MissouriHB20142026 Regular SessionHouseWALLET

Appropriates money for supplemental purposes

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Bill Overview

Analyzed Economic Effects

40 provisions identified: 35 benefits, 2 costs, 3 mixed.

More Medicaid help for drugs and mental health

The law puts more money into MO HealthNet for medicines, doctors, and mental health care. It adds $101.9 million for drug payments and pharmacist fees, and $95.9 million for physician and community behavioral health payments. Certified Community Behavioral Health care now includes Applied Behavioral Analysis (ABA). It also funds about $485.6 million for behavioral health services and $47.7 million more in federal support, plus $113,011 for the Missouri Rx Plan. This means better‑funded care for Medicaid patients and some uninsured people.

More Medicaid help for home and nursing care

The law funds $75.9 million for nursing home care and $90.7 million for home and community services like personal care, meals, adult day care, and waivers. It also adds $28.1 million for consumer‑directed personal care and value‑based payments. People who qualify for nursing home care can choose to receive services in the community and pick the personal care option that meets their needs. The state also funds a $2.65 million campaign to recruit more nurses for nursing homes. This language does not create a new legal entitlement.

More support for people with developmental disabilities

The law provides $23.8 million for community programs and long‑term care transformation for people with developmental disabilities. It adds $12.3 million for health home care coordination for eligible DD waiver participants. The state pays $135,897 in provider tax for state‑run ICF/ID facilities and moves $30,208 to federal accounts to support reimbursement. These steps aim to improve quality, coordination, and access to DD services.

New $100 million for rural health

The law invests $100 million in the Rural Health Transformation Program. It strengthens rural health services and systems under MO HealthNet. Rural residents should see better access to care.

Bigger support for special education

The state adds $35.1 million for early childhood special education. It provides $14.7 million in general revenue for special education excess costs. It also adds $20 million in federal funds for special education services statewide.

More funds to pay tax refunds

The state provides $225.6 million so the Department of Revenue can pay refunds for tax overpayments or erroneous payments. If you paid too much state tax, this money funds your refund.

Big funding for roads and bridges

Transportation receives $518.1 million for construction and local reimbursements. It also gets $117.5 million for road and bridge maintenance. These funds support statewide travel and freight movement.

Major disaster relief and medical response

The state provides $800 million for disaster relief through the Missouri Disaster Fund. It also funds the Missouri Disaster Medical Assistance Team with $390,000 for staff and equipment. This strengthens help for communities after disasters.

Changes to Medicaid managed care and plan payments

The law provides $123.0 million to pay Medicaid managed care plans. The Department must work on emergency room reforms to reduce costs. Some people can choose to enroll in managed care, and a new rate group for aged, blind, and disabled enrollees will be developed. The state also funds $9.0 million for third‑party collections to protect program dollars.

Better staffing and systems for SNAP

The law funds $12.12 million for staff and operations that run income‑maintenance programs like SNAP and TANF. It also adds $32.02 million to upgrade eligibility systems to follow new federal law. This should speed up service, reduce errors, and make enrollment smoother for low‑income households.

Medicaid support for hospitals and inpatient treatment

The law provides $40.1 million for hospital care, graduate medical education, and safety‑net payments. It requires the state to track payments to out‑of‑state hospitals. The state also seeks a federal waiver to expand inpatient mental health treatment in larger facilities. This can improve hospital and psychiatric care access for Medicaid patients.

More community mental health and recovery funding

The law funds payments to community behavioral health providers and psychiatric services. It supports substance use treatment, crisis counseling after disasters, and outpatient competency restoration. It also adds small funds for state mental health centers and a psychology internship program, and transfers $6.6 million into the Mental Health Reinvestment Fund. These dollars expand local treatment capacity and workforce.

More funding for Missouri Veterans’ Homes

The state transfers $2,743,076 into the Missouri Veterans’ Homes Fund. This supports operations and care for veterans served by state veterans’ homes.

More Medicaid coverage for non-hospital services

The law provides $34.0 million for non‑hospital services like rehab, eyeglasses, hearing, ambulance and non‑emergency transport, durable medical equipment, and treatment for children in state custody. This funding helps Medicaid patients get needed care outside the hospital.

More job training and rehab services

The state provides $3.6 million for career and technical education providers. It adds $4.3 million for job training and related activities. It also funds $10.4 million for vocational rehabilitation services to help people with disabilities prepare for work.

Overtime pay for mental health staff

The Department of Mental Health receives $27,864,720 to pay overtime. Nonexempt state employees named in Section 105.935 are paid first. Any remaining funds pay overtime for other state employees.

School safety and student support programs

DESE receives funds for State Board‑run school programs and equipment. It supports safe schools activities under state law. It adds money for literacy programs, services for homeless students, and a program to find students who lack key resources. It also moves and distributes funds for the School Turnaround Program.

Workers’ comp funding for state employees

The state provides $3,400,000 to pay workers’ compensation benefits and related admin and legal costs for state employees. It also moves $400,000 from other funds back to general revenue to repay workers’ comp costs for employees paid from those funds.

More support for blind entrepreneurs

The state provides $4 million in federal funds to the Family Support Division’s business enterprise program for the blind. These funds help blind Missourians start or run small businesses.

More disaster aid for Missouri communities

The law sets aside $30 million for state matches to federal disaster grants and emergency aid. It moves $86 million into the Disaster Relief Fund. It also makes $86 million available to cities not in a county when a presidential disaster is requested. This speeds help to communities hit by disasters.

Prison operations, food, and health care

Corrections receives $679,026 for facility operations and modifications. It gets $5,821,350 for buying, storing, and preparing food. It also gets $7,157,630 for contracts that provide offender physical and mental health care.

