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Office of the Revisor of Statutes

HF 400

5th Engrossment - 91st Legislature (2019 - 2020) Posted on 04/01/2019 03:42pm

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to health; establishing the Opioid Addiction Advisory Council; establishing
the opioid stewardship fund; establishing an opiate product registration fee;
modifying provisions related to opioid addiction prevention, education, intervention,
treatment, and recovery; requiring reports; appropriating money;amending
Minnesota Statutes 2018, sections 16A.151, subdivision 2; 145.9269, subdivision
1; 145C.05, subdivision 2; 151.252, subdivision 1; 151.37, subdivision 12; 151.47,
by adding a subdivision; 151.71, by adding a subdivision; 152.105, subdivision
2; 152.11, subdivision 2d, by adding subdivisions; 214.12, by adding a subdivision;
proposing coding for new law in Minnesota Statutes, chapters 16A; 62Q; 145;
145C; 151.

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

ARTICLE 1

OPIOID PRODUCT STEWARDSHIP

Section 1.

Minnesota Statutes 2018, section 16A.151, subdivision 2, is amended to read:


Subd. 2.

Exceptions.

(a) If a state official litigates or settles a matter on behalf of specific
injured persons or entities, this section does not prohibit distribution of money to the specific
injured persons or entities on whose behalf the litigation or settlement efforts were initiated.
If money recovered on behalf of injured persons or entities cannot reasonably be distributed
to those persons or entities because they cannot readily be located or identified or because
the cost of distributing the money would outweigh the benefit to the persons or entities, the
money must be paid into the general fund.

(b) Money recovered on behalf of a fund in the state treasury other than the general fund
may be deposited in that fund.

(c) This section does not prohibit a state official from distributing money to a person or
entity other than the state in litigation or potential litigation in which the state is a defendant
or potential defendant.

(d) State agencies may accept funds as directed by a federal court for any restitution or
monetary penalty under United States Code, title 18, section 3663(a)(3) or United States
Code, title 18, section 3663A(a)(3). Funds received must be deposited in a special revenue
account and are appropriated to the commissioner of the agency for the purpose as directed
by the federal court.

(e) Tobacco settlement revenues as defined in section 16A.98, subdivision 1, paragraph
(t), may be deposited as provided in section 16A.98, subdivision 12.

new text begin (f) Any money received by the state from a settlement agreement or court order from
litigation brought by the attorney general of the state on behalf of the state or a state agency,
against one or more opioid manufacturers related to violations of consumer fraud laws in
the marketing and sale of opioids in this state or other illegal actions that contributed to the
excessive use of opioids, must be deposited in the opioid stewardship fund established under
section 16A.7245. This paragraph does not apply to attorney fees and costs awarded to the
Attorney General's office, to contract attorneys hired by the Attorney General's office, or
to other state agency attorneys.
new text end

Sec. 2.

new text begin [16A.7245] OPIOID STEWARDSHIP FUND.
new text end

new text begin An opioid stewardship fund is created in the state treasury. The commissioner shall
deposit to the credit of the fund the registration fees collected by the Board of Pharmacy
under section 151.77 and any other money made available to the fund. Notwithstanding
section 11A.20, all investment income and all investment losses attributable to the investment
of the opioid stewardship fund not currently needed must be credited to the opioid
stewardship fund.
new text end

Sec. 3.

Minnesota Statutes 2018, section 151.252, subdivision 1, is amended to read:


Subdivision 1.

Requirements.

(a) No person shall act as a drug manufacturer without
first obtaining a license from the board and paying any applicable fee specified in section
151.065.

new text begin (b) In addition to the license required under paragraph (a), a manufacturer of a Schedule
II through IV opiate controlled substance must pay the applicable registration fee specified
in section 151.77, subdivision 3, by June 1 of each year, beginning June 1, 2020. In the
event of a change of ownership of the manufacturer, the new owner must pay the registration
fee specified under section 151.77, subdivision 3, that the original owner would have been
assessed had it retained ownership. The board may assess a late fee of ten percent per month
for every portion of a month that the registration fee is paid after the due date.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end Application for a drug manufacturer license under this section shall be made in
a manner specified by the board.

