1.1 	A bill for an act
1.2 	relating to health; modifying minor consent for health procedures and records; 
1.3 	amending the retention of blood or tissue samples related to testing of infants 
1.4 	for heritable and congenital disorders; amending Minnesota Statutes 2010, 
1.5 	sections 121A.22, subdivision 2; 144.125, subdivisions 1, 3; 144.128; 144.291, 
1.6 	subdivision 2; proposing coding for new law in Minnesota Statutes, chapter 144; 
1.7 	repealing Minnesota Statutes 2010, sections 144.343; 144.3441.
1.8 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.9 	Section 1. Minnesota Statutes 2010, section 121A.22, subdivision 2, is amended to 
1.10 	read:
1.11 		Subd. 2.Exclusions. In addition, this section does not apply to drugs or medicine 
1.12 	that are:
1.13 	(1) purchased without a prescription;
1.14 	(2) used by a pupil who is 18 years old or older;
1.15 	(3) used in connection with services for which a minor may give effective consent, 
1.16 	including section 144.343, subdivision 1, and any other law 144.3433; 
1.17 	(4) used in situations in which, in the judgment of the school personnel who are 
1.18 	present or available, the risk to the pupil's life or health is of such a nature that drugs or 
1.19 	medicine should be given without delay;
1.20 	(5) used off the school grounds;
1.21 	(6) used in connection with athletics or extra curricular activities;
1.22 	(7) used in connection with activities that occur before or after the regular school day;
1.23 	(8) provided or administered by a public health agency to prevent or control an 
1.24 	illness or a disease outbreak as provided for in sections 144.05 and 144.12; 
2.1 	(9) prescription asthma or reactive airway disease medications self-administered by 
2.2 	a pupil with an asthma inhaler if the district has received a written authorization from the 
2.3 	pupil's parent permitting the pupil to self-administer the medication, the inhaler is properly 
2.4 	labeled for that student, and the parent has not requested school personnel to administer 
2.5 	the medication to the pupil. The parent must submit written authorization for the pupil to 
2.6 	self-administer the medication each school year; or
2.7 	(10) prescription nonsyringe injectors of epinephrine, consistent with section 
2.8 	121A.2205, if the parent and prescribing medical professional annually inform the pupil's 
2.9 	school in writing that (i) the pupil may possess the epinephrine or (ii) the pupil is unable 
2.10 	to possess the epinephrine and requires immediate access to nonsyringe injectors of 
2.11 	epinephrine that the parent provides properly labeled to the school for the pupil as needed. 

2.12 	Sec. 2. Minnesota Statutes 2010, section 144.125, subdivision 1, is amended to read:
2.13 		Subdivision 1.Duty to perform testing. It is the duty of (1) the administrative 
2.14 	officer or other person in charge of each institution caring for infants 28 days or less 
2.15 	of age, (2) the person required in pursuance of the provisions of section 144.215, to 
2.16 	register the birth of a child, or (3) the nurse midwife or midwife in attendance at the 
2.17 	birth, to arrange to have administered to every infant or child in its care tests for heritable 
2.18 	and congenital disorders according to subdivision 2 and rules prescribed by the state 
2.19 	commissioner of health. Testing and the recording and reporting of test results shall be 
2.20 	performed at the times and in the manner prescribed by the commissioner of health. The 
2.21 	commissioner shall charge a fee so that the total of fees collected will approximate the 
2.22 	costs of conducting the tests and implementing and maintaining a system to follow-up 
2.23 	infants with heritable or congenital disorders, including hearing loss detected through the 
2.24 	early hearing detection and intervention program under section 144.966. The fee is $101 
2.25 	per specimen. Effective July 1, 2010, the fee shall be increased to $106 per specimen. The 
2.26 	increased fee amount shall be deposited in the general fund. Costs associated with capital 
2.27 	expenditures and the development of new procedures may be prorated over a three-year 
2.28 	period when calculating the amount of the fees.

