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MissouriHB20112026 Regular SessionHouseWALLET

Appropriates money for the expenses, grants, refunds, and distributions of the Department of Social Services

Sponsored By: Deaton, Dirk (159)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

111 provisions identified: 95 benefits, 11 costs, 5 mixed.

Hospital funding includes psychiatric coverage request

For fiscal year 2027, Missouri provides $555.31 million for Medicaid hospital care, medical training, chronic-care management, psychiatric rate increases, and safety-net payments. Another $1.03 billion funds hospital payments, a required independent disproportionate-share payment audit, statewide hospital poison-control services, and continued emergency psychiatric demonstration services. Missouri must seek a federal waiver allowing Medicaid payment for inpatient treatment in psychiatric hospitals otherwise excluded from coverage. The state share of waiver-covered treatment comes through the Federal Reimbursement Allowance program. The Medicaid agency must also track out-of-state hospital payments by location.

Long-term care funded for Medicaid residents

For fiscal year 2027, Missouri provides $1.21 billion for Medicaid nursing-facility care, quality-of-life work, provider incentives, and elderly home health. A separate $372.98 million funds Nursing Facility Reimbursement Allowance payments. The Money Follows the Person program receives $1.53 million in federal funding. The long-term care budget permits 10% shifts among specified Medicaid accounts and 5% shifts from nursing-facility care to provider incentives. These appropriations do not set payments for individual residents or change stated eligibility rules.

Medicaid health plans and insurance funded

For fiscal year 2027, Missouri provides $2.93 billion for prepaid health plans and authorized frail-elderly waiver programs. Specialty plans and authorized frail-elderly waiver programs receive a separate $472.35 million. These budgets also fund public ground ambulance services for covered people under Missouri’s payment laws. The larger budget includes Tier 1 Safety Net Hospital and affiliated physician-group supplemental payments for federally approved professional services. Another $407.39 million funds insurance payments to insurers, employers, or policyholders, with 10% shifts among specified Medicaid accounts and 3% transfers to another account allowed.

Medicaid medicines and routine care funded

For fiscal year 2027, Missouri provides $1.32 billion for fee-for-service Medicaid medicines, pharmacist fees, and chronic-care management. Another $622.99 million funds doctors, clinics, telemedicine, lab tests, x-rays, family planning, and related care. That funding also covers asthma care, diabetes prevention, obesity-related care, chiropractic services, and major medical prior authorization. Dental care receives $15.56 million, including adult dental procedure codes in Tiers 1–6. The law permits 10% funding shifts among specified Medicaid accounts but sets no individual payment amount.

Children's coverage premiums and eligibility limits

For funded uninsured children's coverage, the law sets a 0% premium rate through 150% of the federal poverty level. The rate is 4% above 150% through 185%, and 8% above 185% through 225%. Above 225% through 300%, the rate is 14%. Premiums cannot exceed 5% of total family income. Families above 300% of the federal poverty level are ineligible.

Children’s health coverage includes income limits

For fiscal year 2027, Missouri provides $580.91 million for programs helping uninsured children get care. The Social Services director must approve service delivery and payment methods. Premium rates are 0% through 150% of the federal poverty level, 4% above 150%–185%, and 8% above 185%–225%. Above 225%–300%, the rate is 14%, but premiums cannot exceed 5% of total income. Families above 300% of the federal poverty level are ineligible.

Medical benefits and premiums for blind recipients

The law provides about $24.44 million for medical benefits for Blind Pension recipients who cannot get MO HealthNet. Premium tiers depend on family income compared with the federal poverty level. They are 0% below 150%, 4% from 150% to below 185%, and 8% from 185% to below 225%. From 225% to below 300%, the premium tier is 14%, capped at 5% of total income. Families at or above 300% do not qualify.

Funding for crime victims and shelters

The law provides about $42.86 million in nonprofit grants for crime victim services. This includes a one-time $9 million from the Missouri State Capitol Commission Capitol Preservation Fund. It also provides about $10.16 million for domestic violence services, including emergency shelters, and $1.75 million for sexual assault services. Up to 3% of the domestic violence funding can move to Section 11.910. The grants fund service providers, not set cash payments to victims.

Legal services for children and parents

The law provides $9.04 million for lawyers handling reunification, guardianship, adoption, and termination of parental rights. These services concern children involved with the Children’s Division and their families. Another $600,000 in federal funds reimburses counties, St. Louis, and qualifying publicly funded organizations for parent and child representation in juvenile or family court. Another $150,000 funds parent representation during Chapter 210 abuse or neglect investigations or potential Chapter 211 court cases. These appropriations do not set payments for individual households.

Money to repay Social Services overcollections

The law provides about $26.55 million for Social Services refunds and incorrectly deposited receipts. The money is available from July 1, 2026, through June 30, 2027. Repayments cover over-collected accounts receivable and incorrectly deposited receipts. A household receives money only when owed a qualifying refund; the amount depends on what is owed.

Alternatives-to-abortion services receive funding and flexibility

The law provides about $12.38 million for alternatives-to-abortion services for women who qualify, including diapers and infant hygiene products. The department must move unused or expected-unused money to other nonprofit organizations or regions. This keeps the money available for qualifying women. The department cannot set a per-client spending limit, but the law does not guarantee an individual award amount.

Court-ordered residential treatment expenses are covered

The law covers expenses for a child's court-ordered placement in a residential treatment facility under the referenced social services programs. Coverage applies even when an independent assessor did not recommend the placement. The provision does not state a dollar limit or individual payment amount.

