1.1 	A bill for an act
1.2 	relating to health; establishing the Opioid Addiction Prevention and Treatment 
1.3 	Advisory Council; establishing the opioid addiction prevention and treatment 
1.4 	account; modifying substance use disorder treatment provider requirements; 
1.5 	modifying provisions related to opioid addiction prevention, education, research, 
1.6 	intervention, treatment, and recovery; appropriating money; requiring reports;
1.7 	amending Minnesota Statutes 2016, sections 145.9269, subdivision 1; 151.01, 
1.8 	subdivision 27; 151.214, subdivision 2; 151.37, subdivision 12; 151.71, by adding 
1.9 	a subdivision; 152.11, subdivision 2d, by adding subdivisions; 214.12, by adding 
1.10 	a subdivision; 256B.0625, subdivision 13e; Minnesota Statutes 2017 Supplement, 
1.11 	sections 120B.021, subdivision 1; 152.105, subdivision 2; 245G.05, subdivision 
1.12 	1; 254A.03, subdivision 3; 254B.12, subdivision 3; proposing coding for new law 
1.13 	in Minnesota Statutes, chapters 120B; 145; 151.
1.14 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.15 	ARTICLE 1
1.16 	OPIOID ADDICTION ADVISORY COUNCIL AND ACCOUNT

1.17 	Section 1. [151.255] OPIOID ADDICTION PREVENTION AND TREATMENT 
1.18 	ADVISORY COUNCIL.
1.19 		Subdivision 1.Establishment of advisory council. (a) The Opioid Addiction Prevention 
1.20 	and Treatment Advisory Council is established to confront the opioid addiction and overdose 
1.21 	epidemic in this state and focus on:
1.22 	(1) prevention and education, including public education and awareness for adults and 
1.23 	youth, prescriber education, and the development and sustainability of substance use disorder 
1.24 	programs;
2.1 	(2) the expansion and enhancement of a continuum of care for opioid-related substance 
2.2 	use disorders, including primary prevention, early intervention, treatment, and recovery 
2.3 	services;
2.4 	(3) training on the treatment of opioid addiction, including the use of all FDA-approved 
2.5 	opioid addiction medications, detoxification, relapse prevention, patient assessment, 
2.6 	individual treatment planning, counseling, recovery supports, diversion control, and other 
2.7 	best practices; and
2.8 	(4) services to ensure overdose prevention as well as public safety and community 
2.9 	well-being, including expanding access to FDA-approved opioid addiction medications and 
2.10 	providing social services to families affected by the opioid overdose epidemic.
2.11 	(b) The council shall:
2.12 	(1) review local, state, and federal initiatives and activities related to education, 
2.13 	prevention, and services for individuals and families experiencing and affected by opioid 
2.14 	addiction;
2.15 	(2) establish priorities and actions to address the state's opioid epidemic for the purpose 
2.16 	of allocating funds;
2.17 	(3) ensure optimal allocation of available funding and alignment of existing state and 
2.18 	federal funding to achieve the greatest impact and ensure a coordinated state effort;
2.19 	(4) develop criteria and procedures to be used in awarding grants and allocating available 
2.20 	funds from the opioid addiction prevention and treatment account; and
2.21 	(5) develop measurable outcomes to determine the effectiveness of the funds allocated.
2.22 	(c) The council shall make recommendations on grant and funding options for the funds 
2.23 	annually appropriated to the commissioner of human services from the opioid addiction 
2.24 	prevention and treatment account. The options for funding may include, but are not limited 
2.25 	to: prescriber education; the development and sustainability of prevention programs; the 
2.26 	creation of a continuum of care for opioid-related substance abuse disorders, including 
2.27 	primary prevention, early intervention, treatment, and recovery services; and additional 
2.28 	funding for child protection case management services for children and families affected 
2.29 	by opioid addiction. The council shall submit recommendations for funding options to the 
2.30 	commissioner of human services and to the chairs and ranking minority members of the 
2.31 	legislative committees with jurisdiction over health and human services policy and finance 
2.32 	by March 1 of each year, beginning March 1, 2019.
3.1 		Subd. 2.Membership. (a) The council shall consist of 21 members appointed by the 
3.2 	commissioner of human services, except as otherwise specified:
3.3 	(1) two members of the house of representatives, one from the majority party appointed 
3.4 	by the speaker of the house and one from the minority party appointed by the minority 
3.5 	leader of the house of representatives;
3.6 	(2) two members of the senate, one from the majority party appointed by the senate 
3.7 	majority leader and one from the minority party appointed by the senate minority leader;
3.8 	(3) one member appointed by the Board of Pharmacy;
3.9 	(4) one member who is a medical doctor appointed by the Minnesota chapter of the 
3.10 	American College of Emergency Physicians;
3.11 	(5) one member representing programs licensed under chapter 245G that specialize in 
3.12 	serving people with opioid use disorders;
3.13 	(6) one member representing the National Alliance on Mental Illness (NAMI);
3.14 	(7) one member who is a medical doctor appointed by the Minnesota Society of Addiction 
3.15 	Medicine;
3.16 	(8) one member representing professionals providing alternative pain management 
3.17 	therapies;
3.18 	(9) the commissioner of education or a designee;
3.19 	(10) one member appointed by the Minnesota Ambulance Association;
3.20 	(11) one member representing the Minnesota courts who is a judge or law enforcement 
3.21 	officer;
3.22 	(12) one member representing the Minnesota Hospital Association;
3.23 	(13) one member representing an Indian tribe;
3.24 	(14) the commissioner of human services or a designee;
3.25 	(15) the commissioner of corrections or a designee;
3.26 	(16) one advanced practice registered nurse appointed by the Board of Nursing;
3.27 	(17) the commissioner of health or a designee;
3.28 	(18) one member representing a local health department; and
3.29 	(19) one member representing a nonprofit entity specializing in providing support to 
3.30 	persons recovering from substance use disorder.
4.1 	(b) The commissioner shall coordinate appointments to provide geographic diversity 
4.2 	and shall ensure that at least one-half of council members reside outside of the seven-county 
4.3 	metropolitan area.
4.4 	(c) The council is governed by section 15.059, except that members of the council shall 
4.5 	receive no compensation other than reimbursement for expenses. Notwithstanding section 
4.6 	15.059, subdivision 6, the council shall not expire.
4.7 	(d) The chair shall convene the council semiannually, and may convene other meetings 
4.8 	as necessary. The chair shall convene meetings at different locations in the state to provide 
4.9 	geographic access and shall ensure that at least one-half of the meetings are held at locations 
4.10 	outside of the seven-county metropolitan area.
4.11 	(e) The commissioner of human services shall provide staff and administrative services 
4.12 	for the advisory council.
4.13 	(f) The council is subject to chapter 13D.

4.14 	Sec. 2. [151.256] OPIOID ADDICTION PREVENTION AND TREATMENT 
4.15 	ACCOUNT.
4.16 		Subdivision 1.Establishment. The opioid addiction prevention and treatment account 
4.17 	is established in the special revenue fund in the state treasury. All state appropriations to 
4.18 	the account, and any federal funds or grant dollars received for the prevention and treatment 
4.19 	of opioid addiction, shall be deposited into the account.
4.20 		Subd. 2.Use of account funds. (a) For fiscal year 2019, money in the account is 
4.21 	appropriated as provided in this act.
4.22 	(b) For fiscal year 2020 and subsequent fiscal years, money in the opioid addiction 
4.23 	prevention and treatment account is appropriated to the commissioner of human services, 
4.24 	to be awarded, in consultation with the Opioid Addiction Prevention and Treatment Advisory 
4.25 	Council, as grants or as other funding as determined appropriate to address the opioid 
4.26 	epidemic in the state. Grants or other funding may be provided to continue or expand 
4.27 	initiatives funded by this act for fiscal year 2019. Each recipient of grants or funding shall 
4.28 	report to the commissioner and the advisory council on how the funds were spent and the 
4.29 	outcomes achieved, in the form and manner specified by the commissioner.
4.30 		Subd. 3.Annual report. Beginning December 1, 2019, and each December 1 thereafter, 
4.31 	the commissioner, in consultation with the Opioid Addiction Prevention and Treatment 
4.32 	Advisory Council, shall report to the chairs and ranking minority members of the legislative 
4.33 	committees with jurisdiction over health and human services policy and finance on the 
5.1 	grants and funds awarded under this section and the outcomes achieved. Each report must 
5.2 	also identify those instances for which the commissioner did not follow the recommendations 
5.3 	of the advisory council and the commissioner's rationale for taking this action.

