HCS/SS/SB 24 - This act creates new provisions relating to vulnerable persons. EMERGENCY SERVICES (Sections 67.145, 105.500, 190.100, 190.103, 190.142, 190.147, 192.2405, 208.1032, 285.040, 321.225, 321.620, 537.037, 650.320, 650.340, and the repeal of Section 190.134) This act repeals references to ambulance attendants, drivers, emergency medical technician paramedics, mobile emergency medical technicians, emergency medical technician basic, and EMT intermediate and adds references to paramedics in various statutes relating to emergency medical services. These provisions are identical to provisions in the truly agreed to and finally passed SS/HB 402 (2023), the truly agreed to and finally passed CCS/HCS/SB 186 (2023), the truly agreed to and finally passed HCS/SS/SB 24 (2023), and SB 625 (2023). Under current law, emergency medical dispatchers shall complete an emergency medical dispatcher course that meets or exceeds the national curriculum of the U.S. Department of Transportation. This act modifies that training requirement and instead requires emergency medical dispatchers to complete training courses approved by the Missouri 911 Service Board. Additionally, the Service Board shall develop rules and regulations, in collaboration with the State EMS Medical Director's Advisory Committee, relating to the medical aspects of pre-arrival medical instructions. This act makes several technical changes to the emergency medical dispatcher statutes. These provisions are identical to provisions in the truly agreed to and finally passed SS/HB 402 (2023) and the truly agreed to and finally passed CCS/HCS/SB 186 (2023), SB 449 (2023), and HB 1143 (2022) and substantially similar to HB 2381 (2022). Currently, paramedic training programs used as part of an emergency medical technician license shall be accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or hold a CAAHEP letter of review. This act repeals this accreditation requirement and such programs shall instead be accredited as required by the National Registry of Emergency Medical Technicians. This provision is identical to a provision in the truly agreed to and finally passed SS/HB 402 (2023), the truly agreed to and finally passed CCS/HCS/SB 186 (2023), and SB 534 (2023). The act adds "telecommunicator first responder" to the definition of "first responder" in various provisions of law. Additionally, this act provides that the Department of Health and Senior Services shall offer a vaccination program to certain Missouri State Highway Patrol telecommunicators who may be exposed to infectious diseases. Furthermore, this act provides that political subdivisions may elect to cover telecommunicator first responders as public safety personnel. These provisions are identical to provisions in the truly agreed to and finally passed CCS/HCS/SB 186 (2023), the truly agreed to and finally passed SS/SCS/SBs 189, et al (2023), the truly agreed to and finally passed HCS/SB 28 (2023), and SCS/HS/HCS/HBs 1108 & 1181, et al (2023) and substantially similar to provisions in SCS/SB 46 (2023), HB 1676 (2022), HB 1637 (2022), HCS/HB 2381 (2022), and SCS/HB 2088, et al (2022). ADOPTION TAX CREDIT (Sections 135.327 to 135.333) Current law authorizes a nonrefundable tax credit for nonrecurring adoption expenses, not to exceed $10,000 per child, with an annual limit of $6 million dollars in tax credits. This act indexes the maximum per-child credit for inflation, makes the tax credit refundable, removes the $6 million limit, and provides that, for tax years ending on or before December 31, 2023, priority for authorizing tax credits shall be given to applications for special needs children who are residents or wards of residents of this state. These provisions are identical to provisions in HCS/SS/SB 143 (2023) and HCS/HB 714 (2023) and are substantially similar to provisions in SCS/SB 455 (2023). EARLY CHILDHOOD EDUCATION SERVICES (Section 161.244) Subject to appropriation, the Department of Elementary and Secondary Education is required to provide grants directly to certain licensed child care providers for the provision of early childhood education services. OPIOID OVERDOSES (Sections 190.255 and 195.206) This act provides that a first responder may administer naloxone or any other drug or device approved by the United Stated Food and Drug Administration that blocks the effects of an opioid overdose. This provision is identical to provisions in the truly agreed to and finally passed CCS/HCS/SB 186 (2023), the truly agreed to and finally passed CCS/HCS/SS/SCS/SBs 45 & 90 (2023), the truly agreed to and finally passed HCS/SS/SCS/SB 70 (2023), and the truly agreed and finally passed CCS/HCS/SS/SCS/SB 157 and substantially similar to HCS/HB 117, 343, & 1091 (2023). SALES TAX FOR EMERGENCY SERVICES (Section 190.327) Currently, an