1.1                          A bill for an act
  1.2             relating to health; extending the health technology 
  1.3             advisory committee; extending deadlines related to a 
  1.4             nuclear materials agreement; establishing fees for the 
  1.5             licensing of radioactive material and source and 
  1.6             special nuclear material; providing for inspections; 
  1.7             determining eligibility for hospital uncompensated 
  1.8             care aid; modifying loan forgiveness provisions for 
  1.9             rural physicians and nurses in nursing homes or 
  1.10            ICF/MRs; providing for loan forgiveness for certain 
  1.11            health care workers; providing for certain grants and 
  1.12            technical assistance; modifying maternal and child 
  1.13            health provisions; modifying vital record and 
  1.14            environmental laboratory certification; modifying fees 
  1.15            and provisions for food and beverage service and 
  1.16            lodging establishments; repealing bone marrow donor 
  1.17            education provisions; appropriating money; amending 
  1.18            Minnesota Statutes 2000, sections 62J.152, subdivision 
  1.19            8; 62J.451, subdivision 5; 144.1202, subdivision 4; 
  1.20            144.148, subdivision 8; 144.1494, by adding a 
  1.21            subdivision; 144.1496, by adding a subdivision; 
  1.22            144.226, subdivision 4; 145.881, subdivision 2; 
  1.23            145.882, subdivision 7, by adding a subdivision; 
  1.24            145.885, subdivision 2; 157.16, subdivision 3; 157.22; 
  1.25            proposing coding for new law in Minnesota Statutes, 
  1.26            chapters 144; 145; repealing Minnesota Statutes 2000, 
  1.27            sections 145.882, subdivisions 3, 4; 145.927. 
  1.28  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.29                             ARTICLE 1
  1.30                           APPROPRIATIONS
  1.31     Section 1.  [HEALTH APPROPRIATIONS.] 
  1.32     The sums shown in the columns marked "APPROPRIATIONS" are 
  1.33  appropriated from the general fund, or another fund named, to 
  1.34  the agencies and for the purposes specified in this act, to be 
  1.35  available for the fiscal years indicated for each purpose.  The 
  1.36  figures "2002" and "2003," where used in this act, mean that the 
  2.1   appropriation or appropriations listed under them are available 
  2.2   for the year ending June 30, 2002, or June 30, 2003, 
  2.3   respectively. 
  2.4                                              APPROPRIATIONS 
  2.5                                          Available for the Year 
  2.6                                              Ending June 30 
  2.7                                             2002         2003 
  2.8   Sec. 2.  COMMISSIONER OF HEALTH 
  2.9   Subdivision 1.  Total 
  2.10  Appropriation                        149,675,000    144,001,000
  2.11                Summary by Fund
  2.12  General              76,366,000    78,718,000 
  2.13  State Government 
  2.14  Special Revenue      24,402,000    26,294,000 
  2.15  Health Care 
  2.16  Access               31,907,000    21,989,000 
  2.17  Federal TANF         17,000,000    17,000,000 
  2.18  Subd. 2.  Family and 
  2.19  Community Health                      72,504,000     75,660,000 
  2.20                Summary by Fund
  2.21  General              50,861,000    52,961,000
  2.22  State Government 
  2.23  Special Revenue         961,000     1,987,000 
  2.24  Health Care 
  2.25  Access                3,682,000     3,712,000 
  2.26  Federal TANF         17,000,000    17,000,000 
  2.27  [HEALTH DISPARITIES.] Of the general 
  2.28  fund appropriation, $6,450,000 in 
  2.29  fiscal year 2002 and $7,450,000 in 
  2.30  fiscal year 2003 is for reducing health 
  2.31  disparities.  The commissioner, in 
  2.32  consultation with other public, 
  2.33  private, or nonprofit organizations 
  2.34  interested in eliminating health 
  2.35  disparities, shall award grants to 
  2.36  public or nonprofit organizations and 
  2.37  American Indian tribal governments in 
  2.38  accordance with Minnesota Statutes, 
  2.39  section 145.9269.  
  2.40  [IMMUNIZATION INFORMATION SERVICE.] Of 
  2.41  the general fund appropriation, 
  2.42  $1,000,000 each year of the biennium is 
  2.43  available to the commissioner of health 
  2.44  for grants to community health boards 
  2.45  as defined in Minnesota Statutes, 
  2.46  section 145A.02, to support the 
  2.47  development and maintenance of a 
  2.48  statewide immunization information 
  2.49  service.  This appropriation shall not 
  2.50  become a part of the agency's base 
  2.51  funding for the 2004-2005 biennium. 
  2.52  [HEALTH YOUTH DEVELOPMENT.] $10,000,000 
  3.1   from the TANF fund in fiscal years 2002 
  3.2   and 2003 is appropriated to the 
  3.3   commissioner of health to award grants 
  3.4   to support healthy youth development in 
  3.5   accordance with Minnesota Statutes, 
  3.6   section 145.9263.  
  3.7   Of this amount, $500,000 each year is 
  3.8   for transfer to the commissioner of 
  3.9   children, families, and learning for 
  3.10  adolescent parent programs.  
  3.11  [HEALTH WORKFORCE DEVELOPMENT.] Of the 
  3.12  general fund appropriation, $600,000 
  3.13  each year is for the community/regional 
  3.14  health workforce grant program, of 
  3.15  which $445,500 is for planning grants 
  3.16  to at least 15 communities and/or 
  3.17  regions to identify and implement local 
  3.18  strategies to meet health workforce 
  3.19  needs.  
  3.20  Of the general fund appropriation, 
  3.21  $1,118,000 in the first year and 
  3.22  $2,082,000 in the second year is to 
  3.23  expand the health professionals loan 
  3.24  program, of which $963,000 in the first 
  3.25  year and $1,927,000 in the second year 
  3.26  is for direct grants to increase the 
  3.27  placement of physicians, dentists, 
  3.28  pharmacists, mental health providers, 
  3.29  health care technicians in rural 
  3.30  communities, and nurses in nursing home 
  3.31  statewide.  
  3.32  [POISON INFORMATION SYSTEM.] Of this 
  3.33  appropriation, $1,360,000 each fiscal 
  3.34  year is for poison control system 
  3.35  grants under Minnesota Statutes, 
  3.36  section 145.93. 
  3.37  [SUICIDE PREVENTION.] Of the general 
  3.38  fund appropriation, $1,100,000 each 
  3.39  year is for suicide prevention and 
  3.40  mental health promotion efforts.  Of 
  3.41  this amount, $825,000 each year is for 
  3.42  competitive community-based planning 
  3.43  and implementation grants targeted to 
  3.44  populations at highest risk, including 
  3.45  teenagers and young adults.  
  3.46  [TANF HOME VISITING CARRYFORWARD.] Any 
  3.47  unexpended balance of the TANF funds 
  3.48  appropriated for family home visiting 
  3.49  in the first year of the biennium does 
  3.50  not cancel but is available for the 
  3.51  second year. 
  3.52  [HEALTHY YOUTH DEVELOPMENT 
  3.53  CARRYFORWARD.] Any unexpended balance 
  3.54  of the TANF funds appropriated for the 
  3.55  healthy youth development grant program 
  3.56  established under Minnesota Statutes, 
  3.57  section 145.9263, in the first fiscal 
  3.58  year of the biennium does not cancel 
  3.59  but is available for the second year. 
  3.60  [WIC TRANSFERS.] The general fund 
  3.61  appropriation for the women, infants, 
  3.62  and children (WIC) food supplement 
  3.63  program is available for either year of 
  4.1   the biennium.  Transfers of these funds 
  4.2   between fiscal years must be either to 
  4.3   maximize federal funds or to minimize 
  4.4   fluctuations in the number of program 
  4.5   participants. 
  4.6   [MINNESOTA CHILDREN WITH SPECIAL HEALTH 
  4.7   NEEDS CARRYFORWARD.] General fund 
  4.8   appropriations for treatment services 
  4.9   in the services for Minnesota children 
  4.10  with special health needs program are 
  4.11  available for either year of the 
  4.12  biennium. 
  4.13  Subd. 3.  Access and Quality 
  4.14  Improvement                           40,933,000     30,318,000 
  4.15                Summary by Fund
  4.16  General               6,306,000     5,549,000 
  4.17  State Government 
  4.18  Special Revenue       6,402,000     6,492,000 
  4.19  Health Care 
  4.20  Access               28,225,000    18,277,000 
  4.21  [MINNESOTA CENTER FOR HEALTH QUALITY.] 
  4.22  Of the appropriation from the health 
  4.23  care access fund, $10,000,000 in the 
  4.24  first year is to carry out the 
  4.25  activities of the Minnesota Center for 
  4.26  Health Quality.  This appropriation is 
  4.27  available until June 30, 2005. 
  4.28  [HEALTH CARE SAFETY NET.] Of the health 
  4.29  care access fund appropriation, 
  4.30  $15,000,000 in each fiscal year is to 
  4.31  provide financial support to Minnesota 
  4.32  health care safety net providers.  This 
  4.33  appropriation shall not become part of 
  4.34  the base funding for the agency for the 
  4.35  2004-2005 biennium.  Of the amounts 
  4.36  available: 
  4.37  (1) $5,000,000 each year is for a grant 
  4.38  program to aid safety net community 
  4.39  clinics. 
  4.40  (2) $5,000,000 each year is for a grant 
  4.41  program to aid hospitals with excess 
  4.42  charity care burdens. 
  4.43  (3) $5,000,000 each year is for a grant 
  4.44  program to provide rural hospital 
  4.45  capital improvement grants described in 
  4.46  Minnesota Statutes, section 144.148. 
  4.47  Subd. 4.  Health Protection           30,783,000     32,156,000 
  4.48                Summary by Fund 
  4.49  General              13,895,000    14,496,000 
  4.50  State Government 
  4.51  Special Revenue      16,888,000    17,660,000 
  4.52  [EMERGING HEALTH THREATS.] Of the 
  4.53  general fund appropriation, $2,200,000 
  4.54  in the first year and $2,600,000 in the 
  4.55  second year is to increase the state 
  5.1   capacity to identify and respond to 
  5.2   emerging health threats.  
  5.3   Of these amounts, $1,900,000 in the 
  5.4   first year and $2,300,000 in the second 
  5.5   year is to expand state laboratory 
  5.6   capacity to identify infectious disease 
  5.7   organisms, evaluate environmental 
  5.8   contaminants, develop new analytical 
  5.9   techniques, provide emergency response, 
  5.10  and support local government by 
  5.11  training health care system workers to 
  5.12  deal with biological and chemical 
  5.13  health threats.  
  5.14  $300,000 each year is to train, 
  5.15  consult, and otherwise assist local 
  5.16  officials responding to clandestine 
  5.17  drug laboratories and minimizing health 
  5.18  risks to responders and the public.  
  5.19  $200,000 in the first year is to 
  5.20  increase laboratory security and safety 
  5.21  systems and for the acquisition of 
  5.22  hazardous materials analysis equipment. 
  5.23  Subd. 5.  Management and 
  5.24  Support Services                       5,455,000      5,867,000 
  5.25                Summary by Fund
  5.26  General               5,304,000     5,712,000 
  5.27  State Government 
  5.28  Special Revenue         151,000       155,000 
  5.29                             ARTICLE 2 
  5.30                         HEALTH PROVISIONS 
  5.31     Section 1.  Minnesota Statutes 2000, section 62J.152, 
  5.32  subdivision 8, is amended to read: 
  5.33     Subd. 8.  [REPEALER.] This section and sections 62J.15 and 
  5.34  62J.156 are repealed effective July 1, 2001 2005. 