deleted text begin (c)deleted text endnew text begin (d)new text end No license shall be issued or renewed for a drug manufacturer unless the applicant
agrees to operate in a manner prescribed by federal and state law and according to Minnesota
Rules.

deleted text begin (d)deleted text endnew text begin (e)new text end No license shall be issued or renewed for a drug manufacturer that is required to
be registered pursuant to United States Code, title 21, section 360, unless the applicant
supplies the board with proof of registration. The board may establish by rule the standards
for licensure of drug manufacturers that are not required to be registered under United States
Code, title 21, section 360.

deleted text begin (e)deleted text endnew text begin (f)new text end No license shall be issued or renewed for a drug manufacturer that is required to
be licensed or registered by the state in which it is physically located unless the applicant
supplies the board with proof of licensure or registration. The board may establish, by rule,
standards for the licensure of a drug manufacturer that is not required to be licensed or
registered by the state in which it is physically located.

deleted text begin (f)deleted text endnew text begin (g)new text end The board shall require a separate license for each facility located within the state
at which drug manufacturing occurs and for each facility located outside of the state at
which drugs that are shipped into the state are manufactured.

deleted text begin (g)deleted text endnew text begin (h)new text end The board shall not issue an initial or renewed license for a drug manufacturing
facility unless the facility passes an inspection conducted by an authorized representative
of the board. In the case of a drug manufacturing facility located outside of the state, the
board may require the applicant to pay the cost of the inspection, in addition to the license
fee in section 151.065, unless the applicant furnishes the board with a report, issued by the
appropriate regulatory agency of the state in which the facility is located or by the United
States Food and Drug Administration, of an inspection that has occurred within the 24
months immediately preceding receipt of the license application by the board. The board
may deny licensure unless the applicant submits documentation satisfactory to the board
that any deficiencies noted in an inspection report have been corrected.

Sec. 4.

new text begin [151.255] OPIOID ADDICTION ADVISORY COUNCIL.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment of advisory council. new text end

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

new text begin (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;
new text end

new text begin (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;
new text end

new text begin (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;
new text end

new text begin (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 adult protective services and other social services to individuals and families
affected by the opioid overdose epidemic; and
new text end

new text begin (5) the development of measures to assess and protect the ability of cancer patients and
survivors, persons battling life threatening illnesses, persons suffering from severe chronic
pain, and persons at the end stages of life, who legitimately need prescription pain
medications, to maintain their quality of life by accessing these pain medications without
facing unnecessary barriers. The measures must also address the needs of individuals
described in this clause who are elderly or who reside in underserved or rural areas of the
state.
new text end

new text begin (b) The council shall:
new text end

new text begin (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;
new text end

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

new text begin (3) ensure available funding is aligned with existing state and federal funding to achieve
the greatest impact and ensure a coordinated state effort;
new text end

new text begin (4) develop criteria and procedures to be used in awarding grants and allocating available
funds from the opioid stewardship fund; and
new text end

new text begin (5) develop measurable outcomes to determine the effectiveness of the funds allocated.
new text end

new text begin (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 stewardship
fund. 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, 2020.
new text end

new text begin Subd. 2. new text end

new text begin Membership. new text end

new text begin (a) The council shall consist of 22 members, appointed by the
commissioner of human services except as otherwise specified:
new text end

new text begin (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;
new text end

new text begin (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;
new text end

new text begin (3) one member appointed by the Board of Pharmacy;
new text end

new text begin (4) one member who is a medical doctor appointed by the Minnesota Medical Association;
new text end

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

new text begin (6) one member representing the National Alliance on Mental Illness (NAMI);
new text end

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

new text begin (8) one member representing professionals providing alternative pain management
therapies;
new text end

new text begin (9) the commissioner of education or a designee;
new text end

new text begin (10) one member representing the Minnesota courts who is a judge or law enforcement
officer;
new text end

new text begin (11) one member representing the Minnesota Hospital Association;
new text end

new text begin (12) two members representing Indian tribes;
new text end

new text begin (13) the commissioner of human services or a designee;
new text end

new text begin (14) the commissioner of corrections or a designee;
new text end

new text begin (15) one advanced practice registered nurse appointed by the Board of Nursing;
new text end

new text begin (16) the commissioner of health or a designee;
new text end

new text begin (17) one member representing a local health department;
new text end

new text begin (18) one member with personal experience of opioid addiction, representing a nonprofit
entity specializing in providing support to persons recovering from substance use disorder;
and
new text end

new text begin (19) one member with personal experience of severe chronic pain.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (d) The chair shall convene the council on a quarterly basis 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.
new text end

