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Capital IconMinnesota Legislature

SF 13

3rd Engrossment - 91st Legislature (2019 - 2020) Posted on 08/20/2020 09:29am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - 3rd Engrossment

Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33
2.34 2.35
2.36 2.37 2.38 2.39 2.40 2.41
2.42 2.43 2.44 2.45 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22
3.23 3.24 3.25 3.26
3.27 3.28 3.29 3.30 3.31 3.32
4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10
6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10
7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27
7.28 7.29 7.30 7.31 7.32 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13
8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26
8.27 8.28 8.29 8.30 8.31
9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13
9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26
11.27 11.28 11.29 11.30 11.31 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24
12.25 12.26 12.27 12.28 12.29 12.30 12.31 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 13.33
14.1 14.2
14.3
14.4
14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16
14.17
14.18 14.19 14.20
14.21 14.22
14.23 14.24 14.25 14.26 14.27 14.28 14.29 15.1 15.2
15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13
15.14 15.15 15.16 15.17 15.18 15.19
15.20 15.21 15.22 15.23 15.24
15.25 15.26 15.27 15.28 15.29 15.30
16.1 16.2 16.3 16.4 16.5 16.6
16.7 16.8 16.9 16.10 16.11
16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16
17.17 17.18 17.19 17.20 17.21
17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 18.1 18.2 18.3
18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16
18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10
21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 22.33 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8
24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19
24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8
25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 26.1 26.2 26.3 26.4 26.5 26.6
26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24
26.25 26.26 26.27 26.28 26.29 26.30 26.31 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9
27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24
27.25 27.26 27.27 27.28 27.29 27.30 27.31 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13
30.14 30.15 30.16 30.17 30.18 30.19
30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 30.32 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 31.33 31.34 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18
33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 33.33 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 34.32 34.33 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11
35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 35.32 35.33 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13
36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15
37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 37.32
37.33
38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12
38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33 39.34 40.1 40.2 40.3
40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 41.33 41.34
42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11
42.12
42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23
42.24
42.25 42.26 42.27 42.28 42.29 42.30 43.1 43.2 43.3 43.4
43.5
43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29
43.30
44.1 44.2 44.3
44.4 44.5
44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 44.32 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12
45.13
45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29
45.30
46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 47.1 47.2 47.3 47.4 47.5 47.6
47.7
47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 48.1 48.2 48.3 48.4 48.5
48.6
48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 49.1 49.2
49.3
49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21
49.22
49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 50.1 50.2 50.3
50.4
50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32 50.33 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19
54.20
54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 55.1 55.2
55.3
55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 56.1 56.2 56.3 56.4 56.5 56.6 56.7
56.8
56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 56.33 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18
57.19
57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 57.31 57.32 57.33 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19
58.20
58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 58.32 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19
60.20
60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32
61.1
61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29
62.30
62.31 62.32 62.33 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31
63.32
64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30
64.31
65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8
65.9
65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29
65.30
66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30
66.31
67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25
67.26
67.27 67.28 67.29 67.30 67.31 67.32 67.33 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9
68.10
68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 69.1 69.2 69.3
69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23
70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 71.1 71.2 71.3 71.4 71.5 71.6
71.7
71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30 71.31
71.32
72.1 72.2 72.3 72.4 72.5 72.6
72.7
72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28
73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 74.33 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 75.33 75.34 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 76.33 76.34 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9
77.10
77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26
77.27
77.28 77.29 77.30 77.31 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12
78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 78.33 78.34 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29
79.30
79.31 79.32 79.33 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11
80.12
80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13
81.14
81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 82.33 82.34 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32 83.33 84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8
84.9
84.10 84.11 84.12 84.13
84.14
84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29
85.30 85.31 85.32 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29
87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20
87.21
87.22 87.23 87.24
87.25
87.26 87.27
87.28 87.29 87.30 87.31 87.32 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23
88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 90.32 90.33 91.1 91.2 91.3 91.4 91.5 91.6 91.7
91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28
92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 92.32 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8
93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 93.32 94.1 94.2 94.3
94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25
94.26 94.27 94.28 94.29 94.30 94.31 95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8
95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 95.32
96.1 96.2 96.3 96.4 96.5 96.6
96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15
96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28
96.29 96.30 96.31 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9
97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30
98.1 98.2 98.3 98.4 98.5
98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14
98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 99.32 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26
102.27 102.28 102.29 102.30 102.31 103.1 103.2 103.3 103.4
103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12
103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 104.1 104.2 104.3 104.4 104.5 104.6
104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28
105.1 105.2 105.3 105.4 105.5 105.6
105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 105.33 105.34
106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23
106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 107.1 107.2 107.3
107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24
107.25 107.26 107.27 107.28 107.29 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10
108.11 108.12 108.13 108.14 108.15
108.16 108.17 108.18 108.19 108.20 108.21
108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17
109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20
110.21 110.22 110.23 110.24 110.25 110.26
110.27 110.28 110.29 110.30 110.31
111.1 111.2 111.3 111.4 111.5
111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17
111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29
111.30 111.31 111.32 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12
112.13 112.14 112.15 112.16 112.17 112.18
112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26
112.27 112.28 112.29 112.30 112.31 113.1 113.2 113.3 113.4 113.5
113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23
113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 114.33 114.34 115.1 115.2 115.3 115.4 115.5 115.6 115.7
115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16
115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26
115.27 115.28 115.29 115.30 115.31 115.32 115.33 116.1 116.2
116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11
117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23
117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 117.33 118.1 118.2
118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17
118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9
119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24
120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20
121.21 121.22 121.23 121.24 121.25 121.26 121.27
121.28 121.29 121.30 121.31 121.32 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8
122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 123.1
123.2 123.3 123.4 123.5 123.6 123.7 123.8
123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12
124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8
125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27
125.28 125.29 125.30 125.31 126.1 126.2 126.3
126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23
126.24 126.25 126.26 126.27 126.28 126.29 126.30
127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10
127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28
127.29 127.30 127.31 128.1 128.2 128.3 128.4 128.5 128.6 128.7
128.8 128.9 128.10 128.11
128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29
129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14
129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23
129.24 129.25 129.26 129.27 129.28 129.29 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18
131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30
132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10
132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 139.1 139.2 139.3 139.4 139.5 139.6 139.7
139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20
139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20
140.21 140.22 140.23 140.24 140.25 140.26 140.27
140.28 140.29 140.30 140.31 140.32 140.33 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24
141.25 141.26 141.27 141.28 141.29 141.30 141.31
142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 142.33 142.34 143.1 143.2 143.3 143.4 143.5
143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28
143.29 143.30 143.31 143.32 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20
146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17
147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14
149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23
149.24 149.25 149.26 149.27 149.28
149.29 149.30 149.31 150.1 150.2 150.3 150.4 150.5
150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14
150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29
151.30 151.31 151.32 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8
152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 153.1 153.2 153.3 153.4
153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14
153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25
153.26 153.27 153.28 153.29 153.30 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16
154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23
155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20
156.21 156.22 156.23 156.24 156.25 156.26 156.27
156.28 156.29 156.30 156.31 156.32 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11
157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30
158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10
158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20
158.21 158.22 158.23 158.24
158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 159.32 159.33 160.1 160.2 160.3
160.4 160.5 160.6 160.7 160.8 160.9 160.10
160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20
160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 161.1 161.2
161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12
161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23
161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 162.1 162.2
162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14
163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12
165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26
165.27 165.28 165.29 165.30 165.31 165.32 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8
166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32 166.33 166.34 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32 167.33 167.34 167.35 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30
169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20
170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17
171.18 171.19 171.20 171.21 171.22 171.23 171.24
171.25 171.26 171.27 171.28 171.29 171.30 171.31 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 172.33 172.34 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11
173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 175.32 175.33 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27
177.28 177.29 177.30 177.31 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 178.33 178.34 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28
179.29 179.30 179.31 179.32 179.33 179.34 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8
180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 181.1 181.2
181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20
181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 182.1 182.2 182.3
182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11
184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27
185.28 185.29 185.30 185.31 185.32 185.33 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23
187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24
189.25 189.26 189.27 189.28 189.29 189.30 189.31
190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 190.32 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25
191.26 191.27 191.28 191.29 191.30 191.31 191.32 191.33 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18
192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31
193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13
194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30
195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 195.33 195.34
196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15
196.16 196.17 196.18 196.19
196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29
196.30 196.31 196.32 197.1 197.2
197.3 197.4 197.5 197.6
197.7 197.8 197.9 197.10 197.11 197.12
197.13 197.14
197.15 197.16
197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17
212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 216.1 216.2 216.3 216.4 216.5 216.6
216.7 216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 216.31 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12

A bill for an act
relating to human services; modifying policy provisions governing health care;
specifying when a provider must furnish requested medical records; modifying
x-ray equipment provisions; requiring an annual unannounced inspection of medical
cannabis manufacturers; modifying eligibility for the reduced patient enrollment
fee for the medical cannabis program; permitting licensed physician assistants to
practice without a delegation agreement; modifying licensed traditional midwifery
scope of practice; modifying the request for proposal for a central drug repository;
authorizing pharmacists to prescribe self-administered hormonal contraceptives,
nicotine replacement medications, and opiate antagonists; allowing telemedicine
examinations to be used to prescribe medications for erectile dysfunction and for
the treatment of substance abuse disorders; changing the terminology and other
technical changes to the opiate epidemic response account and council; adding
advanced practice registered nurses to certain statutes; modifying definitions;
reclassifying certain controlled substances; modifying certain provisions related
to medical cannabis; amending Minnesota Statutes 2018, sections 62A.307,
subdivision 2; 62D.09, subdivision 1; 62E.06, subdivision 1; 62J.17, subdivision
4a; 62J.495, subdivision 1a; 62J.52, subdivision 2; 62J.823, subdivision 3; 62Q.43,
subdivisions 1, 2; 62Q.54; 62Q.57, subdivision 1; 62Q.73, subdivision 7; 62Q.733,
subdivision 3; 62Q.74, subdivision 1; 62S.08, subdivision 3; 62S.20, subdivision
5b; 62S.21, subdivision 2; 62S.268, subdivision 1; 62U.03; 62U.04, subdivision
11; 144.121, subdivisions 1, 2, 5, by adding subdivisions; 144.292, subdivisions
2, 5; 144.3345, subdivision 1; 144.3352; 144.34; 144.441, subdivisions 4, 5;
144.442, subdivision 1; 144.4803, subdivisions 1, 4, 10, by adding a subdivision;
144.4806; 144.4807, subdivisions 1, 2, 4; 144.50, subdivision 2; 144.55, subdivision
6; 144.6501, subdivision 7; 144.651, subdivisions 7, 8, 9, 10, 12, 14, 31, 33;
144.652, subdivision 2; 144.69; 144.7402, subdivision 2; 144.7406, subdivision
2; 144.7407, subdivision 2; 144.7414, subdivision 2; 144.7415, subdivision 2;
144.9502, subdivision 4; 144.966, subdivisions 3, 6; 144A.135; 144A.161,
subdivisions 5, 5a, 5e, 5g; 144A.75, subdivisions 3, 6; 144A.752, subdivision 1;
145.853, subdivision 5; 145.892, subdivision 3; 145.94, subdivision 2; 145B.13;
145C.02; 145C.06; 145C.07, subdivision 1; 145C.16; 147A.01, subdivisions 3,
21, 26, 27, by adding a subdivision; 147A.02; 147A.03, by adding a subdivision;
147A.05; 147A.09; 147A.13, subdivision 1; 147A.14, subdivision 4; 147A.16;
147A.23; 147D.03, subdivision 2; 148.6438, subdivision 1; 151.01, by adding a
subdivision; 151.071, subdivision 8; 151.19, subdivision 4; 151.21, subdivision
4a; 151.37, subdivision 2, by adding subdivisions; 152.02, subdivisions 2, 3, 4;
152.12, subdivision 1; 152.32, subdivision 3; 152.35; 245A.143, subdivision 8;
245A.1435; 245C.02, subdivision 18; 245C.04, subdivision 1; 245D.02, subdivision
11; 245D.11, subdivision 2; 245D.22, subdivision 7; 245D.25, subdivision 2;
245G.08, subdivisions 2, 5; 245G.21, subdivisions 2, 3; 246.711, subdivision 2;
246.715, subdivision 2; 246.716, subdivision 2; 246.721; 246.722; 251.043,
subdivision 1; 252A.02, subdivision 12; 252A.04, subdivision 2; 252A.20,
subdivision 1; 253B.03, subdivisions 4, 6d; 253B.06, subdivision 2; 253B.23,
subdivision 4; 254A.08, subdivision 2; 256.01, subdivision 29; 256.9685,
subdivisions 1a, 1b, 1c; 256.975, subdivisions 7a, 11; 256B.04, subdivision 14a;
256B.043, subdivision 2; 256B.055, subdivision 12; 256B.056, subdivisions 1a,
4, 7, 10; 256B.0561, subdivision 2; 256B.057, subdivisions 1, 10; 256B.0575,
subdivisions 1, 2; 256B.0622, subdivision 2b; 256B.0623, subdivision 2;
256B.0625, subdivisions 1, 12, 13h, 26, 27, 28, 64; 256B.0654, subdivisions 1,
2a, 3, 4; 256B.0659, subdivisions 2, 4, 8; 256B.0751; 256B.0753, subdivision 1;
256B.69, by adding a subdivision; 256B.73, subdivision 5; 256B.75; 256J.08,
subdivision 73a; 256L.03, subdivision 1; 256L.15, subdivision 1; 256R.54,
subdivisions 1, 2; 257.63, subdivision 3; 257B.01, subdivisions 3, 9, 10; 257B.06,
subdivision 7; 446A.081, subdivision 9; Minnesota Statutes 2019 Supplement,
sections 16A.151, subdivision 2; 62J.23, subdivision 2; 62Q.184, subdivision 1;
144.121, subdivisions 1a, 5a; 144.55, subdivision 2; 145C.05, subdivision 2;
147A.06; 151.01, subdivisions 23, 27; 151.065, subdivisions 1, as amended, 3, as
amended, 6, 7, as amended; 151.071, subdivision 2; 151.19, subdivision 3; 151.252,
subdivision 1; 151.555, subdivision 3; 152.29, subdivision 1; 245G.08, subdivision
3; 245H.11; 256.042, subdivisions 2, 4; 256.043; 256B.056, subdivision 7a;
256B.0625, subdivisions 13, 17, 60a; 256B.0659, subdivision 11; 256B.0913,
subdivision 8; 256R.44; Laws 2019, chapter 63, article 3, sections 1; 2; Laws 2019,
First Special Session chapter 9, article 11, section 35; Laws 2020, chapter 73,
section 4, subdivisions 3, 4; proposing coding for new law in Minnesota Statutes,
chapters 62Q; 147A; repealing Minnesota Statutes 2018, sections 62U.15,
subdivision 2; 144.121, subdivisions 3, 5b; 147A.01, subdivisions 4, 11, 16a, 17a,
24, 25; 147A.04; 147A.10; 147A.11; 147A.18, subdivisions 1, 2, 3; 147A.20;
256B.057, subdivision 8; 256B.0752; 256L.04, subdivision 13; Minnesota Rules,
parts 7380.0280; 9505.0365, subpart 3.

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

ARTICLE 1

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2018, section 144.121, subdivision 1, is amended to read:


Subdivision 1.

Registration; fees.

The fee for the registration for x-ray deleted text beginmachinesdeleted text endnew text begin
equipment
new text end and other sources of ionizing radiation required to be registered under rules
adopted by the state commissioner of health pursuant to section 144.12, shall be in an amount
as described in subdivision 1a pursuant to section 144.122. The registration shall expire and
be renewed as prescribed by the commissioner pursuant to section 144.122.

Sec. 2.

Minnesota Statutes 2019 Supplement, section 144.121, subdivision 1a, is amended
to read:


Subd. 1a.

Fees for ionizing radiation-producing equipment.

(a) A facility with ionizing
radiation-producing equipment new text beginand other sources of ionizing radiation new text endmust pay an deleted text beginannualdeleted text end
initial or annual renewal registration fee consisting of a base facility fee of $100 and an
additional fee for each deleted text beginradiation sourcedeleted text endnew text begin x-ray tubenew text end, as follows:

(1)
medical or veterinary equipment
$
100
(2)
dental x-ray equipment
$
40
(3)
x-ray equipment not used on
humans or animals
$
100
(4)
devices with sources of ionizing
radiation not used on humans or
animals
$
100
(5)
security screening system
$
100

(b) A facility with radiation therapy and accelerator equipment must pay an new text begininitial or
new text end annual registration fee of $500. A facility with an industrial accelerator must pay an new text begininitial
or
new text endannual registration fee of $150.

(c) Electron microscopy equipment is exempt from the registration fee requirements of
this section.

(d) For purposes of this section, a security screening system means new text beginionizing
new text end radiation-producing equipment designed and used for security screening of humans who
are in the custody of a correctional or detention facility, and used by the facility to image
and identify contraband items concealed within or on all sides of a human body. For purposes
of this section, a correctional or detention facility is a facility licensed under section 241.021
and operated by a state agency or political subdivision charged with detection, enforcement,
or incarceration in respect to state criminal and traffic laws.

Sec. 3.

Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to
read:


new text begin Subd. 1d. new text end

new text begin Handheld dental x-ray equipment. new text end

new text begin A facility that uses handheld dental x-ray
equipment according to section 144.1215 must comply with this section.
new text end

Sec. 4.

Minnesota Statutes 2018, section 144.121, subdivision 2, is amended to read:


Subd. 2.

Inspections.

Periodic radiation safety inspections of the new text beginx-ray equipment and
other
new text end sources of ionizing radiation shall be made by the deleted text beginstatedeleted text end commissioner of health. The
frequency of safety inspections shall be prescribed by the commissioner on the basis of the
frequency of use of the new text beginx-ray equipment and other new text endsource of ionizing radiationdeleted text begin;deleted text endnew text begin,new text end provided
that each source shall be inspected at least once every four years.

Sec. 5.

Minnesota Statutes 2018, section 144.121, subdivision 5, is amended to read:


Subd. 5.

Examination for individual operating x-ray deleted text beginequipmentdeleted text endnew text begin systemsnew text end.

(a) deleted text beginAfter
January 1, 2008,
deleted text end An individual in a facility with x-ray deleted text beginequipmentdeleted text endnew text begin systemsnew text end for use on new text beginliving
new text end humans that is registered under subdivision 1 may not operate, nor may the facility allow
the individual to operate, x-ray deleted text beginequipmentdeleted text endnew text begin systemsnew text end unless the individual has passed a national
new text begin or state new text endexamination deleted text beginfor limited x-ray machine operators that meets the requirements of
paragraphs (b) and (c) and is approved by the commissioner of health
deleted text end.

deleted text begin (b) The commissioner shall establish criteria for the approval of examinations based on
national standards, such as the examination in radiography from the American Registry of
Radiologic Technologists, the examination for limited scope of practice in radiography from
the American Registry of Radiologic Technologists for limited x-ray machine operators,
and the American Registry of Chiropractic Radiography Technologists for limited
radiography in spines and extremities; or equivalent examinations approved by other states.
Equivalent examinations may be approved by the commissioner, if the examination is
consistent with the standards for educational and psychological testing as recommended by
the American Education Research Association, the American Psychological Association,
the National Council on Measurement in Education, or the National Commission for
Certifying Agencies. The organization proposing the use of an equivalent examination shall
submit a fee to the commissioner of $1,000 per examination to cover the cost of determining
the extent to which the examination meets the examining standards. The collected fee shall
be deposited in the state treasury and credited to the state government special revenue fund.
deleted text end

new text begin (b) Individuals who may operate x-ray systems include:
new text end

new text begin (1) an individual who has passed the American Registry of Radiologic Technologists
(ARRT) registry for radiography examination;
new text end

new text begin (2) an individual who has passed the American Chiropractic Registry of Radiologic
Technologists (ACRRT) registry examination and is limited to radiography of spines and
extremities;
new text end

new text begin (3) a registered limited scope x-ray operator and a registered bone densitometry equipment
operator who passed the examination requirements in paragraphs (d) and (e) and practices
according to subdivision 5a;
new text end

new text begin (4) an x-ray operator who has the original certificate or the original letter of passing the
examination that was required before January 1, 2008, under Minnesota Statutes 2008,
section 144.121, subdivision 5a, paragraph (b), clause (1);
new text end

new text begin (5) an individual who has passed the American Registry of Radiologic Technologists
(ARRT) registry for radiation therapy examination according to subdivision 5e;
new text end

new text begin (6) a cardiovascular technologist according to subdivision 5c;
new text end

new text begin (7) a nuclear medicine technologist according to subdivision 5d;
new text end

new text begin (8) an individual who has passed the examination for a dental hygienist under section
150A.06 and only operates dental x-ray systems;
new text end

new text begin (9) an individual who has passed the examination for a dental therapist under section
150A.06 and only operates dental x-ray systems;
new text end

new text begin (10) an individual who has passed the examination for a dental assistant under section
150A.06, and only operates dental x-ray systems;
new text end

new text begin (11) an individual who has passed the examination under Minnesota Rules, part
3100.8500, subpart 3, and only operates dental x-ray systems; and
new text end

new text begin (12) a qualified practitioner who is licensed by a health-related licensing board with
active practice authority and is working within the practitioner's scope of practice.
new text end

new text begin (c) Except for individuals under clauses (3) and (4), an individual who is participating
in a training or educational program in any of the occupations listed in paragraph (b) is
exempt from the examination requirement within the scope and for the duration of the
training or educational program.
new text end

deleted text begin (c)deleted text endnew text begin (d)new text end The new text beginMinnesota new text endexamination for limitednew text begin scopenew text end x-ray deleted text beginmachinedeleted text end operators must
include:

(1) radiation protection, new text beginradiation physics and radiobiology, new text endequipment deleted text beginmaintenance anddeleted text end
operationnew text begin and quality assurancenew text end, image deleted text beginproductiondeleted text endnew text begin acquisitionnew text end and new text begintechnical new text endevaluation, and
patient deleted text begincaredeleted text endnew text begin interactionsnew text end and management; and

(2) at least one of the following regions of the human anatomy: chest, extremities, skull
and sinus, spine, or deleted text beginankle and footdeleted text endnew text begin podiatrynew text end. The examinations must include the anatomy
of, and deleted text beginpositioningdeleted text endnew text begin radiographic positions and projectionsnew text end for, the specific regions.

new text begin (e) The examination for bone densitometry equipment operators must include:
new text end

new text begin (1) osteoporosis, bone physiology, bone health and patient education, patient preparation,
fundamental principals, biological effects of radiation, units of measurements, radiation
protection in bone densitometry, fundamentals of x-ray production, quality control, measuring
bone mineral testing, determining quality in bone mineral testing, file and database
management; and
new text end

new text begin (2) dual x-ray absorptiometry scanning of the lumbar spine, proximal femur, and forearm.
The examination must include the anatomy, scan acquisition, and scan analysis for these
three procedures.
new text end

deleted text begin (d)deleted text endnew text begin (f)new text end A limited new text beginscope new text endx-ray operatornew text begin, and a bone densitometry equipment operator,new text end
who deleted text beginisdeleted text endnew text begin arenew text end required to take an examination under this subdivision must submit to the
commissioner deleted text beginandeleted text endnew text begin a registrationnew text end application for the examinationdeleted text begin,deleted text endnew text begin andnew text end a $25 processing feedeleted text begin,
and the required examination fee set by the national organization offering the examination
deleted text end.
The processing fee deleted text beginand the examination feedeleted text end shall be deposited in the state treasury and
credited to the state government special revenue fund. deleted text beginThe commissioner shall submit the
fee to the national organization providing the examination.
deleted text end

Sec. 6.

Minnesota Statutes 2019 Supplement, section 144.121, subdivision 5a, is amended
to read:


Subd. 5a.

Limited new text beginscope new text endx-ray deleted text beginmachinedeleted text endnew text begin and bone densitometry equipmentnew text end operator
practice.

deleted text begin(a)deleted text end A new text beginregistered new text endlimited new text beginscope new text endx-ray operator new text beginand a registered bone densitometry
equipment operator
new text endmay only practice medical radiography on limited regions of the human
anatomy for which the operator has successfully passed an examination identified in
subdivision 5, deleted text beginunless the operator meets one of the exemptions described in paragraph (b).
The operator may practice using only routine radiographic procedures, for the interpretation
by and under the direction of a qualified practitioner, excluding
deleted text end new text beginparagraphs (d) and (e) and
may not operate
new text endcomputed tomography, new text begincone beam computed tomography, new text endthe use of contrast
media, and the use of fluoroscopic or mammographic deleted text beginequipmentdeleted text endnew text begin x-ray systemsnew text end.

deleted text begin (b) This subdivision does not apply to:
deleted text end

deleted text begin (1) limited x-ray machine operators who passed the examination that was required before
January 1, 2008;
deleted text end

deleted text begin (2) certified radiologic technologists, licensed dental hygienists, registered dental
assistants, certified registered nurse anesthetists, and registered physician assistants;
deleted text end

deleted text begin (3) individuals who are licensed in Minnesota to practice medicine, osteopathic medicine,
chiropractic, podiatry, or dentistry;
deleted text end

deleted text begin (4) individuals who are participating in a training course in any of the occupations listed
in clause (2), (3), or (5) for the duration and within the scope of the training course; and
deleted text end

deleted text begin (5) cardiovascular technologists who assist with the operation of fluoroscopy equipment
if they:
deleted text end

deleted text begin (i) are credentialed by Cardiovascular Credentialing International as a registered
cardiovascular invasive specialist or as a registered cardiac electrophysiology specialist,
are a graduate of an education program accredited by the Commission on Accreditation of
Allied Health Education Programs, which uses the standards and criteria established by the
Joint Review Committee on Education in Cardiovascular Technology, or are designated on
a variance granted by the commissioner, effective July 31, 2019; and
deleted text end

deleted text begin (ii) are under the personal supervision and in the physical presence of a qualified
practitioner for diagnosing or treating a disease or condition of the cardiovascular system
in fluoroscopically guided interventional procedures. Cardiovascular technologists may not
activate the fluoroscopic system or evaluate quality control tests.
deleted text end

Sec. 7.

Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to
read:


new text begin Subd. 5c. new text end

new text begin Cardiovascular technologist practice. new text end

new text begin (a) Cardiovascular technologists may
assist with the operation of fluoroscopy equipment if they:
new text end

new text begin (1) are credentialed by Cardiovascular Credentialing International as a registered
cardiovascular invasive specialist or as a registered cardiac electrophysiology specialist,
are a graduate of an educational program accredited by the Commission on Accreditation
of Allied Health Education Programs, which uses the standards and criteria established by
the Joint Review Committee on Education in Cardiovascular Technology, or are designated
on a variance granted by the commissioner effective July 31, 2019; and
new text end

new text begin (2) are under the personal supervision and in the physical presence of a qualified
practitioner for diagnosing or treating a disease or condition of the cardiovascular system
in fluoroscopically guided interventional procedures. Cardiovascular technologists may not
activate the fluoroscopic system or evaluate quality control tests.
new text end

new text begin (b) A cardiovascular technologist who is participating in a training or educational program
in any of the occupations listed in this subdivision is exempt from the examination
requirement within the scope and for the duration of the training or educational program.
new text end

Sec. 8.

Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to
read:


new text begin Subd. 5d. new text end

new text begin Nuclear medicine technologist practice. new text end

new text begin (a) Nuclear medicine technologists
who have passed the primary pathway credential in Nuclear Medicine Technology
Certification Board (NMTCB) for nuclear medicine or the American Registry of Radiologic
Technologists (ARRT) for nuclear medicine technology or the American Society of Clinical
Pathologists (NM) (ASCP) may operate a fusion imaging device or a dual imaging device
that uses radioactive material as a point source in transmission scanning and attenuation
correction.
new text end

new text begin (b) A nuclear medicine technologist in paragraph (a) may only operate a stand-alone
computed tomography x-ray system if the technologist has passed the Nuclear Medicine
Technology Certification Board for computed tomography (CT) or is credentialed in
computed tomography (CT) from the American Registry of Radiologic Technologists
(ARRT).
new text end

new text begin (c) A nuclear medicine technologist who meets the requirements under paragraph (a)
and who is participating in a training or educational program to obtain a credential under
paragraph (b) is exempt from the examination requirement within the scope and for the
duration of the training or educational program.
new text end

Sec. 9.

Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to
read:


new text begin Subd. 5e. new text end

new text begin Radiation therapy technologist practice. new text end

new text begin (a) A radiation therapy technologist
who has passed the primary pathway credential in radiation therapy may operate radiation
therapy accelerator and simulator x-ray systems.
new text end

new text begin (b) A radiation therapy technologist in paragraph (a) may only operate a stand-alone
computed tomography x-ray system if the technologist has passed and is credentialed in
computed tomography (CT) from the American Registry of Radiologic Technologists
(ARRT).
new text end

new text begin (c) A radiation therapy technologist who meets the requirements under paragraph (a)
and who is participating in a training or educational program to obtain a credential under
paragraph (b) is exempt from the examination requirement within the scope and for the
duration of the training or educational program.
new text end

Sec. 10.

Minnesota Statutes 2018, section 144.292, subdivision 2, is amended to read:


Subd. 2.

Patient access.

Upon request, a provider shall supply to a patient new text beginwithin 30
calendar days of receiving a written request for medical records
new text endcomplete and current
information possessed by that provider concerning any diagnosis, treatment, and prognosis
of the patient in terms and language the patient can reasonably be expected to understand.

Sec. 11.

Minnesota Statutes 2018, section 144.292, subdivision 5, is amended to read:


Subd. 5.

Copies of health records to patients.

Except as provided in section 144.296,
upon a patient's written request, a provider, at a reasonable cost to the patient, shall deleted text beginpromptlydeleted text end
furnish to the patientnew text begin within 30 calendar days of receiving a written request for medical
records
new text end:

(1) copies of the patient's health record, including but not limited to laboratory reports,
x-rays, prescriptions, and other technical information used in assessing the patient's health
conditions; or

(2) the pertinent portion of the record relating to a condition specified by the patient.

With the consent of the patient, the provider may instead furnish only a summary of the
record. The provider may exclude from the health record written speculations about the
patient's health condition, except that all information necessary for the patient's informed
consent must be provided.

Sec. 12.

Minnesota Statutes 2019 Supplement, section 152.29, subdivision 1, is amended
to read:


Subdivision 1.

Manufacturer; requirements.

(a) A manufacturer deleted text beginshalldeleted text endnew text begin maynew text end operate
eight distribution facilities, which may include the manufacturer's single location for
cultivation, harvesting, manufacturing, packaging, and processing but is not required to
include that location. The commissioner shall designate the geographical service areas to
be served by each manufacturer based on geographical need throughout the state to improve
patient access. A manufacturer shall not have more than two distribution facilities in each
geographical service area assigned to the manufacturer by the commissioner. A manufacturer
shall operate only one location where all cultivation, harvesting, manufacturing, packaging,
and processing of medical cannabis shall be conducted. This location may be one of the
manufacturer's distribution facility sites. The additional distribution facilities may dispense
medical cannabis and medical cannabis products but may not contain any medical cannabis
in a form other than those forms allowed under section 152.22, subdivision 6, and the
manufacturer shall not conduct any cultivation, harvesting, manufacturing, packaging, or
processing at the other distribution facility sites. Any distribution facility operated by the
manufacturer is subject to all of the requirements applying to the manufacturer under sections
152.22 to 152.37, including, but not limited to, security and distribution requirements.

(b) A manufacturer may acquire hemp grown in this state from a hemp grower. A
manufacturer may manufacture or process hemp into an allowable form of medical cannabis
under section 152.22, subdivision 6. Hemp acquired by a manufacturer under this paragraph
is subject to the same quality control program, security and testing requirements, and other
requirements that apply to medical cannabis under sections 152.22 to 152.37 and Minnesota
Rules, chapter 4770.

(c) A medical cannabis manufacturer shall contract with a laboratory approved by the
commissioner, subject to any additional requirements set by the commissioner, for purposes
of testing medical cannabis manufactured or hemp acquired by the medical cannabis
manufacturer as to content, contamination, and consistency to verify the medical cannabis
meets the requirements of section 152.22, subdivision 6. The cost of laboratory testing shall
be paid by the manufacturer.

(d) The operating documents of a manufacturer must include:

(1) procedures for the oversight of the manufacturer and procedures to ensure accurate
record keeping;

(2) procedures for the implementation of appropriate security measures to deter and
prevent the theft of medical cannabis and unauthorized entrance into areas containing medical
cannabis; and

(3) procedures for the delivery and transportation of hemp between hemp growers and
manufacturers.

(e) A manufacturer shall implement security requirements, including requirements for
the delivery and transportation of hemp, protection of each location by a fully operational
security alarm system, facility access controls, perimeter intrusion detection systems, and
a personnel identification system.

(f) A manufacturer shall not share office space with, refer patients to a health care
practitioner, or have any financial relationship with a health care practitioner.

(g) A manufacturer shall not permit any person to consume medical cannabis on the
property of the manufacturer.

(h) A manufacturer is subject to reasonable inspection by the commissioner.

(i) For purposes of sections 152.22 to 152.37, a medical cannabis manufacturer is not
subject to the Board of Pharmacy licensure or regulatory requirements under chapter 151.

(j) A medical cannabis manufacturer may not employ any person who is under 21 years
of age or who has been convicted of a disqualifying felony offense. An employee of a
medical cannabis manufacturer must submit a completed criminal history records check
consent form, a full set of classifiable fingerprints, and the required fees for submission to
the Bureau of Criminal Apprehension before an employee may begin working with the
manufacturer. The bureau must conduct a Minnesota criminal history records check and
the superintendent is authorized to exchange the fingerprints with the Federal Bureau of
Investigation to obtain the applicant's national criminal history record information. The
bureau shall return the results of the Minnesota and federal criminal history records checks
to the commissioner.

(k) A manufacturer may not operate in any location, whether for distribution or
cultivation, harvesting, manufacturing, packaging, or processing, within 1,000 feet of a
public or private school existing before the date of the manufacturer's registration with the
commissioner.

(l) A manufacturer shall comply with reasonable restrictions set by the commissioner
relating to signage, marketing, display, and advertising of medical cannabis.

(m) Before a manufacturer acquires hemp from a hemp grower, the manufacturer must
verify that the hemp grower has a valid license issued by the commissioner of agriculture
under chapter 18K.

new text begin (n) Until a state-centralized, seed-to-sale system is implemented that can track a specific
medical cannabis plant from cultivation through testing and point of sale, the commissioner
shall conduct at least one unannounced inspection per year of each manufacturer that includes
inspection of:
new text end

new text begin (1) business operations;
new text end

new text begin (2) physical locations of the manufacturer's manufacturing facility and distribution
facilities;
new text end

new text begin (3) financial information and inventory documentation, including laboratory testing
results; and
new text end

new text begin (4) physical and electronic security alarm systems.
new text end

Sec. 13.

Minnesota Statutes 2018, section 152.35, is amended to read:


152.35 FEES; DEPOSIT OF REVENUE.

(a) The commissioner shall collect an enrollment fee of $200 from patients enrolled
under this section. If the patient deleted text beginattests todeleted text endnew text begin provides evidence ofnew text end receiving Social Security
disabilitynew text begin insurance (SSDI)new text end, Supplemental Security deleted text beginInsurancedeleted text endnew text begin Income (SSI), veterans
disability, or railroad disability
new text end payments, or being enrolled in medical assistance or
MinnesotaCare, then the fee shall be $50. new text beginFor purposes of this section:
new text end

new text begin (1) a patient is considered to receive SSDI if the patient was receiving SSDI at the time
the patient was transitioned to retirement benefits by the United States Social Security
Administration; and
new text end

new text begin (2) veterans disability payments include VA dependency and indemnity compensation.
new text end

new text begin Unless a patient provides evidence of receiving payments from or participating in one of
the programs specifically listed in this paragraph, the commissioner of health must collect
the $200 enrollment fee from a patient to enroll the patient in the registry program.
new text endThe fees
shall be payable annually and are due on the anniversary date of the patient's enrollment.
The fee amount shall be deposited in the state treasury and credited to the state government
special revenue fund.

(b) The commissioner shall collect an application fee of $20,000 from each entity
submitting an application for registration as a medical cannabis manufacturer. Revenue
from the fee shall be deposited in the state treasury and credited to the state government
special revenue fund.

(c) The commissioner shall establish and collect an annual fee from a medical cannabis
manufacturer equal to the cost of regulating and inspecting the manufacturer in that year.
Revenue from the fee amount shall be deposited in the state treasury and credited to the
state government special revenue fund.

(d) A medical cannabis manufacturer may charge patients enrolled in the registry program
a reasonable fee for costs associated with the operations of the manufacturer. The
manufacturer may establish a sliding scale of patient fees based upon a patient's household
income and may accept private donations to reduce patient fees.

Sec. 14.

Minnesota Statutes 2018, section 446A.081, subdivision 9, is amended to read:


Subd. 9.

Other uses of fund.

(a) The drinking water revolving loan fund may be used
as provided in the act, including the following uses:

(1) to buy or refinance the debt obligations, at or below market rates, of public water
systems for drinking water systems, where the debt was incurred after the date of enactment
of the act, for the purposes of construction of the necessary improvements to comply with
the national primary drinking water regulations under the federal Safe Drinking Water Act;

(2) to purchase or guarantee insurance for local obligations to improve credit market
access or reduce interest rates;

(3) to provide a source of revenue or security for the payment of principal and interest
on revenue or general obligation bonds issued by the authority if the bond proceeds are
deposited in the fund;

(4) to provide loans or loan guarantees for similar revolving funds established by a
governmental unit or state agency;

(5) to earn interest on fund accounts;

(6) to pay the reasonable costs incurred by the authority, the Department of Employment
and Economic Development, and the Department of Health for conducting activities as
authorized and required under the act up to the limits authorized under the act;

(7) to develop and administer programs for water system supervision, source water
protection, and related programs required under the act;

(8) deleted text beginnotwithstanding Minnesota Rules, part 7380.0280,deleted text end to provide principal forgiveness
or grants to the extent permitted under the federal Safe Drinking Water Act and other federal
law, based on the criteria and requirements established for drinking water projects under
the water infrastructure funding program under section 446A.072;

(9) to provide loans, principal forgiveness or grants to the extent permitted under the
federal Safe Drinking Water Act and other federal law to address green infrastructure, water
or energy efficiency improvements, or other environmentally innovative activities; deleted text beginand
deleted text end

(10) to provide principal forgiveness, or grants for deleted text begin50deleted text endnew text begin 80new text end percent of deleted text beginthedeleted text end project deleted text begincostdeleted text endnew text begin costsnew text end
up to a maximum of deleted text begin$10,000deleted text endnew text begin $100,000new text end for projects needed to comply with national primary
drinking water standards for an existingnew text begin nonmunicipalnew text end community deleted text beginor noncommunitydeleted text end public
water systemdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (11) to provide principal forgiveness or grants to the extent permitted under the federal
Safe Drinking Water Act and other federal laws for 50 percent of the project costs up to a
maximum of $250,000 for projects to replace the privately owned portion of drinking water
lead service lines.
new text end

(b) Principal forgiveness or grants provided under paragraph (a), clause (9), may not
exceed 25 percent of the eligible project costs as determined by the Department of Health
for project components directly related to green infrastructure, water or energy efficiency
improvements, or other environmentally innovative activities, up to a maximum of
$1,000,000.

Sec. 15.

Laws 2019, First Special Session chapter 9, article 11, section 35, the effective
date, is amended to read:


EFFECTIVE DATE.

This section is effective deleted text beginAugust 1, 2020deleted text endnew text begin January 1, 2021new text end.

new text begin EFFECTIVE DATE. new text end

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

Sec. 16. new text beginAGE-RELATED MACULAR DEGENERATION; QUALIFYING MEDICAL
CONDITION.
new text end

new text begin (a) In accordance with Minnesota Statutes, section 152.27, subdivision 2, paragraph (b),
the commissioner of health notified the legislature that the commissioner intends to add
age-related macular degeneration as a qualifying medical condition to the medical cannabis
program under Minnesota Statutes, section 152.22, subdivision 14.
new text end

new text begin (b) Minnesota Statutes, section 152. 27, subdivision 2, paragraph (b), specifies that the
proposed qualifying medical condition is added effective August 1 unless the legislature
by law provides otherwise.
new text end

new text begin (c) The legislature hereby states that age-related macular degeneration shall not be added
as a qualifying medical condition under Minnesota Statutes, section 152.22, subdivision
14.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 17. new text beginREPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2018, section 144.121, subdivisions 3 and 5b, new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Rules, part 7380.0280, new text end new text begin is repealed.
new text end

ARTICLE 2

HEALTH-RELATED LICENSING BOARDS

Section 1.

Minnesota Statutes 2018, section 62A.307, subdivision 2, is amended to read:


Subd. 2.

Requirement.

Coverage described in subdivision 1 that covers prescription
drugs must provide the same coverage for a prescription written by a health care provider
authorized to prescribe the particular drug covered by the health coverage described in
subdivision 1, regardless of the type of health care provider that wrote the prescription. This
section is intended to prohibit denial of coverage based on the prescription having been
written by an advanced practice nurse under section 148.235, a physician assistant under
section deleted text begin147A.18deleted text endnew text begin 147A.185new text end, or any other nonphysician health care provider authorized to
prescribe the particular drug.

Sec. 2.

new text begin [62Q.529] COVERAGE FOR DRUGS PRESCRIBED AND DISPENSED BY
PHARMACIES.
new text end

new text begin (a) A health plan that provides prescription coverage must provide coverage for
self-administered hormonal contraceptives, nicotine replacement medications, and opiate
antagonists for the treatment of an acute opiate overdose prescribed and dispensed by a
licensed pharmacist in accordance with section 151.37, subdivision 14, 15, or 16, under the
same terms of coverage that would apply had the prescription drug been prescribed by a
licensed physician, physician assistant, or advanced practice nurse practitioner.
new text end

new text begin (b) A health plan is not required to cover the drug if dispensed by an out-of-network
pharmacy, unless the health plan covers prescription drugs dispensed by out-of-network
pharmacies.
new text end

Sec. 3.

Minnesota Statutes 2018, section 147A.01, subdivision 3, is amended to read:


Subd. 3.

Administer.

"Administer" means the delivery by a physician assistant deleted text beginauthorized
to prescribe legend drugs, a single dose
deleted text end of a legend drugdeleted text begin, including controlled substances,deleted text end
to a patient by injection, inhalation, ingestion, or by any other immediate meansdeleted text begin, and the
delivery by a physician assistant ordered by a physician a single dose of a legend drug by
injection, inhalation, ingestion, or by any other immediate means
deleted text end.

Sec. 4.

Minnesota Statutes 2018, section 147A.01, is amended by adding a subdivision to
read:


new text begin Subd. 6a. new text end

new text begin Collaborating physician. new text end

new text begin "Collaborating physician" means a Minnesota
licensed physician who oversees the performance, practice, and activities of a physician
assistant under a collaborative agreement as described in section 147A.02, paragraph (c).
new text end

Sec. 5.

Minnesota Statutes 2018, section 147A.01, subdivision 21, is amended to read:


Subd. 21.

Prescription.

"Prescription" means a signed written order, an oral order
reduced to writing, or an electronic order meeting current and prevailing standards given
by a physician assistant deleted text beginauthorized to prescribe drugsdeleted text end for patients in the course of the
physician assistant's practicedeleted text begin,deleted text endnew text begin andnew text end issued for an individual patient deleted text beginand containing the
information required in the physician-physician assistant delegation agreement
deleted text end.

Sec. 6.

Minnesota Statutes 2018, section 147A.01, subdivision 26, is amended to read:


Subd. 26.

Therapeutic order.

"Therapeutic order" means deleted text beginandeleted text endnew text begin a written or verbalnew text end order
given to another for the purpose of treating or curing a patient in the course of a physician
assistant's practice. deleted text beginTherapeutic orders may be written or verbal, but do not include the
prescribing of legend drugs or medical devices unless prescribing authority has been
delegated within the physician-physician assistant delegation agreement.
deleted text end

Sec. 7.

Minnesota Statutes 2018, section 147A.01, subdivision 27, is amended to read:


Subd. 27.

Verbal order.

"Verbal order" means an oral order given to another for the
purpose of treating or curing a patient in the course of a physician assistant's practice. deleted text beginVerbal
orders do not include the prescribing of legend drugs unless prescribing authority has been
delegated within the physician-physician assistant delegation agreement.
deleted text end

Sec. 8.

Minnesota Statutes 2018, section 147A.02, is amended to read:


147A.02 QUALIFICATIONS FOR LICENSURE.

deleted text begin Except as otherwise provided in this chapter, an individual shall be licensed by the board
before the individual may practice as a physician assistant.
deleted text end

new text begin (a) new text endThe board may grant a license as a physician assistant to an applicant who:

(1) submits an application on forms approved by the board;

(2) pays the appropriate fee as determined by the board;

(3) has current certification from the National Commission on Certification of Physician
Assistants, or its successor agency as approved by the board;

(4) certifies that the applicant is mentally and physically able to engage safely in practice
as a physician assistant;

(5) has no licensure, certification, or registration as a physician assistant under current
discipline, revocation, suspension, or probation for cause resulting from the applicant's
practice as a physician assistant, unless the board considers the condition and agrees to
licensure;

(6) submits any other information the board deems necessary to evaluate the applicant's
qualifications; and

(7) has been approved by the board.

new text begin (b) new text endAll persons registered as physician assistants as of June 30, 1995, are eligible for
continuing license renewal. All persons applying for licensure after that date shall be licensed
according to this chapter.

new text begin (c) A physician assistant who qualifies for licensure must practice for at least 2,080
hours, within the context of a collaborative agreement, within a hospital or integrated clinical
setting where physician assistants and physicians work together to provide patient care. The
physician assistant shall submit written evidence to the board with the application, or upon
completion of the required collaborative practice experience. For purposes of this paragraph,
a collaborative agreement is a mutually agreed upon plan for the overall working relationship
and collaborative arrangement between a physician assistant, and one or more physicians
licensed under chapter 147, that designates the scope of services that can be provided to
manage the care of patients. The physician assistant and one of the collaborative physicians
must have experience in providing care to patients with the same or similar medical
conditions. The collaborating physician is not required to be physically present so long as
the collaborating physician and physician assistant are or can be easily in contact with each
other by radio, telephone, or other telecommunication device.
new text end

Sec. 9.

Minnesota Statutes 2018, section 147A.03, is amended by adding a subdivision to
read:


new text begin Subd. 1a. new text end

new text begin Licensure required. new text end

new text begin Except as provided under subdivision 2, it is unlawful
for any person to practice as a physician assistant without being issued a valid license
according to this chapter.
new text end

Sec. 10.

Minnesota Statutes 2018, section 147A.05, is amended to read:


147A.05 INACTIVE LICENSE.

new text begin (a) new text endPhysician assistants who notify the board in writing may elect to place their license
on an inactive status. Physician assistants with an inactive license shall be excused from
payment of renewal fees and shall not practice as physician assistants. Persons who engage
in practice while their license is lapsed or on inactive status shall be considered to be
practicing without a license, which shall be grounds for discipline under section 147A.13.
Physician assistants who provide care under the provisions of section 147A.23 shall not be
considered practicing without a license or subject to disciplinary action. Physician assistants
who notify the board of their intent to resume active practice shall be required to pay the
current renewal fees and all unpaid back fees and shall be required to meet the criteria for
renewal specified in section 147A.07.

new text begin (b) Notwithstanding section 147A.03, subdivision 1, a person with an inactive license
may continue to use the protected titles specified in section 147A.03, subdivision 1, so long
as the person does not practice as a physician assistant.
new text end

Sec. 11.

Minnesota Statutes 2019 Supplement, section 147A.06, is amended to read:


147A.06 CANCELLATION OF LICENSE FOR NONRENEWAL.

Subdivision 1.

Cancellation of license.

The board shall not renew, reissue, reinstate, or
restore a license that has lapsed deleted text beginon or after July 1, 1996,deleted text end and has not been renewed within
two annual renewal cycles deleted text beginstarting July 1, 1997deleted text end. A licensee whose license is canceled for
nonrenewal must obtain a new license by applying for licensure and fulfilling all requirements
then in existence for an initial license to practice as a physician assistant.

Subd. 2.

Licensure following lapse of licensed status; transition.

(a) A licensee whose
license has lapsed under subdivision 1 before January 1, 2020, and who seeks to regain
licensed status after January 1, 2020, shall be treated as a first-time licensee only for purposes
of establishing a license renewal schedule, and shall not be subject to the license cycle
conversion provisions in section 147A.29.

(b) This subdivision expires July 1, 2022.

Sec. 12.

Minnesota Statutes 2018, section 147A.09, is amended to read:


147A.09 SCOPE OF PRACTICEdeleted text begin, DELEGATIONdeleted text end.

Subdivision 1.

Scope of practice.

Physician assistants shall practice medicine only deleted text beginwith
physician supervision. Physician assistants may perform those duties and responsibilities
as delegated in the physician-physician assistant delegation agreement and delegation forms
maintained at the address of record by the supervising physician and physician assistant,
including the prescribing, administering, and dispensing of drugs, controlled substances,
and medical devices, excluding anesthetics, other than local anesthetics, injected in
connection with an operating room procedure, inhaled anesthesia and spinal anesthesia
deleted text endnew text begin
under an established practice agreement
new text end.

deleted text begin Patient service must be limited todeleted text endnew text begin A physician assistant's scope of practice includesnew text end:

(1) services within the training and experience of the physician assistant;

(2) new text beginpatient new text endservices customary to the practice of the deleted text beginsupervising physician or alternate
supervising physician
deleted text endnew text begin physician assistant and the practice agreementnew text end;new text begin and
new text end

(3) deleted text beginservices delegated by the supervising physician or alternate supervising physician
under the physician-physician assistant delegation agreement; and
deleted text end

deleted text begin (4)deleted text end services within the parameters of the laws, rules, and standards of the facilities in
which the physician assistant practices.

deleted text begin Nothing in this chapter authorizes physician assistants to perform duties regulated by
the boards listed in section 214.01, subdivision 2, other than the Board of Medical Practice,
and except as provided in this section.
deleted text end

Subd. 2.

deleted text beginDelegationdeleted text endnew text begin Patient servicesnew text end.

Patient services may include, but are not limited
to, the followingdeleted text begin, as delegated by the supervising physician and authorized in the delegation
agreement
deleted text end:

(1) taking patient histories and developing medical status reports;

(2) performing physical examinations;

(3) interpreting and evaluating patient data;

(4) ordering deleted text beginordeleted text endnew text begin,new text end performingnew text begin, or reviewingnew text end diagnostic procedures, including the use of
radiographic imaging systems in compliance with Minnesota Rules 2007, chapter 4732new text begin, but
excluding interpreting computed tomography scans, magnetic resonance imaging scans,
positron emission tomography scans, nuclear scans, and mammography
new text end;

(5) ordering or performing therapeutic procedures including the use of ionizing radiation
in compliance with Minnesota Rules 2007, chapter 4732;

(6) providing instructions regarding patient care, disease prevention, and health
promotion;

(7) deleted text beginassisting the supervising physician indeleted text endnew text begin providingnew text end patient care in the home and in health
care facilities;

(8) creating and maintaining appropriate patient records;

(9) transmitting or executing specific orders deleted text beginat the direction of the supervising physiciandeleted text end;

(10) prescribing, administering, and dispensing drugs, controlled substances, and medical
devices deleted text beginif this function has been delegated by the supervising physician pursuant to and
subject to the limitations of section 147A.18 and chapter 151. For physician assistants who
have been delegated the authority to prescribe controlled substances, such delegation shall
be included in the physician-physician assistant delegation agreement, and all schedules of
controlled substances the physician assistant has the authority to prescribe shall be specified
deleted text endnew text begin,
including administering local anesthetics, but excluding anesthetics injected in connection
with an operating room procedure, inhaled anesthesia, and spinal anesthesia
new text end;

(11) deleted text beginfor physician assistants not delegated prescribing authority, administering legend
drugs and medical devices following prospective review for each patient by and upon
direction of the supervising physician;
deleted text end

deleted text begin (12)deleted text end functioning as an emergency medical technician with permission of the ambulance
service and in compliance with section 144E.127, and ambulance service rules adopted by
the commissioner of health;

deleted text begin (13)deleted text endnew text begin (12)new text end initiating evaluation and treatment procedures essential to providing an
appropriate response to emergency situations;

deleted text begin (14)deleted text endnew text begin (13)new text end certifying a patient's eligibility for a disability parking certificate under section
169.345, subdivision 2;

deleted text begin (15)deleted text endnew text begin (14)new text end assisting at surgery; and

deleted text begin (16)deleted text endnew text begin (15)new text end providing medical authorization for admission for emergency care and treatment
of a patient under section 253B.05, subdivision 2.

deleted text begin Orders of physician assistants shall be considered the orders of their supervising
physicians in all practice-related activities, including, but not limited to, the ordering of
diagnostic, therapeutic, and other medical services.
deleted text end

new text begin Subd. 3. new text end

new text begin Practice agreement review. new text end

new text begin A physician assistant shall have a practice
agreement at the practice level that describes the practice of the physician assistant. The
practice agreement must be reviewed on an annual basis by a licensed physician within the
same clinic, hospital, health system, or other facility as the physician assistant and has
knowledge of the physician assistant's practice to ensure that the physician assistant's medical
practice is consistent with the practice agreement. A document stating that the review
occurred must be maintained at the practice level and made available to the board, upon
request.
new text end

new text begin Subd. 4. new text end

new text begin Scope of practice limitations; spinal injections for acute and chronic
pain.
new text end

new text begin Notwithstanding subdivision 1, a physician assistant may only perform spinal injections
to address acute and chronic pain symptoms upon referral and in collaboration with a
physician licensed under chapter 147. For purposes of performing spinal injections for acute
or chronic pain symptoms, the physician assistant and one or more physicians licensed under
chapter 147 must have a mutually agreed upon plan that designates the scope of collaboration
necessary for treating patients with acute and chronic pain.
new text end

new text begin Subd. 5. new text end

new text begin Scope of practice limitations; psychiatric care for children with emotional
disturbance or adults with serious mental illness.
new text end

new text begin Notwithstanding subdivision 1, a
physician assistant may only provide ongoing psychiatric treatment for children with
emotional disturbance, as defined in section 245.4871, subdivision 15, or adults with serious
mental illness in collaboration with a physician licensed under chapter 147. For purposes
of providing ongoing psychiatric treatment for children with emotional disturbance or adults
with serious mental illness, the practice agreement between the physician assistant and one
or more physicians licensed under chapter 147 must define the collaboration between the
physician assistant and the collaborating physician, including appropriate consultation or
referral to psychiatry.
new text end

Sec. 13.