  5.35     Sec. 2.  Minnesota Statutes 2000, section 62J.451, 
  5.36  subdivision 5, is amended to read: 
  5.37     Subd. 5.  [HEALTH CARE ELECTRONIC DATA INTERCHANGE 
  5.38  SYSTEM.] (a) The health data institute shall establish an 
  5.39  electronic data interchange system that electronically 
  5.40  transmits, collects, archives, and provides users of data with 
  5.41  the data necessary for their specific interests, in order to 
  5.42  promote a high quality, cost-effective, consumer-responsive 
  5.43  health care system.  This public-private information system 
  5.44  shall be developed to make health care claims processing and 
  5.45  financial settlement transactions more efficient and to provide 
  5.46  an efficient, unobtrusive method for meeting the shared 
  6.1   electronic data interchange needs of consumers, group 
  6.2   purchasers, providers, and the state. 
  6.3      (b) The health data institute shall operate the Minnesota 
  6.4   center for health care electronic data interchange established 
  6.5   in section 62J.57, and shall integrate the goals, objectives, 
  6.6   and activities of the center with those of the health data 
  6.7   institute's electronic data interchange system. 
  6.8      Sec. 3.  Minnesota Statutes 2000, section 144.1202, 
  6.9   subdivision 4, is amended to read: 
  6.10     Subd. 4.  [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 
  6.11  agreement entered into before August 2, 2002 2003, must remain 
  6.12  in effect until terminated under the Atomic Energy Act of 1954, 
  6.13  United States Code, title 42, section 2021, paragraph (j).  The 
  6.14  governor may not enter into an initial agreement with the 
  6.15  Nuclear Regulatory Commission after August 1, 2002 2003.  If an 
  6.16  agreement is not entered into by August 1, 2002 2003, any rules 
  6.17  adopted under this section are repealed effective August 1, 2002 
  6.18  2003. 
  6.19     (b) An agreement authorized under subdivision 1 must be 
  6.20  approved by law before it may be implemented. 
  6.21     Sec. 4.  [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND 
  6.22  SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.] 
  6.23     Subdivision 1.  [APPLICATION AND LICENSE RENEWAL FEE.] When 
  6.24  a license is required for radioactive material or source or 
  6.25  special nuclear material by a rule adopted under section 
  6.26  144.1202, subdivision 2, an application fee according to 
  6.27  subdivision 4 must be paid upon initial application for a 
  6.28  license.  The licensee must renew the license 60 days before the 
  6.29  expiration date of the license by paying a license renewal fee 
  6.30  equal to the application fee under subdivision 4.  The 
  6.31  expiration date of a license is the date set by the United 
  6.32  States Nuclear Regulatory Commission before transfer of the 
  6.33  licensing program under section 144.1202 and thereafter as 
  6.34  specified by rule of the commissioner of health. 
  6.35     Subd. 2.  [ANNUAL FEE.] A licensee must pay an annual fee 
  6.36  at least 60 days before the anniversary date of the issuance of 
  7.1   the license.  The annual fee is an amount equal to 80 percent of 
  7.2   the application fee under subdivision 4, rounded to the nearest 
  7.3   whole dollar. 
  7.4      Subd. 3.  [FEE CATEGORIES; INCORPORATION OF FEDERAL 
  7.5   LICENSING CATEGORIES.] (a) Fee categories under this section are 
  7.6   equivalent to the licensing categories used by the United States 
  7.7   Nuclear Regulatory Commission under Code of Federal Regulations, 
  7.8   title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as 
  7.9   provided in paragraph (b). 
  7.10     (b) The category of "Academic, small" is the type of 
  7.11  license required for the use of radioactive materials in a 
  7.12  teaching institution.  Radioactive materials are limited to ten 
  7.13  radionuclides not to exceed a total activity amount of one curie.
  7.14     Subd. 4.  [APPLICATION FEE.] A licensee must pay an 
  7.15  application fee as follows: 
  7.16  Radioactive material,  Application    U.S. Nuclear Regulatory
  7.17  source and             fee            Commission licensing
  7.18  special material                      category as reference
  7.20  Type A broadscope      $20,000        Medical institution type A
  7.21  Type B broadscope      $15,000        Research and development
  7.22                                        type B
  7.23  Type C broadscope      $10,000        Academic type C
  7.24  Medical use            $4,000         Medical
  7.25                                        Medical institution
  7.26                                        Medical private practice
  7.27  Mobile nuclear                                                 
  7.28  medical laboratory     $4,000         Mobile medical laboratory
  7.29  Medical special use                                     
  7.30  sealed sources         $6,000         Teletherapy
  7.31                                        High dose rate remote
  7.32                                        afterloaders
  7.33                                        Stereotactic
  7.34                                        radiosurgery devices
  7.35  In vitro testing       $2,300         In vitro testing
  7.36                                        laboratories
  8.1   Measuring gauge,
  8.2   sealed sources         $2,000         Fixed gauges
  8.3                                         Portable gauges
  8.4                                         Analytical instruments
  8.5                                         Measuring systems - other
  8.6   Gas chromatographs     $1,200         Gas chromatographs
  8.7   Manufacturing and 
  8.8   distribution           $14,700        Manufacturing and 
  8.9                                         distribution - other
  8.10  Distribution only      $8,800         Distribution of
  8.11                                        radioactive material
  8.12                                        for commercial use only
  8.13  Other services         $1,500         Other services
  8.14  Nuclear medicine 
  8.15  pharmacy               $4,100         Nuclear pharmacy
  8.16  Waste disposal         $9,400         Waste disposal service
  8.17                                        prepackage
  8.18                                        Waste disposal service
  8.19                                        processing/repackage
  8.20  Waste storage only     $7,000         To receive and store
  8.21                                        radioactive material waste
  8.22  Industrial
  8.23  radiography            $8,400         Industrial radiography
  8.24                                        fixed location
  8.25                                        Industrial radiography
  8.26                                        portable/temporary sites
  8.27  Irradiator - 
  8.28  self-shielded          $4,100         Irradiators self-shielded
  8.29                                        less than 10,000 curies
  8.30  Irradiator - 
  8.31  less than 10,000 Ci    $7,500         Irradiators less than
  8.32                                        10,000 curies
  8.33  Irradiator - 
  8.34  more than 10,000 Ci    $11,500        Irradiators greater than
  8.35                                        10,000 curies
  8.36  Research and
  9.1   development,
  9.2   no distribution        $4,100         Research and development
  9.3   Radioactive material 
  9.4   possession only        $1,000         Byproduct possession only
  9.5   Source material        $1,000         Source material shielding
  9.6   Special nuclear 
  9.7   material, less than 
  9.8   200 grams              $1,000         Special nuclear material
  9.9                                         plutonium-neutron sources
  9.10                                        less than 200 grams
  9.11  Pacemaker
  9.12  manufacturing          $1,000         Pacemaker byproduct
  9.13                                        and/or special nuclear
  9.14                                        material - medical
  9.15                                        institution
  9.16  General license
  9.17  distribution           $2,100         General license
  9.18                                        distribution
  9.19  General license 
  9.20  distribution, exempt   $1,500         General license 
  9.21                                        distribution -
  9.22                                        certain exempt items
  9.23  Academic, small        $1,000         Possession limit of ten
  9.24                                        radionuclides, not to
  9.25                                        exceed a total of one curie
  9.26                                        of activity
  9.27  Veterinary             $2,000         Veterinary use
  9.28  Well logging           $5,000         Well logging
  9.29     Subd. 5.  [PENALTY FOR LATE PAYMENT.] An annual fee or a 
  9.30  license renewal fee submitted to the commissioner after the due 
  9.31  date specified by rule must be accompanied by an additional 
  9.32  amount equal to 25 percent of the fee due. 
  9.33     Subd. 6.  [INSPECTIONS.] The commissioner of health shall 
  9.34  make periodic safety inspections of the radioactive material and 
  9.35  source and special nuclear material of a licensee.  The 
  9.36  commissioner shall prescribe the frequency of safety inspections 
 10.1   by rule. 
 10.2      Subd. 7.  [RECOVERY OF REINSPECTION COST.] If the 
 10.3   commissioner finds serious violations of public health standards 
 10.4   during an inspection under subdivision 6, the licensee must pay 
 10.5   all costs associated with subsequent reinspection of the 
 10.6   source.  The costs shall be the actual costs incurred by the 
 10.7   commissioner and include, but are not limited to, labor, 
 10.8   transportation, per diem, materials, legal fees, testing, and 
 10.9   monitoring costs. 
 10.10     Subd. 8.  [RECIPROCITY FEE.] A licensee submitting an 
 10.11  application for reciprocal recognition of a materials license 
 10.12  issued by another agreement state or the United States Nuclear 
 10.13  Regulatory Commission for a period of 180 days or less during a 
 10.14  calendar year must pay one-half of the application fee specified 
 10.15  under subdivision 4.  For a period of 181 days or more, the 
 10.16  licensee must pay the entire application fee under subdivision 4.
 10.17     Subd. 9.  [FEES FOR LICENSE AMENDMENTS.] A licensee must 
 10.18  pay a fee to amend a license as follows: 
 10.19     (1) to amend a license requiring no license review 
 10.20  including, but not limited to, facility name change or removal 
 10.21  of a previously authorized user, no fee; 
 10.22     (2) to amend a license requiring review including, but not 
 10.23  limited to, addition of isotopes, procedure changes, new 
 10.24  authorized users, or a new radiation safety officer, $200; and 
 10.25     (3) to amend a license requiring review and a site visit 
 10.26  including, but not limited to, facility move or addition of 
 10.27  processes, $400. 
 10.28     Sec. 5.  Minnesota Statutes 2000, section 144.148, 
 10.29  subdivision 8, is amended to read: 
 10.30     Subd. 8.  [EXPIRATION.] This section expires June 30, 
 10.31  2001 2003. 
 10.32     Sec. 6.  Minnesota Statutes 2000, section 144.1494, is 
 10.33  amended by adding a subdivision to read: 
 10.34     Subd. 3a.  [ADDITIONAL PARTICIPANTS.] Based on availability 
 10.35  of general fund appropriations, the commissioner may accept up 
 10.36  to ten applicants a year in addition to the number of applicants 
 11.1   specified under subdivision 3.  All other terms and conditions 
 11.2   of this section apply to applicants accepted under this 
 11.3   subdivision. 
 11.4      Sec. 7.  Minnesota Statutes 2000, section 144.1496, is 
 11.5   amended by adding a subdivision to read: 
 11.6      Subd. 3a.  [ADDITIONAL PARTICIPANTS.] Based on availability 
 11.7   of general fund appropriations, the commissioner may accept up 
 11.8   to 177 applicants a year in addition to the number of applicants 
 11.9   specified under subdivision 3.  All other terms and conditions 
 11.10  of this section apply to applicants accepted under this 
 11.11  subdivision. 
 11.12     Sec. 8.  [144.1501] [RURAL PHARMACISTS LOAN FORGIVENESS.] 
 11.13     Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
 11.14  section, the terms defined in this subdivision have the meanings 
 11.15  given them. 
 11.16     (b) "Designated rural area" means:  
 11.17     (1) an area in Minnesota outside the counties of Anoka, 
 11.18  Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 
 11.19  excluding the cities of Duluth, Mankato, Moorhead, Rochester, 
 11.20  and St. Cloud; or 
 11.21     (2) a municipal corporation, as defined under section 
 11.22  471.634, that is physically located, in whole or in part, in an 
 11.23  area defined as a designated rural area under clause (1).  
