HF 1930

4th Engrossment - 93rd Legislature (2023 - 2024) Posted on 03/21/2024 03:40pm

A bill for an act
relating to health; establishing an end-of-life option for terminally ill adults with
a prognosis of six months or less; providing criminal penalties; classifying certain
data; requiring reports; providing immunity for certain acts; authorizing
enforcement; amending Minnesota Statutes 2022, section 609.215, subdivision 3;
Minnesota Statutes 2023 Supplement, sections 61A.031; 144.99, subdivision 1;
proposing coding for new law as Minnesota Statutes, chapter 145E.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

END-OF-LIFE OPTION ACT

Section 1.

new text begin [145E.01] CITATION.
new text end

new text begin This chapter may be cited as the "End-of-Life Option Act."
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 2.

new text begin [145E.02] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin For purposes of this chapter, the terms defined in this section
have the meanings given.
new text end

new text begin Subd. 2. new text end

new text begin Attending provider. new text end

new text begin "Attending provider" means the provider who has primary
responsibility for the care of the individual and treatment of the individual's terminal disease.
new text end

new text begin Subd. 3. new text end

new text begin Consulting provider. new text end

new text begin "Consulting provider" means a provider, other than an
individual's attending provider, who is qualified by specialty or experience to make a
professional diagnosis and prognosis regarding the individual's terminal disease.
new text end

new text begin Subd. 4. new text end

new text begin Health care facility. new text end

new text begin "Health care facility" means a hospital, nursing home,
hospice facility, assisted living facility, any other entity governed by chapter 144 or 144A,
or a medical clinic. Health care facility does not include individual providers.
new text end

new text begin Subd. 5. new text end

new text begin Health plan. new text end

new text begin "Health plan" has the meaning given in section 62A.011,
subdivision 3.
new text end

new text begin Subd. 6. new text end

new text begin Informed decision. new text end

new text begin "Informed decision" means a decision by a qualified
individual to request and obtain a prescription for medical aid in dying medication pursuant
to this chapter, after being fully informed by the attending provider and consulting provider
as required under section 145E.15.
new text end

new text begin Subd. 7. new text end

new text begin Intentionally. new text end

new text begin "Intentionally" has the meaning given in section 609.02,
subdivision 9, clause (3).
new text end

new text begin Subd. 8. new text end

new text begin Licensed mental health consultant. new text end

new text begin "Licensed mental health consultant" means
an individual who:
new text end

new text begin (1) is licensed by the profession's licensing board as a: (i) psychiatrist; (ii) psychologist;
(iii) licensed independent clinical social worker; or (iv) registered nurse who is certified as:
(A) a clinical nurse specialist in child or adolescent, family, or adult psychiatric and mental
health nursing by a national nurse certification organization; or (B) a nurse practitioner in
adult or family psychiatric and mental health nursing by a national nurse certification
organization; and
new text end

new text begin (2) has competence, according to the laws governing the practice of their profession, to
determine the mental capability of individuals with a terminal disease.
new text end

new text begin Subd. 9. new text end

new text begin Medical aid in dying. new text end

new text begin "Medical aid in dying" means the practice by a provider
of evaluating a request, determining qualification, providing a prescription for medical aid
in dying medication to a qualified individual, and when permissible dispensing the
medication.
new text end

new text begin Subd. 10. new text end

new text begin Medical aid in dying medication. new text end

new text begin "Medical aid in dying medication" means
a medication prescribed and dispensed pursuant to this chapter that a qualified individual
may self-administer to bring about the qualified individual's peaceful death.
new text end

new text begin Subd. 11. new text end

new text begin Mentally capable. new text end

new text begin "Mentally capable" means the individual requesting medical
aid in dying medication has the ability to make an informed decision.
new text end

new text begin Subd. 12. new text end

new text begin Prognosis of six months or less. new text end

new text begin "Prognosis of six months or less" means
that a terminal disease will, within reasonable medical judgment, result in death within six
months.
new text end

new text begin Subd. 13. new text end

new text begin Provider. new text end

new text begin "Provider" means:
new text end

new text begin (1) a doctor of medicine or osteopathy licensed by the Minnesota Board of Medical
Practice pursuant to chapter 147;
new text end

new text begin (2) an advanced practice registered nurse licensed by the Minnesota Board of Nursing
and certified by a national nurse certification organization acceptable to the board to practice
as a clinical nurse specialist or nurse practitioner pursuant to sections 148.171 to 148.285;
or
new text end

new text begin (3) a physician assistant licensed by the Minnesota Board of Medical Practice pursuant
to chapter 147A.
new text end

new text begin Provider does not include a health care facility.
new text end

new text begin Subd. 14. new text end

new text begin Qualified individual. new text end

new text begin "Qualified individual" means an individual who meets
the criteria in section 145E.10, subdivision 1.
new text end

new text begin Subd. 15. new text end

new text begin Self-administer. new text end

new text begin "Self-administer" means the performance of an affirmative,
conscious, voluntary act to ingest medical aid in dying medication, including by means of
enteral administration. Self-administration does not include administration by intravenous
or other parenteral injection or by infusion.
new text end

new text begin Subd. 16. new text end

new text begin Terminal disease. new text end

new text begin "Terminal disease" means an incurable and irreversible
disease that will, within reasonable medical judgment, produce death within six months.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 3.

