Missouri Statute | Act | Code |Public Health And Welfare| US Code - US Statute | Chapter 205 County Health And Welfare Programs

Any county, subject to the provisions of the Constitution of the
state of Missouri, may establish, maintain, manage and operate a public
health center in the following manner: whenever the county commission
shall be presented with a petition signed by at least ten percent or more
of the voters of the county, as determined by the number of votes cast
for governor at the preceding general election, asking that an annual tax
not in excess of forty cents on each one hundred dollars of the assessed
valuation of property in the county, be levied for the establishment,
maintenance, management and operation of a county health center and the
maintenance of the personnel required for operation of the health center,
or by majority vote of the county commission in any county of the first
classification with more than eighty-two thousand but fewer than
eighty-two thousand one hundred inhabitants, or by majority vote of the
county commission in any county of the third classification without a
township form of government and with more than sixteen thousand six
hundred but fewer than sixteen thousand seven hundred inhabitants, the
county commission shall submit the question to the voters of the county
at an election. (L. 1945 p. 969 § 1, A.L. 1951 p. 779, A.L. 1957 p. 690,
A.L. 1978 H.B. 971, A.L. 1985 S.B. 114, A.L. 1992 H.B. 1228, A.L. 2005
H.B. 58 merged S.B. 210 merged with S.B. 258)

1. The question shall be submitted in substantially the
following form:

Shall there be a maximum tax of ...... per hundred dollars assessed
valuation for a county health center and the maintenance and operation of
same?

2. If a majority of the votes cast on the question shall vote in favor of
such tax, the county commission shall proceed to levy and collect such
tax and deposit same in the county treasury to the credit of the health
center fund and such fund shall be expended as hereinafter provided. (L.
1945 p. 969 § 2, A.L. 1951 p. 779, A.L. 1978 H.B. 971, A.L. 1985 S.B. 81)

1. The county governing body shall appoint five trustees chosen
from the citizens at large with reference to their fitness for such
office, all voters of the county, not more than three of the trustees to
be residents of the city, town or village in which the county health
center is to be located, who shall constitute a board of trustees for the
county health center.

2. The trustees shall hold their offices until the next following
municipal election, when five health center trustees shall be elected who
shall hold their offices, three for two years and two for four years. The
county governing body shall by order of record specify the terms of the
trustees.

3. At each subsequent municipal election the offices of the trustees
whose terms of office are about to expire shall be filled by the election
of health center trustees who each shall serve for a term of four years
and notwithstanding any other law of this state to the contrary all
elective officers in each city of the fourth class with a population of
at least thirty thousand but no more than thirty-three thousand, and
which is located within a county of the first class having a charter form
of government and containing the greater part of a city with a population
of four hundred fifty thousand or more inhabitants, beginning with the
first election after January 1, 1987, shall be elected every four years.

4. Any vacancy in the board of trustees occasioned by removal,
resignation or otherwise shall be reported to the county governing body
and be filled in like manner as original appointments, the appointee to
hold office until the next following municipal election, when such
vacancy shall be filled by election of a trustee to serve during the
remainder of the term of his predecessor.

5. No trustee shall have a personal pecuniary interest, either directly
or indirectly, in the purchase of any supplies for the health center,
unless the same are purchased by competitive bidding.

6. The filing and withdrawal of candidates shall be governed by the
provisions of chapter 115, RSMo, except that if the number of candidates
is no greater than the number of directors to be elected, no election
shall be held, and the candidates shall assume the responsibilities of
their offices at the same time and in the same manner as if they had been
elected. (L. 1951 p. 779 § 205.030, A.L. 1978 H.B. 971, A.L. 1984 H.B.
1120, A.L. 1986 S.B. 553 & 775 merged with H.B. 1471, et al.)

1. Each candidate for the office of health center trustee shall
file with the county election authority an announcement of candidacy in
writing. The announcement shall indicate whether the individual is a
candidate for a full or an unexpired term of a named predecessor. No
filing fee shall be required to be paid upon the filing of any
announcement. If announcements of a sufficient number of trustees are not
filed, the county commission shall appoint such trustee or trustees as
may be necessary to fill all vacancies on the board which result from the
expiration of the term of any trustees and any such appointee shall serve
until the next municipal election when a trustee shall be elected to fill
the remainder of the unexpired term.

2. The ballots shall not contain any designation of the political party
affiliation of any candidate for trustee. The ballots shall designate the
number of trustees to be elected and shall state whether any of the
trustees is to be elected for an unexpired term:

FOR HEALTH CENTER TRUSTEE

(Vote for..........)

....................................................

....................................................

....................................................

....................................................

....................................................

FOR HEALTH CENTER TRUSTEE For unexpired term ending
..........................

(Vote for ............)

....................................................

....................................................

....................................................

....................................................

....................................................

3. The candidates receiving the highest number of votes for the offices
of trustee to be filled shall be declared elected by the county
commission which shall issue commissions to the elected trustees. (L.
1951 p. 779 § 205.040, A.L. 1965 p. 345, A.L. 1978 H.B. 971, A.L. 1993
H.B. 551 & 552)

1. The trustees, within ten days after their appointment or
election, shall qualify by taking the oath of civil officers and organize
as a board of health center trustees by the election of one of their
number as chairman, one as secretary, one as treasurer, and by the
election of such other officers as they may deem necessary, but no bond
shall be required of them.

2. No trustee shall receive any compensation for his services performed,
but he may receive reimbursement for any cash expenditures actually made
for personal expenses incurred as such trustee, and an itemized statement
of all such expenses and money paid out shall be made under oath by each
of such trustees and filed with the secretary and allowed only by the
affirmative vote of all of the trustees present at a meeting of the board.

3. The board of health center trustees shall make and adopt such bylaws,
rules and regulations for its* own guidance and for the government of the
county health center as may be deemed expedient for the economic and
equitable conduct thereof. It** shall have the exclusive control of the
expenditures of all moneys collected to the credit of the county health
center fund, and of the purchase of site or sites, the purchase or
construction of any county health center buildings, and of the
supervision, care and custody of the grounds, rooms or buildings
purchased, constructed, leased or set apart for that purpose. All moneys
received for the county health center shall be credited to the county
health center and deposited in the depositary thereof for the sole use of
such county health center in accordance with the provisions of sections
205.010 to 205.150. All funds received by each county health center shall
be paid out only upon warrants ordered drawn by the treasurer of the
board of trustees upon properly authenticated vouchers of the board of
health center trustees.

4. The board of health center trustees may appoint and remove such
personnel as may be necessary and fix their compensation; and shall in
general carry out the spirit and intent of sections 205.010 to 205.150
pertaining to establishing and maintaining a county health center.

5. The board of health center trustees shall hold meetings at least once
each month, and shall keep a complete record of all of its proceedings.
Three members of the board shall constitute a quorum for the transaction
of business.

6. One of the trustees shall visit and examine the county health center
at least twice each month.

7. When the county health center is established, all personnel and all
persons approaching or coming within the limits of same, and all
furniture and other articles used or brought there shall be subject to
such rules and regulations as the board may prescribe.

8. The board of health center trustees shall determine annually the rate
of the tax levy, except that the rate so determined shall not exceed the
maximum rate authorized by the vote of the people of the county.

9. The board of health center trustees may enter into contracts and
agreements with federal, state, county, school and municipal governments
and with private individuals, partnerships, firms, associations and
corporations for the furtherance of health activities, except as
hereafter prohibited. (L. 1951 p. 779 § 205.045, A.L. 1957 p. 690, A.L.
1973 S.B. 253, A.L. 1982 H.B. 1069)

*Word "their" appears in original rolls.

**Word "They" appears in original rolls.

The public health center is established, maintained and operated
for the improvement of health of all inhabitants of said county or
counties. (L. 1945 p. 969 § 11)

The board of county health center trustees shall not enter into
contracts for the private practice of medicine, nor shall any of its
personnel practice medicine nor dispense drugs, vaccines or serums for
personal gain, nor shall its facilities be used for such purpose in any
way except as it may be necessary and agreed upon between the board and
county commission or commissions for the care of the indigent for whom
the commission or commissions may be responsible, or except in
furtherance of diagnostic and communicable disease control programs. (L.
1945 p. 969 § 13, A.L. 1951 p. 779)

Any person, firm, organization, society or corporation desiring
to make donations of money, personal property or real estate for the
benefit of such health center, shall have the right to vest title of such
property so donated, in the county or counties, to be controlled when so
accepted by the board of health center trustees according to the terms of
deed, gift, devise or bequest of such property. (L. 1945 p. 969 § 10,
A.L. 1951 p. 779)

All buildings that may be erected or constructed under sections
205.010 and 205.020 shall have the plans and specifications approved by
the board of health center trustees and bids advertised for according to
law for other county public buildings. (L. 1945 p. 969 § 8, A.L. 1951 p.
779)

1. On or before the seventh day of January in each year, the
board of health center trustees shall file with the county commission a
report of their proceedings with reference to the county health center
and a sworn statement of all receipts and expenditures during the
preceding calendar year.

2. The board of health center trustees shall prepare and submit to the
county budget officer a budget for the ensuing year at the time and in
the manner provided by the county budget law applicable to such county.
(L. 1945 p. 969 § 5, A.L. 1951 p. 779)

The county commission or commissions shall annually at their
February meeting, appoint the director of the public health center as
county health officer and such county health officer shall exercise all
of the rights and perform all of the duties pertaining to that office as
set forward under the health laws of the state and rules and regulations
of the department of health and senior services. (L. 1945 p. 969 § 7)

The qualifications of all persons employed in the operation of
said health center shall be at least equal to the minimum standard of
qualifications as set forward by the department of health or its
successors for positions of like importance and responsibilities. (L.
1945 p. 969 § 6)

The board of trustees for the county health center may either
through purchase of plans or through plans of self-insurance provide for
suitable retirement, health, life insurance, and employment insurance
plans for all administrators and employees of the county health center as
a part of their compensation, and the employer's cost of such plans shall
be paid by the treasurer of the board of county health trustees in the
same manner as other expenses of the county health center are paid,
except that the board of trustees for the county health center shall be
taken and considered as a "political subdivision" as the term is defined
in section 70.600, RSMo, for the purposes of sections 70.600 to 70.755,
RSMo. (L. 1990 H.B. 1130)

Each school of healing licensed by the state of Missouri shall
have equal rights in said health center. (L. 1945 p. 969 § 12)

The county commission in all counties of the first class not
having a charter form of government, except first class noncharter
counties containing any part of a city with a population of three hundred
thousand or more, in addition to the power to levy taxes for county
purposes, as otherwise provided by law, shall have the power to levy upon
all property subject to its taxing powers, an annual tax in an amount not
to exceed ten cents on each one hundred dollar valuation for the purpose
of operating or maintaining a public county health center or institution.
(L. 1958 2d Ex. Sess. p. 180 § 1, A.L. 1965 p. 348, A.L. 1994 S.B. 700)

The rate of tax levy provided for in section 205.141 * shall be
determined and fixed at the same time the rate of tax is determined and
fixed for county purposes. (L. 1947 V. II p. 335 § 2, A.L. 1961 p. 521,
A.L. 1973 S.B. 253)

*Erroneous reference to § 205.150 appears following § 205.141 in original
rolls.

The county commissions of the several counties of this state,
both within and outside such counties, except in counties of the third or
fourth classification (other than the county in which the hospital is
located) where there already exists a hospital organized pursuant to
chapters 96, 205 or 206, RSMo; provided, however, that this exception
shall not prohibit the continuation of existing activities otherwise
allowed by law, are hereby authorized, as provided in sections 205.160 to
205.340, to establish, construct, equip, improve, extend, repair and
maintain public hospitals and engage in health care activities, and may
issue bonds therefor as authorized by the general law governing the
incurring of indebtedness by counties. (L. 1945 p. 983 § 15192, A. 1949
H.B. 2061, A.L. 1996 S.B. 676)

(1952) County hospital established under §§ 205.160 to 205.370 is not a
political subdivision of the state so as to give supreme court
jurisdiction of suit to which it is party. Stribling v. Jolley, 362 Mo.
995, 245 S.W.2d 885.

1. In addition to the bonds authorized by section 205.160, the
county commission in any county exercising the rights conferred by
sections 205.160 to 205.340 may issue and sell revenue bonds for the
purpose of providing funds for the acquisition, construction, equipment,
improvement, extension and repair, and furnishing of hospitals and
related facilities, including medical office buildings to provide offices
for rental to physicians or dentists on a hospital's medical staff, and
the providing of sites therefor, including offstreet parking space for
motor vehicles. Such revenue bonds shall be payable, both as to principal
and interest, solely from the net income and revenues arising from the
operation of the hospital or the related facility or facilities, or of
the hospital and the related facility or facilities, after providing for
the costs of operation and maintenance thereof, or from other funds made
available from sources other than from proceeds of taxation.

2. Any bonds issued under the provisions of sections 205.161 to 205.169
shall not be deemed to be an indebtedness of the state of Missouri, or of
any county, or of the board of trustees of any such hospital, or of the
individual members of any such board of trustees, and shall not be deemed
to be an indebtedness within the meaning of any constitutional or
statutory limitation upon the incurring of indebtedness. (L. 1972 H.B.
1262 §§ 1, 2, A.L. 1981 H.B. 258)

1. Revenue bonds issued pursuant to the provisions of sections
205.161 to 205.169 shall be such denomination, shall bear such rate or
rates of interest not to exceed the highest rate permitted by law, and
shall mature at such time or times, not exceeding thirty-five years from
their date of issue, as determined by the county commission in its order
or resolution directing the issuance of such bonds. Such bonds may be
either serial bonds or term bonds and may be issued with or without
reservation of the right to call them for payment or redemption in
advance of their maturity, upon the giving of notice, and with or without
a covenant requiring the payment of a premium in the event of a call for
redemption prior to maturity.

2. The bonds when issued and sold shall be negotiable instruments within
the meaning of chapter 400, RSMo, and the interest thereon shall be
exempt from any state or local income taxes under the laws of the state
of Missouri. (L. 1972 H.B. 1262 § 3)

1. The county commission issuing bonds under the provisions of
sections 205.161 to 205.169 shall prescribe the form, details and
incidents of the bonds, and the county commission shall make such
covenants as in its judgment are advisable or necessary properly to
secure the payment thereof; but the form, details, incidents, and
covenants shall not be inconsistent with any of the provisions of
sections 205.161 to 205.169.

2. The holder of any bonds issued hereunder or of any coupons
representing interest accrued thereon* may, by civil action, compel the
county commission issuing such bonds to perform all duties imposed upon
it by the provisions of sections 205.161 to 205.169 and to enforce the
performance of any and all of the covenants made by the county commission
in the issuance of the bonds.

3. The provisions of sections 205.161 to 205.169 shall not be exclusive
of other legal methods of financing hospitals and related facilities, but
shall furnish an alternative method of finance. (L. 1972 H.B. 1262 § 4)

*Word "thereof" appears in original rolls.

