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HF 2184

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to health; modifying the medical education and research cost distribution
formula; appropriating money; amending Minnesota Statutes 2006, section
62J.692, subdivisions 1, 4, 7a, 8, 10.

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

Section 1.

Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

For purposes of this section, the following definitions
apply:

(a) "Accredited clinical training" means the clinical training provided by a
medical education program that is accredited through an organization recognized by the
Department of Education, the Centers for Medicare and Medicaid Services, or another
national body who reviews the accrediting organizations for multiple disciplines and
whose standards for recognizing accrediting organizations are reviewed and approved by
the commissioner of health in consultation with the Medical Education and Research
Advisory Committee.

(b) "Commissioner" means the commissioner of health.

(c) "Clinical medical education program" means the accredited clinical training of
physicians (medical students and residents), doctor of pharmacy practitioners, doctors
of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
physician assistants.

(d) "Sponsoring institution" means a hospital, school, or consortium located in
Minnesota that sponsors and maintains primary organizational and financial responsibility
for a clinical medical education program in Minnesota and which is accountable to the
accrediting body.

(e) "Teaching institution" means a hospital, medical center, clinic, or other
organization that conducts a clinical medical education program in Minnesota.

(f) "Trainee" means a student or resident involved in a clinical medical education
program.

(g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time
equivalent counts, that are at training sites located in Minnesota with deleted text begin adeleted text end new text begin currently
active
new text end medical assistance deleted text begin provider numberdeleted text end new text begin enrollment status and a National Provider
Identification (NPI) number
new text end where training occurs in either an inpatient or ambulatory
patient care setting and where the training is funded, in part, by patient care revenues.

Sec. 2.

Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:


Subd. 4.

Distribution of funds.

(a) The commissioner shall annually distribute
90 percent of deleted text begin available medical educationdeleted text end funds new text begin transferred according to section
256B.69, subdivision 5c, paragraph (a), clause (1),
new text end to all qualifying applicants based on a
distribution formula that reflects a summation of two factors:

(1) an education factor, which is determined by the total number of eligible trainee
FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical
medical education program; and

(2) a public program volume factor, which is determined by the total volume of
public program revenue received by each training site as a percentage of all public
program revenue received by all training sites in the fund pool.

In this formula, the education factor is weighted at 67 percent and the public program
volume factor is weighted at 33 percent.

Public program revenue for the distribution formula includes revenue from medical
assistance, prepaid medical assistance, general assistance medical care, and prepaid
general assistance medical care. Training sites that receive no public program revenue
are ineligible for funds available under this paragraph. Total statewide average costs per
trainee for medical residents is based on audited clinical training costs per trainee in
primary care clinical medical education programs for medical residents. Total statewide
average costs per trainee for dental residents is based on audited clinical training costs
per trainee in clinical medical education programs for dental students. Total statewide
average costs per trainee for pharmacy residents is based on audited clinical training costs
per trainee in clinical medical education programs for pharmacy students.

(b) The commissioner shall annually distribute ten percent of deleted text begin total available medical
education
deleted text end funds new text begin transferred according to section 256B.69, subdivision 5c, paragraph (a),
clause (1),
new text end to all qualifying applicants based on the percentage received by each applicant
under paragraph (a). These funds are to be used to offset clinical education costs at
eligible clinical training sites based on criteria developed by the clinical medical education
program. Applicants may choose to distribute funds allocated under this paragraph based
on the distribution formula described in paragraph (a).

new text begin (c) The commissioner shall annually distribute $5,000,000 of the funds dedicated
to the commissioner under section 297F.10, subdivision 1, clause (2), plus any federal
financial participation on these funds and on funds transferred under subdivision 10, to all
qualifying applicants based on a distribution formula that gives 100 percent weight to a
public program volume factor, which is determined by the total volume of public program
revenue received by each training site as a percentage of all public program revenue
received by all training sites in the fund pool. If federal approval is not obtained for
federal financial participation on any portion of funds distributed under this paragraph,
90 percent of the unmatched funds shall be distributed by the commissioner based on
the formula described in paragraph (a) and ten percent of the unmatched funds shall be
distributed by the commissioner based on the formula described in paragraph (b).
new text end

new text begin (d) The commissioner shall annually distribute $3,060,000 of funds dedicated to the
commissioner under section 297F.10, subdivision 1, clause (2), through a formula giving
100 percent weight to an education factor, which is determined by the total number of
eligible trainee full-time equivalents and the total statewide average costs per trainee, by
type of trainee, in each clinical medical education program. If no matching funds are
received on funds distributed under paragraph (c), funds distributed under this paragraph
shall be distributed by the commissioner based on the formula described in paragraph (a).
new text end

new text begin (e) The commissioner shall annually distribute $340,000 of funds dedicated to the
commissioner under section 297F.10, subdivision 1, clause (2), to all qualifying applicants
based on the percentage received by each applicant under paragraph (a). These funds are
to be used to offset clinical education costs at eligible clinical training sites based on
criteria developed by the clinical medical education program. Applicants may choose to
distribute funds allocated under this paragraph based on the distribution formula described
in paragraph (a). If no matching funds are received on funds distributed under paragraph
(c), funds distributed under this paragraph shall be distributed by the commissioner based
on the formula described in paragraph (b).
new text end

deleted text begin (c)deleted text end new text begin (f)new text end Funds distributed shall not be used to displace current funding appropriations
from federal or state sources.