new text begin [145E.05] INFORMED CONSENT; MEDICAL STANDARD OF CARE.
new text end

new text begin Subdivision 1. new text end

new text begin No limitation on provision of information. new text end

new text begin Nothing in this chapter
limits the information a provider must provide to an individual to comply with Minnesota
informed consent laws and the medical standard of care.
new text end

new text begin Subd. 2. new text end

new text begin Medical standard of care. new text end

new text begin (a) Medical care that complies with the requirements
of this chapter meets the medical standard of care.
new text end

new text begin (b) Nothing in this chapter exempts a provider or other medical personnel from meeting
medical standards of care for the treatment of an individual with a terminal disease.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 4.

new text begin [145E.10] MEDICAL AID IN DYING MEDICATION; QUALIFICATION;
REQUEST.
new text end

new text begin Subdivision 1. new text end

new text begin Qualifications. new text end

new text begin Any individual may request medical aid in dying
medication. In order to obtain a prescription for medical aid in dying medication, the
individual must:
new text end

new text begin (1) be 18 years of age or older;
new text end

new text begin (2) be mentally capable, as determined according to section 145E.15;
new text end

new text begin (3) have a terminal disease with a prognosis of six months or less;
new text end

new text begin (4) not be subject to guardianship or conservatorship; and
new text end

new text begin (5) request a prescription for medical aid in dying medication according to the process
in subdivision 2, from an attending provider who meets the requirements in section 145E.15,
subdivision 1, and a consulting provider who meets the requirements in section 145E.15,
subdivision 2.
new text end

new text begin No individual is a qualified individual solely because of advanced age or disability.
new text end

new text begin Subd. 2. new text end

new text begin Request process. new text end

new text begin (a) An individual seeking medical aid in dying medication
must make one oral request and one written request to the individual's attending provider
and one oral request to the consulting provider. The written request must be in substantially
the form specified in subdivision 4, and witnessed by an individual meeting the requirements
of subdivision 3.
new text end

new text begin (b) Oral and written requests for medical aid in dying medication may be made only by
the individual who will self-administer the medication. A request for medical aid in dying
medication shall not be made by the individual's guardian, conservator, surrogate
decision-maker, health care proxy, or attorney-in-fact for health care, nor via advance health
care directive.
new text end

new text begin (c) For an individual seeking medical aid in dying medication who has difficulty with
oral communication, the following may qualify as an oral request:
new text end

new text begin (1) use of written materials;
new text end

new text begin (2) use of technology-assisted communication;
new text end

new text begin (3) use of an interpreter; or
new text end

new text begin (4) use of other assistance with communication consistent with Title III of the Americans
with Disabilities Act.
new text end

new text begin Subd. 3. new text end

new text begin Witness. new text end

new text begin The witness to a written request for medical aid in dying medication
must be 18 years of age or older and at the time the request is signed must not be:
new text end

new text begin (1) a relative by blood, marriage, or adoption of the requesting individual;
new text end

new text begin (2) entitled to any portion of the estate of the requesting individual upon the requesting
individual's death, under any will or by operation of law;
new text end

new text begin (3) an owner, operator, or employee of a health care facility or provider where the
requesting individual is receiving medical treatment or is a resident;
new text end

new text begin (4) the requesting individual's attending provider; or
new text end

new text begin (5) serving as an interpreter for the requesting individual.
new text end

new text begin Subd. 4. new text end

new text begin Written request. new text end

new text begin In order to be valid, a written request for medical aid in dying
medication must be in substantially the form below, must be signed and dated by the
individual seeking medical aid in dying medication, and must be witnessed by at least one
individual meeting the requirements of subdivision 3 who, in the presence of the individual
seeking medical aid in dying medication, attests that to the best of the witness's knowledge
and belief the individual seeking medical aid in dying medication is mentally capable, acting
voluntarily, and is not being coerced nor unduly influenced to sign the request.
new text end

new text begin Request for Medication to End My Life in a Peaceful Manner
new text end