1. The county commission shall appoint five trustees chosen from
the citizens at large with reference to their fitness for such office,
all residents of the county, not more than three of such trustees to be
residents of the city, town or village in which the hospital is to be
located, who shall constitute a board of trustees for such public
hospital.

2. The trustees appointed pursuant to subsection 1 of this section shall
hold their offices until the next following municipal election, when five
hospital trustees shall be elected and hold their offices for the
following terms, with each of the trustees' respective terms determined
by lot:

(1) One trustee for a one-year term;

(2) One trustee for a two-year term;

(3) One trustee for a three-year term;

(4) One trustee for a four-year term; and

(5) One trustee for a five-year term.

3. For trustees elected prior to January 1, 1995:

(1) If the terms of two trustees expire at the time of the next election
of trustees occurring after January 1, 1995, then:

(a) One trustee shall be elected for a four-year term; and

(b) One trustee shall be elected for a three-year term; and

(2) At the next following municipal election in which the terms of three
trustees expire:

(a) One trustee shall be elected for a five-year term;

(b) One trustee shall be elected for a four-year term;

(c) One trustee shall be elected for a three-year term; or

(3) If the terms of three trustees expire at the time of the next
election of trustees occurring after January 1, 1995, then:

(a) One trustee shall be elected for a five-year term;

(b) One trustee shall be elected for a four-year term;

(c) One trustee shall be elected for a three-year term; and

(4) At the next following municipal election in which the terms of two
trustees expire:

(a) One trustee shall be elected for a five-year term; and

(b) One trustee shall be elected for a four-year term.

4. The terms of the trustees elected pursuant to subsection 3 of this
section shall be determined by lot.

5. The office of a trustee elected pursuant to subsection 3 of this
section whose term of office is about to expire shall be filled by the
election of a hospital trustee who shall serve for a term of five years.
Each trustee subsequently elected shall serve a term of five years.

6. Any vacancy in the board of trustees occasioned by removal,
resignation or otherwise shall be reported to the county commission and
be filled in like manner as original appointments, the appointee to hold
office until the next following municipal election, when such vacancy
shall be filled by election of a trustee to serve during the remainder of
the term of his predecessor.

7. No trustee shall have a personal pecuniary interest, either directly
or indirectly, in the purchase of any supplies for such hospital, unless
the same are purchased by competitive bidding. (RSMo 1939 §§ 15194,
15196, A.L. 1945 p. 983 § 15193, A.L. 1947 V. I p. 323, A.L. 1978 H.B.
971, A.L. 1994 H.B. 1042)

Prior revisions: 1929 §§ 13977, 13979; 1919 §§ 12611, 12613

1. Each candidate for the office of hospital trustee shall file
with the county clerk an announcement of candidacy in writing. The
announcement shall indicate whether the individual is a candidate for a
full or an unexpired term of a named predecessor. No filing fee shall be
required to be paid upon the filing of any announcement. If the number of
candidates is no greater than the number of trustees to be elected, no
election shall be held, and the candidates shall assume the
responsibilities of their offices at the same time and in the same manner
as if they had been elected. If announcements of a sufficient number of
trustees are not filed, the county commission shall appoint such trustee
or trustees as may be necessary to fill all vacancies on the board which
result from the expiration of the term of any trustee or trustees, and
any appointee shall serve until the next general election when a trustee
shall be elected to fill the remainder of the unexpired term.

2. The ballots shall not contain any designation of the political party
affiliation of any candidate for trustees to be elected and shall state
whether any of the trustees are* to be elected for an unexpired term:

FOR HOSPITAL TRUSTEE

(Vote for .................................)

...........................................

...........................................

...........................................

...........................................

FOR HOSPITAL TRUSTEE

For unexpired term ending ..........................

(Vote for .................................)

..........................................

..........................................

..........................................

..........................................

3. The candidates whose names have been placed on the ballot by the
county commission pursuant to sections 205.170 and this section and who
receive the highest number of votes for the offices of trustee to be
filled shall be declared elected by the county commission which shall
issue commissions to the elected trustees. (L. 1947 V. I p. 323 § 15193a,
A.L. 1965 p. 345, A.L. 1978 H.B. 971, A.L. 1999 H.B. 676)

*Word "is" appears in original rolls.

1. The trustees shall, within ten days after their appointment
or election, qualify by taking the oath of civil officers and organize as
a board of hospital trustees by the election of one of their number as
chairman, one as secretary, one as treasurer, and by the election of such
other officers as they may deem necessary.

2. No trustee shall receive any compensation for his or her services
performed, but a trustee may receive reimbursement for any cash
expenditures actually made for personal expenses incurred as such
trustee, and an itemized statement of all such expenses and money paid
out shall be made under oath by each of such trustees and filed with the
secretary and allowed only by the affirmative vote of all of the trustees
present at a meeting of the board.

3. The board of hospital trustees shall make and adopt such bylaws, rules
and regulations for its own guidance and for the government of the
hospital as may be deemed expedient for the economic and equitable
conduct thereof, not inconsistent with sections 205.160 to 205.340 and
the ordinances of the city or town wherein such public hospital is
located. The board shall provide by regulation for the bonding of the
chief executive officer and may require a bond of the treasurer of the
board and of any employee of the hospital as it deems necessary. The
costs of all bonds required shall be paid out of the hospital fund.
Except as provided in subsection 4 of this section, it shall have the
exclusive control of the deposit, investment, and expenditure of all
moneys collected to the credit of the hospital fund, and of the purchase
of site or sites, the purchase or construction of any hospital buildings,
and of the supervision, care and custody of the grounds, rooms or
buildings purchased, constructed, leased or set apart for that purpose;
provided, that all moneys received for such hospital shall be credited to
the hospital and deposited into the depositary thereof for the sole use
of such hospital in accordance with the provisions of sections 205.160 to
205.340. All funds received by each such hospital shall be paid out only
upon warrants ordered drawn by the treasurer of the board of trustees of
said county upon the properly authenticated vouchers of the hospital
board.

4. The trustees shall have authority, both within and outside the county,
except in counties of the third or fourth classification (other than the
county in which the hospital is located) where there already exists a
hospital organized pursuant to chapters 96, 205 or 206, RSMo; provided
that this exception shall not prohibit the continuation of existing
activities otherwise allowed by law, to operate, maintain and manage a
hospital and hospital facilities, and to make and enter into contracts,
for the use, operation or management of a hospital or hospital
facilities; to engage in health care activities; to make and enter into
leases of equipment and real property, a hospital or hospital facilities,
as lessor or lessee, regardless of the duration of such lease; provided
that any lease of substantially all of the hospital, as the term
"hospital" is defined in section 197.020, RSMo, wherein the board of
trustees is lessor shall be entered into only with the approval of the
county commission wherein such hospital is located and provided that in a
county of the second, third or fourth classification, the income to such
county from such lease of substantially all of the hospital shall be
appropriated to provide health care services in the county; and further
to provide rules and regulations for the operation, management or use of
a hospital or hospital facilities. Any agreement entered into pursuant to
this subsection pertaining to the lease of the hospital, as herein
defined, 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 other subjects upon such terms and conditions as the parties may
agree. Notwithstanding any other law to the contrary, the county
commission in any noncharter county of the first classification wherein
such hospital is located may separately negotiate and enter into
contractual agreements with the lessee as a condition of approval of any
lease authorized pursuant to this subsection.

5. The board of hospital trustees shall have power to appoint a suitable
chief executive officer and necessary assistants and fix their
compensation, and shall also have power to remove such appointees; and
shall in general carry out the spirit and intent of sections 205.160 to
205.340 in establishing and maintaining a county public hospital.

6. The board of hospital trustees may establish and operate a day care
center to provide care exclusively for the children of the hospital's
employees. A day care center established by the board shall be licensed
pursuant to the provisions of sections 210.201 to 210.245, RSMo. The
operation of a day care center shall be paid for by fees or charges,
established by the board, and collected from the hospital employees who
use its services. The board, however, is authorized to receive any
private donations or grants from agencies of the federal government
intended for the support of the day care center.

7. The board of hospital trustees shall hold meetings at least once each
month, shall keep a complete record of all its proceedings; and three
members of the board shall constitute a quorum for the transaction of
business.

8. One of the trustees shall visit and examine the hospital at least
twice each month and the board shall, during the first week in January of
each year, file with the county commission of the county a report of its
proceedings with reference to such hospital and a statement of all
receipts and expenditures during the year; and shall at such time certify
the amount necessary to maintain and improve the hospital for the ensuing
year. (RSMo 1939 § 15195, A.L. 1945 p. 983 § 15194, A.L. 1961 p. 522,
A.L. 1981 S.B. 425, A.L. 1982 H.B. 1069, A.L. 1986 H.B. 1571, A.L. 1987
H.B. 810, A.L. 1996 S.B. 676, A.L. 1999 H.B. 796 merged with S.B. 276)

Prior revisions: 1929 § 13978; 1919 § 12612

Effective 5-13-99 (S.B. 276) 7-13-99 (H.B. 796)

The board of hospital trustees may also as part of their
compensation either through purchase of plans or through plans of
self-insurance provide for suitable retirement, health, life insurance,
and employment insurance plans for all hospital administrators and
employees, and the employer's cost of such plans shall be paid by the
treasurer of the board of hospital trustees in the same manner as other
expenses of the hospital are paid; provided that the board of hospital
trustees shall be taken and considered as a "political subdivision" as
the term is defined in section 70.600, RSMo, for the purposes of sections
70.600 to 70.755, RSMo. (L. 1971 S.B. 6, A.L. 1988 H.B. 1707)

1. The board of hospital trustees shall include in its bylaws
that every physician, a podiatrist and dentist requesting permission to
practice in its hospital shall submit an application for staff membership
in writing to it upon forms approved by the board. In his application
each applicant shall give specifically his training and qualifications,
his willingness to accept the board as the supreme governing authority of
the hospital, his willingness to abide by the bylaws of the board and the
staff in all respects, and his determination to practice his profession
in a manner which is legal, moral, and ethical. A written copy of all
such bylaws, with any amendments, shall be kept on file in the office of
the hospital administrator and shall be available to all staff members
and applicants during normal business hours.

2. The professional staff of the hospital shall be an organized group
which shall initiate and, with the approval of the board, adopt bylaws,
rules, regulations, and policies governing professional activities in the
hospital. General practitioners may practice in the hospital in
accordance with their competence as recommended by the professional staff
and as authorized by the board. (L. 1971 H.B. 301)

1. Except in counties operating under the charter form of
government, the county commission in any county wherein a public hospital
shall have been established as provided in sections 205.160 to 205.340
shall levy annually a rate of taxation on all property subject to its
taxing powers in excess of the rates levied for other county purposes to
defray the amount required for the maintenance and improvement of such
public hospital and for constructing and furnishing necessary additions
thereto, as certified to it by the board of trustees of the hospital; the
tax levied for such purpose shall not be in excess of one dollar on the
one hundred dollars assessed valuation. The funds arising from the tax
levied for such purpose shall be used for the purpose for which the tax
was levied and none other.

2. Any funds of the hospital, whether derived from the tax authorized by
this section or from the operation of the hospital, and whether collected
before or after October 13, 1965, may be used for constructing and
furnishing necessary additions to the hospital.

3. For any ballot proposal in which the maximum levy exceeds fifty cents
per one hundred dollars of assessed valuation, the board of trustees
shall publish in a newspaper or newspapers of general circulation and
otherwise make available upon request a summary description of the
board's plans for using the money for ongoing hospital operations. (RSMo
1939 § 15195, A.L. 1945 p. 983, A.L. 1951 p. 776, A.L. 1965 p. 348, A.L.
1984 S.B. 576, A.L. 1999 S.B. 348)

Prior revisions: 1929 § 13978; 1919 § 12612

The governing body in all counties of the first class having a
charter form of government, in addition to the power to levy taxes for
county purposes as otherwise provided by law, shall have the power to
levy upon all real and tangible personal property in the county an annual
tax in an amount not to exceed thirty-eight cents on each one hundred
dollars valuation for the purpose of operating, maintaining or supporting
a public county hospital or public hospital system or for the maintenance
of county patients in state institutions, public hospitals, or other
hospitals and for the purpose of operating or maintaining a public county
health center or institution and conducting public health programs. The
proceeds of the tax shall be used for such purposes and for no other
purposes, and no funds from the general revenue of the county shall
hereafter be appropriated for such purposes. (L. 1945 p. 986 § 1, A.L.
1947 V. II p. 251, A.L. 1951 p. 778, A.L. 1959 H.B. 325, A.L. 1961 p.
524, A.L. 1972 S.B. 559)

The rate of tax levy provided for in sections 205.200 and
205.210 shall be determined and fixed at the same time the rate of tax is
determined and fixed for county purposes. (L. 1945 p. 986 § 2, A.L. 1961
p. 521)

In counties exercising the rights conferred by sections 205.160
to 205.340, the county commission may appropriate each year, in addition
to tax for hospital fund herein provided for, not exceeding five percent
of its general fund for the improvement and maintenance of any public
hospital so established. (RSMo 1939 § 15201)

Prior revisions: 1929 § 13984; 1919 § 12618

If the board of hospital trustees and the owners of any property
desired by them for hospital purposes cannot agree as to the price to be
paid therefor, they shall report the facts to the county commission, and
condemnation proceedings shall be instituted by the county commission and
prosecuted in the name of the county wherein such public hospital is to
be located by the county attorney for such county. (RSMo 1939 § 15198)

Prior revisions: 1929 § 13981; 1919 § 12615

No hospital buildings shall be erected or constructed until the
plans and specifications have been made therefor and adopted by the board
of hospital trustees, and bids advertised for according to law for other
county public buildings. (RSMo 1939 § 15199)

Prior revisions: 1929 § 13982; 1919 § 12616

The jurisdiction of the city, town or village in or near which
such public hospital is located shall extend over all lands used for
hospital purposes outside the corporate limits if so located, and all
ordinances of such cities and towns shall be in full force and effect in
and over the territory occupied by such public hospital. (RSMo 1939 §
15200)

Prior revisions: 1929 § 13983; 1919 § 12617

Every hospital established under sections 205.160 to 205.340
shall be for the benefit of the inhabitants of such county and of any
person falling sick or being injured or maimed within its limits, but
every such inhabitant or person who is not a pauper shall pay to such
board of hospital trustees or such officer as it shall designate for such
county public hospital, a reasonable compensation for occupancy, nursing,
care, medicine, or attendants, according to the rules and regulations
prescribed by said board, such hospital always being subject to such
reasonable rules and regulations as said board may adopt in order to
render the use of said hospital of the greatest benefit to the greatest
number; and said board may exclude from the use of such hospital any and
all inhabitants and persons who shall willfully violate such rules and
regulations. And said board may extend the privileges and use of such
hospital to persons residing outside of such county, upon such terms and
conditions as said board may from time to time by its rules and
regulations prescribe. (RSMo 1939 § 15202)

Prior revisions: 1929 § 13985; 1919 § 12619

When such hospital is established the physicians, nurses,
attendants, the persons sick therein and all persons approaching or
coming within the limits of same, and all furniture and other articles
used or brought there shall be subject to such rules and regulations as
said board may prescribe. (RSMo 1939 § 15203)

Prior revisions: 1929 § 13986; 1919 § 12620

Any person or persons, firm, organization, corporation or
society desiring to make donations of money, personal property or real
estate for the benefit of such hospital, shall have the right to vest
title of the money or real estate so donated in said county, to be
controlled, when accepted, by the board of hospital trustees according to
the terms of the deed, gift, devise or bequest of such property. (RSMo
1939 § 15204)

Prior revisions: 1929 § 13987; 1919 § 12621

1. In the management of such public hospital no discrimination
shall be made against practitioners of any school of medicine recognized
by the laws of Missouri, and all such legal practitioners shall have
equal privileges in treating patients in said hospital.

