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SB 1019MISSOURISession 2026State BillSigned into law

Enacted

Missouri Senate Passes SB 1019 Expanding Hospital Investment Limits and Operating Authorities

Original title: Modifies several provisions relating to health care

Last action · July 13, 2026: Signed by GovernorSponsor: Sandy Crawford

Bill progressHistory & official text ↓

Introduced

Committee

Floor Vote

Passed

Law

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What This Bill Does

Senate Bill 1019 increases the investment limit from 25% to 50% for certain municipal and hospital district funds into mutual funds, high-rated bonds, and money-market investments, provided they receive minimal tax revenues. The measure also modifies geographic operating restrictions for third-class city municipal hospitals and hospital district hospitals.

Why it matters

Qualifying municipal and hospital district boards gain broader authority to invest up to half of their idle funds in diversified equities and bonds while altering where certain public health care facilities can operate and lease related facilities.

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

municipal hospitals in third class cities

Boards of trustees face modified investment limits and altered geographic operating restrictions.

Directly affected

hospital district hospitals

Their investment authority and boundaries for operating related facilities are modified.

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

Which hospitals are eligible to invest up to 50% of their uncommitted funds under SB 1019?

Eligible hospitals are those established under specific statutory chapters that receive less than three percent of their annual revenues from municipal, county, state, or hospital district taxes and appropriated funds.

What types of investments are newly permitted for these hospital funds?

Hospitals may invest in mutual funds holding stocks, bonds, or real estate, highly rated bonds with a final maturity of ten years or less, and money-market investments.

What else do you want to know?

News Coverage

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Check Your Understanding

1.According to version 4774S.01P, what does the bill authorize the board of trustees of an eligible hospital to do regarding its uncommitted funds?

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Votes, people, money & the original source

Where This Stands

Current status: Signed into law.

Procedural history

42 actions

Jul 13, 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 15, 2026Senate
S concurs in HCS, as amended

Show 36 earlier actions

May 15, 2026SenateFloor
S Third Read and Passed
May 15, 2026SenateFloor
Truly Agreed To and Finally Passed
May 14, 2026HouseCommittee
HCS Voted Do Pass H Fiscal Review
May 14, 2026HouseCommittee
HCS Reported Do Pass H Fiscal Review
May 14, 2026House
Bill Placed on H Informal Calendar
May 14, 2026House
HA 1 to HCS H offered & adopted (Stinnett)--(4774H04.27H)
May 14, 2026House
HCS, as amended, H adopted --(4774H.04C)
May 14, 2026HouseFloor
H Third Read and Passed
May 14, 2026HouseFloor
Motion to reconsider H Third Reading Vote H adopted
May 14, 2026House
Motion to reconsider the adoption of the HCS, as amended, H adopted
May 14, 2026House
Motion to reconsider the adoption HA 1 to HCS H adopted
May 14, 2026House
HSA 1 for HA 1 to HCS H offered & adopted (Kalberloh)--(4774H04.34H)
May 14, 2026House
HCS, as amended, H adopted --(4774H.04C)
May 14, 2026HouseFloor
H Third Read and Passed
May 12, 2026HouseCommittee
Referred H Fiscal Review Committee
Apr 28, 2026HouseCommittee
HCS Voted Do Pass H Rules - Administrative
Apr 28, 2026HouseCommittee
HCS Reported Do Pass H Rules - Administrative
Apr 23, 2026HouseCommittee
Referred H Rules - Administrative
Apr 21, 2026HouseCommittee
HCS Voted Do Pass H Health and Mental Health
Apr 21, 2026HouseCommittee
HCS Reported Do Pass H Health and Mental Health
Apr 9, 2026House
Hearing Conducted H Health and Mental Health
Apr 2, 2026HouseCommittee
Referred H Health and Mental Health
Mar 16, 2026HouseFloor
H Second Read
Mar 12, 2026SenateFloor
S Third Read and Passed
Mar 12, 2026HouseIntroduced
H First Read
Mar 10, 2026Senate
Reported Truly Perfected S Rules, Joint Rules, Resolutions and Ethics Committee
Mar 9, 2026Senate
SA 1 S withdrawn
Mar 9, 2026Senate
Perfected
Feb 24, 2026Senate
SA 1 S offered (Lewis)--(4774S01.12S)
Feb 24, 2026Senate
Bill Placed on Informal Calendar
Feb 12, 2026Senate
Reported from S General Laws Committee
Jan 28, 2026SenateCommittee
Voted Do Pass S General Laws Committee
Jan 21, 2026Senate
Hearing Conducted S General Laws Committee
Jan 15, 2026SenateFloor
Second Read and Referred S General Laws Committee
Jan 7, 2026SenateIntroduced
S First Read
Dec 1, 2025Senate
Prefiled