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

new text begin (f) The council is subject to chapter 13D.
new text end

Sec. 5.

new text begin [151.256] USE OF OPIOID STEWARDSHIP FUND.
new text end

new text begin Subdivision 1. new text end

new text begin Use of funds. new text end

new text begin (a) For fiscal year 2020, money in the opioid stewardship
fund established under section 16A.7245 is appropriated as specified in article 5.
new text end

new text begin (b) For fiscal year 2021 and subsequent fiscal years, money in the opioid stewardship
fund is appropriated to the commissioner of human services, to be distributed, in consultation
with the Opioid Addiction Advisory Council, as grants or other funding, or as transfers to
the Department of Health and other state agencies, as determined appropriate to address the
opioid epidemic in the state. The commissioner may retain up to five percent of the
appropriation for administrative costs of implementing this paragraph and for administrative
costs related to the Opioid Addiction Advisory Council. The commissioner, in consultation
with the advisory council, may provide additional appropriations for the initiatives funded
in article 5. 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.
new text end

new text begin Subd. 2. new text end

new text begin Annual report. new text end

new text begin Beginning January 15, 2020, and each January 15 thereafter,
the commissioner, in consultation with the Opioid Addiction 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 article 5 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.
new text end

Sec. 6.

Minnesota Statutes 2018, section 151.47, is amended by adding a subdivision to
read:


new text begin Subd. 1a. new text end

new text begin Controlled substance wholesale drug distributor requirements. new text end

new text begin In addition
to the license required under subdivision 1, a wholesale drug distributor distributing a
Schedule II through IV opiate controlled substance must pay the applicable registration fee
specified in section 151.77, subdivision 4, by June 1 of each year beginning June 1, 2020.
In the event of a change in ownership of the wholesale drug distributor, the new owner must
pay the registration fee specified in section 151.77, subdivision 4, that the original owner
would have been assessed had it retained ownership. The board may assess a late fee of ten
percent per month for every portion of a month that the registration fee is paid after the due
date.
new text end

Sec. 7.

new text begin [151.77] OPIATE PRODUCT REGISTRATION FEE.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For purposes of this section, the following terms have the
meanings given them in this subdivision.
new text end

new text begin (1) "manufacturer" means a manufacturer licensed under section 151.252 that is engaged
in the manufacturing of an opiate;
new text end

new text begin (2) "opiate" means any opiate-containing controlled substance listed in section 152.02,
subdivisions 3 to 5, that is distributed, delivered, sold, or dispensed into or within this state;
and
new text end

new text begin (3) "wholesaler" means a wholesale drug distributor who is licensed under section 151.47,
and is engaged in the wholesale drug distribution of an opiate.
new text end

new text begin Subd. 2. new text end

new text begin Reporting requirements. new text end

new text begin (a) By March 1 of each year, beginning March 1,
2020, each manufacturer and each wholesale drug distributor must report to the board every
sale, delivery, or other distribution within or into this state of any opiate that is made to any
practitioner, pharmacy, hospital, veterinary hospital, or other person who is permitted by
section 151.37 to possess controlled substances for administration or dispensing to patients
that occurred during the previous calendar year. Reporting must be in the automation of
reports and consolidated orders system format unless otherwise specified by the board. If
a manufacturer or wholesaler fails to provide information required under this paragraph on
a timely basis, the board may assess an administrative penalty of $500 per day. This penalty
shall not be considered a form of disciplinary action.
new text end

new text begin (b) By March 1 of each year, beginning March 1, 2020, each owner of a pharmacy with
at least one location within this state must report to the board the intracompany delivery or
distribution into this state of any opiate, to the extent that those deliveries and distributions
are not reported to the board by a licensed wholesale drug distributor owned by, under
contract to, or otherwise operating on behalf of the owner of the pharmacy. Reporting must
be in the manner and format specified by the board for deliveries and distributions that
occurred during the previous calendar year. The report must include the name of the
manufacturer or wholesaler from which the owner of the pharmacy ultimately purchased
the opiate, and the amount and date that the purchases occurred.
new text end