5.4 	Sec. 3. ADVISORY COUNCIL FIRST MEETING.
 5.5 	The commissioner of human services shall convene the first meeting of the Opioid 
5.6 	Addiction Prevention and Treatment Advisory Council established under Minnesota Statutes, 
5.7 	section 151.255, no later than October 1, 2018. The members shall elect a chair at the first 
5.8 	meeting.

5.9 	ARTICLE 2
5.10 	PROVIDER AND OTHER REQUIREMENTS

5.11 	Section 1. Minnesota Statutes 2016, section 151.214, subdivision 2, is amended to read:
5.12 		Subd. 2.No prohibition on disclosure. No contracting agreement between an 
5.13 	employer-sponsored health plan or health plan company, or its contracted pharmacy benefit 
5.14 	manager, and a resident or nonresident pharmacy registered licensed under this chapter, 
5.15 	may prohibit the:
5.16 	(1) a pharmacy from disclosing to patients information a pharmacy is required or given 
5.17 	the option to provide under subdivision 1; or
5.18 	(2) a pharmacist from informing a patient when the amount the patient is required to 
5.19 	pay under the patient's health plan for a particular drug is greater than the amount the patient 
5.20 	would be required to pay for the same drug if purchased out-of-pocket at the pharmacy's 
5.21 	usual and customary price.

5.22 	Sec. 2. Minnesota Statutes 2016, section 151.71, is amended by adding a subdivision to 
5.23 	read:
5.24 		Subd. 3.Lowest cost to consumers. (a) A health plan company or pharmacy benefits 
5.25 	manager shall not require an individual to make a payment at the point of sale for a covered 
5.26 	prescription medication in an amount greater than the allowable cost to consumers, as 
5.27 	defined in paragraph (b).
5.28 	(b) For purposes of paragraph (a), "allowable cost to consumers" means the lowest of: 
5.29 	(1) the applicable co-payment for the prescription medication; or (2) the amount an individual 
5.30 	would pay for the prescription medication if the individual purchased the prescription 
5.31 	medication without using a health plan benefit.

6.1 	Sec. 3. Minnesota Statutes 2017 Supplement, section 245G.05, subdivision 1, is amended 
6.2 	to read:
6.3 		Subdivision 1.Comprehensive assessment. (a) A comprehensive assessment of the 
6.4 	client's substance use disorder must be administered face-to-face by an alcohol and drug 
6.5 	counselor within three calendar days after service initiation for a residential program or 
6.6 	during the initial session for all other programs. A program may permit a licensed staff 
6.7 	person who is not qualified as an alcohol and drug counselor to interview the client in areas 
6.8 	of the comprehensive assessment that are otherwise within the competencies and scope of 
6.9 	practice of that licensed staff person and an alcohol and drug counselor does not need to be 
6.10 	face-to-face with the client during this interview. The alcohol and drug counselor must 
6.11 	review all of the information contained in a comprehensive assessment and, by signature, 
6.12 	confirm the information is accurate and complete and meets the requirements for the 
6.13 	comprehensive assessment. If the comprehensive assessment is not completed during the 
6.14 	initial session, the client-centered reason for the delay must be documented in the client's 
6.15 	file and the planned completion date. If the client received a comprehensive assessment that 
6.16 	authorized the treatment service, an alcohol and drug counselor must review the assessment 
6.17 	to determine compliance with this subdivision, including applicable timelines. If available, 
6.18 	the alcohol and drug counselor may use current information provided by a referring agency 
6.19 	or other source as a supplement. Information gathered more than 45 days before the date 
6.20 	of admission is not considered current. The comprehensive assessment must include sufficient 
6.21 	information to complete the assessment summary according to subdivision 2 and the 
6.22 	individual treatment plan according to section 245G.06. The comprehensive assessment 
6.23 	must include information about the client's needs that relate to substance use and personal 
6.24 	strengths that support recovery, including:
6.25 	(1) age, sex, cultural background, sexual orientation, living situation, economic status, 
6.26 	and level of education;
6.27 	(2) circumstances of service initiation;
6.28 	(3) previous attempts at treatment for substance misuse or substance use disorder, 
6.29 	compulsive gambling, or mental illness;
6.30 	(4) substance use history including amounts and types of substances used, frequency 
6.31 	and duration of use, periods of abstinence, and circumstances of relapse, if any. For each 
6.32 	substance used within the previous 30 days, the information must include the date of the 
6.33 	most recent use and previous withdrawal symptoms;
7.1 	(5) specific problem behaviors exhibited by the client when under the influence of 
7.2 	substances;
7.3 	(6) family status, family history, including history or presence of physical or sexual 
7.4 	abuse, level of family support, and substance misuse or substance use disorder of a family 
7.5 	member or significant other;
7.6 	(7) physical concerns or diagnoses, the severity of the concerns, and whether the concerns 
7.7 	are being addressed by a health care professional;
7.8 	(8) mental health history and psychiatric status, including symptoms, disability, current 
7.9 	treatment supports, and psychotropic medication needed to maintain stability; the assessment 
7.10 	must utilize screening tools approved by the commissioner pursuant to section 245.4863 to 
7.11 	identify whether the client screens positive for co-occurring disorders;
7.12 	(9) arrests and legal interventions related to substance use;
7.13 	(10) ability to function appropriately in work and educational settings;
7.14 	(11) ability to understand written treatment materials, including rules and the client's 
7.15 	rights;
7.16 	(12) risk-taking behavior, including behavior that puts the client at risk of exposure to 
7.17 	blood-borne or sexually transmitted diseases;
7.18 	(13) social network in relation to expected support for recovery and leisure time activities 
7.19 	that are associated with substance use;
7.20 	(14) whether the client is pregnant and, if so, the health of the unborn child and the 
7.21 	client's current involvement in prenatal care;
7.22 	(15) whether the client recognizes problems related to substance use and is willing to 
7.23 	follow treatment recommendations; and
7.24 	(16) collateral information. If the assessor gathered sufficient information from the 
7.25 	referral source or the client to apply the criteria in Minnesota Rules, parts 9530.6620 and 
7.26 	9530.6622, a collateral contact is not required.
7.27 	(b) If the client is identified as having opioid use disorder or seeking treatment for opioid 
7.28 	use disorder, the program must provide educational information to the client concerning:
7.29 	(1) risks for opioid use disorder and dependence;
7.30 	(2) treatment options, including the use of a medication for opioid use disorder;
7.31 	(3) the risk of and recognizing opioid overdose; and
8.1 	(4) the use, availability, and administration of naloxone to respond to opioid overdose.
8.2 	(c) The commissioner shall develop educational materials that are supported by research 
8.3 	and updated periodically. The license holder must use the educational materials that are 
8.4 	approved by the commissioner to comply with this requirement.
8.5 	(d) If the comprehensive assessment is completed to authorize treatment service for the 
8.6 	client, at the earliest opportunity during the assessment interview the assessor shall determine 
8.7 	if:
8.8 	(1) the client is in severe withdrawal and likely to be a danger to self or others;
8.9 	(2) the client has severe medical problems that require immediate attention; or
8.10 	(3) the client has severe emotional or behavioral symptoms that place the client or others 
8.11 	at risk of harm.
8.12 	If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the 
8.13 	assessment interview and follow the procedures in the program's medical services plan 
8.14 	under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The 
8.15 	assessment interview may resume when the condition is resolved.