2. The patient shall have the absolute right to employ at his or her own
expense his or her own physician, and when acting for any patient in such
hospital the physician employed by such patient shall have exclusive
charge of the care and treatment of such patient, and nurses therein
shall as to such patient be subject to the directions of such physician;
subject always to such general rules and regulations as shall be
established by the board of trustees under the provisions of sections
205.160 to 205.340. (RSMo 1939 § 15205)

Prior revisions: 1929 § 13988; 1919 § 12622

(1953) Osteopathic physicians and surgeons held to be practitioners of a
school of medicine and physicians and surgeons within the meaning of the
Missouri statutes and, therefore, a rule of a county hospital prohibiting
such osteopathic physicians and surgeons from practicing within such
hospital is unreasonable and in violation of the law. Stribling v. Jolley
(A.), 253 S.W.2d 519.

The board of trustees of such county public hospital may
establish and maintain in connection therewith and as a part of said
public hospital a training school for nurses. (RSMo 1939 § 15206)

Prior revisions: 1929 § 13989; 1919 § 12623

The board of trustees shall provide a suitable room for the
detention and examination of all persons who are brought before the
probate division of the circuit court of such county for incapacity or
disability proceedings, if such hospital is located at the county seat.
(RSMo 1939 § 15207, A. 1949 S.B. 1061, A.L. 1978 H.B. 1634, A.L. 1983
S.B. 44 & 45)

Prior revisions: 1929 § 13990; 1919 § 12624

The board of hospital trustees shall have power to determine
whether or not patients presented at said public hospital for treatment
are subjects for charity, and shall fix such price for compensation for
patients, other than those unable to assist themselves, as the said board
deems proper, the receipts therefor to be paid to the treasurer of said
county and credited by him to the hospital fund. (RSMo 1939 § 15208)

Prior revisions: 1929 § 13991; 1919 § 12625

The county commission of any county, where no suitable provision
has been made for the care of its indigent tuberculous residents, may
contract with the board of hospital trustees of any public hospital for
the care of such persons in the sanatorium department of said hospital,
upon such reasonable terms as may be agreed upon. (RSMo 1939 § 15209)

Prior revisions: 1929 § 13992; 1919 § 12626

The county commission of any county in this state is hereby
authorized to purchase, not exceeding one hundred and sixty acres of
land, and locate, build and maintain thereon a county hospital. Bonds may
be issued therefor in accordance with the general law governing the
issuance of bonds by counties. (RSMo 1939 § 15157, A.L. 1945 p. 980)

Prior revisions: 1929 § 13941; 1919 § 12217; 1909 § 1351

1. The county commission of any second class county having a
population of at least one hundred thousand and which operates a county
hospital may call a nonbinding preference election to determine the
wishes of the voters of the county as to whether the county hospital is
to be sold. If called by the commission, the election shall be held on
the primary or general election day in 1986.

2. The election shall be conducted by the election authority of the
county in the same manner and in all other respects as in elections for
state and county offices. The results of the election shall be certified
by the county commission. The costs of the election shall be paid and
notice shall be given as otherwise provided by law.

3. The proposition shall be submitted in the following form:

Shall the county commission sell the county hospital?

YES

NO. (L. 1986 H.B. 1471, et al. §§ 3 to 5 merged with S.B. 553 & 775 §§ 2
to 4)

Effective 5-15-86 (S.B. 553 & 775) 6-9-86 (H.B. 1471, et al.)

Whenever a county hospital is established and built by the
county commission, as provided in section 205.350, it shall be the duty
of such county commission to place therein all of the poor persons that
the county commission shall deem proper to place in said county hospital,
who shall be kept there and treated. (RSMo 1939 § 15158)

Prior revisions: 1929 § 13942; 1919 § 12218; 1909 § 1352

The county commission of any such county shall make all rules
and regulations for the government of such a hospital, appoint and employ
such officers and attendants as in their judgment may be proper,
prescribe their duties and fix their compensation. The expenses of
maintaining such hospital, including the compensation of officers and
employees thereof, shall be paid out of the general revenue fund of such
counties, or from the same sources as are provided by law for caring for
the poor by counties. (RSMo 1939 § 15159)

Prior revisions: 1929 § 13943; 1919 § 12219; 1909 § 1353

1. In addition to the bonds authorized by section 205.375, the
county commission in any county, or the township board of any township,
exercising the rights conferred by section 205.375, may issue and sell
revenue bonds for the purpose of providing funds for the acquisition,
construction, equipment, improvement, extension and repair, and
furnishing of nursing homes and related facilities, and of providing a
site therefor, including offstreet parking space for motor vehicles. Such
revenue bonds shall be payable, both as to principal and interest, solely
from the net income and revenues arising from the operation of the
nursing home or the related facility or facilities, or of the nursing
home and the related facility or facilities, after providing for the
costs of operation and maintenance thereof, or from other funds made
available from sources other than from proceeds of taxation.

2. Any bonds issued under the provisions of sections 205.371 to 205.373
shall not be deemed to be an indebtedness of the state of Missouri or of
any county or township, or of the board of trustees of any such nursing
home, or of the individual members of any such board of trustees, and
shall not be deemed to be an indebtedness within the meaning of any
constitutional or statutory limitation upon the incurring of
indebtedness. (L. 1978 H.B. 1769 § 205.990)

1. Revenue bonds issued pursuant to the provisions of sections
205.371 to 205.373 shall be of such denomination, shall bear such rate or
rates of interest not to exceed the highest rate permitted by law, and
shall mature at such time or times, not exceeding thirty-five years from
their date of issue, as determined by the county commission or township
board in its order or resolution directing the issuance of such bonds.
Such bonds may be either serial bonds or term bonds and may be issued
with or without reservation of the right to call them for payment or
redemption in advance of their maturity, upon the giving of notice, and
with or without a covenant requiring the payment of a premium in the
event of a call for redemption prior to maturity.

2. The bonds when issued and sold shall be negotiable instruments within
the meaning of chapter 400, RSMo, and the interest thereon shall be
exempt from any state or local income taxes under the laws of the state
of Missouri. (L. 1978 H.B. 1769 § 205.991)

*No continuity with § 205.372 transferred 1978 to § 205.374.

1. The county commission or township board issuing bonds under
the provisions of sections 205.371 to 205.373 shall prescribe the form,
details and incidents of the bonds, and the county commission or township
board shall make such covenants as in its judgment are advisable or
necessary properly to secure the payment thereof; but the form, details,
incidents, and covenants shall not be inconsistent with any of the
provisions of sections 205.371 to 205.373.

2. The holder of any bonds issued hereunder or of any coupons
representing interest accrued thereon may, by civil action, compel the
county commission or township board issuing such bonds to perform all
duties imposed upon it by the provisions of sections 205.371 to 205.373
and to enforce the performance of any and all of the covenants made by
the county commission or township board in the issuance of the bonds.

3. The provisions of sections 205.371 to 205.373 shall not be exclusive
of other legal methods of financing nursing homes and related facilities,
but shall furnish an alternative method of finance. (L. 1978 H.B. 1769 §
205.992)

1. Upon filing with the county clerk of a resolution adopted by
the board of hospital trustees to sell the county hospital property, both
real and personal, for reasons specified in the resolution, the clerk
shall present the resolution to the commissioners of the county
commission. If the commissioners of the county commission determine that
sale of the hospital property is desirable, the commission shall, by
order, appoint an agent to sell and dispose of such property in the
manner provided for sale of other county property. The deed of the agent,
under the agent's proper hand and seal, for and in behalf of the county,
duly acknowledged and recorded, shall be sufficient to convey to the
purchaser all the right, title, interest and estate which the county has
in the property.

2. The proceeds from the sale of the property shall be applied to the
payment of any interest and principal of any outstanding valid
indebtedness of the county incurred for purchase of the site or
construction of the hospital, or for any repairs, alterations,
improvements, or additions thereto, or for operation of the hospital. If
the proceeds from the sale of the hospital property, and any interest
thereon, are, or will be, insufficient to pay the interest and principal
of any valid outstanding bonded indebtedness as they fall due, the county
commission shall continue to provide for the collection of an annual tax
on all taxable tangible property in the county sufficient to pay the
interest and principal of the indebtedness as it falls due and to retire
the bonds within the time required therein.

3. In a county of the first classification, any balance of the proceeds
from the sale of the county hospital remaining after all indebtedness
incurred in connection with the hospital is paid shall be placed to the
credit of the general fund of the county. In a county of the second,
third or fourth classification:

(1) Any balance of the proceeds from the sale of the county hospital
pursuant to subsection 2 of this section shall be used to provide health
care services in the county; and

(2) Assets donated to a county hospital pursuant to section 205.290 shall
be used to provide health care services in the county, except as
otherwise prescribed by the terms of the deed, gift, devise or bequest.
(L. 1975 S.B. 74, A.L. 1986 H.B. 1554 Revision, A.L. 1999 H.B. 796 merged
with S.B. 276)

*Transferred 1978; formerly 205.372

Effective 5-13-99 (S.B. 276) 7-13-99 (H.B. 796)

1. For the purposes of this section "nursing home" means a
residential care facility I, a residential care facility II, an
intermediate care facility, or a skilled nursing facility as defined in
section 198.006, RSMo:

(1) Which is operated in connection with a hospital, or

(2) In which such nursing care and medical services are prescribed by, or
are performed under the general direction of, persons licensed to
practice medicine or surgery in the state.

2. The county commission of any county or the township board of any
township may acquire land to be used as sites for, construct and equip
nursing homes and may contract for materials, supplies, and services
necessary to carry out such purposes.

3. For the purpose of providing funds for the construction and equipment
of nursing homes the county commissions or township boards may issue
bonds as authorized by the general law governing the incurring of
indebtedness by counties; provided, however, that no such tax shall be
levied upon property which is within a nursing home district as provided
in chapter 198, RSMo, and is taxed for nursing home purposes under the
provisions of that chapter, or may provide for the issuance and payment
of revenue bonds in the manner provided by and in all respects subject to
chapter 176, RSMo, which provides for the issuance of revenue bonds of
state educational institutions.

4. The county commissions or township boards may provide for the leasing
and renting of the nursing homes and equipment on the terms and
conditions that are necessary and proper to any person, firm, corporation
or to any nonprofit organizations for the purpose of operation in the
manner provided in subsection 1 of this section. (L. 1957 p. 689 §§ 1, 2,
3, 4, A.L. 1959 S.B. 252, A.L. 1969 p. 327, A.L. 1971 S.B. 163, A.L. 1978
H.B. 1036, A.L. 1986 H.B. 1563)

(1971) The submission of a bond issue with a portion to be spent for
hospital expansion and a portion to be spent for nursing home facilities
on the hospital grounds as a single submission forms one proposition and
does not constitute "doubleness". State ex rel. Phelps County v. Holman
(Mo.), 461 S.W.2d 689.

1. The county commission of any county having a nursing home
erected under the provisions of section 205.375 may order the conveyance
of the county nursing home and appurtenant property and facilities
necessary for the operation thereof to any nursing home district formed
under the provisions of law that is wholly located within the county. If
the commissioners of the county commission agree to accept the
consideration offered by the nursing home district for the county nursing
home property, both real and personal, the commission, by order, shall
appoint an agent to convey the property. The agent shall not convey the
property unless:

(1) The instrument of conveyance contains a provision prohibiting the
nursing home district from refusing to admit residents of the county
conveying the property solely on the basis that they are not residents of
the district; and

(2) The instrument of conveyance contains a provision that the board of
directors of the nursing home district will perform all duties imposed by
law on the governing body of the county nursing home and all covenants
the governing body of the county nursing home made to secure issuance of
any bonds outstanding at the time the nursing home is conveyed. The deed
of the agent, under his proper hand and seal, for and in behalf of the
county, duly acknowledged and recorded, conveys to the nursing home
district all the right, title, interest and estate which the county has
in property.

2. The consideration to be received by the county for conveyance of the
property may consist exclusively of the assumption of any outstanding
valid indebtedness against the facility, or any bond issued for the
construction or operation thereof, in the discretion of the county
commission.

3. The consideration received by the county for conveying the nursing
home property to the nursing home district shall be applied to the
payment of any interest and principal of any outstanding valid
indebtedness of the county incurred for purchase of the site or
construction of the nursing home, or for any repairs, alterations,
improvements, or additions thereto, or for operation of the nursing home.
If the consideration received by the county for conveying the nursing
home property, and any interest thereon, is, or will be, insufficient to
pay the interest and principal of any valid outstanding bonded
indebtedness as they fall due, the county commission shall continue to
provide for the collection of an annual tax on all taxable tangible
property in the county sufficient to pay the interest and principal of
the indebtedness as it falls due and to retire the bonds within the time
required therein.

4. Any balance of the consideration received by the county for conveying
the nursing home property which remains after all indebtedness incurred
in connection with the nursing home is paid shall be placed to the credit
of the general fund of the county.

5. The holder of any revenue bond issued to finance the erection, site
acquisition or any repair, alteration, improvement or addition to the
county nursing home or for the operation of the home prior to its
conveyance to the nursing home district, or any coupons representing
interest thereon, may, by proper civil action, compel the board of
directors of the nursing home district to perform all duties imposed by
law and to enforce the performance of any other covenants made by the
board of directors of the nursing home district or the governing body of
the county nursing home in the issuance of the bonds. (L. 1978 H.B. 1036
§ 2)

Every inmate in a public institution in all counties of the
first class not having a charter form of government, except those
incarcerated in a jail, correctional or penal institution, who is not a
pauper, shall pay to such county a reasonable compensation for occupancy,
nursing care, medicine or attendance, in such amount as determined by the
county commission, provided that it shall be lawful for such county, to
which such person shall become chargeable, to sue for and receive any
real or personal estate and take charge and dispose of any personal
property belonging to such person and apply the proceeds, or so much
thereof, as is necessary to defray the cost of support and maintenance of
such person. (L. 1965 p. 349 § 1)

1. Notwithstanding the provisions of any of the sections of
chapter 56, RSMo, the board of trustees of a county hospital organized
and existing pursuant to the provisions of sections 205.160 through
205.378, may employ and use legal counsel, other than the prosecuting or
circuit attorney or the county counselor, to represent such hospital when
in the exercise of its sole discretion the board of trustees determines
that such special counsel is necessary to properly protect the hospital's
interests.