new text begin Subd. 3. new text end

new text begin Determination of each manufacturer's registration fee. new text end

new text begin (a) The board shall
annually assess manufacturer registration fees that in an aggregate amount total $12,000,000.
The board shall determine each manufacturer's annual registration fee that is prorated and
based on the manufacturer's percentage of the total number of units reported to the board
under subdivision 2.
new text end

new text begin (b) By April 1 of each year, beginning April 1, 2020, the board shall notify each
manufacturer of the annual amount of the manufacturer's registration fee to be paid by June
1, in accordance with section 151.252, subdivision 1, paragraph (b).
new text end

new text begin (c) In conjunction with the data reported under this section, and notwithstanding section
152.126, subdivision 6, the board may use the data reported under section 152.126,
subdivision 4, to determine the manufacturer registration fees required under this subdivision.
new text end

new text begin (d) A manufacturer may dispute the registration fee as determined by the board no later
than 30 days after the date of notification; however, the manufacturer must still remit the
fee as required by section 151.252, subdivision 1, paragraph (b). The dispute must be filed
with the board in the manner and using the forms specified by the board. A manufacturer
must submit, with the required forms, data satisfactory to the board that demonstrates that
the registration fee was incorrect. The board must make a decision concerning a dispute no
later than 60 days after receiving the required dispute forms. If the board determines that
the manufacturer has satisfactorily demonstrated that the original fee was incorrect, the
board must adjust the manufacturer's registration fee due the next year by the amount that
is in excess of the correct fee that should have been paid.
new text end

new text begin Subd. 4. new text end

new text begin Determination of each wholesaler's registration fee. new text end

new text begin (a) The board shall
annually assess wholesaler registration fees that in an aggregate amount total $8,000,000.
The board shall determine each wholesaler's annual registration fee that is prorated and
based on the wholesaler's percentage of the total number of units reported to the board under
subdivision 2. This paragraph does not apply to a wholesaler if the wholesaler is also licensed
as a drug manufacturer under section 151.252.
new text end

new text begin (b) By April 1 of each year, beginning April 1, 2020, the board shall notify each
wholesaler of the annual amount of the wholesaler's registration fee to be paid by June 1,
in accordance with section 151.47, subdivision 1a.
new text end

new text begin (c) A wholesaler may dispute the registration fee as determined by the board no later
than 30 days after the date of notification. However, the wholesaler must still remit the fee
as required by section 151.47, subdivision 1a. The dispute must be filed with the board in
the manner and using the forms specified by the board. A wholesaler must submit, with the
required forms, data satisfactory to the board that demonstrates that the registration fee was
incorrect. The board must make a decision concerning a dispute no later than 60 days after
receiving the required dispute forms. If the board determines that the wholesaler has
satisfactorily demonstrated that the original fee was incorrect, the board must adjust the
wholesaler's registration fee due the next year by the amount that is in excess of the correct
fee that should have been paid.
new text end

new text begin Subd. 5. new text end

new text begin Report. new text end

new text begin (a) The Board of Pharmacy shall evaluate the registration fee on drug
manufacturers and wholesalers established under this section, and whether the fee has
impacted the prescribing practices for opiates by reducing the number of opiate prescriptions
issued during calendar years 2020, 2021, and 2022, to the extent the board has the ability
to effectively identify a correlation. Notwithstanding section 152.126, subdivision 6, the
board may access the data reported under section 152.126, subdivision 4, to conduct this
evaluation.
new text end

new text begin (b) The board shall submit the results of its evaluation to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance by March 1, 2023.
new text end

new text begin Subd. 6. new text end

new text begin Legislative review. new text end

new text begin The legislature shall review the reports from the Opioid
Addiction Advisory Council under section 151.255, subdivision 1, paragraph (c), the report
from the Board of Pharmacy under subdivision 5, and any other relevant report or information
related to the opioid crisis in Minnesota, to make a determination about whether the opiate
product registration fee assessed under this section should continue beyond July 1, 2023.
new text end

Sec. 8. new text beginADVISORY COUNCIL FIRST MEETING.
new text end

new text begin The commissioner of human services shall convene the first meeting of the Opioid
Addiction Advisory Council established under Minnesota Statutes, section 151.255, no later
than October 1, 2019. The members shall elect a chair at the first meeting.
new text end

