SF 2309

as introduced - 88th Legislature (2013 - 2014) Posted on 03/20/2014 08:41am

A bill for an act
relating to health; making changes to the local public health system; amending
Minnesota Statutes 2012, sections 145A.02, subdivisions 5, 15, by adding
subdivisions; 145A.03, subdivisions 1, 2, 4, 5, by adding a subdivision; 145A.04,
as amended; 145A.05, subdivision 2; 145A.06, subdivisions 2, 5, 6, by adding
subdivisions; 145A.07, subdivisions 1, 2; 145A.08; 145A.11, subdivision 2;
145A.131; Minnesota Statutes 2013 Supplement, section 145A.06, subdivision
7; repealing Minnesota Statutes 2012, sections 145A.02, subdivision 2; 145A.03,
subdivisions 3, 6; 145A.09, subdivisions 1, 2, 3, 4, 5, 7; 145A.10, subdivisions 1,
2, 3, 4, 5a, 7, 9, 10; 145A.12, subdivisions 1, 2, 7.

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

Section 1.

Minnesota Statutes 2012, section 145A.02, is amended by adding a
subdivision to read:

Subd. 1a.

Areas of public health responsibility.

"Areas of public health
responsibility" means:

(1) assuring an adequate local public health infrastructure;

(2) promoting healthy communities and healthy behaviors;

(3) preventing the spread of communicable disease;

(4) protecting against environmental health hazards;

(5) preparing for and responding to emergencies; and

(6) assuring health services.

Sec. 2.

Minnesota Statutes 2012, section 145A.02, subdivision 5, is amended to read:

Subd. 5.

Community health board.

"Community health board" means a board of
health established, operating, and eligible for a the governing body for local public health
grant under sections 145A.09 to 145A.131. in Minnesota. The community health board
may be comprised of a single county, multiple contiguous counties, or in a limited number
of cases, a single city as specified in section 145A.03, subdivision 1. CHBs have the
responsibilities and authority under this chapter.

Sec. 3.

Minnesota Statutes 2012, section 145A.02, is amended by adding a subdivision
to read:

Subd. 6a.

Community health services administrator.

"Community health services
administrator" means a person who meets personnel standards for the position established
under section 145A.06, subdivision 3b, and is working under a written agreement with,
employed by, or under contract with a community health board to provide public health
leadership and to discharge the administrative and program responsibilities on behalf of
the board.

Sec. 4.

Minnesota Statutes 2012, section 145A.02, is amended by adding a subdivision
to read:

Subd. 8a.

Local health department.

"Local health department" means an
operational entity that is responsible for the administration and implementation of
programs and services to address the areas of public health responsibility. It is governed
by a community health board.

Sec. 5.

Minnesota Statutes 2012, section 145A.02, is amended by adding a subdivision
to read:

Subd. 8b.

Essential public health services.

"Essential public health services"
means the public health activities that all communities should undertake. These services
serve as the framework for the National Public Health Performance Standards. In
Minnesota they refer to activities that are conducted to accomplish the areas of public
health responsibility. The ten essential public health services are to:

(1) monitor health status to identify and solve community health problems;

(2) diagnose and investigate health problems and health hazards in the community;

(3) inform, educate, and empower people about health issues;

(4) mobilize community partnerships and action to identify and solve health
problems;

(5) develop policies and plans that support individual and community health efforts;

(6) enforce laws and regulations that protect health and ensure safety;

(7) link people to needed personal health services and assure the provision of health
care when otherwise unavailable;

(8) maintain a competent public health workforce;

(9) evaluate the effectiveness, accessibility, and quality of personal and
population-based health services; and

(10) contribute to research seeking new insights and innovative solutions to health
problems.

Sec. 6.

Minnesota Statutes 2012, section 145A.02, subdivision 15, is amended to read:

Subd. 15.

Medical consultant.

"Medical consultant" means a physician licensed
to practice medicine in Minnesota who is working under a written agreement with,
employed by, or on contract with a community health board of health to provide advice
and information, to authorize medical procedures through standing orders protocols, and
to assist a community health board of health and its staff in coordinating their activities
with local medical practitioners and health care institutions.

Sec. 7.

Minnesota Statutes 2012, section 145A.02, is amended by adding a subdivision
to read:

Subd. 15a.

Performance management.

"Performance management" means the
systematic process of using data for decision making by identifying outcomes and
standards; measuring, monitoring, and communicating progress; and engaging in quality
improvement activities in order to achieve desired outcomes.

Sec. 8.

Minnesota Statutes 2012, section 145A.02, is amended by adding a subdivision
to read:

Subd. 15b.

Performance measures.

"Performance measures" means quantitative
ways to define and measure performance.

Sec. 9.

Minnesota Statutes 2012, section 145A.03, subdivision 1, is amended to read:

Subdivision 1.

Establishment; assignment of responsibilities.

(a) The governing
body of a city or county must undertake the responsibilities of a community health board
of health or establish a board of health by establishing or joining a community health
board according to paragraphs (b) to (f) and assign assigning to it the powers and duties of
a board of health specified under section 145A.04.

(b) A city council may ask a county or joint powers board of health to undertake
the responsibilities of a board of health for the city's jurisdiction. A community health
board must include within its jurisdiction a population of 30,000 or more persons or be
composed of three or more contiguous counties.

