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HF 3254

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

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to health; changing provisions for health professional educational
loan forgiveness program; expanding access to dental care services; amending
Minnesota Statutes 2006, sections 144.1501, subdivisions 1, 2, by adding
subdivisions; 256B.037, subdivisions 1, 1b, 4, by adding subdivisions; repealing
Minnesota Statutes 2006, section 256B.037, subdivisions 1a, 1c, 2, 5, 6.

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

Section 1.

Minnesota Statutes 2006, section 144.1501, subdivision 1, is amended to
read:


Subdivision 1.

Definitions.

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

new text begin (b) "Dental hygienist" means an individual who is licensed by the Board of Dentistry
under section 150A.06, subdivision 2, and "dental assistant" means an individual
registered with the Board of Dentistry under section 150A.06, subdivision 2a.
new text end

deleted text begin (b)deleted text end new text begin (c)new text end "Dentist" means an individual who is licensed to practice dentistry.

deleted text begin (c)deleted text end new text begin (d)new text end "Designated rural area" means:

(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin,
Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead,
Rochester, and St. Cloud; or

(2) a municipal corporation, as defined under section 471.634, that is physically
located, in whole or in part, in an area defined as a designated rural area under clause (1).

deleted text begin (d)deleted text end new text begin (e)new text end "Emergency circumstances" means those conditions that make it impossible
for the participant to fulfill the service commitment, including death, total and permanent
disability, or temporary disability lasting more than two years.

deleted text begin (e)deleted text end new text begin (f)new text end "Medical resident" means an individual participating in a medical residency in
family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

deleted text begin (f)deleted text end new text begin (g)new text end "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
anesthetist, advanced clinical nurse specialist, or physician assistant.

deleted text begin (g)deleted text end new text begin (h)new text end "Nurse" means an individual who has completed training and received
all licensing or certification necessary to perform duties as a licensed practical nurse
or registered nurse.

deleted text begin (h)deleted text end new text begin (i)new text end "Nurse-midwife" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse-midwives.

deleted text begin (i)deleted text end new text begin (j)new text end "Nurse practitioner" means a registered nurse who has graduated from a
program of study designed to prepare registered nurses for advanced practice as nurse
practitioners.

deleted text begin (j)deleted text end new text begin (k)new text end "Pharmacist" means an individual with a valid license issued under chapter
151.

deleted text begin (k)deleted text end new text begin (l)new text end "Physician" means an individual who is licensed to practice medicine in
the areas of family practice, internal medicine, obstetrics and gynecology, pediatrics,
or psychiatry.

deleted text begin (l)deleted text end new text begin (m)new text end "Physician assistant" means a person registered under chapter 147A.

deleted text begin (m)deleted text end new text begin (n)new text end "Qualified educational loan" means a government, commercial, or foundation
loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a health care professional.

deleted text begin (n)deleted text end new text begin (o)new text end "Underserved urban community" means a Minnesota urban area or population
included in the list of designated primary medical care health professional shortage areas
(HPSAs), medically underserved areas (MUAs), or medically underserved populations
(MUPs) maintained and updated by the United States Department of Health and Human
Services.

Sec. 2.

Minnesota Statutes 2006, section 144.1501, subdivision 2, is amended to read:


Subd. 2.

Creation of account.

(a) A health professional education loan forgiveness
program account is established. The commissioner of health shall use money from the
account to establish a loan forgiveness program:

(1) for medical residents agreeing to practice in designated rural areas or underserved
urban communities or specializing in the area of pediatric psychiatry;

(2) for midlevel practitioners agreeing to practice in designated rural areas or to
teach for at least 20 hours per week in the nursing field in a postsecondary program;

(3) for nurses who agree to practice in a Minnesota nursing home or intermediate
care facility for persons with developmental disability or to teach for at least 20 hours per
week in the nursing field in a postsecondary program;

(4) for other health care technicians agreeing to teach for at least 20 hours per week
in their designated field in a postsecondary program. The commissioner, in consultation
with the Healthcare Education-Industry Partnership, shall determine the health care fields
where the need is the greatest, including, but not limited to, respiratory therapy, clinical
laboratory technology, radiologic technology, and surgical technology;new text begin and
new text end

(5) for pharmacists who agree to practice in designated rural areasdeleted text begin ; anddeleted text end new text begin .
new text end

new text begin (b) The commissioner shall use money from the account for loan forgiveness and
scholarships:
new text end

deleted text begin (6)deleted text end new text begin (1)new text end for dentists deleted text begin agreeingdeleted text end new text begin who: (i) agreenew text end to deliver at least deleted text begin 25deleted text end new text begin 20new text end percent of the
dentist's yearly patient encounters to state public program enrollees or patients receiving
sliding fee schedule discounts through a formal sliding fee schedule meeting the standards
established by the United States Department of Health and Human Services under Code of
Federal Regulations, title 42, section 51, chapter 303new text begin , or (ii) have been trained in a foreign
country, received a dental license from the Board of Dentistry, and who agrees to provide
services for a nonprofit organization, community clinic, or federally qualified health clinic
in Minnesota for a period of at least three years
new text end .

deleted text begin (b)deleted text end new text begin (c)new text end Appropriations made to the account do not cancel and are available until
expended, except that at the end of each biennium, any remaining balance in the account
that is not committed by contract and not needed to fulfill existing commitments shall
cancel to the fund.