ARTICLE 2

HEALTH PLAN COMPANY REQUIREMENTS

Section 1.

new text begin [62Q.528] COVERAGE FOR PAIN MANAGEMENT SERVICES.
new text end

new text begin (a) All health plans must cover acupuncture services for the treatment of pain and ongoing
pain management when those services are performed by an individual who is licensed as:
new text end

new text begin (1) new text end new text begin an acupuncture practitioner under chapter 147B; or
new text end

new text begin (2) a chiropractor under chapter 148.
new text end

new text begin (b) Notwithstanding paragraph (a), coverage for acupuncture services under medical
assistance and MinnesotaCare is in accordance with section 256B.0625, subdivision 8f.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020, and applies to health
plans offered, issued, or renewed to a Minnesota resident on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2018, section 151.71, is amended by adding a subdivision to
read:


new text begin Subd. 3. new text end

new text begin Lowest cost to consumers. new text end

new text begin (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).
new text end

new text begin (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.
new text end

ARTICLE 3

PREVENTION AND EDUCATION

Section 1.

Minnesota Statutes 2018, section 145C.05, subdivision 2, is amended to read:


Subd. 2.

Provisions that may be included.

(a) A health care directive may include
provisions consistent with this chapter, including, but not limited to:

(1) the designation of one or more alternate health care agents to act if the named health
care agent is not reasonably available to serve;

(2) directions to joint health care agents regarding the process or standards by which the
health care agents are to reach a health care decision for the principal, and a statement
whether joint health care agents may act independently of one another;

(3) limitations, if any, on the right of the health care agent or any alternate health care
agents to receive, review, obtain copies of, and consent to the disclosure of the principal's
medical records or to visit the principal when the principal is a patient in a health care
facility;

(4) limitations, if any, on the nomination of the health care agent as guardian for purposes
of sections 524.5-202, 524.5-211, 524.5-302, and 524.5-303;

(5) a document of gift for the purpose of making an anatomical gift, as set forth in chapter
525A, or an amendment to, revocation of, or refusal to make an anatomical gift;

(6) a declaration regarding intrusive mental health treatment under section 253B.03,
subdivision 6d
, or a statement that the health care agent is authorized to give consent for
the principal under section 253B.04, subdivision 1a;

(7) a funeral directive as provided in section 149A.80, subdivision 2;

(8) limitations, if any, to the effect of dissolution or annulment of marriage or termination
of domestic partnership on the appointment of a health care agent under section 145C.09,
subdivision 2
;

(9) specific reasons why a principal wants a health care provider or an employee of a
health care provider attending the principal to be eligible to act as the principal's health care
agent;

(10) health care instructions by a woman of child bearing age regarding how she would
like her pregnancy, if any, to affect health care decisions made on her behalf; deleted text beginand
deleted text end

(11) health care instructions regarding artificially administered nutrition or hydrationdeleted text begin.deleted text endnew text begin;
and
new text end

new text begin (12) health care instructions to prohibit administering, dispensing, or prescribing an
opioid, except that these instructions must not be construed to limit the administering,
dispensing, or prescribing an opioid to treat substance abuse, opioid dependence, or an
overdose, unless otherwise prohibited in the health care directive.
new text end

(b) A health care directive may include a statement of the circumstances under which
the directive becomes effective other than upon the judgment of the principal's attending
physician in the following situations:

(1) a principal who in good faith generally selects and depends upon spiritual means or
prayer for the treatment or care of disease or remedial care and does not have an attending
physician, may include a statement appointing an individual who may determine the
principal's decision-making capacity; and

(2) a principal who in good faith does not generally select a physician or a health care
facility for the principal's health care needs may include a statement appointing an individual
who may determine the principal's decision-making capacity, provided that if the need to
determine the principal's capacity arises when the principal is receiving care under the
direction of an attending physician in a health care facility, the determination must be made
by an attending physician after consultation with the appointed individual.

If a person appointed under clause (1) or (2) is not reasonably available and the principal
is receiving care under the direction of an attending physician in a health care facility, an
attending physician shall determine the principal's decision-making capacity.

(c) A health care directive may authorize a health care agent to make health care decisions
for a principal even though the principal retains decision-making capacity.

