Missouri Revised Statutes
Chapter 190 - Emergency Services
Section 190.060 - Powers of district.

Effective - 28 Aug 2016, 2 histories
190.060. Powers of district. — 1. An ambulance district shall have the following governmental powers, and all other powers incidental, necessary, convenient or desirable to carry out and effectuate the express powers:
(1) To establish and maintain an ambulance service within its corporate limits, and to acquire for, develop, expand, extend and improve such service;
(2) To acquire land in fee simple, rights in land and easements upon, over or across land and leasehold interests in land and tangible and intangible personal property used or useful for the location, establishment, maintenance, development, expansion, extension or improvement of an ambulance service. The acquisition may be by dedication, purchase, gift, agreement, lease, use or adverse possession;
(3) To operate, maintain and manage the ambulance service, and to make and enter into contracts for the use, operation or management of and to provide rules and regulations for the operation, management or use of the ambulance service;
(4) To fix, charge and collect reasonable fees and compensation for the use of the ambulance service according to the rules and regulations prescribed by the board from time to time;
(5) To borrow money and to issue bonds, notes, certificates, or other evidences of indebtedness for the purpose of accomplishing any of its corporate purposes, subject to compliance with any condition or limitation set forth in sections 190.001 to 190.090 or otherwise provided by the Constitution of the state of Missouri;
(6) To employ or enter into contracts for the employment of any person, firm, or corporation, and for professional services, necessary or desirable for the accomplishment of the objects of the district or the proper administration, management, protection or control of its property;
(7) To maintain the ambulance service for the benefit of the inhabitants of the area comprising the district regardless of race, creed or color, and to adopt such reasonable rules and regulations as may be necessary to render the highest quality of emergency medical care; to exclude from the use of the ambulance service all persons who willfully disregard any of the rules and regulations so established; to extend the privileges and use of the ambulance service to persons residing outside the area of the district upon such terms and conditions as the board of directors prescribes by its rules and regulations;
(8) To provide for health, accident, disability and pension benefits for the salaried members of its organized ambulance district and such other benefits for the members' spouses and minor children, through either, or both, a contributory or noncontributory plan. The type and amount of such benefits shall be determined by the board of directors of the ambulance district within the level of available revenue of the pension program and other available revenue of the district. If an employee contributory plan is adopted, then at least one voting member of the board of trustees shall be a member of the ambulance district elected by the contributing members. The board of trustees shall not be the same as the board of directors;
(9) To purchase insurance indemnifying the district and its employees, officers, volunteers and directors against liability in rendering services incidental to the furnishing of ambulance services. Purchase of insurance pursuant to this section is not intended to waive sovereign immunity, official immunity or the Missouri public duty doctrine defenses; and
(10) To provide for life insurance, accident, sickness, health, disability, annuity, length of service, pension, retirement and other employee-type fringe benefits, subject to the provisions of section 70.615, for the volunteer members of any organized ambulance district and such other benefits for their spouses and eligible unemancipated children, either through a contributory or noncontributory plan, or both. For purposes of this section, "eligible unemancipated child" means a natural or adopted child of an insured, or a stepchild of an insured who is domiciled with the insured, who is less than twenty-three years of age, who is not married, not employed on a full-time basis, not maintaining a separate residence except for full-time students in an accredited school or institution of higher learning, and who is dependent on parents or guardians for at least fifty percent of his or her support. The type and amount of such benefits shall be determined by the board of directors of the ambulance district within available revenues of the district, including the pension program of the district. The provision and receipt of such benefits shall not make the recipient an employee of the district. Directors who are also volunteer members may receive such benefits while serving as a director of the district.
2. The use of any ambulance service of a district shall be subject to the reasonable regulation and control of the district and upon such reasonable terms and conditions as shall be established by its board of directors.
3. A regulatory ordinance of a district adopted pursuant to any provision of this section may provide for a suspension or revocation of any rights or privileges within the control of the district for a violation of any regulatory ordinance.
4. Nothing in this section or in other provisions of sections 190.001 to 190.245 shall be construed to authorize the district or board to establish or enforce any regulation or rule in respect to the operation or maintenance of the ambulance service within its jurisdiction which is in conflict with any federal or state law or regulation applicable to the same subject matter.
5. After August 28, 1998, the board of directors of an ambulance district that proposes to contract for the total management and operation of the ambulance service, when that ambulance district has not previously contracted out for said service, shall hold a public hearing within a thirty-day period and shall make a finding that the proposed contract to manage and operate the ambulance service will:
(1) Provide benefits to the public health that outweigh the associated costs;
(2) Maintain or enhance public access to ambulance service;
(3) Maintain or improve the public health and promote the continued development of the regional emergency medical services system.
6. (1) Upon a satisfactory finding following the public hearing in subsection 5 of this section and after a sixty-day period, the ambulance district may enter into the proposed contract, however said contract shall not be implemented for at least thirty days.
(2) The provisions of subsection 5 of this section shall not apply to contracts which were executed prior to August 28, 1998, or to the renewal or modification of such contracts or to the signing of a new contract with an ambulance service provider for services that were previously contracted out.
7. All ambulance districts authorized to adopt laws, ordinances, or regulations regarding basic life support ambulances shall require such ambulances to be equipped with an automated external defibrillator and be staffed by at least one individual trained in the use of an automated external defibrillator.
8. The ambulance district may adopt procedures for conducting fingerprint background checks on current and prospective employees, contractors, and volunteers. The ambulance district may submit applicant fingerprints to the Missouri state highway patrol, Missouri criminal records repository, for the purpose of checking the person's criminal history. The fingerprints shall be used to search the Missouri criminal records repository and shall be submitted to the Federal Bureau of Investigation to be used for searching the federal criminal history files. The fingerprints shall be submitted on forms and in the manner prescribed by the Missouri state highway patrol. Fees shall be as set forth in section 43.530.
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(L. 1971 S.B. 108 § 11, A.L. 1986 H.B. 898, et al., A.L. 1993 H.B. 177, A.L. 1998 S.B. 743, A.L. 1999 S.B. 436, A.L. 2010 H.B. 1977, A.L. 2016 S.B. 988)