 11.24     Designated rural areas may be further defined by the 
 11.25  commissioner of health to reflect a shortage of pharmacists as 
 11.26  indicated by the ratio of pharmacists to population and the 
 11.27  distance to the next nearest pharmacy. 
 11.28     (c) "Qualifying educational loans" means government, 
 11.29  commercial, and foundation loans for actual costs paid for 
 11.30  tuition, reasonable education expenses, and reasonable living 
 11.31  expenses related to the graduate or undergraduate education of a 
 11.32  pharmacist. 
 11.33     Subd. 2.  [CREATION OF ACCOUNT; LOAN FORGIVENESS 
 11.34  PROGRAM.] A rural pharmacist education account is established in 
 11.35  the general fund.  The commissioner of health shall use money 
 11.36  from the account to establish a loan forgiveness program for 
 12.1   pharmacists who agree to practice in designated rural areas.  
 12.2   The commissioner may seek advice in establishing the program 
 12.3   from the pharmacists association, the University of Minnesota, 
 12.4   and other interested parties. 
 12.5      Subd. 3.  [ELIGIBILITY.] To be eligible to participate in 
 12.6   the loan forgiveness program, a pharmacy student must submit an 
 12.7   application to the commissioner of health while attending a 
 12.8   program of study designed to prepare the individual to become a 
 12.9   licensed pharmacist.  For fiscal year 2002, applicants may have 
 12.10  graduated from a pharmacy program in calendar year 2001.  A 
 12.11  pharmacy student who is accepted into the loan forgiveness 
 12.12  program must sign a contract to agree to serve a minimum 
 12.13  three-year service obligation within a designated rural area, 
 12.14  which shall begin no later than March 31 of the first year 
 12.15  following completion of a pharmacy program or residency.  If 
 12.16  fewer applications are submitted by pharmacy students than there 
 12.17  are participant slots available, the commissioner may consider 
 12.18  applications submitted by pharmacy program graduates who are 
 12.19  licensed pharmacists.  Pharmacists selected for loan forgiveness 
 12.20  must comply with all terms and conditions of this section.  
 12.21     Subd. 4.  [LOAN FORGIVENESS.] The commissioner of health 
 12.22  may accept up to 14 applicants per year for participation in the 
 12.23  loan forgiveness program.  Applicants are responsible for 
 12.24  securing their own loans.  The commissioner shall select 
 12.25  participants based on their suitability for rural practice, as 
 12.26  indicated by rural experience or training.  The commissioner 
 12.27  shall give preference to applicants closest to completing their 
 12.28  training.  For each year that a participant serves as a 
 12.29  pharmacist in a designated rural area as required under 
 12.30  subdivision 3, up to a maximum of four years, the commissioner 
 12.31  shall make annual disbursements directly to the participant 
 12.32  equivalent to $5,000 per year of service, not to exceed $20,000 
 12.33  or the balance of the qualifying educational loans, whichever is 
 12.34  less.  Before receiving loan repayment disbursements and as 
 12.35  requested, the participant must complete and return to the 
 12.36  commissioner an affidavit of practice form provided by the 
 13.1   commissioner verifying that the participant is practicing as 
 13.2   required in an eligible area.  The participant must provide the 
 13.3   commissioner with verification that the full amount of loan 
 13.4   repayment disbursement received by the participant has been 
 13.5   applied toward the qualifying educational loans.  After each 
 13.6   disbursement, verification must be received by the commissioner 
 13.7   and approved before the next loan repayment disbursement is 
 13.8   made. Participants who move their practice from one designated 
 13.9   rural area to another remain eligible for loan repayment. 
 13.10     Subd. 5.  [PENALTY FOR NONFULFILLMENT.] If a participant 
 13.11  does not fulfill the service commitment under subdivision 3, the 
 13.12  commissioner of health shall collect from the participant 100 
 13.13  percent of any payments made for qualified educational loans and 
 13.14  interest at a rate established according to section 270.75.  The 
 13.15  commissioner shall deposit the money collected in the rural 
 13.16  pharmacist education account established under subdivision 2. 
 13.17     Subd. 6.  [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 
 13.18  service obligations cancel in the event of a participant's 
 13.19  death.  The commissioner of health may waive or suspend payment 
 13.20  or service obligations in cases of total and permanent 
 13.21  disability or long-term temporary disability lasting for more 
 13.22  than two years.  The commissioner shall evaluate all other 
 13.23  requests for suspension or waivers on a case-by-case basis and 
 13.24  may grant a waiver of all or part of the money owed as a result 
 13.25  of a nonfulfillment penalty if emergency circumstances prevented 
 13.26  fulfillment of the required service commitment. 
 13.27     Sec. 9.  [144.1502] [DENTISTS LOAN FORGIVENESS.] 
 13.28     Subdivision 1.  [DEFINITION.] For purposes of this section, 
 13.29  "qualifying educational loans" means government, commercial, and 
 13.30  foundation loans for actual costs paid for tuition, reasonable 
 13.31  education expenses, and reasonable living expenses related to 
 13.32  the graduate or undergraduate education of a dentist. 
 13.33     Subd. 2.  [CREATION OF ACCOUNT; LOAN FORGIVENESS 
 13.34  PROGRAM.] A dentist education account is established in the 
 13.35  general fund.  The commissioner of health shall use money from 
 13.36  the account to establish a loan forgiveness program for dentists 
 14.1   who agree to care for substantial numbers of state public 
 14.2   program participants and other low- to moderate-income uninsured 
 14.3   patients. 
 14.4      Subd. 3.  [ELIGIBILITY.] To be eligible to participate in 
 14.5   the loan forgiveness program, a dental student must submit an 
 14.6   application to the commissioner of health while attending a 
 14.7   program of study designed to prepare the individual to become a 
 14.8   licensed dentist.  For fiscal year 2002, applicants may have 
 14.9   graduated from a dentistry program in calendar year 2001.  A 
 14.10  dental student who is accepted into the loan forgiveness program 
 14.11  must sign a contract to agree to serve a minimum three-year 
 14.12  service obligation during which at least 25 percent of the 
 14.13  dentist's yearly patient encounters are delivered to state 
 14.14  public program enrollees or patients receiving sliding fee 
 14.15  schedule discounts through a formal sliding fee schedule meeting 
 14.16  the standards established by the United States Department of 
 14.17  Health and Human Services under Code of Federal Regulations, 
 14.18  title 42, section 51, chapter 303.  The service obligation shall 
 14.19  begin no later than March 31 of the first year following 
 14.20  completion of training.  If fewer applications are submitted by 
 14.21  dental students than there are participant slots available, the 
 14.22  commissioner may consider applications submitted by dental 
 14.23  program graduates who are licensed dentists.  Dentists selected 
 14.24  for loan forgiveness must comply with all terms and conditions 
 14.25  of this section.  
 14.26     Subd. 4.  [LOAN FORGIVENESS.] The commissioner of health 
 14.27  may accept up to 14 applicants per year for participation in the 
 14.28  loan forgiveness program.  Applicants are responsible for 
 14.29  securing their own loans.  The commissioner shall select 
 14.30  participants based on their suitability for practice serving 
 14.31  public program patients, as indicated by experience or 
 14.32  training.  The commissioner shall give preference to applicants 
 14.33  who have attended a Minnesota dentistry educational institution 
 14.34  and to applicants closest to completing their training.  For 
 14.35  each year that a participant meets the service obligation 
 14.36  required under subdivision 3, up to a maximum of four years, the 
 15.1   commissioner shall make annual disbursements directly to the 
 15.2   participant equivalent to $10,000 per year of service, not to 
 15.3   exceed $40,000 or the balance of the qualifying educational 
 15.4   loans, whichever is less.  Before receiving loan repayment 
 15.5   disbursements and as requested, the participant must complete 
 15.6   and return to the commissioner an affidavit of practice form 
 15.7   provided by the commissioner verifying that the participant is 
 15.8   practicing as required under subdivision 3.  The participant 
 15.9   must provide the commissioner with verification that the full 
 15.10  amount of loan repayment disbursement received by the 
 15.11  participant has been applied toward the designated loans.  After 
 15.12  each disbursement, verification must be received by the 
 15.13  commissioner and approved before the next loan repayment 
 15.14  disbursement is made.  Participants who move their practice 
 15.15  remain eligible for loan repayment as long as they practice as 
 15.16  required under subdivision 3. 
 15.17     Subd. 5.  [PENALTY FOR NONFULFILLMENT.] If a participant 
 15.18  does not fulfill the service commitment under subdivision 3, the 
 15.19  commissioner of health shall collect from the participant 100 
 15.20  percent of any payments made for qualified educational loans and 
 15.21  interest at a rate established according to section 270.75.  The 
 15.22  commissioner shall deposit the money collected in the dentist 
 15.23  education account established under subdivision 2. 
 15.24     Subd. 6.  [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 
 15.25  service obligations cancel in the event of a participant's 
 15.26  death.  The commissioner of health may waive or suspend payment 
 15.27  or service obligations in cases of total and permanent 
 15.28  disability or long-term temporary disability lasting for more 
 15.29  than two years.  The commissioner shall evaluate all other 
 15.30  requests for suspension or waivers on a case-by-case basis and 
 15.31  may grant a waiver of all or part of the money owed as a result 
 15.32  of a nonfulfillment penalty if emergency circumstances prevented 
 15.33  fulfillment of the required service commitment. 
 15.34     Sec. 10.  [144.1503] [RURAL MENTAL HEALTH PROFESSIONAL LOAN 
 15.35  FORGIVENESS.] 
 15.36     Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
 16.1   section, the terms defined in this subdivision have the meanings 
 16.2   given them. 
 16.3      (b) "Designated rural area" means: 
 16.4      (1) an area in Minnesota outside the counties of Anoka, 
 16.5   Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 
 16.6   excluding the cities of Duluth, Mankato, Moorhead, Rochester, 
 16.7   and St. Cloud; or 
 16.8      (2) a municipal corporation, as defined under section 
 16.9   471.634, that is physically located, in whole or in part, in an 
 16.10  area defined as a designated rural area under clause (1). 
 16.11     (c) "Mental health professional" means a psychologist, 
 16.12  clinical social worker, marriage and family therapist, or 
 16.13  psychiatric nurse. 
 16.14     (d) "Qualifying educational loans" means government, 
 16.15  commercial, and foundation loans for actual costs paid for 
 16.16  tuition, reasonable education expenses, and reasonable living 
 16.17  expenses related to the graduate or undergraduate education of a 
 16.18  mental health professional. 
 16.19     Subd. 2.  [CREATION OF ACCOUNT; LOAN FORGIVENESS 
 16.20  PROGRAM.] A rural mental health professional education account 
 16.21  is established in the general fund.  The commissioner of health 
 16.22  shall use money from the account to establish a loan forgiveness 
 16.23  program for mental health professionals who agree to practice in 
 16.24  designated rural areas. 
 16.25     Subd. 3.  [ELIGIBILITY.] To be eligible to participate in 
 16.26  the loan forgiveness program, a mental health professional 
 16.27  student must submit an application to the commissioner of health 
 16.28  while attending a program of study designed to prepare the 
 16.29  individual to become a mental health professional.  For fiscal 
 16.30  year 2002, applicants may have graduated from a mental health 
 16.31  professional educational program in calendar year 2001.  A 
 16.32  mental health professional student who is accepted into the loan 
 16.33  forgiveness program must sign a contract to agree to serve a 
 16.34  minimum three-year service obligation within a designated rural 
 16.35  area, which shall begin no later than March 31 of the first year 
 16.36  following completion of a mental health professional educational 
 17.1   program.  
