License Application - Missouri Department of Health & Senior Services - health mo 2026

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The document is a Ground Ambulance Service License Application from the Missouri Department of Health and Senior Services, Bureau of Emergency Medical Services. It outlines the requirements for initial licensure and relicensure of ambulance services, including details about the service's trade name, operator, medical directors, and service area. The application also includes a certification statement regarding compliance with regulations and a warning against false statements. Additionally, there is an addendum for providing information on satellite service locations.
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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the 'Trade Name of Ambulance Service' and the number of vehicles you operate. Ensure this information is accurate as it will be displayed on your vehicle.
  3. Fill in the 'Operator of Ambulance Service' section with the name of the operator and manager, along with their mailing address and contact numbers. This ensures that all communications are directed correctly.
  4. Complete the 'Medical Director' section by providing their name, contact details, and confirming their agreement to serve. This is crucial for compliance with state regulations.
  5. In the 'Ambulance Service Licensee' section, provide details about your organization, including the CEO's name and business address. Make sure to certify that all information is true and complete.
  6. If applicable, complete the addendum regarding satellite service locations. Indicate if there are any changes since your last licensure period.

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DHSS will achieve optimal health and safety for all Missourians, in all communities, for life by promoting health and safety through prevention, collaboration, education, innovation, and response while maintaining our values of excellence, collaboration, access, integrity, and accountability.
MO HealthNet provides financial assistance with medical expenses for people who meet the programs eligibility guidelines. Prescription drugs and medical treatments that have been approved by your doctor are generally covered, though some restrictions apply to certain medications and procedures.
Both residential care and assisted living facilities must provide at least 70 square feet of usable living space per resident. For every six people in residence, facilities must provide at least one bathroom, and for every 20 residents there must be at least one bath or shower.
Home and Community Based Services are available for adults ages 18 years of age and over who have Medicaid or are potentially Medicaid eligible and in need of assistance in the home.
Sarah Willson was appointed director of the Missouri Department of Health and Senior Services by Gov. Mike Kehoe on Jan. 14, 2025. Willson brings a wealth of valuable experience to DHSS given her background as a practicing nurse and healthcare executive.

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People also ask

Missouri requires home care agencies offering personal care services to obtain a license from the Department of Health and Senior Services (DHSS). If your agency provides only companionship and housekeeping, a license may not be needed, but you should verify local requirements.
The Department of Social Services partners with families and communities to protect children, rehabilitate youth and move families to self sufficiency so that Missourians can lead safe, healthy and productive lives.
The Division of Community and Public Health is responsible for supporting and operating more than 100 programs and offices addressing public health issues such as communicable disease control, chronic disease management, genetic health conditions, cancer, pregnancy, vital statistics, oral health and health care access.

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