HF 4140

as introduced - 93rd Legislature (2023 - 2024) Posted on 03/18/2024 04:21pm

A bill for an act
relating to health; modifying the hospital nursing educational loan forgiveness
program; appropriating money; amending Minnesota Statutes 2023 Supplement,
section 144.1501, subdivisions 1, 2, 3, 4; Laws 2023, chapter 70, article 20, section
3, subdivisions 1, 2; proposing coding for new law in Minnesota Statutes, chapter
144.

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

Section 1.

Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 1, is
amended to read:

Subdivision 1.

Definitions.

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

(b) "Advanced dental therapist" means an individual who is licensed as a dental therapist
under section 150A.06, and who is certified as an advanced dental therapist under section
150A.106.

(c) "Alcohol and drug counselor" means an individual who is licensed as an alcohol and
drug counselor under chapter 148F.

(d) "Dental therapist" means an individual who is licensed as a dental therapist under
section 150A.06.

(e) "Dentist" means an individual who is licensed to practice dentistry.

(f) "Designated rural area" means a statutory and home rule charter city or township that
is outside the seven-county metropolitan area as defined in section 473.121, subdivision 2,
excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.

(g) "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 (h) "Hospital nurse" means an individual who is licensed as a registered nurse and who
is providing direct patient care in a nonprofit hospital setting.
deleted text end

deleted text begin (i) deleted text end new text begin (h) new text end "Mental health professional" means an individual providing clinical services in
the treatment of mental illness who is qualified in at least one of the ways specified in section
245.462, subdivision 18.

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

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

deleted text begin (p) deleted text end new text begin (o) 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 (q) deleted text end new text begin (p) new text end "Physician assistant" means a person licensed under chapter 147A.

deleted text begin (r) deleted text end new text begin (q) new text end "Public health nurse" means a registered nurse licensed in Minnesota who has
obtained a registration certificate as a public health nurse from the Board of Nursing in
accordance with Minnesota Rules, chapter 6316.

deleted text begin (s) deleted text end new text begin (r) 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 (t) deleted text end new text begin (s) 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 2023 Supplement, 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 new text begin in the health care access fund new text end . The commissioner of health
shall use money from the account to establish a loan forgiveness program:

(1) for medical residents, mental health professionals, and alcohol and drug counselors
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
at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program
at the undergraduate level or the equivalent at the graduate level;

(3) for nurses who agree to practice in a Minnesota nursing home; in an intermediate
care facility for persons with developmental disability; in a hospital if the hospital owns
and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked
by the nurse is in the nursing home; in an assisted living facility as defined in section
144G.08, subdivision 7; or for a home care provider as defined in section 144A.43,
subdivision 4; or agree to teach at least 12 credit hours, or 720 hours per year in the nursing
field in a postsecondary program at the undergraduate level or the equivalent at the graduate
level;

(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
hours per year in their designated field in a postsecondary program at the undergraduate
level or the equivalent at the graduate level. 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;

(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses
who agree to practice in designated rural areas; new text begin and
new text end

(6) for dentists agreeing to deliver at least 25 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 303 deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (7) for nurses employed as a hospital nurse by a nonprofit hospital and providing direct
care to patients at the nonprofit hospital.
deleted text end

(b) 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 new text begin
health care access new text end fund.

Sec. 3.

Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 3, is amended
to read:

Subd. 3.

Eligibility.

(a) To be eligible to participate in the loan forgiveness program, an
individual must:

(1) be a medical or dental resident; a licensed pharmacist; or be enrolled in a training or
education program to become a dentist, dental therapist, advanced dental therapist, mental
health professional, alcohol and drug counselor, pharmacist, public health nurse, midlevel
practitioner, registered nurse, or a licensed practical nurse. The commissioner may also
consider applications submitted by graduates in eligible professions who are licensed and
in practice; and

(2) submit an application to the commissioner of health. deleted text begin A nurse applying under
subdivision 2, paragraph (a), clause (7), must also include proof that the applicant is employed
as a hospital nurse.
deleted text end

(b) An applicant selected to participate must sign a contract to agree to serve a minimum
three-year full-time service obligation according to subdivision 2, which shall begin no later
than March 31 following completion of required training, with the exception of:

(1) a nurse, who must agree to serve a minimum two-year full-time service obligation
according to subdivision 2, which shall begin no later than March 31 following completion
of required training; new text begin and
new text end

deleted text begin (2) a nurse selected under subdivision 2, paragraph (a), clause (7), who must agree to
continue as a hospital nurse for a minimum two-year service obligation; and
deleted text end

deleted text begin (3) deleted text end new text begin (2) new text end a nurse who agrees to teach according to subdivision 2, paragraph (a), clause (3),
who must sign a contract to agree to teach for a minimum of two years.