Structure Missouri Revised Statutes

Missouri Revised Statutes

Title XII - Public Health and Welfare

Chapter 190 - Emergency Services

Section 190.001 - Citation.

Section 190.010 - Territory of district may be noncontiguous — ambulance districts authorized except in counties of 400,000 or more population — district, how named.

Section 190.015 - Petition to form, contents — ambulance district boundaries (St. Louis County) — sales tax in lieu of property tax permitted, exception St. Louis County.

Section 190.020 - Public hearing, notice — costs, how paid.

Section 190.025 - Petitions — consolidation, when — amended, how.

Section 190.030 - Sufficiency of petition, county commission to determine.

Section 190.035 - Notice of election, contents.

Section 190.040 - Form of ballot — effect of passage on tax rate — fund created — refunds, when.

Section 190.041 - Tax levy for central dispatching service, when, amount — funds kept separate.

Section 190.043 - Increase in tax rate without voter approval, when, amount.

Section 190.045 - Returns of election, where filed — effect of.

Section 190.050 - Election districts, how established — election of directors — declaration of candidacy filed, where, when.

Section 190.051 - Change in number of board members, when — ballot language.

Section 190.052 - Board member must live in his district — vacancies, how filled.

Section 190.053 - Educational training required for board of directors — failure to attend.

Section 190.055 - Powers of board — seal and bylaws required — reimbursement of board members' expenses — secretary and treasurer, additional compensation — board member attendance fees, when — ineligibility for board employment, when.

Section 190.056 - Recall of directors, procedure.

Section 190.060 - Powers of district.

Section 190.065 - Bonds, issuance of — election, form of ballot.

Section 190.070 - Annexation, petition for — hearing — election, form of ballot.

Section 190.074 - Collection of taxes — levy — procedure.

Section 190.075 - Records, what and how kept.

Section 190.080 - Donated property — title, how taken.

Section 190.085 - Failure to approve bonds, effect of — dissolution — funds, how rebated.

Section 190.087 - Ambulance district serving city in more than one county may be expanded — procedure (Franklin County).

Section 190.088 - Detachment from ambulance district, procedure (City of Riverside) — inapplicable to St. Louis County.

Section 190.090 - Consolidation of ambulance districts, procedure for — form of ballot — transition provisions for consolidation.

Section 190.091 - Vaccination program for first responders offered — definitions — participation voluntary — contingent effective date.

Section 190.092 - Defibrillators, requirements — good faith immunity from civil liability, when — all basic life support ambulances and stretcher vans to be equipped with.

Section 190.094 - Minimum ambulance staffing — volunteer defined.

Section 190.098 - Community paramedic, certification requirements — scope of practice — written agreement — rulemaking authority.

Section 190.100 - Definitions.

Section 190.101 - State advisory council on emergency medical services, members, purpose, duties — subcommittee established, duties.

Section 190.102 - Regional EMS advisory committees.

Section 190.103 - Regional EMS medical director, powers, duties — considered public official, when — online telecommunication medical direction permitted — treatment protocols for special needs patients.

Section 190.104 - Pediatric emergency medical services system.

Section 190.105 - Ambulance license required, exceptions — operation of ambulance services — sale or transfer of ownership, notice required.

Section 190.107 - Contracts for mutual aid services.

Section 190.108 - Air ambulance licenses — sale or transfer of ownership, notice required.

Section 190.109 - Ground ambulance license.

Section 190.111 - Inspection limitation — effect of sale or transfer on a license.