new text begin I, ..................................................., am an adult of sound mind. I have been diagnosed
with ............................................................ and given a prognosis of six months or less to
live. I have been fully informed of the feasible alternative, concurrent, or additional treatment
opportunities for my terminal disease, including but not limited to comfort care, palliative
care, hospice care, or pain control, and of the potential risks and benefits of each. I have
been offered and received resources or referrals to pursue these alternative, concurrent, or
additional treatment opportunities for my terminal disease.
new text end

new text begin I have been fully informed of the nature, risks, and benefits of the medication to be
prescribed, including that the likely outcome of self-administering the medication is death.
I understand that I can rescind this request at any time and that I am under no obligation to
fill the prescription once written, nor to self-administer the medication if I obtain it.
new text end

new text begin I request that my attending provider furnish a prescription for medication that will end
my life in a peaceful manner if I choose to self-administer it, and I authorize my attending
provider to contact a pharmacist to dispense the prescription.
new text end

new text begin I make this request voluntarily, free from coercion or undue influence, and attest that
no one has attempted, by deception, intimidation, or other means, to cause me to request
this prescription.
new text end

.	.
new text begin Requestor Signature new text end	new text begin Date new text end

new text begin Witness:
new text end

new text begin (i) In my presence on ................................................... (date),
................................................... (name) acknowledged his/her signature on this document.
new text end

new text begin (ii) To the best of my knowledge and belief the person named above is mentally capable,
is acting voluntarily, and is not being coerced nor unduly influenced to sign this request for
medical aid in dying medication.
new text end

new text begin (iii) I am at least 18 years of age.
new text end

new text begin (iv) I am not a relative of the person named above by blood, marriage, or adoption.
new text end

new text begin (v) I am not entitled to any portion of the estate of the person named above upon that
person's death under any will or by operation of law.
new text end

new text begin (vi) I am not an owner, operator, or employee of a health care facility or provider where
the person named above is receiving medical treatment or is a resident.
new text end

new text begin (vii) I am not currently the attending provider of the person named above.
new text end

new text begin (viii) I am not currently serving as an interpreter for the person named above.
new text end

new text begin I certify that the information in (i) through (viii) is true and correct.
new text end

.

new text begin Signature of Witness new text end

.

new text begin Address new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 5.

new text begin [145E.15] RESPONSIBILITIES OF ATTENDING PROVIDER,
CONSULTING PROVIDER, LICENSED MENTAL HEALTH CONSULTANT, AND
PHARMACIST.
new text end

new text begin Subdivision 1. new text end

new text begin Attending provider responsibilities. new text end

new text begin (a) If an individual requests a
prescription for medical aid in dying medication from the individual's attending provider,
the attending provider must:
new text end

new text begin (1) determine whether the individual has a terminal disease with a prognosis of six
months or less;
new text end

new text begin (2) determine whether the individual is mentally capable or refer the individual for
confirmation of mental capability in accordance with subdivision 3;
new text end

new text begin (3) confirm that the individual's request does not arise from coercion or undue influence
by asking the individual outside the presence of other persons, except for an interpreter as
necessary, whether anyone has attempted, by deception, intimidation, or other means, to
cause the individual to request this prescription;
new text end

new text begin (4) inform the individual of:
new text end

new text begin (i) the individual's diagnosis;
new text end

new text begin (ii) the individual's prognosis;
new text end

new text begin (iii) the potential risks and benefits and the probable result of self-administering medical
aid in dying medication;
new text end

new text begin (iv) feasible end-of-life care and treatment options for the individual's terminal disease,
including but not limited to alternative, concurrent, or additional treatment options, comfort
care, palliative care, hospice care, and pain control, and the potential risks and benefits of
each; and
new text end

new text begin (v) the individual's right to rescind the request for medical aid in dying medication, or
consent for any other treatment, at any time and in any manner;
new text end

new text begin (5) inform the individual that there is no obligation to fill the prescription nor an
obligation to self-administer the medical aid in dying medication, if the medication is
obtained;
new text end

new text begin (6) offer the individual the opportunity to rescind the individual's request for medical
aid in dying medication;
new text end

new text begin (7) provide the individual with a referral for comfort care, palliative care, hospice care,
pain control, or other end-of-life treatment options as requested or as clinically indicated;
new text end

new text begin (8) refer the individual to a consulting provider for completion of the requirements in
subdivision 2;
new text end

new text begin (9) inform the individual of the benefits of notifying the individual's next of kin or other
important person of the individual's decision to request medical aid in dying medication;
new text end

new text begin (10) educate the individual on:
new text end

new text begin (i) the recommended procedure for self-administering the medical aid in dying medication
to be prescribed;
new text end

new text begin (ii) proper safekeeping and disposal of the medical aid in dying medication in accordance
with state and federal law;
new text end

