2025 Updates Post-MASN Conference
There are several bills that the legislative committee is watching, the following is one that could be cause for a "Call to Action". This is when we ask our members to call or email their legislators and provide education (which we provide) as to why this bill would be harmful to the health and well-being of our students, their families and our communities.
Missouri Association of School Nurses 
Advocating for Every Student's Health and Success
2025 – MASN & SLSSNA Legislative Priorities
MASN legislative update May 5, 2025
The Missouri Association of School Nurses, legislative priorities support our mission: The mission of MASN is to provide leadership, promote professional growth and to advance the practice of nursing for the benefit of children.
Remember, nothing is law until signed by Governor Kehoe.
MASN supports HB 553, SB 94, SB 68 & SB 7 – This bill adds single-use epinephrine nasal spray to provisions of statute that permit the possession and self-administration of the medication to treat a student's chronic health condition, such as asthma or anaphylaxis.
Rationale: Currently, there are 24,362 students K-12 with diagnosed life-threatening food allergies (Data from Students with Disease and Chronic Health Conditions in Public Schools, Missouri 2024-2025). Administration of epinephrine is the 1st line treatment for the onset of a life-threatening anaphylactic reaction. Hesitancy to self inject epinephrine can delay reversal of the reaction or even lead to death. Having the epinephrine nasal spray as an alternative can improve those outcomes. MASN testified in-person on March 5th and has provided written
testimony and informational education through several conversations with various legislators.
The bullets reflect the progress as of 5/5/2025 – After HB 553 passed the House of Representatives (H), it was amended to Senate Bill (SB) 94, SB 68 & SB 7.
SB 94 – Passed Senate, 4/17/2025 - Passed Health and Mental Health Committee
SB 68 – Passed Senate and House, 5/5/2025 Senator Henderson requests recede or conference with House re: amendments.
SB 7 – Passed the Senate and House, 5/5/2025 back to Senate with amendments
MASN supports SB 166, SB 68, HB 232 & HB 416 – requires public schools to develop cardiac emergency response plans. Rationale: According to the American Heart Association, of the 350,000 cardiac arrests that occur outside of the hospital every year, more than 23,000 of those cardiac arrests are children. Did you know that 90 percent of people who suffer cardiac arrest outside of a hospital do not survive. CPR, if performed immediately, can double, or triple a cardiac arrest victim’s chance of survival (AHA, 2025). In some rural areas of Missouri, a 911 response can take up to 45 minutes. Sudden cardiac arrest is a growing concern. Schools are a
place of gathering for students, educators, and the community, as family and friends support children in performances, sporting events, and religious or cultural activities (Evans & Legg, 2024). A recent article reviewed data for pediatric bystander CPR and AED use as it relates to out-of-hospital cardiac arrest survival. The recommendation was that all schools should have a cardiac emergency response plan (Berger, 2020). In 2024, there were three cardiac arrests in three different school districts in Missouri. Today, thanks to their existing cardiac emergency response plans, a parent, and two children are alive and well. MASN and SLSSNA has sent in testimony in Support of these bills. In addition, educational materials have been provided.
SB 166 – 4/10/2025 SB 166 was Third Read and passed by the Senate and had its first
Read in the House. Language similar to SB 166 is amended onto SB 68, HB 232, and HB 416.
SB 68 – 2/27/2025 Third Read and passed by Senate, 4/24/2025 Third Read and
passed by House. Back to Senate 5/5/2025 SS for SCS for SB 68 - (Senator Henderson
requests House to recede or grant conference on amendments). Stay tuned!
HB 232 – 4/10/2025 Third Read and passed by House. 4/29/2025 Voted Do Pass by
Senate Education Committee.
HB 416 – 3/27/2025 Third Read and Passed House. 4/10/2025 Second Read Senate
Education Committee
MASN supports HB 355, which would provide a state supplement for public schools to hire a school nurse and a mental health professional.
Rationale: Currently, approximately 100 MO public schools do not have a registered nurse (school nurse). Most of these schools/districts are in rural MO where in many cases a 911 response can take 45 minutes. Chronic health conditions in school-aged children are on the rise and require monitoring, administration of
medication, nursing and medical procedures and planning for potential emergency care. According to the American Academy of Pediatrics, “a school nurse is a central need for school health services and has the assessment skills to manage the following potentially emergent situations as well as provide daily care.” This bill has been introduced for several years.
Currently, no movement since 3/19/2025, the bill is sitting with the House Education committee. Informational data to support the need for school nurses and mental health professionals given to each Elementary and Secondary Education committee member.
