SF 836

1st Engrossment - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to health; establishing the Health
Information Technology and Infrastructure Advisory
Committee; modifying hospital and clinic grant
programs; eliminating community health center program;
amending Minnesota Statutes 2004, sections 144.147,
subdivision 2; 144.148, subdivision 1; 144.1483;
145.9268; proposing coding for new law in Minnesota
Statutes, chapter 62J; repealing Minnesota Statutes
2004, section 144.1486.

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

Section 1.

new text begin [62J.495] HEALTH INFORMATION TECHNOLOGY AND
INFRASTRUCTURE ADVISORY COMMITTEE.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; members; duties. new text end

new text begin (a) The
commissioner shall establish a Health Information Technology and
Infrastructure Advisory Committee governed by section 15.059 to
advise the commissioner on the following matters:
new text end

new text begin (1) assessment of the use of health information technology
by the state, licensed health care providers and facilities, and
local public health agencies;
new text end

new text begin (2) recommendations for implementing a statewide
interoperable health information infrastructure, to include
estimates of necessary resources, and for determining standards
for administrative data exchange, clinical support programs, and
maintenance of the security and confidentiality of individual
patient data; and
new text end

new text begin (3) other related issues as requested by the commissioner.
new text end

new text begin (b) The members of the Health Information Technology and
Infrastructure Advisory Committee shall include the
commissioners, or commissioners' designees, of health, human
services, and commerce and additional members to be appointed by
the commissioner to include persons representing Minnesota's
local public health agencies, licensed hospitals and other
licensed facilities and providers, the medical and nursing
professions, health insurers and health plans, the state quality
improvement organization, academic and research institutions,
consumer advisory organizations with an interest and expertise
in health information technology, and other stakeholders as
identified by the Health Information Technology and
Infrastructure Advisory Committee.
new text end

new text begin Subd. 2. new text end

new text begin Annual report. new text end

new text begin The commissioner shall prepare
and issue an annual report not later than January 30 of each
year outlining progress to date in implementing a statewide
health information infrastructure and recommending future
projects.
new text end

new text begin Subd. 3. new text end

new text begin Expiration. new text end

new text begin Notwithstanding section 15.059,
this section expires June 30, 2009.
new text end

Sec. 2.

Minnesota Statutes 2004, section 144.147,
subdivision 2, is amended to read:

Subd. 2.

Grants authorized.

The commissioner shall
establish a program of grants to assist eligible rural
hospitals. The commissioner shall award grants to hospitals and
communities for the purposes set forth in paragraphs (a) and (b).

(a) Grants may be used by hospitals and their communities
to develop strategic plans for preserving or enhancing access to
health services. At a minimum, a strategic plan must consist of:

(1) a needs assessment to determine what health services
are needed and desired by the community. The assessment must
include interviews with or surveys of area health professionals,
local community leaders, and public hearings;

(2) an assessment of the feasibility of providing needed
health services that identifies priorities and timeliness for
potential changes; and

(3) an implementation plan.

The strategic plan must be developed by a committee that
includes representatives from the hospital, local public health
agencies, other health providers, and consumers from the
community.

(b) The grants may also be used by eligible rural hospitals
that have developed strategic plans to implement transition
projects to modify the type and extent of services provided, in
order to reflect the needs of that plan. Grants may be used by
hospitals under this paragraph to develop hospital-based
physician practices that integrate hospital and existing medical
practice facilities that agree to transfer their practices,
equipment, staffing, and administration to the hospital. The
grants may also be used by the hospital to establish a health
provider cooperative, a telemedicine system, new text begin an electronic
health records system, new text end or a rural health care system or to cover
expenses associated with being designated as a critical access
hospital for the Medicare rural hospital flexibility program.
Not more than one-third of any grant shall be used to offset
losses incurred by physicians agreeing to transfer their
practices to hospitals. new text begin The commissioner shall give priority to
grant applications for projects involving electronic health
records systems.
new text end

Sec. 3.

Minnesota Statutes 2004, section 144.148,
subdivision 1, is amended to read:

Subdivision 1.

Definition.

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

(b) "Eligible rural hospital" means any nonfederal, general
acute care hospital that:

(1) is either located in a rural area, as defined in the
federal Medicare regulations, Code of Federal Regulations, title
42, section 405.1041, or located in a community with a
population of less than 10,000, according to United States
Census Bureau statistics, outside the seven-county metropolitan
area;

(2) has 50 or fewer beds; and

(3) is not for profit.

