Title XII, PUBLIC HEALTH AND WELFARE

190.001. Citation. — Sections 190.001 to 190.245 shall be known and may be cited as the "Comprehensive Emergency Medical Services Systems Act". ­­-------- (L. 1998 S.B. 743)

190.010. Territory of district may be noncontiguous — ambulance districts authorized except in counties of 400,000 or more population — district, how named. — 1. An ambulance district may be created, incorporated and managed as provided in sections 190.001 to 190.090 and may exer…

190.015. Petition to form, contents — ambulance district boundaries (St. Louis County) — sales tax in lieu of property tax permitted, exception St. Louis County. — 1. Whenever the creation of an ambulance district is desired, a number of voters residing in the proposed district e…

190.020. Public hearing, notice — costs, how paid. — 1. Upon the filing of the petition with the county clerk, he shall present it to the commissioners of the county commission who shall thereupon set the petition for hearing within not less than thirty nor more than forty days a…

190.025. Petitions — consolidation, when — amended, how. — If two or more petitions covering in part the same territory are filed prior to the public hearing upon the petition which is first filed, the petitions shall be consolidated for public hearing, and hearing thereon may be…

190.030. Sufficiency of petition, county commission to determine. — If the territory, petition and proceedings meet the requirements of sections 190.005 to 190.085, the county commissioners shall make a finding determining the sufficiency of the petition and that the territory me…

190.035. Notice of election, contents. — Each notice shall state briefly the purpose of the election, setting forth the proposition to be voted upon and a description of the territory. The notice shall further state that any district upon its establishment shall have the powers, …

190.040. Form of ballot — effect of passage on tax rate — fund created — refunds, when. — 1. For the organization of a district which shall levy a property tax, the question shall be submitted in substantially the following form: Shall there be organized in the counties of ______…

190.041. Tax levy for central dispatching service, when, amount — funds kept separate. — 1. Notwithstanding any other provision of law, an additional tax of not to exceed three cents per one hundred dollars of assessed valuation may be levied and collected by any ambulance distri…

190.043. Increase in tax rate without voter approval, when, amount. — Subject to the provisions of chapter 137, in addition to the tax rate increase allowed pursuant to subdivision (3) of subsection 5 of section 137.073, if an ambulance district voluntarily decreases its tax rate…

190.045. Returns of election, where filed — effect of. — The results of the submission of the question shall be entered upon the records of the commission and a certified copy thereof shall be filed with the county clerk of each other county in which the proposed district lies, w…

190.050. Election districts, how established — election of directors — declaration of candidacy filed, where, when — ordinance to abolish or establish boundaries, procedure. — 1. (1) After the ambulance district has been declared organized, the declaring county commission shall d…

190.051. Change in number of board members, when — ballot language. — 1. Notwithstanding the provisions of sections 190.050 and 190.052 to the contrary, upon a resolution adopted by the board of directors in districts where there are six-member boards, and upon approval by the vo…

190.052. Board member must live in district — vacancies, how filled. — Any member of the board of directors who moves residency from the district shall be disqualified as a member of the board. If one or two vacancies occur in the membership of the board as a result of death, res…

190.053. Educational training required for board of directors — failure to attend. — 1. All members of the board of directors of an ambulance district first elected on or after January 1, 2008, shall attend and complete an educational seminar or conference or other suitable train…

190.055. Powers of board — seal and bylaws required — reimbursement of board members' expenses — secretary and treasurer, additional compensation — board member attendance fees, when — ineligibility for board employment, when. — 1. The board of directors of a district shall posse…

190.056. Recall of directors, procedure. — 1. Each member of an ambulance district board of directors shall be subject to recall from office by the registered voters of the election district from which he or she was elected. Proceedings may be commenced for the recall of any such…

190.060. Powers of district. — 1. An ambulance district shall have the following governmental powers, and all other powers incidental, necessary, convenient or desirable to carry out and effectuate the express powers: (1) To establish and maintain an ambulance service within its …

190.065. Bonds, issuance of — election, form of ballot. — 1. For the purpose of purchasing any property or equipment necessary or incidental to the operation of an ambulance service, the board of directors may borrow money and issue bonds for the payment thereof in the manner pro…

190.070. Annexation, petition for — hearing — election, form of ballot. — 1. A petition for annexation of land to an ambulance district shall be signed by not less than ten percent or fifty voters, whichever is fewer, residing within the territory therein described proposed for a…

190.074. Collection of taxes — levy — procedure. — To levy and collect taxes as herein provided, the board shall fix a rate of levy, not to exceed ten cents on the one hundred dollars valuation of the taxable tangible property within the district as shown by the last completed as…

190.075. Records, what and how kept. — The board shall provide for the proper and safe keeping of its permanent records and for the recording of the corporate action of the district. Such books and records shall be made available for inspection by any member of the board upon req…

190.076. Audit of district, when — availability to public. — Each ambulance district shall arrange for an audit of the records and accounts of the district at least every three years by a certified public accountant or firm of certified public accountants. The audit shall be made…

190.080. Donated property — title, how taken. — Any person desiring to donate property for the benefit of an ambulance district established pursuant to the provisions of sections 190.005 to 190.085 may vest title to the property so donated in the board of directors created pursua…

190.085. Failure to approve bonds, effect of — dissolution — funds, how rebated. — In any ambulance district created under the provisions of sections 190.005 to 190.085, which is not operating an ambulance service and in which the voters of said district have on three separate oc…

