SF 1017

1st Engrossment - 87th Legislature (2011 - 2012) Posted on 03/06/2012 02:45pm

A bill for an act
relating to health; modifying minor consent for health procedures and records;
amending the retention of blood or tissue samples related to testing of infants
for heritable and congenital disorders; amending Minnesota Statutes 2010,
sections 121A.22, subdivision 2; 144.125, subdivisions 1, 3; 144.128; 144.291,
subdivision 2; proposing coding for new law in Minnesota Statutes, chapter 144;
repealing Minnesota Statutes 2010, sections 144.343; 144.3441.

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

Section 1.

Minnesota Statutes 2010, section 121A.22, subdivision 2, is amended to
read:

Subd. 2.

Exclusions.

In addition, this section does not apply to drugs or medicine
that are:

(1) purchased without a prescription;

(2) used by a pupil who is 18 years old or older;

(3) used in connection with services for which a minor may give effective consent,
including section deleted text begin 144.343, subdivision 1, and any other law deleted text end new text begin 144.3433 new text end ;

(4) used in situations in which, in the judgment of the school personnel who are
present or available, the risk to the pupil's life or health is of such a nature that drugs or
medicine should be given without delay;

(5) used off the school grounds;

(6) used in connection with athletics or extra curricular activities;

(7) used in connection with activities that occur before or after the regular school day;

(8) provided or administered by a public health agency to prevent or control an
illness or a disease outbreak as provided for in sections 144.05 and 144.12;

(9) prescription asthma or reactive airway disease medications self-administered by
a pupil with an asthma inhaler if the district has received a written authorization from the
pupil's parent permitting the pupil to self-administer the medication, the inhaler is properly
labeled for that student, and the parent has not requested school personnel to administer
the medication to the pupil. The parent must submit written authorization for the pupil to
self-administer the medication each school year; or

(10) prescription nonsyringe injectors of epinephrine, consistent with section
121A.2205, if the parent and prescribing medical professional annually inform the pupil's
school in writing that (i) the pupil may possess the epinephrine or (ii) the pupil is unable
to possess the epinephrine and requires immediate access to nonsyringe injectors of
epinephrine that the parent provides properly labeled to the school for the pupil as needed.

Sec. 2.

Minnesota Statutes 2010, section 144.125, subdivision 1, is amended to read:

Subdivision 1.

Duty to perform testing.

It is the duty of (1) the administrative
officer or other person in charge of each institution caring for infants 28 days or less
of age, (2) the person required in pursuance of the provisions of section 144.215, to
register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
birth, to arrange to have administered to every infant or child in its care tests for heritable
and congenital disorders according to subdivision 2 and rules prescribed by the state
commissioner of health. Testing deleted text begin and the recording deleted text end and reporting of test results shall be
performed at the times and in the manner prescribed by the commissioner of health. The
commissioner shall charge a fee so that the total of fees collected will approximate the
costs of conducting the tests and implementing and maintaining a system to follow-up
infants with heritable or congenital disorders, including hearing loss detected through the
early hearing detection and intervention program under section 144.966. The fee is $101
per specimen. Effective July 1, 2010, the fee shall be increased to $106 per specimen. The
increased fee amount shall be deposited in the general fund. Costs associated with capital
expenditures and the development of new procedures may be prorated over a three-year
period when calculating the amount of the fees.

Sec. 3.

Minnesota Statutes 2010, section 144.125, subdivision 3, is amended to read:

Subd. 3.

Objection of parents to test.

Persons with a duty to perform testing under
subdivision 1 shall advise parents of infants (1) that the blood or tissue samples new text begin will be
new text end used to perform testing deleted text begin thereunder as well as the results of such testing may be retained by
the Department of Health, (2) the benefit of retaining the blood or tissue sample deleted text end , and deleted text begin (3) deleted text end
new text begin (2) new text end that new text begin a form is available in which new text end the following options deleted text begin are available to them deleted text end new text begin may be
chosen new text end with respect to the testing: (i) to decline to have the tests, or (ii) to elect to have
the tests deleted text begin but deleted text end new text begin and new text end to deleted text begin require that deleted text end new text begin allow new text end all blood samples and records of test results new text begin to new text end be
deleted text begin destroyed within deleted text end new text begin retained by the Department of Health for new text end 24 months deleted text begin of deleted text end new text begin after new text end the testing.
If the parents of an infant object in writing to testing for heritable and congenital disorders
or elect to deleted text begin require that deleted text end new text begin allow new text end blood samples and test results new text begin to new text end be deleted text begin destroyed deleted text end new text begin retained new text end ,
the objection or election shall be recorded on a form that is signed by a parent or legal
guardian and made part of the infant's medical record. A written objection exempts an
infant from the requirements of this section and section 144.128.

Sec. 4.