Section 190.120 - Insurance, what coverage required — policy provisions required — term of policy.

Section 190.131 - Certification of training entities.

Section 190.133 - Emergency medical response agency license.

Section 190.134 - Dispatch agency, requirements.

Section 190.142 - Emergency medical technician license — rules.

Section 190.143 - Temporary emergency medical technician license granted, when — limitations — expiration.

Section 190.144 - Immunity from liability, when.

Section 190.146 - Lapse of license, request to return to active status, procedure.

Section 190.147 - Behavioral health patients — temporary hold, when — memorandum of understanding, contents — physical restraints, use of.

Section 190.160 - Renewals of licenses, requirements.

Section 190.165 - Suspension or revocation of licenses, grounds for — procedure.

Section 190.171 - Aggrieved party may seek review by administrative hearing commission.

Section 190.172 - Settlement agreements permitted, when — written impact statement may be submitted to administrative hearing commission.

Section 190.173 - Confidentiality of information.

Section 190.175 - Records to be maintained by licensee.

Section 190.176 - Data collection system.

Section 190.180 - Penalty for violation.

Section 190.185 - Rules and regulations, department to adopt — procedure.

Section 190.190 - Time to comply granted existing equipment and personnel.

Section 190.196 - Employer to comply with requirements of licensure — report of charges filed against licensee, when.

Section 190.200 - Public information and education.

Section 190.205 - Insurers' duties.

Section 190.240 - At-risk behavioral health patients, notice required before transport of — training of personnel — temporary involuntary hold, patient placed on, when.

Section 190.241 - Trauma, STEMI, or stroke centers, designation by department — site reviews — grounds for suspension or revocation of designation — data submission and analysis — fees — administrative hearing commission to hear persons aggrieved by...

Section 190.242 - Emergency medical services data, hospitals not required to obtain, when — trauma, STEMI, and stroke center regulations, interpretation of, hospitals not required to comply with, when.

Section 190.243 - Transportation to trauma, STEMI, or stroke centers or hospitals, how authorized.

Section 190.245 - Medical records and quality improvement documentation, penalty for failure to provide, purpose for use, names not to be released.

Section 190.246 - Epinephrine auto-injector, possession and use limitations — definitions — use of device considered first aid — violations, penalty.

Section 190.248 - Investigations of allegations of violations, completed when — access to records.

Section 190.250 - Ambulance services to have same statutory lien rights as hospitals — recovery of lien, net proceeds to be shared with patient, when — release of claimant from liability, when.

Section 190.255 - Naloxone, first responder may administer, when — definition.

Section 190.257 - Advisory committee, time-critical diagnosis — recommendations to department — members.

Section 190.260 - Citation — definitions — training for broadcast engineers and technical personnel — credentialing — access to disaster areas.

Section 190.265 - Helipads, hospitals not required to have fencing or barriers.

Section 190.270 - Citation of law.

Section 190.275 - Definitions.

Section 190.280 - Out-of-state businesses not subject to certain state or local requirements — out-of-state employee not a resident for tax purposes — limitations.

Section 190.285 - Notification to secretary of state by out-of-state business required, when, content — information provided to department of revenue, when.

Section 190.286 - Inapplicability to certain out-of-state businesses.

Section 190.290 - Definitions.

Section 190.292 - Emergency services, sales tax levy authorized — ballot language — rate of tax — termination of tax — board to administer funds established, members (Warren County) — prepaid wireless telecommunications service, tax exempt.

Section 190.294 - Powers and duties of the emergency services board — meetings — vacancies — rulemaking authority (Warren County).

Section 190.296 - Board may borrow money and issue bonds — ballot language — duration of loans, rate of interest (Warren County).

Section 190.300 - Definitions.

Section 190.305 - Emergency telephone service may be provided — tax levy authorized — governing body of Christian and Scott counties may contract for services — time limitation on tax — rate — collection.

Section 190.306 - Dissolution of emergency telephone service not required, when (Christian County).

Section 190.307 - No civil liability for operation of emergency system, giving or following emergency instructions, exceptions.

Section 190.308 - Misuse of emergency telephone service unlawful, definitions, penalty — no local fine or penalty for pay telephones for calls to emergency telephone service.

Section 190.309 - Emergency telephone board, powers and duties — members of the board, appointment, terms — personnel — officers — rules — removal of members — vacancies — nepotism prohibited.

Section 190.310 - Tax due quarterly — return filed when, content — record retention period — rate determination, notification — collection fee allowed.

Section 190.315 - Contract for service authorized.

Section 190.320 - Election — ballot form.

Section 190.325 - Central dispatching service for emergency services (Clay, Jackson and Jefferson counties) — use of emergency telephone moneys — tax rate — contracts for service for other political subdivisions — tax collection.