Version history & redline

4 versions on file

Comparing 4774H.04T - Truly Agreed to and Finally Passed → 4774S.01P - Perfected

removed addedOfficial text

EXPLANATION-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 [TRULY AGREED TO AND FINALLY PASSED] HOUSE COMMITTEE SUBSTITUTE FOR [PERFECTED] SENATE BILL NO. 1019 103RD GENERAL ASSEMBLY 2026 4774H.04T INTRODUCED BY SENATOR CRAWFORD. 4774S.01P KRISTINA MARTIN, Secretary AN ACT To repeal sections 96.192, 96.196, and 206.110, RSMo, and section 192.026 as truly agreed to and finally passed by senate substitute for senate committee substitute for house committee substitute for house bill no. 2372, one hundred third general assembly, second regular session, and to enact in lieu thereof five four new sections relating to health care. hospitals. Be it enacted by the General Assembly of the State of Missouri, as follows: Section A. Sections 96.192, 96.196, and 206.110, RSMo, and section 192.026 as truly agreed to and finally passed by senate substitute for senate committee substitute for house committee substitute for house bill no. 2372, one hundred third general assembly, second regular session, are repealed and five four new sections enacted in lieu thereof, to be known as sections 96.192, 96.196, 192.026, 206.110, and 206.158, to read as follows: 96.192. 1. The board of trustees of any hospital authorized under subsection 2 of this section, and established and organized under the provisions of sections 96.150 to 96.229[,]: (1) May 96.229, may invest up to [twenty-five] fifty percent of the hospital's "available funds", defined in this section as [the hospital's] its funds not required for immediate disbursement in obligations or for the operation of the hospital [in any United States investment grade fixed income funds or any diversified stock funds, or both.], both] into: (a) (1) Any mutual funds that invest in stocks, bonds, or real estate, or any combination thereof; (b) (2) Bonds that have: a. (a) One of the five highest long-term ratings or the highest short-term rating issued by a nationally recognized rating agency; and b. (b) A final maturity of ten years or less; (c) Money market (3) Money-market investments; or (d) (4) Any combination of investments described in paragraphs (a) subdivisions (1) to (c) (3) of this subdivision; and (2) Shall subsection. The board shall invest the remaining percentage of any available funds not invested as allowed under subdivision (1) of this subsection required for immediate disbursement into any investment in which the state treasurer is allowed to invest. 2. The provisions of this section shall only apply if the hospital: […] boundaries, the governing body of the city shall approve the hospital's plan for such purchase, operation or lease prior to implementation of the plan. [192.026. 1. Sections 103.190 and 192.026 to 192.029 shall be known and may be cited as the "Missouri Lyme Disease Eradication Act". 2. As used in sections 103.190 and 192.026 to 192.029, the following terms shall mean: (1) "Department", the department of health and senior services; (2) "Lyme disease", a condition caused by an infection of the bacterium Borrelia burgdorferi, Borrelia mayonii, Borrelia afzelii, Borrelia garinii, Borrelia valaisiana, Borrelia lusitaniae, Bartonella, Babesia, Ehrlichia, or related species, transmitted to humans through the bite of infected blacklegged ticks (Ixodes scapularis) or other ticks, as diagnosed by the two-tier serologic testing recommended by the federal Centers for Disease Control and Prevention (CDC) or by a similar blood test ordered by a treating health care provider or by clinical evaluation; (3) "Medically necessary", health care services or products that a treating health care provider exercising prudent clinical judgment would provide to a patient for the purpose of preventing, evaluating, diagnosing, or treating an illness, injury, disease, or symptoms of such, and that are: (a) Clinically appropriate in terms of type, frequency, extent, site, and duration for the specific circumstances; and (b) Not primarily for the mere convenience of the patient, health care provider, or as determined by the provider based on the patient's specific circumstances; (4) "Posttreatment Lyme disease syndrome", a condition characterized by persistent symptoms, including, but not limited to, fatigue, pain, respiratory impairment, neurological impairment, or other cognitive impairment following standard antibiotic or other treatment for Lyme disease. 3. Health care providers, laboratories, and local health departments shall report to the department all confirmed or suspected cases of Lyme disease within seven days of diagnosis using standardized surveillance case definitions developed by the CDC. Any patient who receives a positive or suspected diagnosis of Lyme disease shall be given the option to opt in to having their identifiable information shared with the department, local public health officials, or the CDC. 4. The department shall compile an annual report on the incidence and prevalence of Lyme disease in Missouri, including, but not limited to, demographic data, geographic distribution, treatment outcomes, and barriers to care. The department shall submit the report to the CDC and the general assembly and make such report available to the public on the department's website by no later than December thirty-first of each year. 5. The department shall collaborate with the University of Missouri or any public four- year institution of higher education to integrate Lyme disease surveillance data into existing tick-borne disease monitoring programs. 