Minnesota Statutes 2010, section 144.128, is amended to read:

144.128 COMMISSIONER'S DUTIES new text begin ; STORED BLOOD AND TISSUE
SAMPLES new text end .

The commissioner shall:

(1) notify the physicians of newborns tested of the results of the tests performed;

(2) make referrals for the necessary treatment of diagnosed cases of heritable and
congenital disorders when treatment is indicated;

deleted text begin (3) maintain a registry of the cases of heritable and congenital disorders detected by
the screening program for the purpose of follow-up services;
deleted text end

deleted text begin (4) prepare a separate form for use by parents or by adults who were tested as minors
to direct that blood samples and test results be destroyed;
deleted text end

deleted text begin (5) comply with a destruction request within 45 days after receiving it;
deleted text end

deleted text begin (6) notify individuals who request destruction of samples and test results that the
samples and test results have been destroyed; and
deleted text end

deleted text begin (7) adopt rules to carry out sections 144.125 to 144.128.
deleted text end

new text begin (3) destroy blood or tissue samples obtained from test results immediately after
completion of the test results, unless the parent of the newborn tested elects under section
144.125, subdivision 3, to retain the results, in which case the test results may be retained
for up to 24 months; and
new text end

new text begin (4) destroy all blood or tissue samples and material and records related to stored
samples that were collected and stored by the commissioner before August 1, 2011.
new text end

Sec. 5.

Minnesota Statutes 2010, section 144.291, subdivision 2, is amended to read:

Subd. 2.

Definitions.

For the purposes of sections 144.291 to 144.298, the following
terms have the meanings given.

(a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.

(b) "Health information exchange" means a legal arrangement between health care
providers and group purchasers to enable and oversee the business and legal issues
involved in the electronic exchange of health records between the entities for the delivery
of patient care.

(c) "Health record" means any information, whether oral or recorded in any form or
medium, that relates to the past, present, or future physical or mental health or condition of
a patient; the provision of health care to a patient; or the past, present, or future payment
for the provision of health care to a patient.

(d) "Identifying information" means the patient's name, address, date of birth,
gender, parent's or guardian's name regardless of the age of the patient, and other
nonclinical data which can be used to uniquely identify a patient.

(e) "Individually identifiable form" means a form in which the patient is or can be
identified as the subject of the health records.

(f) "Medical emergency" means medically necessary care which is immediately
needed to preserve life, prevent serious impairment to bodily functions, organs, or parts,
or prevent placing the physical or mental health of the patient in serious jeopardy.

(g) "Patient" means a natural person who has received health care services from a
provider for treatment or examination of a medical, psychiatric, or mental condition, the
surviving spouse and parents of a deceased patient, or a person the patient appoints in
writing as a representative, including a health care agent acting according to chapter 145C,
unless the authority of the agent has been limited by the principal in the principal's health
care directive. Except for minors who have received health care services under deleted text begin sections deleted text end
new text begin section new text end 144.341 deleted text begin to 144.347, deleted text end new text begin ; 144.342; or 144.3433, new text end in the case of a minor, patient includes
a parent or guardian, or a person acting as a parent or guardian in the absence of a parent
or guardian. new text begin A parent or guardian is entitled to full access to a minor child's health records
except as otherwise explicitly provided in law.
new text end

(h) "Provider" means:

(1) any person who furnishes health care services and is regulated to furnish the
services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A,
151, 153, or 153A;

(2) a home care provider licensed under section 144A.46;

(3) a health care facility licensed under this chapter or chapter 144A;

(4) a physician assistant registered under chapter 147A; and

(5) an unlicensed mental health practitioner regulated under sections 148B.60 to
148B.71.

(i) "Record locator service" means an electronic index of patient identifying
information that directs providers in a health information exchange to the location of
patient health records held by providers and group purchasers.

(j) "Related health care entity" means an affiliate, as defined in section 144.6521,
subdivision 3, paragraph (b), of the provider releasing the health records.

Sec. 6.

new text begin [144.3433] CONSENT OF MINOR TO CERTAIN MEDICAL
PROCEDURES.
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 terms
have the meanings given.
new text end

new text begin (b) "Abortion" means the use of any means to terminate the pregnancy of a woman
known to be pregnant with knowledge that the termination with those means will, with
reasonable likelihood, cause the death of the fetus.
new text end

new text begin (c) "Fetus" means any individual human organism from fertilization until birth.
new text end

new text begin (d) "Incest" means conduct prohibited under section 609.365.
new text end

new text begin (e) "Physical abuse" has the meaning given in section 626.556.
new text end

new text begin (f) "Sexual abuse" has the meaning given in section 626.556.
new text end

new text begin Subd. 2. new text end

new text begin Minor's consent invalid; exception for sexual abuse, incest, and
physical abuse. new text end

new text begin (a) A minor may not give effective consent for medical, mental, or
other health services to determine the presence of or to treat pregnancy and associated
conditions, including contraception, abortion, and venereal disease, or to treat alcohol
and other drug abuse.
new text end