(c) A county board or city council within the jurisdiction of a community health
board operating under sections 145A.09 to 145A.131 is preempted from forming a board of
community health board except as specified in section 145A.10, subdivision 2 145A.131.

(d) A county board or a joint powers board that establishes a community health
board and has or establishes an operational human services board under chapter 402 may
assign the powers and duties of a community health board to a human services board.
Eligibility for funding from the commissioner will be maintained if all requirements of
sections 145A.03 and 145A.04 are met.

(e) Community health boards established prior to January 1, 2014, including city
community health boards, are eligible to maintain their status as community health boards
as outlined in this subdivision.

(f) A community health board may authorize, by resolution, the community
health service administrator or other designated agent or agents to act on behalf of the
community health board.

Sec. 10.

Minnesota Statutes 2012, section 145A.03, subdivision 2, is amended to read:

Subd. 2.

Joint powers community health board of health.

Except as preempted
under section 145A.10, subdivision 2, A county may establish a joint community health
board of health by agreement with one or more contiguous counties, or a an existing city
community health board may establish a joint community health board of health with one
or more contiguous cities in the same county, or a city may establish a joint board of health
with the existing city community health boards in the same county or counties within in
which it is located. The agreements must be established according to section 471.59.

Sec. 11.

Minnesota Statutes 2012, section 145A.03, subdivision 4, is amended to read:

Subd. 4.

Membership; duties of chair.

A community health board of health must
have at least five members, one of whom must be elected by the members as chair and one
as vice-chair. The chair, or in the chair's absence, the vice-chair, must preside at meetings
of the community health board of health and sign or authorize an agent to sign contracts and
other documents requiring signature on behalf of the community health board of health.

Sec. 12.

Minnesota Statutes 2012, section 145A.03, subdivision 5, is amended to read:

Subd. 5.

Meetings.

A community health board of health must hold meetings at least
twice a year and as determined by its rules of procedure. The board must adopt written
procedures for transacting business and must keep a public record of its transactions,
findings, and determinations. Members may receive a per diem plus travel and other
eligible expenses while engaged in official duties.

Sec. 13.

Minnesota Statutes 2012, section 145A.03, is amended by adding a
subdivision to read:

Subd. 7.

Community health board; eligibility for funding.

A community health
board that meets the requirements of this section is eligible to receive the local public
health grant under section 145A.131 and for other funds that the commissioner grants to
community health boards to carry out public health activities.

Sec. 14.

Minnesota Statutes 2012, section 145A.04, as amended by Laws 2013, chapter
43, section 21, is amended to read:

145A.04 POWERS AND DUTIES OF COMMUNITY HEALTH BOARD OF
HEALTH.

Subdivision 1.

Jurisdiction; enforcement.

(a) A county or multicounty community
health board of health has the powers and duties of a board of health for all territory within
its jurisdiction not under the jurisdiction of a city board of health. Under the general
supervision of the commissioner, the board shall enforce laws, regulations, and ordinances
pertaining to the powers and duties of a board of health within its jurisdictional area
general responsibility for development and maintenance of a system of community health
services under local administration and within a system of state guidelines and standards.

(b) Under the general supervision of the commissioner, the community health board
shall recommend the enforcement of laws, regulations, and ordinances pertaining to the
powers and duties within its jurisdictional area. In the case of a multicounty or city
community health board, the joint powers agreement under section 145A.03, subdivision
2, or delegation agreement under section 145A.07 shall clearly specify enforcement
authorities.

(c) A member of a community health board may not withdraw from a joint powers
community health board during the first two calendar years following the effective
date of the initial joint powers agreement. The withdrawing member must notify the
commissioner and the other parties to the agreement at least one year before the beginning
of the calendar year in which withdrawal takes effect.

(d) The withdrawal of a county or city from a community health board does not
effect the eligibility for the local public health grant of any remaining county or city for
one calendar year following the effective date of withdrawal.

(e) The local public health grant for a county or city that chooses to withdraw from
a multicounty community health board shall be reduced by the amount of the local
partnership incentive.

Subd. 1a.

Duties.

Consistent with the guidelines and standards established under
section 145A.06, the community health board shall:

(1) identify local public health priorities and implement activities to address the
priorities and the areas of public health responsibility, which include:

(i) assuring an adequate local public health infrastructure by maintaining the basic
foundational capacities to a well-functioning public health system that includes data
analysis and utilization; health planning; partnership development and community
mobilization; policy development, analysis, and decision support; communication; and
public health research, evaluation, and quality improvement;

(ii) promoting healthy communities and healthy behavior through activities
that improve health in a population, such as investing in healthy families; engaging
communities to change policies, systems, or environments to promote positive health or
prevent adverse health; providing information and education about healthy communities
or population health status; and addressing issues of health equity, health disparities, and
the social determinants to health;

(iii) preventing the spread of communicable disease by preventing diseases that are
caused by infectious agents through detecting acute infectious diseases, ensuring the
reporting of infectious diseases, preventing the transmission of infectious diseases, and
implementing control measures during infectious disease outbreaks;

(iv) protecting against environmental health hazards by addressing aspects of the
environment that pose risks to human health, such as monitoring air and water quality;
developing policies and programs to reduce exposure to environmental health risks and
promote healthy environments; and identifying and mitigating environmental risks such as
food and waterborne diseases, radiation, occupational health hazards, and public health
nuisances;