deleted text begin (d)deleted text end new text begin (g)new text end Funds shall be distributed to the sponsoring institutions indicating the amount
to be distributed to each of the sponsor's clinical medical education programs based on
the criteria in this subdivision and in accordance with the commissioner's approval letter.
Each clinical medical education program must distribute funds allocated under paragraph
(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
institutions, which are accredited through an organization recognized by the Department
of Education or the Centers for Medicare and Medicaid Services, may contract directly
with training sites to provide clinical training. To ensure the quality of clinical training,
those accredited sponsoring institutions must:

(1) develop contracts specifying the terms, expectations, and outcomes of the clinical
training conducted at sites; and

(2) take necessary action if the contract requirements are not met. Action may
include the withholding of payments under this section or the removal of students from
the site.

deleted text begin (e)deleted text end new text begin (h)new text end Any funds not distributed in accordance with the commissioner's approval
letter must be returned to the medical education and research fund within 30 days of
receiving notice from the commissioner. The commissioner shall distribute returned funds
to the appropriate training sites in accordance with the commissioner's approval letter.

deleted text begin (f)deleted text end new text begin (i)new text end The commissioner shall distribute by June 30 of each year an amount equal to
the funds transferred under subdivision 10deleted text begin , plus five percent interestdeleted text end to the University of
Minnesota Board of Regents for the instructional costs of health professional programs
at the Academic Health Center and for interdisciplinary academic initiatives within the
Academic Health Center.

deleted text begin (g)deleted text end new text begin (j)new text end A maximum of $150,000 of the funds dedicated to the commissioner
under section 297F.10, subdivision 1, deleted text begin paragraph (b),deleted text end clause (2), may be used by the
commissioner for administrative expenses associated with implementing this section.

Sec. 3.

Minnesota Statutes 2006, section 62J.692, subdivision 7a, is amended to read:


Subd. 7a.

Clinical medical education innovations grants.

(a) The commissioner
shall award grants to teaching institutions and clinical training sites for projects that
increase dental access for underserved populations and promote innovative clinical
training of dental professionals.

new text begin (b) The commissioner shall award grants to teaching institutions and clinical training
sites for projects that increase mental health access for underserved populations, promote
innovative clinical training of mental health professionals, increase the number of mental
health providers in rural or underserved areas, and promote the incorporation of patient
safety principles into clinical medical education programs.
new text end

new text begin (c)new text end In awarding the grants, the commissioner, in consultation with the commissioner
of human services, shall consider the following:

(1) potential to successfully increase access to an underserved population;

(2) the long-term viability of the project to improve access beyond the period
of initial funding;

(3) evidence of collaboration between the applicant and local communities;

(4) the efficiency in the use of the funding; deleted text begin and
deleted text end

(5) the priority level of the project in relation to state clinical education, access,
new text begin patient safety, new text end and workforce goalsdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (6) the potential of the project to impact the number or distribution of the health
care workforce.
new text end

deleted text begin (b)deleted text end new text begin (d)new text end The commissioner shall periodically evaluate the priorities in awarding the
innovations grants in order to ensure that the priorities meet the changing workforce
needs of the state.

Sec. 4.

Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:


Subd. 8.

Federal financial participation.

(a) The commissioner of human
services shall seek to maximize federal financial participation in payments for medical
education and research costs. deleted text begin If the commissioner of human services determines that
federal financial participation is available for the medical education and research, the
commissioner of health shall transfer to the commissioner of human services the amount
of state funds necessary to maximize the federal funds available. The amount transferred
to the commissioner of human services, plus the amount of federal financial participation,
shall be distributed to medical assistance providers in accordance with the distribution
methodology described in subdivision 4.
deleted text end

(b) For the purposes of paragraph (a), the commissioner shall use physician clinic
rates where possible to maximize federal financial participation.

Sec. 5.

Minnesota Statutes 2006, section 62J.692, subdivision 10, is amended to read:


Subd. 10.

Transfers from University of Minnesota.

Of the funds dedicated to the
Academic Health Center under section 297F.10, subdivision 1, clause (1), $4,850,000
shall be transferred annually to the commissioner of health no later than April 15 of each
year for distribution under subdivision 4, paragraph deleted text begin (f)deleted text end new text begin (i)new text end .

Sec. 6. new text begin MERC APPROPRIATIONS.
new text end

new text begin $8,000,000 is appropriated each fiscal year beginning July 1, 2007, from the general
fund to the commissioner of health for distribution of MERC grants as follows:
new text end

new text begin (1) $5,000,000 according to Minnesota Statutes, section 62J.692, subdivision 4,
paragraph (c);
new text end

new text begin (2) $900,000 according to Minnesota Statutes, section 62J.692, subdivision 4,
paragraph (d);
new text end

new text begin (3) $100,000 according to Minnesota Statutes, section 62J.692, subdivision 4,
paragraph (e); and
new text end

new text begin (4) $2,000,000 according to Minnesota Statutes, section 62J.692, subdivision 7a,
paragraph (b).
new text end