Minnesota Statutes 2018, section 147A.13, subdivision 1, is amended to read:


Subdivision 1.

Grounds listed.

The board may refuse to grant licensure or may impose
disciplinary action as described in this subdivision against any physician assistant. The
following conduct is prohibited and is grounds for disciplinary action:

(1) failure to demonstrate the qualifications or satisfy the requirements for licensure
contained in this chapter or rules of the board. The burden of proof shall be upon the applicant
to demonstrate such qualifications or satisfaction of such requirements;

(2) obtaining a license by fraud or cheating, or attempting to subvert the examination
process. Conduct which subverts or attempts to subvert the examination process includes,
but is not limited to:

(i) conduct which violates the security of the examination materials, such as removing
examination materials from the examination room or having unauthorized possession of
any portion of a future, current, or previously administered licensing examination;

(ii) conduct which violates the standard of test administration, such as communicating
with another examinee during administration of the examination, copying another examinee's
answers, permitting another examinee to copy one's answers, or possessing unauthorized
materials; and

(iii) impersonating an examinee or permitting an impersonator to take the examination
on one's own behalf;

(3) conviction, during the previous five years, of a felony reasonably related to the
practice of physician assistant. Conviction as used in this subdivision includes a conviction
of an offense which if committed in this state would be deemed a felony without regard to
its designation elsewhere, or a criminal proceeding where a finding or verdict of guilt is
made or returned but the adjudication of guilt is either withheld or not entered;

(4) revocation, suspension, restriction, limitation, or other disciplinary action against
the person's physician assistant credentials in another state or jurisdiction, failure to report
to the board that charges regarding the person's credentials have been brought in another
state or jurisdiction, or having been refused licensure by any other state or jurisdiction;

(5) advertising which is false or misleading, violates any rule of the board, or claims
without substantiation the positive cure of any disease or professional superiority to or
greater skill than that possessed by another physician assistant;

(6) violating a rule adopted by the board or an order of the board, a state, or federal law
which relates to the practice of a physician assistant, or in part regulates the practice of a
physician assistant, including without limitation sections 604.201, 609.344, and 609.345,
or a state or federal narcotics or controlled substance law;

(7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the
public, or demonstrating a willful or careless disregard for the health, welfare, or safety of
a patient; or practice which is professionally incompetent, in that it may create unnecessary
danger to any patient's life, health, or safety, in any of which cases, proof of actual injury
need not be established;

deleted text begin (8) failure to adhere to the provisions of the physician-physician assistant delegation
agreement;
deleted text end

deleted text begin (9)deleted text endnew text begin (8)new text end engaging in the practice of medicine beyond deleted text beginthatdeleted text endnew text begin what isnew text end allowed deleted text beginby the
physician-physician assistant delegation agreement
deleted text endnew text begin under this chapternew text end, or aiding or abetting
an unlicensed person in the practice of medicine;

deleted text begin (10)deleted text end new text begin(9) new text endadjudication as mentally incompetent, mentally ill or developmentally disabled,
or as a chemically dependent person, a person dangerous to the public, a sexually dangerous
person, or a person who has a sexual psychopathic personality by a court of competent
jurisdiction, within or without this state. Such adjudication shall automatically suspend a
license for its duration unless the board orders otherwise;

deleted text begin (11)deleted text endnew text begin (10)new text end engaging in unprofessional conduct. Unprofessional conduct includes any
departure from or the failure to conform to the minimal standards of acceptable and prevailing
practice in which proceeding actual injury to a patient need not be established;

deleted text begin (12)deleted text endnew text begin (11)new text end inability to practice with reasonable skill and safety to patients by reason of
illness, drunkenness, use of drugs, narcotics, chemicals, or any other type of material, or as
a result of any mental or physical condition, including deterioration through the aging
process or loss of motor skills;

deleted text begin (13)deleted text endnew text begin (12)new text end revealing a privileged communication from or relating to a patient except when
otherwise required or permitted by law;

deleted text begin (14)deleted text endnew text begin (13)new text end any identification of a physician assistant by the title "Physiciandeleted text begin,deleted text end" deleted text begin"Doctor,"
or "Dr."
deleted text end in a patient care setting or in a communication directed to the general public;

deleted text begin (15)deleted text endnew text begin (14)new text end improper management of medical records, including failure to maintain adequate
medical records, to comply with a patient's request made pursuant to sections 144.291 to
144.298, or to furnish a medical record or report required by law;

deleted text begin (16)deleted text endnew text begin (15)new text end engaging in abusive or fraudulent billing practices, including violations of the
federal Medicare and Medicaid laws or state medical assistance laws;

deleted text begin (17)deleted text endnew text begin (16)new text end becoming addicted or habituated to a drug or intoxicant;

deleted text begin (18)deleted text endnew text begin (17)new text end prescribing a drug or device for other than medically accepted therapeutic,
experimental, or investigative purposes authorized by a state or federal agency or referring
a patient to any health care provider as defined in sections 144.291 to 144.298 for services
or tests not medically indicated at the time of referral;

deleted text begin (19)deleted text endnew text begin (18)new text end engaging in conduct with a patient which is sexual or may reasonably be
interpreted by the patient as sexual, or in any verbal behavior which is seductive or sexually
demeaning to a patient;

deleted text begin (20)deleted text endnew text begin (19)new text end failure to make reports as required by section 147A.14 or to cooperate with an
investigation of the board as required by section 147A.15, subdivision 3;

deleted text begin (21)deleted text endnew text begin (20)new text end knowingly providing false or misleading information that is directly related
to the care of that patient unless done for an accepted therapeutic purpose such as the
administration of a placebo;

deleted text begin (22)deleted text endnew text begin (21)new text end aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation
of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an injunction
issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5
; or

(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.
The board shall investigate any complaint of a violation of section 609.215, subdivision 1
or 2; or

deleted text begin (23)deleted text endnew text begin (22)new text end deleted text beginfailure to maintain annually reviewed and updated physician-physician assistant
delegation agreements for each physician-physician assistant practice relationship, or failure
to provide copies of such documents upon request by the board
deleted text end new text beginfailure to maintain the proof
of review document as required under section 147A.09, subdivision 3, or to provide a copy
of the document upon request of the board
new text end.

Sec. 14.

Minnesota Statutes 2018, section 147A.14, subdivision 4, is amended to read:


Subd. 4.

Licensed professionals.

Licensed health professionals and persons holding
residency permits under section 147.0391, shall report to the board personal knowledge of
any conduct which the person reasonably believes constitutes grounds for disciplinary action
under this chapter by a physician assistant, including any conduct indicating that the person
may be incompetent, or may have engaged in unprofessional conduct or may be medically
or physically unable to engage safely in practice as a physician assistant. No report shall be
required if the information was obtained in the course of a deleted text beginphysician-patientdeleted text endnew text begin provider-patientnew text end
relationship if the patient is a physician assistant, and the treating deleted text beginphysiciandeleted text endnew text begin providernew text end
successfully counsels the person to limit or withdraw from practice to the extent required
by the impairment.

Sec. 15.

Minnesota Statutes 2018, section 147A.16, is amended to read:


147A.16 FORMS OF DISCIPLINARY ACTION.

When the board finds that a licensed physician assistant has violated a provision of this
chapter, it may do one or more of the following:

(1) revoke the license;

(2) suspend the license;

(3) impose limitations or conditions on the physician assistant's practice, including
limiting the scope of practice to designated field specialties; deleted text beginimposedeleted text endnew text begin imposingnew text end retraining or
rehabilitation requirements; deleted text beginrequire practice under additional supervision;deleted text end or deleted text begincondition
continued
deleted text endnew text begin limitingnew text end practice deleted text beginondeleted text endnew text begin untilnew text end demonstration of knowledge or skills by appropriate
examination or other review of skill and competence;

(4) impose a civil penalty not exceeding $10,000 for each separate violation, the amount
of the civil penalty to be fixed so as to deprive the physician assistant of any economic
advantage gained by reason of the violation charged or to reimburse the board for the cost
of the investigation and proceeding;new text begin or
new text end

deleted text begin (5) order the physician assistant to provide unremunerated professional service under
supervision at a designated public hospital, clinic, or other health care institution; or
deleted text end

deleted text begin (6)deleted text endnew text begin (5)new text end censure or reprimand the licensed physician assistant.

Upon judicial review of any board disciplinary action taken under this chapter, the
reviewing court shall seal the administrative record, except for the board's final decision,
and shall not make the administrative record available to the public.

Sec. 16.

new text begin [147A.185] PRESCRIBING DRUGS AND THERAPEUTIC DEVICES.
new text end

new text begin Subd. 1. new text end

new text begin Diagnosis, prescribing, and ordering. new text end

new text begin A physician assistant is authorized to:
new text end

new text begin (1) diagnose, prescribe, and institute therapy or referrals of patients to health care agencies
and providers;
new text end

new text begin (2) prescribe, procure, sign for, record, administer, and dispense over-the-counter drugs,
legend drugs, and controlled substances, including sample drugs; and
new text end

new text begin (3) plan and initiate a therapeutic regimen that includes ordering and prescribing durable
medical devices and equipment, nutrition, diagnostic services, and supportive services
including but not limited to home health care, hospice, physical therapy, and occupational
therapy.
new text end

new text begin Subd. 2. new text end

new text begin Drug Enforcement Administration requirements. new text end

new text begin (a) A physician assistant
must:
new text end

new text begin (1) comply with federal Drug Enforcement Administration (DEA) requirements related
to controlled substances; and
new text end

new text begin (2) file any and all of the physician assistant's DEA registrations and numbers with the
board.
new text end

new text begin (b) The board shall maintain current records of all physician assistants with DEA
registration and numbers.
new text end

new text begin Subd. 3. new text end

new text begin Other requirements and restrictions. new text end

new text begin (a) Each prescription initiated by a
physician assistant shall indicate the following:
new text end

new text begin (1) the date of issue;
new text end

new text begin (2) the name and address of the patient;
new text end

new text begin (3) the name and quantity of the drug prescribed;
new text end

new text begin (4) directions for use; and
new text end

new text begin (5) the name and address of the prescribing physician assistant.
new text end

new text begin (b) In prescribing, dispensing, and administering legend drugs, controlled substances,
and medical devices, a physician assistant must comply with this chapter and chapters 151
and 152.
new text end

Sec. 17.

Minnesota Statutes 2018, section 147A.23, is amended to read:


147A.23 RESPONDING TO DISASTER SITUATIONS.

deleted text begin (a)deleted text end A physician assistant duly licensed or credentialed in a United States jurisdiction or
by a federal employer who is responding to a need for medical care created by an emergency
according to section 604A.01, or a state or local disaster may render such care as the
physician assistant is trained to provide, under the physician assistant's license or credentialdeleted text begin,
without the need of a physician-physician assistant delegation agreement or a notice of
intent to practice as required under section 147A.20. A physician assistant may provide
emergency care without physician supervision or under the supervision that is available
deleted text end.

deleted text begin (b) The physician who provides supervision to a physician assistant while the physician
assistant is rendering care in accordance with this section may do so without meeting the
requirements of section 147A.20.
deleted text end

deleted text begin (c) The supervising physician who otherwise provides supervision to a physician assistant
under a physician-physician assistant delegation agreement described in section 147A.20
shall not be held medically responsible for the care rendered by a physician assistant pursuant
to paragraph (a). Services provided by a physician assistant under paragraph (a) shall be
considered outside the scope of the relationship between the supervising physician and the
physician assistant.
deleted text end

Sec. 18.

Minnesota Statutes 2018, section 147D.03, subdivision 2, is amended to read:


Subd. 2.

Scope of practice.

The practice of traditional midwifery includesdeleted text begin,deleted text end but is not
limited to:

(1) initial and ongoing assessment for suitability of traditional midwifery care;

(2) providing prenatal education and coordinating with a licensed health care provider
as necessary to provide comprehensive prenatal care, including the routine monitoring of
vital signs, indicators of fetal developments, and new text beginordering standard prenatal new text endlaboratory testsnew text begin
and imaging
new text end, as needed, with attention to the physical, nutritional, and emotional needs of
the woman and her family;

(3) attending and supporting the natural process of labor and birth;

(4) postpartum care of the mother and an initial assessment of the newborn; deleted text beginand
deleted text end

(5) providing information and referrals to community resources on childbirth preparation,
breastfeeding, exercise, nutrition, parenting, and care of the newborndeleted text begin.deleted text endnew text begin; and
new text end

new text begin (6) ordering ultrasounds, providing point-of-care testing, and ordering laboratory tests
that conform to the standard prenatal protocol of the licensed traditional midwife's standard
of care.
new text end

Sec. 19.

Minnesota Statutes 2019 Supplement, section 151.01, subdivision 23, is amended
to read:


Subd. 23.

Practitioner.

"Practitioner" means a licensed doctor of medicine, licensed
doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of
dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, deleted text beginordeleted text end licensed
advanced practice registered nursedeleted text begin. For purposes of sections 151.15, subdivision 4; 151.211,
subdivision 3; 151.252, subdivision 3; 151.37, subdivision 2, paragraphs (b), (e), and (f);
and 151.461, "practitioner" also means a
deleted text endnew text begin, or licensednew text end physician assistant deleted text beginauthorized to
prescribe, dispense, and administer under chapter 147A
deleted text end. For purposes of sections 151.15,
subdivision 4
; 151.211, subdivision 3; 151.252, subdivision 3; 151.37, subdivision 2,
paragraph (b); and 151.461, "practitioner" also means a dental therapist authorized to dispense
and administer under chapter 150A.new text begin For purposes of sections 151.252, subdivision 3, and
151.461, "practitioner" also means a pharmacist authorized to prescribe self-administered
hormonal contraceptives, nicotine replacement medications, or opiate antagonists under
section 151.37, subdivision 14, 15, or 16.
new text end

Sec. 20.

Minnesota Statutes 2019 Supplement, section 151.01, subdivision 27, is amended
to read:


Subd. 27.

Practice of pharmacy.

"Practice of pharmacy" means:

(1) interpretation and evaluation of prescription drug orders;

(2) compounding, labeling, and dispensing drugs and devices (except labeling by a
manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
and devices);

(3) participation in clinical interpretations and monitoring of drug therapy for assurance
of safe and effective use of drugs, including the performance of laboratory tests that are
waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code,
title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory
tests but may modify drug therapy only pursuant to a protocol or collaborative practice
agreement;

(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; intramuscular and subcutaneous administration used for
the treatment of alcohol or opioid dependence; drug regimen reviews; and drug or
drug-related research;

(5) drug administration, through intramuscular and subcutaneous administration used
to treat mental illnesses as permitted under the following conditions:

(i) upon the order of a prescriber and the prescriber is notified after administration is
complete; or

(ii) pursuant to a protocol or collaborative practice agreement as defined by section
151.01, subdivisions 27b and 27c, and participation in the initiation, management,
modification, administration, and discontinuation of drug therapy is according to the protocol
or collaborative practice agreement between the pharmacist and a dentist, optometrist,
physician, podiatrist, or veterinarian, or an advanced practice registered nurse authorized
to prescribe, dispense, and administer under section 148.235. Any changes in drug therapy
or medication administration made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;

(6) participation in administration of influenza vaccinesnew text begin and vaccines approved by the
United States Food and Drug Administration related to COVID-19 or SARS-CoV-2
new text end to all
eligible individuals six years of age and older and all other vaccines to patients 13 years of
age and older by written protocol with a physician licensed under chapter 147, a physician
assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered
nurse authorized to prescribe drugs under section 148.235, provided that:

(i) the protocol includes, at a minimum:

(A) the name, dose, and route of each vaccine that may be given;

(B) the patient population for whom the vaccine may be given;

(C) contraindications and precautions to the vaccine;

(D) the procedure for handling an adverse reaction;

(E) the name, signature, and address of the physician, physician assistant, or advanced
practice registered nurse;

(F) a telephone number at which the physician, physician assistant, or advanced practice
registered nurse can be contacted; and

(G) the date and time period for which the protocol is valid;

(ii) the pharmacist has successfully completed a program approved by the Accreditation
Council for Pharmacy Education specifically for the administration of immunizations or a
program approved by the board;

(iii) the pharmacist utilizes the Minnesota Immunization Information Connection to
assess the immunization status of individuals prior to the administration of vaccines, except
when administering influenza vaccines to individuals age nine and older;

(iv) the pharmacist reports the administration of the immunization to the Minnesota
Immunization Information Connection; and

(v) the pharmacist complies with guidelines for vaccines and immunizations established
by the federal Advisory Committee on Immunization Practices, except that a pharmacist
does not need to comply with those portions of the guidelines that establish immunization
schedules when administering a vaccine pursuant to a valid, patient-specific order issued
by a physician licensed under chapter 147, a physician assistant authorized to prescribe
drugs under chapter 147A, or an advanced practice new text beginregistered new text endnurse authorized to prescribe
drugs under section 148.235, provided that the order is consistent with the United States
Food and Drug Administration approved labeling of the vaccine;

(7) participation in the initiation, management, modification, and discontinuation of
drug therapy according to a written protocol or collaborative practice agreement between:
(i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists,
or veterinarians; or (ii) one or more pharmacists and one or more physician assistants
authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice
new text begin registered new text endnurses authorized to prescribe, dispense, and administer under section 148.235.
Any changes in drug therapy made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;

(8) participation in the storage of drugs and the maintenance of records;

(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and
devices;

(10) offering or performing those acts, services, operations, or transactions necessary
in the conduct, operation, management, and control of a pharmacy; deleted text beginand
deleted text end

(11) participation in the initiation, management, modification, and discontinuation of
therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:

(i) a written protocol as allowed under clause (6); or

(ii) a written protocol with a community health board medical consultant or a practitioner
designated by the commissioner of health, as allowed under section 151.37, subdivision 13new text begin;
and
new text end

new text begin (12) prescribing self-administered hormonal contraceptives; nicotine replacement
medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant
to section 151.37, subdivision 14, 15, or 16
new text end.

Sec. 21.

Minnesota Statutes 2018, section 151.01, is amended by adding a subdivision to
read:


new text begin Subd. 42. new text end

new text begin Self-administered hormonal contraceptive. new text end

new text begin "Self-administered hormonal
contraceptive" means a drug composed of a combination of hormones that is approved by
the United States Food and Drug Administration to prevent pregnancy and is administered
by the user.
new text end

Sec. 22.

Minnesota Statutes 2018, section 151.37, subdivision 2, is amended to read:


Subd. 2.

Prescribing and filing.

(a) A licensed practitioner in the course of professional
practice only, may prescribe, administer, and dispense a legend drug, and may cause the
same to be administered by a nurse, a physician assistant, or medical student or resident
under the practitioner's direction and supervision, and may cause a person who is an
appropriately certified, registered, or licensed health care professional to prescribe, dispense,
and administer the same within the expressed legal scope of the person's practice as defined
in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, without reference
to a specific patient, by directing a licensed dietitian or licensed nutritionist, pursuant to
section 148.634; a nurse, pursuant to section 148.235, subdivisions 8 and 9; physician
assistant; medical student or resident; or pharmacist according to section 151.01, subdivision
27, to adhere to a particular practice guideline or protocol when treating patients whose
condition falls within such guideline or protocol, and when such guideline or protocol
specifies the circumstances under which the legend drug is to be prescribed and administered.
An individual who verbally, electronically, or otherwise transmits a written, oral, or electronic
order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug.
This paragraph applies to a physician assistant only if the physician assistant meets the
requirements of section 147A.18.

(b) The commissioner of health, if a licensed practitioner, or a person designated by the
commissioner who is a licensed practitioner, may prescribe a legend drug to an individual
or by protocol for mass dispensing purposes where the commissioner finds that the conditions
triggering section 144.4197 or 144.4198, subdivision 2, paragraph (b), exist. The
commissioner, if a licensed practitioner, or a designated licensed practitioner, may prescribe,
dispense, or administer a legend drug or other substance listed in subdivision 10 to control
tuberculosis and other communicable diseases. The commissioner may modify state drug
labeling requirements, and medical screening criteria and documentation, where time is
critical and limited labeling and screening are most likely to ensure legend drugs reach the
maximum number of persons in a timely fashion so as to reduce morbidity and mortality.

(c) A licensed practitioner that dispenses for profit a legend drug that is to be administered
orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must file with the
practitioner's licensing board a statement indicating that the practitioner dispenses legend
drugs for profit, the general circumstances under which the practitioner dispenses for profit,
and the types of legend drugs generally dispensed. It is unlawful to dispense legend drugs
for profit after July 31, 1990, unless the statement has been filed with the appropriate
licensing board. For purposes of this paragraph, "profit" means (1) any amount received by
the practitioner in excess of the acquisition cost of a legend drug for legend drugs that are
purchased in prepackaged form, or (2) any amount received by the practitioner in excess
of the acquisition cost of a legend drug plus the cost of making the drug available if the
legend drug requires compounding, packaging, or other treatment. The statement filed under
this paragraph is public data under section 13.03. This paragraph does not apply to a licensed
doctor of veterinary medicine or a registered pharmacist. Any person other than a licensed
practitioner with the authority to prescribe, dispense, and administer a legend drug under
paragraph (a) shall not dispense for profit. To dispense for profit does not include dispensing
by a community health clinic when the profit from dispensing is used to meet operating
expenses.

(d) A prescription drug order for the following drugs is not valid, unless it can be
established that the prescription drug order was based on a documented patient evaluation,
including an examination, adequate to establish a diagnosis and identify underlying conditions
and contraindications to treatment:

(1) controlled substance drugs listed in section 152.02, subdivisions 3 to 5;

(2) drugs defined by the Board of Pharmacy as controlled substances under section
152.02, subdivisions 7, 8, and 12;

(3) muscle relaxants;

(4) centrally acting analgesics with opioid activity;

(5) drugs containing butalbital; or

(6) phosphodiesterase type 5 inhibitors when used to treat erectile dysfunction.

new text begin For purposes of prescribing drugs listed in clause (6), the requirement for a documented
patient evaluation, including an examination, may be met through the use of telemedicine,
as defined in section 147.033, subdivision 1.
new text end

(e) For the purposes of paragraph (d), the requirement for an examination shall be met
if an in-person examination has been completed in any of the following circumstances:

(1) the prescribing practitioner examines the patient at the time the prescription or drug
order is issued;

(2) the prescribing practitioner has performed a prior examination of the patient;

(3) another prescribing practitioner practicing within the same group or clinic as the
prescribing practitioner has examined the patient;

(4) a consulting practitioner to whom the prescribing practitioner has referred the patient
has examined the patient; or

(5) the referring practitioner has performed an examination in the case of a consultant
practitioner issuing a prescription or drug order when providing services by means of
telemedicine.

(f) Nothing in paragraph (d) or (e) prohibits a licensed practitioner from prescribing a
drug through the use of a guideline or protocol pursuant to paragraph (a).

(g) Nothing in this chapter prohibits a licensed practitioner from issuing a prescription
or dispensing a legend drug in accordance with the Expedited Partner Therapy in the
Management of Sexually Transmitted Diseases guidance document issued by the United
States Centers for Disease Control.

(h) Nothing in paragraph (d) or (e) limits prescription, administration, or dispensing of
legend drugs through a public health clinic or other distribution mechanism approved by
the commissioner of health or a community health board in order to prevent, mitigate, or
treat a pandemic illness, infectious disease outbreak, or intentional or accidental release of
a biological, chemical, or radiological agent.

(i) No pharmacist employed by, under contract to, or working for a pharmacy located
within the state and licensed under section 151.19, subdivision 1, may dispense a legend
drug based on a prescription that the pharmacist knows, or would reasonably be expected
to know, is not valid under paragraph (d).

(j) No pharmacist employed by, under contract to, or working for a pharmacy located
outside the state and licensed under section 151.19, subdivision 1, may dispense a legend
drug to a resident of this state based on a prescription that the pharmacist knows, or would
reasonably be expected to know, is not valid under paragraph (d).

(k) Nothing in this chapter prohibits the commissioner of health, if a licensed practitioner,
or, if not a licensed practitioner, a designee of the commissioner who is a licensed
practitioner, from prescribing legend drugs for field-delivered therapy in the treatment of
a communicable disease according to the Centers For Disease Control and Prevention Partner
Services Guidelines.

Sec. 23.

Minnesota Statutes 2018, section 151.37, is amended by adding a subdivision to
read:


new text begin Subd. 14. new text end

new text begin Self-administered hormonal contraceptives. new text end

new text begin (a) A pharmacist is authorized
to prescribe self-administered hormonal contraceptives if the intended use is contraception
in accordance with this subdivision. By January 1, 2021, the board shall develop a
standardized protocol for the pharmacist to follow in prescribing self-administrated hormonal
contraceptives. In developing the protocol, the board shall consult with the Minnesota Board
of Medical Practice; the Minnesota Board of Nursing; the commissioner of health; the
Minnesota section of the American Congress of Obstetricians and Gynecologists; professional
pharmacy associations; and professional associations of physicians, physician assistants,
and advanced practice registered nurses. The protocol must, at a minimum, include:
new text end

new text begin (1) requiring the patient to complete a self-screening tool to identify patient risk factors
for the use of self-administered hormonal contraceptives, based on the current United States
Medical Eligibility Criteria for Contraceptive Use developed by the federal Centers for
Disease Control and Prevention;
new text end

new text begin (2) requiring the pharmacist to review the screening tool with the patient;
new text end

new text begin (3) other assessments the pharmacist should make before prescribing self-administered
hormonal contraceptives;
new text end

new text begin (4) situations when the prescribing of self-administered hormonal contraceptives by a
pharmacist is contraindicated;
new text end

new text begin (5) situations when the pharmacist must refer a patient to the patient's primary care
provider or, if the patient does not have a primary care provider, to a nearby clinic or hospital;
and
new text end

new text begin (6) any additional information concerning the requirements and prohibitions in this
subdivision that the board considers necessary.
new text end

new text begin (b) Before a pharmacist is authorized to prescribe a self-administered hormonal
contraceptive to a patient under this subdivision, the pharmacist shall successfully complete
a training program on prescribing self-administered hormonal contraceptives that is offered
by a college of pharmacy or by a continuing education provider that is accredited by the
Accreditation Council for Pharmacy Education, or a program approved by the board. To
maintain authorization to prescribe, the pharmacist shall complete continuing education
requirements as specified by the board.
new text end

new text begin (c) Before prescribing a self-administered hormonal contraceptive, the pharmacist shall
follow the standardized protocol developed under paragraph (a), and if appropriate, may
prescribe a self-administered hormonal contraceptive to a patient, if the patient is:
new text end

new text begin (1) 18 years of age or older; or
new text end

new text begin (2) under the age of 18 if the patient has previously been prescribed a self-administered
hormonal contraceptive by a licensed physician, physician assistant, or advanced practice
registered nurse.
new text end

new text begin (d) The pharmacist shall provide counseling to the patient on the use of self-administered
hormonal contraceptives and provide the patient with a fact sheet that includes but is not
limited to the contraindications for use of the drug, the appropriate method for using the
drug, the need for medical follow-up, and any additional information listed in Minnesota
Rules, part 6800.0910, subpart 2, that is required to be given to a patient during the counseling
process. The pharmacist shall also provide the patient with a written record of the
self-administered hormonal contraceptive prescribed by the pharmacist.
new text end

new text begin (e) If a pharmacist prescribes and dispenses a self-administered hormonal contraceptive
under this subdivision, the pharmacist shall not prescribe a refill to the patient unless the
patient has evidence of a clinical visit with a physician, physician assistant, or advanced
practice registered nurse within the preceding three years.
new text end

new text begin (f) A pharmacist who is authorized to prescribe a self-administered hormonal
contraceptive is prohibited from delegating the prescribing to any other person. A pharmacist
intern registered pursuant to section 151.101 may prepare a prescription for a
self-administered hormonal contraceptive, but before the prescription is processed or
dispensed, a pharmacist authorized to prescribe under this subdivision must review, approve,
and sign the prescription.
new text end

new text begin (g) Nothing in this subdivision prohibits a pharmacist from participating in the initiation,
management, modification, and discontinuation of drug therapy according to a protocol or
collaborative agreement as authorized in this section and in section 151.01, subdivision 27.
new text end

Sec. 24.

Minnesota Statutes 2018, section 151.37, is amended by adding a subdivision to
read:


new text begin Subd. 15. new text end

new text begin Nicotine replacement medications. new text end

new text begin (a) A pharmacist is authorized to prescribe
nicotine replacement medications approved by the United States Food and Drug
Administration in accordance with this subdivision. By January 1, 2021, the board shall
develop a standardized protocol for the pharmacist to follow in prescribing nicotine
replacement medications. In developing the protocol, the board shall consult with the
Minnesota Board of Medical Practice; the Minnesota Board of Nursing; the commissioner
of health; professional pharmacy associations; and professional associations of physicians,
physician assistants, and advanced practice registered nurses.
new text end

new text begin (b) Before a pharmacist is authorized to prescribe nicotine replacement medications
under this subdivision, the pharmacist shall successfully complete a training program
specifically developed for prescribing nicotine replacement medications that is offered by
a college of pharmacy or by a continuing education provider that is accredited by the
Accreditation Council for Pharmacy Education, or a program approved by the board. To
maintain authorization to prescribe, the pharmacist shall complete continuing education
requirements as specified by the board.
new text end

new text begin (c) Before prescribing a nicotine replacement medication, the pharmacist shall follow
the appropriate standardized protocol developed under paragraph (a), and if appropriate,
may dispense to a patient a nicotine replacement medication.
new text end

new text begin (d) The pharmacist shall provide counseling to the patient on the use of the nicotine
replacement medication and provide the patient with a fact sheet that includes but is not
limited to the indications and contraindications for use of a nicotine replacement medication,
the appropriate method for using the medication or product, the need for medical follow-up,
and any additional information listed in Minnesota Rules, part 6800.0910, subpart 2, that
is required to be given to a patient during the counseling process. The pharmacist shall also
provide the patient with a written record of the medication prescribed by the pharmacist.
new text end

new text begin (e) A pharmacist who is authorized to prescribe a nicotine replacement medication under
this subdivision is prohibited from delegating the prescribing of the medication to any other
person. A pharmacist intern registered pursuant to section 151.101 may prepare a prescription
for the medication, but before the prescription is processed or dispensed, a pharmacist
authorized to prescribe under this subdivision must review, approve, and sign the prescription.
new text end

new text begin (f) Nothing in this subdivision prohibits a pharmacist from participating in the initiation,
management, modification, and discontinuation of drug therapy according to a protocol or
collaborative agreement as authorized in this section and in section 151.01, subdivision 27.
new text end

Sec. 25.

Minnesota Statutes 2018, section 151.37, is amended by adding a subdivision to
read:


new text begin Subd. 16. new text end

new text begin Opiate antagonists for the treatment of an acute opiate overdose. new text end

new text begin (a) A
pharmacist is authorized to prescribe opiate antagonists for the treatment of an acute opiate
overdose. By January 1, 2021, the board shall develop a standardized protocol for the
pharmacist to follow in prescribing an opiate antagonist. In developing the protocol, the
board shall consult with the Minnesota Board of Medical Practice; the Minnesota Board of
Nursing; the commissioner of health; professional pharmacy associations; and professional
associations of physicians, physician assistants, and advanced practice registered nurses.
new text end

new text begin (b) Before a pharmacist is authorized to prescribe an opiate antagonist under this
subdivision, the pharmacist shall successfully complete a training program specifically
developed for prescribing opiate antagonists for the treatment of an acute opiate overdose
that is offered by a college of pharmacy or by a continuing education provider that is
accredited by the Accreditation Council for Pharmacy Education, or a program approved
by the board. To maintain authorization to prescribe, the pharmacist shall complete continuing
education requirements as specified by the board.
new text end

new text begin (c) Before prescribing an opiate antagonist under this subdivision, the pharmacist shall
follow the appropriate standardized protocol developed under paragraph (a), and if
appropriate, may dispense to a patient an opiate antagonist.
new text end

new text begin (d) The pharmacist shall provide counseling to the patient on the use of the opiate
antagonist and provide the patient with a fact sheet that includes but is not limited to the
indications and contraindications for use of the opiate antagonist, the appropriate method
for using the opiate antagonist, the need for medical follow-up, and any additional
information listed in Minnesota Rules, part 6800.0910, subpart 2, that is required to be given
to a patient during the counseling process. The pharmacist shall also provide the patient
with a written record of the opiate antagonist prescribed by the pharmacist.
new text end

new text begin (e) A pharmacist who prescribes an opiate antagonist under this subdivision is prohibited
from delegating the prescribing of the medication to any other person. A pharmacist intern
registered pursuant to section 151.101 may prepare the prescription for the opiate antagonist,
but before the prescription is processed or dispensed, a pharmacist authorized to prescribe
under this subdivision must review, approve, and sign the prescription.
new text end

new text begin (f) Nothing in this subdivision prohibits a pharmacist from participating in the initiation,
management, modification, and discontinuation of drug therapy according to a protocol as
authorized in this section and in section 151.01, subdivision 27.
new text end

Sec. 26.

Minnesota Statutes 2019 Supplement, section 151.555, subdivision 3, is amended
to read:


Subd. 3.

Central repository requirements.

(a) The board deleted text beginshalldeleted text endnew text begin maynew text end publish a request
for proposal for participants who meet the requirements of this subdivision and are interested
in acting as the central repository for the drug repository program. deleted text beginThe boarddeleted text endnew text begin If the board
publishes a request for proposal, it
new text end shall follow all applicable state procurement procedures
in the selection process.new text begin The board may also work directly with the University of Minnesota
to establish a central repository.
new text end

(b) To be eligible to act as the central repository, the participant must be a wholesale
drug distributor located in Minnesota, licensed pursuant to section 151.47, and in compliance
with all applicable federal and state statutes, rules, and regulations.

(c) The central repository shall be subject to inspection by the board pursuant to section
151.06, subdivision 1.

(d) The central repository shall comply with all applicable federal and state laws, rules,
and regulations pertaining to the drug repository program, drug storage, and dispensing.
The facility must maintain in good standing any state license or registration that applies to
the facility.

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

Minnesota Statutes 2018, section 152.12, subdivision 1, is amended to read:


Subdivision 1.

Prescribing, dispensing, administering controlled substances in
Schedules II through V.

A licensed doctor of medicine, a doctor of osteopathic medicine,
duly licensed to practice medicine, a doctor of dental surgery, a doctor of dental medicine,
a licensed doctor of podiatry, a licensed advanced practice registered nurse,new text begin a licensed
physician assistant,
new text end or a licensed doctor of optometry limited to Schedules IV and V, and
in the course of professional practice only, may prescribe, administer, and dispense a
controlled substance included in Schedules II through V of section 152.02, may cause the
same to be administered by a nurse, an intern or an assistant under the direction and
supervision of the doctor, and may cause a person who is an appropriately certified and
licensed health care professional to prescribe and administer the same within the expressed
legal scope of the person's practice as defined in Minnesota Statutes.

Sec. 28.

Minnesota Statutes 2019 Supplement, section 256B.0625, subdivision 13, is
amended to read:


Subd. 13.

Drugs.

(a) Medical assistance covers drugs, except for fertility drugs when
specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
dispensing physician, or by a physician, physician assistant, or a nurse practitioner employed
by or under contract with a community health board as defined in section 145A.02,
subdivision 5
, for the purposes of communicable disease control.

(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
unless authorized by the commissioner.

(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
ingredient" is defined as a substance that is represented for use in a drug and when used in
the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
excipients which are included in the medical assistance formulary. Medical assistance covers
selected active pharmaceutical ingredients and excipients used in compounded prescriptions
when the compounded combination is specifically approved by the commissioner or when
a commercially available product:

(1) is not a therapeutic option for the patient;

(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and

(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
prescription.

(d) Medical assistance covers the following over-the-counter drugs when prescribed by
a licensed practitioner or by a licensed pharmacist who meets standards established by the
commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
with documented vitamin deficiencies, vitamins for children under the age of seven and
pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions, or
disorders, and this determination shall not be subject to the requirements of chapter 14. A
pharmacist may prescribe over-the-counter medications as provided under this paragraph
for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for potential adverse interactions,
and make referrals as needed to other health care professionals.

(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
individuals, medical assistance may cover drugs from the drug classes listed in United States
Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
not be covered.

(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under common
ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.

new text begin (g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal
contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section
151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a
licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists
used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed
pharmacist in accordance with section 151.37, subdivision 16.
new text end

Sec. 29.

Minnesota Statutes 2018, section 256B.0625, subdivision 13h, is amended to
read:


Subd. 13h.

Medication therapy management services.

(a) Medical assistance covers
medication therapy management services for a recipient taking prescriptions to treat or
prevent one or more chronic medical conditions. For purposes of this subdivision,
"medication therapy management" means the provision of the following pharmaceutical
care services by a licensed pharmacist to optimize the therapeutic outcomes of the patient's
medications:

(1) performing or obtaining necessary assessments of the patient's health status;

(2) formulating a medication treatment plannew text begin, which may include prescribing medications
or products in accordance with section 151.37, subdivision 14, 15, or 16
new text end;

(3) monitoring and evaluating the patient's response to therapy, including safety and
effectiveness;

(4) performing a comprehensive medication review to identify, resolve, and prevent
medication-related problems, including adverse drug events;

(5) documenting the care delivered and communicating essential information to the
patient's other primary care providers;

(6) providing verbal education and training designed to enhance patient understanding
and appropriate use of the patient's medications;

(7) providing information, support services, and resources designed to enhance patient
adherence with the patient's therapeutic regimens; and

(8) coordinating and integrating medication therapy management services within the
broader health care management services being provided to the patient.

Nothing in this subdivision shall be construed to expand or modify the scope of practice of
the pharmacist as defined in section 151.01, subdivision 27.

(b) To be eligible for reimbursement for services under this subdivision, a pharmacist
must meet the following requirements:

(1) have a valid license issued by the Board of Pharmacy of the state in which the
medication therapy management service is being performed;

(2) have graduated from an accredited college of pharmacy on or after May 1996, or
completed a structured and comprehensive education program approved by the Board of
Pharmacy and the American Council of Pharmaceutical Education for the provision and
documentation of pharmaceutical care management services that has both clinical and
didactic elements;

(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
have developed a structured patient care process that is offered in a private or semiprivate
patient care area that is separate from the commercial business that also occurs in the setting,
or in home settings, including long-term care settings, group homes, and facilities providing
assisted living services, but excluding skilled nursing facilities; and

(4) make use of an electronic patient record system that meets state standards.

(c) For purposes of reimbursement for medication therapy management services, the
commissioner may enroll individual pharmacists as medical assistance providers. The
commissioner may also establish contact requirements between the pharmacist and recipient,
including limiting the number of reimbursable consultations per recipient.

(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing
within a reasonable geographic distance of the patient, a pharmacist who meets the
requirements may provide the services via two-way interactive video. Reimbursement shall
be at the same rates and under the same conditions that would otherwise apply to the services
provided. To qualify for reimbursement under this paragraph, the pharmacist providing the
services must meet the requirements of paragraph (b), and must be located within an
ambulatory care setting that meets the requirements of paragraph (b), clause (3). The patient
must also be located within an ambulatory care setting that meets the requirements of
paragraph (b), clause (3). Services provided under this paragraph may not be transmitted
into the patient's residence.

(e) Medication therapy management services may be delivered into a patient's residence
via secure interactive video if the medication therapy management services are performed
electronically during a covered home care visit by an enrolled provider. Reimbursement
shall be at the same rates and under the same conditions that would otherwise apply to the
services provided. To qualify for reimbursement under this paragraph, the pharmacist
providing the services must meet the requirements of paragraph (b) and must be located
within an ambulatory care setting that meets the requirements of paragraph (b), clause (3).

Sec. 30. new text beginISSUANCE OF PRESCRIPTIONS TO TREAT SUBSTANCE USE
DISORDERS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability during a peacetime emergency. new text end

new text begin This section applies
during a peacetime emergency declared by the governor under Minnesota Statutes, section
12.31, subdivision 2, for an outbreak of COVID-19.
new text end

new text begin Subd. 2. new text end

new text begin Use of telemedicine allowed. new text end

new text begin For purposes of Minnesota Statutes, section
151.37, subdivision 2, paragraph (d), the requirement for an examination shall be met if the
prescribing practitioner has performed a telemedicine examination of the patient before
issuing a prescription drug order for the treatment of a substance use disorder.
new text end

new text begin Subd. 3. new text end

new text begin Expiration. new text end

new text begin This section expires 60 days after the peacetime emergency specified
in subdivision 1 is terminated or rescinded by proper authority.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 31. new text beginLICENSE RENEWAL FOR PODIATRISTS; CONTINUING EDUCATION.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 153.16, subdivision 5, for purposes of
obtaining the required hours of continuing education for licensure renewal, any continuing
education hours obtained by a licensed podiatrist through participation in an internet live
online continuing educational activity as defined by the Council on Podiatric Medical
Education from March 13, 2020, to the expiration date of this section, shall be classified
by the board of podiatric medicine in the same manner as if the credits were obtained through
in-person participation.
new text end

new text begin (b) This section expires December 31, 2020, or the day after the peacetime emergency
declared by the governor under Minnesota Statutes, section 12.31, subdivision 2, for an
outbreak of COVID-19 is terminated or rescinded by proper authority, whichever is later.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 32. new text beginOBSERVATION OF PHYSICAL THERAPIST ASSISTANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability during a peacetime emergency. new text end

new text begin This section applies
during a peacetime emergency by the governor under Minnesota Statutes, section 12.31,
subdivision 2, for an outbreak of COVID-19.
new text end

new text begin Subd. 2. new text end

new text begin On-site requirements. new text end

new text begin For purposes of Minnesota Statutes, section 148.706,
subdivision 3, the on-site observation requirement of treatment components delegated to a
physical therapist assistant by a physical therapist may be met through observation via
telemedicine.
new text end

new text begin Subd. 3. new text end

new text begin Expiration. new text end

new text begin This section expires 60 days after the peacetime emergency specified
in subdivision 1 is terminated or rescinded by the proper authority.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 33. new text beginTHERAPEUTIC INTERCHANGE.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability during a peacetime emergency. new text end

new text begin This section applies
during a peacetime emergency declared by the governor under Minnesota Statutes, section
12.31, subdivision 2, for an outbreak of COVID-19.
new text end

new text begin Subd. 2. new text end

new text begin Therapeutic interchange. new text end

new text begin Notwithstanding Minnesota Statutes, section 151.21,
subdivision 7a, paragraph (a), a pharmacist may dispense a therapeutically equivalent and
interchangeable prescribed drug or biological product, without having a protocol in place,
provided:
new text end

new text begin (1) the drug prescribed is in short supply and the pharmacist is unable to obtain it from
the manufacturer, drug wholesalers, or other local pharmacies;
new text end

new text begin (2) the pharmacist is unable to contact the prescriber within a reasonable period of time
to get authorization to dispense a drug that is available;
new text end

new text begin (3) the pharmacist determines a therapeutically equivalent drug to the one prescribed is
available and is in the same American Hospital Formulary Service pharmacologic-therapeutic
classification;
new text end

new text begin (4) the pharmacist informs the patient as required in Minnesota Statutes, section 151.21,
subdivision 7a, paragraph (b), and provides counseling to the patient, as required by the
Board of Pharmacy rules, about the substituted drug;
new text end

new text begin (5) the pharmacist informs the prescriber as soon as possible that the therapeutic
interchange has been made; and
new text end

new text begin (6) the therapeutic interchange pursuant to this section is allowed only until the expiration
date under subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Expiration. new text end

new text begin This section expires 60 days after the peacetime emergency specified
in subdivision 1 is terminated or rescinded by proper authority.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 34. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 147A.01, subdivisions 4, 11, 16a, 17a, 24, and 25;
147A.04; 147A.10; 147A.11; 147A.18, subdivisions 1, 2, and 3; and 147A.20,
new text end new text begin are repealed.
new text end

ARTICLE 3

HEALTH CARE

Section 1.

Minnesota Statutes 2019 Supplement, section 16A.151, subdivision 2, is
amended to read:


Subd. 2.

Exceptions.

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

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

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

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

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

(f) Any money received by the state resulting from a settlement agreement or an assurance
of discontinuance entered into by the attorney general of the state, or a court order in litigation
brought by the attorney general of the state, on behalf of the state or a state agency, against
one or more opioid manufacturers or opioid wholesale drug distributors related to alleged
violations of consumer fraud laws in the marketing, sale, or distribution of opioids in this
state or other alleged illegal actions that contributed to the excessive use of opioids, must
be deposited in a separate account in the state treasury and the commissioner shall notify
the chairs and ranking minority members of the Finance Committee in the senate and the
Ways and Means Committee in the house of representatives that an account has been created.
This paragraph does not apply to attorney fees and costs awarded to the state or the Attorney
General's Office, to contract attorneys hired by the state or Attorney General's Office, or to
other state agency attorneys. If the licensing fees under section 151.065, subdivision 1,
clause (16), and subdivision 3, clause (14), are reduced and the registration fee under section
151.066, subdivision 3, is repealed in accordance with section 256.043, subdivision 4, then
the commissioner shall transfer from the separate account created in this paragraph to the
opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end under section 256.043 an amount that ensures that
$20,940,000 each fiscal year is available for distribution in accordance with section 256.043,
subdivisions 2
and 3.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2018, section 62U.03, is amended to read:


62U.03 PAYMENT RESTRUCTURING; CARE COORDINATION PAYMENTS.

(a) By January 1, 2010, health plan companies shall include health care homes in their
provider networks and by July 1, 2010, shall pay a care coordination fee for their members
who choose to enroll in health care homes certified by the deleted text begincommissioners of health and
human services
deleted text endnew text begin commissionernew text end under section 256B.0751. Health plan companies shall develop
payment conditions and terms for the care coordination fee for health care homes participating
in their network in a manner that is consistent with the system developed under section
256B.0753. Nothing in this section shall restrict the ability of health plan companies to
selectively contract with health care providers, including health care homes. Health plan
companies may reduce or reallocate payments to other providers to ensure that
implementation of care coordination payments is cost neutral.

(b) By July 1, 2010, the commissioner of management and budget shall implement the
care coordination payments for participants in the state employee group insurance program.
The commissioner of management and budget may reallocate payments within the health
care system in order to ensure that the implementation of this section is cost neutral.

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 2018, section 62U.04, subdivision 11, is amended to read:


Subd. 11.

Restricted uses of the all-payer claims data.

(a) Notwithstanding subdivision
4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the commissioner's
designee shall only use the data submitted under subdivisions 4 and 5 for the following
purposes:

(1) to evaluate the performance of the health care home program as authorized under
deleted text begin sectionsdeleted text endnew text begin sectionnew text end 256B.0751, subdivision 6deleted text begin, and 256B.0752, subdivision 2deleted text end;

(2) to study, in collaboration with the reducing avoidable readmissions effectively
(RARE) campaign, hospital readmission trends and rates;

(3) to analyze variations in health care costs, quality, utilization, and illness burden based
on geographical areas or populations;

(4) to evaluate the state innovation model (SIM) testing grant received by the Departments
of Health and Human Services, including the analysis of health care cost, quality, and
utilization baseline and trend information for targeted populations and communities; and

(5) to compile one or more public use files of summary data or tables that must:

(i) be available to the public for no or minimal cost by March 1, 2016, and available by
web-based electronic data download by June 30, 2019;

(ii) not identify individual patients, payers, or providers;

(iii) be updated by the commissioner, at least annually, with the most current data
available;

(iv) contain clear and conspicuous explanations of the characteristics of the data, such
as the dates of the data contained in the files, the absence of costs of care for uninsured
patients or nonresidents, and other disclaimers that provide appropriate context; and

(v) not lead to the collection of additional data elements beyond what is authorized under
this section as of June 30, 2015.

(b) The commissioner may publish the results of the authorized uses identified in
paragraph (a) so long as the data released publicly do not contain information or descriptions
in which the identity of individual hospitals, clinics, or other providers may be discerned.

(c) Nothing in this subdivision shall be construed to prohibit the commissioner from
using the data collected under subdivision 4 to complete the state-based risk adjustment
system assessment due to the legislature on October 1, 2015.

(d) The commissioner or the commissioner's designee may use the data submitted under
subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until July 1,
2023.

(e) The commissioner shall consult with the all-payer claims database work group
established under subdivision 12 regarding the technical considerations necessary to create
the public use files of summary data described in paragraph (a), clause (5).

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2019 Supplement, section 151.065, subdivision 1, as amended
by Laws 2020, chapter 71, article 2, section 5, is amended to read:


Subdivision 1.

Application fees.

Application fees for licensure and registration are as
follows:

(1) pharmacist licensed by examination, $175;

(2) pharmacist licensed by reciprocity, $275;

(3) pharmacy intern, $50;

(4) pharmacy technician, $50;

(5) pharmacy, $260;

(6) drug wholesaler, legend drugs only, $5,260;

(7) drug wholesaler, legend and nonlegend drugs, $5,260;

(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,260;

(9) drug wholesaler, medical gases, $5,260 for the first facility and $260 for each
additional facility;

(10) third-party logistics provider, $260;

(11) drug manufacturer, nonopiate legend drugs only, $5,260;

(12) drug manufacturer, nonopiate legend and nonlegend drugs, $5,260;

(13) drug manufacturer, nonlegend or veterinary legend drugs, $5,260;

(14) drug manufacturer, medical gases, $5,260 for the first facility and $260 for each
additional facility;

(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,260;

(16) drug manufacturer of opiate-containing controlled substances listed in section
152.02, subdivisions 3 to 5, deleted text begin$55,000deleted text endnew text begin $55,260new text end;

(17) medical gas deleted text begindistributordeleted text endnew text begin dispensernew text end, $260;

(18) controlled substance researcher, $75; and

(19) pharmacy professional corporation, $150.

new text begin EFFECTIVE DATE. new text end

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

Sec. 5.

Minnesota Statutes 2019 Supplement, section 151.065, subdivision 3, as amended
by Laws 2020, chapter 71, article 2, section 6, is amended to read:


Subd. 3.

Annual renewal fees.

Annual licensure and registration renewal fees are as
follows:

(1) pharmacist, $175;

(2) pharmacy technician, $50;

(3) pharmacy, $260;

(4) drug wholesaler, legend drugs only, $5,260;

(5) drug wholesaler, legend and nonlegend drugs, $5,260;

(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,260;

(7) drug wholesaler, medical gases, $5,260 for the first facility and $260 for each
additional facility;

(8) third-party logistics provider, $260;

(9) drug manufacturer, nonopiate legend drugs only, $5,260;

(10) drug manufacturer, nonopiate legend and nonlegend drugs, $5,260;

(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $5,260;

(12) drug manufacturer, medical gases, $5,260 for the first facility and $260 for each
additional facility;

(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,260;

(14) drug manufacturer of opiate-containing controlled substances listed in section
152.02, subdivisions 3 to 5, deleted text begin$55,000deleted text endnew text begin $55,260new text end;

(15) medical gas deleted text begindistributordeleted text endnew text begin dispensernew text end, $260;

(16) controlled substance researcher, $75; and

(17) pharmacy professional corporation, $100.

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2019 Supplement, section 151.065, subdivision 6, is amended
to read:


Subd. 6.

Reinstatement fees.

(a) A pharmacist who has allowed the pharmacist's license
to lapse may reinstate the license with board approval and upon payment of any fees and
late fees in arrears, up to a maximum of $1,000.

(b) A pharmacy technician who has allowed the technician's registration to lapse may
reinstate the registration with board approval and upon payment of any fees and late fees
in arrears, up to a maximum of $90.

(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, third-party logistics
provider, or a medical gas deleted text begindistributordeleted text endnew text begin dispensernew text end who has allowed the license of the
establishment to lapse may reinstate the license with board approval and upon payment of
any fees and late fees in arrears.

(d) A controlled substance researcher who has allowed the researcher's registration to
lapse may reinstate the registration with board approval and upon payment of any fees and
late fees in arrears.

(e) A pharmacist owner of a professional corporation who has allowed the corporation's
registration to lapse may reinstate the registration with board approval and upon payment
of any fees and late fees in arrears.

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2019 Supplement, section 151.065, subdivision 7, as amended
by Laws 2020, chapter 71, article 2, section 7, is amended to read:


Subd. 7.

Deposit of fees.

(a) The license fees collected under this section, with the
exception of the fees identified in paragraphs (b) and (c), shall be deposited in the state
government special revenue fund.