Sec. 4.

Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 4, is amended
to read:

Subd. 4.

Loan forgiveness.

(a) The commissioner of health may select applicants each
year for participation in the loan forgiveness program, within the limits of available funding.
In considering applications, the commissioner shall give preference to applicants who
document diverse cultural competencies. The commissioner shall distribute available funds
for loan forgiveness proportionally among the eligible professions according to the vacancy
rate for each profession in the required geographic area, facility type, teaching area, patient
group, or specialty type specified in subdivision 2 deleted text begin , except for hospital nurses deleted text end . The
commissioner shall allocate funds for physician loan forgiveness so that 75 percent of the
funds available are used for rural physician loan forgiveness and 25 percent of the funds
available are used for underserved urban communities and pediatric psychiatry loan
forgiveness. If the commissioner does not receive enough qualified applicants each year to
use the entire allocation of funds for any eligible profession, the remaining funds may be
allocated proportionally among the other eligible professions according to the vacancy rate
for each profession in the required geographic area, patient group, or facility type specified
in subdivision 2. Applicants are responsible for securing their own qualified educational
loans. The commissioner shall select participants based on their suitability for practice
serving the required geographic area or facility type specified in subdivision 2, as indicated
by experience or training. The commissioner shall give preference to applicants closest to
completing their training. Except as specified in paragraph deleted text begin (c) deleted text end new text begin (b) new text end , for each year that a
participant meets the service obligation required under subdivision 3, up to a maximum of
four years, the commissioner shall make annual disbursements directly to the participant
equivalent to 15 percent of the average educational debt for indebted graduates in their
profession in the year closest to the applicant's selection for which information is available,
not to exceed the balance of the participant's qualifying educational loans. Before receiving
loan repayment disbursements and as requested, the participant must complete and return
to the commissioner a confirmation of practice form provided by the commissioner verifying
that the participant is practicing as required under subdivisions 2 and 3. The participant
must provide the commissioner with verification that the full amount of loan repayment
disbursement received by the participant has been applied toward the designated loans.
After each disbursement, verification must be received by the commissioner and approved
before the next loan repayment disbursement is made. Participants who move their practice
remain eligible for loan repayment as long as they practice as required under subdivision
2.

deleted text begin (b) For hospital nurses, the commissioner of health shall select applicants each year for
participation in the hospital nursing education loan forgiveness program, within limits of
available funding for hospital nurses. Before receiving the annual loan repayment
disbursement, the participant must complete and return to the commissioner a confirmation
of practice form provided by the commissioner, verifying that the participant continues to
meet the eligibility requirements under subdivision 3. The participant must provide the
commissioner with verification that the full amount of loan repayment disbursement received
by the participant has been applied toward the designated loans.
deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end For each year that a participant who is a nurse and who has agreed to teach
according to subdivision 2 meets the teaching obligation required in subdivision 3, the
commissioner shall make annual disbursements directly to the participant equivalent to 15
percent of the average annual educational debt for indebted graduates in the nursing
profession in the year closest to the participant's selection for which information is available,
not to exceed the balance of the participant's qualifying educational loans.

Sec. 5.

new text begin [144.1521] HOSPITAL NURSING EDUCATIONAL LOAN FORGIVENESS
PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following definitions
apply.
new text end

new text begin (b) "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.
new text end

new text begin (c) "Hospital nurse" means an individual who is licensed as a registered nurse and who
is providing direct patient care in a nonprofit hospital setting.
new text end

new text begin (d) "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.
new text end

new text begin Subd. 2. new text end

new text begin Creation of account. new text end

new text begin (a) A hospital nursing education loan forgiveness program
account is established in the health care access fund. The commissioner of health shall use
money from the account to establish a loan forgiveness program for licensed registered
nurses employed as hospital nurses by a nonprofit hospital and who provide direct care to
patients at the nonprofit hospital.
new text end

