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SB 975MISSOURISession 2026State BillSigned into law

Enacted

Missouri modifies ambulance district rules, establishes critical stress management program, and creates 988 Public Safety Fund

Original title: Modifies provisions relating to ambulance districts

Last action · July 9, 2026: Signed by GovernorSponsor: Rusty Black

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Committee

Floor Vote

Passed

Law

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What This Bill Does

Missouri law establishes the Critical Incident Stress Management Program within the department of public safety for peace officers and first responders, creates the 988 Public Safety Fund, and updates community paramedic service and ambulance district regulations.

Why it matters

Peace officers and first responders are required to attend mental health check-ins every three to five years, and the state establishes a dedicated fund for crisis intervention services while modifying administrative oversight for ambulance and .

Background

Community paramedic services involve trained paramedics providing non-emergent care under medical oversight, independent of standard 911 emergency response dispatches. context
The Administrative Hearing Commission is an independent Missouri state agency that conducts administrative hearings and issues findings and recommendations on professional license disputes. context

Who It Affects

Groups the bill's text affects, as described in the record. Being affected is not a position for or against it.

Directly affected

Peace officers and first responders

Must complete mandatory mental health check-ins every three to five years and gain access to the Critical Incident Stress Management Program and privileged counseling services.

Directly affected

Ambulance services and community paramedics

Subject to updated memorandum of understanding requirements for operating outside primary service areas, five-year endorsement terms, and revised administrative disciplinary rules.

Directly affected

Department of Public Safety

Must administer the Critical Incident Stress Management Program and oversee disbursements from the newly created 988 Public Safety Fund.

Key Facts

You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.

Frequently Asked Questions

How often must peace officers and first responders complete a mental health check-in?

All peace officers and first responders are required to meet with a program service provider or approved behavioral health program once every three to five years.

Can information disclosed during a first responder's mental health check-in be used in court?

No, disclosures are privileged and cannot be used as evidence in criminal, administrative, or civil proceedings against the officer or first responder, except when necessary to prevent harm, with written consent, or under mandatory reporting laws.

What is the purpose of the 988 Public Safety Fund?

The dedicated fund is used solely by the department of public safety to provide services for peace officers and first responders to assist in coping with stress and potential psychological trauma resulting from critical incidents.

What else do you want to know?

News Coverage

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Votes, people, money & the original source

Where This Stands

Current status: Signed into law.

Procedural history

43 actions

Jul 9, 2026Office of the GovernorEnrolled
Signed by Governor
May 28, 2026Senate
Reported Duly Enrolled Rules, Joint Rules, Resolutions & Ethics Committee
May 28, 2026Senate
Signed by Senate President Pro Tem
May 28, 2026House
Signed by House Speaker
May 28, 2026Office of the Governor
Delivered to Governor
May 14, 2026House
H adopts CCR --(5215S11.1SR)

