department of Revenue (DOR) assume this proposal would allow any
governing body of an ambulance or fire protection district to impose a sales tax in an amount up
to one percent on all retail sales made in such district. Previously the cap was at one-half of one
percent.
This proposal would not allow the districts in Clay, Greene, Jackson, Jefferson, St. Charles
County, and St. Louis City to increase their rates. In order to increase their sales tax, the district
would be required to hold an election and notify the Department of the increase. The first
available election would be April 2026, so the tax would not be collected until October 2026 (FY
2027) and remitted starting November 2026.
DOR notes that DOR is able to retain 1% of all sales tax collected as reimbursement of DOR’s
collection costs. The amount retained is deposited into general revenue.
DOR notes that some districts already have a sales tax that varies from 0.375% to 0.5%. DOR is
unable to predict how many ambulance and fire districts that don’t have this sales tax will adopt
one. This will not have a fiscal impact on the Department to administer unless a political
subdivision adopts the sales tax rate. At that time, it would cost $7,327 to update our computer
system per political subdivision rate change.
This proposal also requires that if a district passes a sales tax, they must adjust their levy to
account for this additional funding. Additionally, this proposal establishes procedures that allow
citizens to repeal this sales tax in the future. These provisions will not impact DOR.
Oversight does not have information to the contrary and therefore, Oversight will reflect the
estimates as provided by DOR for the potential increase in revenue from the 1% administration
fee and the cost for computer updates to DOR’s system for each political subdivision. Oversight
notes in order for the updates to DOR’s computer system to reach the $250,000 threshold, 34
($250,000/$7,327) political subdivisions would need to adopt a new sales tax rate. Those costs
would also be offset by the 1% administration fee. Oversight does not have enough information
at this time to determine the amount of revenue that would be generated from these political
subdivisions if a new sales tax on emergency services is adopted. Therefore, until more
information is available, Oversight will assume the unknown impact to GR will not meet the
$250,000 threshold.
Oversight is unclear how many additional governing bodies of these counties would impose a
sales tax. Therefore, Oversight will reflect a $0 (no sales tax adopted) or unknown revenue to
these LPS for this proposal.
In response to similar legislation from this year, HCS for HB 1268, officials from the Kansas
City Election Board
$800,000. The state would pay their pro-rata share based on registered voters. L.R. No. 0908S.05P
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Oversight assumes the timing for an election to adopt a sales tax for emergency services would
take place during a regular election cycle (April or November). Therefore, Oversight will assume
no direct fiscal impact from this proposal.
SA 1 - §§190.053, 190.076, 190.109, 190.112 & 190.166 – Emergency Medical Services
In response to similar legislation from this year, Perfected SS for SB 7, officials from the
Department of Health and Senior Services (DHSS) stated Section 190.053.2 of the proposed
legislation requires ambulance district board members to complete three hours of continuing
education training for each term of office. Training shall be offered by a statewide association or
program approved by the State Advisory Council on Emergency Medical Services. This will
require the Department of Health and Senior Services (DHSS), Division of Regulation and
Licensure’s (DRL) Bureau of Emergency Medical Services (BEMS) to verify ambulance district
board member training records through the licensure application review process and during
inspections.
The proposed legislation modifies provisions relating to emergency medical services. Sections
190.109.6(12) and 190.109.6(13) require the Department of Health and Senior Services, Bureau
of Emergency Medical Services (BEMS) to promulgate rules related to the requirements for a
ground ambulance service license including “participation with regional emergency medical
services advisory committees” and “ambulance service administrator qualifications.”
Section 190.112 requires licensed ambulance services to identify an individual to DHSS who
will serve as the ambulance service administrator responsible for ambulance service operations
and staffing. Additionally, the identified administrator is required to complete 40 initial training
hours and two hours of continuing education annually related to the operations of an ambulance
service. Training shall be offered by a statewide association or program approved by the State
Advisory Council on Emergency Medical Services. Individuals serving as an ambulance service
administrator as of August 28, 2025, will have until January 1, 2026, to demonstrate compliance
with these provisions. This will require BEMS to verify training records through the licensure
application review process for the individual administrator and the ambulance service, as well as
during inspections of the ambulance service.