The Missouri Association of School Nurses supports HB 553 would add FDA approved, single-use epinephrine nasal spray to provisions of statute that permit the possession and self-administration of the medication to treat a student's chronic health condition, such as asthma or anaphylaxis. Currently, there are 24,362 students K-12 with diagnosed life-threatening food allergies (Students with Disease and Chronic Health Conditions in Public Schools, Missouri 2024-2025). Administration of epinephrine is the 1st line treatment for the onset of a life-threatening anaphylactic reaction. Hesitancy to self-inject epinephrine can delay reversal of the reaction or even lead to death. Having the epinephrine nasal spray as an alternative can improve those outcomes.
MASN testified in-person on March 5th and provided informational education about
epinephrine nasal spray to each Health and Mental Health Committee members and Rules. It
was voted Do Pass by Health and Mental Health on 3/12/2025 and by Rules on 4/10/2025. Next
it will go to a House of Representatives floor vote. If voted Do Pass it will probably go to Fiscal
Oversite, then a Third read in the House then hopefully sent to the Senate. It will either go
through the whole Senate process or may be tagged on to another Bill in progress. Either way,
time is running short.
The Missouri Association of School Nurses supports HB 355, which would provide a state supplement for public schools to hire a school nurse and a mental health professional. Currently, approximately 100 MO public schools do not have a registered nurse (school nurse). Most of these schools/districts are in rural MO where in many cases a 911 response can take 45 minutes. Chronic health conditions in school-aged children are on the rise and require monitoring, administration of medication, nursing and medical procedures and planning for potential emergency care. According to the American Academy of Pediatrics, “a school nurse is a central need for school health services and has the assessment skills to manage the following potentially emergent situations as well as provide daily care.”
This bill has been introduced for several years and would create the "School Nurse Financial Supplement Fund" and the "School Mental Health Professional Financial Supplement Fund". It would require DESE to create rules ensuring that positions funded with supplement money only perform duties associated with the job. Preference would be given to schools with the greatest need. Currently the bill is sitting with the House Education committee. Informational data to support the need for school nurses and mental health professionals given to the Elementary and Secondary Education committee.
The Missouri Association of School Nurses supports SB 166 & HB 232 requires public schools to develop cardiac emergency response plans. According to the American Heart Association, of the 350,000 cardiac arrests that occur outside of the hospital every year, more than 23,000 of those cardiac arrests are children. Did you know that 90 percent of people who suffer cardiac arrest outside of a hospital do not survive. CPR, if performed immediately, can double, or triple a cardiac arrest victim’s chance of survival (AHA, 2025). In some rural areas of Missouri, a 911 response can take up to 45 minutes. Sudden cardiac arrest is a growing concern. Schools are a place of gathering for students, educators, and the community, as family and friends support children in performances, sporting events, and religious or cultural activities (Evans & Legg, 2024). A recent article reviewed data for pediatric bystander CPR and AED use as it relates to out-of-hospital cardiac arrest survival. The recommendation was that all schools should have a cardiac emergency response plan (Berger, 2020). In 2024, there were three cardiac arrests in three different school districts in Missouri. Today, thanks to their existing cardiac emergency response plans, a parent, and two children are alive and well. MASN and SLSSNA has sent in testimony in Support of these bills. In addition, educational materials have been provided.
4/18/2025 updates:
HB 553 - would add single-use epinephrine nasal spray to provisions of our current epinephrine statute. MASN is in support of this legislation and has provided letters of support and testified in person. Currently HB 553 has passed the House and has been amended to SB 7 and SB 94, both are progressing well at this point. Your MASN legislative committee has worked diligently with Representative Terri Violet the sponsor of HB 553 and Representative Brad Christ the House handler of SB 7.
HB 232, HB 416, & SB 166 would require the development of Cardiac Emergency Response Plans in schools by the 2026-2027 school year. MASN is in support of this legislation. HB 232 & 416 have passed the House and are currently in the process of going through the Senate. Senate Bill 166 has passed the Senate and is currently going through the House process. MASN has provided testimony/emails in support of these bills. Additionally other MASN members have shared their stories of saving a life at school thanks to their Cardiac emergency response plan.
HB 355 - would provide a state supplement for public schools to hire a school nurse and a mental health professional. This bill has been re-introduced several times and has failed to make it to the Governor's desk. MASN is in support of this Bill, This year the legislative committee shared the STUDENTS WITH DISEASE AND CHRONIC HEALTH CONDITIONS IN PUBLIC SCHOOLS,
MISSOURI 2024-2025 data sheet with several legislators, The bill is currently sitting with the House Education Committee.
On April 2, 2025 - five MASN members attended Child Advocacy Day in Jefferson City at the Capital, We had some great conversations with our legislators and shared our MASN legislative priorities and data sheets. We were also able to thank some legislators for supporting bills that have the potential to improve child/youth health outcomes and our school nursing practice.
Please look for future legislative messages to learn more about important legislation and how you can make a difference in the health and wellbeing of the children in Missouri.
Respectfully,
Tamara Smith-Hinchey, Legislative Chair
Linda Neumann, Committee member