Minnesota Legislature
HF 3098
as introduced - 86th Legislature (2009 - 2010) Posted on 02/22/2010 11:21am
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A bill for an act
relating to health; modifying provisions for the statewide trauma system;
amending Minnesota Statutes 2008, sections 144.603; 144.605, subdivisions 2,
3, by adding a subdivision; 144.608, subdivision 1, by adding a subdivision;
145.61, subdivision 5; proposing coding for new law in Minnesota Statutes,
chapter 144; repealing Minnesota Statutes 2008, section 144.607.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2008, section 144.603, is amended to read:
144.603 STATEWIDE TRAUMA SYSTEM CRITERIA.
Subdivision 1.
Criteria established.
The commissioner shall adopt criteria to
ensure that severely injured people are promptly transported and treated at trauma
hospitals appropriate to the severity of injury. Minimum criteria shall address emergency
medical service trauma triage and transportation guidelines as approved under section
144E.101, subdivision 14, designation of hospitals as trauma hospitals, interhospital
transfers, a trauma registry, and a trauma system governance structure.
Subd. 2.
Basis; verification.
The commissioner shall base the establishment,
implementation, and modifications to the criteria under subdivision 1 on the
department-published Minnesota comprehensive statewide trauma system plan. The
commissioner shall seek the advice of the Trauma Advisory Council in implementing
and updating the criteria, using accepted and prevailing trauma transport, treatment,
and referral standards of the American College of Surgeons, the American College of
Emergency Physicians, the Minnesota Emergency Medical Services Regulatory Board,
the national Trauma deleted text begin Resources Networkdeleted text end new text begin Center Association of Americanew text end , and other widely
recognized trauma experts. The commissioner shall adapt and modify the standards as
appropriate to accommodate Minnesota's unique geography and the state's hospital and
health professional distribution and shall verify that the criteria are met by each hospital
voluntarily participating in the statewide trauma system.
Subd. 3.
Rule exemption and report to legislature.
In developing and adopting
the criteria under this section, the commissioner of health is exempt from chapter 14,
including section 14.386. deleted text begin By September 1, 2009, the commissioner must report to the
legislature on implementation of the voluntary trauma system, including recommendations
on the need for including the trauma system criteria in rule.
deleted text end
Sec. 2.
Minnesota Statutes 2008, section 144.605, subdivision 2, is amended to read:
Subd. 2.
Designation; reverification.
The commissioner shall designate deleted text begin fourdeleted text end new text begin sixnew text end
levels of trauma hospitals. A hospital that voluntarily meets the criteria for a particular
level of trauma hospital shall apply to the commissioner for designation and, upon the
commissioner's verifying the hospital meets the criteria, be designated a trauma hospital
at the appropriate level for a three-year period. Prior to the expiration of the three-year
designation, a hospital seeking to remain part of the voluntary system must apply for
and successfully complete a reverification process, be awaiting the site visit for the
reverification, or be awaiting the results of the site visit. The commissioner may extend a
hospital's existing designation for up to 18 months on a provisional basis if the hospital has
applied for reverification in a timely manner but has not yet completed the reverification
process within the expiration of the three-year designation and the extension is in the
best interest of trauma system patient safety. To be granted a provisional extension, the
hospital must be:
(1) scheduled and awaiting the site visit for reverification;
(2) awaiting the results of the site visit; or
(3) responding to and correcting identified deficiencies identified in the site visit.
Sec. 3.
Minnesota Statutes 2008, section 144.605, subdivision 3, is amended to read:
Subd. 3.
ACS verification.
The commissioner shall grant the appropriate level I, II,
or III trauma hospital new text begin or level I or II pediatric trauma hospital new text end designation to a hospital that
successfully completes and passes the American College of Surgeons (ACS) verification
standards at the hospital's cost, submits verification documentation to the Trauma Advisory
Council, and formally notifies the Trauma Advisory Council of ACS verification.
Sec. 4.
Minnesota Statutes 2008, section 144.605, is amended by adding a subdivision
to read:
new text begin Subd. 9. new text end
new text begin Designation process protection. new text end
new text begin
All information and reports related to the
designation and redesignation of trauma hospitals pursuant to subdivisions 3 to 5 shall be
classified as private data on individuals, as defined in section 13.02, subdivision 12, and
nonpublic data as defined in section 13.02, subdivision 9.
new text end
Sec. 5.
new text begin
[144.6071] TRAUMA REGISTRY.
new text end
new text begin Subdivision 1. new text end
new text begin Registry. new text end
new text begin
The commissioner of health shall establish and maintain
a central registry of persons who sustain major trauma as defined in section 144.602,
subdivision 3. The registry shall collect information to facilitate the development of
clinical and system quality improvement, injury prevention, treatment, and rehabilitation
programs.
new text end
new text begin Subd. 2. new text end
new text begin Registry participation required. new text end
new text begin
A trauma hospital must participate in
the statewide trauma registry. The consent of the injured person is not required.