emergency services board operating in Jefferson County shall not have a sales tax for emergency services or for providing central dispatching for emergency services greater than one-quarter of one percent. This act repeals this provision. This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS/SB 186 (2023) and to SB 608 (2023) and to a provision in SS/SCS/HCS/HB 301 (2023). EMERGENCY TELEPHONE SERVICE CHARGES (Section 190.460) Under current law, cities and counties which prohibited emergency telephone service charges may adopt such charges and notify the Department of Revenue by November 15, 2019, and the Department shall notify the Missouri 911 Service Board by December 1, 2019. This act repeals those dates and provides the Department shall notify the board within 60 days of receiving notice. This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS/SB 186 (2023) and SS/SCS/HCS/HB 301 (2023). PEER SUPPORT COUNSELING PROGRAMS (SECTION 190.1010) The act creates new provisions relating to communications during peer support counseling programs for certain first responders. With certain exceptions, detailed in the act, a communication made by a first responder or peer support advisor in a peer support counseling session, as well as any oral or written information conveyed in the peer support counseling session, shall be confidential and shall not be disclosed by any person participating in the peer support counseling session or released to any person or entity. Any communication relating to a peer support counseling session made confidential under this act that is made between peer support advisors and the supervisors or staff of a peer support counseling program, or between the supervisor or staff of a peer support counseling program, shall be confidential and shall not be disclosed, except as otherwise provided in the act. An employer of a first responder that establishes a peer support counseling program shall develop a policy or rule that imposes disciplinary measures against a peer support advisor who violates the confidentiality of the peer support counseling program by sharing information learned in a peer support counseling session with personnel who are not supervisors or staff of the peer support counseling program, unless otherwise exempted under the provisions of this act. The act provides that no employer may mandate that any employee participate in a peer support counseling program. This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS/SB 186 (2023), the truly agreed to and finally passed SS/SCS/SBs 189, et al (2023), and to SS/SCS/HCS/HB 301 (2023). RURAL EMERGENCY HOSPITALS (Sections 197.020) This act modifies the term "hospital" for purposes of licensure to include facilities designated as rural emergency hospitals by the Centers for Medicare and Medicaid Services. These provisions are identical to those in the truly agreed to and finally passed SS/HB 402 (2023), a provision in the truly agreed to and finally passed CCS/HCS/SS/SCS/SBs 45 & 90 (2023), the truly agreed to and finally passed HCS/SS/SCS/SB 106 (2023), and SB 420 (2023). WORKERS' COMPENSATION - PTSD AS OCCUPATIONAL DISEASE IN FIRST RESPONDERS (SECTION 287.067) This act establishes post-traumatic stress disorder (PTSD), as described in the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition, (DSM-5) as a compensable occupational disease under workers' compensation when diagnosed in first responders, as defined in by law. A first responder shall not require a physical injury in order to be eligible for benefits, but preexisting PTSD is not compensable. The time for notice of injury or death in cases of compensable PTSD is measured from exposure to one of the qualifying stressors listed in the DSM-5 criteria, or the diagnosis of the disorder, whichever is later. Any claim for compensation for an injury shall be properly noticed to the Division of Workers' Compensation within 52 weeks after the qualifying exposure, or the diagnosis of the disorder, whichever is later. This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS/SB 186 (2023) and a provision in the truly agreed to and finally passed SS/SCS/SBs 189, 36 & 37 (2023) and substantially similar to a provision in SS/SCS/HCS/HB 301 (2023) and in the perfected SS/SCS/SBs 119 & 120 (2023). SECOND INJURY FUND - SUPPLEMENTAL SURCHARGE (SECTION 287.715) Under current law, for calendar year 2023, the Director of the Division of Workers' Compensation is required to collect a supplemental surcharge not to exceed 2.5% of the policyholder's or self-insured's workers' compensation net deposits, net premiums, or net assessments for the previous policy year, rounded up to the nearest one-half of a percentage point. This provision expires December 31, 2023. This act extends that expiration date to December 31, 2026 and lowers