new text begin (iii) the importance of having another person present when the individual self-administers
the medical aid in dying medication; and
new text end

new text begin (iv) not self-administering the medical aid in dying medication in a public place. For
purposes of this item, a health care facility is not considered a public place;
new text end

new text begin (11) document in the individual's medical record the individual's diagnosis and prognosis,
the attending provider's determination of mental capability or referral for confirmation of
mental capability by a licensed mental health consultant, the dates of all oral requests, a
copy of the written request, and a notation that the requirements under this subdivision have
been met; and
new text end

new text begin (12) include in the individual's medical record the consulting provider's written
confirmation that the requirements of subdivision 2 have been met and, if applicable, the
licensed mental health consultant's written determination.
new text end

new text begin (b) Upon the attending provider's completion of the steps in paragraph (a), the consulting
provider's completion of the steps in subdivision 2, and if applicable, the licensed mental
health consultant's completion of the steps in subdivision 3, the attending provider is
authorized to prescribe medical aid in dying medication and any ancillary medications for
the qualified individual. The attending provider must:
new text end

new text begin (1) deliver the prescription personally, by mail, or as an electronic order to a licensed
pharmacist; or
new text end

new text begin (2) if authorized by the Drug Enforcement Administration, dispense medical aid in dying
medication and any ancillary medications to the qualified individual or to an individual
expressly designated in person by the qualified individual to receive the medications.
new text end

new text begin (c) Upon prescribing medical aid in dying medication and any ancillary medications for
the qualified individual, the attending provider must identify the prescribed medications in
the qualified individual's medical record.
new text end

new text begin Subd. 2. new text end

new text begin Consulting provider qualifications and responsibilities. new text end

new text begin (a) If the attending
provider is not a doctor of medicine or osteopathy licensed by the Minnesota Board of
Medical Practice pursuant to chapter 147, the consulting provider must be a doctor of
medicine or osteopathy licensed by the Minnesota Board of Medical Practice pursuant to
chapter 147.
new text end

new text begin (b) Upon receiving a referral from an attending provider of an individual seeking medical
aid in dying medication, a consulting provider must:
new text end

new text begin (1) medically evaluate the individual and the individual's relevant medical records;
new text end

new text begin (2) determine whether the individual is mentally capable or refer the individual for
confirmation of mental capability in accordance with subdivision 3;
new text end

new text begin (3) confirm that the individual's request does not arise from coercion or undue influence
by asking the individual outside the presence of other persons, except for an interpreter as
necessary, whether anyone has attempted, by deception, intimidation, or other means, to
cause the individual to request this prescription;
new text end

new text begin (4) inform the individual of:
new text end

new text begin (i) the individual's diagnosis and prognosis;
new text end

new text begin (ii) feasible end-of-life care and treatment options for the individual's terminal disease,
including but not limited to alternative, concurrent, or additional treatment options, comfort
care, palliative care, hospice care, and pain control, and the risks and benefits of each;
new text end

new text begin (iii) the potential risk associated with taking medical aid in dying medication;
new text end

new text begin (iv) the probable result of taking medical aid in dying medication; and
new text end

new text begin (v) the individual's right to rescind a request for medical aid in dying medication, or
consent for any other treatment, at any time;
new text end

new text begin (5) if so determined by the consulting provider, provide written confirmation to the
attending provider that:
new text end

new text begin (i) the individual has made an oral request to the consulting provider for medical aid in
dying medication;
new text end

new text begin (ii) the individual has a terminal disease with prognosis of six months or less;
new text end

new text begin (iii) the individual is mentally capable or provide documentation that the consulting
provider has referred the individual for further evaluation in accordance with subdivision
3; and
new text end

new text begin (iv) the individual's request for medical aid in dying medication does not arise from
coercion or undue influence; and
new text end

new text begin (6) offer the individual an opportunity to rescind the request.
new text end

new text begin Subd. 3. new text end

new text begin Referral for confirmation of mental capability. new text end

new text begin (a) If either the attending
provider or the consulting provider is unable to confirm that the individual requesting
medical aid in dying medication is mentally capable, the attending provider or consulting
provider who cannot determine mental capability must refer the individual to a licensed
mental health consultant for a determination of mental capability.
new text end

new text begin (b) The licensed mental health consultant who evaluates the individual under this
subdivision must submit to the requesting provider a written determination of whether the
individual is mentally capable.
new text end

new text begin (c) If the licensed mental health consultant determines that the individual is not mentally
capable, the individual is not a qualified individual, and the attending provider must not
prescribe medical aid in dying medication to the individual.
new text end