(v) preparing and responding to emergencies by engaging in activities that prepare
public health departments to respond to events and incidents and assist communities in
recovery, such as providing leadership for public health preparedness activities with
a community; developing, exercising, and periodically reviewing response plans for
public health threats; and developing and maintaining a system of public health workforce
readiness, deployment, and response; and

(vi) assuring health services by engaging in activities such as assessing the
availability of health-related services and health care providers in local communities,
identifying gaps and barriers in services; convening community partners to improve
community health systems; and providing services identified as priorities by the local
assessment and planning process; and

(2) submit to the commissioner of health, at least every five years, a community
health assessment and community health improvement plan, which shall be developed
with input from the community and take into consideration the statewide outcomes, the
areas of responsibility, and essential public health services;

(3) implement a performance management process in order to achieve desired
outcomes; and

(4) annually report to the commissioner on a set of performance measures and be
prepared to provide documentation of ability to meet the performance measures.

Subd. 2.

Appointment of agent community health service (CHS) administrator.

A community health board of health must appoint, employ, or contract with a person or
persons CHS administrator to act on its behalf. The board shall notify the commissioner
of the agent's name, address, and phone number where the agent may be reached between
board meetings CHS administrator's contact information and submit a copy of the
resolution authorizing the agent CHS administrator to act as an agent on the board's behalf.
The resolution must specify the types of action or actions that the CHS administrator is
authorized to take on behalf of the board.

Subd. 2a.

Appointment of medical consultant.

The community health board shall
appoint, employ, or contract with a medical consultant to ensure appropriate medical
advice and direction for the community health board and assist the board and its staff in
the coordination of community health services with local medical care and other health
services.

Subd. 3.

Employment; medical consultant employees.

(a) A community health
board of health may establish a health department or other administrative agency and may
employ persons as necessary to carry out its duties.

(b) Except where prohibited by law, employees of the community health board
of health may act as its agents.

(c) Employees of the board of health are subject to any personnel administration
rules adopted by a city council or county board forming the board of health unless the
employees of the board are within the scope of a statewide personnel administration
system. Persons employed by a county, city, or the state whose functions and duties are
assumed by a community health board shall become employees of the board without
loss in benefits, salaries, or rights.

(d) The board of health may appoint, employ, or contract with a medical consultant
to receive appropriate medical advice and direction.

Subd. 4.

Acquisition of property; request for and acceptance of funds;
collection of fees.

(a) A community health board of health may acquire and hold in the
name of the county or city the lands, buildings, and equipment necessary for the purposes
of sections 145A.03 to 145A.131. It may do so by any lawful means, including gifts,
purchase, lease, or transfer of custodial control.

(b) A community health board of health may accept gifts, grants, and subsidies from
any lawful source, apply for and accept state and federal funds, and request and accept
local tax funds.

(c) A community health board of health may establish and collect reasonable fees
for performing its duties and providing community health services.

(d) With the exception of licensing and inspection activities, access to community
health services provided by or on contract with the community health board of health must
not be denied to an individual or family because of inability to pay.

Subd. 5.

Contracts.

To improve efficiency, quality, and effectiveness, avoid
unnecessary duplication, and gain cost advantages, a community health board of health
may contract to provide, receive, or ensure provision of services.

Subd. 6.

Investigation; reporting and control of communicable diseases.

A
community health board of health shall make investigations, or coordinate with any county
board or city council within its jurisdiction to make investigations and reports and obey
instructions on the control of communicable diseases as the commissioner may direct under
section 144.12, 145A.06, subdivision 2, or 145A.07. Community health boards of health
must cooperate so far as practicable to act together to prevent and control epidemic diseases.

Subd. 6a.

Minnesota Responds Medical Reserve Corps; planning.

A community
health board of health receiving funding for emergency preparedness or pandemic
influenza planning from the state or from the United States Department of Health and
Human Services shall participate in planning for emergency use of volunteer health
professionals through the Minnesota Responds Medical Reserve Corps program of the
Department of Health. A community health board of health shall collaborate on volunteer
planning with other public and private partners, including but not limited to local or
regional health care providers, emergency medical services, hospitals, tribal governments,
state and local emergency management, and local disaster relief organizations.

Subd. 6b.

Minnesota Responds Medical Reserve Corps; agreements.

A
community health board of health, county, or city participating in the Minnesota Responds
Medical Reserve Corps program may enter into written mutual aid agreements for
deployment of its paid employees and its Minnesota Responds Medical Reserve Corps
volunteers with other community health boards of health, other political subdivisions
within the state, or with tribal governments within the state. A community health board
of health may also enter into agreements with the Indian Health Services of the United
States Department of Health and Human Services, and with boards of health, political
subdivisions, and tribal governments in bordering states and Canadian provinces.

Subd. 6c.

Minnesota Responds Medical Reserve Corps; when mobilized.

When
a community health board of health, county, or city finds that the prevention, mitigation,
response to, or recovery from an actual or threatened public health event or emergency
exceeds its local capacity, it shall use available mutual aid agreements. If the event or
emergency exceeds mutual aid capacities, a community health board of health, county, or
city may request the commissioner of health to mobilize Minnesota Responds Medical
Reserve Corps volunteers from outside the jurisdiction of the community health board
of health, county, or city.