2. Legal counsel so employed shall be paid out of the hospital fund in
the manner provided in subsection 4 of section 205.190. (L. 1977 H.B. 378
§§ 1, 2)

The several counties of this state are hereby authorized to
purchase land, and locate, build, equip, and maintain thereon a
tuberculosis hospital and dispensary. Bonds may be issued therefor in
accordance with the general law governing the issuance of bonds by
counties. (L. 1945 p. 981 § 15172)

1. The county commission shall appoint five persons who shall
constitute a board to be known as "The Board of Tuberculosis Hospital
Commissioners". A majority of said board shall constitute a quorum and
shall be authorized to transact the business of the board.

2. Said board shall have exclusive control of all moneys collected to the
credit of the tuberculosis hospital fund, and of the supervision, care
and custody of such hospital, and all moneys received for such hospital
purposes, whether by sale of said bonds or by an appropriation from the
taxes collected annually in each county for the maintenance and support
of said hospital, or from any other source, shall be turned over to the
treasurer of said board, and shall be duly accounted for in monthly and
annual reports made to said board, a copy of which shall be filed with
the clerk of the county commission. The board of tuberculosis hospital
commissioners shall serve without compensation except actual traveling
and incidental expenses incurred in the performance of their duties.

3. They shall have resided in such county for at least three years prior
to their appointment, shall be known for their intelligence, business
qualifications and integrity, and shall be especially interested in the
purposes of said hospital, either because of scientific knowledge in the
prevention of tuberculosis or because of their beneficent attitude toward
those afflicted with tuberculosis, and shall be selected without regard
to their political affiliations, and not fewer than two of them shall be
women nor fewer than two of them shall be men.

4. The board of tuberculosis hospital commissioners first appointed shall
serve respectively for one, two, three, four and five years from the date
of their appointment, and the term of each shall be fixed by the order of
the county commission appointing them, and all such board of tuberculosis
hospital commissioners after the first appointment shall be appointed for
the full term of five years, except that in case of a vacancy, occurring
from death, resignation, removal from the county or removal for cause, a
board of tuberculosis hospital commissioner shall be appointed to fill
the remainder of said term.

5. The board of tuberculosis hospital commissioners shall meet within
sixty days after the date of appointment, and shall elect one of their
number to be chairman of said board, another to be vice chairman and
another to be secretary, for a period of one year, and thereafter
annually said officers shall be elected by said board. Said board shall
annually elect a treasurer who shall not be a member thereof, and shall
require him to give a bond, to be approved by the prosecuting attorney of
the county and by the county commission, in a sufficient sum to secure
the faithful keeping and accounting for of all moneys which may come into
his hand, and shall fix his compensation for the services to be rendered.

6. Said board of tuberculosis hospital commissioners shall have power and
it shall be its duty to administer all affairs pertaining to the
maintenance of said tuberculosis hospital and dispensary, including the
control and direction of all officers and employees of said hospital and
dispensary and to establish the rules and regulations for the control and
restraint of all patients of such hospital and dispensary and otherwise
to perform all acts needful for the proper execution of the powers and
duties granted and imposed upon said board by the provisions of sections
205.380 to 205.450. Said board shall have power to employ a
superintendent, or a superintending physician, or a superintending nurse,
and such other nurses and employees as it deems necessary for the proper
care of the hospital and its inmates and shall fix their respective
salaries and compensation, but all expenses for such employees and the
necessary maintenance of such hospital to be incurred or paid shall be
kept within the limits of the annual income of said hospital.

7. All nurses so employed shall be lawfully licensed or registered
according to the laws of the state. Any such employee may be removed by
said board at any time if in its judgment such removal will promote the
economic administration or best interests of said hospital, preference
being given to nurses who have had training in a public tuberculosis
hospital or sanatorium.

8. Said board shall also have power to prescribe rules and regulations
for the sanitation, disinfection and healthful conditions of said
hospital, and the kind of clothes to be worn by the inmates and
attendants and the foods to be eaten by said inmates, and make other
regulations pertaining to fresh air and healthful surroundings as to them
may seem most helpful to the treatment of tuberculosis patients.

9. No expense or debt of any kind shall be incurred by the superintendent
or any nurse or employee of said hospital except upon the authority of
said board, and said board shall require the superintendent or some other
employee to keep a faithful account of all expenses of every kind
incurred in the maintenance of said hospital.

10. Said board shall make an annual report to the state department of
social services, showing the number of patients or inmates in said
hospital and the manner of caring for and treating them, and any other
beneficial information, and such state department of social services
shall furnish to said hospital board any beneficial or scientific
information it may consider would be helpful to such hospital board in
conducting same.

11. The said board shall establish an office in its county where all
records, papers and documents of such board shall be kept open for public
inspection during all reasonable hours, to be fixed by said board. It
shall hold a regular meeting on the first Monday of each month, in the
office so established, except that by unanimous consent said board may
meet at any place in the county and without notice, and transact any such
business as may be transacted at any regular meeting. The board shall
also hold an annual meeting the first Monday of January of each year, and
at said time require an annual certified report to be made to the county
commission and to the governor of the state, embracing a full statement
of the number of patients of all kinds, the amount of moneys received
within the preceding year, and from what sources, and how expended, and
especially the number of charity patients and the moneys received from
the state and from the county therefor. (RSMo 1939 § 15173, A.L. 1945 p.
981, A.L. 1986 H.B. 1554 Revision)

Prior revisions: 1929 § 13957; 1919 § 12592

Just compensation shall be paid for all property taken for the
establishment of such hospital and the improvements or additions thereto.
When the board of tuberculosis hospital commissioners and the owner of
any land or other property desired for the uses of said hospital cannot
agree upon the price thereof, the same may be condemned in the manner
prescribed by chapter 523, RSMo. In case there shall be located upon any
land acquired by said board, either by purchase or condemnation, any
building or other improvements not suited for hospital purposes, the
tuberculosis hospital board shall have power to sell the same and the
proceeds thereof shall be turned over to the treasurer of said board.
(RSMo 1939 § 15176)

Prior revisions: 1929 § 13960; 1919 § 12595

1. The county commission of any county in which a tuberculosis
hospital has been established is hereby authorized to receive and to hold
in trust for the board of tuberculosis hospital commissioners of such
hospital any grant or devise of land or any gift or bequest of money or
other personal property, as an endowment of such hospital, and if money,
or if other personal property, to convert the same into money, and to
loan the same at the best rate of interest obtainable, regard being had
for the safekeeping and permanency of said fund, and to turn over the net
annual income from any such real estate or from any money loaned, to said
hospital board; or if advisable, to sell any such real estate and convert
the same into money and loan it as aforesaid, or if not sold to authorize
said board to rent or lease the same and receive the income therefrom. In
case of sale of any real estate so given or devised a complete conveyance
thereof may be made by an order spread upon the records of the county
commission and a deed signed in pursuance thereto by the presiding
commissioner and attested by the county clerk.

2. Any such real estate or personal property so given shall be used
inviolate for the purposes of said hospital, unless otherwise designated
in writing by the donor. (RSMo 1939 § 15180)

Prior revisions: 1929 § 13964; 1919 § 12598

1. Any person who shall be a resident of any county which has
erected and is maintaining a hospital under the provisions of sections
205.380 to 205.450, shall be eligible as a patient or inmate of said
hospital, providing that said person shall have been declared tuberculous
and in a relatively advanced state of tuberculosis, by the county health
officer or by a physician licensed by this state, resident within the
county.

2. Said board of commissioners shall have the power to determine whether
or not the person applying or being presented at such hospital for
treatment as a patient is a subject of charity, and it shall fix such a
price or compensation for the keeping and all services to be rendered to
patients other than those declared subjects of charity by said board, the
receipts therefrom to be paid monthly to the treasurer of the board upon
accounts rendered and credited to the hospital fund, and shall be
available for use in the maintenance and repair of such hospital.

3. The board may also admit tuberculous persons residing outside of the
county anywhere within the state on the payment of a monthly compensation
to be fixed by said board, and all moneys so obtained shall be applied as
in the case of other pay patients. (RSMo 1939 § 15177)

Prior revisions: 1929 § 13961; 1919 § 12596

1. The state of Missouri shall pay twenty-five dollars per day
each for the support of all patients admitted to the hospital and
maintained therein and who have been designated by the board of
tuberculosis hospital commissioners as subjects of charity, but no
payment shall be made by the state for such patients for whom the
hospital receives a reasonable reimbursement of the costs of care and
maintenance from private or federal sources. All costs for the
maintenance of charity patients in excess of twenty-five dollars per day
shall be paid by the county from its current revenue, upon orders or
vouchers rendered to the county commission by the hospital board.

2. All patients of the hospital who are not subjects of charity shall pay
such sum for their support and maintenance as they are able to pay as
determined by the judgment of the board, and the state of Missouri shall
pay such additional amount as may be necessary to compensate the board
for their support and maintenance, but not to exceed the sum of
twenty-five dollars per day per patient.

3. The general assembly shall at each annual session make an
appropriation out of the general revenue fund of the state sufficient in
amount to meet its obligations to any county hospital as herein
designated.

4. The chairman and secretary of the board of tuberculosis hospital
commissioners shall make report to the treasurer of the board once per
month, giving the names and number of patients in such hospital and
indicating which patients are subjects of charity and the amount
necessary for the state to pay. The treasurer of the board shall issue a
voucher to the commissioner of administration giving this information,
and a warrant shall be issued on the state treasurer for the amount shown
by the statement. The state treasurer shall pay the warrant to the
treasurer of the board of tuberculosis hospital commissioners. The county
commission in any county in which such a hospital shall be established
shall authorize and issue the warrant of the county payable out of the
current revenue of the county, in favor of the treasurer of the board,
for payment of the costs of all charity patients kept and treated herein,
in excess of twenty-five dollars per day as herein provided, upon a like
voucher presented to the commission by the treasurer of the tuberculosis
hospital.

5. Every such hospital shall, so long as the state pays not less than
twenty-five dollars per day per patient for the support of charity
patients therein, receive patients from any county in this state, in
which case every such county shall pay to the hospital the difference
between the sum of twenty-five dollars per day per patient and the cost
of the care and support of the patient in the hospital; such cost shall
not exceed the per capita cost for the year next preceding, for the care
and support of patients in the rehabilitation center at Mt. Vernon. This
shall supersede any municipal ordinance giving preference to residents of
the respective cities in which the same are located.

6. The state shall pay eight dollars per week each for the follow-up
examination and treatment, including drugs of charity patients released
on an outpatient basis. (RSMo 1939 § 15178, A. 1949 S.B. 1061, A.L. 1951
p. 752, A.L. 1955 p. 673, A.L. 1965 p. 349, A.L. 1967 1st Ex. Sess. p.
898, A.L. 1975 H.B. 32)

Prior revisions: 1929 § 13962; 1919 § 12597

That the department of social services be, and is, hereby
authorized and empowered to purchase from the board of tuberculosis
hospital commissioners of any county of this state, wherein a
tuberculosis hospital may now or hereafter have been erected and operated
continuously under sections 205.380 to 205.450 for a period of more than
five years, all right, title, and interest of said board of said
tuberculosis hospital commissioners and of the county so erecting and
operating such tuberculosis hospital, in and to the buildings, equipment
and land constituting the site of such hospital, at and for the nominal
consideration of one dollar, and the board of tuberculosis hospital
commissioners of every such county is hereby authorized and empowered to
convey title to such hospital buildings, equipment and site, to said
department of social services, for and in consideration of the said sum
of one dollar, same to be in full payment of the purchase price of said
property; provided, that no such sale shall be made unless the same shall
first have been authorized and directed by an order of the county
commission of such county duly made and entered of record; and provided
further, that whenever any such hospital shall be purchased by the
department of social services as herein authorized, the conduct and
management of said hospital shall thereafter be governed by the
provisions of chapter 199, RSMo. (RSMo 1939 § 15179)

Prior revision: 1929 § 13963

1. All tuberculosis hospitals owned and operated by any city
under special charter or by any city organized and operating under a
constitutional charter shall receive the same support for charity
patients and for patients able to pay only part of the total cost for
their support and maintenance therein as is now provided for patients in
county tuberculosis hospitals under the provisions of sections 205.380 to
205.450.

2. The director of the department of public health of the city shall make
a report to the city treasurer once per month giving the names,
addresses, and hospital numbers of such patients in the hospital and the
amount necessary for the state to pay.

3. The city treasurer shall issue a voucher to the commissioner of
administration giving this information and a warrant shall be issued on
the state treasurer for the amount shown by the statement and the state
treasurer shall pay the warrant to the treasurer of the city, who shall
deposit and credit the same to the credit of the hospital for the support
of such patients, and for no other purpose.

4. Every such hospital, so long as the state shall pay not less than
fifteen dollars per day per patient for the support of charity patients
therein, shall receive patients from any county in this state, in which
case every such county shall pay to the hospital the difference between
the sum of fifteen dollars per day per patient and the cost of the care
and support of such patient in the hospital, such cost not to exceed the
per capita cost, for the year next preceding, for the care and support of
patients in the state rehabilitation center at Mt. Vernon. (RSMo 1939 §
15181, A. 1949 S.B. 1061, A.L. 1965 p. 349, A.L. 1967 1st Ex. Sess. p.
898)

1. When twenty-five percent of the voters in any township or
townships in this state, forty percent of whom shall not live at the time
they subscribe thereto within any town of said township or townships
shall petition the county commission of the county of which said township
or townships is a part, asking that a tax not to exceed one-half of one
cent on each dollar be levied for one year only and thereafter an annual
tax not to exceed two mills on the dollar for the establishing, either by
purchase or otherwise or leasing, equipping and maintaining a hospital at
some place in such township or townships to be set forth in said
petition, for the care and treatment of the sick and disabled therein,
such county commission shall submit the question to the voters at an
election.

2. The question shall be submitted in substantially the following form:

Shall there be a ..... tax for the first year and a .... tax thereafter
for a hospital?

