MissouriHB20142026 Regular SessionHouse

Appropriates money for supplemental purposes

How does this bill affect your finances?

Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.

Free to download

Bill Overview

Analyzed Economic Effects

50 provisions identified: 42 benefits, 6 costs, 2 mixed.

Funding for Medicaid and Missouri drug help

The law provides about $101.87 million in federal money for MO HealthNet medicines, pharmacist fees, and chronic care management. It allows 10% funding flexibility among the listed Medicaid appropriations. Another $113,011 in state money funds drug payments under the Missouri Rx Plan. These appropriations set no individual benefit amount and do not state new eligibility rules.

Funding for Medicaid doctors and behavioral care

The law provides about $76.97 million for MO HealthNet doctor visits, clinics, telemedicine, lab tests, family planning, and related care. That includes about $7.70 million in state money and $69.27 million in federal money. Another $18.90 million in state money funds physician and related services through Certified Community Behavioral Health Organizations. Their payment system includes Applied Behavior Analysis services. The law allows 10% funding flexibility among the listed Medicaid appropriations but sets no individual payment amount.

Funding for Medicaid hospitals and safety-net care

The law provides about $10.60 million in federal money for MO HealthNet hospital care, graduate medical education, and chronic care management. Another $29.49 million in state money funds safety-net payments, bringing the total to about $40.09 million. MO HealthNet must track payments to out-of-state hospitals by location. The appropriation does not specify individual payments or coverage changes.

Funding for Medicaid plans and frail seniors

The law provides about $123.01 million for prepaid health plans and approved Frail Elderly Demonstration Project Waiver programs. About $48.75 million comes from state money and $74.26 million from federal money, with 10% flexibility among listed Medicaid appropriations. MO HealthNet members covered by the cited federal maternal and child health provision can choose managed care. Members choosing a plan use the Aged, Blind, and Disabled payment category. The department must also achieve savings through emergency-room service reforms.

Funding for mental health and addiction care

The law provides $114.07 million for behavioral health and substance-use services for MO HealthNet participants and uninsured people. It funds community psychiatric care, substance-use treatment, case management, and certified community behavioral health organizations. Funding includes $59.74 million in federal adult-expansion funds, $47.69 million in other federal Medicaid funds, and $6.64 million from a state transfer fund. The law does not set individual benefit amounts.

Funding for nursing home care and staffing

The law provides about $75.94 million for MO HealthNet nursing facility care and work to improve residents' quality of life. This includes about $26.65 million in state money and $49.30 million in federal money. It allows 10% funding flexibility among the listed Medicaid appropriations. Another $2.65 million from the Nursing Facility Quality of Care Fund supports a campaign to increase nursing home nurses. The campaign partners with the Centers for Medicare and Medicaid Services; no direct payment to nurses or residents is specified.

State employees receive overtime pay funding

The law provides $27.86 million in general revenue for state employee overtime pay. Nonexempt employees identified in Section 105.935, RSMo, are paid first. Any money left pays overtime for other state employees. Each employee's payment depends on overtime worked and available funds.

Funding for disaster relief and recovery

Through June 30, 2026, the law provides $800 million from the Missouri Disaster Fund for disaster-related grants and assistance. Another $30 million in state money covers federal grant matches and emergency help under state law. An $86 million transfer funds disaster expenses for a city outside any county when the Governor requests a presidential disaster declaration. Through the same date, $390,000 supports disaster medical team staff, expenses, and equipment. Another $3.05 million in federal money funds crisis counseling tied to presidential disaster declarations, including $151,309 for staff.

Funding for rural health care improvements

The law provides $100 million from the Rural Health Transformation Fund to MO HealthNet for the Rural Health Transformation Program. The money supports rural health services and communities. The appropriation sets no individual payment, eligibility rule, or service amount.

Funding for Missouri roads and bridges

Through June 30, 2026, the law provides about $518.09 million from the State Road Fund for highway and bridge construction. It covers constitutionally authorized work and reimburses local governments for roads and bridges permanently added to the state system. Another $117.54 million from that fund supports maintenance, preservation, and safety. The law allows 20% flexibility among three transportation appropriations and 10% between maintenance staffing and operating expenses and equipment. Staffing cannot exceed 283.43 full-time equivalent positions for construction and 780.18 for maintenance.

Medicaid program funding and budget flexibility

The law provides $419.23 million for program distributions tied to Missouri's constitutional provision referenced in the appropriation. This includes $73.91 million in General Revenue, $343.84 million in federal Medicaid adult-expansion funds, and money from three other funds. It also allows 10% flexibility among specified MO HealthNet appropriations. These provisions do not set individual eligibility rules or payment amounts.

