SF 1172

1st Engrossment - 89th Legislature (2015 - 2016) Posted on 09/04/2015 02:43pm

A bill for an act
relating to state government; enacting the Radon Mitigation Licensing
Act; changing provisions for lead work standards and methods; modifying
supplemental nursing services provisions; establishing an Excellence in Mental
Health demonstration project; establishing an opioid prescribing improvement
program; amending Minnesota Statutes 2014, sections 144.9508; 144A.72;
proposing coding for new law in Minnesota Statutes, chapters 144; 245; 256B.

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

Section 1.

new text begin [144.4961] MINNESOTA RADON LICENSING ACT.
new text end

new text begin Subdivision 1. new text end

new text begin Citation. new text end

new text begin This section may be cited as the "Minnesota Radon
Licensing Act."
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) As used in this section, the following terms have the
meanings given them.
new text end

new text begin (b) "Mitigation" means the act of repairing or altering a building or building design
for the purpose in whole or in part of reducing the concentration of radon in the indoor
atmosphere.
new text end

new text begin (c) "Radon" means both the radioactive, gaseous element produced by the
disintegration of radium, and the short-lived radionuclides that are decay products of radon.
new text end

new text begin Subd. 3. new text end

new text begin Rulemaking. new text end

new text begin The commissioner of health shall adopt rules for licensure
and enforcement of applicable laws and rules relating to indoor radon in dwellings and
other buildings, with the exception of newly constructed Minnesota homes according
to section 326B.106, subdivision 6. The commissioner shall coordinate, oversee, and
implement all state functions in matters concerning the presence, effects, measurement,
and mitigation of risks of radon in dwellings and other buildings.
new text end

new text begin Subd. 4. new text end

new text begin System tag. new text end

new text begin All radon mitigation systems installed in Minnesota on or
after July 1, 2016, must have a radon mitigation system tag provided by the commissioner.
A radon mitigation professional must attach the tag to the radon mitigation system in
a visible location.
new text end

new text begin Subd. 5. new text end

new text begin License required annually. new text end

new text begin A license is required annually for every
person, firm, or corporation that sells a device or performs a service for compensation
to detect the presence of radon in the indoor atmosphere, performs laboratory analysis,
or performs a service to mitigate radon in the indoor atmosphere. This section does not
apply to retail stores that only sell or distribute radon sampling but are not engaged in the
manufacture of radon sampling devices.
new text end

new text begin Subd. 6. new text end

new text begin Exemptions. new text end

new text begin Radon systems installed in newly constructed Minnesota
homes according to section 326B.106, subdivision 6, prior to the issuance of a certificate
of occupancy are not required to follow the requirements of this section.
new text end

new text begin Subd. 7. new text end

new text begin License applications and other reports. new text end

new text begin The professionals, companies,
laboratories, and examinees listed in subdivision 8 must submit applications for licenses,
system tags, and any other reporting required under this section and Minnesota Rules
on forms prescribed by the commissioner.
new text end

new text begin Subd. 8. new text end

new text begin Licensing fees. new text end

new text begin (a) All radon license applications submitted to the
commissioner of health must be accompanied by the required fees. If the commissioner
determines that insufficient fees were paid, the necessary additional fees must be paid
before the commissioner approves the application. The commissioner shall charge the
following fees for each radon license:
new text end

new text begin (1) Each measurement professional license, $600 per year. "Measurement
professional" means any person who does not require supervision and performs a test to
determine the presence and concentration of radon; provides professional or expert advice
on radon testing, radon exposure, or health risks related to radon exposure; provides
direct supervision of a measurement technician; or makes representations of doing any
of these activities.
new text end

new text begin (2) Each measurement technician license, $300 per year. "Measurement technician"
means any person who is under the direct supervision of a measurement professional,
and who performs a test to determine the presence and concentration of radon; provides
professional or expert advice on radon testing, radon exposure, or health risks related to
radon exposure; or makes representations of doing any of these activities.
new text end

new text begin (3) Each mitigation professional license, $600 per year. "Mitigation professional"
means an individual who does not require supervision and performs radon mitigation;
provides professional or expert advice on radon mitigation or radon entry routes; or
provides on-site supervision of radon mitigation and mitigation technicians; or makes
representations of doing any of these activities.
new text end