Sec. 3.

Minnesota Statutes 2006, section 144.1501, is amended by adding a subdivision
to read:


new text begin Subd. 4a. new text end

new text begin Dental hygienists and dental assistants. new text end

new text begin The commissioner shall
develop a loan forgiveness or scholarship program targeted at:
new text end

new text begin (1) dental hygienists who have entered into a collaborative agreement under section
150A.10, subdivision 1a, with a licensed dentist that is a critical access dental provider
under section 256B.76, and the hygienist provides or agrees to provide dental hygiene
services in a underserved or designated rural area in Minnesota; and
new text end

new text begin (2) dental hygienists and registered dental assistants who have completed training
in expanded restorative functions authorized under section 15A.10, subdivision 4, and
provide services in an underserved or designated rural area in Minnesota in conjunction
with a critical access dental provider under section 256B.76.
new text end

Sec. 4.

Minnesota Statutes 2006, section 144.1501, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin Dental school student scholarship program. new text end

new text begin The commissioner may
award up to three scholarships each year to:
new text end

new text begin (1) internationally trained dental students who enroll in the Program for Advance
Standing Students at the University of Minnesota Dental School and who agree upon
graduation from the program to provide dental services through a nonprofit organization,
community clinic, or federally qualified community health center for a period of at least
three years; or
new text end

new text begin (2) current dental school students who agree upon graduation from the program to
provide dental services through a nonprofit organization, community clinic, or federally
qualified community health center for a period of at least three years.
new text end

new text begin Scholarships awarded under the program must be at least $30,000 each year that the
graduates provide care under the scholarship agreement.
new text end

Sec. 5.

Minnesota Statutes 2006, section 256B.037, subdivision 1, is amended to read:


Subdivision 1.

Contract for dental services.

The commissioner deleted text begin may conduct a
demonstration project to contract, on a prospective per capita payment basis,
deleted text end new text begin shall contractnew text end
with an organization deleted text begin or organizationsdeleted text end licensed under chapter 62C, 62D, or 62N for the
provision of all dental care services beginning July 1, deleted text begin 1994deleted text end new text begin 2009new text end , under the medical
assistance, general assistance medical care, and MinnesotaCare programsdeleted text begin , or when
necessary waivers are granted by the secretary of health and human services, whichever
occurs later. The commissioner shall identify a geographic area or areas, including both
urban and rural areas, where access to dental services has been inadequate, in which to
conduct demonstration projects
deleted text end . The commissioner shall seek any federal waivers or
approvals necessary to implement this section from the secretary of health and human
services.

deleted text begin The commissioner may exclude from participation in the demonstration project any
or all groups currently excluded from participation in the prepaid medical assistance
program under section 256B.69. Except for persons excluded from participation in
the demonstration project, all persons who have been determined eligible for medical
assistance, general assistance medical care and, if applicable, MinnesotaCare and reside
in the designated geographic areas are required to enroll in a dental plan to receive their
dental care services.
deleted text end Except for emergency services or out-of-plan services authorized by
the dental plan, recipients must receive their dental services from dental care providers
who are part of the dental plan provider network.

The commissioner shall select deleted text begin either multiple dental plans ordeleted text end a single dental plan
deleted text begin in a designated areadeleted text end new text begin to administer dental care delivery for the entire statenew text end . A dental
plan under contract with the department must serve deleted text begin bothdeleted text end medical assistance recipientsnew text begin ,new text end
deleted text begin anddeleted text end general assistance medical care recipients in a designated geographic areanew text begin ,new text end and
deleted text begin may servedeleted text end MinnesotaCare recipients. deleted text begin The commissioner may limit the number of dental
plans with which the department contracts within a designated geographic area, taking
into consideration the number of recipients within the designated geographic area; the
number of potential dental plan contractors; the size of the provider network offered by
dental plans; the dental care services offered by a dental plan; qualifications of dental
plan personnel; accessibility of services to recipients; dental plan assurances of recipient
confidentiality; dental plan marketing and enrollment activities; dental plan compliance
with this section; dental plan performance under other contracts with the department to
serve medical assistance, general assistance medical care, or MinnesotaCare recipients;
or any other factors necessary to provide the most economical care consistent with high
standards of dental care.
deleted text end