(c) "Eligible project" means a modernization project to
update, remodel, or replace aging hospital facilities and
equipment necessary to maintain the operations of a hospital new text begin ,
including establishing an electronic health records system new text end . new text begin The
commissioner shall give priority to grant applications for
projects involving electronic health records systems.
new text end

Sec. 4.

Minnesota Statutes 2004, section 144.1483, is
amended to read:

144.1483 RURAL HEALTH INITIATIVES.

The commissioner of health, through the Office of Rural
Health, and consulting as necessary with the commissioner of
human services, the commissioner of commerce, the Higher
Education Services Office, and other state agencies, shall:

(1) develop a detailed plan regarding the feasibility of
coordinating rural health care services by organizing individual
medical providers and smaller hospitals and clinics into
referral networks with larger rural hospitals and clinics that
provide a broader array of services;

(2) deleted text begin develop and implement a program to assist rural
communities in establishing community health centers, as
required by section 144.1486;
deleted text end

deleted text begin (3) deleted text end develop recommendations regarding health education and
training programs in rural areas, including but not limited to a
physician assistants' training program, continuing education
programs for rural health care providers, and rural outreach
programs for nurse practitioners within existing training
programs;

deleted text begin (4) deleted text end new text begin (3) new text end develop a statewide, coordinated recruitment
strategy for health care personnel and maintain a database on
health care personnel as required under section 144.1485;

deleted text begin (5) deleted text end new text begin (4) new text end develop and administer technical assistance
programs to assist rural communities in: (i) planning and
coordinating the delivery of local health care services; and
(ii) hiring physicians, nurse practitioners, public health
nurses, physician assistants, and other health personnel;

deleted text begin (6) deleted text end new text begin (5) new text end study and recommend changes in the regulation of
health care personnel, such as nurse practitioners and physician
assistants, related to scope of practice, the amount of on-site
physician supervision, and dispensing of medication, to address
rural health personnel shortages;

deleted text begin (7) deleted text end new text begin (6) new text end support efforts to ensure continued funding for
medical and nursing education programs that will increase the
number of health professionals serving in rural areas;

deleted text begin (8) deleted text end new text begin (7) new text end support efforts to secure higher reimbursement for
rural health care providers from the Medicare and medical
assistance programs;

deleted text begin (9) deleted text end new text begin (8) new text end coordinate the development of a statewide plan for
emergency medical services, in cooperation with the Emergency
Medical Services Advisory Council;

deleted text begin (10) deleted text end new text begin (9) new text end establish a Medicare rural hospital flexibility
program pursuant to section 1820 of the federal Social Security
Act, United States Code, title 42, section 1395i-4, by
developing a state rural health plan and designating, consistent
with the rural health plan, rural nonprofit or public hospitals
in the state as critical access hospitals. Critical access
hospitals shall include facilities that are certified by the
state as necessary providers of health care services to
residents in the area. Necessary providers of health care
services are designated as critical access hospitals on the
basis of being more than 20 miles, defined as official mileage
as reported by the Minnesota Department of Transportation, from
the next nearest hospital, being the sole hospital in the
county, being a hospital located in a county with a designated
medically underserved area or health professional shortage area,
or being a hospital located in a county contiguous to a county
with a medically underserved area or health professional
shortage area. A critical access hospital located in a county
with a designated medically underserved area or a health
professional shortage area or in a county contiguous to a county
with a medically underserved area or health professional
shortage area shall continue to be recognized as a critical
access hospital in the event the medically underserved area or
health professional shortage area designation is subsequently
withdrawn; and

deleted text begin (11) deleted text end new text begin (10) new text end carry out other activities necessary to address
rural health problems.

Sec. 5.

Minnesota Statutes 2004, section 145.9268, is
amended to read:

145.9268 COMMUNITY CLINIC GRANTS.

Subdivision 1.

Definition.

For purposes of this section,
"eligible community clinic" means:

(1) a new text begin nonprofit new text end clinic that deleted text begin provides deleted text end new text begin is established to
provide health new text end services deleted text begin under conditions as defined in Minnesota
Rules, part 9505.0255, deleted text end new text begin to low income or rural population groups;
provides medical, preventive, dental, or mental health primary
care services; new text end and utilizes a sliding fee scale new text begin or other
procedure new text end to determine eligibility for charity care new text begin or to ensure
that no person will be denied services because of inability to
pay new text end ;

(2) new text begin a governmental entity or new text end an Indian tribal government or
Indian health service unit new text begin that provides services and utilizes a
sliding fee scale or other procedure as described under clause
(1) new text end ; deleted text begin or
deleted text end

(3) a consortium of clinics comprised of entities under
clause (1) or (2) new text begin ; or
new text end

new text begin (4) a nonprofit, tribal, or governmental entity proposing
the establishment of a clinic that will provide services and
utilize a sliding fee scale or other procedure as described
under clause (1) new text end .