8.16 	Sec. 4. Minnesota Statutes 2017 Supplement, section 254A.03, subdivision 3, is amended 
8.17 	to read:
8.18 		Subd. 3.Rules for substance use disorder care. (a) The commissioner of human 
8.19 	services shall establish by rule criteria to be used in determining the appropriate level of 
8.20 	chemical dependency care for each recipient of public assistance seeking treatment for 
8.21 	substance misuse or substance use disorder. Upon federal approval of a comprehensive 
8.22 	assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding 
8.23 	the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of 
8.24 	comprehensive assessments under section 254B.05 may determine and approve the 
8.25 	appropriate level of substance use disorder treatment for a recipient of public assistance. 
8.26 	The process for determining an individual's financial eligibility for the consolidated chemical 
8.27 	dependency treatment fund or determining an individual's enrollment in or eligibility for a 
8.28 	publicly subsidized health plan is not affected by the individual's choice to access a 
8.29 	comprehensive assessment for placement.
8.30 	(b) The commissioner shall develop and implement a utilization review process for 
8.31 	publicly funded treatment placements to monitor and review the clinical appropriateness 
8.32 	and timeliness of all publicly funded placements in treatment.
9.1 	(c) Notwithstanding section 254B.05, subdivision 5, paragraph (b), clause (2), an 
9.2 	individual employed by a county on July 1, 2018, who has been performing assessments 
9.3 	for the purpose of Minnesota Rules, part 9530.6615, is qualified to perform a comprehensive 
9.4 	assessment if the following conditions are met as of July 1, 2018:
9.5 	(1) the individual is exempt from licensure under section 148F.11, subdivision 1;
9.6 	(2) the individual is qualified as an assessor under Minnesota Rules, part 9530.6615, 
9.7 	subpart 2; and
9.8 	(3) the individual has three years employment as an assessor or is under the supervision 
9.9 	of an individual who meets the requirements of an alcohol and drug counselor supervisor 
9.10 	under section 245G.11, subdivision 4.
9.11 	After June 30, 2020, an individual qualified to do a comprehensive assessment under 
9.12 	this paragraph must additionally demonstrate completion of the applicable coursework 
9.13 	requirements of section 245G.11, subdivision 5, paragraph (b).

9.14 	ARTICLE 3
9.15 	PREVENTION, EDUCATION, AND RESEARCH

9.16 	Section 1. Minnesota Statutes 2017 Supplement, section 120B.021, subdivision 1, is 
9.17 	amended to read:
9.18 		Subdivision 1.Required academic standards. (a) The following subject areas are 
9.19 	required for statewide accountability:
9.20 	(1) language arts;
9.21 	(2) mathematics;
9.22 	(3) science;
9.23 	(4) social studies, including history, geography, economics, and government and 
9.24 	citizenship that includes civics consistent with section 120B.02, subdivision 3;
9.25 	(5) physical education;
9.26 	(6) health, for which locally developed academic standards apply, consistent with 
9.27 	paragraph (e); and
9.28 	(7) the arts, for which statewide or locally developed academic standards apply, as 
9.29 	determined by the school district. Public elementary and middle schools must offer at least 
9.30 	three and require at least two of the following four arts areas: dance; music; theater; and 
10.1 	visual arts. Public high schools must offer at least three and require at least one of the 
10.2 	following five arts areas: media arts; dance; music; theater; and visual arts.
10.3 	(b) For purposes of applicable federal law, the academic standards for language arts, 
10.4 	mathematics, and science apply to all public school students, except the very few students 
10.5 	with extreme cognitive or physical impairments for whom an individualized education 
10.6 	program team has determined that the required academic standards are inappropriate. An 
10.7 	individualized education program team that makes this determination must establish 
10.8 	alternative standards.
10.9 	(c) The department must adopt the most recent SHAPE America (Society of Health and 
10.10 	Physical Educators) kindergarten through grade 12 standards and benchmarks for physical 
10.11 	education as the required physical education academic standards. The department may 
10.12 	modify and adapt the national standards to accommodate state interest. The modification 
10.13 	and adaptations must maintain the purpose and integrity of the national standards. The 
10.14 	department must make available sample assessments, which school districts may use as an 
10.15 	alternative to local assessments, to assess students' mastery of the physical education 
10.16 	standards beginning in the 2018-2019 school year.
10.17 	(d) A school district may include child sexual abuse prevention instruction in a health 
10.18 	curriculum, consistent with paragraph (a), clause (6). Child sexual abuse prevention 
10.19 	instruction may include age-appropriate instruction on recognizing sexual abuse and assault, 
10.20 	boundary violations, and ways offenders groom or desensitize victims, as well as strategies 
10.21 	to promote disclosure, reduce self-blame, and mobilize bystanders. A school district may 
10.22 	provide instruction under this paragraph in a variety of ways, including at an annual assembly 
10.23 	or classroom presentation. A school district may also provide parents information on the 
10.24 	warning signs of child sexual abuse and available resources.
10.25 	(e) A school district must include instruction in a health curriculum for students in grades 
10.26 	5, 6, 8, 10, and 12 on substance misuse prevention, including opioids; controlled substances 
10.27 	as defined in section 152.01, subdivision 4; prescription and nonprescription medications; 
10.28 	and illegal drugs. A school district is not required to use a specific methodology or 
10.29 	curriculum.
10.30 	(e) (f) District efforts to develop, implement, or improve instruction or curriculum as a 
10.31 	result of the provisions of this section must be consistent with sections 120B.10, 120B.11, 
10.32 	and 120B.20.

10.33 	EFFECTIVE DATE. This section is effective for the 2019-2020 school year and later.

11.1 	Sec. 2. [120B.215] SUBSTANCE MISUSE PREVENTION.
11.2 	(a) This section may be cited as "Jake's Law."
11.3 	(b) School districts and charter schools are encouraged to provide substance misuse 
11.4 	prevention instruction for students in grades 5 through 12 integrated into existing programs, 
11.5 	curriculum, or the general school environment of a district or charter school. The 
11.6 	commissioner of education, in consultation with the director of the Alcohol and Other Drug 
11.7 	Abuse Section under section 254A.03 and substance misuse prevention and treatment 
11.8 	organizations, must, upon request, provide districts and charter schools with:
11.9 	(1) information regarding substance misuse prevention services; and
11.10 	(2) assistance in using Minnesota student survey results to inform prevention programs.

