SF 1641

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

A bill for an act
relating to health; modifying best practices
guidelines; establishing a quality improvement
investment program; appropriating money; amending
Minnesota Statutes 2004, section 62J.43.

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

Section 1.

Minnesota Statutes 2004, section 62J.43, is
amended to read:

62J.43 deleted text begin BEST PRACTICES deleted text end new text begin EVIDENCE-BASED HEALTH CARE
GUIDELINES new text end AND QUALITY IMPROVEMENT.

deleted text begin (a) deleted text end new text begin Subdivision 1. new text end [ADOPTION OF EVIDENCE-BASED
GUIDELINES.] To improve quality and reduce health care costs,
state agencies shall encourage the deleted text begin adoption deleted text end new text begin use new text end of deleted text begin best practice
deleted text end new text begin evidence-based health care new text end guidelines and participation in deleted text begin best
practices deleted text end new text begin quality of care new text end measurement activities by deleted text begin physicians
deleted text end new text begin medical groups, hospitals new text end , other health care providers, and
health plan companies. The commissioner of health shall
facilitate access to deleted text begin best practice deleted text end new text begin evidence-based health care
new text end guidelines and quality of care measurement information deleted text begin to deleted text end new text begin for
new text end providers, purchasers, and consumers by:

(1) identifying and promoting deleted text begin local community-based,
physician-designed best practices care deleted text end new text begin evidence-based health
care guidelines new text end across the Minnesota health care system new text begin using
local community-based, physician-designed guidelines whenever
they are available and meet the criteria set forth in
subdivision 2 new text end ;

(2) disseminating information available to the commissioner
on deleted text begin adherence to best practices care by physicians deleted text end new text begin the
performance of Minnesota medical groups, hospitals, new text end and other
health care providers deleted text begin in Minnesota deleted text end new text begin in providing care in
accordance with evidence-based health care guidelines new text end ;

(3) educating consumers and purchasers on how to
deleted text begin effectively deleted text end use this information new text begin effectively new text end in choosing their
providers and in making purchasing decisions; and

(4) making deleted text begin best practices deleted text end new text begin evidence-based health care
guidelines new text end and quality new text begin of new text end care measurement information available
to enrollees and program participants through the Department of
Health's Web site. The commissioner may convene an advisory
committee to ensure that the Web site is designed to provide
user friendly and easy accessibility.

deleted text begin (b) The commissioner of health shall collaborate with a
nonprofit Minnesota quality improvement organization
specializing in best practices and quality of care measurements
to provide best practices criteria and assist in the collection
of the data.
deleted text end

deleted text begin (c) deleted text end new text begin Subd. 2. new text end [CRITERIA FOR EVIDENCE-BASED
GUIDELINES.] new text begin Guidelines identified under this section must meet
the following criteria:
new text end

new text begin (1) the scope and intended use of the guideline application
are clearly stated;
new text end

new text begin (2) the authors are listed and any conflicts of interest
are disclosed;
new text end

new text begin (3) the authors represent all pertinent clinical fields or
other means of input have been used for pertinent clinical
fields not represented among the authors;
new text end

new text begin (4) the development process is explicitly stated;
new text end

new text begin (5) the guideline is grounded in evidence;
new text end

new text begin (6) the evidence is cited and graded with respect to its
strength;
new text end

new text begin (7) the document itself is clear and practical;
new text end

new text begin (8) the document is flexible in use, with exceptions noted
or provided for with general statements;
new text end

new text begin (9) measures are included for use in systems improvement
pursued to improve the likelihood that health care will be
provided in accordance with the guideline; and
new text end

new text begin (10) the document provides for scheduled reviews and
updating.
new text end

new text begin Subd. 3. new text end

new text begin Identification of evidence-based health care
guidelines. new text end

new text begin In order to identify evidence-based guidelines for
promotion under this section, the commissioner of health shall
collaborate with a nonprofit Minnesota quality improvement
organization that specializes in producing guidelines and using
them to improve health care. The guidelines identified may be
ones produced by that organization or ones produced by other
nonprofit Minnesota or national organizations, provided that the
guidelines fulfill the criteria set forth in subdivision 2.
new text end

new text begin Subd. 4. new text end

new text begin Initial evidence-based health care guidelines.
new text end

The deleted text begin initial best practices and quality of care measurement
criteria developed deleted text end new text begin topics of the evidence-based health care
guidelines initially identified and promoted new text end shall include
asthma, diabetes, deleted text begin and at least two other preventive health
measures. Hypertension and coronary artery diseases shall be
included within one year following availability deleted text end new text begin hypertension,
coronary artery disease, depression, preventive services, acute
myocardial infarction, heart failure, pneumonia, and surgical
infections. The guidelines on these topics shall be identified
and promotion begun by December 15, 2005 new text end .

new text begin Subd. 5. new text end

new text begin Measurement and reporting of performance. new text end

new text begin In
order to disseminate information on the performance of medical
groups, hospitals, and other health care providers in providing
care in accordance with evidence-based guidelines, the
commissioner shall collaborate with one or more nonprofit
Minnesota organizations that specialize in the development of
health care quality measures derived from evidence-based
guidelines, in the measurement of performance by health care
providers, and in the reporting of performance using publicly
accessible means, including Web sites. The Department of Health
shall not measure performance directly but shall determine
whether performance is being measured competently and accurately
by one or more nonprofit organizations and shall provide on its
Web site links to the Web site or sites of the measuring
organization or organizations chosen by the commissioner. The
commissioner shall encourage the development over time of a
single nonprofit Minnesota measurement and reporting
organization that reports on the performance of medical groups,
hospitals, and other health care providers.
new text end

deleted text begin (d) deleted text end new text begin Subd. 6. new text end [USE IN STATE CONTRACTS WITH HEALTH PLANS.]
The commissioners of human services and employee relations may
use the deleted text begin data deleted text end new text begin publicly reported performance measurements
described in subdivision 5 new text end to make decisions about contracts
they enter into with health plan companies new text begin and to establish
programs of performance payment designed to reward either
high-quality care or improvements in quality achieved by medical
groups, hospitals, and other health care providers new text end .

deleted text begin (e) deleted text end new text begin Subd. 7. new text end [LIMITATIONS.] This section does not apply if
the deleted text begin best practices deleted text end new text begin evidence-based health care new text end guidelines
authorize or recommend denial of treatment, food, or fluids
necessary to sustain life on the basis of the patient's age or
expected length of life or the patient's present or predicted
disability, degree of medical dependency, or quality of life.

deleted text begin (f) The commissioner of health, human services, and
employee relations shall report to the legislature by January
15, 2005, on the status of best practices and quality of care
initiatives, and shall present recommendations to the
legislature on any statutory changes needed to increase the
effectiveness of these initiatives.
deleted text end

deleted text begin (g) This section expires June 30, 2006.
deleted text end

Sec. 2. new text begin QUALITY IMPROVEMENT INVESTMENT PROGRAM.
new text end

new text begin The commissioner of health, in consultation with the
commissioners of finance and administration, shall submit
recommendations to the legislature by December 15, 2005, to
establish a quality improvement investment program to provide
technical assistance, grants, and low-interest loans to health
care organizations and health professional associations to
support establishing or updating electronic information systems
in all health care settings to support the efficient and
effective delivery of safe, evidence-based health care services
and to reduce administrative costs.
new text end

Sec. 3. new text begin APPROPRIATION.
new text end

new text begin $....... is appropriated from the general fund to the
commissioner of health for the fiscal year ending June 30, 2006,
for the report required under section 2.
new text end

Sec. 4. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 to 3 are effective July 1, 2005.
new text end