Sec. 2.

new text begin [145C.17] OPIOID INSTRUCTIONS ENTERED INTO HEALTH RECORD.
new text end

new text begin At the request of the patient or health care agent, a health care provider shall enter into
the patient's health care record any instructions relating to administering, dispensing, or
prescribing an opioid.
new text end

Sec. 3.

Minnesota Statutes 2018, 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.new text begin The sheriff of each county may meet
the requirements of this subdivision through 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.
new text end

Sec. 4.

Minnesota Statutes 2018, section 152.11, subdivision 2d, is amended to read:


Subd. 2d.

Identification requirement for deleted text beginSchedule II or IIIdeleted text end controlled substance
prescriptions.

deleted text begin(a)deleted text end No person may dispense a controlled substance included in deleted text beginSchedule II
or III
deleted text endnew text begin Schedules II through Vnew text end without requiring the person purchasing the controlled
substance, who need not be the deleted text beginpersondeleted text endnew text begin patientnew text end for whom the controlled substance prescription
is written, to present valid photographic identification, unless the person purchasing the
controlled substancedeleted text begin, or if applicable the person for whom the controlled substance
prescription is written,
deleted text end is known to the dispenser.new text begin A doctor of veterinary medicine who
dispenses a controlled substance must comply with this subdivision.
new text end

deleted text begin (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.
deleted text end

Sec. 5.

Minnesota Statutes 2018, section 152.11, is amended by adding a subdivision to
read:


new text begin Subd. 5. new text end

new text begin Limitations on dispensing of opioid prescription drug orders. new text end

new text begin (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.
new text end

new text begin (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.
new text end

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

Sec. 6.

Minnesota Statutes 2018, section 152.11, is amended by adding a subdivision to
read:


new text begin Subd. 6. new text end

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

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

Sec. 7.

Minnesota Statutes 2018, section 214.12, is amended by adding a subdivision to
read:


new text begin Subd. 6. new text end

new text begin Opioid and controlled substances prescribing. new text end

new text begin (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, including nonpharmacological alternatives
for treatment of pain and ongoing pain management, 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.
new text end

new text begin (b) This subdivision expires January 1, 2023.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

ARTICLE 4

INTERVENTION, TREATMENT, AND RECOVERY

Section 1.

Minnesota Statutes 2018, section 145.9269, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

For purposes of this sectionnew text begin and section 145.9272new text end, "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.

new text begin [145.9272] GRANTS FOR OPIOID ADDICTION AND SUBSTANCE USE
DISORDER TREATMENT, RECOVERY, AND PREVENTION PROGRAMS.
new text end

new text begin Subdivision 1. new text end

new text begin Grant program established. new text end

new text begin (a) The commissioner of health shall
distribute grants to qualified entities operating in Minnesota as of January 1, 2019, for
integrated, community-based programs in primary care settings to treat, prevent, and raise
awareness of opioid addiction and substance use disorders. The commissioner shall determine
the maximum award for grants.
new text end

new text begin (b) For purposes of this section, a "qualified entity" means a federally qualified health
center, substance use disorder treatment program, or other provider of opioid prevention,
treatment, and recovery services as designated by the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Grant allocation; allowable uses. new text end

new text begin (a) The commissioner shall allocate grants
to qualified entities operating in Minnesota as of January 1, 2019, through a competitive
process. The commissioner shall award grants to qualified entities to establish new opioid
addiction and substance use disorder programs and to expand existing programs.
new text end

new text begin (b) In awarding grants, the commissioner shall give preference to proposals that expand
access to culturally appropriate services for low-income persons, populations at greatest
risk of opioid addiction, or populations or areas of the state that are underserved.
new text end

new text begin Subd. 3. new text end

new text begin Report. new text end

new text begin Each grant recipient shall report to the commissioner, at a time and in
a manner specified by the commissioner, information on the use of grant funding and
outcomes achieved. The commissioner shall compile this information into a report and shall
provide the report to the chairs and ranking minority members of the legislative committees
with jurisdiction over health and human services policy and finance by December 15, 2020.
new text end

Sec. 3.

