HF 4063

as introduced - 93rd Legislature (2023 - 2024) Posted on 02/22/2024 02:56pm

A bill for an act
relating to health; requiring the commissioner of health to establish a provider
orders for life-sustaining treatment program; authorizing rulemaking; classifying
data; establishing immunity for certain acts; appropriating money; amending
Minnesota Statutes 2022, section 13.3806, by adding a subdivision; proposing
coding for new law in Minnesota Statutes, chapter 145C.

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

Section 1.

Minnesota Statutes 2022, section 13.3806, is amended by adding a subdivision
to read:

new text begin Subd. 23. new text end

new text begin POLST registry data. new text end

new text begin Data collected and maintained by the POLST registry
is governed by section 145C.27.
new text end

Sec. 2.

new text begin [145C.20] CITATION.
new text end

new text begin Sections 145C.20 to 145C.28 may be cited as the "Provider Orders for Life-Sustaining
Treatment Program Act."
new text end

Sec. 3.

new text begin [145C.21] 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 sections 145C.20 to 145C.28, the following
terms have the meanings given.
new text end

new text begin Subd. 2. new text end

new text begin Authorized user. new text end

new text begin "Authorized user" means a person authorized by the
commissioner to provide information to or obtain information from the POLST registry
established under section 145C.24.
new text end

new text begin Subd. 3. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of health.
new text end

new text begin Subd. 4. new text end

new text begin Life-sustaining treatment. new text end

new text begin "Life-sustaining treatment" means any medical
procedure, prescription drug, medical device, or medical intervention that maintains life by
sustaining, restoring, or supplanting a vital function. Life-sustaining treatment does not
include routine care necessary to keep a patient clean or comfortable.
new text end

new text begin Subd. 5. new text end

new text begin Minnesota POLST Steering Committee. new text end

new text begin "Minnesota POLST Steering
Committee" means the multidisciplinary committee established and administered by the
Minnesota Medical Association that provides POLST education and training according to
a contract with the commissioner.
new text end

new text begin Subd. 6. new text end

new text begin Nurse practitioner. new text end

new text begin "Nurse practitioner" means an individual licensed by the
Board of Nursing under sections 148.171 to 148.285 as an advanced practice registered
nurse and certified by a national nurse certification organization acceptable to the board to
practice as a nurse practitioner.
new text end

new text begin Subd. 7. new text end

new text begin Physician. new text end

new text begin "Physician" means an individual licensed by the Board of Medical
Practice under chapter 147 as a doctor of medicine or doctor of osteopathic medicine.
new text end

new text begin Subd. 8. new text end

new text begin Physician assistant. new text end

new text begin "Physician assistant" means an individual licensed by the
Board of Medical Practice under chapter 147A as a physician assistant.
new text end

new text begin Subd. 9. new text end

new text begin POLST. new text end

new text begin "POLST" means a provider order for life-sustaining treatment signed
by a physician, nurse practitioner, or physician assistant.
new text end

new text begin Subd. 10. new text end

new text begin POLST program. new text end

new text begin "POLST program" means the program established under
section 145C.23 and includes the POLST registry established under section 145C.24, the
POLST registry call center established under section 145C.25, and the education and training
required under section 145C.26, subdivision 1.
new text end

Sec. 4.

new text begin [145C.22] POLST NOT REQUIRED; REVOCATION; CHOICE TO
REMOVE OR NOT INCLUDE.
new text end

new text begin (a) Nothing in sections 145C.20 to 145C.28:
new text end

new text begin (1) requires a patient to have a POLST;
new text end

new text begin (2) requires a physician, nurse practitioner, or physician assistant to execute a POLST
for a patient; or
new text end

new text begin (3) requires the commissioner to prescribe the form or content of a POLST or to
disseminate forms to be used for a POLST.
new text end

new text begin (b) The patient for whom a POLST is executed, or the patient's legal representative:
new text end

new text begin (1) may at any time revoke the patient's POLST;
new text end

new text begin (2) may at any time choose to have the patient's POLST removed from the POLST
registry; and
new text end

new text begin (3) may choose to not have the patient's POLST included in the POLST registry.
new text end

Sec. 5.

new text begin [145C.23] POLST PROGRAM ESTABLISHED.
new text end

new text begin (a) The commissioner must establish and administer a statewide POLST program to
help ensure the medical treatment preferences of a patient nearing the end of the patient's
life are honored. In establishing the POLST program, the commissioner must comply with
all applicable state and federal privacy and security laws and must pursue any changes to
state law needed to establish and administer the program.
new text end

new text begin (b) The POLST program must be based on and consistent with the recommendations in
the report required under Laws 2023, chapter 70, article 4, section 100, subdivision 3.
new text end

Sec. 6.