 17.2      Subd. 4.  [LOAN FORGIVENESS.] The commissioner of health 
 17.3   may accept up to 12 applicants per year for participation in the 
 17.4   loan forgiveness program.  Applicants are responsible for 
 17.5   securing their own loans.  The commissioner shall select 
 17.6   participants based on their suitability for rural practice, as 
 17.7   indicated by rural experience or training.  The commissioner 
 17.8   shall give preference to applicants who have attended a 
 17.9   Minnesota mental health professional educational institution and 
 17.10  to applicants closest to completing their training.  For each 
 17.11  year that a participant serves as a mental health professional 
 17.12  in a designated rural area as required under subdivision 3, up 
 17.13  to a maximum of four years, the commissioner shall make annual 
 17.14  disbursements directly to the participant equivalent to $4,000 
 17.15  per year of service, not to exceed $16,000 or the balance of the 
 17.16  qualifying educational loans, whichever is less.  Before 
 17.17  receiving loan repayment disbursements and as requested, the 
 17.18  participant must complete and return to the commissioner an 
 17.19  affidavit of practice form provided by the commissioner 
 17.20  verifying that the participant is practicing as required in an 
 17.21  eligible area.  The participant must provide the commissioner 
 17.22  with verification that the full amount of loan repayment 
 17.23  disbursement received by the participant has been applied toward 
 17.24  the qualifying educational loans.  After each disbursement, 
 17.25  verification must be received by the commissioner and approved 
 17.26  before the next loan repayment disbursement is made.  
 17.27  Participants who move their practice from one designated rural 
 17.28  area to another remain eligible for loan repayment. 
 17.29     Subd. 5.  [PENALTY FOR NONFULFILLMENT.] If a participant 
 17.30  does not fulfill the service commitment under subdivision 3, the 
 17.31  commissioner of health shall collect from the participant 100 
 17.32  percent of any payments made for qualified educational loans and 
 17.33  interest at a rate established according to section 270.75.  The 
 17.34  commissioner shall deposit the money collected in the rural 
 17.35  mental health professional education account established under 
 17.36  subdivision 2. 
 18.1      Subd. 6.  [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 
 18.2   service obligations cancel in the event of a participant's 
 18.3   death.  The commissioner of health may waive or suspend payment 
 18.4   or service obligations in cases of total and permanent 
 18.5   disability or long-term temporary disability lasting for more 
 18.6   than two years.  The commissioner shall evaluate all other 
 18.7   requests for suspension or waivers on a case-by-case basis and 
 18.8   may grant a waiver of all or part of the money owed as a result 
 18.9   of a nonfulfillment penalty if emergency circumstances prevented 
 18.10  fulfillment of the required service commitment. 
 18.11     Sec. 11.  [144.1504] [RURAL HEALTH CARE TECHNICIANS LOAN 
 18.12  FORGIVENESS.] 
 18.13     Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
 18.14  section, the terms defined in this subdivision have the meanings 
 18.15  given them. 
 18.16     (b) "Clinical laboratory scientist" means a person who 
 18.17  performs and interprets results of medical tests that require 
 18.18  the exercise of independent judgment and responsibility, with 
 18.19  minimal supervision by the director or supervisor, in only those 
 18.20  specialties or subspecialties in which the person is qualified 
 18.21  by education, training, and experience and has demonstrated 
 18.22  ongoing competency by certification or other means.  A clinical 
 18.23  laboratory scientist may also be called a medical technologist. 
 18.24     (c) "Clinical laboratory technician" means any person other 
 18.25  than a medical laboratory director, clinical laboratory 
 18.26  scientist, or trainee who functions under the supervision of a 
 18.27  medical laboratory director or clinical laboratory scientist and 
 18.28  performs diagnostic and analytical laboratory tests in only 
 18.29  those specialties or subspecialties in which the person is 
 18.30  qualified by education, training, and experience and has 
 18.31  demonstrated ongoing competency by certification or other 
 18.32  means.  A clinical laboratory technician may also be called a 
 18.33  medical technician. 
 18.34     (d) "Designated rural area" means: 
 18.35     (1) an area in Minnesota outside the counties of Anoka, 
 18.36  Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 
 19.1   excluding the cities of Duluth, Mankato, Moorhead, Rochester, 
 19.2   and St. Cloud; or 
 19.3      (2) a municipal corporation, as defined under section 
 19.4   471.634, that is physically located, in whole or in part, in an 
 19.5   area defined as a designated rural area under clause (1). 
 19.6      (e) "Health care technician" means a clinical laboratory 
 19.7   scientist, clinical laboratory technician, radiologic 
 19.8   technologist, dental hygienist, dental assistant, or paramedic. 
 19.9      (f) "Paramedic" means a person certified under chapter 144E 
 19.10  by the emergency medical services regulatory board as an 
 19.11  emergency medical technician-paramedic.  
 19.12     (g) "Qualifying educational loans" means government, 
 19.13  commercial, and foundation loans for actual costs paid for 
 19.14  tuition, reasonable education expenses, and reasonable living 
 19.15  expenses related to the graduate or undergraduate education of a 
 19.16  health care technician. 
 19.17     (h) "Radiologic technologist" means a person, other than a 
 19.18  licensed physician, who has demonstrated competency by 
 19.19  certification, registration, or other means for administering 
 19.20  medical imaging or radiation therapy procedures to other persons 
 19.21  for medical purposes.  Radiologic technologist includes, but is 
 19.22  not limited to, radiographers, radiation therapists, and nuclear 
 19.23  medicine technologists. 
 19.24     Subd. 2.  [CREATION OF ACCOUNT; LOAN FORGIVENESS 
 19.25  PROGRAM.] A rural health care technician education account is 
 19.26  established in the general fund.  The commissioner of health 
 19.27  shall use money from the account to establish a loan forgiveness 
 19.28  program for health care technicians who agree to practice in 
 19.29  designated rural areas. 
 19.30     Subd. 3.  [ELIGIBILITY.] To be eligible to participate in 
 19.31  the loan forgiveness program, a health care technician student 
 19.32  must submit an application to the commissioner of health while 
 19.33  attending a program of study designed to prepare the individual 
 19.34  to become a health care technician.  For fiscal year 2002, 
 19.35  applicants may have graduated from a health care technician 
 19.36  program in calendar year 2001.  A health care technician student 
 20.1   who is accepted into the loan forgiveness program must sign a 
 20.2   contract to agree to serve a minimum one-year service obligation 
 20.3   within a designated rural area, which shall begin no later than 
 20.4   March 31 of the first year following completion of a health care 
 20.5   technician program. 
 20.6      Subd. 4.  [LOAN FORGIVENESS.] The commissioner of health 
 20.7   may accept up to 30 applicants per year for participation in the 
 20.8   loan forgiveness program.  Applicants are responsible for 
 20.9   securing their own loans.  The commissioner shall select 
 20.10  participants based on their suitability for rural practice, as 
 20.11  indicated by rural experience or training.  The commissioner 
 20.12  shall give preference to applicants who have attended a 
 20.13  Minnesota health care technician educational institution and to 
 20.14  applicants closest to completing their training.  For each year 
 20.15  that a participant serves as a health care technician in a 
 20.16  designated rural area as required under subdivision 3, up to a 
 20.17  maximum of two years, the commissioner shall make annual 
 20.18  disbursements directly to the participant equivalent to $2,500 
 20.19  per year of service, not to exceed $5,000 or the balance of the 
 20.20  qualifying educational loans, whichever is less.  Before 
 20.21  receiving loan repayment disbursements and as requested, the 
 20.22  participant must complete and return to the commissioner an 
 20.23  affidavit of practice form provided by the commissioner 
 20.24  verifying that the participant is practicing as required in an 
 20.25  eligible area.  The participant must provide the commissioner 
 20.26  with verification that the full amount of loan repayment 
 20.27  disbursement received by the participant has been applied toward 
 20.28  the qualifying educational loans.  After each disbursement, 
 20.29  verification must be received by the commissioner and approved 
 20.30  before the next loan repayment disbursement is made.  
 20.31  Participants who move their practice from one designated rural 
 20.32  area to another remain eligible for loan repayment. 
 20.33     Subd. 5.  [PENALTY FOR NONFULFILLMENT.] If a participant 
 20.34  does not fulfill the service commitment under subdivision 3, the 
 20.35  commissioner of health shall collect from the participant 100 
 20.36  percent of any payments made for qualified educational loans and 
 21.1   interest at a rate established according to section 270.75.  The 
 21.2   commissioner shall deposit the money collected in the rural 
 21.3   health care technician education account established under 
 21.4   subdivision 2. 
 21.5      Subd. 6.  [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 
 21.6   service obligations cancel in the event of a participant's 
 21.7   death.  The commissioner of health may waive or suspend payment 
 21.8   or service obligations in cases of total and permanent 
 21.9   disability or long-term temporary disability lasting for more 
 21.10  than two years.  The commissioner shall evaluate all other 
 21.11  requests for suspension or waivers on a case-by-case basis and 
 21.12  may grant a waiver of all or part of the money owed as a result 
 21.13  of a nonfulfillment penalty if emergency circumstances prevented 
 21.14  fulfillment of the required service commitment. 
 21.15     Sec. 12.  [144.1505] [COMMUNITY OR REGIONAL HEALTH 
 21.16  WORKFORCE GRANTS AND TECHNICAL ASSISTANCE.] 
 21.17     Subdivision 1.  [DEFINITION.] For purposes of this section, 
 21.18  a "community or regional health workforce council" means a 
 21.19  locally defined coalition whose membership may include, but is 
 21.20  not limited to, members or representatives of the following 
 21.21  groups: 
 21.22     (1) health professional associations; 
 21.23     (2) community health boards; 
 21.24     (3) employers of health professionals; 
 21.25     (4) minority communities; 
 21.26     (5) city and county government; 
 21.27     (6) economic development authorities; 
 21.28     (7) workforce centers; 
 21.29     (8) higher education institutions; 
 21.30     (9) University of Minnesota extension service; 
 21.31     (10) chambers of commerce; 
 21.32     (11) guidance counselors or other representatives of 
 21.33  kindergarten through grade 12; or 
 21.34     (12) health care consumers. 
 21.35     Subd. 2.  [GRANTS AUTHORIZED.] The commissioner of health 
 21.36  shall award grants to community or regional health workforce 
 22.1   councils to plan for and implement local and regional 
 22.2   initiatives to alleviate health worker shortages.  The 
 22.3   commissioner shall award grants for the following purposes: 
 22.4      (1) data collection and analysis to assess local or 
 22.5   regional health worker shortages; 
 22.6      (2) creation of detailed implementation plans for local or 
 22.7   regional initiatives to alleviate health worker shortages; and 
 22.8      (3) implementation of specific local or regional 
 22.9   initiatives to alleviate health worker shortages. 
 22.10     Subd. 3.  [ALLOCATION OF GRANTS.] (a) To receive a grant 
 22.11  under this section, a community or regional health workforce 
 22.12  council must: 
 22.13     (1) submit a proposal to the commissioner of health 
 22.14  according to a timeline determined by the commissioner; and 
 22.15     (2) demonstrate that the council includes a substantial 
 22.16  number of the parties listed under subdivision 1, clauses (1) to 
 22.17  (12), or give a reasonable explanation for not including these 
 22.18  parties. 
 22.19     (b) In determining which proposals to fund under this 
 22.20  section, the commissioner shall give priority to proposals that: 
 22.21     (1) include a reasonable work plan indicating the 
 22.22  likelihood of a successful project outcome and incorporating 
 22.23  proposed outcome measures; 
 22.24     (2) involve innovative approaches to alleviating health 
 22.25  worker shortages or the negative effects of health worker 
 22.26  shortages; or 
 22.27     (3) are research-based or based on proven effective 
 22.28  strategies. 