Minnesota Statutes 2018, 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);
deleted text begin and
deleted text end

(3) staff of community-based health disease prevention or social service programsdeleted text begin.deleted text endnew text begin;
new text end

new text begin (4) a probation or supervised release officer;
new text end

new text begin (5) a volunteer firefighter; and
new text end

new text begin (6) a licensed school nurse or certified public health nurse employed by, or under contract
with, a school board under section 121A.21.
new text end

(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.

ARTICLE 5

APPROPRIATIONS

Section 1. new text beginBUREAU OF CRIMINAL APPREHENSION.
new text end

new text begin $288,000 in fiscal year 2020 and $288,000 in fiscal year 2021 are appropriated from the
opioid stewardship fund to the Bureau of Criminal Apprehension for two additional special
agent positions within the bureau 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. The Bureau of Criminal Apprehension shall report by November
1, 2021, to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services policy and finance and public safety, on the
initiatives funded under this section. This is an ongoing appropriation from the opioid
stewardship fund.
new text end

Sec. 2.

new text begin COMMISSIONER OF HUMAN SERVICES.
new text end

new text begin (a) $8,283,000 in fiscal year 2020 is appropriated from the opioid stewardship fund to
the commissioner of human services. The commissioner, in consultation with the Opioid
Addiction Advisory Council, shall distribute the appropriation according to this section.
All appropriations in this section are onetime, unless otherwise specified.
new text end

new text begin (b) At least 30 percent of the available funds shall be used for county social services
agencies and tribal social service agency initiative projects authorized by the commissioner
under section 256.01, subdivision 14b, to provide services to children in placement. The
commissioner shall distribute the money allocated under this subdivision proportionally to
counties and tribes based on the number of open child protection case management cases
using data from the previous calendar year.
new text end

new text begin (c) At least ten percent of the available funds shall be used to provide grants to county
boards to fund programs and services to prevent and treat opioid addiction.
new text end

new text begin (d) The commissioner may use up to five percent of the available funds for administration
of this section and to provide staff and administrative services for the Opioid Addiction
Advisory Council.
new text end

new text begin (e) The remaining appropriation must be used for providing grants to nonprofit
organizations for the purpose of expanding prescriber education and public awareness and
the purchase of opiate antagonists for distribution to the health care and public safety
communities.
new text end

new text begin (f) Each recipient of grants or funding for fiscal year 2020 shall report to the
commissioner and the Opioid Addiction Advisory Council on how the funds were spent
and the outcomes achieved, in the form and manner specified by the commissioner.
new text end

Sec. 3. new text beginCOMMISSIONER OF HEALTH.
new text end

new text begin Subdivision 1. new text end

new text begin Grants to qualified entities. new text end

new text begin $2,000,000 in fiscal year 2020 is appropriated
from the opioid stewardship fund to the commissioner of health for grants to qualified
entities for opioid addiction and substance use disorder programs under Minnesota Statutes,
section 145.9272. This is a onetime appropriation.
new text end

new text begin Subd. 2. new text end

new text begin Opioid prevention pilot project. new text end

new text begin $2,400,000 in fiscal year 2020 is appropriated
from the opioid stewardship fund to the commissioner of health to continue and expand
opioid abuse prevention pilot projects under Laws 2017, First Special Session chapter 6,
article 10, section 144. This is a onetime appropriation.
new text end

new text begin Subd. 3. new text end

new text begin Non-narcotic pain management and wellness. new text end

new text begin $1,250,000 is appropriated in
fiscal year 2020 from the opioid stewardship fund to the commissioner of health, to provide
funding for:
new text end

new text begin (1) statewide mapping and assessment of community-based non-narcotic pain
management and wellness resources, including access to implantable and nonimplantable
medical devices; and
new text end

new text begin (2) up to five demonstration projects in different geographic areas of the state to provide
community-based non-narcotic pain management and wellness resources, including
implantable and nonimplantable medical devices, to patients and consumers.
new text end

new text begin The demonstration projects must include an evaluation component and scalability analysis.
The commissioner shall award the grant for the statewide mapping and assessment, and the
demonstration project grants, through a competitive request for proposal process. Grants
for statewide mapping and assessment and demonstration projects may be awarded
simultaneously. In awarding demonstration project grants, the commissioner shall give
preference to proposals that incorporate innovative community partnerships, are informed
and led by people in the community where the project is taking place, and are culturally
relevant and delivered by culturally competent providers. This is a onetime appropriation.
new text end