new text begin (b) Appropriations made to the account do not cancel and are available until expended.
new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin (a) To be eligible to participate in the hospital nursing loan
forgiveness program, an individual must: (1) be a hospital nurse who has been employed
as a hospital nurse for at least three years; (2) submit an application to the commissioner of
health; and (3) submit proof that the applicant is employed as a hospital nurse and has been
so employed for at least three years.
new text end

new text begin (b) The commissioner must accept a signed work verification form from the applicant's
supervisor as proof of the applicant's tenure providing direct patient care in a nonprofit
hospital setting.
new text end

new text begin (c) An applicant selected to participate in the loan forgiveness program must sign a
contract to agree to continue as a hospital nurse for a minimum two-year service obligation.
new text end

new text begin Subd. 4. new text end

new text begin Loan forgiveness. new text end

new text begin (a) Within the limits of available funding, the commissioner
of health shall select applicants each year for participation in the loan forgiveness program.
If the total requests from eligible applicants exceeds the available funding, the commissioner
shall randomly select grantees from among eligible applicants.
new text end

new text begin (b) Applicants are responsible for securing their own qualified educational loans.
new text end

new text begin (c) For each year that a participant meets the service obligation required under subdivision
3, up to a maximum of four years, the commissioner shall make annual disbursements
directly to the participant equivalent to 15 percent of the average educational debt for
indebted graduates in their profession in the year closest to the applicant's selection for
which information is available, not to exceed the balance of the participant's qualifying
educational loans. Before receiving loan repayment disbursements and as requested, the
participant must complete and return to the commissioner a confirmation of practice form
provided by the commissioner verifying that the participant is practicing as required under
subdivisions 2 and 3.
new text end

new text begin (d) The participant must provide the commissioner with verification that the full amount
of loan repayment disbursement received by the participant has been applied toward the
designated loans. After each disbursement, verification must be received by the commissioner
and approved before the next loan repayment disbursement is made.
new text end

new text begin (e) Participants who move their practice remain eligible for loan repayment as long as
they practice as required under subdivisions 2 and 3.
new text end

new text begin Subd. 5. new text end

new text begin Penalty for nonfulfillment. new text end

new text begin (a) If a participant does not fulfill the required
minimum commitment of service according to subdivision 3, the commissioner of health
shall collect from the participant the total amount paid to the participant under the loan
forgiveness program. The commissioner shall deposit the money collected from the
participant in the health care access fund to be credited to the hospital nursing education
loan forgiveness program account established in subdivision 2.
new text end

new text begin (b) The commissioner shall allow waivers of all or part of the money owed to the
commissioner as a result of a nonfulfillment penalty if the participant is unable to fulfill the
minimum service commitment due to emergency circumstances, life changes outside the
applicant's control, inability to obtain required hours as a result of a scheduling decision by
the hospital, or other circumstances as determined by the commissioner.
new text end

new text begin Subd. 6. new text end

new text begin Rules. new text end

new text begin The commissioner may adopt rules to implement this section.
new text end

Sec. 6.

Laws 2023, chapter 70, article 20, section 3, subdivision 1, is amended to read:

Subdivision 1. Total Appropriation

$

432,805,000

$

deleted text begin 416,822,000 deleted text end new text begin 411,505,000 new text end

Appropriations by Fund
	2024	2025
General	287,367,000	deleted text begin 265,615,000 deleted text end new text begin 260,298,000 new text end
State Government Special Revenue	84,674,000	86,204,000
Health Care Access	49,051,000	53,290,000
Federal TANF	11,713,000	11,713,000

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

Sec. 7.

Laws 2023, chapter 70, article 20, section 3, subdivision 2, is amended to read:

Subd. 2. Health Improvement

Appropriations by Fund
General	229,600,000	deleted text begin 210,030,000 deleted text end new text begin 204,713,000 new text end
State Government Special Revenue	12,392,000	12,682,000
Health Care Access	49,051,000	53,290,000
Federal TANF	11,713,000	11,713,000

(a) Studies of telehealth expansion and
payment parity. $1,200,000 in fiscal year
2024 is from the general fund for studies of
telehealth expansion and payment parity. This
is a onetime appropriation and is available
until June 30, 2025.

