HCS/SS/SB 7 - This act modifies several provisions relating to health care, including: (1) This act modifies several provisions relating to health care, including: (1) hospital investments and service areas; (2) epinephrine products; (3) emergency medical services; (4) patient medical records; (5) the "Missouri State Loan Repayment Program"; (6) sexually transmitted infections; (7) telehealth; (8) forensic examinations of victims of sexual offenses; (9) limits on the sale of over-the-counter drugs; (10) pseudoephedrine; (11) administration of medications; (12) MO HealthNet coverage of hearing-related devices; (13) prenatal tests for certain diseases; (14) food-born allergies; (15) the Missouri Emergency Response Commission; (16) license plates; (17) the practice of dentistry in correctional centers; (18) licensure of dentists and dental hygienists; (19) the administration of certain vaccines; (20) the "RX Cares for Missouri Program"; (21) clinical fellowships for speech-language pathologists and audiologists; (22) insurance coverage of self-administered hormonal contraceptives; (23) insurance coverage of alternatives to opioid drugs; (24) liability for care provided in an emergency; and (25) mammograms.

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. These provisions shall only apply if the hospital receives less than three percent of its annual revenues from municipal, county, hospital district, or state taxes or appropriated funds from the municipality in which such hospital is located.

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 perfected HCS/HB 943 (2025) and SCS/SB 317 (2025) and substantially similar to SB 244 (2025).

EPINEPHRINE PRODUCTS (Sections 167.627, 167.630, 190.246, 196.990, and 321.621)

This act changes "epinephrine auto-injector" to "epinephrine delivery device" throughout statute.

These provisions are similar to provisions in HB 165 (2025) and HB 553 (2025).

EMERGENCY MEDICAL SERVICES (Sections 190.053, 190.076, 190.098, 190.101, 190.109, 190.112, 190.166, and 190.800)

This act modifies training requirements for members of an ambulance district board of directors. Under this act, board members shall complete three hours of continuing education for each term of office. Failure to do so shall result in immediate disqualification and the office shall be vacant until filled.

This provision is identical to a provision in the perfected HCS/HB 943 (2025) and SCS/SB 317 (2025) and substantially similar to a provision in SB 548 (2025), SB 7 (2025), SB 206 (2025), SCS/SB 1382 (2024), and SB 1340 (2024).

Under this act, each ambulance district shall arrange for an audit of the district's records and accounts every three years by a certified public accountant. The audit shall be made available to the public on the district's website or otherwise freely available by other electronic means.

This provision is identical to a provision in the perfected HCS/HB 943 (2025), SCS/SB 317 (2025), SB 548 (2025), SB 7 (2025), SB 206 (2025), SCS/SB 1382 (2024), and SB 1340 (2024).

This act modifies provisions relating to certification of community paramedics and the provision of community paramedic services. Community paramedic services shall mean those services provided by an entity that employs licensed paramedics certified by the Department of Health and Senior Services as community paramedics for services that are provided in a nonemergent setting, consistent with the education and training of a community paramedic and the supervisory standard approved by the medical director, and documented in the entity's patient care plans or protocols.

Any ambulance service that seeks to provide community paramedic services outside of its service area shall have a memorandum of understanding (MOU) with the ambulance service of that area if that ambulance service is already providing those services or shall notify the ambulance services of that area if that ambulance service is not providing community paramedic services. Emergency medical response agencies (EMRAs) may provide community paramedic services in a ground ambulance service's service area. If the ground ambulance service is already providing those services or provides them after the EMRA offers them, then the EMRA and ground ambulance service shall enter into a MOU for the coordination of services.

The Department shall promulgate rules and regulations for the purpose of certifying community paramedic services entities and the standards necessary to provide such services. Certified entities shall be eligible to provide community paramedic services for 5 years.

This provisions is identical to a provision in the perfected HCS/HB 943 (2025) and SCS/SB 317 (2025) and similar to a provision in SB 548 (2025), SB 206 (2025), and SCS/SB 1382 (2024).