new text begin [145C.24] POLST REGISTRY.
new text end

new text begin Subdivision 1. new text end

new text begin Registry established. new text end

new text begin The commissioner must establish and administer
a statewide POLST registry for the collection and dissemination of provider orders for
life-sustaining treatment. The POLST registry must be aligned with the most recent federal
and state health information technology standards and policies to achieve interoperability,
improve quality, and leverage national and state activities.
new text end

new text begin Subd. 2. new text end

new text begin Authorized users. new text end

new text begin (a) Authorized users of the POLST registry must include
but are not limited to:
new text end

new text begin (1) emergency medical responders as defined in section 144E.001, subdivision 6;
new text end

new text begin (2) medical response units registered under section 144E.275;
new text end

new text begin (3) emergency medical technicians, advanced emergency medical technicians, and
paramedics as defined in section 144E.001, subdivisions 5c, 5d, and 5e; and
new text end

new text begin (4) health care professionals providing services at a hospital, medical clinic, assisted
living facility, or skilled nursing facility, or providing services with a home care provider
or hospice provider.
new text end

new text begin (b) Authorized users of the POLST registry are subject to state and federal privacy and
security laws and policies, as applicable according to the authorized user's role and
organization.
new text end

new text begin Subd. 3. new text end

new text begin Submission. new text end

new text begin (a) The POLST registry must permit authorized users to submit
to the registry:
new text end

new text begin (1) except POLSTs which a patient or the patient's legal representative chooses to not
include in the registry, a copy of each current and valid POLST; and
new text end

new text begin (2) notice of revocation of the POLST, if the patient or the patient's legal representative
revokes the POLST.
new text end

new text begin (b) Unless a patient or the patient's legal representative chooses to not have the patient's
POLST included in the registry, all current and valid POLSTs must be submitted to the
registry in a prompt manner. An effort must be made to ensure that all current and valid
POLSTs, other than those which a patient or the patient's legal representative chooses to
not include in the registry, are submitted to the registry.
new text end

new text begin Subd. 4. new text end

new text begin Obtaining POLSTs. new text end

new text begin (a) The POLST registry must have multiple methods for
authorized users to obtain POLSTs in a timely manner regardless of the authorized user's
location or technological capabilities. Access may be provided through a web-based portal,
a POLST registry call center accessed by telephone or radio, and an electronic health record.
new text end

new text begin (b) The POLST registry must have one or more consumer access methods for patients
and their legal representatives to obtain the patient's POLST.
new text end

new text begin Subd. 5. new text end

new text begin Access by qualified researchers. new text end

new text begin The commissioner may authorize qualified
researchers to access data from POLSTs in the POLST registry. If the commissioner
authorizes qualified researchers to access data from POLSTs, the commissioner must adopt
rules governing qualified researcher access to data from POLSTs that must at least address:
new text end

new text begin (1) the process for a qualified researcher to request access to data from POLSTs in the
POLST registry;
new text end

new text begin (2) the types of data a qualified researcher may access; and
new text end

new text begin (3) steps a qualified researcher must take to protect data obtained under this subdivision.
new text end

new text begin Subd. 6. new text end

new text begin Contract. new text end

new text begin The commissioner may contract with a public or private entity to
establish and administer the POLST registry.
new text end

Sec. 7.

new text begin [145C.25] POLST REGISTRY CALL CENTER.
new text end

new text begin The commissioner must establish and administer a POLST registry call center that must
operate 24 hours a day, seven days a week to allow authorized users to obtain POLSTs from
the POLST registry without the use of broadband service. The POLST registry call center:
new text end

new text begin (1) must allow authorized users to obtain POLSTs from the POLST registry by telephone
or radio; and
new text end

new text begin (2) must be staffed with medically knowledgeable staff.
new text end

Sec. 8.

new text begin [145C.26] MINNESOTA POLST STEERING COMMITTEE.
new text end

new text begin Subdivision 1. new text end

new text begin Training and education. new text end

new text begin The commissioner must contract with the
Minnesota POLST Steering Committee to develop and provide training and education to
the public, authorized users, and other health care providers on the use of POLSTs and on
the POLST registry.
new text end

new text begin Subd. 2. new text end

new text begin Advice to commissioner. new text end

new text begin The Minnesota POLST Steering Committee must
advise the commissioner on:
new text end

new text begin (1) the form and content of a valid POLST, including any updates to a POLST; and
new text end

new text begin (2) the procedure for completing a valid POLST.
new text end

Sec. 9.

new text begin [145C.27] DATA PRACTICES.
new text end

new text begin Except for access authorized under section 145C.24 or 145C.25, all data collected,
received, or maintained by the POLST registry that identifies or could be used to identify
a patient, authorized user, health care provider, or health care facility is classified as private
data on individuals as defined in section 13.02, subdivision 12, or nonpublic data as defined
in section 13.02, subdivision 9. Data in the POLST registry is not subject to a civil or
administrative subpoena and is not subject to discovery in a civil action, including but not
limited to a judicial, administrative, arbitration, or mediation proceeding.
new text end

Sec. 10.

new text begin [145C.28] IMMUNITY.
new text end

new text begin A person who reports information in good faith to the POLST registry or who acts in
good faith on information obtained from the POLST registry is immune from any civil
liability or criminal prosecution that might otherwise apply to the reporting of information
to the POLST registry or acting on information obtained from the POLST registry.
new text end

Sec. 11. new text begin IMPLEMENTATION.
new text end

new text begin All elements of the POLST program as defined in Minnesota Statutes, section 145C.21,
subdivision 10, must be implemented by January 1, 2025.
new text end

Sec. 12. new text begin APPROPRIATIONS.
new text end

new text begin (a) $500,000 in fiscal year 2025 is appropriated from the general fund to the commissioner
of health for establishment and administration of the POLST registry and POLST registry
call center under Minnesota Statutes, sections 145C.24 and 145C.25. The base for this
appropriation is $400,000 in fiscal year 2026 and $400,000 in fiscal year 2027.
new text end

new text begin (b) $100,000 in fiscal year 2025 is appropriated from the general fund to the commissioner
of health for a contract with the Minnesota POLST Steering Committee under Minnesota
Statutes, section 145C.26, subdivision 1.
new text end