11.11 	EFFECTIVE DATE. This section is effective July 1, 2018.

11.12 	Sec. 3. [151.72] VOLUNTARY NONOPIOID DIRECTIVE.
11.13 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
11.14 	apply.
11.15 	(b) "Board" means the Board of Pharmacy.
11.16 	(c) "Opioid" means any product containing opium or opiates listed in section 152.02, 
11.17 	subdivision 3, paragraphs (b) and (c); any product containing narcotics listed in section 
11.18 	152.02, subdivision 4, paragraphs (e) and (h); or any product containing narcotic drugs 
11.19 	listed in section 152.02, subdivision 5, paragraph (b), other than products containing 
11.20 	difenoxin or eluxadoline.
11.21 		Subd. 2.Execution of directive. (a) An individual who is 18 years of age or older or 
11.22 	an emancipated minor, a parent or legal guardian of a minor, or an individual's guardian or 
11.23 	other person appointed by the individual or the court to manage the individual's health care 
11.24 	may execute a voluntary nonopioid directive instructing health care providers that an opioid 
11.25 	may not be administered or prescribed to the individual or the minor. The directive must 
11.26 	be in the format prescribed by the board. The person executing the directive may submit 
11.27 	the directive to a health care provider or hospital.
11.28 	(b) An individual executing a directive may revoke the directive at any time in writing 
11.29 	or orally.
11.30 		Subd. 3.Duties of the board. (a) The board shall adopt rules establishing guidelines to 
11.31 	govern the use of voluntary nonopioid health care directives. The guidelines must:
12.1 	(1) include verification by a health care provider and comply with the written consent 
12.2 	requirements under United States Code, title 42, section 290dd-2(b);
12.3 	(2) specify standard procedures for the person executing a directive to use when 
12.4 	submitting the directive to a health care provider or hospital;
12.5 	(3) specify procedures to include the directive in the individual's medical record or 
12.6 	interoperable electronic health record, and to submit the directive to the prescription 
12.7 	monitoring program database;
12.8 	(4) specify procedures to modify, override, or revoke a directive;
12.9 	(5) include exemptions for the administration of naloxone or other opioid overdose drugs 
12.10 	in an emergency situation;
12.11 	(6) ensure the confidentiality of a voluntary nonopioid directive; and
12.12 	(7) ensure exemptions for an opioid used to treat substance abuse or opioid dependence.
12.13 		Subd. 4.Exemption from liability. (a) A health care provider, a hospital, or an employee 
12.14 	of a health care provider or hospital may not be subject to disciplinary action by the health 
12.15 	care provider's or employee's professional licensing board or held civilly or criminally liable 
12.16 	for failure to administer, prescribe, or dispense an opioid, or for inadvertent administration 
12.17 	of an opioid, to an individual or minor who has a voluntary nonopioid directive.
12.18 	(b) A prescription presented to a pharmacy is presumed to be valid, and a pharmacist 
12.19 	may not be subject to disciplinary action by the pharmacist's professional licensing board 
12.20 	or held civilly or criminally liable for dispensing an opioid in contradiction to an individual's 
12.21 	or minor's voluntary nonopioid directive.
12.22 		Subd. 5.Construction. Nothing in this section shall be construed to:
12.23 	(1) alter a health care directive under chapter 145C;
12.24 	(2) limit the prescribing, dispensing, or administering of an opioid overdose drug; or
12.25 	(3) limit an authorized health care provider or pharmacist from prescribing, dispensing, 
12.26 	or administering an opioid for the treatment of substance abuse or opioid dependence.

12.27 	Sec. 4. Minnesota Statutes 2017 Supplement, section 152.105, subdivision 2, is amended 
12.28 	to read:
12.29 		Subd. 2.Sheriff to maintain collection receptacle.  The sheriff of each county shall 
12.30 	maintain or contract for the maintenance of at least one collection receptacle for the disposal 
12.31 	of noncontrolled substances, pharmaceutical controlled substances, and other legend drugs, 
13.1 	as permitted by federal law. For purposes of this section, "legend drug" has the meaning 
13.2 	given in section 151.01, subdivision 17. The collection receptacle must comply with federal 
13.3 	law. In maintaining and operating the collection receptacle, the sheriff shall follow all 
13.4 	applicable provisions of Code of Federal Regulations, title 21, parts 1300, 1301, 1304, 1305, 
13.5 	1307, and 1317, as amended through May 1, 2017. The sheriff of each county may meet 
13.6 	the requirements of this subdivision though the use of an alternative method for the disposal 
13.7 	of noncontrolled substances, pharmaceutical controlled substances, and other legend drugs 
13.8 	that has been approved by the Board of Pharmacy. This may include making available to 
13.9 	the public, without charge, at-home prescription drug deactivation and disposal products 
13.10 	that render drugs and medications inert and irretrievable.

13.11 	Sec. 5. Minnesota Statutes 2016, section 152.11, subdivision 2d, is amended to read:
13.12 		Subd. 2d.Identification requirement for Schedule II or III controlled substance 
13.13 	prescriptions. (a) No person may dispense a controlled substance included in Schedule II 
13.14 	or III Schedules II through V without requiring the person purchasing the controlled 
13.15 	substance, who need not be the person patient for whom the controlled substance prescription 
13.16 	is written, to present valid photographic identification, unless the person purchasing the 
13.17 	controlled substance, or if applicable the person for whom the controlled substance 
13.18 	prescription is written, is known to the dispenser. A doctor of veterinary medicine who 
13.19 	dispenses a controlled substance must comply with this subdivision.
13.20 	(b) This subdivision applies only to purchases of controlled substances that are not 
13.21 	covered, in whole or in part, by a health plan company or other third-party payor.

13.22 	Sec. 6. Minnesota Statutes 2016, section 152.11, is amended by adding a subdivision to 
13.23 	read:
13.24 		Subd. 5.Limitations on the dispensing of opioid prescription drug orders. (a) No 
13.25 	prescription drug order for an opioid drug listed in Schedule II may be dispensed by a 
13.26 	pharmacist or other dispenser more than 30 days after the date on which the prescription 
13.27 	drug order was issued.
13.28 	(b) No prescription drug order for an opioid drug listed in Schedules III through V may 
13.29 	be initially dispensed by a pharmacist or other dispenser more than 30 days after the date 
13.30 	on which the prescription drug order was issued. No prescription drug order for an opioid 
13.31 	drug listed in Schedules III through V may be refilled by a pharmacist or other dispenser 
13.32 	more than 30 days after the previous date on which it was dispensed.
14.1 	(c) For purposes of this section, "dispenser" has the meaning given in section 152.126, 
14.2 	subdivision 1.

14.3 	Sec. 7. Minnesota Statutes 2016, section 152.11, is amended by adding a subdivision to 
14.4 	read:
14.5 		Subd. 6.Limit on quantity of opiates prescribed for acute pain associated with a 
14.6 	major trauma or surgical procedure. (a) When used for the treatment of acute pain 
14.7 	associated with a major trauma or surgical procedure, initial prescriptions for opiate or 
14.8 	narcotic pain relievers listed in Schedules II through IV of section 152.02 shall not exceed 
14.9 	a seven-day supply. The quantity prescribed shall be consistent with the dosage listed in 
14.10 	the professional labeling for the drug that has been approved by the United States Food and 
14.11 	Drug Administration.
14.12 	(b) For the purposes of this subdivision, "acute pain" means pain resulting from disease, 
14.13 	accidental or intentional trauma, surgery, or another cause that the practitioner reasonably 
14.14 	expects to last only a short period of time. Acute pain does not include chronic pain or pain 
14.15 	being treated as part of cancer care, palliative care, or hospice or other end-of-life care.
14.16 	(c) Notwithstanding paragraph (a), if in the professional clinical judgment of a practitioner 
14.17 	more than a seven-day supply of a prescription listed in Schedules II through IV of section 
14.18 	152.02 is required to treat a patient's acute pain, the practitioner may issue a prescription 
14.19 	for the quantity needed to treat such acute pain.
14.20 	(d) This subdivision does not apply to the treatment of acute dental pain or acute pain 
14.21 	associated with refractive surgery, and the quantity of opiates that may be prescribed for 
14.22 	those conditions is governed by subdivision 4.

14.23 	Sec. 8. Minnesota Statutes 2016, section 214.12, is amended by adding a subdivision to 
14.24 	read:
14.25 		Subd. 6.Opioid and controlled substances prescribing. (a) The Board of Medical 
14.26 	Practice, the Board of Nursing, the Board of Dentistry, the Board of Optometry, and the 
14.27 	Board of Podiatric Medicine shall require that licensees with the authority to prescribe 
14.28 	controlled substances obtain at least two hours of continuing education credit on best practices 
14.29 	in prescribing opioids and controlled substances, as part of the continuing education 
14.30 	requirements for licensure renewal. Licensees shall not be required to complete more than 
14.31 	two credit hours of continuing education on best practices in prescribing opioids and 
14.32 	controlled substances before this subdivision expires. Continuing education credit on best 
14.33 	practices in prescribing opioids and controlled substances must meet board requirements.
15.1 	(b) This subdivision expires January 1, 2023.

15.2 	EFFECTIVE DATE. This section is effective January 1, 2019.

15.3 	ARTICLE 4
15.4 	INTERVENTION, TREATMENT, AND RECOVERY

15.5 	Section 1. Minnesota Statutes 2016, section 145.9269, subdivision 1, is amended to read:
15.6 		Subdivision 1.Definitions. For purposes of this section and section 145.9272, "federally 
15.7 	qualified health center" means an entity that is receiving a grant under United States Code, 
15.8 	title 42, section 254b, or, based on the recommendation of the Health Resources and Services 
15.9 	Administration within the Public Health Service, is determined by the secretary to meet the 
15.10 	requirements for receiving such a grant.

