Mo. Rev. Stat. § 189.025

The director shall promptly propose such allocations in the statements which he shall determine to be reasonably necessary to conform to the provisions of sections 189.010 to 189.085 and which are within the limits of the budget recommendations. He shall, thereupon, determine the local public hospital tax effort for patient care for the fiscal year. He shall report this amount to the state board of health and senior services and the chief fiscal officers of the city, county, corporation, or district, accompanied by the proposed allocations.