new text begin Subd. 4. new text end

new text begin Pharmacist responsibilities. new text end

new text begin A pharmacist who receives a prescription for
medical aid in dying medication may dispense the medication and any ancillary medications
to the attending provider, to the qualified individual, or to an individual expressly designated
in person by the qualified individual. If dispensed, the medical aid in dying medication and
any ancillary medications must be dispensed in person or, with a signature required on
delivery, by mail service, common carrier, or messenger service.
new text end

new text begin Subd. 5. new text end

new text begin No duty to provide medical aid in dying. new text end

new text begin (a) A provider must provide sufficient
information to an individual with a terminal disease regarding available options, the
alternatives, and the foreseeable risks and benefits of each so that the individual is able to
make informed decisions regarding the individual's end-of-life health care.
new text end

new text begin (b) A provider may choose whether or not to practice medical aid in dying.
new text end

new text begin (c) If a provider is unable or unwilling to fulfill an individual's request for medical aid
in dying medication or to provide related information or services requested by the individual,
the provider must, upon request, transfer the individual's care and medical records to a new
provider consistent with federal and Minnesota law.
new text end

new text begin (d) Consistent with section 147.091, subdivision 1, paragraph (v); 147A.13, subdivision
1, clause (20); or 148.261, subdivision 1, clause (19), a provider must not engage in false,
misleading, or deceptive practices relating to the provider's willingness to qualify an
individual or to provide a prescription to a qualified individual for medical aid in dying
medication.
new text end

new text begin Subd. 6. new text end

new text begin No duty to fill a medical aid in dying medication prescription. new text end

new text begin (a) A
pharmacist may choose whether or not to fill a prescription for medical aid in dying
medication.
new text end

new text begin (b) Consistent with Minnesota Rules, part 6800.2250, a pharmacist must not engage in
false, misleading, or deceptive practices relating to the pharmacist's willingness to fill a
prescription for medical aid in dying medication.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 6.

new text begin [145E.20] SAFE DISPOSAL OF UNUSED MEDICATIONS.
new text end

new text begin After a qualified individual's death, an individual, facility, or staff member who has
possession, custody, or control of medical aid in dying medications must ensure disposal
of the medication in accordance with state or federal law or guidelines.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 7.

new text begin [145E.25] HEALTH CARE FACILITIES; PERMISSIBLE PROHIBITIONS
AND DUTIES.
new text end

new text begin Subdivision 1. new text end

new text begin Facility policies. new text end

new text begin (a) A health care facility may prohibit providers or
pharmacists from qualifying individuals or prescribing or dispensing medical aid in dying
medication while performing duties for the facility. A prohibiting health care facility must
give providers and pharmacists advance written notice of this policy at the time of hiring,
contracting with, or privileging the provider or pharmacist.
new text end

new text begin (b) No health care facility shall prohibit a provider or pharmacist from fulfilling the
requirements of informed consent and meeting the standard of medical care by:
new text end

new text begin (1) providing information to an individual regarding the individual's health status,
including but not limited to diagnosis, prognosis, recommended treatment, treatment
alternatives, and any potential risks to the individual's health;
new text end

new text begin (2) providing information about available services, relevant community resources, and
how to access those resources to obtain the care of the individual's choice; or
new text end

new text begin (3) providing information regarding health care services available under this chapter,
information about relevant community resources, and information about how to access those
resources for obtaining care of the individual's choice.
new text end

new text begin Subd. 2. new text end

new text begin Timely transfer. new text end

new text begin If an individual wishes to transfer care to another health care
facility, the facility currently providing care to the individual shall cooperate with a timely
transfer to the new facility, including transfer of the individual's medical records, in a manner
consistent with applicable federal and state laws.
new text end

new text begin Subd. 3. new text end

new text begin False, misleading, or deceptive practices prohibited. new text end

new text begin In accordance with
section 144.651, a health care facility shall not engage in false, misleading, or deceptive
practices relating to its policy with respect to medical aid in dying, including:
new text end

new text begin (1) whether it has a policy which prohibits affiliated providers or pharmacists from
determining an individual's qualification for medical aid in dying or from prescribing or
dispensing medical aid in dying medication to a qualified individual; or
new text end

new text begin (2) intentionally denying an individual access to medical aid in dying medication by
failing to transfer an individual and the individual's medical records to another provider or
health care facility in a timely manner.
new text end

new text begin Subd. 4. new text end

new text begin Conflict. new text end

new text begin If any part of this section is found to conflict with federal requirements
which are a required condition to the receipt of federal funds by a health care facility or the
state, the conflicting part of this section is inoperative solely to the extent of the conflict
with respect to the facility directly affected, and such finding or determination shall not
affect the operation of the remainder of this chapter.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 8.

