reglab/statecodes huggingface dataset:
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.300 - Definitions.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018, 2 histories
190.300. Definitions. —
As used in sections 190.300 to 190.340, the following terms and phrases mean:
(1)
"Emergency telephone service"
, a telephone system utilizing a single three-digit number "911" for reporting police, fire, medical or other emergency situations;
(2)
"Emergency telephone tax"
, a tax to finance the operation of emergency telephone service;
(3)
"Exchange access facilities"
, all facilities provided by the service supplier for local telephone exchange access to a service user;
(4)
"Governing body"
, the legislative body for a city, county or city not within a county;
(5)
"Person"
, any individual, firm, partnership, copartnership, joint venture, association, cooperative organization, corporation, municipal or private, and whether organized for profit or not, state, county, political subdivision, state department, commission, board, bureau or fraternal organization, estate, trust, business or common law trust, receiver, assignee for the benefit of creditors, trustee or trustee in bankruptcy, or any other service user;
(6)
"Public agency"
, any city, county, city not within a county, municipal corporation, public district or public authority located in whole or in part within this state which provides or has authority to provide fire fighting, law enforcement, ambulance, emergency medical, or other emergency services;
(7)
"Service supplier"
, any person providing exchange telephone services to any service user in this state;
(8)
"Service user"
, any person, other than a person providing pay telephone service pursuant to the provisions of section 392.520 not otherwise exempt from taxation, who is provided exchange telephone service in this state;
(9)
"Tariff rate"
, the rate or rates billed by a service supplier to a service user as stated in the service supplier's tariffs, contracts, service agreements, or similar documents governing the provision of the service, which represent the service supplier's recurring charges for exchange access facilities or their equivalent, or equivalent rates contained in contracts, service agreements, or similar documents, exclusive of all taxes, fees, licenses, or similar charges whatsoever.
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(L. 1981 H.B. 437 § 1, A.L. 1993 S.B. 160, A.L. 2018 H.B. 1456)
CROSS REFERENCE:
Missouri 911 service board, created, members, terms, qualifications, powers and duties, staffed by department of public safety, 650.325, 650.330
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.306 - Dissolution of emergency telephone service not required, when (Christian County).

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2004
190.306. Dissolution of emergency telephone service not required, when (Christian County). —
No provision in this chapter shall be construed to require any municipality within any county of the third classification without a township form of government and with more than fifty-four thousand two hundred but less than fifty-four thousand three hundred inhabitants that has established an emergency telephone service to dissolve the service in the event that the county in which the municipality is located establishes an emergency telephone service and moves to a higher county classification.
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(L. 2004 H.B. 795, et al.)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.307 - No civil liability for operation of emergency system, giving or following emergency instructions, exceptions.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2021, 2 histories
190.307. No civil liability for operation of emergency system, giving or following emergency instructions, exceptions. —
1. No public agency or public safety agency, nor any officer, agent or employee of any public agency, shall be liable for any civil damages as a result of any act or omission except willful and wanton misconduct or gross negligence, in connection with developing, adopting, operating or implementing any plan or system required by sections 190.300 to 190.340.
2. No person who gives emergency instructions through a system established pursuant to sections 190.300 to 190.340 to persons rendering services in an emergency at another location, nor any persons following such instructions in rendering such services, shall be liable for any civil damages as a result of issuing or following the instructions, unless issuing or following the instructions constitutes willful and wanton misconduct, or gross negligence.
3. Nothing in this section shall be deemed to abrogate any immunity that would exist in the absence of this section including, but not limited to, sovereign immunity, official immunity, or the public duty doctrine.
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(L. 1990 H.B. 951, A.L. 1999 H.B. 268 merged with S.B. 436, A.L. 2021 S.B. 26)
(2005) Section supercedes the common law official immunity doctrine for certain individuals and agencies and provides qualified immunity allowing civil liability only where gross negligence can be established. State ex rel. Golden v. Crawford, 165 S.W.3d 147 (Mo.banc).
