SF 2452

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 04/29/2019 10:24am

A bill for an act
relating to health; establishing the health and human services budget; modifying
provisions governing health care, health insurance, Department of Human Services
operations, Department of Health, and MNsure; requiring care coordination;
modifying medical cannabis requirements; permitting licensed hemp growers to
sell hemp to medical cannabis manufacturers; permitting electronic monitoring in
health care facilities; requiring hospital charges disclosure; modifying public
interest review; authorizing statewide tobacco cessation services; modifying
requirements for PPEC centers; modifying benefits for MnCare and MA for adults;
requiring physicians to allow the opportunity to view ultrasound imaging prior to
an abortion; prohibiting abortions after 20 weeks post fertilization; requiring health
care facilities to post the women's right to know information on their website;
modifying the positive alternatives grant eligibility; modifying the SHIP program;
requiring coverage of 3D mammograms as a preventive service; exempting certain
seasonal food stands from licensure; adjusting license fees for social workers and
optometrists; requiring reports; making technical changes; appropriating money;
amending Minnesota Statutes 2018, sections 16A.055, subdivision 1a; 18K.03;
62A.30, by adding a subdivision; 62J.495, subdivisions 1, 3; 62V.05, subdivisions
2, 5, 10; 62V.08; 144.1506, subdivision 2; 144.3831, subdivision 1; 144.552;
144.586, by adding a subdivision; 144.966, subdivision 2; 144H.01, subdivision
5; 144H.04, subdivision 1, by adding a subdivision; 144H.06; 144H.07, subdivisions
1, 2; 144H.08, subdivision 2; 144H.11, subdivisions 2, 3, 4; 145.4131, subdivision
1; 145.4235, subdivision 2; 145.4242; 145.4244; 145.928, subdivisions 1, 7;
145.986, subdivisions 1, 1a, 4, 5, 6; 148.59; 148E.180; 152.126, subdivision 6;
152.22, subdivision 6, by adding a subdivision; 152.25, subdivision 4; 152.28,
subdivision 1; 152.29, subdivisions 1, 2, 3, 3a; 152.31; 157.22; 256B.04,
subdivision 14; 256B.056, subdivisions 1, 3, 7a; 256B.0625, subdivision 56a, by
adding a subdivision; 256B.69, subdivisions 4, 31; 256L.03, subdivision 5, by
adding a subdivision; 525A.11; Laws 2015, chapter 71, article 12, section 8;
proposing coding for new law in Minnesota Statutes, chapters 8; 144; 145; 254A;
256B; proposing coding for new law as Minnesota Statutes, chapter 245I; repealing
Minnesota Statutes 2018, sections 16A.724, subdivision 2; 144.1464; 144.1911;
256B.0625, subdivision 31c.

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

ARTICLE 1

DEPARTMENT OF HEALTH

Section 1.

new text begin [8.40] LITIGATION DEFENSE FUND.
new text end

new text begin (a) There is created in the special revenue fund an account entitled the Pain-Capable
Unborn Child Protection Act litigation account for the purpose of providing funds to pay
for any costs and expenses incurred by the state attorney general in relation to actions
surrounding defense of sections 145.4141 to 145.4147.
new text end

new text begin (b) The account shall be maintained by the commissioner of management and budget.
new text end

new text begin (c) The litigation account shall consist of:
new text end

new text begin (1) appropriations made to the account by the legislature; and
new text end

new text begin (2) any donations, gifts, or grants made to the account by private citizens or entities.
new text end

new text begin (d) The litigation account shall retain the interest income derived from the money credited
to the account.
new text end

new text begin (e) Any funds in the litigation account are appropriated to the attorney general for the
purposes described in paragraph (a).
new text end

Sec. 2.

Minnesota Statutes 2018, section 18K.03, is amended to read:

18K.03 AGRICULTURAL CROP; POSSESSION AUTHORIZED.

new text begin Subdivision 1. new text end

new text begin Industrial hemp. new text end

Industrial hemp is an agricultural crop in this state. A
person may possess, transport, process, sell, or buy industrial hemp that is grown pursuant
to this chapter.

new text begin Subd. 2. new text end

new text begin Sale to medical cannabis manufacturers. new text end

new text begin A licensee under this chapter may
sell hemp products derived from industrial hemp grown in this state to medical cannabis
manufacturers as authorized under sections 152.22 to 152.37.
new text end

Sec. 3.

Minnesota Statutes 2018, section 62J.495, subdivision 1, is amended to read:

Subdivision 1.

Implementation.

deleted text begin By January 1, 2015, all hospitals and health care
providers, as defined in section 62J.03, subdivision 8, must have in place an interoperable
electronic health records system within their hospital system or clinical practice setting. deleted text end
The commissioner of health, in consultation with the e-Health Advisory Committee, shall
develop deleted text begin a statewide plan to meet this goal, including deleted text end uniform standards to be used for the
interoperable new text begin electronic health records new text end system for sharing and synchronizing patient data
across systems. The standards must be compatible with federal efforts. The uniform standards
must be developed by January 1, 2009, and updated on an ongoing basis. The commissioner
shall include an update on standards development as part of an annual report to the legislature.
Individual health care providers in private practice with no other providers and health care
providers that do not accept reimbursement from a group purchaser, as defined in section
62J.03, subdivision 6, are excluded from the requirements of this section.

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 2018, section 62J.495, subdivision 3, is amended to read:

Subd. 3.

Interoperable electronic health record requirements.

(a) deleted text begin To meet the
requirements of subdivision 1, deleted text end Hospitals and health care providers must meet the following
criteria when implementing an interoperable electronic health records system within their
hospital system or clinical practice setting.

(b) The electronic health record must be a qualified electronic health record.

(c) The electronic health record must be certified by the Office of the National
Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and health
care providers if a certified electronic health record product for the provider's particular
practice setting is available. This criterion shall be considered met if a hospital or health
care provider is using an electronic health records system that has been certified within the
last three years, even if a more current version of the system has been certified within the
three-year period.

(d) The electronic health record must meet the standards established according to section
3004 of the HITECH Act as applicable.

(e) The electronic health record must have the ability to generate information on clinical
quality measures and other measures reported under sections 4101, 4102, and 4201 of the
HITECH Act.

(f) The electronic health record system must be connected to a state-certified health
information organization either directly or through a connection facilitated by a state-certified
health data intermediary as defined in section 62J.498.

(g) A health care provider who is a prescriber or dispenser of legend drugs must have
an electronic health record system that meets the requirements of section 62J.497.

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 2018, section 144.1506, subdivision 2, is amended to read:

Subd. 2.

Expansion grant program.

(a) The commissioner of health shall award primary
care residency expansion grants to eligible primary care residency programs to plan and
implement new residency slots. A planning grant shall not exceed $75,000, and a training
grant shall not exceed $150,000 per new residency slot for the first year, $100,000 for the
second year, and $50,000 for the third year of the new residency slot. new text begin For eligible residency
programs longer than three years, training grants may be awarded for the duration of the
residency, not exceeding an average of $100,000 per residency slot per year.
new text end

(b) Funds may be spent to cover the costs of:

(1) planning related to establishing an accredited primary care residency program;

(2) obtaining accreditation by the Accreditation Council for Graduate Medical Education
or another national body that accredits residency programs;

(3) establishing new residency programs or new resident training slots;

(4) recruitment, training, and retention of new residents and faculty;

(5) travel and lodging for new residents;

(6) faculty, new resident, and preceptor salaries related to new residency slots;

(7) training site improvements, fees, equipment, and supplies required for new primary
care resident training slots; and

(8) supporting clinical education in which trainees are part of a primary care team model.

Sec. 6.

Minnesota Statutes 2018, section 144.3831, subdivision 1, is amended to read:

Subdivision 1.

Fee setting.

The commissioner of health may assess an annual fee of
deleted text begin $6.36 deleted text end new text begin $9.72 new text end for every service connection to a public water supply that is owned or operated
by a home rule charter city, a statutory city, a city of the first class, or a town. The
commissioner of health may also assess an annual fee for every service connection served
by a water user district defined in section 110A.02.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end

Sec. 7.

new text begin [144.397] STATEWIDE TOBACCO CESSATION SERVICES.
new text end

new text begin (a) The commissioner of health shall administer, or contract for the administration of,
statewide tobacco cessation services to assist Minnesotans who are seeking advice or services
to help them quit using tobacco products. The commissioner shall establish statewide public
awareness activities to inform the public of the availability of the services and encourage
the public to utilize the services because of the dangers and harm of tobacco use and
dependence.
new text end

new text begin (b) Services to be provided may include, but are not limited to:
new text end

new text begin (1) telephone-based coaching and counseling;
new text end

new text begin (2) referrals;
new text end

new text begin (3) written materials mailed upon request;
new text end

new text begin (4) web-based texting or e-mail services; and
new text end

new text begin (5) free Food and Drug Administration-approved tobacco cessation medications.
new text end

new text begin (c) Services provided must be consistent with evidence-based best practices in tobacco
cessation services. Services provided must be coordinated with health plan company tobacco
prevention and cessation services that may be available to individuals depending on their
health coverage.
new text end

Sec. 8.

Minnesota Statutes 2018, section 144.552, is amended to read:

144.552 PUBLIC INTEREST REVIEW.

(a) The following entities must submit a plan to the commissioner:

(1) a hospital seeking to increase its number of licensed beds; or

(2) an organization seeking to obtain a hospital license and notified by the commissioner
under section 144.553, subdivision 1, paragraph (c), that it is subject to this section.

The plan must include information that includes an explanation of how the expansion will
meet the public's interest. When submitting a plan to the commissioner, an applicant shall
pay the commissioner for the commissioner's cost of reviewing and monitoring the plan,
as determined by the commissioner and notwithstanding section 16A.1283. Money received
by the commissioner under this section is appropriated to the commissioner for the purpose
of administering this section. new text begin If the commissioner does not issue a finding within the time
limit specified in paragraph (c), the commissioner must return to the applicant the entire
amount the applicant paid to the commissioner. new text end For a hospital that is seeking an exception
to the moratorium under section 144.551, the plan must be submitted to the commissioner
no later than August 1 of the calendar year prior to the year when the exception will be
considered by the legislature.

(b) Plans submitted under this section shall include detailed information necessary for
the commissioner to review the plan and reach a finding. The commissioner may request
additional information from the hospital submitting a plan under this section and from others
affected by the plan that the commissioner deems necessary to review the plan and make a
finding. If the commissioner determines that additional information is required from the
hospital submitting a plan under this section, the commissioner shall notify the hospital of
the additional information required no more than 30 days after the initial submission of the
plan. new text begin A hospital submitting a plan from whom the commissioner has requested additional
information shall submit the requested additional information within 14 calendar days of
the commissioner's request.
new text end

(c) The commissioner shall review the plan and, within deleted text begin 90 deleted text end new text begin 150 calendar new text end days deleted text begin , but no
more than six months if extenuating circumstances apply deleted text end new text begin of the initial submission of the
plan new text end , issue a finding on whether the plan is in the public interest. In making the
recommendation, the commissioner shall consider issues including but not limited to:

(1) whether the new hospital or hospital beds are needed to provide timely access to care
or access to new or improved services new text begin given the number of available beds. For the purposes
of this clause, "available beds" means the number of licensed acute care beds that are
immediately available for use or could be brought online within 48 hours without significant
facility modifications new text end ;

(2) the financial impact of the new hospital or hospital beds on existing acute-care
hospitals that have emergency departments in the region;

(3) how the new hospital or hospital beds will affect the ability of existing hospitals in
the region to maintain existing staff;

(4) the extent to which the new hospital or hospital beds will provide services to
nonpaying or low-income patients relative to the level of services provided to these groups
by existing hospitals in the region; and

(5) the views of affected parties.

(d) If the plan is being submitted by an existing hospital seeking authority to construct
a new hospital, the commissioner shall also consider:

(1) the ability of the applicant to maintain the applicant's current level of community
benefit as defined in section 144.699, subdivision 5, at the existing facility; and

(2) the impact on the workforce at the existing facility including the applicant's plan for:

(i) transitioning current workers to the new facility;

(ii) retraining and employment security for current workers; and

(iii) addressing the impact of layoffs at the existing facility on affected workers.

(e) Prior to making a recommendation, the commissioner shall conduct a public hearing
in the affected hospital service area to take testimony from interested persons.

(f) Upon making a recommendation under paragraph (c), the commissioner shall provide
a copy of the recommendation to the chairs of the house of representatives and senate
committees having jurisdiction over health and human services policy and finance.

(g) If an exception to the moratorium is approved under section 144.551 after a review
under this section, the commissioner shall monitor the implementation of the exception up
to completion of the construction project. Thirty days after completion of the construction
project, the hospital shall submit to the commissioner a report on how the construction has
met the provisions of the plan originally submitted under the public interest review process
or a plan submitted pursuant to section 144.551, subdivision 1, paragraph (b), clause (20).

Sec. 9.

Minnesota Statutes 2018, section 144.586, is amended by adding a subdivision to
read:

new text begin Subd. 3. new text end

new text begin Care coordination implementation. new text end

new text begin (a) This subdivision applies to hospital
discharges involving a child with a high-cost medical or chronic condition who needs
post-hospital continuing aftercare, including but not limited to home health care services,
post-hospital extended care services, or outpatient services for follow-up or ancillary care,
or is at risk of recurrent hospitalization or emergency room services due to a medical or
chronic condition.
new text end

new text begin (b) In addition to complying with the discharge planning requirements in subdivision
2, the hospital must ensure that the following conditions are met and arrangements made
before discharging any patient described in paragraph (a):
new text end

new text begin (1) the patient's primary care provider and either the health carrier or, if the patient is
enrolled in medical assistance, the managed care organization are notified of the patient's
date of anticipated discharge and provided a description of the patient's aftercare needs and
a copy of the patient's discharge plan, including any necessary medical information release
forms;
new text end

new text begin (2) the appropriate arrangements for home health care or post-hospital extended care
services are made and the initial services as indicated on the discharge plan are scheduled;
and
new text end

new text begin (3) if the patient is eligible for care coordination services through a health plan or health
certified medical home, the appropriate care coordinator has connected with the patient's
family.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 10.

new text begin [144.591] DISCLOSURE OF HOSPITAL CHARGES.
new text end

new text begin (a) Each hospital, including hospitals designated as critical access hospitals, shall provide
to each discharged patient within 30 calendar days of discharge an itemized description of
billed charges for medical services and goods the patient received during the hospital stay.
The itemized description of billed charges may include technical terms to describe the
medical services and goods if the technical terms are defined on the itemized description
with limited medical nomenclature. The itemized description of billed charges must not
describe a billed charge using only a medical billing code, "miscellaneous charges," or
"supply charges."
new text end

new text begin (b) A hospital may not bill or otherwise charge a patient for the itemized description of
billed charges.
new text end

new text begin (c) A hospital must provide an itemized description by secure e-mail, via a secure online
portal, or, upon request, by mail.
new text end

new text begin (d) This section does not apply to patients enrolled in Medicare, medical assistance, the
MinnesotaCare program, or who receive health care coverage through an employer
self-insured health plan.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2020.
new text end

Sec. 11.

new text begin [144.6502] ELECTRONIC MONITORING IN CERTAIN HEALTH CARE
FACILITIES.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

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

new text begin (b) "Electronic monitoring" means the placement and use of an electronic monitoring
device by a resident in the resident's room or private living unit in accordance with this
section.
new text end

new text begin (c) "Commissioner" means the commissioner of health.
new text end

new text begin (d) "Department" means the Department of Health.
new text end

new text begin (e) "Electronic monitoring device" means a camera or other device that captures, records,
or broadcasts audio, video, or both, that is placed in a resident's room or private living unit
and is used to monitor the resident or activities in the room or private living unit.
new text end

new text begin (f) "Facility" means a nursing home licensed under chapter 144A, a boarding care home
licensed under sections 144.50 to 144.56, or a housing with services establishment registered
under chapter 144D that is either subject to chapter 144G or has a disclosed special unit
under section 325F.72.
new text end

new text begin (g) "Resident" means a person 18 years of age or older residing in a facility.
new text end

new text begin (h) "Resident representative" means one of the following in the order of priority listed,
to the extent the person may reasonably be identified and located:
new text end

new text begin (1) a court-appointed guardian;
new text end

new text begin (2) a health care agent under section 145C.01, subdivision 2; or
new text end

new text begin (3) a person who is not an agent of a facility or of a home care provider designated in
writing by the resident and maintained in the resident's records on file with the facility or
with the resident's executed housing with services contract.
new text end

new text begin Subd. 2. new text end

new text begin Electronic monitoring. new text end

new text begin (a) A resident or a resident representative may conduct
electronic monitoring of the resident's room or private living unit through the use of electronic
monitoring devices placed in the resident's room or private living unit as provided in this
section.
new text end

new text begin (b) Nothing in this section precludes the use of electronic monitoring of health care
allowed under other law.
new text end

new text begin (c) Electronic monitoring authorized under this section is not a covered service under
home and community-based waivers under sections 256B.0913, 256B.0915, 256B.092, and
256B.49.
new text end

new text begin (d) This section does not apply to monitoring technology authorized as a home and
community-based service under section 256B.0913, 256B.0915, 256B.092, or 256B.49.
new text end

new text begin Subd. 3. new text end

new text begin Consent to electronic monitoring. new text end

new text begin (a) Except as otherwise provided in this
subdivision, a resident must consent to electronic monitoring in the resident's room or private
living unit in writing on a notification and consent form. If the resident has not affirmatively
objected to electronic monitoring and the resident's medical professional determines that
the resident currently lacks the ability to understand and appreciate the nature and
consequences of electronic monitoring, the resident representative may consent on behalf
of the resident. For purposes of this subdivision, a resident affirmatively objects when the
resident orally, visually, or through the use of auxiliary aids or services declines electronic
monitoring. The resident's response must be documented on the notification and consent
form.
new text end

new text begin (b) Prior to a resident representative consenting on behalf of a resident, the resident must
be asked if the resident wants electronic monitoring to be conducted. The resident
representative must explain to the resident:
new text end

new text begin (1) the type of electronic monitoring device to be used;
new text end

new text begin (2) the standard conditions that may be placed on the electronic monitoring device's use,
including those listed in subdivision 6;
new text end

new text begin (3) with whom the recording may be shared under subdivision 10 or 11; and
new text end

new text begin (4) the resident's ability to decline all recording.
new text end

new text begin (c) A resident, or resident representative when consenting on behalf of the resident, may
consent to electronic monitoring with any conditions of the resident's or resident
representative's choosing, including the list of standard conditions provided in subdivision
6. A resident, or resident representative when consenting on behalf of the resident, may
request that the electronic monitoring device be turned off or the visual or audio recording
component of the electronic monitoring device be blocked at any time.
new text end

new text begin (d) Prior to implementing electronic monitoring, a resident, or resident representative
when acting on behalf of the resident, must obtain the written consent on the notification
and consent form of any other resident residing in the shared room or shared private living
unit. A roommate's or roommate's resident representative's written consent must comply
with the requirements of paragraphs (a) to (c). Consent by a roommate or a roommate's
resident representative under this paragraph authorizes the resident's use of any recording
obtained under this section, as provided under subdivision 10 or 11.
new text end

