SS SB 975 Missouri Senate · 2026 Regular Session

SS/SB 975 - AMBULANCE DISTRICT BOARD MEMBERSHIP Current law requires county commissions to divide newly formed ambulance districts into six election districts for the election of members of the board of directors. This act makes the election for all such directors at-large, and allows ambulance districts the option of dividing into six election districts. (Section 190.050) Current law authorizes six-member ambulance districts to adopt a resolution increasing the board to seven members. This act requires that any such resolution shall state the names of the existing directors as well as any vacancies to be filled in a subsequent election. If a six-member ambulance district votes to decrease the number of directors to five or three, all existing board members shall complete their terms. (Section 190.051) Current law requires the county commission to fill vacancies on an ambulance board if the board is unable to fill such vacancies on its own within sixty days or if there are more than two vacancies at a time, with such appointment made by the county commission within ten days. This act modifies such provision by requiring a written request from the ambulance board or the ambulance service administrator prior to the county commission filling a vacancy, and by increasing the deadline to fill such vacancy from ten days to thirty calendar days. (Section 190.052) DISTRICT ANNEXATION OF LAND Current law requires a petition for the annexation of land into an ambulance district to be filed with the county clerk, with the county commission ordering an election if such petition complies with state law. This act moves such responsibilities to the ambulance district board of directors. (Section 190.070) AMBULANCE DISTRICT CONSOLIDATION This act requires every petition or resolution for the consolidation of two or more ambulance districts to be accompanied by a consolidation plan, which shall include information described in the act. Petitions and resolutions for consolidation shall be received from all consolidating ambulance districts within the same calendar year or shall be considered null and void. Notice of intent is required to be published in a newspaper of general circulation in every county in which the proposed consolidated district will be located, and a joint public hearing shall be held no more than ten days after the date of the second publication of the notice of intent. If no objections are filed within thirty days after the public hearing, the county commission shall order the districts consolidated. If a qualified objection is made, the county commission shall order the submission of the question of consolidation to the voters. A consolidated ambulance district may impose a tax levy not to exceed the highest tax levy imposed among the consolidating districts, provided that such rate is approved by the voters. No tax rate greater than the lowest rate imposed by the consolidating districts shall be imposed without a vote of the district voters. Any ambulance district that has contracted for ambulance service with another ambulance district for more than five consecutive years may consolidate into such district without providing notice or a public hearing. (Section 190.090) TRISTAN BENSON JR

Summary
SS/SB 975 - AMBULANCE DISTRICT BOARD MEMBERSHIP Current law requires county commissions to divide newly formed ambulance districts into six election districts for the election of members of the board of directors. This act makes the election for all such directors at-large, and allows ambulance districts the option of dividing into six election districts. (Section 190.050) Current law authorizes six-member ambulance districts to adopt a resolution increasing the board to seven members. This act requires that any such resolution shall state the names of the existing directors as well as any vacancies to be filled in a subsequent election. If a six-member ambulance district votes to decrease the number of directors to five or three, all existing board members shall complete their terms. (Section 190.051) Current law requires the county commission to fill vacancies on an ambulance board if the board is unable to fill such vacancies on its own within sixty days or if there are more than two vacancies at a time, with such appointment made by the county commission within ten days. This act modifies such provision by requiring a written request from the ambulance board or the ambulance service administrator prior to the county commission filling a vacancy, and by increasing the deadline to fill such vacancy from ten days to thirty calendar days. (Section 190.052) DISTRICT ANNEXATION OF LAND Current law requires a petition for the annexation of land into an ambulance district to be filed with the county clerk, with the county commission ordering an election if such petition complies with state law. This act moves such responsibilities to the ambulance district board of directors. (Section 190.070) AMBULANCE DISTRICT CONSOLIDATION This act requires every petition or resolution for the consolidation of two or more ambulance districts to be accompanied by a consolidation plan, which shall include information described in the act. Petitions and resolutions for consolidation shall be received from all consolidating ambulance districts within the same calendar year or shall be considered null and void. Notice of intent is required to be published in a newspaper of general circulation in every county in which the proposed consolidated district will be located, and a joint public hearing shall be held no more than ten days after the date of the second publication of the notice of intent. If no objections are filed within thirty days after the public hearing, the county commission shall order the districts consolidated. If a qualified objection is made, the county commission shall order the submission of the question of consolidation to the voters. A consolidated ambulance district may impose a tax levy not to exceed the highest tax levy imposed among the consolidating districts, provided that such rate is approved by the voters. No tax rate greater than the lowest rate imposed by the consolidating districts shall be imposed without a vote of the district voters. Any ambulance district that has contracted for ambulance service with another ambulance district for more than five consecutive years may consolidate into such district without providing notice or a public hearing. (Section 190.090) TRISTAN BENSON JR
Bill status passed 3 of 5 stages cleared
Introduction
Dec 2025
Committee Review
Mar 2026
Senate Passage
Mar 2026
House Passage
Governor
Introduced Dec 1, 2025 Last action Mar 25, 2026
Maddy AI version diff · 3 comparisons