new text begin (b) Notwithstanding paragraph (a), a minor may give effective consent and the
consent of no other person is required, if the minor declares that the minor is a victim of
physical abuse, sexual abuse, or incest perpetrated by the minor's parent or legal guardian
and a court under subdivision 4 determines that the abuse or incest occurred and that
having the services performed is in the best interests of the minor. If this occurs, the
minor's parents or legal guardian must not have access to the minor's health records
without express authorization from the minor. Notice of a minor's declaration that the
minor is a victim of physical abuse, sexual abuse, or incest shall be made to the proper
authorities as provided in section 626.556, subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Exception. new text end

new text begin Subdivision 2 does not apply if the attending physician certifies
in the minor's medical record that the services are necessary to prevent the minor's death
and there is insufficient time to obtain consent.
new text end

new text begin Subd. 4. new text end

new text begin Judicial determination. new text end

new text begin (a) This subdivision applies if a minor declares
that the minor may give consent to a service under subdivision 2, paragraph (b).
new text end

new text begin (b) A judge, upon petition or motion and after an appropriate hearing, may authorize
a health care provider to provide a service if the judge determines that:
new text end

new text begin (1) the minor is a victim of physical abuse, sexual abuse, or incest perpetrated by
the minor's parent or legal guardian; and
new text end

new text begin (2) it would be in the minor's best interests to receive the service.
new text end

new text begin (c) A minor may participate in proceedings in the court on the minor's own behalf,
and the court may appoint a guardian ad litem for the minor. The court shall advise the
minor that the minor has a right to court appointed counsel and shall, upon request,
appoint counsel.
new text end

new text begin (d) Proceedings in the court under this section are confidential and must be given
precedence over other pending matters so that the court may reach a decision promptly
and without delay so as to serve the best interests of the minor. A judge who conducts
proceedings under this section shall make specific written factual findings and conclusions
supporting the decision and shall order a record of the evidence to be maintained,
including the judge's own findings and conclusions.
new text end

new text begin (e) An expedited confidential appeal must be available to a minor for whom the
court denies an order under this section. An order authorizing a service is not subject to
appeal. No filing fee may be required of a minor at the trial or the appellate level. Access
to the trial court for the purposes of a petition or motion, and access to the appellate
courts for purposes of making an appeal from a denial of a request, must be available 24
hours a day, seven days a week.
new text end

new text begin Subd. 5. new text end

new text begin Costs associated with judicial determination; calculation by court,
reimbursement by commissioner of management and budget. new text end

new text begin A court making the
determinations required in subdivision 4 shall calculate the amount of court resources
dedicated to doing so, including the use of any guardian ad litem and court appointed
counsel, and forward this calculation to the state court administrator. The state court
administrator shall determine the monetary value of the resources used and submit this
determination to the commissioner of management and budget. Within 30 days of
receiving the state court administrator's determination, the commissioner shall reimburse
the administrator for the expenses.
new text end

new text begin Subd. 6. new text end

new text begin Penalty. new text end

new text begin Performance of a service in violation of this section is
a misdemeanor and is grounds for a civil action by a parent wrongfully denied the
opportunity to give effective consent on behalf of the minor. A person is not liable under
this section if the person establishes by written evidence that the person relied upon
evidence sufficient to convince a careful and prudent person that the representations of the
minor regarding information necessary to comply with this section are bona fide and true.
new text end

new text begin Subd. 7. new text end

new text begin Severability. new text end

new text begin If any provision, word, phrase or clause of this section or its
application to any person or circumstance is held invalid, this invalidity does not affect
the provisions, words, phrases, clauses, or application of this section that can be given
effect without the invalid provision, word, phrase, clause, or application, and to this end
the provisions, words, phrases, and clauses of this section are declared to be severable.
new text end

Sec. 7.

new text begin [144.349] MINORS IN OUT-OF-HOME PLACEMENT.
new text end

new text begin (a) The executive director, program manager, or a designee of a licensed residential
facility providing outreach, community support, and short-term shelter for unaccompanied
homeless, runaway, or abandoned youth may give effective consent after reasonable efforts
have been made to contact the parent or legal guardian of the minor for medical, mental,
and other health services, except for family planning services, for a minor child while the
minor child is receiving services from the licensed residential facility, and the consent of
no other person is required. If a minor receives medical, mental, or other health services
under this section, the minor's parents must have access to the minor's health records.
new text end

new text begin (b) For purposes of this section, "residential facility" means a facility or program
licensed by the commissioner of human services under chapter 245A to serve children
in out-of-home placement that has a specific contract with the facility's host county to
provide services to youth identified under paragraph (a).
new text end

Sec. 8.

new text begin [144.3491] ORGANIZATIONS RECEIVING TITLE X FUNDS.
new text end

new text begin Nothing in section 144.3433 requires an organization that receives federal funds
under Title X of the Public Health Service Act to refrain from performing any service
that is required to be provided as a condition of receiving Title X funds, as specified by
the provisions of Title X or the Title X program guidelines for project grants for family
planning services published by the United States Department of Health and Human
Services.
new text end

Sec. 9. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2010, sections 144.343; and 144.3441, new text end new text begin are repealed.
new text end