 22.29     (c) The commissioner may consider relevant factors other 
 22.30  than those specified under paragraph (b) when the commissioner 
 22.31  deems it appropriate. 
 22.32     (d) A planning grant under subdivision 2, clause (1) or 
 22.33  (2), to a community or regional health workforce council may not 
 22.34  exceed $30,000 per year and may be renewed for a second year 
 22.35  upon demonstration of satisfactory progress in accomplishing the 
 22.36  work plan. 
 23.1      (e) An implementation grant under subdivision 2, clause 
 23.2   (3), to a community or regional health workforce council may not 
 23.3   exceed $50,000 per year and may be renewed for a total duration 
 23.4   of up to five years upon demonstration of satisfactory progress 
 23.5   in accomplishing the work plan. 
 23.6      (f) A community or regional health workforce council must 
 23.7   have local matching funds, cash or in-kind, in a 1:1 ratio for 
 23.8   all planning and implementation grants. 
 23.9      Subd. 4.  [TECHNICAL ASSISTANCE.] (a) The commissioner of 
 23.10  health shall provide technical assistance to: 
 23.11     (1) nonprofit and community organizations, local 
 23.12  government, and community health boards to assist in forming 
 23.13  community or regional health workforce councils; and 
 23.14     (2) community or regional health workforce councils to 
 23.15  assist in analyzing health workforce issues and in developing 
 23.16  and implementing projects to alleviate worker shortages. 
 23.17     (b) The commissioner shall prepare and disseminate 
 23.18  workforce data, program planning materials, and other relevant 
 23.19  information to assist community or regional health workforce 
 23.20  council efforts. 
 23.21     Subd. 5.  [EVALUATION.] The commissioner of health shall 
 23.22  evaluate the overall effectiveness of the grant and technical 
 23.23  assistance program.  The commissioner may collect from community 
 23.24  or regional health workforce councils the information necessary 
 23.25  to evaluate the program.  The commissioner shall prepare and 
 23.26  disseminate information on successful models emerging from the 
 23.27  program. 
 23.28     Sec. 13.  Minnesota Statutes 2000, section 144.226, 
 23.29  subdivision 4, is amended to read: 
 23.30     Subd. 4.  [VITAL RECORDS SURCHARGE.] In addition to any fee 
 23.31  prescribed under subdivision 1, there is a nonrefundable 
 23.32  surcharge of $3 $2 for each certified and noncertified birth or 
 23.33  death record, and for a certification that the record cannot be 
 23.34  found.  The local or state registrar shall forward this amount 
 23.35  to the state treasurer to be deposited into the state government 
 23.36  special revenue fund.  This surcharge shall not be charged under 
 24.1   those circumstances in which no fee for a birth or death record 
 24.2   is permitted under subdivision 1, paragraph (a).  This surcharge 
 24.3   requirement expires June 30, 2002. 
 24.4      Sec. 14.  [144.585] [HOSPITAL UNCOMPENSATED CARE AID.] 
 24.5      Subdivision 1.  [PURPOSE.] The purpose of uncompensated 
 24.6   care aid is to help offset excess charity care burdens at 
 24.7   Minnesota acute care, short-term hospitals that play a 
 24.8   disproportionate role in servicing the uninsured and low-income 
 24.9   populations. 
 24.10     Subd. 2.  [DEFINITIONS.] (a) For purposes of this section, 
 24.11  the terms defined in this subdivision have the meanings given to 
 24.12  them. 
 24.13     (b) "Uncompensated care" means the sum of charity care and 
 24.14  bad debt. 
 24.15     (c) "Charity care" has the meaning given in rules adopted 
 24.16  by the commissioner of health under sections 144.695 to 144.703. 
 24.17  Charity care shall be adjusted to cost-basis using the 
 24.18  cost-to-charge ratio. 
 24.19     (d) "Bad debt" has the meaning given in rules adopted by 
 24.20  the commissioner of health under sections 144.695 to 144.703.  
 24.21  Bad debt shall be adjusted to cost-basis using the 
 24.22  cost-to-charge ratio. 
 24.23     (e) "Uncompensated care ratio" means a hospital's 
 24.24  uncompensated care divided by its operating expenses, as defined 
 24.25  in rules adopted by the commissioner of health under sections 
 24.26  144.695 to 144.703. 
 24.27     (f) "Cost-to-charge ratio" means a hospital's total 
 24.28  operating expenses over the sum of gross patient revenue and 
 24.29  other operating revenue, as reported to the commissioner of 
 24.30  health under rules adopted under sections 144.695 to 144.703. 
 24.31     Subd. 3.  [ELIGIBLE HOSPITALS.] A hospital is eligible for 
 24.32  uncompensated care aid if its uncompensated care ratio exceeds 
 24.33  the statewide average uncompensated care ratio in both of the 
 24.34  two most recent hospital reporting years for which data is 
 24.35  available. 
 24.36     Subd. 4.  [ALLOCATION OF FUNDS.] An eligible hospital's 
 25.1   share of the available uncompensated care aid is equal to that 
 25.2   hospital's share of uncompensated care relative to the total 
 25.3   uncompensated care provided by eligible hospitals. 
 25.4      Subd. 5.  [REPORTS BY HOSPITALS.] Hospitals receiving 
 25.5   uncompensated care aid under this section must file with the 
 25.6   commissioner of health a report containing a list of the most 
 25.7   common diagnoses that remain uncompensated with the associated 
 25.8   number of cases and amounts of charity care and bad debt; 
 25.9   descriptive aggregate statistics of the characteristics of 
 25.10  patients who receive charity care and incur bad debt; and 
 25.11  information describing the county of origin of patients 
 25.12  receiving charity care.  The information must be submitted to 
 25.13  the commissioner at a date and on forms determined by the 
 25.14  commissioner. 
 25.15     Sec. 15.  Minnesota Statutes 2000, section 145.881, 
 25.16  subdivision 2, is amended to read: 
 25.17     Subd. 2.  [DUTIES.] The advisory task force shall meet on a 
 25.18  regular basis to perform the following duties:  
 25.19     (a) review and report on the health care needs of mothers 
 25.20  and children throughout the state of Minnesota; 
 25.21     (b) review and report on the type, frequency and impact of 
 25.22  maternal and child health care services provided to mothers and 
 25.23  children under existing maternal and child health care programs, 
 25.24  including programs administered by the commissioner of health; 
 25.25     (c) establish, review, and report to the commissioner a 
 25.26  list of program guidelines and criteria which the advisory task 
 25.27  force considers essential to providing an effective maternal and 
 25.28  child health care program to low income populations and high 
 25.29  risk persons and fulfilling the purposes defined in section 
 25.30  145.88; 
 25.31     (d) review staff recommendations of the department of 
 25.32  health regarding maternal and child health grant awards before 
 25.33  the awards are made; 
 25.34     (e) make recommendations to the commissioner for the use of 
 25.35  other federal and state funds available to meet maternal and 
 25.36  child health needs; 
 26.1      (f) make recommendations to the commissioner of health on 
 26.2   priorities for funding the following maternal and child health 
 26.3   services:  (1) prenatal, delivery and postpartum care, (2) 
 26.4   comprehensive health care for children, especially from birth 
 26.5   through five years of age, (3) adolescent health services, (4) 
 26.6   family planning services, (5) preventive dental care, (6) 
 26.7   special services for chronically ill and handicapped children 
 26.8   and (7) any other services which promote the health of mothers 
 26.9   and children; and 
 26.10     (g) make recommendations to the commissioner of health on 
 26.11  the process to distribute, award and administer the maternal and 
 26.12  child health block grant funds; and 
 26.13     (h) review the measures that are used to define the 
 26.14  variables of the funding distribution formula in section 
 26.15  145.882, subdivision 4a, every two years and make 
 26.16  recommendations to the commissioner of health for changes based 
 26.17  upon principles established by the advisory task force for this 
 26.18  purpose.  
 26.19     Sec. 16.  Minnesota Statutes 2000, section 145.882, is 
 26.20  amended by adding a subdivision to read: 
 26.21     Subd. 4a.  [ALLOCATION TO COMMUNITY HEALTH BOARDS.] (a) 
 26.22  Federal maternal and child health block grant money remaining 
 26.23  after distributions made under subdivision 2 and money 
 26.24  appropriated for allocation to community health boards must be 
 26.25  allocated according to paragraphs (b) to (d) to community health 
 26.26  boards as defined in section 145A.02, subdivision 5.  
 26.27     (b) All community health boards must receive 95 percent of 
 26.28  the funding awarded to them for the 1998-1999 funding cycle.  If 
 26.29  the amount of state and federal funding available is less than 
 26.30  95 percent of the amount awarded to community health boards for 
 26.31  the 1998-1999 funding cycle, the available funding must be 
 26.32  apportioned to reflect a proportional decrease for each 
 26.33  recipient.  
 26.34     (c) The federal and state funding remaining after 
 26.35  distributions made under paragraph (b) must be allocated to each 
 26.36  community health board based on the following three variables: 
 27.1      (1) 25 percent based on the maternal and child population 
 27.2   in the area served by the community health board; 
 27.3      (2) 50 percent based on the following factors as determined 
 27.4   by averaging the data available for the three most current years:
 27.5      (i) the proportion of infants in the area served by the 
 27.6   community health board whose weight at birth is less than 2,500 
 27.7   grams; 
 27.8      (ii) the proportion of mothers in the area served by the 
 27.9   community health board who received inadequate or no prenatal 
 27.10  care; 
 27.11     (iii) the proportion of births in the area served by the 
 27.12  community health board to women under age 19; and 
 27.13     (iv) the proportion of births in the area served by the 
 27.14  community health board to American Indians and women of color; 
 27.15  and 
 27.16     (3) 25 percent based on the income of the maternal and 
 27.17  child population in the area served by the community health 
 27.18  board. 
 27.19     (d) Each variable must be expressed as a city or county 
 27.20  score consisting of the city or county frequency of each 
 27.21  variable divided by the statewide frequency of the variable.  A 
 27.22  total score for each city or county jurisdiction must be 
 27.23  computed by totaling the scores of the three variables.  Each 
 27.24  community health board must be allocated an amount equal to the 
 27.25  total score obtained for the city, county, or counties in its 
 27.26  area multiplied by the amount of money available. 
 27.27     Sec. 17.  Minnesota Statutes 2000, section 145.882, 
 27.28  subdivision 7, is amended to read: 
 27.29     Subd. 7.  [USE OF BLOCK GRANT MONEY.] (a) Maternal and 
 27.30  child health block grant money allocated to a community health 
 27.31  board or community health services area under this section must 
 27.32  be used for qualified programs for high risk and low-income 
 27.33  individuals.  Block grant money must be used for programs that: 
 27.34     (1) specifically address the highest risk populations, 
 27.35  particularly low-income and minority groups with a high rate of 
 27.36  infant mortality and children with low birth weight, by 
 28.1   providing services, including prepregnancy family planning 
 28.2   services, calculated to produce measurable decreases in infant 
 28.3   mortality rates, instances of children with low birth weight, 
 28.4   and medical complications associated with pregnancy and 
 28.5   childbirth, including infant mortality, low birth rates, and 
 28.6   medical complications arising from chemical abuse by a mother 
 28.7   during pregnancy; 
 28.8      (2) specifically target pregnant women whose age, medical 
 28.9   condition, maternal history, or chemical abuse substantially 
 28.10  increases the likelihood of complications associated with 
 28.11  pregnancy and childbirth or the birth of a child with an 
 28.12  illness, disability, or special medical needs; 
 28.13     (3) specifically address the health needs of young children 
 28.14  who have or are likely to have a chronic disease or disability 
 28.15  or special medical needs, including physical, neurological, 
 28.16  emotional, and developmental problems that arise from chemical 
 28.17  abuse by a mother during pregnancy; 
 28.18     (4) provide family planning and preventive medical care for 
 28.19  specifically identified target populations, such as minority and 
 28.20  low-income teenagers, in a manner calculated to decrease the 
 28.21  occurrence of inappropriate pregnancy and minimize the risk of 
 28.22  complications associated with pregnancy and childbirth; or 
 28.23     (5) specifically address the frequency and severity of 
 28.24  childhood injuries and other child and adolescent health 
 28.25  problems in high risk target populations by providing services 
 28.26  calculated to produce measurable decreases in mortality and 
 28.27  morbidity.  However, money may be used for this purpose only if 
 28.28  the community health board's application includes program 
 28.29  components for the purposes in clauses (1) to (4) in the 
 28.30  proposed geographic service area and the total expenditure for 
 28.31  injury-related programs under this clause does not exceed ten 
 28.32  percent of the total allocation under subdivision 3. 
