reglab/statecodes huggingface dataset:
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.615 - Death of a patient, not suicide or homicide — effect of order on life insurance — order does not authorize mercy killing or euthanasia.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2007
190.615. Death of a patient, not suicide or homicide — effect of order on life insurance — order does not authorize mercy killing or euthanasia. —
1. A patient's death resulting from the withholding or withdrawal in good faith of cardiopulmonary resuscitation under an outside the hospital do-not-resuscitate order is not, for any purpose, a suicide or homicide.
2. The possession of an outside the hospital do-not-resuscitate identification or execution of an outside the hospital do-not-resuscitate order does not affect in any manner the sale, procurement, or issuance of any policy of life insurance, nor does it modify the terms of an existing policy of life insurance. Notwithstanding any term of a policy to the contrary, a policy of life insurance is not legally impaired or invalidated in any manner by the withholding or withdrawal of cardiopulmonary resuscitation from an insured patient possessing an outside the hospital do-not-resuscitate identification or outside the hospital do-not-resuscitate order.
3. A physician, health care facility, or other health care provider or a health care service plan, insurer issuing disability insurance, self-insured employee welfare benefit plan, or nonprofit hospital plan shall not require a patient to possess an outside the hospital do-not-resuscitate identification or execute an out of hospital do-not-resuscitate order as a condition for being insured for or receiving health care services.
4. Sections 190.600 to 190.621 do not prejudice any right that a patient has to effect the obtaining, withholding, or withdrawal of medical care in any lawful manner apart from sections 190.600 to 190.621. In that respect, the rights of patients authorized under sections 190.600 to 190.621 are cumulative.
5. The provisions of sections 190.600 to 190.621 shall not be construed to condone, authorize, or approve mercy killing or euthanasia, or to permit any affirmative or deliberate act or omission to shorten or end life.
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(L. 2007 H.B. 182)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.618 - Rules — rulemaking authority.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2007
190.618. Rules — rulemaking authority. —
1. By June 30, 2008, the department shall promulgate rules relating to the outside the hospital do-not-resuscitate protocol, the outside the hospital do-not-resuscitate identification, and the outside the hospital do-not-resuscitate forms under sections 190.600 to 190.621.
2. 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, 2007, shall be invalid and void.
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(L. 2007 H.B. 182)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.621 - Penalty for concealing or falsifying an order.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 01 Jan 2017, 2 histories, see footnote
190.621. Penalty for concealing or falsifying an order. —
1. Any person who knowingly conceals, cancels, defaces, or obliterates the outside the hospital do-not-resuscitate order or the outside the hospital do-not-resuscitate identification of another person without the consent of the other person, or who knowingly falsifies or forges a revocation of the outside the hospital do-not-resuscitate order or the outside the hospital do-not-resuscitate identification of another person, is guilty of a class A misdemeanor.
2. Any person who knowingly executes, falsifies, or forges an outside the hospital do-not-resuscitate order or an outside the hospital do-not-resuscitate identification of another person without the consent of the other person, or who knowingly conceals or withholds personal knowledge of a revocation of an outside the hospital do-not-resuscitate order or an outside the hospital do-not-resuscitate identification of another person, is guilty of a class E felony.
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(L. 2007 H.B. 182, A.L. 2014 S.B. 491)
Effective 1-01-17
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.800 - Imposition of tax — definitions.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2022, 2 histories
190.800. Imposition of tax — definitions. —
1. Each ground ambulance service, except for any ambulance service owned and operated by an entity owned and operated by the state of Missouri, including but not limited to any hospital owned or operated by the board of curators, as defined in chapter 172, or any department of the state, shall, in addition to all other fees and taxes now required or paid, pay an ambulance service reimbursement allowance tax for the privilege of engaging in the business of providing ambulance services in this state.
2. For the purpose of this section, the following terms shall mean:
(1)
"Ambulance"
, the same meaning as such term is defined in section 190.100;
(2)
"Ambulance service"
, the same meaning as such term is defined in section 190.100;
(3)
"Engaging in the business of providing ambulance services in this state"
, accepting payment for such services.