Funding for foster families and services

For July 1, 2026–June 30, 2027, Missouri provides $95.89 million for foster care maintenance payments. It provides $5.56 million for placement expenses, respite care, transportation, and training, including $15,000 for licensed community recruitment programs. Another $3.45 million supports foster parent expenses and equipment. Community groups receive $62.94 million for case management, in-home help, family reunification, and related foster care services. The law allows 3% of the case-management funding to move to another specified budget account; it sets no household payment amount.

Funding for refugee benefits and resettlement

The law provides about $37.9 million in federal funds for refugee benefits, services, and statewide resettlement coordination. The recipient must be a nonprofit established in 2018 that partners or subcontracts with local resettlement programs across Missouri. The funding supports services under the Refugee Act, not a set payment for each household.

Help with adoption and guardianship costs

The law provides $3.05 million for one-time costs directly tied to a child’s legal adoption or guardianship. Covered costs include reasonable and necessary adoption fees, court costs, attorney fees, and related expenses. Another $200,000 funds nonprofit legal help for uncontested kinship guardianships that help children safely avoid foster care. That legal help is limited to counties meeting the population and county-seat thresholds in Section 11.095. The law sets no individual household payment amount.

Payments funded for seniors and disabled residents

For fiscal year 2027, Missouri provides $38.84 million for Blind Pension and supplemental payments to eligible blind residents. Another $22.34 million funds nursing care payments for eligible aged, blind, or disabled residents. That money also covers legally required personal funds for Supplemental Nursing Care recipients. A separate $6,120 funds supplemental payments to aged or disabled people. These appropriations do not set individual payment amounts or create a new eligibility formula.

Subsidies for adoptive families and guardians

For fiscal year 2027, Missouri provides $121.65 million for adoption subsidies and $47.61 million for guardianship subsidies. Payments support families and guardians eligible for these Children’s Division programs. The law allows 10% funding shifts within the subsidy section and 5% shifts among specified child-service accounts. It does not set a payment amount for each family.

Summer grocery benefits funded for families

For fiscal year 2027, Missouri provides $51.5 million in federal money for SuN Bucks summer food benefits. The money funds benefit payments through the Summer Electronic Benefit Transfer program. This appropriation does not set each household’s benefit amount or a new eligibility formula.

Treatment and housing for foster children

For fiscal year 2027, Missouri provides $5.47 million for room and board in therapeutic foster homes. Another $28.14 million covers room and board in designated Qualified Residential Treatment Programs, including facilities classified as mental-disease institutions. The law provides $43.26 million for residential treatment, therapeutic services, alternatives to inpatient psychiatric care, and help reaching permanent family placements. An additional $900,000 funds behavioral intervention services in areas of need. The law permits 5% shifts among specified child-service accounts and 10% shifts among specified treatment accounts.

Home energy help for low-income households

The law provides about $93.62 million in federal funds for low-income home energy assistance. The stated household income limit is 150% of the federal poverty level or 60% of state median income. The law does not set a payment amount for each household.

Funding for child welfare caseworkers

The law provides about $110.18 million for Children’s Division field staff and operations. That funding supports up to 1,781.86 full-time-equivalent staff positions. Another $1.83 million funds staff training, including contracted training, with up to two full-time-equivalent positions. These funds support child welfare work rather than direct household payments.

Funding for mental health and recovery

The law includes behavioral-health payment blocks of $402.27 million and $933.67 million for the Department of Mental Health. They support psychiatric rehabilitation, substance-use treatment, case management, and certified community behavioral-health services for MO HealthNet participants or uninsured people. A separate $500,000 grant from the Opioid Addiction Treatment and Recovery Fund supports treatment, family services, healthy food, and shelter. That nonprofit recipient must have been founded in 1981 and be located in a city outside any county. These funds do not set individual household payments.

Funding supports rural hospitals and care

For July 1, 2026–June 30, 2027, the law provides $216.276818 million for rural health networks, staff, data sharing, and provider improvements. Up to 25% can move between program subsections; physician education funds cover required one-hour nutrition training. It also provides $15 million for the Transformation of Rural Community Health hospital hub. A separate, one-time $1.5 million buys a mobile MRI and trailer for a qualifying hospital. That hospital must be in a city spanning multiple counties with more than 16,000 but fewer than 18,000 residents.

Health program funding for Missouri families

The law provides $148.22 million for the Show-Me Healthy Babies Program. It allows 10% funding flexibility among listed MO HealthNet appropriations and 3% flexibility from this section to Section 11.910. Another $120.33 million funds MO HealthNet fee-for-service care through the Department of Elementary and Secondary Education. These appropriations do not set individual household payment amounts.

Medicaid community care and transportation funded

For fiscal year 2027, Missouri provides $484.7 million for rehabilitation, eye and hearing care, medical equipment, eyeglasses, and medical transportation. Residential rehabilitation for children in Children’s Division custody requires authorization. Community behavioral health organizations receive $107.05 million, with Applied Behavioral Analysis included in their payment system. Health homes receive $34.14 million, and another $3.84 million supports health-center outreach, preventive care, chronic-condition management, and incentives. Outreach contractors must qualify under Section 330(l) or 330(m) of the federal Public Health Service Act.

Medicaid systems and payment administration funded

For fiscal year 2027, Missouri provides $228.12 million to operate and update Medicaid information systems. These include enrollment, data storage, pharmacy and medical claims, clinical management, managed-care tools, and electronic visit verification. Another $8.42 million funds program transformation, including $1.91 million in state money and $6.51 million in federal money. The law provides $24.4 million for third-party collection fees and services that recover money or avoid program costs. Systems funding permits 10% shifts within the section and 3% transfers to another specified account; these provisions establish no household payment or eligibility change.

