Official Summary Text
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Truly Agreed to and Finally Passed
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HCS/SB 1019 - This act modifies several provisions relating to health care.
HOSPITAL INVESTMENTS AND SERVICE AREAS (Sections 96.192, 96.196, 206.110, and 206.158)
This act modifies the investment authority of boards of trustees of municipal hospitals in third class cities and hospital district hospitals. Current law permits investment of up to 25% of funds not required for operations of the hospital or other obligations. This act permits investment of up to 50% of funds not required for operations or other obligations in a manner described in the act, with the remaining portion to be invested into any investment in which the Treasurer is allowed to invest.
Under this act, municipal hospitals in third class cities may operate in areas where hospital district hospitals and county hospitals operate. Hospital district hospitals may operate in areas where municipal hospitals in third class cities and county hospitals operate.
These provisions are identical to provisions in the truly agreed to and finally passed SS/SCS/HCS/SB 2372 (2026) and SB 244 (2025) and substantially similar to provisions in SS/SCS/SB 841 (2026), SCS/HCS/HB 2372 (2026), SCS/HCS/HB 943 (2025), SCS/SB 317 (2025), and HCS/SS/SB 7 (2025).
LYME DISEASE (Section 192.026)
This act establishes the "Missouri Lyme Disease Eradication Act." The Department shall compile an annual report on the incidence and prevalence of Lyme disease in Missouri, as described in the act. The Department shall collaborate with public four-year institutions of higher education to integrate Lyme disease surveillance data into existing tick-borne disease monitoring programs.
This act also contains a repeal of this section as truly agreed to and finally passed in SS/SCS/HCS/HB 2372 (2026).
This provision is substantially similar to a provision in SB 887 (2026).
SARAH HASKINS
House Amendment
Print
HCS/SB 1019 - This act modifies several provisions relating to health care.
HOSPITAL INVESTMENTS AND SERVICE AREAS (Sections 96.192, 96.196, 206.110, and 206.158)
This act modifies the investment authority of boards of trustees of municipal hospitals in third class cities and hospital district hospitals. Current law permits investment of up to 25% of funds not required for operations of the hospital or other obligations. This act permits investment of up to 50% of funds not required for operations or other obligations in a manner described in the act, with the remaining portion to be invested into any investment in which the Treasurer is allowed to invest.
Under this act, municipal hospitals in third class cities may operate in areas where hospital district hospitals and county hospitals operate. Hospital district hospitals may operate in areas where municipal hospitals in third class cities and county hospitals operate.
These provisions are identical to SB 244 (2025) and substantially similar to provisions in SS/SCS/SB 841 (2026), SCS/HCS/HB 2372 (2026), SCS/HCS/HB 943 (2025), SCS/SB 317 (2025), and HCS/SS/SB 7 (2025).
TELEHEALTH (Sections 191.1146 and 334.108)
Currently, the establishment of a physician-patient relationship for purposes of telehealth shall include an interview and a physical examination. Under this act, an evaluation is required, but a physical examination shall be required only if needed to meet the standard of care.
Current law prohibits the use of an internet or telephone questionnaire completed by a patient from constituting an acceptable medical interview for the provision of treatment by telehealth. This act permits such questionnaires if the information provided is sufficient as though the medical evaluation was performed in person, with a report to be provided to the patient's primary health care provider within fourteen days of evaluation, as described in the act.
Additionally, current law requires a physician-patient relationship for purposes of telehealth to include a sufficient dialogue with the patient regarding treatment. This act changes "dialogue" to "exchange" with the patient regarding treatment.
Finally, current law prohibits a health care provider from prescribing any drug, controlled substance, or other treatment to a patient based solely on an internet request or questionnaire. Under this act, a health care provider shall not prescribe any drug, controlled substance, or other treatment to a patient in the absence of a proper provider-patient relationship.
These provision are identical to provisions in SS/SCS/SB 841 (2026) and SCS/HCS/HB 2372 (2026), substantially similar to SB 108 (2025) and SB 851 (2024), and similar to SCS/SB 418 (2023) and HB 710 (2023).
DEPARTMENT OF HEALTH AND SENIOR SERVICES CONTRACTS FOR PUBLIC HEALTH (Section 192.021)
This act authorizes the Department of Health and Senior Services to contract with a Missouri affiliate of a national public health association or public health institute, or a similar or successor entity, in order to assist in carrying out its duties to promote the health and well-being of Missouri residents. Such contracts may include efforts to assist in the delivery of health services throughout the state and the administration of grant funds and related programs. The Department and the designated affiliate shall provide a report to the General Assembly as specified in the act.
This provision is identical to a provision in SS/SCS/SB 841 (2026) SB 1525 and substantially similar to provisions in SB 1037 (2026), HCS/SB 94 (2025), and SB 549 (2025).
HOSPITAL WORKPLACE VIOLENCE (Section 197.708)
Under this act, each hospital shall prominently display a printed sign, in all capital letters, warning that assaulting a health care professional is a serious crime which may be punishable as a class A misdemeanor.
This provision is identical to provisions in the perfected HCS/HB 2372 (2026), HCS/SB 94 (2025), and HCS/HB 1213 (2025) and substantially similar provisions in SS/SCS/SB 841 (2026) and SB 791 (2025).
MO HEALTHNET COVERAGE OF CERTAIN CLINICAL PATHOLOGY SERVICES (Section 208.149)
This act requires that the fee for the professional component of clinical pathology services shall be paid by MO HealthNet for professional services provided by a hospital-based pathologist for inpatient clinical pathology services rendered to MO HealthNet patients. The reimbursement shall be set at no less than thirty percent of the approved MO HealthNet Independent Lab-Technical Component fee schedule, as described in the act, as shall be made directly to the physician providing the services or the entity the physician has assigned the right to receive payment.