new text begin (e) Any resident conducting electronic monitoring must immediately remove or disable
an electronic monitoring device prior to a new roommate moving into a shared room or
shared private living unit, unless the resident obtains the roommate's or roommate's resident
representative's written consent as provided under paragraph (d) prior to the roommate
moving into the shared room or shared private living unit. Upon obtaining the new
roommate's signed notification and consent form and submitting the form to the facility as
required under subdivision 5, the resident may resume electronic monitoring.
new text end

new text begin (f) The resident or roommate, or the resident representative or roommate's resident
representative if the representative is consenting on behalf of the resident or roommate, may
withdraw consent at any time and the withdrawal of consent must be documented on the
original consent form as provided under subdivision 5, paragraph (c).
new text end

new text begin Subd. 4. new text end

new text begin Refusal of roommate to consent. new text end

new text begin If a resident of a facility who is residing in
a shared room or shared living unit, or the resident representative of such a resident when
acting on behalf of the resident, wants to conduct electronic monitoring and another resident
living in or moving into the same shared room or shared living unit refuses to consent to
the use of an electronic monitoring device, the facility shall make a reasonable attempt to
accommodate the resident who wants to conduct electronic monitoring. A facility has met
the requirement to make a reasonable attempt to accommodate a resident or resident
representative who wants to conduct electronic monitoring when, upon notification that a
roommate has not consented to the use of an electronic monitoring device in the resident's
room, the facility offers to move the resident to another shared room or shared living unit
that is available at the time of the request. If a resident chooses to reside in a private room
or private living unit in a facility in order to accommodate the use of an electronic monitoring
device, the resident must pay either the private room rate in a nursing home setting, or the
applicable rent in a housing with services establishment. If a facility is unable to
accommodate a resident due to lack of space, the facility must reevaluate the request every
two weeks until the request is fulfilled. A facility is not required to provide a private room,
a single-bed room, or a private living unit to a resident who is unable to pay.
new text end

new text begin Subd. 5. new text end

new text begin Notice to facility. new text end

new text begin (a) Electronic monitoring may begin only after the resident
or resident representative who intends to place an electronic monitoring device and any
roommate or roommate's resident representative completes the notification and consent
form and submits the form to the facility.
new text end

new text begin (b) Upon receipt of any completed notification and consent form, the facility must place
the original form in the resident's file or file the original form with the resident's housing
with services contract. The facility must provide a copy to the resident and the resident's
roommate, if applicable.
new text end

new text begin (c) In the event that a resident or roommate, or the resident representative or roommate's
resident representative if the representative is consenting on behalf of the resident or
roommate, chooses to alter the conditions under which consent to electronic monitoring is
given or chooses to withdraw consent to electronic monitoring, the facility must make
available the original notification and consent form so that it may be updated. Upon receipt
of the updated form, the facility must place the updated form in the resident's file or file the
original form with the resident's signed housing with services contract. The facility must
provide a copy of the updated form to the resident and the resident's roommate, if applicable.
new text end

new text begin (d) If a new roommate, or the new roommate's resident representative when consenting
on behalf of the new roommate, does not submit to the facility a completed notification and
consent form and the resident conducting the electronic monitoring does not remove or
disable the electronic monitoring device, the facility must remove the electronic monitoring
device.
new text end

new text begin (e) If a roommate, or the roommate's resident representative when withdrawing consent
on behalf of the roommate, submits an updated notification and consent form withdrawing
consent and the resident conducting electronic monitoring does not remove or disable the
electronic monitoring device, the facility must remove the electronic monitoring device.
new text end

new text begin (f) Notwithstanding paragraph (a), the resident or resident representative who intends
to place an electronic monitoring device may do so without submitting a notification and
consent form to the facility, provided that:
new text end

new text begin (1) the resident or resident representative reasonably fears retaliation by the facility;
new text end

new text begin (2) the resident does not have a roommate;
new text end

new text begin (3) the resident or resident representative submits the completed notification and consent
form to the Office of the Ombudsman for Long-Term Care;
new text end

new text begin (4) the resident or resident representative submits the notification and consent form to
the facility within 14 calendar days of placing the electronic monitoring device; and
new text end

new text begin (5) the resident or resident representative immediately submits a Minnesota Adult Abuse
Reporting Center report or police report upon evidence from the electronic monitoring
device that suspected maltreatment has occurred between the time the electronic monitoring
device is placed under this paragraph and the time the resident or resident representative
submits the completed notification and consent form to the facility.
new text end

new text begin Subd. 6. new text end

new text begin Form requirements. new text end

new text begin (a) The notification and consent form completed by the
resident must include, at a minimum, the following information:
new text end

new text begin (1) the resident's signed consent to electronic monitoring or the signature of the resident
representative, if applicable. If a person other than the resident signs the consent form, the
form must document the following:
new text end

new text begin (i) the date the resident was asked if the resident wants electronic monitoring to be
conducted;
new text end

new text begin (ii) who was present when the resident was asked;
new text end

new text begin (iii) an acknowledgment that the resident did not affirmatively object; and
new text end

new text begin (iv) the source of authority allowing the resident representative to sign the notification
and consent form on the resident's behalf;
new text end

new text begin (2) the resident's roommate's signed consent or the signature of the roommate's resident
representative, if applicable. If a roommate's resident representative signs the consent form,
the form must document the following:
new text end

new text begin (i) the date the roommate was asked if the roommate wants electronic monitoring to be
conducted;
new text end

new text begin (ii) who was present when the roommate was asked;
new text end

new text begin (iii) an acknowledgment that the roommate did not affirmatively object; and
new text end

new text begin (iv) the source of authority allowing the resident representative to sign the notification
and consent form on the resident's behalf;
new text end

new text begin (3) the type of electronic monitoring device to be used;
new text end

new text begin (4) a list of standard conditions or restrictions that the resident or a roommate may elect
to place on the use of the electronic monitoring device, including but not limited to:
new text end

new text begin (i) prohibiting audio recording;
new text end

new text begin (ii) prohibiting video recording;
new text end

new text begin (iii) prohibiting broadcasting of audio or video;
new text end

new text begin (iv) turning off the electronic monitoring device or blocking the visual recording
component of the electronic monitoring device for the duration of an exam or procedure by
a health care professional;
new text end

new text begin (v) turning off the electronic monitoring device or blocking the visual recording
component of the electronic monitoring device while dressing or bathing is performed; and
new text end

new text begin (vi) turning off the electronic monitoring device for the duration of a visit with a spiritual
adviser, ombudsman, attorney, financial planner, intimate partner, or other visitor;
new text end

new text begin (5) any other condition or restriction elected by the resident or roommate on the use of
an electronic monitoring device;
new text end

new text begin (6) a statement of the circumstances under which a recording may be disseminated under
subdivision 10;
new text end

new text begin (7) a signature box for documenting that the resident or roommate has withdrawn consent;
and
new text end

new text begin (8) an acknowledgment that the resident, in accordance with subdivision 3, consents,
authorizes, and allows the Office of Ombudsman for Long-Term Care and representatives
of its office to disclose information about the form limited to:
new text end

new text begin (i) the fact that the form was received from the resident or resident representative;
new text end

new text begin (ii) if signed by a resident representative, the name of the resident representative and
the source of authority allowing the resident representative to sign the notification and
consent form on the resident's behalf; and
new text end

new text begin (iii) the type of electronic monitoring device placed.
new text end

new text begin (b) Facilities must make the notification and consent form available to the residents and
inform residents of their option to conduct electronic monitoring of their rooms or private
living unit.
new text end

new text begin (c) Notification and consent forms received by the Office of Ombudsman for Long-Term
Care are data protected under section 256.9744.
new text end

new text begin Subd. 7. new text end

new text begin Cost and installation. new text end

new text begin (a) A resident choosing to conduct electronic monitoring
must do so at the resident's own expense, including paying purchase, installation,
maintenance, and removal costs.
new text end

new text begin (b) If a resident chooses to place an electronic monitoring device that uses Internet
technology for visual or audio monitoring, the resident may be responsible for contracting
with an Internet service provider.
new text end

new text begin (c) The facility shall make a reasonable attempt to accommodate the resident's installation
needs, including allowing access to the facility's public-use Internet or Wi-Fi systems when
available for other public uses.
new text end

new text begin (d) All electronic monitoring device installations and supporting services must be
UL-listed.
new text end

new text begin Subd. 8. new text end

new text begin Notice to visitors. new text end

new text begin (a) A facility shall post a sign at each facility entrance
accessible to visitors that states "Security cameras and audio devices may be present to
record persons and activities."
new text end

new text begin (b) The facility is responsible for installing and maintaining the signage required in this
subdivision.
new text end

new text begin Subd. 9. new text end

new text begin Obstruction of electronic monitoring devices. new text end

new text begin (a) A person must not knowingly
hamper, obstruct, tamper with, or destroy an electronic monitoring device placed in a
resident's room or private living unit without the permission of the resident or resident
representative.
new text end

new text begin (b) It is not a violation of paragraph (a) if a person turns off the electronic monitoring
device or blocks the visual recording component of the electronic monitoring device at the
direction of the resident or resident representative, or if consent has been withdrawn.
new text end

new text begin Subd. 10. new text end

new text begin Dissemination of recordings. new text end

new text begin (a) No person may access any video or audio
recording created through authorized electronic monitoring without the written consent of
the resident or resident representative.
new text end

new text begin (b) Except as required under other law, a recording or copy of a recording made as
provided in this section may only be disseminated for the purpose of addressing health,
safety, or welfare concerns of a resident or residents.
new text end

new text begin (c) A person disseminating a recording or copy of a recording made as provided in this
section in violation of paragraph (b) may be civilly or criminally liable.
new text end

new text begin Subd. 11. new text end

new text begin Admissibility of evidence. new text end

new text begin Subject to applicable rules of evidence and
procedure, any video or audio recording created through electronic monitoring under this
section may be admitted into evidence in a civil, criminal, or administrative proceeding.
new text end

new text begin Subd. 12. new text end

new text begin Liability. new text end

new text begin (a) For the purposes of state law, the mere presence of an electronic
monitoring device in a resident's room or private living unit is not a violation of the resident's
right to privacy under section 144.651 or 144A.44.
new text end

new text begin (b) For the purposes of state law, a facility or home care provider is not civilly or
criminally liable for the mere disclosure by a resident or a resident representative of a
recording.
new text end

new text begin Subd. 13. new text end

new text begin Immunity from liability. new text end

new text begin The Office of Ombudsman for Long-Term Care
and representatives of the office are immune from liability as provided under section
256.9742, subdivision 2.
new text end

new text begin Subd. 14. new text end

new text begin Resident protections. new text end

new text begin (a) A facility must not:
new text end

new text begin (1) refuse to admit a potential resident or remove a resident because the facility disagrees
with the potential resident's or the resident's decisions regarding electronic monitoring,
including when the decision is made by a resident representative acting on behalf of the
resident;
new text end

new text begin (2) retaliate or discriminate against any resident for consenting or refusing to consent
to electronic monitoring; or
new text end

new text begin (3) prevent the placement or use of an electronic monitoring device by a resident who
has provided the facility or the Office of the Ombudsman for Long-Term Care with notice
and consent as required under this section.
new text end

new text begin (b) Any contractual provision prohibiting, limiting, or otherwise modifying the rights
and obligations in this section is contrary to public policy and is void and unenforceable.
new text end

new text begin Subd. 15. new text end

new text begin Employee discipline. new text end

new text begin An employee of the facility or of a contractor providing
services at the facility, including an arranged home care provider as defined in section
144D.01, subdivision 2a, who is the subject of proposed corrective or disciplinary action
based upon evidence obtained by electronic monitoring must be given access to that evidence
for purposes of defending against the proposed action. The recording or a copy of the
recording must be treated confidentially by the employee and must not be further
disseminated to any other person except as required under law. Any copy of the recording
must be returned to the facility or resident who provided the copy when it is no longer
needed for purposes of defending against a proposed action.
new text end

new text begin Subd. 16. new text end

new text begin Penalties. new text end

new text begin (a) The commissioner may issue a correction order as provided
under section 144A.10, 144A.45, or 144A.474, upon a finding that the facility has failed to
comply with subdivision 5, paragraphs (b) to (e); 6, paragraph (b); 7, paragraph (c); 8; 9;
10; or 14. For each violation of this section, the commissioner may impose a fine up to $500
upon a finding of noncompliance with a correction order issued according to this subdivision.
new text end

new text begin (b) The commissioner may exercise the commissioner's authority provided under section
144D.05 to compel a housing with services establishment to meet the requirements of this
section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020, and applies to all
agreements in effect, entered into, or renewed on or after that date.
new text end

Sec. 12.

Minnesota Statutes 2018, section 144.966, subdivision 2, is amended to read:

Subd. 2.

Newborn Hearing Screening Advisory Committee.

(a) The commissioner
of health shall establish a Newborn Hearing Screening Advisory Committee to advise and
assist the Department of Health and the Department of Education in:

(1) developing protocols and timelines for screening, rescreening, and diagnostic
audiological assessment and early medical, audiological, and educational intervention
services for children who are deaf or hard-of-hearing;

(2) designing protocols for tracking children from birth through age three that may have
passed newborn screening but are at risk for delayed or late onset of permanent hearing
loss;

(3) designing a technical assistance program to support facilities implementing the
screening program and facilities conducting rescreening and diagnostic audiological
assessment;

(4) designing implementation and evaluation of a system of follow-up and tracking; and

(5) evaluating program outcomes to increase effectiveness and efficiency and ensure
culturally appropriate services for children with a confirmed hearing loss and their families.

(b) The commissioner of health shall appoint at least one member from each of the
following groups with no less than two of the members being deaf or hard-of-hearing:

(1) a representative from a consumer organization representing culturally deaf persons;

(2) a parent with a child with hearing loss representing a parent organization;

(3) a consumer from an organization representing oral communication options;

(4) a consumer from an organization representing cued speech communication options;

(5) an audiologist who has experience in evaluation and intervention of infants and
young children;

(6) a speech-language pathologist who has experience in evaluation and intervention of
infants and young children;

(7) two primary care providers who have experience in the care of infants and young
children, one of which shall be a pediatrician;

(8) a representative from the early hearing detection intervention teams;

(9) a representative from the Department of Education resource center for the deaf and
hard-of-hearing or the representative's designee;

(10) a representative of the Commission of the Deaf, DeafBlind and Hard of Hearing;

(11) a representative from the Department of Human Services Deaf and Hard-of-Hearing
Services Division;

(12) one or more of the Part C coordinators from the Department of Education, the
Department of Health, or the Department of Human Services or the department's designees;

(13) the Department of Health early hearing detection and intervention coordinators;

(14) two birth hospital representatives from one rural and one urban hospital;

(15) a pediatric geneticist;

(16) an otolaryngologist;

(17) a representative from the Newborn Screening Advisory Committee under this
subdivision; and

(18) a representative of the Department of Education regional low-incidence facilitators.

The commissioner must complete the appointments required under this subdivision by
September 1, 2007.

(c) The Department of Health member shall chair the first meeting of the committee. At
the first meeting, the committee shall elect a chair from its membership. The committee
shall meet at the call of the chair, at least four times a year. The committee shall adopt
written bylaws to govern its activities. The Department of Health shall provide technical
and administrative support services as required by the committee. These services shall
include technical support from individuals qualified to administer infant hearing screening,
rescreening, and diagnostic audiological assessments.

Members of the committee shall receive no compensation for their service, but shall be
reimbursed as provided in section 15.059 for expenses incurred as a result of their duties
as members of the committee.

(d) By February 15, 2015, and by February 15 of the odd-numbered years after that date,
the commissioner shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and data privacy on the activities of the committee
that have occurred during the past two years.

(e) This subdivision expires June 30, deleted text begin 2019 deleted text end new text begin 2025 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. 13.

Minnesota Statutes 2018, section 144H.01, subdivision 5, is amended to read:

Subd. 5.

Medically complex or technologically dependent child.

"Medically complex
or technologically dependent child" means a child under deleted text begin 21 deleted text end new text begin seven new text end years of age who, because
of a medical condition, requires continuous therapeutic interventions or skilled nursing
supervision deleted text begin which deleted text end new text begin that new text end must be prescribed by a licensed physician and administered by, or
under the direct supervision of, a licensed registered nurse.

Sec. 14.

Minnesota Statutes 2018, section 144H.04, subdivision 1, is amended to read:

Subdivision 1.

Licenses.

A person seeking licensure for a PPEC center must submit a
completed application for licensure to the commissioner, in a form and manner determined
by the commissioner. The applicant must also submit the application fee, in the amount
specified in section 144H.05, subdivision 1. deleted text begin Effective January 1, 2018, deleted text end new text begin Beginning July 1,
2020, new text end the commissioner shall issue a license for a PPEC center if the commissioner
determines that the applicant and center meet the requirements of this chapter and rules that
apply to PPEC centers. A license issued under this subdivision is valid for two years.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from January 1, 2018.
new text end

Sec. 15.

Minnesota Statutes 2018, section 144H.04, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Licensure phase-in. new text end

new text begin (a) The commissioner shall phase in licensure of PPEC
centers by issuing prior to June 30, 2024, no more than two licenses to applicants the
commissioner determines meet the requirements of this chapter. A license issued under this
subdivision is valid until June 30, 2024.
new text end

new text begin (b) This subdivision expires July 1, 2024.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon the effective date of section 12.
new text end

Sec. 16.

Minnesota Statutes 2018, section 144H.06, is amended to read:

144H.06 APPLICATION OF RULES FOR HOSPICE SERVICES AND
RESIDENTIAL HOSPICE FACILITIES.

Minnesota Rules, chapter 4664, shall apply to PPEC centers licensed under this chapter,
except that the following parts, subparts, new text begin and new text end items deleted text begin , and subitems deleted text end do not apply:

(1) Minnesota Rules, part 4664.0003, subparts 2, 6, 7, 11, 12, 13, 14, and 38;

(2) Minnesota Rules, part 4664.0008;

(3) Minnesota Rules, part 4664.0010, subparts 3; 4, deleted text begin items A, subitem (6), and deleted text end new text begin item new text end B;
and 8;

(4) Minnesota Rules, part 4664.0020, subpart 13;

(5) Minnesota Rules, part 4664.0370, subpart 1;

(6) Minnesota Rules, part 4664.0390, subpart 1, items A, C, and E;

(7) Minnesota Rules, part 4664.0420;

(8) Minnesota Rules, part 4664.0425, subparts 3, item A; 4; and 6;

(9) Minnesota Rules, part 4664.0430, subparts 3, 4, 5, 7, 8, 9, 10, 11, and 12;

(10) Minnesota Rules, part 4664.0490; and

(11) Minnesota Rules, part 4664.0520.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 17.

Minnesota Statutes 2018, section 144H.07, subdivision 1, is amended to read:

Subdivision 1.

Services.

A PPEC center must provide basic services to medically complex
or technologically dependent children, based on a protocol of care established for each child.
A PPEC center may provide services up to deleted text begin 14 deleted text end new text begin 12.5 new text end hours a day and up to six days a week new text begin
with hours of operation during normal waking hours new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 18.