Subd. 6d.

Minnesota Responds Medical Reserve Corps; liability coverage.

A Minnesota Responds Medical Reserve Corps volunteer responding to a request for
training or assistance at the call of a community health board of health, county, or city
must be deemed an employee of the jurisdiction for purposes of workers' compensation,
tort claim defense, and indemnification.

Subd. 7.

Entry for inspection.

To enforce public health laws, ordinances or rules, a
member or agent of a community health board of health, county, or city may enter a
building, conveyance, or place where contagion, infection, filth, or other source or cause
of preventable disease exists or is reasonably suspected.

Subd. 8.

Removal and abatement of public health nuisances.

(a) If a threat to the
public health such as a public health nuisance, source of filth, or cause of sickness is found
on any property, the community health board of health, county, city, or its agent shall order
the owner or occupant of the property to remove or abate the threat within a time specified
in the notice but not longer than ten days. Action to recover costs of enforcement under
this subdivision must be taken as prescribed in section 145A.08.

(b) Notice for abatement or removal must be served on the owner, occupant, or agent
of the property in one of the following ways:

(1) by registered or certified mail;

(2) by an officer authorized to serve a warrant; or

(3) by a person aged 18 years or older who is not reasonably believed to be a party to
any action arising from the notice.

(c) If the owner of the property is unknown or absent and has no known representative
upon whom notice can be served, the community health board of health, county, or city,
or its agent, shall post a written or printed notice on the property stating that, unless the
threat to the public health is abated or removed within a period not longer than ten days,
the community health board, county, or city will have the threat abated or removed at the
expense of the owner under section 145A.08 or other applicable state or local law.

(d) If the owner, occupant, or agent fails or neglects to comply with the requirement
of the notice provided under paragraphs (b) and (c), then the community health board of
health, county, city, or its a designated agent of the board, county, or city shall remove or
abate the nuisance, source of filth, or cause of sickness described in the notice from the
property.

Subd. 9.

Injunctive relief.

In addition to any other remedy provided by law, the
community health board of health, county, or city may bring an action in the court of
appropriate jurisdiction to enjoin a violation of statute, rule, or ordinance that the board
has power to enforce, or to enjoin as a public health nuisance any activity or failure to
act that adversely affects the public health.

Subd. 10.

Hindrance of enforcement prohibited; penalty.

It is a misdemeanor
deliberately to deliberately hinder a member of a community health board of health,
county or city, or its agent from entering a building, conveyance, or place where contagion,
infection, filth, or other source or cause of preventable disease exists or is reasonably
suspected, or otherwise to interfere with the performance of the duties of the board of
health responsible jurisdiction.

Subd. 11.

Neglect of enforcement prohibited; penalty.

It is a misdemeanor for
a member or agent of a community health board of health, county, or city to refuse or
neglect to perform a duty imposed on a board of health an applicable jurisdiction by
statute or ordinance.

Subd. 12.

Other powers and duties established by law.

This section does not limit
powers and duties of a community health board of health, county, or city prescribed in
other sections.

Subd. 13.

Recommended legislation.

The community health board may recommend
local ordinances pertaining to community health services to any county board or city
council within its jurisdiction and advise the commissioner on matters relating to public
health that require assistance from the state, or that may be of more than local interest.

Subd. 14.

Equal access to services.

The community health board must ensure that
community health services are accessible to all persons on the basis of need. No one shall
be denied services because of race, color, sex, age, language, religion, nationality, inability
to pay, political persuasion, or place of residence.

Subd. 15.

State and local advisory committees.

(a) A state community
health services advisory committee is established to advise, consult with, and make
recommendations to the commissioner on the development, maintenance, funding, and
evaluation of local public health services. Each community health board may appoint a
member to serve on the committee. The committee must meet at least quarterly, and
special meetings may be called by the committee chair or a majority of the members.
Members or their alternates may be reimbursed for travel and other necessary expenses
while engaged in their official duties.

(b) Notwithstanding section 15.059, the State Community Health Services Advisory
Committee does not expire.

(c) The city boards or county boards that have established or are members of a
community health board may appoint a community health advisory to advise, consult
with, and make recommendations to the community health board on the duties under
subdivision 1a.

Sec. 15.

Minnesota Statutes 2012, section 145A.05, subdivision 2, is amended to read:

Subd. 2.

Animal control.

In addition to powers under sections 35.67 to 35.69, a
county board, city council, or municipality may adopt ordinances to issue licenses or
otherwise regulate the keeping of animals, to restrain animals from running at large, to
authorize the impounding and sale or summary destruction of animals, and to establish
pounds.

Sec. 16.

Minnesota Statutes 2012, section 145A.06, subdivision 2, is amended to read:

Subd. 2.

Supervision of local enforcement.

(a) In the absence of provision for a
community health board of health, the commissioner may appoint three or more persons
to act as a board until one is established. The commissioner may fix their compensation,
which the county or city must pay.

(b) The commissioner by written order may require any two or more community
health boards of health, counties, or cities to act together to prevent or control epidemic
diseases.

(c) If a community health board, county, or city fails to comply with section 145A.04,
subdivision 6, the commissioner may employ medical and other help necessary to control
communicable disease at the expense of the board of health jurisdiction involved.