Subd. 2.

Grants authorized.

The commissioner of health
shall award grants to eligible community clinics to new text begin plan,
establish, or operate services to new text end improve the ongoing viability
of Minnesota's clinic-based safety net providers. Grants shall
be awarded to support the capacity of eligible community clinics
to serve low-income populations, reduce current or future
uncompensated care burdens, or provide for improved care
delivery infrastructure. The commissioner shall award grants to
community clinics in metropolitan and rural areas of the state,
and shall ensure geographic representation in grant awards among
all regions of the state.

Subd. 3.

Allocation of grants.

(a) To receive a grant
under this section, an eligible community clinic must submit an
application to the commissioner of health by the deadline
established by the commissioner. A grant may be awarded upon
the signing of a grant contract. Community clinics may apply
for and the commissioner may award grants for one-year or
two-year periods.

(b) An application must be on a form and contain
information as specified by the commissioner but at a minimum
must contain:

(1) a description of the purpose or project for which grant
funds will be used;

(2) a description of the problem or problems the grant
funds will be used to address; deleted text begin and
deleted text end

(3) a description of achievable objectives, a workplan, and
a timeline for implementation and completion of processes or
projects enabled by the grant new text begin ; and
new text end

new text begin (4) a process for documenting and evaluating results of the
grant new text end .

(c) The commissioner shall review each application to
determine whether the application is complete and whether the
applicant and the project are eligible for a grant. In
evaluating applications according to paragraph (d), the
commissioner shall establish criteria including, but not limited
to: the deleted text begin priority level deleted text end new text begin eligibility new text end of the project; the
applicant's thoroughness and clarity in describing the problem
grant funds are intended to address; a description of the
applicant's proposed project; new text begin a description of the population
demographics and service area of the proposed project; new text end the
manner in which the applicant will demonstrate the effectiveness
of any projects undertaken; and evidence of efficiencies and
effectiveness gained through collaborative efforts. The
commissioner may also take into account other relevant factors,
including, but not limited to, the percentage for which
uninsured patients represent the applicant's patient base and
the degree to which grant funds will be used to support services
increasing new text begin or maintaining new text end access to health care services.
During application review, the commissioner may request
additional information about a proposed project, including
information on project cost. Failure to provide the information
requested disqualifies an applicant. The commissioner has
discretion over the number of grants awarded.

(d) In determining which eligible community clinics will
receive grants under this section, the commissioner shall give
preference to those grant applications that show evidence of
collaboration with other eligible community clinics, hospitals,
health care providers, or community organizations. deleted text begin In addition,
the commissioner shall give priority, in declining order, to
grant applications for projects that: deleted text end new text begin In addition, the
commissioner shall give priority to grant applications for
projects involving electronic health records systems.
new text end

new text begin Subd. 3a. new text end

new text begin Awarding grants. new text end

new text begin (a) The commissioner may
award grants for activities to:
new text end

(1) provide a direct offset to expenses incurred for
services provided to the clinic's target population;

(2) establish, update, or improve information, data
collection, or billing systems new text begin , including electronic health
records systems new text end ;

(3) procure, modernize, remodel, or replace equipment used
in the delivery of direct patient care at a clinic;

(4) provide improvements for care delivery, such as
increased translation and interpretation services; deleted text begin or
deleted text end

(5) new text begin build a new clinic or expand an existing facility; or
new text end

new text begin (6) new text end other projects determined by the commissioner to
improve the ability of applicants to provide care to the
vulnerable populations they serve.

deleted text begin (e) deleted text end new text begin (b) new text end A grant awarded to an eligible community clinic may
not exceed $300,000 per eligible community clinic. For an
applicant applying as a consortium of clinics, a grant may not
exceed $300,000 per clinic included in the consortium. The
commissioner has discretion over the number of grants awarded.

Subd. 4.

Evaluation and report.

The commissioner of
health shall evaluate the overall effectiveness of the grant
program. The commissioner shall collect progress reports to
evaluate the grant program from the eligible community clinics
receiving grants. Every two years, as part of this evaluation,
the commissioner shall report to the legislature on deleted text begin priority
areas for grants set under subdivision 3 deleted text end new text begin the needs of community
clinics new text end and provide any recommendations for adding or
changing deleted text begin priority areas deleted text end new text begin eligible activities new text end .

Sec. 6. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2004, section 144.1486, is repealed.
new text end