Minnesota Statutes 2018, section 144H.07, subdivision 2, is amended to read:

Subd. 2.

Limitations.

A PPEC center must comply with the following standards related
to services:

(1) a child is prohibited from attending a PPEC center for more than deleted text begin 14 deleted text end new text begin 12.5 new text end hours within
a 24-hour period;

(2) a PPEC center is prohibited from providing services other than those provided to
medically complex or technologically dependent children; and

(3) the maximum capacity for medically complex or technologically dependent children
at a center shall not exceed 45 children.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 19.

Minnesota Statutes 2018, section 144H.08, subdivision 2, is amended to read:

Subd. 2.

deleted text begin Duties of administrator deleted text end new text begin Administrators new text end .

new text begin (a) new text end The center administrator is
responsible and accountable for overall management of the center. The administrator must:

(1) designate in writing a person to be responsible for the center when the administrator
is absent from the center for more than 24 hours;

(2) maintain the following written records, in a place and form and using a system that
allows for inspection of the records by the commissioner during normal business hours:

(i) a daily census record, which indicates the number of children currently receiving
services at the center;

(ii) a record of all accidents or unusual incidents involving any child or staff member
that caused, or had the potential to cause, injury or harm to a person at the center or to center
property;

(iii) copies of all current agreements with providers of supportive services or contracted
services;

(iv) copies of all current agreements with consultants employed by the center,
documentation of each consultant's visits, and written, dated reports; and

(v) a personnel record for each employee, which must include an application for
employment, references, employment history for the preceding five years, and copies of all
performance evaluations;

(3) develop and maintain a current job description for each employee;

(4) provide necessary qualified personnel and ancillary services to ensure the health,
safety, and proper care for each child; and

(5) develop and implement infection control policies that comply with rules adopted by
the commissioner regarding infection control.

new text begin (b) In order to serve as an administrator of a PPEC center, an individual must have at
least two years of experience in the past five years caring for or managing the care of
medically complex or technologically dependent individuals.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 20.

Minnesota Statutes 2018, section 144H.11, subdivision 2, is amended to read:

Subd. 2.

Registered nurses.

A registered nurse employed by a PPEC center must be a
registered nurse licensed in Minnesota, new text begin and new text end hold a current certification in cardiopulmonary
resuscitation deleted text begin , and have experience in the previous 24 months in being responsible for the
care of acutely ill or chronically ill children deleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 21.

Minnesota Statutes 2018, section 144H.11, subdivision 3, is amended to read:

Subd. 3.

Licensed practical nurses.

A licensed practical nurse employed by a PPEC
center must be supervised by a registered nurse and must be a licensed practical nurse
licensed in Minnesota, deleted text begin have at least two years of experience in pediatrics, deleted text end and hold a current
certification in cardiopulmonary resuscitation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 22.

Minnesota Statutes 2018, section 144H.11, subdivision 4, is amended to read:

Subd. 4.

Other direct care personnel.

(a) Direct care personnel governed by this
subdivision new text begin may new text end include nursing assistants deleted text begin and deleted text end new text begin or new text end individuals with training and experience
in the field of education, social services, or child care.

(b) All direct care personnel employed by a PPEC center must work under the supervision
of a registered nurse and are responsible for providing direct care to children at the center.
Direct care personnel must have extensive, documented education and skills training in
providing care to infants and toddlers, provide employment references documenting skill
in the care of infants and children, and hold a current certification in cardiopulmonary
resuscitation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 23.

Minnesota Statutes 2018, section 145.4131, subdivision 1, is amended to read:

Subdivision 1.

Forms.

(a) Within 90 days of July 1, 1998, the commissioner shall prepare
a reporting form for use by physicians or facilities performing abortions. A copy of this
section shall be attached to the form. A physician or facility performing an abortion shall
obtain a form from the commissioner.

(b) The form shall require the following information:

(1) the number of abortions performed by the physician in the previous calendar year,
reported by month;

(2) the method used for each abortion;

(3) the approximate gestational age expressed in one of the following increments:

(i) less than nine weeks;

(ii) nine to ten weeks;

(iii) 11 to 12 weeks;

(iv) 13 to 15 weeks;

(v) 16 to 20 weeks;

(vi) 21 to 24 weeks;

(vii) 25 to 30 weeks;

(viii) 31 to 36 weeks; or

(ix) 37 weeks to term;

(4) the age of the woman at the time the abortion was performed;

(5) the specific reason for the abortion, including, but not limited to, the following:

(i) the pregnancy was a result of rape;

(ii) the pregnancy was a result of incest;

(iii) economic reasons;

(iv) the woman does not want children at this time;

(v) the woman's emotional health is at stake;

(vi) the woman's physical health is at stake;

(vii) the woman will suffer substantial and irreversible impairment of a major bodily
function if the pregnancy continues;

(viii) the pregnancy resulted in fetal anomalies; or

(ix) unknown or the woman refused to answer;

(6) the number of prior induced abortions;

(7) the number of prior spontaneous abortions;

(8) whether the abortion was paid for by:

(i) private coverage;

(ii) public assistance health coverage; or

(iii) self-pay;

(9) whether coverage was under:

(i) a fee-for-service plan;

(ii) a capitated private plan; or

(iii) other;

(10) complications, if any, for each abortion and for the aftermath of each abortion.
Space for a description of any complications shall be available on the form;

(11) the medical specialty of the physician performing the abortion;

(12) if the abortion was performed via telemedicine, the facility code for the patient and
the facility code for the physician; deleted text begin and
deleted text end

(13) whether the abortion resulted in a born alive infant, as defined in section 145.423,
subdivision 4, and:

(i) any medical actions taken to preserve the life of the born alive infant;

(ii) whether the born alive infant survived; and

(iii) the status of the born alive infant, should the infant survive, if known deleted text begin . deleted text end new text begin ;
new text end

new text begin (14) whether a determination of probable postfertilization age was made and the probable
postfertilization age determined, including:
new text end

new text begin (i) the method used to make such a determination; or
new text end

new text begin (ii) if a determination was not made prior to performing an abortion, the basis of the
determination that a medical emergency existed; and
new text end

new text begin (15) for abortions performed after a determination of postfertilization age of 20 or more
weeks, the basis of the determination that the pregnant woman had a condition that so
complicated her medical condition as to necessitate the abortion of her pregnancy to avert
her death or to avert serious risk of substantial and irreversible physical impairment of a
major bodily function, not including psychological or emotional conditions.
new text end

Sec. 24.

new text begin [145.4141] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin For purposes of sections 145.4141 to 145.4147, the following
terms have the meanings given them.
new text end

new text begin Subd. 2. new text end

new text begin Abortion. new text end

new text begin "Abortion" means the use or prescription of any instrument, medicine,
drug, or any other substance or device to terminate the pregnancy of a woman known to be
pregnant, with an intention other than to increase the probability of a live birth; to preserve
the life or health of the child after live birth; or to remove a dead unborn child who died as
the result of natural causes in utero, accidental trauma, or a criminal assault on the pregnant
woman or her unborn child; and which causes the premature termination of the pregnancy.
new text end

new text begin Subd. 3. new text end

new text begin Attempt to perform or induce an abortion. new text end

new text begin "Attempt to perform or induce
an abortion" means an act, or an omission of a statutorily required act, that, under the
circumstances as the actor believes them to be, constitutes a substantial step in a course of
conduct planned to culminate in the performance or induction of an abortion in this state in
violation of sections 145.4141 to 145.4147.
new text end

new text begin Subd. 4. new text end

new text begin Fertilization. new text end

new text begin "Fertilization" means the fusion of a human spermatozoon with
a human ovum.
new text end

new text begin Subd. 5. new text end

new text begin Medical emergency. new text end

new text begin "Medical emergency" means a condition that, in reasonable
medical judgment, so complicates the medical condition of the pregnant woman that it
necessitates the immediate abortion of her pregnancy without first determining
postfertilization age to avert her death or for which the delay necessary to determine
postfertilization age will create serious risk of substantial and irreversible physical impairment
of a major bodily function not including psychological or emotional conditions. No condition
shall be deemed a medical emergency if based on a claim or diagnosis that the woman will
engage in conduct which she intends to result in her death or in substantial and irreversible
physical impairment of a major bodily function.
new text end

new text begin Subd. 6. new text end

new text begin Physician. new text end

new text begin "Physician" means any person licensed to practice medicine and
surgery or osteopathic medicine and surgery in this state.
new text end

new text begin Subd. 7. new text end

new text begin Postfertilization age. new text end

new text begin "Postfertilization age" means the age of the unborn child
as calculated from the fusion of a human spermatozoon with a human ovum.
new text end

new text begin Subd. 8. new text end

new text begin Probable postfertilization age of the unborn child. new text end

new text begin "Probable postfertilization
age of the unborn child" means what, in reasonable medical judgment, will with reasonable
probability be the postfertilization age of the unborn child at the time the abortion is planned
to be performed or induced.
new text end

new text begin Subd. 9. new text end

new text begin Reasonable medical judgment. new text end

new text begin "Reasonable medical judgment" means a
medical judgment that would be made by a reasonably prudent physician knowledgeable
about the case and the treatment possibilities with respect to the medical conditions involved.
new text end

new text begin Subd. 10. new text end

new text begin Unborn child or fetus. new text end

new text begin "Unborn child" or "fetus" means an individual organism
of the species homo sapiens from fertilization until live birth.
new text end

new text begin Subd. 11. new text end

new text begin Woman. new text end

new text begin "Woman" means a female human being whether or not she has
reached the age of majority.
new text end

Sec. 25.

new text begin [145.4142] LEGISLATIVE FINDINGS.
new text end

new text begin (a) The legislature makes the following findings.
new text end

new text begin (b) Pain receptors (nociceptors) are present throughout an unborn child's entire body
and nerves link these receptors to the brain's thalamus and subcortical plate by 20 weeks.
new text end

new text begin (c) By eight weeks after fertilization, an unborn child reacts to touch. After 20 weeks
an unborn child reacts to stimuli that would be recognized as painful if applied to an adult
human, for example by recoiling.
new text end

new text begin (d) In the unborn child, application of such painful stimuli is associated with significant
increases in stress hormones known as the stress response.
new text end

new text begin (e) Subjection to such painful stimuli is associated with long-term harmful
neurodevelopmental effects, such as altered pain sensitivity and, possibly, emotional,
behavioral, and learning disabilities later in life.
new text end

new text begin (f) For the purposes of surgery on an unborn child, fetal anesthesia is routinely
administered and is associated with a decrease in stress hormones compared to the level
when painful stimuli is applied without anesthesia.
new text end

new text begin (g) The position, asserted by some medical experts, that an unborn child is incapable of
experiencing pain until a point later in pregnancy than 20 weeks after fertilization
predominately rests on the assumption that the ability to experience pain depends on the
cerebral cortex and requires nerve connections between the thalamus and the cortex.
However, recent medical research and analysis, especially since 2007, provides strong
evidence for the conclusion that a functioning cortex is not necessary to experience pain.
new text end

new text begin (h) Substantial evidence indicates that children born missing the bulk of the cerebral
cortex, those with hydranencephaly, nevertheless experience pain.
new text end

new text begin (i) In adults, stimulation or ablation of the cerebral cortex does not alter pain perception,
while stimulation or ablation of the thalamus does.
new text end

new text begin (j) Substantial evidence indicates that structures used for pain processing in early
development differ from those of adults, using different neural elements available at specific
times during development, such as the subcortical plate, to fulfill the role of pain processing.
new text end

new text begin (k) The position asserted by some medical experts, that the unborn child remains in a
coma-like sleep state that precludes the unborn child experiencing pain is inconsistent with
the documented reaction of unborn children to painful stimuli and with the experience of
fetal surgeons who have found it necessary to sedate the unborn child with anesthesia to
prevent the unborn child from thrashing about in reaction to invasive surgery.
new text end

new text begin (l) Consequently, there is substantial medical evidence that an unborn child is capable
of experiencing pain by 20 weeks after fertilization.
new text end

new text begin (m) It is the purpose of the state to assert a compelling state interest in protecting the
lives of unborn children from the stage at which substantial medical evidence indicates that
they are capable of feeling pain.
new text end

Sec. 26.

new text begin [145.4143] DETERMINATION OF POSTFERTILIZATION AGE.
new text end

new text begin Subdivision 1. new text end

new text begin Determination of postfertilization age. new text end

new text begin Except in the case of a medical
emergency, no abortion shall be performed or induced or be attempted to be performed or
induced unless the physician performing or inducing it has first made a determination of
the probable postfertilization age of the unborn child or relied upon such a determination
made by another physician. In making such a determination, the physician shall make those
inquiries of the woman and perform or cause to be performed those medical examinations
and tests that a reasonably prudent physician, knowledgeable about the case and the medical
conditions involved, would consider necessary to perform in making an accurate diagnosis
with respect to postfertilization age.
new text end

new text begin Subd. 2. new text end

new text begin Unprofessional conduct. new text end

new text begin Failure by any physician to conform to any
requirement of this section constitutes unprofessional conduct under section 147.091,
subdivision 1, paragraph (k).
new text end

Sec. 27.

new text begin [145.4144] ABORTION OF UNBORN CHILD OF 20 OR MORE WEEKS
POSTFERTILIZATION AGE PROHIBITED; CAPABLE OF FEELING PAIN.
new text end

new text begin Subdivision 1. new text end

new text begin Abortion prohibition; exemption. new text end

new text begin No person shall perform or induce
or attempt to perform or induce an abortion upon a woman when it has been determined,
by the physician performing or inducing or attempting to perform or induce the abortion,
or by another physician upon whose determination that physician relies, that the probable
postfertilization age of the woman's unborn child is 20 or more weeks unless, in reasonable
medical judgment, she has a condition which so complicates her medical condition as to
necessitate the abortion of her pregnancy to avert her death or to avert serious risk of
substantial and irreversible physical impairment of a major bodily function, not including
psychological or emotional conditions. No such condition shall be deemed to exist if it is
based on a claim or diagnosis that the woman will engage in conduct which she intends to
result in her death or in substantial and irreversible physical impairment of a major bodily
function.
new text end

new text begin Subd. 2. new text end

new text begin When abortion not prohibited. new text end

new text begin When an abortion upon a woman whose
unborn child has been determined to have a probable postfertilization age of 20 or more
weeks is not prohibited by this section, the physician shall terminate the pregnancy in the
manner which, in reasonable medical judgment, provides the best opportunity for the unborn
child to survive unless, in reasonable medical judgment, termination of the pregnancy in
that manner would pose a greater risk either of the death of the pregnant woman or of the
substantial and irreversible physical impairment of a major bodily function, not including
psychological or emotional conditions, of the woman than would other available methods.
No such greater risk shall be deemed to exist if it is based on a claim or diagnosis that the
woman will engage in conduct which she intends to result in her death or in substantial and
irreversible physical impairment of a major bodily function.
new text end

Sec. 28.

new text begin [145.4145] ENFORCEMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Criminal penalties. new text end

new text begin A person who intentionally or recklessly performs
or induces or attempts to perform or induce an abortion in violation of sections 145.4141
to 145.4147 shall be guilty of a felony. No penalty may be assessed against the woman upon
whom the abortion is performed or induced or attempted to be performed or induced.
new text end

new text begin Subd. 2. new text end

new text begin Civil remedies. new text end

new text begin (a) A woman upon whom an abortion has been performed or
induced in violation of sections 145.4141 to 145.4147, or the father of the unborn child who
was the subject of such an abortion, may maintain an action against the person who performed
or induced the abortion in intentional or reckless violation of sections 145.4141 to 145.4147
for damages. A woman upon whom an abortion has been attempted in violation of sections
145.4141 to 145.4147 may maintain an action against the person who attempted to perform
or induce the abortion in an intentional or reckless violation of sections 145.4141 to 145.4147
for damages.
new text end

new text begin (b) A cause of action for injunctive relief against a person who has intentionally violated
sections 145.4141 to 145.4147 may be maintained by the woman upon whom an abortion
was performed or induced or attempted to be performed or induced in violation of sections
145.4141 to 145.4147; by a person who is the father of the unborn child subject to an
abortion, parent, sibling, or guardian of, or a current or former licensed health care provider
of, the woman upon whom an abortion has been performed or induced or attempted to be
performed or induced in violation of sections 145.4141 to 145.4147; by a county attorney
with appropriate jurisdiction; or by the attorney general. The injunction shall prevent the
abortion provider from performing or inducing or attempting to perform or induce further
abortions in this state in violation of sections 145.4141 to 145.4147.
new text end

new text begin (c) If judgment is rendered in favor of the plaintiff in an action described in this section,
the court shall also render judgment for reasonable attorney fees in favor of the plaintiff
against the defendant.
new text end

new text begin (d) If judgment is rendered in favor of the defendant and the court finds that the plaintiff's
suit was frivolous and brought in bad faith, the court shall also render judgment for reasonable
attorney fees in favor of the defendant against the plaintiff.
new text end

new text begin (e) No damages or attorney fees may be assessed against the woman upon whom an
abortion was performed or induced or attempted to be performed or induced except according
to paragraph (d).
new text end

Sec. 29.

new text begin [145.4146] PROTECTION OF PRIVACY IN COURT PROCEEDINGS.
new text end

new text begin In every civil or criminal proceeding or action brought under the Pain-Capable Unborn
Child Protection Act, the court shall rule on whether the anonymity of a woman upon whom
an abortion has been performed or induced or attempted to be performed or induced shall
be preserved from public disclosure if she does not give her consent to such disclosure. The
court, upon motion or sua sponte, shall make such a ruling and, upon determining that her
anonymity should be preserved, shall issue orders to the parties, witnesses, and counsel and
shall direct the sealing of the record and exclusion of individuals from courtrooms or hearing
rooms to the extent necessary to safeguard her identity from public disclosure. Each such
order shall be accompanied by specific written findings explaining why the anonymity of
the woman should be preserved from public disclosure, why the order is essential to that
end, how the order is narrowly tailored to serve that interest, and why no reasonable, less
restrictive alternative exists. In the absence of written consent of the woman upon whom
an abortion has been performed or induced or attempted to be performed or induced, anyone,
other than a public official, who brings an action under section 145.4145, subdivision 2,
shall do so under a pseudonym. This section may not be construed to conceal the identity
of the plaintiff or of witnesses from the defendant or from attorneys for the defendant.
new text end

Sec. 30.

new text begin [145.4147] SEVERABILITY.
new text end

new text begin If any one or more provisions, sections, subsections, sentences, clauses, phrases, or
words of sections 145.4141 to 145.4146, or the application thereof to any person or
circumstance is found to be unconstitutional, the same is hereby declared to be severable
and the balance of sections 145.4141 to 145.4146 shall remain effective notwithstanding
such unconstitutionality. The legislature hereby declares that it would have passed sections
145.4141 to 145.4146, and each provision, section, subsection, sentence, clause, phrase, or
word thereof, irrespective of the fact that any one or more provisions, sections, subsections,
sentences, clauses, phrases, or words of sections 145.4141 to 145.4146, or the application
of sections 145.4141 to 145.4146, would be declared unconstitutional.
new text end

Sec. 31.

