MO SB975

Ambulance district directors will be elected at-large from within the district rather than from numbered election districts, with six directors serving three-year terms; directors holding office as of August 28, 2026, continue as at-large directors for their existing terms

Ambulance districts may adopt election subdistricts by ordinance with a two-thirds majority vote of the board, requiring each board member to reside in the subdistrict they represent

Annexation petitions for ambulance districts will now be presented to the district's board of directors rather than the county commission, with approval requiring a majority vote from all voters in both the existing district and the area proposed for annexation

Consolidation of ambulance districts requires a detailed consolidation plan including proposed tax levies, assets, debts, initial directors, and a timeline not exceeding 180 days; if no voter objections are filed within 30 days of a public hearing, consolidation proceeds without an election

Community paramedic services requirements are expanded, requiring memoranda of understanding between ambulance services operating outside their primary service areas and establishing a five-year endorsement system for community paramedic service entities

Peace officers and first responders must complete a mental health check-in with a program service provider once every three to five years, with information disclosed during these sessions generally privileged from use in legal proceedings