1.1 	A bill for an act
1.2 	relating to health; permitting a community emergency medical technician to be a 
1.3 	member of a basic life support ambulance service; modifying an occupational title 
1.4 	of certain emergency medical technicians;amending Minnesota Statutes 2018, 
1.5 	sections 144E.001, subdivision 5h; 144E.275, subdivision 7; 256B.0625, 
1.6 	subdivisions 3b, 60a.
1.7 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.8 	Section 1. Minnesota Statutes 2018, section 144E.001, subdivision 5h, is amended to read:
1.9 		Subd. 5h.Community medical response emergency medical technician. "Community 
1.10 	medical response emergency medical technician" or "CEMT" means a person who is certified 
1.11 	as an emergency medical technician, who is a member of a registered medical response unit 
1.12 	under section 144E.275 or a basic life support ambulance service, and who meets the 
1.13 	requirements for additional certification as a CEMT as specified in section 144E.275, 
1.14 	subdivision 7.

1.15 	Sec. 2. Minnesota Statutes 2018, section 144E.275, subdivision 7, is amended to read:
1.16 		Subd. 7.Community medical response emergency medical technician. (a) To be 
1.17 	eligible for certification by the board as a CEMT, an individual shall:
1.18 	(1) be currently certified as an EMT or AEMT;
1.19 	(2) have two years of service as an EMT or AEMT;
1.20 	(3) be a member of: (i) a registered medical response unit as defined under this section;
1.21 	or
2.1 	(ii) a basic life support ambulance service that meets the requirements of section 
2.2 	144E.101, subdivision 6;
2.3 	(4) successfully complete a CEMT education program from a college or university that 
2.4 	has been approved by the board or accredited by a board-approved national accrediting 
2.5 	organization. The education must include clinical experience under the supervision of the 
2.6 	medical response unit or ambulance service medical director, an advanced practice registered 
2.7 	nurse, a physician assistant, or a public health nurse operating under the direct authority of 
2.8 	a local unit of government;
2.9 	(5) successfully complete an education program that includes education in providing 
2.10 	culturally appropriate care; and
2.11 	(6) complete a board-approved application form.
2.12 	(b) A CEMT must practice in accordance with protocols and supervisory standards 
2.13 	established by the medical response unit or ambulance service medical director in accordance 
2.14 	with section 144E.265.
2.15 	(c) A CEMT may provide services within the CEMT skill set as approved by the medical 
2.16 	response unit or ambulance service medical director.
2.17 	(d) A CEMT may provide episodic individual patient education and prevention education 
2.18 	but only as directed by a patient care plan developed by the patient's primary physician, an 
2.19 	advanced practice registered nurse, or a physician assistant, in conjunction with the medical 
2.20 	response unit or ambulance service medical director and relevant local health care providers. 
2.21 	The patient care plan must ensure that the services provided by the CEMT are consistent 
2.22 	with services offered by the patient's health care home, if one exists, that the patient receives 
2.23 	the necessary services, and that there is no duplication of services to the patient.
2.24 	(e) A CEMT is subject to all certification, disciplinary, complaint, and other regulatory 
2.25 	requirements that apply to EMTs under this chapter.
2.26 	(f) A CEMT may not provide services as defined in section 144A.471, subdivisions 6 
2.27 	and 7, except a CEMT may provide verbal or visual reminders to the patient to:
2.28 	(1) take a regularly scheduled medication, but not to provide or bring the patient 
2.29 	medication; and
2.30 	(2) follow regularly scheduled treatment or exercise plans.