(d) If the commissioner has reason to believe that the provisions of this chapter have
been violated, the commissioner shall inform the attorney general and submit information
to support the belief. The attorney general shall institute proceedings to enforce the
provisions of this chapter or shall direct the county attorney to institute proceedings.

Sec. 17.

Minnesota Statutes 2012, section 145A.06, is amended by adding a
subdivision to read:

Subd. 3a.

Assistance to community health boards.

The commissioner shall help
and advise community health boards that ask for assistance in developing, administering,
and carrying out public health services and programs. This assistance may consist of,
but is not limited to:

(1) informational resources, consultation, and training to assist community health
boards plan, develop, integrate, provide, and evaluate community health services; and

(2) administrative and program guidelines and standards developed with the advice
of the State Community Health Services Advisory Committee.

Sec. 18.

Minnesota Statutes 2012, section 145A.06, is amended by adding a
subdivision to read:

Subd. 3b.

Personnel standards.

In accordance with chapter 14, and in consultation
with the State Community Health Services Advisory Committee, the commissioner
may adopt rules to set standards for administrative and program personnel to ensure
competence in administration and planning.

Sec. 19.

Minnesota Statutes 2012, section 145A.06, subdivision 5, is amended to read:

Subd. 5.

Deadly infectious diseases.

The commissioner shall promote measures
aimed at preventing businesses from facilitating sexual practices that transmit deadly
infectious diseases by providing technical advice to community health boards of health
to assist them in regulating these practices or closing establishments that constitute
a public health nuisance.

Sec. 20.

Minnesota Statutes 2012, section 145A.06, is amended by adding a
subdivision to read:

Subd. 5a.

System-level performance management.

To improve public health
and ensure the integrity and accountability of the statewide local public health system,
the commissioner, in consultation with the State Community Health Services Advisory
Committee, shall develop performance measures and implement a process to monitor
statewide outcomes and performance improvement.

Sec. 21.

Minnesota Statutes 2012, section 145A.06, subdivision 6, is amended to read:

Subd. 6.

Health volunteer program.

(a) The commissioner may accept grants from
the United States Department of Health and Human Services for the emergency system
for the advanced registration of volunteer health professionals (ESAR-VHP) established
under United States Code, title 42, section 247d-7b. The ESAR-VHP program as
implemented in Minnesota is known as the Minnesota Responds Medical Reserve Corps.

(b) The commissioner may maintain a registry of volunteers for the Minnesota
Responds Medical Reserve Corps and obtain data on volunteers relevant to possible
deployments within and outside the state. All state licensing and certifying boards
shall cooperate with the Minnesota Responds Medical Reserve Corps and shall verify
volunteers' information. The commissioner may also obtain information from other states
and national licensing or certifying boards for health practitioners.

(c) The commissioner may share volunteers' data, including any data classified
as private data, from the Minnesota Responds Medical Reserve Corps registry with
community health boards of health, cities or counties, the University of Minnesota's
Academic Health Center or other public or private emergency preparedness partners, or
tribal governments operating Minnesota Responds Medical Reserve Corps units as needed
for credentialing, organizing, training, and deploying volunteers. Upon request of another
state participating in the ESAR-VHP or of a Canadian government administering a similar
health volunteer program, the commissioner may also share the volunteers' data as needed
for emergency preparedness and response.

Sec. 22.

Minnesota Statutes 2013 Supplement, section 145A.06, subdivision 7, is
amended to read:

Subd. 7.

Commissioner requests for health volunteers.

(a) When the
commissioner receives a request for health volunteers from:

(1) a local board of health community health board, county, or city according to
section 145A.04, subdivision 6c;

(2) the University of Minnesota Academic Health Center;

(3) another state or a territory through the Interstate Emergency Management
Assistance Compact authorized under section 192.89;

(4) the federal government through ESAR-VHP or another similar program; or

(5) a tribal or Canadian government;

the commissioner shall determine if deployment of Minnesota Responds Medical Reserve
Corps volunteers from outside the requesting jurisdiction is in the public interest. If so,
the commissioner may ask for Minnesota Responds Medical Reserve Corps volunteers to
respond to the request. The commissioner may also ask for Minnesota Responds Medical
Reserve Corps volunteers if the commissioner finds that the state needs health volunteers.

(b) The commissioner may request Minnesota Responds Medical Reserve Corps
volunteers to work on the Minnesota Mobile Medical Unit (MMU), or on other mobile
or temporary units providing emergency patient stabilization, medical transport, or
ambulatory care. The commissioner may utilize the volunteers for training, mobilization
or demobilization, inspection, maintenance, repair, or other support functions for the
MMU facility or for other emergency units, as well as for provision of health care services.

(c) A volunteer's rights and benefits under this chapter as a Minnesota Responds
Medical Reserve Corps volunteer is not affected by any vacation leave, pay, or other
compensation provided by the volunteer's employer during volunteer service requested by
the commissioner. An employer is not liable for actions of an employee while serving as a
Minnesota Responds Medical Reserve Corps volunteer.