 28.33     (b) Maternal and child health block grant money may be used 
 28.34  for purposes other than the purposes listed in this subdivision 
 28.35  only under the following conditions:  
 28.36     (1) the community health board or community health services 
 29.1   area can demonstrate that existing programs fully address the 
 29.2   needs of the highest risk target populations described in this 
 29.3   subdivision; or 
 29.4      (2) the money is used to continue projects that received 
 29.5   funding before creation of the maternal and child health block 
 29.6   grant in 1981. 
 29.7      (c) (b) Projects that received funding before creation of 
 29.8   the maternal and child health block grant in 1981, must be 
 29.9   allocated at least the amount of maternal and child health 
 29.10  special project grant funds received in 1989, unless (1) the 
 29.11  local board of health provides equivalent alternative funding 
 29.12  for the project from another source; or (2) the local board of 
 29.13  health demonstrates that the need for the specific services 
 29.14  provided by the project has significantly decreased as a result 
 29.15  of changes in the demographic characteristics of the population, 
 29.16  or other factors that have a major impact on the demand for 
 29.17  services.  If the amount of federal funding to the state for the 
 29.18  maternal and child health block grant is decreased, these 
 29.19  projects must receive a proportional decrease as required in 
 29.20  subdivision 1.  Increases in allocation amounts to local boards 
 29.21  of health under subdivision 4 may be used to increase funding 
 29.22  levels for these projects may be continued at the discretion of 
 29.23  the community health board. 
 29.24     Sec. 18.  Minnesota Statutes 2000, section 145.885, 
 29.25  subdivision 2, is amended to read: 
 29.26     Subd. 2.  [ADDITIONAL REQUIREMENTS FOR COMMUNITY BOARDS OF 
 29.27  HEALTH.] Applications by community health boards as defined in 
 29.28  section 145A.02, subdivision 5, under section 145.882, 
 29.29  subdivision 3 4a, must also contain a summary of the process 
 29.30  used to develop the local program, including evidence that the 
 29.31  community health board notified local public and private 
 29.32  providers of the availability of funding through the community 
 29.33  health board for maternal and child health services; a list of 
 29.34  all public and private agency requests for grants submitted to 
 29.35  the community health board indicating which requests were 
 29.36  included in the grant application; and an explanation of how 
 30.1   priorities were established for selecting the requests to be 
 30.2   included in the grant application.  The community health board 
 30.3   shall include, with the grant application, a written statement 
 30.4   of the criteria to be applied to public and private agency 
 30.5   requests for funding. 
 30.6      Sec. 19.  [145.9263] [HEALTHY YOUTH DEVELOPMENT.] 
 30.7      Subdivision 1.  [ESTABLISHMENT.] The commissioner shall 
 30.8   establish a grant program to support healthy youth development 
 30.9   by reducing risk factors, increasing protective factors, 
 30.10  building youth competencies, and improving youth outcomes.  
 30.11     Subd. 2.  [STATE-COMMUNITY PARTNERSHIP.] The commissioner, 
 30.12  in consultation with the commissioner of children, families, and 
 30.13  learning; the commissioner of human services; the maternal and 
 30.14  child health advisory task force as defined in section 145.881; 
 30.15  the Indian affairs council as defined in section 3.922; the 
 30.16  council on affairs of Chicano/Latino people as defined in 
 30.17  section 3.9223; the council on Black Minnesotans as defined in 
 30.18  section 3.9225; the council on Asian-Pacific Minnesotans as 
 30.19  defined in section 3.9226; nonprofit community organizations; 
 30.20  and others interested in youth, shall develop and implement a 
 30.21  comprehensive coordinated plan to promote and support positive 
 30.22  healthy youth behaviors.  
 30.23     Subd. 3.  [MEASURABLE OUTCOMES.] The commissioner, in 
 30.24  consultation with other public and private nonprofit 
 30.25  organizations interested in youth development efforts, shall 
 30.26  establish measurable outcomes to determine the effectiveness of 
 30.27  the grants receiving funds under this section.  
 30.28     Subd. 4.  [STATEWIDE ASSESSMENT.] The commissioner shall 
 30.29  use and enhance current statewide assessments of youth risk 
 30.30  behaviors and attitudes among youth to establish a baseline to 
 30.31  measure the statewide effect of prevention activities.  To the 
 30.32  extent feasible, the commissioner must conduct the assessment so 
 30.33  that the results may be compared to nationwide data.  
 30.34     Subd. 5.  [PROCESS.] The commissioner, in consultation with 
 30.35  community partners, shall develop the criteria and procedures to 
 30.36  allocate the grants under this section.  In developing the 
 31.1   criteria, the commissioner shall establish an administrative 
 31.2   cost limit for grant recipients.  The outcomes established under 
 31.3   subdivision 3 must be specified to the grant recipients 
 31.4   receiving grants under this section at the time the grant is 
 31.5   awarded.  
 31.6      Subd. 6.  [DISPARITY GRANTS.] (a) The commissioner shall 
 31.7   award competitive grants to reduce the disparities in youth risk 
 31.8   behaviors in populations most adversely affected.  
 31.9      (b) Eligible applicants may include, but are not limited 
 31.10  to, nonprofit organizations, schools, and faith-based 
 31.11  organizations.  Applicants must submit proposals to the 
 31.12  commissioner.  The proposals must specify the strategies to be 
 31.13  implemented and must take into account the need for a 
 31.14  coordinated statewide prevention effort.  The strategies to be 
 31.15  implemented may include youth development programs, such as 
 31.16  youth clubs, sports and recreation, peer counseling and 
 31.17  teaching, mentoring, community service or volunteerism, after 
 31.18  school programs, and ethnic or cultural enrichment.  
 31.19     (c) The commissioner shall give priority to applicants, 
 31.20  which demonstrate that the proposed project: 
 31.21     (1) is research based or based on proven effective 
 31.22  strategies; 
 31.23     (2) is designed to coordinate with related youth risk 
 31.24  behavior reduction activities; 
 31.25     (3) involves youth and parents in the development and 
 31.26  implementation; 
 31.27     (4) reflects racial and ethnic appropriate approaches; 
 31.28  and/or 
 31.29     (5) is implemented through or with community-based 
 31.30  organizations reflecting the race and ethnicity of the 
 31.31  population to be reached.  
 31.32     Subd. 7.  [HIGH-RISK COMMUNITY PREVENTION GRANTS.] (a) The 
 31.33  commissioner shall award grants to communities whose youth are 
 31.34  at high risk, have in place current youth development programs, 
 31.35  and are interested in expanding existing efforts to enhance 
 31.36  youth development efforts.  
 32.1      (b) Eligible applicants must be either tribal governments 
 32.2   or community health boards.  Applicants must submit proposals to 
 32.3   the commissioner.  The proposals must specify the strategies to 
 32.4   be implemented.  Strategies may include, but are not limited to, 
 32.5   youth development programs, youth mentor programs, academic 
 32.6   support programs, and after-school enrichment programs.  
 32.7      (c) Based on areas with the highest risk factors, grants 
 32.8   shall be awarded to up to 15 community health boards and three 
 32.9   tribal governments.  
 32.10     (d) Applicants must demonstrate that the proposed project: 
 32.11     (1) is research based or based on proven effective 
 32.12  strategies; 
 32.13     (2) is designed to coordinate with related youth risk 
 32.14  behavior reduction activities; 
 32.15     (3) involves youth and parents in the development and 
 32.16  implementation; 
 32.17     (4) reflects racial and ethnic appropriate approaches; and 
 32.18     (5) is implemented through or with community-based 
 32.19  organizations reflecting the race and ethnicity of the 
 32.20  population to be reached.  
 32.21     (e) The commissioner, in consultation with the maternal and 
 32.22  child health advisory task force as defined in section 145.881, 
 32.23  shall identify the high-risk factors that will determine 
 32.24  eligible grantees.  
 32.25     Subd. 8.  [LOCAL PUBLIC HEALTH GRANTS.] (a) The 
 32.26  commissioner shall award grants to community health boards for 
 32.27  youth development efforts.  Applicants must submit proposals to 
 32.28  the commissioner.  Available funds will be distributed according 
 32.29  to the formula in section 145.882, subdivision 4a.  
 32.30     (b) Applicants must demonstrate that their proposed project:
 32.31     (1) is research based or based on proven effective 
 32.32  strategies; 
 32.33     (2) is designed to coordinate with related youth risk 
 32.34  behavior reduction activities; 
 32.35     (3) involves youth and parents in the development and 
 32.36  implementation; 
 33.1      (4) is implemented through or with community-based 
 33.2   organizations reflecting the race and ethnicity of the 
 33.3   population to be reached; and 
 33.4      (5) reflects racial and ethnic appropriate approaches.  
 33.5      Subd. 9.  [TRIBAL GOVERNMENT GRANTS.] (a) The commissioner 
 33.6   shall award grants to American Indian tribal governments for 
 33.7   youth development efforts.  Applicants must submit proposals to 
 33.8   the commissioner.  The commissioner, in consultation with the 
 33.9   tribes, shall establish a formula for distribution of available 
 33.10  funds.  
 33.11     (b) Applicants must demonstrate that their proposed project:
 33.12     (1) is research based or based on proven effective 
 33.13  strategies; 
 33.14     (2) is designed to coordinate with related youth risk 
 33.15  behavior reduction activities; 
 33.16     (3) involves youth and parents in the development and 
 33.17  implementation; 
 33.18     (4) is implemented through or with community-based 
 33.19  organizations reflecting the race and ethnicity of the 
 33.20  population to be reached; and 
 33.21     (5) reflects racial and ethnic appropriate approaches.  
 33.22     Subd. 10.  [STATEWIDE GRANTS.] (a) The commissioner shall 
 33.23  award competitive grants to eligible applicants for projects and 
 33.24  initiatives directed at youth development.  The project areas 
 33.25  for grants include: 
 33.26     (1) statewide public education and information campaigns; 
 33.27     (2) regional or statewide training activities; and 
 33.28     (3) special projects such as development of a Web site, a 
 33.29  resource clearinghouse, and the development of culturally 
 33.30  appropriate materials. 
 33.31     (b) Eligible applicants may include, but are not limited 
 33.32  to, nonprofit organizations, colleges and universities, 
 33.33  professional health associations, and community health boards.  
 33.34  Applicants must submit proposals to the commissioner.  The 
 33.35  proposals must specify the strategies to be implemented to 
 33.36  target high-risk behaviors among youth, and must take into 
 34.1   account the need for a coordinated statewide effort. 