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(L. 2009 S.B. 307, A.L. 2022 S.B. 725)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.803 - Formula for tax based on gross receipts — challenge of validity of rules.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2022, 2 histories
190.803. Formula for tax based on gross receipts — challenge of validity of rules. —
1. Each ambulance service's reimbursement allowance shall be based on a formula established by the department of social services by regulations and rules as provided in section 190.836. The ambulance reimbursement allowance shall be consistent with permissible health care related taxes, as defined in 42 CFR 433, Subpart B, as amended.
2. Notwithstanding any other provision of law to the contrary, any action respecting the validity of the rules promulgated under this section or section 190.815 or 190.833 shall be filed in the circuit court of Cole County. The circuit court of Cole County shall hear the matter as the court of original jurisdiction.
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(L. 2009 S.B. 307, A.L. 2022 S.B. 725)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.806 - Record-keeping requirements, confidentiality.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2022, 2 histories
190.806. Record-keeping requirements, confidentiality. —
Each ambulance service shall keep such records as may be necessary to determine the amount of its reimbursement allowance. On or before the first day of October of each year, every ambulance service shall submit to the department of social services a statement that accurately reflects such information as is necessary to determine such ambulance service's reimbursement allowance tax. The information obtained by the department of social services shall be confidential.
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(L. 2009 S.B. 307, A.L. 2022 S.B. 725)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.809 - Amount due, determination — notification procedure — offset permitted, when — quarterly adjustment of tax permitted.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2009
190.809. Amount due, determination — notification procedure — offset permitted, when — quarterly adjustment of tax permitted. —
1. The director of the department of social services shall make a determination as to the amount of ambulance service reimbursement allowance tax due from each ambulance service.
2. The director of the department of social services shall notify each ambulance service of the annual amount of its reimbursement allowance tax on or before the first day of October each year. Such amount may be paid in monthly increments over the balance of the reimbursement allowance tax period, as set forth in subsection 1 of section 190.821.
3. The department of social services is authorized to offset the federal reimbursement allowance tax owed by an ambulance service against any MO HealthNet payment due such ambulance service, if the ambulance service requests such an offset. The amounts to be offset shall result, so far as practicable, in withholding from the ambulance service an amount substantially equivalent to the assessment to be due from the ambulance service. The office of administration and state treasurer are authorized to make any fund transfers necessary to execute the offset.
4. The department of social services may adjust the tax rate quarterly on a prospective basis. The department of social services may adjust more frequently for individual ambulance services if there is a substantial and statistically significant change in their service provider characteristics. The department of social services may define such adjustment criteria by rule.
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(L. 2009 S.B. 307)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.812 - Determination of tax final, when — timely protest permitted.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2009
190.812. Determination of tax final, when — timely protest permitted. —
1. Each ambulance service reimbursement allowance tax determination shall be final after receipt of written notice from the department of social services, unless the ambulance service files a protest with the director of the department of social services setting forth the grounds on which the protest is based within thirty days from the date of receipt of written notice from the department of social services to the ambulance service.
2. If a timely protest is filed, the director of the department of social services shall reconsider the determination and, if the ambulance service has so requested, the director or the director's designee shall grant the ambulance service a hearing to be held within forty-five days after the protest is filed, unless extended by agreement between the ambulance service and the director. The director shall issue a final decision within forty-five days of the completion of the hearing. After reconsideration of the reimbursement allowance determination and a final decision by the director of the department of social services, an ambulance service's appeal of the director's final decision shall be to the administrative hearing commission in accordance with section 208.156 and section 621.055.
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(L. 2009 S.B. 307)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.815 - Rulemaking authority.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2022, 2 histories
190.815. Rulemaking authority. —
The director of the department of social services shall prescribe by rule the form and content of any document required to be filed under sections 190.800 to 190.836.