This provision is identical to a provision in SS/SCS/SB 841 (2026) and the perfected HCS/HB 2376 (2026) and substantially similar to a provision in HCS/SB 94 (2025) and SCS/HCS/HB 943 (2025).
LICENSE RECIPROCITY (Section 324.009)
Those health care providers, who hold a current license issued by another jurisdiction and are licensed in Missouri with a waiver of examination, educational, or experience requirements, shall be deemed to be fully licensed to practice within the profession's scope of practice in Missouri and may provide telehealth services to the same extent and manner as health care providers who receive a license without a waiver.
This provision is identical to a provision in SS/SCS/SB 841 (2026), SB 1691 (2026), a provision in the perfected HCS/HB 2372 (2026), and HCS/HB 2974 (2026).
SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS (Section 345.050)
This act modifies the requirements for licensure as a speech-language pathologist or audiologist by providing for completion of a clinical fellowship under the direct supervision of a licensed speech-language pathologist in good standing, rather than under the direct supervision of a person licensed by the state of Missouri in the profession in which the applicant seeks to be licensed.
This provision is identical to a provision in SS/SCS/SB 841 (2026), SB 1405 (2026), the perfected HCS/HB 2372 (2026), in HCS/SS/SB 7 (2025), in the perfected SS/SB 61 (2025), in the perfected HCS/HB 268 (2025), SB 431 (2025), in the perfected HB 478 (2025), in HB 765 (2025), and in SCS/HB 834 (2025), and is substantially similar to the perfected HB 2591 (2026).
340B DRUGS (Section 376.417)
Under this act, a health carrier, a pharmacy benefits manager, or an agent or affiliate of such, shall not discriminate against a covered entity, as defined in the act, including by reimbursing the covered entity for a quantity of a 340B drug in an amount less than it would pay similarly situated non-covered entities for such drugs, imposing different terms and conditions as compared to similarly situated entities, refusing to cover 340B drugs or discriminating in reimbursement for 340B drugs, and other situations described under this act. The Director of the Department of Commerce and Insurance shall impose a civil penalty on any health carrier, pharmacy benefits manager, or agent or affiliate of such, that violates this provision, not to exceed $5,000 per violation per day.
This provision is identical to a provision in SS/SCS/SB 841 (2026), SCS/HCS/HB 943 (2025) and HB 784 (2025).
MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS (Sections 376.1000-376.1017)
This act modifies the definition of "multiple employer-self insure health plan" by including two or more self-employed individuals, each with at least one common-law employee, and their dependents.
Currently, funds collected from the participating employers under the health plans are held in trust and trustees are required to file an annual report with the director of the Department of Commerce and Insurance showing the condition and affairs of the plan as of the preceding thirty first day of December. This act requires the annual report be filed with the National Association of Insurance Commissioners and comply with current law.
This act requires plans to establish a surplus account equal to the greater of six hundred thousand dollars or an amount equal to two times the authorized control level risk-based capital, as defined by current law.
These provisions are identical to provisions in SS/SCS/SB 841 (2026) and the perfected HCS/HB 2596 (2026) and similar to SB 1464 (2026).
INSURANCE COVERAGE OF ALTERNATIVES TO OPIOID DRUGS (Section 376.1280)
This act provides that an enrollee's health benefit plan shall not deny coverage of a non-opioid prescription drug in favor of an opioid drug, require the enrollee to try an opioid drug before covering the non-opioid prescription drug, or require a higher level of cost-sharing for a non-opioid prescription drug than for an opioid drug.
This act shall apply to health benefit plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2027.
These provisions shall only be applicable when multiple nonopioid medications are approved by the U.S. Food and Drug Administration for the treatment of chronic or acute pain.
This provision is identical in the perfected HCS/HB 2372 (2026) and substantially similar to a provision in SS/SCS/SB 841 (2026) and SB 158 (2025).
ARTIFICIAL INTELLIGENCE IN MENTAL HEALTH (Section 407.3007)
The act provides that no person or entity that develops or deploys artificial intelligence (AI) shall advertise or represent to the public that the AI is or is able to act as a mental health professional, as defined in the act, or is capable of providing therapy services, psychotherapy services, or a mental health diagnosis.
A violation under the act shall be considered an unlawful practice under the Missouri Merchandising Practices Act.
The Attorney General shall enforce the provisions of the act. Any individual may report violations of the act to the Attorney General. If the Attorney General finds that a violation occurred, the Attorney General shall commence a civil action. If the court finds that a violation occurred, the court may grant relief as described in the act.
This provision is identical to a provision in SS/SCS/SB 841 (2026), the perfected HCS/HB 2372 (2026), and SCS/SB 1444 (2026) and similar to HB 2368 (2026).
NOTARIZATION REQUIREMENTS FOR MENTAL HEALTH FACILITY DETENTION (Section 632.305)
This act modifies notarization requirements for applications for detention for evaluation and treatment at a mental health facility. Under this act, no notarization shall be required for the application or any affidavits, declarations, or other supporting documents filed under certain provisions of law, including when filed in court by an adult, when a peace officer takes a person into custody for detention at the facility for a period of 96 hours, when a person presents themselves at the facility and the health care provider completes the application, or if the person executing the application is an employee acting on behalf of a hospital.
This provision is identical to provisions in SS/SCS/SB 841 (2026), the perfected SS/SCS/SB 1015 (2026), the perfected HB 1977 (2026), a provision in the perfected HCS/HB 2372 (2026), and provisions in SCS/HCS/HB 1259 (2025) and substantially similar to SB 1274 (2026) and SB 436 (2025).