new text begin (4) Each mitigation technician license, $300 per year. "Mitigation technician" means
any person who is under the direct supervision of a mitigation professional and who
performs radon mitigation; provides professional or expert advice on radon mitigation or
radon entry routes; or makes representations of doing any of these activities.
new text end

new text begin (5) Each mitigation company license, $800 per year. "Mitigation company" means
any business or government entity that performs or authorizes employees to perform radon
mitigation. This fee is waived if the company is a sole proprietorship.
new text end

new text begin (6) Each radon analysis laboratory license, $500 per year. "Radon analysis
laboratory" means a business entity or government entity that analyzes passive radon
detection devices to determine the presence and concentration of radon in the devices.
new text end

new text begin (7) Each Minnesota Department of Health radon measurement exam, $125 per exam.
"Minnesota Department of Health radon measurement exam" means a radon measurement
exam administered by the commissioner of health.
new text end

new text begin (8) Each Minnesota Department of Health radon mitigation exam, $125 per exam.
"Minnesota Department of Health radon mitigation exam" means a radon mitigation exam
administered by the commissioner of health.
new text end

new text begin (9) Each Minnesota Department of Health radon mitigation system tag, $50 per tag.
"Minnesota Department of Health radon mitigation system tag" or "system tag" means a
unique identifiable radon system label provided by the commissioner of health.
new text end

new text begin (b) Fees collected under this section shall be deposited in the state treasury and
credited to the state government special revenue fund.
new text end

new text begin Subd. 9. new text end

new text begin Enforcement. new text end

new text begin The commissioner shall enforce this section under the
provisions of sections 144.989 to 144.993.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2015, except subdivisions 4
and 5, which are effective July 1, 2016.
new text end

Sec. 2.

Minnesota Statutes 2014, section 144.9508, is amended to read:

144.9508 RULES.

Subdivision 1.

Sampling and analysis.

The commissioner shall adopt, by rule,
methods for:

(1) lead inspections, lead hazard screens, lead risk assessments, and clearance
inspections;

(2) environmental surveys of lead in paint, soil, dust, and drinking water to determine
areas at high risk for toxic lead exposure;

(3) soil sampling for soil used as replacement soil;

(4) drinking water sampling, which shall be done in accordance with lab certification
requirements and analytical techniques specified by Code of Federal Regulations, title
40, section 141.89; and

(5) sampling to determine whether at least 25 percent of the soil samples collected
from a census tract within a standard metropolitan statistical area contain lead in
concentrations that exceed 100 parts per million.

Subd. 2.

Regulated lead work standards and methods.

(a) The commissioner shall
adopt rules establishing regulated lead work standards and methods in accordance with the
provisions of this section, for lead in paint, dust, drinking water, and soil in a manner that
protects public health and the environment for all residences, including residences also
used for a commercial purpose, child care facilities, playgrounds, and schools.

(b) In the rules required by this section, the commissioner shall require lead hazard
reduction of intact paint only if the commissioner finds that the intact paint is on a
chewable or lead-dust producing surface that is a known source of actual lead exposure to
a specific individual. The commissioner shall prohibit methods that disperse lead dust into
the air that could accumulate to a level that would exceed the lead dust standard specified
under this section. The commissioner shall work cooperatively with the commissioner
of administration to determine which lead hazard reduction methods adopted under this
section may be used for lead-safe practices including prohibited practices, preparation,
disposal, and cleanup. The commissioner shall work cooperatively with the commissioner
of the Pollution Control Agency to develop disposal procedures. In adopting rules under
this section, the commissioner shall require the best available technology for regulated
lead work methods, paint stabilization, and repainting.

(c) The commissioner of health shall adopt regulated lead work standards and
methods for lead in bare soil in a manner to protect public health and the environment.
The commissioner shall adopt a maximum standard of 100 parts of lead per million in
bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts
of lead per million. Soil lead hazard reduction methods shall focus on erosion control
and covering of bare soil.

(d) The commissioner shall adopt regulated lead work standards and methods for lead
in dust in a manner to protect the public health and environment. Dust standards shall use
a weight of lead per area measure and include dust on the floor, on the window sills, and
on window wells. Lead hazard reduction methods for dust shall focus on dust removal and
other practices which minimize the formation of lead dust from paint, soil, or other sources.

