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HF 1440

5th Engrossment - 90th Legislature (2017 - 2018) Posted on 05/15/2018 10:28am

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Current Version - 5th Engrossment

A bill for an act
relating to health; establishing the Opioid Addiction Prevention and Treatment
Advisory Council; establishing the opioid addiction prevention and treatment
account; modifying substance use disorder treatment provider requirements;
modifying provisions related to opioid addiction prevention, education, research,
intervention, treatment, and recovery; appropriating money; requiring reports;
amending Minnesota Statutes 2016, sections 145.9269, subdivision 1; 151.01,
subdivision 27; 151.214, subdivision 2; 151.37, subdivision 12; 151.71, by adding
a subdivision; 152.11, subdivision 2d, by adding subdivisions; 214.12, by adding
a subdivision; 256B.0625, subdivision 13e; Minnesota Statutes 2017 Supplement,
sections 120B.021, subdivision 1; 152.105, subdivision 2; 245G.05, subdivision
1; 254A.03, subdivision 3; 254B.12, subdivision 3; proposing coding for new law
in Minnesota Statutes, chapters 120B; 145; 151.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

OPIOID ADDICTION ADVISORY COUNCIL AND ACCOUNT

Section 1.

[151.255] OPIOID ADDICTION PREVENTION AND TREATMENT
ADVISORY COUNCIL.

Subdivision 1.

Establishment of advisory council.

(a) The Opioid Addiction Prevention
and Treatment Advisory Council is established to confront the opioid addiction and overdose
epidemic in this state and focus on:

(1) prevention and education, including public education and awareness for adults and
youth, prescriber education, and the development and sustainability of substance use disorder
programs;

(2) the expansion and enhancement of a continuum of care for opioid-related substance
use disorders, including primary prevention, early intervention, treatment, and recovery
services;

(3) training on the treatment of opioid addiction, including the use of all FDA-approved
opioid addiction medications, detoxification, relapse prevention, patient assessment,
individual treatment planning, counseling, recovery supports, diversion control, and other
best practices; and

(4) services to ensure overdose prevention as well as public safety and community
well-being, including expanding access to FDA-approved opioid addiction medications and
providing social services to families affected by the opioid overdose epidemic.

(b) The council shall:

(1) review local, state, and federal initiatives and activities related to education,
prevention, and services for individuals and families experiencing and affected by opioid
addiction;

(2) establish priorities and actions to address the state's opioid epidemic for the purpose
of allocating funds;

(3) ensure optimal allocation of available funding and alignment of existing state and
federal funding to achieve the greatest impact and ensure a coordinated state effort;

(4) develop criteria and procedures to be used in awarding grants and allocating available
funds from the opioid addiction prevention and treatment account; and

(5) develop measurable outcomes to determine the effectiveness of the funds allocated.

(c) The council shall make recommendations on grant and funding options for the funds
annually appropriated to the commissioner of human services from the opioid addiction
prevention and treatment account. The options for funding may include, but are not limited
to: prescriber education; the development and sustainability of prevention programs; the
creation of a continuum of care for opioid-related substance abuse disorders, including
primary prevention, early intervention, treatment, and recovery services; and additional
funding for child protection case management services for children and families affected
by opioid addiction. The council shall submit recommendations for funding options to the
commissioner of human services and to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and finance
by March 1 of each year, beginning March 1, 2019.

Subd. 2.

Membership.

(a) The council shall consist of 21 members appointed by the
commissioner of human services, except as otherwise specified:

(1) two members of the house of representatives, one from the majority party appointed
by the speaker of the house and one from the minority party appointed by the minority
leader of the house of representatives;

(2) two members of the senate, one from the majority party appointed by the senate
majority leader and one from the minority party appointed by the senate minority leader;

(3) one member appointed by the Board of Pharmacy;

(4) one member who is a medical doctor appointed by the Minnesota chapter of the
American College of Emergency Physicians;

(5) one member representing programs licensed under chapter 245G that specialize in
serving people with opioid use disorders;

(6) one member representing the National Alliance on Mental Illness (NAMI);

(7) one member who is a medical doctor appointed by the Minnesota Society of Addiction
Medicine;

(8) one member representing professionals providing alternative pain management
therapies;

(9) the commissioner of education or a designee;

(10) one member appointed by the Minnesota Ambulance Association;

(11) one member representing the Minnesota courts who is a judge or law enforcement
officer;

(12) one member representing the Minnesota Hospital Association;

(13) one member representing an Indian tribe;

(14) the commissioner of human services or a designee;

(15) the commissioner of corrections or a designee;

(16) one advanced practice registered nurse appointed by the Board of Nursing;

(17) the commissioner of health or a designee;

(18) one member representing a local health department; and

(19) one member representing a nonprofit entity specializing in providing support to
persons recovering from substance use disorder.

(b) The commissioner shall coordinate appointments to provide geographic diversity
and shall ensure that at least one-half of council members reside outside of the seven-county
metropolitan area.

(c) The council is governed by section 15.059, except that members of the council shall
receive no compensation other than reimbursement for expenses. Notwithstanding section
15.059, subdivision 6, the council shall not expire.

(d) The chair shall convene the council semiannually, and may convene other meetings
as necessary. The chair shall convene meetings at different locations in the state to provide
geographic access and shall ensure that at least one-half of the meetings are held at locations
outside of the seven-county metropolitan area.

(e) The commissioner of human services shall provide staff and administrative services
for the advisory council.

(f) The council is subject to chapter 13D.

Sec. 2.

[151.256] OPIOID ADDICTION PREVENTION AND TREATMENT
ACCOUNT.

Subdivision 1.

Establishment.

The opioid addiction prevention and treatment account
is established in the special revenue fund in the state treasury. All state appropriations to
the account, and any federal funds or grant dollars received for the prevention and treatment
of opioid addiction, shall be deposited into the account.

Subd. 2.

Use of account funds.

(a) For fiscal year 2019, money in the account is
appropriated as provided in this act.

(b) For fiscal year 2020 and subsequent fiscal years, money in the opioid addiction
prevention and treatment account is appropriated to the commissioner of human services,
to be awarded, in consultation with the Opioid Addiction Prevention and Treatment Advisory
Council, as grants or as other funding as determined appropriate to address the opioid
epidemic in the state. Grants or other funding may be provided to continue or expand
initiatives funded by this act for fiscal year 2019. Each recipient of grants or funding shall
report to the commissioner and the advisory council on how the funds were spent and the
outcomes achieved, in the form and manner specified by the commissioner.

