Missouri Revised Statutes
Chapter 190 - Emergency Services
Section 190.924 - Establishment of the interstate commission for EMS personnel practice.

Effective - 28 Aug 2018
190.924. Establishment of the interstate commission for EMS personnel practice. — 1. The compact states hereby create and establish a joint public agency known as the "Interstate Commission for EMS Personnel Practice".
(1) The commission is a body politic and an instrumentality of the compact states.
(2) Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located. The commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings.
(3) Nothing in this compact shall be construed to be a waiver of sovereign immunity.
2. Each member state shall have and be limited to one delegate. The responsible official of the state EMS authority or his or her designee shall be the delegate to this compact for each member state. Any delegate may be removed or suspended from office as provided by the law of the state from which the delegate is appointed. Any vacancy occurring in the commission shall be filled in accordance with the laws of the member state in which the vacancy exists. In the event that more than one board, office, or other agency with the legislative mandate to license EMS personnel at and above the level of EMT exists, the governor of the state shall determine which entity shall be responsible for assigning the delegate.
(1) Each delegate shall be entitled to one vote with regard to the promulgation of rules and creation of bylaws, and shall otherwise have an opportunity to participate in the business and affairs of the commission. A delegate shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for delegates' participation in meetings by telephone or other means of communication.
(2) The commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.
(3) All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rulemaking provisions in section 190.930.
(4) The commission may convene in a closed, nonpublic meeting if the commission must discuss:
(a) Noncompliance of a member state with its obligations under the compact;
(b) The employment, compensation, discipline or other personnel matters, practices, or procedures related to specific employees, or other matters related to the commission's internal personnel practices and procedures;
(c) Current, threatened, or reasonably anticipated litigation;
(d) Negotiation of contracts for the purchase or sale of goods, services, or real estate;
(e) Accusing any person of a crime or formally censuring any person;
(f) Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
(g) Disclosure of information of a personal nature if disclosure would constitute a clearly unwarranted invasion of personal privacy;
(h) Disclosure of investigatory records compiled for law enforcement purposes;
(i) Disclosure of information related to any investigatory reports prepared by or on behalf of or for use of the commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to the compact; or
(j) Matters specifically exempted from disclosure by federal or member state statute.
(5) If a meeting or portion of a meeting is closed under this section, the commission's legal counsel or designee shall certify that the meeting may be closed and shall reference each relevant exempting provision. The commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken and the reasons therefor, including a description of the views expressed. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the commission or order of a court of competent jurisdiction.
3. The commission shall, by a majority vote of the delegates, prescribe bylaws and rules to govern its conduct as may be necessary or appropriate to carry out the purposes and exercise the powers of the compact including, but not limited to:
(1) Establishing the fiscal year of the commission;
(2) Providing reasonable standards and procedures:
(a) For the establishment and meetings of other committees; and
(b) Governing any general or specific delegation of any authority or function of the commission;
(3) Providing reasonable procedures for calling and conducting meetings of the commission, ensuring reasonable advance notice of all meetings, and providing an opportunity for attendance of such meetings by interested parties, with enumerated exceptions designed to protect the public's interest, the privacy of individuals, and proprietary information, including trade secrets. The commission may meet in closed session only after a majority of the membership votes to close a meeting in whole or in part. As soon as practicable, the commission shall make public a copy of the vote to close the meeting revealing the vote of each member with no proxy votes allowed;
(4) Establishing the titles, duties and authority, and reasonable procedures for the election of the officers of the commission;
(5) Providing reasonable standards and procedures for the establishment of the personnel policies and programs of the commission. Notwithstanding any civil service or other similar laws of any member state, the bylaws shall exclusively govern the personnel policies and programs of the commission;
(6) Promulgating a code of ethics to address permissible and prohibited activities of commission members and employees;
(7) Providing a mechanism for winding up the operations of the commission and the equitable disposition of any surplus funds that may exist after the termination of the compact after the payment or reserving of all of its debts and obligations;
(8) Publishing* its bylaws and file a copy thereof, and a copy of any amendment thereto, with the appropriate agency or officer in each of the member states, if any;
(9) Maintaining** its financial records in accordance with the bylaws; and
(10) Meeting and taking*** such actions as are consistent with the provisions of this compact and the bylaws.
