HCS SS SCS SB 1107 -- EMERGENCY SERVICES

SPONSOR:  Childers (Hoppe)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Local
Government and Related Matters by a vote of 13 to 1.

This substitute makes changes to laws regarding emergency
services and emergency service personnel.

EMERGENCY SERVICES RETIREMENT (Sections 87.177 - 87.238, RSMo)

The substitute allows members of St. Louis Firefighters'
Retirement System at age 62 with five to 20 years of service to
apply for a service retirement allowance benefit.  The benefit
will be 2% times years of service times the average final
compensation.  The member must be repaid the total amount of the
member's contribution, without interest.  The benefit is to be
paid in lieu of the refund of accumulated contributions.
Survivor benefits will be 50% of the member benefit or a refund
of accumulated contributions.  Members will also receive a
cost-of-living allowance of 5% per year for a maximum of five
years.

Outdated language is removed regarding the distribution of the
cost-of-living adjustment under the St. Louis Firefighters'
Retirement Plan.

The substitute also allows a minimum benefit of $525 per month to
a surviving spouse of a St. Louis firefighter if the surviving
spouse is receiving less than that amount currently.
Firefighters are allowed to receive a minimum retirement benefit
of $625.

This portion of the substitute contains an emergency clause.


EMERGENCY SERVICES REIMBURSEMENT FROM TAX INCREMENT FINANCING
DISTRICTS (Section 99.847)

Under current law, emergency services districts must be
reimbursed for direct costs related to increased demands for
services within a tax increment financing (TIF) district.
Reimbursement is allowed only if the increased tax revenue
resulting from the TIF project is insufficient to fund these
direct costs and if the emergency services district can provide
proof that increased costs were incurred.  Reimbursement is to be
at least 25%, but no more than 100%, of the emergency services
district's tax increment.

The substitute removes the reimbursement requirements that the
district show that it incurred costs not covered by increased tax
revenue and that it must provide proof of the increased costs.
The substitute also changes the reimbursement amount of at least
25% to 50%, but not more than 100%, of the emergency services
district's tax increment.


AMBULANCE SERVICES

The substitute:

(1)  Repeals state law prohibiting the taxation by both an
ambulance district and a fire district in counties of the third
classification (Section 190.044);

(2)  Changes the residency requirements for candidates for
directors of ambulance districts (Section 190.050);

(3)  Allows ambulance boards to increase to seven members or
decrease to five or three members upon voter approval (Section
190.051);

(4)  Allows for the recall by petition of an ambulance board
member.  If a board member is recalled, the election authority
must order an election for a new member at the next scheduled
public election (Sections 190.053 - 190.054);

(5)  Changes requirements for the use of an automated external
defibrillator (Section 190.092);

(6)  Removes the requirement that Cass, Bates, Henry, Johnson,
and St. Clair counties have a mobile emergency medical technician
in the ambulance when transporting a patient (Section 190.094);

(7)  Defines an emergency medical technician-intermediate and
specialty care transportation.  The substitute also allows the
Department of Health and Senior Services to license emergency
medical technician-intermediates only in the counties of Clay,
Platte, and Jackson (Sections 190.100 and 190.131);

(8)  Increases the number of persons serving on the state
advisory council on emergency medical services by one person who
must reside in the City of St. Louis (Section 190.100);

(9)  Requires most ground ambulances to have at least two
licensed individuals when transporting a patient (Section
190.105);

(10)  Requires the owner, upon the sale or transfer of an
ambulance service, to notify the department of the change within
30 days.  The department is required to inspect the service to
verify compliance with licensure standards (Sections 190.105 -
190.108);

(11)  Changes the requirements for the county letter of
endorsement to the department for new ambulance service within
unincorporated portions of a county.  The letter must state the
public health benefits of the service and show that the service
has the expertise and resources to operate the service (Section
190.109);

(12)  Requires all ambulance services, including services in St.
Louis City, to maintain adequate insurance coverage or proof of
financial responsibility with adequate reserves maintained.
Provisions for the self-insurance of St. Louis City ambulance
services are removed (Sections 190.100 and 190.120);

(13)  Requires the department to reissue a license to an
emergency medical technician within two years of the lapse of the
license if certain conditions are met (Section 190.145);

(14)  Expands causes for which a complaint may be filed with the
Administrative Hearing Commission against an ambulance service
(Section 190.165);

(15)  Forbids relicensure of any individual whose license has
been revoked twice within a 10-year period (Section 190.165);

(16)  Requires the department to submit a copy of certain
licensee settlement agreements to the Administrative Hearing
Commission (Section 190.172);

(17)  Requires a patient care report to be completed for each
run.  A patient care report is also required to be given by a
health care facility when a patient is transferred to another
facility (Section 190.175);

(18)  Requires an ambulance service to report to the department
within 72 hours of its having knowledge of certain felony charges
filed against an employee of the licensee.  The employee of a
service is also required to notify the service of these charges
within 72 hours (Section 190.196); and

(19)  Requires any investigation into violation of ambulance laws
to be completed within six months.  The department is given
access to all records related to the investigation (Section
190.248).