6. Any information collected or reported under this section shall be done in a manner that protects individually identifiable or potentially identifiable information and that is consistent with state and federal privacy laws. 7. The department may promulgate any rules and regulations necessary to implement the provisions of sections 192.026 to 192.028. Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2026, shall be invalid and void.] 192.026. 1. Sections 103.190 and 192.026 to 192.02 Borrelia lusitaniae, transmitted to humans through the bite1 of infected blacklegged ticks (Ixodes scapularis) or other1 ticks, as defined by the national reporting case definition1 and posted by the Centers for Disease Control and Prevention1 National Notifiable Diseases Surveillance System;1 (3) "Medically necessary", health care services or1 products that a treating health care provider exercising1 prudent clinical judgment would provide to a patient for the1 purpose of preventing, evaluating, diagnosing, or treating1 are:2 (a) Clinically appropriate in terms of type,2 frequency, extent, site, and duration for the specific2 circumstances; and2 (b) Not primarily for the mere convenience of the2 patient, health care provider, or as determined by the2 provider based on the patient's specific circumstances;2 (4) "Posttreatment Lyme disease syndrome", a condition2 characterized by persistent symptoms, including, but not2 neurological impairment, or other cognitive impairment3 following standard antibiotic or other treatment for Lyme3 disease.3 3. Health care providers, laboratories, and local3 health departments shall report to the department all3 confirmed or suspected cases of Lyme disease within three3 days of diagnosis using standardized surveillance case3 definitions developed by the CDC. Any patient who receives3 a positive or suspected diagnosis of Lyme disease shall be3 information shared with the department, local public health4 officials, or the CDC.4 4. The department shall compile an annual report on4 the incidence and prevalence of Lyme disease in Missouri,4 including, but not limited to, demographic data, geographic4 distribution, treatment outcomes, and barriers to care. The4 department shall submit the report to the CDC and the4 general assembly and make such report available to the4 public on the department's website by no later than December4 5. The department shall collaborate with the5 University of Missouri or any public four-year institution5 of higher education to integrate Lyme disease surveillance5 data into existing tick-borne disease monitoring programs.5 6. Any information collected or reported under this5 section shall be done in a manner that protects individually5 identifiable or potentially identifiable information and5 that is consistent with state and federal privacy laws.5 7. The department may promulgate any rules and5 sections 192.026 to 192.028. Any rule or portion of a rule,6 as that term is defined in section 536.010, that is created6 under the authority delegated in this section shall become6 effective only if it complies with and is subject to all of6 the provisions of chapter 536 and, if applicable, section6 536.028. This section and chapter 536 are nonseverable and6 if any of the powers vested with the general assembly6 pursuant to chapter 536 to review, to delay the effective6 date, or to disapprove and annul a rule are subsequently6 206.110. 1. A hospital district, both within and outside such district, except in counties of the third or fourth classification (other than within the […] jurisdiction which is in conflict with any federal or state law or regulation applicable to the same subject matter. 206.158. 1. The board of directors trustees of any hospital district authorized under subsection 2 of this section, and established and organized under the provisions of this chapter: (1) May sections 206.010 to 206.160, may invest up to fifty percent of its "available funds", defined in this section as funds not required for immediate disbursement in obligations or for the operation of the hospital district, into: (a) (1) Any mutual funds that invest in stocks, bonds, or real estate, or any combination thereof; (b) (2) Bonds that have: a. (a) One of the five highest long-term ratings or the highest short-term rating issued by a nationally recognized rating agency; and b. (b) A final maturity of ten years or less; (c) Money market (3) Money-market investments; or (d) (4) Any combination of investments described in paragraphs (a) subdivisions (1) to (c) (3) of this subdivision; and (2) Shall subsection. The board shall invest the remaining percentage of any available funds not invested as allowed under subdivision (1) of this subsection required for immediate disbursement into any investment in which the state treasurer is allowed to invest. 2. The provisions of this section shall apply only apply if the hospital district receives less than three percent of its annual revenues from hospital district or state taxes.

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 shift95% confidence

Expanded Investment Portfolio Options for Local Hospitals

The legislation doubles the proportion of uncommitted reserves that certain tax-independent hospitals can place into diversified equities, high-grade bonds, and money-market instruments.

Sandy Crawford

Connected Entities

General Assembly, Sandy Crawford

OrganizationGeneral Assembly“Legislative body of the State of Missouri”Map →

PersonSandy Crawford“Senator, District 28, who introduced SB 1019”Map →

Sources

Open source document

www.senate.mo.gov

Analysis Score

0–100

Significance65
How much this matters to a regular citizen
Controversy15
Intensity of disagreement among stakeholders
Entertainment5
Compellingness for a non-policy-wonk reader
Buzz25
Current news / social attention level

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