Show 37 earlier actions

May 14, 2026HouseFloor
CCS H Third Read and Passed --(5215S.11S)
May 14, 2026SenateFloor
Truly Agreed To and Finally Passed
May 13, 2026Senate
CCR S offered & adopted (5251S11.1SR)
May 13, 2026SenateFloor
CCS S Third Read and Passed
May 12, 2026House
H distributes CCR/CCS
May 12, 2026Senate
S distributes CCR (5215S11.1SR)
May 12, 2026Senate
S distributes CCS (5215S.11S)
May 6, 2026Senate
Senate conferees appointed: Black, Bernskoetter, Henderson, Beck, May
May 4, 2026House
H refuses to recede and grants conference
May 4, 2026House
House conferees appointed: Farnan, Hinman, Billington, Walsh Moore, Smith (74)
Apr 30, 2026Senate
S refuses to concur in HCS, as amended and requests H recede or grant conference
Apr 23, 2026House
HA 1 to HCS H offered & adopted (Hinman)--(5215H07.06H)
Apr 23, 2026House
HCS, as amended, H adopted --(5215H.07C)
Apr 23, 2026HouseFloor
H Third Read and Passed
Apr 9, 2026HouseCommittee
HCS Voted Do Pass H Rules - Administrative
Apr 9, 2026HouseCommittee
HCS Reported Do Pass H Rules - Administrative
Apr 7, 2026HouseCommittee
Referred H Rules - Administrative
Apr 2, 2026HouseCommittee
HCS Reported Do Pass H Local Government
Apr 1, 2026HouseCommittee
HCS Voted Do Pass H Local Government
Mar 25, 2026House
Hearing Conducted H Local Government
Mar 12, 2026HouseCommittee
Referred H Local Government
Mar 9, 2026HouseFloor
H Second Read
Mar 5, 2026SenateFloor
S Third Read and Passed
Mar 5, 2026HouseIntroduced
H First Read
Feb 25, 2026Senate
Reported Truly Perfected S Rules, Joint Rules, Resolutions and Ethics Committee
Feb 24, 2026Senate
SS S offered (Black)--(5215S.04F)
Feb 24, 2026Senate
SA 1 to SS S offered & adopted (May)--(5215S04.06S)
Feb 24, 2026Senate
SA 2 to SS S offered & adopted (Hough)--(5215S04.01F)
Feb 24, 2026SenateFloor
SS, as amended, S adopted
Feb 24, 2026Senate
Perfected
Feb 12, 2026Senate
Reported from S Local Government, Elections and Pensions Committee
Feb 9, 2026SenateCommittee
Voted Do Pass S Local Government, Elections and Pensions Committee
Jan 29, 2026Senate
Hearing Conducted S Local Government, Elections and Pensions Committee
Jan 26, 2026Senate
Hearing Cancelled S Local Government, Elections and Pensions Committee
Jan 8, 2026SenateFloor
Second Read and Referred S Local Government, Elections and Pensions Committee
Jan 7, 2026SenateIntroduced
S First Read
Dec 1, 2025Senate
Prefiled

Version history & redline

12 versions on file

Official version history is partial: 2 linked texts are unavailable or incomplete. Source links remain available below.

Comparing 2/24/2026 - SS S offered (Black)--(5215S.04F) 2/24/2026 - Adopted, as amended → 5215S.04P - Perfected

Administrative Hearing Commission Department of Health and Senior Services Department of Public Safety State Treasurer