(e) The commissioner shall adopt lead hazard reduction standards and methods for
lead in drinking water both at the tap and public water supply system or private well
in a manner to protect the public health and the environment. The commissioner may
adopt the rules for controlling lead in drinking water as contained in Code of Federal
Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include
an educational approach of minimizing lead exposure from lead in drinking water.

(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that
removal of exterior lead-based coatings from residences and steel structures by abrasive
blasting methods is conducted in a manner that protects health and the environment.

(g) All regulated lead work standards shall provide reasonable margins of safety that
are consistent with more than a summary review of scientific evidence and an emphasis on
overprotection rather than underprotection when the scientific evidence is ambiguous.

(h) No unit of local government shall have an ordinance or regulation governing
regulated lead work standards or methods for lead in paint, dust, drinking water, or soil
that require a different regulated lead work standard or method than the standards or
methods established under this section.

(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit
of local government of an innovative lead hazard reduction method which is consistent
in approach with methods established under this section.

(j) The commissioner shall adopt rules for issuing lead orders required under section
144.9504, rules for notification of abatement or interim control activities requirements,
and other rules necessary to implement sections 144.9501 to 144.9512.

(k) The commissioner shall adopt rules consistent with section 402(c)(3) of the
Toxic Substances Control Act to ensure that renovation in a pre-1978 affected property
where a child or pregnant female resides is conducted in a manner that protects health
and the environment. new text begin Notwithstanding sections 14.125 and 14.128, the authority to adopt
these rules does not expire.
new text end

(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b)
of the Toxic Substances Control Act. new text begin Notwithstanding sections 14.125 and 14.128, the
authority to adopt these rules does not expire.
new text end

Subd. 2a.

Lead standards for exterior surfaces and street dust.

The
commissioner may, by rule, establish lead standards for exterior horizontal surfaces,
concrete or other impervious surfaces, and street dust on residential property to protect the
public health and the environment.

Subd. 3.

Licensure and certification.

The commissioner shall adopt rules to license
lead supervisors, lead workers, lead project designers, lead inspectors, lead risk assessors,
and lead sampling technicians. The commissioner shall also adopt rules requiring
certification of firms that perform regulated lead work. The commissioner shall require
periodic renewal of licenses and certificates and shall establish the renewal periods.

Subd. 4.

Lead training course.

The commissioner shall establish by rule
requirements for training course providers and the renewal period for each lead-related
training course required for certification or licensure. The commissioner shall establish
criteria in rules for the content and presentation of training courses intended to qualify
trainees for licensure under subdivision 3. The commissioner shall establish criteria in
rules for the content and presentation of training courses for lead renovation and lead
sampling technicians. deleted text begin Training course permit fees shall be nonrefundable and must be
submitted with each application in the amount of $500 for an initial training course, $250
for renewal of a permit for an initial training course, $250 for a refresher training course,
and $125 for renewal of a permit of a refresher training course.
deleted text end

Subd. 5.

Variances.

In adopting the rules required under this section, the
commissioner shall provide variance procedures for any provision in rules adopted under
this section, except for the numerical standards for the concentrations of lead in paint,
dust, bare soil, and drinking water. A variance shall be considered only according to the
procedures and criteria in Minnesota Rules, parts 4717.7000 to 4717.7050.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 3.

Minnesota Statutes 2014, section 144A.72, is amended to read:

144A.72 REGISTRATION REQUIREMENTS; PENALTIES.

Subdivision 1.

Minimum criteria.

new text begin (a) new text end The commissioner shall require that, as a
condition of registration:

(1) the supplemental nursing services agency shall document that each temporary
employee provided to health care facilities currently meets the minimum licensing, training,
and continuing education standards for the position in which the employee will be working;

(2) the supplemental nursing services agency shall comply with all pertinent
requirements relating to the health and other qualifications of personnel employed in
health care facilities;

(3) the supplemental nursing services agency must not restrict in any manner the
employment opportunities of its employees;

(4) the supplemental nursing services agency shall carry medical malpractice
insurance to insure against the loss, damage, or expense incident to a claim arising out
of the death or injury of any person as the result of negligence or malpractice in the
provision of health care services by the supplemental nursing services agency or by any
employee of the agency;