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.308 - Misuse of emergency telephone service unlawful, definitions, penalty — no local fine or penalty for pay telephones for calls to emergency telephone service.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018, 2 histories
190.308. Misuse of emergency telephone service unlawful, definitions, penalty — no local fine or penalty for pay telephones for calls to emergency telephone service. —
1. In any county that has established an emergency telephone service pursuant to sections 190.300 to 190.340, it shall be unlawful for any person to misuse the emergency telephone service. For the purposes of this section,
"emergency"
means any incident involving danger to life or property that calls for an emergency response dispatch of police, fire, EMS or other public safety organization,
"misuse the emergency telephone service"
includes, but is not limited to, repeatedly calling the "911" for nonemergency situations causing operators or equipment to be in use when emergency situations may need such operators or equipment and
"repeatedly"
means three or more times within a one-month period.
2. Any violation of this section is a class B misdemeanor.
3. No political subdivision shall impose any fine or penalty on the owner of a pay telephone or on the owner of any property upon which a pay telephone is located for calls to the emergency telephone service made from the pay telephone. Any such fine or penalty is hereby void.
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(L. 1996 H.B. 1304, A.L. 1997 H.B. 95 merged with S.B. 133, A.L. 2011 H.B. 68, A.L. 2018 H.B. 1456)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.310 - Tax due quarterly — return filed when, content — record retention period — rate determination, notification — collection fee allowed.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 12 Jun 1990, see footnote
190.310. Tax due quarterly — return filed when, content — record retention period — rate determination, notification — collection fee allowed. —
1. The tax imposed by sections 190.300 to 190.320 and the amounts required to be collected are due quarterly. The amount of tax collected in one calendar quarter by the service supplier shall be remitted to the governing body no later than sixty days after the close of a calendar quarter. On or before the sixtieth day of each calendar quarter following, a return for the preceding quarter shall be filed with the governing body in such form as the governing body and service supplier shall agree. The service supplier will include the list of any service user refusing to pay the tax imposed by sections 190.300 to 190.320 with each return filing. The service supplier required to file the return shall deliver the return, together with a remittance of the amount of the tax collected under the provisions of sections 190.300 to 190.320. The records shall be maintained for a period of one year from the time the tax is collected.
2. From every remittance to the governing body made on or before the date when the same becomes due, the service supplier required to remit the same shall be entitled to deduct and retain, as a collection fee, an amount equal to two percent thereof.
3. At least once each calendar year, the governing body shall establish a tax rate, not to exceed the amount authorized, that together with any surplus revenues carried forward will produce sufficient revenues to fund the expenditures authorized by sections 190.300 to 190.320. Amounts collected in excess of that necessary within a given year shall be carried forward to subsequent years. The governing body shall make its determination of such tax rate each year no later than September first and shall fix the new rate which shall be collected as provided in sections 190.300 to 190.320. Immediately upon making its determination and fixing the rate, the governing body shall publish in its minutes the new rate, and it shall notify by mail every service supplier registered with it of the new rate. The governing body may require an audit of the service supplier's books and records concerning the collection and remittance of the tax authorized by sections 190.300 to 190.320.
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(L. 1981 H.B. 437 § 3, A.L. 1990 H.B. 951)
Effective 6-12-90
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.315 - Contract for service authorized.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 1986
190.315. Contract for service authorized. —
Any governing body imposing the tax authorized herein may contract directly with the provider of the emergency telephone service or may contract and cooperate with any public agency or with other states or their political subdivisions or with any association or corporation for the administration of emergency telephone service as provided by law.
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(L. 1981 H.B. 437 § 4, A.L. 1986 H.B. 1268)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.320 - Election — ballot form.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 1981
190.320. Election — ballot form. —
Before any governing body may establish emergency telephone service and impose an emergency telephone tax under the provisions of sections 190.300 to 190.320, it shall submit a proposal to its voters for the approval of such service and such tax. The ballot of submission shall contain, but need not be limited to, the following language:
May the (City, County) of ______ establish an emergency telephone service and impose a telephone tax to finance such service?
☐ YES
☐ NO
The initial tax imposed shall be ______
(Here the governing body in 25 words or less shall describe the tax per telephone per year or any other wording which will give the voter an approximation of what the tax will cost the taxpayer.)