 34.2      (c) The commissioner shall give priority to applicants who 
 34.3   demonstrate that the proposed project: 
 34.4      (1) is research based or based on proven effective 
 34.5   strategies; 
 34.6      (2) is designed to coordinate with other related risk 
 34.7   behavior reduction activities and education messages; 
 34.8      (3) utilizes and enhances existing prevention activities 
 34.9   and resources; and 
 34.10     (4) involves youth in the development and implementation.  
 34.11     Subd. 11.  [COORDINATION.] The commissioner shall 
 34.12  coordinate the projects and initiatives funded under this 
 34.13  section with other efforts at the local, state, and national 
 34.14  level to avoid duplication and promote complementary efforts.  
 34.15     Subd. 12.  [EVALUATION.] (a) Using the outcome measures 
 34.16  established in subdivision 3, the commissioner of health shall 
 34.17  conduct a biennial evaluation of the youth development efforts 
 34.18  funded under this section.  
 34.19     (b) Grant recipients; the commissioner of children, 
 34.20  families, and learning; tribal governments; and community health 
 34.21  boards, shall cooperate with the commissioner of health in the 
 34.22  evaluation and provide the commissioner with the information 
 34.23  necessary to conduct the evaluation.  
 34.24     Subd. 13.  [REPORT.] The commissioner shall submit biennial 
 34.25  reports to the legislature on the activities of the projects 
 34.26  funded under this section and the results of the biennial 
 34.27  evaluation.  These reports are due by January 15 of every other 
 34.28  year, beginning in the year 2004.  
 34.29     Sec. 20.  [145.9268] [COMMUNITY CLINIC GRANTS.] 
 34.30     Subdivision 1.  [DEFINITION.] For purposes of this section, 
 34.31  "eligible community clinic" means: 
 34.32     (1) a clinic that provides services under conditions as 
 34.33  defined in Minnesota Rules, part 9505.0255, and utilizes a 
 34.34  sliding fee scale to determine eligibility for charity care; 
 34.35     (2) an Indian tribal government or Indian health service 
 34.36  unit; or 
 35.1      (3) a consortium of clinics comprised of entities under 
 35.2   clause (1) or (2). 
 35.3      Subd. 2.  [GRANTS AUTHORIZED.] The commissioner of health 
 35.4   shall award grants to eligible community clinics to improve the 
 35.5   ongoing viability of Minnesota's clinic-based safety net 
 35.6   providers.  Grants shall be awarded to support the capacity of 
 35.7   eligible community clinics to serve low-income populations, 
 35.8   reduce current or future uncompensated care burdens, or provide 
 35.9   for improved care delivery infrastructure. 
 35.10     Subd. 3.  [ALLOCATION OF GRANTS.] (a) To receive a grant 
 35.11  under this section, an eligible community clinic must submit an 
 35.12  application to the commissioner of health by the deadline 
 35.13  established by the commissioner.  A grant may be awarded upon 
 35.14  the signing of a grant contract. 
 35.15     (b) An application must be on a form and contain 
 35.16  information as specified by the commissioner but at a minimum 
 35.17  must contain: 
 35.18     (1) a description of the project for which grant funds will 
 35.19  be used; 
 35.20     (2) a description of the problem the proposed project will 
 35.21  address; and 
 35.22     (3) a description of achievable objectives, a workplan, and 
 35.23  a timeline for project completion. 
 35.24     (c) The commissioner shall review each application to 
 35.25  determine whether the application is complete and whether the 
 35.26  applicant and the project are eligible for a grant.  In 
 35.27  evaluating applications according to paragraph (e), the 
 35.28  commissioner shall establish criteria including, but not limited 
 35.29  to:  the priority level of the project; the applicant's 
 35.30  thoroughness and clarity in describing the problem; a 
 35.31  description of the applicant's proposed project; the manner in 
 35.32  which the applicant will demonstrate the effectiveness of the 
 35.33  project; and evidence of efficiencies and effectiveness gained 
 35.34  through collaborative efforts.  The commissioner may also take 
 35.35  into account other relevant factors, including, but not limited 
 35.36  to, the percentage for which uninsured patients represent the 
 36.1   applicant's patient base.  During application review, the 
 36.2   commissioner may request additional information about a proposed 
 36.3   project, including information on project cost.  Failure to 
 36.4   provide the information requested disqualifies an applicant. 
 36.5      (d) A grant awarded to an eligible community clinic may not 
 36.6   exceed $300,000 per eligible community clinic.  For an applicant 
 36.7   applying as a consortium of clinics, a grant may not exceed 
 36.8   $300,000 per clinic included in the consortium.  The 
 36.9   commissioner has discretion over the number of grants awarded. 
 36.10     (e) In determining which eligible community clinics will 
 36.11  receive grants under this section, the commissioner shall give 
 36.12  preference to those grant applications that show evidence of 
 36.13  collaboration with other eligible community clinics, hospitals, 
 36.14  health care providers, or community organizations.  In addition, 
 36.15  the commissioner shall give priority, in declining order, to 
 36.16  grant applications for projects that: 
 36.17     (1) establish, update, or improve information, data 
 36.18  collection, or billing systems; 
 36.19     (2) procure, modernize, remodel, or replace equipment used 
 36.20  in the delivery of direct patient care at a clinic; 
 36.21     (3) provide improvements for care delivery, such as 
 36.22  increased translation and interpretation services; 
 36.23     (4) provide a direct offset to expenses incurred for 
 36.24  charity care services; or 
 36.25     (5) other projects determined by the commissioner to 
 36.26  improve the ability of applicants to provide care to the 
 36.27  vulnerable populations they serve. 
 36.28     Subd. 4.  [EVALUATION.] The commissioner of health shall 
 36.29  evaluate the overall effectiveness of the grant program.  The 
 36.30  commissioner shall collect progress reports to evaluate the 
 36.31  grant program from the eligible community clinics receiving 
 36.32  grants. 
 36.33     Sec. 21.  [145.9269] [ELIMINATING HEALTH DISPARITIES.] 
 36.34     Subdivision 1.  [STATE-COMMUNITY PARTNERSHIPS.] The 
 36.35  commissioner, in partnership with culturally based community 
 36.36  organizations; the Indian affairs council as defined in section 
 37.1   3.922; the council on affairs of Chicano/Latino people as 
 37.2   defined in section 3.9223; the council on Black Minnesotans as 
 37.3   defined in section 3.9225; the council on Asian-Pacific 
 37.4   Minnesotans as defined in section 3.9226; community health 
 37.5   boards; and tribal governments, shall develop and implement a 
 37.6   comprehensive coordinated plan to reduce health disparities 
 37.7   experienced by American Indians and communities of color in 
 37.8   infant mortality, breast and cervical cancer screening, 
 37.9   HIV/AIDS/STDs, immunizations, cardiovascular disease, diabetes, 
 37.10  injury, and violence.  
 37.11     Subd. 2.  [MEASURABLE OUTCOMES.] The commissioner, in 
 37.12  consultation with community partners, shall establish measurable 
 37.13  outcomes to determine the effectiveness of the grants and other 
 37.14  activities receiving funds under this section in reducing health 
 37.15  disparities.  The goal of the grants shall be to decrease by 
 37.16  one-half the ratio of American Indians and communities of color 
 37.17  specific health condition rates to white rates in the areas 
 37.18  identified in subdivision 1.  
 37.19     Subd. 3.  [STATEWIDE ASSESSMENT.] The commissioner shall 
 37.20  enhance current data tools to assure a statewide assessment of 
 37.21  the risk behaviors associated with the areas identified in 
 37.22  subdivision 1.  This statewide assessment must be used to 
 37.23  establish a baseline to measure the effect of activities funded 
 37.24  under this section.  To the extent feasible, the commissioner of 
 37.25  health must conduct the assessment so that the results may be 
 37.26  compared to nationwide data.  
 37.27     Subd. 4.  [TECHNICAL ASSISTANCE.] The commissioner shall 
 37.28  provide the necessary expertise to community organizations to 
 37.29  ensure that submitted proposals are likely to be successful in 
 37.30  reducing health disparities.  The commissioner shall provide 
 37.31  grant recipients with guidance and training on strategies 
 37.32  related to reducing the health disparities identified in this 
 37.33  section.  The commissioner shall also provide grant recipients 
 37.34  with assistance in the development of evaluation of local 
 37.35  community activities.  
 37.36     Subd. 5.  [PROCESS.] (a) The commissioner shall, in 
 38.1   consultation with community partners, develop the criteria and 
 38.2   procedures to allocate the grants under this section.  In 
 38.3   developing the criteria, the commissioner shall establish an 
 38.4   administrative cost limit for grant recipients.  The outcomes 
 38.5   established under subdivision 2 must be specified to the grant 
 38.6   recipients receiving grants under this section at the time the 
 38.7   grant is awarded.  
 38.8      (b) A grant recipient must coordinate the activities 
 38.9   related to reducing health disparities with other grant 
 38.10  recipients receiving funding under this section within the 
 38.11  recipient's service area.  
 38.12     Subd. 6.  [COMMUNITY GRANT PROGRAM.] (a) The commissioner 
 38.13  shall award grants to eligible applicants for local or regional 
 38.14  projects and initiatives directed at reducing health 
 38.15  disparities.  Grant proposals must address one or more of the 
 38.16  following priority areas:  
 38.17     (1) decreasing racial and ethnic disparities in infant 
 38.18  mortality rates; 
 38.19     (2) decreasing racial and ethnic disparities in morbidity 
 38.20  and mortality rates relating to breast and cervical cancer; 
 38.21     (3) decreasing racial and ethnic disparities in morbidity 
 38.22  and mortality rates relating to HIV/AIDS/STDs; 
 38.23     (4) increasing adult and child immunization rates in racial 
 38.24  and ethnic populations; 
 38.25     (5) decreasing racial and ethnic disparities in morbidity 
 38.26  and mortality rates relating to cardiovascular disease; 
 38.27     (6) decreasing racial and ethnic disparities in morbidity 
 38.28  and mortality rates relating to diabetes; and 
 38.29     (7) decreasing racial and ethnic disparities in morbidity 
 38.30  and mortality rates relating to injury or violence. 
 38.31     (b) The commissioner may award up to 20 percent of the 
 38.32  funds available as planning grants.  Planning grant proposals 
 38.33  must be used to address such areas as community assessment, 
 38.34  determining community priority areas, coordination activities, 
 38.35  and development of community-supported strategies.  
 38.36     (c) Eligible applicants may include, but are not limited 
 39.1   to, faith-based organizations, social service organizations, 
 39.2   community nonprofit organizations, and community clinics.  
 39.3   Applicants must submit proposals to the commissioner.  The 
 39.4   proposals must specify the strategies to be implemented to 
 39.5   reduce one or more of the project areas listed under paragraph 
 39.6   (a), and must be targeted to achieve the outcomes established in 
 39.7   subdivision 2.  
 39.8      (d) The commissioner must give priority to applicants who 
 39.9   demonstrate that the proposed project or initiative: 
 39.10     (1) is supported by the community the applicant will be 
 39.11  serving; 
 39.12     (2) is research-based or based on promising strategies; 
 39.13     (3) is designed to complement other related community 
 39.14  activities; 
 39.15     (4) utilizes strategies that positively impact more than 
 39.16  one priority area; and 
 39.17     (5) is implemented through or with community-based 
 39.18  organizations that reflect the race or ethnicity of the 
 39.19  population to be reached.  