Minnesota Statutes 2018, section 145.4235, subdivision 2, is amended to read:

Subd. 2.

Eligibility for grants.

(a) The commissioner shall award grants to eligible
applicants under paragraph (c) for the reasonable expenses of alternatives to abortion
programs to support, encourage, and assist women in carrying their pregnancies to term and
caring for their babies after birth by providing information on, referral to, and assistance
with securing necessary services that enable women to carry their pregnancies to term and
care for their babies after birth. Necessary services must include, but are not limited to:

(1) medical care;

(2) nutritional services;

(3) housing assistance;

(4) adoption services;

(5) education and employment assistance, including services that support the continuation
and completion of high school;

(6) child care assistance; and

(7) parenting education and support services.

An applicant may not provide or assist a woman to obtain adoption services from a provider
of adoption services that is not licensed.

(b) In addition to providing information and referral under paragraph (a), an eligible
program may provide one or more of the necessary services under paragraph (a) that assists
women in carrying their pregnancies to term. To avoid duplication of efforts, grantees may
refer to other public or private programs, rather than provide the care directly, if a woman
meets eligibility criteria for the other programs.

(c) To be eligible for a grant, an agency or organization must:

(1) be a private, nonprofit organization;

(2) demonstrate that the program is conducted under appropriate supervision;

(3) not charge women for services provided under the program;

(4) provide each pregnant woman counseled with accurate information on the
developmental characteristics of babies and of unborn children, including offering the printed
information described in section 145.4243;

(5) ensure that its alternatives-to-abortion program's purpose is to assist and encourage
women in carrying their pregnancies to term and to maximize their potentials thereafter;

(6) ensure that none of the money provided is used to encourage or affirmatively counsel
a woman to have an abortion not necessary to prevent her death, to provide her an abortion,
or to directly refer her to an abortion provider for an abortion. The agency or organization
may provide nondirective counseling; and

(7) have had the alternatives to abortion program in existence deleted text begin for at least one year as of
July 1, 2011; or incorporated an alternative to abortion program that has been in existence
for at least one year as of July 1, 2011 deleted text end new text begin for at least two years prior to the date the agency or
organization submits an application to the commissioner for a grant under this section new text end .

(d) The provisions, words, phrases, and clauses of paragraph (c) are inseverable from
this subdivision, and if any provision, word, phrase, or clause of paragraph (c) or its
application to any person or circumstance is held invalid, the invalidity applies to all of this
subdivision.

(e) An organization that provides abortions, promotes abortions, or directly refers to an
abortion provider for an abortion is ineligible to receive a grant under this program. An
affiliate of an organization that provides abortions, promotes abortions, or directly refers
to an abortion provider for an abortion is ineligible to receive a grant under this section
unless the organizations are separately incorporated and independent from each other. To
be independent, the organizations may not share any of the following:

(1) the same or a similar name;

(2) medical facilities or nonmedical facilities, including but not limited to, business
offices, treatment rooms, consultation rooms, examination rooms, and waiting rooms;

(3) expenses;

(4) employee wages or salaries; or

(5) equipment or supplies, including but not limited to, computers, telephone systems,
telecommunications equipment, and office supplies.

(f) An organization that receives a grant under this section and that is affiliated with an
organization that provides abortion services must maintain financial records that demonstrate
strict compliance with this subdivision and that demonstrate that its independent affiliate
that provides abortion services receives no direct or indirect economic or marketing benefit
from the grant under this section.

(g) The commissioner shall approve any information provided by a grantee on the health
risks associated with abortions to ensure that the information is medically accurate.

Sec. 32.

Minnesota Statutes 2018, section 145.4242, is amended to read:

145.4242 INFORMED CONSENT.

(a) No abortion shall be performed in this state except with the voluntary and informed
consent of the female upon whom the abortion is to be performed. Except in the case of a
medical emergency or if the fetus has an anomaly incompatible with life, and the female
has declined perinatal hospice care, consent to an abortion is voluntary and informed only
if:

(1) the female is told the following, by telephone or in person, by the physician who is
to perform the abortion or by a referring physician, at least 24 hours before the abortion:

(i) the particular medical risks associated with the particular abortion procedure to be
employed including, when medically accurate, the risks of infection, hemorrhage, breast
cancer, danger to subsequent pregnancies, and infertility;

(ii) the probable gestational age of the unborn child at the time the abortion is to be
performed;

(iii) the medical risks associated with carrying her child to term; and

(iv) for abortions after 20 weeks gestational, whether or not an anesthetic or analgesic
would eliminate or alleviate organic pain to the unborn child caused by the particular method
of abortion to be employed and the particular medical benefits and risks associated with the
particular anesthetic or analgesic.

The information required by this clause may be provided by telephone without conducting
a physical examination or tests of the patient, in which case the information required to be
provided may be based on facts supplied to the physician by the female and whatever other
relevant information is reasonably available to the physician. It may not be provided by a
tape recording, but must be provided during a consultation in which the physician is able
to ask questions of the female and the female is able to ask questions of the physician. If a
physical examination, tests, or the availability of other information to the physician
subsequently indicate, in the medical judgment of the physician, a revision of the information
previously supplied to the patient, that revised information may be communicated to the
patient at any time prior to the performance of the abortion. Nothing in this section may be
construed to preclude provision of required information in a language understood by the
patient through a translator;

(2) the female is informed, by telephone or in person, by the physician who is to perform
the abortion, by a referring physician, or by an agent of either physician at least 24 hours
before the abortion:

(i) that medical assistance benefits may be available for prenatal care, childbirth, and
neonatal care;

(ii) that the father is liable to assist in the support of her child, even in instances when
the father has offered to pay for the abortion; and

(iii) that she has the right to review the printed materials described in section 145.4243,
that these materials are available on a state-sponsored website, and what the website address
is. The physician or the physician's agent shall orally inform the female that the materials
have been provided by the state of Minnesota and that they describe the unborn child, list
agencies that offer alternatives to abortion, and contain information on fetal pain. If the
female chooses to view the materials other than on the website, they shall either be given
to her at least 24 hours before the abortion or mailed to her at least 72 hours before the
abortion by certified mail, restricted delivery to addressee, which means the postal employee
can only deliver the mail to the addressee.

The information required by this clause may be provided by a tape recording if provision
is made to record or otherwise register specifically whether the female does or does not
choose to have the printed materials given or mailed to her;

(3) the female certifies in writing, prior to the abortion, that the information described
in clauses (1) and (2) has been furnished to her and that she has been informed of her
opportunity to review the information referred to in clause (2), item (iii); and

(4) prior to the performance of the abortion, the physician who is to perform the abortion
or the physician's agent obtains a copy of the written certification prescribed by clause (3)
and retains it on file with the female's medical record for at least three years following the
date of receipt.

(b) Prior to administering the anesthetic or analgesic as described in paragraph (a), clause
(1), item (iv), the physician must disclose to the woman any additional cost of the procedure
for the administration of the anesthetic or analgesic. If the woman consents to the
administration of the anesthetic or analgesic, the physician shall administer the anesthetic
or analgesic or arrange to have the anesthetic or analgesic administered.

(c) A female seeking an abortion of her unborn child diagnosed with fetal anomaly
incompatible with life must be informed of available perinatal hospice services and offered
this care as an alternative to abortion. If perinatal hospice services are declined, voluntary
and informed consent by the female seeking an abortion is given if the female receives the
information required in paragraphs (a), clause (1), and (b). The female must comply with
the requirements in paragraph (a), clauses (3) and (4).

new text begin (d) If, at any time prior to the performance of an abortion, a female undergoes an
ultrasound examination, or a physician determines that ultrasound imaging will be used
during the course of a patient's abortion, the physician or the physician's agent shall orally
inform the patient of the opportunity to view or decline to view an active ultrasound image
of the unborn child.
new text end

Sec. 33.

Minnesota Statutes 2018, section 145.4244, is amended to read:

145.4244 INTERNET WEBSITE.

new text begin (a) new text end The commissioner of health shall develop and maintain a stable Internet website to
provide the information described under section 145.4243. No information regarding who
uses the website shall be collected or maintained. The commissioner of health shall monitor
the website on a weekly basis to prevent and correct tampering.

new text begin (b) A health care facility performing abortions must provide the information described
in section 145.4243 on the facility's website or provide a link to the Department of Health
website where this information may be viewed.
new text end

Sec. 34.

Minnesota Statutes 2018, section 145.928, subdivision 1, is amended to read:

Subdivision 1.

Goal; establishment.

It is the goal of the state deleted text begin , by 2010, deleted text end to decrease deleted text begin by
50 percent deleted text end the disparities in infant mortality rates and adult and child immunization rates
for American Indians and populations of color, as compared with rates for whites. To do
so and to achieve other measurable outcomes, the commissioner of health shall establish a
program to close the gap in the health status of American Indians and populations of color
as compared with whites in the following priority areas: infant mortality, new text begin access to and
utilization of high-quality prenatal care, new text end breast and cervical cancer screening, HIV/AIDS
and sexually transmitted infections, adult and child immunizations, cardiovascular disease,
diabetes, and accidental injuries and violence.

Sec. 35.

Minnesota Statutes 2018, section 145.928, subdivision 7, is amended to read:

Subd. 7.

Community grant program; immunization rates new text begin , prenatal care access and
utilization, new text end and infant mortality rates.

(a) The commissioner shall award grants to eligible
applicants for local or regional projects and initiatives directed at reducing health disparities
in one or deleted text begin both deleted text end new text begin more new text end of the following priority areas:

(1) decreasing racial and ethnic disparities in infant mortality rates; deleted text begin or
deleted text end

new text begin (2) decreasing racial and ethnic disparities in access to and utilization of high-quality
prenatal care; or
new text end

deleted text begin (2) deleted text end new text begin (3) new text end increasing adult and child immunization rates in nonwhite racial and ethnic
populations.

(b) The commissioner may award up to 20 percent of the funds available as planning
grants. Planning grants must be used to address such areas as community assessment,
coordination activities, and development of community supported strategies.

(c) Eligible applicants may include, but are not limited to, faith-based organizations,
social service organizations, community nonprofit organizations, community health boards,
tribal governments, and community clinics. Applicants must submit proposals to the
commissioner. A proposal must specify the strategies to be implemented to address one or
deleted text begin both deleted text end new text begin more new text end of the priority areas listed in paragraph (a) and must be targeted to achieve the
outcomes established according to subdivision 3.

(d) The commissioner shall give priority to applicants who demonstrate that their
proposed project or initiative:

(1) is supported by the community the applicant will serve;

(2) is research-based or based on promising strategies;

(3) is designed to complement other related community activities;

(4) utilizes strategies that positively impact deleted text begin both deleted text end new text begin two or more new text end priority areas;

(5) reflects racially and ethnically appropriate approaches; and

(6) will be implemented through or with community-based organizations that reflect the
race or ethnicity of the population to be reached.

Sec. 36.

Minnesota Statutes 2018, section 145.986, subdivision 1, is amended to read:

Subdivision 1.

Purpose.

The purpose of the statewide health improvement program is
to:

(1) address the deleted text begin top three deleted text end leading preventable causes of illness and death deleted text begin : tobacco use
and exposure, poor diet, and lack of regular physical activity deleted text end new text begin as determined by the
commissioner through the statewide health assessment new text end ;

(2) promote the development, availability, and use of evidence-based, community level,
comprehensive strategies to create healthy communities; and

(3) measure the impact of the evidence-based, community health improvement practices
which over time work to contain health care costs and reduce chronic diseases.

Sec. 37.

Minnesota Statutes 2018, section 145.986, subdivision 1a, is amended to read:

Subd. 1a.

Grants to local communities.

(a) deleted text begin Beginning July 1, 2009, deleted text end The commissioner
of health shall award competitive grants to community health boards and tribal governments
to convene, coordinate, and implement deleted text begin evidence-based deleted text end new text begin proven-effective new text end strategies deleted text begin targeted
at reducing the percentage of Minnesotans who are obese or overweight and to reduce the
use of tobacco deleted text end new text begin , and promising practices or activities that can be evaluated using experimental
or quasi-experimental design new text end . Grants shall be awarded to all community health boards and
tribal governments whose proposals demonstrate the ability to implement programs designed
to achieve the purposes in subdivision 1 and other requirements of this section.

(b) Grantee activities shall:

(1) be based on scientific evidence;

(2) be based on community input;

(3) address behavior change at the individual, community, and systems levels;

(4) occur in community, school, work site, and health care settings;

(5) be focused on policy, systems, and environmental changes that support healthy
behaviors; and

(6) address the health disparities and inequities that exist in the grantee's community.

(c) To receive a grant under this section, community health boards and tribal governments
must submit proposals to the commissioner. A local match of ten percent of the total funding
allocation is required. This local match may include funds donated by community partners.

(d) In order to receive a grant, community health boards and tribal governments must
submit a health improvement plan to the commissioner of health for approval. The
commissioner may require the plan to identify a community leadership team, community
partners, and a community action plan that includes an assessment of area strengths and
needs, proposed action strategies, technical assistance needs, and a staffing plan.

(e) The grant recipient must implement the health improvement plan, evaluate the
effectiveness of the strategies, and modify or discontinue strategies found to be ineffective.

(f) Grant recipients shall report their activities and their progress toward the outcomes
established under subdivision 2 to the commissioner in a format and at a time specified by
the commissioner.

(g) All grant recipients shall be held accountable for making progress toward the
measurable outcomes established in subdivision 2. The commissioner shall require a
corrective action plan and may reduce the funding level of grant recipients that do not make
adequate progress toward the measurable outcomes.

(h) deleted text begin Beginning November 1, 2015, the commissioner shall offer grant recipients the
option of using a grant awarded under this subdivision to implement health improvement
strategies that improve the health status, delay the expression of dementia, or slow the
progression of dementia, for a targeted population at risk for dementia and shall award at
least two of the grants awarded on November 1, 2015, for these purposes. The grants must
meet all other requirements of this section. The commissioner shall coordinate grant planning
activities with the commissioner of human services, the Minnesota Board on Aging, and
community-based organizations with a focus on dementia. Each grant must include selected
outcomes and evaluation measures related to the incidence or progression of dementia
among the targeted population using the procedure described in subdivision 2. deleted text end new text begin For purposes
of this subdivision, "proven-effective strategy" means a strategy or practice that offers a
high level of research on effectiveness for at least one outcome of interest; and "promising
practice or activity" means a practice or activity that is supported by research demonstrating
effectiveness for at least one outcome of interest.
new text end

deleted text begin (i) Beginning July 1, 2017, the commissioner shall offer grant recipients the option of
using a grant awarded under this subdivision to confront the opioid addiction and overdose
epidemic, and shall award at least two of the grants awarded on or after July 1, 2017, for
these purposes. The grants awarded under this paragraph must meet all other requirements
of this section. The commissioner shall coordinate grant planning activities with the
commissioner of human services. Each grant shall include selected outcomes and evaluation
measures related to addressing the opioid epidemic.
deleted text end

Sec. 38.

Minnesota Statutes 2018, section 145.986, subdivision 4, is amended to read:

Subd. 4.

Evaluation.

(a) Using the outcome measures established in subdivision 3, the
commissioner shall conduct a biennial evaluation of the statewide health improvement
program new text begin grants new text end funded under this section. new text begin The evaluation must use the most appropriate
experimental or quasi-experimental design suitable for the grant activity or project. new text end Grant
recipients shall cooperate with the commissioner in the evaluation and provide the
commissioner with the information necessary to conduct the evaluation, including information
on any impact on the health indicators listed in section 62U.10, subdivision 6, within the
geographic area or among the population targeted.

(b) Grant recipients will collect, monitor, and submit to the Department of Health baseline
and annual data and provide information to improve the quality and impact of community
health improvement strategies.

(c) For the purposes of carrying out the grant program under this section, including for
administrative purposes, the commissioner shall award contracts to appropriate entities to
assist in designing and implementing evaluation systems. new text begin The commissioner shall consult
with the commissioner of management and budget to ensure that the evaluation process is
using experimental or quasi-experimental design.
new text end

(d) Contracts awarded under paragraph (c) may be used to:

(1) develop grantee monitoring and reporting systems to track grantee progress, including
aggregated and disaggregated data;

(2) manage, analyze, and report program evaluation data results; and

(3) utilize innovative support tools to analyze and predict the impact of prevention
strategies on health outcomes and state health care costs over time.

new text begin (e) For purposes of this subdivision, "experimental design" means a method of evaluating
the impact of a strategy that uses random assignment to establish statistically similar groups,
so that any difference in outcomes found at the end of the evaluation can be attributed to
the strategy being evaluated; and "quasi-experimental design" means a method of evaluating
the impact of a strategy that uses an approach other than random assignment to establish
statistically similar groups, so that any difference in outcomes found at the end of the
evaluation can be attributed to the strategy being evaluated.
new text end

Sec. 39.

Minnesota Statutes 2018, section 145.986, subdivision 5, is amended to read:

Subd. 5.

Report.

The commissioner shall submit a biennial report to the legislature on
the statewide health improvement program funded under this section. The report must
include information on each grant recipient, including the activities that were conducted by
the grantee using grant funds, the grantee's progress toward achieving the measurable
outcomes established under subdivision 2, and the data provided to the commissioner by
the grantee to measure these outcomes for grant activities. The commissioner shall provide
information on grants in which a corrective action plan was required under subdivision 1a,
the types of plan action, and the progress that has been made toward meeting the measurable
outcomes. In addition, the commissioner shall provide recommendations on future areas of
focus for health improvement. These reports are due by January 15 of every other year,
beginning in 2010. deleted text begin In the report due on January 15, 2014, deleted text end new text begin In the reports due beginning
January 15, 2020, new text end the commissioner shall include a description of the contracts awarded
under subdivision 4, paragraph (c), and the monitoring and evaluation systems that were
designed and implemented under these contracts.

Sec. 40.

Minnesota Statutes 2018, section 145.986, subdivision 6, is amended to read:

Subd. 6.

Supplantation of existing funds.

Community health boards and tribal
governments must use funds received under this section to develop new programs, expand
current programs deleted text begin that work to reduce the percentage of Minnesotans who are obese or
overweight or who use tobacco deleted text end , or replace discontinued state or federal funds deleted text begin previously
used to reduce the percentage of Minnesotans who are obese or overweight or who use
tobacco deleted text end . Funds must not be used to supplant current state or local funding to community
health boards or tribal governments deleted text begin used to reduce the percentage of Minnesotans who are
obese or overweight or to reduce tobacco use deleted text end .

Sec. 41.

Minnesota Statutes 2018, section 152.22, is amended by adding a subdivision to
read:

new text begin Subd. 5a. new text end

new text begin Hemp. new text end

new text begin "Hemp" means industrial hemp as defined in section 18K.02,
subdivision 3.
new text end

Sec. 42.

Minnesota Statutes 2018, section 152.22, subdivision 6, is amended to read:

Subd. 6.

Medical cannabis.