World Cup and counter‑drone safety grants

Public Safety receives $59.5 million for a World Cup grant program. It also gets $14.24 million to build counter‑drone capacity, including $50,000 for staff and $14.19 million for equipment. These funds support event safety and law enforcement.

State IT rules and federal funds shift

Agencies must check and prefer existing enterprise IT agreements before buying new IT services. The state also transfers $5,468,361 in federal funds to the Office of Administration’s IT fund to support projects.

Medicaid rates frozen and capped

The law freezes most Medicaid provider rates at January 1, 2025 levels and sets hard caps. For behavioral health, only narrow exceptions apply; children’s residential care is capped at $194.47, $239.16, and $253.80 per day (Levels II–IV), and the $105.90 per‑member‑per‑month DD Health Home rate is barred. For seniors and home care, Private Duty Nursing is capped at $15.20 per 15‑minute unit, reassessments at $100 unless in the Value‑Based Purchasing program, and home‑delivered meals at $7.14 per meal. Nursing facility rates stay at rebased FY2022 levels in aggregate; home health increases are limited to $12.42 per visit above the January 1, 2024 rate; some services are capped at $17 per day; CNA training reimbursement is capped at $1,500 per enrollee. Managed care plan rates cannot exceed the actuarial lower bound, and consumer‑directed personal care pay cannot be more than 60% of the average monthly Medicaid nursing facility cost.

Limited new Medicaid waiver slots

The law blocks state spending tied to waiver slots assigned on July 1, 2025, but adds targeted openings. It adds 400 Crisis Residential slots; 54 slots for people leaving nursing homes; 48 slots for children leaving DSS‑funded waivers; 500 Community Support Waiver slots to prevent an in‑home wait list; 200 Partnership for Hope slots; and 83 slots for children leaving the MoCDD Waiver.

State funds employee Social Security and pensions

The state transfers $1,147,204 to cover Social Security (OASDHI) contributions for eligible employees. It also transfers $2,851,170 to the State Retirement Contributions Fund for pension contributions. This keeps required state shares paid for covered public workers.

More help for kids in state care

The law funds $3.71 million for room and board in Qualified Residential Treatment Programs (QRTP). It also provides $116,923 to help counties and St. Louis pay for care of delinquent or dependent children. These funds support safe housing and care for children in custody.

More money for state employee health plan

The law adds $11.83 million to the Missouri Consolidated Health Care Plan Benefit Fund. This pays part of the state’s share for covered employee health costs. It helps keep the employee health plan funded.

Highway Patrol operations and employee benefits

The Highway Patrol receives $200,000 for administration expenses and equipment. It also gets $290,361 for employee fringe benefits and insurance premiums.

Drug testing and child exam support

Public Safety receives $250,000 to expand wastewater testing for fentanyl and other dangerous drugs. It also provides $180,000 to reimburse SAFE‑Care providers for pediatric forensic exams in suspected child abuse cases.

Funds lottery vendors and shifts cash

The law provides $1,085,495 from the Lottery Enterprise Fund to pay lottery game vendors. It also moves $1,085,495 from the State Lottery Fund into the Lottery Enterprise Fund. This keeps lottery operations and contracts funded.

Funds state animal health lab work

The Department of Agriculture receives $400,000 for lab expenses and equipment. This supports animal health testing and operations.

More funding for state buildings upkeep

The state provides $4,766,274 for asset management of state‑owned and leased buildings and to run the Board of Public Buildings. It also provides $36,000 for leased parking at the Fletcher Daniel building.

Public flight plans for official trips

State money cannot pay for flights with elected officials on state aircraft unless the flight plan is posted publicly. The plan must be on a global aviation data service with a free website and mobile app for flight tracking.

Funding for roads and public safety IT

The law pays $5.06 million from General Revenue to reimburse highway tax collection costs above the 3% limit. It provides $7.07 million from the State Road Fund for DOT administration (up to 79.23 FTE, with 20% flexibility between listed sections). It also gives $2.03 million from the Missouri Veterans’ Homes Fund for IT services and equipment supporting the Department of Public Safety.

Keep state buildings and utilities running

The law provides $3,026,217 for leases, utilities, furniture, and structural work for state facilities and departmental space. It also provides $1,345,740 for operating institutional facilities, including utilities and building needs for agencies like DESE, DMH, and DSS.

State refunds and small fund transfers

The law sets aside $1.15 million so the state can return over‑collected payments and fix wrong deposits. It moves $9,076 from the Parks Sales Tax Fund and $9,076 from the Soil and Water Sales Tax Fund into General Revenue. It also funds $943,500 for revenue staff and tools to collect highway fees and taxes. These are small budget moves that keep refunds and collections working.

Grant to build drug ingredient capacity

A public university with a qualifying nonprofit partner receives $1,927,554 to help start in‑state manufacturing of active pharmaceutical ingredients. This supports reshoring critical drug supplies.

State Fair bond payments capped at $4.2M

The law allows up to $4.2 million per year from general revenue for Missouri State Fair project bond payments. The bonds can finance up to $55 million in projects.

Moves $60K from Economic Distress Fund

The state transfers $60,000 from the Economic Distress Zone Fund into the General Revenue Fund. This reduces dollars in the distress fund but increases general revenue for other state uses.

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Sponsors & Cosponsors

Sponsor

Dirk Deaton
Republican • House

Cosponsors

This bill has no Co-Sponsors.
Affiliation unavailable

Roll Call Votes

All Roll Calls

Yes: 450 • No: 44

House vote • 3/5/2026

House Adopts - SS SCS

Yes: 135 • No: 14 • Other: 1