Section 190.166.3 of the proposed legislation requires the department to “provide notice of any
determination by the department of insolvency or insufficiency of operations of a license holder
to other license holders operating in the license holder's vicinity, members of the general
assembly who represent the license holder's service area, the governing officials of any county or
municipal entity in the license holder's service area, the appropriate regional emergency medical
services advisory committee, and the state advisory council on emergency medical services.”
The BEMS has the ability to mail or email a notice to all entities required by this section.
Section 190.166.4 of the proposed legislation requires the department to “immediately engage
with other license holders in the area to determine the extent to which ground ambulance service L.R. No. 0908S.05P
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may be provided to the affected service area during the time in which the license holder is unable
to provide adequate services, including any long-term service arrangements.”
It is assumed that the Department can absorb the costs of this bill with current resources.
However, if the workload significantly increased or other legislation was enacted, additional
resources would be requested through the appropriation process.
Oversight does not have any information to the contrary. Therefore, Oversight assumes DHSS
will be able to perform any additional duties required by this proposal with current staff and
resources and will reflect no fiscal impact to DHSS for fiscal note purposes.
In response to similar legislation from this year, Perfected SS for SB 7, officials from the
Department of Public Safety – Division of Fire Safety, and theassumed
the proposal would have no fiscal impact on their respective organizations. Oversight does not
have any information to the contrary. Therefore, Oversight will reflect a zero impact in the fiscal
note for these agencies.
§ 197.135 - Specialty hospital forensic examinations of victims of sexual offenses
In response to similar legislation from this year, Perfected SS for SB 7, officials from the
Department of Health and Senior Services stated Section 197.135.7 of the proposed legislation
exempts specialty hospitals from Sections 192.2520 and 197.135, RSMo, which set forth the
mandatory forensic exams and evidence collection for sexual assaults and being part of the
Sexual Assault Network tele-reporting. Specialty hospitals would be exempt only if they have a
policy to transfer those patients to an acute care hospital with an Emergency Department. The
Division of Regulation and Licensure’s (DRL) Section for Health Standards and Licensure
(HSL) is responsible for conducting inspections of hospitals. Should the proposed legislation
become law, HSL would make review of this policy part of the inspection protocol. Adding this
component to inspection protocol would be within the normal ebb and flow of work scope.
It is assumed that the Department can absorb the costs of this bill with current resources.
However, if the workload significantly increased or other legislation was enacted, additional
resources would be requested through the appropriation process.
Oversight does not have any information to the contrary. Therefore, Oversight assumes DHSS
will be able to perform any additional duties required by this proposal with current staff and
resources and will reflect no fiscal impact to DHSS for fiscal note purposes.
§ 537.038 - Modifies the immunity from liability for care or assistance rendered in emergency
In response to similar legislation from the current session (SB 521), officials from the Attorney
General’s Office and the Office of the State Courts Administrator each assumed the proposal
would have no fiscal impact on their respective organizations. Oversight does not have any L.R. No. 0908S.05P
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information to the contrary. Therefore, Oversight will reflect a zero impact in the fiscal note for
these agencies for this section.
SA 2 - §§87.140, 87.145, 87.155, 87.260 & 87.350 – The Firefighters' Retirement System of St.
Louis City
In response to a similar legislation from this year, Perfected HB 147, officials from the City of
St. Louis stated the proposed legislation would allow the trustees of the Firemen's Retirement
System (FRS, a plan that was frozen in 2013) to act as trustees of the newer Firefighters'
Retirement Plan (FRP) which originated in 2013 as part of a pension plan reform effort to
address rising costs partly due to failures under the old FRS board. The reform was successful
and has reduced pension costs which had been rising to an increasingly greater proportion of
operating costs of the Fire Department. The proposed legislation jeopardizes the progress made
through this reform effort.
Oversight notes this proposal allows the Board of the Firemen’s Retirement Plan of St. Louis to
act on behalf of all other city firefighter retirement plans in St. Louis City including the
Firefighter’s Retirement Plan of St. Louis.
Oversight assumes any decision by the Board to alter retirement benefits for the Firefighter’s
Retirement Plan of St. Louis would be an indirect impact. Therefore, Oversight will reflect a zero
impact in the fiscal note.