(b) $5,000 of each fee collected under subdivision 1, clauses (6) to (9), and (11) to (15),
and subdivision 3, clauses (4) to (7), and (9) to (13), and deleted text beginthe feesdeleted text endnew text begin $55,000 of each feenew text end
collected under subdivision 1, clause (16), and subdivision 3, clause (14), shall be deposited
in the opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end established in section 256.043.

(c) If the fees collected under subdivision 1, clause (16), or subdivision 3, clause (14),
are reducednew text begin under section 256.043new text end, $5,000 of the reduced fee shall be deposited in the opiate
epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end in section 256.043.

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2019 Supplement, section 151.071, subdivision 2, is amended
to read:


Subd. 2.

Grounds for disciplinary action.

The following conduct is prohibited and is
grounds for disciplinary action:

(1) failure to demonstrate the qualifications or satisfy the requirements for a license or
registration contained in this chapter or the rules of the board. The burden of proof is on
the applicant to demonstrate such qualifications or satisfaction of such requirements;

(2) obtaining a license by fraud or by misleading the board in any way during the
application process or obtaining a license by cheating, or attempting to subvert the licensing
examination process. Conduct that subverts or attempts to subvert the licensing examination
process includes, but is not limited to: (i) conduct that violates the security of the examination
materials, such as removing examination materials from the examination room or having
unauthorized possession of any portion of a future, current, or previously administered
licensing examination; (ii) conduct that violates the standard of test administration, such as
communicating with another examinee during administration of the examination, copying
another examinee's answers, permitting another examinee to copy one's answers, or
possessing unauthorized materials; or (iii) impersonating an examinee or permitting an
impersonator to take the examination on one's own behalf;

(3) for a pharmacist, pharmacy technician, pharmacist intern, applicant for a pharmacist
or pharmacy license, or applicant for a pharmacy technician or pharmacist intern registration,
conviction of a felony reasonably related to the practice of pharmacy. Conviction as used
in this subdivision includes a conviction of an offense that if committed in this state would
be deemed a felony without regard to its designation elsewhere, or a criminal proceeding
where a finding or verdict of guilt is made or returned but the adjudication of guilt is either
withheld or not entered thereon. The board may delay the issuance of a new license or
registration if the applicant has been charged with a felony until the matter has been
adjudicated;

(4) for a facility, other than a pharmacy, licensed or registered by the board, if an owner
or applicant is convicted of a felony reasonably related to the operation of the facility. The
board may delay the issuance of a new license or registration if the owner or applicant has
been charged with a felony until the matter has been adjudicated;

(5) for a controlled substance researcher, conviction of a felony reasonably related to
controlled substances or to the practice of the researcher's profession. The board may delay
the issuance of a registration if the applicant has been charged with a felony until the matter
has been adjudicated;

(6) disciplinary action taken by another state or by one of this state's health licensing
agencies:

(i) revocation, suspension, restriction, limitation, or other disciplinary action against a
license or registration in another state or jurisdiction, failure to report to the board that
charges or allegations regarding the person's license or registration have been brought in
another state or jurisdiction, or having been refused a license or registration by any other
state or jurisdiction. The board may delay the issuance of a new license or registration if an
investigation or disciplinary action is pending in another state or jurisdiction until the
investigation or action has been dismissed or otherwise resolved; and

(ii) revocation, suspension, restriction, limitation, or other disciplinary action against a
license or registration issued by another of this state's health licensing agencies, failure to
report to the board that charges regarding the person's license or registration have been
brought by another of this state's health licensing agencies, or having been refused a license
or registration by another of this state's health licensing agencies. The board may delay the
issuance of a new license or registration if a disciplinary action is pending before another
of this state's health licensing agencies until the action has been dismissed or otherwise
resolved;

(7) for a pharmacist, pharmacy, pharmacy technician, or pharmacist intern, violation of
any order of the board, of any of the provisions of this chapter or any rules of the board or
violation of any federal, state, or local law or rule reasonably pertaining to the practice of
pharmacy;

(8) for a facility, other than a pharmacy, licensed by the board, violations of any order
of the board, of any of the provisions of this chapter or the rules of the board or violation
of any federal, state, or local law relating to the operation of the facility;

(9) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the
public, or demonstrating a willful or careless disregard for the health, welfare, or safety of
a patient; or pharmacy practice that is professionally incompetent, in that it may create
unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of
actual injury need not be established;

(10) aiding or abetting an unlicensed person in the practice of pharmacy, except that it
is not a violation of this clause for a pharmacist to supervise a properly registered pharmacy
technician or pharmacist intern if that person is performing duties allowed by this chapter
or the rules of the board;

(11) for an individual licensed or registered by the board, adjudication as mentally ill
or developmentally disabled, or as a chemically dependent person, a person dangerous to
the public, a sexually dangerous person, or a person who has a sexual psychopathic
personality, by a court of competent jurisdiction, within or without this state. Such
adjudication shall automatically suspend a license for the duration thereof unless the board
orders otherwise;

(12) for a pharmacist or pharmacy intern, engaging in unprofessional conduct as specified
in the board's rules. In the case of a pharmacy technician, engaging in conduct specified in
board rules that would be unprofessional if it were engaged in by a pharmacist or pharmacist
intern or performing duties specifically reserved for pharmacists under this chapter or the
rules of the board;

(13) for a pharmacy, operation of the pharmacy without a pharmacist present and on
duty except as allowed by a variance approved by the board;

(14) for a pharmacist, the inability to practice pharmacy with reasonable skill and safety
to patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type
of material or as a result of any mental or physical condition, including deterioration through
the aging process or loss of motor skills. In the case of registered pharmacy technicians,
pharmacist interns, or controlled substance researchers, the inability to carry out duties
allowed under this chapter or the rules of the board with reasonable skill and safety to
patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type
of material or as a result of any mental or physical condition, including deterioration through
the aging process or loss of motor skills;

(15) for a pharmacist, pharmacy, pharmacist intern, pharmacy technician, medical gas
deleted text begin distributordeleted text endnew text begin dispensernew text end, or controlled substance researcher, revealing a privileged
communication from or relating to a patient except when otherwise required or permitted
by law;

(16) for a pharmacist or pharmacy, improper management of patient records, including
failure to maintain adequate patient records, to comply with a patient's request made pursuant
to sections 144.291 to 144.298, or to furnish a patient record or report required by law;

(17) fee splitting, including without limitation:

(i) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate,
kickback, or other form of remuneration, directly or indirectly, for the referral of patients;

(ii) referring a patient to any health care provider as defined in sections 144.291 to
144.298 in which the licensee or registrant has a financial or economic interest as defined
in section 144.6521, subdivision 3, unless the licensee or registrant has disclosed the
licensee's or registrant's financial or economic interest in accordance with section 144.6521;
and

(iii) any arrangement through which a pharmacy, in which the prescribing practitioner
does not have a significant ownership interest, fills a prescription drug order and the
prescribing practitioner is involved in any manner, directly or indirectly, in setting the price
for the filled prescription that is charged to the patient, the patient's insurer or pharmacy
benefit manager, or other person paying for the prescription or, in the case of veterinary
patients, the price for the filled prescription that is charged to the client or other person
paying for the prescription, except that a veterinarian and a pharmacy may enter into such
an arrangement provided that the client or other person paying for the prescription is notified,
in writing and with each prescription dispensed, about the arrangement, unless such
arrangement involves pharmacy services provided for livestock, poultry, and agricultural
production systems, in which case client notification would not be required;

(18) engaging in abusive or fraudulent billing practices, including violations of the
federal Medicare and Medicaid laws or state medical assistance laws or rules;

(19) engaging in conduct with a patient that is sexual or may reasonably be interpreted
by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning
to a patient;

(20) failure to make reports as required by section 151.072 or to cooperate with an
investigation of the board as required by section 151.074;

(21) knowingly providing false or misleading information that is directly related to the
care of a patient unless done for an accepted therapeutic purpose such as the dispensing and
administration of a placebo;

(22) aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation
of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an injunction
issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5; or

(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.
The board deleted text beginshalldeleted text endnew text begin mustnew text end investigate any complaint of a violation of section 609.215, subdivision
1 or 2;

(23) for a pharmacist, practice of pharmacy under a lapsed or nonrenewed license. For
a pharmacist intern, pharmacy technician, or controlled substance researcher, performing
duties permitted to such individuals by this chapter or the rules of the board under a lapsed
or nonrenewed registration. For a facility required to be licensed under this chapter, operation
of the facility under a lapsed or nonrenewed license or registration; and

(24) for a pharmacist, pharmacist intern, or pharmacy technician, termination or discharge
from the health professionals services program for reasons other than the satisfactory
completion of the program.

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2018, section 151.071, subdivision 8, is amended to read:


Subd. 8.

Temporary suspension of license for pharmacies, drug wholesalers, drug
manufacturers, medical gas manufacturers, and medical gas deleted text begindistributorsdeleted text endnew text begin dispensersnew text end.

In
addition to any other remedy provided by law, the board may, without a hearing, temporarily
suspend the license or registration of a pharmacy, drug wholesaler, drug manufacturer,
medical gas manufacturer, or medical gas deleted text begindistributordeleted text endnew text begin dispensernew text end if the board finds that the
licensee or registrant has violated a statute or rule that the board is empowered to enforce
and continued operation of the licensed facility would create a serious risk of harm to the
public. The suspension deleted text beginshalldeleted text endnew text begin mustnew text end take effect upon written notice to the licensee or registrant,
specifying the statute or rule violated. The suspension deleted text beginshalldeleted text endnew text begin mustnew text end remain in effect until the
board issues a final order in the matter after a hearing. At the time it issues the suspension
notice, the board deleted text beginshalldeleted text endnew text begin mustnew text end schedule a disciplinary hearing to be held pursuant to the
Administrative Procedure Act. The licensee or registrant deleted text beginshalldeleted text endnew text begin mustnew text end be provided with at
least 20 days' notice of any hearing held pursuant to this subdivision. The hearing deleted text beginshalldeleted text endnew text begin mustnew text end
be scheduled to begin no later than 30 days after the issuance of the suspension order.

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

Minnesota Statutes 2019 Supplement, section 151.19, subdivision 3, is amended
to read:


Subd. 3.

Sale of federally restricted medical gases.

(a) A person or establishment not
licensed as a pharmacy or a practitioner deleted text beginshalldeleted text endnew text begin mustnew text end not engage in the retail sale or deleted text begindistributiondeleted text endnew text begin
dispensing
new text end of federally restricted medical gases without first obtaining a registration from
the board and paying the applicable fee specified in section 151.065. The registration deleted text beginshalldeleted text endnew text begin
must
new text end be displayed in a conspicuous place in the business for which it is issued and expires
on the date set by the board. It is unlawful for a person to sell or deleted text begindistributedeleted text endnew text begin dispensenew text end federally
restricted medical gases unless a certificate has been issued to that person by the board.

(b) Application for a medical gas deleted text begindistributordeleted text endnew text begin dispensernew text end registration under this section
deleted text begin shalldeleted text endnew text begin mustnew text end be made in a manner specified by the board.

(c) deleted text beginNodeleted text endnew text begin Anew text end registration deleted text beginshalldeleted text endnew text begin must notnew text end be issued or renewed for a medical gas deleted text begindistributordeleted text endnew text begin
dispenser
new text end located within the state unless the applicant agrees to operate in a manner prescribed
by federal and state law and according to the rules adopted by the board. deleted text beginNodeleted text endnew text begin Anew text end license deleted text beginshalldeleted text endnew text begin
must not
new text end be issued for a medical gas deleted text begindistributordeleted text endnew text begin dispensernew text end located outside of the state unless
the applicant agrees to operate in a manner prescribed by federal law and, when deleted text begindistributingdeleted text endnew text begin
dispensing
new text end medical gases for residents of this state, the laws of this state and Minnesota
Rules.

(d) deleted text beginNodeleted text endnew text begin Anew text end registration deleted text beginshalldeleted text endnew text begin must notnew text end be issued or renewed for a medical gas deleted text begindistributordeleted text endnew text begin
dispenser
new text end that is required to be licensed or registered by the state in which it is physically
located unless the applicant supplies the board with proof of the licensure or registration.
The board may, by rule, establish standards for the registration of a medical gas deleted text begindistributordeleted text endnew text begin
dispenser
new text end that is not required to be licensed or registered by the state in which it is physically
located.

(e) The board deleted text beginshalldeleted text endnew text begin mustnew text end require a separate registration for each medical gas deleted text begindistributordeleted text endnew text begin
dispenser
new text end located within the state and for each facility located outside of the state from
which medical gases are deleted text begindistributeddeleted text endnew text begin dispensednew text end to residents of this state.

(f) Prior to the issuance of an initial or renewed registration for a medical gas deleted text begindistributordeleted text endnew text begin
dispenser
new text end, the board may require the medical gas deleted text begindistributordeleted text endnew text begin dispensernew text end to pass an inspection
conducted by an authorized representative of the board. In the case of a medical gas
deleted text begin distributordeleted text endnew text begin dispensernew text end located outside of the state, the board may require the applicant to pay
the cost of the inspection, in addition to the license fee in section 151.065, unless the applicant
furnishes the board with a report, issued by the appropriate regulatory agency of the state
in which the facility is located, of an inspection that has occurred within the 24 months
immediately preceding receipt of the license application by the board. The board may deny
licensure unless the applicant submits documentation satisfactory to the board that any
deficiencies noted in an inspection report have been corrected.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2019 Supplement, section 151.252, subdivision 1, is amended
to read:


Subdivision 1.

Requirements.

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

(b) In addition to the license required under paragraph (a), each manufacturer required
to pay the registration fee under section 151.066 must pay the fee by June 1 of each year,
beginning June 1, 2020. In the event of a change of ownership of the manufacturer, the new
owner must pay the registration fee specified under section 151.066, subdivision 3, that the
original owner would have been assessed had the original owner retained ownership. The
registration fee collected under this paragraph shall be deposited in the opiate epidemic
response deleted text beginaccountdeleted text endnew text begin fundnew text end established under section 256.043.

(c) Application for a drug manufacturer license under this section shall be made in a
manner specified by the board.

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

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

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

(g) The board shall require a separate license for each facility located within the state at
which drug manufacturing occurs and for each facility located outside of the state at which
drugs that are shipped into the state are manufactured, except a manufacturer of
opiate-containing controlled substances shall not be required to pay the fee under section
151.065, subdivision 1, clause (16), or subdivision 3, clause (14), for more than one facility.

(h) Prior to the issuance of an initial or renewed license for a drug manufacturing facility,
the board may require the facility to pass a current good manufacturing practices inspection
conducted by an authorized representative of the board. In the case of a drug manufacturing
facility located outside of the state, the board may require the applicant to pay the cost of
the inspection, in addition to the license fee in section 151.065, unless the applicant furnishes
the board with a report, issued by the appropriate regulatory agency of the state in which
the facility is located or by the United States Food and Drug Administration, of an inspection
that has occurred within the 24 months immediately preceding receipt of the license
application by the board. The board may deny licensure unless the applicant submits
documentation satisfactory to the board that any deficiencies noted in an inspection report
have been corrected.

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

Minnesota Statutes 2018, section 256.01, subdivision 29, is amended to read:


Subd. 29.

State medical review team.

(a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under sections
256B.055, deleted text beginsubdivisiondeleted text end new text beginsubdivisions new text end7, paragraph (b), new text beginand 12, and new text end256B.057, subdivision 9,
deleted text begin and 256B.055, subdivision 12,deleted text end the commissioner shall review all medical evidence deleted text beginsubmitted
by county agencies with a referral
deleted text end and seek deleted text beginadditionaldeleted text end information from providers, applicants,
and enrollees to support the determination of disability where necessary. Disability shall
be determined according to the rules of title XVI and title XIX of the Social Security Act
and pertinent rules and policies of the Social Security Administration.

(b) Prior to a denial or withdrawal of a requested determination of disability due to
insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary
and appropriate to a determination of disability, and (2) assist applicants and enrollees to
obtain the evidence, including, but not limited to, medical examinations and electronic
medical records.

(c) The commissioner shall provide the chairs of the legislative committees with
jurisdiction over health and human services finance and budget the following information
on the activities of the state medical review team by February 1 of each year:

(1) the number of applications to the state medical review team that were denied,
approved, or withdrawn;

(2) the average length of time from receipt of the application to a decision;

(3) the number of appeals, appeal results, and the length of time taken from the date the
person involved requested an appeal for a written decision to be made on each appeal;

(4) for applicants, their age, health coverage at the time of application, hospitalization
history within three months of application, and whether an application for Social Security
or Supplemental Security Income benefits is pending; and

(5) specific information on the medical certification, licensure, or other credentials of
the person or persons performing the medical review determinations and length of time in
that position.

(d) Any appeal made under section 256.045, subdivision 3, of a disability determination
made by the state medical review team must be decided according to the timelines under
section 256.0451, subdivision 22, paragraph (a). If a written decision is not issued within
the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal must be
immediately reviewed by the chief human services judge.

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2019 Supplement, section 256.042, subdivision 2, is amended
to read:


Subd. 2.

Membership.

(a) The council shall consist of the following 19 voting members,
appointed by the commissioner of human services except as otherwise specified, and three
nonvoting members:

(1) two members of the house of representatives, appointed in the following sequence:
the first from the majority party appointed by the speaker of the house and the second from
the minority party appointed by the minority leader. Of these two members, one member
must represent a district outside of the seven-county metropolitan area, and one member
must represent a district that includes the seven-county metropolitan area. The appointment
by the minority leader must ensure that this requirement for geographic diversity in
appointments is met;

(2) two members of the senate, appointed in the following sequence: the first from the
majority party appointed by the senate majority leader and the second from the minority
party appointed by the senate minority leader. Of these two members, one member must
represent a district outside of the seven-county metropolitan area and one member must
represent a district that includes the seven-county metropolitan area. The appointment by
the minority leader must ensure that this requirement for geographic diversity in appointments
is met;

(3) one member appointed by the Board of Pharmacy;

(4) one member who is a physician appointed by the Minnesota Medical Association;

(5) one member representing opioid treatment programs, sober living programs, or
substance use disorder programs licensed under chapter 245G;

(6) one member appointed by the Minnesota Society of Addiction Medicine who is an
addiction psychiatrist;

(7) one member representing professionals providing alternative pain management
therapies, including, but not limited to, acupuncture, chiropractic, or massage therapy;

(8) one member representing nonprofit organizations conducting initiatives to address
the opioid epidemic, with the commissioner's initial appointment being a member
representing the Steve Rummler Hope Network, and subsequent appointments representing
this or other organizations;

(9) one member appointed by the Minnesota Ambulance Association who is serving
with an ambulance service as an emergency medical technician, advanced emergency
medical technician, or paramedic;

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

(11) one public member who is a Minnesota resident and who is in opioid addiction
recovery;

(12) two members representing Indian tribes, one representing the Ojibwe tribes and
one representing the Dakota tribes;

(13) one public member who is a Minnesota resident and who is suffering from chronic
pain, intractable pain, or a rare disease or condition;

(14) one mental health advocate representing persons with mental illness;

(15) one member deleted text beginrepresentingdeleted text endnew text begin appointed bynew text end the Minnesota Hospital Association;

(16) one member representing a local health department; and

(17) the commissioners of human services, health, and corrections, or their designees,
who shall be ex officio nonvoting members of the council.

(b) The commissioner of human services shall coordinate the commissioner's
appointments to provide geographic, racial, and gender diversity, and shall ensure that at
least one-half of council members appointed by the commissioner reside outside of the
seven-county metropolitan area. Of the members appointed by the commissioner, to the
extent practicable, at least one member must represent a community of color
disproportionately affected by the opioid epidemic.

(c) The council is governed by section 15.059, except that members of the council new text beginshall
serve three-year terms and
new text endshall receive no compensation other than reimbursement for
expenses. Notwithstanding section 15.059, subdivision 6, the council shall not expire.

(d) The chair shall convene the council at least quarterly, and may convene other meetings
as necessary. The chair shall convene meetings at different locations in the state to provide
geographic access, and shall ensure that at least one-half of the meetings are held at locations
outside of the seven-county metropolitan area.

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

(f) The council is subject to chapter 13D.

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

Minnesota Statutes 2019 Supplement, section 256.042, subdivision 4, is amended
to read:


Subd. 4.

Grants.

(a) The commissioner of human services shall submit a report of the
grants proposed by the advisory council to be awarded for the upcoming fiscal year to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health and human services policy and finance, by March 1 of each year, beginning March
1, 2020.

(b) The commissioner of human services shall award grants from the opiate epidemic
response deleted text beginaccountdeleted text endnew text begin fundnew text end under section 256.043. The grants shall be awarded to proposals
selected by the advisory council that address the priorities in subdivision 1, paragraph (a),
clauses (1) to (4), unless otherwise appropriated by the legislature. No more than three
percent of the grant amount may be used by a grantee for administration.

new text begin EFFECTIVE DATE. new text end

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

Sec. 15.

Minnesota Statutes 2019 Supplement, section 256.043, is amended to read:


256.043 OPIATE EPIDEMIC RESPONSE deleted text beginACCOUNTdeleted text endnew text begin FUNDnew text end.

Subdivision 1.

Establishment.

The opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end is established
in the deleted text beginspecial revenue fund in thedeleted text end state treasury. The registration fees assessed by the Board
of Pharmacy under section 151.066 and the license fees identified in section 151.065,
subdivision 7
, paragraphs (b) and (c), shall be deposited into the deleted text beginaccountdeleted text endnew text begin fundnew text end. Beginning
in fiscal year 2021, for each fiscal year, the deleted text beginfunds in the accountdeleted text endnew text begin fundnew text end shall be administered
according to this section.

deleted text begin Subd. 2. deleted text end

deleted text begin Transfers from account to state agencies. deleted text end

deleted text begin (a) The commissioner shall transfer
the following amounts to the agencies specified in this subdivision.
deleted text end

deleted text begin (b) $126,000 to the Board of Pharmacy for the collection of the registration fees under
section 151.066.
deleted text end

deleted text begin (c) $672,000 to the commissioner of public safety for the Bureau of Criminal
Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies and $288,000
is for special agent positions focused on drug interdiction and drug trafficking.
deleted text end

Subd. 3.

Appropriations from deleted text beginaccountdeleted text endnew text begin fundnew text end.

(a) After the deleted text begintransfers described in
subdivision 2, and the
deleted text end appropriations in new text beginLaws 2019, chapter 63, new text endarticle 3, section 1,
paragraphs (e), (f), (g), and (h) are made, $249,000 is appropriated new text beginto the commissioner of
human services
new text endfor the provision of administrative services to the Opiate Epidemic Response
Advisory Council and for the administration of the grants awarded under paragraph deleted text begin(c)deleted text endnew text begin (e)new text end.

new text begin (b) $126,000 is appropriated to the Board of Pharmacy for the collection of the registration
fees under section 151.066.
new text end

new text begin (c) $672,000 is appropriated to the commissioner of public safety for the Bureau of
Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies
and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
new text end

deleted text begin (b)deleted text endnew text begin (d)new text end After the deleted text begintransfers in subdivision 2 and thedeleted text end appropriations in deleted text beginparagraphdeleted text endnew text begin paragraphsnew text end
(a)new text begin to (c)new text end are made, 50 percent of the remaining amount is appropriated to the commissioner
new text begin of human services new text endfor distribution to county social service and tribal social service agencies
to provide child protection services to children and families who are affected by addiction.
The commissioner shall distribute this money proportionally to counties and tribal social
service agencies based on out-of-home placement episodes where parental drug abuse is
the primary reason for the out-of-home placement using data from the previous calendar
year. County and tribal social service agencies receiving funds from the opiate epidemic
response deleted text beginaccountdeleted text endnew text begin fundnew text end must annually report to the commissioner on how the funds were
used to provide child protection services, including measurable outcomes, as determined
by the commissioner. County social service agencies and tribal social service agencies must
not use funds received under this paragraph to supplant current state or local funding received
for child protection services for children and families who are affected by addiction.

deleted text begin (c)deleted text endnew text begin (e)new text end After making the deleted text begintransfers in subdivision 2 and thedeleted text end appropriations in paragraphs
(a) deleted text beginand (b)deleted text endnew text begin to (d)new text end, the remaining deleted text beginfunds in the account aredeleted text endnew text begin amount in the fund isnew text end appropriated
to the commissioner to award grants as specified by the Opiate Epidemic Response Advisory
Council in accordance with section 256.042, unless otherwise appropriated by the legislature.

Subd. 4.

Settlement; sunset.

(a) If the state receives a total sum of $250,000,000 either
as a result of a settlement agreement or an assurance of discontinuance entered into by the
attorney general of the state, or resulting from a court order in litigation brought by the
attorney general of the state on behalf of the state or a state agency, against one or more
opioid manufacturers or opioid wholesale drug distributors related to alleged violations of
consumer fraud laws in the marketing, sale, or distribution of opioids in this state, or other
alleged illegal actions that contributed to the excessive use of opioids, or from the fees
collected under sections 151.065, subdivisions 1 and 3, and 151.066, that are deposited into
the opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end established in new text beginthis new text endsection deleted text begin256.043deleted text end, or from a
combination of both, the fees specified in section 151.065, subdivisions 1, clause (16), and
3, clause (14), shall be reduced to $5,260, and the opiate registration fee in section 151.066,
subdivision 3
, shall be repealed.

(b) The commissioner of management and budget shall inform the board of pharmacy,
the governor, and the legislature when the amount specified in paragraph (a) has been
reached. The board shall apply the reduced license fee for the next licensure period.

(c) Notwithstanding paragraph (a), the reduction of the license fee in section 151.065,
subdivisions 1
and 3, and the repeal of the registration fee in section 151.066 shall not occur
before July 1, 2024.

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

Minnesota Statutes 2018, section 256B.056, subdivision 1a, is amended to read:


Subd. 1a.

Income and assets generally.

(a)(1) Unless specifically required by state law
or rule or federal law or regulation, the methodologies used in counting income and assets
to determine eligibility for medical assistance for persons whose eligibility category is based
on blindness, disability, or age of 65 or more years, the methodologies for the Supplemental
Security Income program shall be used, except as provided under subdivision 3, paragraph
(a), clause (6).

(2) Increases in benefits under title II of the Social Security Act shall not be counted as
income for purposes of this subdivision until July 1 of each year. Effective upon federal
approval, for children eligible under section 256B.055, subdivision 12, or for home and
community-based waiver services whose eligibility for medical assistance is determined
without regard to parental income, child support payments, including any payments made
by an obligor in satisfaction of or in addition to a temporary or permanent order for child
support, and Social Security payments are not counted as income.

(b)(1) The modified adjusted gross income methodology as defined in deleted text beginthe Affordable
Care Act
deleted text endnew text begin United States Code, title 42, section 1396a(e)(14),new text end shall be used for eligibility
categories based on:

(i) children under age 19 and their parents and relative caretakers as defined in section
256B.055, subdivision 3a;

(ii) children ages 19 to 20 as defined in section 256B.055, subdivision 16;

(iii) pregnant women as defined in section 256B.055, subdivision 6;

(iv) infants as defined in sections 256B.055, subdivision 10, and 256B.057, subdivision
deleted text begin 8deleted text endnew text begin 1new text end; and

(v) adults without children as defined in section 256B.055, subdivision 15.

For these purposes, a "methodology" does not include an asset or income standard, or
accounting method, or method of determining effective dates.

(2) For individuals whose income eligibility is determined using the modified adjusted
gross income methodology in clause (1)deleted text begin,deleted text endnew text begin:
new text end

new text begin (i) new text endthe commissioner shall subtract from the individual's modified adjusted gross income
an amount equivalent to five percent of the federal poverty guidelinesdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (ii) the individual's current monthly income and household size is used to determine
eligibility for the 12-month eligibility period. If an individual's income is expected to vary
month to month, eligibility is determined based on the income predicted for the 12-month
eligibility period.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 17.

Minnesota Statutes 2018, section 256B.056, subdivision 4, is amended to read:


Subd. 4.

Income.

(a) To be eligible for medical assistance, a person eligible under section
256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of the federal
poverty guidelines. Effective January 1, 2000, and each successive January, recipients of
Supplemental Security Income may have an income up to the Supplemental Security Income
standard in effect on that date.

(b) deleted text beginEffective January 1, 2014,deleted text end To be eligible for medical assistancedeleted text begin,deleted text end under section
256B.055, subdivision 3a, a parent or caretaker relative may have an income up to 133
percent of the federal poverty guidelines for the household size.

(c) To be eligible for medical assistance under section 256B.055, subdivision 15, a
person may have an income up to 133 percent of federal poverty guidelines for the household
size.

(d) To be eligible for medical assistance under section 256B.055, subdivision 16, a child
age 19 to 20 may have an income up to 133 percent of the federal poverty guidelines for
the household size.

(e) To be eligible for medical assistance under section 256B.055, subdivision 3a, a child
under age 19 may have income up to 275 percent of the federal poverty guidelines for the
household size deleted text beginor an equivalent standard when converted using modified adjusted gross
income methodology as required under the Affordable Care Act. Children who are enrolled
in medical assistance as of December 31, 2013, and are determined ineligible for medical
assistance because of the elimination of income disregards under modified adjusted gross
income methodology as defined in subdivision 1a remain eligible for medical assistance
under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law
111-3, until the date of their next regularly scheduled eligibility redetermination as required
in subdivision 7a
deleted text end.

(f) In computing income to determine eligibility of persons under paragraphs (a) to (e)
who are not residents of long-term care facilities, the commissioner shall disregard increases
in income as required by Public Laws 94-566, section 503; 99-272; and 99-509. For persons
eligible under paragraph (a), veteran aid and attendance benefits and Veterans Administration
unusual medical expense payments are considered income to the recipient.

new text begin EFFECTIVE DATE. new text end

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

Sec. 18.

Minnesota Statutes 2018, section 256B.056, subdivision 7, is amended to read:


Subd. 7.

Period of eligibility.

new text begin(a) new text endEligibility is available for the month of application
and for three months prior to application if the person was eligible in those prior months.
A redetermination of eligibility must occur every 12 months.

new text begin (b) For a person eligible for an insurance affordability program as defined in section
256B.02, subdivision 19, who reports a change that makes the person eligible for medical
assistance, eligibility is available for the month the change was reported and for three months
prior to the month the change was reported, if the person was eligible in those prior months.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 19.

Minnesota Statutes 2019 Supplement, section 256B.056, subdivision 7a, is
amended to read:


Subd. 7a.

Periodic renewal of eligibility.

(a) The commissioner shall make an annual
redetermination of eligibility based on information contained in the enrollee's case file and
other information available to the agency, including but not limited to information accessed
through an electronic database, without requiring the enrollee to submit any information
when sufficient data is available for the agency to renew eligibility.

(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), the
commissioner must provide the enrollee with a prepopulated renewal form containing
eligibility information available to the agency and permit the enrollee to submit the form
with any corrections or additional information to the agency and sign the renewal form via
any of the modes of submission specified in section 256B.04, subdivision 18.

(c) An enrollee who is terminated for failure to complete the renewal process may
subsequently submit the renewal form and required information within four months after
the date of termination and have coverage reinstated without a lapse, if otherwise eligible
under this chapter. The local agency may close the enrollee's case file if the required
information is not submitted within four months of termination.

(d) Notwithstanding paragraph (a), deleted text beginindividualsdeleted text endnew text begin a person who isnew text end eligible under subdivision
5 shall be deleted text beginrequired to renew eligibilitydeleted text endnew text begin subject to a review of the person's incomenew text end every six
months.

new text begin EFFECTIVE DATE. new text end

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

Sec. 20.

Minnesota Statutes 2018, section 256B.056, subdivision 10, is amended to read:


Subd. 10.

Eligibility verification.

(a) The commissioner shall require women who are
applying for the continuation of medical assistance coverage following the end of the 60-day
postpartum period to update their income and asset information and to submit any required
income or asset verification.

(b) The commissioner shall determine the eligibility of private-sector health care coverage
for infants less than one year of age eligible under section 256B.055, subdivision 10, or
256B.057, subdivision 1, paragraph deleted text begin(b)deleted text endnew text begin (c)new text end, and shall pay for private-sector coverage if this
is determined to be cost-effective.

(c) The commissioner shall verify assets and income for all applicants, and for all
recipients upon renewal.

(d) The commissioner shall utilize information obtained through the electronic service
established by the secretary of the United States Department of Health and Human Services
and other available electronic data sources in Code of Federal Regulations, title 42, sections
435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish
standards to define when information obtained electronically is reasonably compatible with
information provided by applicants and enrollees, including use of self-attestation, to
accomplish real-time eligibility determinations and maintain program integrity.

new text begin (e) Each person applying for or receiving medical assistance under section 256B.055,
subdivision 7, and any other person whose resources are required by law to be disclosed to
determine the applicant's or recipient's eligibility must authorize the commissioner to obtain
information from financial institutions to identify unreported accounts as required in section
256.01, subdivision 18f. If a person refuses or revokes the authorization, the commissioner
may determine that the applicant or recipient is ineligible for medical assistance. For purposes
of this paragraph, an authorization to identify unreported accounts meets the requirements
of the Right to Financial Privacy Act, United States Code, title 12, chapter 35, and need not
be furnished to the financial institution.
new text end

new text begin (f) County and tribal agencies shall comply with the standards established by the
commissioner for appropriate use of the asset verification system specified in section 256.01,
subdivision 18f.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 21.

Minnesota Statutes 2018, section 256B.0561, subdivision 2, is amended to read:


Subd. 2.

Periodic data matching.

(a) deleted text beginBeginning April 1, 2018,deleted text end The commissioner shall
conduct periodic data matching to identify recipients who, based on available electronic
data, may not meet eligibility criteria for the public health care program in which the recipient
is enrolled. The commissioner shall conduct data matching for medical assistance or
MinnesotaCare recipients at least once during a recipient's 12-month period of eligibility.

(b) If data matching indicates a recipient may no longer qualify for medical assistance
or MinnesotaCare, the commissioner must notify the recipient and allow the recipient no
more than 30 days to confirm the information obtained through the periodic data matching
or provide a reasonable explanation for the discrepancy to the state or county agency directly
responsible for the recipient's case. If a recipient does not respond within the advance notice
period or does not respond with information that demonstrates eligibility or provides a
reasonable explanation for the discrepancy within the 30-day time period, the commissioner
shall terminate the recipient's eligibility in the manner provided for by the laws and
regulations governing the health care program for which the recipient has been identified
as being ineligible.

(c) The commissioner shall not terminate eligibility for a recipient who is cooperating
with the requirements of paragraph (b) and needs additional time to provide information in
response to the notification.

new text begin (d) A recipient whose eligibility was terminated according to paragraph (b) may be
eligible for medical assistance no earlier than the first day of the month in which the recipient
provides information that demonstrates the recipient's eligibility.
new text end

deleted text begin (d)deleted text endnew text begin (e)new text end Any termination of eligibility for benefits under this section may be appealed as
provided for in sections 256.045 to 256.0451, and the laws governing the health care
programs for which eligibility is terminated.

new text begin EFFECTIVE DATE. new text end

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

Sec. 22.

Minnesota Statutes 2018, section 256B.057, subdivision 1, is amended to read:


Subdivision 1.

Infants and pregnant women.

(a) An infant less than two years of age
deleted text begin or a pregnant womandeleted text end is eligible for medical assistance if the deleted text beginindividual'sdeleted text endnew text begin infant'snew text end countable
household income is equal to or less than deleted text begin275deleted text endnew text begin 283new text end percent of the federal poverty guideline
for the same household size deleted text beginor an equivalent standard when converted using modified
adjusted gross income methodology as required under the Affordable Care Act
deleted text end.new text begin Medical
assistance for an uninsured infant younger than two years of age may be paid with federal
funds available under title XXI of the Social Security Act and the state children's health
insurance program, for an infant with countable income above 275 percent and equal to or
less than 283 percent of the federal poverty guideline for the household size.
new text end

new text begin (b) A pregnant woman is eligible for medical assistance if the woman's countable income
is equal to or less than 278 percent of the federal poverty guideline for the applicable
household size.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end An infant born to a woman who was eligible for and receiving medical assistance
on the date of the child's birth shall continue to be eligible for medical assistance without
redetermination until the child's first birthday.

new text begin EFFECTIVE DATE. new text end

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

Sec. 23.

Minnesota Statutes 2018, section 256B.057, subdivision 10, is amended to read:


Subd. 10.

Certain persons needing treatment for breast or cervical cancer.

(a)
Medical assistance may be paid for a person who:

(1) has been screened for breast or cervical cancer by deleted text beginthe Minnesotadeleted text endnew text begin any Centers for
Disease Control and Prevention (CDC) National Breast and Cervical Cancer Early Detection
Program (NBCCEDP)-funded
new text end breast and cervical cancer control program, and program
funds have been used to pay for the person's screening;

(2) according to the person's treating health professional, needs treatment, including
diagnostic services necessary to determine the extent and proper course of treatment, for
breast or cervical cancer, including precancerous conditions and early stage cancer;

(3) meets the income eligibility guidelines for deleted text beginthe Minnesotadeleted text endnew text begin any CDC NBCCEDP-fundednew text end
breast and cervical cancer control program;

(4) is under age 65;

(5) is not otherwise eligible for medical assistance under United States Code, title 42,
section 1396a(a)(10)(A)(i); and

(6) is not otherwise covered under creditable coverage, as defined under United States
Code, title 42, section 1396a(aa).

(b) Medical assistance provided for an eligible person under this subdivision shall be
limited to services provided during the period that the person receives treatment for breast
or cervical cancer.

(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance
without meeting the eligibility criteria relating to income and assets in section 256B.056,
subdivisions 1a to 5a.

Sec. 24.

Minnesota Statutes 2018, section 256B.0575, subdivision 1, is amended to read:


Subdivision 1.

Income deductions.

When an institutionalized person is determined
eligible for medical assistance, the income that exceeds the deductions in paragraphs (a)
and (b) must be applied to the cost of institutional care.

(a) The following amounts must be deducted from the institutionalized person's income
in the following order:

(1) the personal needs allowance under section 256B.35 or, for a veteran who does not
have a spouse or child, or a surviving spouse of a veteran having no child, the amount of
an improved pension received from the veteran's administration deleted text beginnot exceeding $90 per
month
deleted text endnew text begin, whichever amount is greaternew text end;

(2) the personal allowance for disabled individuals under section 256B.36;

(3) if the institutionalized person has a legally appointed guardian or conservator, five
percent of the recipient's gross monthly income up to $100 as reimbursement for guardianship
or conservatorship services;

(4) a monthly income allowance determined under section 256B.058, subdivision 2, but
only to the extent income of the institutionalized spouse is made available to the community
spouse;

(5) a monthly allowance for children under age 18 which, together with the net income
of the children, would provide income equal to the medical assistance standard for families
and children according to section 256B.056, subdivision 4, for a family size that includes
only the minor children. This deduction applies only if the children do not live with the
community spouse and only to the extent that the deduction is not included in the personal
needs allowance under section 256B.35, subdivision 1, as child support garnished under a
court order;

(6) a monthly family allowance for other family members, equal to one-third of the
difference between 122 percent of the federal poverty guidelines and the monthly income
for that family member;

(7) reparations payments made by the Federal Republic of Germany and reparations
payments made by the Netherlands for victims of Nazi persecution between 1940 and 1945;

(8) all other exclusions from income for institutionalized persons as mandated by federal
law; and

(9) amounts for reasonable expenses, as specified in subdivision 2, incurred for necessary
medical or remedial care for the institutionalized person that are recognized under state law,
not medical assistance covered expenses, and not subject to payment by a third party.

For purposes of clause (6), "other family member" means a person who resides with the
community spouse and who is a minor or dependent child, dependent parent, or dependent
sibling of either spouse. "Dependent" means a person who could be claimed as a dependent
for federal income tax purposes under the Internal Revenue Code.

(b) Income shall be allocated to an institutionalized person for a period of up to three
calendar months, in an amount equal to the medical assistance standard for a family size of
one if:

(1) a physician or advanced practice registered nurse certifies that the person is expected
to reside in the long-term care facility for three calendar months or less;

(2) if the person has expenses of maintaining a residence in the community; and

(3) if one of the following circumstances apply:

(i) the person was not living together with a spouse or a family member as defined in
paragraph (a) when the person entered a long-term care facility; or

(ii) the person and the person's spouse become institutionalized on the same date, in
which case the allocation shall be applied to the income of one of the spouses.

For purposes of this paragraph, a person is determined to be residing in a licensed nursing
home, regional treatment center, or medical institution if the person is expected to remain
for a period of one full calendar month or more.

Sec. 25.

Minnesota Statutes 2018, section 256B.0575, subdivision 2, is amended to read:


Subd. 2.

Reasonable expenses.

For the purposes of subdivision 1, paragraph (a), clause
(9), reasonable expenses are limited to expenses that have not been previously used as a
deduction from income and were not:

(1) for long-term care expenses incurred during a period of ineligibility as defined in
section 256B.0595, subdivision 2;

(2) incurred more than three months before the month of application associated with the
current period of eligibility;

(3) for expenses incurred by a recipient that are duplicative of services that are covered
under chapter 256B; deleted text beginor
deleted text end

(4) nursing facility expenses incurred without a timely assessment as required under
section 256B.0911deleted text begin.deleted text endnew text begin; or
new text end

new text begin (5) for private room fees incurred by an assisted living client as defined in section
144G.01, subdivision 3.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 26.

Minnesota Statutes 2018, section 256B.0625, subdivision 1, is amended to read:


Subdivision 1.

Inpatient hospital services.

(a) Medical assistance covers inpatient
hospital servicesnew text begin performed by hospitals holding Medicare certifications for the services
performed
new text end. deleted text beginA second medical opinion is required prior to reimbursement for elective surgeries
requiring a second opinion. The commissioner shall publish in the State Register a list of
elective surgeries that require a second medical opinion prior to reimbursement, and the
criteria and standards for deciding whether an elective surgery should require a second
medical opinion. The list and the criteria and standards are not subject to the requirements
of sections 14.001 to 14.69. The commissioner's decision whether a second medical opinion
is required, made in accordance with rules governing that decision, is not subject to
administrative appeal.
deleted text end

(b) When determining medical necessity for inpatient hospital services, the medical
review agent shall follow industry standard medical necessity criteria in determining the
following:

(1) whether a recipient's admission is medically necessary;

(2) whether the inpatient hospital services provided to the recipient were medically
necessary;

(3) whether the recipient's continued stay was or will be medically necessary; and

(4) whether all medically necessary inpatient hospital services were provided to the
recipient.

The medical review agent will determine medical necessity of inpatient hospital services,
including inpatient psychiatric treatment, based on a review of the patient's medical condition
and records, in conjunction with industry standard evidence-based criteria to ensure consistent
and optimal application of medical appropriateness criteria.

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

Minnesota Statutes 2018, section 256B.0625, subdivision 27, is amended to read:


Subd. 27.

Organ and tissue transplants.

deleted text beginAll organ transplants must be performed at
transplant centers meeting united network for organ sharing criteria or at Medicare-approved
organ transplant centers.
deleted text end new text beginOrgan and tissue transplants are a covered service. new text endStem cell or
bone marrow transplant centers must meet the standards established by the Foundation for
the Accreditation of Hematopoietic Cell Therapy.

new text begin EFFECTIVE DATE. new text end

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

Sec. 28.

Minnesota Statutes 2018, section 256B.0625, subdivision 64, is amended to read:


Subd. 64.

Investigational drugs, biological products, deleted text beginanddeleted text end devicesnew text begin, and clinical
trials
new text end.

deleted text begin(a)deleted text end Medical assistance and the early periodic screening, diagnosis, and treatment
(EPSDT) program do not cover new text beginthe new text endcosts new text beginof any services that are new text endincidental to, associated
with, or resulting from the use of investigational drugs, biological products, or devices as
defined in section 151.375new text begin or any other treatment that is part of an approved clinical trial
as defined in section 62Q.526. Participation of an enrollee in an approved clinical trial does
not preclude coverage of medically necessary services covered under this chapter that are
not related to the approved clinical trial
new text end.

deleted text begin (b) Notwithstanding paragraph (a), stiripentol may be covered by the EPSDT program
if all the following conditions are met:
deleted text end

deleted text begin (1) the use of stiripentol is determined to be medically necessary;
deleted text end

deleted text begin (2) the enrollee has a documented diagnosis of Dravet syndrome, regardless of whether
an SCN1A genetic mutation is found, or the enrollee is a child with malignant migrating
partial epilepsy in infancy due to an SCN2A genetic mutation;
deleted text end

deleted text begin (3) all other available covered prescription medications that are medically necessary for
the enrollee have been tried without successful outcomes; and
deleted text end

deleted text begin (4) the United States Food and Drug Administration has approved the treating physician's
individual patient investigational new drug application (IND) for the use of stiripentol for
treatment.
deleted text end

deleted text begin This paragraph does not apply to MinnesotaCare coverage under chapter 256L.
deleted text end

Sec. 29.

Minnesota Statutes 2018, section 256B.0751, is amended to read:


256B.0751 HEALTH CARE HOMES.

Subdivision 1.

Definitions.

(a) For purposes of deleted text beginsectionsdeleted text endnew text begin sectionnew text end 256B.0751 deleted text beginto 256B.0753deleted text end,
the following definitions apply.

(b) "Commissioner" means the commissioner of deleted text beginhuman servicesdeleted text endnew text begin healthnew text end.

deleted text begin (c) "Commissioners" means the commissioner of human services and the commissioner
of health, acting jointly.
deleted text end

deleted text begin (d)deleted text endnew text begin (c)new text end "Health plan company" has the meaning provided in section 62Q.01, subdivision
4
.

deleted text begin (e)deleted text endnew text begin (d)new text end "Personal clinician" means a physician licensed under chapter 147, a physician
assistant licensed and practicing under chapter 147A, or an advanced practice nurse licensed
and registered to practice under chapter 148.

deleted text begin (f) "State health care program" means the medical assistance and MinnesotaCare
programs.
deleted text end

Subd. 2.

Development and implementation of standards.

(a) deleted text beginBy July 1, 2009,deleted text end The
deleted text begin commissionersdeleted text endnew text begin commissionernew text end of health deleted text beginand human servicesdeleted text end shall develop and implement
standards of certification for health care homes deleted text beginfor state health care programsdeleted text end. In developing
these standards, the deleted text begincommissionersdeleted text endnew text begin commissionernew text end shall consider existing standards developed
by national independent accrediting and medical home organizations. The standards
developed by the deleted text begincommissionersdeleted text endnew text begin commissionernew text end must meet the following criteria:

(1) emphasize, enhance, and encourage the use of primary care, and include the use of
primary care physicians, advanced practice nurses, and physician assistants as personal
clinicians;

(2) focus on delivering high-quality, efficient, and effective health care services;

(3) encourage patient-centered care, including active participation by the patient and
family or a legal guardian, or a health care agent as defined in chapter 145C, as appropriate
in decision making and care plan development, and providing care that is appropriate to the
patient's race, ethnicity, and language;

(4) provide patients with a consistent, ongoing contact with a personal clinician or team
of clinical professionals to ensure continuous and appropriate care for the patient's condition;

(5) ensure that health care homes develop and maintain appropriate comprehensive care
plans for their patients with complex or chronic conditions, including an assessment of
health risks and chronic conditions;

(6) enable and encourage utilization of a range of qualified health care professionals,
including dedicated care coordinators, in a manner that enables providers to practice to the
fullest extent of their license;

(7) focus initially on patients who have or are at risk of developing chronic health
conditions;

(8) incorporate measures of quality, resource use, cost of care, and patient experience;

(9) ensure the use of health information technology and systematic follow-up, including
the use of patient registries; and

(10) encourage the use of scientifically based health care, patient decision-making aids
that provide patients with information about treatment options and their associated benefits,
risks, costs, and comparative outcomes, and other clinical decision support tools.

(b) In developing these standards, the deleted text begincommissionersdeleted text endnew text begin commissionernew text end shall consult with
national and local organizations working on health care home models, physicians, relevant
state agencies, health plan companies, hospitals, other providers, patients, and patient
advocates. deleted text beginThe commissioners may satisfy this requirement by continuing the provider
directed care coordination advisory committee.
deleted text end

(c) For the purposes of developing and implementing these standards, the deleted text begincommissionersdeleted text endnew text begin
commissioner
new text end may use the expedited rulemaking process under section 14.389.

Subd. 3.

Requirements for clinicians certified as health care homes.

(a) A personal
clinician or a primary care clinic may be certified as a health care home. If a primary care
clinic is certified, all of the primary care clinic's clinicians must meet the criteria of a health
care home. deleted text beginIn orderdeleted text end To be certified as a health care home, a clinician or clinic must meet
the standards set by the deleted text begincommissionersdeleted text endnew text begin commissionernew text end in accordance with this section.
Certification as a health care home is voluntary. deleted text beginIn orderdeleted text end To maintain their status as health
care homes, clinicians or clinics must renew their certification every three years.

(b) Clinicians or clinics certified as health care homes must offer their health care home
services to all their patients with complex or chronic health conditions who are interested
in participation.

(c) Health care homes must participate in the health care home collaborative established
under subdivision 5.

Subd. 4.

Alternative models and waivers of requirements.

(a) Nothing in this section
deleted text begin shall precludedeleted text endnew text begin precludesnew text end the continued development of existing medical or health care home
projects currently operating or under development by the commissioner of human services
or deleted text beginprecludedeleted text endnew text begin precludesnew text end the commissioner new text beginof human services new text endfrom establishing alternative
models and payment mechanisms for persons who are enrolled in integrated Medicare and
Medicaid programs under section 256B.69, subdivisions 23 and 28, are enrolled in managed
care long-term care programs under section 256B.69, subdivision 6b, are dually eligible for
Medicare and medical assistance, are in the waiting period for Medicare, or who have other
primary coverage.

(b) The commissioner deleted text beginof healthdeleted text end shall waive health care home certification requirements
if an applicant demonstrates that compliance with a certification requirement will create a
major financial hardship or is not feasible, and the applicant establishes an alternative way
to accomplish the objectives of the certification requirement.

Subd. 5.

Health care home collaborative.

deleted text beginBy July 1, 2009,deleted text end The deleted text begincommissionersdeleted text endnew text begin
commissioner
new text end shall establish a health care home collaborative to provide an opportunity for
health care homes and state agencies to exchange information related to quality improvement
and best practices.

Subd. 6.

Evaluation and continued development.

(a) For continued certification under
this section, health care homes must meet process, outcome, and quality standards as
developed and specified by the deleted text begincommissionersdeleted text endnew text begin commissionernew text end. The deleted text begincommissionersdeleted text endnew text begin
commissioner
new text end shall collect data from health care homes necessary for monitoring compliance
with certification standards and for evaluating the impact of health care homes on health
care quality, cost, and outcomes.

(b) The deleted text begincommissionersdeleted text endnew text begin commissionernew text end may contract with a private entity to perform an
evaluation of the effectiveness of health care homes. Data collected under this subdivision
is classified as nonpublic data under chapter 13.

Subd. 7.

Outreach.

deleted text beginBeginning July 1, 2009,deleted text end The commissioner new text beginof human services new text endshall
encourage state health care program enrollees who have a complex or chronic condition to
select a primary care clinic with clinicians who have been certified as health care homes.

Subd. 8.

Coordination with local services.

The health care home and the county shall
coordinate care and services provided to patients enrolled with a health care home who have
complex medical needs or a disability, and who need and are eligible for additional local
services administered by counties, including but not limited to waivered services, mental
health services, social services, public health services, transportation, and housing. The
coordination of care and services must be as provided in the plan established by the patient
and new text beginthe new text endhealth care home.

Subd. 9.

Pediatric care coordination.

The commissioner new text beginof human services new text endshall
implement a pediatric care coordination service for children with high-cost medical or
high-cost psychiatric conditions who are at risk of recurrent hospitalization or emergency
room use for acute, chronic, or psychiatric illness, who receive medical assistance services.
Care coordination services must be targeted to children not already receiving care
coordination through another service and may include but are not limited to the provision
of health care home services to children admitted to hospitals that do not currently provide
care coordination. Care coordination services must be provided by care coordinators who
are directly linked to provider teams in the care delivery setting, but who may be part of a
community care team shared by multiple primary care providers or practices. For purposes
of this subdivision, the commissioner new text beginof human services new text endshall, to the extent possible, use
the existing health care home certification and payment structure established under this
section and section 256B.0753.

Subd. 10.

Health care homes advisory committee.

(a) The deleted text begincommissioners of health
and human services
deleted text endnew text begin commissionernew text end shall establish a health care homes advisory committee
to advise the deleted text begincommissionersdeleted text endnew text begin commissionernew text end on the ongoing statewide implementation of the
health care homes program authorized in this section.

(b) The deleted text begincommissionersdeleted text endnew text begin commissionernew text end shall establish an advisory committee that includes
representatives of the health care professions such as primary care providersdeleted text begin;deleted text endnew text begin,new text end mental health
providersdeleted text begin;deleted text endnew text begin,new text end nursing and care coordinatorsdeleted text begin;deleted text endnew text begin,new text end certified health care home clinics with statewide
representationdeleted text begin;deleted text endnew text begin,new text end health plan companiesdeleted text begin;deleted text endnew text begin,new text end state agenciesdeleted text begin;deleted text endnew text begin,new text end employersdeleted text begin;deleted text endnew text begin,new text end academic researchersdeleted text begin;deleted text endnew text begin,new text end
consumersdeleted text begin;deleted text endnew text begin,new text end and organizations that work to improve health care quality in Minnesota. At
least 25 percent of the committee members must be consumers or patients in health care
homes. The deleted text begincommissionersdeleted text endnew text begin commissionernew text end, in making appointments to the committee, shall
ensure geographic representation of all regions of the state.