the surcharge to 1% for that duration, rather than revert to 3%. This provision is identical to a provision in SCS/SB 521 (2023), SCS/HB 585 (2023), . MISSOURI TASK FORCE ONE EMPLOYMENT RIGHTS (SECTION 320.336) Any member of Missouri Task Force One shall be entitled to initial employment rights, re-employment rights, retention in employment rights, promotion rights, and discrimination protections as provided by federal law for members of the military and as provided by state law. The Attorney General shall enforce these rights as contained in this act. This provision is identical to SB 211 (2023), HB 392 (2023), HB 2193 (2022), and certain provisions in SCS/HB 2455 (2022) and similar to HB 317 (2021) and HB 2472 (2020). VOLUNTARY CRITICAL ILLNESS BENEFITS POOL (SECTIONS 287.245 AND 320.400) Current law contains a voluntary cancer benefits pool established for the purpose of providing benefits for firefighters who have contracted cancer in connection with employment as a firefighter. This act expands the pool to allow other first responders, specifically emergency medical technician-basic, emergency medical technician-paramedic, and telecommunicators, to have access to benefits through the pool for exposure to a diagnosable trauma stress event, or diagnosable cumulative post traumatic stress injury over the course of a career. The act additionally allows covered individuals to join the pool. Furthermore, any professional organization formed for the purpose, in whole or in part, of representing or providing resources for any covered individual may make contributions to the pool on behalf of any covered individual without the organization itself joining the pool. A payment may be made from the pool to a covered individual for the actual award, up to ten thousand dollars, for seeking treatment with a licensed psychiatrist or a licensed psychologist and any subsequent courses of treatment recommended by such licensed individuals. If a covered individual returns to the same position of employment after a post traumatic stress injury diagnosis, the covered individual may receive benefits in this section for the continued treatment of such injury or any subsequently covered post traumatic stress injury diagnosis. Current law allows for the State Fire Marshal to disburse grants to voluntary critical illness pools. This provision expires June 30, 2023. This act repeals the sunset date. These provisions are identical to provisions in the truly agreed to and finally passed CCS/HCS/SB 186(2023), the truly agreed to and finally passed SS/SCS/SBs 189, 36 & 37 (2023), and SS/SCS/HCS/HB 301 (2023). FENTANYL TESTING (Section 579.088) Under this act, it shall not be unlawful to manufacture, possess, sell, deliver, or use any device, equipment, or other material for the purpose of analyzing controlled substances to detect the presence of fentanyl or any synthetic controlled substance fentanyl analogue. This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/SBs 189, 36, & 37 (2023), the truly agreed to and finally passed HCS/SS/SCS/SB 70 (2023), the truly agreed to and finally passed CCS/HCS/SS/SCS/SBs 45 & 90 (2023), the truly agreed to and finally passed SS/HB 402 (2023), SB 480 (2023), HB 927 (2023), HB 250 (2023), and SCS/HCS/HBs 117, 343, & 1091 (2023). RIGHTS OF VICTIMS OF CRIMES (Section 595.209) Under current law, victims of certain crimes shall be notified by the prosecutor's office and law enforcement of certain filings or status updates in the criminal case of which he or she is a victim. This act adds that the victim shall be notified by certified mail or by electronic mail. This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/SBs 189, et al (2023), the truly agreed to and finally passed CCS/HCS/SB 186 (2023), the truly agreed to and finally passed HCS/SCS/SB 103 (2023), and SS/SCS/HB 301 (2023) and to SB 337 (2023). LOANS AND FINANCIAL ASSISTANCE FROM PREPAID WIRELESS EMERGENCY TELEPHONE CHARGES (Section 650.335) The act permits a regional planning commission that provides emergency telephone service to multiple counties, when the prepaid wireless emergency telephone service charge is collected in the county or city, to submit an application for loan funds or other financial assistance to the board for the purpose of financing all or a portion of the costs incurred in implementing a 911 communications service project. ADVANCE HEALTH CARE DIRECTIVES (SECTION 1) The act repeals a provision in the truly agreed to and finally passed SS/HB 402 (2023) relating to voluntary nonopioid directive forms and replaces with a new provision relating to advance health care directives. Specifically, the Department of Health and Senior Services is required to include on its website an advance health care directive form and directions for completing such form. SCOTT SVAGERA