1.1                          A bill for an act 
  1.2             relating to health; modifying reimbursement provisions 
  1.3             for volunteer ambulance attendant training; providing 
  1.4             for grants to volunteer ambulance services; requiring 
  1.5             a study; appropriating money; amending Minnesota 
  1.6             Statutes 2000, sections 144E.35, subdivision 1; 
  1.7             144E.42, subdivision 2; proposing coding for new law 
  1.8             in Minnesota Statutes, chapter 144E. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  Minnesota Statutes 2000, section 144E.35, 
  1.11  subdivision 1, is amended to read: 
  1.12     Subdivision 1.  [REPAYMENT FOR VOLUNTEER TRAINING.] Any 
  1.13  political subdivision, or nonprofit hospital or nonprofit 
  1.14  corporation operating a licensed ambulance service shall be 
  1.15  reimbursed by the board for the necessary expense of the initial 
  1.16  training of a volunteer ambulance attendant upon successful 
  1.17  completion by the attendant of a basic emergency care course, or 
  1.18  a continuing education course courses for basic emergency care, 
  1.19  or both, which has have been approved by the board, pursuant to 
  1.20  section 144E.285.  Reimbursement may include tuition, 
  1.21  transportation, food, lodging, hourly payment for the time spent 
  1.22  in the training course, and other necessary expenditures, except 
  1.23  that in no instance shall a volunteer ambulance attendant be 
  1.24  reimbursed more than $450 $500 for successful completion of a 
  1.25  basic course, and $225 $300 for successful completion of a 
  1.26  continuing education course. 
  1.27     Sec. 2.  [144E.36] [GRANTS FOR VOLUNTEER AMBULANCE 
  2.1   SERVICES.] 
  2.2      Subdivision 1.  [DEFINITION.] For purposes of this section, 
  2.3   "volunteer ambulance service" means a licensed ambulance service 
  2.4   in which a majority of the individuals whose primary 
  2.5   responsibility is direct patient care are volunteer ambulance 
  2.6   attendants. 
  2.7      Subd. 2.  [MATCHING GRANTS.] (a) The board may award a 
  2.8   matching grant to a volunteer ambulance service that faces 
  2.9   revenue shortages resulting from the federal Balanced Budget Act 
  2.10  of 1997, Public Law No. 105-33.  The volunteer ambulance service 
  2.11  may use the grant to: 
  2.12     (1) pay volunteer ambulance attendants, certified under 
  2.13  section 144E.28, for services; 
  2.14     (2) pay for ambulance maintenance and operating expenses; 
  2.15     (3) purchase equipment required for direct patient care; 
  2.16  and 
  2.17     (4) pay any other expenses incurred in providing ambulance 
  2.18  services within the volunteer ambulance service's primary 
  2.19  service area. 
  2.20     (b) To qualify for a grant under this subdivision, a 
  2.21  volunteer ambulance service must have matching funds available 
  2.22  in a ratio of 1:1.  Matching funds may be local government 
  2.23  funds, other grants, gifts, or any other revenue source. 
  2.24     (c) A volunteer ambulance service seeking a grant under 
  2.25  this subdivision shall apply to the board on a form prescribed 
  2.26  by the board. 
  2.27     Subd. 3.  [EMERGENCY RELIEF GRANTS.] (a) The board may 
  2.28  award a grant to a volunteer ambulance service that faces 
  2.29  serious operating deficits that could affect direct patient 
  2.30  care.  The volunteer ambulance service may use the grant to: 
  2.31     (1) pay volunteer ambulance attendants, certified under 
  2.32  section 144E.28, for services; 
  2.33     (2) pay for ambulance maintenance and operating expenses; 
  2.34     (3) purchase equipment required for direct patient care; 
  2.35  and 
  2.36     (4) pay any other expenses incurred in providing ambulance 
  3.1   services within the volunteer ambulance service's primary 
  3.2   service area. 
  3.3      (b) A grant under this subdivision may not exceed $........ 
  3.4      (c) A volunteer ambulance service seeking a grant under 
  3.5   this subdivision shall apply to the board on a form prescribed 
  3.6   by the board. 
  3.7      Subd. 4.  [CRITERIA; AWARD.] The board shall establish 
  3.8   criteria to award grants under this section.  Award decisions of 
  3.9   the board are final and are not subject to the contested case 
  3.10  provisions of chapter 14. 
  3.11     Sec. 3.  Minnesota Statutes 2000, section 144E.42, 
  3.12  subdivision 2, is amended to read: 
  3.13     Subd. 2.  [TRUST ACCOUNT.] (a) There is established in the 
  3.14  general fund an ambulance service personnel longevity award and 
  3.15  incentive trust account and an ambulance service personnel 
  3.16  longevity award and incentive suspense account.  
  3.17     (b) The trust account must be credited with: 
  3.18     (1) $1,000,000 annually appropriated from the general fund; 
  3.19     (2) other general fund appropriations for that purpose; 
  3.20     (2) (3) transfers from the ambulance service personnel 
  3.21  longevity award and incentive suspense account; and 
  3.22     (3) (4) investment earnings on those accumulated proceeds.  
  3.23  The assets and income of the trust account must be held and 
  3.24  managed by the commissioner of finance and the state board of 
  3.25  investment for the benefit of the state of Minnesota and its 
  3.26  general creditors. 