(c) The advisory committee shall advise the deleted text begincommissionersdeleted text endnew text begin commissionernew text end on ongoing
implementation of the health care homes program, including, but not limited to, the following
activities:

(1) implementation of certified health care homes across the state on performance
management and implementation of benchmarking;

(2) implementation of modifications to the health care homes program based on results
of the legislatively mandated health care homes evaluation;

(3) statewide solutions for engagement of employers and commercial payers;

(4) potential modifications of the health care homes rules or statutes;

(5) consumer engagement, including patient and family-centered care, patient activation
in health care, and shared decision making;

(6) oversight for health care homes subject matter task forces or workgroups; and

(7) other related issues as requested by the deleted text begincommissionersdeleted text endnew text begin commissionernew text end.

(d) The advisory committee shall have the ability to establish subcommittees on specific
topics. The advisory committee is governed by section 15.059. Notwithstanding section
15.059, the advisory committee does not expire.

new text begin EFFECTIVE DATE. new text end

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

Sec. 30.

Minnesota Statutes 2018, section 256B.0753, subdivision 1, is amended to read:


Subdivision 1.

Development.

The commissioner of human services, in coordination
with the commissioner of health, shall develop a payment system that provides per-person
care coordination payments to health care homes certified under section 256B.0751 for
providing care coordination services and directly managing on-site or employing care
coordinators. The care coordination payments under this section are in addition to the quality
incentive payments in section 256B.0754, subdivision 1. The care coordination payment
system must vary the fees paid by thresholds of care complexity, with the highest fees being
paid for care provided to individuals requiring the most intensive care coordination. In
developing the criteria for care coordination payments, the commissioner shall consider the
feasibility of including the additional time and resources needed by patients with limited
English-language skills, cultural differences, or other barriers to health care. The
commissioner may determine a schedule for phasing in care coordination fees such that the
fees will be applied first to individuals who have, or are at risk of developing, complex or
chronic health conditions. deleted text beginDevelopment of the payment system must be completed by
January 1, 2010.
deleted text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 31.

Minnesota Statutes 2018, section 256B.69, is amended by adding a subdivision
to read:


new text begin Subd. 6e. new text end

new text begin Dental services. new text end

new text begin (a) If a dental provider is providing services to an enrollee
of a managed care plan or county-based purchasing plan based on a treatment plan that
requires more than one visit, the managed care plan or county-based purchasing plan or the
plan's subcontractor, if the plan subcontracts with a third party to administer dental services
to the plan's enrollees, must not require the completion of the treatment plan as a condition
of payment to the dental provider for services performed as part of the treatment plan. The
health plan or subcontractor must reimburse the dental provider for all services performed
by the provider regardless of whether the treatment plan is completed, as long as the enrollee
was covered under the plan at the time the service was performed.
new text end

new text begin (b) Nothing in paragraph (a) prevents a health plan or its subcontractor from paying for
services using a bundled payment method. If a bundled payment method is used and the
treatment plan covered by the payment is not completed for any reason, the health plan or
its subcontractor must reimburse the dental provider for the services performed, as long as
the enrollee was covered under the plan at the time the service was performed.
new text end

Sec. 32.

Minnesota Statutes 2018, section 256B.75, is amended to read:


256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.

(a) For outpatient hospital facility fee payments for services rendered on or after October
1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge,
or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for
which there is a federal maximum allowable payment. Effective for services rendered on
or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and
emergency room facility fees shall be increased by eight percent over the rates in effect on
December 31, 1999, except for those services for which there is a federal maximum allowable
payment. Services for which there is a federal maximum allowable payment shall be paid
at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total
aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare
upper limit. If it is determined that a provision of this section conflicts with existing or
future requirements of the United States government with respect to federal financial
participation in medical assistance, the federal requirements prevail. The commissioner
may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial
participation resulting from rates that are in excess of the Medicare upper limitations.

(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory
surgery hospital facility fee services for critical access hospitals designated under section
144.1483, clause (9), shall be paid on a cost-based payment system that is based on the
cost-finding methods and allowable costs of the Medicare program. Effective for services
provided on or after July 1, 2015, rates established for critical access hospitals under this
paragraph for the applicable payment year shall be the final payment and shall not be settled
to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal
year ending in deleted text begin2016deleted text endnew text begin 2017new text end, the rate for outpatient hospital services shall be computed using
information from each hospital's Medicare cost report as filed with Medicare for the year
that is two years before the year that the rate is being computed. Rates shall be computed
using information from Worksheet C series until the department finalizes the medical
assistance cost reporting process for critical access hospitals. After the cost reporting process
is finalized, rates shall be computed using information from Title XIX Worksheet D series.
The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs
related to rural health clinics and federally qualified health clinics, divided by ancillary
charges plus outpatient charges, excluding charges related to rural health clinics and federally
qualified health clinics.

(c) Effective for services provided on or after July 1, 2003, rates that are based on the
Medicare outpatient prospective payment system shall be replaced by a budget neutral
prospective payment system that is derived using medical assistance data. The commissioner
shall provide a proposal to the 2003 legislature to define and implement this provision.

(d) For fee-for-service services provided on or after July 1, 2002, the total payment,
before third-party liability and spenddown, made to hospitals for outpatient hospital facility
services is reduced by .5 percent from the current statutory rate.

(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility
services before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from
this paragraph.

(f) In addition to the reductions in paragraphs (d) and (e), the total payment for
fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
hospital facility services before third-party liability and spenddown, is reduced three percent
from the current statutory rates. Mental health services and facilities defined under section
256.969, subdivision 16, are excluded from this paragraph.

new text begin EFFECTIVE DATE. new text end

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

Sec. 33.

Minnesota Statutes 2018, section 256L.03, subdivision 1, is amended to read:


Subdivision 1.

Covered health services.

(a) "Covered health services" means the health
services reimbursed under chapter 256B, with the exception of special education services,
home care nursing services, adult dental care services other than services covered under
section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation
services, personal care assistance and case management services, new text beginbehavioral health home
services under section 256B.0757,
new text endand nursing home or intermediate care facilities services.

(b) No public funds shall be used for coverage of abortion under MinnesotaCare except
where the life of the female would be endangered or substantial and irreversible impairment
of a major bodily function would result if the fetus were carried to term; or where the
pregnancy is the result of rape or incest.

(c) Covered health services shall be expanded as provided in this section.

(d) For the purposes of covered health services under this section, "child" means an
individual younger than 19 years of age.

new text begin EFFECTIVE DATE. new text end

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

Sec. 34.

Minnesota Statutes 2018, section 256L.15, subdivision 1, is amended to read:


Subdivision 1.

Premium determination for MinnesotaCare.

(a) Families with children
and individuals shall pay a premium determined according to subdivision 2.

(b) Members of the military and their families who meet the eligibility criteria for
MinnesotaCare upon eligibility approval made within 24 months following the end of the
member's tour of active duty shall have their premiums paid by the commissioner. The
effective date of coverage for an individual or family who meets the criteria of this paragraph
shall be the first day of the month following the month in which eligibility is approved. This
exemption applies for 12 months.

(c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and their
families shall have their premiums waived by the commissioner in accordance with section
5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. An
individual must indicate status as an American Indian, as defined under Code of Federal
Regulations, title 42, section 447.50, to qualify for the waiver of premiums. The
commissioner shall accept attestation of an individual's status as an American Indian as
verification until the United States Department of Health and Human Services approves an
electronic data source for this purpose.

deleted text begin (d) For premiums effective August 1, 2015, and after, the commissioner, after consulting
with the chairs and ranking minority members of the legislative committees with jurisdiction
over human services, shall increase premiums under subdivision 2 for recipients based on
June 2015 program enrollment. Premium increases shall be sufficient to increase projected
revenue to the fund described in section 16A.724 by at least $27,800,000 for the biennium
ending June 30, 2017. The commissioner shall publish the revised premium scale on the
Department of Human Services website and in the State Register no later than June 15,
2015. The revised premium scale applies to all premiums on or after August 1, 2015, in
place of the scale under subdivision 2.
deleted text end

deleted text begin (e) By July 1, 2015, the commissioner shall provide the chairs and ranking minority
members of the legislative committees with jurisdiction over human services the revised
premium scale effective August 1, 2015, and statutory language to codify the revised
premium schedule.
deleted text end

deleted text begin (f) Premium changes authorized under paragraph (d) must only apply to enrollees not
otherwise excluded from paying premiums under state or federal law. Premium changes
authorized under paragraph (d) must satisfy the requirements for premiums for the Basic
Health Program under title 42 of Code of Federal Regulations, section 600.505.
deleted text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 35.

Laws 2019, chapter 63, article 3, section 1, is amended to read:


Section 1. APPROPRIATIONS.

(a) Board of Pharmacy; administration. $244,000 in fiscal year 2020 is appropriated
from the general fund to the Board of Pharmacy for onetime information technology and
operating costs for administration of licensing activities under Minnesota Statutes, section
151.066. This is a onetime appropriation.

(b) Commissioner of human services; administration. $309,000 in fiscal year 2020
is appropriated from the general fund and $60,000 in fiscal year 2021 is appropriated from
the opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end to the commissioner of human services for the
provision of administrative services to the Opiate Epidemic Response Advisory Council
and for the administration of the grants awarded under paragraphs (f), (g), and (h). The
opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end base for this appropriation is $60,000 in fiscal year
2022, $60,000 in fiscal year 2023, $60,000 in fiscal year 2024, and $0 in fiscal year 2025.

(c) Board of Pharmacy; administration. $126,000 in fiscal year 2020 is appropriated
from the general fund to the Board of Pharmacy for the collection of the registration fees
under section 151.066.

(d) Commissioner of public safety; enforcement activities. $672,000 in fiscal year
2020 is appropriated from the general fund to the commissioner of public safety for the
Bureau of Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab
supplies and $288,000 is for special agent positions focused on drug interdiction and drug
trafficking.

(e) Commissioner of management and budget; evaluation activities. $300,000 in
fiscal year 2020 is appropriated from the general fund and $300,000 in fiscal year 2021 is
appropriated from the opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end to the commissioner of
management and budget for evaluation activities under Minnesota Statutes, section 256.042,
subdivision 1
, paragraph (c). The opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end base for this
appropriation is $300,000 in fiscal year 2022, $300,000 in fiscal year 2023, $300,000 in
fiscal year 2024, and $0 in fiscal year 2025.

(f) Commissioner of human services; grants for Project ECHO. $400,000 in fiscal
year 2020 is appropriated from the general fund and $400,000 in fiscal year 2021 is
appropriated from the opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end to the commissioner of human
services for grants of $200,000 to CHI St. Gabriel's Health Family Medical Center for the
opioid-focused Project ECHO program and $200,000 to Hennepin Health Care for the
opioid-focused Project ECHO program. The opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end base
for this appropriation is $400,000 in fiscal year 2022, $400,000 in fiscal year 2023, $400,000
in fiscal year 2024, and $0 in fiscal year 2025.

(g) Commissioner of human services; opioid overdose prevention grant. $100,000
in fiscal year 2020 is appropriated from the general fund and $100,000 in fiscal year 2021
is appropriated from the opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end to the commissioner of
human services for a grant to a nonprofit organization that has provided overdose prevention
programs to the public in at least 60 counties within the state, for at least three years, has
received federal funding before January 1, 2019, and is dedicated to addressing the opioid
epidemic. The grant must be used for opioid overdose prevention, community asset mapping,
education, and overdose antagonist distribution. The opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end
base for this appropriation is $100,000 in fiscal year 2022, $100,000 in fiscal year 2023,
$100,000 in fiscal year 2024, and $0 in fiscal year 2025.

(h) Commissioner of human services; traditional healing. $2,000,000 in fiscal year
2020 is appropriated from the general fund and $2,000,000 in fiscal year 2021 is appropriated
from the opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end to the commissioner of human services to
award grants to tribal nations and five urban Indian communities for traditional healing
practices to American Indians and to increase the capacity of culturally specific providers
in the behavioral health workforce. The opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end base for
this appropriation is $2,000,000 in fiscal year 2022, $2,000,000 in fiscal year 2023,
$2,000,000 in fiscal year 2024, and $0 in fiscal year 2025.

(i) Board of Dentistry; continuing education. $11,000 in fiscal year 2020 is
appropriated from the state government special revenue fund to the Board of Dentistry to
implement the continuing education requirements under Minnesota Statutes, section 214.12,
subdivision 6
.

(j) Board of Medical Practice; continuing education. $17,000 in fiscal year 2020 is
appropriated from the state government special revenue fund to the Board of Medical Practice
to implement the continuing education requirements under Minnesota Statutes, section
214.12, subdivision 6.

(k) Board of Nursing; continuing education. $17,000 in fiscal year 2020 is appropriated
from the state government special revenue fund to the Board of Nursing to implement the
continuing education requirements under Minnesota Statutes, section 214.12, subdivision
6
.

(l) Board of Optometry; continuing education. $5,000 in fiscal year 2020 is
appropriated from the state government special revenue fund to the Board of Optometry to
implement the continuing education requirements under Minnesota Statutes, section 214.12,
subdivision 6
.

(m) Board of Podiatric Medicine; continuing education. $5,000 in fiscal year 2020
is appropriated from the state government special revenue fund to the Board of Podiatric
Medicine to implement the continuing education requirements under Minnesota Statutes,
section 214.12, subdivision 6.

(n) Commissioner of health; nonnarcotic pain management and wellness. $1,250,000
is appropriated in fiscal year 2020 from the general fund to the commissioner of health, to
provide funding for:

(1) statewide mapping and assessment of community-based nonnarcotic pain management
and wellness resources; and

(2) up to five demonstration projects in different geographic areas of the state to provide
community-based nonnarcotic pain management and wellness resources to patients and
consumers.

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

(o) Commissioner of health; administration. $38,000 in fiscal year 2020 is appropriated
from the general fund to the commissioner of health for the administration of the grants
awarded in paragraph (n).

new text begin EFFECTIVE DATE. new text end

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

Sec. 36.

Laws 2019, chapter 63, article 3, section 2, is amended to read:


Sec. 2. TRANSFER.

By June 30, 2021, the commissioner of human services shall transfer $5,439,000 from
the opiate epidemic response deleted text beginaccountdeleted text endnew text begin fundnew text end to the general fund. This is a onetime transfer.

new text begin EFFECTIVE DATE. new text end

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

Sec. 37.

Laws 2020, chapter 73, section 4, subdivision 3, is amended to read:


Subd. 3.

Access to urgent-need insulin.

(a) MNsure shall develop an application form
to be used by an individual who is in urgent need of insulin. The application must ask the
individual to attest to the eligibility requirements described in subdivision 2. The form shall
be accessible through MNsure's website. MNsure shall also make the form available to
pharmacies and health care providers who prescribe or dispense insulin, hospital emergency
departments, urgent care clinics, and community health clinics. By submitting a completed,
signed, and dated application to a pharmacy, the individual attests that the information
contained in the application is correct.

(b) If the individual is in urgent need of insulin, the individual may present a completed,
signed, and dated application form to a pharmacy. The individual must also:

(1) have a valid insulin prescription; and

(2) present the pharmacist with identification indicating Minnesota residency in the form
of a valid Minnesota identification card, driver's licensedeleted text begin,deleted text end or permitnew text begin, or tribal identification
card as defined in section 171.072, paragraph (b)
new text end. If the individual in urgent need of insulin
is under the age of 18, the individual's parent or legal guardian must provide the pharmacist
with proof of residency.

(c) Upon receipt of a completed and signed application, the pharmacist shall dispense
the prescribed insulin in an amount that will provide the individual with a 30-day supply.
The pharmacy must notify the health care practitioner who issued the prescription order no
later than 72 hours after the insulin is dispensed.

(d) The pharmacy may submit to the manufacturer of the dispensed insulin product or
to the manufacturer's vendor a claim for payment that is in accordance with the National
Council for Prescription Drug Program standards for electronic claims processing, unless
the manufacturer agrees to send to the pharmacy a replacement supply of the same insulin
as dispensed in the amount dispensed. If the pharmacy submits an electronic claim to the
manufacturer or the manufacturer's vendor, the manufacturer or vendor shall reimburse the
pharmacy in an amount that covers the pharmacy's acquisition cost.

(e) The pharmacy may collect an insulin co-payment from the individual to cover the
pharmacy's costs of processing and dispensing in an amount not to exceed $35 for the 30-day
supply of insulin dispensed.

(f) The pharmacy shall also provide each eligible individual with the information sheet
described in subdivision 7 and a list of trained navigators provided by the Board of Pharmacy
for the individual to contact if the individual is in need of accessing ongoing insulin coverage
options, including assistance in:

(1) applying for medical assistance or MinnesotaCare;

(2) applying for a qualified health plan offered through MNsure, subject to open and
special enrollment periods;

(3) accessing information on providers who participate in prescription drug discount
programs, including providers who are authorized to participate in the 340B program under
section 340b of the federal Public Health Services Act, United States Code, title 42, section
256b; and

(4) accessing insulin manufacturers' patient assistance programs, co-payment assistance
programs, and other foundation-based programs.

(g) The pharmacist shall retain a copy of the application form submitted by the individual
to the pharmacy for reporting and auditing purposes.

Sec. 38.

Laws 2020, chapter 73, section 4, subdivision 4, is amended to read:


Subd. 4.

Continuing safety net program; general.

(a) Each manufacturer shall make
a patient assistance program available to any individual who meets the requirements of this
subdivision. Each manufacturer's patient assistance programs must meet the requirements
of this section. Each manufacturer shall provide the Board of Pharmacy with information
regarding the manufacturer's patient assistance program, including contact information for
individuals to call for assistance in accessing their patient assistance program.

(b) To be eligible to participate in a manufacturer's patient assistance program, the
individual must:

(1) be a Minnesota resident with a valid Minnesota identification card that indicates
Minnesota residency in the form of a Minnesota identification card deleted text beginordeleted text endnew text begin,new text end driver's license or
permitnew text begin, or tribal identification card as defined in section 171.072, paragraph (b)new text end. If the
individual is under the age of 18, the individual's parent or legal guardian must provide
proof of residency;

(2) have a family income that is equal to or less than 400 percent of the federal poverty
guidelines;

(3) not be enrolled in medical assistance or MinnesotaCare;

(4) not be eligible to receive health care through a federally funded program or receive
prescription drug benefits through the Department of Veterans Affairs; and

(5) not be enrolled in prescription drug coverage through an individual or group health
plan that limits the total amount of cost-sharing that an enrollee is required to pay for a
30-day supply of insulin, including co-payments, deductibles, or coinsurance to $75 or less,
regardless of the type or amount of insulin needed.

(c) Notwithstanding the requirement in paragraph (b), clause (4), an individual who is
enrolled in Medicare Part D is eligible for a manufacturer's patient assistance program if
the individual has spent $1,000 on prescription drugs in the current calendar year and meets
the eligibility requirements in paragraph (b), clauses (1) to (3).

(d) An individual who is interested in participating in a manufacturer's patient assistance
program may apply directly to the manufacturer; apply through the individual's health care
practitioner, if the practitioner participates; or contact a trained navigator for assistance in
finding a long-term insulin supply solution, including assistance in applying to a
manufacturer's patient assistance program.

Sec. 39. new text beginREVISOR INSTRUCTION.
new text end

new text begin (a) The revisor of statutes shall number the existing language in Minnesota Statutes,
section 62U.03, as subdivision 1 and renumber the provisions of Minnesota Statutes listed
in column A to the references listed in column B.
new text end

new text begin Column A
new text end
new text begin Column B
new text end
new text begin 256B.0751, subdivision 1
new text end
new text begin 62U.03, subdivision 2
new text end
new text begin 256B.0751, subdivision 2
new text end
new text begin 62U.03, subdivision 3
new text end
new text begin 256B.0751, subdivision 3
new text end
new text begin 62U.03, subdivision 4
new text end
new text begin 256B.0751, subdivision 4
new text end
new text begin 62U.03, subdivision 5
new text end
new text begin 256B.0751, subdivision 5
new text end
new text begin 62U.03, subdivision 6
new text end
new text begin 256B.0751, subdivision 6
new text end
new text begin 62U.03, subdivision 7
new text end
new text begin 256B.0751, subdivision 7
new text end
new text begin 62U.03, subdivision 8
new text end
new text begin 256B.0751, subdivision 8
new text end
new text begin 62U.03, subdivision 9
new text end
new text begin 256B.0751, subdivision 9
new text end
new text begin 62U.03, subdivision 10
new text end
new text begin 256B.0751, subdivision 10
new text end
new text begin 62U.03, subdivision 11
new text end

new text begin (b) The revisor of statutes shall change the applicable references to Minnesota Statutes,
section 256B.0751, to section 62U.03. The revisor shall make necessary cross-reference
changes in Minnesota Statutes consistent with the renumbering. The revisor shall also make
technical and other necessary changes to sentence structure to preserve the meaning of the
text.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 40. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 62U.15, subdivision 2; 256B.057, subdivision 8;
256B.0752; and 256L.04, subdivision 13,
new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 4

ADVANCED PRACTICE REGISTERED NURSE PROVISIONS

Section 1.

Minnesota Statutes 2018, section 62D.09, subdivision 1, is amended to read:


Subdivision 1.

Marketing requirements.

(a) Any written marketing materials which
may be directed toward potential enrollees and which include a detailed description of
benefits provided by the health maintenance organization shall include a statement of enrollee
information and rights as described in section 62D.07, subdivision 3, clauses (2) and (3).
Prior to any oral marketing presentation, the agent marketing the plan must inform the
potential enrollees that any complaints concerning the material presented should be directed
to the health maintenance organization, the commissioner of health, or, if applicable, the
employer.

(b) Detailed marketing materials must affirmatively disclose all exclusions and limitations
in the organization's services or kinds of services offered to the contracting party, including
but not limited to the following types of exclusions and limitations:

(1) health care services not provided;

(2) health care services requiring co-payments or deductibles paid by enrollees;

(3) the fact that access to health care services does not guarantee access to a particular
provider type; and

(4) health care services that are or may be provided only by referral of a physiciannew text begin or
advanced practice registered nurse
new text end.

(c) No marketing materials may lead consumers to believe that all health care needs will
be covered. All marketing materials must alert consumers to possible uncovered expenses
with the following language in bold print: "THIS HEALTH CARE PLAN MAY NOT
COVER ALL YOUR HEALTH CARE EXPENSES; READ YOUR CONTRACT
CAREFULLY TO DETERMINE WHICH EXPENSES ARE COVERED." Immediately
following the disclosure required under paragraph (b), clause (3), consumers must be given
a telephone number to use to contact the health maintenance organization for specific
information about access to provider types.

(d) The disclosures required in paragraphs (b) and (c) are not required on billboards or
image, and name identification advertisement.

Sec. 2.

Minnesota Statutes 2018, section 62E.06, subdivision 1, is amended to read:


Subdivision 1.

Number three plan.

A plan of health coverage shall be certified as a
number three qualified plan if it otherwise meets the requirements established by chapters
62A, 62C, and 62Q, and the other laws of this state, whether or not the policy is issued in
Minnesota, and meets or exceeds the following minimum standards:

(a) The minimum benefits for a covered individual shall, subject to the other provisions
of this subdivision, be equal to at least 80 percent of the cost of covered services in excess
of an annual deductible which does not exceed $150 per person. The coverage shall include
a limitation of $3,000 per person on total annual out-of-pocket expenses for services covered
under this subdivision. The coverage shall not be subject to a lifetime maximum on essential
health benefits.

The prohibition on lifetime maximums for essential health benefits and $3,000 limitation
on total annual out-of-pocket expenses shall not be subject to change or substitution by use
of an actuarially equivalent benefit.

(b) Covered expenses shall be the usual and customary charges for the following services
and articles when prescribed by a physiciannew text begin or advanced practice registered nursenew text end:

(1) hospital services;

(2) professional services for the diagnosis or treatment of injuries, illnesses, or conditions,
other than dental, which are rendered by a physiciannew text begin or advanced practice registered nursenew text end
or at the physician'snew text begin or advanced practice registered nurse'snew text end direction;

(3) drugs requiring a physician'snew text begin or advanced practice registered nurse'snew text end prescription;

(4) services of a nursing home for not more than 120 days in a year if the services would
qualify as reimbursable services under Medicare;

(5) services of a home health agency if the services would qualify as reimbursable
services under Medicare;

(6) use of radium or other radioactive materials;

(7) oxygen;

(8) anesthetics;

(9) prostheses other than dental but including scalp hair prostheses worn for hair loss
suffered as a result of alopecia areata;

(10) rental or purchase, as appropriate, of durable medical equipment other than
eyeglasses and hearing aids, unless coverage is required under section 62Q.675;

(11) diagnostic x-rays and laboratory tests;

(12) oral surgery for partially or completely unerupted impacted teeth, a tooth root
without the extraction of the entire tooth, or the gums and tissues of the mouth when not
performed in connection with the extraction or repair of teeth;

(13) services of a physical therapist;

(14) transportation provided by licensed ambulance service to the nearest facility qualified
to treat the condition; or a reasonable mileage rate for transportation to a kidney dialysis
center for treatment; and

(15) services of an occupational therapist.

(c) Covered expenses for the services and articles specified in this subdivision do not
include the following:

(1) any charge for care for injury or disease either (i) arising out of an injury in the course
of employment and subject to a workers' compensation or similar law, (ii) for which benefits
are payable without regard to fault under coverage statutorily required to be contained in
any motor vehicle, or other liability insurance policy or equivalent self-insurance, or (iii)
for which benefits are payable under another policy of accident and health insurance,
Medicare, or any other governmental program except as otherwise provided by section
62A.04, subdivision 3, clause (4);

(2) any charge for treatment for cosmetic purposes other than for reconstructive surgery
when such service is incidental to or follows surgery resulting from injury, sickness, or
other diseases of the involved part or when such service is performed on a covered dependent
child because of congenital disease or anomaly which has resulted in a functional defect as
determined by the attending physiciannew text begin or advanced practice registered nursenew text end;

(3) care which is primarily for custodial or domiciliary purposes which would not qualify
as eligible services under Medicare;

(4) any charge for confinement in a private room to the extent it is in excess of the
institution's charge for its most common semiprivate room, unless a private room is prescribed
as medically necessary by a physiciannew text begin or advanced practice registered nursenew text end, provided,
however, that if the institution does not have semiprivate rooms, its most common semiprivate
room charge shall be considered to be 90 percent of its lowest private room charge;

(5) that part of any charge for services or articles rendered or prescribed by a physician,new text begin
advanced practice registered nurse,
new text end dentist, or other health care personnel which exceeds
the prevailing charge in the locality where the service is provided; and

(6) any charge for services or articles the provision of which is not within the scope of
authorized practice of the institution or individual rendering the services or articles.

(d) The minimum benefits for a qualified plan shall include, in addition to those benefits
specified in clauses (a) and (e), benefits for well baby care, effective July 1, 1980, subject
to applicable deductibles, coinsurance provisions, and maximum lifetime benefit limitations.

(e) Effective July 1, 1979, the minimum benefits of a qualified plan shall include, in
addition to those benefits specified in clause (a), a second opinion from a physician on all
surgical procedures expected to cost a total of $500 or more in physician, laboratory, and
hospital fees, provided that the coverage need not include the repetition of any diagnostic
tests.

(f) Effective August 1, 1985, the minimum benefits of a qualified plan must include, in
addition to the benefits specified in clauses (a), (d), and (e), coverage for special dietary
treatment for phenylketonuria when recommended by a physiciannew text begin or advanced practice
registered nurse
new text end.

(g) Outpatient mental health coverage is subject to section 62A.152, subdivision 2.

Sec. 3.

Minnesota Statutes 2018, section 62J.17, subdivision 4a, is amended to read:


Subd. 4a.

Expenditure reporting.

Each hospital, outpatient surgical center, diagnostic
imaging center, and physiciannew text begin or advanced practice registered nursenew text end clinic shall report
annually to the commissioner on all major spending commitments, in the form and manner
specified by the commissioner. The report shall include the following information:

(1) a description of major spending commitments made during the previous year,
including the total dollar amount of major spending commitments and purpose of the
expenditures;

(2) the cost of land acquisition, construction of new facilities, and renovation of existing
facilities;

(3) the cost of purchased or leased medical equipment, by type of equipment;

(4) expenditures by type for specialty care and new specialized services;

(5) information on the amount and types of added capacity for diagnostic imaging
services, outpatient surgical services, and new specialized services; and

(6) information on investments in electronic medical records systems.

For hospitals and outpatient surgical centers, this information shall be included in reports
to the commissioner that are required under section 144.698. For diagnostic imaging centers,
this information shall be included in reports to the commissioner that are required under
section 144.565. For all other health care providers that are subject to this reporting
requirement, reports must be submitted to the commissioner by March 1 each year for the
preceding calendar year.

Sec. 4.

Minnesota Statutes 2019 Supplement, section 62J.23, subdivision 2, is amended
to read:


Subd. 2.

Restrictions.

(a) From July 1, 1992, until rules are adopted by the commissioner
under this section, the restrictions in the federal Medicare antikickback statutes in section
1128B(b) of the Social Security Act, United States Code, title 42, section 1320a-7b(b), and
rules adopted under the federal statutes, apply to all persons in the state, regardless of whether
the person participates in any state health care program.

(b) Nothing in paragraph (a) shall be construed to prohibit an individual from receiving
a discount or other reduction in price or a limited-time free supply or samples of a prescription
drug, medical supply, or medical equipment offered by a pharmaceutical manufacturer,
medical supply or device manufacturer, health plan company, or pharmacy benefit manager,
so long as:

(1) the discount or reduction in price is provided to the individual in connection with
the purchase of a prescription drug, medical supply, or medical equipment prescribed for
that individual;

(2) it otherwise complies with the requirements of state and federal law applicable to
enrollees of state and federal public health care programs;

(3) the discount or reduction in price does not exceed the amount paid directly by the
individual for the prescription drug, medical supply, or medical equipment; and

(4) the limited-time free supply or samples are provided by a physiciannew text begin, advanced practice
registered nurse,
new text end or pharmacist, as provided by the federal Prescription Drug Marketing
Act.

For purposes of this paragraph, "prescription drug" includes prescription drugs that are
administered through infusion, and related services and supplies.

(c) No benefit, reward, remuneration, or incentive for continued product use may be
provided to an individual or an individual's family by a pharmaceutical manufacturer,
medical supply or device manufacturer, or pharmacy benefit manager, except that this
prohibition does not apply to:

(1) activities permitted under paragraph (b);

(2) a pharmaceutical manufacturer, medical supply or device manufacturer, health plan
company, or pharmacy benefit manager providing to a patient, at a discount or reduced
price or free of charge, ancillary products necessary for treatment of the medical condition
for which the prescription drug, medical supply, or medical equipment was prescribed or
provided; and

(3) a pharmaceutical manufacturer, medical supply or device manufacturer, health plan
company, or pharmacy benefit manager providing to a patient a trinket or memento of
insignificant value.

(d) Nothing in this subdivision shall be construed to prohibit a health plan company
from offering a tiered formulary with different co-payment or cost-sharing amounts for
different drugs.

Sec. 5.

Minnesota Statutes 2018, section 62J.495, subdivision 1a, is amended to read:


Subd. 1a.

Definitions.

(a) "Certified electronic health record technology" means an
electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH Act
to meet the standards and implementation specifications adopted under section 3004 as
applicable.

(b) "Commissioner" means the commissioner of health.

(c) "Pharmaceutical electronic data intermediary" means any entity that provides the
infrastructure to connect computer systems or other electronic devices utilized by prescribing
practitioners with those used by pharmacies, health plans, third-party administrators, and
pharmacy benefit managers in order to facilitate the secure transmission of electronic
prescriptions, refill authorization requests, communications, and other prescription-related
information between such entities.

(d) "HITECH Act" means the Health Information Technology for Economic and Clinical
Health Act in division A, title XIII and division B, title IV of the American Recovery and
Reinvestment Act of 2009, including federal regulations adopted under that act.

(e) "Interoperable electronic health record" means an electronic health record that securely
exchanges health information with another electronic health record system that meets
requirements specified in subdivision 3, and national requirements for certification under
the HITECH Act.

(f) "Qualified electronic health record" means an electronic record of health-related
information on an individual that includes patient demographic and clinical health information
and has the capacity to:

(1) provide clinical decision support;

(2) support deleted text beginphysiciandeleted text endnew text begin providernew text end order entry;

(3) capture and query information relevant to health care quality; and

(4) exchange electronic health information with, and integrate such information from,
other sources.

Sec. 6.

Minnesota Statutes 2018, section 62J.52, subdivision 2, is amended to read:


Subd. 2.

Uniform billing form CMS 1500.

(a) On and after January 1, 1996, all
noninstitutional health care services rendered by providers in Minnesota except dental or
pharmacy providers, that are not currently being billed using an equivalent electronic billing
format, must be billed using the most current version of the health insurance claim form
CMS 1500.

(b) The instructions and definitions for the use of the uniform billing form CMS 1500
shall be in accordance with the manual developed by the Administrative Uniformity
Committee entitled standards for the use of the CMS 1500 form, dated February 1994, as
further defined by the commissioner.

(c) Services to be billed using the uniform billing form CMS 1500 include physician
services and supplies, durable medical equipment, noninstitutional ambulance services,
independent ancillary services including occupational therapy, physical therapy, speech
therapy and audiology, home infusion therapy, podiatry services, optometry services, mental
health licensed professional services, substance abuse licensed professional services, deleted text beginnursing
practitioner professional services, certified registered nurse anesthetists
deleted text endnew text begin advanced practice
registered nurse services
new text end, chiropractors, physician assistants, laboratories, medical suppliers,
waivered services, personal care attendants, and other health care providers such as day
activity centers and freestanding ambulatory surgical centers.

(d) Services provided by Medicare Critical Access Hospitals electing Method II billing
will be allowed an exception to this provision to allow the inclusion of the professional fees
on the CMS 1450.

Sec. 7.

Minnesota Statutes 2018, section 62J.823, subdivision 3, is amended to read:


Subd. 3.

Applicability and scope.

Any hospital, as defined in section 144.696,
subdivision 3, and outpatient surgical center, as defined in section 144.696, subdivision 4,
shall provide a written estimate of the cost of a specific service or stay upon the request of
a patient, doctor,new text begin advanced practice registered nurse,new text end or the patient's representative. The
request must include:

(1) the health coverage status of the patient, including the specific health plan or other
health coverage under which the patient is enrolled, if any; and

(2) at least one of the following:

(i) the specific diagnostic-related group code;

(ii) the name of the procedure or procedures to be performed;

(iii) the type of treatment to be received; or

(iv) any other information that will allow the hospital or outpatient surgical center to
determine the specific diagnostic-related group or procedure code or codes.

Sec. 8.

Minnesota Statutes 2019 Supplement, section 62Q.184, subdivision 1, is amended
to read:


Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms in this
subdivision have the meanings given them.

(b) "Clinical practice guideline" means a systematically developed statement to assist
health care providers and enrollees in making decisions about appropriate health care services
for specific clinical circumstances and conditions developed independently of a health plan
company, pharmaceutical manufacturer, or any entity with a conflict of interest. A clinical
practice guideline also includes a preferred drug list developed in accordance with section
256B.0625.

(c) "Clinical review criteria" means the written screening procedures, decision abstracts,
clinical protocols, and clinical practice guidelines used by a health plan company to determine
the medical necessity and appropriateness of health care services.

(d) "Health plan company" has the meaning given in section 62Q.01, subdivision 4, but
also includes a county-based purchasing plan participating in a public program under chapter
256B or 256L and an integrated health partnership under section 256B.0755.

(e) "Step therapy protocol" means a protocol or program that establishes the specific
sequence in which prescription drugs for a specified medical condition, including
self-administered deleted text beginand physician-administereddeleted text end drugsnew text begin and drugs that are administered by a
physician or advanced practice nurse practitioner
new text end, are medically appropriate for a particular
enrollee and are covered under a health plan.

(f) "Step therapy override" means that the step therapy protocol is overridden in favor
of coverage of the selected prescription drug of the prescribing health care provider because
at least one of the conditions of subdivision 3, paragraph (a), exists.

Sec. 9.

Minnesota Statutes 2018, section 62Q.43, subdivision 1, is amended to read:


Subdivision 1.

Closed-panel health plan.

For purposes of this section, "closed-panel
health plan" means a health plan as defined in section 62Q.01 that requires an enrollee to
receive all or a majority of primary care services from a specific clinic or deleted text beginphysiciandeleted text endnew text begin primary
care provider
new text end designated by the enrollee that is within the health plan company's clinic or
deleted text begin physiciandeleted text endnew text begin providernew text end network.

Sec. 10.

Minnesota Statutes 2018, section 62Q.43, subdivision 2, is amended to read:


Subd. 2.

Access requirement.

Every closed-panel health plan must allow enrollees
under the age of 26 years to change their designated clinic or deleted text beginphysiciandeleted text endnew text begin primary care providernew text end
at least once per month, as long as the clinic or deleted text beginphysiciandeleted text endnew text begin providernew text end is part of the health plan
company's statewide clinic or deleted text beginphysiciandeleted text endnew text begin providernew text end network. A health plan company shall not
charge enrollees who choose this option higher premiums or cost sharing than would
otherwise apply to enrollees who do not choose this option. A health plan company may
require enrollees to provide 15 days' written notice of intent to change their designated clinic
or deleted text beginphysiciandeleted text endnew text begin primary care providernew text end.

Sec. 11.

Minnesota Statutes 2018, section 62Q.54, is amended to read:


62Q.54 REFERRALS FOR RESIDENTS OF HEALTH CARE FACILITIES.

If an enrollee is a resident of a health care facility licensed under chapter 144A or a
housing with services establishment registered under chapter 144D, the enrollee's primary
care deleted text beginphysiciandeleted text endnew text begin providernew text end must refer the enrollee to that facility's skilled nursing unit or that
facility's appropriate care setting, provided that the health plan company and the provider
can best meet the patient's needs in that setting, if the following conditions are met:

(1) the facility agrees to be reimbursed at that health plan company's contract rate
negotiated with similar providers for the same services and supplies; and

(2) the facility meets all guidelines established by the health plan company related to
quality of care, utilization, referral authorization, risk assumption, use of health plan company
network, and other criteria applicable to providers under contract for the same services and
supplies.

Sec. 12.

Minnesota Statutes 2018, section 62Q.57, subdivision 1, is amended to read:


Subdivision 1.

Choice of primary care provider.

(a) If a health plan company offering
a group health plan, or an individual health plan that is not a grandfathered plan, requires
or provides for the designation by an enrollee of a participating primary care provider, the
health plan company shall permit each enrollee to:

(1) designate any participating primary care provider available to accept the enrollee;
and

(2) for a child, designate any participating physiciannew text begin or advanced practice registered
nurse
new text end who specializes in pediatrics as the child's primary care provider and is available to
accept the child.

(b) This section does not waive any exclusions of coverage under the terms and conditions
of the health plan with respect to coverage of pediatric care.

Sec. 13.

Minnesota Statutes 2018, section 62Q.73, subdivision 7, is amended to read:


Subd. 7.

Standards of review.

(a) For an external review of any issue in an adverse
determination that does not require a medical necessity determination, the external review
must be based on whether the adverse determination was in compliance with the enrollee's
health benefit plan.

(b) For an external review of any issue in an adverse determination by a health plan
company licensed under chapter 62D that requires a medical necessity determination, the
external review must determine whether the adverse determination was consistent with the
definition of medically necessary care in Minnesota Rules, part 4685.0100, subpart 9b.

(c) For an external review of any issue in an adverse determination by a health plan
company, other than a health plan company licensed under chapter 62D, that requires a
medical necessity determination, the external review must determine whether the adverse
determination was consistent with the definition of medically necessary care in section
62Q.53, subdivision 2.

(d) For an external review of an adverse determination involving experimental or
investigational treatment, the external review entity must base its decision on all documents
submitted by the health plan company and enrollee, including medical records, the attending
physiciannew text begin, advanced practice registered nurse,new text end or health care professional's recommendation,
consulting reports from health care professionals, the terms of coverage, federal Food and
Drug Administration approval, and medical or scientific evidence or evidence-based
standards.

Sec. 14.

Minnesota Statutes 2018, section 62Q.733, subdivision 3, is amended to read:


Subd. 3.

Health care provider or provider.

"Health care provider" or "provider" means
a physician, new text beginadvanced practice registered nurse, new text endchiropractor, dentist, podiatrist, or other
provider as defined under section 62J.03, other than hospitals, ambulatory surgical centers,
or freestanding emergency rooms.

Sec. 15.

Minnesota Statutes 2018, section 62Q.74, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For purposes of this section, "category of coverage"
means one of the following types of health-related coverage:

(1) health;

(2) no-fault automobile medical benefits; or

(3) workers' compensation medical benefits.

(b) "Health care provider" or "provider" means a physician, new text beginadvanced practice registered
nurse,
new text endchiropractor, dentist, podiatrist, hospital, ambulatory surgical center, freestanding
emergency room, or other provider, as defined in section 62J.03.

Sec. 16.

Minnesota Statutes 2018, section 62S.08, subdivision 3, is amended to read:


Subd. 3.

Mandatory format.

The following standard format outline of coverage must
be used, unless otherwise specifically indicated:

COMPANY NAME

ADDRESS - CITY AND STATE

TELEPHONE NUMBER

LONG-TERM CARE INSURANCE

OUTLINE OF COVERAGE

Policy Number or Group Master Policy and Certificate Number

(Except for policies or certificates which are guaranteed issue, the following caution
statement, or language substantially similar, must appear as follows in the outline of
coverage.)

CAUTION: The issuance of this long-term care insurance (policy) (certificate) is based
upon your responses to the questions on your application. A copy of your (application)
(enrollment form) (is enclosed) (was retained by you when you applied). If your answers
are incorrect or untrue, the company has the right to deny benefits or rescind your policy.
The best time to clear up any questions is now, before a claim arises. If, for any reason, any
of your answers are incorrect, contact the company at this address: (insert address).

(1) This policy is (an individual policy of insurance) (a group policy) which was issued
in the (indicate jurisdiction in which group policy was issued).

(2) PURPOSE OF OUTLINE OF COVERAGE. This outline of coverage provides a
very brief description of the important features of the policy. You should compare this
outline of coverage to outlines of coverage for other policies available to you. This is not
an insurance contract, but only a summary of coverage. Only the individual or group policy
contains governing contractual provisions. This means that the policy or group policy sets
forth in detail the rights and obligations of both you and the insurance company. Therefore,
if you purchase this coverage, or any other coverage, it is important that you READ YOUR
POLICY (OR CERTIFICATE) CAREFULLY.

(3) THIS PLAN IS INTENDED TO BE A QUALIFIED LONG-TERM CARE
INSURANCE CONTRACT AS DEFINED UNDER SECTION 7702(B)(b) OF THE
INTERNAL REVENUE CODE OF 1986.

(4) TERMS UNDER WHICH THE POLICY OR CERTIFICATE MAY BE
CONTINUED IN FORCE OR DISCONTINUED.

(a) (For long-term care health insurance policies or certificates describe one of the
following permissible policy renewability provisions:)

(1) (Policies and certificates that are guaranteed renewable shall contain the following
statement:) RENEWABILITY: THIS POLICY (CERTIFICATE) IS GUARANTEED
RENEWABLE. This means you have the right, subject to the terms of your policy,
(certificate) to continue this policy as long as you pay your premiums on time. (Company
name) cannot change any of the terms of your policy on its own, except that, in the future,
IT MAY INCREASE THE PREMIUM YOU PAY.

(2) (Policies and certificates that are noncancelable shall contain the following statement:)
RENEWABILITY: THIS POLICY (CERTIFICATE) IS NONCANCELABLE. This means
that you have the right, subject to the terms of your policy, to continue this policy as long
as you pay your premiums on time. (Company name) cannot change any of the terms of
your policy on its own and cannot change the premium you currently pay. However, if your
policy contains an inflation protection feature where you choose to increase your benefits,
(company name) may increase your premium at that time for those additional benefits.

(b) (For group coverage, specifically describe continuation/conversion provisions
applicable to the certificate and group policy.)

(c) (Describe waiver of premium provisions or state that there are not such provisions.)

(5) TERMS UNDER WHICH THE COMPANY MAY CHANGE PREMIUMS.

(In bold type larger than the maximum type required to be used for the other provisions
of the outline of coverage, state whether or not the company has a right to change the
premium and, if a right exists, describe clearly and concisely each circumstance under which
the premium may change.)

(6) TERMS UNDER WHICH THE POLICY OR CERTIFICATE MAY BE RETURNED
AND PREMIUM REFUNDED.

(a) (Provide a brief description of the right to return -- "free look" provision of the policy.)

(b) (Include a statement that the policy either does or does not contain provisions
providing for a refund or partial refund of premium upon the death of an insured or surrender
of the policy or certificate. If the policy contains such provisions, include a description of
them.)

(7) THIS IS NOT MEDICARE SUPPLEMENT COVERAGE. If you are eligible for
Medicare, review the Medicare Supplement Buyer's Guide available from the insurance
company.

(a) (For agents) neither (insert company name) nor its agents represent Medicare, the
federal government, or any state government.

(b) (For direct response) (insert company name) is not representing Medicare, the federal
government, or any state government.

(8) LONG-TERM CARE COVERAGE. Policies of this category are designed to provide
coverage for one or more necessary or medically necessary diagnostic, preventive,
therapeutic, rehabilitative, maintenance, or personal care services, provided in a setting
other than an acute care unit of a hospital, such as in a nursing home, in the community, or
in the home.

This policy provides coverage in the form of a fixed dollar indemnity benefit for covered
long-term care expenses, subject to policy (limitations), (waiting periods), and (coinsurance)
requirements. (Modify this paragraph if the policy is not an indemnity policy.)

(9) BENEFITS PROVIDED BY THIS POLICY.

(a) (Covered services, related deductible(s), waiting periods, elimination periods, and
benefit maximums.)

(b) (Institutional benefits, by skill level.)

(c) (Noninstitutional benefits, by skill level.)

(d) (Eligibility for payment of benefits.)

(Activities of daily living and cognitive impairment shall be used to measure an insured's
need for long-term care and must be defined and described as part of the outline of coverage.)

(Any benefit screens must be explained in this section. If these screens differ for different
benefits, explanation of the screen should accompany each benefit description. If an attending
physiciannew text begin, advanced practice registered nurse,new text end or other specified person must certify a certain
level of functional dependency in order to be eligible for benefits, this too must be specified.
If activities of daily living (ADLs) are used to measure an insured's need for long-term care,
then these qualifying criteria or screens must be explained.)

(10) LIMITATIONS AND EXCLUSIONS:

Describe:

(a) preexisting conditions;

(b) noneligible facilities/provider;

(c) noneligible levels of care (e.g., unlicensed providers, care or treatment provided by
a family member, etc.);

(d) exclusions/exceptions; and

(e) limitations.

(This section should provide a brief specific description of any policy provisions which
limit, exclude, restrict, reduce, delay, or in any other manner operate to qualify payment of
the benefits described in paragraph (8).)

THIS POLICY MAY NOT COVER ALL THE EXPENSES ASSOCIATED WITH
YOUR LONG-TERM CARE NEEDS.

(11) RELATIONSHIP OF COST OF CARE AND BENEFITS. Because the costs of
long-term care services will likely increase over time, you should consider whether and
how the benefits of this plan may be adjusted. As applicable, indicate the following:

(a) that the benefit level will not increase over time;

(b) any automatic benefit adjustment provisions;

(c) whether the insured will be guaranteed the option to buy additional benefits and the
basis upon which benefits will be increased over time if not by a specified amount or
percentage;

(d) if there is such a guarantee, include whether additional underwriting or health
screening will be required, the frequency and amounts of the upgrade options, and any
significant restrictions or limitations; and

(e) whether there will be any additional premium charge imposed and how that is to be
calculated.

(12) ALZHEIMER'S DISEASE AND OTHER ORGANIC BRAIN DISORDERS. (State
that the policy provides coverage for insureds clinically diagnosed as having Alzheimer's
disease or related degenerative and dementing illnesses. Specifically, describe each benefit
screen or other policy provision which provides preconditions to the availability of policy
benefits for such an insured.)

(13) PREMIUM.

(a) State the total annual premium for the policy.

(b) If the premium varies with an applicant's choice among benefit options, indicate the
portion of annual premium which corresponds to each benefit option.

(14) ADDITIONAL FEATURES.

(a) Indicate if medical underwriting is used.

(b) Describe other important features.

(15) CONTACT THE STATE DEPARTMENT OF COMMERCE OR SENIOR
LINKAGE LINE IF YOU HAVE GENERAL QUESTIONS REGARDING LONG-TERM
CARE INSURANCE. CONTACT THE INSURANCE COMPANY IF YOU HAVE
SPECIFIC QUESTIONS REGARDING YOUR LONG-TERM CARE INSURANCE
POLICY OR CERTIFICATE.

Sec. 17.

Minnesota Statutes 2018, section 62S.20, subdivision 5b, is amended to read:


Subd. 5b.

Benefit triggers.

Activities of daily living and cognitive impairment must be
used to measure an insured's need for long-term care and must be described in the policy
or certificate in a separate paragraph and must be labeled "Eligibility for the Payment of
Benefits." Any additional benefit triggers must also be explained in this section. If these
triggers differ for different benefits, explanation of the trigger must accompany each benefit
description. If an attending physiciannew text begin, advanced practice registered nurse,new text end or other specified
person must certify a certain level of functional dependency in order to be eligible for
benefits, this too shall be specified.

Sec. 18.

Minnesota Statutes 2018, section 62S.21, subdivision 2, is amended to read:


Subd. 2.

Medication information required.

If an application for long-term care
insurance contains a question which asks whether the applicant has had medication prescribed
by a physiciannew text begin or advanced practice registered nursenew text end, it must also ask the applicant to list
the medication that has been prescribed. If the medications listed in the application were
known by the insurer, or should have been known at the time of application, to be directly
related to a medical condition for which coverage would otherwise be denied, then the
policy or certificate shall not be rescinded for that condition.

Sec. 19.

Minnesota Statutes 2018, section 62S.268, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

For purposes of this section, the following terms have the
meanings given them:

(a) "Qualified long-term care services" means services that meet the requirements of
section 7702(c)(1) of the Internal Revenue Code of 1986, as amended, as follows: necessary
diagnostic, preventive, therapeutic, curative, treatment, mitigation, and rehabilitative services,
and maintenance or personal care services which are required by a chronically ill individual,
and are provided pursuant to a plan of care prescribed by a licensed health care practitioner.

(b) "Chronically ill individual" has the meaning prescribed for this term by section
7702B(c)(2) of the Internal Revenue Code of 1986, as amended. Under this provision, a
chronically ill individual means any individual who has been certified by a licensed health
care practitioner as being unable to perform, without substantial assistance from another
individual, at least two activities of daily living for a period of at least 90 days due to a loss
of functional capacity, or requiring substantial supervision to protect the individual from
threats to health and safety due to severe cognitive impairment.

The term "chronically ill individual" does not include an individual otherwise meeting
these requirements unless within the preceding 12-month period a licensed health care
practitioner has certified that the individual meets these requirements.

(c) "Licensed health care practitioner" means a physician, as defined in section 1861(r)(1)
of the Social Security Act,new text begin an advanced practice registered nurse,new text end a registered professional
nurse, licensed social worker, or other individual who meets requirements prescribed by
the Secretary of the Treasury.

(d) "Maintenance or personal care services" means any care the primary purpose of
which is the provision of needed assistance with any of the disabilities as a result of which
the individual is a chronically ill individual, including the protection from threats to health
and safety due to severe cognitive impairment.

Sec. 20.

Minnesota Statutes 2018, section 144.3345, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) The following definitions are used for the purposes of
this section.

(b) "Eligible community e-health collaborative" means an existing or newly established
collaborative to support the adoption and use of interoperable electronic health records. A
collaborative must consist of at least two or more eligible health care entities in at least two
of the categories listed in paragraph (c) and have a focus on interconnecting the members
of the collaborative for secure and interoperable exchange of health care information.

(c) "Eligible health care entity" means one of the following:

(1) community clinics, as defined under section 145.9268;

(2) hospitals eligible for rural hospital capital improvement grants, as defined in section
144.148;

(3) physiciannew text begin or advanced practice registered nursenew text end clinics located in a community with
a population of less than 50,000 according to United States Census Bureau statistics and
outside the seven-county metropolitan area;

(4) nursing facilities licensed under sections 144A.01 to 144A.27;

(5) community health boards as established under chapter 145A;

(6) nonprofit entities with a purpose to provide health information exchange coordination
governed by a representative, multi-stakeholder board of directors; and

(7) other providers of health or health care services approved by the commissioner for
which interoperable electronic health record capability would improve quality of care,
patient safety, or community health.

Sec. 21.

Minnesota Statutes 2018, section 144.3352, is amended to read:


144.3352 HEPATITIS B MATERNAL CARRIER DATA; INFANT
IMMUNIZATION.

The commissioner of health or a community health board may inform the physiciannew text begin or
advanced practice registered nurse
new text end attending a newborn of the hepatitis B infection status
of the biological mother.

Sec. 22.