­­If a majority of the votes cast on the proposal by the qualified voters voting thereon are in favor of the proposal, then the governing body may establish the service and impose the tax allowed by the provisions of sections 190.300 to 190.320. If a majority of the votes cast on the proposal by the qualified voters voting thereon are opposed to the proposal, then the governing body submitting the proposal shall not be allowed to implement the provisions of sections 190.300 to 190.320 until it has again submitted such proposal to its qualified voters and a majority of the votes cast are in favor of the proposal.
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(L. 1981 H.B. 437 § 5)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.328 - Election of board, Christian and Scott counties, when — terms.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018, 2 histories
190.328. Election of board, Christian and Scott counties, when — terms. —
1. Beginning in 1997, within the area from which voters and the commission have approved the provision of central dispatching for emergency services by a public agency for an area containing third or fourth class cities in counties of the third classification with a population of at least thirty-two thousand but no greater than forty thousand that border a county of the first classification but do not border the Mississippi River, the initial board shall consist of two members from each township within such area and one at-large member who shall serve as the initial chairperson of such board.
2. Within the area from which voters and the commission have approved the provision of central dispatching for emergency services by a public agency for an area containing third or fourth class cities in counties of the third classification with a population of at least thirty-two thousand but no greater than forty thousand that border a county of the first classification, voters shall elect a board to administer funds and oversee the provision of central dispatching for emergency services. Such board shall consist of two members elected from each of the townships within such area and one member elected at large who shall serve as the chairperson of the board.
3. Of those initially elected to the board as provided in this section, four from the townships shall be elected to a term of two years, and four from the townships and the at-large member shall be elected to a term of four years. Upon the expiration of these initial terms, all members shall thereafter be elected to terms of four years; provided that, if a board established in this section consolidates with a board established under section 190.327 or 190.335, under the provisions of section 190.470, the term of office for the existing board members shall end on the thirtieth day following the appointment of the initial board of directors for the consolidated district.
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(L. 1997 H.B. 249, A.L. 2018 H.B. 1456)
CROSS REFERENCE:
Audit of board authorized, 190.334
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.329 - Election of board, exceptions, when — terms.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018, 2 histories
190.329. Election of board, exceptions, when — terms. —
1. Except in areas from which voters and the commission have approved the provision of central dispatching for emergency services by a public agency for an area containing third or fourth class cities located in counties of the third classification with a population of at least thirty-two thousand but no greater than forty thousand that border a county of the first classification but do not border the Mississippi River, the initial board shall consist of seven members appointed without regard for political party who shall be selected from and shall represent the fire protection districts, ambulance districts, sheriff's department, municipalities, any other emergency services and the general public. This initial board shall serve until its successor board is duly elected and installed in office. The commission shall ensure geographic representation of the county by appointing no more than four members from any one commission district of the county.
2. Beginning in 1992, three members shall be elected from each commission district and one member shall be elected at large, with such at-large member to be a voting member and chairman of the board. Of those first elected, four members from commission districts shall be elected for terms of two years and two members from commission districts and the member at large shall be elected for terms of four years. In 1994, and thereafter, all terms of office shall be for four years, except as otherwise provided in this subsection or as provided in subsection 3 of this section. Any vacancy on the board shall be filled in the same manner as the initial appointment was made. Four members shall constitute a quorum. If a board established in section 190.327 consolidates with a board established under section 190.327, 190.328, or 190.335, under the provisions of section 190.470, the term of office for the existing board members shall end on the thirtieth day following the appointment of the initial board of directors for the consolidated district.
3. Upon approval by the county commission for the election of board members to be held on general municipal election day, pursuant to subsection 2 of section 190.327, the terms of those board members then holding office shall be reduced by seven months. After a board member's term has been reduced, all following terms for that position shall be for four years, except as otherwise provided under subsection 2 of this section.