 39.20     Subd. 7.  [LOCAL PUBLIC HEALTH.] The commissioner shall 
 39.21  award grants to community health boards for local health 
 39.22  promotion and protection activities aimed at reducing maternal 
 39.23  and child health disparities between whites and American Indians 
 39.24  and populations of color.  The commissioner shall distribute 
 39.25  these funds to community health boards according to the formula 
 39.26  in section 145.882, subdivision 4a.  
 39.27     Subd. 8.  [TRIBAL GOVERNMENTS.] The commissioner shall 
 39.28  award grants to American Indian tribal governments for 
 39.29  implementation of community interventions to reduce health 
 39.30  disparities for the project areas listed under subdivision 6, 
 39.31  paragraph (a), and must be targeted to achieve the outcomes 
 39.32  established in subdivision 2.  The distribution formula shall be 
 39.33  determined by the commissioner, in consultation with the tribal 
 39.34  governments.  
 39.35     Subd. 9.  [REFUGEE AND IMMIGRANT HEALTH.] The commissioner 
 39.36  shall award grants to community health boards for health 
 40.1   screening and follow-up services for foreign-born persons.  
 40.2      Subd. 10.  [COORDINATION.] The commissioner shall 
 40.3   coordinate the projects and initiatives funded under this 
 40.4   section with other efforts at the local, state, or national 
 40.5   level to avoid duplication of effort and promote complementary 
 40.6   efforts.  
 40.7      Subd. 11.  [EVALUATION.] Using the outcome measures 
 40.8   established in subdivision 2, the commissioner shall conduct a 
 40.9   biennial evaluation of the community grants program, community 
 40.10  health board activities, and tribal government activities funded 
 40.11  under this section.  Grant recipients, tribal governments, and 
 40.12  community health boards shall cooperate with the commissioner in 
 40.13  the evaluation and provide the commissioner with the information 
 40.14  necessary to conduct the evaluation.  
 40.15     Subd. 12.  [REPORT.] The commissioner shall submit a 
 40.16  biennial report to the legislature on the local community 
 40.17  projects, tribal government, and community health board 
 40.18  prevention activities funded under this section.  These reports 
 40.19  must include information on grant recipients, activities that 
 40.20  were conducted using grant funds, evaluation data, and outcome 
 40.21  measures, if available.  These reports are due by January 15 of 
 40.22  every other year, beginning in the year 2004.  
 40.23     Sec. 22.  Minnesota Statutes 2000, section 157.16, 
 40.24  subdivision 3, is amended to read: 
 40.25     Subd. 3.  [ESTABLISHMENT FEES; DEFINITIONS.] (a) The 
 40.26  following fees are required for food and beverage service 
 40.27  establishments, hotels, motels, lodging establishments, and 
 40.28  resorts licensed under this chapter.  Food and beverage service 
 40.29  establishments must pay the highest applicable fee under 
 40.30  paragraph (e), clause (1), (2), (3), or (4), and establishments 
 40.31  serving alcohol must pay the highest applicable fee under 
 40.32  paragraph (e), clause (6) or (7).  The license fee for new 
 40.33  operators previously licensed under this chapter for the same 
 40.34  calendar year is one-half of the appropriate annual license fee, 
 40.35  plus any penalty that may be required.  The license fee for 
 40.36  operators opening on or after October 1 is one-half of the 
 41.1   appropriate annual license fee, plus any penalty that may be 
 41.2   required. 
 41.3      (b) All food and beverage service establishments, except 
 41.4   special event food stands, and all hotels, motels, lodging 
 41.5   establishments, and resorts shall pay an annual base fee of 
 41.6   $100 $145. 
 41.7      (c) A special event food stand shall pay a flat fee 
 41.8   of $30 $35 annually.  "Special event food stand" means a fee 
 41.9   category where food is prepared or served in conjunction with 
 41.10  celebrations, county fairs, or special events from a special 
 41.11  event food stand as defined in section 157.15. 
 41.12     (d) In addition to the base fee in paragraph (b), each food 
 41.13  and beverage service establishment, other than a special event 
 41.14  food stand, and each hotel, motel, lodging establishment, and 
 41.15  resort shall pay an additional annual fee for each fee category 
 41.16  as specified in this paragraph: 
 41.17     (1) Limited food menu selection, $30 $40.  "Limited food 
 41.18  menu selection" means a fee category that provides one or more 
 41.19  of the following: 
 41.20     (i) prepackaged food that receives heat treatment and is 
 41.21  served in the package; 
 41.22     (ii) frozen pizza that is heated and served; 
 41.23     (iii) a continental breakfast such as rolls, coffee, juice, 
 41.24  milk, and cold cereal; 
 41.25     (iv) soft drinks, coffee, or nonalcoholic beverages; or 
 41.26     (v) cleaning for eating, drinking, or cooking utensils, 
 41.27  when the only food served is prepared off site. 
 41.28     (2) Small establishment, including boarding establishments, 
 41.29  $55 $75.  "Small establishment" means a fee category that has no 
 41.30  salad bar and meets one or more of the following: 
 41.31     (i) possesses food service equipment that consists of no 
 41.32  more than a deep fat fryer, a grill, two hot holding containers, 
 41.33  and one or more microwave ovens; 
 41.34     (ii) serves dipped ice cream or soft serve frozen desserts; 
 41.35     (iii) serves breakfast in an owner-occupied bed and 
 41.36  breakfast establishment; 
 42.1      (iv) is a boarding establishment; or 
 42.2      (v) meets the equipment criteria in clause (3), item (i) or 
 42.3   (ii), and has a maximum patron seating capacity of not more than 
 42.4   50.  
 42.5      (3) Medium establishment, $150 $210.  "Medium establishment"
 42.6   means a fee category that meets one or more of the following: 
 42.7      (i) possesses food service equipment that includes a range, 
 42.8   oven, steam table, salad bar, or salad preparation area; 
 42.9      (ii) possesses food service equipment that includes more 
 42.10  than one deep fat fryer, one grill, or two hot holding 
 42.11  containers; or 
 42.12     (iii) is an establishment where food is prepared at one 
 42.13  location and served at one or more separate locations. 
 42.14     Establishments meeting criteria in clause (2), item (v), 
 42.15  are not included in this fee category.  
 42.16     (4) Large establishment, $250 $350.  "Large establishment" 
 42.17  means either: 
 42.18     (i) a fee category that (A) meets the criteria in clause 
 42.19  (3), items (i) or (ii), for a medium establishment, (B) seats 
 42.20  more than 175 people, and (C) offers the full menu selection an 
 42.21  average of five or more days a week during the weeks of 
 42.22  operation; or 
 42.23     (ii) a fee category that (A) meets the criteria in clause 
 42.24  (3), item (iii), for a medium establishment, and (B) prepares 
 42.25  and serves 500 or more meals per day. 
 42.26     (5) Other food and beverage service, including food carts, 
 42.27  mobile food units, seasonal temporary food stands, and seasonal 
 42.28  permanent food stands, $30 $40. 
 42.29     (6) Beer or wine table service, $30 $40.  "Beer or wine 
 42.30  table service" means a fee category where the only alcoholic 
 42.31  beverage service is beer or wine, served to customers seated at 
 42.32  tables. 
 42.33     (7) Alcoholic beverage service, other than beer or wine 
 42.34  table service, $75 $105. 
 42.35     "Alcohol beverage service, other than beer or wine table 
 42.36  service" means a fee category where alcoholic mixed drinks are 
 43.1   served or where beer or wine are served from a bar. 
 43.2      (8) Lodging per sleeping accommodation unit, $4 $6, 
 43.3   including hotels, motels, lodging establishments, and resorts, 
 43.4   up to a maximum of $400 $600.  "Lodging per sleeping 
 43.5   accommodation unit" means a fee category including the number of 
 43.6   guest rooms, cottages, or other rental units of a hotel, motel, 
 43.7   lodging establishment, or resort; or the number of beds in a 
 43.8   dormitory. 
 43.9      (9) First public swimming pool, $100 $140; each additional 
 43.10  public swimming pool, $50 $80.  "Public swimming pool" means a 
 43.11  fee category that has the meaning given in Minnesota Rules, part 
 43.12  4717.0250, subpart 8. 
 43.13     (10) First spa, $50 $80; each additional spa, $25 $40.  
 43.14  "Spa pool" means a fee category that has the meaning given in 
 43.15  Minnesota Rules, part 4717.0250, subpart 9. 
 43.16     (11) Private sewer or water, $30 $40.  "Individual private 
 43.17  water" means a fee category with a water supply other than a 
 43.18  community public water supply as defined in Minnesota Rules, 
 43.19  chapter 4720.  "Individual private sewer" means a fee category 
 43.20  with an individual sewage treatment system which uses subsurface 
 43.21  treatment and disposal. 
 43.22     (e) A fee is not required for a food and beverage service 
 43.23  establishment operated by a school as defined in sections 
 43.24  120A.05, subdivisions 9, 11, 13, and 17 and 120A.22. 
 43.25     (f) A fee of $150 for review of the construction plans must 
 43.26  accompany the initial license application for food and beverage 
 43.27  service establishments, hotels, motels, lodging establishments, 
 43.28  or resorts. 
 43.29     (g) (f) When existing food and beverage service 
 43.30  establishments, hotels, motels, lodging establishments, or 
 43.31  resorts are extensively remodeled, a fee of $150 must be 
 43.32  submitted with the remodeling plans. 
 43.33     (h) (g) Seasonal temporary food stands and special event 
 43.34  food stands are not required to submit construction or 
 43.35  remodeling plans for review. 
 43.36     Sec. 23.  Minnesota Statutes 2000, section 157.22, is 
 44.1   amended to read: 
 44.2      157.22 [EXEMPTIONS.] 
 44.3      This chapter shall not be construed to apply to: 
 44.4      (1) interstate carriers under the supervision of the United 
 44.5   States Department of Health and Human Services; 
 44.6      (2) any building constructed and primarily used for 
 44.7   religious worship; 
 44.8      (3) any building owned, operated, and used by a college or 
 44.9   university in accordance with health regulations promulgated by 
 44.10  the college or university under chapter 14; 
 44.11     (4) any person, firm, or corporation whose principal mode 
 44.12  of business is licensed under sections 28A.04 and 28A.05, is 
 44.13  exempt at that premises from licensure as a food or beverage 
 44.14  establishment; provided that the holding of any license pursuant 
 44.15  to sections 28A.04 and 28A.05 shall not exempt any person, firm, 
 44.16  or corporation from the applicable provisions of this chapter or 
 44.17  the rules of the state commissioner of health relating to food 
 44.18  and beverage service establishments; 
 44.19     (5) family day care homes and group family day care homes 
 44.20  governed by sections 245A.01 to 245A.16; 
 44.21     (6) nonprofit senior citizen centers for the sale of 
 44.22  home-baked goods; and 
 44.23     (7) food not prepared at an establishment and brought in by 
 44.24  individuals attending a potluck event for consumption at the 
 44.25  potluck event.  An organization sponsoring a potluck event under 
 44.26  this clause may advertise the potluck event to the public 
 44.27  through any means.  Individuals who are not members of an 
 44.28  organization sponsoring a potluck event under this clause may 
 44.29  attend the potluck event and consume the food at the event.  
 44.30  Licensed food establishments cannot be sponsors of potluck 
 44.31  events.  Potluck event food shall not be brought into a licensed 
 44.32  food establishment kitchen; and 
 44.33     (8) a home school in which a child is provided instruction 
 44.34  at home.  
 44.35     Sec. 24.  [REPEALER.] 
 44.36     Minnesota Statutes 2000, sections 145.882, subdivisions 3 
 45.1   and 4; and 145.927, are repealed.  
 45.2      Sec. 25.  [EFFECTIVE DATE.] 
 45.3      Section 4 is effective July 1, 2002.