15.11 	Sec. 2. [145.9272] FEDERALLY QUALIFIED HEALTH CENTERS; GRANTS FOR 
15.12 	INTEGRATED COMMUNITY-BASED OPIOID ADDICTION AND SUBSTANCE 
15.13 	USE DISORDER TREATMENT, RECOVERY, AND PREVENTION PROGRAMS.
15.14 		Subdivision 1.Grant program established. The commissioner of health shall distribute 
15.15 	grants to federally qualified health centers operating in Minnesota as of January 1, 2018, 
15.16 	for integrated, community-based programs in primary care settings to treat, prevent, and 
15.17 	raise awareness of opioid addiction and substance use disorders.
15.18 		Subd. 2.Grant allocation. (a) For each grant cycle, the commissioner shall allocate 
15.19 	grants to federally qualified health centers operating in Minnesota as of January 1, 2018, 
15.20 	through a competitive process and according to the following guidelines:
15.21 	(1) 25 percent of the funds shall be for federally qualified health centers to establish new 
15.22 	opioid addiction and substance use disorder programs;
15.23 	(2) 70 percent of the funds shall be for federally qualified health centers with existing 
15.24 	opioid addiction and substance use disorder programs to expand these programs to serve 
15.25 	additional low-income patients; and
15.26 	(3) five percent of the funds shall be for federally qualified health centers to invest in 
15.27 	network infrastructure and evaluation activities, to identify and document successful opioid 
15.28 	addiction and substance use disorder prevention and treatment strategies for rural or 
15.29 	underserved populations.
15.30 	(b) The commissioner shall ensure, for each grant cycle, that at least 30 percent of the 
15.31 	funds are allocated to federally qualified health centers in the state located outside the 
16.1 	seven-county metropolitan area and that each federally qualified health center in the state 
16.2 	is allocated at least three percent of the total amount available for that grant cycle.
16.3 	(c) The commissioner shall consult with a state organization representing Minnesota's 
16.4 	community health centers to assess and classify the levels of substance use disorder services 
16.5 	and programs available at federally qualified health centers in the state as of July 1, 2018, 
16.6 	and to develop measures for federally qualified health centers to use in assessing the 
16.7 	effectiveness of substance use disorder programs funded under this section in supporting 
16.8 	sobriety and long-term recovery, stopping cycles of intergenerational substance use, enabling 
16.9 	patients to return to work or school, and supporting family unity.
16.10 		Subd. 3.Allowable uses for grant funds. In establishing a new opioid addiction and 
16.11 	substance use disorder program or expanding an existing program, a federally qualified 
16.12 	health center must use grant funds distributed under this section for one or more of the 
16.13 	following activities:
16.14 	(1) integrating behavioral health services and substance use disorder services on-site at 
16.15 	the federally qualified health center or off-site through partnerships with other providers;
16.16 	(2) establishing or expanding programs in which patients with substance use disorders 
16.17 	receive services using integrated, interprofessional care teams;
16.18 	(3) implementing or expanding patient care coordination, outreach, and education services 
16.19 	related to substance use disorders;
16.20 	(4) implementing or expanding medication assisted treatment by providing, directly or 
16.21 	by referral, all drugs approved by the Food and Drug Administration for the treatment of 
16.22 	opioid use disorder, including maintenance, detoxification, overdose reversal, and relapse 
16.23 	prevention;
16.24 	(5) implementing and evaluating specific, effective substance use disorder interventions 
16.25 	tailored to specific populations, including but not limited to communities of color, individuals 
16.26 	experiencing homelessness, veterans, and adolescents;
16.27 	(6) developing infrastructure, including infrastructure to allow for telehealth services, 
16.28 	for federally qualified health center networks to support coordinated interventions across 
16.29 	delivery systems; and
16.30 	(7) training current and future health care professionals and students, including dental 
16.31 	providers.
16.32 		Subd. 4.Reports. After the conclusion of each grant cycle, each federally qualified 
16.33 	health center shall report to the commissioner, at a time and in a manner specified by the 
17.1 	commissioner, data regarding the effectiveness measures developed under subdivision 2. 
17.2 	The commissioner shall compile this information into a report for each grant cycle and shall 
17.3 	provide the report to the chairs and ranking minority members of the legislative committees 
17.4 	with jurisdiction over health care.

17.5 	Sec. 3. Minnesota Statutes 2016, section 151.01, subdivision 27, is amended to read:
17.6 		Subd. 27.Practice of pharmacy. "Practice of pharmacy" means:
17.7 	(1) interpretation and evaluation of prescription drug orders;
17.8 	(2) compounding, labeling, and dispensing drugs and devices (except labeling by a 
17.9 	manufacturer or packager of nonprescription drugs or commercially packaged legend drugs 
17.10 	and devices);
17.11 	(3) participation in clinical interpretations and monitoring of drug therapy for assurance 
17.12 	of safe and effective use of drugs, including the performance of laboratory tests that are 
17.13 	waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code, 
17.14 	title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory 
17.15 	tests but may modify drug therapy only pursuant to a protocol or collaborative practice 
17.16 	agreement;
17.17 	(4) participation in drug and therapeutic device selection; drug administration for first 
17.18 	dosage, injectable or implantable medications to treat substance use disorders, and medical 
17.19 	emergencies; drug regimen reviews; and drug or drug-related research;
17.20 	(5) participation in administration of influenza vaccines to all eligible individuals six 
17.21 	years of age and older and all other vaccines to patients 13 years of age and older by written 
17.22 	protocol with a physician licensed under chapter 147, a physician assistant authorized to 
17.23 	prescribe drugs under chapter 147A, or an advanced practice registered nurse authorized to 
17.24 	prescribe drugs under section 148.235, provided that:
17.25 	(i) the protocol includes, at a minimum:
17.26 	(A) the name, dose, and route of each vaccine that may be given;
17.27 	(B) the patient population for whom the vaccine may be given;
17.28 	(C) contraindications and precautions to the vaccine;
17.29 	(D) the procedure for handling an adverse reaction;
17.30 	(E) the name, signature, and address of the physician, physician assistant, or advanced 
17.31 	practice registered nurse;
18.1 	(F) a telephone number at which the physician, physician assistant, or advanced practice 
18.2 	registered nurse can be contacted; and
18.3 	(G) the date and time period for which the protocol is valid;
18.4 	(ii) the pharmacist has successfully completed a program approved by the Accreditation 
18.5 	Council for Pharmacy Education specifically for the administration of immunizations or a 
18.6 	program approved by the board;
18.7 	(iii) the pharmacist utilizes the Minnesota Immunization Information Connection to 
18.8 	assess the immunization status of individuals prior to the administration of vaccines, except 
18.9 	when administering influenza vaccines to individuals age nine and older;
18.10 	(iv) the pharmacist reports the administration of the immunization to the Minnesota 
18.11 	Immunization Information Connection; and
18.12 	(v) the pharmacist complies with guidelines for vaccines and immunizations established 
18.13 	by the federal Advisory Committee on Immunization Practices, except that a pharmacist 
18.14 	does not need to comply with those portions of the guidelines that establish immunization 
18.15 	schedules when administering a vaccine pursuant to a valid, patient-specific order issued 
18.16 	by a physician licensed under chapter 147, a physician assistant authorized to prescribe 
18.17 	drugs under chapter 147A, or an advanced practice nurse authorized to prescribe drugs 
18.18 	under section 148.235, provided that the order is consistent with the United States Food 
18.19 	and Drug Administration approved labeling of the vaccine;
18.20 	(6) participation in the initiation, management, modification, and discontinuation of 
18.21 	drug therapy according to a written protocol or collaborative practice agreement between: 
18.22 	(i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists, 
18.23 	or veterinarians; or (ii) one or more pharmacists and one or more physician assistants 
18.24 	authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice 
18.25 	nurses authorized to prescribe, dispense, and administer under section 148.235. Any changes 
18.26 	in drug therapy made pursuant to a protocol or collaborative practice agreement must be 
18.27 	documented by the pharmacist in the patient's medical record or reported by the pharmacist 
18.28 	to a practitioner responsible for the patient's care;
18.29 	(7) participation in the storage of drugs and the maintenance of records;
18.30 	(8) patient counseling on therapeutic values, content, hazards, and uses of drugs and 
18.31 	devices;
18.32 	(9) offering or performing those acts, services, operations, or transactions necessary in 
18.33 	the conduct, operation, management, and control of a pharmacy; and
19.1 	(10) participation in the initiation, management, modification, and discontinuation of 
19.2 	therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:
19.3 	(i) a written protocol as allowed under clause (6); or
19.4 	(ii) a written protocol with a community health board medical consultant or a practitioner 
19.5 	designated by the commissioner of health, as allowed under section 151.37, subdivision 13.