Oversight did not receive a response from the Firemen’s Retirement Plan of St. Louis or the
Firefighter’s Retirement Plan of St. Louis related to the fiscal impact of this proposal. Oversight
has presented this fiscal note on the best current information available. Upon the receipt of
additional responses, Oversight will review to determine if an updated fiscal note should be
prepared and seek the necessary approval to publish a new fiscal note.
SA 3 - §190.800 - Ground ambulance service reimbursement allowance tax
In response to similar legislation from the current session (HB 1133), officials from the
University of Missouri Health Care (UMHC) provided an updated response stating they have
reviewed the proposed legislation and have determined that, as written, using the State MMIS
(Medicaid Management Information System) data for CY2023 the positive benefit would be
$35,000 and using the State MMIS data for CY2024 the positive benefit would be $60,000.
Oversight notes the UMHC would have a positive benefit of up to $60,000 annually from the
enhanced fee reimbursement.
In response to similar legislation from this year, Perfected HCS for HB 943, officials from the
Department of Social Services stated the passage of the proposed legislation would allow a new
ground ambulance provider to pay an ambulance service reimbursement allowance tax. By
adding this provider, the MO HealthNet Division (MHD) estimates that there would be a net L.R. No. 0908S.05P
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increase in revenue in the Ambulance Federal Reimbursement Allowance (AFRA) fund.
However, this would be offset by a decrease in the GR amount by that same amount annually.
FY26 Total: $0 (GR: ($35,000) – ($60,000); AFRA: $35,000 - $60,000).
Upon further inquiry, Oversight notes this would be an unknown savings to GR.
In response to similar legislation from the current session (HB 1133), officials from the
Department of Health and Senior Services assume the proposal will have no fiscal impact on
their organization. Oversight does not have any information to the contrary. Therefore,
Oversight will reflect a zero impact in the fiscal note.
Responses regarding the proposed legislation as a whole, as amended
In response to the pervious version, officials from the Missouri Department of Agriculture
Phelps County Sheriff’s Office and State Tax Commission each assumed the proposal would
have no fiscal impact on their respective organizations. Oversight does not have any information
to the contrary. Therefore, Oversight will reflect a zero impact in the fiscal note for these
agencies.
Officials from the Department of Social Services, the Phelps County Sheriff’s Office and the
Public Schools and Education Employee Retirement Systems each assume the proposal will
have no fiscal impact on their respective organizations. Oversight does not have any information
to the contrary. Therefore, Oversight will reflect a zero impact in the fiscal note for these
agencies.
Oversight has requested additional information from the Department of Social Services
regarding their no impact response. Upon the receipt of this information, Oversight will review
to determine if an updated fiscal note should be prepared and seek the necessary approval to
publish a new fiscal note if needed.
Oversight only reflects the responses received from state agencies and political subdivisions;
however, other cities, local election authorities, counties, county assessors, local law
enforcement agencies, fire protection districts, ambulance districts, retirement agencies and
hospitals were requested to respond to this proposed legislation but did not. A listing of political
subdivisions included in the Missouri Legislative Information System (MOLIS) database is
available upon request.
Rule Promulgation
In response to similar proposals, officials from the Joint Committee on Administrative Rules
assume this proposal is not anticipated to cause a fiscal impact beyond its current appropriation.
In response to similar proposals, officials from the Office of the Secretary of State (SOS) note
many bills considered by the General Assembly include provisions allowing or requiring L.R. No. 0908S.05P
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agencies to submit rules and regulations to implement the act. The SOS is provided with core
funding to handle a certain amount of normal activity resulting from each year's legislative
session. The fiscal impact for this fiscal note to the SOS for Administrative Rules is less than
$5,000. The SOS recognizes that this is a small amount and does not expect that additional
funding would be required to meet these costs. However, the SOS also recognizes that many
such bills may be passed by the General Assembly in a given year and that collectively the costs
may be in excess of what the office can sustain with its core budget. Therefore, the SOS reserves
the right to request funding for the cost of supporting administrative rules requirements should
the need arise based on a review of the finally approved bills signed by the governor.