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(L. 2009 S.B. 307, A.L. 2022 S.B. 725)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.818 - Remittance of tax — fund created, use of moneys.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2009
190.818. Remittance of tax — fund created, use of moneys. —
1. The ambulance service reimbursement allowance tax owed or, if an offset has been requested, the balance, if any, after such offset shall be remitted by the ambulance service to the department of social services. The remittance shall be made payable to the director of the department of revenue. The amount remitted shall be deposited in the state treasury to the credit of the "Ambulance Service Reimbursement Allowance Fund", which is hereby created for the sole purpose of providing payments to ambulance services. All investment earnings of the ambulance service reimbursement allowance fund shall be credited to the ambulance service reimbursement allowance fund. The unexpended balance in the ambulance service reimbursement allowance fund at the end of the biennium is exempt from the provisions of section 33.080. The unexpended balance shall not revert to the general revenue fund, but shall accumulate in the ambulance service reimbursement allowance fund from year to year.
2. An offset as authorized by this section or a payment to the ambulance service reimbursement allowance fund shall be accepted as payment of the ambulance service's obligation imposed by section 190.800.
3. The state treasurer shall maintain records that show the amount of money in the ambulance service reimbursement allowance fund at any time and the amount of any investment earnings on that amount. The department of social services shall disclose such information to any interested party upon written request.
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(L. 2009 S.B. 307)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.821 - Tax period — failure to pay, delinquency, enforcement procedures.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2009
190.821. Tax period — failure to pay, delinquency, enforcement procedures. —
1. An ambulance service reimbursement allowance tax period as provided in sections 190.800 to 190.836 shall be from the first day of October to the thirtieth day of September. The department shall notify each ambulance service with a balance due on the thirtieth day of September of each year the amount of such balance due. If any ambulance service fails to pay its ambulance service reimbursement allowance tax within thirty days of such notice, the reimbursement allowance shall be delinquent. The reimbursement allowance tax may remain unpaid during an appeal as provided in section 190.812.
2. Except as otherwise provided in this section, if any reimbursement allowance tax imposed under section 190.800 is unpaid and delinquent, the department of social services may proceed to enforce the state's lien against the property of the ambulance service and to compel the payment of such reimbursement allowance tax in the circuit court having jurisdiction in the county where the ambulance service is located. In addition, the director of the department of social services or the director's designee may cancel or refuse to issue, extend, or reinstate a MO HealthNet participation agreement to any ambulance service which fails to pay such delinquent reimbursement allowance tax required by section 190.800 unless under appeal as allowed in section 190.812.
3. Except as otherwise provided in this section, failure to pay a delinquent reimbursement allowance tax imposed under section 190.800 shall be grounds for denial, suspension, or revocation of a license granted under this chapter. The director of the department of social services may notify the department of health and senior services to deny, suspend, or revoke the license of any ambulance service which fails to pay a delinquent reimbursement allowance tax unless under appeal as provided in section 190.812.
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(L. 2009 S.B. 307)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.824 - Tax-exempt status of ambulance service not affected.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2009
190.824. Tax-exempt status of ambulance service not affected. —
Nothing in sections 190.800 to 190.836 shall be deemed to affect or in any way limit the tax-exempt or nonprofit status of any ambulance service granted by state or federal law.
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(L. 2009 S.B. 307)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.827 - Payments to ambulance services, when.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2009
190.827. Payments to ambulance services, when. —
The department of social services shall make payments to those ambulance services that have a valid MO HealthNet participation agreement with the department. The ambulance service reimbursement allowance shall not be used to supplant, and shall be in addition to, general revenue payments to ambulance services.
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(L. 2009 S.B. 307)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.830 - Federal financial participation required.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2009
190.830. Federal financial participation required. —
The requirements of sections 190.800 to 190.830 shall apply only so long as the revenues generated under section 190.800 are eligible for federal financial participation as provided in sections 190.800 to 190.836 and payments are made under section 190.800. For the purpose of this section,
"federal financial participation"
means the federal government's share of Missouri's expenditures under the MO HealthNet program. Notwithstanding any other provision of this section to the contrary, in the event federal financial participation is either denied, discontinued, reduced in excess of five percent per year, or no longer available for the revenues generated under section 190.800, the director of the department of social services shall cause disbursement of all moneys held in the ambulance service reimbursement allowance fund to be made to all ambulance services in accordance with rules promulgated by the department of social services, along with a full accounting of such disbursements, within forty-five days of receipt of notice thereof by the department of social services.