For purposes of this section, "dental plan" means an organization licensed under
chapter 62C, 62D, or 62N that contracts with the department to provide covered dental
care services deleted text begin to recipients on a prepaid capitation basisdeleted text end . "Emergency services" has the
meaning given in section 256B.0625, subdivision 4. deleted text begin "Multiple dental plan area" means a
designated area in which more than one dental plan is offered.
deleted text end "Participating provider"
means a dentist or dental clinic who is employed by or under contract with a dental plan to
provide dental care services to recipients. deleted text begin "Single dental plan area" means a designated
area in which only one dental plan is available.
deleted text end

Sec. 6.

Minnesota Statutes 2006, section 256B.037, subdivision 1b, is amended to read:


Subd. 1b.

Single dental plan areas.

After the department has executed a contract
with a dental plan to provide covered dental care services as the sole dental plan deleted text begin in a
geographic area
deleted text end new text begin for the statenew text end , the provisions in paragraphs (a) to (c) apply.

(a) The department shall assure that applicants and recipients are informed, in
writing, of participating providers in the dental plan and when dental plan participation
begins.

(b) The dental plan may require the recipient to select a specific dentist or dental
clinic and may assign to a specific dentist or dental clinic recipients who fail to notify
the dental plan of their selection.

(c) new text begin If assignment is made, new text end the dental plan shall notify recipients in writing of their
assigned providers deleted text begin before the effective date of dental plan participationdeleted text end .

Sec. 7.

Minnesota Statutes 2006, section 256B.037, is amended by adding a
subdivision to read:


new text begin Subd. 2a. new text end

new text begin Dental advisory committee. new text end

new text begin The dental plan administrator shall establish
a dental advisory committee to assist the plan in the development and implementation
of statewide dental administration. The advisory committee shall include participating
providers, including representatives of private practice dentistry, community clinics,
public health, and the commissioner of human services. The advisory committee shall
develop strategies for recruitment and retention of participating providers.
new text end

Sec. 8.

Minnesota Statutes 2006, section 256B.037, subdivision 4, is amended to read:


Subd. 4.

Information required by commissioner.

A contractor shall submit
encounter-specific information as required by the commissioner, including, but not limited
to, information required for assessing client satisfaction, quality of care, and cost and
utilization of services. deleted text begin Dental plansdeleted text end new text begin The contractornew text end and participating providers must
provide the commissioner access to recipient dental records to monitor compliance with
the requirements of this section.

Sec. 9.

Minnesota Statutes 2006, section 256B.037, is amended by adding a
subdivision to read:


new text begin Subd. 5a. new text end

new text begin Critical access dental providers. new text end

new text begin A dental plan awarded a contract under
this section must comply with increased reimbursements to critical access dental providers
as required under section 256B.76, paragraph (c), or other increased reimbursements
required by the commissioner.
new text end

Sec. 10. new text begin COMMUNITY DENTAL HEALTH COORDINATOR.
new text end

new text begin The commissioner of health shall study the feasibility of the creation and use of
community dental health coordinators to help provide dental care access and education
to specific populations in need of dental care under state programs. The commissioner
shall consider the education and training requirements of this new position as developed
by the American Dental Association and the success of this position in other states
piloting the use of community dental health coordinators. The commissioner shall report
to the legislature by January 2009 on whether the state should consider certification or
registration of community dental health coordinators in Minnesota.
new text end

Sec. 11. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the references in clauses (1) to (4) as follows:
new text end

new text begin (1) In Minnesota Statutes, section 144.608, subdivision 1, change "144.1501,
subdivision 1, paragraph (b)" to "144.1501, subdivision 1, paragraph (d)";
new text end

new text begin (2) In Minnesota Statutes, section 144.608, subdivision 1, change "144.1501,
subdivision 1, paragraph (h)" to "144.1501, subdivision 1, paragraph (j)";
new text end

new text begin (3) In Minnesota Statutes, section 144.608, subdivision 1, change "144.1501,
subdivision 1, paragraph (j)" to "144.1501, subdivision 1, paragraph (m)"; and
new text end

new text begin (4) In Minnesota Statutes, section 147A.08, change "144.1501, subdivision 1,
paragraphs (f), (h), and (i)" to "144.1501, subdivision 1, paragraphs (h), (j), and (l)".
new text end

Sec. 12. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2006, section 256B.037, subdivisions 1a, 1c, 2, 5, and 6, new text end new text begin are
repealed.
new text end