MO HB2600

County commissions may now choose between dividing ambulance districts into six election subdistricts OR allowing all six directors to be elected at-large from within the district.

Ambulance district boards can abolish election subdistricts by two-thirds vote if unable to find qualified candidates, converting to at-large director elections; boards can also establish new subdistricts by two-thirds vote.

Board size may be changed from six members to seven, five, or three members with voter approval, and if fewer candidates file than positions available, no election is held and candidates automatically assume office.

Consolidation of two or more ambulance districts requires a detailed consolidation plan specifying assets, debts, tax levies, initial directors, and a timeline not exceeding 180 days; consolidation proceeds without voter approval unless 5% of voters file objections within 30 days of a public hearing.

Consolidated districts cannot impose property or sales taxes higher than the lowest rate among the merging districts without voter approval, though they may impose up to the highest rate if specifically approved on the ballot.