Disability waiver limits with added service slots

The law restricts funding for Department of Mental Health waiver slots assigned on July 1, 2025, with listed exceptions. Exceptions include 400 Crisis Residential Services slots, 500 Community Support Waiver slots to prevent in-home wait lists, and 200 Partnership for Hope slots. It also allows 54 nursing-home transition slots and 48 slots for children leaving Children's Division-funded waiver slots. Another exception covers 83 slots for children transitioning out of the Missouri Children with Developmental Disabilities Waiver. These are funding limits, not new charges for people receiving care.

Medicaid community care funding with payment limits

The law provides $90.69 million for Medicaid community care, including personal care, respite, meals, and waiver services. Another $28.05 million supports consumer-directed care and related payment programs; care rates cannot exceed 60% of average monthly Medicaid nursing-facility costs. Eligible Personal Care Option participants must be allowed to choose the option that best meets their unmet needs. People eligible for or receiving nursing home care must be offered community care funding based on unmet needs under 19 CSR 30-81.030. The law allows 10% funding shifts between the linked programs but creates no benefits beyond those established by statute.

Funding to return over-collected social services money

The law provides $1.15 million for the Department of Social Services to handle refunds and incorrectly deposited receipts. This includes repaying recipients for over-collected accounts. It sets no individual refund amount and allows 10% funding flexibility between federal and other funds.

Funding for children's treatment and abuse exams

The law provides about $34.00 million for Medicaid non-institutional care and rehabilitation for children in Children's Division custody. Residential rehabilitation requires division approval; this funding allows 10% flexibility among listed Medicaid appropriations. Another $3.71 million funds children's residential treatment room and board: $2.69 million for non-IMD placements and $1.02 million for IMD placements. Those categories distinguish facilities not classified as institutions for mental diseases from those that are; 10% flexibility applies between them. Through June 30, 2026, $180,000 reimburses SAFE-Care providers for forensic medical exams of children suspected of physical abuse.

Funding for people with developmental disabilities

The law provides about $23.76 million in federal money for developmental disability community programs and long-term care changes. This includes work on provider payments tied to identified care outcomes. Another $12.32 million funds coordinated health home care for eligible people with chronic conditions receiving developmental disability home and community services. Care comes from a designated provider, a provider working with a health care team, or a health team the person selects. The law also provides $135,897 to pay state-operated intellectual disability facilities' provider tax, not a new tax on residents.

Funding for state employee health benefits

Through June 30, 2026, the law provides about $11.83 million for state contributions to the Missouri Consolidated Health Care Plan. That includes $10.50 million from general revenue, without specifying changes to members' premiums, coverage, or eligibility. Another $3.40 million funds state employee workers' compensation benefits and authorized administrative and legal expenses through that date. Coverage can use Office of Administration self-insurance, a private carrier, or both.

State must seek psychiatric hospital coverage

Social Services must seek a federal waiver for inpatient mental health treatment in psychiatric hospitals for MO HealthNet participants. The request seeks an exception to the federal Institutions for Mental Diseases exclusion. The state share must come through the federal reimbursement allowance. The law requires a request; it does not establish federal approval or new coverage.

Public employee benefit contributions receive funding

Through June 30, 2026, the law provides $2.85 million for the Missouri State Employees' Retirement System. It transfers $1.15 million for Social Security and Medicare contributions covering state employees and participating local governments. Another $290,361 supports retirement contributions and insurance premiums for covered transportation and Highway Patrol employees. These appropriations fund contributions, not stated increases in individual benefits.

Funding refunds for overpaid Missouri taxes

Missouri provides $225.6 million for refunds of overpaid or wrongly paid taxes and other payments credited to General Revenue. The funding covers refund payments through June 30, 2026. Only people or entities owed a qualifying refund benefit. The law does not set individual refund amounts.

Business program funding for blind entrepreneurs

The law provides $4 million in Social Services federal funds for business enterprise programs for blind people. Any direct financial benefit depends on participation in a funded program. The law does not set individual awards or give detailed eligibility rules.

Counties receive funding for children's care

The law provides $116,923 in general revenue to counties and the City of St. Louis. The money supports care and maintenance of delinquent or dependent children under Section 211.156, RSMo. Payments go to local governments, not directly to families.

Funding for counter-drone and police operations

Through June 30, 2026, the law provides about $14.24 million in federal money for counter-drone grants, staff, expenses, and equipment. It also provides $250,000 in state money for statewide wastewater testing for fentanyl and other dangerous drugs for law enforcement. Another $200,000 from the State Highways and Transportation Department Fund supports Highway Patrol administration and equipment. These appropriations do not create direct household payments.