FISCAL IMPACT – State GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028GENERAL REVENUEPotential Revenue Gain - §144.757 -
DOR 1% Collection Fee p. 4$0
$0 or
Unknown
$0 or
Unknown
Revenue – DOR – potential collection
of 1% administration fee on the
adoption of a sales tax for emergency
services §§321.552, 321.554, 321.556
p. 5 $0$0 or Unknown $0 or Unknown
Cost – DOR – updates to computer
system per local political subdivision’s
rate change §144.757 and §§321.552,
321.554, 321.556 p. 4-5$0
$0 or
(Unknown)
$0 or
(Unknown)
Savings - DSS (§190.800) Offset –
provider tax being paid by UMHC,
rather than GR p. 9UnknownUnknownUnknown
ESTIMATED NET EFFECT ON
GENERAL REVENUEUnknown
Unknown or
(Unknown)
Unknown or
(Unknown)
UNIVERSITY OF MISSOURI
HEALTHCARE
Cost - UMHC (§190.800) Payment of
ambulance provider tax p. 9(Unknown)(Unknown)(Unknown) L.R. No. 0908S.05P
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FISCAL IMPACT – State GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028Income – UMHC (§190.800) enhanced
fee drawdown p. 9UnknownUnknownUnknown
ESTIMATED NET EFFECT ON
THE UNIVERSITY OF MISSOURI
HEALTHCAREUp to $60,000Up to $60,000Up to $60,000
FISCAL IMPACT – Local GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028LOCAL POLITCAL
SUBDIVISIONS
Potential Revenue Gain - §144.757 -
Local Use Tax p. 4$0$0 or Unknown $0 or Unknown
Revenue – potential revenue on new
sales taxes adopted for emergency
services §§321.552, 321.554, 321.556
p. 5 $0$0 or Unknown$0 or Unknown
ESTIMATED NET EFFECT ON
LOCAL POLITICAL
SUBDIVISIONS$0
$0 or
Unknown
$0 or
Unknown
FISCAL IMPACT – Small Business
Small businesses within a taxing district for emergency services could be impacted by this
proposal. (§§321.552, 321.554, 321.556)
FISCAL DESCRIPTION
This act modifies provisions relating to emergency services.
FIRE PROTECTION ORDINANCES
This act provides that any fire protection or fire prevention ordinance adopted by any county in
this state shall not be exercised so as to impose regulations or to require permits with respect to
the erection, maintenance, repair, alteration, or extension of farm buildings or farm structures.
(Section 64.003) L.R. No. 0908S.05P
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Additionally, current law authorizes fire protection district boards to adopt and amend fire
protection and fire prevention ordinances. This act provides that any fire protection and fire
prevention ordinances adopted shall not be exercised so as to impose regulations or to require
permits with respect to the erection, maintenance, repair, alteration, or extension of farm
buildings or farm structures. (Section 321.220)
FIREMEN'S RETIREMENT SYSTEM OF ST. LOUIS
This act provides that the Board of Trustees of the Firemen's Retirement System of St. Louis
("Board") shall not be prevented from simultaneously acting as the trustees of any other pension
plan that provides retirement, disability, and death benefits for firefighters employed by St. Louis
City. The administration of the other plan shall be in accordance with the terms of such plan.
Additionally, the administration of the other plan includes the ability of the Board to establish
rules and regulations for the administration of the plan's funds and for the transaction of the
plan's business. The Board shall maintain separate records of all proceedings of the pension plan.
Furthermore, this act provides that the Board of Trustees shall have the authority and discretion
to invest funds of the other pension plan in property of any kind. The Board may choose to invest
the funds of the Firemen's Retirement System of St. Louis and the funds of the plan in the same
investments if the amounts invested and the gains, profits, or losses are accounted for separately.
No benefits due from the pension plan shall be paid from the funds of the System. Additionally,
no expenses incurred by the Board in the administration of the other pension plan or in the
investment of the other pension plan's funds shall be paid by the funds of the System. Finally,
nothing in this act shall prevent the Board of Aldermen of St. Louis City from adopting
ordinances relating to the pensioning of firefighters and their dependents in regards to other
pension plans administered by the Board.