Subd. 3.

Annual report.

Beginning December 1, 2019, and each December 1 thereafter,
the commissioner, in consultation with the Opioid Addiction Prevention and Treatment
Advisory Council, shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services policy and finance on the
grants and funds awarded under this section and the outcomes achieved. Each report must
also identify those instances for which the commissioner did not follow the recommendations
of the advisory council and the commissioner's rationale for taking this action.

Sec. 3. ADVISORY COUNCIL FIRST MEETING.

The commissioner of human services shall convene the first meeting of the Opioid
Addiction Prevention and Treatment Advisory Council established under Minnesota Statutes,
section 151.255, no later than October 1, 2018. The members shall elect a chair at the first
meeting.

ARTICLE 2

PROVIDER AND OTHER REQUIREMENTS

Section 1.

Minnesota Statutes 2016, section 151.214, subdivision 2, is amended to read:


Subd. 2.

No prohibition on disclosure.

No contracting agreement between an
employer-sponsored health plan or health plan company, or its contracted pharmacy benefit
manager, and a resident or nonresident pharmacy registered licensed under this chapter,
may prohibit the:

(1) a pharmacy from disclosing to patients information a pharmacy is required or given
the option to provide under subdivision 1; or

(2) a pharmacist from informing a patient when the amount the patient is required to
pay under the patient's health plan for a particular drug is greater than the amount the patient
would be required to pay for the same drug if purchased out-of-pocket at the pharmacy's
usual and customary price
.

Sec. 2.

Minnesota Statutes 2016, section 151.71, is amended by adding a subdivision to
read:


Subd. 3.

Lowest cost to consumers.

(a) A health plan company or pharmacy benefits
manager shall not require an individual to make a payment at the point of sale for a covered
prescription medication in an amount greater than the allowable cost to consumers, as
defined in paragraph (b).

(b) For purposes of paragraph (a), "allowable cost to consumers" means the lowest of:
(1) the applicable co-payment for the prescription medication; or (2) the amount an individual
would pay for the prescription medication if the individual purchased the prescription
medication without using a health plan benefit.

Sec. 3.

Minnesota Statutes 2017 Supplement, section 245G.05, subdivision 1, is amended
to read:


Subdivision 1.

Comprehensive assessment.

(a) A comprehensive assessment of the
client's substance use disorder must be administered face-to-face by an alcohol and drug
counselor within three calendar days after service initiation for a residential program or
during the initial session for all other programs. A program may permit a licensed staff
person who is not qualified as an alcohol and drug counselor to interview the client in areas
of the comprehensive assessment that are otherwise within the competencies and scope of
practice of that licensed staff person and an alcohol and drug counselor does not need to be
face-to-face with the client during this interview. The alcohol and drug counselor must
review all of the information contained in a comprehensive assessment and, by signature,
confirm the information is accurate and complete and meets the requirements for the
comprehensive assessment.
If the comprehensive assessment is not completed during the
initial session, the client-centered reason for the delay must be documented in the client's
file and the planned completion date. If the client received a comprehensive assessment that
authorized the treatment service, an alcohol and drug counselor must review the assessment
to determine compliance with this subdivision, including applicable timelines. If available,
the alcohol and drug counselor may use current information provided by a referring agency
or other source as a supplement. Information gathered more than 45 days before the date
of admission is not considered current. The comprehensive assessment must include sufficient
information to complete the assessment summary according to subdivision 2 and the
individual treatment plan according to section 245G.06. The comprehensive assessment
must include information about the client's needs that relate to substance use and personal
strengths that support recovery, including:

(1) age, sex, cultural background, sexual orientation, living situation, economic status,
and level of education;

(2) circumstances of service initiation;

(3) previous attempts at treatment for substance misuse or substance use disorder,
compulsive gambling, or mental illness;

(4) substance use history including amounts and types of substances used, frequency
and duration of use, periods of abstinence, and circumstances of relapse, if any. For each
substance used within the previous 30 days, the information must include the date of the
most recent use and previous withdrawal symptoms;

(5) specific problem behaviors exhibited by the client when under the influence of
substances;

(6) family status, family history, including history or presence of physical or sexual
abuse, level of family support, and substance misuse or substance use disorder of a family
member or significant other;

(7) physical concerns or diagnoses, the severity of the concerns, and whether the concerns
are being addressed by a health care professional;

(8) mental health history and psychiatric status, including symptoms, disability, current
treatment supports, and psychotropic medication needed to maintain stability; the assessment
must utilize screening tools approved by the commissioner pursuant to section 245.4863 to
identify whether the client screens positive for co-occurring disorders;

(9) arrests and legal interventions related to substance use;

(10) ability to function appropriately in work and educational settings;

(11) ability to understand written treatment materials, including rules and the client's
rights;

(12) risk-taking behavior, including behavior that puts the client at risk of exposure to
blood-borne or sexually transmitted diseases;

(13) social network in relation to expected support for recovery and leisure time activities
that are associated with substance use;

(14) whether the client is pregnant and, if so, the health of the unborn child and the
client's current involvement in prenatal care;

(15) whether the client recognizes problems related to substance use and is willing to
follow treatment recommendations; and

(16) collateral information. If the assessor gathered sufficient information from the
referral source or the client to apply the criteria in Minnesota Rules, parts 9530.6620 and
9530.6622, a collateral contact is not required.

(b) If the client is identified as having opioid use disorder or seeking treatment for opioid
use disorder, the program must provide educational information to the client concerning:

(1) risks for opioid use disorder and dependence;

(2) treatment options, including the use of a medication for opioid use disorder;

(3) the risk of and recognizing opioid overdose; and

(4) the use, availability, and administration of naloxone to respond to opioid overdose.

(c) The commissioner shall develop educational materials that are supported by research
and updated periodically. The license holder must use the educational materials that are
approved by the commissioner to comply with this requirement.

(d) If the comprehensive assessment is completed to authorize treatment service for the
client, at the earliest opportunity during the assessment interview the assessor shall determine
if:

(1) the client is in severe withdrawal and likely to be a danger to self or others;

(2) the client has severe medical problems that require immediate attention; or

(3) the client has severe emotional or behavioral symptoms that place the client or others
at risk of harm.