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(L. 2009 S.B. 307)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.833 - No tax imposed prior to effective date.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2009
190.833. No tax imposed prior to effective date. —
The ambulance service reimbursement allowance tax provided in section 190.800 shall not be imposed prior to the effective date of rules promulgated by the department of social services, but in no event prior to October 1, 2009.
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(L. 2009 S.B. 307)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.836 - Rules requirements, authority.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2009
190.836. Rules requirements, authority. —
No rules implementing sections 190.800 to 190.836 may be filed with the secretary of state without first being provided to interested parties registered on a list of such parties to be maintained by the director of the department of social services. Rules shall be provided to all interested parties seventy-two hours prior to being filed with the secretary of state. Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in sections 190.800 to 190.836 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. Sections 190.800 to 190.836 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, 2009, shall be invalid and void.
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(L. 2009 S.B. 307)
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.839 - Expiration date.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Sep 2021, 8 histories, see footnote
190.839. Expiration date. —
Sections 190.800 to 190.839 shall expire on September 30, 2024.
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(L. 2009 S.B. 307, A.L. 2011 S.B. 62, A.L. 2015 S.B. 210, A.L. 2016 H.B. 1534, A.L. 2018 S.B. 775, A.L. 2019 S.B. 29, A.L. 2020 H.B. 2456, A.L. 2021 1st Ex. Sess. S.B. 1)
Effective 9-28-21
Expires 9-30-24
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.840 - Nonseverability clause.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
Effective - 28 Aug 2011
190.840. Nonseverability clause. —
Notwithstanding the provisions of section 1.140 to the contrary, the provisions of this act
*
shall be nonseverable, and if any provision is for any reason held to be invalid, such decision shall invalidate all of the remaining provisions of this act
*
.
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(L. 2011 S.B. 62 § 1)
*"This act" contained numerous sections. Consult Disposition of Sections table for a definitive listing.
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.903 - Home state licensure.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.903. Home state licensure. —
1. Any member state in which an individual holds a current license shall be deemed a home state for purposes of this compact.
2. Any member state may require an individual to obtain and retain a license to be authorized to practice in the member state under circumstances not authorized by the privilege to practice under the terms of this compact.
3. A home state's license authorizes an individual to practice in a remote state under the privilege to practice only if the home state:
(1) Currently requires the use of the National Registry of Emergency Medical Technicians (NREMT) examination as a condition of issuing initial licenses at the EMT and paramedic levels;
(2) Has a mechanism in place for receiving and investigating complaints about individuals;
(3) Notifies the commission, in compliance with the terms herein, of any adverse action or significant investigatory information regarding an individual;
(4) No later than five years after activation of the compact, requires a criminal background check of all applicants for initial licensure, including the use of the results of fingerprint or other biometric data checks compliant with the requirements of the Federal Bureau of Investigation, with the exception of federal employees who have suitability determination in accordance with 5 CFR 731.202 and submit documentation of such as promulgated in the rules of the commission; and
(5) Complies with the rules of the commission.
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(L. 2018 H.B. 1355 merged with S.B. 870)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.906 - Compact privilege to practice.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.906. Compact privilege to practice. —
1. Member states shall recognize the privilege to practice of an individual licensed in another member state that is in conformance with section 190.903.
2. To exercise the privilege to practice under the terms and provisions of this compact, an individual shall:
(1) Be at least eighteen years of age;
(2) Possess a current unrestricted license in a member state as an EMT, AEMT, paramedic, or state-recognized and licensed level with a scope of practice and authority between EMT and paramedic; and
(3) Practice under the supervision of a medical director.
3. An individual providing patient care in a remote state under the privilege to practice shall function within the scope of practice authorized by the home state unless and until modified by an appropriate authority in the remote state, as may be defined in the rules of the commission.
4. Except as provided in subsection 3 of this section, an individual practicing in a remote state shall be subject to the remote state's authority and laws. A remote state may, in accordance with due process and that state's laws, restrict, suspend, or revoke an individual's privilege to practice in the remote state and may take any other necessary actions to protect the health and safety of its citizens. If a remote state takes action, it shall promptly notify the home state and the commission.