(a) "Medical cannabis" means any species of the genus
cannabis plant, or any mixture or preparation of them, including whole plant extracts and
resins, and is delivered in the form of:

(1) liquid, including, but not limited to, oil;

(2) pill;

(3) vaporized delivery method with use of liquid or oil but which does not require the
use of dried leaves or plant form; or

(4) any other method, excluding smoking, approved by the commissioner.

(b) This definition includes any part of the genus cannabis plant prior to being processed
into a form allowed under paragraph (a), that is possessed by a person while that person is
engaged in employment duties necessary to carry out a requirement under sections 152.22
to 152.37 for a registered manufacturer or a laboratory under contract with a registered
manufacturer. new text begin This definition also includes any hemp acquired by a manufacturer by a hemp
grower licensed under chapter 18K as permitted under section 152.29, subdivision 1,
paragraph (b).
new text end

Sec. 43.

Minnesota Statutes 2018, section 152.25, subdivision 4, is amended to read:

Subd. 4.

Reports.

(a) The commissioner shall provide regular updates to the task force
on medical cannabis therapeutic research and to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services, public safety,
judiciary, and civil law regarding new text begin : (1) new text end any changes in federal law or regulatory restrictions
regarding the use of medical cannabis new text begin and hemp; and (2) the market demand and supply in
this state for hemp products that can be used for medicinal purposes new text end .

(b) The commissioner may submit medical research based on the data collected under
sections 152.22 to 152.37 to any federal agency with regulatory or enforcement authority
over medical cannabis to demonstrate the effectiveness of medical cannabis for treating a
qualifying medical condition.

Sec. 44.

Minnesota Statutes 2018, section 152.28, subdivision 1, is amended to read:

Subdivision 1.

Health care practitioner duties.

(a) Prior to a patient's enrollment in
the registry program, a health care practitioner shall:

(1) determine, in the health care practitioner's medical judgment, whether a patient suffers
from a qualifying medical condition, and, if so determined, provide the patient with a
certification of that diagnosis;

(2) determine whether a patient is developmentally or physically disabled and, as a result
of that disability, the patient is unable to self-administer medication or acquire medical
cannabis from a distribution facility, and, if so determined, include that determination on
the patient's certification of diagnosis;

(3) advise patients, registered designated caregivers, and parents or legal guardians who
are acting as caregivers of the existence of any nonprofit patient support groups or
organizations;

(4) provide explanatory information from the commissioner to patients with qualifying
medical conditions, including disclosure to all patients about the experimental nature of
therapeutic use of medical cannabis; the possible risks, benefits, and side effects of the
proposed treatment; the application and other materials from the commissioner; and provide
patients with the Tennessen warning as required by section 13.04, subdivision 2; and

(5) agree to continue treatment of the patient's qualifying medical condition and report
medical findings to the commissioner.

(b) Upon notification from the commissioner of the patient's enrollment in the registry
program, the health care practitioner shall:

(1) participate in the patient registry reporting system under the guidance and supervision
of the commissioner;

(2) report health records of the patient throughout the ongoing treatment of the patient
to the commissioner in a manner determined by the commissioner and in accordance with
subdivision 2;

(3) determine, on a yearly basis, if the patient continues to suffer from a qualifying
medical condition and, if so, issue the patient a new certification of that diagnosis; and

(4) otherwise comply with all requirements developed by the commissioner.

new text begin (c) A health care practitioner may conduct a patient assessment to issue a recertification
as required under paragraph (b), clause (3), via telemedicine as defined under section
62A.671, subdivision 9.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end Nothing in this section requires a health care practitioner to participate in the
registry program.

Sec. 45.

Minnesota Statutes 2018, section 152.29, subdivision 1, is amended to read:

Subdivision 1.

Manufacturer; requirements.

(a) A manufacturer shall operate deleted text begin four deleted text end new text begin
eight new text end 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. deleted text begin A manufacturer is required to begin distribution of medical cannabis
from at least one distribution facility by July 1, 2015. All distribution facilities must be
operational and begin distribution of medical cannabis by July 1, 2016. The distribution
facilities shall be located deleted text end new text begin The commissioner shall designate the geographical service areas
to be served by each manufacturer new text end based on geographical need throughout the state to
improve patient access. deleted text begin A manufacturer shall disclose the proposed locations for the
distribution facilities to the commissioner during the registration process. deleted text end new text begin A manufacturer
shall not have more than two distribution facilities in each geographical service area assigned
to the manufacturer by the commissioner. new text end A manufacturer shall operate only one location
where all cultivation, harvesting, manufacturing, packaging, and processing new text begin of medical
cannabis new text end shall be conducted. deleted text begin Any deleted text end new text begin This location may be one of the manufacturer's distribution
facility sites. The new text end 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 deleted text begin an additional deleted text end new text begin
the other new text end distribution facility deleted text begin site deleted text end new text begin sites new text end . 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.

new text begin (b) A manufacturer may obtain hemp from a hemp grower licensed with the commissioner
of agriculture under chapter 18K if the hemp was grown in this state. A manufacturer may
use hemp for the purpose of making it available in a form allowable under section 152.22,
subdivision 6. Any hemp acquired by a manufacturer under this paragraph is subject to the
same quality control program, security and testing requirements, and any other requirement
for medical cannabis under sections 152.22 to 152.37 and Minnesota Rules, chapter 4770.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end 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 new text begin or hemp acquired new text end 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.

deleted text begin (c) deleted text end new text begin (d) new text end The operating documents of a manufacturer must include:

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

(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 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (3) procedures for the delivery and transportation of hemp between hemp growers
licensed under chapter 18K and manufacturers.
new text end

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

deleted text begin (e) deleted text end new text begin (f) new text end 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.

deleted text begin (f) deleted text end new text begin (g) new text end A manufacturer shall not permit any person to consume medical cannabis on the
property of the manufacturer.

deleted text begin (g) deleted text end new text begin (h) new text end A manufacturer is subject to reasonable inspection by the commissioner.

deleted text begin (h) deleted text end new text begin (i) new text end 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.

deleted text begin (i) deleted text end new text begin (j) new text end 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.

deleted text begin (j) deleted text end new text begin (k) new text end 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.

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

new text begin (m) Before a manufacturer acquires hemp, the manufacturer must verify that the person
from whom the manufacturer is acquiring hemp has a valid license issued by the
commissioner of agriculture under chapter 18K.
new text end

Sec. 46.

Minnesota Statutes 2018, section 152.29, subdivision 2, is amended to read:

Subd. 2.

Manufacturer; production.

(a) A manufacturer of medical cannabis shall
provide a reliable and ongoing supply of all medical cannabis needed for the registry program.

(b) All cultivation, harvesting, manufacturing, packaging, and processing of medical
cannabis new text begin or manufacturing, packaging, or processing of hemp acquired by the manufacturer
new text end must take place in an enclosed, locked facility at a physical address provided to the
commissioner during the registration process.

(c) A manufacturer must process and prepare any medical cannabis plant material into
a form allowable under section 152.22, subdivision 6, prior to distribution of any medical
cannabis.

Sec. 47.

Minnesota Statutes 2018, section 152.29, subdivision 3, is amended to read:

Subd. 3.

Manufacturer; distribution.

(a) A manufacturer shall require that employees
licensed as pharmacists pursuant to chapter 151 be the only employees to give final approval
for the distribution of medical cannabis to a patient.

(b) A manufacturer may dispense medical cannabis products, whether or not the products
have been manufactured by the manufacturer, but is not required to dispense medical cannabis
products.

(c) Prior to distribution of any medical cannabis, the manufacturer shall:

(1) verify that the manufacturer has received the registry verification from the
commissioner for that individual patient;

(2) verify that the person requesting the distribution of medical cannabis is the patient,
the patient's registered designated caregiver, or the patient's parent or legal guardian listed
in the registry verification using the procedures described in section 152.11, subdivision
2d;

(3) assign a tracking number to any medical cannabis distributed from the manufacturer;

(4) ensure that any employee of the manufacturer licensed as a pharmacist pursuant to
chapter 151 has consulted with the patient to determine the proper dosage for the individual
patient after reviewing the ranges of chemical compositions of the medical cannabis and
the ranges of proper dosages reported by the commissioner. For purposes of this clause, a
consultation may be conducted remotely using a videoconference, so long as the employee
providing the consultation is able to confirm the identity of the patient, the consultation
occurs while the patient is at a distribution facility, and the consultation adheres to patient
privacy requirements that apply to health care services delivered through telemedicine;

(5) properly package medical cannabis in compliance with the United States Poison
Prevention Packing Act regarding child-resistant packaging and exemptions for packaging
for elderly patients, and label distributed medical cannabis with a list of all active ingredients
and individually identifying information, including:

(i) the patient's name and date of birth;

(ii) the name and date of birth of the patient's registered designated caregiver or, if listed
on the registry verification, the name of the patient's parent or legal guardian, if applicable;

(iii) the patient's registry identification number;

(iv) the chemical composition of the medical cannabis; and

(v) the dosage; and

(6) ensure that the medical cannabis distributed contains a maximum of a deleted text begin 30-day deleted text end new text begin 90-day new text end
supply of the dosage determined for that patient.

(d) A manufacturer shall require any employee of the manufacturer who is transporting
medical cannabis or medical cannabis products to a distribution facility to carry identification
showing that the person is an employee of the manufacturer.

Sec. 48.

Minnesota Statutes 2018, section 152.29, subdivision 3a, is amended to read:

Subd. 3a.

Transportation of medical cannabis; staffing.

new text begin (a) new text end A medical cannabis
manufacturer may staff a transport motor vehicle with only one employee if the medical
cannabis manufacturer is transporting medical cannabis to either a certified laboratory for
the purpose of testing or a facility for the purpose of disposal. If the medical cannabis
manufacturer is transporting medical cannabis for any other purpose or destination, the
transport motor vehicle must be staffed with a minimum of two employees as required by
rules adopted by the commissioner.

new text begin (b) Notwithstanding paragraph (a), a medical cannabis manufacturer that is only
transporting hemp for any purpose may staff the transport motor vehicle with only one
employee.
new text end

Sec. 49.

Minnesota Statutes 2018, section 152.31, is amended to read:

152.31 DATA PRACTICES.

(a) Government data in patient files maintained by the commissioner and the health care
practitioner, and data submitted to or by a medical cannabis manufacturer, are private data
on individuals, as defined in section 13.02, subdivision 12, or nonpublic data, as defined in
section 13.02, subdivision 9, but may be used for purposes of complying with chapter 13
and complying with a request from the legislative auditor or the state auditor in the
performance of official duties. The provisions of section 13.05, subdivision 11, apply to a
registration agreement entered between the commissioner and a medical cannabis
manufacturer under section 152.25.

(b) Not public data maintained by the commissioner may not be used for any purpose
not provided for in sections 152.22 to 152.37, and may not be combined or linked in any
manner with any other list, dataset, or database.

new text begin (c) The commissioner may execute data sharing arrangements with the commissioner
of agriculture to verify licensing information, inspection, and compliance related to hemp
growers under chapter 18K.
new text end

Sec. 50.

Minnesota Statutes 2018, section 157.22, is amended to read:

157.22 EXEMPTIONS.

This chapter does not apply to:

(1) interstate carriers under the supervision of the United States Department of Health
and Human Services;

(2) weddings, fellowship meals, or funerals conducted by a faith-based organization
using any building constructed and primarily used for religious worship or education;

(3) any building owned, operated, and used by a college or university in accordance
with health regulations promulgated by the college or university under chapter 14;

(4) any person, firm, or corporation whose principal mode of business is licensed under
sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food or beverage
establishment; provided that the holding of any license pursuant to sections 28A.04 and
28A.05 shall not exempt any person, firm, or corporation from the applicable provisions of
this chapter or the rules of the state commissioner of health relating to food and beverage
service establishments;

(5) family day care homes and group family day care homes governed by sections
245A.01 to 245A.16;

(6) nonprofit senior citizen centers for the sale of home-baked goods;

(7) fraternal, sportsman, or patriotic organizations that are tax exempt under section
501(c)(3), 501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue
Code of 1986, or organizations related to, affiliated with, or supported by such fraternal,
sportsman, or patriotic organizations for events held in the building or on the grounds of
the organization and at which home-prepared food is donated by organization members for
sale at the events, provided:

(i) the event is not a circus, carnival, or fair;

(ii) the organization controls the admission of persons to the event, the event agenda, or
both; and

(iii) the organization's licensed kitchen is not used in any manner for the event;

(8) food not prepared at an establishment and brought in by individuals attending a
potluck event for consumption at the potluck event. An organization sponsoring a potluck
event under this clause may advertise the potluck event to the public through any means.
Individuals who are not members of an organization sponsoring a potluck event under this
clause may attend the potluck event and consume the food at the event. Licensed food
establishments other than schools cannot be sponsors of potluck events. A school may
sponsor and hold potluck events in areas of the school other than the school's kitchen,
provided that the school's kitchen is not used in any manner for the potluck event. For
purposes of this clause, "school" means a public school as defined in section 120A.05,
subdivisions 9, 11, 13, and 17, or a nonpublic school, church, or religious organization at
which a child is provided with instruction in compliance with sections 120A.22 and 120A.24.
Potluck event food shall not be brought into a licensed food establishment kitchen;

(9) a home school in which a child is provided instruction at home;

(10) school concession stands serving commercially prepared, nonpotentially hazardous
foods, as defined in Minnesota Rules, chapter 4626;

(11) group residential facilities of ten or fewer beds licensed by the commissioner of
human services under Minnesota Rules, chapter 2960, provided the facility employs or
contracts with a certified food manager under Minnesota Rules, part 4626.2015;

(12) food served at fund-raisers or community events conducted in the building or on
the grounds of a faith-based organization, provided that a certified food manager, or a
volunteer trained in a food safety course, trains the food preparation workers in safe food
handling practices. This exemption does not apply to faith-based organizations at the state
agricultural society or county fairs or to faith-based organizations that choose to apply for
a license;

(13) food service events conducted following a disaster for purposes of feeding disaster
relief staff and volunteers serving commercially prepared, nonpotentially hazardous foods,
as defined in Minnesota Rules, chapter 4626; deleted text begin and
deleted text end

(14) chili or soup served at a chili or soup cook-off fund-raiser conducted by a
community-based nonprofit organization, provided:

(i) the municipality where the event is located approves the event;

(ii) the sponsoring organization must develop food safety rules and ensure that participants
follow these rules; and

(iii) if the food is not prepared in a kitchen that is licensed or inspected, a visible sign
or placard must be posted that states: "These products are homemade and not subject to
state inspection."

Foods exempt under this clause must be labeled to accurately reflect the name and
address of the person preparing the foods deleted text begin . deleted text end new text begin ; and
new text end

new text begin (15) a special event food stand or a seasonal temporary food stand provided:
new text end

new text begin (i) the stand is operated solely by a person or persons under the age of 14;
new text end

new text begin (ii) the stand is located on private property with the permission of the property owner;
new text end

new text begin (iii) the stand has gross receipts or contributions of $1,000 or less in a calendar year;
and
new text end

new text begin (iv) the operator of the stand posts a sign or placard at the site that states "The products
sold at this stand are not subject to state inspection or regulation.", if the stand offers for
sale potentially hazardous food as defined in Minnesota Rules, part 4626.0020, subdivision
62.
new text end

Sec. 51. new text begin DIRECTION TO THE COMMISSIONER OF HEALTH.
new text end

new text begin The commissioner of health shall prescribe the notification and consent form described
in Minnesota Statutes, section 144.6502, subdivision 6, no later than January 1, 2020. The
commissioner shall make the form available on the department's website.
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. 52. new text begin PERINATAL HOSPICE GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Eligible program entity" means a hospital, hospice, health care facility, or
community-based organization. An eligible program entity must have a perinatal hospice
program coordinator who is eligible to be certified in perinatal loss care.
new text end

new text begin (c) "Eligible training entity" means an eligible program entity that has experience
providing perinatal hospice services, or a qualified individual who is eligible to be certified
in perinatal loss care and has experience providing perinatal hospice services.
new text end

new text begin (d) "Eligible to be certified in perinatal loss care" means an individual who meets the
criteria to sit for the perinatal loss care exam, or is already certified in perinatal loss care,
by the Hospice and Palliative Credentialing Center.
new text end

new text begin (e) "Life-limiting prenatal diagnosis" means a fetal condition diagnosed before birth that
will with reasonable certainty result in the death of the child within six months after birth.
new text end

new text begin (f) "Perinatal hospice" means comprehensive support to the pregnant woman and her
family that includes family-centered multidisciplinary care to meet their medical, spiritual,
and emotional needs from the time of a life-limiting prenatal diagnosis through the birth,
life, and natural death of the child, and through the postpartum period. Supportive care may
be provided by medical staff, counselors, clergy, mental health providers, social workers,
geneticists, certified nurse midwives, hospice professionals, and others.
new text end

new text begin Subd. 2. new text end

new text begin Perinatal hospice development grants. new text end

new text begin Perinatal hospice development grants
are available to eligible program entities and must be used for expenditures to:
new text end

new text begin (1) establish a new perinatal hospice program;
new text end

new text begin (2) expand an existing perinatal hospice program;
new text end

new text begin (3) recruit a perinatal hospice program coordinator; or
new text end

new text begin (4) fund perinatal hospice administrative and coordinator expenses for a period of not
more than six months.
new text end

new text begin Subd. 3. new text end

new text begin Perinatal hospice training grants. new text end

new text begin Perinatal hospice training grants are available
to eligible training entities and may be used for expenses to enable existing perinatal hospice
programs to provide training for members of a multidisciplinary team providing perinatal
hospice services. Funds must be used for:
new text end

new text begin (1) development and operation of a perinatal hospice training program. The curriculum
must include but is not limited to training to provide the following services to families
eligible for perinatal hospice:
new text end

new text begin (i) counseling at the time of a life-limiting prenatal diagnosis;
new text end

new text begin (ii) specialized birth planning;
new text end

new text begin (iii) specialized advance care planning;
new text end

new text begin (iv) services to address the emotional needs of the family through prenatal and postpartum
counseling that:
new text end

new text begin (A) helps the family prepare for the death of their child;
new text end

new text begin (B) helps the family work within the health care delivery system to create a safe and
professionally supported environment where parents can parent their child during their brief
life in a way that is meaningful for that family and baby; and
new text end

new text begin (C) helps the family with the grief that begins at diagnosis and continues after the death
of the child; and
new text end

new text begin (v) evidence-based perinatal bereavement care;
new text end

new text begin (2) trainer support, including travel expenses and reasonable living expenses during the
period of training;
new text end

new text begin (3) trainee support, including tuition, books, travel expenses, program fees, and reasonable
living expenses during the period of training; or
new text end

new text begin (4) materials used in the provision of training.
new text end

new text begin Subd. 4. new text end

new text begin Perinatal hospice awareness grants. new text end

new text begin Perinatal hospice awareness grants are
available to eligible program entities and may be used for the creation and distribution of
materials promoting awareness of perinatal hospice programs.
new text end

new text begin Subd. 5. new text end

new text begin Report. new text end

new text begin The commissioner of health shall report to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services finance by February 1, 2023, on how the grant funds have been used.
new text end