(5) the supplemental nursing services agency shall carry an employee dishonesty
bond in the amount of $10,000;

(6) the supplemental nursing services agency shall maintain insurance coverage
for workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies
provided or procured by the agency;

(7) the supplemental nursing services agency shall file with the commissioner of
revenue: (i) the name and address of the bank, savings bank, or savings association
in which the supplemental nursing services agency deposits all employee income tax
withholdings; and (ii) the name and address of any nurse, nursing assistant, nurse aide, or
orderly whose income is derived from placement by the agency, if the agency purports
the income is not subject to withholding;

(8) the supplemental nursing services agency must not, in any contract with any
employee or health care facility, require the payment of liquidated damages, employment
fees, or other compensation should the employee be hired as a permanent employee of a
health care facility; deleted text begin and
deleted text end

(9) the supplemental nursing services agency shall document that each temporary
employee provided to health care facilities is an employee of the agency and is not
an independent contractor deleted text begin . deleted text end new text begin ; and
new text end

new text begin (10) the supplemental nursing services agency shall retain all records for five
calendar years. All records of the supplemental nursing services agency must be
immediately available to the department.
new text end

new text begin (b) In order to retain registration, the supplemental nursing services agency must
provide services to a health care facility during the year preceding the supplemental
nursing services agency's registration renewal date.
new text end

Subd. 2.

Penalties.

deleted text begin A pattern of deleted text end Failure to comply with this section shall subject
the supplemental nursing services agency to revocation or nonrenewal of its registration.
Violations of section 144A.74 are subject to a fine equal to 200 percent of the amount
billed or received in excess of the maximum permitted under that section.

Subd. 3.

Revocation.

Notwithstanding subdivision 2, the registration of a
supplemental nursing services agency that knowingly supplies to a health care facility a
person with an illegally or fraudulently obtained or issued diploma, registration, license,
certificate, or background study shall be revoked by the commissioner. The commissioner
shall notify the supplemental nursing services agency 15 days in advance of the date
of revocation.

Subd. 4.

Hearing.

(a) No supplemental nursing services agency's registration
may be revoked without a hearing held as a contested case in accordance with deleted text begin chapter
14. The hearing must commence within 60 days after the proceedings are initiated deleted text end new text begin
section 144A.475, subdivisions 3a and 7, except the hearing must be conducted by an
administrative law judge within 60 calendar days of the request for assignment new text end .

(b) If a controlling person has been notified by the commissioner of health that the
supplemental nursing services agency will not receive an initial registration or that a
renewal of the registration has been denied, the controlling person or a legal representative
on behalf of the supplemental nursing services agency may request and receive a hearing
on the denial. deleted text begin This deleted text end new text begin The new text end hearing shall be deleted text begin held as a contested case in accordance with
chapter 14 deleted text end new text begin a contested case in accordance with section 144A.475, subdivisions 3a and 7,
except the hearing must be conducted by an administrative law judge within 60 calendar
days of the request for assignment new text end .

Subd. 5.

Period of ineligibility.

(a) The controlling person of a supplemental
nursing services agency whose registration has not been renewed or has been revoked
because of noncompliance with the provisions of sections 144A.70 to 144A.74 shall not
be eligible to apply for nor will be granted a registration for five years following the
effective date of the nonrenewal or revocation.

(b) The commissioner shall not issue or renew a registration to a supplemental
nursing services agency if a controlling person includes any individual or entity who was
a controlling person of a supplemental nursing services agency whose registration was
not renewed or was revoked as described in paragraph (a) for five years following the
effective date of nonrenewal or revocation.