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(L. 1990 H.B. 951 § 1 subsecs. 3, 4, A.L. 1995 H.B. 452, et al., A.L. 1996 S.B. 532, A.L. 1997 H.B. 249, A.L. 2018 H.B. 1456)
CROSS REFERENCE:
Audit of board authorized, 190.334
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.334 - Performance and fiscal audits authorized.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018, 2 histories
190.334. Performance and fiscal audits authorized. —
The state auditor shall have the authority to conduct performance and fiscal audits of any board, dispatch center, joint emergency communications entity, or trust fund established under section 190.327, 190.328, 190.329, 190.335, 190.420, 190.455, 190.460, 190.465, 190.470, or 650.325.
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(L. 2017 S.B. 503 § 1, A.L. 2018 H.B. 1456)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.337 - Revenue, purpose for which shall be used — procedure to terminate tax, ballot form — reestablishing emergency service using telephone tax, procedure.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 1993
190.337. Revenue, purpose for which shall be used — procedure to terminate tax, ballot form — reestablishing emergency service using telephone tax, procedure. —
1. The sales tax established by a county according to the provisions of section 190.335 shall be permanent and revenues from it shall be disbursed only for the purposes for which it was collected. Upon receipt of a petition signed by a number of voters in the county equal to ten percent of the number of voters in the county who voted in the most recent gubernatorial election requesting the submission of the question of continuation or termination, the county commission in any county which has adopted the sales tax as a means of paying for emergency services in lieu of financing such services through taxes as provided in section 190.305, shall submit to the voters of the county the question to continue or to terminate the sales tax.
2. The question shall be submitted in the following form:
Shall the county of ______ (insert name of county) continue to impose a county sales tax of ______ (insert rate of percent) percent for the purpose of providing central dispatching of fire protection, emergency ambulance, or emergency telephone, services?
☐ YES
☐ NO
3. If a majority of those voting on the question vote "YES" for continuation, the sales tax shall be continued unless and until terminated by a vote of the qualified voters voting thereon; if a majority of those voting on the question vote "NO" for the termination of the sales tax, the county commission shall declare the sales tax terminated effective the first day of the second calendar quarter following notification to the director of revenue that the tax has been repealed and shall discharge any board appointed pursuant to section 190.335. Any order adopted by the board shall be void and of no effect from and after the termination of the sales tax.
4. If the majority of the voters vote "NO" pursuant to subsection 3 of this section, the emergency services shall be deemed to have been terminated. Such emergency services may be reestablished in the county pursuant to the provisions of section 190.305.
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(L. 1993 S.B. 157 & 29 § 2)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.340 - Emergency services board, officers duties, rules and regulations.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 1996
190.340. Emergency services board, officers duties, rules and regulations. —
1. It shall be the duty of the chairperson to preside at all board meetings, to act as official head of the emergency services board and to execute all contracts required to be executed by the board. In the absence and disability of the chairperson, the vice chairperson shall assume the duties of the chairperson.
2. The secretary shall keep the official records of the meetings of the board, shall attest all official documents with the seal of the board, shall, when called upon, make reports pertaining to the business of the secretary's office, attend the board meetings and perform such other duties as may be imposed upon the secretary by the provisions of sections 190.335 to 190.342 and the rules of the board.
3. The treasurer shall be the custodian of the funds of the board and pay money out of the treasury only upon valid checks or drafts drawn on the treasury.
4. The board may, from time to time, provide for additional rules and regulations concerning the duties of its officers.
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(L. 1996 H.B. 1460)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.353 - Powers and duties of department of health and senior services — establishment of regional poison information center — center to provide certain services.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
Effective - 28 Aug 2006
190.353. Powers and duties of department of health and senior services — establishment of regional poison information center — center to provide certain services. —
1. The department of health and senior services shall:
(1) Provide for the establishment of a "Missouri Regional Poison Information Center" capable of providing the services described in subsection 2 of this section based on the best demonstrated ability to perform such services as evidenced by past performance of such services and by current certification as a regional poison control center by the American Association of Poison Control Centers. The department shall, in conjunction with local health agencies and health care providers, determine the region to be served by the center; and
(2) Provide for the establishment of a "Missouri Poison Control Network" to consist of poison prevention and treatment centers throughout the state of Missouri, representing all federally designated emergency medical services areas.