(b) Advancing equity through capacity
building and resource allocation grant
program. $916,000 in fiscal year 2024 and
$916,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, section 144.9821. This is a onetime
appropriation.

(c) Grant to Minnesota Community Health
Worker Alliance. $971,000 in fiscal year
2024 and $971,000 in fiscal year 2025 are
from the general fund for Minnesota Statutes,
section 144.1462.

(d) Community solutions for healthy child
development grants. $2,730,000 in fiscal year
2024 and $2,730,000 in fiscal year 2025 are
from the general fund for grants under
Minnesota Statutes, section 145.9257. The
base for this appropriation is $2,415,000 in
fiscal year 2026 and $2,415,000 in fiscal year
2027.

(e) Comprehensive Overdose and Morbidity
Prevention Act. $9,794,000 in fiscal year
2024 and $10,458,000 in fiscal year 2025 are
from the general fund for comprehensive
overdose and morbidity prevention strategies
under Minnesota Statutes, section 144.0528.
The base for this appropriation is $10,476,000
in fiscal year 2026 and $10,476,000 in fiscal
year 2027.

(f) Emergency preparedness and response.
$10,486,000 in fiscal year 2024 and
$14,314,000 in fiscal year 2025 are from the
general fund for public health emergency
preparedness and response, the sustainability
of the strategic stockpile, and COVID-19
pandemic response transition. The base for
this appropriation is $11,438,000 in fiscal year
2026 and $11,362,000 in fiscal year 2027.

(g) Healthy Beginnings, Healthy Families.
(1) $8,440,000 in fiscal year 2024 and
$7,305,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, sections 145.9571 to 145.9576. The
base for this appropriation is $1,500,000 in
fiscal year 2026 and $1,500,000 in fiscal year
2027. (2) Of the amount in clause (1),
$400,000 in fiscal year 2024 is to support the
transition from implementation of activities
under Minnesota Statutes, section 145.4235,
to implementation of activities under
Minnesota Statutes, sections 145.9571 to
145.9576. The commissioner shall award four
sole-source grants of $100,000 each to Face
to Face, Cradle of Hope, Division of Indian
Work, and Minnesota Prison Doula Project.
The amount in this clause is a onetime
appropriation.

(h) Help Me Connect. $463,000 in fiscal year
2024 and $921,000 in fiscal year 2025 are
from the general fund for the Help Me
Connect program under Minnesota Statutes,
section 145.988.

(i) Home visiting. $2,000,000 in fiscal year
2024 and $2,000,000 in fiscal year 2025 are
from the general fund for home visiting under
Minnesota Statutes, section 145.87, to provide
home visiting to priority populations under
Minnesota Statutes, section 145.87,
subdivision 1, paragraph (e).

(j) No Surprises Act enforcement.
$1,210,000 in fiscal year 2024 and $1,090,000
in fiscal year 2025 are from the general fund
for implementation of the federal No Surprises
Act under Minnesota Statutes, section
62Q.021, and an assessment of the feasibility
of a statewide provider directory. The general
fund base for this appropriation is $855,000
in fiscal year 2026 and $855,000 in fiscal year
2027.

(k) Office of African American Health.
$1,000,000 in fiscal year 2024 and $1,000,000
in fiscal year 2025 are from the general fund
for grants under the authority of the Office of
African American Health under Minnesota
Statutes, section 144.0756.

(l) Office of American Indian Health.
$1,000,000 in fiscal year 2024 and $1,000,000
in fiscal year 2025 are from the general fund
for grants under the authority of the Office of
American Indian Health under Minnesota
Statutes, section 144.0757.

(m) Public health system transformation
grants. (1) $9,844,000 in fiscal year 2024 and
$9,844,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, section 145A.131, subdivision 1,
paragraph (f).

(2) $535,000 in fiscal year 2024 and $535,000
in fiscal year 2025 are from the general fund
for grants under Minnesota Statutes, section
145A.14, subdivision 2b.

(3) $321,000 in fiscal year 2024 and $321,000
in fiscal year 2025 are from the general fund
for grants under Minnesota Statutes, section
144.0759.

(n) Health care workforce. (1) $1,010,000
in fiscal year 2024 and $2,550,000 in fiscal
year 2025 are from the health care access fund
for rural training tracks and rural clinicals
grants under Minnesota Statutes, sections
144.1505 and 144.1507. The base for this
appropriation is $4,060,000 in fiscal year 2026
and $3,600,000 in fiscal year 2027.

