Thank you
As you may have heard, I was out with an unexpected illness and emergency surgery on May 12. I have been blessed with a great employer, skilled providers and an out of this world support system. From my family and friends to so many of you – my professional colleagues – who have kept me and my family in their thoughts, checked on us, sent emails and cards, and more, I just want to say thank you. I am glad to report I am on the road to recovery!
The Federal Front
Uncertainties persist as to what the final health and safety infrastructure and funding mechanisms will look like on the federal level. While all things are subject to change, health and safety priorities have remained relatively stable for the past several administrations. The current administration has communicated clearly that there will be a strengthened focus on shifting the healthcare system towards a greater emphasis on prevention and personalized care, with the goal of "Making America Healthy Again."
The MAHA initiative focuses on several key areas, one of which includes promoting patient engagement in healthy lifestyles and preventing or managing chronic diseases, such as obesity and autoimmune disorders. The MAHA Commission recently released its report. The report relays what the Commission believes to be some of the root causes of chronic disease and the need to address those rather than continue to address the symptoms of chronic disease. The report highlights the importance of efforts to improve nutrition policies, such as establishing a national standard for phasing out certain food dyes. There is a focus on encouraging nutrition, ingredient transparency and fitness to improve children's health.
There is also focus on public health, highlighting the need to evaluate and reform the current health care system to align with MAHA priorities. This may result in regulatory shifts toward preventive care and wellness programs. Additionally, a focus on combating areas of fraud, waste and abuse in the healthcare sector.
The full President's budget request, including the FY2026 discretionary budget request, was released by the White House on May 30, 2025. As it relates to Health and Human Services, the following budget brief provides a summary of the focal points of the FFY26 budget. At the Department of Health and Senior Services, we have been working to understand the potential impact of a changing environment and how we can facilitate progress and strengthening Missouri’s public health system. The department is evaluating where current alignment exists and where future opportunities may lie.
The Legislative Review
I'd like to congratulate all the legislative, policy, legal and budget team members at DHSS and within your teams who worked to make the 2025 Legislative Session such a success. It was fruitful not only for the department, but -- most importantly -- also for the Missourians we serve. I enjoyed getting to know many legislators and their priorities in my first session as director. I look forward to serving as a trusted source of information for public health and health care.
Thank you to DHSS Legislative Liaison Ben Terrell for providing the legislative review below. There were a number of initiatives Truly Agreed and Finally Passed (TAFP) by the General Assembly that are awaiting the Governor’s signature. The department works with the Governor’s Office and members of the General Assembly to educate on public health related issues impacting Missourians and to carry out the laws as written. The Governor has until July 14 to take action on legislation and until June 30 to take action on budget items.
Note: Those in bold were DHSS proposals. These items are all pending the Governor’s approval.
Legislation:
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Healthcare Workforce Recruitment – The legislature modified an existing student loan repayment program that provides incentives to healthcare workers to work in an underserved area. Specifically, these changes added all professions that are eligible under the federal program, allowing DHSS to apply for the full program funding (a potential increase of up to $575,000 a year), and added protections for existing professions in statute to ensure existing professions do not lose funding.
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SB 79: Expedited Partner Therapy – The legislature will allow more health care professionals to offer expedited partner therapy (EPT), which is a practice where licensed professionals can prescribe treatment to an individual with a sexually transmitted infection (STI) and also prescribe that same treatment to their partner without an evaluation. Current law limited EPT’s use to chlamydia or gonorrhea and the legislation adds trichomoniasis (“trig”) and other diseases designated by DHSS or recommended by the CDC.
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SB 79: Telehealth Services – The legislature expanded the use of telehealth to include audiovisual and audio only technologies.
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SB 79 and SB 271: SANE Telehealth Cleanup – The legislature removed requirements for specialty hospitals (such as mental institutions) to comply with the sexual assault forensic program.
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SB 79: Medicaid Coverage for Hearing Devices – This legislation made hearing devices eligible for Medicaid coverage, pending a State Plan Amendment.
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SB 79: Prenatal Testing – Current law requires physicians to offer testing for certain diseases to pregnant women early in their pregnancy. The legislation requires physicians to offer more frequent testing, now including at the first prenatal exam (or shortly thereafter), at 28 weeks of pregnancy, and then a final test after birth. Tests that must be offered are for syphilis, hepatitis B, hepatitis C, human immunodeficiency virus (HIV), and other diseases as determined by the DHSS.
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SB 79: Coverage for Contraceptives – The legislature mandated insurance coverage allow for up to a six months supply of generic contraceptives.
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SB 79: Mammograms – The legislature removed a confusing statutory requirement for mammography reports, allowing a more thorough and flexible federal standard to be the sole standard.
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HB 121, SB 43, and Budget: Newborn Safety Incubators – The legislature created a fund of $250,000 to support the instillation of newborn safety incubators.
- SB 68: Lead Standard Cleanup – Current law establishes two different sections that govern lead contamination in schools, which can lead to confusion on how to implement these standards. This legislation condensed these standards into one section to clear up this confusion for schools, thus expediting the management of lead in school drinking water.
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SB 348: Awareness months:
- Ovarian Cancer Awareness Month – September
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“Believe in Gianna” Day – November 13, meant to raise awareness of Sanfilippo Syndrome.
- Alpha-Gal Syndrome Awareness Month – May
- Amyloidosis Awareness Day – May 8
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SB 271 and HB 225: EMS Regulation Modifications:
- Ground Ambulance Reimbursement Allowance Tax – Allows the University of Missouri to participate in the reimbursement allowance tax which will increase federal FRA drawdown.
- Training Requirements for Ambulance Districts – Establishes training requirements for members of an ambulance district administrators and board of directors and provides for the enforcement of these requirements.
- Ambulance District Fiscal Oversight – Gives the DHSS authority to intervene in the instance of an ambulance districts insolvency.
- State Advisory Council on Emergency Medical Services – Allows for the appointment of advisory council members by the Director of the DHSS and modifies the membership of this council.
Budget Items:
- Additional DHSS Staffing – DHSS was granted additional FTE in a variety of areas to support departmental operations. These areas include ongoing administrative duties as well as for support that DHSS provides to MO HealthNet to best protect the state’s public health.
- Complex Care Assistant Program – Funding was included in the DHSS budget for a model of in-home care for medically complex children that is provided by care assistants as opposed to nurses. Care will still be directed by nurses but will allow for more flexibility in selecting caregivers to help alleviate the nursing shortage.
- Emergency Communication System – DHSS administers funding that supports the technology platform EMResource, which is how hospitals and EMS providers communicate in order to safely take patients to the best place for treatment. This funding was included due to the federal funding source being eliminated.
- Parkinson’s Disease Registry – The legislature included funding to support the University of Missouri creating a Parkinson’s disease registry.
- Prescribed Pediatric Extended Care – Funding was included to effectively implement the legislation passed in 2024 that established the Prescribed Pediatric Extended Care model. This model is for medically complex children that need skilled nursing care and it allows them to receive this care in a childcare setting so they can be with other children as they develop. This is also a Medicaid reimbursable program.
- Tobacco Prevention and Cessation – The legislature added more funding for the Department’s tobacco prevention and cessation programs, amounting to a $3.9 million increase.
- Ventilator Maintenance – Funding was included to maintain 100 ventilators that DHSS already owns that can be deployed during emergencies and for facilities needing additional ventilators on a more routine basis.
- Vital Records System Upgrade – Federal funding supporting the Missouri Vital Records system upgrade ended earlier this year, so the Missouri General Assembly included funding to maintain this project and ensure every Missourian can benefit from the improvements this system will bring.
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