new text begin [145E.30] IMMUNITIES FOR ACTIONS IN GOOD FAITH; PROHIBITION
AGAINST REPRISALS.
new text end

new text begin (a) No individual, including no provider, pharmacist, licensed mental health consultant,
or hospice provider employee, shall be subject to criminal liability or professional disciplinary
action, including censure, suspension, loss of license, loss of privileges, or any other penalty
for engaging in good faith compliance with this chapter.
new text end

new text begin (b) No provider or health care facility shall subject a provider, pharmacist, or licensed
mental health consultant to discharge, demotion, censure, discipline, suspension, loss of
license, loss of privileges, discrimination, or any other penalty for:
new text end

new text begin (1) providing medical aid in dying in accordance with the standard of care and in good
faith under this chapter while engaged in the outside practice of the individual's profession
and off the facility premises;
new text end

new text begin (2) providing scientific and accurate information about medical aid in dying to an
individual when discussing end-of-life care options; or
new text end

new text begin (3) choosing not to practice or participate in medical aid in dying.
new text end

new text begin (c) No individual shall be subject to civil or criminal liability or professional disciplinary
action if, at the request of the qualified individual, the individual is present outside the scope
of their employment contract and off the facility premises when the qualified individual
self-administers medical aid in dying medication or at the time of death. An individual who
is present may, without civil or criminal liability, assist the qualified individual by preparing
the medical aid in dying medication, including opening medication containers, measuring
the medication, or preparing an enteral dispenser containing the medication. The assisting
individual is not permitted to assist the qualified individual by administering a prepared
enteral dispenser to the qualified individual.
new text end

new text begin (d) The following acts do not constitute neglect or elder abuse and are not a basis for
appointment of a guardian or conservator:
new text end

new text begin (1) a request by an individual for medical aid in dying medication; or
new text end

new text begin (2) the provision of medical aid in dying medication.
new text end

new text begin (e) A failure by a provider or a licensed mental health consultant to confirm that an
individual requesting medical aid in dying medication is mentally capable is not a basis for
appointment of a guardian or conservator.
new text end

new text begin (f) This section does not limit civil liability for intentional or negligent misconduct.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 9.

new text begin [145E.35] REPORTING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Forms. new text end

new text begin The commissioner of health must develop and maintain an
attending provider checklist form and attending provider follow-up form to facilitate the
collection of the information described in this section. The commissioner must post the
forms on the Department of Health website. Failure by the commissioner to develop the
attending provider checklist form and attending provider follow-up form shall not delay the
effective date of this chapter and shall not relieve an attending provider of the responsibility
to submit the information in subdivision 2 or 3, as applicable, to the commissioner of health.
new text end

new text begin Subd. 2. new text end

new text begin Attending provider checklist form; submission requirements. new text end

new text begin Within 30
calendar days after providing a prescription for medical aid in dying medication, the attending
provider must submit to the Department of Health an attending provider checklist form with
the following information:
new text end

new text begin (1) the qualified individual's name and date of birth;
new text end

new text begin (2) the qualified individual's terminal diagnosis and prognosis;
new text end

new text begin (3) notice that the requirements under section 145E.15 were completed; and
new text end

new text begin (4) notice that the attending provider prescribed medical aid in dying medication to the
qualified individual.
new text end

new text begin Subd. 3. new text end

new text begin Attending provider follow-up form; submission requirements. new text end

new text begin Within 60
calendar days after receiving notice of a qualified individual's death from self-administration
of medical aid in dying medication prescribed by the attending provider, the attending
provider must submit to the Department of Health an attending provider follow-up form
with the following information:
new text end

new text begin (1) the qualified individual's name and date of birth;
new text end

new text begin (2) the date of the qualified individual's death; and
new text end

new text begin (3) an annotation of whether or not the qualified individual was enrolled in hospice
services at the time of the qualified individual's death.
new text end

new text begin Subd. 4. new text end

new text begin Review of forms; annual report. new text end

new text begin (a) Effective August 1, 2024, through July
31, 2028, the commissioner of health must annually review all of the forms submitted under
this section to ensure completeness, timeliness, and accuracy of submitted forms. Effective
August 1, 2028, the commissioner of health must annually review a sample of the forms
submitted under this section to ensure completeness, timeliness, and accuracy of submitted
forms.
new text end

new text begin (b) The commissioner of health must annually issue a public report with summary data
on the following for the most recent reporting period:
new text end

new text begin (1) the number of prescriptions for medical aid in dying medication provided;
new text end

new text begin (2) the number of providers who provided prescriptions for medical aid in dying
medication; and
new text end

new text begin (3) the number of qualified individuals who died following self-administration of medical
aid in dying medication.
new text end

new text begin (c) For purposes of this subdivision, "summary data" has the meaning given in section
13.02, subdivision 19.
new text end

new text begin Subd. 5. new text end

new text begin Data practices. new text end

new text begin Information submitted to the commissioner of health under
subdivision 2 or 3 is classified as private data on individuals as defined in section 13.02,
subdivision 12.
new text end

new text begin Subd. 6. new text end

new text begin Enforcement. new text end

new text begin The commissioner of health may enforce this section using the
powers and authority in sections 144.989 to 144.993.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 10.