19.6 	Sec. 4. Minnesota Statutes 2016, section 151.37, subdivision 12, is amended to read:
19.7 		Subd. 12.Administration of opiate antagonists for drug overdose. (a) A licensed 
19.8 	physician, a licensed advanced practice registered nurse authorized to prescribe drugs 
19.9 	pursuant to section 148.235, or a licensed physician assistant authorized to prescribe drugs 
19.10 	pursuant to section 147A.18 may authorize the following individuals to administer opiate 
19.11 	antagonists, as defined in section 604A.04, subdivision 1:
19.12 	(1) an emergency medical responder registered pursuant to section 144E.27;
19.13 	(2) a peace officer as defined in section 626.84, subdivision 1, paragraphs (c) and (d); 
19.14 	and
19.15 	(3) staff of community-based health disease prevention or social service programs.;
19.16 	(4) a probation or supervised release officer; and
19.17 	(5) a volunteer firefighter.
19.18 	(b) For the purposes of this subdivision, opiate antagonists may be administered by one 
19.19 	of these individuals only if:
19.20 	(1) the licensed physician, licensed physician assistant, or licensed advanced practice 
19.21 	registered nurse has issued a standing order to, or entered into a protocol with, the individual; 
19.22 	and
19.23 	(2) the individual has training in the recognition of signs of opiate overdose and the use 
19.24 	of opiate antagonists as part of the emergency response to opiate overdose.
19.25 	(c) Nothing in this section prohibits the possession and administration of naloxone 
19.26 	pursuant to section 604A.04.

19.27 	Sec. 5. Minnesota Statutes 2017 Supplement, section 254B.12, subdivision 3, is amended 
19.28 	to read:
19.29 		Subd. 3.Chemical dependency provider rate increase. For the chemical dependency 
19.30 	services listed in section 254B.05, subdivision 5, and provided on or after July 1, 2017 2018, 
20.1 	payment rates shall be increased by one percent a percentage established by the 
20.2 	commissioner, based on the available appropriation, over the rates in effect on January 1, 
20.3 	2017 2018, for vendors who meet the requirements of section 254B.05.

20.4 	Sec. 6. Minnesota Statutes 2016, section 256B.0625, subdivision 13e, is amended to read:
20.5 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment shall 
20.6 	be the lower of the actual acquisition costs of the drugs or the maximum allowable cost by 
20.7 	the commissioner plus the fixed dispensing fee; or the usual and customary price charged 
20.8 	to the public. The amount of payment basis must be reduced to reflect all discount amounts 
20.9 	applied to the charge by any provider/insurer agreement or contract for submitted charges 
20.10 	to medical assistance programs. The net submitted charge may not be greater than the patient 
20.11 	liability for the service. The pharmacy dispensing fee shall be $3.65 for legend prescription 
20.12 	drugs, except that the dispensing fee for intravenous solutions which must be compounded 
20.13 	by the pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and 
20.14 	$30 per bag for total parenteral nutritional products dispensed in one liter quantities, or $44 
20.15 	per bag for total parenteral nutritional products dispensed in quantities greater than one liter. 
20.16 	The pharmacy dispensing fee for over-the-counter drugs shall be $3.65, except that the fee 
20.17 	shall be $1.31 for retrospectively billing pharmacies when billing for quantities less than 
20.18 	the number of units contained in the manufacturer's original package. Actual acquisition 
20.19 	cost includes quantity and other special discounts except time and cash discounts. The actual 
20.20 	acquisition cost of a drug shall be estimated by the commissioner at wholesale acquisition 
20.21 	cost plus four percent for independently owned pharmacies located in a designated rural 
20.22 	area within Minnesota, and at wholesale acquisition cost plus two percent for all other 
20.23 	pharmacies. A pharmacy is "independently owned" if it is one of four or fewer pharmacies 
20.24 	under the same ownership nationally. A "designated rural area" means an area defined as 
20.25 	a small rural area or isolated rural area according to the four-category classification of the 
20.26 	Rural Urban Commuting Area system developed for the United States Health Resources 
20.27 	and Services Administration. Effective January 1, 2014, the actual acquisition cost of a drug 
20.28 	acquired through the federal 340B Drug Pricing Program shall be estimated by the 
20.29 	commissioner at wholesale acquisition cost minus 40 percent. Wholesale acquisition cost 
20.30 	is defined as the manufacturer's list price for a drug or biological to wholesalers or direct 
20.31 	purchasers in the United States, not including prompt pay or other discounts, rebates, or 
20.32 	reductions in price, for the most recent month for which information is available, as reported 
20.33 	in wholesale price guides or other publications of drug or biological pricing data. The 
20.34 	maximum allowable cost of a multisource drug may be set by the commissioner and it shall 
20.35 	be comparable to, but no higher than, the maximum amount paid by other third-party payors 
21.1 	in this state who have maximum allowable cost programs. Establishment of the amount of 
21.2 	payment for drugs shall not be subject to the requirements of the Administrative Procedure 
21.3 	Act.
21.4 	(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using 
21.5 	an automated drug distribution system meeting the requirements of section 151.58, or a 
21.6 	packaging system meeting the packaging standards set forth in Minnesota Rules, part 
21.7 	6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ 
21.8 	retrospective billing for prescription drugs dispensed to long-term care facility residents. A 
21.9 	retrospectively billing pharmacy must submit a claim only for the quantity of medication 
21.10 	used by the enrolled recipient during the defined billing period. A retrospectively billing 
21.11 	pharmacy must use a billing period not less than one calendar month or 30 days.
21.12 	(c) An additional dispensing fee of $.30 may be added to the dispensing fee paid to 
21.13 	pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities 
21.14 	when a unit dose blister card system, approved by the department, is used. Under this type 
21.15 	of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National 
21.16 	Drug Code (NDC) from the drug container used to fill the blister card must be identified 
21.17 	on the claim to the department. The unit dose blister card containing the drug must meet 
21.18 	the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return 
21.19 	of unused drugs to the pharmacy for reuse. A pharmacy provider using packaging that meets 
21.20 	the standards set forth in Minnesota Rules, part 6800.2700, is required to credit the 
21.21 	department for the actual acquisition cost of all unused drugs that are eligible for reuse, 
21.22 	unless the pharmacy is using retrospective billing. The commissioner may permit the drug 
21.23 	clozapine to be dispensed in a quantity that is less than a 30-day supply.
21.24 	(d) Whenever a maximum allowable cost has been set for a multisource drug, payment 
21.25 	shall be the lower of the usual and customary price charged to the public or the maximum 
21.26 	allowable cost established by the commissioner unless prior authorization for the brand 
21.27 	name product has been granted according to the criteria established by the Drug Formulary 
21.28 	Committee as required by subdivision 13f, paragraph (a), and the prescriber has indicated 
21.29 	"dispense as written" on the prescription in a manner consistent with section 151.21, 
21.30 	subdivision 2.
21.31 	(e) The basis for determining the amount of payment for drugs administered in an 
21.32 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
21.33 	provider, 106 percent of the average sales price as determined by the United States 
21.34 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
21.35 	federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost 
22.1 	set by the commissioner. If average sales price is unavailable, the amount of payment must 
22.2 	be lower of the usual and customary cost submitted by the provider, the wholesale acquisition 
22.3 	cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. 
22.4 	Effective January 1, 2014, the commissioner shall discount the payment rate for drugs 
22.5 	obtained through the federal 340B Drug Pricing Program by 20 percent. With the exception 
22.6 	of paragraph (f), the payment for drugs administered in an outpatient setting shall be made 
22.7 	to the administering facility or practitioner. A retail or specialty pharmacy dispensing a drug 
22.8 	for administration in an outpatient setting is not eligible for direct reimbursement.
22.9 	(f) Notwithstanding paragraph (e), payment for injectable drugs used to treat substance 
22.10 	abuse administered by a practitioner in an outpatient setting shall be made either to the 
22.11 	administering facility or the practitioner, or directly to the dispensing pharmacy. The 
22.12 	practitioner or administering facility shall submit the claim for the drug, if the practitioner 
22.13 	purchases the drug directly from a wholesale distributor licensed under section 151.47 or 
22.14 	from a manufacturer licensed under section 151.252. The dispensing pharmacy shall submit 
22.15 	the claim if the pharmacy dispenses the drug pursuant to a prescription issued by the 
22.16 	practitioner and delivers the filled prescription to the practitioner for subsequent 
22.17 	administration. Payment shall be made according to this section. The administering 
22.18 	practitioner and pharmacy shall ensure that claims are not duplicated. A pharmacy shall not 
22.19 	dispense a practitioner-administered injectable drug described in this paragraph directly to 
22.20 	an enrollee. For purposes of this paragraph, "dispense" and "dispensing" have the meaning 
22.21 	provided in section 151.01, subdivision 30.
22.22 	(g) The commissioner may negotiate lower reimbursement rates for specialty pharmacy 
22.23 	products than the rates specified in paragraph (a). The commissioner may require individuals 
22.24 	enrolled in the health care programs administered by the department to obtain specialty 
22.25 	pharmacy products from providers with whom the commissioner has negotiated lower 
22.26 	reimbursement rates. Specialty pharmacy products are defined as those used by a small 
22.27 	number of recipients or recipients with complex and chronic diseases that require expensive 
22.28 	and challenging drug regimens. Examples of these conditions include, but are not limited 
22.29 	to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, growth hormone deficiency, 
22.30 	Crohn's Disease, rheumatoid arthritis, and certain forms of cancer. Specialty pharmaceutical 
22.31 	products include injectable and infusion therapies, biotechnology drugs, antihemophilic 
22.32 	factor products, high-cost therapies, and therapies that require complex care. The 
22.33 	commissioner shall consult with the formulary committee to develop a list of specialty 
22.34 	pharmacy products subject to this paragraph. In consulting with the formulary committee 
22.35 	in developing this list, the commissioner shall take into consideration the population served 
23.1 	by specialty pharmacy products, the current delivery system and standard of care in the 
23.2 	state, and access to care issues. The commissioner shall have the discretion to adjust the 
23.3 	reimbursement rate to prevent access to care issues.
23.4 	(g) (h) Home infusion therapy services provided by home infusion therapy pharmacies 
23.5 	must be paid at rates according to subdivision 8d.