If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the
assessment interview and follow the procedures in the program's medical services plan
under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The
assessment interview may resume when the condition is resolved.

Sec. 4.

Minnesota Statutes 2017 Supplement, section 254A.03, subdivision 3, is amended
to read:


Subd. 3.

Rules for substance use disorder care.

(a) The commissioner of human
services shall establish by rule criteria to be used in determining the appropriate level of
chemical dependency care for each recipient of public assistance seeking treatment for
substance misuse or substance use disorder. Upon federal approval of a comprehensive
assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding
the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of
comprehensive assessments under section 254B.05 may determine and approve the
appropriate level of substance use disorder treatment for a recipient of public assistance.
The process for determining an individual's financial eligibility for the consolidated chemical
dependency treatment fund or determining an individual's enrollment in or eligibility for a
publicly subsidized health plan is not affected by the individual's choice to access a
comprehensive assessment for placement.

(b) The commissioner shall develop and implement a utilization review process for
publicly funded treatment placements to monitor and review the clinical appropriateness
and timeliness of all publicly funded placements in treatment.

(c) Notwithstanding section 254B.05, subdivision 5, paragraph (b), clause (2), an
individual employed by a county on July 1, 2018, who has been performing assessments
for the purpose of Minnesota Rules, part 9530.6615, is qualified to perform a comprehensive
assessment if the following conditions are met as of July 1, 2018:

(1) the individual is exempt from licensure under section 148F.11, subdivision 1;

(2) the individual is qualified as an assessor under Minnesota Rules, part 9530.6615,
subpart 2; and

(3) the individual has three years employment as an assessor or is under the supervision
of an individual who meets the requirements of an alcohol and drug counselor supervisor
under section 245G.11, subdivision 4.

After June 30, 2020, an individual qualified to do a comprehensive assessment under
this paragraph must additionally demonstrate completion of the applicable coursework
requirements of section 245G.11, subdivision 5, paragraph (b).

ARTICLE 3

PREVENTION, EDUCATION, AND RESEARCH

Section 1.

Minnesota Statutes 2017 Supplement, section 120B.021, subdivision 1, is
amended to read:


Subdivision 1.

Required academic standards.

(a) The following subject areas are
required for statewide accountability:

(1) language arts;

(2) mathematics;

(3) science;

(4) social studies, including history, geography, economics, and government and
citizenship that includes civics consistent with section 120B.02, subdivision 3;

(5) physical education;

(6) health, for which locally developed academic standards apply, consistent with
paragraph (e)
; and

(7) the arts, for which statewide or locally developed academic standards apply, as
determined by the school district. Public elementary and middle schools must offer at least
three and require at least two of the following four arts areas: dance; music; theater; and
visual arts. Public high schools must offer at least three and require at least one of the
following five arts areas: media arts; dance; music; theater; and visual arts.

(b) For purposes of applicable federal law, the academic standards for language arts,
mathematics, and science apply to all public school students, except the very few students
with extreme cognitive or physical impairments for whom an individualized education
program team has determined that the required academic standards are inappropriate. An
individualized education program team that makes this determination must establish
alternative standards.

(c) The department must adopt the most recent SHAPE America (Society of Health and
Physical Educators) kindergarten through grade 12 standards and benchmarks for physical
education as the required physical education academic standards. The department may
modify and adapt the national standards to accommodate state interest. The modification
and adaptations must maintain the purpose and integrity of the national standards. The
department must make available sample assessments, which school districts may use as an
alternative to local assessments, to assess students' mastery of the physical education
standards beginning in the 2018-2019 school year.

(d) A school district may include child sexual abuse prevention instruction in a health
curriculum, consistent with paragraph (a), clause (6). Child sexual abuse prevention
instruction may include age-appropriate instruction on recognizing sexual abuse and assault,
boundary violations, and ways offenders groom or desensitize victims, as well as strategies
to promote disclosure, reduce self-blame, and mobilize bystanders. A school district may
provide instruction under this paragraph in a variety of ways, including at an annual assembly
or classroom presentation. A school district may also provide parents information on the
warning signs of child sexual abuse and available resources.

(e) A school district must include instruction in a health curriculum for students in grades
5, 6, 8, 10, and 12 on substance misuse prevention, including opioids; controlled substances
as defined in section 152.01, subdivision 4; prescription and nonprescription medications;
and illegal drugs. A school district is not required to use a specific methodology or
curriculum.

(e) (f) District efforts to develop, implement, or improve instruction or curriculum as a
result of the provisions of this section must be consistent with sections 120B.10, 120B.11,
and 120B.20.

EFFECTIVE DATE.

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

Sec. 2.

[120B.215] SUBSTANCE MISUSE PREVENTION.

(a) This section may be cited as "Jake's Law."

(b) School districts and charter schools are encouraged to provide substance misuse
prevention instruction for students in grades 5 through 12 integrated into existing programs,
curriculum, or the general school environment of a district or charter school. The
commissioner of education, in consultation with the director of the Alcohol and Other Drug
Abuse Section under section 254A.03 and substance misuse prevention and treatment
organizations, must, upon request, provide districts and charter schools with:

(1) information regarding substance misuse prevention services; and

(2) assistance in using Minnesota student survey results to inform prevention programs.

EFFECTIVE DATE.

This section is effective July 1, 2018.

Sec. 3.

[151.72] VOLUNTARY NONOPIOID DIRECTIVE.

Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply.

(b) "Board" means the Board of Pharmacy.

(c) "Opioid" means any product containing opium or opiates listed in section 152.02,
subdivision 3, paragraphs (b) and (c); any product containing narcotics listed in section
152.02, subdivision 4, paragraphs (e) and (h); or any product containing narcotic drugs
listed in section 152.02, subdivision 5, paragraph (b), other than products containing
difenoxin or eluxadoline.

Subd. 2.

Execution of directive.

(a) An individual who is 18 years of age or older or
an emancipated minor, a parent or legal guardian of a minor, or an individual's guardian or
other person appointed by the individual or the court to manage the individual's health care
may execute a voluntary nonopioid directive instructing health care providers that an opioid
may not be administered or prescribed to the individual or the minor. The directive must
be in the format prescribed by the board. The person executing the directive may submit
the directive to a health care provider or hospital.

(b) An individual executing a directive may revoke the directive at any time in writing
or orally.

Subd. 3.

Duties of the board.