new text end
new text begin Subd. 3. new text end
new text begin Registry information. new text end
new text begin
Trauma hospitals must electronically submit the
following information to the registry:
new text end
new text begin
(1) demographic information of the injured person;
new text end
new text begin
(2) information about the date, location, and cause of the injury;
new text end
new text begin
(3) information about the condition of the injured person;
new text end
new text begin
(4) information about the treatment, comorbidities, and diagnosis of the injured
person;
new text end
new text begin
(5) information about the outcome and disposition of the injured person; and
new text end
new text begin
(6) other information required by the commissioner.
new text end
new text begin Subd. 4. new text end
new text begin Rules. new text end
new text begin
The commissioner may adopt rules to collect other information
required to facilitate the development of clinical and system quality improvement, injury
prevention, treatment, and rehabilitation programs. The commissioner may adopt rules at
any time to implement this section and is not subject to the requirements of section 14.125.
new text end
new text begin Subd. 5. new text end
new text begin Reporting without liability. new text end
new text begin
Any person or facility furnishing information
required in this section shall not be subject to any action for damages or other relief,
provided that the person or facility is acting in good faith.
new text end
new text begin Subd. 6. new text end
new text begin Data classification. new text end
new text begin
Data on individuals collected by the commissioner
of health under this section are private data on individuals, as defined in section 13.02,
subdivision 12. Data not on individuals are nonpublic data as defined in section 13.02,
subdivision 9. The commissioner shall provide summary registry data to public and
private entities to conduct studies using data collected by the registry. The commissioner
may charge a fee under section 13.03, subdivision 3, for all out-of-pocket expenses
associated with the provision of data or data analysis.
new text end
new text begin Subd. 7. new text end
new text begin Report requirements. new text end
new text begin
The commissioner shall use the registry to annually
publish a report that includes comparative demographic and risk-adjusted epidemiological
data on designated trauma hospitals. Any analyses or reports that identify providers
may only be published after the provider has been provided the opportunity by the
commissioner to review the underlying data and submit comments. The provider shall
have 21 days to review the data for accuracy.
new text end
Sec. 6.
Minnesota Statutes 2008, section 144.608, subdivision 1, is amended to read:
Subdivision 1.
Trauma Advisory Council established.
(a) A Trauma Advisory
Council is established to advise, consult with, and make recommendations to the
commissioner on the development, maintenance, and improvement of a statewide trauma
system.
(b) The council shall consist of the following members:
(1) a trauma surgeon certified by the American deleted text begin College of Surgeonsdeleted text end new text begin Board of
Surgery or the American Osteopathic Board of Surgerynew text end who practices in a level I or
II trauma hospital;
(2) a general surgeon certified by the American deleted text begin College of Surgeonsdeleted text end new text begin Board
of Surgery or the American Osteopathic Board of Surgerynew text end whose practice includes
trauma and who practices in a designated rural area as defined under section 144.1501,
subdivision 1, paragraph (b);
(3) a neurosurgeon certified by the American Board of Neurological Surgery who
practices in a level I or II trauma hospital;
(4) a trauma program nurse manager or coordinator practicing in a level I or II
trauma hospital;
(5) an emergency physician certified by the American deleted text begin Collegedeleted text end new text begin Boardnew text end of Emergency
deleted text begin Physiciansdeleted text end new text begin Medicine or the American Osteopathic Board of Emergency Medicinenew text end whose
practice includes emergency room care in a level I, II, III, or IV trauma hospital;
(6) deleted text begin an emergency room nurse managerdeleted text end new text begin a trauma program manager or coordinatornew text end
who practices in a level III or IV trauma hospital;
(7) a deleted text begin family practicedeleted text end physician new text begin certified by the American Board of Family Medicine
or the American Osteopathic Board of Family Practice new text end whose practice includes emergency
deleted text begin roomdeleted text end new text begin departmentnew text end care in a level III or IV trauma hospital located in a designated rural area
as defined under section 144.1501, subdivision 1, paragraph (b);
(8) a nurse practitioner, as defined under section 144.1501, subdivision 1, paragraph
(h), or a physician assistant, as defined under section 144.1501, subdivision 1, paragraph
(j), whose practice includes emergency room care in a level IV trauma hospital located in
a designated rural area as defined under section 144.1501, subdivision 1, paragraph (b);
(9) a pediatrician certified by the American deleted text begin Academydeleted text end new text begin Boardnew text end of Pediatrics new text begin or the
American Osteopathic Board of Pediatrics new text end whose practice includes emergency deleted text begin roomdeleted text end new text begin
departmentnew text end care in a level I, II, III, or IV trauma hospital;
(10) an orthopedic surgeon certified by the American Board of Orthopaedic Surgery
new text begin or the American Osteopathic Board of Orthopedic Surgery new text end whose practice includes trauma
and who practices in a level I, II, or III trauma hospital;
(11) the state emergency medical services medical director appointed by the
Emergency Medical Services Regulatory Board;
(12) a hospital administrator of a level III or IV trauma hospital located in a
designated rural area as defined under section 144.1501, subdivision 1, paragraph (b);
(13) a rehabilitation specialist whose practice includes rehabilitation of patients
with major trauma injuries or traumatic brain injuries and spinal cord injuries as defined
under section 144.661;
(14) an attendant or ambulance director who is an EMT, EMT-I, or EMT-P within
the meaning of section 144E.001 and who actively practices with a licensed ambulance
service in a primary service area located in a designated rural area as defined under section
144.1501, subdivision 1, paragraph (b); and
(15) the commissioner of public safety or the commissioner's designee.
deleted text begin
(c) Council members whose appointment is dependent on practice in a level III or IV
trauma hospital may be appointed to an initial term based upon their statements that the
hospital intends to become a level III or IV facility by July 1, 2009.
deleted text end
Sec. 7.