(d) If the commissioner matches the request under paragraph (a) with Minnesota
Responds Medical Reserve Corps volunteers, the commissioner shall facilitate deployment
of the volunteers from the sending Minnesota Responds Medical Reserve Corps units to
the receiving jurisdiction. The commissioner shall track volunteer deployments and assist
sending and receiving jurisdictions in monitoring deployments, and shall coordinate
efforts with the division of homeland security and emergency management for out-of-state
deployments through the Interstate Emergency Management Assistance Compact or
other emergency management compacts.

(e) Where the commissioner has deployed Minnesota Responds Medical Reserve
Corps volunteers within or outside the state, the provisions of paragraphs (f) and (g) must
apply. Where Minnesota Responds Medical Reserve Corps volunteers were deployed
across jurisdictions by mutual aid or similar agreements prior to a commissioner's call,
the provisions of paragraphs (f) and (g) must apply retroactively to volunteers deployed
as of their initial deployment in response to the event or emergency that triggered a
subsequent commissioner's call.

(f)(1) A Minnesota Responds Medical Reserve Corps volunteer responding to a
request for training or assistance at the call of the commissioner must be deemed an
employee of the state for purposes of workers' compensation and tort claim defense and
indemnification under section 3.736, without regard to whether the volunteer's activity is
under the direction and control of the commissioner, the division of homeland security
and emergency management, the sending jurisdiction, the receiving jurisdiction, or of a
hospital, alternate care site, or other health care provider treating patients from the public
health event or emergency.

(2) For purposes of calculating workers' compensation benefits under chapter 176,
the daily wage must be the usual wage paid at the time of injury or death for similar services
performed by paid employees in the community where the volunteer regularly resides, or
the wage paid to the volunteer in the volunteer's regular employment, whichever is greater.

(g) The Minnesota Responds Medical Reserve Corps volunteer must receive
reimbursement for travel and subsistence expenses during a deployment approved by the
commissioner under this subdivision according to reimbursement limits established for
paid state employees. Deployment begins when the volunteer leaves on the deployment
until the volunteer returns from the deployment, including all travel related to the
deployment. The Department of Health shall initially review and pay those expenses to
the volunteer. Except as otherwise provided by the Interstate Emergency Management
Assistance Compact in section 192.89 or agreements made thereunder, the department
shall bill the jurisdiction receiving assistance and that jurisdiction shall reimburse the
department for expenses of the volunteers.

(h) In the event Minnesota Responds Medical Reserve Corps volunteers are
deployed outside the state pursuant to the Interstate Emergency Management Assistance
Compact, the provisions of the Interstate Emergency Management Assistance Compact
must control over any inconsistent provisions in this section.

(i) When a Minnesota Responds Medical Reserve Corps volunteer makes a claim
for workers' compensation arising out of a deployment under this section or out of a
training exercise conducted by the commissioner, the volunteer's workers compensation
benefits must be determined under section 176.011, subdivision 9, clause (25), even if the
volunteer may also qualify under other clauses of section 176.011, subdivision 9.

Sec. 23.

Minnesota Statutes 2012, section 145A.07, subdivision 1, is amended to read:

Subdivision 1.

Agreements to perform duties of commissioner.

(a) The
commissioner of health may enter into an agreement with any community health board of
health, county, or city to delegate all or part of the licensing, inspection, reporting, and
enforcement duties authorized under sections 144.12; 144.381 to 144.387; 144.411 to
144.417; 144.71 to 144.74; 145A.04, subdivision 6; provisions of chapter 103I pertaining
to construction, repair, and abandonment of water wells; chapter 157; and sections 327.14
to 327.28.

(b) Agreements are subject to subdivision 3.

(c) This subdivision does not affect agreements entered into under Minnesota
Statutes 1986, section 145.031, 145.55, or 145.918, subdivision 2.

Sec. 24.

Minnesota Statutes 2012, section 145A.07, subdivision 2, is amended to read:

Subd. 2.

Agreements to perform duties of community health board of health.

A community health board of health may authorize a township board, city council, or
county board within its jurisdiction to establish a board of health under section 145A.03
and delegate to the board of health by agreement any powers or duties under sections
145A.04, 145A.07, subdivision 2, and 145A.08 carry out activities to fulfill community
health board responsibilities. An agreement to delegate community health board powers
and duties of a board of health to a county or city must be approved by the commissioner
and is subject to subdivision 3.

Sec. 25.

Minnesota Statutes 2012, section 145A.08, is amended to read:

145A.08 ASSESSMENT OF COSTS; TAX LEVY AUTHORIZED.

Subdivision 1.

Cost of care.

A person who has or whose dependent or spouse has a
communicable disease that is subject to control by the community health board of health is
financially liable to the unit or agency of government that paid for the reasonable cost of
care provided to control the disease under section 145A.04, subdivision 6.

Subd. 2.

Assessment of costs of enforcement.

(a) If costs are assessed for
enforcement of section 145A.04, subdivision 8, and no procedure for the assessment
of costs has been specified in an agreement established under section 145A.07, the
enforcement costs must be assessed as prescribed in this subdivision.

(b) A debt or claim against an individual owner or single piece of real property
resulting from an enforcement action authorized by section 145A.04, subdivision 8, must
not exceed the cost of abatement or removal.

(c) The cost of an enforcement action under section 145A.04, subdivision 8, may be
assessed and charged against the real property on which the public health nuisance, source
of filth, or cause of sickness was located. The auditor of the county in which the action is
taken shall extend the cost so assessed and charged on the tax roll of the county against the
real property on which the enforcement action was taken.