(a) The board shall adopt rules establishing guidelines to
govern the use of voluntary nonopioid health care directives. The guidelines must:

(1) include verification by a health care provider and comply with the written consent
requirements under United States Code, title 42, section 290dd-2(b);

(2) specify standard procedures for the person executing a directive to use when
submitting the directive to a health care provider or hospital;

(3) specify procedures to include the directive in the individual's medical record or
interoperable electronic health record, and to submit the directive to the prescription
monitoring program database;

(4) specify procedures to modify, override, or revoke a directive;

(5) include exemptions for the administration of naloxone or other opioid overdose drugs
in an emergency situation;

(6) ensure the confidentiality of a voluntary nonopioid directive; and

(7) ensure exemptions for an opioid used to treat substance abuse or opioid dependence.

Subd. 4.

Exemption from liability.

(a) A health care provider, a hospital, or an employee
of a health care provider or hospital may not be subject to disciplinary action by the health
care provider's or employee's professional licensing board or held civilly or criminally liable
for failure to administer, prescribe, or dispense an opioid, or for inadvertent administration
of an opioid, to an individual or minor who has a voluntary nonopioid directive.

(b) A prescription presented to a pharmacy is presumed to be valid, and a pharmacist
may not be subject to disciplinary action by the pharmacist's professional licensing board
or held civilly or criminally liable for dispensing an opioid in contradiction to an individual's
or minor's voluntary nonopioid directive.

Subd. 5.

Construction.

Nothing in this section shall be construed to:

(1) alter a health care directive under chapter 145C;

(2) limit the prescribing, dispensing, or administering of an opioid overdose drug; or

(3) limit an authorized health care provider or pharmacist from prescribing, dispensing,
or administering an opioid for the treatment of substance abuse or opioid dependence.

Sec. 4.

Minnesota Statutes 2017 Supplement, section 152.105, subdivision 2, is amended
to read:


Subd. 2.

Sheriff to maintain collection receptacle.

The sheriff of each county shall
maintain or contract for the maintenance of at least one collection receptacle for the disposal
of noncontrolled substances, pharmaceutical controlled substances, and other legend drugs,
as permitted by federal law. For purposes of this section, "legend drug" has the meaning
given in section 151.01, subdivision 17. The collection receptacle must comply with federal
law. In maintaining and operating the collection receptacle, the sheriff shall follow all
applicable provisions of Code of Federal Regulations, title 21, parts 1300, 1301, 1304, 1305,
1307, and 1317, as amended through May 1, 2017. The sheriff of each county may meet
the requirements of this subdivision though the use of an alternative method for the disposal
of noncontrolled substances, pharmaceutical controlled substances, and other legend drugs
that has been approved by the Board of Pharmacy. This may include making available to
the public, without charge, at-home prescription drug deactivation and disposal products
that render drugs and medications inert and irretrievable.

Sec. 5.

Minnesota Statutes 2016, section 152.11, subdivision 2d, is amended to read:


Subd. 2d.

Identification requirement for Schedule II or III controlled substance
prescriptions.

(a) No person may dispense a controlled substance included in Schedule II
or III
Schedules II through V without requiring the person purchasing the controlled
substance, who need not be the person patient for whom the controlled substance prescription
is written, to present valid photographic identification, unless the person purchasing the
controlled substance, or if applicable the person for whom the controlled substance
prescription is written,
is known to the dispenser. A doctor of veterinary medicine who
dispenses a controlled substance must comply with this subdivision.

(b) This subdivision applies only to purchases of controlled substances that are not
covered, in whole or in part, by a health plan company or other third-party payor.

Sec. 6.

Minnesota Statutes 2016, section 152.11, is amended by adding a subdivision to
read:


Subd. 5.

Limitations on the dispensing of opioid prescription drug orders.

(a) No
prescription drug order for an opioid drug listed in Schedule II may be dispensed by a
pharmacist or other dispenser more than 30 days after the date on which the prescription
drug order was issued.

(b) No prescription drug order for an opioid drug listed in Schedules III through V may
be initially dispensed by a pharmacist or other dispenser more than 30 days after the date
on which the prescription drug order was issued. No prescription drug order for an opioid
drug listed in Schedules III through V may be refilled by a pharmacist or other dispenser
more than 30 days after the previous date on which it was dispensed.

(c) For purposes of this section, "dispenser" has the meaning given in section 152.126,
subdivision 1.

Sec. 7.

Minnesota Statutes 2016, section 152.11, is amended by adding a subdivision to
read:


Subd. 6.

Limit on quantity of opiates prescribed for acute pain associated with a
major trauma or surgical procedure.

(a) When used for the treatment of acute pain
associated with a major trauma or surgical procedure, initial prescriptions for opiate or
narcotic pain relievers listed in Schedules II through IV of section 152.02 shall not exceed
a seven-day supply. The quantity prescribed shall be consistent with the dosage listed in
the professional labeling for the drug that has been approved by the United States Food and
Drug Administration.

(b) For the purposes of this subdivision, "acute pain" means pain resulting from disease,
accidental or intentional trauma, surgery, or another cause that the practitioner reasonably
expects to last only a short period of time. Acute pain does not include chronic pain or pain
being treated as part of cancer care, palliative care, or hospice or other end-of-life care.

(c) Notwithstanding paragraph (a), if in the professional clinical judgment of a practitioner
more than a seven-day supply of a prescription listed in Schedules II through IV of section
152.02 is required to treat a patient's acute pain, the practitioner may issue a prescription
for the quantity needed to treat such acute pain.

(d) This subdivision does not apply to the treatment of acute dental pain or acute pain
associated with refractive surgery, and the quantity of opiates that may be prescribed for
those conditions is governed by subdivision 4.

Sec. 8.

Minnesota Statutes 2016, section 214.12, is amended by adding a subdivision to
read:


Subd. 6.

Opioid and controlled substances prescribing.

(a) The Board of Medical
Practice, the Board of Nursing, the Board of Dentistry, the Board of Optometry, and the
Board of Podiatric Medicine shall require that licensees with the authority to prescribe
controlled substances obtain at least two hours of continuing education credit on best practices
in prescribing opioids and controlled substances, as part of the continuing education
requirements for licensure renewal. Licensees shall not be required to complete more than
two credit hours of continuing education on best practices in prescribing opioids and
controlled substances before this subdivision expires. Continuing education credit on best
practices in prescribing opioids and controlled substances must meet board requirements.