3. The notice shall include the rate of taxation to be voted upon. If
two-thirds of the voters of each township voting on said proposition
shall vote for such tax, the said tax specified in such notice shall be
levied and collected in like manner as other general taxes of said
township or townships and be known as "Hospital Fund" and turned over by
the collector of said tax to the treasurer of such hospital. The tax
shall cease in case the voters in such township or townships by a
two-thirds vote of the total vote cast at a municipal election held
therein shall so determine. (RSMo 1939 § 15210, A.L. 1978 H.B. 971)

Prior revision: 1929 § 13993

When any such township or townships shall decide to establish
and maintain a hospital under the provisions of sections 205.460 to
205.570, the county commission of such county of which said township or
townships is a part shall appoint a board of six trustees for the same,
chosen from the voters of such township or townships. Such trustees shall
serve without compensation. Such trustees appointed under the provisions
of sections 205.460 to 205.570 shall hold office respectively for the
term of two and four years as indicated and fixed in the order of the
county commission appointing them. Every two years thereafter three
trustees shall be elected at the municipal election who shall hold their
office for the term of four years and until their successors are elected.
(RSMo 1939 § 15211, A.L. 1978 H.B. 971)

Prior revision: 1929 § 13994

If a vacancy occurs in the office of director by death,
resignation, refusal to serve, repeated neglect of duty or removal from
the district of such hospital, the remaining trustees shall, before
transacting any official business, appoint some suitable person to fill
such vacancy; the person appointed shall serve until the next municipal
election. (RSMo 1939 § 15212, A.L. 1978 H.B. 971)

Prior revision: 1929 § 13995

The members of said board shall meet at some place to be agreed
upon by the trustees appointed within ten days after their appointments
have been made and organize by electing one of their members president,
and one vice president, a treasurer and a secretary which position they
shall hold for two years. They shall elect such other officers as they
deem necessary. They shall make and adopt such bylaws, rules and
regulations for the management of such hospitals and the admission and
discharge of patients as they shall deem expedient. A majority of the
board shall constitute a quorum for business. (RSMo 1939 § 15213)

Prior revision: 1929 § 13996

The treasurer, before entering upon the discharge of his duties
as such, shall enter into a bond to the hospital, with two or more
sureties, to be approved by the board, conditioned that he will render a
faithful and just account of all money that may come into his hands as
such treasurer, and otherwise perform the duties of his office according
to law, said bond to be filed with the president of the board. (RSMo 1939
§ 15214)

Prior revision: 1929 § 13997

1. The secretary may or may not be a member of the board and
shall draw such salary as the trustees shall agree upon. He shall keep a
record of all the proceedings of said board which shall be open at all
times to public scrutiny. The secretary shall keep a record of all money
or property received from all sources and of all expenditures therefrom,
also a complete record of all patients treated therein.

2. The treasurer shall receive an annual salary of one dollar. (RSMo 1939
§ 15215)

Prior revision: 1929 § 13998

The board shall control the expenditures of all moneys collected
to the credit of the hospital fund, and the construction, leasing,
equipping of such hospital and the grounds and other property real and
personal belonging to such hospital, providing all moneys from taxes,
donations and from any other source shall be deposited in the hospital
treasury, and drawn upon by warrants signed by the president and
secretary of hospital. The board shall also employ such help,
professional and otherwise, as may be necessary to carry out the spirit
and intent of sections 205.460 to 205.570, and all such assistants and
employees shall serve at the pleasure of the board. (RSMo 1939 § 15216)

Prior revision: 1929 § 13999

The board shall meet every Monday to look after the business of
the hospital. They shall make on the first day of January and the first
day of July of each year a detailed report, showing the receipts of all
funds and the expenditures therefrom, and showing each donation, giving
the name of the donor, and the date and amount of his donation, and the
name of each patient and the amount paid by said patient. Said report
shall be made and placed on the secretary's book and a copy posted in the
office of the hospital. (RSMo 1939 § 15217)

Prior revision: 1929 § 14000

Any person making bequests or donations to such hospital shall
have the right to vest the title to the real estate or personal property
so bequeathed or donated in the board and to be held and controlled by
said board, and to all such property the board shall be held to be
special trustees. (RSMo 1939 § 15218)

Prior revision: 1929 § 14001

The taxes authorized and provided by the terms of sections
205.460 to 205.570 shall be levied against the township or townships
forming the hospital district and collected in the same manner as the
regular township taxes are levied and collected. (RSMo 1939 § 15219)

Prior revision: 1929 § 14002

When two-thirds of the voters as provided in section 205.460
shall vote to cease paying said tax the county commission of said county
shall within three years thereafter order the same sold and all money
acquired from the sale after paying all indebtedness of said hospital
shall be turned into the school funds of said township or townships as
their interest may appear; provided, the voters of said township or
townships do not, by a vote of two-thirds reconsider and vote to continue
said tax as before. (RSMo 1939 § 15220)

Prior revision: 1929 § 14003

The department of social services may, subject to appropriation,
use, administer and dispose of any gifts, grants, or* in-kind services
and may award grants to qualifying entities to carry out the caring
communities program. (L. 1995 H.B. 573 § 1 merged with S.B. 445 § 1)

*Word "or" does not appear in original rolls.

Poor persons shall be relieved, maintained and supported by the
county of which they are inhabitants. (RSMo 1939 § 9590)

Prior revisions: 1929 § 12950; 1919 § 12199; 1909 § 1333

Aged, infirm, lame, blind or sick persons, who are unable to
support themselves, and when there are no other persons required by law
and able to maintain them, shall be deemed poor persons. (RSMo 1939 §
9591)

Prior revisions: 1929 § 12951; 1919 § 12200; 1909 § 1334

No person shall be deemed an inhabitant within the meaning of
sections 205.580 to 205.760, who has not resided in the county for the
space of twelve months next preceding the time of any order being made
respecting such poor person, or who shall have removed from another
county for the purpose of imposing the burden of keeping such poor person
on the county where he or she last resided for the time aforesaid. (RSMo
1939 § 9592)

Prior revisions: 1929 § 12952; 1919 § 12201; 1909 § 1335

The county commission of each county, on the knowledge of the
judges of such tribunal, or any of them, or on the information of any
associate circuit judge of the county in which any person entitled to the
benefit of the provisions of sections 205.580 to 205.760 resides, shall
from time to time, and as often and for as long a time as may be
necessary, provide, at the expense of the county, for the relief,
maintenance and support of such persons. (RSMo 1939 § 9593)

Prior revisions: 1929 § 12953; 1919 § 12202; 1909 § 1336

The county commission shall at all times use its discretion and
grant relief to all persons, without regard to residence, who may require
its assistance. (RSMo 1939 § 9594)

Prior revisions: 1929 § 12954; 1919 § 12203; 1909 § 1337

The county commission of the proper county shall allow such sum
as it shall think reasonable, for the funeral expenses of any person who
shall die within the county without means to pay such funeral expenses.
(RSMo 1939 § 9595)

Prior revisions: 1929 § 12955; 1919 § 12204; 1909 § 1338

The several county commissions shall have power, whenever they
may think it expedient, to purchase or lease, or may purchase and lease,
any quantity of land in their respective counties, not exceeding three
hundred and twenty acres, and receive a conveyance to their county for
the same. (RSMo 1939 § 9596)

Prior revisions: 1929 § 12956; 1919 § 12205; 1909 § 1339

Such county commission may cause to be erected on the land so
purchased or leased a convenient poorhouse or houses, and cause other
necessary labor to be done, and repairs and improvements made, and may
appropriate from the revenues of their respective counties such sums as
will be sufficient to pay the purchase money in one or more payments to
improve the same, and to defray the necessary expenses. (RSMo 1939 § 9597)

Prior revisions: 1929 § 12957; 1919 § 12206; 1909 § 1340

The county commission shall have power to make all necessary and
proper orders and rules for the support and government of the poor kept
at such poorhouse, and for supplying them with the necessary raw
materials to be converted by their labor into articles of use, and for
the disposing of the products of such labor and applying the proceeds
thereof to the support of the institution. (RSMo 1939 § 9600)

Prior revisions: 1929 § 12960; 1919 § 12209; 1909 § 1343

The several county commissions shall set apart from the revenues
of the counties such sums for the annual support of the poor as shall
seem reasonable, which sums the county treasurers shall keep separate
from other funds, and pay the same out on the warrants of their county
commissions. (RSMo 1939 § 9601)

Prior revisions: 1929 § 12961; 1919 § 12210; 1909 § 1344

Any county which now has or may hereafter have within such
county a city having a special charter and which city now has or may
hereafter have a population of not less than ten thousand inhabitants and
not more than thirty thousand inhabitants shall, out of the funds of such
county, provide for the care of the poor in said county, including poor
of such city or cities, and no such city shall hereafter be exempt from
any tax for the support of the poor of such county. No money shall
hereafter be refunded to any such city by any such county on account of
any money expended by said county for the support of the poor of said
county. (RSMo 1939 § 7523)

Prior revision: 1929 § 7370

Whenever such poorhouse or houses are erected, the county
commission shall have power to appoint a fit and discreet person to
superintend the same and the poor who may be kept thereat, and to allow
such superintendent a reasonable compensation for his services. (RSMo
1939 § 9598)

Prior revisions: 1929 § 12958; 1919 § 12207; 1909 § 1341

Such superintendent shall have power to cause persons kept at
such poorhouse, who are able to do useful labor, to perform the same by
reasonable and humane coercion. (RSMo 1939 § 9599)

Prior revisions: 1929 § 12959; 1919 § 12208; 1909 § 1342

The county commission may at any time, for good cause, remove
the superintendent and appoint another to fill the vacancy. (RSMo 1939 §
9602)

Prior revisions: 1929 § 12962; 1919 § 12211; 1909 § 1345

It shall be the duty of the superintendent of the poor, or poor
farm, as provided for in sections 205.580 to 205.760, to keep a book
furnished by the county commission, and enter therein a book account of
all business transactions had or done or caused to be done by him as
superintendent. Said book shall show an itemized account of all farm
products, stock and other articles sold by the superintendent or by his
authority, and of all articles purchased for the use of the poor, or for
the use or improvement of the poor farm or the buildings thereon, and of
all expenses for farm labor and other work or services done by order or
contract of the superintendent, and of such other items as may be ordered
kept therein by the county commission. (RSMo 1939 § 9603)

Prior revisions: 1929 § 12963; 1919 § 12212; 1909 § 1346

It shall be the duty of the superintendent to appear before the
county commission on the first day of every regular session thereof, and
at such other times as the commission may require, and present said book
to said commission for their inspection. Should the superintendent fail
or refuse to keep such book and present the same to the county
commission, as provided in sections 205.580 to 205.760, it shall be
considered sufficient cause for his removal, and it shall be the duty of
the county commission to remove the same, and appoint another to fill the
vacancy. (RSMo 1939 § 9604)

Prior revisions: 1929 § 12964; 1919 § 12213; 1909 § 1347

All money that shall come into the hands of the superintendent
from the sale of farm products, stock or other articles belonging to the
county, and all other money belonging to the county that shall come into
his hands from other sources, except by warrants drawn in his favor by
the county commission, shall be paid into the county treasury and placed
with the fund for the support of the poor, and a receipt taken for the
same. (RSMo 1939 § 9605)

Prior revisions: 1929 § 12965; 1919 § 12214; 1909 § 1348

Every superintendent, before entering upon his duties, shall
enter into a bond to the state of Missouri in a sum not less than five
hundred nor more than three thousand dollars, to be determined by the
county commission, conditioned that he will faithfully account for all
money belonging to the county that shall come into his hands, and that he
will exercise due diligence and care over property belonging to the
county, under his control. Said bond shall be approved by the county
commission and filed with the clerk thereof. (RSMo 1939 § 9606)

Prior revisions: 1929 § 12966; 1919 § 12215; 1909 § 1349

Sections 205.720 to 205.750 shall not apply to any county where
the support and keeping of the poor is let out by contract, nor to any
county where the superintendent rents or leases the poor farm and stocks
the same and furnishes the necessary farm implements used thereon at his
own expense, and carries on said farm at his own expense. (RSMo 1939 §
9607)

Prior revisions: 1929 § 12967; 1919 § 12216; 1909 § 1350

1. The county commission of any county of the first class may by
resolution create a department of health and welfare which department
shall be operated in the manner hereinafter set out.

2. Notwithstanding the provisions of subsection 1, no department of
health and welfare shall be created in any county of the first class not
having a charter form of government in which a county health center has
been established pursuant to the provisions of sections 205.010 to
205.150, whether or not the health center is established prior to the
county's attaining first class status. (L. 1951 p. 786 § 1, A.L. 1973
H.B. 642)

1. The commissioners of the county commission shall during their
term of office serve as commissioners of health and welfare of their
respective counties and shall have charge and control of all county
hospitals, clinics, health centers, institutions for the insane and all
county corrective, welfare and eleemosynary institutions except the
county jail and the place of detention used by the juvenile court.

2. Said commissioners shall have supervision of the rehabilitation of all
state prisoners in the county jail after conviction and sentence thereto,
subject to the approval of the county sheriff.

3. They shall perform investigational case work, excepting that relating
to adoption, probation and detention of juveniles, in all cases involving
the distribution and expenditure of any county funds.

4. They shall administer all laws relating to the county support of the
poor and shall have charge of all boarding home care for all juveniles
subject to the jurisdiction of the juvenile court and shall perform such
other duties as provided by law. (L. 1951 p. 786 § 2)

The commissioners of health and welfare may appoint a director
of health and welfare and the commissioners shall fix his compensation.
The commissioners may also employ such assistants as are necessary and
shall fix their compensation. The cost of salaries and expenses of the
department shall be apportioned to any appropriate county fund. (L. 1951
p. 786 § 3, A.L. 1953 p. 622, A.L. 1973 H.B. 642)

1. Any first class county not having a charter form of
government and adjacent to a county of the first class having a charter
form of government which does not contain a city with a population of
three hundred thousand or more, and adjacent to not more than one county
of the second class, may make health inspections of premises on or from
which food is prepared, served, or sold to members of the general public
for consumption by humans; except this act shall not apply to hospitals
licensed under chapter 197, RSMo, or to nursing homes licensed under
chapter 198, RSMo. Any county which makes inspections as authorized by
this section shall also have the power and authority to issue licenses
and to charge reasonable fees for such inspections, which fees shall not
exceed the amount necessary to fund and implement an inspection program
established pursuant to this section.

2. Such inspections shall be performed at least annually according to
procedures established by the Missouri department of health and senior
services and shall be performed in the most cost efficient manner.
Inspections shall be performed by qualified employees of the county, or
by contracting such services on a fee basis, at the discretion of the
county commission. Any person making such inspections must meet the
Missouri department of health and senior services qualifications.

3. No establishment described in subsection 1 of this section shall be
issued a county license until it has passed inspection. Any such
establishment which has been licensed and subsequently fails an
inspection shall be given ten days to correct its deficiencies and if
such establishment fails to correct its deficiencies, it shall be subject
to license suspension and suspension of operations. If the establishment
operates without the license, the owner is guilty of a class B
misdemeanor. The license shall remain suspended until the deficiencies
are corrected.

4. New establishments must submit plans for their operation to the county
health department before construction proceeds and licenses are sought.
Establishments already doing business in the county shall not be subject
to this subsection.

5. All religious, educational, nonprofit, fraternal or civic
organizations shall be exempt from the fees authorized by the provisions
of subsection 1 of this section.

6. From and after August 13, 1986, health inspections of the
establishments described in subsection 1 of this section shall be
performed only by the county and the state. Municipalities may provide
for such health inspections only in those counties which do not provide
for a health inspection throughout the county. (L. 1986 H.B. 1196 § 1)

1. In any county of the second class in this state there may be
created and established by order of the county commission of any such
county a board which shall be styled "The Social Welfare Board of the
County of .........".

2. All powers and duties connected with and incident to the betterment of
social and physical causes of dependency, the relief and care of the
indigent, and the care of sick dependents, with the exception of the
mentally ill and those suffering with contagious, infectious and
transmissible diseases shall be exclusively invested in and exercised by
the board.