2.29 	Sec. 3. Minnesota Statutes 2010, section 144.125, subdivision 3, is amended to read:
2.30 		Subd. 3.Objection of parents to test. Persons with a duty to perform testing under 
2.31 	subdivision 1 shall advise parents of infants (1) that the blood or tissue samples will be 
2.32 	used to perform testing thereunder as well as the results of such testing may be retained by 
2.33 	the Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3)
2.34 	(2) that a form is available in which the following options are available to themmay be 
3.1 	chosen with respect to the testing: (i) to decline to have the tests, or (ii) to elect to have 
3.2 	the tests butand to require thatallow all blood samples and records of test results to be 
3.3 	destroyed within retained by the Department of Health for 24 months ofafter the testing. 
3.4 	If the parents of an infant object in writing to testing for heritable and congenital disorders 
3.5 	or elect to require thatallow blood samples and test results to be destroyed retained, 
3.6 	the objection or election shall be recorded on a form that is signed by a parent or legal 
3.7 	guardian and made part of the infant's medical record. A written objection exempts an 
3.8 	infant from the requirements of this section and section 144.128.

3.9 	Sec. 4. Minnesota Statutes 2010, section 144.128, is amended to read:
3.10 	144.128 COMMISSIONER'S DUTIES; STORED BLOOD AND TISSUE 
3.11 	SAMPLES.
3.12 	The commissioner shall:
3.13 	(1) notify the physicians of newborns tested of the results of the tests performed;
3.14 	(2) make referrals for the necessary treatment of diagnosed cases of heritable and 
3.15 	congenital disorders when treatment is indicated;
3.16 	(3) maintain a registry of the cases of heritable and congenital disorders detected by 
3.17 	the screening program for the purpose of follow-up services;
3.18 	(4) prepare a separate form for use by parents or by adults who were tested as minors 
3.19 	to direct that blood samples and test results be destroyed;
3.20 	(5) comply with a destruction request within 45 days after receiving it;
3.21 	(6) notify individuals who request destruction of samples and test results that the 
3.22 	samples and test results have been destroyed; and
3.23 	(7) adopt rules to carry out sections 144.125 to 144.128.
3.24 	(3) destroy blood or tissue samples obtained from test results immediately after 
3.25 	completion of the test results, unless the parent of the newborn tested elects under section 
3.26 	144.125, subdivision 3, to retain the results, in which case the test results may be retained 
3.27 	for up to 24 months; and
3.28 	(4) destroy all blood or tissue samples and material and records related to stored 
3.29 	samples that were collected and stored by the commissioner before August 1, 2011.

3.30 	Sec. 5. Minnesota Statutes 2010, section 144.291, subdivision 2, is amended to read:
3.31 		Subd. 2.Definitions. For the purposes of sections 144.291 to 144.298, the following 
3.32 	terms have the meanings given.
3.33 	(a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
4.1 	(b) "Health information exchange" means a legal arrangement between health care 
4.2 	providers and group purchasers to enable and oversee the business and legal issues 
4.3 	involved in the electronic exchange of health records between the entities for the delivery 
4.4 	of patient care.
4.5 	(c) "Health record" means any information, whether oral or recorded in any form or 
4.6 	medium, that relates to the past, present, or future physical or mental health or condition of 
4.7 	a patient; the provision of health care to a patient; or the past, present, or future payment 
4.8 	for the provision of health care to a patient.
4.9 	(d) "Identifying information" means the patient's name, address, date of birth, 
4.10 	gender, parent's or guardian's name regardless of the age of the patient, and other 
4.11 	nonclinical data which can be used to uniquely identify a patient.
4.12 	(e) "Individually identifiable form" means a form in which the patient is or can be 
4.13 	identified as the subject of the health records.
4.14 	(f) "Medical emergency" means medically necessary care which is immediately 
4.15 	needed to preserve life, prevent serious impairment to bodily functions, organs, or parts, 
4.16 	or prevent placing the physical or mental health of the patient in serious jeopardy.
4.17 	(g) "Patient" means a natural person who has received health care services from a 
4.18 	provider for treatment or examination of a medical, psychiatric, or mental condition, the 
4.19 	surviving spouse and parents of a deceased patient, or a person the patient appoints in 
4.20 	writing as a representative, including a health care agent acting according to chapter 145C, 
4.21 	unless the authority of the agent has been limited by the principal in the principal's health 
4.22 	care directive. Except for minors who have received health care services under sections
4.23 	section 144.341to 144.347,; 144.342; or 144.3433, in the case of a minor, patient includes 
4.24 	a parent or guardian, or a person acting as a parent or guardian in the absence of a parent 
4.25 	or guardian. A parent or guardian is entitled to full access to a minor child's health records 
4.26 	except as otherwise explicitly provided in law.
4.27 	(h) "Provider" means:
4.28 	(1) any person who furnishes health care services and is regulated to furnish the 
4.29 	services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A, 
4.30 	151, 153, or 153A;
4.31 	(2) a home care provider licensed under section 144A.46;
4.32 	(3) a health care facility licensed under this chapter or chapter 144A;
4.33 	(4) a physician assistant registered under chapter 147A; and
4.34 	(5) an unlicensed mental health practitioner regulated under sections 148B.60 to 
4.35 	148B.71.
5.1 	(i) "Record locator service" means an electronic index of patient identifying 
5.2 	information that directs providers in a health information exchange to the location of 
5.3 	patient health records held by providers and group purchasers.
5.4 	(j) "Related health care entity" means an affiliate, as defined in section 144.6521, 
5.5 	subdivision 3, paragraph (b), of the provider releasing the health records.