This act modifies the State Advisory Council on Emergency Medical Services by changing the number of council members from 16 to no more than 23 and specifying the members who shall serve on the Council. Currently, members are appointed by the Governor with the advice and consent of the Senate. Under this act, the Director of the Department of Health and Senior Services, the regional EMS advisory committees, and the Time-Critical Diagnosis Advisory Committee shall appoint members.

This provision is identical to a provision in the perfected HCS/HB 943 (2025) and substantially similar to a provision in SCS/SB 317 (2025), SB 548 (2025), SB 206 (2025), SB 270 (2025), SB 1277 (2024), and a provision in SCS/SB 1382 (2024).

The Department of Health and Seniors Services, as a part of regulating ground ambulance service licenses, shall promulgate rules regarding participation with regional emergency medical services advisory committees and ambulance service administrator qualifications.

This act requires ambulance services to report to the Department individuals serving as ambulance service administrators. These administrators shall be required to complete training as described in the act.

Finally, the Department may refuse to issue, deny renewal of, or suspend a license required for ground ambulance services or take other corrective actions for reasons specified in the act. If the Department makes a determination of insolvency or insufficiency of services, then the Department may require the license holder to submit and complete a corrective plan, as described in the act.

The Department shall be required to provide notice of any determination of insolvency or insufficiency of services to persons and entities specified in the act. The Department shall immediately engage with other license holders in the area to determine how ground ambulance services may be provided to the affected area during the service disruption. Assisting license holders may be compensated for such assistance as described in the act.

These provisions are identical to provisions in the perfected HCS/HB 943 (2025) and SCS/SB 317 943 (2025) and substantially similar to provisions in SB 548 (2025), SB 7 (2025), SB 206 (2025), SB 1340 (2024), and provisions in SCS/SB 1382 (2024).

Current law establishing the Ground Ambulance Service Reimbursement Allowance excludes any ambulance service owned or operated by an entity owned and operated by Missouri, including any hospital owned or operated by the University of Missouri Board of Curators. This act removes this exception.

This provision is identical to SB 629 (2025) and the perfected HCS/HB 943 (2025).

PATIENT MEDICAL RECORDS (Section 191.227)

Under this act, records containing a patient's health history and treatment created by an emergency care provider or telecommunicator first responder, in the course of their official duties while responding to a formal request for assistance, shall be made available to the patient or patient's representative, upon written request.

This provision is identical to HB 457 (2025) and a provision in the perfected HCS/HB 943 (2025).

"MISSOURI STATE LOAN REPAYMENT PROGRAM" (Sections 191.600-615)

This act modifies the "Health Professional Student Loan Repayment Program" to be the "Missouri Student Loan Repayment Program" or "MOSLRP". MOSLRP shall be for persons who practice in areas of defined need after graduating from an accredited graduate training program in disciplines defined in rule by the Department of Health and Senior Services. MOSLRP shall not include areas of need for chiropractic services, unlike the current "Health Professional Student Loan Repayment Program". At least 35% of appropriated funds each year shall be designated for awards to primary care physicians and general dentists.

The standards the Department may establish shall not include enrollment as a full-time student in certain courses of study as in the current program, but shall include authorization to practice certain types of health professions and in areas of defined need.

This provision is identical to HCS/HB 720 (2025) and similar to SB 635 (2025).

SEXUALLY TRANSMITTED INFECTIONS (Section 191.648)

Currently, a physician may utilize expedited partner therapy, meaning the practice of treating the sex partners of persons with chlamydia or gonorrhea without an intervening medical evaluation or professional prevention counseling, to prescribe and dispense medications for the treatment of chlamydia or gonorrhea even without an established physician/patient relationship.

Under this act, certain health care professionals may use expedited partner therapy and such therapy may be used for designated sexually transmitted infections beyond chlamydia and gonorrhea. This act repeals the requirement that antibiotic medications prescribed and dispensed through expedited partner therapy for the treatment of chlamydia or gonorrhea be in pill form.