4. The commission shall have the following powers:
(1) To promulgate uniform rules to facilitate and coordinate implementation and administration of this compact. The rules shall have the force and effect of law and shall be binding on all member states;
(2) To bring and prosecute legal proceedings or actions in the name of the commission; provided that, the standing of any state EMS authority or other regulatory body responsible for EMS personnel licensure to sue or be sued under applicable law shall not be affected;
(3) To purchase and maintain insurance and bonds;
(4) To borrow, accept, or contract for services of personnel including, but not limited to, employees of a member state;
(5) To hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of the compact, and to establish the commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters;
(6) To accept any and all appropriate donations and grants of money, equipment, supplies, materials, and services, and to receive, utilize, and dispose of the same; provided that, at all times the commission shall strive to avoid any appearance of impropriety and conflict of interest;
(7) To lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve, or use any property, real, personal, or mixed; provided that, at all times the commission shall strive to avoid any appearance of impropriety;
(8) To sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;
(9) To establish a budget and make expenditures;
(10) To borrow money;
(11) To appoint committees, including advisory committees comprised of members, state regulators, state legislators or their representatives, consumer representatives, and such other interested persons as may be designated in this compact and the bylaws;
(12) To provide and receive information from, and to cooperate with, law enforcement agencies;
(13) To adopt and use an official seal; and
(14) To perform such other functions as may be necessary or appropriate to achieve the purposes of this compact consistent with the state regulation of EMS personnel licensure and practice.
5. (1) The commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.
(2) The commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services.
(3) The commission may levy on and collect an annual assessment from each member state or impose fees on other parties to cover the cost of the operations and activities of the commission and its staff, which shall be in a total amount sufficient to cover its annual budget as approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated based upon a formula to be determined by the commission, which shall promulgate a rule binding upon all member states; provided, that Missouri shall not be assessed more than ten thousand dollars annually calculated and the assessment amount shall not include an annual increase equivalent to the annual average of the Consumer Price Index for All Urban Consumers for the United States as reported by the Bureau of Labor Statistics, or its successor index. Missouri shall not authorize an annual assessment above this level.
(4) The commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same; nor shall the commission pledge the credit of any of the member states, except by and with the authority of the member state.
(5) The commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the commission shall be subject to the audit and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the commission.
6. (1) The members, officers, executive director, employees, and representatives of the commission shall be immune from suit and liability, either personally or in their official capacity, for any claim, damage to or loss of property, personal injury, or other civil liability caused by or arising out of any actual or alleged act, error, or omission that occurred or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities; provided that, nothing in this subdivision shall be construed to protect any such person from suit or liability for any damage, loss, injury, or liability caused by the intentional, willful, or wanton misconduct of that person.
(2) The commission shall defend any member, officer, executive director, employee, or representative of the commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities; provided that, nothing herein shall be construed to prohibit that person from retaining his or her own counsel; and provided further, that the actual or alleged act, error, or omission did not result from that person's intentional, willful, or wanton misconduct.
(3) The commission shall indemnify and hold harmless any member, officer, executive director, employee, or representative of the commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities; provided that, the actual or alleged act, error, or omission did not result from the person's intentional, willful, or wanton misconduct ****.
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(L. 2018 H.B. 1355 merged with S.B. 870)
*Words "The commission shall publish" appear in original rolls of H.B. 1355, 2018.
**Words "The commission shall maintain" appear in original rolls of H.B. 1355, 2018.
***Words "The commission shall meet and take" appear in original rolls of H.B. 1355, 2018.
****Words "of the person" appear here in original rolls of H.B. 1355, 2018.

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.