Minnesota Statutes 2018, section 144.34, is amended to read:


144.34 INVESTIGATION AND CONTROL OF OCCUPATIONAL DISEASES.

Any physiciannew text begin or advanced practice registered nursenew text end having under professional care any
person whom the physiciannew text begin or advanced practice registered nursenew text end believes to be suffering
from poisoning from lead, phosphorus, arsenic, brass, silica dust, carbon monoxide gas,
wood alcohol, or mercury, or their compounds, or from anthrax or from compressed-air
illness or any other disease contracted as a result of the nature of the employment of such
person shall within five days mail to the Department of Health a report stating the name,
address, and occupation of such patient, the name, address, and business of the patient's
employer, the nature of the disease, and such other information as may reasonably be required
by the department. The department shall prepare and furnish the physiciansnew text begin and advanced
practice registered nurses
new text end of this state suitable blanks for the reports herein required. No
report made pursuant to the provisions of this section shall be admissible as evidence of the
facts therein stated in any action at law or in any action under the Workers' Compensation
Act against any employer of such diseased person. The Department of Health is authorized
to investigate and to make recommendations for the elimination or prevention of occupational
diseases which have been reported to it, or which shall be reported to it, in accordance with
the provisions of this section. The department is also authorized to study and provide advice
in regard to conditions that may be suspected of causing occupational diseases. Information
obtained upon investigations made in accordance with the provisions of this section shall
not be admissible as evidence in any action at law to recover damages for personal injury
or in any action under the Workers' Compensation Act. Nothing herein contained shall be
construed to interfere with or limit the powers of the Department of Labor and Industry to
make inspections of places of employment or issue orders for the protection of the health
of the persons therein employed. When upon investigation the commissioner of health
reaches a conclusion that a condition exists which is dangerous to the life and health of the
workers in any industry or factory or other industrial institutions the commissioner shall
file a report thereon with the Department of Labor and Industry.

Sec. 23.

Minnesota Statutes 2018, section 144.441, subdivision 4, is amended to read:


Subd. 4.

Screening of employees.

As determined by the commissioner under subdivision
2, a person employed by the designated school or school district shall submit to the
administrator or other person having general control and supervision of the school one of
the following:

(1) a statement from a physiciannew text begin, advanced practice registered nurse,new text end or public clinic
stating that the person has had a negative Mantoux test reaction within the past year, provided
that the person has no symptoms suggestive of tuberculosis or evidence of a new exposure
to active tuberculosis;

(2) a statement from a physiciannew text begin, advanced practice registered nurse,new text end or public clinic
stating that a person who has a positive Mantoux test reaction has had a negative chest
roentgenogram (X-ray) for tuberculosis within the past year, provided that the person has
no symptoms suggestive of tuberculosis or evidence of a new exposure to active tuberculosis;

(3) a statement from a physiciannew text begin, advanced practice registered nurse,new text end or public health
clinic stating that the person (i) has a history of adequately treated active tuberculosis; (ii)
is currently receiving tuberculosis preventive therapy; (iii) is currently undergoing therapy
for active tuberculosis and the person's presence in a school building will not endanger the
health of other people; or (iv) has completed a course of preventive therapy or was intolerant
to preventive therapy, provided the person has no symptoms suggestive of tuberculosis or
evidence of a new exposure to active tuberculosis; or

(4) a notarized statement signed by the person stating that the person has not submitted
the proof of tuberculosis screening as required by this subdivision because of conscientiously
held beliefs. This statement must be forwarded to the commissioner of health.

Sec. 24.

Minnesota Statutes 2018, section 144.441, subdivision 5, is amended to read:


Subd. 5.

Exceptions.

Subdivisions 3 and 4 do not apply to:

(1) a person with a history of either a past positive Mantoux test reaction or active
tuberculosis who has a documented history of completing a course of tuberculosis therapy
or preventive therapy when the school or school district holds a statement from a physiciannew text begin,
advanced practice registered nurse,
new text end or public health clinic indicating that such therapy was
provided to the person and that the person has no symptoms suggestive of tuberculosis or
evidence of a new exposure to active tuberculosis; and

(2) a person with a history of a past positive Mantoux test reaction who has not completed
a course of preventive therapy. This determination shall be made by the commissioner based
on currently accepted public health standards and the person's health status.

Sec. 25.

Minnesota Statutes 2018, section 144.442, subdivision 1, is amended to read:


Subdivision 1.

Administration; notification.

In the event that the commissioner
designates a school or school district under section 144.441, subdivision 2, the school or
school district or community health board may administer Mantoux screening tests to some
or all persons enrolled in or employed by the designated school or school district. Any
Mantoux screening provided under this section shall be under the direction of a licensed
physiciannew text begin or advanced practice registered nursenew text end.

Prior to administering the Mantoux test to such persons, the school or school district or
community health board shall inform in writing such persons and parents or guardians of
minor children to whom the test may be administered, of the following:

(1) that there has been an occurrence of active tuberculosis or evidence of a higher than
expected prevalence of tuberculosis infection in that school or school district;

(2) that screening is necessary to avoid the spread of tuberculosis;

(3) the manner by which tuberculosis is transmitted;

(4) the risks and possible side effects of the Mantoux test;

(5) the risks from untreated tuberculosis to the infected person and others;

(6) the ordinary course of further diagnosis and treatment if the Mantoux test is positive;

(7) that screening has been scheduled; and

(8) that no person will be required to submit to the screening if the person submits a
statement of objection due to the conscientiously held beliefs of the person employed or of
the parent or guardian of a minor child.

Sec. 26.

Minnesota Statutes 2018, section 144.4803, subdivision 1, is amended to read:


Subdivision 1.

Active tuberculosis.

"Active tuberculosis" includes infectious and
noninfectious tuberculosis and means:

(1) a condition evidenced by a positive culture for mycobacterium tuberculosis taken
from a pulmonary or laryngeal source;

(2) a condition evidenced by a positive culture for mycobacterium tuberculosis taken
from an extrapulmonary source when there is clinical evidence such as a positive skin test
for tuberculosis infection, coughing, sputum production, fever, or other symptoms compatible
with pulmonary tuberculosis; or

(3) a condition in which clinical specimens are not available for culture, but there is
radiographic evidence of tuberculosis such as an abnormal chest x-ray, and clinical evidence
such as a positive skin test for tuberculosis infection, coughing, sputum production, fever,
or other symptoms compatible with pulmonary tuberculosis, that lead a physiciannew text begin or advanced
practice registered nurse
new text end to reasonably diagnose active tuberculosis according to currently
accepted standards of medical practice and to initiate treatment for tuberculosis.

Sec. 27.

Minnesota Statutes 2018, section 144.4803, is amended by adding a subdivision
to read:


new text begin Subd. 1a. new text end

new text begin Advanced practice registered nurse. new text end

new text begin "Advanced practice registered nurse"
means a person who is licensed by the Board of Nursing under chapter 148 to practice as
an advanced practice registered nurse.
new text end

Sec. 28.

Minnesota Statutes 2018, section 144.4803, subdivision 4, is amended to read:


Subd. 4.

Clinically suspected of having active tuberculosis.

"Clinically suspected of
having active tuberculosis" means presenting a reasonable possibility of having active
tuberculosis based upon epidemiologic, clinical, or radiographic evidence, laboratory test
results, or other reliable evidence as determined by a physiciannew text begin or advanced practice
registered nurse
new text end using currently accepted standards of medical practice.

Sec. 29.

Minnesota Statutes 2018, section 144.4803, subdivision 10, is amended to read:


Subd. 10.

Endangerment to the public health.

"Endangerment to the public health"
means a carrier who may transmit tuberculosis to another person or persons because the
carrier has engaged or is engaging in any of the following conduct:

(1) refuses or fails to submit to a diagnostic tuberculosis examination that is ordered by
a physiciannew text begin or advanced practice registered nursenew text end and is reasonable according to currently
accepted standards of medical practice;

(2) refuses or fails to initiate or complete treatment for tuberculosis that is prescribed
by a physiciannew text begin or advanced practice registered nursenew text end and is reasonable according to currently
accepted standards of medical practice;

(3) refuses or fails to keep appointments for treatment of tuberculosis;

(4) refuses or fails to provide the commissioner, upon request, with evidence showing
the completion of a course of treatment for tuberculosis that is prescribed by a physiciannew text begin or
advanced practice registered nurse
new text end and is reasonable according to currently accepted standards
of medical practice;

(5) refuses or fails to initiate or complete a course of directly observed therapy that is
prescribed by a physiciannew text begin or advanced practice registered nursenew text end and is reasonable according
to currently accepted standards of medical practice;

(6) misses at least 20 percent of scheduled appointments for directly observed therapy,
or misses at least two consecutive appointments for directly observed therapy;

(7) refuses or fails to follow contagion precautions for tuberculosis after being instructed
on the precautions by a licensed health professional or by the commissioner;

(8) based on evidence of the carrier's past or present behavior, may not complete a course
of treatment for tuberculosis that is reasonable according to currently accepted standards
of medical practice; or

(9) may expose other persons to tuberculosis based on epidemiological, medical, or other
reliable evidence.

Sec. 30.

Minnesota Statutes 2018, section 144.4806, is amended to read:


144.4806 PREVENTIVE MEASURES UNDER HEALTH ORDER.

A health order may include, but need not be limited to, an order:

(1) requiring the carrier's attending physiciannew text begin, advanced practice registered nurse,new text end or
treatment facility to isolate and detain the carrier for treatment or for a diagnostic examination
for tuberculosis, pursuant to section 144.4807, subdivision 1, if the carrier is an endangerment
to the public health and is in a treatment facility;

(2) requiring a carrier who is an endangerment to the public health to submit to diagnostic
examination for tuberculosis and to remain in the treatment facility until the commissioner
receives the results of the examination;

(3) requiring a carrier who is an endangerment to the public health to remain in or present
at a treatment facility until the carrier has completed a course of treatment for tuberculosis
that is prescribed by a physiciannew text begin or advanced practice registered nursenew text end and is reasonable
according to currently accepted standards of medical practice;

(4) requiring a carrier who is an endangerment to the public health to complete a course
of treatment for tuberculosis that is prescribed by a physiciannew text begin or advanced practice registered
nurse
new text end and is reasonable according to currently accepted standards of medical practice and,
if necessary, to follow contagion precautions for tuberculosis;

(5) requiring a carrier who is an endangerment to the public health to follow a course
of directly observed therapy that is prescribed by a physiciannew text begin or advanced practice registered
nurse
new text end and is reasonable according to currently accepted standards of medical practice;

(6) excluding a carrier who is an endangerment to the public health from the carrier's
place of work or school, or from other premises if the commissioner determines that exclusion
is necessary because contagion precautions for tuberculosis cannot be maintained in a
manner adequate to protect others from being exposed to tuberculosis;

(7) requiring a licensed health professional or treatment facility to provide to the
commissioner certified copies of all medical and epidemiological data relevant to the carrier's
tuberculosis and status as an endangerment to the public health;

(8) requiring the diagnostic examination for tuberculosis of other persons in the carrier's
household, workplace, or school, or other persons in close contact with the carrier if the
commissioner has probable cause to believe that the persons may have active tuberculosis
or may have been exposed to tuberculosis based on epidemiological, medical, or other
reliable evidence; or

(9) requiring a carrier or other persons to follow contagion precautions for tuberculosis.

Sec. 31.

Minnesota Statutes 2018, section 144.4807, subdivision 1, is amended to read:


Subdivision 1.

Obligation to isolate.

If the carrier is in a treatment facility, the
commissioner or a carrier's attending physiciannew text begin or advanced practice registered nursenew text end, after
obtaining approval from the commissioner, may issue a notice of obligation to isolate to a
treatment facility if the commissioner or attending physiciannew text begin or advanced practice registered
nurse
new text end has probable cause to believe that a carrier is an endangerment to the public health.

Sec. 32.

Minnesota Statutes 2018, section 144.4807, subdivision 2, is amended to read:


Subd. 2.

Obligation to examine.

If the carrier is clinically suspected of having active
tuberculosis, the commissioner may issue a notice of obligation to examine to the carrier's
attending physiciannew text begin or advanced practice registered nursenew text end to conduct a diagnostic examination
for tuberculosis on the carrier.

Sec. 33.

Minnesota Statutes 2018, section 144.4807, subdivision 4, is amended to read:


Subd. 4.

Service of health order on carrier.

When issuing a notice of obligation to
isolate or examine to the carrier's physiciannew text begin or advanced practice registered nursenew text end or a
treatment facility, the commissioner shall simultaneously serve a health order on the carrier
ordering the carrier to remain in the treatment facility for treatment or examination.

Sec. 34.

Minnesota Statutes 2018, section 144.50, subdivision 2, is amended to read:


Subd. 2.

Hospital, sanitarium, other institution; definition.

Hospital, sanitarium or
other institution for the hospitalization or care of human beings, within the meaning of
sections 144.50 to 144.56 shall mean any institution, place, building, or agency, in which
any accommodation is maintained, furnished, or offered for five or more persons for: the
hospitalization of the sick or injured; the provision of care in a swing bed authorized under
section 144.562; elective outpatient surgery for preexamined, prediagnosed low risk patients;
emergency medical services offered 24 hours a day, seven days a week, in an ambulatory
or outpatient setting in a facility not a part of a licensed hospital; or the institutional care of
human beings. Nothing in sections 144.50 to 144.56 shall apply to a clinic, a physician'snew text begin or
advanced practice registered nurse's
new text end office or to hotels or other similar places that furnish
only board and room, or either, to their guests.

Sec. 35.

Minnesota Statutes 2019 Supplement, section 144.55, subdivision 2, is amended
to read:


Subd. 2.

Definitions.

(a) For the purposes of this section, the terms in this subdivision
have the meanings given them.

(b) "Outpatient surgical center" or "center" means a facility organized for the specific
purpose of providing elective outpatient surgery for preexamined, prediagnosed, low-risk
patients. An outpatient surgical center is not organized to provide regular emergency medical
services and does not include a physician'snew text begin, advanced practice nurse's, new text end or dentist's office
or clinic for the practice of medicine, the practice of dentistry, or the delivery of primary
care.

(c) "Approved accrediting organization" means any organization recognized as an
accreditation organization by the Centers for Medicare and Medicaid Services.

Sec. 36.

Minnesota Statutes 2018, section 144.55, subdivision 6, is amended to read:


Subd. 6.

Suspension, revocation, and refusal to renew.

(a) The commissioner may
refuse to grant or renew, or may suspend or revoke, a license on any of the following grounds:

(1) violation of any of the provisions of sections 144.50 to 144.56 or the rules or standards
issued pursuant thereto, or Minnesota Rules, chapters 4650 and 4675;

(2) permitting, aiding, or abetting the commission of any illegal act in the institution;

(3) conduct or practices detrimental to the welfare of the patient; or

(4) obtaining or attempting to obtain a license by fraud or misrepresentation; or

(5) with respect to hospitals and outpatient surgical centers, if the commissioner
determines that there is a pattern of conduct that one or more physiciansnew text begin or advanced practice
registered nurses
new text end who have a "financial or economic interest," as defined in section 144.6521,
subdivision 3
, in the hospital or outpatient surgical center, have not provided the notice and
disclosure of the financial or economic interest required by section 144.6521.

(b) The commissioner shall not renew a license for a boarding care bed in a resident
room with more than four beds.

Sec. 37.

Minnesota Statutes 2018, section 144.6501, subdivision 7, is amended to read:


Subd. 7.

Consent to treatment.

An admission contract must not include a clause
requiring a resident to sign a consent to all treatment ordered by any physiciannew text begin or advanced
practice registered nurse
new text end. An admission contract may require consent only for routine nursing
care or emergency care. An admission contract must contain a clause that informs the
resident of the right to refuse treatment.

Sec. 38.

Minnesota Statutes 2018, section 144.651, subdivision 7, is amended to read:


Subd. 7.

Physician'snew text begin or advanced practice registered nurse'snew text end identity.

Patients and
residents shall have or be given, in writing, the name, business address, telephone number,
and specialty, if any, of the physiciannew text begin or advanced practice registered nursenew text end responsible for
coordination of their care. In cases where it is medically inadvisable, as documented by the
attending physiciannew text begin or advanced practice registered nursenew text end in a patient's or resident's care
record, the information shall be given to the patient's or resident's guardian or other person
designated by the patient or resident as a representative.

Sec. 39.

Minnesota Statutes 2018, section 144.651, subdivision 8, is amended to read:


Subd. 8.

Relationship with other health services.

Patients and residents who receive
services from an outside provider are entitled, upon request, to be told the identity of the
provider. Residents shall be informed, in writing, of any health care services which are
provided to those residents by individuals, corporations, or organizations other than their
facility. Information shall include the name of the outside provider, the address, and a
description of the service which may be rendered. In cases where it is medically inadvisable,
as documented by the attending physiciannew text begin or advanced practice registered nursenew text end in a patient's
or resident's care record, the information shall be given to the patient's or resident's guardian
or other person designated by the patient or resident as a representative.

Sec. 40.

Minnesota Statutes 2018, section 144.651, subdivision 9, is amended to read:


Subd. 9.

Information about treatment.

Patients and residents shall be given by their
physiciansnew text begin or advanced practice registered nursesnew text end complete and current information
concerning their diagnosis, treatment, alternatives, risks, and prognosis as required by the
physician'snew text begin or advanced practice registered nurse'snew text end legal duty to disclose. This information
shall be in terms and language the patients or residents can reasonably be expected to
understand. Patients and residents may be accompanied by a family member or other chosen
representative, or both. This information shall include the likely medical or major
psychological results of the treatment and its alternatives. In cases where it is medically
inadvisable, as documented by the attending physiciannew text begin or advanced practice registered nursenew text end
in a patient's or resident's medical record, the information shall be given to the patient's or
resident's guardian or other person designated by the patient or resident as a representative.
Individuals have the right to refuse this information.

Every patient or resident suffering from any form of breast cancer shall be fully informed,
prior to or at the time of admission and during her stay, of all alternative effective methods
of treatment of which the treating physiciannew text begin or advanced practice registered nursenew text end is
knowledgeable, including surgical, radiological, or chemotherapeutic treatments or
combinations of treatments and the risks associated with each of those methods.

Sec. 41.

Minnesota Statutes 2018, section 144.651, subdivision 10, is amended to read:


Subd. 10.

Participation in planning treatment; notification of family members.

(a)
Patients and residents shall have the right to participate in the planning of their health care.
This right includes the opportunity to discuss treatment and alternatives with individual
caregivers, the opportunity to request and participate in formal care conferences, and the
right to include a family member or other chosen representative, or both. In the event that
the patient or resident cannot be present, a family member or other representative chosen
by the patient or resident may be included in such conferences. A chosen representative
may include a doula of the patient's choice.

(b) If a patient or resident who enters a facility is unconscious or comatose or is unable
to communicate, the facility shall make reasonable efforts as required under paragraph (c)
to notify either a family member or a person designated in writing by the patient as the
person to contact in an emergency that the patient or resident has been admitted to the
facility. The facility shall allow the family member to participate in treatment planning,
unless the facility knows or has reason to believe the patient or resident has an effective
advance directive to the contrary or knows the patient or resident has specified in writing
that they do not want a family member included in treatment planning. After notifying a
family member but prior to allowing a family member to participate in treatment planning,
the facility must make reasonable efforts, consistent with reasonable medical practice, to
determine if the patient or resident has executed an advance directive relative to the patient
or resident's health care decisions. For purposes of this paragraph, "reasonable efforts"
include:

(1) examining the personal effects of the patient or resident;

(2) examining the medical records of the patient or resident in the possession of the
facility;

(3) inquiring of any emergency contact or family member contacted under this section
whether the patient or resident has executed an advance directive and whether the patient
or resident has a physiciannew text begin or advanced practice registered nursenew text end to whom the patient or
resident normally goes for care; and

(4) inquiring of the physiciannew text begin or advanced practice registered nursenew text end to whom the patient
or resident normally goes for care, if known, whether the patient or resident has executed
an advance directive. If a facility notifies a family member or designated emergency contact
or allows a family member to participate in treatment planning in accordance with this
paragraph, the facility is not liable to the patient or resident for damages on the grounds
that the notification of the family member or emergency contact or the participation of the
family member was improper or violated the patient's privacy rights.

(c) In making reasonable efforts to notify a family member or designated emergency
contact, the facility shall attempt to identify family members or a designated emergency
contact by examining the personal effects of the patient or resident and the medical records
of the patient or resident in the possession of the facility. If the facility is unable to notify
a family member or designated emergency contact within 24 hours after the admission, the
facility shall notify the county social service agency or local law enforcement agency that
the patient or resident has been admitted and the facility has been unable to notify a family
member or designated emergency contact. The county social service agency and local law
enforcement agency shall assist the facility in identifying and notifying a family member
or designated emergency contact. A county social service agency or local law enforcement
agency that assists a facility in implementing this subdivision is not liable to the patient or
resident for damages on the grounds that the notification of the family member or emergency
contact or the participation of the family member was improper or violated the patient's
privacy rights.

Sec. 42.

Minnesota Statutes 2018, section 144.651, subdivision 12, is amended to read:


Subd. 12.

Right to refuse care.

Competent patients and residents shall have the right
to refuse treatment based on the information required in subdivision 9. Residents who refuse
treatment, medication, or dietary restrictions shall be informed of the likely medical or major
psychological results of the refusal, with documentation in the individual medical record.
In cases where a patient or resident is incapable of understanding the circumstances but has
not been adjudicated incompetent, or when legal requirements limit the right to refuse
treatment, the conditions and circumstances shall be fully documented by the attending
physiciannew text begin or advanced practice registered nursenew text end in the patient's or resident's medical record.

Sec. 43.

Minnesota Statutes 2018, section 144.651, subdivision 14, is amended to read:


Subd. 14.

Freedom from maltreatment.

Patients and residents shall be free from
maltreatment as defined in the Vulnerable Adults Protection Act. "Maltreatment" means
conduct described in section 626.5572, subdivision 15, or the intentional and nontherapeutic
infliction of physical pain or injury, or any persistent course of conduct intended to produce
mental or emotional distress. Every patient and resident shall also be free from nontherapeutic
chemical and physical restraints, except in fully documented emergencies, or as authorized
in writing after examination by a patient's or resident's physiciannew text begin or advanced practice
registered nurse
new text end for a specified and limited period of time, and only when necessary to
protect the resident from self-injury or injury to others.

Sec. 44.

Minnesota Statutes 2018, section 144.651, subdivision 31, is amended to read:


Subd. 31.

Isolation and restraints.

A minor patient who has been admitted to a
residential program as defined in section 253C.01 has the right to be free from physical
restraint and isolation except in emergency situations involving a likelihood that the patient
will physically harm the patient's self or others. These procedures may not be used for
disciplinary purposes, to enforce program rules, or for the convenience of staff. Isolation
or restraint may be used only upon the prior authorization of a physician,new text begin advanced practice
registered nurse,
new text end psychiatrist, or licensed psychologist, only when less restrictive measures
are ineffective or not feasible and only for the shortest time necessary.

Sec. 45.

Minnesota Statutes 2018, section 144.651, subdivision 33, is amended to read:


Subd. 33.

Restraints.

(a) Competent nursing home residents, family members of residents
who are not competent, and legally appointed conservators, guardians, and health care agents
as defined under section 145C.01, have the right to request and consent to the use of a
physical restraint in order to treat the medical symptoms of the resident.

(b) Upon receiving a request for a physical restraint, a nursing home shall inform the
resident, family member, or legal representative of alternatives to and the risks involved
with physical restraint use. The nursing home shall provide a physical restraint to a resident
only upon receipt of a signed consent form authorizing restraint use and a written order
from the attending physiciannew text begin or advanced practice registered nursenew text end that contains statements
and determinations regarding medical symptoms and specifies the circumstances under
which restraints are to be used.

(c) A nursing home providing a restraint under paragraph (b) must:

(1) document that the procedures outlined in that paragraph have been followed;

(2) monitor the use of the restraint by the resident; and

(3) periodically, in consultation with the resident, the family, and the attending physiciannew text begin
or advanced practice registered nurse
new text end, reevaluate the resident's need for the restraint.

(d) A nursing home shall not be subject to fines, civil money penalties, or other state or
federal survey enforcement remedies solely as the result of allowing the use of a physical
restraint as authorized in this subdivision. Nothing in this subdivision shall preclude the
commissioner from taking action to protect the health and safety of a resident if:

(1) the use of the restraint has jeopardized the health and safety of the resident; and

(2) the nursing home failed to take reasonable measures to protect the health and safety
of the resident.

(e) For purposes of this subdivision, "medical symptoms" include:

(1) a concern for the physical safety of the resident; and

(2) physical or psychological needs expressed by a resident. A resident's fear of falling
may be the basis of a medical symptom.

A written order from the attending physiciannew text begin or advanced practice registered nursenew text end that
contains statements and determinations regarding medical symptoms is sufficient evidence
of the medical necessity of the physical restraint.

(f) When determining nursing facility compliance with state and federal standards for
the use of physical restraints, the commissioner of health is bound by the statements and
determinations contained in the attending physician'snew text begin or advanced practice registered nurse'snew text end
order regarding medical symptoms. For purposes of this order, "medical symptoms" include
the request by a competent resident, family member of a resident who is not competent, or
legally appointed conservator, guardian, or health care agent as defined under section
145C.01, that the facility provide a physical restraint in order to enhance the physical safety
of the resident.

Sec. 46.

Minnesota Statutes 2018, section 144.652, subdivision 2, is amended to read:


Subd. 2.

Correction order; emergencies.

A substantial violation of the rights of any
patient or resident as defined in section 144.651, shall be grounds for issuance of a correction
order pursuant to section 144.653 or 144A.10. The issuance or nonissuance of a correction
order shall not preclude, diminish, enlarge, or otherwise alter private action by or on behalf
of a patient or resident to enforce any unreasonable violation of the patient's or resident's
rights. Compliance with the provisions of section 144.651 shall not be required whenever
emergency conditions, as documented by the attending physiciannew text begin or advanced practice
registered nurse
new text end in a patient's medical record or a resident's care record, indicate immediate
medical treatment, including but not limited to surgical procedures, is necessary and it is
impossible or impractical to comply with the provisions of section 144.651 because delay
would endanger the patient's or resident's life, health, or safety.

Sec. 47.

Minnesota Statutes 2018, section 144.69, is amended to read:


144.69 CLASSIFICATION OF DATA ON INDIVIDUALS.

Notwithstanding any law to the contrary, including section 13.05, subdivision 9, data
collected on individuals by the cancer surveillance system, including the names and personal
identifiers of persons required in section 144.68 to report, shall be private and may only be
used for the purposes set forth in this section and sections 144.671, 144.672, and 144.68.
Any disclosure other than is provided for in this section and sections 144.671, 144.672, and
144.68, is declared to be a misdemeanor and punishable as such. Except as provided by
rule, and as part of an epidemiologic investigation, an officer or employee of the
commissioner of health may interview patients named in any such report, or relatives of
any such patient, only after the consent of the attending physiciannew text begin, advanced practice
registered nurse,
new text end or surgeon is obtained.

Sec. 48.

Minnesota Statutes 2018, section 144.7402, subdivision 2, is amended to read:


Subd. 2.

Conditions.

A facility shall follow the procedures outlined in sections 144.7401
to 144.7415 when all of the following conditions are met:

(1) the facility determines that significant exposure has occurred, following the protocol
under section 144.7414;

(2) the licensed physiciannew text begin or advanced practice registered nursenew text end for the emergency
medical services person needs the source individual's blood-borne pathogen test results to
begin, continue, modify, or discontinue treatment, in accordance with the most current
guidelines of the United States Public Health Service, because of possible exposure to a
blood-borne pathogen; and

(3) the emergency medical services person consents to provide a blood sample for testing
for a blood-borne pathogen. If the emergency medical services person consents to blood
collection, but does not consent at that time to blood-borne pathogen testing, the facility
shall preserve the sample for at least 90 days. If the emergency medical services person
elects to have the sample tested within 90 days, the testing shall be done as soon as feasible.

Sec. 49.

Minnesota Statutes 2018, section 144.7406, subdivision 2, is amended to read:


Subd. 2.

Procedures without consent.

If the source individual has provided a blood
sample with consent but does not consent to blood-borne pathogen testing, the facility shall
test for blood-borne pathogens if the emergency medical services person or emergency
medical services agency requests the test, provided all of the following criteria are met:

(1) the emergency medical services person or emergency medical services agency has
documented exposure to blood or body fluids during performance of that person's occupation
or while acting as a Good Samaritan under section 604A.01 or executing a citizen's arrest
under section 629.30;

(2) the facility has determined that a significant exposure has occurred and a licensed
physiciannew text begin or advanced practice registered nursenew text end for the emergency medical services person
has documented in the emergency medical services person's medical record that blood-borne
pathogen test results are needed for beginning, modifying, continuing, or discontinuing
medical treatment for the emergency medical services person under section 144.7414,
subdivision 2
;

(3) the emergency medical services person provides a blood sample for testing for
blood-borne pathogens as soon as feasible;

(4) the facility asks the source individual to consent to a test for blood-borne pathogens
and the source individual does not consent;

(5) the facility has provided the source individual with all of the information required
by section 144.7403; and

(6) the facility has informed the emergency medical services person of the confidentiality
requirements of section 144.7411 and the penalties for unauthorized release of source
information under section 144.7412.

Sec. 50.

Minnesota Statutes 2018, section 144.7407, subdivision 2, is amended to read:


Subd. 2.

Procedures without consent.

(a) An emergency medical services agency, or,
if there is no agency, an emergency medical services person, may bring a petition for a court
order to require a source individual to provide a blood sample for testing for blood-borne
pathogens. The petition shall be filed in the district court in the county where the source
individual resides or is hospitalized. The petitioner shall serve the petition on the source
individual at least three days before a hearing on the petition. The petition shall include one
or more affidavits attesting that:

(1) the facility followed the procedures in sections 144.7401 to 144.7415 and attempted
to obtain blood-borne pathogen test results according to those sections;

(2) it has been determined under section 144.7414, subdivision 2, that a significant
exposure has occurred to the emergency medical services person; and

(3) a physician with specialty training in infectious diseases, including HIV, has
documented that the emergency medical services person has provided a blood sample and
consented to testing for blood-borne pathogens and blood-borne pathogen test results are
needed for beginning, continuing, modifying, or discontinuing medical treatment for the
emergency medical services person.

(b) Facilities shall cooperate with petitioners in providing any necessary affidavits to
the extent that facility staff can attest under oath to the facts in the affidavits.

(c) The court may order the source individual to provide a blood sample for blood-borne
pathogen testing if:

(1) there is probable cause to believe the emergency medical services person has
experienced a significant exposure to the source individual;

(2) the court imposes appropriate safeguards against unauthorized disclosure that must
specify the persons who have access to the test results and the purposes for which the test
results may be used;

(3) a licensed physiciannew text begin or advanced practice registered nursenew text end for the emergency medical
services person needs the test results for beginning, continuing, modifying, or discontinuing
medical treatment for the emergency medical services person; and

(4) the court finds a compelling need for the test results. In assessing compelling need,
the court shall weigh the need for the court-ordered blood collection and test results against
the interests of the source individual, including, but not limited to, privacy, health, safety,
or economic interests. The court shall also consider whether the involuntary blood collection
and testing would serve the public interest.

(d) The court shall conduct the proceeding in camera unless the petitioner or the source
individual requests a hearing in open court and the court determines that a public hearing
is necessary to the public interest and the proper administration of justice.

(e) The court shall conduct an ex parte hearing if the source individual does not attend
the noticed hearing and the petitioner complied with the notice requirements in paragraph
(a).

(f) The source individual has the right to counsel in any proceeding brought under this
subdivision.

(g) The court may order a source individual taken into custody by a peace officer for
purposes of obtaining a blood sample if the source individual does not comply with an order
issued by the court pursuant to paragraph (c). The source individual shall be held no longer
than is necessary to secure a blood sample. A person may not be held for more than 24 hours
without receiving a court hearing.

Sec. 51.

Minnesota Statutes 2018, section 144.7414, subdivision 2, is amended to read:


Subd. 2.

Facility protocol requirements.

Every facility shall adopt and follow a
postexposure protocol for emergency medical services persons who have experienced a
significant exposure. The postexposure protocol must adhere to the most current
recommendations of the United States Public Health Service and include, at a minimum,
the following:

(1) a process for emergency medical services persons to report an exposure in a timely
fashion;

(2) a process for an infectious disease specialist, or a licensed physiciannew text begin or advanced
practice registered nurse
new text end who is knowledgeable about the most current recommendations
of the United States Public Health Service in consultation with an infectious disease specialist,
(i) to determine whether a significant exposure to one or more blood-borne pathogens has
occurred and (ii) to provide, under the direction of a licensed physiciannew text begin or advanced practice
registered nurse
new text end, a recommendation or recommendations for follow-up treatment appropriate
to the particular blood-borne pathogen or pathogens for which a significant exposure has
been determined;

(3) if there has been a significant exposure, a process to determine whether the source
individual has a blood-borne pathogen through disclosure of test results, or through blood
collection and testing as required by sections 144.7401 to 144.7415;

(4) a process for providing appropriate counseling prior to and following testing for a
blood-borne pathogen regarding the likelihood of blood-borne pathogen transmission and
follow-up recommendations according to the most current recommendations of the United
States Public Health Service, recommendations for testing, and treatment to the emergency
medical services person;

(5) a process for providing appropriate counseling under clause (4) to the emergency
medical services person and the source individual; and

(6) compliance with applicable state and federal laws relating to data practices,
confidentiality, informed consent, and the patient bill of rights.

Sec. 52.

Minnesota Statutes 2018, section 144.7415, subdivision 2, is amended to read:


Subd. 2.

Immunity.

A facility, licensed physician,new text begin advanced practice registered nurse,new text end
and designated health care personnel are immune from liability in any civil, administrative,
or criminal action relating to the disclosure of test results to an emergency medical services
person or emergency medical services agency and the testing of a blood sample from the
source individual for blood-borne pathogens if a good faith effort has been made to comply
with sections 144.7401 to 144.7415.

Sec. 53.

Minnesota Statutes 2018, section 144.9502, subdivision 4, is amended to read:


Subd. 4.

Blood lead analyses and epidemiologic information.

The blood lead analysis
reports required in this section must specify:

(1) whether the specimen was collected as a capillary or venous sample;

(2) the date the sample was collected;

(3) the results of the blood lead analysis;

(4) the date the sample was analyzed;

(5) the method of analysis used;

(6) the full name, address, and phone number of the laboratory performing the analysis;

(7) the full name, address, and phone number of the physiciannew text begin, advanced practice
registered nurse,
new text end or facility requesting the analysis;

(8) the full name, address, and phone number of the person with the blood lead level,
and the person's birthdate, gender, and race.

Sec. 54.

Minnesota Statutes 2018, section 144.966, subdivision 3, is amended to read:


Subd. 3.

Early hearing detection and intervention programs.

All hospitals shall
establish an early hearing detection and intervention (EHDI) program. Each EHDI program
shall:

(1) in advance of any hearing screening testing, provide to the newborn's or infant's
parents or parent information concerning the nature of the screening procedure, applicable
costs of the screening procedure, the potential risks and effects of hearing loss, and the
benefits of early detection and intervention;

(2) comply with parental election as described under section 144.125, subdivision 4;

(3) develop policies and procedures for screening and rescreening based on Department
of Health recommendations;

(4) provide appropriate training and monitoring of individuals responsible for performing
hearing screening tests as recommended by the Department of Health;

(5) test the newborn's hearing prior to discharge, or, if the newborn is expected to remain
in the hospital for a prolonged period, testing shall be performed prior to three months of
age or when medically feasible;

(6) develop and implement procedures for documenting the results of all hearing screening
tests;

(7) inform the newborn's or infant's parents or parent, primary care physiciannew text begin or advanced
practice registered nurse
new text end, and the Department of Health according to recommendations of
the Department of Health of the results of the hearing screening test or rescreening if
conducted, or if the newborn or infant was not successfully tested. The hospital that
discharges the newborn or infant to home is responsible for the screening; and

(8) collect performance data specified by the Department of Health.

Sec. 55.

Minnesota Statutes 2018, section 144.966, subdivision 6, is amended to read:


Subd. 6.

Civil and criminal immunity and penalties.

(a) No physiciannew text begin, advanced
practice registered nurse,
new text end or hospital shall be civilly or criminally liable for failure to conduct
hearing screening testing.

(b) No physician, midwife, nurse, other health professional, or hospital acting in
compliance with this section shall be civilly or criminally liable for any acts conforming
with this section, including furnishing information required according to this section.

Sec. 56.

Minnesota Statutes 2018, section 144A.135, is amended to read:


144A.135 TRANSFER AND DISCHARGE APPEALS.

(a) The commissioner shall establish a mechanism for hearing appeals on transfers and
discharges of residents by nursing homes or boarding care homes licensed by the
commissioner. The commissioner may adopt permanent rules to implement this section.

(b) Until federal regulations are adopted under sections 1819(f)(3) and 1919(f)(3) of the
Social Security Act that govern appeals of the discharges or transfers of residents from
nursing homes and boarding care homes certified for participation in Medicare or medical
assistance, the commissioner shall provide hearings under sections 14.57 to 14.62 and the
rules adopted by the Office of Administrative Hearings governing contested cases. To appeal
the discharge or transfer, or notification of an intended discharge or transfer, a resident or
the resident's representative must request a hearing in writing no later than 30 days after
receiving written notice, which conforms to state and federal law, of the intended discharge
or transfer.

(c) Hearings under this section shall be held no later than 14 days after receipt of the
request for hearing, unless impractical to do so or unless the parties agree otherwise. Hearings
shall be held in the facility in which the resident resides, unless impractical to do so or unless
the parties agree otherwise.

(d) A resident who timely appeals a notice of discharge or transfer, and who resides in
a certified nursing home or boarding care home, may not be discharged or transferred by
the nursing home or boarding care home until resolution of the appeal. The commissioner
can order the facility to readmit the resident if the discharge or transfer was in violation of
state or federal law. If the resident is required to be hospitalized for medical necessity before
resolution of the appeal, the facility shall readmit the resident unless the resident's attending
physiciannew text begin or advanced practice registered nursenew text end documents, in writing, why the resident's
specific health care needs cannot be met in the facility.

(e) The commissioner and Office of Administrative Hearings shall conduct the hearings
in compliance with the federal regulations described in paragraph (b), when adopted.

(f) Nothing in this section limits the right of a resident or the resident's representative
to request or receive assistance from the Office of Ombudsman for Long-Term Care or the
Office of Health Facility Complaints with respect to an intended discharge or transfer.

(g) A person required to inform a health care facility of the person's status as a registered
predatory offender under section 243.166, subdivision 4b, who knowingly fails to do so
shall be deemed to have endangered the safety of individuals in the facility under Code of
Federal Regulations, chapter 42, section 483.12. Notwithstanding paragraph (d), any appeal
of the notice and discharge shall not constitute a stay of the discharge.

Sec. 57.

Minnesota Statutes 2018, section 144A.161, subdivision 5, is amended to read:


Subd. 5.

Licensee responsibilities related to sending the notice in subdivision 5a.

(a)
The licensee shall establish an interdisciplinary team responsible for coordinating and
implementing the plan. The interdisciplinary team shall include representatives from the
county social services agency, the Office of Ombudsman for Long-Term Care, the Office
of the Ombudsman for Mental Health and Developmental Disabilities, facility staff that
provide direct care services to the residents, and facility administration.

(b) Concurrent with the notice provided in subdivision 5a, the licensee shall provide an
updated resident census summary document to the county social services agency, the
Ombudsman for Long-Term Care, and the Ombudsman for Mental Health and Developmental
Disabilities that includes the following information on each resident to be relocated:

(1) resident name;

(2) date of birth;

(3) Social Security number;

(4) payment source and medical assistance identification number, if applicable;

(5) county of financial responsibility if the resident is enrolled in a Minnesota health
care program;

(6) date of admission to the facility;

(7) all current diagnoses;

(8) the name of and contact information for the resident's physiciannew text begin or advanced practice
registered nurse
new text end;

(9) the name and contact information for the resident's responsible party;

(10) the name of and contact information for any case manager, managed care coordinator,
or other care coordinator, if known;

(11) information on the resident's status related to commitment and probation; and

(12) the name of the managed care organization in which the resident is enrolled, if
known.

Sec. 58.

Minnesota Statutes 2018, section 144A.161, subdivision 5a, is amended to read:


Subd. 5a.

Administrator and licensee responsibility to provide notice.

At least 60
days before the proposed date of closing, reduction, or change in operations as agreed to in
the plan, the administrator shall send a written notice of closure, reduction, or change in
operations to each resident being relocated, the resident's responsible party, the resident's
managed care organization if it is known, the county social services agency, the commissioner
of health, the commissioner of human services, the Office of Ombudsman for Long-Term
Care and the Office of Ombudsman for Mental Health and Developmental Disabilities, the
resident's attending physiciannew text begin or advanced practice registered nursenew text end, and, in the case of a
complete facility closure, the Centers for Medicare and Medicaid Services regional office
designated representative. The notice must include the following:

(1) the date of the proposed closure, reduction, or change in operations;

(2) the contact information of the individual or individuals in the facility responsible for
providing assistance and information;

(3) notification of upcoming meetings for residents, responsible parties, and resident
and family councils to discuss the plan for relocation of residents;

(4) the contact information of the county social services agency contact person; and

(5) the contact information of the Office of Ombudsman for Long-Term Care and the
Office of Ombudsman for Mental Health and Developmental Disabilities.

Sec. 59.

Minnesota Statutes 2018, section 144A.161, subdivision 5e, is amended to read:


Subd. 5e.

Licensee responsibility for site visits.

The licensee shall assist residents
desiring to make site visits to facilities with available beds or other appropriate living options
to which the resident may relocate, unless it is medically inadvisable, as documented by
the attending physiciannew text begin or advanced practice registered nursenew text end in the resident's care record.
The licensee shall make available to the resident at no charge transportation for up to three
site visits to facilities or other living options within the county or contiguous counties.

Sec. 60.

Minnesota Statutes 2018, section 144A.161, subdivision 5g, is amended to read:


Subd. 5g.

Licensee responsibilities for final written discharge notice and records
transfer.

(a) The licensee shall provide the resident, the resident's responsible parties, the
resident's managed care organization, if known, and the resident's attending physiciannew text begin or
advanced practice registered nurse
new text end with a final written discharge notice prior to the relocation
of the resident. The notice must:

(1) be provided prior to the actual relocation; and

(2) identify the effective date of the anticipated relocation and the destination to which
the resident is being relocated.

(b) The licensee shall provide the receiving facility or other health, housing, or care
entity with complete and accurate resident records including contact information for family
members, responsible parties, social service or other caseworkers, and managed care
coordinators. These records must also include all information necessary to provide appropriate
medical care and social services. This includes, but is not limited to, information on
preadmission screening, Level I and Level II screening, minimum data set (MDS), all other
assessments, current resident diagnoses, social, behavioral, and medication information,
required forms, and discharge summaries.

(c) For residents with special care needs, the licensee shall consult with the receiving
facility or other placement entity and provide staff training or other preparation as needed
to assist in providing for the special needs.

Sec. 61.

Minnesota Statutes 2018, section 144A.75, subdivision 3, is amended to read:


Subd. 3.

Core services.

"Core services" means physician services, registered nursing
services,new text begin advanced practice registered nurse services,new text end medical social services, and counseling
services. A hospice must ensure that at least two core services are regularly provided directly
by hospice employees. A hospice provider may use contracted staff if necessary to
supplement hospice employees in order to meet the needs of patients during peak patient
loads or under extraordinary circumstances.

Sec. 62.

Minnesota Statutes 2018, section 144A.75, subdivision 6, is amended to read:


Subd. 6.

Hospice patient.

"Hospice patient" means an individual whose illness has been
documented by the individual's attending physiciannew text begin or advanced practice registered nursenew text end
and hospice medical director, who alone or, when unable, through the individual's family
has voluntarily consented to and received admission to a hospice provider, and who:

(1) has been diagnosed as terminally ill, with a probable life expectancy of under one
year; or

(2) is 21 years of age or younger; has been diagnosed with a chronic, complex, and
life-threatening illness contributing to a shortened life expectancy; and is not expected to
survive to adulthood.

Sec. 63.

Minnesota Statutes 2018, section 144A.752, subdivision 1, is amended to read:


Subdivision 1.

Rules.

The commissioner shall adopt rules for the regulation of hospice
providers according to sections 144A.75 to 144A.755. The rules shall include the following:

(1) provisions to ensure, to the extent possible, the health, safety, well-being, and
appropriate treatment of persons who receive hospice care;

(2) requirements that hospice providers furnish the commissioner with specified
information necessary to implement sections 144A.75 to 144A.755;

(3) standards of training of hospice provider personnel;

(4) standards for medication management, which may vary according to the nature of
the hospice care provided, the setting in which the hospice care is provided, or the status of
the patient;

(5) standards for hospice patient and hospice patient's family evaluation or assessment,
which may vary according to the nature of the hospice care provided or the status of the
patient; and

(6) requirements for the involvement of a patient's physiciannew text begin or advanced practice
registered nurse
new text end; documentation of physicians'new text begin or advanced practice registered nurses'new text end orders,
if required, and the patient's hospice plan of care; and maintenance of accurate, current
clinical records.

Sec. 64.

Minnesota Statutes 2018, section 145.853, subdivision 5, is amended to read:


Subd. 5.

Notification; medical care.

A law enforcement officer who determines or has
reason to believe that a disabled person is suffering from an illness causing the person's
condition shall promptly notify the person's physiciannew text begin or advanced practice registered nursenew text end,
if practicable. If the officer is unable to ascertain the physician'snew text begin or advanced practice
registered nurse's
new text end identity or to communicate with the physiciannew text begin or advanced practice
registered nurse
new text end, the officer shall make a reasonable effort to cause the disabled person to
be transported immediately to a medical practitioner or to a facility where medical treatment
is available. If the officer believes it unduly dangerous to move the disabled person, the
officer shall make a reasonable effort to obtain the assistance of a medical practitioner.

Sec. 65.

Minnesota Statutes 2018, section 145.892, subdivision 3, is amended to read:


Subd. 3.

Pregnant woman.

"Pregnant woman" means an individual determined by a
licensed physician,new text begin advanced practice registered nurse,new text end midwife, or appropriately trained
registered nurse to have one or more fetuses in utero.

Sec. 66.

Minnesota Statutes 2018, section 145.94, subdivision 2, is amended to read:


Subd. 2.

Disclosure of information.

The commissioner may disclose to individuals or
to the community, information including data made nonpublic by law, relating to the
hazardous properties and health hazards of hazardous substances released from a workplace
if the commissioner finds:

(1) evidence that a person requesting the information may have suffered or is likely to
suffer illness or injury from exposure to a hazardous substance; or

(2) evidence of a community health risk and if the commissioner seeks to have the
employer cease an activity which results in release of a hazardous substance.

Nonpublic data obtained under subdivision 1 is subject to handling, use, and storage
according to established standards to prevent unauthorized use or disclosure. If the nonpublic
data is required for the diagnosis, treatment, or prevention of illness or injury, a personal
physiciannew text begin or advanced practice registered nursenew text end may be provided with this information if
the physiciannew text begin or advanced practice registered nursenew text end agrees to preserve the confidentiality
of the information, except for patient health records subject to sections 144.291 to 144.298.
After the disclosure of any hazardous substance information relating to a particular
workplace, the commissioner shall advise the employer of the information disclosed, the
date of the disclosure, and the person who received the information.

Sec. 67.

Minnesota Statutes 2018, section 145B.13, is amended to read:


145B.13 REASONABLE MEDICAL PRACTICE REQUIRED.

In reliance on a patient's living will, a decision to administer, withhold, or withdraw
medical treatment after the patient has been diagnosed by the attending physiciannew text begin or advanced
practice registered nurse
new text end to be in a terminal condition must always be based on reasonable
medical practice, including:

(1) continuation of appropriate care to maintain the patient's comfort, hygiene, and human
dignity and to alleviate pain;

(2) oral administration of food or water to a patient who accepts it, except for clearly
documented medical reasons; and

(3) in the case of a living will of a patient that the attending physiciannew text begin or advanced
practice registered nurse
new text end knows is pregnant, the living will must not be given effect as long
as it is possible that the fetus could develop to the point of live birth with continued
application of life-sustaining treatment.

Sec. 68.

Minnesota Statutes 2018, section 145C.02, is amended to read:


145C.02 HEALTH CARE DIRECTIVE.

A principal with the capacity to do so may execute a health care directive. A health care
directive may include one or more health care instructions to direct health care providers,
others assisting with health care, family members, and a health care agent. A health care
directive may include a health care power of attorney to appoint a health care agent to make
health care decisions for the principal when the principal, in the judgment of the principal's
attending physiciannew text begin or advanced practice registered nursenew text end, lacks decision-making capacity,
unless otherwise specified in the health care directive.

Sec. 69.

Minnesota Statutes 2019 Supplement, section 145C.05, subdivision 2, is amended
to read:


Subd. 2.

Provisions that may be included.

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

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

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

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

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

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

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

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

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

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

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

(11) health care instructions regarding artificially administered nutrition or hydration;
and

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

(b) A health care directive may include a statement of the circumstances under which
the directive becomes effective other than upon the judgment of the principal's attending
physician new text beginor advanced practice registered nurse new text endin the following situations:

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

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

If a person appointed under clause (1) or (2) is not reasonably available and the principal
is receiving care under the direction of an attending physician new text beginor advanced practice registered
nurse
new text endin a health care facility, an attending physician new text beginor advanced practice registered nurse
new text end shall determine the principal's decision-making capacity.

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

Sec. 70.

Minnesota Statutes 2018, section 145C.06, is amended to read:


145C.06 WHEN EFFECTIVE.

A health care directive is effective for a health care decision when:

(1) it meets the requirements of section 145C.03, subdivision 1; and

(2) the principal, in the determination of the attending physiciannew text begin or advanced practice
registered nurse
new text end of the principal, lacks decision-making capacity to make the health care
decision; or if other conditions for effectiveness otherwise specified by the principal have
been met.

A health care directive is not effective for a health care decision when the principal, in
the determination of the attending physiciannew text begin or advanced practice registered nursenew text end of the
principal, recovers decision-making capacity; or if other conditions for effectiveness
otherwise specified by the principal have been met.

Sec. 71.

Minnesota Statutes 2018, section 145C.07, subdivision 1, is amended to read:


Subdivision 1.

Authority.

The health care agent has authority to make any particular
health care decision only if the principal lacks decision-making capacity, in the determination
of the attending physiciannew text begin or advanced practice registered nursenew text end, to make or communicate
that health care decision; or if other conditions for effectiveness otherwise specified by the
principal have been met. The physiciannew text begin, advanced practice registered nurse,new text end or other health
care provider shall continue to obtain the principal's informed consent to all health care
decisions for which the principal has decision-making capacity, unless other conditions for
effectiveness otherwise specified by the principal have been met. An alternate health care
agent has authority to act if the primary health care agent is not reasonably available to act.

Sec. 72.

Minnesota Statutes 2018, section 145C.16, is amended to read:


145C.16 SUGGESTED FORM.

The following is a suggested form of a health care directive and is not a required form.

HEALTH CARE DIRECTIVE

I, ..........................., understand this document allows me to do ONE OR BOTH of the
following:

PART I: Name another person (called the health care agent) to make health care decisions
for me if I am unable to decide or speak for myself. My health care agent must make health
care decisions for me based on the instructions I provide in this document (Part II), if any,
the wishes I have made known to him or her, or must act in my best interest if I have not
made my health care wishes known.

AND/OR

PART II: Give health care instructions to guide others making health care decisions for
me. If I have named a health care agent, these instructions are to be used by the agent. These
instructions may also be used by my health care providers, others assisting with my health
care and my family, in the event I cannot make decisions for myself.

PART I: APPOINTMENT OF HEALTH CARE AGENT

THIS IS WHO I WANT TO MAKE HEALTH CARE DECISIONS

FOR ME IF I AM UNABLE TO DECIDE OR SPEAK FOR MYSELF

(I know I can change my agent or alternate agent at any time and I know I do not have
to appoint an agent or an alternate agent)

NOTE: If you appoint an agent, you should discuss this health care directive with your agent
and give your agent a copy. If you do not wish to appoint an agent, you may leave Part I
blank and go to Part II.

When I am unable to decide or speak for myself, I trust and appoint .......................... to
make health care decisions for me. This person is called my health care agent.

Relationship of my health care agent to me: .

Telephone number of my health care agent: .

Address of my health care agent: .

(OPTIONAL) APPOINTMENT OF ALTERNATE HEALTH CARE AGENT: If my
health care agent is not reasonably available, I trust and appoint .................... to be my health
care agent instead.

Relationship of my alternate health care agent to me: .

Telephone number of my alternate health care agent: .

Address of my alternate health care agent: .

THIS IS WHAT I WANT MY HEALTH CARE AGENT TO BE ABLE TO

DO IF I AM UNABLE TO DECIDE OR SPEAK FOR MYSELF

(I know I can change these choices)

My health care agent is automatically given the powers listed below in (A) through (D).
My health care agent must follow my health care instructions in this document or any other
instructions I have given to my agent. If I have not given health care instructions, then my
agent must act in my best interest.

Whenever I am unable to decide or speak for myself, my health care agent has the power
to:

(A) Make any health care decision for me. This includes the power to give, refuse, or
withdraw consent to any care, treatment, service, or procedures. This includes deciding
whether to stop or not start health care that is keeping me or might keep me alive, and
deciding about intrusive mental health treatment.

(B) Choose my health care providers.

(C) Choose where I live and receive care and support when those choices relate to my
health care needs.

(D) Review my medical records and have the same rights that I would have to give my
medical records to other people.