State funds Medicare drug payment obligations

For fiscal year 2027, Missouri provides $393.56 million in state money for its Medicare Part D drug-program payment obligation. These payments are often called clawback payments. The law permits 10% funding shifts between this appropriation and specified Medicaid accounts. It does not provide checks to Medicare enrollees or change their stated coverage or costs.

Limits on out-of-state Medicaid payments

The department cannot use money under Sections 11.780 and 11.820 for out-of-state payments. This limits public funding for out-of-state care paid through those appropriations, not all Medicaid services. The restriction does not itself require patients to pay for care.

Monthly cash benefits for blind recipients capped

The state cannot fund Blind Pension rates above $949 per month. Supplemental Aid to the Blind rates cannot exceed $794 per month. These are payment ceilings, not guaranteed payment amounts or stated cuts from prior rates.

Family planning help with spending restrictions

The law provides about $3.08 million for family planning and related services for uninsured women ages 18 through 55. They must be legal Missouri residents with household modified adjusted gross income no higher than 201% of the federal poverty level. These funds cannot directly or indirectly support abortion procedures or administrative functions of nonhospital abortion providers or their affiliates. The law also bars specified abortion-related services, with an exception for abortions needed to save the mother's life.

Real-time income checks for benefit programs

The law provides about $15.02 million for real-time employment and income data used in benefit eligibility decisions and renewals. Social Services must obtain current, non-modeled data supplied by employers or payroll providers. Contractors must also check monthly for covered participants who died, moved out of state, or were incarcerated over 90 days. These checks support current eligibility decisions while adding recurring reviews of participant status. The provision does not itself set benefit amounts or require automatic benefit termination.

Funding helps manage children's benefits and money

The law provides $1.864 million for contractors helping children and youth apply for benefits and manage benefits and accounts. Accounts can include special needs trusts and ABLE accounts. It also authorizes $12 million in Alternative Care Trust Fund transactions involving money belonging to children in care. Money can go to a child’s account, directly to the child, back to the funding agency, or as otherwise legally required. It can also cover unmet needs the Division is not legally required to fund; no individual amount is set.

Quarterly reports on children’s trust money

DSS must provide a quarterly accounting of money it receives for a child through the Alternative Care Trust Fund. Reports go to the child’s parents and court-appointed guardian ad litem. Children age 15 or older also receive the reports. This requirement provides information about the money but does not increase it.

Transit help for underserved communities

The law provides a one-time $1 million for on-demand transit, mobility coordination, and workforce training. Services primarily target people in areas underserved by existing public transit routes. The funding aims to improve access to health care and work opportunities. It does not set a fare subsidy or household payment.

Cash assistance funding for low-income families

The law provides $14.66 million for Temporary Assistance for Needy Families and Temporary Assistance Diversion transitional benefits. The money funds cash assistance through those programs. This appropriation does not set a new household payment amount or change eligibility.

Child care funded at adult schools

For fiscal year 2027, Missouri provides $1.51 million in state funding for child care at adult high school locations. The appropriation supports care at those sites but does not state individual eligibility rules or a per-family amount.

Clothing payments and placement help for children

Covered children's clothing allowances must be paid at least once every three months; amounts and eligibility do not change. The Department of Social Services can also use specified funds to help children in Children's Division custody leave certain placements. Funds can help children leave or avoid out-of-state placements, hospital boarding, or hotel boarding. This funding authority does not guarantee a specific service or household payment.

Expanded information portal for foster families

The law provides $750,000 to expand foster-care portal software. The portal supports communication among caseworkers, licensed foster families, foster-license applicants, parents, guardians, and other key parties. This funds information sharing, not cash payments to families.

Food distribution and local purchases funded

The law provides about $6.78 million in federal funds for food distribution, donated food payments, and local food purchases. It funds the Food Distribution Program, Donated Food Program, and Local Food Purchase Assistance Cooperative Program. The appropriation does not set household eligibility rules or a household benefit amount.

Food support funding for struggling households

The law provides $10 million for food banks serving low-income people. Another $250,000 supports fresh, affordable food through a nonprofit founded in 2016. That nonprofit must serve over 250,000 food-insecure residents and be in a multi-county city with more than 400,000 people. A one-time $750,000 grant supports children’s feeding, outreach, disaster response, and program partnerships. Its recipient must be headquartered in a Missouri city with more than 160,000 but fewer than 200,000 people.

Funding for blind and low-vision services

The law provides about $7.41 million for services for people with visual impairments. Another $6.08 million funds blind-services administration, including staff, expenses, and equipment. These appropriations support service delivery but do not specify new eligibility rules, service amounts, or household payments.

Funding for family refunds and distributions

For fiscal year 2027, Missouri sets aside $35 million for Temporary Assistance for Needy Families reimbursements and related payments. The money also covers bond refunds, refunds of support payments or overpayments, and distributions to families. This appropriation does not set individual eligibility rules or payment amounts.

Funding for Medicaid applications and renewals

The law provides $1.25 million for public acute-care hospital partnerships helping determine Medicaid and CHIP eligibility. Another $9.24 million funds Medicaid renewal processing contracts and training materials. For July 1, 2026–June 30, 2027, it provides $4 million for a Medicaid application and communication platform. The platform supports application processing, data collection, transparency, and two-way communication; purchasing must follow Missouri’s Chapter 34 procurement law. These funds do not change eligibility standards or household benefit amounts.

Grants for pregnancy and adoption support

The law provides $1.5 million for adoption organizations, maternity homes, diaper banks, and groups helping people facing unintended pregnancies. Another $625,000 in federal TANF funds supports an organization providing adoption, maternity-home, and material assistance services. That organization must be in a city with more than 36,500 but fewer than 40,000 people. The second grant includes $125,000 in one-time funding. Neither grant sets a benefit amount for each household.