SEXUALLY VIOLENT PREDATOR CIVIL COMMITMENT (Sections 632.489, 632.492, 632.495, 632.504, and 632.520)
Under this act, if a person is ordered to the Department of Mental Health for evaluation as to whether the person is a sexually violent predator, the Director of the Department of Mental Health shall determine the appropriate secure facility, which may include the Department of Corrections. The Department of Mental Health and the Department of Corrections may enter into an interagency agreement, which may permit the Department of Corrections to enter into a contract agreement with one or more licensed professionals or providers of health care services to provide health care services to such persons. Persons in the control and care of the Department of Corrections under this provision shall be housed and managed separately from other offenders.
These provisions are identical to provisions in the truly agreed and finally passed HCS/SB 982 (2026).
ASSISTED OUTPATIENT TREATMENT (Sections 632.580-632.610)
This act establishes procedures for authorizing or continuing an individual's assisted outpatient treatment. A petition in court for such treatment may be filed by individuals specified in the act. A court may issue an order requiring the individual to participate in assisted outpatient treatment if the individual is at least 18 years of age, is suffering from a mental disorder, will not obtain treatment in the community voluntarily, and is unable to make an informed decision to see or comply with voluntary treatment. Additional grounds for ordering treatment shall consider the necessity of treatment to prevent a deterioration in the individual's mental illness likely to result in harm to the individual or others or the individual's history of lack of compliance with treatment for the illness, as described in the act.
The act sets forth the procedures for the hearing process, including the option for a jury trial. If the court or jury finds, by clear and convincing evidence, that the individual meets the criteria for assisted outpatient treatment and that an appropriate mental health program has agreed to accept the individual, the court shall issue an order requiring the individual to participate in treatment for a period not to exceed two years, unless extended by the court as described in the act.
Current provisions of law exempting certain professionals from civil liability for investigating, detaining, transporting, conditionally releasing, or discharging a person shall apply to assisted outpatient treatment under this act.
The court shall assign a case manager from a certified community behavioral health clinic to each individual ordered to participate in assisted outpatient treatment. The case manager and individual shall report to the court at least once every ninety days.
If a court determines that the individual is not complying with an order of assisted outpatient treatment, the court may order, without a hearing, that the individual be evaluated at a community mental health center, be hospitalized in a psychiatric hospital for a period of not more than ten days, and potentially be hospitalized for longer upon the recommendation of the community mental health center; provided such extended hospitalization does not exceed the duration of the order for assisted outpatient treatment or ninety days, whichever is less. If the individual objects to such hospitalization, the court shall schedule a hearing as described in the act.
Beginning December 1, 2028, the Office of State Courts Administrator shall submit an annual report to the General Assembly regarding certain statistics of individuals receiving treatment under this act and the impact of such treatment on hospitalization and incarceration rates.
These provisions are identical to provisions in the perfected SS/SCS/SB 1015 (2026) and substantially similar to HB 1154 (2025).
SARAH HASKINS
HA#1: MODIFIES SECTIONS 96.192 AND 206.158 RELATING TO HOSPITAL INVESTMENTS AND SERVICE AREAS FROM THE SENATE PERFECTED BILL; ADDS SECTION 192.026 RELATING TO LYME DISEASE REPORTING; AND REPEALS ALL PROVISIONS ADDED IN THE HOUSE COMMITTEE SUBSTITUTE
House Committee Substitute
Print
HCS/SB 1019 - This act modifies several provisions relating to health care.
HOSPITAL INVESTMENTS AND SERVICE AREAS (Sections 96.192, 96.196, 206.110, and 206.158)
This act modifies the investment authority of boards of trustees of municipal hospitals in third class cities and hospital district hospitals. Current law permits investment of up to 25% of funds not required for operations of the hospital or other obligations. This act permits investment of up to 50% of funds not required for operations or other obligations in a manner described in the act, with the remaining portion to be invested into any investment in which the Treasurer is allowed to invest.
Under this act, municipal hospitals in third class cities may operate in areas where hospital district hospitals and county hospitals operate. Hospital district hospitals may operate in areas where municipal hospitals in third class cities and county hospitals operate.
These provisions are identical to SB 244 (2025) and substantially similar to provisions in SS/SCS/SB 841 (2026), SCS/HCS/HB 2372 (2026), SCS/HCS/HB 943 (2025), SCS/SB 317 (2025), and HCS/SS/SB 7 (2025).
TELEHEALTH (Sections 191.1146 and 334.108)
Currently, the establishment of a physician-patient relationship for purposes of telehealth shall include an interview and a physical examination. Under this act, an evaluation is required, but a physical examination shall be required only if needed to meet the standard of care.
Current law prohibits the use of an internet or telephone questionnaire completed by a patient from constituting an acceptable medical interview for the provision of treatment by telehealth. This act permits such questionnaires if the information provided is sufficient as though the medical evaluation was performed in person, with a report to be provided to the patient's primary health care provider within fourteen days of evaluation, as described in the act.
Additionally, current law requires a physician-patient relationship for purposes of telehealth to include a sufficient dialogue with the patient regarding treatment. This act changes "dialogue" to "exchange" with the patient regarding treatment.
Finally, current law prohibits a health care provider from prescribing any drug, controlled substance, or other treatment to a patient based solely on an internet request or questionnaire. Under this act, a health care provider shall not prescribe any drug, controlled substance, or other treatment to a patient in the absence of a proper provider-patient relationship.