5. If an individual's license in any home state is restricted, suspended, or revoked, the individual shall not be eligible to practice in a remote state under the privilege to practice until the individual's home state license is restored.
6. If an individual's privilege to practice in any remote state is restricted, suspended, or revoked, the individual shall not be eligible to practice in any remote state until the individual's privilege to practice is restored.
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(L. 2018 H.B. 1355 merged with S.B. 870)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.909 - Conditions of practice in a remote state.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.909. Conditions of practice in a remote state. —
An individual may practice in a remote state under a privilege to practice only in the performance of the individual's EMS duties as assigned by an appropriate authority, as defined in the rules of the commission, and under the following circumstances:
(1) The individual originates a patient transport in a home state and transports the patient to a remote state;
(2) The individual originates in the home state and enters a remote state to pick up a patient and provides care and transport of the patient to the home state;
(3) The individual enters a remote state to provide patient care or transport within that remote state;
(4) The individual enters a remote state to pick up a patient and provides care and transport to a third member state; or
(5) Other conditions as determined by rules promulgated by the commission.
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(L. 2018 H.B. 1355 merged with S.B. 870)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.912 - Relationship to emergency management assistance compact.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.912. Relationship to emergency management assistance compact. —
Upon a member state's governor's declaration of a state of emergency or disaster that activates the Emergency Management Assistance Compact (EMAC), all relevant terms and provisions of EMAC shall apply, and to the extent any terms or provisions of this compact conflict with EMAC, the terms of EMAC shall prevail with respect to any individual practicing in the remote state in response to such declaration.
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(L. 2018 H.B. 1355 merged with S.B. 870)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.915 - Veterans, service members separating from active duty military, and their spouses.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.915. Veterans, service members separating from active duty military, and their spouses. —
1. Member states shall consider a veteran, active military service member, or member of the National Guard and Reserves separating from an active duty tour, or a spouse thereof, who holds a current, valid, and unrestricted NREMT certification at or above the level of the state license being sought as satisfying the minimum training and examination requirements for such licensure.
2. Member states shall expedite the process of licensure applications submitted by veterans, active military service members, or members of the National Guard and Reserves separating from an active duty tour, or their spouses.
3. All individuals functioning with a privilege to practice under this section remain subject to the adverse action provisions of section 190.918.
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(L. 2018 H.B. 1355 merged with S.B. 870)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.918 - Adverse actions.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.918. Adverse actions. —
1. A home state shall have exclusive power to impose adverse action against an individual's license issued by the home state.
2. If an individual's license in any home state is restricted, suspended, or revoked, the individual shall not be eligible to practice in a remote state under the privilege to practice until the individual's home state license is restored.
(1) All home state adverse action orders shall include a statement that the individual's compact privileges are inactive. The order may allow the individual to practice in remote states with prior written authorization from both the home state and the remote state's EMS authority.
(2) An individual currently subject to adverse action in the home state shall not practice in any remote state without prior written authorization from both the home state and remote state's EMS authority.
3. A member state shall report adverse actions and any occurrences that the individual's compact privileges are restricted, suspended, or revoked to the commission in accordance with the rules of the commission.
4. A remote state may take adverse action on an individual's privilege to practice within that state.
5. Any member state may take adverse action against an individual's privilege to practice in that state based on the factual findings of another member state, so long as each state follows its own procedures for imposing such adverse action.
6. A home state's EMS authority shall coordinate investigative activities, share information via the coordinated database, and take appropriate action with respect to reported conduct in a remote state as it would if such conduct had occurred within the home state. In such cases, the home state's law shall control in determining the appropriate adverse action.
7. Nothing in this compact shall override a member state's decision that participation in an alternative program may be used in lieu of adverse action and that such participation shall remain nonpublic if required by the member state's laws. Member states shall require individuals who enter any alternative programs to agree not to practice in any other member state during the term of the alternative program without prior authorization from such other member state.