If I DO NOT want my health care agent to have a power listed above in (A) through (D)
OR if I want to LIMIT any power in (A) through (D), I MUST say that here:

.

.

.

My health care agent is NOT automatically given the powers listed below in (1) and (2).
If I WANT my agent to have any of the powers in (1) and (2), I must INITIAL the line in
front of the power; then my agent WILL HAVE that power.

.
(1)
To decide whether to donate any parts of my body, including organs, tissues,
and eyes, when I die.
.
(2)
To decide what will happen with my body when I die (burial, cremation).

If I want to say anything more about my health care agent's powers or limits on the
powers, I can say it here:

.

.

.

PART II: HEALTH CARE INSTRUCTIONS

NOTE: Complete this Part II if you wish to give health care instructions. If you appointed
an agent in Part I, completing this Part II is optional but would be very helpful to your agent.
However, if you chose not to appoint an agent in Part I, you MUST complete some or all
of this Part II if you wish to make a valid health care directive.

These are instructions for my health care when I am unable to decide or speak for myself.
These instructions must be followed (so long as they address my needs).

THESE ARE MY BELIEFS AND VALUES ABOUT MY HEALTH CARE

(I know I can change these choices or leave any of them blank)

I want you to know these things about me to help you make decisions about my health
care:

My goals for my health care: .

.

.

My fears about my health care: .

.

.

My spiritual or religious beliefs and traditions: .

.

.

My beliefs about when life would be no longer worth living: .

.

.

My thoughts about how my medical condition might affect my family:

.

.

THIS IS WHAT I WANT AND DO NOT WANT FOR MY HEALTH CARE

(I know I can change these choices or leave any of them blank)

Many medical treatments may be used to try to improve my medical condition or to
prolong my life. Examples include artificial breathing by a machine connected to a tube in
the lungs, artificial feeding or fluids through tubes, attempts to start a stopped heart, surgeries,
dialysis, antibiotics, and blood transfusions. Most medical treatments can be tried for a
while and then stopped if they do not help.

I have these views about my health care in these situations:

(Note: You can discuss general feelings, specific treatments, or leave any of them blank)

If I had a reasonable chance of recovery, and were temporarily unable to decide or speak
for myself, I would want: .

.

.

If I were dying and unable to decide or speak for myself, I would want: .

.

.

If I were permanently unconscious and unable to decide or speak for myself, I would
want: .

.

.

If I were completely dependent on others for my care and unable to decide or speak for
myself, I would want: .

.

.

In all circumstances, my doctors new text begin or advanced practice registered nurses new text end will try to keep
me comfortable and reduce my pain. This is how I feel about pain relief if it would affect
my alertness or if it could shorten my life: .

.

.

There are other things that I want or do not want for my health care, if possible:

Who I would like to be my doctor new text begin or advanced practice registered nurse new text end : .

.

.

Where I would like to live to receive health care: .

.

.

Where I would like to die and other wishes I have about dying: .

.

.

My wishes about donating parts of my body when I die: .

.

.

My wishes about what happens to my body when I die (cremation, burial): .

.

.

Any other things: .

.

.

PART III: MAKING THE DOCUMENT LEGAL

This document must be signed by me. It also must either be verified by a notary public
(Option 1) OR witnessed by two witnesses (Option 2). It must be dated when it is verified
or witnessed.

I am thinking clearly, I agree with everything that is written in this document, and I have
made this document willingly.

.
My Signature
Date signed:
.
Date of birth:
.
Address:
.
.
If I cannot sign my name, I can ask someone to sign this document for me.
.
Signature of the person who I asked to sign this document for me.
.
Printed name of the person who I asked to sign this document for me.

Option 1: Notary Public

In my presence on .................... (date), ....................... (name) acknowledged his/her
signature on this document or acknowledged that he/she authorized the person signing this
document to sign on his/her behalf. I am not named as a health care agent or alternate health
care agent in this document.

.
(Signature of Notary)
(Notary Stamp)

Option 2: Two Witnesses

Two witnesses must sign. Only one of the two witnesses can be a health care provider
or an employee of a health care provider giving direct care to me on the day I sign this
document.

Witness One:

(i) In my presence on ............... (date), ............... (name) acknowledged his/her signature
on this document or acknowledged that he/she authorized the person signing this document
to sign on his/her behalf.

(ii) I am at least 18 years of age.

(iii) I am not named as a health care agent or an alternate health care agent in this
document.

(iv) If I am a health care provider or an employee of a health care provider giving direct
care to the person listed above in (A), I must initial this box: [ ]

I certify that the information in (i) through (iv) is true and correct.

.
(Signature of Witness One)
Address:
.
.

Witness Two:

(i) In my presence on .............. (date), ................. (name) acknowledged his/her signature
on this document or acknowledged that he/she authorized the person signing this document
to sign on his/her behalf.

(ii) I am at least 18 years of age.

(iii) I am not named as a health care agent or an alternate health care agent in this
document.

(iv) If I am a health care provider or an employee of a health care provider giving direct
care to the person listed above in (A), I must initial this box: [ ]

I certify that the information in (i) through (iv) is true and correct.

.
(Signature of Witness Two)
Address:
.
.

REMINDER: Keep this document with your personal papers in a safe place (not in a safe
deposit box). Give signed copies to your doctorsnew text begin or advanced practice registered nursesnew text end,
family, close friends, health care agent, and alternate health care agent. Make sure your
doctornew text begin or advanced practice registered nursenew text end is willing to follow your wishes. This document
should be part of your medical record at your physician'snew text begin or advanced practice registered
nurse's
new text end office and at the hospital, home care agency, hospice, or nursing facility where you
receive your care.

Sec. 73.

Minnesota Statutes 2018, section 148.6438, subdivision 1, is amended to read:


Subdivision 1.

Required notification.

In the absence of a physiciannew text begin or advanced practice
registered nurse
new text end referral or prior authorization, and before providing occupational therapy
services for remuneration or expectation of payment from the client, an occupational therapist
must provide the following written notification in all capital letters of 12-point or larger
boldface type, to the client, parent, or guardian:

"Your health care provider, insurer, or plan may require a physiciannew text begin or advanced practice
registered nurse
new text end referral or prior authorization and you may be obligated for partial or full
payment for occupational therapy services rendered."

Information other than this notification may be included as long as the notification
remains conspicuous on the face of the document. A nonwritten disclosure format may be
used to satisfy the recipient notification requirement when necessary to accommodate the
physical condition of a client or client's guardian.

Sec. 74.

Minnesota Statutes 2018, section 151.19, subdivision 4, is amended to read:


Subd. 4.

Licensing of physiciansnew text begin and advanced practice registered nursesnew text end to dispense
drugs; renewals.

(a) The board may grant a license to any physician licensed under chapter
147new text begin or advanced practice registered nurse licensed under chapter 148new text end who provides services
in a health care facility located in a designated health professional shortage area authorizing
the physiciannew text begin or advanced practice registered nursenew text end to dispense drugs to individuals for
whom pharmaceutical care is not reasonably available. The license may be renewed annually.
Any physiciannew text begin or advanced practice registered nursenew text end licensed under this subdivision shall
be limited to dispensing drugs in a limited service pharmacy and shall be governed by the
rules adopted by the board when dispensing drugs.

(b) For the purposes of this subdivision, pharmaceutical care is not reasonably available
if the limited service pharmacy in which the physiciannew text begin or advanced practice registered nursenew text end
is dispensing drugs is located in a health professional shortage area, and no other licensed
pharmacy is located within 15 miles of the limited service pharmacy.

(c) For the purposes of this subdivision, section 151.15, subdivision 2, shall not apply,
and section 151.215 shall not apply provided that a physiciannew text begin or advanced practice registered
nurse
new text end granted a license under this subdivision certifies each filled prescription in accordance
with Minnesota Rules, part 6800.3100, subpart 3.

(d) Notwithstanding section 151.102, a physiciannew text begin or advanced practice registered nursenew text end
granted a license under this subdivision may be assisted by a pharmacy technician if the
technician holds a valid certification from the Pharmacy Technician Certification Board or
from another national certification body for pharmacy technicians that requires passage of
a nationally recognized psychometrically valid certification examination for certification
as determined by the board. The physiciannew text begin or advanced practice registered nursenew text end may
supervise the pharmacy technician as long as the physiciannew text begin or advanced practice registered
nurse
new text end assumes responsibility for all functions performed by the technician. For purposes of
this subdivision, supervision does not require the physiciannew text begin or advanced practice registered
nurse
new text end to be physically present if the physiciannew text begin, advanced practice registered nurse,new text end or a
licensed pharmacist is available, either electronically or by telephone.

(e) Nothing in this subdivision shall be construed to prohibit a physiciannew text begin or advanced
practice registered nurse
new text end from dispensing drugs pursuant to section 151.37 and Minnesota
Rules, parts 6800.9950 to 6800.9954.

Sec. 75.

Minnesota Statutes 2018, section 151.21, subdivision 4a, is amended to read:


Subd. 4a.

Sign.

A pharmacy must post a sign in a conspicuous location and in a typeface
easily seen at the counter where prescriptions are dispensed stating: "In order to save you
money, this pharmacy will substitute whenever possible an FDA-approved, less expensive,
generic drug product, which is therapeutically equivalent to and safely interchangeable with
the one prescribed by your doctornew text begin or advanced practice registered nursenew text end, unless you object
to this substitution."

Sec. 76.

Minnesota Statutes 2018, section 152.32, subdivision 3, is amended to read:


Subd. 3.

Discrimination prohibited.

(a) No school or landlord may refuse to enroll or
lease to and may not otherwise penalize a person solely for the person's status as a patient
enrolled in the registry program under sections 152.22 to 152.37, unless failing to do so
would violate federal law or regulations or cause the school or landlord to lose a monetary
or licensing-related benefit under federal law or regulations.

(b) For the purposes of medical care, including organ transplants, a registry program
enrollee's use of medical cannabis under sections 152.22 to 152.37 is considered the
equivalent of the authorized use of any other medication used at the discretion of a physiciannew text begin
or advanced practice registered nurse
new text end and does not constitute the use of an illicit substance
or otherwise disqualify a patient from needed medical care.

(c) Unless a failure to do so would violate federal law or regulations or cause an employer
to lose a monetary or licensing-related benefit under federal law or regulations, an employer
may not discriminate against a person in hiring, termination, or any term or condition of
employment, or otherwise penalize a person, if the discrimination is based upon either of
the following:

(1) the person's status as a patient enrolled in the registry program under sections 152.22
to 152.37; or

(2) a patient's positive drug test for cannabis components or metabolites, unless the
patient used, possessed, or was impaired by medical cannabis on the premises of the place
of employment or during the hours of employment.

(d) An employee who is required to undergo employer drug testing pursuant to section
181.953 may present verification of enrollment in the patient registry as part of the employee's
explanation under section 181.953, subdivision 6.

(e) A person shall not be denied custody of a minor child or visitation rights or parenting
time with a minor child solely based on the person's status as a patient enrolled in the registry
program under sections 152.22 to 152.37. There shall be no presumption of neglect or child
endangerment for conduct allowed under sections 152.22 to 152.37, unless the person's
behavior is such that it creates an unreasonable danger to the safety of the minor as
established by clear and convincing evidence.

Sec. 77.

Minnesota Statutes 2018, section 245A.143, subdivision 8, is amended to read:


Subd. 8.

Nutritional services.

(a) The license holder shall ensure that food served is
nutritious and meets any special dietary needs of the participants as prescribed by the
participant's physiciannew text begin, advanced practice registered nurse,new text end or dietitian as specified in the
service delivery plan.

(b) Food and beverages must be obtained, handled, and properly stored to prevent
contamination, spoilage, or a threat to the health of a resident.

Sec. 78.

Minnesota Statutes 2018, section 245A.1435, is amended to read:


245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT DEATH
IN LICENSED PROGRAMS.

(a) When a license holder is placing an infant to sleep, the license holder must place the
infant on the infant's back, unless the license holder has documentation from the infant's
physiciannew text begin or advanced practice registered nursenew text end directing an alternative sleeping position
for the infant. The physiciannew text begin or advanced practice registered nursenew text end directive must be on a
form approved by the commissioner and must remain on file at the licensed location. An
infant who independently rolls onto its stomach after being placed to sleep on its back may
be allowed to remain sleeping on its stomach if the infant is at least six months of age or
the license holder has a signed statement from the parent indicating that the infant regularly
rolls over at home.

(b) The license holder must place the infant in a crib directly on a firm mattress with a
fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress, and
overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner of
the sheet with reasonable effort. The license holder must not place anything in the crib with
the infant except for the infant's pacifier, as defined in Code of Federal Regulations, title
16, part 1511. The requirements of this section apply to license holders serving infants
younger than one year of age. Licensed child care providers must meet the crib requirements
under section 245A.146. A correction order shall not be issued under this paragraph unless
there is evidence that a violation occurred when an infant was present in the license holder's
care.

(c) If an infant falls asleep before being placed in a crib, the license holder must move
the infant to a crib as soon as practicable, and must keep the infant within sight of the license
holder until the infant is placed in a crib. When an infant falls asleep while being held, the
license holder must consider the supervision needs of other children in care when determining
how long to hold the infant before placing the infant in a crib to sleep. The sleeping infant
must not be in a position where the airway may be blocked or with anything covering the
infant's face.

(d) Placing a swaddled infant down to sleep in a licensed setting is not recommended
for an infant of any age and is prohibited for any infant who has begun to roll over
independently. However, with the written consent of a parent or guardian according to this
paragraph, a license holder may place the infant who has not yet begun to roll over on its
own down to sleep in a one-piece sleeper equipped with an attached system that fastens
securely only across the upper torso, with no constriction of the hips or legs, to create a
swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter,
the license holder must obtain informed written consent for the use of swaddling from the
parent or guardian of the infant on a form provided by the commissioner and prepared in
partnership with the Minnesota Sudden Infant Death Center.

Sec. 79.

Minnesota Statutes 2018, section 245C.02, subdivision 18, is amended to read:


Subd. 18.

Serious maltreatment.

(a) "Serious maltreatment" means sexual abuse,
maltreatment resulting in death, neglect resulting in serious injury which reasonably requires
the care of a physiciannew text begin or advanced practice registered nursenew text end whether or not the care of a
physiciannew text begin or advanced practice registered nursenew text end was sought, or abuse resulting in serious
injury.

(b) For purposes of this definition, "care of a physiciannew text begin or advanced practice registered
nurse
new text end" is treatment received or ordered by a physician, physician assistant,new text begin advanced practice
registered nurse,
new text end or nurse practitioner, but does not include:

(1) diagnostic testing, assessment, or observation;

(2) the application of, recommendation to use, or prescription solely for a remedy that
is available over the counter without a prescription; or

(3) a prescription solely for a topical antibiotic to treat burns when there is no follow-up
appointment.

(c) For purposes of this definition, "abuse resulting in serious injury" means: bruises,
bites, skin laceration, or tissue damage; fractures; dislocations; evidence of internal injuries;
head injuries with loss of consciousness; extensive second-degree or third-degree burns and
other burns for which complications are present; extensive second-degree or third-degree
frostbite and other frostbite for which complications are present; irreversible mobility or
avulsion of teeth; injuries to the eyes; ingestion of foreign substances and objects that are
harmful; near drowning; and heat exhaustion or sunstroke.

(d) Serious maltreatment includes neglect when it results in criminal sexual conduct
against a child or vulnerable adult.

Sec. 80.

Minnesota Statutes 2018, section 245C.04, subdivision 1, is amended to read:


Subdivision 1.

Licensed programs; other child care programs.

(a) The commissioner
shall conduct a background study of an individual required to be studied under section
245C.03, subdivision 1, at least upon application for initial license for all license types.

(b) The commissioner shall conduct a background study of an individual required to be
studied under section 245C.03, subdivision 1, including a child care background study
subject as defined in section 245C.02, subdivision 6a, in a family child care program, licensed
child care center, certified license-exempt child care center, or legal nonlicensed child care
provider, on a schedule determined by the commissioner. Except as provided in section
245C.05, subdivision 5a, a child care background study must include submission of
fingerprints for a national criminal history record check and a review of the information
under section 245C.08. A background study for a child care program must be repeated
within five years from the most recent study conducted under this paragraph.

(c) At reapplication for a family child care license:

(1) for a background study affiliated with a licensed family child care center or legal
nonlicensed child care provider, the individual shall provide information required under
section 245C.05, subdivision 1, paragraphs (a), (b), and (d), to the county agency, and be
fingerprinted and photographed under section 245C.05, subdivision 5;

(2) the county agency shall verify the information received under clause (1) and forward
the information to the commissioner to complete the background study; and

(3) the background study conducted by the commissioner under this paragraph must
include a review of the information required under section 245C.08.

(d) The commissioner is not required to conduct a study of an individual at the time of
reapplication for a license if the individual's background study was completed by the
commissioner of human services and the following conditions are met:

(1) a study of the individual was conducted either at the time of initial licensure or when
the individual became affiliated with the license holder;

(2) the individual has been continuously affiliated with the license holder since the last
study was conducted; and

(3) the last study of the individual was conducted on or after October 1, 1995.

(e) The commissioner of human services shall conduct a background study of an
individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6),
who is newly affiliated with a child foster care license holder:

(1) the county or private agency shall collect and forward to the commissioner the
information required under section 245C.05, subdivisions 1 and 5, when the child foster
care applicant or license holder resides in the home where child foster care services are
provided;

(2) the child foster care license holder or applicant shall collect and forward to the
commissioner the information required under section 245C.05, subdivisions 1 and 5, when
the applicant or license holder does not reside in the home where child foster care services
are provided; and

(3) the background study conducted by the commissioner of human services under this
paragraph must include a review of the information required under section 245C.08,
subdivisions 1
, 3, and 4.

(f) The commissioner shall conduct a background study of an individual specified under
section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated
with an adult foster care or family adult day services and with a family child care license
holder or a legal nonlicensed child care provider authorized under chapter 119B and:

(1) except as provided in section 245C.05, subdivision 5a, the county shall collect and
forward to the commissioner the information required under section 245C.05, subdivision
1
, paragraphs (a) and (b), and subdivision 5, paragraphs (a), (b), and (d), for background
studies conducted by the commissioner for all family adult day services, for adult foster
care when the adult foster care license holder resides in the adult foster care residence, and
for family child care and legal nonlicensed child care authorized under chapter 119B;

(2) the license holder shall collect and forward to the commissioner the information
required under section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs
(a) and (b), for background studies conducted by the commissioner for adult foster care
when the license holder does not reside in the adult foster care residence; and

(3) the background study conducted by the commissioner under this paragraph must
include a review of the information required under section 245C.08, subdivision 1, paragraph
(a), and subdivisions 3 and 4.

(g) Applicants for licensure, license holders, and other entities as provided in this chapter
must submit completed background study requests to the commissioner using the electronic
system known as NETStudy before individuals specified in section 245C.03, subdivision
1
, begin positions allowing direct contact in any licensed program.

(h) For an individual who is not on the entity's active roster, the entity must initiate a
new background study through NETStudy when:

(1) an individual returns to a position requiring a background study following an absence
of 120 or more consecutive days; or

(2) a program that discontinued providing licensed direct contact services for 120 or
more consecutive days begins to provide direct contact licensed services again.

The license holder shall maintain a copy of the notification provided to the commissioner
under this paragraph in the program's files. If the individual's disqualification was previously
set aside for the license holder's program and the new background study results in no new
information that indicates the individual may pose a risk of harm to persons receiving
services from the license holder, the previous set-aside shall remain in effect.

(i) For purposes of this section, a physician licensed under chapter 147new text begin or advanced
practice registered nurse licensed under chapter 148
new text end is considered to be continuously affiliated
upon the license holder's receipt from the commissioner of health or human services of the
physician'snew text begin or advanced practice registered nurse'snew text end background study results.

(j) For purposes of family child care, a substitute caregiver must receive repeat
background studies at the time of each license renewal.

(k) A repeat background study at the time of license renewal is not required if the family
child care substitute caregiver's background study was completed by the commissioner on
or after October 1, 2017, and the substitute caregiver is on the license holder's active roster
in NETStudy 2.0.

(l) Before and after school programs authorized under chapter 119B, are exempt from
the background study requirements under section 123B.03, for an employee for whom a
background study under this chapter has been completed.

Sec. 81.

Minnesota Statutes 2018, section 245D.02, subdivision 11, is amended to read:


Subd. 11.

Incident.

"Incident" means an occurrence which involves a person and requires
the program to make a response that is not a part of the program's ordinary provision of
services to that person, and includes:

(1) serious injury of a person as determined by section 245.91, subdivision 6;

(2) a person's death;

(3) any medical emergency, unexpected serious illness, or significant unexpected change
in an illness or medical condition of a person that requires the program to call 911, physiciannew text begin
or advanced practice registered nurse
new text end treatment, or hospitalization;

(4) any mental health crisis that requires the program to call 911, a mental health crisis
intervention team, or a similar mental health response team or service when available and
appropriate;

(5) an act or situation involving a person that requires the program to call 911, law
enforcement, or the fire department;

(6) a person's unauthorized or unexplained absence from a program;

(7) conduct by a person receiving services against another person receiving services
that:

(i) is so severe, pervasive, or objectively offensive that it substantially interferes with a
person's opportunities to participate in or receive service or support;

(ii) places the person in actual and reasonable fear of harm;

(iii) places the person in actual and reasonable fear of damage to property of the person;
or

(iv) substantially disrupts the orderly operation of the program;

(8) any sexual activity between persons receiving services involving force or coercion
as defined under section 609.341, subdivisions 3 and 14;

(9) any emergency use of manual restraint as identified in section 245D.061 or successor
provisions; or

(10) a report of alleged or suspected child or vulnerable adult maltreatment under section
626.556 or 626.557.

Sec. 82.

Minnesota Statutes 2018, section 245D.11, subdivision 2, is amended to read:


Subd. 2.

Health and welfare.

The license holder must establish policies and procedures
that promote health and welfare by ensuring:

(1) use of universal precautions and sanitary practices in compliance with section
245D.06, subdivision 2, clause (5);

(2) if the license holder operates a residential program, health service coordination and
care according to the requirements in section 245D.05, subdivision 1;

(3) safe medication assistance and administration according to the requirements in
sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in
consultation with a registered nurse, deleted text beginnurse practitionerdeleted text endnew text begin advanced practice registered nursenew text end,
physician assistant, or medical doctor and require completion of medication administration
training according to the requirements in section 245D.09, subdivision 4a, paragraph (d).
Medication assistance and administration includes, but is not limited to:

(i) providing medication-related services for a person;

(ii) medication setup;

(iii) medication administration;

(iv) medication storage and security;

(v) medication documentation and charting;

(vi) verification and monitoring of effectiveness of systems to ensure safe medication
handling and administration;

(vii) coordination of medication refills;

(viii) handling changes to prescriptions and implementation of those changes;

(ix) communicating with the pharmacy; and

(x) coordination and communication with prescriber;

(4) safe transportation, when the license holder is responsible for transportation of
persons, with provisions for handling emergency situations according to the requirements
in section 245D.06, subdivision 2, clauses (2) to (4);

(5) a plan for ensuring the safety of persons served by the program in emergencies as
defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies
to the license holder. A license holder with a community residential setting or a day service
facility license must ensure the policy and procedures comply with the requirements in
section 245D.22, subdivision 4;

(6) a plan for responding to all incidents as defined in section 245D.02, subdivision 11;
and reporting all incidents required to be reported according to section 245D.06, subdivision
1. The plan must:

(i) provide the contact information of a source of emergency medical care and
transportation; and

(ii) require staff to first call 911 when the staff believes a medical emergency may be
life threatening, or to call the mental health crisis intervention team or similar mental health
response team or service when such a team is available and appropriate when the person is
experiencing a mental health crisis; and

(7) a procedure for the review of incidents and emergencies to identify trends or patterns,
and corrective action if needed. The license holder must establish and maintain a
record-keeping system for the incident and emergency reports. Each incident and emergency
report file must contain a written summary of the incident. The license holder must conduct
a review of incident reports for identification of incident patterns, and implementation of
corrective action as necessary to reduce occurrences. Each incident report must include:

(i) the name of the person or persons involved in the incident. It is not necessary to
identify all persons affected by or involved in an emergency unless the emergency resulted
in an incident;

(ii) the date, time, and location of the incident or emergency;

(iii) a description of the incident or emergency;

(iv) a description of the response to the incident or emergency and whether a person's
coordinated service and support plan addendum or program policies and procedures were
implemented as applicable;

(v) the name of the staff person or persons who responded to the incident or emergency;
and

(vi) the determination of whether corrective action is necessary based on the results of
the review.

Sec. 83.

Minnesota Statutes 2018, section 245D.22, subdivision 7, is amended to read:


Subd. 7.

Telephone and posted numbers.

A facility must have a non-coin-operated
telephone that is readily accessible. A list of emergency numbers must be posted in a
prominent location. When an area has a 911 number or a mental health crisis intervention
team number, both numbers must be posted and the emergency number listed must be 911.
In areas of the state without a 911 number, the numbers listed must be those of the local
fire department, police department, emergency transportation, and poison control center.
The names and telephone numbers of each person's representative, physiciannew text begin or advanced
practice registered nurse
new text end, and dentist must be readily available.

Sec. 84.

Minnesota Statutes 2018, section 245D.25, subdivision 2, is amended to read:


Subd. 2.

Food.

Food served must meet any special dietary needs of a person as prescribed
by the person's physiciannew text begin, advanced practice registered nurse,new text end or dietitian. Three nutritionally
balanced meals a day must be served or made available to persons, and nutritious snacks
must be available between meals.

Sec. 85.

Minnesota Statutes 2018, section 245G.08, subdivision 2, is amended to read:


Subd. 2.

Procedures.

The applicant or license holder must have written procedures for
obtaining a medical intervention for a client, that are approved in writing by a physician
who is licensed under chapter 147new text begin or advanced practice registered nurse who is licensed
under chapter 148
new text end, unless:

(1) the license holder does not provide a service under section 245G.21; and

(2) a medical intervention is referred to 911, the emergency telephone number, or the
client's physiciannew text begin or advanced practice registered nursenew text end.

Sec. 86.

Minnesota Statutes 2019 Supplement, section 245G.08, subdivision 3, is amended
to read:


Subd. 3.

Standing order protocol.

A license holder that maintains a supply of naloxone
available for emergency treatment of opioid overdose must have a written standing order
protocol by a physician who is licensed under chapter 147new text begin or advanced practice registered
nurse who is licensed under chapter 148
new text end, that permits the license holder to maintain a supply
of naloxone on site. A license holder must require staff to undergo training in the specific
mode of administration used at the program, which may include intranasal administration,
intramuscular injection, or both.

Sec. 87.

Minnesota Statutes 2018, section 245G.08, subdivision 5, is amended to read:


Subd. 5.

Administration of medication and assistance with self-medication.

(a) A
license holder must meet the requirements in this subdivision if a service provided includes
the administration of medication.

(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a
licensed practitioner or a registered nurse the task of administration of medication or assisting
with self-medication, must:

(1) successfully complete a medication administration training program for unlicensed
personnel through an accredited Minnesota postsecondary educational institution. A staff
member's completion of the course must be documented in writing and placed in the staff
member's personnel file;

(2) be trained according to a formalized training program that is taught by a registered
nurse and offered by the license holder. The training must include the process for
administration of naloxone, if naloxone is kept on site. A staff member's completion of the
training must be documented in writing and placed in the staff member's personnel records;
or

(3) demonstrate to a registered nurse competency to perform the delegated activity. A
registered nurse must be employed or contracted to develop the policies and procedures for
administration of medication or assisting with self-administration of medication, or both.

(c) A registered nurse must provide supervision as defined in section 148.171, subdivision
23. The registered nurse's supervision must include, at a minimum, monthly on-site
supervision or more often if warranted by a client's health needs. The policies and procedures
must include:

(1) a provision that a delegation of administration of medication is limited to the
administration of a medication that is administered orally, topically, or as a suppository, an
eye drop, an ear drop, or an inhalant;

(2) a provision that each client's file must include documentation indicating whether
staff must conduct the administration of medication or the client must self-administer
medication, or both;

(3) a provision that a client may carry emergency medication such as nitroglycerin as
instructed by the client's physiciannew text begin or advanced practice registered nursenew text end;

(4) a provision for the client to self-administer medication when a client is scheduled to
be away from the facility;

(5) a provision that if a client self-administers medication when the client is present in
the facility, the client must self-administer medication under the observation of a trained
staff member;

(6) a provision that when a license holder serves a client who is a parent with a child,
the parent may only administer medication to the child under a staff member's supervision;

(7) requirements for recording the client's use of medication, including staff signatures
with date and time;

(8) guidelines for when to inform a nurse of problems with self-administration of
medication, including a client's failure to administer, refusal of a medication, adverse
reaction, or error; and

(9) procedures for acceptance, documentation, and implementation of a prescription,
whether written, verbal, telephonic, or electronic.

Sec. 88.

Minnesota Statutes 2018, section 245G.21, subdivision 2, is amended to read:


Subd. 2.

Visitors.

A client must be allowed to receive visitors at times prescribed by
the license holder. The license holder must set and post a notice of visiting rules and hours,
including both day and evening times. A client's right to receive visitors other than a personal
physiciannew text begin or advanced practice registered nursenew text end, religious adviser, county case manager,
parole or probation officer, or attorney may be subject to visiting hours established by the
license holder for all clients. The treatment director or designee may impose limitations as
necessary for the welfare of a client provided the limitation and the reasons for the limitation
are documented in the client's file. A client must be allowed to receive visits at all reasonable
times from the client's personal physiciannew text begin or advanced practice registered nursenew text end, religious
adviser, county case manager, parole or probation officer, and attorney.

Sec. 89.

Minnesota Statutes 2018, section 245G.21, subdivision 3, is amended to read:


Subd. 3.

Client property management.

A license holder who provides room and board
and treatment services to a client in the same facility, and any license holder that accepts
client property must meet the requirements for handling client funds and property in section
245A.04, subdivision 13. License holders:

(1) may establish policies regarding the use of personal property to ensure that treatment
activities and the rights of other clients are not infringed upon;

(2) may take temporary custody of a client's property for violation of a facility policy;

(3) must retain the client's property for a minimum of seven days after the client's service
termination if the client does not reclaim property upon service termination, or for a minimum
of 30 days if the client does not reclaim property upon service termination and has received
room and board services from the license holder; and

(4) must return all property held in trust to the client at service termination regardless
of the client's service termination status, except that:

(i) a drug, drug paraphernalia, or drug container that is subject to forfeiture under section
609.5316, must be given to the custody of a local law enforcement agency. If giving the
property to the custody of a local law enforcement agency violates Code of Federal
Regulations, title 42, sections 2.1 to 2.67, or title 45, parts 160 to 164, a drug, drug
paraphernalia, or drug container must be destroyed by a staff member designated by the
program director; and

(ii) a weapon, explosive, and other property that can cause serious harm to the client or
others must be given to the custody of a local law enforcement agency, and the client must
be notified of the transfer and of the client's right to reclaim any lawful property transferred;
and

(iii) a medication that was determined by a physiciannew text begin or advanced practice registered
nurse
new text end to be harmful after examining the client must be destroyed, except when the client's
personal physiciannew text begin or advanced practice registered nursenew text end approves the medication for
continued use.

Sec. 90.

Minnesota Statutes 2019 Supplement, section 245H.11, is amended to read:


245H.11 REPORTING.

(a) The certification holder must comply and must have written policies for staff to
comply with the reporting requirements for abuse and neglect specified in section 626.556.
A person mandated to report physical or sexual child abuse or neglect occurring within a
certified center shall report the information to the commissioner.

(b) The certification holder must inform the commissioner within 24 hours of:

(1) the death of a child in the program; and

(2) any injury to a child in the program that required treatment by a physiciannew text begin or advanced
practice registered nurse
new text end.

Sec. 91.

Minnesota Statutes 2018, section 246.711, subdivision 2, is amended to read:


Subd. 2.

Conditions.

The secure treatment facility shall follow the procedures in sections
246.71 to 246.722 when all of the following conditions are met:

(1) a licensed physiciannew text begin or advanced practice registered nursenew text end determines that a significant
exposure has occurred following the protocol under section 246.721;

(2) the licensed physiciannew text begin or advanced practice registered nursenew text end for the employee needs
the patient's blood-borne pathogens test results to begin, continue, modify, or discontinue
treatment in accordance with the most current guidelines of the United States Public Health
Service, because of possible exposure to a blood-borne pathogen; and

(3) the employee consents to providing a blood sample for testing for a blood-borne
pathogen.

Sec. 92.

Minnesota Statutes 2018, section 246.715, subdivision 2, is amended to read:


Subd. 2.

Procedures without consent.

If the patient has provided a blood sample, but
does not consent to blood-borne pathogens testing, the secure treatment facility shall ensure
that the blood is tested for blood-borne pathogens if the employee requests the test, provided
all of the following criteria are met:

(1) the employee and secure treatment facility have documented exposure to blood or
body fluids during performance of the employee's work duties;

(2) a licensed physiciannew text begin or advanced practice registered nursenew text end has determined that a
significant exposure has occurred under section 246.711 and has documented that blood-borne
pathogen test results are needed for beginning, modifying, continuing, or discontinuing
medical treatment for the employee as recommended by the most current guidelines of the
United States Public Health Service;

(3) the employee provides a blood sample for testing for blood-borne pathogens as soon
as feasible;

(4) the secure treatment facility asks the patient to consent to a test for blood-borne
pathogens and the patient does not consent;

(5) the secure treatment facility has provided the patient and the employee with all of
the information required by section 246.712; and

(6) the secure treatment facility has informed the employee of the confidentiality
requirements of section 246.719 and the penalties for unauthorized release of patient
information under section 246.72.

Sec. 93.

Minnesota Statutes 2018, section 246.716, subdivision 2, is amended to read:


Subd. 2.

Procedures without consent.

(a) A secure treatment facility or an employee
of a secure treatment facility may bring a petition for a court order to require a patient to
provide a blood sample for testing for blood-borne pathogens. The petition shall be filed in
the district court in the county where the patient is receiving treatment from the secure
treatment facility. The secure treatment facility shall serve the petition on the patient three
days before a hearing on the petition. The petition shall include one or more affidavits
attesting that:

(1) the secure treatment facility followed the procedures in sections 246.71 to 246.722
and attempted to obtain blood-borne pathogen test results according to those sections;

(2) a licensed physiciannew text begin or advanced practice registered nursenew text end knowledgeable about the
most current recommendations of the United States Public Health Service has determined
that a significant exposure has occurred to the employee of a secure treatment facility under
section 246.721; and

(3) a physiciannew text begin or advanced practice registered nursenew text end has documented that the employee
has provided a blood sample and consented to testing for blood-borne pathogens and
blood-borne pathogen test results are needed for beginning, continuing, modifying, or
discontinuing medical treatment for the employee under section 246.721.

(b) Facilities shall cooperate with petitioners in providing any necessary affidavits to
the extent that facility staff can attest under oath to the facts in the affidavits.

(c) The court may order the patient to provide a blood sample for blood-borne pathogen
testing if:

(1) there is probable cause to believe the employee of a secure treatment facility has
experienced a significant exposure to the patient;

(2) the court imposes appropriate safeguards against unauthorized disclosure that must
specify the persons who have access to the test results and the purposes for which the test
results may be used;

(3) a licensed physiciannew text begin or advanced practice registered nursenew text end for the employee of a
secure treatment facility needs the test results for beginning, continuing, modifying, or
discontinuing medical treatment for the employee; and

(4) the court finds a compelling need for the test results. In assessing compelling need,
the court shall weigh the need for the court-ordered blood collection and test results against
the interests of the patient, including, but not limited to, privacy, health, safety, or economic
interests. The court shall also consider whether involuntary blood collection and testing
would serve the public interests.

(d) The court shall conduct the proceeding in camera unless the petitioner or the patient
requests a hearing in open court and the court determines that a public hearing is necessary
to the public interest and the proper administration of justice.

(e) The patient may arrange for counsel in any proceeding brought under this subdivision.

Sec. 94.

Minnesota Statutes 2018, section 246.721, is amended to read:


246.721 PROTOCOL FOR EXPOSURE TO BLOOD-BORNE PATHOGENS.

(a) A secure treatment facility shall follow applicable Occupational Safety and Health
Administration guidelines under Code of Federal Regulations, title 29, part 1910.1030, for
blood-borne pathogens.

(b) Every secure treatment facility shall adopt and follow a postexposure protocol for
employees at a secure treatment facility who have experienced a significant exposure. The
postexposure protocol must adhere to the most current recommendations of the United
States Public Health Service and include, at a minimum, the following:

(1) a process for employees to report an exposure in a timely fashion;

(2) a process for an infectious disease specialist, or a licensed physiciannew text begin or advanced
practice registered nurse
new text end who is knowledgeable about the most current recommendations
of the United States Public Health Service in consultation with an infectious disease specialist,
(i) to determine whether a significant exposure to one or more blood-borne pathogens has
occurred, and (ii) to provide, under the direction of a licensed physiciannew text begin or advanced practice
registered nurse
new text end, a recommendation or recommendations for follow-up treatment appropriate
to the particular blood-borne pathogen or pathogens for which a significant exposure has
been determined;

(3) if there has been a significant exposure, a process to determine whether the patient
has a blood-borne pathogen through disclosure of test results, or through blood collection
and testing as required by sections 246.71 to 246.722;

(4) a process for providing appropriate counseling prior to and following testing for a
blood-borne pathogen regarding the likelihood of blood-borne pathogen transmission and
follow-up recommendations according to the most current recommendations of the United
States Public Health Service, recommendations for testing, and treatment;

(5) a process for providing appropriate counseling under clause (4) to the employee of
a secure treatment facility and to the patient; and

(6) compliance with applicable state and federal laws relating to data practices,
confidentiality, informed consent, and the patient bill of rights.

Sec. 95.

Minnesota Statutes 2018, section 246.722, is amended to read:


246.722 IMMUNITY.

A secure treatment facility, licensed physiciannew text begin or advanced practice registered nursenew text end,
and designated health care personnel are immune from liability in any civil, administrative,
or criminal action relating to the disclosure of test results of a patient to an employee of a
secure treatment facility and the testing of a blood sample from the patient for blood-borne
pathogens if a good faith effort has been made to comply with sections 246.71 to 246.722.

Sec. 96.

Minnesota Statutes 2018, section 251.043, subdivision 1, is amended to read:


Subdivision 1.

Duty to seek treatment.

If upon the evidence mentioned in the preceding
section, the workers' compensation division finds that an employee is suffering from
tuberculosis contracted in the institution or department by contact with inmates or patients
therein or by contact with tuberculosis contaminated material therein, it shall order the
employee to seek the services of a physiciannew text begin, advanced practice registered nurse,new text end or medical
care facility. There shall be paid to the physiciannew text begin, advanced practice registered nurse,new text end or
facility where the employee may be received, the same fee for the maintenance and care of
the person as is received by the institution for the maintenance and care of a nonresident
patient. If the employee worked in a state hospital or nursing home, payment for the care
shall be made by the commissioner of human services. If employed in any other institution
or department the payment shall be made from funds allocated or appropriated for the
operation of the institution or department. If the employee dies from the effects of the disease
of tuberculosis and if the tuberculosis was the primary infection and the authentic cause of
death, the workers' compensation division shall order payment to dependents as provided
for under the general provisions of the workers' compensation law.

Sec. 97.

Minnesota Statutes 2018, section 252A.02, subdivision 12, is amended to read:


Subd. 12.

Comprehensive evaluation.

"Comprehensive evaluation" shall consist of:

(1) a medical report on the health status and physical condition of the proposed ward,
prepared under the direction of a licensed physiciannew text begin or advanced practice registered nursenew text end;

(2) a report on the proposed ward's intellectual capacity and functional abilities, specifying
the tests and other data used in reaching its conclusions, prepared by a psychologist who is
qualified in the diagnosis of developmental disability; and

(3) a report from the case manager that includes:

(i) the most current assessment of individual service needs as described in rules of the
commissioner;

(ii) the most current individual service plan under section 256B.092, subdivision 1b;
and

(iii) a description of contacts with and responses of near relatives of the proposed ward
notifying them that a nomination for public guardianship has been made and advising them
that they may seek private guardianship.

Each report shall contain recommendations as to the amount of assistance and supervision
required by the proposed ward to function as independently as possible in society. To be
considered part of the comprehensive evaluation, reports must be completed no more than
one year before filing the petition under section 252A.05.

Sec. 98.

Minnesota Statutes 2018, section 252A.04, subdivision 2, is amended to read:


Subd. 2.

Medication; treatment.

A proposed ward who, at the time the comprehensive
evaluation is to be performed, has been under medical care shall not be so under the influence
or so suffer the effects of drugs, medication, or other treatment as to be hampered in the
testing or evaluation process. When in the opinion of the licensed physiciannew text begin or advanced
practice registered nurse
new text end attending the proposed ward, the discontinuance of medication or
other treatment is not in the proposed ward's best interest, the physiciannew text begin or advanced practice
registered nurse
new text end shall record a list of all drugs, medication or other treatment which the
proposed ward received 48 hours immediately prior to any examination, test or interview
conducted in preparation for the comprehensive evaluation.

Sec. 99.

Minnesota Statutes 2018, section 252A.20, subdivision 1, is amended to read:


Subdivision 1.

Witness and attorney fees.

In each proceeding under sections 252A.01
to 252A.21, the court shall allow and order paid to each witness subpoenaed the fees and
mileage prescribed by law; to each physician,new text begin advanced practice registered nurse,new text end
psychologist, or social worker who assists in the preparation of the comprehensive evaluation
and who is not in the employ of the local agency or the state Department of Human Services,
a reasonable sum for services and for travel; and to the ward's counsel, when appointed by
the court, a reasonable sum for travel and for each day or portion of a day actually employed
in court or actually consumed in preparing for the hearing. Upon order the county auditor
shall issue a warrant on the county treasurer for payment of the amount allowed.

Sec. 100.

Minnesota Statutes 2018, section 253B.03, subdivision 4, is amended to read:


Subd. 4.

Special visitation; religion.

A patient has the right to meet with or call a
personal physiciannew text begin or advanced practice registered nursenew text end, spiritual advisor, and counsel at
all reasonable times. The patient has the right to continue the practice of religion.

Sec. 101.

Minnesota Statutes 2018, section 253B.03, subdivision 6d, is amended to read:


Subd. 6d.

Adult mental health treatment.

(a) A competent adult may make a declaration
of preferences or instructions regarding intrusive mental health treatment. These preferences
or instructions may include, but are not limited to, consent to or refusal of these treatments.

(b) A declaration may designate a proxy to make decisions about intrusive mental health
treatment. A proxy designated to make decisions about intrusive mental health treatments
and who agrees to serve as proxy may make decisions on behalf of a declarant consistent
with any desires the declarant expresses in the declaration.

(c) A declaration is effective only if it is signed by the declarant and two witnesses. The
witnesses must include a statement that they believe the declarant understands the nature
and significance of the declaration. A declaration becomes operative when it is delivered
to the declarant's physiciannew text begin, advanced practice registered nurse,new text end or other mental health
treatment provider. The physiciannew text begin, advanced practice registered nurse,new text end or provider must
comply with it to the fullest extent possible, consistent with reasonable medical practice,
the availability of treatments requested, and applicable law. The physiciannew text begin, advanced practice
registered nurse,
new text end or provider shall continue to obtain the declarant's informed consent to all
intrusive mental health treatment decisions if the declarant is capable of informed consent.
A treatment provider may not require a person to make a declaration under this subdivision
as a condition of receiving services.

(d) The physiciannew text begin, advanced practice registered nurse,new text end or other provider shall make the
declaration a part of the declarant's medical record. If the physiciannew text begin, advanced practice
registered nurse,
new text end or other provider is unwilling at any time to comply with the declaration,
the physiciannew text begin, advanced practice registered nurse,new text end or provider must promptly notify the
declarant and document the notification in the declarant's medical record. If the declarant
has been committed as a patient under this chapter, the physiciannew text begin, advanced practice
registered nurse,
new text end or provider may subject a declarant to intrusive treatment in a manner
contrary to the declarant's expressed wishes, only upon order of the committing court. If
the declarant is not a committed patient under this chapter, the physiciannew text begin, advanced practice
registered nurse,
new text end or provider may subject the declarant to intrusive treatment in a manner
contrary to the declarant's expressed wishes, only if the declarant is committed as mentally
ill or mentally ill and dangerous to the public and a court order authorizing the treatment
has been issued.

(e) A declaration under this subdivision may be revoked in whole or in part at any time
and in any manner by the declarant if the declarant is competent at the time of revocation.
A revocation is effective when a competent declarant communicates the revocation to the
attending physiciannew text begin, advanced practice registered nurse,new text end or other provider. The attending
physiciannew text begin, advanced practice registered nurse,new text end or other provider shall note the revocation
as part of the declarant's medical record.

(f) A provider who administers intrusive mental health treatment according to and in
good faith reliance upon the validity of a declaration under this subdivision is held harmless
from any liability resulting from a subsequent finding of invalidity.

(g) In addition to making a declaration under this subdivision, a competent adult may
delegate parental powers under section 524.5-211 or may nominate a guardian under sections
524.5-101 to 524.5-502.

Sec. 102.

Minnesota Statutes 2018, section 253B.06, subdivision 2, is amended to read:


Subd. 2.

Chemically dependent persons.

Patients hospitalized as chemically dependent
pursuant to section 253B.04 or 253B.05 shall also be examined within 48 hours of admission.
At a minimum, the examination shall consist of a physical evaluation by facility staff
according to procedures established by a physiciannew text begin or advanced practice registered nursenew text end
and an evaluation by staff knowledgeable and trained in the diagnosis of the alleged disability
related to the need for admission as a chemically dependent person.

Sec. 103.

Minnesota Statutes 2018, section 253B.23, subdivision 4, is amended to read:


Subd. 4.

Immunity.

All persons acting in good faith, upon either actual knowledge or
information thought by them to be reliable, who act pursuant to any provision of this chapter
or who procedurally or physically assist in the commitment of any individual, pursuant to
this chapter, are not subject to any civil or criminal liability under this chapter. Any privilege
otherwise existing between patient and physician,new text begin patient and advanced practice registered
nurse, patient and registered nurse,
new text end patient and psychologist, patient and examiner, or patient
and social worker, is waived as to any physician, new text beginadvanced practice registered nurse,
registered nurse,
new text endpsychologist, examiner, or social worker who provides information with
respect to a patient pursuant to any provision of this chapter.

Sec. 104.

Minnesota Statutes 2018, section 254A.08, subdivision 2, is amended to read:


Subd. 2.

Program requirements.

For the purpose of this section, a detoxification
program means a social rehabilitation program licensed by the Department of Human
Services under chapter 245A, and governed by the standards of Minnesota Rules, parts
9530.6510 to 9530.6590, and established for the purpose of facilitating access into care and
treatment by detoxifying and evaluating the person and providing entrance into a
comprehensive program. Evaluation of the person shall include verification by a professional,
after preliminary examination, that the person is intoxicated or has symptoms of substance
misuse or substance use disorder and appears to be in imminent danger of harming self or
others. A detoxification program shall have available the services of a licensed physiciannew text begin
or advanced practice registered nurse
new text end for medical emergencies and routine medical
surveillance. A detoxification program licensed by the Department of Human Services to
serve both adults and minors at the same site must provide for separate sleeping areas for
adults and minors.

Sec. 105.

Minnesota Statutes 2018, section 256.9685, subdivision 1a, is amended to read:


Subd. 1a.

Administrative reconsideration.

Notwithstanding section 256B.04,
subdivision 15
, the commissioner shall establish an administrative reconsideration process
for appeals of inpatient hospital services determined to be medically unnecessary. A
physiciannew text begin, advanced practice registered nurse,new text end or hospital may request a reconsideration of
the decision that inpatient hospital services are not medically necessary by submitting a
written request for review to the commissioner within 30 days after receiving notice of the
decision. The reconsideration process shall take place prior to the procedures of subdivision
1b and shall be conducted by the medical review agent that is independent of the case under
reconsideration.

Sec. 106.

Minnesota Statutes 2018, section 256.9685, subdivision 1b, is amended to read:


Subd. 1b.

Appeal of reconsideration.

Notwithstanding section 256B.72, the
commissioner may recover inpatient hospital payments for services that have been determined
to be medically unnecessary after the reconsideration and determinations. A physiciannew text begin,
advanced practice registered nurse,
new text end or hospital may appeal the result of the reconsideration
process by submitting a written request for review to the commissioner within 30 days after
receiving notice of the action. The commissioner shall review the medical record and
information submitted during the reconsideration process and the medical review agent's
basis for the determination that the services were not medically necessary for inpatient
hospital services. The commissioner shall issue an order upholding or reversing the decision
of the reconsideration process based on the review.

Sec. 107.

Minnesota Statutes 2018, section 256.9685, subdivision 1c, is amended to read:


Subd. 1c.

Judicial review.

A hospital deleted text beginordeleted text endnew text begin,new text end physiciannew text begin, or advanced practice registered
nurse
new text end aggrieved by an order of the commissioner under subdivision 1b may appeal the order
to the district court of the county in which the physiciannew text begin, advanced practice registered nurse,new text end
or hospital is located by:

(1) serving a written copy of a notice of appeal upon the commissioner within 30 days
after the date the commissioner issued the order; and

(2) filing the original notice of appeal and proof of service with the court administrator
of the district court. The appeal shall be treated as a dispositive motion under the Minnesota
General Rules of Practice, rule 115. The district court scope of review shall be as set forth
in section 14.69.

Sec. 108.

Minnesota Statutes 2018, section 256.975, subdivision 7a, is amended to read:


Subd. 7a.

Preadmission screening activities related to nursing facility admissions.

(a)
All individuals seeking admission to Medicaid-certified nursing facilities, including certified
boarding care facilities, must be screened prior to admission regardless of income, assets,
or funding sources for nursing facility care, except as described in subdivision 7b, paragraphs
(a) and (b). The purpose of the screening is to determine the need for nursing facility level
of care as described in section 256B.0911, subdivision 4e, and to complete activities required
under federal law related to mental illness and developmental disability as outlined in
paragraph (b).

(b) A person who has a diagnosis or possible diagnosis of mental illness or developmental
disability must receive a preadmission screening before admission regardless of the
exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify the need for further
evaluation and specialized services, unless the admission prior to screening is authorized
by the local mental health authority or the local developmental disabilities case manager,
or unless authorized by the county agency according to Public Law 101-508.

(c) The following criteria apply to the preadmission screening:

(1) requests for preadmission screenings must be submitted via an online form developed
by the commissioner;

(2) the Senior LinkAge Line must use forms and criteria developed by the commissioner
to identify persons who require referral for further evaluation and determination of the need
for specialized services; and

(3) the evaluation and determination of the need for specialized services must be done
by:

(i) a qualified independent mental health professional, for persons with a primary or
secondary diagnosis of a serious mental illness; or

(ii) a qualified developmental disability professional, for persons with a primary or
secondary diagnosis of developmental disability. For purposes of this requirement, a qualified
developmental disability professional must meet the standards for a qualified developmental
disability professional under Code of Federal Regulations, title 42, section 483.430.

(d) The local county mental health authority or the state developmental disability authority
under Public Laws 100-203 and 101-508 may prohibit admission to a nursing facility if the
individual does not meet the nursing facility level of care criteria or needs specialized
services as defined in Public Laws 100-203 and 101-508. For purposes of this section,
"specialized services" for a person with developmental disability means active treatment as
that term is defined under Code of Federal Regulations, title 42, section 483.440 (a)(1).

(e) In assessing a person's needs, the screener shall:

(1) use an automated system designated by the commissioner;

(2) consult with care transitions coordinators deleted text beginordeleted text endnew text begin,new text end physiciannew text begin, or advanced practice registered
nurse
new text end; and

(3) consider the assessment of the individual's physiciannew text begin or advanced practice registered
nurse
new text end.

Other personnel may be included in the level of care determination as deemed necessary
by the screener.

Sec. 109.

Minnesota Statutes 2018, section 256.975, subdivision 11, is amended to read:


Subd. 11.

Regional and local dementia grants.

(a) The Minnesota Board on Aging
shall award competitive grants to eligible applicants for regional and local projects and
initiatives targeted to a designated community, which may consist of a specific geographic
area or population, to increase awareness of Alzheimer's disease and other dementias,
increase the rate of cognitive testing in the population at risk for dementias, promote the
benefits of early diagnosis of dementias, or connect caregivers of persons with dementia to
education and resources.

(b) The project areas for grants include:

(1) local or community-based initiatives to promote the benefits of physiciannew text begin or advanced
practice registered nurse
new text end consultations for all individuals who suspect a memory or cognitive
problem;

(2) local or community-based initiatives to promote the benefits of early diagnosis of
Alzheimer's disease and other dementias; and

(3) local or community-based initiatives to provide informational materials and other
resources to caregivers of persons with dementia.

(c) Eligible applicants for local and regional grants may include, but are not limited to,
community health boards, school districts, colleges and universities, community clinics,
tribal communities, nonprofit organizations, and other health care organizations.

(d) Applicants must:

(1) describe the proposed initiative, including the targeted community and how the
initiative meets the requirements of this subdivision; and

(2) identify the proposed outcomes of the initiative and the evaluation process to be used
to measure these outcomes.