These provision are identical to provisions in SS/SCS/SB 841 (2026) and SCS/HCS/HB 2372 (2026), substantially similar to SB 108 (2025) and SB 851 (2024), and similar to SCS/SB 418 (2023) and HB 710 (2023).
DEPARTMENT OF HEALTH AND SENIOR SERVICES CONTRACTS FOR PUBLIC HEALTH (Section 192.021)
This act authorizes the Department of Health and Senior Services to contract with a Missouri affiliate of a national public health association or public health institute, or a similar or successor entity, in order to assist in carrying out its duties to promote the health and well-being of Missouri residents. Such contracts may include efforts to assist in the delivery of health services throughout the state and the administration of grant funds and related programs. The Department and the designated affiliate shall provide a report to the General Assembly as specified in the act.
This provision is identical to a provision in SS/SCS/SB 841 (2026) SB 1525 and substantially similar to provisions in SB 1037 (2026), HCS/SB 94 (2025), and SB 549 (2025).
HOSPITAL WORKPLACE VIOLENCE (Section 197.708)
Under this act, each hospital shall prominently display a printed sign, in all capital letters, warning that assaulting a health care professional is a serious crime which may be punishable as a class A misdemeanor.
This provision is identical to provisions in the perfected HCS/HB 2372 (2026), HCS/SB 94 (2025), and HCS/HB 1213 (2025) and substantially similar provisions in SS/SCS/SB 841 (2026) and SB 791 (2025).
MO HEALTHNET COVERAGE OF CERTAIN CLINICAL PATHOLOGY SERVICES (Section 208.149)
This act requires that the fee for the professional component of clinical pathology services shall be paid by MO HealthNet for professional services provided by a hospital-based pathologist for inpatient clinical pathology services rendered to MO HealthNet patients. The reimbursement shall be set at no less than thirty percent of the approved MO HealthNet Independent Lab-Technical Component fee schedule, as described in the act, as shall be made directly to the physician providing the services or the entity the physician has assigned the right to receive payment.
This provision is identical to a provision in SS/SCS/SB 841 (2026) and the perfected HCS/HB 2376 (2026) and substantially similar to a provision in HCS/SB 94 (2025) and SCS/HCS/HB 943 (2025).
LICENSE RECIPROCITY (Section 324.009)
Those health care providers, who hold a current license issued by another jurisdiction and are licensed in Missouri with a waiver of examination, educational, or experience requirements, shall be deemed to be fully licensed to practice within the profession's scope of practice in Missouri and may provide telehealth services to the same extent and manner as health care providers who receive a license without a waiver.
This provision is identical to a provision in SS/SCS/SB 841 (2026), SB 1691 (2026), a provision in the perfected HCS/HB 2372 (2026), and HCS/HB 2974 (2026).
SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS (Section 345.050)
This act modifies the requirements for licensure as a speech-language pathologist or audiologist by providing for completion of a clinical fellowship under the direct supervision of a licensed speech-language pathologist in good standing, rather than under the direct supervision of a person licensed by the state of Missouri in the profession in which the applicant seeks to be licensed.
This provision is identical to a provision in SS/SCS/SB 841 (2026), SB 1405 (2026), the perfected HCS/HB 2372 (2026), in HCS/SS/SB 7 (2025), in the perfected SS/SB 61 (2025), in the perfected HCS/HB 268 (2025), SB 431 (2025), in the perfected HB 478 (2025), in HB 765 (2025), and in SCS/HB 834 (2025), and is substantially similar to the perfected HB 2591 (2026).
340B DRUGS (Section 376.417)
Under this act, a health carrier, a pharmacy benefits manager, or an agent or affiliate of such, shall not discriminate against a covered entity, as defined in the act, including by reimbursing the covered entity for a quantity of a 340B drug in an amount less than it would pay similarly situated non-covered entities for such drugs, imposing different terms and conditions as compared to similarly situated entities, refusing to cover 340B drugs or discriminating in reimbursement for 340B drugs, and other situations described under this act. The Director of the Department of Commerce and Insurance shall impose a civil penalty on any health carrier, pharmacy benefits manager, or agent or affiliate of such, that violates this provision, not to exceed $5,000 per violation per day.
This provision is identical to a provision in SS/SCS/SB 841 (2026), SCS/HCS/HB 943 (2025) and HB 784 (2025).
MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS (Sections 376.1000-376.1017)
This act modifies the definition of "multiple employer-self insure health plan" by including two or more self-employed individuals, each with at least one common-law employee, and their dependents.
Currently, funds collected from the participating employers under the health plans are held in trust and trustees are required to file an annual report with the director of the Department of Commerce and Insurance showing the condition and affairs of the plan as of the preceding thirty first day of December. This act requires the annual report be filed with the National Association of Insurance Commissioners and comply with current law.
This act requires plans to establish a surplus account equal to the greater of six hundred thousand dollars or an amount equal to two times the authorized control level risk-based capital, as defined by current law.
These provisions are identical to provisions in SS/SCS/SB 841 (2026) and the perfected HCS/HB 2596 (2026) and similar to SB 1464 (2026).
INSURANCE COVERAGE OF ALTERNATIVES TO OPIOID DRUGS (Section 376.1280)
This act provides that an enrollee's health benefit plan shall not deny coverage of a non-opioid prescription drug in favor of an opioid drug, require the enrollee to try an opioid drug before covering the non-opioid prescription drug, or require a higher level of cost-sharing for a non-opioid prescription drug than for an opioid drug.
This act shall apply to health benefit plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2027.
These provisions shall only be applicable when multiple nonopioid medications are approved by the U.S. Food and Drug Administration for the treatment of chronic or acute pain.