23.6 	Sec. 7. OPIOID OVERDOSE REDUCTION PILOT PROGRAM.
 23.7 		Subdivision 1.Establishment. The commissioner of health shall provide grants to 
23.8 	ambulance services to fund activities by community paramedic teams to reduce opioid 
23.9 	overdoses in the state. Under this pilot program, ambulance services shall develop and 
23.10 	implement projects in which community paramedics connect with patients who are discharged 
23.11 	from a hospital following an opioid overdose episode, develop personalized care plans for 
23.12 	those patients, and provide follow-up services to those patients.
23.13 		Subd. 2.Priority areas; services. (a) In a project developed under this section, an 
23.14 	ambulance service must target community paramedic team services to portions of the service 
23.15 	area with high levels of opioid use, high death rates from opioid overdoses, and urgent needs 
23.16 	for interventions.
23.17 	(b) In a project developed under this section, a community paramedic team shall:
23.18 	(1) provide services to patients released from a hospital following an opioid overdose 
23.19 	episode and place priority on serving patients who were administered the opiate antagonist 
23.20 	naloxone hydrochloride by emergency medical services personnel in response to a 911 call 
23.21 	during the opioid overdose episode;
23.22 	(2) provide the following evaluations during an initial home visit: a home safety 
23.23 	assessment including whether there is a need to dispose of prescription drugs that are expired 
23.24 	or no longer needed, medication reconciliation, an HIV risk assessment, instruction on the 
23.25 	use of naloxone hydrochloride, and a basic needs assessment;
23.26 	(3) provide patients with health assessments, medication management, chronic disease 
23.27 	monitoring and education, and assistance in following hospital discharge orders; and
23.28 	(4) work with a multidisciplinary team to address the overall physical and mental health 
23.29 	needs of patients and health needs related to substance use disorder treatment.
23.30 		Subd. 3.Evaluation. An ambulance service that receives a grant under this section must 
23.31 	evaluate the extent to which the project was successful in reducing the number of opioid 
23.32 	overdoses and opioid overdose deaths among patients who received services and in reducing 
24.1 	the inappropriate use of opioids by patients who received services. The commissioner of 
24.2 	health shall develop specific evaluation measures and reporting timelines for ambulance 
24.3 	services receiving grants. Ambulance services must submit the information required by the 
24.4 	commissioner to the commissioner and the chairs and ranking minority members of the 
24.5 	legislative committees with jurisdiction over health and human services by December 1, 
24.6 	2019.

24.7 	ARTICLE 5
24.8 	APPROPRIATIONS

24.9	Section 1. APPROPRIATIONS
 	
24.10 	The appropriations shown are from the general fund, or other named fund, and are 
24.11 	available for the fiscal years indicated for each purpose. The figures "2018" and "2019" 
24.12 	used in this article mean that the appropriation noted under them are available for the fiscal 
24.13 	year ending June 30, 2018, or June 30, 2019, respectively.

24.14				APPROPRIATIONS
	
24.15				Available for the Year
	
24.16				Ending June 30
	
24.17					2018
		2019

24.18	Sec. 2. CRIMINAL APPREHENSION
 	$
	0
	$
	420,000
	
24.19 	Bureau of Criminal Apprehension Special 
24.20 	Agents. $420,000 in fiscal year 2019 is for 
24.21 	two additional special agent positions within 
24.22 	the Bureau of Criminal Apprehension focused 
24.23 	on drug interdiction and drug trafficking. The 
24.24 	special agents whose positions are authorized 
24.25 	under this section shall, whenever possible, 
24.26 	coordinate with the federal Drug Enforcement 
24.27 	Administration in efforts to address drug 
24.28 	trafficking in Minnesota.

24.29
24.30	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

24.31	Subdivision 1.Total Appropriation
 	$
	0
	$
	4,900,000
	
25.1 	The amounts that may be spent for each 
25.2 	purpose are specified in the following 
25.3 	subdivisions.

25.4	Subd. 2.Central Office Operations
 		0
		900,000
	
25.5 	Native American Juvenile Treatment 
25.6 	Center; White Earth Reservation. $900,000 
25.7 	in fiscal year 2019 is for a grant to the tribal 
25.8 	council of the White Earth Nation to refurbish 
25.9 	and equip the White Earth Opiate Treatment 
25.10 	Facility on the White Earth Reservation. The 
25.11 	facility shall treat Native Americans and 
25.12 	provide culturally specific programming to 
25.13 	individuals placed in the treatment center. This 
25.14 	appropriation is available until the project is 
25.15 	completed or abandoned, subject to Minnesota 
25.16 	Statutes, section 16A.642. This is a onetime 
25.17 	appropriation.