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(L. 2018 H.B. 1355 merged with S.B. 870)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.921 - Additional powers invested in a member state's EMS authority.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.921. Additional powers invested in a member state's EMS authority. —
A member state's EMS authority, in addition to any other powers granted under state law, is authorized under this compact to:
(1) Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses and the production of evidence. Subpoenas issued by a member state's EMS authority for the attendance and testimony of witnesses or the production of evidence from another member state shall be enforced in the remote state by any court of competent jurisdiction according to that court's practice and procedure in considering subpoenas issued in its own proceedings. The issuing state's EMS authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state where the witnesses or evidence is located; and
(2) Issue cease and desist orders to restrict, suspend, or revoke an individual's privilege to practice in the state.
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(L. 2018 H.B. 1355 merged with S.B. 870)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.927 - Coordinated database.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.927. Coordinated database. —
1. The commission shall provide for the development and maintenance of a coordinated database and reporting system containing licensure, adverse action, and significant investigatory information on all licensed individuals in member states.
2. Notwithstanding any other provision of state law to the contrary, a member state shall submit a uniform data set to the coordinated database on all individuals to whom this compact is applicable as required by the rules of the commission, including:
(1) Identifying information;
(2) Licensure data;
(3) Significant investigatory information;
(4) Adverse actions against an individual's license;
(5) An indicator that an individual's privilege to practice is restricted, suspended, or revoked;
(6) Nonconfidential information related to alternative program participation;
(7) Any denial of application for licensure and the reasons for such denial; and
(8) Other information that may facilitate the administration of this compact, as determined by the rules of the commission.
3. The coordinated database administrator shall promptly notify all member states of any adverse action taken against, or significant investigative information on, any individual in a member state.
4. Member states contributing information to the coordinated database may designate information that shall not be shared with the public without the express permission of the contributing state.
5. Any information submitted to the coordinated database that is subsequently required to be expunged by the laws of the member state contributing the information shall be removed from the coordinated database.
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(L. 2018 H.B. 1355 merged with S.B. 870)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.936 - Date of implementation of the interstate commission for EMS personnel practice and associated rules, and amendment.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.936. Date of implementation of the interstate commission for EMS personnel practice and associated rules, and amendment. —
*
1. The compact shall come into effect on the date on which the compact statute is enacted into law in the tenth member state. The provisions, which become effective at that time, shall be limited to the powers granted to the commission relating to assembly and the promulgation of rules. Thereafter, the commission shall meet and exercise rulemaking powers necessary to the implementation and administration of the compact.
2. Any state that joins the compact subsequent to the commission's initial adoption of the rules shall be subject to the rules as they exist on the date on which the compact becomes law in that state. Any rule that has been previously adopted by the commission shall have the full force and effect of law on the day the compact becomes law in that state.
3. Any member state may withdraw from this compact by enacting a statute repealing the same.
(1) A member state's withdrawal shall not take effect until six months after enactment of the repealing statute.
(2) Withdrawal shall not affect the continuing requirement of the withdrawing state's EMS authority to comply with the investigative and adverse action reporting requirements of sections 190.900 to 190.939
**
prior to the effective date of withdrawal.
4. Nothing contained in this compact shall be construed to invalidate or prevent any EMS personnel licensure agreement or other cooperative arrangement between a member state and a nonmember state that does not conflict with the provisions of this compact.
5. This compact may be amended by the member states. No amendment to this compact shall become effective and binding upon any member state until it is enacted into the laws of all member states.
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(L. 2018 H.B. 1355 merged with S.B. 870)
*On May 8, 2017, the tenth state enacted REPLICA.
**Words "this act" appear in original rolls of H.B. 1355 and S.B. 870, 2018.
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.939 - Construction and severability.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
• Effective - 28 Aug 2018
190.939. Construction and severability. —
1. This compact shall be liberally construed so as to effectuate the purposes thereof. If this compact shall be held contrary to the constitution of any member state thereto, the compact shall remain in full force and effect as to the remaining member states. Nothing in this compact supersedes state law or rules related to licensure of EMS agencies.