(e) In awarding the regional and local dementia grants, the Minnesota Board on Aging
must give priority to applicants who demonstrate that the proposed project:

(1) is supported by and appropriately targeted to the community the applicant serves;

(2) is designed to coordinate with other community activities related to other health
initiatives, particularly those initiatives targeted at the elderly;

(3) is conducted by an applicant able to demonstrate expertise in the project areas;

(4) utilizes and enhances existing activities and resources or involves innovative
approaches to achieve success in the project areas; and

(5) strengthens community relationships and partnerships in order to achieve the project
areas.

(f) The board shall divide the state into specific geographic regions and allocate a
percentage of the money available for the local and regional dementia grants to projects or
initiatives aimed at each geographic region.

(g) The board shall award any available grants by January 1, 2016, and each July 1
thereafter.

(h) Each grant recipient shall report to the board on the progress of the initiative at least
once during the grant period, and within two months of the end of the grant period shall
submit a final report to the board that includes the outcome results.

(i) The Minnesota Board on Aging shall:

(1) develop the criteria and procedures to allocate the grants under this subdivision,
evaluate all applicants on a competitive basis and award the grants, and select qualified
providers to offer technical assistance to grant applicants and grantees. The selected provider
shall provide applicants and grantees assistance with project design, evaluation methods,
materials, and training; and

(2) submit by January 15, 2017, and on each January 15 thereafter, a progress report on
the dementia grants programs under this subdivision to the chairs and ranking minority
members of the senate and house of representatives committees and divisions with jurisdiction
over health finance and policy. The report shall include:

(i) information on each grant recipient;

(ii) a summary of all projects or initiatives undertaken with each grant;

(iii) the measurable outcomes established by each grantee, an explanation of the
evaluation process used to determine whether the outcomes were met, and the results of the
evaluation; and

(iv) an accounting of how the grant funds were spent.

Sec. 110.

Minnesota Statutes 2018, section 256B.04, subdivision 14a, is amended to read:


Subd. 14a.

Level of need determination.

Nonemergency medical transportation level
of need determinations must be performed by a physician, a registered nurse working under
direct supervision of a physician, a physician assistant,deleted text begin a nurse practitionerdeleted text endnew text begin an advanced
practice registered nurse
new text end, a licensed practical nurse, or a discharge planner. Nonemergency
medical transportation level of need determinations must not be performed more than
annually on any individual, unless the individual's circumstances have sufficiently changed
so as to require a new level of need determination. Individuals residing in licensed nursing
facilities are exempt from a level of need determination and are eligible for special
transportation services until the individual no longer resides in a licensed nursing facility.
If a person authorized by this subdivision to perform a level of need determination determines
that an individual requires stretcher transportation, the individual is presumed to maintain
that level of need until otherwise determined by a person authorized to perform a level of
need determination, or for six months, whichever is sooner.

Sec. 111.

Minnesota Statutes 2018, section 256B.043, subdivision 2, is amended to read:


Subd. 2.

Access to care.

(a) The commissioners of human services and health, as part
of their ongoing duties, shall consider the adequacy of the current system of community
health clinics and centers both statewide and in urban areas with significant disparities in
health status and access to services across racial and ethnic groups, including:

(1) methods to provide 24-hour availability of care through the clinics and centers;

(2) methods to expand the availability of care through the clinics and centers;

(3) the use of grants to expand the number of clinics and centers, the services provided,
and the availability of care; and

(4) the extent to which increased use of physician assistants, deleted text beginnurse practitionersdeleted text endnew text begin advanced
practice registered nurses
new text end, medical residents and interns, and other allied health professionals
in clinics and centers would increase the availability of services.

(b) The commissioners shall make departmental modifications and legislative
recommendations as appropriate on the basis of their considerations under paragraph (a).

Sec. 112.

Minnesota Statutes 2018, section 256B.055, subdivision 12, is amended to read:


Subd. 12.

Children with disabilities.

(a) A person is eligible for medical assistance if
the person is under age 19 and qualifies as a disabled individual under United States Code,
title 42, section 1382c(a), and would be eligible for medical assistance under the state plan
if residing in a medical institution, and the child requires a level of care provided in a hospital,
nursing facility, or intermediate care facility for persons with developmental disabilities,
for whom home care is appropriate, provided that the cost to medical assistance under this
section is not more than the amount that medical assistance would pay for if the child resides
in an institution. After the child is determined to be eligible under this section, the
commissioner shall review the child's disability under United States Code, title 42, section
1382c(a) and level of care defined under this section no more often than annually and may
elect, based on the recommendation of health care professionals under contract with the
state medical review team, to extend the review of disability and level of care up to a
maximum of four years. The commissioner's decision on the frequency of continuing review
of disability and level of care is not subject to administrative appeal under section 256.045.
The county agency shall send a notice of disability review to the enrollee six months prior
to the date the recertification of disability is due. Nothing in this subdivision shall be
construed as affecting other redeterminations of medical assistance eligibility under this
chapter and annual cost-effective reviews under this section.

(b) For purposes of this subdivision, "hospital" means an institution as defined in section
144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part 4640.3600, and
licensed pursuant to sections 144.50 to 144.58. For purposes of this subdivision, a child
requires a level of care provided in a hospital if the child is determined by the commissioner
to need an extensive array of health services, including mental health services, for an
undetermined period of time, whose health condition requires frequent monitoring and
treatment by a health care professional or by a person supervised by a health care
professional, who would reside in a hospital or require frequent hospitalization if these
services were not provided, and the daily care needs are more complex than a nursing facility
level of care.

A child with serious emotional disturbance requires a level of care provided in a hospital
if the commissioner determines that the individual requires 24-hour supervision because
the person exhibits recurrent or frequent suicidal or homicidal ideation or behavior, recurrent
or frequent psychosomatic disorders or somatopsychic disorders that may become life
threatening, recurrent or frequent severe socially unacceptable behavior associated with
psychiatric disorder, ongoing and chronic psychosis or severe, ongoing and chronic
developmental problems requiring continuous skilled observation, or severe disabling
symptoms for which office-centered outpatient treatment is not adequate, and which overall
severely impact the individual's ability to function.

(c) For purposes of this subdivision, "nursing facility" means a facility which provides
nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to sections
144A.02 to 144A.10, which is appropriate if a person is in active restorative treatment; is
in need of special treatments provided or supervised by a licensed nurse; or has unpredictable
episodes of active disease processes requiring immediate judgment by a licensed nurse. For
purposes of this subdivision, a child requires the level of care provided in a nursing facility
if the child is determined by the commissioner to meet the requirements of the preadmission
screening assessment document under section 256B.0911, adjusted to address age-appropriate
standards for children age 18 and under.

(d) For purposes of this subdivision, "intermediate care facility for persons with
developmental disabilities" or "ICF/DD" means a program licensed to provide services to
persons with developmental disabilities under section 252.28, and chapter 245A, and a
physical plant licensed as a supervised living facility under chapter 144, which together are
certified by the Minnesota Department of Health as meeting the standards in Code of Federal
Regulations, title 42, part 483, for an intermediate care facility which provides services for
persons with developmental disabilities who require 24-hour supervision and active treatment
for medical, behavioral, or habilitation needs. For purposes of this subdivision, a child
requires a level of care provided in an ICF/DD if the commissioner finds that the child has
a developmental disability in accordance with section 256B.092, is in need of a 24-hour
plan of care and active treatment similar to persons with developmental disabilities, and
there is a reasonable indication that the child will need ICF/DD services.

(e) For purposes of this subdivision, a person requires the level of care provided in a
nursing facility if the person requires 24-hour monitoring or supervision and a plan of mental
health treatment because of specific symptoms or functional impairments associated with
a serious mental illness or disorder diagnosis, which meet severity criteria for mental health
established by the commissioner and published in March 1997 as the Minnesota Mental
Health Level of Care for Children and Adolescents with Severe Emotional Disorders.

(f) The determination of the level of care needed by the child shall be made by the
commissioner based on information supplied to the commissioner by the parent or guardian,
the child's physician or physiciansnew text begin or advanced practice registered nurse or advanced practice
registered nurses
new text end, and other professionals as requested by the commissioner. The
commissioner shall establish a screening team to conduct the level of care determinations
according to this subdivision.

(g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner
must assess the case to determine whether:

(1) the child qualifies as a disabled individual under United States Code, title 42, section
1382c(a), and would be eligible for medical assistance if residing in a medical institution;
and

(2) the cost of medical assistance services for the child, if eligible under this subdivision,
would not be more than the cost to medical assistance if the child resides in a medical
institution to be determined as follows:

(i) for a child who requires a level of care provided in an ICF/DD, the cost of care for
the child in an institution shall be determined using the average payment rate established
for the regional treatment centers that are certified as ICF's/DD;

(ii) for a child who requires a level of care provided in an inpatient hospital setting
according to paragraph (b), cost-effectiveness shall be determined according to Minnesota
Rules, part 9505.3520, items F and G; and

(iii) for a child who requires a level of care provided in a nursing facility according to
paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota Rules,
part 9505.3040, except that the nursing facility average rate shall be adjusted to reflect rates
which would be paid for children under age 16. The commissioner may authorize an amount
up to the amount medical assistance would pay for a child referred to the commissioner by
the preadmission screening team under section 256B.0911.

Sec. 113.

Minnesota Statutes 2018, section 256B.0622, subdivision 2b, is amended to
read:


Subd. 2b.

Continuing stay and discharge criteria for assertive community
treatment.

(a) A client receiving assertive community treatment is eligible to continue
receiving services if:

(1) the client has not achieved the desired outcomes of their individual treatment plan;

(2) the client's level of functioning has not been restored, improved, or sustained over
the time frame outlined in the individual treatment plan;

(3) the client continues to be at risk for relapse based on current clinical assessment,
history, or the tenuous nature of the functional gains; or

(4) the client is functioning effectively with this service and discharge would otherwise
be indicated but without continued services the client's functioning would decline; and

(5) one of the following must also apply:

(i) the client has achieved current individual treatment plan goals but additional goals
are indicated as evidenced by documented symptoms;

(ii) the client is making satisfactory progress toward meeting goals and there is
documentation that supports that continuation of this service shall be effective in addressing
the goals outlined in the individual treatment plan;

(iii) the client is making progress, but the specific interventions in the individual treatment
plan need to be modified so that greater gains, which are consistent with the client's potential
level of functioning, are possible; or

(iv) the client fails to make progress or demonstrates regression in meeting goals through
the interventions outlined in the individual treatment plan.

(b) Clients receiving assertive community treatment are eligible to be discharged if they
meet at least one of the following criteria:

(1) the client and the ACT team determine that assertive community treatment services
are no longer needed based on the attainment of goals as identified in the individual treatment
plan and a less intensive level of care would adequately address current goals;

(2) the client moves out of the ACT team's service area and the ACT team has facilitated
the referral to either a new ACT team or other appropriate mental health service and has
assisted the individual in the transition process;

(3) the client, or the client's legal guardian when applicable, chooses to withdraw from
assertive community treatment services and documented attempts by the ACT team to
re-engage the client with the service have not been successful;

(4) the client has a demonstrated need for a medical nursing home placement lasting
more than three months, as determined by a physiciannew text begin or advanced practice registered nursenew text end;

(5) the client is hospitalized, in residential treatment, or in jail for a period of greater
than three months. However, the ACT team must make provisions for the client to return
to the ACT team upon their discharge or release from the hospital or jail if the client still
meets eligibility criteria for assertive community treatment and the team is not at full capacity;

(6) the ACT team is unable to locate, contact, and engage the client for a period of greater
than three months after persistent efforts by the ACT team to locate the client; or

(7) the client requests a discharge, despite repeated and proactive efforts by the ACT
team to engage the client in service planning. The ACT team must develop a transition plan
to arrange for alternate treatment for clients in this situation who have a history of suicide
attempts, assault, or forensic involvement.

(c) For all clients who are discharged from assertive community treatment to another
service provider within the ACT team's service area there is a three-month transfer period,
from the date of discharge, during which a client who does not adjust well to the new service,
may voluntarily return to the ACT team. During this period, the ACT team must maintain
contact with the client's new service provider.

Sec. 114.

Minnesota Statutes 2018, section 256B.0623, subdivision 2, is amended to read:


Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings
given them.

(a) "Adult rehabilitative mental health services" means mental health services which are
rehabilitative and enable the recipient to develop and enhance psychiatric stability, social
competencies, personal and emotional adjustment, independent living, parenting skills, and
community skills, when these abilities are impaired by the symptoms of mental illness.
Adult rehabilitative mental health services are also appropriate when provided to enable a
recipient to retain stability and functioning, if the recipient would be at risk of significant
functional decompensation or more restrictive service settings without these services.

(1) Adult rehabilitative mental health services instruct, assist, and support the recipient
in areas such as: interpersonal communication skills, community resource utilization and
integration skills, crisis assistance, relapse prevention skills, health care directives, budgeting
and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills,
transportation skills, medication education and monitoring, mental illness symptom
management skills, household management skills, employment-related skills, parenting
skills, and transition to community living services.

(2) These services shall be provided to the recipient on a one-to-one basis in the recipient's
home or another community setting or in groups.

(b) "Medication education services" means services provided individually or in groups
which focus on educating the recipient about mental illness and symptoms; the role and
effects of medications in treating symptoms of mental illness; and the side effects of
medications. Medication education is coordinated with medication management services
and does not duplicate it. Medication education services are provided by physicians,new text begin advanced
practice registered nurses,
new text end pharmacists, physician assistants, or registered nurses.

(c) "Transition to community living services" means services which maintain continuity
of contact between the rehabilitation services provider and the recipient and which facilitate
discharge from a hospital, residential treatment program under Minnesota Rules, chapter
9505, board and lodging facility, or nursing home. Transition to community living services
are not intended to provide other areas of adult rehabilitative mental health services.

Sec. 115.

Minnesota Statutes 2018, section 256B.0625, subdivision 12, is amended to
read:


Subd. 12.

Eyeglasses, dentures, and prosthetic devices.

new text begin(a) new text endMedical assistance covers
eyeglasses, dentures, and prosthetic new text beginand orthotic new text enddevices if prescribed by a licensed
practitioner.

new text begin (b) For purposes of prescribing prosthetic and orthotic devices, "licensed practitioner"
includes a physician, an advanced practice registered nurse, or a podiatrist.
new text end

Sec. 116.

Minnesota Statutes 2019 Supplement, section 256B.0625, subdivision 13, is
amended to read:


Subd. 13.

Drugs.

(a) Medical assistance covers drugs, except for fertility drugs when
specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
dispensing physician, or by a physician, new text begina new text endphysician assistant, or deleted text begina nurse practitionerdeleted text endnew text begin an
advanced practice registered nurse
new text end employed by or under contract with a community health
board as defined in section 145A.02, subdivision 5, for the purposes of communicable
disease control.

(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
unless authorized by the commissioner.

(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
ingredient" is defined as a substance that is represented for use in a drug and when used in
the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
excipients which are included in the medical assistance formulary. Medical assistance covers
selected active pharmaceutical ingredients and excipients used in compounded prescriptions
when the compounded combination is specifically approved by the commissioner or when
a commercially available product:

(1) is not a therapeutic option for the patient;

(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and

(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
prescription.

(d) Medical assistance covers the following over-the-counter drugs when prescribed by
a licensed practitioner or by a licensed pharmacist who meets standards established by the
commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
with documented vitamin deficiencies, vitamins for children under the age of seven and
pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions, or
disorders, and this determination shall not be subject to the requirements of chapter 14. A
pharmacist may prescribe over-the-counter medications as provided under this paragraph
for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for potential adverse interactions,
and make referrals as needed to other health care professionals.

(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
individuals, medical assistance may cover drugs from the drug classes listed in United States
Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
not be covered.

(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under common
ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.

Sec. 117.

Minnesota Statutes 2019 Supplement, section 256B.0625, subdivision 17, is
amended to read:


Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transit, as defined in section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers.

(c) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.

(d) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(e) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner in consultation with the
Nonemergency Medical Transportation Advisory Committee;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.

(f) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).

(g) The commissioner may use an order by the recipient's attending physiciannew text begin, advanced
practice registered nurse,
new text end or a medical or mental health professional to certify that the
recipient requires nonemergency medical transportation services. Nonemergency medical
transportation providers shall perform driver-assisted services for eligible individuals, when
appropriate. Driver-assisted service includes passenger pickup at and return to the individual's
residence or place of business, assistance with admittance of the individual to the medical
facility, and assistance in passenger securement or in securing of wheelchairs, child seats,
or stretchers in the vehicle.

Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency.

Nonemergency medical transportation providers may not bill for separate base rates for
the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

(h) The administrative agency shall use the level of service process established by the
commissioner in consultation with the Nonemergency Medical Transportation Advisory
Committee to determine the client's most appropriate mode of transportation. If public transit
or a certified transportation provider is not available to provide the appropriate service mode
for the client, the client may receive a onetime service upgrade.

(i) The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

(j) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
commissioner has developed, made available, and funded the web-based single administrative
structure, assessment tool, and level of need assessment under subdivision 18e. The local
agency's financial obligation is limited to funds provided by the state or federal government.

(k) The commissioner shall:

(1) in consultation with the Nonemergency Medical Transportation Advisory Committee,
verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

(l) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.

(m) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (h), not the type of vehicle used to provide the service. The
medical assistance reimbursement rates for nonemergency medical transportation services
that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
medical transportation provider;

(4) $13 for the base rate and $1.30 per mile for assisted transport;

(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;

(6) $75 for the base rate and $2.40 per mile for protected transport; and

(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.

(n) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7).

(o) For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) and (n), the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.

(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.

(q) The commissioner, when determining reimbursement rates for nonemergency medical
transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed
under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

Sec. 118.

Minnesota Statutes 2018, section 256B.0625, subdivision 26, is amended to
read:


Subd. 26.

Special education services.

(a) Medical assistance covers evaluations necessary
in making a determination for eligibility for individualized education program and
individualized family service plan services and for medical services identified in a recipient's
individualized education program and individualized family service plan and covered under
the medical assistance state plan. Covered services include occupational therapy, physical
therapy, speech-language therapy, clinical psychological services, nursing services, school
psychological services, school social work services, personal care assistants serving as
management aides, assistive technology devices, transportation services, health assessments,
and other services covered under the medical assistance state plan. Mental health services
eligible for medical assistance reimbursement must be provided or coordinated through a
children's mental health collaborative where a collaborative exists if the child is included
in the collaborative operational target population. The provision or coordination of services
does not require that the individualized education program be developed by the collaborative.

The services may be provided by a Minnesota school district that is enrolled as a medical
assistance provider or its subcontractor, and only if the services meet all the requirements
otherwise applicable if the service had been provided by a provider other than a school
district, in the following areas: medical necessity, physician'snew text begin or advanced practice registered
nurse's
new text end orders, documentation, personnel qualifications, and prior authorization requirements.
The nonfederal share of costs for services provided under this subdivision is the responsibility
of the local school district as provided in section 125A.74. Services listed in a child's
individualized education program are eligible for medical assistance reimbursement only
if those services meet criteria for federal financial participation under the Medicaid program.

(b) Approval of health-related services for inclusion in the individualized education
program does not require prior authorization for purposes of reimbursement under this
chapter. The commissioner may require physiciannew text begin or advanced practice registered nursenew text end
review and approval of the plan not more than once annually or upon any modification of
the individualized education program that reflects a change in health-related services.

(c) Services of a speech-language pathologist provided under this section are covered
notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person:

(1) holds a masters degree in speech-language pathology;

(2) is licensed by the Professional Educator Licensing and Standards Board as an
educational speech-language pathologist; and

(3) either has a certificate of clinical competence from the American Speech and Hearing
Association, has completed the equivalent educational requirements and work experience
necessary for the certificate or has completed the academic program and is acquiring
supervised work experience to qualify for the certificate.

(d) Medical assistance coverage for medically necessary services provided under other
subdivisions in this section may not be denied solely on the basis that the same or similar
services are covered under this subdivision.

(e) The commissioner shall develop and implement package rates, bundled rates, or per
diem rates for special education services under which separately covered services are grouped
together and billed as a unit in order to reduce administrative complexity.

(f) The commissioner shall develop a cost-based payment structure for payment of these
services. Only costs reported through the designated Minnesota Department of Education
data systems in distinct service categories qualify for inclusion in the cost-based payment
structure. The commissioner shall reimburse claims submitted based on an interim rate, and
shall settle at a final rate once the department has determined it. The commissioner shall
notify the school district of the final rate. The school district has 60 days to appeal the final
rate. To appeal the final rate, the school district shall file a written appeal request to the
commissioner within 60 days of the date the final rate determination was mailed. The appeal
request shall specify (1) the disputed items and (2) the name and address of the person to
contact regarding the appeal.

(g) Effective July 1, 2000, medical assistance services provided under an individualized
education program or an individual family service plan by local school districts shall not
count against medical assistance authorization thresholds for that child.

(h) Nursing services as defined in section 148.171, subdivision 15, and provided as an
individualized education program health-related service, are eligible for medical assistance
payment if they are otherwise a covered service under the medical assistance program.
Medical assistance covers the administration of prescription medications by a licensed nurse
who is employed by or under contract with a school district when the administration of
medications is identified in the child's individualized education program. The simple
administration of medications alone is not covered under medical assistance when
administered by a provider other than a school district or when it is not identified in the
child's individualized education program.

Sec. 119.

Minnesota Statutes 2018, section 256B.0625, subdivision 28, is amended to
read:


Subd. 28.

deleted text beginCertified nurse practitionerdeleted text endnew text begin Advanced practice registered nursenew text end
services.

Medical assistance covers services performed by a certified pediatric deleted text beginnurse
practitioner
deleted text endnew text begin advanced practice registered nursenew text end, a certified family deleted text beginnurse practitionerdeleted text endnew text begin advanced
practice registered nurse
new text end, a certified adult deleted text beginnurse practitionerdeleted text endnew text begin advanced practice registered
nurse
new text end, a certified obstetric/gynecological deleted text beginnurse practitionerdeleted text endnew text begin advanced practice registered
nurse
new text end, a certified neonatal deleted text beginnurse practitionerdeleted text endnew text begin advanced practice registered nursenew text end, or a certified
geriatric deleted text beginnurse practitionerdeleted text endnew text begin advanced practice registered nursenew text end in independent practice, if:

(1) the service provided on an inpatient basis is not included as part of the cost for
inpatient services included in the operating payment rate;

(2) the service is otherwise covered under this chapter as a physician service; and

(3) the service is within the scope of practice of the deleted text beginnurse practitioner'sdeleted text endnew text begin advanced practice
registered nurse's
new text end license as a registered nurse, as defined in section 148.171.

Sec. 120.

Minnesota Statutes 2019 Supplement, section 256B.0625, subdivision 60a, is
amended to read:


Subd. 60a.

Community emergency medical technician services.

(a) Medical assistance
covers services provided by a community emergency medical technician (CEMT) who is
certified under section 144E.275, subdivision 7, when the services are provided in accordance
with this subdivision.

(b) A CEMT may provide a postdischarge visit, after discharge from a hospital or skilled
nursing facility, when ordered by a treating physiciannew text begin or advanced practice registered nursenew text end.
The postdischarge visit includes:

(1) verbal or visual reminders of discharge orders;

(2) recording and reporting of vital signs to the patient's primary care provider;

(3) medication access confirmation;

(4) food access confirmation; and

(5) identification of home hazards.

(c) An individual who has repeat ambulance calls due to falls or has been identified by
the individual's primary care provider as at risk for nursing home placement, may receive
a safety evaluation visit from a CEMT when ordered by a primary care provider in accordance
with the individual's care plan. A safety evaluation visit includes:

(1) medication access confirmation;

(2) food access confirmation; and

(3) identification of home hazards.

(d) A CEMT shall be paid at $9.75 per 15-minute increment. A safety evaluation visit
may not be billed for the same day as a postdischarge visit for the same individual.

Sec. 121.

Minnesota Statutes 2018, section 256B.0654, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) "Complex home care nursing" means home care nursing
services provided to recipients who meet the criteria for regular home care nursing and
require life-sustaining interventions to reduce the risk of long-term injury or death.

(b) "Home care nursing" means ongoing deleted text beginphysician-ordereddeleted text end hourly nursingnew text begin ordered by
a physician or advanced practice registered nurse and
new text end services performed by a registered
nurse or licensed practical nurse within the scope of practice as defined by the Minnesota
Nurse Practice Act under sections 148.171 to 148.285, in order to maintain or restore a
person's health.

(c) "Home care nursing agency" means a medical assistance enrolled provider licensed
under chapter 144A to provide home care nursing services.

(d) "Regular home care nursing" means home care nursing provided because:

(1) the recipient requires more individual and continuous care than can be provided
during a skilled nurse visit; or

(2) the cares are outside of the scope of services that can be provided by a home health
aide or personal care assistant.

(e) "Shared home care nursing" means the provision of home care nursing services by
a home care nurse to two recipients at the same time and in the same setting.

Sec. 122.

Minnesota Statutes 2018, section 256B.0654, subdivision 2a, is amended to
read:


Subd. 2a.

Home care nursing services.

(a) Home care nursing services must be used:

(1) in the recipient's home or outside the home when normal life activities require;

(2) when the recipient requires more individual and continuous care than can be provided
during a skilled nurse visit; and

(3) when the care required is outside of the scope of services that can be provided by a
home health aide or personal care assistant.

(b) Home care nursing services must be:

(1) assessed by a registered nurse on a form approved by the commissioner;

(2) ordered by a physiciannew text begin or advanced practice registered nursenew text end and documented in a
plan of care that is reviewed by the physician at least once every 60 days; and

(3) authorized by the commissioner under section 256B.0652.

Sec. 123.

Minnesota Statutes 2018, section 256B.0654, subdivision 3, is amended to read:


Subd. 3.

Shared home care nursing option.

(a) Medical assistance payments for shared
home care nursing services by a home care nurse shall be limited according to this
subdivision. Unless otherwise provided in this subdivision, all other statutory and regulatory
provisions relating to home care nursing services apply to shared home care nursing services.
Nothing in this subdivision shall be construed to reduce the total number of home care
nursing hours authorized for an individual recipient.

(b) Shared home care nursing is the provision of nursing services by a home care nurse
to two medical assistance eligible recipients at the same time and in the same setting. This
subdivision does not apply when a home care nurse is caring for multiple recipients in more
than one setting.

(c) For the purposes of this subdivision, "setting" means:

(1) the home residence or foster care home of one of the individual recipients as defined
in section 256B.0651;

(2) a child care program licensed under chapter 245A or operated by a local school
district or private school;

(3) an adult day care service licensed under chapter 245A; or

(4) outside the home residence or foster care home of one of the recipients when normal
life activities take the recipients outside the home.

(d) The home care nursing agency must offer the recipient the option of shared or
one-on-one home care nursing services. The recipient may withdraw from participating in
a shared service arrangement at any time.

(e) The recipient or the recipient's legal representative, and the recipient's physiciannew text begin or
advanced practice registered nurse
new text end, in conjunction with the home care nursing agency, shall
determine:

(1) whether shared home care nursing care is an appropriate option based on the individual
needs and preferences of the recipient; and

(2) the amount of shared home care nursing services authorized as part of the overall
authorization of nursing services.

(f) The recipient or the recipient's legal representative, in conjunction with the home
care nursing agency, shall approve the setting, grouping, and arrangement of shared home
care nursing care based on the individual needs and preferences of the recipients. Decisions
on the selection of recipients to share services must be based on the ages of the recipients,
compatibility, and coordination of their care needs.

(g) The following items must be considered by the recipient or the recipient's legal
representative and the home care nursing agency, and documented in the recipient's health
service record:

(1) the additional training needed by the home care nurse to provide care to two recipients
in the same setting and to ensure that the needs of the recipients are met appropriately and
safely;

(2) the setting in which the shared home care nursing care will be provided;

(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness of
the service and process used to make changes in service or setting;

(4) a contingency plan which accounts for absence of the recipient in a shared home
care nursing setting due to illness or other circumstances;

(5) staffing backup contingencies in the event of employee illness or absence; and

(6) arrangements for additional assistance to respond to urgent or emergency care needs
of the recipients.

(h) The documentation for shared home care nursing must be on a form approved by
the commissioner for each individual recipient sharing home care nursing. The documentation
must be part of the recipient's health service record and include:

(1) permission by the recipient or the recipient's legal representative for the maximum
number of shared nursing hours per week chosen by the recipient and permission for shared
home care nursing services provided in and outside the recipient's home residence;

(2) revocation by the recipient or the recipient's legal representative for the shared home
care nursing permission, or services provided to others in and outside the recipient's
residence; and

(3) daily documentation of the shared home care nursing services provided by each
identified home care nurse, including:

(i) the names of each recipient receiving shared home care nursing services;

(ii) the setting for the shared services, including the starting and ending times that the
recipient received shared home care nursing care; and

(iii) notes by the home care nurse regarding changes in the recipient's condition, problems
that may arise from the sharing of home care nursing services, and scheduling and care
issues.

(i) The commissioner shall provide a rate methodology for shared home care nursing.
For two persons sharing nursing care, the rate paid to a provider must not exceed 1.5 times
the regular home care nursing rates paid for serving a single individual by a registered nurse
or licensed practical nurse. These rates apply only to situations in which both recipients are
present and receive shared home care nursing care on the date for which the service is billed.

Sec. 124.

Minnesota Statutes 2018, section 256B.0654, subdivision 4, is amended to read:


Subd. 4.

Hardship criteria; home care nursing.

(a) Payment is allowed for extraordinary
services that require specialized nursing skills and are provided by parents of minor children,
family foster parents, spouses, and legal guardians who are providing home care nursing
care under the following conditions:

(1) the provision of these services is not legally required of the parents, spouses, or legal
guardians;

(2) the services are necessary to prevent hospitalization of the recipient; and

(3) the recipient is eligible for state plan home care or a home and community-based
waiver and one of the following hardship criteria are met:

(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to
provide nursing care for the recipient;

(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with
less compensation to provide nursing care for the recipient;

(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to provide
nursing care for the recipient; or

(iv) because of labor conditions, special language needs, or intermittent hours of care
needed, the parent, spouse, or legal guardian is needed in order to provide adequate home
care nursing services to meet the medical needs of the recipient.

(b) Home care nursing may be provided by a parent, spouse, family foster parent, or
legal guardian who is a nurse licensed in Minnesota. Home care nursing services provided
by a parent, spouse, family foster parent, or legal guardian cannot be used in lieu of nursing
services covered and available under liable third-party payors, including Medicare. The
home care nursing provided by a parent, spouse, family foster parent, or legal guardian must
be included in the service agreement. Authorized nursing services for a single recipient or
recipients with the same residence and provided by the parent, spouse, family foster parent,
or legal guardian may not exceed 50 percent of the total approved nursing hours, or eight
hours per day, whichever is less, up to a maximum of 40 hours per week. A parent or parents,
spouse, family foster parent, or legal guardian shall not provide more than 40 hours of
services in a seven-day period. For parents, family foster parents, and legal guardians, 40
hours is the total amount allowed regardless of the number of children or adults who receive
services. Nothing in this subdivision precludes the parent's, spouse's, or legal guardian's
obligation of assuming the nonreimbursed family responsibilities of emergency backup
caregiver and primary caregiver.

(c) A parent, family foster parent, or a spouse may not be paid to provide home care
nursing care if:

(1) the parent or spouse fails to pass a criminal background check according to chapter
245C;

(2) it has been determined by the home care nursing agency, the case manager, or the
physiciannew text begin or advanced practice registered nursenew text end that the home care nursing provided by the
parent, family foster parent, spouse, or legal guardian is unsafe; or

(3) the parent, family foster parent, spouse, or legal guardian does not follow physiciannew text begin
or advanced practice registered nurse
new text end orders.

(d) For purposes of this section, "assessment" means a review and evaluation of a
recipient's need for home care services conducted in person. Assessments for home care
nursing must be conducted by a registered nurse.

Sec. 125.

Minnesota Statutes 2018, section 256B.0659, subdivision 2, is amended to read:


Subd. 2.

Personal care assistance services; covered services.

(a) The personal care
assistance services eligible for payment include services and supports furnished to an
individual, as needed, to assist in:

(1) activities of daily living;

(2) health-related procedures and tasks;

(3) observation and redirection of behaviors; and

(4) instrumental activities of daily living.

(b) Activities of daily living include the following covered services:

(1) dressing, including assistance with choosing, application, and changing of clothing
and application of special appliances, wraps, or clothing;

(2) grooming, including assistance with basic hair care, oral care, shaving, applying
cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included,
except for recipients who are diabetic or have poor circulation;

(3) bathing, including assistance with basic personal hygiene and skin care;

(4) eating, including assistance with hand washing and application of orthotics required
for eating, transfers, and feeding;

(5) transfers, including assistance with transferring the recipient from one seating or
reclining area to another;

(6) mobility, including assistance with ambulation, including use of a wheelchair.
Mobility does not include providing transportation for a recipient;

(7) positioning, including assistance with positioning or turning a recipient for necessary
care and comfort; and

(8) toileting, including assistance with helping recipient with bowel or bladder elimination
and care including transfers, mobility, positioning, feminine hygiene, use of toileting
equipment or supplies, cleansing the perineal area, inspection of the skin, and adjusting
clothing.

(c) Health-related procedures and tasks include the following covered services:

(1) range of motion and passive exercise to maintain a recipient's strength and muscle
functioning;

(2) assistance with self-administered medication as defined by this section, including
reminders to take medication, bringing medication to the recipient, and assistance with
opening medication under the direction of the recipient or responsible party, including
medications given through a nebulizer;

(3) interventions for seizure disorders, including monitoring and observation; and

(4) other activities considered within the scope of the personal care service and meeting
the definition of health-related procedures and tasks under this section.

(d) A personal care assistant may provide health-related procedures and tasks associated
with the complex health-related needs of a recipient if the procedures and tasks meet the
definition of health-related procedures and tasks under this section and the personal care
assistant is trained by a qualified professional and demonstrates competency to safely
complete the procedures and tasks. Delegation of health-related procedures and tasks and
all training must be documented in the personal care assistance care plan and the recipient's
and personal care assistant's files. A personal care assistant must not determine the medication
dose or time for medication.

(e) Effective January 1, 2010, for a personal care assistant to provide the health-related
procedures and tasks of tracheostomy suctioning and services to recipients on ventilator
support there must be:

(1) delegation and training by a registered nurse,new text begin advanced practice registered nurse,new text end
certified or licensed respiratory therapist, or a physician;

(2) utilization of clean rather than sterile procedure;

(3) specialized training about the health-related procedures and tasks and equipment,
including ventilator operation and maintenance;

(4) individualized training regarding the needs of the recipient; and

(5) supervision by a qualified professional who is a registered nurse.

(f) Effective January 1, 2010, a personal care assistant may observe and redirect the
recipient for episodes where there is a need for redirection due to behaviors. Training of
the personal care assistant must occur based on the needs of the recipient, the personal care
assistance care plan, and any other support services provided.

(g) Instrumental activities of daily living under subdivision 1, paragraph (i).

Sec. 126.

Minnesota Statutes 2018, section 256B.0659, subdivision 4, is amended to read:


Subd. 4.

Assessment for personal care assistance services; limitations.

(a) An
assessment as defined in subdivision 3a must be completed for personal care assistance
services.

(b) The following limitations apply to the assessment:

(1) a person must be assessed as dependent in an activity of daily living based on the
person's daily need or need on the days during the week the activity is completed for:

(i) cuing and constant supervision to complete the task; or

(ii) hands-on assistance to complete the task; and

(2) a child may not be found to be dependent in an activity of daily living if because of
the child's age an adult would either perform the activity for the child or assist the child
with the activity. Assistance needed is the assistance appropriate for a typical child of the
same age.

(c) Assessment for complex health-related needs must meet the criteria in this paragraph.
A recipient qualifies as having complex health-related needs if the recipient has one or more
of the interventions that are ordered by a physiciannew text begin or advanced practice registered nursenew text end,
specified in a personal care assistance care plan or community support plan developed under
section 256B.0911, and found in the following:

(1) tube feedings requiring:

(i) a gastrojejunostomy tube; or

(ii) continuous tube feeding lasting longer than 12 hours per day;

(2) wounds described as:

(i) stage III or stage IV;

(ii) multiple wounds;

(iii) requiring sterile or clean dressing changes or a wound vac; or

(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized
care;

(3) parenteral therapy described as:

(i) IV therapy more than two times per week lasting longer than four hours for each
treatment; or

(ii) total parenteral nutrition (TPN) daily;

(4) respiratory interventions, including:

(i) oxygen required more than eight hours per day;

(ii) respiratory vest more than one time per day;

(iii) bronchial drainage treatments more than two times per day;

(iv) sterile or clean suctioning more than six times per day;

(v) dependence on another to apply respiratory ventilation augmentation devices such
as BiPAP and CPAP; and

(vi) ventilator dependence under section 256B.0652;

(5) insertion and maintenance of catheter, including:

(i) sterile catheter changes more than one time per month;

(ii) clean intermittent catheterization, and including self-catheterization more than six
times per day; or

(iii) bladder irrigations;

(6) bowel program more than two times per week requiring more than 30 minutes to
perform each time;

(7) neurological intervention, including:

(i) seizures more than two times per week and requiring significant physical assistance
to maintain safety; or

(ii) swallowing disorders diagnosed by a physiciannew text begin or advanced practice registered nursenew text end
and requiring specialized assistance from another on a daily basis; and

(8) other congenital or acquired diseases creating a need for significantly increased direct
hands-on assistance and interventions in six to eight activities of daily living.

(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient
qualifies as having a need for assistance due to behaviors if the recipient's behavior requires
assistance at least four times per week and shows one or more of the following behaviors:

(1) physical aggression towards self or others, or destruction of property that requires
the immediate response of another person;

(2) increased vulnerability due to cognitive deficits or socially inappropriate behavior;
or

(3) increased need for assistance for recipients who are verbally aggressive or resistive
to care so that the time needed to perform activities of daily living is increased.

Sec. 127.

Minnesota Statutes 2018, section 256B.0659, subdivision 8, is amended to read:


Subd. 8.

Communication with recipient's physiciannew text begin or advanced practice registered
nurse
new text end.

The personal care assistance program requires communication with the recipient's
physiciannew text begin or advanced practice registered nursenew text end about a recipient's assessed needs for personal
care assistance services. The commissioner shall work with the state medical director to
develop options for communication with the recipient's physiciannew text begin or advanced practice
registered nurse
new text end.

Sec. 128.

Minnesota Statutes 2019 Supplement, section 256B.0659, subdivision 11, is
amended to read:


Subd. 11.

Personal care assistant; requirements.

(a) A personal care assistant must
meet the following requirements:

(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of
age with these additional requirements:

(i) supervision by a qualified professional every 60 days; and

(ii) employment by only one personal care assistance provider agency responsible for
compliance with current labor laws;

(2) be employed by a personal care assistance provider agency;

(3) enroll with the department as a personal care assistant after clearing a background
study. Except as provided in subdivision 11a, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study on
the personal care assistant under chapter 245C, and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:

(i) not disqualified under section 245C.14; or

(ii) disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22;

(4) be able to effectively communicate with the recipient and personal care assistance
provider agency;

(5) be able to provide covered personal care assistance services according to the recipient's
personal care assistance care plan, respond appropriately to recipient needs, and report
changes in the recipient's condition to the supervising qualified professional deleted text beginordeleted text endnew text begin, new text end physiciannew text begin,
or advanced practice registered nurse
new text end;

(6) not be a consumer of personal care assistance services;

(7) maintain daily written records including, but not limited to, time sheets under
subdivision 12;

(8) effective January 1, 2010, complete standardized training as determined by the
commissioner before completing enrollment. The training must be available in languages
other than English and to those who need accommodations due to disabilities. Personal care
assistant training must include successful completion of the following training components:
basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic
roles and responsibilities of personal care assistants including information about assistance
with lifting and transfers for recipients, emergency preparedness, orientation to positive
behavioral practices, fraud issues, and completion of time sheets. Upon completion of the
training components, the personal care assistant must demonstrate the competency to provide
assistance to recipients;

(9) complete training and orientation on the needs of the recipient; and

(10) be limited to providing and being paid for up to 275 hours per month of personal
care assistance services regardless of the number of recipients being served or the number
of personal care assistance provider agencies enrolled with. The number of hours worked
per day shall not be disallowed by the department unless in violation of the law.

(b) A legal guardian may be a personal care assistant if the guardian is not being paid
for the guardian services and meets the criteria for personal care assistants in paragraph (a).

(c) Persons who do not qualify as a personal care assistant include parents, stepparents,
and legal guardians of minors; spouses; paid legal guardians of adults; family foster care
providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of
a residential setting.

(d) Personal care assistance services qualify for the enhanced rate described in subdivision
17a if the personal care assistant providing the services:

(1) provides covered services to a recipient who qualifies for 12 or more hours per day
of personal care assistance services; and

(2) satisfies the current requirements of Medicare for training and competency or
competency evaluation of home health aides or nursing assistants, as provided in the Code
of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved
training or competency requirements.

Sec. 129.

Minnesota Statutes 2019 Supplement, section 256B.0913, subdivision 8, is
amended to read:


Subd. 8.

Requirements for individual coordinated service and support plan.

(a) The
case manager shall implement the coordinated service and support plan for each alternative
care client and ensure that a client's service needs and eligibility are reassessed at least every
12 months. The coordinated service and support plan must meet the requirements in section
256S.10. The plan shall include any services prescribed by the individual's attending
physician new text beginor advanced practice registered nurse new text endas necessary to allow the individual to
remain in a community setting. In developing the individual's care plan, the case manager
should include the use of volunteers from families and neighbors, religious organizations,
social clubs, and civic and service organizations to support the formal home care services.
The lead agency shall be held harmless for damages or injuries sustained through the use
of volunteers under this subdivision including workers' compensation liability. The case
manager shall provide documentation in each individual's plan and, if requested, to the
commissioner that the most cost-effective alternatives available have been offered to the
individual and that the individual was free to choose among available qualified providers,
both public and private, including qualified case management or service coordination
providers other than those employed by any county; however, the county or tribe maintains
responsibility for prior authorizing services in accordance with statutory and administrative
requirements. The case manager must give the individual a ten-day written notice of any
denial, termination, or reduction of alternative care services.

(b) The county of service or tribe must provide access to and arrange for case management
services, including assuring implementation of the coordinated service and support plan.
"County of service" has the meaning given it in Minnesota Rules, part 9505.0015, subpart
11. The county of service must notify the county of financial responsibility of the approved
care plan and the amount of encumbered funds.

Sec. 130.

Minnesota Statutes 2018, section 256B.73, subdivision 5, is amended to read:


Subd. 5.

Enrollee benefits.

(a) Eligible persons enrolled by a demonstration provider
shall receive a health services benefit package that includes health services which the
enrollees might reasonably require to be maintained in good health, including emergency
care, inpatient hospital and physiciannew text begin or advanced practice registered nursenew text end care, outpatient
health services, and preventive health services.

(b) Services related to chemical dependency, mental illness, vision care, dental care,
and other benefits may be excluded or limited upon approval by the commissioners. The
coalition may petition the commissioner of commerce or health, whichever is appropriate,
for waivers that allow these benefits to be excluded or limited.

(c) The commissioners, the coalition, and demonstration providers shall work together
to design a package of benefits or packages of benefits that can be provided to enrollees for
an affordable monthly premium.

Sec. 131.

Minnesota Statutes 2018, section 256J.08, subdivision 73a, is amended to read:


Subd. 73a.

Qualified professional.

(a) For physical illness, injury, or incapacity, a
"qualified professional" means a licensed physician, a physician assistant, deleted text begina nurse practitionerdeleted text endnew text begin
an advanced practice registered nurse
new text end, or a licensed chiropractor.

(b) For developmental disability and intelligence testing, a "qualified professional"
means an individual qualified by training and experience to administer the tests necessary
to make determinations, such as tests of intellectual functioning, assessments of adaptive
behavior, adaptive skills, and developmental functioning. These professionals include
licensed psychologists, certified school psychologists, or certified psychometrists working
under the supervision of a licensed psychologist.

(c) For learning disabilities, a "qualified professional" means a licensed psychologist or
school psychologist with experience determining learning disabilities.

(d) For mental health, a "qualified professional" means a licensed physician or a qualified
mental health professional. A "qualified mental health professional" means:

(1) for children, in psychiatric nursing, a registered nursenew text begin or advanced practice registered
nurse
new text end who is licensed under sections 148.171 to 148.285, and who is certified as a clinical
specialist in child and adolescent psychiatric or mental health nursing by a national nurse
certification organization or who has a master's degree in nursing or one of the behavioral
sciences or related fields from an accredited college or university or its equivalent, with at
least 4,000 hours of post-master's supervised experience in the delivery of clinical services
in the treatment of mental illness;

(2) for adults, in psychiatric nursing, a registered nursenew text begin or advanced practice registered
nurse
new text end who is licensed under sections 148.171 to 148.285, and who is certified as a clinical
specialist in adult psychiatric and mental health nursing by a national nurse certification
organization or who has a master's degree in nursing or one of the behavioral sciences or
related fields from an accredited college or university or its equivalent, with at least 4,000
hours of post-master's supervised experience in the delivery of clinical services in the
treatment of mental illness;

(3) in clinical social work, a person licensed as an independent clinical social worker
under chapter 148D, or a person with a master's degree in social work from an accredited
college or university, with at least 4,000 hours of post-master's supervised experience in
the delivery of clinical services in the treatment of mental illness;

(4) in psychology, an individual licensed by the Board of Psychology under sections
148.88 to 148.98, who has stated to the Board of Psychology competencies in the diagnosis
and treatment of mental illness;

(5) in psychiatry, a physician licensed under chapter 147 and certified by the American
Board of Psychiatry and Neurology or eligible for board certification in psychiatry;

(6) in marriage and family therapy, the mental health professional must be a marriage
and family therapist licensed under sections 148B.29 to 148B.39, with at least two years of
post-master's supervised experience in the delivery of clinical services in the treatment of
mental illness; and

(7) in licensed professional clinical counseling, the mental health professional shall be
a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours
of post-master's supervised experience in the delivery of clinical services in the treatment
of mental illness.

Sec. 132.

Minnesota Statutes 2019 Supplement, section 256R.44, is amended to read:


256R.44 RATE ADJUSTMENT FOR PRIVATE ROOMS FOR MEDICAL
NECESSITY.

(a) The amount paid for a private room is 111.5 percent of the established total payment
rate for a resident if the resident is a medical assistance recipient and the private room is
considered a medical necessity for the resident or others who are affected by the resident's
condition, except as provided in Minnesota Rules, part 9549.0060, subpart 11, item C.
Conditions requiring a private room must be determined by the resident's attending physician
new text begin or advanced practice registered nurse new text endand submitted to the commissioner for approval or
denial by the commissioner on the basis of medical necessity.

(b) For a nursing facility with a total property payment rate determined under section
256R.26, subdivision 8, the amount paid for a private room is 111.5 percent of the established
total payment rate for a resident if the resident is a medical assistance recipient and the
private room is considered a medical necessity for the resident or others who are affected
by the resident's condition. Conditions requiring a private room must be determined by the
resident's attending physician and submitted to the commissioner for approval or denial by
the commissioner on the basis of medical necessity.

Sec. 133.

Minnesota Statutes 2018, section 256R.54, subdivision 1, is amended to read:


Subdivision 1.

Setting payment; monitoring use of therapy services.

(a) The
commissioner shall adopt rules under the Administrative Procedure Act to set the amount
and method of payment for ancillary materials and services provided to recipients residing
in nursing facilities. Payment for materials and services may be made to either the vendor
of ancillary services pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475, or to a
nursing facility pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475.

(b) Payment for the same or similar service to a recipient shall not be made to both the
nursing facility and the vendor. The commissioner shall ensure: (1) the avoidance of double
payments through audits and adjustments to the nursing facility's annual cost report as
required by section 256R.12, subdivisions 8 and 9; and (2) that charges and arrangements
for ancillary materials and services are cost-effective and as would be incurred by a prudent
and cost-conscious buyer.

(c) Therapy services provided to a recipient must be medically necessary and appropriate
to the medical condition of the recipient. If the vendor, nursing facility, or ordering physiciannew text begin
or advanced practice registered nurse
new text end cannot provide adequate medical necessity justification,
as determined by the commissioner, the commissioner may recover or disallow the payment
for the services and may require prior authorization for therapy services as a condition of
payment or may impose administrative sanctions to limit the vendor, nursing facility, or
ordering physician'snew text begin or advanced practice registered nurse'snew text end participation in the medical
assistance program. If the provider number of a nursing facility is used to bill services
provided by a vendor of therapy services that is not related to the nursing facility by
ownership, control, affiliation, or employment status, no withholding of payment shall be
imposed against the nursing facility for services not medically necessary except for funds
due the unrelated vendor of therapy services as provided in subdivision 5. For the purpose
of this subdivision, no monetary recovery may be imposed against the nursing facility for
funds paid to the unrelated vendor of therapy services as provided in subdivision 5, for
services not medically necessary.

(d) For purposes of this section and section 256R.12, subdivisions 8 and 9, therapy
includes physical therapy, occupational therapy, speech therapy, audiology, and mental
health services that are covered services according to Minnesota Rules, parts 9505.0170 to
9505.0475.

(e) For purposes of this subdivision, "ancillary services" includes transportation defined
as a covered service in section 256B.0625, subdivision 17.

Sec. 134.

Minnesota Statutes 2018, section 256R.54, subdivision 2, is amended to read:


Subd. 2.

Certification that treatment is appropriate.

The physical therapist,
occupational therapist, speech therapist, mental health professional, or audiologist who
provides or supervises the provision of therapy services, other than an initial evaluation, to
a medical assistance recipient must certify in writing that the therapy's nature, scope, duration,
and intensity are appropriate to the medical condition of the recipient every 30 days. The
therapist's statement of certification must be maintained in the recipient's medical record
together with the specific orders by the physiciannew text begin or advanced practice registered nursenew text end and
the treatment plan. If the recipient's medical record does not include these documents, the
commissioner may recover or disallow the payment for such services. If the therapist
determines that the therapy's nature, scope, duration, or intensity is not appropriate to the
medical condition of the recipient, the therapist must provide a statement to that effect in
writing to the nursing facility for inclusion in the recipient's medical record. The
commissioner shall make recommendations regarding the medical necessity of services
provided.

Sec. 135.

Minnesota Statutes 2018, section 257.63, subdivision 3, is amended to read:


Subd. 3.

Medical privilege.

Testimony of a physiciannew text begin or advanced practice registered
nurse
new text end concerning the medical circumstances of the pregnancy itself and the condition and
characteristics of the child upon birth is not privileged.

Sec. 136.

Minnesota Statutes 2018, section 257B.01, subdivision 3, is amended to read:


Subd. 3.

Attending physiciannew text begin or advanced practice registered nursenew text end.

"Attending
physiciannew text begin or advanced practice registered nursenew text end" means a physiciannew text begin or advanced practice
registered nurse
new text end who has primary responsibility for the treatment and care of the designator.
If physiciansnew text begin or advanced practice registered nursesnew text end share responsibility, another physiciannew text begin
or advanced practice registered nurse
new text end is acting on the attending physician'snew text begin or advanced
practice registered nurse's
new text end behalf, or no physiciannew text begin or advanced practice registered nursenew text end has
primary responsibility, any physiciannew text begin or advanced practice registered nursenew text end who is familiar
with the designator's medical condition may act as an attending physiciannew text begin or advanced
practice registered nurse
new text end under this chapter.

Sec. 137.

Minnesota Statutes 2018, section 257B.01, subdivision 9, is amended to read:


Subd. 9.

Determination of debilitation.

"Determination of debilitation" means a written
finding made by an attending physiciannew text begin or advanced practice registered nursenew text end which states
that the designator suffers from a physically incapacitating disease or injury. No identification
of the illness in question is required.

Sec. 138.

Minnesota Statutes 2018, section 257B.01, subdivision 10, is amended to read:


Subd. 10.

Determination of incapacity.

"Determination of incapacity" means a written
finding made by an attending physiciannew text begin or advanced practice registered nursenew text end which states
the nature, extent, and probable duration of the designator's mental or organic incapacity.

Sec. 139.

Minnesota Statutes 2018, section 257B.06, subdivision 7, is amended to read:


Subd. 7.

Restored capacity.

If a licensed physiciannew text begin or advanced practice registered
nurse
new text end determines that the designator has regained capacity, the co-custodian's authority that
commenced on the occurrence of a triggering event becomes inactive. Failure of a
co-custodian to immediately return the child(ren) to the designator's care entitles the
designator to an emergency hearing within five days of a request for a hearing.

Sec. 140. new text beginREPEALER.
new text end

new text begin Minnesota Rules, part 9505.0365, subpart 3, new text end new text begin is repealed.
new text end

ARTICLE 5

CONTROLLED SUBSTANCES SCHEDULES

Section 1.

Minnesota Statutes 2018, section 152.02, subdivision 2, is amended to read:


Subd. 2.

Schedule I.

(a) Schedule I consists of the substances listed in this subdivision.