Minnesota Statutes 2008, section 144.608, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Review organization. new text end
new text begin
When the Trauma Advisory Council or a regional
trauma council is meeting as a review organization as defined in section 145.61, it is
exempt from the requirements of chapter 13D.
new text end
Sec. 8.
Minnesota Statutes 2008, section 145.61, subdivision 5, is amended to read:
Subd. 5.
Review organization.
"Review organization" means a nonprofit
organization acting according to clause (l), a committee as defined under section
144E.32, subdivision 2, new text begin the Trauma Advisory Council and regional trauma advisory
councils as defined under section 144.608, new text end or a committee whose membership is
limited to professionals, administrative staff, and consumer directors, except where
otherwise provided for by state or federal law, and which is established by one or more
of the following: a hospital, a clinic, a nursing home, an ambulance service or first
responder service regulated under chapter 144E, one or more state or local associations
of professionals, an organization of professionals from a particular area or medical
institution, a health maintenance organization as defined in chapter 62D, a community
integrated service network as defined in chapter 62N, a nonprofit health service plan
corporation as defined in chapter 62C, a preferred provider organization, a professional
standards review organization established pursuant to United States Code, title 42, section
1320c-1 et seq., a medical review agent established to meet the requirements of section
256B.04, subdivision 15, or 256D.03, subdivision 7, paragraph (b), the Department of
Human Services, or a nonprofit corporation that owns, operates, or is established by one or
more of the above referenced entities, to gather and review information relating to the care
and treatment of patients for the purposes of:
(a) evaluating and improving the quality of health care;
(b) reducing morbidity or mortality;
(c) obtaining and disseminating statistics and information relative to the treatment
and prevention of diseases, illness and injuries;
(d) developing and publishing guidelines showing the norms of health care in the
area or medical institution or in the entity or organization that established the review
organization;
(e) developing and publishing guidelines designed to keep within reasonable bounds
the cost of health care;
(f) developing and publishing guidelines designed to improve the safety of care
provided to individuals;
(g) reviewing the safety, quality, or cost of health care services provided to enrollees
of health maintenance organizations, community integrated service networks, health
service plans, preferred provider organizations, and insurance companies;
(h) acting as a professional standards review organization pursuant to United States
Code, title 42, section 1320c-1 et seq.;
(i) determining whether a professional shall be granted staff privileges in a medical
institution, membership in a state or local association of professionals, or participating
status in a nonprofit health service plan corporation, health maintenance organization,
community integrated service network, preferred provider organization, or insurance
company, or whether a professional's staff privileges, membership, or participation status
should be limited, suspended or revoked;
(j) reviewing, ruling on, or advising on controversies, disputes or questions between:
(1) health insurance carriers, nonprofit health service plan corporations, health
maintenance organizations, community integrated service networks, self-insurers and their
insureds, subscribers, enrollees, or other covered persons;
(2) professional licensing boards and health providers licensed by them;
(3) professionals and their patients concerning diagnosis, treatment or care, or the
charges or fees therefor;
(4) professionals and health insurance carriers, nonprofit health service plan
corporations, health maintenance organizations, community integrated service networks,
or self-insurers concerning a charge or fee for health care services provided to an insured,
subscriber, enrollee, or other covered person;
(5) professionals or their patients and the federal, state, or local government, or
agencies thereof;
(k) providing underwriting assistance in connection with professional liability
insurance coverage applied for or obtained by dentists, or providing assistance to
underwriters in evaluating claims against dentists;
(l) acting as a medical review agent under section 256B.04, subdivision 15, or
256D.03, subdivision 7, paragraph (b);
(m) providing recommendations on the medical necessity of a health service, or the
relevant prevailing community standard for a health service;
(n) providing quality assurance as required by United States Code, title 42, sections
1396r(b)(1)(b) and 1395i-3(b)(1)(b) of the Social Security Act;
(o) providing information to group purchasers of health care services when that
information was originally generated within the review organization for a purpose
specified by this subdivision;
(p) providing information to other, affiliated or nonaffiliated review organizations,
when that information was originally generated within the review organization for a
purpose specified by this subdivision, and as long as that information will further the
purposes of a review organization as specified by this subdivision; or
(q) participating in a standardized incident reporting system, including Internet-based
applications, to share information for the purpose of identifying and analyzing trends in
medical error and iatrogenic injury.
Sec. 9. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2008, section 144.607,
new text end
new text begin
is repealed.
new text end