25.18
25.19	Subd. 3.Forecasted Programs; Medical 
Assistance
 		0
		4,000,000

25.20	Sec. 4. COMMISSIONER OF HEALTH
 	$
	0
	$
	5,000,000
	
25.21 	(a) FQHC Grants. $1,000,000 in fiscal year 
25.22 	2019 is for grants to federally qualified health 
25.23 	centers for opioid addiction and substance use 
25.24 	disorder programs under Minnesota Statutes, 
25.25 	section 145.9272. This is a onetime 
25.26 	appropriation.
25.27 	(b) Community Paramedic Teams. 
25.28 	$1,000,000 in fiscal year 2019 is for an opioid 
25.29 	overdose reduction pilot program using 
25.30 	community paramedic teams. This 
25.31 	appropriation is available until June 30, 2021. 
25.32 	Of this appropriation, the commissioner may 
25.33 	use up to $50,000 to administer the program. 
25.34 	This is a onetime appropriation.
26.1 	(c) Opioid Prevention Pilot Project. 
26.2 	$2,000,000 in fiscal year 2019 is for opioid 
26.3 	abuse prevention pilot projects under Laws 
26.4 	2017, First Special Session chapter 6, article 
26.5 	10, section 144. Of this amount, $1,400,000 
26.6 	is for the opioid abuse prevention pilot project 
26.7 	through CHI St. Gabriel's Health Family 
26.8 	Medical Center, also known as Unity Family 
26.9 	Health Care. $600,000 is for Project Echo 
26.10 	through CHI St. Gabriel's Health Family 
26.11 	Medical Center for e-learning sessions 
26.12 	centered around opioid case management and 
26.13 	best practices for opioid abuse prevention. 
26.14 	This is a onetime appropriation.
26.15 	(d) Prescription Drug Deactivation And 
26.16 	Disposal. $1,000,000 in fiscal year 2019 is to 
26.17 	provide grants to prescription drug dispensers 
26.18 	and health care providers to purchase 
26.19 	omnidegradeable, at-home prescription drug 
26.20 	deactivation and disposal products to assist 
26.21 	individuals in the disposal of prescription 
26.22 	drugs in a safe, environmentally sound 
26.23 	manner. Grant awards shall not exceed 
26.24 	$25,000 per dispenser or provider, or $100,000 
26.25 	for applicants applying on behalf of a group 
26.26 	of dispensers or providers. Grant recipients 
26.27 	must provide these deactivation and disposal 
26.28 	products free of charge to members of the 
26.29 	public. In awarding grants, the commissioner 
26.30 	shall give priority to regions of the state with 
26.31 	the highest rates of opioid overdoses and 
26.32 	opioid-related deaths. This is a onetime 
26.33 	appropriation.

26.34	Sec. 5. DEPARTMENT OF EDUCATION
 	$
	0
	$
	400,000
	
27.1 	For Jake's Sake Foundation. (a) $400,000 
27.2 	in fiscal year 2019 is for a grant to the For 
27.3 	Jake's Sake Foundation to collaborate with 
27.4 	school districts throughout Minnesota to 
27.5 	integrate evidence-based substance misuse 
27.6 	prevention instruction on the dangers of 
27.7 	substance misuse, particularly the use of 
27.8 	opioids, into school district programs and 
27.9 	curricula, including health education curricula.
27.10 	(b) Funds appropriated in this section are to:
27.11 	(1) identify effective substance misuse 
27.12 	prevention tools and strategies, including 
27.13 	innovative uses of technology and media;
27.14 	(2) develop and promote a comprehensive 
27.15 	substance misuse prevention curriculum for 
27.16 	students in grades 5 through 12 that educates 
27.17 	students and families about the dangers of 
27.18 	substance misuse;
27.19 	(3) integrate substance misuse prevention into 
27.20 	curricula across subject areas;
27.21 	(4) train school district teachers, athletic 
27.22 	coaches, and other school staff in effective 
27.23 	substance misuse prevention strategies; and
27.24 	(5) collaborate with school districts to evaluate 
27.25 	the effectiveness of districts' substance misuse 
27.26 	prevention efforts.
27.27 	(c) By February 15, 2019, the grantee must 
27.28 	submit a report detailing expenditures and 
27.29 	outcomes of the grant to the chairs and ranking 
27.30 	minority members of the legislative 
27.31 	committees with primary jurisdiction over 
27.32 	kindergarten through grade 12 education 
27.33 	policy and finance. The report must identify 
27.34 	the school districts that have implemented or 
28.1 	plan to implement the substance misuse 
28.2 	prevention curriculum.
28.3 	(d) The department may retain up to five 
28.4 	percent of the appropriation amount to 
28.5 	administer the grant program and assist school 
28.6 	districts with implementation of substance 
28.7 	misuse prevention instruction.

28.8	Sec. 6. HEALTH RELATED BOARDS

28.9	Subdivision 1.Total Appropriation
 	$
	0
	$
	985,000

28.10	Appropriations by Fund
	
28.11		2018
	2019
	
28.12	General
	0
	965,000
	
28.13
28.14	State Government 
Special Revenue
	0
	20,000
	
28.15 	The amounts that may be spent for each 
28.16 	purpose are specified in the following 
28.17 	subdivisions.

28.18	Subd. 2.Board of Dentistry
 		0
		5,000
	
28.19 	Continuing Education. $5,000 in fiscal year 
28.20 	2019 is from the state government special 
28.21 	revenue fund for costs associated with 
28.22 	continuing education on prescribing opioids 
28.23 	and controlled substances. This is a onetime 
28.24 	appropriation.

28.25	Subd. 3.Board of Nursing
 		0
		5,000
	
28.26 	Continuing Education. $5,000 in fiscal year 
28.27 	2019 is from the state government special 
28.28 	revenue fund for costs associated with 
28.29 	continuing education on prescribing opioids 
28.30 	and controlled substances. This is a onetime 
28.31 	appropriation.

29.1	Subd. 4.Board of Optometry
 		0
		5,000
	
29.2 	Continuing Education. $5,000 in fiscal year 
29.3 	2019 is from the state government special 
29.4 	revenue fund for costs associated with 
29.5 	continuing education on prescribing opioids 
29.6 	and controlled substances. This is a onetime 
29.7 	appropriation.

29.8	Subd. 5.Board of Pharmacy
 		0
		965,000
	
29.9 	Prescription Monitoring Program and 
29.10 	Electronic Health Records. $965,000 in 
29.11 	fiscal year 2019 is from the general fund to 
29.12 	integrate the prescription monitoring program 
29.13 	database with electronic health records on a 
29.14 	statewide basis. The integration of access to 
29.15 	the prescription monitoring database with 
29.16 	electronic health records shall not modify any 
29.17 	requirements or procedures in Minnesota 
29.18 	Statutes, section 152.126, regarding the 
29.19 	information that must be reported to the 
29.20 	database, who can access the database and for 
29.21 	what purpose, and the data classification of 
29.22 	information in the database, and shall not 
29.23 	require a prescriber to access the database 
29.24 	prior to issuing a prescription for a controlled 
29.25 	substance. The board may use this funding to 
29.26 	contract with a vendor for technical assistance, 
29.27 	provide grants to health care providers, and to 
29.28 	make any necessary technological 
29.29 	modifications to the prescription monitoring 
29.30 	program database. This funding does not 
29.31 	cancel and is available until expended. This 
29.32 	is a onetime appropriation.

29.33	Subd. 6.Board of Podiatric Medicine
 		0
		5,000
	
29.34 	Continuing Education. $5,000 in fiscal year 
29.35 	2019 is from the state government special 
30.1 	revenue fund for costs associated with 
30.2 	continuing education on prescribing opioids 
30.3 	and controlled substances. This is a onetime 
30.4 	appropriation.

30.5 	Sec. 7. DUPLICATE APPROPRIATIONS.
 30.6 	If an appropriation in this act is enacted more than once in the 2018 legislative session, 
30.7 	the appropriation must be given effect only once.