Sec. 4.

new text begin [245.735] EXCELLENCE IN MENTAL HEALTH DEMONSTRATION
PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Excellence in Mental Health demonstration project. new text end

new text begin The
commissioner shall develop and execute projects to reform the mental health system by
participating in the Excellence in Mental Health demonstration project.
new text end

new text begin Subd. 2. new text end

new text begin Federal proposal. new text end

new text begin The commissioner shall develop and submit to the
United States Department of Health and Human Services a proposal for the Excellence
in Mental Health demonstration project. The proposal shall include any necessary state
plan amendments, waivers, requests for new funding, realignment of existing funding, and
other authority necessary to implement the projects specified in subdivision 4.
new text end

new text begin Subd. 3. new text end

new text begin Rules. new text end

new text begin By January 15, 2017, the commissioner shall adopt rules that meet
the criteria in subdivision 4, paragraph (a), to establish standards for state certification
of community behavioral health clinics, and rules that meet the criteria in subdivision 4,
paragraph (b), to implement a prospective payment system for medical assistance payment
of mental health services delivered in certified community behavioral health clinics. These
rules shall comply with federal requirements for certification of community behavioral
health clinics and the prospective payment system and shall apply to community mental
health centers, mental health clinics, mental health residential treatment centers, essential
community providers, federally qualified health centers, and rural health clinics. The
commissioner may adopt rules under this subdivision using the expedited process in
section 14.389.
new text end

new text begin Subd. 4. new text end

new text begin Reform projects. new text end

new text begin (a) The commissioner shall establish standards
for state certification of a clinic as a certified community behavioral health clinic, in
accordance with the criteria published on or before September 1, 2015, by the United
States Department of Health and Human Services. Certification standards established by
the commissioner shall require that:
new text end

new text begin (1) clinic staff have backgrounds in diverse disciplines, include licensed mental
health professionals, and are culturally and linguistically trained to serve the needs of the
clinic's patient population;
new text end

new text begin (2) clinic services are available and accessible and that crisis management services
are available 24 hours per day;
new text end

new text begin (3) fees for clinic services are established using a sliding fee scale and services to
patients are not denied or limited due to a patient's inability to pay for services;
new text end

new text begin (4) clinics provide coordination of care across settings and providers to ensure
seamless transitions for patients across the full spectrum of health services, including
acute, chronic, and behavioral needs. Care coordination may be accomplished through
partnerships or formal contracts with federally qualified health centers, inpatient
psychiatric facilities, substance use and detoxification facilities, community-based mental
health providers, and other community services, supports, and providers including
schools, child welfare agencies, juvenile and criminal justice agencies, Indian Health
Services clinics, tribally licensed health care and mental health facilities, urban Indian
health clinics, Department of Veterans Affairs medical centers, outpatient clinics, drop-in
centers, acute care hospitals, and hospital outpatient clinics;
new text end

new text begin (5) services provided by clinics include crisis mental health services, emergency
crisis intervention services, and stabilization services; screening, assessment, and diagnosis
services, including risk assessments and level of care determinations; patient-centered
treatment planning; outpatient mental health and substance use services; targeted case
management; psychiatric rehabilitation services; peer support and counselor services and
family support services; and intensive community-based mental health services, including
mental health services for members of the armed forces and veterans; and
new text end

new text begin (6) clinics comply with quality assurance reporting requirements and other reporting
requirements, including any required reporting of encounter data, clinical outcomes data,
and quality data.
new text end

new text begin (b) The commissioner shall establish standards and methodologies for a prospective
payment system for medical assistance payments for mental health services delivered by
certified community behavioral health clinics, in accordance with guidance issued on or
before September 1, 2015, by the Centers for Medicare and Medicaid Services. During the
operation of the demonstration project, payments shall comply with federal requirements
for a 90 percent enhanced federal medical assistance percentage.
new text end

new text begin Subd. 5. new text end

new text begin Public participation. new text end

new text begin In developing the projects under subdivision 4, the
commissioner shall consult with mental health providers, advocacy organizations, licensed
mental health professionals, and Minnesota health care program enrollees who receive
mental health services and their families.
new text end

new text begin Subd. 6. new text end

new text begin Information systems support. new text end

new text begin The commissioner and the state chief
information officer shall provide information systems support to the projects as necessary
to comply with federal requirements and the deadlines in subdivision 3.
new text end

Sec. 5.