3. The board shall have power to receive and expend donations for social
welfare purposes and shall have exclusive control over the distribution
and expenditure of any public funds set aside and appropriated by such
counties and by any city located in any such county for the relief of the
temporarily dependent. The board shall have power to promote the general
welfare of the poor within the limits of such counties by social and
sanitary reforms, by industrial instruction, by the inculcation of habits
of providence and self-dependence, and by the establishment and
maintenance of any activities to these ends. The board shall have power
to sue and be sued, complain and defend in all courts, to assume the care
of or take, by gift, grant, devise, bequest or otherwise, any money, real
estate, personal property, right of property, or other valuable things,
and may use, enjoy, control, sell or convey the same for charitable
purposes, to have and to use a common seal and alter the same at pleasure.

4. The board may make bylaws for its own guidance, rules and regulations
for the government of its agents, servants and employees, and for the
distribution of the funds under its control.

5. If any second class county which has established a social welfare
board pursuant to the provisions of this section, subsequently becomes a
first class or a third class county, such county may retain its social
welfare board and continue to function pursuant to the provisions of
sections 205.770 to 205.840. (RSMo 1939 § 9578, A.L. 1945 p. 1754, A.L.
1989 H.B. 452)

Prior revisions: 1929 § 12938; 1919 § 12187; 1909 § 1322

Said board shall have the exclusive power to make all suitable
provisions for the relief, maintenance and support of all indigent
persons within said county and within any city in said county who may
appropriate for the support of said board, and to make suitable
provisions for the care and maintenance to the sick dependents and those
who are unable to support themselves; to enforce the laws of the state,
the ordinances of such cities located within said county, in regard to
the indigent, and to make such rules and regulations in the conduct of
its business not inconsistent with the laws of the state of Missouri and
the ordinances of such cities; to have exclusive control, care and
management of all public hospitals owned or operated by said counties or
said cities, except those for the care of the insane and those suffering
with contagious, infectious and transmissible diseases; to recommend to
the common council of said city the passage of such ordinances as said
board may deem necessary for the welfare of the indigent of said city; to
have the power to appoint competent physicians and surgeons, who shall
hold their office at the pleasure of said board, at a salary to be fixed
by said board, and said physicians and surgeons shall perform such duties
as may be prescribed by said board, and shall render medical attendance
to all those who may come within the provisions of this law; said board
shall have the power and it shall be the duty of said board to employ and
discharge all persons or officers in their judgment necessary to carry
out the matters over which said board is given jurisdiction or control.
(RSMo 1939 § 9579, A.L. 1945 p. 1754)

Prior revisions: 1929 § 12939; 1919 § 12188

1. Said board shall be nonpartisan and nonsectarian in
character, and the members and officers thereof shall receive no
compensation as such.

2. Said board shall consist of the mayor of such cities and the presiding
commissioner of the county commission of such counties, who shall be ex
officio members thereof, and six other members, three of whom shall be
appointed by the county commission of such counties, who shall hold
office, one for one year, one for two years and one for three years,
whose terms of office shall be designated by such county commission,
three by the mayor and common council of such cities, who shall hold
office, one for one year, one for two years and one for three years,
whose terms of office shall be designated by the mayor.

3. Whenever the term of office of any member so appointed expires, the
appointment of his successor shall be for three years. All such
appointments shall date from the first of June following their
appointment.

4. Vacancies from any causes shall be filled in like manner as original
appointment. The mayor may, for misconduct or neglect of duty, remove any
member appointed by him in the manner required for removal of officers of
such cities. The county commission may, by a majority vote, for
misconduct or neglect of duty, remove any member appointed by them. (RSMo
1939 § 9580)

Prior revisions: 1929 § 12940; 1919 § 12189; 1909 § 1323

Said members shall immediately after their appointment, and
annually thereafter, meet and organize by electing out of their number a
president, vice president, treasurer and secretary. All subordinate
officers, agents and employees appointed shall give such bonds for the
faithful discharge of their duties as may be required by the board. (RSMo
1939 § 9581)

Prior revisions: 1929 § 12941; 1919 § 12190; 1909 § 1324

All moneys received or appropriated for the use of said board
shall be deposited with the treasurer, who shall give good and sufficient
bond to said board for the safekeeping and proper expenditure of all
funds placed in his hands, by or for the use of said board. (RSMo 1939 §
9582)

Prior revisions: 1929 § 12942; 1919 § 12191; 1909 § 1325

It shall be the duty of said board to keep a record of its
proceedings and of its receipts, expenditures and operations, and shall
annually render a full and complete itemized report, stating the
condition of their trust, together with such other suggestions as they
may deem of general interest to the mayor and common council of said
cities and the county commission of said counties; provided, said board
shall render reports concerning receipts, expenditures, operations, etc.,
whenever called for by the common council of said cities or the county
commission of said counties. (RSMo 1939 § 9583)

Prior revisions: 1929 § 12943; 1919 § 12192; 1909 § 1326

1. It shall be the duty of said board, when any person by
himself, herself, or another apply for relief to make immediate inquiry
into the state and circumstances of the applicant, and if it shall appear
that he or she is in such indigent circumstances as to require temporary
relief, the said board shall furnish, out of the funds in their hands,
such relief as the circumstances of the case may require; provided, that
in all cases where the applicant for aid may be found dependent and said
applicant or member of said applicant's family is an able-bodied male
person capable of performing manual labor, said board shall require such
person to perform work to the value of the aid given, and the city
engineer and the street commissioners of such cities in their respective
departments are required to utilize the services of such able-bodied
persons upon receiving notice from said board that such person has
received or is entitled to such aid. Where the applicant or a member of
the applicant's family is an able-bodied female, said board shall,
whenever practicable, require that labor to the value of the aid given be
performed. They shall make investigations of cases of dependence for
individuals or other charitable organizations and furnish such reports
upon the same as in their judgment seems advisable.

2. Their office shall be a center of intercommunication between the
various charitable agencies in the city. They shall foster harmonious
cooperation between them and endeavor to eradicate the evils of
overlapping relief, and for this purpose shall maintain a confidential
registration bureau.

3. When it is impossible to repress mendicancy by the above means they
shall prosecute imposters. They shall carefully work out such plans for
helping families to self-dependence as may seem most practicable. They
shall make concentrated attack on social causes of hardship, such as
unsanitary housing, child labor, extortionate charges by pawnshops,
salary loan and chattel mortgage agreements. (RSMo 1939 § 9584)

Prior revisions: 1929 § 12944; 1919 § 12193; 1909 § 1327

It shall be the duty of the board of police commissioners of
said cities, and the health officers of said cities and counties to
render said social welfare board, its officers and agents, such aid as
may be requested by them, or either of them, whenever such aid requested
shall reasonably come within the duties of said police board, its agents
or officers or the health officers aforesaid. (RSMo 1939 § 9585)

Prior revisions: 1929 § 12945; 1919 § 12194; 1909 § 1328

The county commission in counties of the third and fourth
classes may in its discretion, with an order of the juvenile court
showing approval, appoint a county superintendent of public welfare, and
such assistants as it may deem necessary. Whenever the county commission
of any county has appointed a superintendent of public welfare such
officer shall assume all the powers and duties now conferred by law upon
the probation or parole officer of such county and shall assume all the
powers and duties of the attendance officer in said county and all the
powers and the duties of the attendance officer in any incorporated town
or village having a population of more than one thousand inhabitants, and
no other or different probation or parole officer or attendance officer
or officers shall be appointed by the judge of the juvenile court, by the
county superintendent of public schools, or by the school board or any
incorporated city, town, or village school district or consolidated
school district. (RSMo 1939 § 9791, A.L. 1943 p. 351, A.L. 1945 p. 629)

Prior revision: 1929 § 14182

The county commission shall fix the salary of the county
superintendent of public welfare and of his assistants in its county.
(RSMo 1939 § 9720)

Prior revision: 1929 § 14183

It shall be the duty of the county superintendent of public
welfare to administer all of the funds of the county devoted to outdoor
relief and allowances to needy mothers. He shall seek to discover any
cases of neglect, dependent, defective or delinquent children in the
county, and take all reasonable action in his power to secure for them
the full benefit of the laws enacted for their benefit. Assistants to the
county superintendents of public welfare shall perform such of the duties
of the county superintendent of public welfare as he may assign to them.
(RSMo 1939 § 9721)

Prior revision: 1929 § 14184

The county superintendent of public welfare may be deputized or
authorized and required by the department of social services to act as
its agent in relation to any work to be done by said department within
the county, and when said county superintendent is so authorized as the
agent of the department of social services, he shall have the same powers
and authority as are given to the department of social services. The
county superintendent of public welfare may at any time call on the
department of social services for advice and assistance in the
performance of his duties. (RSMo 1939 § 9722)

Prior revision: 1929 § 14185

The county superintendent of public welfare in each county
shall, upon the request of the department of mental health, and in
accordance with its direction, give special care and attention to the
needs of any patient recently discharged from the state hospital for the
insane who resides in his county, either on parole or permanent
discharge, to the end that such patients may be established in such
favorable circumstances as shall tend to prevent their relapse into
insanity, and shall report on the progress of such former patients to the
department of mental health, and under its direction, to the institution
from which they have been paroled or discharged. (RSMo 1939 § 9723)

Prior revision: 1929 § 14186

1. The county superintendent of public welfare in each county
shall give oversight and supervision to prisoners on parole or probation
by any court in the state of Missouri and shall investigate applications
for clemency when requested to do so by said courts, and shall report in
regard to each person placed under his supervision to the court placing
said persons under his supervision.

2. The county superintendent of public welfare shall also give oversight
and supervision to children placed on parole or probation by the juvenile
court or the court having jurisdiction of children's cases in his county
when requested to do so by said court and shall report to said court upon
progress of persons thus placed on parole or probation. (RSMo 1939 §
9724, A.L. 2004 H.B. 1631 & 1623)

Prior revision: 1929 § 14187

The county superintendent of public welfare in each county shall
cooperate with the state employment bureaus and shall, upon request of
the head of such bureaus, furnish data with regard to the opportunities
for employment in their respective counties and shall aid and assist in
any practical way in securing employment for the unemployed in his
county. (RSMo 1939 § 9725)

Prior revision: 1929 § 14189

The county superintendent of public welfare and his assistants
may be deputized by the director of the inspection section of the
department of labor and industrial relations, as his agent or agents, and
when they are so deputized by the director, they shall have the same
powers and authority as deputy industrial inspectors. (RSMo 1939 § 9726)

Prior revision: 1929 § 14190

The county superintendent of public welfare shall investigate
the conditions of living among the poor, sick and delinquent in the
county and examine thoroughly into causes of crime and poverty in the
county and shall make recommendations from time to time to the proper
state department, and to proper local authorities as to any change in
conditions or in legislation necessary to prevent or reduce poverty,
crime or distress in the state. (RSMo 1939 § 9727, A. 1949 S.B. 1061)

Prior revision: 1929 § 14191

The records of cases handled and business transacted by the
county superintendent of public welfare shall be kept in such manner and
form as may be prescribed by the department of social services. (RSMo
1939 § 9730)

Prior revision: 1929 § 14195

The county superintendent of public welfare shall each year
prepare and keep on file, a full report of his work and proceedings
during the year, and shall file a copy with the county commission and
with the secretary of the department of social services. (RSMo 1939 §
9731)

Prior revision: 1929 § 14196

The division of family services by itself, or upon the
application of the county commission, or the governing body of any county
or city not within a county, may establish and put into effect in any
county or any city not within a county a program for the distribution of
federally donated commodities or for the sale and issuance of federal
food stamps or coupons to needy persons and participating families
pursuant to any act of Congress of the United States; and may execute
agreements necessary to maintain the eligibility of this state to receive
surplus food commodities and to distribute federal food stamps or
coupons, including agreements with banking corporations, counties and
other agencies of this state, in carrying into effect the provisions of
sections 205.960 to 205.966. Payment of the expenses of any program
instituted under sections 205.960 to 205.966 shall be made pursuant to
those sections only during the times when federal and state funds are
provided and made available for such purposes. (L. 1963 p. 376 §§ 1 to 3,
A.L. 1969 S.B. 23, A.L. 1972 S.B. 426)

Effective 3-29-72

The division of family services shall make and promulgate
necessary and reasonable rules and regulations for the administration of
the programs established pursuant to section 205.960, and when required
by federal law or regulation the division of family services shall be the
certifying agency responsible for certifying individuals or households as
eligible to receive surplus agricultural commodities or for the issuance
of federal food stamps. (L. 1969 S.B. 23 § 205.965)

1. The division of family services shall enter into a written
agreement with the county commission or governing body of any county
which desires to participate in a program for the distribution of
agricultural commodities within such county. Any agreement shall cover
the responsibility of the parties thereto for the administration of the
program and shall contain such terms and conditions as are required by
regulations prescribed under federal laws governing distribution of such
commodities as well as regulations of the division of family services. No
county commission or governing body of a county shall participate in the
administration of such program unless it has an agreement with the
division of family services under this section. Expenses incurred in
connection with a federally donated agricultural commodities food
distribution program, including sums expended for the acquisition,
warehousing, cold storage, safekeeping, maintenance of proper records and
distribution of surplus agricultural commodities shall be paid by the
county and division of family services in pursuance of the agreement
entered into under this section or, in the absence of such agreement, by
the division of family services. A county commission which has an
agreement for distributing food commodities with the division of family
services shall not be required to pay over fifteen percent of the total
distribution costs in its county.

2. For the payment of expenses incurred in connection with the sale and
distribution of federal food stamps in any county the division of family
services may enter into agreements with banking corporations and with the
county for the purpose of establishing and maintaining a food stamp
distribution program in the county, and may accept moneys, services or
quarters as a contribution toward the support and maintenance of such
program. Any funds so received shall be payable to the director of
revenue and deposited in the proper special account in the state treasury
and become and be a part of the state funds appropriated for the use of
the division of family services. (L. 1969 S.B. 23 § 205.970, A.L. 1972
S.B. 426)

Effective 3-29-72

In counties where a federal food stamp program is in effect
there shall be no distribution of federally owned surplus agricultural
commodities to individuals or households except during emergency
situations or as authorized by federal law or the U.S. Secretary of
Agriculture. Individuals are not eligible to receive federal food stamps
or coupons under a food stamp plan or to receive federal surplus
agricultural commodities under a food distribution program unless they
reside in a county in which such plan or program is in effect. (L. 1969
S.B. 23 § 205.975)

Any loss for which this state or its agencies or counties may be
liable to reimburse the federal government in accordance with federal
laws, rules and regulations applicable to federal food stamp plans or
federal surplus agricultural commodities distribution programs shall be
paid from funds appropriated to the division of family services for the
administration of these programs. Any loss in a county in which a program
of surplus agricultural commodities distribution is in effect, and with
respect to which loss is incurred, shall be paid by the county to the
division of family services in the amount payable to the federal
government under this section. The payment for any loss by the state or
county shall not relieve any person of any civil or criminal liability to
this state. (L. 1969 S.B. 23 § 205.980)

1. Counties, state agencies, issuing agencies, retail food
outlets, wholesale food concerns, banks and all persons who participate
in or administer any part of the distribution program of surplus
agricultural commodities or a food stamp plan shall comply with all state
and federal laws, rules and regulations applicable to such program or
plans and shall be subject to inspection and audit by the division of
family services with respect to the operation of the program or plan.