(2) $420,000 in fiscal year 2024 and $420,000
in fiscal year 2025 are from the health care
access fund for immigrant international
medical graduate training grants under
Minnesota Statutes, section 144.1911.

(3) $5,654,000 in fiscal year 2024 and
$5,550,000 in fiscal year 2025 are from the
health care access fund for site-based clinical
training grants under Minnesota Statutes,
section 144.1508. The base for this
appropriation is $4,657,000 in fiscal year 2026
and $3,451,000 in fiscal year 2027.

(4) $1,000,000 in fiscal year 2024 and
$1,000,000 in fiscal year 2025 are from the
health care access fund for mental health for
health care professional grants. This is a
onetime appropriation and is available until
June 30, 2027.

(5) $502,000 in fiscal year 2024 and $502,000
in fiscal year 2025 are from the health care
access fund for workforce research and data
analysis of shortages, maldistribution of health
care providers in Minnesota, and the factors
that influence decisions of health care
providers to practice in rural areas of
Minnesota.

(o) School health. $800,000 in fiscal year
2024 and $1,300,000 in fiscal year 2025 are
from the general fund for grants under
Minnesota Statutes, section 145.903. The base
for this appropriation is $2,300,000 in fiscal
year 2026 and $2,300,000 in fiscal year 2027.

(p) Long COVID. $3,146,000 in fiscal year
2024 and $3,146,000 in fiscal year 2025 are
from the general fund for grants and to
implement Minnesota Statutes, section
145.361.

(q) Workplace safety grants. $4,400,000 in
fiscal year 2024 is from the general fund for
grants to health care entities to improve
employee safety or security. This is a onetime
appropriation and is available until June 30,
2027. The commissioner may use up to ten
percent of this appropriation for
administration.

(r) Clinical dental education innovation
grants. $1,122,000 in fiscal year 2024 and
$1,122,000 in fiscal year 2025 are from the
general fund for clinical dental education
innovation grants under Minnesota Statutes,
section 144.1913.

(s) Emmett Louis Till Victims Recovery
Program. $500,000 in fiscal year 2024 is from
the general fund for a grant to the Emmett
Louis Till Victims Recovery Program. The
commissioner must not use any of this
appropriation for administration. This is a
onetime appropriation and is available until
June 30, 2025.

(t) Center for health care affordability.
$2,752,000 in fiscal year 2024 and $3,989,000
in fiscal year 2025 are from the general fund
to establish a center for health care
affordability and to implement Minnesota
Statutes, section 62J.312. The general fund
base for this appropriation is $3,988,000 in
fiscal year 2026 and $3,988,000 in fiscal year
2027.

(u) Federally qualified health centers
apprenticeship program. $690,000 in fiscal
year 2024 and $690,000 in fiscal year 2025
are from the general fund for grants under
Minnesota Statutes, section 145.9272.

(v) Alzheimer's public information
program. $80,000 in fiscal year 2024 and
$80,000 in fiscal year 2025 are from the
general fund for grants to community-based
organizations to co-create culturally specific
messages to targeted communities and to
promote public awareness materials online
through diverse media channels.

(w) Keeping Nurses at the Bedside Act;
contingent appropriation. The appropriations
in this paragraph are contingent upon
legislative enactment of 2023 Senate File 1384
by the 93rd Legislature. The appropriations
in this paragraph are available until June 30,
2027.

(1) $5,317,000 in fiscal year 2024 and
deleted text begin $5,317,000 deleted text end new text begin $0 new text end in fiscal year 2025 are from the
general fund for loan forgiveness under
Minnesota Statutes, section 144.1501, for
eligible nurses who have agreed to work as
hospital nurses in accordance with Minnesota
Statutes, section 144.1501, subdivision 2,
paragraph (a), clause (7).

(2) $66,000 in fiscal year 2024 and $66,000
in fiscal year 2025 are from the general fund
for loan forgiveness under Minnesota Statutes,
section 144.1501, for eligible nurses who have
agreed to teach in accordance with Minnesota
Statutes, section 144.1501, subdivision 2,
paragraph (a), clause (3).