This provision is identical to a provision in the perfected HCS/HB 943 (2025) and SCS/SB 317 (2025), substantially similar to a provision in SB 548 (2025), SB 178 (2025), the perfected HCS/HB 2413 (2024), and SB 1445 (2024), and similar to HB 1879 (2024).

TELEHEALTH (Section 191.1145)

Under this act, "telehealth" or "telemedicine" shall include the delivery of health care services through audiovisual and audio-only technologies and shall not be limited only to services delivered via select third-party corporate platforms.

This provision is identical to a provision in HB 825 (2025), SCS/SB 317 (2025), SS#2/SB 79 (2025), SB 94 (2025), and HB 1873 (2024) and substantially similar to SB 931 (2024), SB 669 (2023), and HB 1098 (2023).

FORENSIC EXAMINATIONS OF VICTIMS OF SEXUAL OFFENSES (Section 192.2521)

Under this act, a specialty hospital, meaning a hospital other than a general acute care hospital, shall not be required to comply with certain statutory provisions relating to forensic examinations of victims of sexual assault if such hospital has in place a policy for the transfer of such victims to an appropriate hospital with an emergency department.

This provision is identical to a provision in the perfected HCS/HB 943 (2025), SB 178 (2025), SCS/SB 317 (2025), and the perfected HCS/HB 2413 (2024) and substantially similar to SB 1326 (2024).

LIMITS ON SALE OF OVER-THE-COUNTER DRUGS (Sections 195.417 and 579.060)

Current law prohibits the sale, purchase, or dispensation of ephedrine, phenylpropanolamine, or pseudoephedrine to the same individual in a twelve-month period in any total amount greater than 43.2 grams without a valid prescription. This act changes the total amount to 61.2 grams.

These provisions are identical to provisions in SB 548 (2025), SB 143 (2025), the perfected HCS/HB 943 (2025), SCS/SB 317 (2025), SS/SCS/HCS/HB 1659 (2024), and SCS/SB 1485 (2024) and similar to HB 2824 (2024).

PSEUDOEPHEDRINE (Sections 195.417 and 579.060)

Beginning October 1, 2025, any manufacturer of any drug product containing any detectable amount of ephedrine, phenylpropanolamine, or pseudoephedrine sold in this state shall fees to the administrator of the real-time electronic pseudoephedrine tracking system, as specified in the act. A manufacturer who fails to knowingly pay such fee shall have committed the offense of unlawful sale, distribution, or purchase of over-the-counter methamphetamine precursor drugs, which is a Class A misdemeanor.

These provisions are identical to a provision in HB 1036 (2025).

ADMINISTRATION OF MEDICATIONS (Sections 196.990 and 335.081)

This act adds licensed long-term care facilities and child care facilities to the definition of "authorized entity" in current law permitting such entities to stock a supply of epinephrine delivery devices for use in an emergency. Additionally, the administration by technicians, nurses' aides, or their equivalent in long-term care facilities of epinephrine delivery devices and subcutaneous injectable medications to treat diabetes shall not be prohibited by nurse licensing laws.

These provisions are similar to provisions in the perfected HCS/HB 943 (2025), SB 548 (2025), SCS/SB 317 (2025), and HCS/HB 2824 (2024).

MO HEALTHNET COVERAGE OF HEARING-RELATED DEVICES (Section 208.152)

Currently, reimbursable MO HealthNet services include hearing aids for eligible needy children, pregnant women, and blind persons. This act mandates MO HealthNet coverage of medically necessary cochlear implants and hearing instruments for all eligible participants.

This provision is identical to provisions in the perfected HCS/HB 943 (2025), SCS/SB 317 (2025), and SB 1443 (2024) and substantially similar to provisions in HCS/HBs 2626 & 1918 (2024).