new text begin [256B.0638] OPIOID PRESCRIBING IMPROVEMENT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Program established. new text end

new text begin The commissioner of human services, in
conjunction with the commissioner of health, shall coordinate and implement an opioid
prescribing improvement program to reduce opioid dependency and substance use by
Minnesotans due to the prescribing of opioid analgesics by health care providers.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms defined in this
subdivision have the meanings given them.
new text end

new text begin (b) "Commissioner" means the commissioner of human services.
new text end

new text begin (c) "Commissioners" means the commissioner of human services and the
commissioner of health.
new text end

new text begin (d) "DEA" means the United States Drug Enforcement Administration.
new text end

new text begin (e) "Opioid disenrollment standards" means parameters of opioid prescribing
practices that fall outside community standard thresholds for prescribing to such a degree
that a provider must be disenrolled as a medical assistance provider.
new text end

new text begin (f) "Opioid prescriber" means a licensed health care provider who prescribes opioids
to medical assistance and MinnesotaCare enrollees under the fee-for-service system or
under a managed care or county-based purchasing plan.
new text end

new text begin (g) "Opioid quality improvement standard thresholds" means parameters of opioid
prescribing practices that fall outside community standards for prescribing to such a
degree that quality improvement is required.
new text end

new text begin (h) "Program" means the statewide opioid prescribing improvement program
established under this section.
new text end

new text begin (i) "Provider group" means a clinic, hospital, or primary or specialty practice group
that employs, contracts with, or is affiliated with an opioid prescriber. Provider group does
not include a professional association supported by dues-paying members.
new text end

new text begin (j) "Sentinel measures" means measures of opioid use that identify variations in
prescribing practices during the prescribing intervals.
new text end

new text begin Subd. 3. new text end

new text begin Opioid prescribing work group. new text end

new text begin (a) The commissioner of human
services, in consultation with the commissioner of health, shall appoint the following
voting members to an opioid prescribing work group:
new text end

new text begin (1) two consumer members who have been impacted by an opioid abuse disorder or
opioid dependence disorder, either personally or with family members;
new text end

new text begin (2) one member who is a licensed physician actively practicing in Minnesota and
registered as a practitioner with the DEA;
new text end

new text begin (3) one member who is a licensed pharmacist actively practicing in Minnesota and
registered as a practitioner with the DEA;
new text end

new text begin (4) one member who is a licensed nurse practitioner actively practicing in Minnesota
and registered as a practitioner with the DEA;
new text end

new text begin (5) one member who is a licensed dentist actively practicing in Minnesota and
registered as a practitioner with the DEA;
new text end

new text begin (6) two members who are nonphysician licensed health care professionals actively
engaged in the practice of their profession in Minnesota, and their practice includes
treating pain;
new text end

new text begin (7) one member who is a mental health professional who is licensed or registered
in a mental health profession, who is actively engaged in the practice of that profession
in Minnesota, and whose practice includes treating patients with chemical dependency
or substance abuse;
new text end

new text begin (8) one member who is a medical examiner for a Minnesota county;
new text end

new text begin (9) one member of the Health Services Policy Committee established under section
256B.0625, subdivisions 3c to 3e;
new text end

new text begin (10) one member who is a medical director of a health plan company doing business
in Minnesota;
new text end

new text begin (11) one member who is a pharmacy director of a health plan company doing
business in Minnesota; and
new text end

new text begin (12) one member representing Minnesota law enforcement.
new text end

new text begin (b) In addition, the work group shall include the following nonvoting members:
new text end

new text begin (1) the medical director for the medical assistance program;
new text end

new text begin (2) the Department of Human Services pharmacy program manager; and
new text end

new text begin (3) the medical director for the Department of Labor and Industry.
new text end

new text begin (c) An honorarium of $200 per meeting and reimbursement for mileage and parking
shall be paid to each voting member in attendance.
new text end

new text begin Subd. 4. new text end

new text begin Program components. new text end

new text begin (a) The working group shall recommend to the
commissioners the components of the statewide opioid prescribing improvement program,
including, but not limited to, the following:
new text end

new text begin (1) developing criteria for opioid prescribing protocols, including:
new text end

new text begin (i) prescribing for the interval of up to four days immediately after an acute painful
event;
new text end

new text begin (ii) prescribing for the interval of up to 45 days after an acute painful event; and
new text end

new text begin (iii) prescribing for chronic pain, which means pain lasting longer than 45 days
after an acute painful event;
new text end

new text begin (2) developing sentinel measures;
new text end

new text begin (3) developing educational resources for opioid prescribers about communicating
with patients about pain management and the use of opioids to treat pain;
new text end