(3) $545,000 in fiscal year 2024 and $879,000
in fiscal year 2025 are from the general fund
to administer Minnesota Statutes, section
144.7057; to perform the evaluation duties
described in Minnesota Statutes, section
144.7058; to continue prevention of violence
in health care program activities; to analyze
potential links between adverse events and
understaffing; to convene stakeholder groups
and create a best practices toolkit; and for a
report on the current status of the state's
nursing workforce employed by hospitals. The
base for this appropriation is $624,000 in fiscal
year 2026 and $454,000 in fiscal year 2027.

(x) Supporting healthy development of
babies. $260,000 in fiscal year 2024 and
$260,000 in fiscal year 2025 are from the
general fund for a grant to the Amherst H.
Wilder Foundation for the African American
Babies Coalition initiative. The base for this
appropriation is $520,000 in fiscal year 2026
and $0 in fiscal year 2027. Any appropriation
in fiscal year 2026 is available until June 30,
2027. This paragraph expires on June 30,
2027.

(y) Health professional education loan
forgiveness. $2,780,000 in fiscal year 2024
is from the general fund for eligible mental
health professional loan forgiveness under
Minnesota Statutes, section 144.1501. This is
a onetime appropriation. The commissioner
may use up to ten percent of this appropriation
for administration.

(z) Primary care residency expansion grant
program. $400,000 in fiscal year 2024 and
$400,000 in fiscal year 2025 are from the
general fund for a psychiatry resident under
Minnesota Statutes, section 144.1506.

(aa) Pediatric primary care mental health
training grant program. $1,000,000 in fiscal
year 2024 and $1,000,000 in fiscal year 2025
are from the general fund for grants under
Minnesota Statutes, section 144.1509. The
commissioner may use up to ten percent of
this appropriation for administration.

(bb) Mental health cultural community
continuing education grant program.
$500,000 in fiscal year 2024 and $500,000 in
fiscal year 2025 are from the general fund for
grants under Minnesota Statutes, section
144.1511. The commissioner may use up to
ten percent of this appropriation for
administration.

(cc) Labor trafficking services grant
program. $500,000 in fiscal year 2024 and
$500,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, section 144.3885.

(dd) Palliative Care Advisory Council.
$40,000 in fiscal year 2024 and $40,000 in
fiscal year 2025 are from the general fund for
grants under Minnesota Statutes, section
144.059.

(ee) Analysis of a universal health care
financing system. $1,815,000 in fiscal year
2024 and $580,000 in fiscal year 2025 are
from the general fund to the commissioner to
contract for an analysis of the benefits and
costs of a legislative proposal for a universal
health care financing system and a similar
analysis of the current health care financing
system. The base for this appropriation is
$580,000 in fiscal year 2026 and $0 in fiscal
year 2027. This appropriation is available until
June 30, 2027.

(ff) Charitable assets public interest review.
(1) The appropriations under this paragraph
are contingent upon legislative enactment of
2023 House File 402 by the 93rd Legislature.

(2) $1,584,000 in fiscal year 2024 and
$769,000 in fiscal year 2025 are from the
general fund to review certain health care
entity transactions; to conduct analyses of the
impacts of health care transactions on health
care cost, quality, and competition; and to
issue public reports on health care transactions
in Minnesota and their impacts. The base for
this appropriation is $710,000 in fiscal year
2026 and $710,000 in fiscal year 2027.

(gg) Study of the development of a statewide
registry for provider orders for
life-sustaining treatment. $365,000 in fiscal
year 2024 and $365,000 in fiscal year 2025
are from the general fund for a study of the
development of a statewide registry for
provider orders for life-sustaining treatment.
This is a onetime appropriation.

(hh) Task Force on Pregnancy Health and
Substance Use Disorders. $199,000 in fiscal
year 2024 and $100,000 in fiscal year 2025
are from the general fund for the Task Force
on Pregnancy Health and Substance Use
Disorders. This is a onetime appropriation and
is available until June 30, 2025.

(ii) 988 Suicide and crisis lifeline. $4,000,000
in fiscal year 2024 is from the general fund
for 988 national suicide prevention lifeline
grants under Minnesota Statutes, section
145.561. This is a onetime appropriation.

(jj) Equitable Health Care Task Force.
$779,000 in fiscal year 2024 and $749,000 in
fiscal year 2025 are from the general fund for
the Equitable Health Care Task Force. This is
a onetime appropriation.