Funding for prison food and health care

The law provides about $7.16 million in state money for contracted physical and mental health care for incarcerated people. Another $5.82 million in state money covers prison food, transportation, storage, and food-preparation operations. Through June 30, 2026, $679,026 supports correctional facility operations, utilities, furniture, and building changes. That amount includes $194,800 from general revenue and $484,226 from the Working Capital Revolving Fund. The appropriations do not set individual payment amounts.

Officials' state flights require public tracking

The state cannot fund a state-aircraft flight carrying an elected official unless its flight plan is publicly available. Disclosure must use a global aviation data service offering free private and commercial aircraft tracking through a website and mobile app. The rule adds public access to flight information, not a household reporting duty.

Funding for adult and youth psychiatric care

The law provides $58,335 for adult psychiatric services and about $3.72 million for adult psychiatric services and community programs. Another $14.35 million supports youth psychiatric services and community programs, including $6.51 million in state and $7.84 million in federal money. Outpatient competency restoration services receive about $3.05 million under state law. That includes about $1.47 million in state money and $1.58 million in federal money. These appropriations set no individual payments or new eligibility rules.

Funding for alcohol and drug treatment

The law provides about $3.62 million for alcohol and drug treatment, including $607,662 from the opioid treatment and recovery fund. It also provides about $8.77 million for treatment through Certified Community Behavioral Health Organizations. That amount includes $6.60 million from the Mental Health Reinvestment Fund. A separate $6.60 million transfer from the Health Reinvestment Fund supports substance use treatment and education in the receiving fund. Interest, investment earnings, and money left after the two-year budget period stay in that fund rather than returning to general revenue.

Operating funds for state psychiatric hospitals

The law funds expenses and equipment at four state mental health facilities using state general revenue. Fulton State Hospital receives $75,458, and Northwest Missouri Psychiatric Rehabilitation Center receives $165,716. The Forensic Treatment Center receives $176,689, and Southeast Missouri Mental Health Center receives $70,734. The funding does not specify added services or direct payments to patients.

Schools receive literacy and student support funding

Through June 30, 2026, the law provides $3.2 million for literacy and $3 million for State Board-operated school programs. It provides $951,299 to identify, enroll, and support homeless children and youths in school. Another $320,000 funds efforts to identify students who lack resources and support. Safe schools programs receive $97,524, and the School Turnaround Fund receives a $73,450 general-revenue transfer and appropriation. The money supports school programs rather than direct family payments.

Agencies must review existing technology first

Departments must check existing state technology agreements and assets before taking on covered ongoing technology costs or new subscriptions. The rule covers technology for citizen services and support for state workers and programs. Existing statewide agreements get preference when they provide suitable functions. Office of Administration technology purchases must include a compliance statement. The law does not specify savings.

Animal health laboratory receives operating funds

The law provides $400,000 from the Animal Health Laboratory Fee Fund for animal health expenses and equipment. The money is available through June 30, 2026. The provision does not state a fee change or a direct household payment.

Funding state offices and facility operations

The law provides $1.07 million for agency leases, utilities, furniture, building changes, expenses, and equipment. It separately funds state-owned facility operations and agency costs. Listed allocations include $191,406 for Elementary and Secondary Education, $101,793 for Revenue, and $229,271 for Administration. The supplied facility provision does not show a full section total. These funds support agency operations, not direct household payments.

Highway administration and tax collection receive funding

Through June 30, 2026, the law provides $7.07 million from the State Road Fund for highway administration. It allows up to 20% funding flexibility among Sections 14.105, 14.110, and 14.115. Administrative staffing cannot exceed 79.23 full-time equivalent positions. Another $943,500 funds collection of highway-related fees and taxes from the State Highways and Transportation Department Fund. The collection appropriation does not change the fees or taxes households owe.

Lottery game vendors receive operating funds

The law provides $1.09 million from the Lottery Enterprise Fund for game vendors through June 30, 2026. It covers game design, manufacturing, licensing, leasing, processing, and delivery. The money cannot cover purposes already funded in House Bill 4, Section 4.180, lines 8–11 and 16–23. Payments go to vendors, not households.

Missouri World Cup grants receive funding

The law provides $59.52 million from the Department of Public Safety Federal Fund for Missouri's FIFA World Cup Grant Program. The money is available through June 30, 2026. The provision does not set household eligibility rules or individual grant amounts.

State agencies receive technology and equipment funding

The law provides $2.03 million from the Missouri Veterans' Homes Fund for Public Safety technology costs through June 30, 2026. It also provides $3.03 million in state and federal funds for expenses and equipment at listed agencies. These appropriations support agency operations, not direct household payments. No specific public-facing service change is stated.