2. The state advisory council on emergency medical services established under section 190.101 shall review decisions of the interstate commission for emergency medical services personnel practice established under this compact and, upon approval by the commission of any action that will have the result of increasing the cost to the state of membership in the compact, the council may recommend to the general assembly that the state withdraw from the compact.
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(L. 2018 H.B. 1355 merged with S.B. 870)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 190 - Emergency Services › Section 190.1005 - CPR training or courses to include instruction on proper use of automated external defibrillators.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 190
Effective - 28 Aug 2020
190.1005. CPR training or courses to include instruction on proper use of automated external defibrillators. —
Notwithstanding any other provision of law to the contrary, any training or course in cardiopulmonary resuscitation shall also include instruction on the proper use of automated external defibrillators. Such training or course shall follow the standards created by the American Red Cross or the American Heart Association, or equivalent evidence-based standards from a nationally recognized organization.
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(L. 2020 H.B. 1682)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 191 - Health and Welfare › Section 191.005 - Information exchange between departments, rulemaking authority.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 191
Effective - 28 Aug 1999
191.005. Information exchange between departments, rulemaking authority. —
1. The departments of health and senior services and social services shall promulgate rules and regulations requiring the exchange of information, including regulatory violations, between the departments to ensure the protection of individuals who are served by health care providers regulated by either the department of health and senior services or the department of social services.
2. No rule or portion of a rule promulgated pursuant to the provisions of this section shall become effective unless it has been promulgated pursuant to chapter 536.
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(L. 1999 S.B. 8 & 173 § 3)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 191 - Health and Welfare › Section 191.127 - Land may be leased for farming or grazing — procedure.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 191
Effective - 28 Aug 1980
191.127. Land may be leased for farming or grazing — procedure. —
1. The director of the department of social services is hereby authorized to lease real property operated by the department of social services previously used for grazing or farming and determined by the chief administrative authority at each facility to be in excess of the immediate needs and requirements of the state facilities.
2. The state director of the division of purchasing shall offer for lease such lands by sealed bids to the general public. The bids shall be opened by the state director of the division of purchasing, but all bids may be rejected.
3. The term of the lease shall be for a period of one year or less, and the lessor shall have the option of renewing the lease from year to year, and the lease shall include conditions that the lessee shall use and maintain the land for agricultural purposes and will maintain all fences and buildings on the leased land.
4. The administrative official of the state facility where the land is located or his representative shall periodically inspect the property to insure compliance with all provisions of the lease.
5. The director of the department of social services shall sign the lease on behalf of the state.
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(L. 1972 H.B. 1071 §§ 1 to 5, A.L. 1980 H.B. 1724)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 191 - Health and Welfare › Section 191.150 - Purchase of food limited to use of institution inmates.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 191
• Effective - 28 Aug 1980
191.150. Purchase of food limited to use of institution inmates. —
Any purchase of food in any institution under the control of the department of social services, other than the usual quality purchased for the inmates thereof, to be used by or for anyone other than the inmates of the institution shall be charged directly to the individual responsible for such purchase.
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(L. 1947 V. I p. 314 § 10c, A.L. 1980 H.B. 1724)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 191 - Health and Welfare › Section 191.160 - Board and living quarters for employees of institutions.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 191
• Effective - 28 Aug 1980
191.160. Board and living quarters for employees of institutions. —
The department of social services may provide any employee in any institution under its control with board and living quarters in addition to salary, or wages, when the director shall determine that it is for the best interest of the state to do so.
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(L. 1947 V. I p. 314 § 10d, A.L. 1980 H.B. 1724)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 191 - Health and Welfare › Section 191.170 - Mistreatment of inmates — penalty.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 191
• Effective - 28 Aug 1980
191.170. Mistreatment of inmates — penalty. —
Every person who shall willfully beat, strike, wound or injure any inmate of any institution under the control of the department of social services, or who shall in any other manner whatsoever mistreat or maltreat, handle or treat any such inmate in a brutal or inhuman manner, or who, in the handling of any such inmate, shall use any more force than is reasonably or apparently necessary for the proper control, treatment or management of such inmate, shall, upon conviction, be punished by a fine of not less than five dollars nor more than one hundred dollars, or by imprisonment in the county or city jail for not less than ten days nor more than six months, or by both such fine and imprisonment.