(b) Opiates. Unless specifically excepted or unless listed in another schedule, any of the
following substances, including their analogs, isomers, esters, ethers, salts, and salts of
isomers, esters, and ethers, whenever the existence of the analogs, isomers, esters, ethers,
and salts is possible:

(1) acetylmethadol;

(2) allylprodine;

(3) alphacetylmethadol (except levo-alphacetylmethadol, also known as levomethadyl
acetate);

(4) alphameprodine;

(5) alphamethadol;

(6) alpha-methylfentanyl benzethidine;

(7) betacetylmethadol;

(8) betameprodine;

(9) betamethadol;

(10) betaprodine;

(11) clonitazene;

(12) dextromoramide;

(13) diampromide;

(14) diethyliambutene;

(15) difenoxin;

(16) dimenoxadol;

(17) dimepheptanol;

(18) dimethyliambutene;

(19) dioxaphetyl butyrate;

(20) dipipanone;

(21) ethylmethylthiambutene;

(22) etonitazene;

(23) etoxeridine;

(24) furethidine;

(25) hydroxypethidine;

(26) ketobemidone;

(27) levomoramide;

(28) levophenacylmorphan;

(29) 3-methylfentanyl;

(30) acetyl-alpha-methylfentanyl;

(31) alpha-methylthiofentanyl;

(32) benzylfentanyl beta-hydroxyfentanyl;

(33) beta-hydroxy-3-methylfentanyl;

(34) 3-methylthiofentanyl;

(35) thenylfentanyl;

(36) thiofentanyl;

(37) para-fluorofentanyl;

(38) morpheridine;

(39) 1-methyl-4-phenyl-4-propionoxypiperidine;

(40) noracymethadol;

(41) norlevorphanol;

(42) normethadone;

(43) norpipanone;

(44) 1-(2-phenylethyl)-4-phenyl-4-acetoxypiperidine (PEPAP);

(45) phenadoxone;

(46) phenampromide;

(47) phenomorphan;

(48) phenoperidine;

(49) piritramide;

(50) proheptazine;

(51) properidine;

(52) propiram;

(53) racemoramide;

(54) tilidine;

(55) trimeperidine;

(56) N-(1-Phenethylpiperidin-4-yl)-N-phenylacetamide (acetyl fentanyl);

(57) 3,4-dichloro-N-[(1R,2R)-2-(dimethylamino)cyclohexyl]-N-
methylbenzamide(U47700);

(58) N-phenyl-N-[1-(2-phenylethyl)piperidin-4-yl]furan-2-carboxamide(furanylfentanyl);
deleted text begin and
deleted text end

(59) 4-(4-bromophenyl)-4-dimethylamino-1-phenethylcyclohexanol (bromadol)deleted text begin.deleted text endnew text begin;
new text end

new text begin (60) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopropanecarboxamide (Cyclopropryl
fentanyl);
new text end

new text begin (61) N-(1-phenethylpiperidin-4-yl)-N-phenylbutanamide) (butyryl fentanyl);
new text end

new text begin (62) 1-cyclohexyl-4-(1,2-diphenylethyl)piperazine) (MT-45);
new text end

new text begin (63) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopentanecarboxamide (cyclopentyl
fentanyl);
new text end

new text begin (64) N-(1-phenethylpiperidin-4-yl)-N-phenylisobutyramide (isobutyryl fentanyl);
new text end

new text begin (65) N-(1-phenethylpiperidin-4-yl)-N-phenylpentanamide (valeryl fentanyl);
new text end

new text begin (66) N-(4-chlorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide
(para-chloroisobutyryl fentanyl);
new text end

new text begin (67) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)butyramide (para-fluorobutyryl
fentanyl);
new text end

new text begin (68) N-(4-methoxyphenyl)-N-(1-phenethylpiperidin-4-yl)butyramide
(para-methoxybutyryl fentanyl);
new text end

new text begin (69) N-(2-fluorophenyl)-2-methoxy-N-(1-phenethylpiperidin-4-yl)acetamide (ocfentanil);
new text end

new text begin (70) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide (4-fluoroisobutyryl
fentanyl or para-fluoroisobutyryl fentanyl);
new text end

new text begin (71) N-(1-phenethylpiperidin-4-yl)-N-phenylacrylamide (acryl fentanyl or
acryloylfentanyl);
new text end

new text begin (72) 2-methoxy-N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide (methoxyacetyl
fentanyl);
new text end

new text begin (73) N-(2-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)propionamide (ortho-fluorofentanyl
or 2-fluorofentanyl);
new text end

new text begin (74) N-(1-phenethylpiperidin-4-yl)-N-phenyltetrahydrofuran-2-carboxamide
(tetrahydrofuranyl fentanyl); and
new text end

new text begin (75) Fentanyl-related substances, their isomers, esters, ethers, salts and salts of isomers,
esters and ethers, meaning any substance not otherwise listed under another federal
Administration Controlled Substance Code Number or not otherwise listed in this section,
and for which no exemption or approval is in effect under section 505 of the Federal Food,
Drug, and Cosmetic Act, United States Code , title 21, section 355, that is structurally related
to fentanyl by one or more of the following modifications:
new text end

new text begin (i) replacement of the phenyl portion of the phenethyl group by any monocycle, whether
or not further substituted in or on the monocycle;
new text end

new text begin (ii) substitution in or on the phenethyl group with alkyl, alkenyl, alkoxyl, hydroxyl, halo,
haloalkyl, amino, or nitro groups;
new text end

new text begin (iii) substitution in or on the piperidine ring with alkyl, alkenyl, alkoxyl, ester, ether,
hydroxyl, halo, haloalkyl, amino, or nitro groups;
new text end

new text begin (iv) replacement of the aniline ring with any aromatic monocycle whether or not further
substituted in or on the aromatic monocycle; or
new text end

new text begin (v) replacement of the N-propionyl group by another acyl group.
new text end

(c) Opium derivatives. Any of the following substances, their analogs, salts, isomers,
and salts of isomers, unless specifically excepted or unless listed in another schedule,
whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:

(1) acetorphine;

(2) acetyldihydrocodeine;

(3) benzylmorphine;

(4) codeine methylbromide;

(5) codeine-n-oxide;

(6) cyprenorphine;

(7) desomorphine;

(8) dihydromorphine;

(9) drotebanol;

(10) etorphine;

(11) heroin;

(12) hydromorphinol;

(13) methyldesorphine;

(14) methyldihydromorphine;

(15) morphine methylbromide;

(16) morphine methylsulfonate;

(17) morphine-n-oxide;

(18) myrophine;

(19) nicocodeine;

(20) nicomorphine;

(21) normorphine;

(22) pholcodine; and

(23) thebacon.

(d) Hallucinogens. Any material, compound, mixture or preparation which contains any
quantity of the following substances, their analogs, salts, isomers (whether optical, positional,
or geometric), and salts of isomers, unless specifically excepted or unless listed in another
schedule, whenever the existence of the analogs, salts, isomers, and salts of isomers is
possible:

(1) methylenedioxy amphetamine;

(2) methylenedioxymethamphetamine;

(3) methylenedioxy-N-ethylamphetamine (MDEA);

(4) n-hydroxy-methylenedioxyamphetamine;

(5) 4-bromo-2,5-dimethoxyamphetamine (DOB);

(6) 2,5-dimethoxyamphetamine (2,5-DMA);

(7) 4-methoxyamphetamine;

(8) 5-methoxy-3, 4-methylenedioxyamphetamine;

(9) alpha-ethyltryptamine;

(10) bufotenine;

(11) diethyltryptamine;

(12) dimethyltryptamine;

(13) 3,4,5-trimethoxyamphetamine;

(14) 4-methyl-2, 5-dimethoxyamphetamine (DOM);

(15) ibogaine;

(16) lysergic acid diethylamide (LSD);

(17) mescaline;

(18) parahexyl;

(19) N-ethyl-3-piperidyl benzilate;

(20) N-methyl-3-piperidyl benzilate;

(21) psilocybin;

(22) psilocyn;

(23) tenocyclidine (TPCP or TCP);

(24) N-ethyl-1-phenyl-cyclohexylamine (PCE);

(25) 1-(1-phenylcyclohexyl) pyrrolidine (PCPy);

(26) 1-[1-(2-thienyl)cyclohexyl]-pyrrolidine (TCPy);

(27) 4-chloro-2,5-dimethoxyamphetamine (DOC);

(28) 4-ethyl-2,5-dimethoxyamphetamine (DOET);

(29) 4-iodo-2,5-dimethoxyamphetamine (DOI);

(30) 4-bromo-2,5-dimethoxyphenethylamine (2C-B);

(31) 4-chloro-2,5-dimethoxyphenethylamine (2C-C);

(32) 4-methyl-2,5-dimethoxyphenethylamine (2C-D);

(33) 4-ethyl-2,5-dimethoxyphenethylamine (2C-E);

(34) 4-iodo-2,5-dimethoxyphenethylamine (2C-I);

(35) 4-propyl-2,5-dimethoxyphenethylamine (2C-P);

(36) 4-isopropylthio-2,5-dimethoxyphenethylamine (2C-T-4);

(37) 4-propylthio-2,5-dimethoxyphenethylamine (2C-T-7);

(38) 2-(8-bromo-2,3,6,7-tetrahydrofuro [2,3-f][1]benzofuran-4-yl)ethanamine
(2-CB-FLY);

(39) bromo-benzodifuranyl-isopropylamine (Bromo-DragonFLY);

(40) alpha-methyltryptamine (AMT);

(41) N,N-diisopropyltryptamine (DiPT);

(42) 4-acetoxy-N,N-dimethyltryptamine (4-AcO-DMT);

(43) 4-acetoxy-N,N-diethyltryptamine (4-AcO-DET);

(44) 4-hydroxy-N-methyl-N-propyltryptamine (4-HO-MPT);

(45) 4-hydroxy-N,N-dipropyltryptamine (4-HO-DPT);

(46) 4-hydroxy-N,N-diallyltryptamine (4-HO-DALT);

(47) 4-hydroxy-N,N-diisopropyltryptamine (4-HO-DiPT);

(48) 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DiPT);

(49) 5-methoxy-α-methyltryptamine (5-MeO-AMT);

(50) 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT);

(51) 5-methylthio-N,N-dimethyltryptamine (5-MeS-DMT);

(52) 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT);

(53) 5-methoxy-α-ethyltryptamine (5-MeO-AET);

(54) 5-methoxy-N,N-dipropyltryptamine (5-MeO-DPT);

(55) 5-methoxy-N,N-diethyltryptamine (5-MeO-DET);

(56) 5-methoxy-N,N-diallyltryptamine (5-MeO-DALT);

(57) methoxetamine (MXE);

(58) 5-iodo-2-aminoindane (5-IAI);

(59) 5,6-methylenedioxy-2-aminoindane (MDAI);

(60) 2-(4-bromo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25B-NBOMe);

(61) 2-(4-chloro-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25C-NBOMe);

(62) 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25I-NBOMe);

(63) 2-(2,5-Dimethoxyphenyl)ethanamine (2C-H);

(64) 2-(4-Ethylthio-2,5-dimethoxyphenyl)ethanamine (2C-T-2);

(65) N,N-Dipropyltryptamine (DPT);

(66) 3-[1-(Piperidin-1-yl)cyclohexyl]phenol (3-HO-PCP);

(67) N-ethyl-1-(3-methoxyphenyl)cyclohexanamine (3-MeO-PCE);

(68) 4-[1-(3-methoxyphenyl)cyclohexyl]morpholine (3-MeO-PCMo);

(69) 1-[1-(4-methoxyphenyl)cyclohexyl]-piperidine (methoxydine, 4-MeO-PCP);

(70) 2-(2-Chlorophenyl)-2-(ethylamino)cyclohexan-1-one (N-Ethylnorketamine,
ethketamine, NENK);

(71) methylenedioxy-N,N-dimethylamphetamine (MDDMA);

(72) 3-(2-Ethyl(methyl)aminoethyl)-1H-indol-4-yl (4-AcO-MET); and

(73) 2-Phenyl-2-(methylamino)cyclohexanone (deschloroketamine).

(e) Peyote. All parts of the plant presently classified botanically as Lophophora williamsii
Lemaire, whether growing or not, the seeds thereof, any extract from any part of the plant,
and every compound, manufacture, salts, derivative, mixture, or preparation of the plant,
its seeds or extracts. The listing of peyote as a controlled substance in Schedule I does not
apply to the nondrug use of peyote in bona fide religious ceremonies of the American Indian
Church, and members of the American Indian Church are exempt from registration. Any
person who manufactures peyote for or distributes peyote to the American Indian Church,
however, is required to obtain federal registration annually and to comply with all other
requirements of law.

(f) Central nervous system depressants. Unless specifically excepted or unless listed in
another schedule, any material compound, mixture, or preparation which contains any
quantity of the following substances, their analogs, salts, isomers, and salts of isomers
whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:

(1) mecloqualone;

(2) methaqualone;

(3) gamma-hydroxybutyric acid (GHB), including its esters and ethers;

(4) flunitrazepam; deleted text beginand
deleted text end

(5) 2-(2-Methoxyphenyl)-2-(methylamino)cyclohexanone (2-MeO-2-deschloroketamine,
methoxyketamine)deleted text begin.deleted text endnew text begin;
new text end

new text begin (6) tianeptine;
new text end

new text begin (7) clonazolam;
new text end

new text begin (8) etizolam;
new text end

new text begin (9) flubromazolam; and
new text end

new text begin (10) flubromazepam.
new text end

(g) Stimulants. Unless specifically excepted or unless listed in another schedule, any
material compound, mixture, or preparation which contains any quantity of the following
substances, their analogs, salts, isomers, and salts of isomers whenever the existence of the
analogs, salts, isomers, and salts of isomers is possible:

(1) aminorex;

(2) cathinone;

(3) fenethylline;

(4) methcathinone;

(5) methylaminorex;

(6) N,N-dimethylamphetamine;

(7) N-benzylpiperazine (BZP);

(8) methylmethcathinone (mephedrone);

(9) 3,4-methylenedioxy-N-methylcathinone (methylone);

(10) methoxymethcathinone (methedrone);

(11) methylenedioxypyrovalerone (MDPV);

(12) 3-fluoro-N-methylcathinone (3-FMC);

(13) methylethcathinone (MEC);

(14) 1-benzofuran-6-ylpropan-2-amine (6-APB);

(15) dimethylmethcathinone (DMMC);

(16) fluoroamphetamine;

(17) fluoromethamphetamine;

(18) α-methylaminobutyrophenone (MABP or buphedrone);

(19) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)butan-1-one (butylone);

(20) 2-(methylamino)-1-(4-methylphenyl)butan-1-one (4-MEMABP or BZ-6378);

(21) 1-(naphthalen-2-yl)-2-(pyrrolidin-1-yl) pentan-1-one (naphthylpyrovalerone or
naphyrone);

(22) (alpha-pyrrolidinopentiophenone (alpha-PVP);

(23) (RS)-1-(4-methylphenyl)-2-(1-pyrrolidinyl)-1-hexanone (4-Me-PHP or MPHP);

(24) 2-(1-pyrrolidinyl)-hexanophenone (Alpha-PHP);

(25) 4-methyl-N-ethylcathinone (4-MEC);

(26) 4-methyl-alpha-pyrrolidinopropiophenone (4-MePPP);

(27) 2-(methylamino)-1-phenylpentan-1-one (pentedrone);

(28) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)pentan-1-one (pentylone);

(29) 4-fluoro-N-methylcathinone (4-FMC);

(30) 3,4-methylenedioxy-N-ethylcathinone (ethylone);

(31) alpha-pyrrolidinobutiophenone (α-PBP);

(32) 5-(2-Aminopropyl)-2,3-dihydrobenzofuran (5-APDB);

(33) 1-phenyl-2-(1-pyrrolidinyl)-1-heptanone (PV8);

(34) 6-(2-Aminopropyl)-2,3-dihydrobenzofuran (6-APDB);

(35) 4-methyl-alpha-ethylaminopentiophenone (4-MEAPP);

(36) 4'-chloro-alpha-pyrrolidinopropiophenone (4'-chloro-PPP);

(37) 1-(1,3-Benzodioxol-5-yl)-2-(dimethylamino)butan-1-one (dibutylone, bk-DMBDB);

(38) 1-(3-chlorophenyl) piperazine (meta-chlorophenylpiperazine or mCPP); deleted text beginand
deleted text end

(39) new text begin1-(1,3-benzodioxol-5-yl)-2-(ethylamino)-pentan-1-one (N-ethylpentylone, ephylone);
and
new text end

new text begin (40) new text endany other substance, except bupropion or compounds listed under a different
schedule, that is structurally derived from 2-aminopropan-1-one by substitution at the
1-position with either phenyl, naphthyl, or thiophene ring systems, whether or not the
compound is further modified in any of the following ways:

(i) by substitution in the ring system to any extent with alkyl, alkylenedioxy, alkoxy,
haloalkyl, hydroxyl, or halide substituents, whether or not further substituted in the ring
system by one or more other univalent substituents;

(ii) by substitution at the 3-position with an acyclic alkyl substituent;

(iii) by substitution at the 2-amino nitrogen atom with alkyl, dialkyl, benzyl, or
methoxybenzyl groups; or

(iv) by inclusion of the 2-amino nitrogen atom in a cyclic structure.

(h) Marijuana, tetrahydrocannabinols, and synthetic cannabinoids. Unless specifically
excepted or unless listed in another schedule, any natural or synthetic material, compound,
mixture, or preparation that contains any quantity of the following substances, their analogs,
isomers, esters, ethers, salts, and salts of isomers, esters, and ethers, whenever the existence
of the isomers, esters, ethers, or salts is possible:

(1) marijuana;

(2) tetrahydrocannabinols naturally contained in a plant of the genus Cannabis, synthetic
equivalents of the substances contained in the cannabis plant or in the resinous extractives
of the plant, or synthetic substances with similar chemical structure and pharmacological
activity to those substances contained in the plant or resinous extract, including, but not
limited to, 1 cis or trans tetrahydrocannabinol, 6 cis or trans tetrahydrocannabinol, and 3,4
cis or trans tetrahydrocannabinol;

(3) synthetic cannabinoids, including the following substances:

(i) Naphthoylindoles, which are any compounds containing a 3-(1-napthoyl)indole
structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl,
alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group, whether or not further substituted in the indole ring to any
extent and whether or not substituted in the naphthyl ring to any extent. Examples of
naphthoylindoles include, but are not limited to:

(A) 1-Pentyl-3-(1-naphthoyl)indole (JWH-018 and AM-678);

(B) 1-Butyl-3-(1-naphthoyl)indole (JWH-073);

(C) 1-Pentyl-3-(4-methoxy-1-naphthoyl)indole (JWH-081);

(D) 1-[2-(4-morpholinyl)ethyl]-3-(1-naphthoyl)indole (JWH-200);

(E) 1-Propyl-2-methyl-3-(1-naphthoyl)indole (JWH-015);

(F) 1-Hexyl-3-(1-naphthoyl)indole (JWH-019);

(G) 1-Pentyl-3-(4-methyl-1-naphthoyl)indole (JWH-122);

(H) 1-Pentyl-3-(4-ethyl-1-naphthoyl)indole (JWH-210);

(I) 1-Pentyl-3-(4-chloro-1-naphthoyl)indole (JWH-398);

(J) 1-(5-fluoropentyl)-3-(1-naphthoyl)indole (AM-2201).

(ii) Napthylmethylindoles, which are any compounds containing a
1H-indol-3-yl-(1-naphthyl)methane structure with substitution at the nitrogen atom of the
indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl,
1-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group, whether or not further
substituted in the indole ring to any extent and whether or not substituted in the naphthyl
ring to any extent. Examples of naphthylmethylindoles include, but are not limited to:

(A) 1-Pentyl-1H-indol-3-yl-(1-naphthyl)methane (JWH-175);

(B) 1-Pentyl-1H-indol-3-yl-(4-methyl-1-naphthyl)methane (JWH-184).

(iii) Naphthoylpyrroles, which are any compounds containing a 3-(1-naphthoyl)pyrrole
structure with substitution at the nitrogen atom of the pyrrole ring by an alkyl, haloalkyl,
alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the pyrrole ring to any
extent, whether or not substituted in the naphthyl ring to any extent. Examples of
naphthoylpyrroles include, but are not limited to,
(5-(2-fluorophenyl)-1-pentylpyrrol-3-yl)-naphthalen-1-ylmethanone (JWH-307).

(iv) Naphthylmethylindenes, which are any compounds containing a naphthylideneindene
structure with substitution at the 3-position of the indene ring by an alkyl, haloalkyl, alkenyl,
cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the indene ring to any
extent, whether or not substituted in the naphthyl ring to any extent. Examples of
naphthylemethylindenes include, but are not limited to,
E-1-[1-(1-naphthalenylmethylene)-1H-inden-3-yl]pentane (JWH-176).

(v) Phenylacetylindoles, which are any compounds containing a 3-phenylacetylindole
structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl,
alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any
extent, whether or not substituted in the phenyl ring to any extent. Examples of
phenylacetylindoles include, but are not limited to:

(A) 1-(2-cyclohexylethyl)-3-(2-methoxyphenylacetyl)indole (RCS-8);

(B) 1-pentyl-3-(2-methoxyphenylacetyl)indole (JWH-250);

(C) 1-pentyl-3-(2-methylphenylacetyl)indole (JWH-251);

(D) 1-pentyl-3-(2-chlorophenylacetyl)indole (JWH-203).

(vi) Cyclohexylphenols, which are compounds containing a
2-(3-hydroxycyclohexyl)phenol structure with substitution at the 5-position of the phenolic
ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl,
1-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group whether or not substituted
in the cyclohexyl ring to any extent. Examples of cyclohexylphenols include, but are not
limited to:

(A) 5-(1,1-dimethylheptyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol (CP 47,497);

(B) 5-(1,1-dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol
(Cannabicyclohexanol or CP 47,497 C8 homologue);

(C) 5-(1,1-dimethylheptyl)-2-[(1R,2R)-5-hydroxy-2-(3-hydroxypropyl)cyclohexyl]
-phenol (CP 55,940).

(vii) Benzoylindoles, which are any compounds containing a 3-(benzoyl)indole structure
with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl,
cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any
extent and whether or not substituted in the phenyl ring to any extent. Examples of
benzoylindoles include, but are not limited to:

(A) 1-Pentyl-3-(4-methoxybenzoyl)indole (RCS-4);

(B) 1-(5-fluoropentyl)-3-(2-iodobenzoyl)indole (AM-694);

(C) (4-methoxyphenyl-[2-methyl-1-(2-(4-morpholinyl)ethyl)indol-3-yl]methanone (WIN
48,098 or Pravadoline).

(viii) Others specifically named:

(A) (6aR,10aR)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)
-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (HU-210);

(B) (6aS,10aS)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)
-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (Dexanabinol or HU-211);

(C) 2,3-dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo[1,2,3-de]
-1,4-benzoxazin-6-yl-1-naphthalenylmethanone (WIN 55,212-2);

(D) (1-pentylindol-3-yl)-(2,2,3,3-tetramethylcyclopropyl)methanone (UR-144);

(E) (1-(5-fluoropentyl)-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl)methanone
(XLR-11);

(F) 1-pentyl-N-tricyclo[3.3.1.13,7]dec-1-yl-1H-indazole-3-carboxamide
(AKB-48(APINACA));

(G) N-((3s,5s,7s)-adamantan-1-yl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide
(5-Fluoro-AKB-48);

(H) 1-pentyl-8-quinolinyl ester-1H-indole-3-carboxylic acid (PB-22);

(I) 8-quinolinyl ester-1-(5-fluoropentyl)-1H-indole-3-carboxylic acid (5-Fluoro PB-22);

(J) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-pentyl-1H-indazole- 3-carboxamide
(AB-PINACA);

(K) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-[(4-fluorophenyl)methyl]-
1H-indazole-3-carboxamide (AB-FUBINACA);

(L) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-(cyclohexylmethyl)-1H-
indazole-3-carboxamide(AB-CHMINACA);

(M) (S)-methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3- methylbutanoate
(5-fluoro-AMB);

(N) [1-(5-fluoropentyl)-1H-indazol-3-yl](naphthalen-1-yl) methanone (THJ-2201);

(O) (1-(5-fluoropentyl)-1H-benzo[d]imidazol-2-yl)(naphthalen-1-yl)methanone)
(FUBIMINA);

(P) (7-methoxy-1-(2-morpholinoethyl)-N-((1S,2S,4R)-1,3,3-trimethylbicyclo
[2.2.1]heptan-2-yl)-1H-indole-3-carboxamide (MN-25 or UR-12);

(Q) (S)-N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)
-1H-indole-3-carboxamide (5-fluoro-ABICA);

(R) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl)
-1H-indole-3-carboxamide;

(S) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl)
-1H-indazole-3-carboxamide;

(T) methyl 2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido) -3,3-dimethylbutanoate;

(U) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1(cyclohexylmethyl)-1
H-indazole-3-carboxamide (MAB-CHMINACA);

(V) N-(1-Amino-3,3-dimethyl-1-oxo-2-butanyl)-1-pentyl-1H-indazole-3-carboxamide
(ADB-PINACA);

(W) methyl (1-(4-fluorobenzyl)-1H-indazole-3-carbonyl)-L-valinate (FUB-AMB);

(X) N-[(1S)-2-amino-2-oxo-1-(phenylmethyl)ethyl]-1-(cyclohexylmethyl)-1H-Indazole-
3-carboxamide. (APP-CHMINACA);

(Y) quinolin-8-yl 1-(4-fluorobenzyl)-1H-indole-3-carboxylate (FUB-PB-22); and

(Z) methyl N-[1-(cyclohexylmethyl)-1H-indole-3-carbonyl]valinate (MMB-CHMICA).

new text begin (ix) Additional substances specifically named:
new text end

new text begin (A) 1-(5-fluoropentyl)-N-(2-phenylpropan-2-yl)-1
H-pyrrolo[2,3-B]pyridine-3-carboxamide (5F-CUMYL-P7AICA);
new text end

new text begin (B) 1-(4-cyanobutyl)-N-(2- phenylpropan-2-yl)-1 H-indazole-3-carboxamide
(4-CN-Cumyl-Butinaca);
new text end

new text begin (C) naphthalen-1-yl-1-(5-fluoropentyl)-1-H-indole-3-carboxylate (NM2201; CBL2201);
new text end

new text begin (D) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)-1
H-indazole-3-carboxamide (5F-ABPINACA);
new text end

new text begin (E) methyl-2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3,3-dimethylbutanoate
(MDMB CHMICA);
new text end

new text begin (F) methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate
(5F-ADB; 5F-MDMB-PINACA); and
new text end

new text begin (G) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)
1H-indazole-3-carboxamide (ADB-FUBINACA).
new text end

(i) A controlled substance analog, to the extent that it is implicitly or explicitly intended
for human consumption.

Sec. 2.

Minnesota Statutes 2018, section 152.02, subdivision 3, is amended to read:


Subd. 3.

Schedule II.

(a) Schedule II consists of the substances listed in this subdivision.

(b) Unless specifically excepted or unless listed in another schedule, any of the following
substances whether produced directly or indirectly by extraction from substances of vegetable
origin or independently by means of chemical synthesis, or by a combination of extraction
and chemical synthesis:

(1) Opium and opiate, and any salt, compound, derivative, or preparation of opium or
opiate.

(i) Excluding:

(A) apomorphine;

(B) thebaine-derived butorphanol;

(C) dextrophan;

(D) nalbuphine;

(E) nalmefene;

(F) naloxegol;

(G) naloxone;

(H) naltrexone; and

(I) their respective salts;

(ii) but including the following:

(A) opium, in all forms and extracts;

(B) codeine;

(C) dihydroetorphine;

(D) ethylmorphine;

(E) etorphine hydrochloride;

(F) hydrocodone;

(G) hydromorphone;

(H) metopon;

(I) morphine;

(J) oxycodone;

(K) oxymorphone;

(L) thebaine;

(M) oripavine;

(2) any salt, compound, derivative, or preparation thereof which is chemically equivalent
or identical with any of the substances referred to in clause (1), except that these substances
shall not include the isoquinoline alkaloids of opium;

(3) opium poppy and poppy straw;

(4) coca leaves and any salt, cocaine compound, derivative, or preparation of coca leaves
(including cocaine and ecgonine and their salts, isomers, derivatives, and salts of isomers
and derivatives), and any salt, compound, derivative, or preparation thereof which is
chemically equivalent or identical with any of these substances, except that the substances
shall not include decocainized coca leaves or extraction of coca leaves, which extractions
do not contain cocaine or ecgonine;

(5) concentrate of poppy straw (the crude extract of poppy straw in either liquid, solid,
or powder form which contains the phenanthrene alkaloids of the opium poppy).

(c) Any of the following opiates, including their isomers, esters, ethers, salts, and salts
of isomers, esters and ethers, unless specifically excepted, or unless listed in another schedule,
whenever the existence of such isomers, esters, ethers and salts is possible within the specific
chemical designation:

(1) alfentanil;

(2) alphaprodine;

(3) anileridine;

(4) bezitramide;

(5) bulk dextropropoxyphene (nondosage forms);

(6) carfentanil;

(7) dihydrocodeine;

(8) dihydromorphinone;

(9) diphenoxylate;

(10) fentanyl;

(11) isomethadone;

(12) levo-alpha-acetylmethadol (LAAM);

(13) levomethorphan;

(14) levorphanol;

(15) metazocine;

(16) methadone;

(17) methadone - intermediate, 4-cyano-2-dimethylamino-4, 4-diphenylbutane;

(18) moramide - intermediate, 2-methyl-3-morpholino-1, 1-diphenyl-propane-carboxylic
acid;

(19) pethidine;

(20) pethidine - intermediate - a, 4-cyano-1-methyl-4-phenylpiperidine;

(21) pethidine - intermediate - b, ethyl-4-phenylpiperidine-4-carboxylate;

(22) pethidine - intermediate - c, 1-methyl-4-phenylpiperidine-4-carboxylic acid;

(23) phenazocine;

(24) piminodine;

(25) racemethorphan;

(26) racemorphan;

(27) remifentanil;

(28) sufentanil;

(29) tapentadol;

(30) deleted text begin4-Anilino-N-phenethyl-4-piperidine (ANPP)deleted text end new text begin4-Anilino-N-phenethylpiperidinenew text end.

(d) Unless specifically excepted or unless listed in another schedule, any material,
compound, mixture, or preparation which contains any quantity of the following substances
having a stimulant effect on the central nervous system:

(1) amphetamine, its salts, optical isomers, and salts of its optical isomers;

(2) methamphetamine, its salts, isomers, and salts of its isomers;

(3) phenmetrazine and its salts;

(4) methylphenidate;

(5) lisdexamfetamine.

(e) Unless specifically excepted or unless listed in another schedule, any material,
compound, mixture, or preparation which contains any quantity of the following substances
having a depressant effect on the central nervous system, including its salts, isomers, and
salts of isomers whenever the existence of such salts, isomers, and salts of isomers is possible
within the specific chemical designation:

(1) amobarbital;

(2) glutethimide;

(3) secobarbital;

(4) pentobarbital;

(5) phencyclidine;

(6) phencyclidine immediate precursors:

(i) 1-phenylcyclohexylamine;

(ii) 1-piperidinocyclohexanecarbonitrile;

(7) phenylacetone.

(f) deleted text beginHallucinogenic substancesdeleted text endnew text begin Cannabinoidsnew text end:

new text begin (1)new text end nabilonedeleted text begin.deleted text endnew text begin;
new text end

new text begin (2) dronabinol [(-)-delta-9-trans-tetrahydrocannabinol (delta-9-THC)] in an oral solution
in a drug product approved for marketing by the United States Food and Drug Administration.
new text end

Sec. 3.

Minnesota Statutes 2018, section 152.02, subdivision 4, is amended to read:


Subd. 4.

Schedule III.

(a) Schedule III consists of the substances listed in this subdivision.

(b) Stimulants. Unless specifically excepted or unless listed in another schedule, any
material, compound, mixture, or preparation which contains any quantity of the following
substances having a potential for abuse associated with a stimulant effect on the central
nervous system, including its salts, isomers, and salts of such isomers whenever the existence
of such salts, isomers, and salts of isomers is possible within the specific chemical
designation:

(1) benzphetamine;

(2) chlorphentermine;

(3) clortermine;

(4) phendimetrazine.

(c) Depressants. Unless specifically excepted or unless listed in another schedule, any
material, compound, mixture, or preparation which contains any quantity of the following
substances having a potential for abuse associated with a depressant effect on the central
nervous system:

(1) any compound, mixture, or preparation containing amobarbital, secobarbital,
pentobarbital or any salt thereof and one or more other active medicinal ingredients which
are not listed in any schedule;

(2) any suppository dosage form containing amobarbital, secobarbital, pentobarbital, or
any salt of any of these drugs and approved by the food and drug administration for marketing
only as a suppository;

(3) any substance which contains any quantity of a derivative of barbituric acid, or any
salt of a derivative of barbituric acid, except those substances which are specifically listed
in other schedules;

(4) any drug product containing gamma hydroxybutyric acid, including its salts, isomers,
and salts of isomers, for which an application is approved under section 505 of the federal
Food, Drug, and Cosmetic Act;

(5) any of the following substances:

(i) chlorhexadol;

(ii) ketamine, its salts, isomers and salts of isomers;

(iii) lysergic acid;

(iv) lysergic acid amide;

(v) methyprylon;

(vi) sulfondiethylmethane;

(vii) sulfonenthylmethane;

(viii) sulfonmethane;

(ix) tiletamine and zolazepam and any salt thereof;

(x) embutramide;

(xi) Perampanel [2-(2-oxo-1-phenyl-5-pyridin-2-yl-1,2-Dihydropyridin-3-yl)
benzonitrile].

(d) Nalorphine.

(e) Narcotic drugs. Unless specifically excepted or unless listed in another schedule,
any material, compound, mixture, or preparation containing any of the following narcotic
drugs, or their salts calculated as the free anhydrous base or alkaloid, in limited quantities
as follows:

(1) not more than 1.80 grams of codeine per 100 milliliters or not more than 90 milligrams
per dosage unit, with an equal or greater quantity of an isoquinoline alkaloid of opium;

(2) not more than 1.80 grams of codeine per 100 milliliters or not more than 90 milligrams
per dosage unit, with one or more active, nonnarcotic ingredients in recognized therapeutic
amounts;

(3) not more than 1.80 grams of dihydrocodeine per 100 milliliters or not more than 90
milligrams per dosage unit, with one or more active, nonnarcotic ingredients in recognized
therapeutic amounts;

(4) not more than 300 milligrams of ethylmorphine per 100 milliliters or not more than
15 milligrams per dosage unit, with one or more active, nonnarcotic ingredients in recognized
therapeutic amounts;

(5) not more than 500 milligrams of opium per 100 milliliters or per 100 grams, or not
more than 25 milligrams per dosage unit, with one or more active, nonnarcotic ingredients
in recognized therapeutic amounts;

(6) not more than 50 milligrams of morphine per 100 milliliters or per 100 grams with
one or more active, nonnarcotic ingredients in recognized therapeutic amounts;

(f) Anabolic steroids, human growth hormone, and chorionic gonadotropin.

(1) Anabolic steroids, for purposes of this subdivision, means any drug or hormonal
substance, chemically and pharmacologically related to testosterone, other than estrogens,
progestins, corticosteroids, and dehydroepiandrosterone, and includes:

(i) 3[beta],17[beta]-dihydroxy-5[alpha]-androstane;

(ii) 3[alpha],17[beta]-dihydroxy-5[alpha]-androstane;

(iii) androstanedione (5[alpha]-androstan-3,17-dione);

(iv) 1-androstenediol (3[beta],17[beta]-dihydroxy-5[alpha]-androst-l-ene;

(v) 3[alpha],17[beta]-dihydroxy-5[alpha]-androst-1-ene);

(vi) 4-androstenediol (3[beta],17[beta]-dihydroxy-androst-4-ene);

(vii) 5-androstenediol (3[beta],17[beta]-dihydroxy-androst-5-ene);

(viii) 1-androstenedione (5[alpha]-androst-1-en-3,17-dione);

(ix) 4-androstenedione (androst-4-en-3,17-dione);

(x) 5-androstenedione (androst-5-en-3,17-dione);

(xi) bolasterone (7[alpha],17[alpha]-dimethyl-17[beta]-hydroxyandrost-4-en-3-one);

(xii) boldenone (17[beta]-hydroxyandrost-1,4-diene-3-one);

(xiii) boldione (androsta-1,4-diene-3,17-dione);

(xiv) calusterone (7[beta],17[alpha]-dimethyl-17[beta]-hydroxyandrost-4-en-3-one);

(xv) clostebol (4-chloro-17[beta]-hydroxyandrost-4-en-3-one);

(xvi) dehydrochloromethyltestosterone
(4-chloro-17[beta]-hydroxy-17[alpha]-methylandrost-1,4-dien-3-one);

(xvii) desoxymethyltestosterone (17[alpha]-methyl-5[alpha]-androst-2-en-17[beta]-ol);

(xviii) [delta]1-dihydrotestosterone- (17[beta]-hydroxy-5[alpha]-androst-1-en-3-one);

(xix) 4-dihydrotestosterone (17[beta]-hydroxy-androstan-3-one);

(xx) drostanolone (17[beta]hydroxy-2[alpha]-methyl-5[alpha]-androstan-3-one);

(xxi) ethylestrenol (17[alpha]-ethyl-17[beta]-hydroxyestr-4-ene);

(xxii) fluoxymesterone
(9-fluoro-17[alpha]-methyl-11[beta],17[beta]-dihydroxyandrost-4-en-3-one);

(xxiii) formebolone
(2-formyl-17[alpha]-methyl-11[alpha],17[beta]-dihydroxyandrost-1,4-dien-3-one);

(xxiv) furazabol
(17[alpha]-methyl-17[beta]-hydroxyandrostano[2,3-c]-furazan)13[beta]-ethyl-17[beta]
-hydroxygon-4-en-3-one;

(xxv) 4-hydroxytestosterone (4,17[beta]-dihydroxyandrost-4-en-3-one);

(xxvi) 4-hydroxy-19-nortestosterone (4,17[beta]-dihydroxyestr-4-en-3-one);

(xxvii) mestanolone (17[alpha]-methyl-17[beta]-hydroxy-5[alpha]-androstan-3-one);

(xxviii) mesterolone (1[alpha]-methyl-17[beta]-hydroxy-5[alpha]-androstan-3-one);

(xxix) methandienone (17[alpha]-methyl-17[beta]-hydroxyandrost-1,4-dien-3-one);

(xxx) methandriol (17[alpha]-methyl-3[beta],17[beta]-dihydroxyandrost-5-ene);

(xxxi) methasterone (2 alpha-17 alpha-dimethyl-5 alpha-androstan-17beta-ol-3-one);

(xxxii) methenolone (1-methyl-17[beta]-hydroxy-5[alpha]-androst-1-en-3-one);

(xxxiii) 17[alpha]-methyl-3[beta],17[beta]-dihydroxy-5[alpha]-androstane;

(xxxiv) 17[alpha]-methyl-3[alpha],17[beta]-dihydroxy-5[alpha]-androstane;

(xxxv) 17[alpha]-methyl-3[beta],17[beta]-dihydroxyandrost-4-ene;

(xxxvi) 17[alpha]-methyl-4-hydroxynandrolone
(17[alpha]-methyl-4-hydroxy-17[beta]-hydroxyestr-4-en-3-one);

(xxxvii) methyldienolone (17[alpha]-methyl-17[beta]-hydroxyestra-4,9(10)-dien-3-one);

(xxxviii) methyltrienolone (17[alpha]-methyl-17[beta]-hydroxyestra-4,9-11-trien-3-one);

(xxxix) methyltestosterone (17[alpha]-methyl-17[beta]-hydroxyandrost-4-en-3-one);

(xl) mibolerone (7[alpha],17[alpha]-dimethyl-17[beta]-hydroxyestr-4-en-3-one);

(xli) 17[alpha]-methyl-[delta]1-dihydrotestosterone
(17[beta]-hydroxy-17[alpha]-methyl-5[alpha]-androst-1-en-3-one);

(xlii) nandrolone (17[beta]-hydroxyestr-4-en-3-one);

(xliii) 19-nor-4-androstenediol (3[beta],17[beta]-dihydroxyestr-4-ene;

(xliv) 3[alpha],17[beta]-dihydroxyestr-4-ene); 19-nor-5-androstenediol
(3[beta],17[beta]-dihydroxyestr-5-ene;

(xlv) 3[alpha],17[beta]-dihydroxyestr-5-ene);

(xlvi) 19-nor-4,9(10)-androstadienedione (estra-4,9(10)-diene-3,17-dione);

(xlvii) 19-nor-5-androstenedione (estr-5-en-3,17-dione);

(xlviii) norbolethone (13[beta],17[alpha]-diethyl-17[beta]-hydroxygon-4-en-3-one);

(xlix) norclostebol (4-chloro-17[beta]-hydroxyestr-4-en-3-one);

(l) norethandrolone (17[alpha]-ethyl-17[beta]-hydroxyestr-4-en-3-one);

(li) normethandrolone (17[alpha]-methyl-17[beta]-hydroxyestr-4-en-3-one);

(lii) oxandrolone (17[alpha]-methyl-17[beta]-hydroxy-2-oxa-5[alpha]-androstan-3-one);

(liii) oxymesterone (17[alpha]-methyl-4,17[beta]-dihydroxyandrost-4-en-3-one);

(liv) oxymetholone
(17[alpha]-methyl-2-hydroxymethylene-17[beta]-hydroxy-5[alpha]-androstan-3-one);

(lv) prostanozol (17 beta-hydroxy-5 alpha-androstano[3,2-C]pryazole;

(lvi) stanozolol
(17[alpha]-methyl-17[beta]-hydroxy-5[alpha]-androst-2-eno[3,2-c]-pyrazole);

(lvii) stenbolone (17[beta]-hydroxy-2-methyl-5[alpha]-androst-1-en-3-one);

(lviii) testolactone (13-hydroxy-3-oxo-13,17-secoandrosta-1,4-dien-17-oic acid lactone);

(lix) testosterone (17[beta]-hydroxyandrost-4-en-3-one);

(lx) tetrahydrogestrinone
(13[beta],17[alpha]-diethyl-17[beta]-hydroxygon-4,9,11-trien-3-one);

(lxi) trenbolone (17[beta]-hydroxyestr-4,9,11-trien-3-one);

(lxii) any salt, ester, or ether of a drug or substance described in this paragraph.

Anabolic steroids are not included if they are: (A) expressly intended for administration
through implants to cattle or other nonhuman species; and (B) approved by the United States
Food and Drug Administration for that use;

(2) Human growth hormones.

(3) Chorionic gonadotropinnew text begin, except that a product containing chorionic gonadotropin is
not included if it is:
new text end

new text begin (i) expressly intended for administration to cattle or other nonhuman species; and
new text end

new text begin (ii) approved by the United States Food and Drug Administration for that usenew text end.

(g) Hallucinogenic substances. Dronabinol (synthetic) in sesame oil and encapsulated
in a soft gelatin capsule in a United States Food and Drug Administration approved product.

(h) Any material, compound, mixture, or preparation containing the following narcotic
drug or its salt: buprenorphine.

APPENDIX

Repealed Minnesota Statutes: S0013-3

62U.15 ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING MEASURES.

Subd. 2.

Learning collaborative.

By July 1, 2012, the commissioner shall develop a health care home learning collaborative curriculum that includes screening and education on best practices regarding identification and management of Alzheimer's and other dementia patients under section 256B.0751, subdivision 5, for providers, clinics, care coordinators, clinic administrators, patient partners and families, and community resources including public health.

144.121 X-RAY MACHINES; OTHER SOURCES OF IONIZING RADIATION.

Subd. 3.

Exemption.

Notwithstanding rules adopted by the commissioner under section 144.12, subdivision 1, clause (15), practitioners of veterinary medicine are not required to conduct densitometry and sensitometry tests as part of any ionizing radiation quality assurance program.

Subd. 5b.

Variance of scope of practice.

The commissioner may grant a variance according to Minnesota Rules, parts 4717.7000 to 4717.7050, to a facility for the scope of practice of an x-ray operator in cases where the delivery of health care would otherwise be compromised if a variance were not granted. The request for a variance must be in writing, state the circumstances that constitute hardship, state the period of time the facility wishes to have the variance for the scope of practice in place, and state the alternative measures that will be taken if the variance is granted. The commissioner shall set forth in writing the reasons for granting or denying the variance. Variances granted by the commissioner must specify in writing the time limitation and required alternative measures to be taken by the facility. A request for the variance shall be denied if the commissioner finds the circumstances stated by the facility do not support a claim of hardship, the requested time period for the variance is unreasonable, the alternative measures proposed by the facility are not equivalent to the scope of practice, or the request for the variance is not submitted to the commissioner in a timely manner.

147A.01 DEFINITIONS.

Subd. 4.

Agreement.

"Agreement" means the document described in section 147A.20.

Subd. 11.

Drug category.

"Drug category" means one of the categories listed on the physician-physician assistant delegation agreement.

Subd. 16a.

Notice of intent to practice.

"Notice of intent to practice" means a document sent to the board by a licensed physician assistant that documents the adoption of a physician-physician assistant delegation agreement and provides the names, addresses, and information required by section 147A.20.

Subd. 17a.

Physician-physician assistant delegation agreement.

"Physician-physician assistant delegation agreement" means the document prepared and signed by the physician and physician assistant affirming the supervisory relationship and defining the physician assistant scope of practice. The physician-physician assistant delegation agreement outlines the role of the physician assistant in the practice, describes the means of supervision, and specifies the categories of drugs, controlled substances, and medical devices that the supervising physician delegates to the physician assistant to prescribe. The physician-physician assistant delegation agreement must comply with the requirements of section 147A.20, be kept on file at the address of record, and be made available to the board or its representative upon request.

Subd. 24.

Supervision.

"Supervision" means overseeing the activities of, and accepting responsibility for, the medical services rendered by a physician assistant. The constant physical presence of the supervising physician is not required so long as the supervising physician and physician assistant are or can be easily in contact with one another by radio, telephone, or other telecommunication device. The scope and nature of the supervision shall be defined by the individual physician-physician assistant delegation agreement.

Subd. 25.

Temporary license.

"Temporary license" means a license granted to a physician assistant who meets all of the qualifications for licensure but has not yet been approved for licensure at a meeting of the board.

147A.04 TEMPORARY LICENSE.

The board may issue a temporary license to practice to a physician assistant eligible for licensure under this chapter only if the application for licensure is complete, all requirements have been met, and a nonrefundable fee set by the board has been paid. The temporary license remains valid only until the next meeting of the board at which a decision is made on the application for licensure.

147A.10 SATELLITE SETTINGS.

Physician assistants may render services in a setting geographically remote from the supervising physician.

147A.11 EXCLUSIONS OF LIMITATIONS ON EMPLOYMENT.

Nothing in this chapter shall be construed to limit the employment arrangement of a physician assistant licensed under this chapter.

147A.18 DELEGATED AUTHORITY TO PRESCRIBE, DISPENSE, AND ADMINISTER DRUGS AND MEDICAL DEVICES.

Subdivision 1.

Delegation.

(a) A supervising physician may delegate to a physician assistant who is licensed by the board, certified by the National Commission on Certification of Physician Assistants or successor agency approved by the board, and who is under the supervising physician's supervision, the authority to prescribe, dispense, and administer legend drugs, controlled substances, and medical devices subject to the requirements in this section. The authority to dispense includes, but is not limited to, the authority to request, receive, and dispense sample drugs. This authority to dispense extends only to those drugs described in the written agreement developed under paragraph (b).

(b) The delegation agreement between the physician assistant and supervising physician must include a statement by the supervising physician regarding delegation or nondelegation of the functions of prescribing, dispensing, and administering legend drugs, controlled substances, and medical devices to the physician assistant. The statement must include categories of drugs for which the supervising physician delegates prescriptive and dispensing authority, including controlled substances when applicable. The delegation must be appropriate to the physician assistant's practice and within the scope of the physician assistant's training. Physician assistants who have been delegated the authority to prescribe, dispense, and administer legend drugs, controlled substances, and medical devices shall provide evidence of current certification by the National Commission on Certification of Physician Assistants or its successor agency when applying for licensure or license renewal as physician assistants. Physician assistants who have been delegated the authority to prescribe controlled substances must also hold a valid DEA registration. Supervising physicians shall retrospectively review the prescribing, dispensing, and administering of legend drugs, controlled substances, and medical devices by physician assistants, when this authority has been delegated to the physician assistant as part of the physician-physician assistant delegation agreement. The process and schedule for the review must be outlined in the physician-physician assistant delegation agreement.

(c) The board may establish by rule:

(1) a system of identifying physician assistants eligible to prescribe, administer, and dispense legend drugs and medical devices;

(2) a system of identifying physician assistants eligible to prescribe, administer, and dispense controlled substances;

(3) a method of determining the categories of legend drugs, controlled substances, and medical devices that each physician assistant is allowed to prescribe, administer, and dispense; and

(4) a system of transmitting to pharmacies a listing of physician assistants eligible to prescribe legend drugs, controlled substances, and medical devices.

Subd. 2.

Termination and reinstatement of prescribing authority.

The authority of a physician assistant to prescribe, dispense, and administer legend drugs, controlled substances, and medical devices shall end immediately when:

(1) the physician-physician assistant delegation agreement is terminated;

(2) the authority to prescribe, dispense, and administer is terminated or withdrawn by the supervising physician;

(3) the physician assistant's license is placed on inactive status;

(4) the physician assistant loses National Commission on Certification of Physician Assistants or successor agency certification; or

(5) the physician assistant loses or terminates licensure status.

Subd. 3.

Other requirements and restrictions.

(a) Each prescription initiated by a physician assistant shall indicate the following:

(1) the date of issue;

(2) the name and address of the patient;

(3) the name and quantity of the drug prescribed;

(4) directions for use; and

(5) the name and address of the prescribing physician assistant.

(b) In prescribing, dispensing, and administering legend drugs, controlled substances, and medical devices, a physician assistant must conform with the agreement, chapter 151, and this chapter.

147A.20 PHYSICIAN-PHYSICIAN ASSISTANT AGREEMENT DOCUMENTS.

Subdivision 1.

Physician-physician assistant delegation agreement.

(a) A physician assistant and supervising physician must sign a physician-physician assistant delegation agreement which specifies scope of practice and manner of supervision as required by the board. The agreement must contain:

(1) a description of the practice setting;

(2) a listing of categories of delegated duties;

(3) a description of supervision type; and

(4) a description of the process and schedule for review of prescribing, dispensing, and administering legend and controlled drugs and medical devices by the physician assistant authorized to prescribe.

(b) The agreement must be maintained by the supervising physician and physician assistant and made available to the board upon request. If there is a delegation of prescribing, administering, and dispensing of legend drugs, controlled substances, and medical devices, the agreement shall include a description of the prescriptive authority delegated to the physician assistant. Physician assistants shall have a separate agreement for each place of employment. Agreements must be reviewed and updated on an annual basis. The supervising physician and physician assistant must maintain the physician-physician assistant delegation agreement at the address of record.

(c) Physician assistants must provide written notification to the board within 30 days of the following:

(1) name change;

(2) address of record change; and

(3) telephone number of record change.

Subd. 2.

Practice location notification.

A licensed physician assistant shall submit a practice location notification to the board within 30 business days of starting practice, changing practice location, or changing supervising physician. The notification shall include the name, business address, and telephone number of the supervising physician and the physician assistant. Individuals who practice without submitting a practice location notification shall be subject to disciplinary action under section 147A.13 for practicing without a license, unless the care is provided in response to a disaster or emergency situation pursuant to section 147A.23.

256B.057 ELIGIBILITY REQUIREMENTS FOR SPECIAL CATEGORIES.

Subd. 8.

Children under age two.

Medical assistance may be paid for a child under two years of age whose countable household income is above 275 percent of the federal poverty guidelines for the same household size but less than or equal to 280 percent of the federal poverty guidelines for the same household size or an equivalent standard when converted using modified adjusted gross income methodology as required under the Affordable Care Act.

256B.0752 HEALTH CARE HOME REPORTING REQUIREMENTS.

Subdivision 1.

Annual reports on implementation and administration.

The commissioners shall report annually to the legislature on the implementation and administration of the health care home model for state health care program enrollees in the fee-for-service, managed care, and county-based purchasing sectors beginning December 15, 2009, and each December 15 thereafter.

Subd. 2.

Evaluation reports.

The commissioners shall provide to the legislature comprehensive evaluations of the health care home model three years and five years after implementation. The report must include:

(1) the number of state health care program enrollees in health care homes and the number and characteristics of enrollees with complex or chronic conditions, identified by income, race, ethnicity, and language;

(2) the number and geographic distribution of health care home providers;

(3) the performance and quality of care of health care homes;

(4) measures of preventive care;

(5) health care home payment arrangements, and costs related to implementation and payment of care coordination fees;

(6) the estimated impact of health care homes on health disparities; and

(7) estimated savings from implementation of the health care home model for the fee-for-service, managed care, and county-based purchasing sectors.

256L.04 ELIGIBLE PERSONS.

Subd. 13.

Families with relative caretakers, foster parents, or legal guardians.

Beginning January 1, 1999, in families that include a relative caretaker as defined in the medical assistance program, foster parent, or legal guardian, the relative caretaker, foster parent, or legal guardian may apply as a family or may apply separately for the children. If the caretaker applies separately for the children, only the children's income is counted and the provisions of subdivision 1, paragraph (b), do not apply. If the relative caretaker, foster parent, or legal guardian applies with the children, their income is included in the gross family income for determining eligibility and premium amount.

Repealed Minnesota Rule: S0013-3

7380.0280

[Repealed, L 2020 c 115 art 1 s 17]

9505.0365 PROSTHETIC AND ORTHOTIC DEVICES.

Subp. 3.

[Repealed, L 2020 c 115 art 4 s 140]

Prior authorization of an ambulatory aid is required for an aid that costs in excess of the limits specified in the provider's performance agreement.