removed addedOfficial text

5215S.04F 1 SENATE SUBSTITUTE FOR SENATE BILL NO. 975 AN ACT To repeal sections 190.050, 190.051, 190.052, 190.070, and 190.090, RSMo, and to enact in lieu thereof five new sections relating to ambulance districts. Be it enacted by the General Assembly of the State of Missouri, as follows: Section A. Sections 190.050, 190.051, 190.052, 190.070, and 190.090, RSMo, are repealed and five new sections enacted in lieu thereof, to be known as sections 190.050, 190.051, 190.050. 1. After the ambulance district has been declared organized, the declaring county commission[, except in counties of the second class having more than one hundred five thousand inhabitants located adjacent to a county of the first class having a charter form of government which has a population of over nine hundred thousand inhabitants, shall divide the district into six election districts as equal in population as possible, and shall by lot number the districts from one to six inclusive. The county commission shall cause an election to be held in the ambulance district within ninety days after the order establishing the ambulance district to elect ambulance district directors. Each voter shall vote for one director from the ambulance election district in which the voter resides. The directors elected from districts one and four shall serve for a term of one year, the directors elected from districts two and five shall serve for a term of two years, and the directors from districts three and six shall serve for a term of three years; thereafter, the terms of all directors shall be three years. All directors shall serve the term to which they were elected or appointed, and until their successors are elected and qualified, except in cases of resignation or disqualification. The county commission shall reapportion the ambulance districts within sixty days after the population of the county is reported to the governor for each decennial census of the United States. Notwithstanding any other provision of law, if the number of candidates for the office of director is no greater than the number of directors to be elected, no election shall be held, and the candidates shall assume the responsibilities of their offices at the same time and in the same manner as if they have been elected. 2. In all counties of the second class having more than one hundred five thousand inhabitants located adjacent to a county of the first class having a charter form of government which has a population of over nine hundred thousand inhabitants,] shall order an election be held on the next regularly scheduled election date and the voters shall vote for six directors elected at large from within the district for a term of three years. [Those directors holding office in any district in such a county on August 13, 1976, shall continue to hold office until the expiration of their terms, and their successors shall be elected from the district at large for a term of three years. In any district formed in such counties after August 13, 1976, the governing body of the county shall cause an election to be held in that district within ninety days after the order establishing the ambulance district to elect ambulance district directors.] Each voter shall vote for six directors. The two candidates receiving the highest number of votes at such election shall be elected for a term of three years, the two candidates receiving the third and fourth highest number of votes shall be elected for a term of two years, the two candidates receiving the fifth and sixth highest number of votes shall be elected for a term of one year; thereafter, the term of all directors shall be three years. A director holding office as of August 28, 2026, shall continue as an at-large director for the remainder of such director's existing term. [3.] 2. A candidate for director of the ambulance district shall, at the time of filing, be a citizen of the United States, [a qualified voter of the election district as provided in subsection 1 of this section,] a resident of the district for two years next preceding the election, and shall be at least twenty-four years of age. In an established district which is located within the jurisdiction of more than one election authority, the candidate shall file his or her declaration of candidacy with the secretary of the board. In all other districts, a candidate shall file a declaration of candidacy with the county clerk of the county in which he or she resides. A candidate shall file a statement under oath that he or she possesses the required qualifications. No candidate's name shall be printed on any official ballot unless the candidate has filed a written declaration of candidacy pursuant to subsection 5 of section 115.127. If the time between the county commission's call for a special election and the date of the election is not sufficient to allow compliance with subsection 5 of section 115.127, the county commission shall, at the time it calls the special election, set the closing date for filing declarations of candidacy. 3. Any ambulance district may adopt and establish election subdistricts by ordinance, providing that each election subdistrict shall be composed of contiguous territory as compact and as nearly equal in population as may be, and that each board member shall be a resident of the election subdistrict that they represent at the time of their election and for the duration of their term. Such ordinance shall only be adopted, amended, or repealed by a two-thirds majority vote of the board of directors. 4. Notwithstanding any other provision of law to the contrary, if the number of candidates for the office of director is less than the number of directors to be elected, no election shall be held, and the candidates shall assume the responsibilities of their offices at the same time and in the same manner as if they were elected. 190.051. 1. Notwithstanding the provisions of sections 190.050 and 190.052 to the contrary, upon a [motion] resolution adopted by the board of directors in districts where there are six-member boards, and upon approval by the voters in the district, the number of directors may be increased to seven [with one board member running district wide,] or decreased to five or three board members. The resolution shall state the names of the existing directors who will fill the positions on the board if such measure is approved by the voters, as well as any vacancies to be filled by subsequent election, and shall state the dates on which those terms shall conclude. 2. The ballot to be used for the approval of the voters to increase or decrease the number of members on the board of directors of the ambulance district shall be substantially in the following form: [3.] 