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(L. 1947 V. I p. 314 § 10e, A.L. 1980 H.B. 1724)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 191 - Health and Welfare › Section 191.180 - Furnishing unfit food to institution — penalty.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 191
• Effective - 28 Aug 1980
191.180. Furnishing unfit food to institution — penalty. —
Every person who shall knowingly furnish or deliver any diseased, putrid or otherwise unwholesome meat, or the meat from any animal or fowl that was diseased or otherwise unfit for food, to any institution under the control of the department of social services, or who shall furnish or deliver any other unwholesome food, vegetables or provisions whatsoever to any such institution, to be used as food by the inmates or employees thereof, and any employee of such institution who knowingly shall receive, or consent to the receiving, of any such diseased or unwholesome meat, food or provisions at or by such institution, shall, upon conviction, be punished by a fine of not less than five dollars nor more than one hundred dollars, or by imprisonment in the county or city jail for not less than ten days nor more than six months, or by both such fine and imprisonment.
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(L. 1947 V. I p. 314 § 10f, A.L. 1980 H.B. 1724)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 191 - Health and Welfare › Section 191.190 - Accessory to mistreatment of inmates or furnishing of unwholesome food — penalty.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 191
• Effective - 28 Aug 1980
191.190. Accessory to mistreatment of inmates or furnishing of unwholesome food — penalty. —
If any person or employee of any institution under the control of the department of social services shall be witness or shall in any other manner have knowledge of any violation of the provisions of sections 191.170 and 191.180, and shall fail to forthwith communicate such fact or facts to the superintendent of the institution or to the director of the department of social services, he or she shall be deemed an accessory to such act and violation, and, upon conviction, shall be punished by a fine of not less than five dollars nor more than one hundred dollars. Any person convicted of a violation of this or of section 191.170 or 191.180 shall be disqualified for holding any position for a period of one year in any institution in this state under the control of the state government.
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(L. 1947 V. I p. 314 § 10g, A.L. 1980 H.B. 1724)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 191 - Health and Welfare › Section 191.210 - Attendance of patient by private physician.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 191
• Effective - 28 Aug 1980
191.210. Attendance of patient by private physician. —
Any person having any relative committed to the custody of any institution under the control of the state department of social services may, at their own expense, employ a licensed physician or other qualified practitioner to administer treatments to such patients. Persons so employed shall confine such treatment to the individual patient concerned. The state shall not be liable for any additional cost incurred as a result of the employment of such persons.
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(L. 1947 V. I p. 314 § 10i, A.L. 1980 H.B. 1724)
2023 Missouri Revised Statutes › Title XII - Public Health and Welfare › Chapter 191 - Health and Welfare › Section 191.211 - Funding of certain programs.

Title XII PUBLIC HEALTH AND WELFARE
Chapter 191
• Effective - 28 Aug 2001
191.211. Funding of certain programs. —
State expenditures for new programs and initiatives enacted by sections 103.178, 143.999, 188.230, 191.231, 191.825 to 191.839, 208.177, 208.178
*
, 208.179 and 208.181, 211.490, 285.240, 337.093, 374.126, 376.891 to 376.894, 431.064, 660.016, 660.017 and 660.018, and the state expenditures for the new initiatives and expansion of programs enacted by revising sections 105.711 and 105.721, 191.520
**
, 191.600, 198.090, 208.151, 208.152 and 208.215, as provided by H.B. 564, 1993, shall be funded exclusively by federal funds and the funding sources established in sections 149.011, 149.015, 149.035, 149.061, 149.065, 149.160, 149.170, 149.180, 149.190 and 149.192, and no future general revenue shall be appropriated to fund such new programs or expansions.
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(L. 1993 H.B. 564 § 36, A.L. 2001 S.B. 393)
*Section 208.178 was repealed by S.B. 975 & 1024 Revision, 2018.
**Section 191.520 was repealed by H.B. 402 merged with S.B. 45 & 90 merged with S.B. 70 merged with S.B. 106 merged with S.B. 157, 2023.