This provision is identical in the perfected HCS/HB 2372 (2026) and substantially similar to a provision in SS/SCS/SB 841 (2026) and SB 158 (2025).
ARTIFICIAL INTELLIGENCE IN MENTAL HEALTH (Section 407.3007)
The act provides that no person or entity that develops or deploys artificial intelligence (AI) shall advertise or represent to the public that the AI is or is able to act as a mental health professional, as defined in the act, or is capable of providing therapy services, psychotherapy services, or a mental health diagnosis.
A violation under the act shall be considered an unlawful practice under the Missouri Merchandising Practices Act.
The Attorney General shall enforce the provisions of the act. Any individual may report violations of the act to the Attorney General. If the Attorney General finds that a violation occurred, the Attorney General shall commence a civil action. If the court finds that a violation occurred, the court may grant relief as described in the act.
This provision is identical to a provision in SS/SCS/SB 841 (2026), the perfected HCS/HB 2372 (2026), and SCS/SB 1444 (2026) and similar to HB 2368 (2026).
NOTARIZATION REQUIREMENTS FOR MENTAL HEALTH FACILITY DETENTION (Section 632.305)
This act modifies notarization requirements for applications for detention for evaluation and treatment at a mental health facility. Under this act, no notarization shall be required for the application or any affidavits, declarations, or other supporting documents filed under certain provisions of law, including when filed in court by an adult, when a peace officer takes a person into custody for detention at the facility for a period of 96 hours, when a person presents themselves at the facility and the health care provider completes the application, or if the person executing the application is an employee acting on behalf of a hospital.
This provision is identical to provisions in SS/SCS/SB 841 (2026), the perfected SS/SCS/SB 1015 (2026), the perfected HB 1977 (2026), a provision in the perfected HCS/HB 2372 (2026), and provisions in SCS/HCS/HB 1259 (2025) and substantially similar to SB 1274 (2026) and SB 436 (2025).
SEXUALLY VIOLENT PREDATOR CIVIL COMMITMENT (Sections 632.489, 632.492, 632.495, 632.504, and 632.520)
Under this act, if a person is ordered to the Department of Mental Health for evaluation as to whether the person is a sexually violent predator, the Director of the Department of Mental Health shall determine the appropriate secure facility, which may include the Department of Corrections. The Department of Mental Health and the Department of Corrections may enter into an interagency agreement, which may permit the Department of Corrections to enter into a contract agreement with one or more licensed professionals or providers of health care services to provide health care services to such persons. Persons in the control and care of the Department of Corrections under this provision shall be housed and managed separately from other offenders.
These provisions are identical to provisions in the truly agreed and finally passed HCS/SB 982 (2026).
ASSISTED OUTPATIENT TREATMENT (Sections 632.580-632.610)
This act establishes procedures for authorizing or continuing an individual's assisted outpatient treatment. A petition in court for such treatment may be filed by individuals specified in the act. A court may issue an order requiring the individual to participate in assisted outpatient treatment if the individual is at least 18 years of age, is suffering from a mental disorder, will not obtain treatment in the community voluntarily, and is unable to make an informed decision to see or comply with voluntary treatment. Additional grounds for ordering treatment shall consider the necessity of treatment to prevent a deterioration in the individual's mental illness likely to result in harm to the individual or others or the individual's history of lack of compliance with treatment for the illness, as described in the act.
The act sets forth the procedures for the hearing process, including the option for a jury trial. If the court or jury finds, by clear and convincing evidence, that the individual meets the criteria for assisted outpatient treatment and that an appropriate mental health program has agreed to accept the individual, the court shall issue an order requiring the individual to participate in treatment for a period not to exceed two years, unless extended by the court as described in the act.
Current provisions of law exempting certain professionals from civil liability for investigating, detaining, transporting, conditionally releasing, or discharging a person shall apply to assisted outpatient treatment under this act.
The court shall assign a case manager from a certified community behavioral health clinic to each individual ordered to participate in assisted outpatient treatment. The case manager and individual shall report to the court at least once every ninety days.
If a court determines that the individual is not complying with an order of assisted outpatient treatment, the court may order, without a hearing, that the individual be evaluated at a community mental health center, be hospitalized in a psychiatric hospital for a period of not more than ten days, and potentially be hospitalized for longer upon the recommendation of the community mental health center; provided such extended hospitalization does not exceed the duration of the order for assisted outpatient treatment or ninety days, whichever is less. If the individual objects to such hospitalization, the court shall schedule a hearing as described in the act.
Beginning December 1, 2028, the Office of State Courts Administrator shall submit an annual report to the General Assembly regarding certain statistics of individuals receiving treatment under this act and the impact of such treatment on hospitalization and incarceration rates.
These provisions are identical to provisions in the perfected SS/SCS/SB 1015 (2026) and substantially similar to HB 1154 (2025).
SARAH HASKINS
Perfected
Print
SB 1019 - This act modifies the investment authority of boards of trustees of municipal hospitals in third class cities and hospital district hospitals. Current law permits investment of up to 25% of funds not required for operations of the hospital or other obligations. This act permits investment of up to 50% of funds not required for operations or other obligations in a manner described in the act, with the remaining portion to be invested into any investment in which the Treasurer is allowed to invest.
Under this act, municipal hospitals in third class cities may operate in areas where hospital district hospitals and county hospitals operate. Hospital district hospitals may operate in areas where municipal hospitals in third class cities and county hospitals operate.
This act is identical to SB 244 (2025) and substantially similar to provisions in SCS/HCS/HB 943 (2025), SCS/SB 317 (2025), and HCS/SS/SB 7 (2025).