PRENATAL TESTS FOR CERTAIN DISEASES (Section 210.030)

Currently, a physician or other health care provider shall draw and test a pregnant woman's blood at or soon after her first prenatal examination, with her consent, for syphilis, hepatitis B, or other similar diseases. Under this act, the testing of the pregnant woman's blood shall also occur at the twenty-eighth week of her pregnancy and immediately after birth. Additionally, the test shall include hepatitis C and HIV. If a mother tests positive for syphilis, hepatitis B, hepatitis C, or HIV, the physician or other health care provider shall treat the mother in accordance with the most recent accepted medical practice.

Current law requires the Department of Health and Senior Services to work in consultation with the Missouri Genetic Disease Advisory Committee to make rules pertaining to these blood tests. This act repeals the requirement to work with the Committee and requires that the tests be approved or accepted by the U.S. Food and Drug Administration.

This provision is identical to provisions in SCS/SB 178 (2025), substantially similar to a provision in SCS/SB 317 (2025) and the perfected HCS/HB 943 (2025), and similar to provisions in SB 548 (2025), the perfected HCS/HB 2413 (2024), and similar to SB 1260 (2024).

FOOD-BORNE ALLERGIES (Section 210.225)

This act establishes "Elijah's Law". Before July 1, 2027, each licensed child care provider shall adopt a policy on allergy prevention and response with a focus on potentially deadly food-borne allergies, as specified in the act. The Department of Elementary and Secondary Education shall develop a model policy or policies before July 1, 2026.

This provision is substantially similar to SB 783 (2025) and HB 580 (2025).

MISSOURI EMERGENCY RESPONSE COMMISSION (Section 292.606)

This act extends the authority for the collection of certain fees by the Missouri Emergency Response Commission for six years, beginning August 28, 2025. A one-time fee shall be assessed and paid by November 1, 2025, as described in the act

This provision is substantially similar to provisions in SB 564 (2025), SS#2/SCS/SB 10 (2025), SCS/SB 1356 (2024), and the perfected HB 1870 (2024).

LICENSE PLATES (Section 301.142)

This act adds licensed occupational therapists to the definition of "other authorized health care practitioner" for purposes of the physician's statement required for issuance of a disabled license plate or placard.

This provision is substantially similar to a provision in the perfected HCS/HB 943 (2025) and similar to SB 616 (2025) and HB 620 (2025).

PRACTICE OF DENTISTRY IN CORRECTIONAL CENTERS (Section 332.081)

Current law provides that no corporation shall practice dentistry unless that corporation is a nonprofit corporation or a professional corporation under Missouri law. This act provides that such provision shall not apply to entities contracted with the state to provide care in correctional centers.

This provision is identical to a provision in the perfected HCS/HB 943 (2025), SB 143 (2025), SB 548 (2025), SCS/SB 317 (2025), SS/SCS/HCS/HB 1659 (2024), SB 1287 (2024), and HB 2280 (2024).

LICENSURE OF DENTISTS AND DENTAL HYGIENISTS (Sections 332.211, 332.281, and 332.700-760)

Current law provides that the Missouri Dental Board ("Board") shall grant without examination a license to a dentist who has been licensed in another state for at least five consecutive years immediately preceding the application for licensure in this state if the Board is satisfied that the qualifications are at least equivalent to the Missouri licensure requirements. Additionally, current law provides that the Board shall grant without examination a license to a dental hygienist who has been licensed in another state for at least two consecutive years immediately preceding the application for licensure in this state if the Board is satisfied that the qualifications are at least equivalent to the Missouri licensure requirements.

This act repeals this provision and provides the Board shall waive, within six months, any examination, educational, or experience requirements for licensure to any person who holds a valid current dentist or dental hygienist license issued by another state or territory of the United States or a branch or unit of the Armed Forces of the United States for at least one year if it determines that the person met the minimum requirements of the other state. The Board may require an applicant to take and pass an examination specific to Missouri law. For military spouses with licensure in another state, the Board shall waive such examination, educational, or experience requirements and issue a license within thirty days.

The Board shall not waive any examination, educational, or