Section 190.327 - Board appointed, when — board elected, when — duties — commission to relinquish duties to board — qualifications — board, powers and duties — board appointed for other political subdivisions contracting for service — limitation on s...

Section 190.328 - Election of board, Christian and Scott counties, when — terms.

Section 190.329 - Election of board, exceptions, when — terms.

Section 190.334 - Performance and fiscal audits authorized.

Section 190.335 - Central dispatch for emergency services, alternative funding by county sales tax, procedure, ballot form, rate of tax — collection, limitations — adoption of alternate tax, telephone tax to expire, when — board appointment and elect...

Section 190.336 - Recall, board members subject to — procedure.

Section 190.337 - Revenue, purpose for which shall be used — procedure to terminate tax, ballot form — reestablishing emergency service using telephone tax, procedure.

Section 190.339 - Emergency services board, powers and duties — officers — removal of board members, reasons, hearing procedure — vacancies — employment by board, limitations.

Section 190.340 - Emergency services board, officers duties, rules and regulations.

Section 190.353 - Powers and duties of department of health and senior services — establishment of regional poison information center — center to provide certain services.

Section 190.355 - Use of existing resources required.

Section 190.400 - Definitions — interoperability service agreements, what agencies.

Section 190.420 - Fund established.

Section 190.450 - Department to complete study, issue plan for provision of best 911 technology and services statewide.

Section 190.455 - Subscriber fees — election, ballot — deposit of moneys — confidentiality of proprietary information — immunity from liability, when — limitations on fees.

Section 190.460 - Prepaid wireless emergency telephone service charge — definitions — amount, how collected — deposit and use of moneys — rates, how set — effective date.

Section 190.462 - Pre-emption of taxes by declaratory ruling — definitions — effect of — expiration date.

Section 190.465 - Consolidation of emergency communications operations — joint entity established, when.

Section 190.470 - Alternate consolidation — petition, election — board appointed, requirements.

Section 190.475 - Centralized database to be maintained, updates.

Section 190.500 - Temporary license — qualified health care professions — declared emergency.

Section 190.525 - Definitions.

Section 190.528 - License required — political subdivisions not precluded from governing operation of service or enforcing ordinances — responsibilities and restrictions on operation of stretcher van services — rules.

Section 190.531 - Refusal to issue or denial of renewal of licenses permitted — complaint procedure — rules — immunity from liability, when — suspension of license, when.

Section 190.534 - Violations, penalty — attorney general to have concurrent jurisdiction.

Section 190.537 - Rulemaking authority.

Section 190.550 - Schedule of fees established, rules — collection and deposit.

Section 190.600 - Citation of act — definitions.

Section 190.603 - Outside the hospital do-not-resuscitate order may be executed, when — maintained in medical records — transfers with patient.

Section 190.606 - Immunity from liability, what persons and entities.

Section 190.609 - Order effective, when — limitations of order.

Section 190.612 - Emergency medical services personnel to comply with order, when — physician to transfer patient, when.

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.

Section 190.618 - Rules — rulemaking authority.

Section 190.621 - Penalty for concealing or falsifying an order.

Section 190.800 - Imposition of tax — definitions.

Section 190.803 - Formula for tax based on gross receipts — challenge of validity of rules.

Section 190.806 - Record-keeping requirements, confidentiality.

Section 190.809 - Amount due, determination — notification procedure — offset permitted, when — quarterly adjustment of tax permitted.

Section 190.812 - Determination of tax final, when — timely protest permitted.

Section 190.815 - Rulemaking authority.

Section 190.818 - Remittance of tax — fund created, use of moneys.

Section 190.821 - Tax period — failure to pay, delinquency, enforcement procedures.

Section 190.824 - Tax-exempt status of ambulance service not affected.

Section 190.827 - Payments to ambulance services, when.

Section 190.830 - Federal financial participation required.

Section 190.833 - No tax imposed prior to effective date.

Section 190.836 - Rules requirements, authority.

Section 190.839 - Expiration date.

Section 190.840 - Nonseverability clause.

Section 190.900 - REPLICA enacted — definitions.

Section 190.903 - Home state licensure.

Section 190.906 - Compact privilege to practice.

Section 190.909 - Conditions of practice in a remote state.

Section 190.912 - Relationship to emergency management assistance compact.

Section 190.915 - Veterans, service members separating from active duty military, and their spouses.

Section 190.918 - Adverse actions.

Section 190.921 - Additional powers invested in a member state's EMS authority.

Section 190.924 - Establishment of the interstate commission for EMS personnel practice.

Section 190.927 - Coordinated database.

Section 190.930 - Rulemaking.

Section 190.933 - Oversight, dispute resolution, and enforcement.

Section 190.936 - Date of implementation of the interstate commission for EMS personnel practice and associated rules, and amendment.

Section 190.939 - Construction and severability.

Section 190.1005 - CPR training or courses to include instruction on proper use of automated external defibrillators.