SARAH HASKINS
Introduced
Print
SB 1019 - This act modifies the investment authority of boards of trustees of municipal hospitals in third class cities and hospital district hospitals. Current law permits investment of up to 25% of funds not required for operations of the hospital or other obligations. This act permits investment of up to 50% of funds not required for operations or other obligations in a manner described in the act, with the remaining portion to be invested into any investment in which the Treasurer is allowed to invest.
Under this act, municipal hospitals in third class cities may operate in areas where hospital district hospitals and county hospitals operate. Hospital district hospitals may operate in areas where municipal hospitals in third class cities and county hospitals operate.
This act is identical to SB 244 (2025) and substantially similar to provisions in SCS/HCS/HB 943 (2025), SCS/SB 317 (2025), and HCS/SS/SB 7 (2025).
SARAH HASKINS
Current Bill Text
Read the full stored bill text
EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
and is intended to be omitted in the law.
SECOND REGULAR SESSION
[TRULY AGREED TO AND FINALLY PASSED]
HOUSE COMMITTEE SUBSTITUTE FOR
SENATE BILL NO. 1019
103RD GENERAL ASSEMBLY
2026
4774H.04T
AN ACT
To repeal sections 96.192, 96.196, and 206.110, RSMo, and section 192.026 as truly agreed to and
finally passed by senate substitute for senate committee substitute for house committee
substitute for house bill no. 2372, one hundred third general assembly, second regular
session, and to enact in lieu thereof five new sections relating to health care.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Sections 96.192, 96.196, and 206.110, RSMo, 1
and section 192.026 as truly agreed to and finally passed by 2
senate substitute for senate committee substitute for house 3
committee substitute for house bill no. 2372, one hundred third 4
general assembly, second regular session, are repealed and five 5
new sections enacted in lieu thereof, to be known as sections 6
96.192, 96.196, 192.026, 206.110, and 206.158, to read as 7
follows:8
96.192. 1. The board of trustees of any hospital 1
authorized under subsection 2 of this section, and 2
established and organized under the provisions of sections 3
96.150 to 96.229[,]: 4
(1) May invest up to [twenty-five] fifty percent of 5
the hospital's "available funds", defined in this section as 6
funds not required for immediate disbursement in obligations 7
or for the operation of the hospital [in any United States 8
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investment grade fixed income funds or any diversified stock 9
funds, or both.], into: 10
(a) Any mutual funds that invest in stocks, bonds, or 11
real estate, or any combination thereof; 12
(b) Bonds that have: 13
a. One of the five highest long-term ratings or the 14
highest short-term rating issued by a nationally recognized 15
rating agency; and 16
b. A final maturity of ten years or less; 17
(c) Money market investments; or 18
(d) Any combination of investments described in 19
paragraphs (a) to (c) of this subdivision; and 20
(2) Shall invest the remaining percentage of any 21
available funds not invested as allowed under subdivision 22
(1) of this subsection into any investment in which the 23
state treasurer is allowed to invest. 24
2. The provisions of this section shall only apply if 25
the hospital: 26
(1) Receives less than [one] three percent of its 27
annual revenues from municipal, county, or state taxes; and 28
(2) Receives less than [one] three percent of its 29
annual revenue from appropriated funds from the municipality 30
in which such hospital is located. 31
96.196. 1. A hospital organized under this chapter 1
may purchase, operate or lease, as lessor or lessee, related 2
facilities or engage in health care activities, except in 3
counties of the third or fourth classification (other than 4
the county in which the hospital is located) where there 5
already exists a hospital organized pursuant to this chapter 6
[and chapter 205 or 206]; provided, however, that this 7
exception shall not prohibit the continuation of existing 8
activities otherwise allowed by law. 9
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2. If a hospital organized pursuant to this chapter 10
accepts appropriated funds from the city during the twelve 11
months immediately preceding the date that the hospital 12
purchases, operates or leases its first related facility 13
outside the city boundaries or engages in its first health 14
care activity outside the city boundaries, the governing 15
body of the city shall approve the hospital's plan for such 16
purchase, operation or lease prior to implementation of the 17
plan. 18
[192.026. 1. Sections 103.190 and 192.026 1
to 192.029 shall be known and may be cited as 2
the "Missouri Lyme Disease Eradication Act". 3
2. As used in sections 103.190 and 192.026 4
to 192.029, the following terms shall mean: 5
(1) "Department", the department of health 6
and senior services; 7
(2) "Lyme disease", a condition caused by 8
an infection of the bacterium Borrelia 9
burgdorferi, Borrelia mayonii, Borrelia afzelii, 10
Borrelia garinii, Borrelia valaisiana, Borrelia 11
lusitaniae, Bartonella, Babesia, Ehrlichia, or 12
related species, transmitted to humans through 13
the bite of infected blacklegged ticks (Ixodes 14
scapularis) or other ticks, as diagnosed by the 15
two-tier serologic testing recommended by the 16
federal Centers for Disease Control and 17
Prevention (CDC) or by a similar blood test 18
ordered by a treating health care provider or by 19
clinical evaluation; 20
(3) "Medically necessary", health care 21
services or products that a treating health care 22
provider exercising prudent clinical judgment 23
would provide to a patient for the purpose of 24
preventing, evaluating, diagnosing, or treating 25
an illness, injury, disease, or symptoms of 26
such, and that are: 27
(a) Clinically appropriate in terms of 28
type, frequency, extent, site, and duration for 29
the specific circumstances; and 30
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(b) Not primarily for the mere convenience 31
of the patient, health care provider, or as 32
determined by the provider based on the 33
patient's specific circumstances; 34
(4) "Posttreatment Lyme disease syndrome", 35
a condition characterized by persistent 36
symptoms, including, but not limited to, 37
fatigue, pain, respiratory impairment, 38
neurological impairment, or other cognitive 39
impairment following standard antibiotic or 40
other treatment for Lyme disease. 41
3. Health care providers, laboratories, 42