Residential recovery support for adult men

A one-time $500,000 grant supports residential services for men over 21 rebuilding their lives after alcohol or drug use. The provider must be a 501(c)(3) incorporated in 1971. It must be located in a city with over 400,000 residents that spans more than one county. The law does not set an individual payment amount.

Social Security distributions for youth

The law provides $200,000 to distribute Social Security benefits received on behalf of youth in Division of Youth Services care. The money comes from the division's Child Benefits Fund. The law does not set an individual payment amount.

Some Medicaid recipients can choose managed-care

The law lets a specified group of eligible MO HealthNet recipients choose the Managed Care Program. This option applies to those described in Section 501(a)(1)(D) of Title V of the Social Security Act. Enrollment is voluntary.

One-time funding for small transitional housing facility

The law provides a one-time $1 million state appropriation for transitional housing expected to house 15 to 20 people. The facility must be in a county with more than 200,000 but fewer than 230,000 residents. It will provide shared residential amenities; the law does not set an individual rent subsidy.

Adult high school help gets funding

The law provides $8.4 million to help low-income people attend adult high schools. It separately provides $5.1 million in federal funds for SNAP recipients to attend adult high schools. Both appropriations require schools designated by the Missouri Department of Elementary and Secondary Education. Neither sets an individual award, and the low-income appropriation does not state an income cutoff.

Foster youth education costs get funding

The law provides about $1.69 million for current or former foster youth attending education after high school. Covered costs include tuition, books, fees, room, and board. The department can move 3% of this funding to Section 11.910. Separately, Children's Division tuition assistance receives $308,000: $77,000 in state funds and $231,000 in federal funds. That separate appropriation does not identify who qualifies, and neither appropriation sets individual awards.

Job seekers get funded training services

The law provides about $10.14 million for Missouri SkillUp and $13.87 million for Missouri Work Assistance Programs. Pet-grooming training and expansion receive about $1.595 million, including $995,354 in one-time state funds and $600,000 in federal TANF funds. That nonprofit must be in a Missouri city with over 400,000 people spanning more than one county. Another $250,000 in TANF funds supports family and job-seeker services through a partnership in a Missouri city outside any county. That partnership must involve the described family services program and century-old regional employment-assistance nonprofit; no individual award amounts are set.

Student career program gets funding

The law provides $4.5 million in federal Temporary Assistance for Needy Families funds for Jobs for America's Graduates. The money supports students served by the program. This appropriation does not set individual awards or program eligibility rules.

Students get education-to-work support funding

The law provides $3 million for HyperCare, a multi-year counseling and support service for high school students. It connects students with training, college credit, an information technology degree, and full-time work. Course credit must be accredited and come from Missouri higher education institutions. The service must provide multi-year support through full-time employment. Support continues through degree completion when the participant requests it.

Students get tutoring and attendance support

The law provides $1.5 million for an evidence-based school program that identifies problems early and responds with support. It aims to improve attendance, behavior, reading, and math by identifying the causes of student difficulties. A separate one-time $150,000 in TANF funds supports volunteer training and resources for public elementary school tutoring. That recipient must be a 501(c)(3) nonprofit formed in 1969, with over 30 employees. It must be in a city with more than 160,000 but fewer than 200,000 people.

Youth clubs and after-school programs funded

The law provides $1 million for after-school support, $2 million for out-of-school support, and $7 million for out-of-school enrichment. All three appropriations use federal TANF funds. A one-time $3.5 million funds youth clubs, after-school, and summer programs at a nonprofit serving youth for over 20 years. That nonprofit must be in a county-seat city with more than 16,000 but fewer than 18,000 people, in a county with more than 40,000 but fewer than 50,000 people. A separate one-time $20,000 supports youth soccer through a professional women's team in a city with over 400,000 people spanning multiple counties.

Better records for child welfare cases

The law provides about $17.78 million to develop and connect a comprehensive child welfare information system. Another $1.7 million supports child welfare eligibility administration from July 1, 2026, through June 30, 2027. By September 1, 2026, the state courts office and Social Services must sign an agreement giving the department needed court-order access. This access supports timely case information and efforts to maximize federal foster-care funding, including Title IV-E funds. Social Services must specify which staff classifications can access the orders; the funding does not change household eligibility rules.

Community grants and violence prevention services

The law provides about $8.24 million for Community Partnerships, community initiatives, contracts, and related expenses. Up to 3% can move to Section 11.910. A separate one-time $1 million TANF grant supports regional violence de-escalation, conflict mediation, and links to community resources. That recipient must be a century-old nonprofit in a city not within a county, serving over 100,000 regional clients annually.

Counseling and support for family relationships

A one-time $100,000 federal TANF grant funds counseling, education, and family support during and after divorce. The recipient must have been founded in 1977, in a city with over 8,000 but under 9,000 residents. Its county must have over one million residents. Another $500,000 in TANF funds supports a healthy marriage and fatherhood initiative at multiple Missouri locations. Its Missouri nonprofit provider must have its main office in a city with over 160,000 but under 200,000 residents.

Funding for child safety and oversight

The law provides $7.69 million for Children’s Division administration, supporting up to 75.43 full-time-equivalent positions. It provides $2.15 million for residential program operations, supporting up to 33 full-time-equivalent positions. The child abuse and neglect hotline gets $5.63 million, supporting up to 89 full-time-equivalent positions. Another $423,688 supports oversight of psychiatric medicines for children in the division’s custody. That work includes medical records, informed consent, second reviews, and training.

