MissouriSB2712025 1st Extraordinary SessionSenateWALLET

Modifies provisions relating to emergency services

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Bill Overview

Analyzed Economic Effects

13 provisions identified: 6 benefits, 4 costs, 3 mixed.

Unpaid emergency helpers gain liability protection

People giving unpaid emergency care or assistance at an emergency or accident scene are protected from civil damages for that help. Protection does not cover gross negligence or willful or wanton acts or failures to act.

Higher district sales taxes, lower property levies

With voter approval, ambulance and fire districts can raise sales taxes from the former 0.5% cap to 1%; prior county exclusions are removed. Revenue must fund voter-approved purposes, and no property-tax reduction is required during the first collection year. After that, districts must lower their property-tax levy so revenue drops by 50% of the prior year's sales-tax receipts. A one-time levy correction can recover money owed for the prior year, after adopting the otherwise-authorized tax rate ceiling and within state constitutional limits. A petition signed by at least 20% of district registered voters who voted in the last governor's election triggers a repeal vote; majority approval ends the sales tax December 31 that year and restores the prior property-tax levy.

Emergency workers gain license fee protection

The state health department cannot create or raise emergency medical services personnel license fees to fund the interstate licensing compact's annual assessment. The restriction applies only to that funding purpose. The department can still set or raise fees for other purposes.

Farms avoid local fire permit rules

Counties and fire protection districts cannot use fire-protection or fire-prevention ordinances to regulate or require permits for farm buildings or structures. This covers construction, maintenance, repairs, changes, and extensions. The exemption does not remove other requirements outside these fire ordinances.

Firefighter pension plans keep money separate

A firefighters' retirement board can also oversee a separate plan for firefighters employed by a city outside any county. That plan must provide retirement, disability, and death benefits for firefighters and covered dependents. The plans can share investments, but each plan's money and investment gains or losses must be tracked separately. The separate plan's expenses and benefits cannot be paid from the firefighters' retirement system's funds.

Stronger state checks on ambulance services

The state health department can deny, refuse to renew, or suspend ambulance licenses, or order corrective action. Grounds include insolvency, inadequate operations or staffing, criminal liability, Medicare or MO HealthNet ineligibility, and required training failures. Excessive reliance on mutual aid means more than 10% of an area's runs in any month. Smaller services must keep one ambulance staffed around the clock by at least two licensed emergency medical technicians and plan for a second unit. For insolvency or insufficient operations, the department can require a corrective plan within 15 days and implementation within 30 days. It must notify specified officials and work with nearby providers on service coverage.

Payment rights for backup ambulance providers

Licensed ambulance providers covering a suspended service's area can seek reasonable payment from that suspended provider. Payment covers calls, standby time, emergency responses, and reasonable operating expenses during the suspension. Assisting providers can also recover enforcement costs and reasonable attorney fees through an enforcement action.

Fire districts can charge nonresident callers

Fire districts can adopt local rules charging nonresidents who receive emergency services inside the district. Charges cannot exceed actual and reasonable costs. The limits are $100 for each fire call or alarm response, plus $250 per hour spent fighting the fire or emergency. Time charges are proportional for each quarter hour.

Voters can approve matching emergency use taxes

Jurisdictions with an emergency-services sales tax can seek voter approval for a matching use tax on the same property and services. A governing-body majority and a majority of votes cast must approve it. The ballot must explain that the use-tax rate changes with the linked sales-tax rate. Collections begin on the first day of a calendar quarter starting at least 45 days after the revenue director receives notice. Counties and municipalities must send a proportional share to emergency services; advertising cannot promote the measure as a “new tax.”

Ambulance administrators face new training rules

Each licensed ambulance service must identify its administrator to the state health department. Administrators must complete at least 40 hours of basic training and two hours of continuing education each year. Training must come from a statewide ambulance-district association or receive state emergency medical services advisory council approval. Administrators serving on August 28, 2025, had to show compliance by January 1, 2026. State licensing rules must also address administrator qualifications and participation in regional emergency medical services advisory committees.

More ambulance providers must pay tax

Ground ambulance services that accept payment must pay Missouri's ambulance service reimbursement allowance tax. Only services owned and operated by a state department remain exempt. This narrower exemption brings some previously excluded providers into the tax, including some university-operated hospital services. The supplied text does not state the rate or whether providers pass costs to patients.

Specialty hospitals can transfer assault victims

State-designated specialty hospitals outside the general acute care category can qualify for an exemption from sexual-assault forensic exam and related requirements. They must have a policy to transfer victims to an appropriate hospital with an emergency department. Patients may need to receive those services at the receiving hospital instead.

Ambulance districts face training and audits

Ambulance district board members must complete initial training plus three hours of continuing education each term. Training must come from a statewide ambulance-district association or receive state emergency medical services advisory council approval. Missing the required election or appointment anniversary deadline immediately disqualifies the member and leaves the seat vacant. Each district must arrange a certified public accountant or accounting-firm audit at least once every three years. Districts must post audits online or provide them free through another electronic method.

Sponsors & Cosponsors

Sponsor

Rusty Black
Republican • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 20 • No: 1

House vote • 5/6/2025

Reported Do Pass

Yes: 8 • No: 0

House vote • 4/30/2025