2. To the extent authorized by federal law, all food stamp vendors shall
be approved and licensed by the division of family services. The division
may promulgate rules and regulations necessary to administer the
provisions of this section. The division shall set the amount of the fees
for licensing food stamp vendors at a level to produce revenue which
shall not substantially exceed the cost and expense of administering the
provisions of this section. An action may be brought by the department to
temporarily or permanently enjoin or restrain any violation of this
subsection or the regulations applicable thereto. Any action brought
under the provisions of this subsection shall be heard by the court
within no more than twenty days after the action has been filed and
service made upon the vendor. Any person who in any way conducts business
as a food stamp vendor without approval and license by the division of
family services shall be guilty of a class A misdemeanor. A second
offense within five years after the first conviction shall be a class D
felony.

3. No rule or portion of a rule promulgated under the authority of this
chapter shall become effective unless it has been promulgated pursuant to
the provisions of section 536.024, RSMo. (L. 1969 S.B. 23 § 205.985, A.L.
1992 H.B. 899, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3)

1. As used in this section:

(1) "Public assistance benefits, programs and services" means anything of
value, including money, food, food stamps, commodities, clothing,
utilities, utilities payments, shelter, drugs and medicine, materials,
goods, and any service, including institutional care, medical care,
dental care, child care, psychiatric and psychological service,
rehabilitation instruction, training, or counseling provided pursuant to
chapters 198, 207, 208, 209, and 660, RSMo, or benefits, programs, and
services provided or administered by the department of social services;

(2) The term "person" means any individual or corporation who received
any form of public assistance benefit in any manner for any reason.

2. Any person or corporation who obtains or attempts to obtain, or aids
or abets any other person to obtain, by means of a willfully false
statement or representation, or by willful concealment or failure to
report any fact or event required to be reported by any law, regulation,
or rule of this state or the United States, or by impersonation,
collusion, or other fraudulent device, any public assistance benefits,
programs, and services, shall be guilty of the crime of stealing as
defined by section 570.030, RSMo, and shall be punished as provided in
section 570.030, RSMo.

3. If at any time during the continuance of assistance to any person or
corporation, the recipient thereof becomes possessed of any money,
property, or income, from any source in any way or reason, it shall be
the duty of the recipient to notify the person to whom that recipient's
case is assigned, within ten days of the receipt of the money, income, or
property, and that person may, after investigation, if required, cancel
or modify the assistance payment in accordance with the circumstances.

4. In an action or proceeding for the recovery of public assistance
benefits, programs, and services or criminal prosecution for illegal
receipt thereof, paid to or received by an alleged ineligible recipient,
person, or corporation, proof that the recipient, person, or corporation
possesses or did possess property or income that does or would have
rendered that person or corporation ineligible to receive such assistance
shall be deemed prima facie evidence that such assistance was unlawfully
received.

5. If during the life or on the death of any person, or during the life
or at the dissolution of a corporation, it is found that the recipient
was possessed of income or property in excess of the amount reported or
ascertained at the time of granting assistance, and if it be shown that
such assistance was obtained by an ineligible recipient, the total amount
of the assistance may be recoverable by the director of the department of
social services as a seventh class claim from the estate of the recipient
or in an action brought against the recipient while living. (L. 1975 S.B.
255 § 1, A.L. 1981 H.B. 901)

Effective 6-16-81

1. As set forth in section 205.971, when a levy is approved by
the voters, the governing body of any county or city not within a county
of this state shall establish a board of directors. The board of
directors shall be a legal entity empowered to establish and/or operate a
sheltered workshop as defined in section 178.900, RSMo, residence
facilities, or related services, for the care or employment, or both, of
handicapped persons. The facility may operate at one or more locations in
the county or city not within a county. Once established, the board may,
in its own name engage in and contract for any and all types of services,
actions or endeavors, not contrary to the law, necessary to the
successful and efficient prosecution and continuation of the business and
purposes for which it is created, and may purchase, receive, lease or
otherwise acquire, own, hold, improve, use, sell, convey, exchange,
transfer, and otherwise dispose of real and personal property, or any
interest therein, or other assets wherever situated and may incur
liability and may borrow money at rates of interest up to the market rate
published by the Missouri division of finance. The board shall be taken
and considered as a "political subdivision" as the term is defined in
section 70.600, RSMo, for the purposes of sections 70.600 to 70.755, RSMo.

2. Services may only be provided for those persons defined as handicapped
persons in section 178.900, RSMo, and those persons defined as
handicapped persons in this section whether or not employed at the
facility or in the community, and for persons who are handicapped due to
developmental disability. Persons having substantial functional
limitations due to a mental illness as defined in section 630.005, RSMo,
shall not be eligible for services under the provisions of sections
205.968 to 205.972 except that those persons may participate in services
under the provisions of sections 205.968 to 205.972. All persons
otherwise eligible for facilities or services under this section shall be
eligible regardless of their age; except that, individuals employed in
sheltered workshops must be at least sixteen years of age. The board may,
in its discretion, impose limitations with respect to individuals to be
served and services to be provided. Such limitations shall be reasonable
in the light of available funds, needs of the persons and community to be
served as assessed by the board, and the appropriateness and efficiency
of combining services to persons with various types of handicaps or
disabilities.

3. For the purposes of sections 205.968 to 205.972, the term

(1) "Developmental disability" shall mean either or both paragraph (a) or
(b) of this subsection:

(a) A disability which is attributable to mental retardation, cerebral
palsy, autism, epilepsy, a learning disability related to a brain
dysfunction or a similar condition found by comprehensive evaluation to
be closely related to such conditions, or to require habilitation similar
to that required for mentally retarded persons; and

a. Which originated before age eighteen; and

b. Which can be expected to continue indefinitely;

(b) A developmental disability as defined in section 630.005, RSMo;

(2) "Handicapped person" shall mean a person who is lower range educable
or upper range trainable mentally retarded or a person who has a
developmental disability. (L. 1969 S.B. 40 § 1, A.L. 1975 H.B. 240, A.L.
1984 H.B. 1385, A.L. 1990 H.B. 1383, A.L. 1993 S.B. 366, A.L. 1995 H.B.
416, et al.)

1. The board may provide a sheltered workshop program for the
county or city not within a county and as part of the program shall
conduct work and developmental programs as provided by section 178.910,
RSMo, pursuant to rules and standards developed and adopted by the
department of elementary and secondary education.

2. The board may provide places of residence and related activity or
social centers for those eligible persons. (L. 1969 S.B. 40 § 2, A.L.
1975 H.B. 240, A.L. 1984 H.B. 1385, A.L. 1993 S.B. 366)

1. When approved by the voters pursuant to section 205.971, the
governing body of the county or city not within a county shall appoint a
board of directors consisting of a total of nine members, two of whom
shall be related by blood or marriage within the third degree to a
handicapped person as defined in section 205.968, and four of whom shall
be public members. At least seven of the board members shall be residents
of the county or city not within a county where the facility is located.
After September 28, 1979, all board members shall be appointed to serve
for a term of three years, except that of the first board appointed after
September 28, 1979, three members shall be appointed for one-year terms,
three members for two-year terms and three members for three-year terms.
Board members may be reappointed. The directors shall not receive
compensation for their services, but may be reimbursed for their actual
and necessary expenses.

2. The administrative control and management of the facility shall rest
solely with the board, and the board shall employ all necessary
personnel, fix their compensation, and provide suitable quarters and
equipment for the operation of the facility from funds made available for
this purpose.

3. Notwithstanding any provision of law to the contrary, and irrespective
of whether or not a county sheltered workshop or residence facility has
been established, the board may contract to provide services relating in
whole or in part to the services which the board may provide to
handicapped persons as defined in this law and for such purpose may
expend the tax funds or other funds.

4. The board shall elect a chairman, vice chairman, treasurer, and such
other officers as it deems necessary for its membership. Before taking
office, the treasurer shall furnish a surety bond, in an amount to be
determined and in a form to be approved by the board, for the faithful
performance of his duties and faithful accounting of all moneys that may
come into his hands. The treasurer shall enter into the surety bond with
a surety company authorized to do business in Missouri, and the cost of
such bond shall be paid by the board of directors.

5. The board shall set rules for admission to the facility, and shall do
all other things necessary to carry out the purposes of sections 205.968
to 205.972.

6. The board may contract with any not-for-profit corporation including
any corporation which is incorporated for the purpose of implementing the
provisions of sections 178.900 to 178.970, RSMo, for any common services,
or for the common use of any property of either group.

7. The board may accept any gift of property or money for the use and
benefit of the facility, and the board is authorized to sell or exchange
any such property which it believes would be to the benefit of the
facility so long as the proceeds are used exclusively for facility
purposes. The board shall have exclusive control of all gifts, property
or money it may accept; of all interest or other proceeds which may
accrue from the investment of such gifts or money or from the sale of
such property; of all tax revenues collected by the county on behalf of
the facilities or services; and of all other funds granted, appropriated,
or loaned to it by the federal government, the state, or its political
subdivisions so long as these resources are used solely to benefit the
facility or related services except those paid for transportation
purposes under the provisions of section 94.645, RSMo.

8. Any board member may, following notice and an opportunity to be heard,
be removed from office by a majority vote of the other members of the
board for any of the following grounds:

(1) Failure to attend five consecutive meetings, without good cause;

(2) Conduct prejudicial to the good order and efficient operation of the
facility or services; or

(3) Neglect of duty. The chairman of the board shall preside at such
removal hearing, unless he or she is the person sought to be removed. In
which case the hearing shall be presided over by another member elected
by the majority vote of the other board members. All interested parties
may present testimony and arguments at such hearing, and the witnesses
shall be sworn by oath or affirmation before testifying. Any interested
party may, at his or her own expense, record the proceedings.

9. Vacancies in the board occasioned by removals, resignations or
otherwise shall be reported by the board chairman to the mayor's office
of a city not within a county or the county commission or county
executive officer and shall be filled in like manner as original
appointments; except that, if the vacancy occurs during an unexpired
term, the appointment shall be for only the unexpired portion of that
term.

10. Individual board members shall not be eligible for employment by the
board within twelve months of termination of service as a member of the
board.

11. No person shall be employed by the board who is related within the
third degree by blood or by marriage to any member of the board. (L. 1969
S.B. 40 § 3, A.L. 1975 H.B. 240, A.L. 1977 S.B. 359, A.L. 1979 H.B. 797,
A.L. 1984 H.B. 1385, A.L. 1993 S.B. 366)

The board of aldermen or other governing body of a city not
within a county and the county commission or other governing body of the
county, except for a county of the first classification having a charter
form of government containing in part a city with a population of more
than three hundred fifty thousand inhabitants, or a county of the first
classification having a charter form of government with a population of
at least nine hundred thousand inhabitants may, upon approval of a
majority of the qualified voters of such city or county thereon, levy and
collect a tax not to exceed four mills per dollar of assessed valuation
upon all taxable property within the city or county for the purpose of
establishing and maintaining the county sheltered workshop, residence,
facility and/or related services. The county commission or other
governing body of a county of the first classification having a charter
form of government containing in whole or part a city with a population
of more than three hundred fifty thousand inhabitants, or a county of the
first classification having a charter form of government with a
population of at least nine hundred thousand inhabitants may, upon
approval of a majority of the qualified voters of such county or city
voting thereon, levy and collect a tax not to exceed two mills per dollar
of assessed valuation upon all taxable property within such county or
city for the purpose of establishing and maintaining the county or city
sheltered workshop, residence, facility and/or related services. The tax
so levied shall be collected along with other county taxes, or in the
case of a city not within a county, with other city taxes, in the manner
provided by law. All funds collected for this purpose shall be deposited
in a special fund and shall be used for no other purpose. Deposits in the
fund shall be expended only upon approval of the board. (L. 1969 S.B. 40
§ 4, A.L. 1975 H.B. 240, A.L. 1990 H.B. 1383, A.L. 1992 S.B. 630, A.L.
1993 S.B. 366)

1. The tax may not be levied to exceed forty cents per each one
hundred dollars assessed valuation therefor except for a county of the
first classification having a charter form of government containing in
whole or part a city with a population of more than three hundred fifty
thousand inhabitants, or a county of the first classification having a
charter form of government with a population of at least nine hundred
thousand inhabitants voting thereon shall not levy a tax to exceed twenty
cents per each one hundred dollars assessed valuation therefor.

2. The question shall be submitted in substantially the following form:

OFFICIAL BALLOT

Shall ..... (name of county or city not within a county) establish,
improve, (and) (or) maintain a sheltered workshop (and) (or) residence
facility (and) (or) related services for developmentally disabled and
handicapped persons, and for which the county or city shall levy a tax of
.... (insert exact amount to be voted upon) cents per each one hundred
dollars assessed valuation therefor?

YES NO (L. 1969 S.B. 40 § 5, A.L. 1972 S.B. 449, A.L. 1975 H.B. 240, A.L.
1978 H.B. 971, A.L. 1990 H.B. 1383, A.L. 1992 S.B. 630, A.L. 1993 S.B.
366)

No employer of a handicapped or developmentally disabled person
employed in a sheltered workshop shall be liable for any head tax imposed
by any city in this state. (L. 1984 H.B. 1385 § A)

As used in sections 205.975 to 205.990, the following words and
terms mean:

(1) "Board of trustees", board appointed by a governing body or jointly
by governing bodies within a service area for the purposes of
administering a county community mental health fund to establish and
operate a community mental health center, mental health clinics, or any
comprehensive mental health services; to supplement existing funds for a
center, clinics, or services, or to purchase services from a center,
clinics, or public facilities and not-for-profit corporations providing
any comprehensive mental health services;

(2) "Community mental health center", a legal entity through which
comprehensive mental health services are provided to individuals residing
in a certain service area;

(3) "Comprehensive mental health services", inpatient services,
outpatient services, day care and other partial hospitalization services,
emergency services, diagnostic and treatment services, liaison and
follow-up services, consultation and education services, rehabilitation
services, prevention services, screening services, follow-up care
services, transitional living services, alcoholism and alcohol abuse
prevention and treatment services, and drug addiction and drug abuse
prevention and treatment services;

(4) "Department", department of mental health;

(5) "Governing body", county commission, county legislature, or other
chief legislative body of a county or city not within a county;

(6) "Mental health clinic", a health entity offering community services
delivered from a fixed place or from various places within a service area
on an outpatient and consultative basis for the prevention, diagnosis,
and treatment of emotional or mental disorders, alcoholism, or drug abuse;

(7) "Participating counties", counties which choose to appropriate funds
from their general tax revenues or levy and collect special taxes to
support, with other counties, a community mental health center, mental
health clinics, or any comprehensive mental health services;

(8) "Service area", a defined geographic area as set forth in the state
plan for comprehensive mental health services prepared by the department.
(L. 1969 S.B. 168 § 1, A.L. 1978 S.B. 652, A.L. 1990 H.B. 1383)

Effective 1-1-91

*No continuity with § 205.975 repealed by L. 1978 S.B. 652.