Funding for family case services

The law provides about $3.74 million for Family Centered Services administration and $3.81 million for Team Decision Making administration. Each program supports up to 20 full-time-equivalent staff positions. It also provides $368,820 in federal TANF funds for Birth Match, including program distribution and up to two staff positions. Another $697,687 funds court-ordered drug testing in Children’s Division matters. This funding does not create a general drug-testing requirement or set household payments.

Funding supports child abuse investigations

The law provides about $1.96 million for Missouri's State Technical Assistance Team in fiscal year 2027. The money supports prevention and investigations of child abuse, neglect, sexual abuse, exploitation, child pornography, and child deaths. It also covers administrative costs.

Funding supports child protection and advocacy

The law provides $4.450523 million for Regional Child Assessment Centers, with up to 3% transferable to another specified account. Another $500,000 supports programs against commercial sexual exploitation of children through the centers’ statewide association. Federal funds provide $1.251341 million for child abuse prevention and Children’s Justice Act grants. They also provide $150,000 for Court Appointed Special Advocate training costs allowed under Title IV-E. Another $175,000 in federal funds pays counties for residential placements of children in juvenile court custody.

Funding supports family centers and services

The law provides $25.775955 million for Family Resource Centers through the Children’s Division. It allows 5% funding flexibility among specified child-service accounts. Another $1 million in federal Temporary Assistance for Needy Families funds supports a children and family services nonprofit. That nonprofit must have operated for over 100 years and be in a Missouri city outside any county.

Funding supports youth moving toward independence

The law provides $6.118803 million for youth independent living placements and transitional living services through the Children’s Division. It allows 5% funding flexibility among specified child-service accounts. The appropriation does not set an individual payment amount.

Funding to protect children from trafficking

The law provides a one-time $150,000 for nonprofit grants supporting statewide human trafficking prevention and education. The program must reach public and charter schools. Another $112,125 funds a statewide specialist and services for children harmed by sex trafficking or sexual exploitation. That funding supports up to one full-time-equivalent staff position.

Help finding relatives to care for children

The law provides about $1.28 million to search for relatives who can care for children served by the Children’s Division. The search funding supports up to 24 full-time-equivalent staff positions. Another $372,318 in federal funds supports kinship navigator services for families. Neither appropriation sets a direct payment to relatives.

Local care and court help for children

The law provides about $1.32 million to counties and St. Louis for care of delinquent or dependent children. That funding runs from July 1, 2026, through June 30, 2027. A one-time $200,000 federal grant expands a nonprofit’s court volunteer services for abused and neglected children into surrounding counties. The recipient must be a 501(c)(3) founded in 1989, in a city with over 160,000 but under 200,000 residents.

Local support for abuse survivors

A one-time $500,000 federal TANF grant supports a nonprofit serving women and children affected by domestic violence. A separate one-time $250,000 TANF grant supports family services, help overcoming barriers to self-sufficiency, and healthy co-parenting. Both recipients must be in a city not within a county. Another one-time $200,000 supports resources and community education for abused and neglected women and teens. That nonprofit must be in a county with over one million residents; none of these grants sets an individual payment.

Outreach funding for alternatives to abortion

The law provides $550,000 for public awareness of alternatives-to-abortion services. The program helps Social Services contractors and subcontractors reach pregnant women when digital platforms block or suppress the agencies. Covered platforms include search engines, social media platforms, and digital advertising networks. This funds outreach, not direct household payments or a guaranteed service.

Treatment and diversion funding for youth

For fiscal year 2027, Missouri provides $61.55 million for Division of Youth Services treatment, foster care, and contracted services. Up to $500,000 of that funding can support juvenile court diversion. Counties operating community-based youth treatment programs receive $3.98 million in incentive funding. The treatment budget permits 10% shifts between federal funds and 5% shifts between staffing and operating accounts. Both appropriations allow 3% transfers to another specified budget account.

Fatherhood and marriage services get funding

The law provides $500,000 from the Child Support Enforcement Fund for responsible fatherhood and healthy marriage services. Activities can include collecting child support checks. The nonprofit must have been founded in 2008. It must be in a city with more than 125,000 but fewer than 160,000 people. The department must apply for any waivers needed to let the nonprofit spend the money.

Funding for local community support programs

For July 1, 2026–June 30, 2027, the law provides $23.44 million for Community Services Block Grant programs. Community Action Agencies and eligible nonprofits deliver these services to Missouri residents. The law does not set a benefit amount for each household.

Funding for marriage and fatherhood services

The law provides $1.25 million in federal TANF funds for a healthy marriage and fatherhood initiative. The appropriation does not spell out individual services, eligibility, or household payments.

Funding for nursing home care oversight

The law transfers $1.5 million to the Nursing Facility Quality of Care Fund. The Department of Health and Senior Services uses it for inspections, surveys, training, and technical help. The funding covers facilities licensed under Chapter 198 and does not create resident payments.

Funding supports community substance abuse prevention

The law provides $5.7 million for substance abuse prevention network grants. This includes a network linked to a Federally Qualified Health Center. That center must be in a county with more than 260,000 but fewer than 300,000 residents.

Funding to recruit and train foster parents

The law provides $1.164 million for foster-parent recruitment and retention and $976,447 for foster-parent training contracts. Another $750,000 funds a foster-care nonprofit, including $500,000 in one-time money. That nonprofit must have federal 501(c)(3) status, more than 25 employees, multiple offices, and have formed in 1991. Its main office must be in a city with more than 125,000 but fewer than 160,000 people. It must mainly license, train, and advocate for foster parents and operate a foster-care neighborhood.

