SB 1019 — Modifies several provisions relating to health care

Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.

This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2026, shall be invalid and void.] 192.026.

1.

Sections 103.190 and 192.026 to 192.029 shall be known and may be cited as the "Missouri Lyme Disease Eradication Act".

2.

As used in sections 103.190 and 192.026 to 192.029, the following terms shall mean:

(1) "Department", the department of health and senior services;

(2) "Lyme disease", a condition caused by an infection of the bacterium Borrelia burgdorferi, Borrelia mayonii, Borrelia afzelii, Borrelia garinii, Borrelia valaisiana, or Borrelia lusitaniae, transmitted to humans through the bite of infected blacklegged ticks (Ixodes scapularis) or other ticks, as defined by the national reporting case definition and posted by the Centers for Disease Control and Prevention National Notifiable Diseases Surveillance System;

(3) "Medically necessary", health care services or products that a treating health care provider exercising prudent clinical judgment would provide to a patient for the purpose of preventing, evaluating, diagnosing, or treating HCS SB 1019 6 an illness, injury, disease, or symptoms of such, and that are:

(a) Clinically appropriate in terms of type, frequency, extent, site, and duration for the specific circumstances;

and (b) Not primarily for the mere convenience of the patient, health care provider, or as determined by the provider based on the patient's specific circumstances;

(4) "Posttreatment Lyme disease syndrome", a condition characterized by persistent symptoms, including, but not limited to, fatigue, pain, respiratory impairment, neurological impairment, or other cognitive impairment following standard antibiotic or other treatment for Lyme disease.

3.

Health care providers, laboratories, and local health departments shall report to the department all confirmed or suspected cases of Lyme disease within three days of diagnosis using standardized surveillance case definitions developed by the CDC.

Any patient who receives a positive or suspected diagnosis of Lyme disease shall be given the option to opt in to having their identifiable information shared with the department, local public health officials, or the CDC.

4.

The department shall compile an annual report on the incidence and prevalence of Lyme disease in Missouri, including, but not limited to, demographic data, geographic distribution, treatment outcomes, and barriers to care.

The department shall submit the report to the CDC and the general assembly and make such report available to the public on the department's website by no later than December thirty-first of each year.

HCS SB 1019 7 5.

The department shall collaborate with the University of Missouri or any public four-year institution of higher education to integrate Lyme disease surveillance data into existing tick-borne disease monitoring programs.

6.

Any information collected or reported under this section shall be done in a manner that protects individually identifiable or potentially identifiable information and that is consistent with state and federal privacy laws.

7.

The department may promulgate any rules and regulations necessary to implement the provisions of sections 192.026 to 192.028.

Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.

This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2026, shall be invalid and void.

206.110.

1.

provided, however, that this exception shall not prohibit the continuation or expansion of existing activities otherwise allowed by law, shall have and exercise the following governmental powers, and all other powers incidental, HCS SB 1019 8 necessary, convenient or desirable to carry out and effectuate the express powers:

and to make and enter into leases of equipment and real SB 1019 4 property, a hospital or hospital facilities, as lessor or lessee, regardless of the duration of such lease;

Any agreement entered into pursuant to this subsection pertaining to the lease of the hospital shall have a definite termination date as negotiated by the parties, but this shall not preclude the trustees from entering into a renewal of the agreement with the same or other parties pertaining to the same or HCS SB 1019 9 other subjects upon such terms and conditions as the parties may agree;

(7) To maintain the hospital for the benefit of the inhabitants of the area comprising the district who are sick, injured, or maimed regardless of race, creed or color, SB 1019 5 and to adopt such reasonable rules and regulations as may be necessary to render the use of the hospital of the greatest benefit to the greatest number;

HCS SB 1019 10 (8) To police its property and to exercise police powers in respect thereto or in respect to the enforcement of any rule or regulation provided by the ordinances of the district and to employ and commission police officers and other qualified persons to enforce the same;

Nothing in this section or in other provisions of this chapter shall be construed to authorize the district or board to establish or enforce any regulation or rule in respect to hospitalization or the operation or maintenance SB 1019 6 of such hospital or any hospital facilities within its jurisdiction which is in conflict with any federal or state law or regulation applicable to the same subject matter.

The board of trusteesdirectors of any hospital district authorized under subsection 2 of this section, and established and organized under the provisions of sectionsthis 206.010chapter: to 206.160, may invest up to fifty percent of its funds not required for immediate disbursement in obligations or for the operation of the hospital into:

(1) AnyMay mutualinvest fundsup thatto investfifty percent of its "available funds", defined in stocks,this bonds,section oras realfunds estate,not required for HCS SB 1019 11 immediate disbursement in obligations or anyfor combinationthe thereof;operation of the hospital district, into:

(2)(a) BondsAny mutual funds that have:invest in stocks, bonds, or real estate, or any combination thereof;

(a)(b) OneBonds ofthat thehave: five highest long-term ratings or the highest short-term rating issued by a nationally recognized rating agency;

anda. (b) A final maturity of ten years or less;

(3)One Money-marketof investments;the five highest long-term ratings or the highest short-term rating issued by a nationally recognized rating agency;

orand (4)b. Any combination of investments described in subdivisions (1) to (3) of this subsection.

TheA boardfinal shallmaturity invest the remaining percentage of fundsten notyears requiredor forless; immediate disbursement into any investment in which the state treasurer is allowed to invest.

(c) Money market investments;

or (d) Any combination of investments described in paragraphs (a) to (c) of this subdivision;

and (2) Shall invest the remaining percentage of any available funds not invested as allowed under subdivision (1) of this subsection into any investment in which the state treasurer is allowed to invest.

The provisions of this section shall only apply only if the hospital district receives less than three percent of its annual revenues from hospital district or state taxes.