190.087. Ambulance district serving city in more than one county may be expanded — procedure (Franklin County). — The boundaries of any ambulance district established pursuant to chapter 190, which is located in a noncharter county of the first classification with a population of…

190.089. Consolidation of districts, department to prioritize and expedite. — Upon voter approval of an ambulance district consolidation at an election, the department shall prioritize and expedite any activities necessary to facilitate the consolidation. ­­-------- (L. 2026 S.B.…

190.090. Consolidation of ambulance districts, procedure for — form of ballot — consolidation plan, contents — notice requirements, form — ballot form — tax levy, amount. — 1. Two or more organized ambulance districts may consolidate into one ambulance district by following the p…

190.091. Vaccination program for first responders and telecommunicators offered — definitions — participation voluntary, exception — contingent effective date. — 1. As used in this section, the following terms mean: (1) "Bioterrorism", the intentional use of any microorganism, vi…

190.092. Defibrillators, requirements — good faith immunity from civil liability, when — all basic life support ambulances and stretcher vans to be equipped with. — 1. This section shall be known and may be cited as the "Public Access to Automated External Defibrillator Act". 2. …

190.094. Minimum ambulance staffing — volunteer defined. — 1. Any ambulance licensed in this state, when used as an ambulance and staffed with volunteer staff, shall be staffed with a minimum of one emergency medical technician and one other crew member who may be a licensed emer…

190.098. Community paramedic, certification requirements — scope of practice — written agreement — rulemaking authority. — 1. As used in this section, the term "community paramedic services" means services that are: (1) Provided by any entity that: (a) Employs licensed paramedics…

190.100. Definitions. — As used in sections 190.001 to 190.245 and section 190.257, the following words and terms mean: (1) "Advanced emergency medical technician" or "AEMT", a person who has successfully completed a course of instruction in certain aspects of advanced life suppo…

190.1005. CPR training or courses to include instruction on proper use of automated external defibrillators. — Notwithstanding any other provision of law to the contrary, any training or course in cardiopulmonary resuscitation shall also include instruction on the proper use of a…

190.101. State advisory council on emergency medical services, members, appointment, purpose, duties — subcommittee established, duties. — 1. There is hereby established a "State Advisory Council on Emergency Medical Services" which shall consist of no more than twenty-three memb…

190.1010. Peer support counseling, confidentiality, exceptions — requirements. — 1. As used in this section, the following terms shall mean: (1) "Employee", a first responder employed by an employer; (2) "Employer", the state, a unit of local government, or a public hospital or a…

190.102. Regional EMS advisory committees. — 1. The department shall designate through regulation EMS regions and committees. The purpose of the regional EMS advisory committees is to advise and make recommendations to the region and the department on: (1) Coordination of emergen…

190.103. Regional EMS medical director, powers, duties — considered public official, when — online telecommunication medical direction permitted — treatment protocols for special needs patients. — 1. One physician with expertise in emergency medical services from each of the EMS …

190.104. Pediatric emergency medical services system. — 1. The department is authorized to establish a program to improve the quality of emergency care for pediatric patients throughout the state and to implement a comprehensive pediatric emergency medical services system in acco…

190.105. Ambulance license required, exceptions — operation of ambulance services — sale or transfer of ownership, notice required. — 1. No person, either as owner, agent or otherwise, shall furnish, operate, conduct, maintain, advertise, or otherwise be engaged in or profess to …

190.106. Criminal background check, fingerprint submission. — 1. The department of health and senior services may require that fingerprint submissions be made as part of an application seeking licensure as an emergency medical technician or "EMT", an advanced emergency medical te…

190.107. Contracts for mutual aid services. — 1. Any municipally operated ambulance service, ambulance district, fire protection district that provides ambulance service or any other ambulance service may enter into contracts providing for mutual aid services provided by such amb…

190.108. Air ambulance licenses — sale or transfer of ownership, notice required. — 1. The department shall, within a reasonable time after receipt of an application, cause such investigation as the department deems necessary to be made of the applicant for an air ambulance licen…

190.109. Ground ambulance license. — 1. The department shall, within a reasonable time after receipt of an application, cause such investigation as the department deems necessary to be made of the applicant for a ground ambulance license. 2. Any person that owned and operated a l…

190.111. Inspection limitation — effect of sale or transfer on a license. — The inspection conducted under subsection 14 of section 190.105 shall be limited to the verification of compliance with standards for renewal of an existing license, and shall not include the criteria set…

190.112. Ambulance service administrator — training, requirements. — 1. Each ambulance service licensed under this chapter shall identify to the department the individual serving as the ambulance service administrator who is responsible for the operations and staffing of the ambu…

190.120. Insurance, what coverage required — policy provisions required — term of policy. — 1. No ambulance service license shall be issued pursuant to sections 190.001 to 190.245, nor shall such license be valid after issuance, nor shall any ambulance be operated in Missouri unl…

190.131. Certification of training entities. — 1. The department shall accredit or certify training entities for emergency medical responders, emergency medical dispatchers, and emergency medical technicians, for a period of five years, if the applicant meets the requirements est…

190.133. Emergency medical response agency license. — 1. The department shall, within a reasonable time after receipt of an application, cause such investigation as the department deems necessary to be made of the applicant for an emergency medical response agency license. 2. The…

190.142. Emergency medical technician license, requirements — rules. — 1. (1) For applications submitted before the recognition of EMS personnel licensure interstate compact under sections 190.900 to 190.939 takes effect, the department shall, within a reasonable time after recei…