Sec. 53. new text begin PLAN FOR A WORKING GROUP ON LINKS BETWEEN HEALTH
DISPARITIES AND EDUCATIONAL ACHIEVEMENT FOR CHILDREN FROM
AMERICAN INDIAN COMMUNITIES AND COMMUNITIES OF COLOR.
new text end

new text begin (a) The commissioner of health, in consultation with the commissioner of education,
shall develop a plan to convene one or more working groups to:
new text end

new text begin (1) examine the links between health disparities and disparities in educational achievement
for children from American Indian communities and communities of color; and
new text end

new text begin (2) develop recommendations for programs, services, or funding to address health
disparities and decrease disparities in educational achievement for children from American
Indian communities and communities of color.
new text end

new text begin (b) The plan shall include the possible membership of the proposed working group and
the duties for the proposed working group.
new text end

new text begin (c) The commissioner shall submit the plan for the working group, including proposed
legislation establishing the working group, to the chairs and ranking minority members of
the legislative committees with jurisdiction over health and education by February 15, 2020.
new text end

Sec. 54. new text begin SHORT TITLE.
new text end

new text begin Minnesota Statutes, sections 145.4141 to 145.4147 may be cited as the "Pain-Capable
Unborn Child Protection Act."
new text end

Sec. 55. new text begin STUDY ON BREASTFEEDING DISPARITIES; STAKEHOLDER
ENGAGEMENT.
new text end

new text begin (a) The commissioner of health shall work with community stakeholders in Minnesota
including but not limited to representatives from the Minnesota Breastfeeding Coalition;
Academy of Lactation Policy and Practice; International Board of Lactation Consultant
Examiners; DONA International; HealthConnect; Reaching Sisters Everywhere; the La
Leche League; the women, infants, and children program; hospitals and clinics; local public
health professionals and organizations; community-based organizations; and representatives
of populations with low breastfeeding rates to carry out a study to identify barriers,
challenges, and successes affecting the initiation, duration, and exclusivity of breastfeeding.
new text end

new text begin (b) The study must address policy, systemic, and environmental factors that both support
and create barriers to breastfeeding. The study must also identify and make recommendations
regarding culturally appropriate practices that have been shown to increase breastfeeding
rates in populations that have the greatest breastfeeding disparity rates.
new text end

new text begin (c) The commissioner shall submit a report on the study with any recommendations to
the chairs and ranking minority members of the legislative committees with jurisdiction
over health care policy and finance on or before September 15, 2020.
new text end

Sec. 56. new text begin TRANSITION TO AUTHORIZED ELECTRONIC MONITORING IN
CERTAIN HEALTH CARE FACILITIES.
new text end

new text begin Any resident, resident representative, or other person conducting electronic monitoring
in a resident's room or private living unit prior to January 1, 2020, must comply with the
requirements of Minnesota Statutes, section 144.6502, by January 1, 2020.
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. 57. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 144.1464; and 144.1911, new text end new text begin are repealed.
new text end

ARTICLE 2

DEPARTMENT OF HUMAN SERVICES; HEALTH CARE

Section 1.

new text begin [254A.21] FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION
GRANTS.
new text end

new text begin (a) The commissioner of human services shall award a grant to a statewide organization
that focuses solely on prevention of and intervention with fetal alcohol spectrum disorders.
The grant recipient must make subgrants to eligible regional collaboratives in rural and
urban areas of the state for the purposes specified in paragraph (c).
new text end

new text begin (b) "Eligible regional collaboratives" means a partnership between at least one local
government and at least one community-based organization and, where available, a family
home visiting program. For purposes of this paragraph, a local government includes a county
or a multicounty organization, a tribal government, a county-based purchasing entity, or a
community health board.
new text end

new text begin (c) Eligible regional collaboratives must use subgrant funds to reduce the incidence of
fetal alcohol spectrum disorders and other prenatal drug-related effects in children in
Minnesota by identifying and serving pregnant women suspected of or known to use or
abuse alcohol or other drugs. Eligible regional collaboratives must provide intensive services
to chemically dependent women to increase positive birth outcomes.
new text end

new text begin (d) An eligible regional collaborative that receives a subgrant under this section must
report to the grant recipient by January 15 of each year on the services and programs funded
by the subgrant. The report must include measurable outcomes for the previous year,
including the number of pregnant women served and the number of toxic-free babies born.
The grant recipient must compile the information in the subgrant reports and submit a
summary report to the commissioner of human services by February 15 of each year.
new text end

Sec. 2.

Minnesota Statutes 2018, section 256B.04, subdivision 14, is amended to read:

Subd. 14.

Competitive bidding.

(a) When determined to be effective, economical, and
feasible, the commissioner may utilize volume purchase through competitive bidding and
negotiation under the provisions of chapter 16C, to provide items under the medical assistance
program including but not limited to the following:

(1) eyeglasses;

(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
on a short-term basis, until the vendor can obtain the necessary supply from the contract
dealer;

(3) hearing aids and supplies; and

(4) durable medical equipment, including but not limited to:

(i) hospital beds;

(ii) commodes;

(iii) glide-about chairs;

(iv) patient lift apparatus;

(v) wheelchairs and accessories;

(vi) oxygen administration equipment;

(vii) respiratory therapy equipment;

(viii) electronic diagnostic, therapeutic and life-support systems;

(5) nonemergency medical transportation level of need determinations, disbursement of
public transportation passes and tokens, and volunteer and recipient mileage and parking
reimbursements; and

(6) drugs.

(b) Rate changes and recipient cost-sharing under this chapter and chapter 256L do not
affect contract payments under this subdivision unless specifically identified.

(c) The commissioner may not utilize volume purchase through competitive bidding
and negotiation deleted text begin for special transportation services deleted text end under the provisions of chapter 16C new text begin for
special transportation services or incontinence products and related supplies 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. 3.

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

Subdivision 1.

Residency.

new text begin (a) new text end To be eligible for medical assistance, a person must reside
in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota, in
accordance with Code of Federal Regulations, title 42, section 435.403.

new text begin (b) The commissioner shall identify individuals who are enrolled in medical assistance
and who are absent from the state for more than 30 consecutive days, but who continue to
qualify for medical assistance in accordance with paragraph (a).
new text end

new text begin (c) If the individual is absent from the state for more than 30 consecutive days but still
deemed a resident of Minnesota in accordance with paragraph (a), any covered service
provided to the individual must be paid through the fee-for-service system and not through
the managed care capitated rate payment system under section 256B.69 or 256L.12.
new text end

Sec. 4.

Minnesota Statutes 2018, section 256B.056, subdivision 3, is amended to read:

Subd. 3.

Asset limitations for certain individuals.

(a) To be eligible for medical
assistance, a person must not individually own more than $3,000 in assets, or if a member
of a household with two family members, husband and wife, or parent and child, the
household must not own more than $6,000 in assets, plus $200 for each additional legal
dependent. In addition to these maximum amounts, an eligible individual or family may
accrue interest on these amounts, but they must be reduced to the maximum at the time of
an eligibility redetermination. The accumulation of the clothing and personal needs allowance
according to section 256B.35 must also be reduced to the maximum at the time of the
eligibility redetermination. The value of assets that are not considered in determining
eligibility for medical assistance is the value of those assets excluded under the Supplemental
Security Income program for aged, blind, and disabled persons, with the following
exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considered;

(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security
Income program;

(4) assets designated as burial expenses are excluded to the same extent excluded by the
Supplemental Security Income program. Burial expenses funded by annuity contracts or
life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses;

(5) for a person who no longer qualifies as an employed person with a disability due to
loss of earnings, assets allowed while eligible for medical assistance under section 256B.057,
subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility
as an employed person with a disability, to the extent that the person's total assets remain
within the allowed limits of section 256B.057, subdivision 9, paragraph (d);

(6) when a person enrolled in medical assistance under section 256B.057, subdivision
9, is age 65 or older and has been enrolled during each of the 24 consecutive months before
the person's 65th birthday, the assets owned by the person and the person's spouse must be
disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when
determining eligibility for medical assistance under section 256B.055, subdivision 7. The
income of a spouse of a person enrolled in medical assistance under section 256B.057,
subdivision 9, during each of the 24 consecutive months before the person's 65th birthday
must be disregarded when determining eligibility for medical assistance under section
256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions
in section 256B.059; and

(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.

(b) new text begin Upon initial enrollment, new text end no asset limit shall apply to persons eligible under section
256B.055, subdivision 15. new text begin Upon renewal, a person eligible under section 256B.055,
subdivision 15, must not own either individually or as a member of a household more than
$1,000,000 in assets to continue to be eligible for medical assistance.
new text end

Sec. 5.

Minnesota Statutes 2018, 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. new text begin The local agency may close the enrollee's case file if the required
information is not submitted within four months of termination.
new text end

(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
required to renew eligibility every six months.

Sec. 6.

Minnesota Statutes 2018, section 256B.0625, subdivision 56a, is amended to read:

Subd. 56a.

deleted text begin Post-arrest deleted text end new text begin Officer-involved new text end community-based deleted text begin service deleted text end new text begin care new text end
coordination.

(a) Medical assistance covers deleted text begin post-arrest deleted text end new text begin officer-involved new text end community-based
deleted text begin service deleted text end new text begin care new text end coordination for an individual who:

(1) has been identified as having a mental illness or substance use disorder using a
screening tool approved by the commissioner;

(2) does not require the security of a public detention facility and is not considered an
inmate of a public institution as defined in Code of Federal Regulations, title 42, section
435.1010;

(3) meets the eligibility requirements in section 256B.056; and

(4) has agreed to participate in deleted text begin post-arrest deleted text end new text begin officer-involved new text end community-based deleted text begin service deleted text end new text begin
care new text end coordination through a diversion contract in lieu of incarceration.

(b) deleted text begin Post-arrest deleted text end new text begin Officer-involved new text end community-based deleted text begin service deleted text end new text begin care new text end coordination means
navigating services to address a client's mental health, chemical health, social, economic,
and housing needs, or any other activity targeted at reducing the incidence of jail utilization
and connecting individuals with existing covered services available to them, including, but
not limited to, targeted case management, waiver case management, or care coordination.

(c) deleted text begin Post-arrest deleted text end new text begin Officer-involved new text end community-based deleted text begin service deleted text end new text begin care new text end coordination must be
provided by an individual who is an employee of a county or is under contract with a county
to provide deleted text begin post-arrest deleted text end new text begin officer-involved new text end community-based new text begin care new text end coordination and is qualified
under one of the following criteria:

(1) a licensed mental health professional as defined in section 245.462, subdivision 18,
clauses (1) to (6);

(2) a mental health practitioner as defined in section 245.462, subdivision 17, working
under the clinical supervision of a mental health professional; or

(3) a certified peer specialist under section 256B.0615, working under the clinical
supervision of a mental health professional.

(d) Reimbursement is allowed for up to 60 days following the initial determination of
eligibility.

(e) Providers of deleted text begin post-arrest deleted text end new text begin officer-involved new text end community-based deleted text begin service deleted text end new text begin care new text end coordination
shall annually report to the commissioner on the number of individuals served, and number
of the community-based services that were accessed by recipients. The commissioner shall
ensure that services and payments provided under deleted text begin post-arrest deleted text end new text begin officer-involved new text end
community-based deleted text begin service deleted text end new text begin care new text end coordination do not duplicate services or payments provided
under section 256B.0625, subdivision 20, 256B.0753, 256B.0755, or 256B.0757.

deleted text begin (f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for
post-arrest community-based service coordination services shall be provided by the county
providing the services, from sources other than federal funds or funds used to match other
federal funds.
deleted text end

Sec. 7.

Minnesota Statutes 2018, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 66. new text end

new text begin Prescribed pediatric extended care (PPEC) center basic services. new text end

new text begin Medical
assistance covers PPEC center basic services as defined under section 144H.01, subdivision
2. PPEC basic services shall be reimbursed according to section 256B.86.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020, or upon federal approval,
whichever occurs later. The commissioner of human services shall notify the commissioner
of health and the revisor of statutes when federal approval is obtained.
new text end

Sec. 8.

new text begin [256B.0633] MINNESOTA EHB BENCHMARK PLAN.
new text end

new text begin Notwithstanding section 256B.0625, 256B.69, or any other law to the contrary, the
services covered for parents and caretakers and for a single adult without children who are
eligible for medical assistance under section 256B.055, subdivisions 3a and 15, shall be the
services covered under the Minnesota EHB Benchmark Plan for plan year 2016 or the
actuarial equivalent.
new text end

Sec. 9.

Minnesota Statutes 2018, section 256B.69, subdivision 4, is amended to read:

Subd. 4.

Limitation of choice.

(a) The commissioner shall develop criteria to determine
when limitation of choice may be implemented in the experimental counties. The criteria
shall ensure that all eligible individuals in the county have continuing access to the full
range of medical assistance services as specified in subdivision 6.

(b) The commissioner shall exempt the following persons from participation in the
project, in addition to those who do not meet the criteria for limitation of choice:

(1) persons eligible for medical assistance according to section 256B.055, subdivision
1;

(2) persons eligible for medical assistance due to blindness or disability as determined
by the Social Security Administration or the state medical review team, unless:

(i) they are 65 years of age or older; or

(ii) they reside in Itasca County or they reside in a county in which the commissioner
conducts a pilot project under a waiver granted pursuant to section 1115 of the Social
Security Act;

(3) recipients who currently have private coverage through a health maintenance
organization;

(4) recipients who are eligible for medical assistance by spending down excess income
for medical expenses other than the nursing facility per diem expense;

(5) recipients who receive benefits under the Refugee Assistance Program, established
under United States Code, title 8, section 1522(e);

(6) children who are both determined to be severely emotionally disturbed and receiving
case management services according to section 256B.0625, subdivision 20, except children
who are eligible for and who decline enrollment in an approved preferred integrated network
under section 245.4682;

(7) adults who are both determined to be seriously and persistently mentally ill and
received case management services according to section 256B.0625, subdivision 20;

(8) persons eligible for medical assistance according to section 256B.057, subdivision
10; deleted text begin and
deleted text end

(9) persons with access to cost-effective employer-sponsored private health insurance
or persons enrolled in a non-Medicare individual health plan determined to be cost-effective
according to section 256B.0625, subdivision 15 new text begin ; and
new text end

new text begin (10) persons who are absent from the state for more than 30 consecutive days but still
deemed a resident of Minnesota, identified in accordance with section 256B.056, subdivision
1, paragraph (b) new text end .

Children under age 21 who are in foster placement may enroll in the project on an elective
basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an elective
basis. The commissioner may enroll recipients in the prepaid medical assistance program
for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by spending
down excess income.

(c) The commissioner may allow persons with a one-month spenddown who are otherwise
eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay their monthly
spenddown to the state.

(d) The commissioner may require those individuals to enroll in the prepaid medical
assistance program who otherwise would have been excluded under paragraph (b), clauses
(1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.

(e) Before limitation of choice is implemented, eligible individuals shall be notified and
after notification, shall be allowed to choose only among demonstration providers. The
commissioner may assign an individual with private coverage through a health maintenance
organization, to the same health maintenance organization for medical assistance coverage,
if the health maintenance organization is under contract for medical assistance in the
individual's county of residence. After initially choosing a provider, the recipient is allowed
to change that choice only at specified times as allowed by the commissioner. If a
demonstration provider ends participation in the project for any reason, a recipient enrolled
with that provider must select a new provider but may change providers without cause once
more within the first 60 days after enrollment with the second provider.

(f) An infant born to a woman who is eligible for and receiving medical assistance and
who is enrolled in the prepaid medical assistance program shall be retroactively enrolled to
the month of birth in the same managed care plan as the mother once the child is enrolled
in medical assistance unless the child is determined to be excluded from enrollment in a
prepaid plan under this section.

Sec. 10.

Minnesota Statutes 2018, section 256B.69, subdivision 31, is amended to read:

Subd. 31.

Payment reduction.

(a) Beginning September 1, 2011, the commissioner
shall reduce payments and limit future rate increases paid to managed care plans and
county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved on a
statewide aggregate basis by program. The commissioner may use competitive bidding,
payment reductions, or other reductions to achieve the reductions and limits in this
subdivision.

(b) Beginning September 1, 2011, the commissioner shall reduce payments to managed
care plans and county-based purchasing plans as follows:

(1) 2.0 percent for medical assistance elderly basic care. This shall not apply to Medicare
cost-sharing, nursing facility, personal care assistance, and elderly waiver services;

(2) 2.82 percent for medical assistance families and children;

(3) 10.1 percent for medical assistance adults without children; and

(4) 6.0 percent for MinnesotaCare families and children.

(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed care
plans and county-based purchasing plans for calendar year 2012 to a percentage of the rates
in effect on August 31, 2011, as follows:

(1) 98 percent for medical assistance elderly basic care. This shall not apply to Medicare
cost-sharing, nursing facility, personal care assistance, and elderly waiver services;

(2) 97.18 percent for medical assistance families and children;

(3) 89.9 percent for medical assistance adults without children; and

(4) 94 percent for MinnesotaCare families and children.

(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit the
maximum annual trend increases to rates paid to managed care plans and county-based
purchasing plans as follows:

(1) 7.5 percent for medical assistance elderly basic care. This shall not apply to Medicare
cost-sharing, nursing facility, personal care assistance, and elderly waiver services;

(2) 5.0 percent for medical assistance special needs basic care;

(3) 2.0 percent for medical assistance families and children;

(4) 3.0 percent for medical assistance adults without children;

(5) 3.0 percent for MinnesotaCare families and children; and

(6) 3.0 percent for MinnesotaCare adults without children.

(e) The commissioner may limit trend increases to less than the maximum. Beginning
July 1, 2014, the commissioner shall limit the maximum annual trend increases to rates paid
to managed care plans and county-based purchasing plans as follows for calendar years
2014 and 2015:

(1) 7.5 percent for medical assistance elderly basic care. This shall not apply to Medicare
cost-sharing, nursing facility, personal care assistance, and elderly waiver services;

(2) 5.0 percent for medical assistance special needs basic care;

(3) 2.0 percent for medical assistance families and children;

(4) 3.0 percent for medical assistance adults without children;

(5) 3.0 percent for MinnesotaCare families and children; and

(6) 4.0 percent for MinnesotaCare adults without children.

new text begin (f) new text end The commissioner may limit trend increases to less than the maximum. For calendar
year 2014, the commissioner shall reduce the maximum aggregate trend increases by
$47,000,000 in state and federal funds to account for the reductions in administrative
expenses in subdivision 5i.

new text begin (g) Beginning July 1, 2019, the commissioner shall limit the maximum annual trend
increases to rates paid to managed care plans and county-based purchasing plans as follows
for calendar years 2020, 2021, 2023, and 2024:
new text end

new text begin (1) 4.0 percent for medical assistance elderly basic care. This shall not apply to Medicare
cost-sharing, nursing facility, personal care assistance, and elderly waiver services;
new text end

new text begin (2) 4.0 percent for medical assistance special needs basic care;
new text end

new text begin (3) 3.0 percent for medical assistance families and children; and
new text end

new text begin (4) 3.0 percent for medical assistance adults without children.
new text end

Sec. 11.

new text begin [256B.86] PRESCRIBED PEDIATRIC EXTENDED CARE (PPEC) CENTER
SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Reimbursement rates. new text end

new text begin The daily per-child payment rates for PPEC basic
services covered by medical assistance and provided at PPEC centers licensed under chapter
144H are:
new text end

new text begin (1) for intense complexity: $550 for four or more hours and $275 for less than four hours;
new text end

new text begin (2) for high complexity: $450 for four or more hours and $225 for less than four hours;
and
new text end

new text begin (3) for moderate complexity: $400 for four or more hours and $200 for less than four
hours.
new text end

new text begin Subd. 2. new text end

new text begin Determination of complexity level. new text end

new text begin Complexity level shall be determined
based on the level of nursing intervention required for each child using an assessment tool
approved by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020, or upon federal approval,
whichever occurs later. The commissioner of human services shall notify the revisor of
statutes when federal approval is obtained.
new text end

Sec. 12.