What changed between versions

2/24/2026 - SS S offered (Black)--(5215S.04F) 2/24/2026 - Adopted, as amended 2/24/2026 - SA 1 to SS S offered & adopted (May)--(5215S04.06S) 2/24/2026 - Adopted · 5 edits
MODERATE
The bill was amended to add a new section defining and regulating community paramedic services, including eligibility requirements for certification, operational protocols, and inter-agency coordination rules. This expands the legislative framework beyond ambulance district elections to include standards for non-emergency paramedic care.
Scope change
The bill's scope expanded from solely governing ambulance district elections and director terms to also include regulations for community paramedic services, their certification, and service delivery protocols.
DEFINITION

Added a new definition for 'community paramedic services' specifying they must be provided by licensed paramedics certified by the department in non-emergent settings.

ELIGIBILITY

Established eligibility requirements for community paramedic certification including current paramedic licensure, completion of a certification program, and application approval.

REQUIREMENT

Created requirements for ambulance services providing community paramedic services outside their primary area to have memorandums of understanding with local services.

Added coordination requirements for emergency medical response agencies offering community paramedic services in areas where ground ambulance services already provide such services.

TECHNICAL

Changed the document header from Senate Substitute to Senate Amendment No. and updated the bill reference number.

Floor votes

How they voted

This bill passed the Senate by voice vote (no roll call recorded).
Full legislative history

Actions timeline

Total actions
18
Key actions
9
Committee
6
Mar 12, 2026
Committee
Referred H Local Government
lower
Mar 5, 2026
Upper · Passed
S Third Read and Passed
upper
Feb 25, 2026
Upper · Passed
Reported Truly Perfected S Rules, Joint Rules, Resolutions and Ethics Committee
upper
Feb 24, 2026
Upper · Passed
SS, as amended, S adopted
upper
Feb 24, 2026
Upper · Passed
SA 2 to SS S offered & adopted (Hough)--(5215S04.01F)
upper
Feb 24, 2026
Upper · Passed
SA 1 to SS S offered & adopted (May)--(5215S04.06S)
upper
Feb 12, 2026
Upper · Passed
Reported from S Local Government, Elections and Pensions Committee
upper
Feb 9, 2026
Upper · Passed
Voted Do Pass S Local Government, Elections and Pensions Committee
upper
Jan 29, 2026
Upper · Passed
Hearing Conducted S Local Government, Elections and Pensions Committee
upper
Jan 26, 2026
Upper · Passed
Hearing Cancelled S Local Government, Elections and Pensions Committee
upper
Dec 1, 2025
Introduced
Prefiled
upper
1 primary · 0 co-sponsors

Sponsors

Role
Legislator
Party
State
District
P
Photo of Rusty Black
Rusty Black
RRepublican
MO
12