One-time health prevention funding for teens

For fiscal year 2027, Missouri provides a one-time $200,000 for school staff training on suicide prevention, online bullying, and mental-health resources. The nonprofit recipient must be in a county with more than 400,000 but fewer than 500,000 residents. A separate one-time $400,000 funds an adolescent pregnancy-prevention program. Both grants use federal Temporary Assistance for Needy Families money and do not continue beyond June 30, 2027. Neither appropriation sets an individual payment or guarantees services at a particular school.

Treatment and crisis care for children

The law provides $33.86 million for children’s treatment and crisis care, including home-based care, day treatment, prevention, and reunification. Another $500,000 covers treatment in licensed or accredited outdoor-learning foster-care programs. Outdoor-program rates come from a cost study, add to other service rates, and cannot exceed the appropriation. DSS cannot pay vendors that fail legally required crime reporting. It also cannot pay vendors that fail to remove employees from treatment duties after learning of a charge or indictment.

Mentoring and transition help for youth

The law provides $935,000 in federal funds for the Missouri Mentoring Partnership. Another $150,000 in TANF funds supports development and self-sufficiency programs for at-risk or foster-care youth ages 16–24. That recipient must be a 501(c)(3) formed in 2010, in a city with over 160,000 but under 200,000 residents. A separate one-time $100,000 grant supports a youth-serving nonprofit in a county with over one million residents. These appropriations do not set individual youth payments.

Youth mentoring and scholarships get funding

The law funds youth mentoring, scholarships, college preparation, job readiness, and related family support. A national-service mentoring program receives a one-time $25,000 for career exploration and scholarships for needy, talented students in grades 6–12. It must operate in a Missouri county with more than 70,000 but fewer than 80,000 people. A nonprofit in a county with over one million people receives $1.0805 million in TANF funds for virtual or in-person youth opportunities. A nonprofit in a county with over one million people also receives a one-time $70,000 for skills and peer mentoring for at-risk and under-represented youth and young adults.

Funding for benefit oversight and administration

For July 1, 2026, through June 30, 2027, the law funds several Social Services oversight functions. It provides $7 million for a Medicaid case management, provider enrollment, and fraud detection system. Another $2.39 million supports compliance administration and contracted compliance and financial monitoring. It also provides $600,000 in federal and TANF funds for contractors seeking revenue for the department and General Assembly. These funds pay for agency operations, not new household benefits or fees.

Funding keeps social services offices operating

For fiscal year 2027, the law provides $420,419 for the Director’s Office, capped at 2.93 full-time equivalent positions. It provides $679,203 for Human Resources Center operations, capped at 10.50 full-time equivalent positions. Another $334,412 from General Revenue pays Critical Event Program staff. Finance and Administrative Services receives $6.20702 million. This includes $1.2 million from the Administrative Trust Fund for inventory operations, reimbursable goods and services, and related equipment maintenance.

Funding supports social services technology operations

The law provides $62.42427 million for Social Services technology and purchasing operations in fiscal year 2027. This covers applications, security, project management, and technology purchases supporting state and federal compliance. Another $216,319 funds Technology Unit personnel, capped at 2 full-time equivalent positions. The law also provides $17.910261 million to build, maintain, and operate a Medicaid provider enrollment system. These are agency operating funds, not direct household payments.

Shared artificial intelligence tools for agencies

The law provides $1 million for a shared artificial intelligence development environment for state agencies. Funding runs from July 1, 2026, through June 30, 2027. It covers tools, platforms, and dedicated staff for responsible, secure use of artificial intelligence. The environment must support staff productivity and modernization aimed at reducing manual work and improving service delivery.

Social services funding flexibility and technology transfer

For July 1, 2026–June 30, 2027, Social Services can receive and spend up to about $2.034 million becoming available between legislative sessions. Qualifying money includes grants, donations, contracts, and payments from private, federal, and other government sources. Before spending new funds, the department must notify the General Assembly in writing of their source and purpose. The law also transfers about $3.69 million from Social Services' federal fund to the state's information technology federal fund. These authorities do not create household payments or guarantee that new outside funds arrive.

Funding for hospitals and emergency transport

The law provides $48.55 million in supplemental payments to Tier 1 Safety Net Hospitals or affiliated physician groups. Physician groups must supply hospital physicians, and the services require Centers for Medicare and Medicaid Services approval. Public ground emergency transport providers receive separate appropriations of $3.29 million and $23.29 million under Missouri’s transport-payment laws. These cover people whose services are funded under Sections 11.825 and 11.845, respectively. The payments go to providers, not households.

Funding improves health data sharing systems

The law provides $50 million to improve health information exchanges and turn existing exchanges into a Health Data Utility. Funded analysis supports MO HealthNet, care delivery, system efficiency, and health outcomes in underserved communities. Exchanges must follow HIPAA and other state and federal patient privacy laws. This funding does not change individual coverage or payment amounts.

Funding reviews Medicaid rides and fraud

The law provides $3.415263 million to redesign Missouri’s non-emergency medical transportation program. The money covers analysis and support for putting the redesign in place. It also funds a rapid review of Medicaid fraud, waste, and abuse, with recommendations. The appropriation itself does not change eligibility or guarantee additional rides.

Funding supports benefit application computer systems

The law provides $29.658376 million for Medicaid and children’s health insurance eligibility systems using modified adjusted gross income. It provides $15.746228 million for SNAP system development and $200,000 for Temporary Assistance system development. Another $1.32352 million pays for independent verification and validation services. A further $2.681367 million supports the department’s electronic content management system. These funds cover expenses and equipment, not employee administrative costs, and do not themselves change eligibility or benefit amounts.