2. The Missouri poison information center shall provide:
(1) A twenty-four-hour toll-free telephone referral and information service for the general public and health care professionals, supervised by a physician who is board-certified in the field of clinical toxicology and staffed by licensed professionals who are certified as information specialists or whose certification is pending, according to the requirements of the American Association of Poison Control Centers;
(2) Design and coordination of appropriate public and professional education services in the area of poison treatment and prevention;
(3) Plans for cooperation between the Missouri poison control network and health and emergency service agencies and associations involved in poison control activities;
(4) Program evaluation and systematic data collection on poison exposures in cooperation with the department of health and senior services; and
(5) Coordination of poison control, treatment, and education activities of poison prevention and treatment centers.
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(L. 1985 H.B. 435 § 2, A.L. 2006 H.B. 1437)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.355 - Use of existing resources required.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
Effective - 28 Aug 2006
190.355. Use of existing resources required. —
The Missouri regional poison information center shall fully utilize existing institutions and services for the control and treatment of poisons.
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(L. 1985 H.B. 435 § 3, A.L. 2006 H.B. 1437)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.420 - Fund established.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018, 2 histories
190.420. Fund established. —
1. There is hereby established a special trust fund to be known as the "Missouri 911 Service Trust Fund". All fees collected pursuant to sections 190.400 to 190.460 shall be remitted to the director of the department of revenue.
2. The director of the department of revenue shall deposit such payments into the Missouri 911 service trust fund. Moneys in the fund shall be used for the purpose of reimbursing expenditures actually incurred in the implementation and operation of the Missouri 911 systems and for the answering and dispatching of emergency calls as determined to be appropriate by the governing body of the county or city imposing the fee.
3. Any unexpended balance in the fund shall be exempt from the provisions of section 33.080, relating to the transfer of unexpended balances to the general revenue fund, and shall remain in the fund. Any interest earned on the moneys in the fund shall be deposited into the fund.
4. The moneys in the trust fund shall not be deemed to be state funds and shall not be commingled with any funds of the state. The director of revenue shall keep accurate records of the amount of moneys in the trust fund which were collected in each county, city not within a county, or home rule city with more than fifteen thousand but fewer than seventeen thousand inhabitants and partially located in any county of the third classification without a township form of government and with more than thirty-seven thousand but fewer than forty-one thousand inhabitants under sections 190.400 to 190.460, and the records shall be open to the inspection of officers of a participating county or city and the public.
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(L. 1998 S.B. 743, A.L. 2018 H.B. 1456)
CROSS REFERENCE:
Audit of fund authorized, 190.334
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.450 - Department to complete study, issue plan for provision of best 911 technology and services statewide.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2017
190.450. Department to complete study, issue plan for provision of best 911 technology and services statewide. —
By December 31, 2017, the department of public safety shall complete a study of the number of public safety answering points necessary to provide the best possible 911 technology and service to all areas of the state in the most efficient and economical manner possible, issue a state public safety answering point consolidation plan based on the study, and provide such plan to the Missouri 911 service board.
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(L. 2017 S.B. 503)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.475 - Centralized database to be maintained, updates.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.475. Centralized database to be maintained, updates. —
The director of the department of revenue shall maintain a centralized database, which shall be made available to the Missouri 911 service board established under section 650.325, specifying the current monthly fee or tax imposed by each county or city under section 190.292, 190.305, 190.325, 190.335, or 190.455. The database shall be updated no less than sixty days prior to the effective date of the establishment or modification of any monthly fee or tax listed in the database.
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(L. 2018 H.B. 1456)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.500 - Temporary license — qualified health care professions — declared emergency.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
Effective - 28 Aug 2002, 2 histories
190.500. Temporary license — qualified health care professions — declared emergency. —
1. Notwithstanding any other provision of law to the contrary, a temporary license may be issued for no more than a twelve-month period by the appropriate licensing board to any otherwise qualified health care professional licensed and in good standing in another state and who meets such other requirements as the licensing board may prescribe by rule and regulation, if the health care professional:
(1) Is acting pursuant to federal military orders under Title X for active duty personnel or Title XXXII for National Guard members; and
(2) Is enrolled in an accredited training program for trauma treatment and disaster response in a hospital in this state; or
(3) If the health care professional is acting pursuant to the governor's declaration of an emergency as defined in section 44.010, such temporary licensure shall be issued pursuant to this subdivision for a two-week period and, upon license verification, may be reissued every two weeks thereafter.