4. If a majority of the voters voting on a3 proposition to decrease the number of board members vote in3 favor of the proposition, then the [county clerk shall3 redraw the district into the resulting number of3 subdistricts with equal population bases and hold elections3 by subdistricts pursuant to section 190.050] existing board3 members stated in the board resolution shall complete the3 terms specified therein. Thereafter, members of the board3 shall be elected to serve terms of three years and until3 [4. Members of the board of directors in office on the4 date of an election pursuant to this section to increase or4 decrease the number of members of the board of directors4 shall serve the term to which they were elected or appointed4 190.052. Any member of the board of directors who moves their residency from the district [from which the member was elected] 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, resignation, or disqualification, the remaining members shall appoint one or two qualified persons, as provided in section 190.050, to fill the vacancies until the end of the unexpired term. Such appointment shall be made with the consent of a majority of the remaining members of the board. If the board is unable to agree in filling a vacancy [within sixty days or if there are more than two vacancies at any one time], the county commission, upon [notice from the board of failure to agree in filling the vacancies] the written request of a majority of the remaining board members or the ambulance service administrator, as described in section 190.112, shall within [ten] thirty calendar days fill them by appointment of qualified persons, as provided in section 190.050, and shall notify the persons in writing of their appointment. The persons appointed shall serve for the unexpired term. 190.070. 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 annexation and shall be [filed with the county clerk of the county in which the district or the greater portion thereof is situated, and shall be addressed to the commissioners of the county commission] presented to the board of directors of the ambulance district. A hearing shall be held thereon as nearly as possible as in the case of a formation petition. If upon the hearing the [commissioners of the county commission find] board of directors finds that the petition is in compliance with the provisions of sections 190.005 to 190.085, they shall order the question to be submitted to the voters within the territory and within the district. 2. The question shall be submitted in substantially the following form to all of the voters in the existing ambulance district and the area proposed to be annexed: Shall ______ (description of territory) be annexed to the ______ ambulance district, and a tax imposed within such annexed area equal to the existing rate of the _____ ambulance district? 3. If a majority of the votes cast on the question [in the district and in the territory described in the petition, respectively,] are in favor of the annexation, the [commissioners of the county commission shall by order declare] board of directors shall enact an ordinance incorporating the territory annexed and shall describe the altered boundaries of the district. A copy of the same shall be filed with the county clerk. 190.090. 1. Two or more organized ambulance districts may consolidate into one ambulance district by following the procedures set forth in this section. 2. If the consolidation of existing ambulance districts is desired, a number of voters residing in an existing ambulance district equal to ten percent of the vote cast for governor in the existing district in the next preceding gubernatorial election may file with the county clerk in which the territory or greater part of the proposed consolidated district is situated a petition requesting the consolidation of two or more existing ambulance districts. 3. The petition shall be in the following form: We, the undersigned voters of the ______ ambulance district do hereby petition that ______ existing ambulance districts be consolidated into one consolidated ambulance district to be known as the _____ Ambulance District, subject to the attached consolidation plan. 4. An alternative procedure of consolidation may be followed, if the board of directors of the existing ambulance districts pass a resolution in the following form: Be it resolved by the board of directors of the ambulance district that the ______ ambulance districts be consolidated into one consolidated ambulance district to be known as the _____ Ambulance District, subject to the attached consolidation plan. 5. Every petition or resolution shall be accompanied by a consolidation plan outlining the process for the proposed consolidation. At a minimum, the consolidation plan shall include the following: (1) The name of the proposed consolidated district, a legal description of the boundaries of such consolidated district, and the proposed tax levy to be imposed by the consolidated district. In the event that the proposed plan is for the consolidation into an existing district, the consolidation plan shall clearly state that the existing district shall continue as the legal entity into which the other districts are consolidated; (2) The names of the districts to be consolidated, accompanied by a list of all real property owned and financial assets currently held by the district, all outstanding bonds or debts of each of said districts, and the current tax levies imposed by each of said districts; (3) The name of the district which shall be responsible for maintaining ambulance service during the consolidation, including continuing operations, administration, and governance of the consolidated district, provided that there shall be a presumption that the district with the largest operating budget in the preceding fiscal year shall assume such responsibility; (4) The proposed number of board members and specific individuals who will serve as the initial directors, provided that such directors shall be chosen from among the existing board members of the districts to be consolidated such that there is at least one director from each of the districts to be consolidated; and (5) A proposed time line for consolidation, which shall not exceed one hundred eighty days, provided that such time line shall be subject to modification by the board of the consolidated district for good cause. 6. Upon the filing of a petition, or a resolution, and a consolidation plan with the county clerk from each of the ambulance districts proposed to be consolidated, the county clerk shall present the petition or resolution and consolidation plan to the commissioners of the county commission [having jurisdiction who shall thereupon order the submission of the question to the voters of the districts. The filing of each of the petitions in the ambulance districts shall have occurred within a continuous twelve-month period. 6. The notice shall set forth the names of the existing ambulance districts to be included in the consolidated district. 7. The question shall be submitted in substantially the following form: Shall the existing ______ ambulance districts be consolidated into one ambulance district? 8. If the county commission having jurisdiction finds that the question to consolidate the districts received a majority of the votes cast, the commission shall make and enter its order declaring that the proposition passed. 9. Within thirty days after the district has been declared consolidated, the county commission shall divide the district into six election districts and shall order an election to be held and conducted as provided in section 190.050 for the election of directors. 