STRETCHER VAN SERVICE

The substitute also contains provisions related to the regulation
of stretcher van services.  A stretcher van service provides
transportation to passengers who are confined to stretchers and
whose conditions are not likely to need medical attention during
transportation.  The substitute:

(1)  Requires any person, owner, or agent to be licensed by the
department if the person or entity advertises, operates,
maintains, engages, or proposes to engage in the transport of
persons confined to stretchers.  The department can issue these
licenses for a period of five years (Section 190.528);

(2)  Allows political subdivisions that are authorized to provide
ambulance service, prior to August 28, 2001, to continue to
enforce laws, ordinances, and regulations regarding ambulance
service (Section 190.528);

(3)  Allows the governing body in St. Louis County to set
standards for all stretcher van services.  Any service in the
county must be licensed by the state.  The county may not
prohibit a licensed service from operating in the county as long
as the service meets county standards (Section 190.528);

(4)  Requires stretcher vans to operate with a two-person crew
(Section 190.528);

(5)  Requires stretcher van operators to immediately contact the
appropriate ground ambulance service if a passenger's medical
condition deteriorates (Section 190.528);

(6)  Prohibits services from transporting persons currently
admitted to a hospital or persons being transported to a hospital
for admission or emergency treatment (Section 190.528);

(7)  Requires the department to establish regulations requiring
adequate insurance, vehicle maintenance and specifications,
passenger safety, and service records and reports (Section
190.528);

(8)  Requires the department to establish the application forms
for stretcher van service licenses in order to ensure compliance
with rules (Section 190.528);

(9)  Requires services to notify the department upon the sale or
transfer of any service ownership.  The department must inspect
the new service to verify compliance with licensure standards
(Section 190.528);

(10)  Allows the department to refuse to issue or deny renewal of
a stretcher van license for failure to comply with the law or any
regulation promulgated by the department.  Guidelines for
disciplinary action and relicensure are established.  The
department may cause a complaint to be filed with the
Administrative Hearing Commission against a licensee for
noncompliance with regulations.  Procedures are established for
the notification of the applicant that a license has been refused
and for the applicant to file a complaint with the commission.
An individual whose license has been revoked must wait one year
to apply for relicensure.  The department may notify any other
state in which a person is licensed of a suspended or revoked
license in this state (Section 190.531);

(11)  Protects any person or organization from civil damage when
in good faith the person provides information to the department
regarding stretcher van regulations (Section 190.531);

(12)  Allows the department to suspend a license if it finds that
there is an imminent threat to public health.  The department
must file a complaint with the Administrative Hearing Commission
upon the suspension.  Procedures are established for the
suspension and appeal of suspension (Section 190.531); and

(13)  Makes persons violating the stretcher van provisions guilty
of a class B misdemeanor.  Each day that any violation continues
constitutes a separate offense, but the court may stay the
cumulative penalties (Section 190.534).


HEALTH AND WELFARE OF EMERGENCY SERVICE WORKERS (Sections 191.630
- 191.631)

The substitute requires persons who receive care from an
emergency service provider and who have exposed the provider to
blood or other potentially infectious materials to consent to a
test for infectious diseases.


RESIDENTIAL CARE FACILITIES (Section 198.199)

The substitute excludes residential care facilities from
licensing and certification provisions if the facility has
complied with certain conditions.


FIRE PROTECTION DISTRICT DIRECTORS (Section 321.130)

The substitute changes the qualifications of candidates for fire
protection district directors in third and fourth classification
counties.  A candidate must reside in the district for two years
before the election or appointment.  Currently, the candidate
must reside in the county in which the district is located for
two years.  A candidate for director in a newly formed district
must reside in the district for one year before the election or
appointment.


AMBULANCE DISTRICT AND FIRE PROTECTION DISTRICT SALES TAX
(Sections 321.552 - 321.556)

In all counties, except Greene County, any ambulance or fire
protection district may impose a retail sales tax of up to
one-half of 1% on all retail sales made within the district, upon
voter approval.  The tax must be used for the operation of the
district and for the reduction of property taxes.  The ambulance
or fire protection district must reduce property tax revenues by
an amount equal to 50% of the amount of sales tax collected in
the preceding year.  The Department of Revenue will collect the
retail sales taxes.  When the fire protection district or
ambulance district receives a petition signed by at least 20% of
the qualified voters in the last gubernatorial election calling
for an election to repeal the sales tax, the district must submit
the question to the voters.


EMERGENCY COMMUNICATIONS SYSTEM (Sections 650.390 - 650.411)

The substitute allows St. Louis County to establish an emergency
communications system within the county.  The purpose of the
system is to provide a wireless communication network that
permits governmental or public safety entities to communicate
within the area served.  The district would be managed by a
seven-member commission appointed by the chief executive officer
of the county.  The substitute outlines the qualifications and
term of office of commission members and the powers of the
commission.  The commission may issue bonds.  The issuance of
bonds must be approved by the voters of the district.  The
county, upon voter approval, may also levy and collect a sales
tax not to exceed one-tenth of 1% or a property tax not to exceed
six cents per $100 of assessed valuation for the purpose of
establishing and maintaining the system.  All funds collected
from the tax will be deposited in the Emergency Communication
System Fund established by the substitute.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of $925
in FY 2003, $28,731 in FY 2004, and $1,178 in FY 2005.

PROPONENTS:  Supporters say that the substitute is a clean-up
bill from the legislation passed a few years ago.  The substitute
also takes care of other problems related to fire and ambulance
districts.

Testifying for the bill were Senator Childers; Missouri Ambulance
Association; Missouri Emergency Services Association; Missouri
State Council of Firefighters; Ambulance District Association of
Missouri; and Missouri Hospital Association.

OPPONENTS:  Those who oppose the substitute say that too many
sales taxes are imposed on citizens.  Cities often depend on
sales taxes and must compete with districts for this tax base.

Testifying against the bill were Missouri Municipal League; and
Missouri Association of Counties.

Steve Bauer, Legislative Analyst

Missouri House of Representatives
Last Updated October 11, 2002 at 9:04 am