5.6 	Sec. 6. [144.3433] CONSENT OF MINOR TO CERTAIN MEDICAL 
5.7 	PROCEDURES.
5.8 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms 
5.9 	have the meanings given.
5.10 	(b) "Abortion" means the use of any means to terminate the pregnancy of a woman 
5.11 	known to be pregnant with knowledge that the termination with those means will, with 
5.12 	reasonable likelihood, cause the death of the fetus.
5.13 	(c) "Fetus" means any individual human organism from fertilization until birth.
5.14 	(d) "Incest" means conduct prohibited under section 609.365.
5.15 	(e) "Physical abuse" has the meaning given in section 626.556.
5.16 	(f) "Sexual abuse" has the meaning given in section 626.556.
5.17 		Subd. 2.Minor's consent invalid; exception for sexual abuse, incest, and 
5.18 	physical abuse. (a) A minor may not give effective consent for medical, mental, or 
5.19 	other health services to determine the presence of or to treat pregnancy and associated 
5.20 	conditions, including contraception, abortion, and venereal disease, or to treat alcohol 
5.21 	and other drug abuse.
5.22 	(b) Notwithstanding paragraph (a), a minor may give effective consent and the 
5.23 	consent of no other person is required, if the minor declares that the minor is a victim of 
5.24 	physical abuse, sexual abuse, or incest perpetrated by the minor's parent or legal guardian 
5.25 	and a court under subdivision 4 determines that the abuse or incest occurred and that 
5.26 	having the services performed is in the best interests of the minor. If this occurs, the 
5.27 	minor's parents or legal guardian must not have access to the minor's health records 
5.28 	without express authorization from the minor. Notice of a minor's declaration that the 
5.29 	minor is a victim of physical abuse, sexual abuse, or incest shall be made to the proper 
5.30 	authorities as provided in section 626.556, subdivision 3.
5.31 		Subd. 3.Exception. Subdivision 2 does not apply if the attending physician certifies 
5.32 	in the minor's medical record that the services are necessary to prevent the minor's death 
5.33 	and there is insufficient time to obtain consent.
5.34 		Subd. 4.Judicial determination. (a) This subdivision applies if a minor declares 
5.35 	that the minor may give consent to a service under subdivision 2, paragraph (b).
6.1 	(b) A judge, upon petition or motion and after an appropriate hearing, may authorize 
6.2 	a health care provider to provide a service if the judge determines that:
6.3 	(1) the minor is a victim of physical abuse, sexual abuse, or incest perpetrated by 
6.4 	the minor's parent or legal guardian; and
6.5 	(2) it would be in the minor's best interests to receive the service.
6.6 	(c) A minor may participate in proceedings in the court on the minor's own behalf, 
6.7 	and the court may appoint a guardian ad litem for the minor. The court shall advise the 
6.8 	minor that the minor has a right to court appointed counsel and shall, upon request, 
6.9 	appoint counsel.
6.10 	(d) Proceedings in the court under this section are confidential and must be given 
6.11 	precedence over other pending matters so that the court may reach a decision promptly 
6.12 	and without delay so as to serve the best interests of the minor. A judge who conducts 
6.13 	proceedings under this section shall make specific written factual findings and conclusions 
6.14 	supporting the decision and shall order a record of the evidence to be maintained, 
6.15 	including the judge's own findings and conclusions.
6.16 	(e) An expedited confidential appeal must be available to a minor for whom the 
6.17 	court denies an order under this section. An order authorizing a service is not subject to 
6.18 	appeal. No filing fee may be required of a minor at the trial or the appellate level. Access 
6.19 	to the trial court for the purposes of a petition or motion, and access to the appellate 
6.20 	courts for purposes of making an appeal from a denial of a request, must be available 24 
6.21 	hours a day, seven days a week.
6.22 		Subd. 5.Costs associated with judicial determination; calculation by court, 
6.23 	reimbursement by commissioner of management and budget. A court making the 
6.24 	determinations required in subdivision 4 shall calculate the amount of court resources 
6.25 	dedicated to doing so, including the use of any guardian ad litem and court appointed 
6.26 	counsel, and forward this calculation to the state court administrator. The state court 
6.27 	administrator shall determine the monetary value of the resources used and submit this 
6.28 	determination to the commissioner of management and budget. Within 30 days of 
6.29 	receiving the state court administrator's determination, the commissioner shall reimburse 
6.30 	the administrator for the expenses.
6.31 		Subd. 6.Penalty. Performance of a service in violation of this section is 
6.32 	a misdemeanor and is grounds for a civil action by a parent wrongfully denied the 
6.33 	opportunity to give effective consent on behalf of the minor. A person is not liable under 
6.34 	this section if the person establishes by written evidence that the person relied upon 
6.35 	evidence sufficient to convince a careful and prudent person that the representations of the 
6.36 	minor regarding information necessary to comply with this section are bona fide and true.
7.1 		Subd. 7.Severability. If any provision, word, phrase or clause of this section or its 
7.2 	application to any person or circumstance is held invalid, this invalidity does not affect 
7.3 	the provisions, words, phrases, clauses, or application of this section that can be given 
7.4 	effect without the invalid provision, word, phrase, clause, or application, and to this end 
7.5 	the provisions, words, phrases, and clauses of this section are declared to be severable.