and local health departments shall report to the 43
department all confirmed or suspected cases of 44
Lyme disease within seven days of diagnosis 45
using standardized surveillance case definitions 46
developed by the CDC. Any patient who receives 47
a positive or suspected diagnosis of Lyme 48
disease shall be given the option to opt in to 49
having their identifiable information shared 50
with the department, local public health 51
officials, or the CDC. 52
4. The department shall compile an annual 53
report on the incidence and prevalence of Lyme 54
disease in Missouri, including, but not limited 55
to, demographic data, geographic distribution, 56
treatment outcomes, and barriers to care. The 57
department shall submit the report to the CDC 58
and the general assembly and make such report 59
available to the public on the department's 60
website by no later than December thirty-first 61
of each year. 62
5. The department shall collaborate with 63
the University of Missouri or any public four- 64
year institution of higher education to 65
integrate Lyme disease surveillance data into 66
existing tick-borne disease monitoring programs. 67
6. Any information collected or reported 68
under this section shall be done in a manner 69
that protects individually identifiable or 70
potentially identifiable information and that is 71
consistent with state and federal privacy laws. 72
7. The department may promulgate any rules 73
and regulations necessary to implement the 74
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provisions of sections 192.026 to 192.028. Any 75
rule or portion of a rule, as that term is 76
defined in section 536.010, that is created 77
under the authority delegated in this section 78
shall become effective only if it complies with 79
and is subject to all of the provisions of 80
chapter 536 and, if applicable, section 81
536.028. This section and chapter 536 are 82
nonseverable and if any of the powers vested 83
with the general assembly pursuant to chapter 84
536 to review, to delay the effective date, or 85
to disapprove and annul a rule are subsequently 86
held unconstitutional, then the grant of 87
rulemaking authority and any rule proposed or 88
adopted after August 28, 2026, shall be invalid 89
and void.] 90
192.026. 1. Sections 103.190 and 192.026 to 192.029 1
shall be known and may be cited as the "Missouri Lyme 2
Disease Eradication Act". 3
2. As used in sections 103.190 and 192.026 to 192.029, 4
the following terms shall mean: 5
(1) "Department", the department of health and senior 6
services; 7
(2) "Lyme disease", a condition caused by an infection 8
of the bacterium Borrelia burgdorferi, Borrelia mayonii, 9
Borrelia afzelii, Borrelia garinii, Borrelia valaisiana, or 10
Borrelia lusitaniae, transmitted to humans through the bite 11
of infected blacklegged ticks (Ixodes scapularis) or other 12
ticks, as defined by the national reporting case definition 13
and posted by the Centers for Disease Control and Prevention 14
National Notifiable Diseases Surveillance System; 15
(3) "Medically necessary", health care services or 16
products that a treating health care provider exercising 17
prudent clinical judgment would provide to a patient for the 18
purpose of preventing, evaluating, diagnosing, or treating 19
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an illness, injury, disease, or symptoms of such, and that 20
are: 21
(a) Clinically appropriate in terms of type, 22
frequency, extent, site, and duration for the specific 23
circumstances; and 24
(b) Not primarily for the mere convenience of the 25
patient, health care provider, or as determined by the 26
provider based on the patient's specific circumstances; 27
(4) "Posttreatment Lyme disease syndrome", a condition 28
characterized by persistent symptoms, including, but not 29
limited to, fatigue, pain, respiratory impairment, 30
neurological impairment, or other cognitive impairment 31
following standard antibiotic or other treatment for Lyme 32
disease. 33
3. Health care providers, laboratories, and local 34
health departments shall report to the department all 35
confirmed or suspected cases of Lyme disease within three 36
days of diagnosis using standardized surveillance case 37
definitions developed by the CDC. Any patient who receives 38
a positive or suspected diagnosis of Lyme disease shall be 39
given the option to opt in to having their identifiable 40
information shared with the department, local public health 41
officials, or the CDC. 42
4. The department shall compile an annual report on 43
the incidence and prevalence of Lyme disease in Missouri, 44
including, but not limited to, demographic data, geographic 45
distribution, treatment outcomes, and barriers to care. The 46
department shall submit the report to the CDC and the 47
general assembly and make such report available to the 48
public on the department's website by no later than December 49
thirty-first of each year. 50
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5. The department shall collaborate with the 51
University of Missouri or any public four-year institution 52
of higher education to integrate Lyme disease surveillance 53
data into existing tick-borne disease monitoring programs. 54
6. Any information collected or reported under this 55
section shall be done in a manner that protects individually 56
identifiable or potentially identifiable information and 57
that is consistent with state and federal privacy laws. 58
7. The department may promulgate any rules and 59
regulations necessary to implement the provisions of 60
sections 192.026 to 192.028. Any rule or portion of a rule, 61
as that term is defined in section 536.010, that is created 62
under the authority delegated in this section shall become 63
effective only if it complies with and is subject to all of 64
the provisions of chapter 536 and, if applicable, section 65
536.028. This section and chapter 536 are nonseverable and 66
if any of the powers vested with the general assembly 67
pursuant to chapter 536 to review, to delay the effective 68
date, or to disapprove and annul a rule are subsequently 69
held unconstitutional, then the grant of rulemaking 70
authority and any rule proposed or adopted after August 28, 71
2026, shall be invalid and void. 72
206.110. 1. A hospital district, both within and 1
outside such district, except in counties of the third or 2
fourth classification (other than within the district 3
boundaries) where there already exists a hospital organized 4
pursuant to [chapters 96, 205 or] this chapter; provided, 5
however, that this exception shall not prohibit the 6