2. Licensure information and confirmation of health care professionals acting pursuant to this section may be obtained by any available means, including electronic mail.
3. For purposes of this section, the term
"health care professional"
shall have the same meaning as such term is defined in section 383.130.
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(L. 1999 H.B. 343 § 6, A.L. 2001 H.B. 431, A.L. 2002 S.B. 712 merged with S.B. 714)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.525 - Definitions.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2002
190.525. Definitions. —
As used in sections 190.525 to 190.537, the following terms mean:
(1)
"Department"
, the department of health and senior services;
(2)
"Director"
, the director of the department of health and senior services or the director's duly authorized representative;
(3)
"Passenger"
, an individual needing transportation in a supine position who does not require medical monitoring, observation, aid, care or treatment during transportation, with the exception of self-administered oxygen as ordered by a physician during transportation;
(4)
"Patient"
, an individual who is sick, injured, wounded, diseased, or otherwise incapacitated or helpless, and who may require medical monitoring, medical observation, aid, care or treatment during transportation, with the exception of self-administered oxygen as ordered by a physician;
(5)
"Person"
, any individual, firm, partnership, copartnership, joint venture, association, cooperative organization, corporation, municipal or private, and whether organized for profit or not, state, county, political subdivision, state department, commission, board, bureau or fraternal organization, estate, public trust, business or common law trust, receiver, assignee for the benefit of creditors, trustee or trustee in bankruptcy, or any other service user or provider;
(6)
"Stretcher van"
, any vehicle other than an ambulance designed and equipped to transport passengers in a supine position. No such vehicle shall be used to provide medical services;
(7)
"Stretcher van service"
, any person or agency that provides stretcher van transportation to passengers who are confined to stretchers and whose conditions are such that they do not need and are not likely to need medical attention during transportation.
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(L. 2002 S.B. 1107)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.534 - Violations, penalty — attorney general to have concurrent jurisdiction.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2002
190.534. Violations, penalty — attorney general to have concurrent jurisdiction. —
1. Any person violating, or failing to comply with, the provisions of sections 190.525 to 190.537 is guilty of a class B misdemeanor.
2. Each day that any violation of, or failure to comply with, sections 190.525 to 190.537 is committed or permitted to continue shall constitute a separate and distinct offense, and shall be punishable as a separate offense pursuant to this section; but the court may, in appropriate cases, stay the cumulation of penalties.
3. The attorney general shall have concurrent jurisdiction with any and all prosecuting attorneys to prosecute persons in violation of sections 190.525 to 190.537, and the attorney general or prosecuting attorney may institute injunctive proceedings against any person operating in violation of sections 190.525 to 190.537.
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(L. 2002 S.B. 1107)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.537 - Rulemaking authority.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2002
190.537. Rulemaking authority. —
Any rule or portion of a rule, as that term is defined in section 536.010, that is created pursuant to the authority of sections 190.525 to 190.537 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, 2002, shall be invalid and void.
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(L. 2002 S.B. 1107)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.550 - Schedule of fees established, rules — collection and deposit.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
Effective - 28 Aug 2005
190.550. Schedule of fees established, rules — collection and deposit. —
1. The department of health and senior services shall by rule establish a schedule of fees to be paid by applicants for specific licensure or accreditation under sections 190.001 to 190.250 and sections 190.525 to 190.537; except that, such fee shall not be imposed for specific licensure or accreditation of persons employed by volunteer ambulance services. 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, 2005, shall be invalid and void.
2. All fees imposed under this section shall be collected by the department and deposited in the Missouri public health services fund established in section 192.900. Moneys in the fund deposited under this section shall be used upon appropriation by the general assembly for the purpose of implementing the provisions of sections 190.001 to 190.250 and sections 190.525 to 190.537. Notwithstanding the provisions of section 33.080, moneys deposited to the credit of the fund under this section shall not revert to the credit of general revenue at the end of the biennium.