(b) This subdivision expires January 1, 2023.

EFFECTIVE DATE.

This section is effective January 1, 2019.

ARTICLE 4

INTERVENTION, TREATMENT, AND RECOVERY

Section 1.

Minnesota Statutes 2016, section 145.9269, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

For purposes of this section and section 145.9272, "federally
qualified health center" means an entity that is receiving a grant under United States Code,
title 42, section 254b, or, based on the recommendation of the Health Resources and Services
Administration within the Public Health Service, is determined by the secretary to meet the
requirements for receiving such a grant.

Sec. 2.

[145.9272] FEDERALLY QUALIFIED HEALTH CENTERS; GRANTS FOR
INTEGRATED COMMUNITY-BASED OPIOID ADDICTION AND SUBSTANCE
USE DISORDER TREATMENT, RECOVERY, AND PREVENTION PROGRAMS.

Subdivision 1.

Grant program established.

The commissioner of health shall distribute
grants to federally qualified health centers operating in Minnesota as of January 1, 2018,
for integrated, community-based programs in primary care settings to treat, prevent, and
raise awareness of opioid addiction and substance use disorders.

Subd. 2.

Grant allocation.

(a) For each grant cycle, the commissioner shall allocate
grants to federally qualified health centers operating in Minnesota as of January 1, 2018,
through a competitive process and according to the following guidelines:

(1) 25 percent of the funds shall be for federally qualified health centers to establish new
opioid addiction and substance use disorder programs;

(2) 70 percent of the funds shall be for federally qualified health centers with existing
opioid addiction and substance use disorder programs to expand these programs to serve
additional low-income patients; and

(3) five percent of the funds shall be for federally qualified health centers to invest in
network infrastructure and evaluation activities, to identify and document successful opioid
addiction and substance use disorder prevention and treatment strategies for rural or
underserved populations.

(b) The commissioner shall ensure, for each grant cycle, that at least 30 percent of the
funds are allocated to federally qualified health centers in the state located outside the
seven-county metropolitan area and that each federally qualified health center in the state
is allocated at least three percent of the total amount available for that grant cycle.

(c) The commissioner shall consult with a state organization representing Minnesota's
community health centers to assess and classify the levels of substance use disorder services
and programs available at federally qualified health centers in the state as of July 1, 2018,
and to develop measures for federally qualified health centers to use in assessing the
effectiveness of substance use disorder programs funded under this section in supporting
sobriety and long-term recovery, stopping cycles of intergenerational substance use, enabling
patients to return to work or school, and supporting family unity.

Subd. 3.

Allowable uses for grant funds.

In establishing a new opioid addiction and
substance use disorder program or expanding an existing program, a federally qualified
health center must use grant funds distributed under this section for one or more of the
following activities:

(1) integrating behavioral health services and substance use disorder services on-site at
the federally qualified health center or off-site through partnerships with other providers;

(2) establishing or expanding programs in which patients with substance use disorders
receive services using integrated, interprofessional care teams;

(3) implementing or expanding patient care coordination, outreach, and education services
related to substance use disorders;

(4) implementing or expanding medication assisted treatment by providing, directly or
by referral, all drugs approved by the Food and Drug Administration for the treatment of
opioid use disorder, including maintenance, detoxification, overdose reversal, and relapse
prevention;

(5) implementing and evaluating specific, effective substance use disorder interventions
tailored to specific populations, including but not limited to communities of color, individuals
experiencing homelessness, veterans, and adolescents;

(6) developing infrastructure, including infrastructure to allow for telehealth services,
for federally qualified health center networks to support coordinated interventions across
delivery systems; and

(7) training current and future health care professionals and students, including dental
providers.

Subd. 4.

Reports.

After the conclusion of each grant cycle, each federally qualified
health center shall report to the commissioner, at a time and in a manner specified by the
commissioner, data regarding the effectiveness measures developed under subdivision 2.
The commissioner shall compile this information into a report for each grant cycle and shall
provide the report to the chairs and ranking minority members of the legislative committees
with jurisdiction over health care.

Sec. 3.

Minnesota Statutes 2016, section 151.01, subdivision 27, is amended to read:


Subd. 27.

Practice of pharmacy.

"Practice of pharmacy" means:

(1) interpretation and evaluation of prescription drug orders;

(2) compounding, labeling, and dispensing drugs and devices (except labeling by a
manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
and devices);

(3) participation in clinical interpretations and monitoring of drug therapy for assurance
of safe and effective use of drugs, including the performance of laboratory tests that are
waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code,
title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory
tests but may modify drug therapy only pursuant to a protocol or collaborative practice
agreement;

(4) participation in drug and therapeutic device selection; drug administration for first
dosage, injectable or implantable medications to treat substance use disorders, and medical
emergencies; drug regimen reviews; and drug or drug-related research;

(5) participation in administration of influenza vaccines to all eligible individuals six
years of age and older and all other vaccines to patients 13 years of age and older by written
protocol with a physician licensed under chapter 147, a physician assistant authorized to
prescribe drugs under chapter 147A, or an advanced practice registered nurse authorized to
prescribe drugs under section 148.235, provided that:

(i) the protocol includes, at a minimum:

(A) the name, dose, and route of each vaccine that may be given;

(B) the patient population for whom the vaccine may be given;

(C) contraindications and precautions to the vaccine;

(D) the procedure for handling an adverse reaction;

(E) the name, signature, and address of the physician, physician assistant, or advanced
practice registered nurse;

(F) a telephone number at which the physician, physician assistant, or advanced practice
registered nurse can be contacted; and

(G) the date and time period for which the protocol is valid;

(ii) the pharmacist has successfully completed a program approved by the Accreditation
Council for Pharmacy Education specifically for the administration of immunizations or a
program approved by the board;

(iii) the pharmacist utilizes the Minnesota Immunization Information Connection to
assess the immunization status of individuals prior to the administration of vaccines, except
when administering influenza vaccines to individuals age nine and older;

(iv) the pharmacist reports the administration of the immunization to the Minnesota
Immunization Information Connection; and

(v) the pharmacist complies with guidelines for vaccines and immunizations established
by the federal Advisory Committee on Immunization Practices, except that a pharmacist
does not need to comply with those portions of the guidelines that establish immunization
schedules when administering a vaccine pursuant to a valid, patient-specific order issued
by a physician licensed under chapter 147, a physician assistant authorized to prescribe
drugs under chapter 147A, or an advanced practice nurse authorized to prescribe drugs
under section 148.235, provided that the order is consistent with the United States Food
and Drug Administration approved labeling of the vaccine;