new text begin Subd. 4. new text end

new text begin Culturally specific opioid addiction prevention and treatment programs. new text end

new text begin (a)
$4,520,000 in fiscal year 2020 and $4,520,000 in fiscal year 2021 are appropriated from
the opioid stewardship fund to the commissioner of health, to award, beginning July 1,
2019, five-year grants to: (1) tribal governments; and (2) American Indian organizations
providing services to American Indians residing in urban areas of the state. Grant dollars
may be used to design, implement, and evaluate culturally specific opioid addiction
prevention and treatment programs, or to expand or modify existing programs. Program
design, implementation, expansion, modification, and evaluation shall be conducted by
tribal health and elected leaders, and the leaders of American Indian organizations awarded
grants. These leaders shall also determine which strategies and activities are culturally
appropriate. The commissioner shall provide the tribes and organizations awarded grants
with technical assistance. Grant awards may be used to support competitive compensation
for staff members and to pay for fringe, indirect, training and continued education, travel,
supply, and evaluation costs. Base funding for these grants is $4,520,000 for fiscal year
2022 and $4,520,000 for fiscal year 2023.
new text end

new text begin (b) Of the appropriation in paragraph (a), $3,300,000 each fiscal year is for the
commissioner to provide grants of equal value to each tribe and to apportion an additional
amount among the tribes based on the number of tribal members.
new text end

new text begin (c) Of the appropriation in paragraph (a), $1,250,000 each fiscal year is for the
commissioner to award grants to American Indian organizations providing services in urban
areas, using a competitive request for proposal process. A grant to an organization shall not
exceed $250,000 per fiscal year.
new text end

new text begin Subd. 5. new text end

new text begin Administration. new text end

new text begin $890,000 in fiscal year 2020 and $702,000 in fiscal year 2021
are appropriated from the opioid stewardship fund to the commissioner of health to administer
the programs in this section. The base for administration is $485,000 in fiscal year 2022
and $485,000 in fiscal year 2023.
new text end

Sec. 4. new text beginHEALTH RELATED BOARDS.
new text end

new text begin Subdivision 1. new text end

new text begin Board of Dentistry; continuing education. new text end

new text begin $11,000 in fiscal year 2020
is appropriated from the opioid stewardship fund to the Board of Dentistry for costs associated
with continuing education on prescribing opioids and controlled substances and
nonpharmacologic alternatives for pain management. This is a onetime appropriation.
new text end

new text begin Subd. 2. new text end

new text begin Board of Nursing; continuing education. new text end

new text begin $17,000 in fiscal year 2020 is
appropriated from the opioid stewardship fund to the Board of Nursing for costs associated
with continuing education on prescribing opioids and controlled substances and
nonpharmacologic alternatives for pain management. This is a onetime appropriation.
new text end

new text begin Subd. 3. new text end

new text begin Board of Optometry; continuing education. new text end

new text begin $5,000 in fiscal year 2020 is
appropriated from the opioid stewardship fund to the Board of Optometry for costs associated
with continuing education on prescribing opioids and controlled substances. This is a onetime
appropriation.
new text end

new text begin Subd. 4. new text end

new text begin Board of Podiatric Medicine; continuing education. new text end

new text begin $5,000 in fiscal year
2020 is appropriated from the opioid stewardship fund to the Board of Podiatric Medicine
for costs associated with continuing education on prescribing opioids and controlled
substances. This is a onetime appropriation.
new text end

new text begin Subd. 5. new text end

new text begin Board of Medical Practice; continuing education. new text end

new text begin $17,000 in fiscal year
2020 is appropriated from the opioid stewardship fund to the Board of Medical Practice for
costs associated with continuing education on prescribing opioids and controlled substances
and nonpharmacologic alternatives for pain management. This is a onetime appropriation.
new text end

new text begin Subd. 6. new text end

new text begin Board of Pharmacy. new text end

new text begin $284,000 in fiscal year 2020 and $126,000 in fiscal year
2021 are appropriated from the opioid stewardship fund to the Board of Pharmacy for
collection of the registration fee under Minnesota Statutes, section 151.77. This is an ongoing
appropriation from the opioid stewardship fund.
new text end