1.1                          A bill for an act 
  1.2             relating to health; establishing a loan forgiveness 
  1.3             program for certain pharmacy students; authorizing 
  1.4             sole community pharmacy financial assistance; 
  1.5             establishing a pilot project for drug therapy 
  1.6             management; appropriating money; proposing coding for 
  1.7             new law in Minnesota Statutes, chapter 144. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  [144.1498] [LOAN FORGIVENESS FOR RURAL AND 
  1.10  UNDERSERVED URBAN AREA PHARMACISTS.] 
  1.11     Subdivision 1.  [DEFINITIONS.] (a) For purposes of sections 
  1.12  144.1498 and 144.1499, the terms defined in this subdivision 
  1.13  have the meanings given them, unless the context clearly 
  1.14  indicates otherwise. 
  1.15     (b) "Designated rural or underserved urban area" means a 
  1.16  geographic area given that designation by the commissioner of 
  1.17  health. 
  1.18     (c) "Eligible applicant" means a pharmacist licensed under 
  1.19  chapter 151 and practicing in Minnesota. 
  1.20     (d) "Qualified loan" means a government or commercial loan 
  1.21  for actual costs paid for tuition, reasonable education 
  1.22  expenses, and reasonable living expenses related to the graduate 
  1.23  or undergraduate education of a pharmacist. 
  1.24     Subd. 2.  [CREATION OF ACCOUNT.] A rural or underserved 
  1.25  urban area pharmacist education account is established in the 
  1.26  health care access fund.  The commissioner shall use money from 
  2.1   the account to establish a loan forgiveness program for 
  2.2   pharmacists agreeing to practice in designated rural or 
  2.3   underserved urban areas.  The commissioner shall contract with a 
  2.4   statewide pharmacist association representing all pharmacy 
  2.5   practice settings to administer the program.  The program shall 
  2.6   cover up to 25 participants. 
  2.7      Subd. 3.  [SELECTION CRITERIA; STARTING DATES.] The 
  2.8   commissioner shall determine selection criteria for applicants.  
  2.9   The commissioner shall also determine the participant's starting 
  2.10  date of service in a rural or underserved urban area.  
  2.11     Subd. 4.  [LOAN FORGIVENESS.] A pharmacist who is accepted 
  2.12  must sign a contract to serve at least five years in a 
  2.13  designated rural or underserved urban area.  For each year that 
  2.14  a participant serves as a pharmacist in a designated rural or 
  2.15  underserved urban area, the commissioner shall annually pay to 
  2.16  the program administrator an amount equal to one year of 
  2.17  qualified loans for all participants.  Participants who move 
  2.18  their practice from one designated rural or underserved urban 
  2.19  area to another remain eligible for loan repayment. 
  2.20     Subd. 5.  [PROCEDURE FOR LOAN REPAYMENT.] A program 
  2.21  participant, at the time of signing a contract, shall designate 
  2.22  the qualifying loan or loans up to a maximum of $10,000 per year 
  2.23  for not more than five years.  A participant must make payments 
  2.24  directly on the participant's loans.  The program administrator 
  2.25  is responsible for verifying the amount of debt, the 
  2.26  participant's timely repayment of debt, and the participant's 
  2.27  length and terms of service.  The program administrator shall 
  2.28  reimburse the participant on a monthly basis for payments made 
  2.29  by the participant on qualifying loans in an amount not to 
  2.30  exceed $10,000 per year when annualized.  If the amount 
  2.31  reimbursed by the program administrator is less than $10,000 
  2.32  during a 12-month period, the program administrator shall pay 
  2.33  during the 12th month an additional amount toward a loan or 
  2.34  loans designated by the participant, to bring the total paid to 
  2.35  $10,000.  The total amount reimbursed by the program 
  2.36  administrator must not exceed the amount of principal and 
  3.1   accrued interest of the designated loans. 
  3.2      Subd. 6.  [TAX RESPONSIBILITY.] The participant is 
  3.3   responsible for reporting on federal income tax returns any 
  3.4   amount paid by the state on designated loans, if required to do 
  3.5   so by federal law. 
  3.6      Subd. 7.  [PENALTY FOR NONFULFILLMENT.] If a participant 
  3.7   does not fulfill the required five-year minimum commitment of 
  3.8   service in a designated rural or underserved urban area, the 
  3.9   program administrator shall recover from the participant the 
  3.10  amount paid under the loan forgiveness program.  All money 
  3.11  recovered from participants shall be deposited in the rural 
  3.12  pharmacist education account established in subdivision 2.  A 
  3.13  program participant who fails to complete at least three years 
  3.14  of obligated service shall repay the amount paid, as well as a 
  3.15  financial penalty based upon the length of the service 
  3.16  obligation not fulfilled.  If the participant has served at 
  3.17  least two years, the financial penalty is the number of unserved 
  3.18  months multiplied by $1,000.  If the participant has served less 
  3.19  than two years, the financial penalty is the total number of 
  3.20  obligated months multiplied by $1,000.  The program 
  3.21  administrator has the authority to collect on all loan defaults. 