7.6 	Sec. 7. [144.349] MINORS IN OUT-OF-HOME PLACEMENT.
7.7 	(a) The executive director, program manager, or a designee of a licensed residential 
7.8 	facility providing outreach, community support, and short-term shelter for unaccompanied 
7.9 	homeless, runaway, or abandoned youth may give effective consent after reasonable efforts 
7.10 	have been made to contact the parent or legal guardian of the minor for medical, mental, 
7.11 	and other health services, except for family planning services, for a minor child while the 
7.12 	minor child is receiving services from the licensed residential facility, and the consent of 
7.13 	no other person is required. If a minor receives medical, mental, or other health services 
7.14 	under this section, the minor's parents must have access to the minor's health records.
7.15 	(b) For purposes of this section, "residential facility" means a facility or program 
7.16 	licensed by the commissioner of human services under chapter 245A to serve children 
7.17 	in out-of-home placement that has a specific contract with the facility's host county to 
7.18 	provide services to youth identified under paragraph (a).

7.19 	Sec. 8. [144.3491] ORGANIZATIONS RECEIVING TITLE X FUNDS.
7.20 	Nothing in section 144.3433 requires an organization that receives federal funds 
7.21 	under Title X of the Public Health Service Act to refrain from performing any service 
7.22 	that is required to be provided as a condition of receiving Title X funds, as specified by 
7.23 	the provisions of Title X or the Title X program guidelines for project grants for family 
7.24 	planning services published by the United States Department of Health and Human 
7.25 	Services.

7.26 	Sec. 9.  REPEALER.
 7.27 	Minnesota Statutes 2010, sections 144.343; and 144.3441, are repealed.