  3.27     (c) The suspense account must be credited with transfers 
  3.28  from the excess police state-aid holding account established in 
  3.29  section 69.021, subdivision 11, any per-year-of-service 
  3.30  allocation under section 144E.45, subdivision 2, paragraph (c), 
  3.31  that was not made for an individual, and investment earnings on 
  3.32  those accumulated proceeds.  The suspense account must be 
  3.33  managed by the commissioner of finance and the state board of 
  3.34  investment.  From the suspense account to the trust account 
  3.35  there must be transferred to the ambulance service personnel 
  3.36  longevity award and incentive trust account, as the suspense 
  4.1   account balance permits, the following amounts: 
  4.2      (1) an amount equal to any general fund appropriation to 
  4.3   the ambulance service personnel longevity award and incentive 
  4.4   trust account for that fiscal year; and 
  4.5      (2) an amount equal to the percentage of the remaining 
  4.6   balance in the account after the deduction of the amount under 
  4.7   clause (1), as specified for the applicable fiscal year: 
  4.8             Fiscal year            Percentage  
  4.9               1995                    20  
  4.10              1996                    40 
  4.11              1997                    50 
  4.12              1998                    60 
  4.13              1999                    70 
  4.14              2000                    80 
  4.15              2001                    90 
  4.16              2002 and thereafter    100 
  4.17     Sec. 4.  [RURAL AMBULANCE SERVICE STUDY.] 
  4.18     (a) The board of the center for rural policy and 
  4.19  development shall establish an advisory committee to conduct a 
  4.20  study according to this section.  The advisory committee shall 
  4.21  include, at a minimum, representation from: 
  4.22     (1) local elected officials; 
  4.23     (2) the Minnesota ambulance association; 
  4.24     (3) the Minnesota hospital and health care partnership; 
  4.25     (4) the Minnesota rural health association; 
  4.26     (5) the emergency medical services regulatory board; 
  4.27     (6) the Minnesota association of fire chiefs; 
  4.28     (7) the regional board designated by the emergency medical 
  4.29  services regulatory board to serve south central Minnesota; 
  4.30     (8) the Minnesota emergency medical services association; 
  4.31     (9) the Minnesota chapter of the American College of 
  4.32  Emergency Physicians; and 
  4.33     (10) the Minnesota academy of physician's assistants. 
  4.34     (b) The advisory committee shall conduct a study of rural 
  4.35  ambulance service that identifies challenges to rural ambulance 
  4.36  services, including, but not limited to: 
  5.1      (1) staffing shortages for volunteer ambulance services; 
  5.2      (2) personnel shortages for full-time, paid ambulance 
  5.3   services; 
  5.4      (3) funding for ambulance operations; and 
  5.5      (4) the impact on rural ambulance services from changes in 
  5.6   ambulance reimbursement as a result of the federal Balanced 
  5.7   Budget Act of 1997, Public Law No. 105-33. 
  5.8      (c) The advisory committee may also examine: 
  5.9      (1) whether state law allows adequate flexibility to 
  5.10  address operational and staffing problems encountered by rural 
  5.11  ambulance services in providing adequate care in a timely 
  5.12  manner; and 
  5.13     (2) whether current programs, such as the volunteer 
  5.14  ambulance recruitment program, and state reimbursement for 
  5.15  volunteer training are adequately funded to ensure a viable pool 
  5.16  of ambulance service volunteers in rural areas. 
  5.17     (d) The advisory committee shall identify existing state, 
  5.18  regional, and local resources to support the provision of local 
  5.19  ambulance services in rural areas. 
  5.20     (e) The advisory committee shall make recommendations for 
  5.21  resolving issues identified under paragraphs (b) and (c) and 
  5.22  propose alternative delivery models for rural volunteer 
  5.23  ambulance services, such as multiprovider service coalitions, 
  5.24  purchasing cooperatives, regional response strategies, and 
  5.25  better utilization of first responder and rescue squads. 
  5.26     (f) The advisory committee shall report its findings and 
  5.27  recommendations to the legislature by January 15, 2002. 
  5.28     Sec. 5.  [AUTOMATIC DEFIBRILLATOR STUDY.] 
  5.29     The emergency medical services regulatory board, in 
  5.30  consultation with the department of public safety, shall study 
  5.31  and report to the legislature by December 15, 2002, regarding 
  5.32  the availability of automatic defibrillators outside the 
  5.33  seven-county metropolitan area.  The report shall include 
  5.34  recommendations to make these devices accessible within a 
  5.35  reasonable distance throughout the nonmetropolitan area, 
  5.36  including recommendations for funding their acquisition and 
  6.1   distribution. 
  6.2      Sec. 6.  [APPROPRIATIONS.] 
  6.3      (a) $....... is appropriated from the general fund to the 
  6.4   emergency medical services regulatory board to provide grants 
  6.5   according to section 2.  The money is available until expended. 
  6.6      (b) $115,000 is appropriated from the general fund to the 
  6.7   board of the center for rural policy and development for 
  6.8   purposes of section 4. 
  6.9      (c) $75,000 is appropriated from the general fund to the 
  6.10  emergency services regulatory board for the purposes of section 
  6.11  5.