  3.22     Subd. 8.  [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 
  3.23  service obligations cancel in the event of a participant's 
  3.24  death.  The commissioner may waive or suspend payment or service 
  3.25  obligations in case of total and permanent disability or 
  3.26  long-term temporary disability lasting for more than two years.  
  3.27  The commissioner shall evaluate all other requests for 
  3.28  suspension or waivers on a case-by-case basis and may grant a 
  3.29  waiver of all or part of the money owed as a result of a 
  3.30  nonfulfillment penalty if emergency circumstances prevented 
  3.31  fulfillment of the required service commitment. 
  3.32     Sec. 2.  [144.1499] [RURAL AND UNDERSERVED URBAN AREA 
  3.33  PHARMACY FINANCIAL ASSISTANCE.] 
  3.34     Subdivision 1.  [ACCOUNT ESTABLISHED.] A rural or 
  3.35  underserved urban area pharmacy financial assistance account is 
  3.36  established in the health care access fund.  The commissioner of 
  4.1   health shall award financial assistance grants to pharmacies in 
  4.2   rural or underserved urban areas designated as sole community 
  4.3   pharmacies.  
  4.4      Subd. 2.  [PROGRAM ADMINISTRATION.] The commissioner shall 
  4.5   contract with a statewide pharmacist association representing 
  4.6   all pharmacy practice settings to administer the program.  The 
  4.7   commissioner shall establish criteria for determining sole 
  4.8   community pharmacies in rural and underserved urban areas.  
  4.9      Subd. 3.  [EVIDENCE OF LOCAL SUPPORT.] In selecting 
  4.10  pharmacies to receive grants, the program administrator shall 
  4.11  take into account the extent of local support for the pharmacy.  
  4.12  Evidence of local support may include statements issued by a 
  4.13  local government entity, such as a city or county, and loans, 
  4.14  grants, or donations to the pharmacy from local government 
  4.15  entities, private organizations, or individuals. 
  4.16     Subd. 4.  [GRANT AWARDS.] The program administrator shall 
  4.17  determine the amount of the award to be given to each eligible 
  4.18  pharmacy based on the pharmacy's total operating losses as a 
  4.19  percentage of total operating revenue for two of the previous 
  4.20  three most recent consecutive fiscal years.  For purposes of 
  4.21  calculating a pharmacy's operating loss margin, total operating 
  4.22  revenue does not include grant funding provided under this 
  4.23  section.  The available funds shall be disbursed proportionately 
  4.24  based on the operating loss margins of all eligible pharmacies. 
  4.25     Sec. 3.  [PILOT PROGRAM FOR PHARMACIST DRUG THERAPY 
  4.26  MANAGEMENT.] 
  4.27     (a) The commissioner of human services shall award grants 
  4.28  to create and develop a pilot program to involve pharmacists in 
  4.29  coordinating drug therapy management services.  Pharmacist drug 
  4.30  therapy management (1) does not include the initiation of a 
  4.31  prescription drug order by a pharmacist, and (2) does not permit 
  4.32  a pharmacist to make any unauthorized decisions about modifying 
  4.33  or substituting drug therapies under this pilot program.  A 
  4.34  pharmacist participating in this pilot program must comply with 
  4.35  Minnesota Statutes, section 151.21, subdivision 1. The pilot 
  4.36  program shall reimburse licensed Minnesota pharmacists for 
  5.1   coordinating drug therapy management services to at-risk patient 
  5.2   populations, including persons with asthma, hypertension, high 
  5.3   cholesterol, diabetes, HIV, and tobacco addiction.  The program 
  5.4   shall commence on February 1, 2000, and terminate on January 31, 
  5.5   2001.  The commissioner of human services shall issue a request 
  5.6   for information (RFI) from the public by August 1, 1999.  A 
  5.7   report to the Minnesota legislature is due by February 1, 2000.  
  5.8   The commissioner of human services shall also issue a request 
  5.9   for proposal (RFP) to award a grant to the appropriate bidder to 
  5.10  implement the pilot program by October 1, 1999.  The 
  5.11  commissioner of human services shall issue a final report to the 
  5.12  Minnesota legislature by March 15, 2001. 
  5.13     (b) The commissioner of health shall contract with the 
  5.14  University of Minnesota college of pharmacy to evaluate the 
  5.15  program established in paragraph (a).  The commissioner shall 
  5.16  issue a final report to the legislature by March 15, 2001, the 
  5.17  results of the evaluation. 
  5.18     Sec. 4.  [APPROPRIATIONS.] 
  5.19     (a) $....... is appropriated from the health care access 
  5.20  fund to the commissioner of health for the biennium beginning 
  5.21  July 1, 1999, for the purposes of Minnesota Statutes, section 
  5.22  144.1498.  
  5.23     (b) $....... is appropriated from the health care access 
  5.24  fund to the commissioner of health for the biennium beginning 
  5.25  July 1, 1999, for the purposes of Minnesota Statutes, section 
  5.26  144.1499. 
  5.27     (c) $....... is appropriated from the health care access 
  5.28  fund to the commissioner of human services for the biennium 
  5.29  beginning July 1, 1999, for the purposes of section 3.