Minnesota Statutes 2018, section 256L.03, subdivision 5, is amended to read:

Subd. 5.

Cost-sharing.

(a) Co-payments, coinsurance, and deductibles do not apply to
children under the age of 21 and to American Indians as defined in Code of Federal
Regulations, title 42, section 600.5.

(b) The commissioner shall adjust co-payments, coinsurance, and deductibles for covered
services in a manner sufficient to maintain the actuarial value of the benefit to 94 percent new text begin
for families or individuals with incomes equal to or below 150 percent of the federal poverty
guidelines; and to 87 percent for families or individuals with incomes that are above 150
percent of the federal poverty guidelines and equal to or less than 200 percent of the federal
poverty guidelines for the applicable family size new text end . The cost-sharing changes described in
this paragraph do not apply to eligible recipients or services exempt from cost-sharing under
state law. The cost-sharing changes described in this paragraph shall not be implemented
prior to January 1, 2016.

(c) The cost-sharing changes authorized under paragraph (b) must satisfy the requirements
for cost-sharing under the Basic Health Program as set forth in Code of Federal Regulations,
title 42, sections 600.510 and 600.520.

Sec. 13.

Minnesota Statutes 2018, section 256L.03, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Minnesota EHB Benchmark Plan. new text end

new text begin Notwithstanding subdivisions 1, 2, 3, 3a,
and 3b, and section 256L.12, or any other law to the contrary, the services covered for
parents, caretakers, foster parents, or legal guardians and single adults without children
eligible for MinnesotaCare under section 256L.04 shall be the services covered under the
Minnesota EHB Benchmark Plan for plan year 2016 or the actuarial equivalent.
new text end

Sec. 14. new text begin CORRECTIVE PLAN TO ELIMINATE DUPLICATE PERSONAL
IDENTIFICATION NUMBERS.
new text end

new text begin (a) The commissioner of human services shall design and implement a corrective plan
to address the issue of medical assistance enrollees being assigned more than one personal
identification number. Any corrections or fixes that are necessary to address this issue are
required to be completed by June 30, 2021.
new text end

new text begin (b) By February 15, 2020, the commissioner shall submit a report to the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services policy and finance on the progress of the corrective plan required in paragraph
(a), including an update on meeting the June 30, 2021, deadline. The report must also include
information on:
new text end

new text begin (1) the number of medical assistance enrollees who have been assigned two or more
personal identification numbers;
new text end

new text begin (2) any possible financial effect of enrollees having duplicate personal identification
numbers on health care providers and managed care organizations, including the effect on
reimbursement rates, meeting withhold requirements, and capitated payments; and
new text end

new text begin (3) any effect on federal payments received by the state.
new text end

Sec. 15. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
QUALITY MEASURES FOR PRESCRIBED PEDIATRIC EXTENDED CARE
(PPEC) CENTERS.
new text end

new text begin (a) The commissioner of human services, in consultation with community stakeholders
as defined by the commissioner and PPEC centers licensed prior to June 30, 2024, shall
develop quality measures for PPEC centers, procedures for PPEC centers to report quality
measures to the commissioner, and methods for the commissioner to make the results of
the quality measures available to the public.
new text end

new text begin (b) The commissioner of human services shall submit by February 1, 2024, a report on
the topics described in paragraph (a) to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon the effective date of section 13.
new text end

Sec. 16. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 16A.724, subdivision 2; and 256B.0625, subdivision
31c, 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 3

OPERATIONS

Section 1.

Minnesota Statutes 2018, section 16A.055, subdivision 1a, is amended to read:

Subd. 1a.

Additional duties.

The commissioner may assist state agencies by providing
analytical, statistical new text begin , program evaluation using experimental or quasi-experimental design new text end ,
and organizational development services to state agencies in order to assist the agency to
achieve the agency's mission and to operate efficiently and effectively. new text begin For purposes of this
section, "experimental design" means a method of evaluating the impact of a service that
uses random assignment to assign participants into groups that respectively receive the
studied service and those that receive service as usual, so that any difference in outcomes
found at the end of the evaluation can be attributed to the studied service; and
"quasi-experimental design" means a method of evaluating the impact of a service that uses
strategies other than random assignment to establish statistically similar groups that
respectively receive the service and those that receive service as usual, so that any difference
in outcomes found at the end of the evaluation can be attributed to the studied service.
new text end

Sec. 2.

new text begin [245I.01] OFFICE OF INSPECTOR GENERAL.
new text end

new text begin Subdivision 1. new text end

new text begin Creation. new text end

new text begin A state Office of Inspector General is created.
new text end

new text begin Subd. 2. new text end

new text begin Director. new text end

new text begin (a) The office shall be under the direction of an inspector general
who shall be appointed by the governor, with the advice and consent of the senate, for a
term ending on June 30 of the sixth calendar year after appointment. Senate confirmation
of the inspector general shall be as provided by section 15.066. The inspector general shall
appoint deputies to serve in the office as necessary to fulfill the duties of the office. The
inspector general may delegate to a subordinate employee the exercise of a specified statutory
power or duty, subject to the control of the inspector general. Every delegation must be by
written order filed with the secretary of state.
new text end

new text begin (b) The inspector general shall be in the unclassified service, but may be removed only
for cause.
new text end

new text begin Subd. 3. new text end

new text begin Duties. new text end

new text begin The inspector general shall, in coordination with counties where
applicable:
new text end

new text begin (1) develop and maintain the licensing and regulatory functions related to hospitals,
boarding care homes, outpatient surgical centers, birthing centers, nursing homes, home
care agencies, supplemental nursing services agencies, hospice providers, housing with
services establishments, assisted living facilities, prescribed pediatric extended care centers,
and board and lodging establishments with special services consistent with chapters 144A,
144D, 144G, and 144H, and sections 144.50 to 144.58, 144.615, and 157.17;
new text end

new text begin (2) notwithstanding the requirement under section 144A.52, subdivision 1, that the
director of the Office of Health Facility Complaints be appointed by the commissioner of
health, assume the role of director of the Office of Health Facility Complaints;
new text end

new text begin (3) develop and maintain the licensing and regulatory functions related to adult day care,
child care and early education, children's residential facilities, foster care, home and
community-based services, independent living assistance for youth, outpatient mental health
clinics or centers, residential mental health treatment for adults, and substance use disorder
treatment consistent with chapters 245, 245A, 245D, 245F, 245G, 245H, 252, and 256;
new text end

new text begin (4) conduct background studies according to sections 144.058, 144A.476, 144A.62,
144A.754, and 157.17 and chapter 245C. For the purpose of completing background studies,
the inspector general shall have authority to access maltreatment data maintained by local
welfare agencies or agencies responsible for assessing or investigating reports under section
626.556, and names of substantiated perpetrators related to maltreatment of vulnerable
adults maintained by the commissioner of human services under section 626.557;
new text end

new text begin (5) develop and maintain the background study requirements consistent with chapter
245C;
new text end

new text begin (6) be responsible for ensuring the detection, prevention, investigation, and resolution
of fraudulent activities or behavior by applicants, recipients, providers, and other participants
in the human services programs administered by the Department of Human Services;
new text end

new text begin (7) require county agencies to identify overpayments, establish claims, and utilize all
available and cost-beneficial methodologies to collect and recover these overpayments in
the human services programs administered by the Department of Human Services; and
new text end

new text begin (8) develop, maintain, and administer the common entry point established on July 1,
2015, under section 626.557, subdivision 9.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

Sec. 3.

new text begin [245I.02] TRANSFER OF DUTIES.
new text end

new text begin Subdivision 1. new text end

new text begin Transfer and reorganization orders. new text end

new text begin (a) Section 15.039 applies to the
transfer of duties required by this chapter.
new text end

new text begin (b) For an employee affected by the transfer of duties required by this chapter, the
seniority accrued by the employee at the employee's former agency transfers to the employee's
new agency.
new text end

new text begin Subd. 2. new text end

new text begin Transfer of duties from the commissioner of human services. new text end

new text begin The
commissioner of administration, with approval of the governor, may issue reorganization
orders under section 16B.37 as necessary to carry out the transfer of duties of the
commissioner of human services required by this chapter. The provision of section 16B.37,
subdivision 1, stating that transfers under that section may be made only to an agency that
has been in existence for at least one year does not apply to transfers to an agency created
by this chapter.
new text end

new text begin Subd. 3. new text end

new text begin Transfer of duties from the commissioner of health. new text end

new text begin The commissioner of
administration, with approval of the governor, may issue reorganization orders under section
16B.37 as necessary to carry out the transfer of duties of the commissioner of health required
by this chapter. The provision of section 16B.37, subdivision 1, stating that transfers under
that section may be made only to an agency that has been in existence for at least one year
does not apply to transfers to an agency created by this chapter.
new text end

new text begin Subd. 4. new text end

new text begin Aggregate cost limit. new text end

new text begin The commissioner of management and budget must
ensure that the aggregate cost for the inspector general of the Office of Inspector General
is not more than the aggregate cost of the primary executives in the Office of Inspector
General at the Department of Human Services and the Health Regulation Division at the
Department of Health immediately before the effective date of subdivision 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Subdivisions 1, 2, and 4, are effective July 1, 2020. Subdivision
3 is effective July 1, 2022.
new text end

Sec. 4. new text begin INFORMATION TECHNOLOGY PROJECTS; PERFORMANCE
REQUIREMENT.
new text end

new text begin The commissioner of human services shall incorporate measurable indicators of progress
toward completion into every information technology project contract. The indicators of
progress toward completion must be periodic and at least measure progress for every 25
percent increment toward completion of the project. Every contract must withhold at least
ten percent of the total contract amount until the project is complete. The contract must
specify that in every instance where an indicator of progress toward completion is not met,
a specified proportion of the contract shall be withheld. The minimum amount withheld
shall be ten percent of the cumulative amount of the contract up to the date of the failure to
meet the indicator of progress toward completion. If an information technology project is
not completed on time according to the original contract, the commissioner shall reduce the
amount of the contract by ten percent.
new text end

Sec. 5. new text begin REDUCING APPROPRIATIONS FOR UNFILLED POSITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Reduction required. new text end

new text begin The general fund and nongeneral fund appropriations
to the Department of Human Services for agency operations for the biennium ending June
30, 2021, are reduced for salary and benefit amounts attributable to any positions that are
not filled within 180 days of the posting of the position. This section applies only to positions
that are posted in fiscal years 2019, 2020, and 2021. Reductions made under this section
must be reflected as reductions in agency base budgets for fiscal years 2022 and 2023.
new text end

new text begin Subd. 2. new text end

new text begin Reporting. new text end

new text begin The commissioner of management and budget must report to the
chairs and ranking minority members of the senate and the house of representatives health
and human services finance committees regarding the amount of reductions in appropriations
under this section.
new text end

Sec. 6. new text begin EVALUATION OF GRANT PROGRAMS; PROVEN-EFFECTIVE
PRACTICES.
new text end

new text begin (a) In consultation with the commissioner of management and budget, the commissioner
of human services shall establish a schedule to review the services delivered under grant
programs administered by the commissioner of human services to determine whether the
grant program prioritizes proven-effective or promising practices.
new text end

new text begin (b) In accordance with the schedule established in paragraph (a), the commissioner of
human services, in consultation with the commissioner of management and budget, shall
identify services to evaluate using an experimental or quasi-experimental design to provide
information needed to modify or develop grant programs to promote proven-effective
practices to improve the intended outcomes of the grant program.
new text end

new text begin (c) The commissioner of human services, in consultation with the commissioner of
management and budget, shall develop reports for the legislature and other stakeholders to
provide information on incorporating proven-effective practices in program and budget
decisions. The commissioner of management and budget, under Minnesota Statutes, section
15.08, may obtain additional relevant data to support the evaluation activities under this
section.
new text end

new text begin (d) For purposes of this section, the following terms have the meanings given:
new text end

new text begin (1) "proven-effective practice" means a service or practice that offers a high level of
research on effectiveness for at least one outcome of interest, as determined through multiple
evaluations outside of Minnesota or one or more local evaluation in Minnesota. The research
on effectiveness used to determine whether a service is proven-effective must use rigorously
implemented experimental or quasi-experimental designs; and
new text end

new text begin (2) "promising practices" means a service or practice that is supported by research
demonstrating effectiveness for at least one outcome of interest, and includes a single
evaluation that is not contradicted by other studies, but does not meet the full criteria for
the proven-effective designation. The research on effectiveness used to determine whether
a service is a promising practice must use rigorously implemented experimental or
quasi-experimental designs.
new text end

Sec. 7. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes, in consultation with staff from the House Research Department;
House Fiscal Analysis; the Office of Senate Counsel, Research, and Fiscal Analysis; and
the respective departments shall prepare legislation for introduction in the 2020 legislative
session proposing the statutory changes needed to implement the transfers of duties required
by sections 245I.01 and 245I.02.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2019.
new text end

ARTICLE 4

MNSURE

Section 1.

Minnesota Statutes 2018, section 62V.05, subdivision 2, is amended to read:

Subd. 2.

Operations funding.

deleted text begin (a) Prior to January 1, 2015, MNsure shall retain or collect
up to 1.5 percent of total premiums for individual and small group market health plans and
dental plans sold through MNsure to fund the cash reserves of MNsure, but the amount
collected shall not exceed a dollar amount equal to 25 percent of the funds collected under
section 62E.11, subdivision 6, for calendar year 2012.
deleted text end

deleted text begin (b) Beginning January 1, 2015, MNsure shall retain or collect up to 3.5 percent of total
premiums for individual and small group market health plans and dental plans sold through
MNsure to fund the operations of MNsure, but the amount collected shall not exceed a
dollar amount equal to 50 percent of the funds collected under section 62E.11, subdivision
6, for calendar year 2012.
deleted text end

deleted text begin (c) deleted text end new text begin (a) new text end Beginning January 1, 2016, new text begin through December 31, 2019, new text end MNsure shall retain or
collect up to 3.5 percent of total premiums for individual and small group market health
plans and dental plans sold through MNsure to fund the operations of MNsure, but the
amount collected may never exceed a dollar amount greater than 100 percent of the funds
collected under section 62E.11, subdivision 6, for calendar year 2012.

deleted text begin (d) For fiscal years 2014 and 2015, the commissioner of management and budget is
authorized to provide cash flow assistance of up to $20,000,000 from the special revenue
fund or the statutory general fund under section 16A.671, subdivision 3, paragraph (a), to
MNsure. Any funds provided under this paragraph shall be repaid, with interest, by June
30, 2015.
deleted text end

new text begin (b) Beginning January 1, 2020, MNsure shall retain or collect up to two percent of total
premiums for individual and small group health plans and dental plans sold through MNsure
to fund the operations of MNsure, but the amount collected may never exceed a dollar
amount greater than 25 percent of the funds collected under section 62E.11, subdivision 6,
for calendar year 2012.
new text end

deleted text begin (e) deleted text end new text begin (c) new text end Funding for the operations of MNsure shall cover any compensation provided to
navigators participating in the navigator program.

new text begin (d) Interagency agreements between MNsure and the Department of Human Services,
and the Public Assistance Cost Allocation Plan for the Department of Human Services,
shall not be modified to reflect any changes to the percentage of premiums that MNsure is
allowed to retain or collect under this section, and no additional funding shall be transferred
from the Department of Human Services to MNsure as a result of any changes to the
percentage of premiums that MNsure is allowed to retain or collect under this section.
new text end

Sec. 2.

Minnesota Statutes 2018, section 62V.05, subdivision 5, is amended to read:

Subd. 5.

Health carrier and health plan requirements; participation.

(a) Beginning
January 1, 2015, the board may establish certification requirements for health carriers and
health plans to be offered through MNsure that satisfy federal requirements under deleted text begin section
1311(c)(1) of the Affordable Care Act, Public Law 111-148 deleted text end new text begin United States Code, title 42,
section 18031(c)(1) new text end .

(b) Paragraph (a) does not apply if by June 1, 2013, the legislature enacts regulatory
requirements that:

(1) apply uniformly to all health carriers and health plans in the individual market;

(2) apply uniformly to all health carriers and health plans in the small group market; and

(3) satisfy minimum federal certification requirements under deleted text begin section 1311(c)(1) of the
Affordable Care Act, Public Law 111-148 deleted text end new text begin United States Code, title 42, section 18031(c)(1) new text end .

(c) In accordance with deleted text begin section 1311(e) of the Affordable Care Act, Public Law 111-148 deleted text end new text begin
United States Code, title 42, section 18031(e) new text end , the board shall establish policies and
procedures for certification and selection of health plans to be offered as qualified health
plans through MNsure. The board shall certify and select a health plan as a qualified health
plan to be offered through MNsure, if:

(1) the health plan meets the minimum certification requirements established in paragraph
(a) or the market regulatory requirements in paragraph (b);

(2) the board determines that making the health plan available through MNsure is in the
interest of qualified individuals and qualified employers;

(3) the health carrier applying to offer the health plan through MNsure also applies to
offer health plans at each actuarial value level and service area that the health carrier currently
offers in the individual and small group markets; and

(4) the health carrier does not apply to offer health plans in the individual and small
group markets through MNsure under a separate license of a parent organization or holding
company under section 60D.15, that is different from what the health carrier offers in the
individual and small group markets outside MNsure.