10. Within thirty days after the election of the initial board of directors of the district, the directors shall meet and the time and place of the first meeting of the board shall be designated by the county commission. At the first meeting the newly elected board of directors shall choose a name for the consolidated district and shall notify the clerk of the county commission of each county within which the consolidated district is located of the name of the consolidated district. 11. On the thirtieth day following the election of the board of directors, the existing ambulance districts shall cease to exist and the consolidated district shall assume all of the powers and duties exercised by those districts. All assets and obligations of the existing ambulance districts shall become assets and obligations of the consolidated district], who shall record such documents in the records of the county. A petition or resolution for a proposed consolidation shall be received from all ambulance districts within the same calendar year or shall be considered null and void. 7. Each of the ambulance districts seeking to consolidate shall post the notice of the intent to consolidate in the same manner as district public meetings are posted. In addition, publication of such notice of intent shall be made in a newspaper of general circulation in every county in which the proposed consolidated ambulance district shall be located, with publication to be made once per week for two consecutive weeks. A public hearing shall be held jointly by all ambulance districts seeking to consolidate at a location within the boundaries of the proposed consolidated ambulance district, provided that such hearing shall be no more than ten days after the date of the second publication. The notice of intent shall be in substantially the following form: 8. If no objections are filed with the county clerk15 within thirty days after the public hearing, then within15 forty-five days following the date of the public hearing,15 the county commission shall order the districts consolidated15 pursuant to the terms of the consolidation plan and shall15 further appoint as directors those individuals identified in15 12 12 12 13 13 13 13 13 13 13 13 13 clerk shall verify that such objections are signed by the16 necessary number of voters of the district. If said16 objections are signed by an appropriate number of voters,16 the county commission of each county in which the proposed16 consolidated district is to be located shall thereupon order16 the submission of the question to the voters of the16 districts. The question shall be submitted in substantially16 If the county commission having jurisdiction finds that the17 question to consolidate the districts received a majority of17 order declaring that the proposition passed. The county18 commission shall further order the districts consolidated18 pursuant to the terms of the consolidation plan and shall18 further appoint as directors those individuals identified in18 the consolidation plan. The county commission shall further18 set a date, time, and location for the first meeting of the18 directors of the newly consolidated district.18 10. Notwithstanding any other provision of law to the18 16 17 17 17 17 17 17 17 districts, provided such tax levy is specifically set forth19 in the ballot language submitted to and approved by the19 voters of the consolidating district.19 11. Without a vote of the residents of the19 consolidated district as provided in this section, no19 consolidated ambulance district shall be permitted to impose19 a property tax greater than the lowest of any existing19 property tax rate of the districts to be consolidated, nor19 shall the consolidated ambulance district be permitted to19 sales tax rate of the districts to be consolidated.20 12. Upon written certification by the board of20 directors of the consolidated district to the prior district20 that the consolidated district has obtained the necessary20 licenses and permits to operate an ambulance service and all20 directors of such consolidated district have completed the20 training required by section 190.053, the existing ambulance20 districts shall cease to exist and the consolidated district20 shall assume all of the powers and duties exercised by those20 districts. All assets and obligations of the existing2 ambulance districts shall become assets and obligations of2 the consolidated district.2 13. Any ambulance district that has contracted for2 ambulance service with another ambulance district for more2 than five consecutive years may submit a joint resolution2 executed by the boards of both ambulance districts to the2 county clerk of the county in which the larger area of the2 proposed consolidated district is located, requesting2 consolidation of said districts by consolidating the smaller2 districts into the larger district. Such resolution shall2 be accompanied by a consolidation plan as provided in this2 section. Upon the receipt of such joint resolution, the2 county commission shall promptly order the smaller districts2 consolidated into the larger district pursuant to the terms2 of the consolidation plan without the necessity of providing2 notice or public hearing.2EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted and is intended to be omitted in the law. SECOND REGULAR SESSION [PERFECTED] SENATE SUBSTITUTE FOR SENATE BILL NO. 975 103RD GENERAL ASSEMBLY INTRODUCED BY SENATOR BLACK. 5215S.04P KRISTINA MARTIN, Secretary AN ACT To repeal sections 190.050, 190.051, 190.052, 190.070, 190.090, 190.098, 190.165, and 590.192, RSMo, and to enact in lieu thereof eight new sections relating to ambulance districts. Be it enacted by the General Assembly of the State of Missouri, as follows: Section A. Sections 190.050, 190.051, 190.052, 190.070, 190.090, 190.098, 190.165, and 590.192, RSMo, are repealed and eight new sections enacted in lieu thereof, to be known as sections 190.050, 190.051, 190.052, 190.070, 190.090, 190.098, 190.050. 1. After the ambulance district has been declared organized, the declaring county commission[, except in counties of the second class having more than one hundred five thousand inhabitants located adjacent to a county of the first class having a charter form of government which has a population of over nine hundred thousand inhabitants, shall divide the district into six election districts as equal in population as possible, and shall by lot number the districts from one to six inclusive. The county commission shall cause an election to be held in the ambulance district within ninety days after the order establishing the ambulance district to elect ambulance district directors. Each voter shall vote for one director from the ambulance election district in which the voter resides. The directors elected from districts one and four shall serve for a term of one year, the directors elected from districts two and five shall serve for a term of two years, and the directors from districts three and six shall serve for a term of three years; thereafter, the terms of all directors shall be three years. All directors shall serve the term to which they were elected or appointed, and 36,905 more added characters - read this version