LOCAL USE TAXES
Current law authorizes counties and municipalities to impose a local use tax if a local sales tax is
imposed. This act extends such authority to any political subdivision with the ability to impose a
sales tax for emergency services. (Section 144.757)
AMBULANCE DISTRICT TRAINING
This act modifies training requirements for members of an ambulance district board of directors.
Under this act, board members shall complete three hours of continuing education for each term
of office. Failure to do so shall result in immediate disqualification and the office shall be vacant
until filled.
Under this act, each ambulance district shall arrange for an audit of the district's records and
accounts every three years by a certified public accountant. The audit shall be made available to
the public on the district's website or otherwise freely available by other electronic means.
The Department of Health and Senior Services, as a part of regulating ground ambulance service
licenses, shall promulgate rules regarding participation with regional emergency medical
services advisory committees and ambulance service administrator qualifications. L.R. No. 0908S.05P
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This act requires ambulance services to report to the Department individuals serving as
ambulance service administrators. These administrators shall be required to complete training as
described in the act.
Finally, the Department may refuse to issue, deny renewal of, or suspend a license required for
ground ambulance services or take other corrective actions for reasons specified in the act. If the
Department makes a determination of insolvency or insufficiency of services, then the
Department may require the license holder to submit and complete a corrective plan, as
described in the act.
The Department shall be required to provide notice of any determination of insolvency or
insufficiency of services to persons and entities specified in the act. The Department shall
immediately engage with other license holders in the area to determine how ground ambulance
services may be provided to the affected area during the service disruption. Assisting license
holders may be compensated for such assistance as described in the act.
Under this act, a specialty hospital, meaning a hospital other than a general acute care hospital,
shall not be required to comply with certain statutory provisions relating to forensic
examinations of victims of sexual assault if such hospital has in place a policy for the transfer of
such victims to an appropriate hospital with an emergency department.
Under current law certain medical professionals, individuals with first aid training, or in cases of
suicide attempts, any other individual renders emergency care or assistance at a scene of an
emergency or accident, then such individual shall not liable for any civil damages except if
damages are caused by gross negligence or willful or wanton acts. This act expands such liability
protections to any person rendering emergency care or assistance. (Sections 190.053, 190.076,
190.109, 190.112, 190.166, 197.135, and 537.038)
STATE ADVISORY COUNCIL ON EMERGENCY MEDICAL SERVICES
This act modifies the State Advisory Council on Emergency Medical Services by changing the
number of council members from 16 to no more than 23 and specifying the members who shall
serve on the Council. Currently, members are appointed by the Governor with the advice and
consent of the Senate. Under this act, the Director of the Department of Health and Senior
Services, the regional EMS advisory committees, and the Time-Critical Diagnosis Advisory
Committee shall appoint members. (Section 190.101)
GROUND AMBULANCE SERVICE REIMBURSEMENT ALLOWANCE
Current law establishing the Ground Ambulance Service Reimbursement Allowance excludes
any ambulance service owned or operated by an entity owned and operated by Missouri,
including any hospital owned or operated by the University of Missouri Board of Curators. This
act removes this exception. (Section 190.800)
FIRE PROTECTION AND AMBULANCE DISTRICTS SALES TAX L.R. No. 0908S.05P
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Current law authorizes ambulance and fire protection districts in certain counties to propose a
sales tax at a rate of up to 0.5%. This act allows such districts to propose a sales tax of up to
1.0%, and repeals a prohibition on certain counties imposing such tax. (Sections 321.552 to
321.556)
This legislation is not federally mandated, would not duplicate any other program and would not
require additional capital improvements or rental space.
SOURCES OF INFORMATION
Missouri Department of Agriculture
Kansas City
O’Fallon
Florissant Valley Fire Protection District
Office of Administration
Budget and Planning
Department of Revenue
Kansas City Election Board
Office of the Secretary of State
State Tax Commission
Attorney General’s Office
Department of Health and Senior Services
Department of Public Safety – Division of Fire Safety
Department of Social Services
Joint Committee on Administrative Rules
Office of the State Courts Administrator
O’Fallon
St. Louis City
University of Missouri Healthcare
Phelps County Sheriff’s Office
Public Schools and Education Employee Retirement Systems
Julie MorffJessica HarrisDirectorAssistant DirectorApril 15, 2025April 15, 2025