State facilities receive operating and improvement funds

The law provides $4.77 million to operate state buildings and facilities through June 30, 2026. Another $36,000 pays for leased parking at the Fletcher Daniel state office building through that date. It also provides $1.35 million for institutional operations, utilities, furniture, and structural changes. That includes $189,251 for education, $964,478 for mental health, and $192,011 for social services, including $35,859 in federal money. These funds support state facilities rather than direct household payments.

State Fair bond payments receive funding

The law provides about $4.2 million for Missouri State Fair bond payments and related expenses through June 30, 2026. Bond proceeds can cover no more than $55 million in specified project costs. Each bond series can last no more than 20 years, and total annual debt service cannot exceed $4.2 million. The appropriation allows full flexibility between general revenue and other funds. It does not provide household payments.

University grant supports Missouri drug ingredient manufacturing

The law provides $1.93 million for a public university to establish active drug ingredient manufacturing in Missouri. The university must have an established partnership with a nonprofit that received a similar state grant for that purpose. The money is available through June 30, 2026. The provision does not guarantee lower drug prices or direct household payments.

Income support offices receive staffing and upgrades

The law provides $12.12 million for Family Support Division income maintenance staff and operations. That includes $3.03 million in state money and $9.09 million in federal money. Another $32.02 million funds eligibility-system updates and implementation of federal Public Law No. 119-21. That includes $9.04 million in state money and $22.97 million in federal money. These provisions fund administration; they do not themselves set new eligibility rules or benefit amounts.

Career training programs receive added funding

The law provides $3.6 million in federal funds to career and technical education providers. Another $4.3 million from the Job Development and Training Fund supports job training and related activities. Both appropriations run through June 30, 2026. They do not set individual payments or new participant eligibility rules.

Psychology internships receive state program funding

The law provides $228,692 from the Mental Health Earnings Fund for a psychology internship program. The money covers staff, operating costs, and equipment. It does not set individual stipends, awards, or eligibility rules.

Schools receive special education funding

The law provides $20 million in federal funds for special education. State funding adds $14.71 million for special education excess costs and $35.10 million for early childhood special education. The money supports these programs through June 30, 2026. These provisions do not create individual student awards or change who qualifies.

Vocational rehabilitation receives added program funding

Missouri provides $10.44 million for its Vocational Rehabilitation Program through June 30, 2026. This includes $2.22 million from general revenue and $8.21 million from the Vocational Rehabilitation Fund. The provision does not change eligibility or set individual award amounts.

Daily Social Services reimbursement is capped

Social Services cannot use funds under the appropriation referenced in Section 14.330 to reimburse more than $17 per day. The supplied provision does not identify the service covered. This is a state reimbursement cap, not a stated household payment.

Home care providers face reimbursement caps

The health department generally cannot fund provider rates above those in effect on January 1, 2025. Private Duty Nursing payments are capped at $15.20 per 15-minute unit, and Medicaid home-delivered meals at $7.14 each. Reassessments are capped at $100 unless the provider joins the Value Based Purchasing Reassessment Program. A separate Social Services home-health limit sets a $12.42-per-visit ceiling tied to the January 1, 2024 rate baseline. These limits govern provider payments, not new household charges.

Mental health providers face payment limits

The mental health department generally cannot fund provider rates above those in effect on January 1, 2025. Certified Community Behavioral Health Clinics can receive Medicare Economic Index increases up to 2.5%, subject to the revenue-maximization exception. Specified cost-based or actuarially sound changes for substance-use treatment and compulsive gambling services are also excepted. Children's residential treatment daily caps are $194.47 for Level II, $239.16 for Level III, and $253.80 for Level IV. The law also bars spending toward a Developmental Disabilities Health Home rate of $105.90 per member monthly; no replacement rate is stated.

Nursing facilities face state payment ceilings

The law caps nursing-facility payments at the aggregate rebased rate drawn from fiscal year 2022 cost reports. Adjustments for residents' care needs and value-based payments are excepted. The ceiling limits state reimbursement, not a resident's direct payment obligation.

Payment ceiling for Medicaid health plans

The law caps payments under the covered Social Services managed care contracts at the lowest actuarially sound rate. This is the bottom of the rate range calculated to cover expected care costs. The cap limits state payments to health plans. It does not specify changes to household premiums or benefits.

Nursing assistant training reimbursement is capped

The law caps Certified Nursing Assistant training reimbursement at $1,500 per enrollee under two covered appropriations. The cap applies to Health and Senior Services funding and Social Services funding. It does not establish payments to trainees or state what trainees must pay.

Sponsors & Cosponsors

Sponsor

Deaton, Dirk (159)
Affiliation unavailable

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 450 • No: 44

House vote • 3/5/2026

Truly Agreed To and Finally Passed

Yes: 137 • No: 13