new text begin (4) developing opioid quality improvement standard thresholds and opioid
disenrollment standards for opioid prescribers and provider groups. In developing opioid
disenrollment standards, the standards may be described in terms of the length of time in
which prescribing practices fall outside community standards and the nature and amount
of opioid prescribing that fall outside community standards; and
new text end

new text begin (5) addressing other program issues as determined by the commissioners.
new text end

new text begin (b) The opioid prescribing protocols shall not apply to opioids prescribed for patients
who are experiencing pain caused by a malignant condition or who are receiving hospice
care, or to opioids prescribed as medication-assisted therapy to treat opioid dependency.
new text end

new text begin (c) All opioid prescribers who prescribe opioids to medical assistance or
MinnesotaCare enrollees must participate in the program in accordance with subdivision
5. Any other prescriber who prescribed opioids may comply with the components of this
program described in paragraph (a) on a voluntary basis.
new text end

new text begin Subd. 5. new text end

new text begin Program implementation. new text end

new text begin (a) The commissioner shall implement the
program within the medical assistance and MinnesotaCare programs to improve the health
of and quality of care provided to medical assistance and MinnesotaCare enrollees. The
commissioner shall annually collect and report to opioid prescribers data showing the
sentinel measures of their opioid prescribing patterns compared to their anonymized peers.
new text end

new text begin (b) The commissioner shall notify an opioid prescriber and all provider groups
with which the opioid prescriber is employed or affiliated when the opioid prescriber's
prescribing pattern exceeds the opioid quality improvement standard thresholds. An
opioid prescriber and any provider group that receives a notice under this paragraph shall
submit to the commissioner a quality improvement plan for review and approval by the
commissioner with the goal of bringing the opioid prescriber's prescribing practices into
alignment with community standards. A quality improvement plan must include:
new text end

new text begin (1) components of the program described in subdivision 4, paragraph (a);
new text end

new text begin (2) internal practice-based measures to review the prescribing practice of the
opioid prescriber and, where appropriate, any other opioid prescribers employed by or
affiliated with any of the provider groups with which the opioid prescriber is employed or
affiliated; and
new text end

new text begin (3) appropriate use of the prescription monitoring program under section 152.126.
new text end

new text begin (c) If, after a year from the commissioner's notice under paragraph (b), the opioid
prescriber's prescribing practices do not improve so that they are consistent with
community standards, the commissioner shall take one or more of the following steps:
new text end

new text begin (1) monitor prescribing practices more frequently than annually;
new text end

new text begin (2) monitor more aspects of the opioid prescriber's prescribing practices than the
sentinel measures; or
new text end

new text begin (3) require the opioid prescriber to participate in additional quality improvement
efforts, including but not limited to mandatory use of the prescription monitoring program
established under section 152.126.
new text end

new text begin (d) The commissioner shall disenroll from the medical assistance and MinnesotaCare
programs all opioid prescribers and provider groups whose prescribing practices fall
within the applicable opioid disenrollment standards.
new text end

new text begin Subd. 6. new text end

new text begin Data practices. new text end

new text begin (a) Reports and data identifying an opioid prescriber
are private data on individuals as defined under section 13.02, subdivision 12, until an
opioid prescriber is subject to disenrollment as a medical assistance provider under this
section. Notwithstanding this data classification, the commissioner shall share with all of
the provider groups with which an opioid prescriber is employed or affiliated, a report
identifying an opioid prescriber who is subject to quality improvement activities under
subdivision 5, paragraph (b) or (c).
new text end

new text begin (b) Reports and data identifying a provider group are nonpublic data as defined
under section 13.02, subdivision 9, until the provider group is subject to disenrollment as a
medical assistance provider under this section.
new text end

new text begin (c) Upon disenrollment under this section, reports and data identifying an opioid
prescriber or provider group are public, except that any identifying information of medical
assistance or MinnesotaCare enrollees must be redacted by the commissioner.
new text end

new text begin Subd. 7. new text end

new text begin Annual report to legislature. new text end

new text begin By September 15, 2016, and annually
thereafter, the commissioner of human services shall report to the legislature on the
implementation of the opioid prescribing improvement program in the medical assistance
and MinnesotaCare programs. The report must include data on the utilization of opioids
within the medical assistance and MinnesotaCare programs.
new text end