(6) participation in the initiation, management, modification, and discontinuation of
drug therapy according to a written protocol or collaborative practice agreement between:
(i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists,
or veterinarians; or (ii) one or more pharmacists and one or more physician assistants
authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice
nurses authorized to prescribe, dispense, and administer under section 148.235. Any changes
in drug therapy made pursuant to a protocol or collaborative practice agreement must be
documented by the pharmacist in the patient's medical record or reported by the pharmacist
to a practitioner responsible for the patient's care;

(7) participation in the storage of drugs and the maintenance of records;

(8) patient counseling on therapeutic values, content, hazards, and uses of drugs and
devices;

(9) offering or performing those acts, services, operations, or transactions necessary in
the conduct, operation, management, and control of a pharmacy; and

(10) participation in the initiation, management, modification, and discontinuation of
therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:

(i) a written protocol as allowed under clause (6); or

(ii) a written protocol with a community health board medical consultant or a practitioner
designated by the commissioner of health, as allowed under section 151.37, subdivision 13.

Sec. 4.

Minnesota Statutes 2016, section 151.37, subdivision 12, is amended to read:


Subd. 12.

Administration of opiate antagonists for drug overdose.

(a) A licensed
physician, a licensed advanced practice registered nurse authorized to prescribe drugs
pursuant to section 148.235, or a licensed physician assistant authorized to prescribe drugs
pursuant to section 147A.18 may authorize the following individuals to administer opiate
antagonists, as defined in section 604A.04, subdivision 1:

(1) an emergency medical responder registered pursuant to section 144E.27;

(2) a peace officer as defined in section 626.84, subdivision 1, paragraphs (c) and (d);
and

(3) staff of community-based health disease prevention or social service programs.;

(4) a probation or supervised release officer; and

(5) a volunteer firefighter.

(b) For the purposes of this subdivision, opiate antagonists may be administered by one
of these individuals only if:

(1) the licensed physician, licensed physician assistant, or licensed advanced practice
registered nurse has issued a standing order to, or entered into a protocol with, the individual;
and

(2) the individual has training in the recognition of signs of opiate overdose and the use
of opiate antagonists as part of the emergency response to opiate overdose.

(c) Nothing in this section prohibits the possession and administration of naloxone
pursuant to section 604A.04.

Sec. 5.

Minnesota Statutes 2017 Supplement, section 254B.12, subdivision 3, is amended
to read:


Subd. 3.

Chemical dependency provider rate increase.

For the chemical dependency
services listed in section 254B.05, subdivision 5, and provided on or after July 1, 2017 2018,
payment rates shall be increased by one percent a percentage established by the
commissioner, based on the available appropriation,
over the rates in effect on January 1,
2017 2018, for vendors who meet the requirements of section 254B.05.

Sec. 6.

Minnesota Statutes 2016, section 256B.0625, subdivision 13e, is amended to read:


Subd. 13e.

Payment rates.

(a) The basis for determining the amount of payment shall
be the lower of the actual acquisition costs of the drugs or the maximum allowable cost by
the commissioner plus the fixed dispensing fee; or the usual and customary price charged
to the public. The amount of payment basis must be reduced to reflect all discount amounts
applied to the charge by any provider/insurer agreement or contract for submitted charges
to medical assistance programs. The net submitted charge may not be greater than the patient
liability for the service. The pharmacy dispensing fee shall be $3.65 for legend prescription
drugs, except that the dispensing fee for intravenous solutions which must be compounded
by the pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and
$30 per bag for total parenteral nutritional products dispensed in one liter quantities, or $44
per bag for total parenteral nutritional products dispensed in quantities greater than one liter.
The pharmacy dispensing fee for over-the-counter drugs shall be $3.65, except that the fee
shall be $1.31 for retrospectively billing pharmacies when billing for quantities less than
the number of units contained in the manufacturer's original package. Actual acquisition
cost includes quantity and other special discounts except time and cash discounts. The actual
acquisition cost of a drug shall be estimated by the commissioner at wholesale acquisition
cost plus four percent for independently owned pharmacies located in a designated rural
area within Minnesota, and at wholesale acquisition cost plus two percent for all other
pharmacies. A pharmacy is "independently owned" if it is one of four or fewer pharmacies
under the same ownership nationally. A "designated rural area" means an area defined as
a small rural area or isolated rural area according to the four-category classification of the
Rural Urban Commuting Area system developed for the United States Health Resources
and Services Administration. Effective January 1, 2014, the actual acquisition cost of a drug
acquired through the federal 340B Drug Pricing Program shall be estimated by the
commissioner at wholesale acquisition cost minus 40 percent. Wholesale acquisition cost
is defined as the manufacturer's list price for a drug or biological to wholesalers or direct
purchasers in the United States, not including prompt pay or other discounts, rebates, or
reductions in price, for the most recent month for which information is available, as reported
in wholesale price guides or other publications of drug or biological pricing data. The
maximum allowable cost of a multisource drug may be set by the commissioner and it shall
be comparable to, but no higher than, the maximum amount paid by other third-party payors
in this state who have maximum allowable cost programs. Establishment of the amount of
payment for drugs shall not be subject to the requirements of the Administrative Procedure
Act.

(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
an automated drug distribution system meeting the requirements of section 151.58, or a
packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents. A
retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.

(c) An additional dispensing fee of $.30 may be added to the dispensing fee paid to
pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities
when a unit dose blister card system, approved by the department, is used. Under this type
of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National
Drug Code (NDC) from the drug container used to fill the blister card must be identified
on the claim to the department. The unit dose blister card containing the drug must meet
the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return
of unused drugs to the pharmacy for reuse. A pharmacy provider using packaging that meets
the standards set forth in Minnesota Rules, part 6800.2700, is required to credit the
department for the actual acquisition cost of all unused drugs that are eligible for reuse,
unless the pharmacy is using retrospective billing. The commissioner may permit the drug
clozapine to be dispensed in a quantity that is less than a 30-day supply.