Redline computed from the official version text (record lane).View this version →

Lobbying Activity

No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.

Full breakdown

Who this bill affects and the strongest case for and against it, written only from the bill’s own text.

Discoveries

1 pattern noticed across the record

Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.

policy shift98% confidence

Mandatory Mental Health Framework for First Responders

The legislation transitions mental health check-ins for peace officers and first responders from optional wellness support to a mandatory requirement occurring every three to five years.

Department of Public Safety

Connected Entities

Department of Health and Senior Services, Rusty Black, State Treasurer and 2 more

OrganizationDepartment of Health and Senior Services“Handles endorsements and disciplinary proceedings for community paramedics and a”Map →

PersonRusty Black“Republican Senator, District 12”Map →

PersonState Treasurer“Serves as custodian of the 988 Public Safety Fund and approves disbursements”Map →

OrganizationDepartment of Public Safety“Houses the Critical Incident Stress Management Program and administers the 988 P”Map →

OrganizationAdministrative Hearing Commission“Hears complaints and makes recommendations regarding disciplinary actions agains”Map →

Sources

Open source document

www.senate.mo.gov

Analysis Score

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Significance75
How much this matters to a regular citizen
Controversy15
Intensity of disagreement among stakeholders
Entertainment5
Compellingness for a non-policy-wonk reader
Buzz35
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Missouri modifies ambulance district rules, establishes critical stress management program, and creates 988 Public Safety Fund

What This Bill Does

Who It Affects

Key Facts

Frequently Asked Questions

News Coverage

Where This Stands

Procedural history

Version history & redline

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Mandatory Mental Health Framework for First Responders

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