(d) The cost of an enforcement action taken by a town or city board of health under
section 145A.04, subdivision 8, may be recovered from the county in which the town or
city is located if the city clerk or other officer certifies the costs of the enforcement action
to the county auditor as prescribed in this section. Taxes equal to the full amount of the
enforcement action but not exceeding the limit in paragraph (b) must be collected by the
county treasurer and paid to the city or town as other taxes are collected and paid.

Subd. 3.

Tax levy authorized.

A city council or county board that has formed or is
a member of a community health board of health may levy taxes on all taxable property in
its jurisdiction to pay the cost of performing its duties under this chapter.

Sec. 26.

Minnesota Statutes 2012, section 145A.11, subdivision 2, is amended to read:

Subd. 2.

Levying taxes.

In levying taxes authorized under section 145A.08,
subdivision 3, a city council or county board that has formed or is a member of a
community health board must consider the income and expenditures required to meet
local public health priorities established under section 145A.10, subdivision 5a 145A.04,
subdivision 1a, clause (2), and statewide outcomes established under section 145A.12,
subdivision 7 145A.04, subdivision 1a, clause (1).

Sec. 27.

Minnesota Statutes 2012, section 145A.131, is amended to read:

145A.131 LOCAL PUBLIC HEALTH GRANT.

Subdivision 1.

Funding formula for community health boards.

(a) Base funding
for each community health board eligible for a local public health grant under section
145A.09, subdivision 2 145A.03, subdivision 7, shall be determined by each community
health board's fiscal year 2003 allocations, prior to unallotment, for the following grant
programs: community health services subsidy; state and federal maternal and child health
special projects grants; family home visiting grants; TANF MN ENABL grants; TANF
youth risk behavior grants; and available women, infants, and children grant funds in fiscal
year 2003, prior to unallotment, distributed based on the proportion of WIC participants
served in fiscal year 2003 within the CHS service area.

(b) Base funding for a community health board eligible for a local public health grant
under section 145A.09, subdivision 2 145A.03, subdivision 7, as determined in paragraph
(a), shall be adjusted by the percentage difference between the base, as calculated in
paragraph (a), and the funding available for the local public health grant.

(c) Multicounty or multicity community health boards shall receive a local
partnership base of up to $5,000 per year for each county or city in the case of a multicity
community health board included in the community health board.

(d) The State Community Health Advisory Committee may recommend a formula to
the commissioner to use in distributing state and federal funds to community health boards
organized and operating under sections 145A.09 145A.03 to 145A.131 to achieve locally
identified priorities under section 145A.12, subdivision 7, by July 1, 2004 145A.04,
subdivision 1a, for use in distributing funds to community health boards beginning
January 1, 2006, and thereafter.

Subd. 2.

Local match.

(a) A community health board that receives a local public
health grant shall provide at least a 75 percent match for the state funds received through
the local public health grant described in subdivision 1 and subject to paragraphs (b) to (d).

(b) Eligible funds must be used to meet match requirements. Eligible funds include
funds from local property taxes, reimbursements from third parties, fees, other local funds,
and donations or nonfederal grants that are used for community health services described
in section 145A.02, subdivision 6.

(c) When the amount of local matching funds for a community health board is less
than the amount required under paragraph (a), the local public health grant provided for
that community health board under this section shall be reduced proportionally.

(d) A city organized under the provision of sections 145A.09 145A.03 to 145A.131
that levies a tax for provision of community health services is exempt from any county
levy for the same services to the extent of the levy imposed by the city.

Subd. 3.

Accountability.

(a) Community health boards accepting local public health
grants must document progress toward the statewide outcomes established in section
145A.12, subdivision 7, to maintain eligibility to receive the local public health grant.
meet all of the requirements and perform all of the duties described in sections 145A.03
and 145A.04, to maintain eligibility to receive the local public health grant.

(b) In determining whether or not the community health board is documenting
progress toward statewide outcomes, the commissioner shall consider the following factors:

(1) whether the community health board has documented progress to meeting
essential local activities related to the statewide outcomes, as specified in the grant
agreement;

(2) the effort put forth by the community health board toward the selected statewide
outcomes;

(3) whether the community health board has previously failed to document progress
toward selected statewide outcomes under this section;

(4) the amount of funding received by the community health board to address the
statewide outcomes; and

(5) other factors as the commissioner may require, if the commissioner specifically
identifies the additional factors in the commissioner's written notice of determination.

(c) If the commissioner determines that a community health board has not by
the applicable deadline documented progress toward the selected statewide outcomes
established under section 145.8821 or 145A.12, subdivision 7, the commissioner shall
notify the community health board in writing and recommend specific actions that the
community health board should take over the following 12 months to maintain eligibility
for the local public health grant.

(d) During the 12 months following the written notification, the commissioner shall
provide administrative and program support to assist the community health board in
taking the actions recommended in the written notification.

(e) If the community health board has not taken the specific actions recommended by
the commissioner within 12 months following written notification, the commissioner may
determine not to distribute funds to the community health board under section 145A.12,
subdivision 2, for the next fiscal year.

(f) If the commissioner determines not to distribute funds for the next fiscal year, the
commissioner must give the community health board written notice of this determination
and allow the community health board to appeal the determination in writing.