(d) Whenever a maximum allowable cost has been set for a multisource drug, payment
shall be the lower of the usual and customary price charged to the public or the maximum
allowable cost established by the commissioner unless prior authorization for the brand
name product has been granted according to the criteria established by the Drug Formulary
Committee as required by subdivision 13f, paragraph (a), and the prescriber has indicated
"dispense as written" on the prescription in a manner consistent with section 151.21,
subdivision 2
.

(e) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
set by the commissioner. If average sales price is unavailable, the amount of payment must
be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
Effective January 1, 2014, the commissioner shall discount the payment rate for drugs
obtained through the federal 340B Drug Pricing Program by 20 percent. With the exception
of paragraph (f),
the payment for drugs administered in an outpatient setting shall be made
to the administering facility or practitioner. A retail or specialty pharmacy dispensing a drug
for administration in an outpatient setting is not eligible for direct reimbursement.

(f) Notwithstanding paragraph (e), payment for injectable drugs used to treat substance
abuse administered by a practitioner in an outpatient setting shall be made either to the
administering facility or the practitioner, or directly to the dispensing pharmacy. The
practitioner or administering facility shall submit the claim for the drug, if the practitioner
purchases the drug directly from a wholesale distributor licensed under section 151.47 or
from a manufacturer licensed under section 151.252. The dispensing pharmacy shall submit
the claim if the pharmacy dispenses the drug pursuant to a prescription issued by the
practitioner and delivers the filled prescription to the practitioner for subsequent
administration. Payment shall be made according to this section. The administering
practitioner and pharmacy shall ensure that claims are not duplicated. A pharmacy shall not
dispense a practitioner-administered injectable drug described in this paragraph directly to
an enrollee. For purposes of this paragraph, "dispense" and "dispensing" have the meaning
provided in section 151.01, subdivision 30.

(g) The commissioner may negotiate lower reimbursement rates for specialty pharmacy
products than the rates specified in paragraph (a). The commissioner may require individuals
enrolled in the health care programs administered by the department to obtain specialty
pharmacy products from providers with whom the commissioner has negotiated lower
reimbursement rates. Specialty pharmacy products are defined as those used by a small
number of recipients or recipients with complex and chronic diseases that require expensive
and challenging drug regimens. Examples of these conditions include, but are not limited
to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, growth hormone deficiency,
Crohn's Disease, rheumatoid arthritis, and certain forms of cancer. Specialty pharmaceutical
products include injectable and infusion therapies, biotechnology drugs, antihemophilic
factor products, high-cost therapies, and therapies that require complex care. The
commissioner shall consult with the formulary committee to develop a list of specialty
pharmacy products subject to this paragraph. In consulting with the formulary committee
in developing this list, the commissioner shall take into consideration the population served
by specialty pharmacy products, the current delivery system and standard of care in the
state, and access to care issues. The commissioner shall have the discretion to adjust the
reimbursement rate to prevent access to care issues.

(g) (h) Home infusion therapy services provided by home infusion therapy pharmacies
must be paid at rates according to subdivision 8d.

Sec. 7. OPIOID OVERDOSE REDUCTION PILOT PROGRAM.

Subdivision 1.

Establishment.

The commissioner of health shall provide grants to
ambulance services to fund activities by community paramedic teams to reduce opioid
overdoses in the state. Under this pilot program, ambulance services shall develop and
implement projects in which community paramedics connect with patients who are discharged
from a hospital following an opioid overdose episode, develop personalized care plans for
those patients, and provide follow-up services to those patients.

Subd. 2.

Priority areas; services.

(a) In a project developed under this section, an
ambulance service must target community paramedic team services to portions of the service
area with high levels of opioid use, high death rates from opioid overdoses, and urgent needs
for interventions.

(b) In a project developed under this section, a community paramedic team shall:

(1) provide services to patients released from a hospital following an opioid overdose
episode and place priority on serving patients who were administered the opiate antagonist
naloxone hydrochloride by emergency medical services personnel in response to a 911 call
during the opioid overdose episode;

(2) provide the following evaluations during an initial home visit: a home safety
assessment including whether there is a need to dispose of prescription drugs that are expired
or no longer needed, medication reconciliation, an HIV risk assessment, instruction on the
use of naloxone hydrochloride, and a basic needs assessment;

(3) provide patients with health assessments, medication management, chronic disease
monitoring and education, and assistance in following hospital discharge orders; and

(4) work with a multidisciplinary team to address the overall physical and mental health
needs of patients and health needs related to substance use disorder treatment.

Subd. 3.

Evaluation.

An ambulance service that receives a grant under this section must
evaluate the extent to which the project was successful in reducing the number of opioid
overdoses and opioid overdose deaths among patients who received services and in reducing
the inappropriate use of opioids by patients who received services. The commissioner of
health shall develop specific evaluation measures and reporting timelines for ambulance
services receiving grants. Ambulance services must submit the information required by the
commissioner to the commissioner and the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services by December 1,
2019.

ARTICLE 5

APPROPRIATIONS

Section 1. APPROPRIATIONS

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

APPROPRIATIONS
Available for the Year
Ending June 30
2018
2019

Sec. 2. CRIMINAL APPREHENSION

$
0
$
420,000

Bureau of Criminal Apprehension Special
Agents.
$420,000 in fiscal year 2019 is for
two additional special agent positions within
the Bureau of Criminal Apprehension focused
on drug interdiction and drug trafficking. The
special agents whose positions are authorized
under this section shall, whenever possible,
coordinate with the federal Drug Enforcement
Administration in efforts to address drug
trafficking in Minnesota.

Sec. 3. COMMISSIONER OF HUMAN
SERVICES

Subdivision 1.

Total Appropriation

$
0
$
4,900,000

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2.

Central Office Operations

0
900,000

Native American Juvenile Treatment
Center; White Earth Reservation.
$900,000
in fiscal year 2019 is for a grant to the tribal
council of the White Earth Nation to refurbish
and equip the White Earth Opiate Treatment
Facility on the White Earth Reservation. The
facility shall treat Native Americans and
provide culturally specific programming to
individuals placed in the treatment center. This
appropriation is available until the project is
completed or abandoned, subject to Minnesota
Statutes, section 16A.642. This is a onetime
appropriation.

Subd. 3.

Forecasted Programs; Medical
Assistance

0
4,000,000

Sec. 4. COMMISSIONER OF HEALTH

$
0
$
5,000,000

(a) FQHC Grants. $1,000,000 in fiscal year
2019 is for grants to federally qualified health
centers for opioid addiction and substance use
disorder programs under Minnesota Statutes,
section 145.9272. This is a onetime
appropriation.