The department shall establish service areas within which
comprehensive mental health services and programs shall be conducted as
defined and designated in the most recent state plan of the department. A
service area may contain several counties situated entirely within its
boundaries or one or more service areas may be contained entirely within
the boundaries of a county. (L. 1969 S.B. 168 § 2, A.L. 1978 S.B. 652,
A.L. 1990 H.B. 1383)

Effective 1-1-91

*No continuity with § 205.976 repealed by L. 1978 S.B. 652.

Any county which has one or more service areas within its
boundaries or which is within the boundaries of a service area may, by a
majority vote of the qualified voters voting thereon, levy and collect a
tax to accomplish any of the following purposes:

(1) Providing necessary funds to establish, operate, and maintain
community mental health centers, mental health clinics, or any
comprehensive mental health services;

(2) Providing funds to supplement existing funds for the operation and
maintenance of community mental health centers, mental health clinics, or
any comprehensive mental health services;

(3) Purchasing any of the comprehensive mental health services from
community mental health centers, mental health clinics, and other public
facilities or not-for-profit corporations which are designated by the
department. (L. 1969 S.B. 168 § 3, A.L. 1978 S.B. 652, A.L. 1990 H.B.
1383)

Effective 1-1-91

*No continuity with § 205.977 as repealed by L. 1978 S.B. 652.

1. The board of trustees may request that the governing body of
the county or counties request the election officials of any county or
city not within a county containing all or part of such service area to
submit to the qualified voters of such county, or city not within a
county, at a** general, primary, or special election the proposition
contained in subsection 3 of this section. Such election officials shall
give legal notice at least sixty days prior to such general, primary, or
special election in at least two newspapers that such proposition shall
be submitted at any general, primary, or special election held for
submission of the proposal. A request by the board of trustees for a
proposition to be submitted to the voters as set out in this section
shall be considered a request of the county, or city not within a county,
for purposes of section 115.063, RSMo.

2. The tax may not be levied to exceed forty cents per each one hundred
dollars assessed valuation therefor.

3. The ballot to be used for voting on the proposition shall be
substantially in the following form:

OFFICIAL BALLOT

(Check the one for which you wish to vote.)

Shall (name of county) establish a community mental health fund to
establish, improve (and) (or) maintain a community mental health service,
and for which the (county) shall levy a tax of (insert exact amount to be
voted upon) cents per each one hundred dollars assessed valuation
therefor?

YES NO

4. The election shall be conducted and the vote canvassed in the same
manner as other county elections. (L. 1969 S.B. 168 § 5, A.L. 1978 S.B.
652, A.L. 1990 H.B. 1383)

Effective 1-1-91

*No continuity with § 205.979 as repealed by L. 1978 S.B. 652.

**Words "at a" do not appear in original rolls.

1. The governing body of the county shall, upon approval of a
majority of the qualified voters of such county voting thereon, levy and
collect a tax as specified on the ballot, not to exceed forty cents per
one hundred dollars of assessed valuation upon all taxable property
within the county, to accomplish the purposes as set out in section
205.977.

2. The tax so levied shall be collected along with other county taxes in
the manner provided by law. All funds collected for this purpose shall be
deposited in a special fund to be designated "Community Mental Health
Fund" to accomplish the purposes as set out in section 205.977 and shall
be used for no other purpose. Deposits in the fund shall be expended only
upon approval of the board of trustees.

3. Tax levies once approved by a majority of the voters shall continue in
effect if the question is resubmitted either to raise or lower the levy
and not approved by a majority of votes cast on the question. (L. 1969
S.B. 168 § 6, A.L. 1978 S.B. 652, A.L. 1990 H.B. 1383)

Effective 1-1-91

*No continuity with § 205.980 as repealed by L. 1978 S.B. 652.

1. The board of trustees may contract with a community mental
health center, mental health clinic, or other public facility or
not-for-profit corporation as designated by the department for such
comprehensive mental health services for the residents of such county as
may be mutually agreeable between the board of trustees or officials of
such center, clinic, facility, or corporation and the board of trustees
of the county requesting the services for the residents thereof.

2. The consideration for the provision of services under this section
shall be appropriated out of the county's community mental health fund or
may be appropriated out of the county's general revenue fund and shall
not exceed an amount of revenue that could be derived from a tax levy
authorized by sections 205.977 to 205.980.

3. Each contract may be for a term of not exceeding five years, but may
be renewed from time to time. (L. 1969 S.B. 168 § 7, A.L. 1978 S.B. 652,
A.L. 1990 H.B. 1383, A.L. 1995 S.B. 454)

*No continuity with § 205.981 as repealed by L. 1978 S.B. 652.

1. Governing bodies of counties within a service area may enter
into contractual agreements with each other to accomplish any of the
following purposes:

(1) The joint provision of necessary funds to establish, operate, and
maintain a community mental health center, mental health clinic, or any
comprehensive mental health services;

(2) The joint provision of funds to supplement existing funds for the
establishment, operation, or maintenance of a community mental health
center, mental health clinic, or any comprehensive mental health services;

(3) The joint provision for purchasing any comprehensive mental health
services from a community mental health center, mental health clinic, or
other public facilities or not-for-profit corporations as designated by
the department;

(4) The provision for operation of services and facilities by one
participating county under contract with other participating counties.

2. If two or more counties enter into a joint agreement in accordance
with subsection 1 of this section, it shall be the obligation of the
board of trustees or other governing board of each community mental
health center, mental health clinic, public facility, or not-for-profit
corporation receiving funds pursuant to the agreement to submit to the
governing bodies of the counties, prior to the budget submission date of
each governing body, an estimate of the proportionate share of costs of
mental health services to be borne by each governing body under the
agreement.

3. Any county desiring to withdraw from a joint program may submit to the
board of trustees and to any entity receiving funds pursuant to the joint
agreement a resolution requesting withdrawal therefrom together with a
plan for the equitable adjustment and division of the assets, property,
debts, and obligations, if any, of the program. Unless all participating
counties by votes of their governing bodies agree to an earlier
withdrawal, no county participating in a joint program may withdraw
therefrom without the consent of any entity receiving funds pursuant to
the joint agreement for services earlier than two years after submission
of the withdrawal resolution to the entities receiving funds. (L. 1969
S.B. 168 § 8, A.L. 1978 S.B. 652, A.L. 1990 H.B. 1383)

Effective 1-1-91

*No continuity with § 205.982 as repealed by L. 1978 S.B. 652.

1. Any participating county may provide for the financing of its
share or portion of the costs or expenses of the joint agreements entered
into pursuant to section 205.982 in a manner and by the same procedures
for the financing by a single county to accomplish the same purposes in
accordance with sections 205.977 to 205.981, if acting alone and on its
own behalf.

2. All moneys received from each participating county pursuant to the
joint agreements shall be deposited in a special fund designated as a
"Community Mental Health Fund" and disbursed with the approval of the
board of trustees in accordance with the joint agreements entered into by
the participating counties.

3. The treasurer of the board of trustees, before funds are received from
any participating county, shall enter into a bond to each participating
county with two or more sureties, to be approved by the board of
trustees, conditioned that he will render a faithful and just account of
all money that may be deposited into the community mental health fund,
and otherwise perform his duties according to law, such bond to be filed
with each participating county. (L. 1969 S.B. 168 § 9, A.L. 1978 S.B. 652)

*No continuity with § 205.983 as repealed by L. 1978 S.B. 652.

1. There shall be established a board of trustees of not less
than nine members appointed by the county or participating counties in a
service area. The regional advisory council, as defined in section
632.040, RSMo, or any other interested party may nominate individuals for
membership on the board. The governing body of the county or counties
shall appoint the members to such board of trustees within one year of
January 1, 1991. No more than one-third of the members shall represent
public or private entities involved in the provision of services as
provided by sections 205.975 to 205.990. At least one-third of the
members shall represent consumers of psychiatric services or the families
of such consumers. Employees of public or private entities which are
recipients of funds pursuant to sections 205.975 to 205.990 are
prohibited from serving on this board of trustees.

2. The composition of the board of trustees shall be representative of
the residents of the county or participating counties within a service
area, taking into consideration their employment, age, sex, and place of
residence and other demographic characteristics of the area. At least one
member shall be a licensed physician and at least one-half of the members
of such body shall be individuals who are not providers of health care.

3. For multicounty service areas, each participating county shall have at
least one representative on the board of trustees. The remaining members
shall be appointed in proportion to the populations of the participating
counties within the service area.

4. The terms of office of the members of the board of trustees shall be
three years except that of the first appointments, the terms of the
members shall be staggered as follows:

(1) In multicounty service areas, one member from each county shall be
appointed to a three-year term. Counties which have two or more
representatives shall appoint one member to a two-year term. Counties
having more than two representatives shall appoint one-third of its
members to one-year terms, one-third to two-year terms, and one-third to
three-year terms.

(2) In service areas entirely within a county, one-third of the members
shall be appointed for one year, one-third for two years, and one-third
for three years. (L. 1969 S.B. 168 § 10, A.L. 1978 S.B. 652, A.L. 1990
H.B. 1383)

Effective 1-1-91

*This section has no continuity with § 205.984 repealed by S.B. 652, 1978.

1. Sections 205.975 to 205.990 shall not affect the validity of
community mental health centers and other providers of any comprehensive
mental health services as designated by the department and governing
boards of such centers and providers established and appointed before a
county or combination of counties elects to provide funds to accomplish
the purposes as set out in sections 205.975 to 205.990. However, this
section shall not be construed to preclude reconstitution of the centers
or other entities and their governing boards to include all or a portion
of the board of trustees.

2. Nothing in sections 205.975 to 205.990 shall preclude a board of
trustees of a service area within a county or of a combination of
counties within a service area from contracting with an existing public
facility or not-for-profit organization to provide any comprehensive
mental health services for the residents of the county or the area to be
served. (L. 1969 S.B. 168 § 11, A.L. 1978 S.B. 652, A.L. 1990 H.B. 1383)

Effective 1-1-91

*This section has no continuity with § 205.985 repealed by S.B. 652, 1978.

The board of trustees appointed by a county or participating
counties shall have the following powers and responsibilities to
administratively control and manage the community mental health fund to
accomplish the purposes as set out in sections 205.977 and 205.982:

(1) In the case of a community mental health center, mental health
clinic, or any comprehensive mental health service established by a
county or combination of counties, the center, clinic, or service shall
be under the administrative control and management of the board of
trustees which shall be the governing board which may employ necessary
personnel, fix their compensation, and provide quarters and equipment for
the operation with funds from federal, state, county, and city
governments available for that purpose and which shall take steps as it
deems necessary to secure private and public funds to help support the
centers, clinics, or services;

(2) In the case of a county or combination of counties providing funds to
supplement existing funds or purchase services from an existing community
mental health center, mental health clinic, or other public facility or
not-for-profit corporation as designated by the department, the board of
trustees shall administer and disburse the community mental health fund
for the provision of any comprehensive mental health services;

(3) The board of trustees has the authority to contract with existing
public facilities or not-for-profit corporations to provide services for
the residents of the county or the service area to be served;

(4) The board of trustees shall submit information as required on the
disbursement of moneys from the community mental health fund set up to
accomplish the purposes as set out in sections 205.977 and 205.982 to the
department by such date as it specifies in order to facilitate annual
preparation of regional and state plans. (L. 1969 S.B. 168 § 12, A.L.
1978 S.B. 652, A.L. 1990 H.B. 1383)

Effective 1-1-91

*No continuity with § 205.986 as repealed by L. 1978 S.B. 652.

1. In consultation with the state advisory council for
comprehensive psychiatric services and existing public or private
entities providing any comprehensive community mental health services,
the department shall develop and promulgate standards of construction,
staffing, operations, and services which any public or private entity
providing any comprehensive mental health services shall meet before
funds collected pursuant to sections 205.975 to 205.990 may be disbursed.
The records, operations, and services provided by any entity under
sections 205.975 to 205.990 shall be subject to annual review or
inspection by the department.

2. Any entity which provides or seeks to provide any comprehensive mental
health service and desires to apply for federal community mental health
grants for the purpose of constructing, operating, maintaining, or
staffing a comprehensive mental health service shall meet all standards
of construction, staffing, operations, and maintenance as developed and
promulgated by the department in consultation with the state advisory
council for comprehensive psychiatric services and existing public or
private entities providing any comprehensive mental health services. Such
entities shall be subject to annual review and inspection by the
department. (L. 1969 S.B. 168 § 13, A.L. 1978 S.B. 652)

*No continuity with § 205.987 as repealed by L. 1978 S.B. 652.

In addition to duties and powers elsewhere provided in sections
205.975 to 205.990, the department shall do the following:

(1) Develop and establish arrangements and procedures for the effective
coordination and integration of department services and community mental
health services;

(2) Provide consultative services to counties seeking to establish or
support community mental health services, and provide other consultative
services to the counties, community mental health centers, mental health
clinics, or any comprehensive mental health service as the department may
deem feasible and appropriate;

(3) Develop and collect information needed to perform its duties in such
a manner that the identity of any individual who receives a service from
an entity receiving funds pursuant to sections 205.975 to 205.990 shall
be confidential in accordance with state and federal law. (L. 1978 S.B.
652)

1. No person because of inability to pay shall be denied the
services of a community mental health center, mental health clinic, or
other public facility or not-for-profit corporation in which a county or
participating counties have established services or provided funds
pursuant to sections 205.975 to 205.990.

2. Based on their abilities to pay, persons receiving any comprehensive
mental health services funded either in whole or in part in accordance
with sections 205.975 to 205.990 shall be charged for the services. The
amounts necessary to be charged for the services shall be related to the
actual per capita inpatient costs or actual outpatient or examination or
other service costs. (L. 1978 S.B. 652)

1. If a community mental health center, mental health clinic, or
any comprehensive mental health service is supported by some
participating counties, but not by all the counties within the service
area, then the center or clinic shall charge the nonparticipating
counties for services rendered to persons not able to pay who are
residents of such nonparticipating counties.

2. The amounts to be charged to the counties not participating shall be
the same proportion of the actual per capita inpatient costs or actual
outpatient costs for examination or other service costs as the proportion
borne by the participating counties of the actual expenses of providing
the comprehensive mental health service rendered to each person not able
to pay who is a resident of a county not participating.

3. For the purpose of this section, the county of residence shall be
determined as follows:

(1) If an individual is receiving a service that includes nighttime
sleeping accommodations, his county of residence shall be that county in
which the individual maintains his primary place of residence at the time
he entered the community mental health center, mental health clinic, or
other comprehensive mental health service;

(2) If an individual is receiving a service that does not include
nighttime sleeping accommodations, his county of residence shall be that
county in which the individual maintains his primary place of residence.
(L. 1978 S.B. 652, A.L. 1990 H.B. 1383)

Effective 1-1-91

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