(g) If the commissioner determines not to distribute funds for the next fiscal year
to a community health board that has not documented progress toward the statewide
outcomes and not taken the actions recommended by the commissioner, the commissioner
may retain local public health grant funds that the community health board would have
otherwise received and directly carry out essential local activities to meet the statewide
outcomes, or contract with other units of government or community-based organizations
to carry out essential local activities related to the statewide outcomes.

(h) If the community health board that does not document progress toward the
statewide outcomes is a city, the commissioner shall distribute the local public health
funds that would have been allocated to that city to the county in which the city is located,
if that county is part of a community health board.

(i) The commissioner shall establish a reporting system by which community health
boards will document their progress toward statewide outcomes. This system will be
developed in consultation with the State Community Health Services Advisory Committee
established in section 145A.10, subdivision 10, paragraph (a).

(b) By January 1 of each year, the commissioner shall notify community health
boards of the performance-related accountability requirements of the local public health
grant for that calendar year. Performance-related accountability requirements will be
comprised of a subset of the annual performance measures and will be selected in
consultation with the State Community Health Services Advisory Committee.

(c) If the commissioner determines that a community health board has not met the
accountability requirements, the commissioner shall notify the community health board in
writing and recommend specific actions the community health board must take over the
next six months in order to maintain eligibility for the Local Public Health Act grant.

(d) Following the written notification in paragraph (c), the commissioner shall
provide administrative and program support to assist the community health board as
required in section 145A.06, subdivision 3a.

(e) The commissioner shall provide the community health board two months
following the written notification to appeal the determination in writing.

(f) If the community health board has not submitted an appeal within two months
or has not taken the specific actions recommended by the commissioner within six
months following written notification, the commissioner may elect to not reimburse
invoices for funds submitted after the six-month compliance period and shall reduce by
1/12 the community health board's annual award allocation for every successive month
of noncompliance.

(g) The commissioner may retain the amount of funding that would have been
allocated to the community health board and assume responsibility for public health
activities in the geographic area served by the community health board.

Subd. 4.

Responsibility of commissioner to ensure a statewide public health
system.

If a county withdraws from a community health board and operates as a board of
health or If a community health board elects not to accept the local public health grant,
the commissioner may retain the amount of funding that would have been allocated to
the community health board using the formula described in subdivision 1 and assume
responsibility for public health activities to meet the statewide outcomes in the geographic
area served by the board of health or community health board. The commissioner may
elect to directly provide public health activities to meet the statewide outcomes or contract
with other units of government or with community-based organizations. If a city that is
currently a community health board withdraws from a community health board or elects
not to accept the local public health grant, the local public health grant funds that would
have been allocated to that city shall be distributed to the county in which the city is
located, if the county is part of a community health board.

Subd. 5.

Local public health priorities Use of funds.

Community health boards
may use their local public health grant to address local public health priorities identified
under section 145A.10, subdivision 5a. funds to address the areas of public health
responsibility and local priorities developed through the community health assessment and
community health improvement planning process.

Sec. 28. REVISOR'S INSTRUCTION.

(a) The revisor shall change the terms "board of health" or "local board of health" or
any derivative of those terms to "community health board" where it appears in Minnesota
Statutes, sections 13.3805, subdivision 1, paragraph (b); 13.46, subdivision 2, paragraph
(a), clause (24); 35.67; 35.68; 38.02, subdivision 1, paragraph (b), clause (1); 121A.15,
subdivisions 7 and 8; 144.055, subdivision 1; 144.065; 144.12, subdivision 1; 144.255,
subdivision 2a; 144.3351; 144.383; 144.417, subdivision 3; 144.4172, subdivision
6; 144.4173, subdivision 2; 144.4174; 144.49, subdivision 1; 144.6581; 144A.471,
subdivision 9, clause (19); 145.9255, subdivision 2; 175.35; 308A.201, subdivision 14;
375A.04, subdivision 1; and 412.221, subdivision 22, paragraph (c).

(b) The revisor shall change the cross-reference from "145A.02, subdivision 2"
to "145A.02, subdivision 5" where it appears in Minnesota Statutes, sections 13.3805,
subdivision 1, paragraph (b); 13.46, subdivision 2, paragraph (a), clause (24); 35.67; 35.68;
38.02, subdivision 1, paragraph (b), clause (1); 121A.15, subdivisions 7 and 8; 144.055,
subdivision 1; 144.065; 144.12, subdivision 1; 144.225, subdivision 2a; 144.3351;
144.383; 144.417, subdivision 3; 144.4172, subdivision 6; 144.4173, subdivision 2;
144.4174; 144.49, subdivision 1; 144A.471, subdivision 9, clause (19); 175.35; 308A.201,
subdivision 14; 375A.04, subdivision 1; and 412.221, subdivision 22, paragraph (c).

Sec. 29. REPEALER.

Minnesota Statutes 2012, sections 145A.02, subdivision 2; 145A.03, subdivisions
3 and 6; 145A.09, subdivisions 1, 2, 3, 4, 5, and 7; 145A.10, subdivisions 1, 2, 3, 4,
5a, 7, 9, and 10; and 145A.12, subdivisions 1, 2, and 7, are repealed. The revisor shall
remove cross-references to these repealed sections and make changes necessary to correct
punctuation, grammar, or structure of the remaining text.