(b) Community Paramedic Teams.
$1,000,000 in fiscal year 2019 is for an opioid
overdose reduction pilot program using
community paramedic teams. This
appropriation is available until June 30, 2021.
Of this appropriation, the commissioner may
use up to $50,000 to administer the program.
This is a onetime appropriation.

(c) Opioid Prevention Pilot Project.
$2,000,000 in fiscal year 2019 is for opioid
abuse prevention pilot projects under Laws
2017, First Special Session chapter 6, article
10, section 144. Of this amount, $1,400,000
is for the opioid abuse prevention pilot project
through CHI St. Gabriel's Health Family
Medical Center, also known as Unity Family
Health Care. $600,000 is for Project Echo
through CHI St. Gabriel's Health Family
Medical Center for e-learning sessions
centered around opioid case management and
best practices for opioid abuse prevention.
This is a onetime appropriation.

(d) Prescription Drug Deactivation And
Disposal.
$1,000,000 in fiscal year 2019 is to
provide grants to prescription drug dispensers
and health care providers to purchase
omnidegradeable, at-home prescription drug
deactivation and disposal products to assist
individuals in the disposal of prescription
drugs in a safe, environmentally sound
manner. Grant awards shall not exceed
$25,000 per dispenser or provider, or $100,000
for applicants applying on behalf of a group
of dispensers or providers. Grant recipients
must provide these deactivation and disposal
products free of charge to members of the
public. In awarding grants, the commissioner
shall give priority to regions of the state with
the highest rates of opioid overdoses and
opioid-related deaths. This is a onetime
appropriation.

Sec. 5. DEPARTMENT OF EDUCATION

$
0
$
400,000

For Jake's Sake Foundation. (a) $400,000
in fiscal year 2019 is for a grant to the For
Jake's Sake Foundation to collaborate with
school districts throughout Minnesota to
integrate evidence-based substance misuse
prevention instruction on the dangers of
substance misuse, particularly the use of
opioids, into school district programs and
curricula, including health education curricula.

(b) Funds appropriated in this section are to:

(1) identify effective substance misuse
prevention tools and strategies, including
innovative uses of technology and media;

(2) develop and promote a comprehensive
substance misuse prevention curriculum for
students in grades 5 through 12 that educates
students and families about the dangers of
substance misuse;

(3) integrate substance misuse prevention into
curricula across subject areas;

(4) train school district teachers, athletic
coaches, and other school staff in effective
substance misuse prevention strategies; and

(5) collaborate with school districts to evaluate
the effectiveness of districts' substance misuse
prevention efforts.

(c) By February 15, 2019, the grantee must
submit a report detailing expenditures and
outcomes of the grant to the chairs and ranking
minority members of the legislative
committees with primary jurisdiction over
kindergarten through grade 12 education
policy and finance. The report must identify
the school districts that have implemented or
plan to implement the substance misuse
prevention curriculum.

(d) The department may retain up to five
percent of the appropriation amount to
administer the grant program and assist school
districts with implementation of substance
misuse prevention instruction.

Sec. 6. HEALTH RELATED BOARDS

Subdivision 1.

Total Appropriation

$
0
$
985,000
Appropriations by Fund
2018
2019
General
0
965,000
State Government
Special Revenue
0
20,000

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2.

Board of Dentistry

0
5,000

Continuing Education. $5,000 in fiscal year
2019 is from the state government special
revenue fund for costs associated with
continuing education on prescribing opioids
and controlled substances. This is a onetime
appropriation.

Subd. 3.

Board of Nursing

0
5,000

Continuing Education. $5,000 in fiscal year
2019 is from the state government special
revenue fund for costs associated with
continuing education on prescribing opioids
and controlled substances. This is a onetime
appropriation.

Subd. 4.

Board of Optometry

0
5,000

Continuing Education. $5,000 in fiscal year
2019 is from the state government special
revenue fund for costs associated with
continuing education on prescribing opioids
and controlled substances. This is a onetime
appropriation.

Subd. 5.

Board of Pharmacy

0
965,000

Prescription Monitoring Program and
Electronic Health Records.
$965,000 in
fiscal year 2019 is from the general fund to
integrate the prescription monitoring program
database with electronic health records on a
statewide basis. The integration of access to
the prescription monitoring database with
electronic health records shall not modify any
requirements or procedures in Minnesota
Statutes, section 152.126, regarding the
information that must be reported to the
database, who can access the database and for
what purpose, and the data classification of
information in the database, and shall not
require a prescriber to access the database
prior to issuing a prescription for a controlled
substance. The board may use this funding to
contract with a vendor for technical assistance,
provide grants to health care providers, and to
make any necessary technological
modifications to the prescription monitoring
program database. This funding does not
cancel and is available until expended. This
is a onetime appropriation.

Subd. 6.

Board of Podiatric Medicine

0
5,000

Continuing Education. $5,000 in fiscal year
2019 is from the state government special
revenue fund for costs associated with
continuing education on prescribing opioids
and controlled substances. This is a onetime
appropriation.

Sec. 7. DUPLICATE APPROPRIATIONS.

If an appropriation in this act is enacted more than once in the 2018 legislative session,
the appropriation must be given effect only once.

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13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 14.1 14.2
14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22
14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 14.33 15.1
15.2
15.3 15.4
15.5 15.6 15.7 15.8 15.9 15.10
15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 17.1 17.2 17.3 17.4
17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 18.33 19.1 19.2 19.3 19.4 19.5
19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26
19.27 19.28 19.29 19.30 20.1 20.2 20.3
20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 20.34 20.35 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 21.34 21.35 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 22.33 22.34 22.35 23.1 23.2 23.3 23.4 23.5
23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 24.1 24.2 24.3 24.4 24.5 24.6
24.7 24.8
24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17
24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28
24.29 24.30 24.31 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19
25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 25.33 25.34 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33
26.34 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 27.34 28.1 28.2 28.3 28.4 28.5 28.6 28.7
28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 29.33 29.34 29.35 30.1 30.2 30.3 30.4
30.5 30.6 30.7

700 State Office Building, 100 Rev. Dr. Martin Luther King Jr. Blvd., St. Paul, MN 55155 ♦ Phone: (651) 296-2868 ♦ TTY: 1-800-627-3529 ♦ Fax: (651) 296-0569