Funding supports Medicaid audits and oversight

The law provides $6.68941 million for the Missouri Medicaid Audit and Compliance Unit. This includes $357,634 for expanded fraud, waste, and abuse efforts using data analysis and national program-integrity strategies. Another $1.2 million from the Recovery Audit and Compliance Fund pays for Medicaid recovery audits. These appropriations do not themselves change benefits or create new payment duties for households or providers.

Funding supports Missouri's Food Nutrition Program

The law provides $7.031849 million from the Department of Social Services Federal Fund for the Food Nutrition Program. The money supports program operations. The appropriation does not set a new individual benefit amount or change who qualifies.

Funding supports prescription assistance and payments

The law provides $6.375 million for medicine payments under the Missouri Rx Plan. It also provides $13 million for Pharmacy Reimbursement Allowance payments under existing law. These appropriations do not set a new household payment amount or change who qualifies for prescription help.

Funding supports safety-net hospitals and clinics

The law provides $14.322792 million for enhanced Tier 1 safety-net hospital rates and regional Barriers to Care planning. The plan uses existing state and local money to seek federal Medicaid matching funds for currently unmatched services. Another $19.709102 million funds indirect medical education payments at qualifying public acute-care safety-net hospitals. Hospitals must be primary teaching hospitals for either Missouri public medical school; payments bridge diagnosis-based payments and 100% of allowable funds. Federally Qualified Health Centers also receive $257,732 in grants.

Funding supports seniors and long-term care

The law provides $10.950768 million for public long-term care services, support contracts, and supplemental nursing-facility payments. It provides $15.43792 million for the Program for All-Inclusive Care for the Elderly, serving eligible older adults. The law allows 10% funding flexibility between that program and specified MO HealthNet accounts. It also appropriates $2 for physician-ordered rehabilitation and preventive care delivered by assisted living facilities. That $2 appropriation allows 100% flexibility between its funding sources.

Funding supports wheelchairs and adaptive equipment

The law provides $12.930662 million for complex rehabilitation equipment for eligible MO HealthNet participants. Equipment includes power wheelchairs, highly adjustable manual wheelchairs, adaptive seating, standing frames, and gait trainers. It must be medically necessary to prevent hospitalization or institutional care.

Funding updates benefit and health systems

For July 1, 2026–June 30, 2027, the law funds Missouri's social services systems and project management. It provides about $49.59 million for income assistance eligibility systems and work to carry out Public Law No. 119-21. Another $4.02 million covers the department's project management office expenses and equipment. A one-time $1.495 million funds reviews of state health data systems and shared statewide data standards and oversight. These appropriations do not themselves change household benefits, eligibility, or payments.

Medicaid emergency care and payment planning

DSS must implement measures to save money through emergency-room service reforms. The law does not name specific reforms or set a savings target. DSS must also have its contracted actuary develop a separate managed-care payment group for aged, blind, and disabled members. That group must reflect costs for members who choose to enroll in a managed-care plan. These requirements do not set individual benefits or payments.

Psychiatric hospital payment and coverage planning

The law sets a $1,194.22 daily minimum Medicaid rate for freestanding inpatient psychiatric hospitals under Sections 11.780 and 11.820. That matches the state fiscal year 2025 weighted average daily rate. DSS must seek a federal waiver of the institutions-for-mental-disease exclusion for inpatient psychiatric-hospital treatment under the 21st Century Cures Act. Seeking the waiver does not guarantee approval or itself change coverage. MO HealthNet must also track payments to out-of-state hospitals by location.

Fatherhood programs receive job and parenting funding

A one-time $50,000 federal family assistance grant funds parenting skills and employment, health care, legal, and social-service help for men. That program must be in a city with more than 400,000 residents that lies in more than one county. Another $1 million in federal family assistance funds supports healthy relationships, job placement, job readiness, and employment retention. That program must be in a city outside any county and aims to reduce absentee fatherhood. The grants fund services, not direct household payments.

Regional job seekers get funded employment services

The law provides $1 million in federal family assistance funds for regional employment help through Missouri Work Programs. The recipient must be a century-old, viable nonprofit in a city outside any county. It must serve more than 100,000 clients regionally each year. The appropriation funds services and does not establish direct participant payments.

Targeted school and youth services receive funding

The law provides $1 million in federal family assistance funds for school-based student support with local community partners. Only public schools meeting Section 11.180's city, county, and county-seat population ranges are covered. A separate, one-time $500,000 state grant supports tutoring, job training, transportation, food, clothing, and sports through a nonprofit. That nonprofit must be in a city with more than 400,000 residents that lies in more than one county. These grants fund services, not direct household payments.

Funding for blind people's business programs

The law provides about $44.6 million in federal funds for Missouri business enterprise programs for blind people. It does not set individual payments or guarantee a particular household benefit.

Payment caps for foster and treatment providers

The Department of Social Services cannot pay outdoor learning foster care providers more than $258 per day. Psychiatric Residential Treatment Facility payments under Sections 11.440 and 11.780 cannot exceed $471.46 per day. Provider rates under Sections 11.425, 11.435, 11.445, 11.450, 11.455, 11.460, 11.480, 11.485, 11.495, 11.545, 11.765, 11.775, 11.780, and 11.815 cannot exceed January 1, 2025 levels. These limits govern state payments to providers, not charges imposed on families.

Certain constitution-linked program payments are barred

The state cannot use Section 11.845 funds for program distributions tied to Article IV, Section 36(c), of Missouri's Constitution. The provision does not state the funding amount affected or individual payment amounts.

State reimbursements and contracts face payment caps

The state cannot use Section 11.080 funds for reimbursement rates above $17 per day. It cannot use Section 11.160 funds for contract rates above January 1, 2025 levels. The supplied provisions do not identify the services or contracts involved. Neither limit directly sets a household charge.