new text begin [145E.40] EFFECT ON CONSTRUCTION OF WILLS AND CONTRACTS.
new text end

new text begin (a) No provision in a contract, will, or other agreement, whether written or oral, that
would determine whether an individual may make or rescind a request for medical aid in
dying medication is valid.
new text end

new text begin (b) No obligation owing under any currently existing contract shall be conditioned on
or affected by an individual's act of making or rescinding a request for medical aid in dying
medication.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 11.

new text begin [145E.45] INSURANCE OR ANNUITY POLICIES.
new text end

new text begin (a) The sale, procurement, or issuance of a life, health, or accident insurance or annuity
policy or the rate charged for a policy shall not be conditioned on or affected by an
individual's act of making or rescinding a request for medical aid in dying medication.
new text end

new text begin (b) A qualified individual's act of self-administering medical aid in dying medication
does not invalidate any part of a life, health, or accident insurance or annuity policy.
new text end

new text begin (c) An insurer, or the commissioner of human services when delivering services under
medical assistance or MinnesotaCare through managed care or fee-for-service, must not
deny or alter health care benefits otherwise available to an individual with a terminal disease
who is an enrollee of the health plan based on the availability of medical aid in dying, the
individual's request for medical aid in dying medication, or the absence of a request for
medical aid in dying medication.
new text end

new text begin (d) An insurer must not attempt to coerce an individual with a terminal disease to request
medical aid in dying medication.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 12.

new text begin [145E.50] DEATH RECORD.
new text end

new text begin (a) Notwithstanding any other provision of law, the attending provider may sign the
death record of a qualified individual who obtained and self-administered medical aid in
dying medication.
new text end

new text begin (b) When a qualified individual dies after self-administering medical aid in dying
medication:
new text end

new text begin (1) the cause of death on the qualified individual's death record shall be attributed to the
qualified individual's underlying terminal disease; and
new text end

new text begin (2) the death shall not be designated on the death record as a suicide or homicide.
new text end

new text begin (c) Death of a qualified individual after self-administration of medical aid in dying
medication does not constitute grounds for postmortem inquiry by a coroner or medical
examiner. A coroner or medical examiner notified of a qualified individual's death after
self-administration of medical aid in dying medication shall decline jurisdiction over the
death record and refer the death record to the attending provider according to paragraph (a).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 13.

new text begin [145E.55] OFFENSES, PENALTIES, AND CLAIMS FOR COSTS
INCURRED.
new text end

new text begin Subdivision 1. new text end

new text begin Offenses. new text end

new text begin Whoever does any of the following is guilty of a felony and
may be sentenced as provided in subdivision 2:
new text end

new text begin (1) intentionally alters or falsifies a request for medical aid in dying medication for
another individual;
new text end

new text begin (2) without authority of law, intentionally destroys, mutilates, or conceals another
individual's rescission of a request for medical aid in dying medication;
new text end

new text begin (3) compels another individual to request medical aid in dying medication through the
use of coercion, undue influence, harassment, duress, compulsion, or other enticement; or
new text end

new text begin (4) compels another individual to self-administer medical aid in dying medication through
the use of coercion, undue influence, harassment, duress, compulsion, or other enticement
and murder in the first or second degree was not committed thereby.
new text end

new text begin Subd. 2. new text end

new text begin Penalties. new text end

new text begin (a) An individual who violates subdivision 1, clause (1) or (2), may
be sentenced to imprisonment for not more than five years or to payment of a fine of not
more than $10,000, or both.
new text end

new text begin (b) An individual who violates subdivision 1, clause (3), may be sentenced to
imprisonment for not more than ten years or to payment of a fine of not more than $20,000,
or both.
new text end

new text begin (c) An individual who violates subdivision 1, clause (4), may be sentenced to:
new text end

new text begin (1) imprisonment for not more than 20 years or to payment of a fine of not more than
$40,000, or both; or
new text end

new text begin (2) if the person accomplished the violation through the use of force, imprisonment for
not more than 25 years or to payment of a fine of not more than $50,000, or both.
new text end

new text begin Subd. 3. new text end

new text begin Venue. new text end

new text begin Notwithstanding anything to the contrary in section 627.01, an offense
committed under this section may be prosecuted in: (1) the county where any part of the
offense occurred; or (2) the county of residence of the victim or one of the victims.
new text end