continuation or expansion of existing activities otherwise 7
allowed by law, shall have and exercise the following 8
governmental powers, and all other powers incidental, 9
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necessary, convenient or desirable to carry out and 10
effectuate the express powers: 11
(1) To establish and maintain a hospital or hospitals 12
and hospital facilities, and to construct, acquire, develop, 13
expand, extend and improve any such hospital or hospital 14
facility including medical office buildings to provide 15
offices for rental to physicians and dentists on the 16
district hospital's medical or dental staff, and the 17
providing of sites therefor, including offstreet parking 18
space for motor vehicles; 19
(2) To acquire land in fee simple, rights in land and 20
easements upon, over or across land and leasehold interest 21
in land and tangible and intangible personal property used 22
or useful for the location, establishment, maintenance, 23
development, expansion, extension or improvement of any 24
hospital or hospital facility. The acquisition may be by 25
dedication, purchase, gift, agreement, lease, use or adverse 26
possession or by condemnation; 27
(3) To operate, maintain and manage a hospital and 28
hospital facilities, and to make and enter into contracts, 29
for the use, operation or management of a hospital or 30
hospital facilities; to engage in health care activities; 31
and to make and enter into leases of equipment and real 32
property, a hospital or hospital facilities, as lessor or 33
lessee, regardless of the duration of such lease; and to 34
provide rules and regulations for the operation, management 35
or use of a hospital or hospital facilities. Any agreement 36
entered into pursuant to this subsection pertaining to the 37
lease of the hospital shall have a definite termination date 38
as negotiated by the parties, but this shall not preclude 39
the trustees from entering into a renewal of the agreement 40
with the same or other parties pertaining to the same or 41
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other subjects upon such terms and conditions as the parties 42
may agree; 43
(4) To fix, charge and collect reasonable fees and 44
compensation for the use or occupancy of the hospital or any 45
part thereof, or any hospital facility, and for nursing 46
care, medicine, attendance, or other services furnished by 47
the hospital or hospital facilities, according to the rules 48
and regulations prescribed by the board from time to time; 49
(5) To borrow money and to issue bonds, notes, 50
certificates, or other evidences of indebtedness for the 51
purpose of accomplishing any of its corporate purposes, 52
subject to compliance with any condition or limitation set 53
forth in this chapter or otherwise provided by the 54
Constitution of the state of Missouri; 55
(6) To employ or enter into contracts for the 56
employment of any person, firm, or corporation, and for 57
professional services, necessary or desirable for the 58
accomplishment of the corporate objects of the district or 59
the proper administration, management, protection or control 60
of its property; 61
(7) To maintain the hospital for the benefit of the 62
inhabitants of the area comprising the district who are 63
sick, injured, or maimed regardless of race, creed or color, 64
and to adopt such reasonable rules and regulations as may be 65
necessary to render the use of the hospital of the greatest 66
benefit to the greatest number; to exclude from the use of 67
the hospital all persons who willfully disregard any of the 68
rules and regulations so established; to extend the 69
privileges and use of the hospital to persons residing 70
outside the area of the district upon such terms and 71
conditions as the board of directors prescribes by its rules 72
and regulations; 73
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(8) To police its property and to exercise police 74
powers in respect thereto or in respect to the enforcement 75
of any rule or regulation provided by the ordinances of the 76
district and to employ and commission police officers and 77
other qualified persons to enforce the same; 78
(9) To lease to or allow for any institution of higher 79
education to use or occupy the hospital, any real estate or 80
facility owned or leased by the district or any part thereof 81
for the purpose of health care-related and general education 82
or training. 83
2. The use of any hospital or hospital facility of a 84
district shall be subject to the reasonable regulation and 85
control of the district and upon such reasonable terms and 86
conditions as shall be established by its board of directors. 87
3. A regulatory ordinance of a district adopted under 88
any provision of this section may provide for a suspension 89
or revocation of any rights or privileges within the control 90
of the district for a violation of any such regulatory 91
ordinance. 92
4. Nothing in this section or in other provisions of 93
this chapter shall be construed to authorize the district or 94
board to establish or enforce any regulation or rule in 95
respect to hospitalization or the operation or maintenance 96
of such hospital or any hospital facilities within its 97
jurisdiction which is in conflict with any federal or state 98
law or regulation applicable to the same subject matter. 99
206.158. 1. The board of directors of any hospital 1
district authorized under subsection 2 of this section, and 2
established and organized under the provisions of this 3
chapter: 4
(1) May invest up to fifty percent of its "available 5
funds", defined in this section as funds not required for 6
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immediate disbursement in obligations or for the operation 7
of the hospital district, into: 8
(a) Any mutual funds that invest in stocks, bonds, or 9
real estate, or any combination thereof; 10
(b) Bonds that have: 11
a. One of the five highest long-term ratings or the 12
highest short-term rating issued by a nationally recognized 13
rating agency; and 14
b. A final maturity of ten years or less; 15
(c) Money market investments; or 16
(d) Any combination of investments described in 17
paragraphs (a) to (c) of this subdivision; and 18
(2) Shall invest the remaining percentage of any 19
available funds not invested as allowed under subdivision 20
(1) of this subsection into any investment in which the 21
state treasurer is allowed to invest. 22
2. The provisions of this section shall apply only if 23
the hospital district receives less than three percent of 24
its annual revenues from hospital district or state taxes. 25
✓