Medicaid dental payments face rate caps

Under Section 11.725, the department generally cannot pay dental rates above January 1, 2025 levels. Dental anesthesia codes are capped at 80% of comparable January 1, 2024 Usual Customary and Reasonable rates. Dentist extraction codes are capped at 38.5% of those rates. These limits apply to provider payments, not directly to patient bills.

Medicaid physician payments face rate caps

Under Section 11.715, the department generally cannot pay physician rates above January 1, 2024 levels. Certified Community Behavioral Health Clinic actuarial rates cannot exceed Department of Mental Health-approved levels; autism rates use January 1, 2025 limits. Independent laboratory rates are capped at 90% of the 2023 Medicare allowed rate, and ophthalmologist rates at 85%. Dental anesthesia in medical-surgical centers is capped at 63% of Medicare's anesthesia conversion factor. These limits govern provider payments, not patient bills.

Medicaid plan payments face spending limits

The department cannot pay managed care contract rates above the lower end of the actuarially sound range. That restriction applies to Sections 11.770 and 11.775. Separately, per-person payments under Section 11.720 cannot exceed what fee-for-service payments otherwise cost. These caps limit program payments without directly changing household premiums or setting patient bills.

Nursing and home health payments capped

The law caps aggregate nursing facility rates at rebased levels determined from fiscal year 2022 cost reports. Adjustments for residents' care needs and value-based payments are exceptions to that cap. Home health payments are capped at $12.42 per visit. Certified Nursing Assistant training reimbursement is capped at $1,500 per enrollee. These are limits on state payments, not new household bills.

Outpatient and coordinated-care payments face caps

The department's outpatient hospital fee schedule cannot exceed 90% of the 2026 Medicare rate under Sections 11.780 and 11.820. Payments to primary care health homes under Section 11.815 cannot exceed $80.19 per member each month. Both limits apply to state payments to providers. They do not directly set patient bills or premiums.

Rehabilitation and medical transport payments capped

Under Section 11.755, rehabilitation and specialty provider rates generally cannot exceed January 1, 2025 levels. Non-emergency medical transportation rates use the lower end of the actuarially sound range. Hospice rates are limited to a 2.8% increase over the January 1, 2025 blended rate, plus a nursing-facility room-and-board limit. Air ambulance rates cannot exceed 90% of the 2024 Medicare rate. These restrictions limit provider payments, not directly household bills.

Sponsors & Cosponsors

Sponsor

  • Deaton, Dirk (159)

    Affiliation unavailable

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 499 • No: 69

House vote • 5/6/2026

House Adopts Conference Committee Report

Yes: 124 • No: 22 • Other: 4

Senate vote • 5/6/2026

Senate Adopts Conference Committee Report

Yes: 31 • No: 1

House vote • 5/6/2026

Third Read and Passed

Yes: 123 • No: 24 • Other: 3

Senate vote • 5/6/2026

Truly Agreed To and Finally Passed

Yes: 31 • No: 1

Senate vote • 4/22/2026

Third Read and Passed

Yes: 21 • No: 10

House vote • 3/26/2026

Third Read and Passed

Yes: 138 • No: 11

House vote • 3/12/2026

HCS Reported Do Pass - with a time limit of five and a half hours of debate on Perfection pursuant to Rule 24(4)(d)

Yes: 31 • No: 0

Actions Timeline

  1. Delivered to Secretary of State (G)

    6/30/2026House

  2. Vetoed in Part by Governor (G)

    6/30/2026House

  3. Delivered to Governor

    5/28/2026House

  4. Signed by President Pro Tem

    5/28/2026Senate

  5. Signed by House Speaker

    5/28/2026House

  6. Senate Message

    5/7/2026Senate

  7. Truly Agreed To and Finally Passed - AYES: 31 NOES: 1 PRESENT: 0

    5/6/2026Senate

  8. Senate Adopts Conference Committee Report - AYES: 31 NOES: 1 PRESENT: 0

    5/6/2026Senate

  9. Senate Submits Conference Committee Report

    5/6/2026Senate

  10. House Message

    5/6/2026House

  11. Third Read and Passed - AYES: 123 NOES: 24 PRESENT: 3

    5/6/2026House

  12. House Adopts Conference Committee Report - AYES: 124 NOES: 22 PRESENT: 4

    5/6/2026House

  13. House Submits Conference Committee Report

    5/6/2026House

  14. House Distributes Conference Committee Report

    5/5/2026House

  15. Senate Message

    4/28/2026Senate

  16. Senate Conference Committee Appointed - SENATORS BLACK, HUDSON, CIERPIOT, MAY, WASHINGTON

    4/28/2026Senate

  17. House Message

    4/27/2026House

  18. House Conference Committee Appointed - REPRESENTATIVES DEATON, DAVIDSON, CHAPPELL, FOGLE, PROUDIE

    4/27/2026House

  19. Senate Message

    4/23/2026Senate

  20. Senate Refuses to Recede, Grants Conference

    4/23/2026Senate

  21. House Message

    4/23/2026House

  22. House Refuses to Adopt, Requests Senate to Recede or Grant Conference

    4/23/2026House

  23. Taken Up

    4/23/2026House

  24. Reported to the House with... - SS SCS

    4/23/2026House

  25. Third Read and Passed - AYES: 21 NOES: 10 PRESENT: 0

    4/22/2026Senate

Bill Text

  • Truly Agreed

    5/6/2026

    PDF

  • Perfected

    3/24/2026

    PDF

  • Committee Substitute

    3/12/2026

    PDFPDF

  • Senate Substitute

    3/12/2026

    PDFPDF

  • Introduced

    1/22/2026

    PDF

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