3.1 	Sec. 3. Minnesota Statutes 2018, section 256B.0625, subdivision 3b, is amended to read:
3.2 		Subd. 3b.Telemedicine services. (a) Medical assistance covers medically necessary 
3.3 	services and consultations delivered by a licensed health care provider via telemedicine in 
3.4 	the same manner as if the service or consultation was delivered in person. Coverage is 
3.5 	limited to three telemedicine services per enrollee per calendar week. Telemedicine services 
3.6 	shall be paid at the full allowable rate.
3.7 	(b) The commissioner shall establish criteria that a health care provider must attest to 
3.8 	in order to demonstrate the safety or efficacy of delivering a particular service via 
3.9 	telemedicine. The attestation may include that the health care provider:
3.10 	(1) has identified the categories or types of services the health care provider will provide 
3.11 	via telemedicine;
3.12 	(2) has written policies and procedures specific to telemedicine services that are regularly 
3.13 	reviewed and updated;
3.14 	(3) has policies and procedures that adequately address patient safety before, during, 
3.15 	and after the telemedicine service is rendered;
3.16 	(4) has established protocols addressing how and when to discontinue telemedicine 
3.17 	services; and
3.18 	(5) has an established quality assurance process related to telemedicine services.
3.19 	(c) As a condition of payment, a licensed health care provider must document each 
3.20 	occurrence of a health service provided by telemedicine to a medical assistance enrollee. 
3.21 	Health care service records for services provided by telemedicine must meet the requirements 
3.22 	set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:
3.23 	(1) the type of service provided by telemedicine;
3.24 	(2) the time the service began and the time the service ended, including an a.m. and p.m. 
3.25 	designation;
3.26 	(3) the licensed health care provider's basis for determining that telemedicine is an 
3.27 	appropriate and effective means for delivering the service to the enrollee;
3.28 	(4) the mode of transmission of the telemedicine service and records evidencing that a 
3.29 	particular mode of transmission was utilized;
3.30 	(5) the location of the originating site and the distant site;
4.1 	(6) if the claim for payment is based on a physician's telemedicine consultation with 
4.2 	another physician, the written opinion from the consulting physician providing the 
4.3 	telemedicine consultation; and
4.4 	(7) compliance with the criteria attested to by the health care provider in accordance 
4.5 	with paragraph (b).
4.6 	(d) For purposes of this subdivision, unless otherwise covered under this chapter, 
4.7 	"telemedicine" is defined as the delivery of health care services or consultations while the 
4.8 	patient is at an originating site and the licensed health care provider is at a distant site. A 
4.9 	communication between licensed health care providers, or a licensed health care provider 
4.10 	and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission 
4.11 	does not constitute telemedicine consultations or services. Telemedicine may be provided 
4.12 	by means of real-time two-way, interactive audio and visual communications, including the 
4.13 	application of secure video conferencing or store-and-forward technology to provide or 
4.14 	support health care delivery, which facilitate the assessment, diagnosis, consultation, 
4.15 	treatment, education, and care management of a patient's health care.
4.16 	(e) For purposes of this section, "licensed health care provider" means a licensed health 
4.17 	care provider under section 62A.671, subdivision 6, and a community paramedic as defined 
4.18 	under section 144E.001, subdivision 5f, or a mental health practitioner defined under section 
4.19 	245.462, subdivision 17, or 245.4871, subdivision 26, working under the general supervision 
4.20 	of a mental health professional; "health care provider" is defined under section 62A.671, 
4.21 	subdivision 3; and "originating site" is defined under section 62A.671, subdivision 7.

4.22 	Sec. 4. Minnesota Statutes 2018, section 256B.0625, subdivision 60a, is amended to read:
4.23 		Subd. 60a.Community medical response emergency medical technician services. (a) 
4.24 	Medical assistance covers services provided by a community medical response emergency 
4.25 	medical technician (CEMT) who is certified under section 144E.275, subdivision 7, when 
4.26 	the services are provided in accordance with this subdivision.
4.27 	(b) A CEMT may provide a postdischarge visit, after discharge from a hospital or skilled 
4.28 	nursing facility, when ordered by a treating physician. The postdischarge visit includes:
4.29 	(1) verbal or visual reminders of discharge orders;
4.30 	(2) recording and reporting of vital signs to the patient's primary care provider;
4.31 	(3) medication access confirmation;
4.32 	(4) food access confirmation; and
5.1 	(5) identification of home hazards.
5.2 	(c) An individual who has repeat ambulance calls due to falls or has been identified by 
5.3 	the individual's primary care provider as at risk for nursing home placement, may receive 
5.4 	a safety evaluation visit from a CEMT when ordered by a primary care provider in accordance 
5.5 	with the individual's care plan. A safety evaluation visit includes:
5.6 	(1) medication access confirmation;
5.7 	(2) food access confirmation; and
5.8 	(3) identification of home hazards.
5.9 	(d) A CEMT shall be paid at $9.75 per 15-minute increment. A safety evaluation visit 
5.10 	may not be billed for the same day as a postdischarge visit for the same individual.