(kk) Psychedelic Medicine Task Force.
$338,000 in fiscal year 2024 and $171,000 in
fiscal year 2025 are from the general fund for
the Psychedelic Medicine Task Force. This is
a onetime appropriation.

(ll) Medical education and research costs.
$300,000 in fiscal year 2024 and $300,000 in
fiscal year 2025 are from the general fund for
the medical education and research costs
program under Minnesota Statutes, section
62J.692.

(mm) Special Guerilla Unit Veterans grant
program. $250,000 in fiscal year 2024 and
$250,000 in fiscal year 2025 are from the
general fund for a grant to the Special
Guerrilla Units Veterans and Families of the
United States of America to offer
programming and culturally specific and
specialized assistance to support the health
and well-being of Special Guerilla Unit
Veterans. The base for this appropriation is
$500,000 in fiscal year 2026 and $0 in fiscal
year 2027. Any amount appropriated in fiscal
year 2026 is available until June 30, 2027.
This paragraph expires June 30, 2027.

(nn) Safe harbor regional navigator.
$300,000 in fiscal year 2024 and $300,000 in
fiscal year 2025 are for a regional navigator
in northwestern Minnesota. The commissioner
may use up to ten percent of this appropriation
for administration.

(oo) Network adequacy. $798,000 in fiscal
year 2024 and $491,000 in fiscal year 2025
are from the general fund for reviews of
provider networks under Minnesota Statutes,
section 62K.10, to determine network
adequacy.

(pp)(1) TANF Appropriations. TANF funds
must be used as follows:

(i) $3,579,000 in fiscal year 2024 and
$3,579,000 in fiscal year 2025 are from the
TANF fund for home visiting and nutritional
services listed under Minnesota Statutes,
section 145.882, subdivision 7, clauses (6) and
(7). Funds must be distributed to community
health boards according to Minnesota Statutes,
section 145A.131, subdivision 1;

(ii) $2,000,000 in fiscal year 2024 and
$2,000,000 in fiscal year 2025 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;

(iii) $4,978,000 in fiscal year 2024 and
$4,978,000 in fiscal year 2025 are from the
TANF fund for the family home visiting grant
program under Minnesota Statutes, section
145A.17. $4,000,000 of the funding in fiscal
year 2024 and $4,000,000 in fiscal year 2025
must be distributed to community health
boards under Minnesota Statutes, section
145A.131, subdivision 1. $978,000 of the
funding in fiscal year 2024 and $978,000 in
fiscal year 2025 must be distributed to Tribal
governments under Minnesota Statutes, section
145A.14, subdivision 2a;

(iv) $1,156,000 in fiscal year 2024 and
$1,156,000 in fiscal year 2025 are from the
TANF fund for sexual and reproductive health
services grants under Minnesota Statutes,
section 145.925; and

(v) the commissioner may use up to 6.23
percent of the funds appropriated from the
TANF fund each fiscal year to conduct the
ongoing evaluations required under Minnesota
Statutes, section 145A.17, subdivision 7, and
training and technical assistance as required
under Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.

(2) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year does not cancel but is available in the
second year.

(qq) Base level adjustments. The general
fund base is $197,644,000 in fiscal year 2026
and $195,714,000 in fiscal year 2027. The
health care access fund base is $53,354,000
in fiscal year 2026 and $50,962,000 in fiscal
year 2027.

Sec. 8. new text begin USE OF APPROPRIATION; LOAN FORGIVENESS ADMINISTRATION.
new text end

new text begin The commissioner of health may use the appropriation in Minnesota Laws 2023, chapter
70, article 20, section 3, subdivision 2, paragraph (w), clause (3), for administering Minnesota
Statutes, section 144.1521.
new text end

Sec. 9. new text begin APPROPRIATION; HOSPITAL NURSING LOAN FORGIVENESS
PROGRAM.
new text end

new text begin (a) $30,317,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of health for the hospital nursing educational loan forgiveness program under
Minnesota Statutes, section 144.1521. The general fund base for this appropriation is
$5,317,000 in fiscal year 2026, $5,317,000 in fiscal year 2027, and $0 in fiscal year 2028.
new text end

new text begin (b) The appropriations in paragraph (a) are available until 2033. The commissioner of
health must deposit the appropriations under this section in the hospital nursing educational
loan forgiveness program account in the health care access fund.
new text end