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(L. 2005 S.B. 177)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.603 - Outside the hospital do-not-resuscitate order may be executed, when — maintained in medical records — transfers with patient.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2023, 2 histories
190.603. Outside the hospital do-not-resuscitate order may be executed, when — maintained in medical records — transfers with patient. —
1. A patient or patient's representative and the patient's attending physician may execute an outside the hospital do-not-resuscitate order. An outside the hospital do-not-resuscitate order shall not be effective unless it is executed by the patient or patient's representative and the patient's attending physician, and it is in the form promulgated by rule of the department.
2. A patient under eighteen years of age is not authorized to execute an outside the hospital do-not-resuscitate order for himself or herself but may have a do-not-resuscitate order issued on his or her behalf by one parent or legal guardian or by a juvenile or family court under the provisions of section 191.250. Such do-not-resuscitate order shall also function as an outside the hospital do-not-resuscitate order for the purposes of sections 190.600 to 190.621 unless such do-not-resuscitate order authorized under the provisions of section 191.250 states otherwise.
3. If an outside the hospital do-not-resuscitate order has been executed, it shall be maintained as the first page of a patient's medical record in a health care facility unless otherwise specified in the health care facility's policies and procedures.
4. An outside the hospital do-not-resuscitate order shall be transferred with the patient when the patient is transferred from one health care facility to another health care facility. If the patient is transferred outside of a hospital, the outside the hospital DNR form shall be provided to any other facility, person, or agency responsible for the medical care of the patient or to the patient or patient's representative.
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(L. 2007 H.B. 182, A.L. 2023 H.B. 402 merged with S.B. 45 & 90 merged with S.B. 106)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.606 - Immunity from liability, what persons and entities.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2023, 3 histories
190.606. Immunity from liability, what persons and entities. —
The following persons and entities shall not be subject to civil, criminal, or administrative liability and are not guilty of unprofessional conduct for the following acts or omissions that follow discovery of an outside the hospital do-not-resuscitate identification upon a patient or a do-not-resuscitate order functioning as an outside the hospital do-not-resuscitate order for a patient under eighteen years of age, or upon being presented with an outside the hospital do-not-resuscitate order; provided that the acts or omissions are done in good faith and in accordance with the provisions of sections 190.600 to 190.621 and the provisions of an outside the hospital do-not-resuscitate order executed under sections 190.600 to 190.621:
(1) Physicians, persons under the direction or authorization of a physician, emergency medical services personnel, or health care facilities that cause or participate in the withholding or withdrawal of cardiopulmonary resuscitation from such patient; and
(2) Physicians, persons under the direction or authorization of a physician, emergency medical services personnel, or health care facilities that provide cardiopulmonary resuscitation to such patient under an oral or written request communicated to them by the patient or the patient's representative.
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(L. 2007 H.B. 182, A.L. 2020 H.B. 1682, A.L. 2023 H.B. 402 merged with S.B. 45 & 90 merged with S.B. 106)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.609 - Order effective, when — limitations of order.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2007
190.609. Order effective, when — limitations of order. —
1. An outside the hospital do-not-resuscitate order shall only be effective when the patient has not been admitted to or is not being treated within a hospital.
2. An outside the hospital do-not-resuscitate order and the outside the hospital do-not-resuscitate protocol shall not authorize the withholding or withdrawing of other medical interventions, such as intravenous fluids, oxygen, or therapies other than cardiopulmonary resuscitation. Outside the hospital do-not-resuscitate orders and the outside the hospital do-not-resuscitate protocol shall not authorize the withholding or withdrawing of therapies deemed necessary to provide comfort care or alleviate pain. Any authorization for withholding or withdrawing interventions or therapies that is inconsistent with sections 190.600 to 190.621 and is found or included in any outside the hospital do-not-resuscitate order or in the outside the hospital do-not-resuscitate protocol shall be null, void, and of no effect. Nothing in this section shall prejudice any other lawful directives concerning such medical interventions and therapies.