new text begin Subd. 4. new text end

new text begin Civil liability; other criminal penalties. new text end

new text begin (a) Nothing in this section limits civil
liability nor damages arising from negligent conduct or intentional misconduct related to
the provision of medical aid in dying, including failure to obtain informed consent by any
person, provider, or health care facility.
new text end

new text begin (b) The penalties in this section do not preclude criminal penalties applicable under other
laws for conduct that violates this chapter.
new text end

new text begin Subd. 5. new text end

new text begin Claims by governmental entity for costs incurred. new text end

new text begin A governmental entity
that incurs costs resulting from a qualified individual's self-administration, in a public place,
of medical aid in dying medication prescribed under section 145E.15 shall have a claim
against the estate of the qualified individual to recover such costs and reasonable attorney
fees related to enforcing the claim.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Subdivisions 1 to 3 and 4, paragraph (b), are effective August 1,
2024, and apply to crimes committed on or after that date. Subdivisions 4, paragraph (a),
and 5 are effective August 1, 2024.
new text end

Sec. 14.

new text begin [145E.60] CONSTRUCTION.
new text end

new text begin (a) Nothing in this chapter authorizes a provider or any other person, including the
qualified individual, to end the qualified individual's life by lethal injection, lethal infusion,
mercy killing, homicide, murder, manslaughter, euthanasia, or any other criminal act.
new text end

new text begin (b) Actions taken in accordance with this chapter do not, for any purpose, constitute
suicide, assisted suicide, euthanasia, mercy killing, homicide, murder, manslaughter, elder
abuse or neglect, or any other civil or criminal violation under the law.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 15. new text begin COMMISSIONER OF HEALTH; DEVELOPMENT OF FORMS.
new text end

new text begin By August 1, 2024, the commissioner of health must develop and post on the Department
of Health website the attending provider checklist form and attending provider follow-up
form required under Minnesota Statutes, section 145E.35.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

ARTICLE 2

OTHER PROVISIONS

Section 1.

Minnesota Statutes 2023 Supplement, section 61A.031, is amended to read:

61A.031 SUICIDE PROVISIONS.

(a) The sanity or insanity of a person shall not be a factor in determining whether a
person committed suicide within the terms of an individual or group life insurance policy
regulating the payment of benefits in the event of the insured's suicide. This paragraph shall
not be construed to alter present law but is intended to clarify present law.

(b) A life insurance policy or certificate issued or delivered in this state may exclude or
restrict liability for any death benefit in the event the insured dies as a result of suicide
within one year from the date of the issue of the policy or certificate. Any exclusion or
restriction shall be clearly stated in the policy or certificate. Any life insurance policy or
certificate which contains any exclusion or restriction under this paragraph shall also provide
that in the event any death benefit is denied because the insured dies as a result of suicide
within one year from the date of issue of the policy or certificate, the insurer shall refund
all premiums paid for coverage providing the denied death benefit on the insured. new text begin An
exclusion or restriction authorized under this paragraph shall not apply in the event the
insured dies due to self-administration of medical aid in dying medication obtained in
accordance with chapter 145E.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 2.

Minnesota Statutes 2023 Supplement, section 144.99, subdivision 1, is amended
to read:

Subdivision 1.

Remedies available.

The provisions of chapters 103I and 157 and sections
115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14),
and (15); 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385;
144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98;
144.992; new text begin 145E.35; new text end 326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all
rules, orders, stipulation agreements, settlements, compliance agreements, licenses,
registrations, certificates, and permits adopted or issued by the department or under any
other law now in force or later enacted for the preservation of public health may, in addition
to provisions in other statutes, be enforced under this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024.
new text end

Sec. 3.

Minnesota Statutes 2022, section 609.215, subdivision 3, is amended to read:

Subd. 3.

Acts or omissions not considered aiding suicide or aiding attempted
suicide.

(a) A health care provider, as defined in section 145B.02, subdivision 6, who
administers, prescribes, or dispenses medications or procedures to relieve another person's
pain or discomfort, even if the medication or procedure may hasten or increase the risk of
death, does not violate this section unless the medications or procedures are knowingly
administered, prescribed, or dispensed to cause death.

(b) A health care provider, as defined in section 145B.02, subdivision 6, who withholds
or withdraws a life-sustaining procedure in compliance with chapter 145B or 145C or in
accordance with reasonable medical practice does not violate this section.

new text begin (c) A provider, as defined in section 145E.02, subdivision 13, or pharmacist who
prescribes or provides a medical aid in dying medication in compliance with chapter 145E
does not violate this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2024, and applies to crimes
committed on or after that date.
new text end