3. An outside the hospital do-not-resuscitate order shall not be effective during such time as the patient is pregnant; provided, however, that physicians, persons under the direction or authorization of a physician, emergency medical services personnel, and health care facilities shall not be subject to civil, criminal, or administrative liability and are not guilty of unprofessional conduct if, while acting in accordance with the provisions of sections 190.600 to 190.621 and the provisions of an outside the hospital do-not-resuscitate order executed under sections 190.600 to 190.621, such persons and entities:
(1) Comply with an outside the hospital do-not-resuscitate order and withdraw or withhold cardiopulmonary resuscitation from a pregnant patient while believing in good faith that the patient is not pregnant; or
(2) Despite the presence of an outside the hospital do-not-resuscitate order, provide cardiopulmonary resuscitation to a nonpregnant patient while believing in good faith that the patient is pregnant.
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(L. 2007 H.B. 182)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.612 - Emergency medical services personnel to comply with order, when — physician to transfer patient, when.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2023, 3 histories
190.612. Emergency medical services personnel to comply with order, when — physician to transfer patient, when. —
1. Emergency medical services personnel are authorized to comply with the outside the hospital do-not-resuscitate protocol when presented with an outside the hospital do-not-resuscitate identification or an outside the hospital do-not-resuscitate order. However, emergency medical services personnel shall not comply with an outside the hospital do-not-resuscitate order or the outside the hospital do-not-resuscitate protocol when the patient or patient's representative expresses to such personnel in any manner, before or after the onset of a cardiac or respiratory arrest, the desire to be resuscitated.
2. (1) Except as provided in subdivision (2) of this subsection, emergency medical services personnel are authorized to comply with the outside the hospital do-not-resuscitate protocol when presented with a do-not-resuscitate order functioning as an outside the hospital do-not-resuscitate order for a patient under eighteen years of age if such do-not-resuscitate order has been authorized by one parent or legal guardian or by a juvenile or family court under the provisions of section 191.250.
(2) Emergency medical services personnel shall not comply with a do-not-resuscitate order or the outside the hospital do-not-resuscitate protocol when the patient under eighteen years of age, either parent of such patient, the patient's legal guardian, or the juvenile or family court expresses to such personnel in any manner, before or after the onset of a cardiac or respiratory arrest, the desire for the patient to be resuscitated.
3. If a physician or a health care facility other than a hospital admits or receives a patient with an outside the hospital do-not-resuscitate identification or an outside the hospital do-not-resuscitate order, and the patient or patient's representative has not expressed or does not express to the physician or health care facility the desire to be resuscitated, and the physician or health care facility is unwilling or unable to comply with the outside the hospital do-not-resuscitate order, the physician or health care facility shall take all reasonable steps to transfer the patient to another physician or health care facility where the outside the hospital do-not-resuscitate order will be complied with.
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(L. 2007 H.B. 182, A.L. 2020 H.B. 1682, A.L. 2023 H.B. 402 merged with S.B. 45 & 90 merged with S.B. 106)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.613 - Out-of-state order, physician may execute order, when.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2023
190.613. Out-of-state order, physician may execute order, when. —
1. A patient or patient's representative and the patient's attending physician may execute an outside the hospital do-not-resuscitate order through the presentation of a properly executed outside the hospital do-not-resuscitate order from another state, the District of Columbia, or a territory of the United States, or a Transportable Physician Orders for Patient Preferences (TPOPP)/Physician Orders for Life-Sustaining Treatment (POLST) form containing a specific do-not-resuscitate section.
2. Any outside the hospital do-not-resuscitate form identified from another state, the District of Columbia, or a territory of the United States, or a TPOPP/POLST form, shall:
(1) Have been previously reviewed and approved by the department as in compliance with the provisions of sections 190.600 to 190.621;
(2) Not be accepted for a patient under eighteen years of age, except as allowed under section 191.250; and
(3) Not be effective during such time as the patient is pregnant as set forth in section 190.609.
­­A patient or patient's representative may express to emergency medical services personnel, at any time and by any means, the intent to revoke the outside the hospital do-not-resuscitate order.
3. The provisions of section 190.606 shall apply to the good faith acts or omissions of emergency medical services personnel under this section.
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(L. 2023 H.B. 402 merged with S.B. 45 & 90 merged with S.B. 106)