(d) In determining the interests of qualified individuals and employers under paragraph
(c), clause (2), the board may not exclude a health plan for any reason specified under deleted text begin section
1311(e)(1)(B) of the Affordable Care Act, Public Law 111-148 deleted text end new text begin United States Code, title
42, section 18031(e)(1)(B) new text end . deleted text begin The board may consider:
deleted text end

deleted text begin (1) affordability;
deleted text end

deleted text begin (2) quality and value of health plans;
deleted text end

deleted text begin (3) promotion of prevention and wellness;
deleted text end

deleted text begin (4) promotion of initiatives to reduce health disparities;
deleted text end

deleted text begin (5) market stability and adverse selection;
deleted text end

deleted text begin (6) meaningful choices and access;
deleted text end

deleted text begin (7) alignment and coordination with state agency and private sector purchasing strategies
and payment reform efforts; and
deleted text end

deleted text begin (8) other criteria that the board determines appropriate.
deleted text end

new text begin (e) A health plan that meets the minimum certification requirements under paragraph
(c) and United States Code, title 42, section 18031(c)(1), and any regulations and guidance
issued under that section, is deemed to be in the interest of qualified individuals and qualified
employers. The board shall not establish certification requirements for health carriers and
health plans for participation in MNsure that are in addition to the certification requirements
under paragraph (c) and United States Code, title 42, section 18031(c)(1), and any regulations
and guidance issued under that section. The board shall not determine the cost of, cost-sharing
elements of, or benefits provided in health plans sold through MNsure.
new text end

deleted text begin (e) deleted text end new text begin (f) new text end For qualified health plans offered through MNsure on or after January 1, 2015,
the board shall establish policies and procedures under paragraphs (c) and (d) for selection
of health plans to be offered as qualified health plans through MNsure by February 1 of
each year, beginning February 1, 2014. The board shall consistently and uniformly apply
all policies and procedures and any requirements, standards, or criteria to all health carriers
and health plans. For any policies, procedures, requirements, standards, or criteria that are
defined as rules under section 14.02, subdivision 4, the board may use the process described
in subdivision 9.

deleted text begin (f) For 2014, the board shall not have the power to select health carriers and health plans
for participation in MNsure. The board shall permit all health plans that meet the certification
requirements under section 1311(c)(1) of the Affordable Care Act, Public Law 111-148, to
be offered through MNsure.
deleted text end

(g) Under this subdivision, the board shall have the power to verify that health carriers
and health plans are properly certified to be eligible for participation in MNsure.

(h) The board has the authority to decertify health carriers and health plans that fail to
maintain compliance with deleted text begin section 1311(c)(1) of the Affordable Care Act, Public Law 111-148 deleted text end new text begin
United States Code, title 42, section 18031(c)(1) new text end .

(i) For qualified health plans offered through MNsure beginning January 1, 2015, health
carriers must use the most current addendum for Indian health care providers approved by
the Centers for Medicare and Medicaid Services and the tribes as part of their contracts with
Indian health care providers. MNsure shall comply with all future changes in federal law
with regard to health coverage for the tribes.

Sec. 3.

Minnesota Statutes 2018, section 62V.05, subdivision 10, is amended to read:

Subd. 10.

Limitations; risk-bearing.

(a) The board shall not bear insurance risk or enter
into any agreement with health care providers to pay claims.

(b) Nothing in this subdivision shall prevent MNsure from providing insurance for its
employees.

new text begin (c) The commissioner of human services shall not bear insurance risk or enter into any
agreement with providers to pay claims for any health coverage administered by the
commissioner that is made available for purchase through the MNsure website as a qualifying
health plan or as an alternative to purchasing a qualifying health plan through MNsure or
an individual health plan offered outside of MNsure.
new text end

new text begin (d) Nothing in this subdivision shall prohibit:
new text end

new text begin (1) the commissioner of human services from administering the medical assistance
program under chapter 256B and the MinnesotaCare program under chapter 256L, as long
as health coverage under these programs is not purchased by the individual through the
MNsure Web site; and
new text end

new text begin (2) employees of the Department of Human Services from obtaining insurance from the
state employee group insurance program.
new text end

Sec. 4.

Minnesota Statutes 2018, section 62V.08, is amended to read:

62V.08 REPORTS.

(a) MNsure shall submit a report to the legislature by January 15, 2015, and each January
15 thereafter, on: (1) the performance of MNsure operations; (2) meeting MNsure
responsibilities; (3) an accounting of MNsure budget activities; (4) practices and procedures
that have been implemented to ensure compliance with data practices laws, and a description
of any violations of data practices laws or procedures; and (5) the effectiveness of the
outreach and implementation activities of MNsure in reducing the rate of uninsurance.

(b) MNsure must publish its administrative and operational costs on a website to educate
consumers on those costs. The information published must include: (1) the amount of
premiums and federal premium subsidies collected; (2) the amount and source of revenue
received under section 62V.05, subdivision 1, paragraph (b), clause (3); (3) the amount and
source of any other fees collected for purposes of supporting operations; and (4) any misuse
of funds as identified in accordance with section 3.975. The website must be updated at
least annually.

new text begin (c) As part of the report required to be submitted to the legislature in paragraph (a), and
the information required to be published in paragraph (b), MNsure shall include the total
amount spent on business continuity planning, data privacy protection, and cyber security
provisions.
new text end

Sec. 5.

Laws 2015, chapter 71, article 12, section 8, is amended to read:

Sec. 8. EXPANDED ACCESS TO QUALIFIED HEALTH PLANS AND SUBSIDIES.

The commissioner of commerce, in consultation with the Board of Directors of MNsure
and the MNsure Legislative Oversight Committee, shall develop a proposal to allow
individuals to purchase qualified health plans outside of MNsure directly from health plan
companies and to allow eligible individuals to receive advanced premium tax credits and
cost-sharing reductions when purchasing these health plans. The commissioner shall seek
all federal waivers and approvals necessary to implement this proposal new text begin and shall submit the
necessary federal waivers and approvals to the federal government no later than October 1,
2019 new text end . The commissioner shall submit a draft proposal to the MNsure board and the MNsure
Legislative Oversight Committee deleted text begin at least 30 days before submitting a final proposal to the
federal government deleted text end new text begin no later than September 1, 2019, new text end and shall notify the board and legislative
oversight committee of any federal decision or action related to the proposal.

Sec. 6. new text begin MNSURE PROGRAM DEVELOPMENT.
new text end

new text begin No funds shall be appropriated to the Board of Directors of MNsure for new program
development until 834 EDI transmissions are being processed automatically and are
conveying accurate information without the intervention of manual reviews and processes.
new text end

Sec. 7. new text begin RATES FOR INDIVIDUAL MARKET HEALTH AND DENTAL PLANS
FOR 2020.
new text end

new text begin (a) Health carriers must take into account the reduction in the premium withhold
percentage under Minnesota Statutes, section 62V.05, subdivision 2, applicable beginning
in calendar year 2020 for individual market health plans and dental plans sold through
MNsure when setting rates for individual market health plans and dental plans for calendar
year 2020.
new text end

new text begin (b) For purposes of this section, "dental plan," "health carrier," "health plan," and
"individual market" have the meanings given in Minnesota Statutes, section 62V.02.
new text end

Sec. 8. new text begin REQUEST FOR INFORMATION ON A PRIVATIZED STATE-BASED
MARKETPLACE SYSTEM.
new text end

new text begin (a) The commissioner of human services, in consultation with the commissioners of
commerce and health, and interested stakeholders, shall develop a request for information
to consider the feasibility for a private vendor to provide the technology functionality for
the individual market currently provided by MNsure. The request shall seek options for a
privately run automated web-based broker system that provides certain core functions
including eligibility and enrollment functions, consumer outreach and assistance, and the
ability for consumers to compare and choose different qualified health plans. The system
must have the ability to integrate with the federal data hub and have account transfer
functionality to accept application handoffs compatible with the Medicaid and MinnesotaCare
eligibility and enrollment system maintained by the Department of Human Services.
new text end

new text begin (b) The commissioner shall report to the chairs and ranking minority members of the
legislative committees with jurisdiction over health insurance by February 15, 2020, the
results of the request for information and an analysis of the option for a privatized
marketplace, including estimated costs.
new text end

ARTICLE 5

MISCELLANEOUS

Section 1.

Minnesota Statutes 2018, section 62A.30, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Mammograms. new text end

new text begin (a) For purposes of subdivision 2, coverage for a preventive
mammogram screening (1) includes digital breast tomosynthesis for enrollees at risk for
breast cancer, and (2) is covered as a preventive item or service, as described under section
62Q.46.
new text end

new text begin (b) For purposes of this subdivision, "digital breast tomosynthesis" means a radiologic
procedure that involves the acquisition of projection images over the stationary breast to
produce cross-sectional digital three-dimensional images of the breast. "At risk for breast
cancer" means:
new text end

new text begin (1) having a family history with one or more first- or second-degree relatives with breast
cancer;
new text end

new text begin (2) testing positive for BRCA1 or BRCA2 mutations;
new text end

new text begin (3) having heterogeneously dense breasts or extremely dense breasts based on the Breast
Imaging Reporting and Data System established by the American College of Radiology; or
new text end

new text begin (4) having a previous diagnosis of breast cancer.
new text end

new text begin (c) This subdivision does not apply to coverage provided through a public health care
program under chapter 256B or 256L.
new text end

new text begin (d) Nothing in this subdivision limits the coverage of digital breast tomosynthesis in a
policy, plan, certificate, or contract referred to in subdivision 1 that is in effect prior to
January 1, 2020.
new text end

new text begin (e) Nothing in this subdivision prohibits a policy, plan, certificate, or contract referred
to in subdivision 1 from covering digital breast tomosynthesis for an enrollee who is not at
risk for breast cancer.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020, and applies to health
plans issued, sold, or renewed on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2018, section 148.59, is amended to read:

148.59 LICENSE RENEWAL; LICENSE AND REGISTRATION FEES.

A licensed optometrist shall pay to the state Board of Optometry a fee as set by the board
in order to renew a license as provided by board rule. No fees shall be refunded. Fees may
not exceed the following amounts but may be adjusted lower by board direction and are for
the exclusive use of the board:

(1) optometry licensure application, $160;

(2) optometry annual licensure renewal, deleted text begin $135 deleted text end new text begin $170 new text end ;

(3) optometry late penalty fee, $75;

(4) annual license renewal card, $10;

(5) continuing education provider application, $45;

(6) emeritus registration, $10;

(7) endorsement/reciprocity application, $160;

(8) replacement of initial license, $12; deleted text begin and
deleted text end

(9) license verification, $50 deleted text begin . deleted text end new text begin ;
new text end

new text begin (10) jurisprudence state examination, $75;
new text end

new text begin (11) Optometric Education Continuing Education data bank registration, $20; and
new text end

new text begin (12) data requests and labels, $50.
new text end

Sec. 3.

Minnesota Statutes 2018, section 148E.180, is amended to read:

148E.180 FEE AMOUNTS.

Subdivision 1.

Application fees.

new text begin Nonrefundable new text end application fees for licensure deleted text begin are as
follows deleted text end new text begin may not exceed the following amounts new text end :

(1) for a licensed social worker, deleted text begin $45 deleted text end new text begin $54 new text end ;

(2) for a licensed graduate social worker, deleted text begin $45 deleted text end new text begin $54 new text end ;

(3) for a licensed independent social worker, deleted text begin $45 deleted text end new text begin $54 new text end ;

(4) for a licensed independent clinical social worker, deleted text begin $45 deleted text end new text begin $54 new text end ;

(5) for a temporary license, $50; and

(6) for a licensure by endorsement, deleted text begin $85 deleted text end new text begin $92 new text end .

The fee for criminal background checks is the fee charged by the Bureau of Criminal
Apprehension. The criminal background check fee must be included with the application
fee as required according to section 148E.055.

Subd. 2.

License fees.

new text begin Nonrefundable new text end license fees deleted text begin are as follows deleted text end new text begin may not exceed the
following amounts but may be adjusted lower by board action new text end :

(1) for a licensed social worker, deleted text begin $81 deleted text end new text begin $97 new text end ;

(2) for a licensed graduate social worker, deleted text begin $144 deleted text end new text begin $172 new text end ;

(3) for a licensed independent social worker, deleted text begin $216 deleted text end new text begin $258 new text end ;

(4) for a licensed independent clinical social worker, deleted text begin $238.50 deleted text end new text begin $284 new text end ;

(5) for an emeritus inactive license, deleted text begin $43.20 deleted text end new text begin $51 new text end ;

(6) for an emeritus active license, one-half of the renewal fee specified in subdivision
3; and

(7) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.

If the licensee's initial license term is less or more than 24 months, the required license
fees must be prorated proportionately.

Subd. 3.

Renewal fees.

new text begin Nonrefundable new text end renewal fees for deleted text begin licensure are as follows deleted text end new text begin the
two-year renewal term may not exceed the following amounts but may be adjusted lower
by board action new text end :

(1) for a licensed social worker, deleted text begin $81 deleted text end new text begin $97 new text end ;

(2) for a licensed graduate social worker, deleted text begin $144 deleted text end new text begin $172 new text end ;

(3) for a licensed independent social worker, deleted text begin $216 deleted text end new text begin $258 new text end ; and

(4) for a licensed independent clinical social worker, deleted text begin $238.50 deleted text end new text begin $284 new text end .

Subd. 4.

Continuing education provider fees.

Continuing education provider fees are
deleted text begin as follows deleted text end new text begin the following nonrefundable amounts new text end :

(1) for a provider who offers programs totaling one to eight clock hours in a one-year
period according to section 148E.145, deleted text begin $50 deleted text end new text begin $60 new text end ;

(2) for a provider who offers programs totaling nine to 16 clock hours in a one-year
period according to section 148E.145, deleted text begin $100 deleted text end new text begin $120 new text end ;

(3) for a provider who offers programs totaling 17 to 32 clock hours in a one-year period
according to section 148E.145, deleted text begin $200 deleted text end new text begin $240 new text end ;

(4) for a provider who offers programs totaling 33 to 48 clock hours in a one-year period
according to section 148E.145, deleted text begin $400 deleted text end new text begin $480 new text end ; and

(5) for a provider who offers programs totaling 49 or more clock hours in a one-year
period according to section 148E.145, deleted text begin $600 deleted text end new text begin $720 new text end .

Subd. 5.

Late fees.

Late fees are deleted text begin as follows deleted text end new text begin the following nonrefundable amounts new text end :

(1) renewal late fee, one-fourth of the renewal fee specified in subdivision 3;

(2) supervision plan late fee, $40; and

(3) license late fee, $100 plus the prorated share of the license fee specified in subdivision
2 for the number of months during which the individual practiced social work without a
license.

Subd. 6.

License cards and wall certificates.

(a) The fee for a license card as specified
in section 148E.095 is $10.

(b) The fee for a license wall certificate as specified in section 148E.095 is $30.

Subd. 7.

Reactivation fees.

Reactivation fees are deleted text begin as follows deleted text end new text begin the following nonrefundable
amounts new text end :

(1) reactivation from a temporary leave or emeritus status, the prorated share of the
renewal fee specified in subdivision 3; and

(2) reactivation of an expired license, 1-1/2 times the renewal fees specified in subdivision
3.

Sec. 4.

Minnesota Statutes 2018, section 152.126, subdivision 6, is amended to read:

Subd. 6.

Access to reporting system data.

(a) Except as indicated in this subdivision,
the data submitted to the board under subdivision 4 is private data on individuals as defined
in section 13.02, subdivision 12, and not subject to public disclosure.

(b) Except as specified in subdivision 5, the following persons shall be considered
permissible users and may access the data submitted under subdivision 4 in the same or
similar manner, and for the same or similar purposes, as those persons who are authorized
to access similar private data on individuals under federal and state law:

(1) a prescriber or an agent or employee of the prescriber to whom the prescriber has
delegated the task of accessing the data, to the extent the information relates specifically to
a current patient, to whom the prescriber is:

(i) prescribing or considering prescribing any controlled substance;

(ii) providing emergency medical treatment for which access to the data may be necessary;

(iii) providing care, and the prescriber has reason to believe, based on clinically valid
indications, that the patient is potentially abusing a controlled substance; or

(iv) providing other medical treatment for which access to the data may be necessary
for a clinically valid purpose and the patient has consented to access to the submitted data,
and with the provision that the prescriber remains responsible for the use or misuse of data
accessed by a delegated agent or employee;

(2) a dispenser or an agent or employee of the dispenser to whom the dispenser has
delegated the task of accessing the data, to the extent the information relates specifically to
a current patient to whom that dispenser is dispensing or considering dispensing any
controlled substance and with the provision that the dispenser remains responsible for the
use or misuse of data accessed by a delegated agent or employee;

(3) a licensed pharmacist who is providing pharmaceutical care for which access to the
data may be necessary to the extent that the information relates specifically to a current
patient for whom the pharmacist is providing pharmaceutical care: (i) if the patient has
consented to access to the submitted data; or (ii) if the pharmacist is consulted by a prescriber
who is requesting data in accordance with clause (1);

(4) an individual who is the recipient of a controlled substance prescription for which
data was submitted under subdivision 4, or a guardian of the individual, parent or guardian
of a minor, or health care agent of the individual acting under a health care directive under
chapter 145C;

(5) personnel or designees of a health-related licensing board listed in section 214.01,
subdivision 2, or of the Emergency Medical Services Regulatory Board, assigned to conduct
a bona fide investigation of a complaint received by that board that alleges that a specific
licensee is impaired by use of a drug for which data is collected under subdivision 4, has
engaged in activity that would constitute a crime as defined in section 152.025, or has
engaged in the behavior specified in subdivision 5, paragraph (a);

(6) personnel of the board engaged in the collection, review, and analysis of controlled
substance prescription information as part of the assigned duties and responsibilities under
this section;

(7) authorized personnel of a vendor under contract with the state of Minnesota who are
engaged in the design, implementation, operation, and maintenance of the prescription
monitoring program as part of the assigned duties and responsibilities of their employment,
provided that access to data is limited to the minimum amount necessary to carry out such
duties and responsibilities, and subject to the requirement of de-identification and time limit
on retention of data specified in subdivision 5, paragraphs (d) and (e);

(8) federal, state, and local law enforcement authorities acting pursuant to a valid search
warrant;

(9) personnel of the Minnesota health care programs assigned to use the data collected
under this section to identify and manage recipients whose usage of controlled substances
may warrant restriction to a single primary care provider, a single outpatient pharmacy, and
a single hospital;

(10) personnel of the Department of Human Services assigned to access the data pursuant
to paragraph (i);

(11) personnel of the health professionals services program established under section
214.31, to the extent that the information relates specifically to an individual who is currently
enrolled in and being monitored by the program, and the individual consents to access to
that information. The health professionals services program personnel shall not provide this
data to a health-related licensing board or the Emergency Medical Services Regulatory
Board, except as permitted under section 214.33, subdivision 3.

For purposes of clause (4), access by an individual includes persons in the definition of
an individual under section 13.02; and

(12) personnel or designees of a health-related licensing board listed in section 214.01,
subdivision 2, assigned to conduct a bona fide investigation of a complaint received by that
board that alleges that a specific licensee is inappropriately prescribing controlled substances
as defined in this section.

(c) By July 1, 2017, every prescriber licensed by a health-related licensing board listed
in section 214.01, subdivision 2, practicing within this state who is authorized to prescribe
controlled substances for humans and who holds a current registration issued by the federal
Drug Enforcement Administration, and every pharmacist licensed by the board and practicing
within the state, shall register and maintain a user account with the prescription monitoring
program. Data submitted by a prescriber, pharmacist, or their delegate during the registration
application process, other than their name, license number, and license type, is classified
as private pursuant to section 13.02, subdivision 12.

(d) Only permissible users identified in paragraph (b), clauses (1), (2), (3), (6), (7), (9),
and (10), may directly access the data electronically. No other permissible users may directly
access the data electronically. If the data is directly accessed electronically, the permissible
user shall implement and maintain a comprehensive information security program that
contains administrative, technical, and physical safeguards that are appropriate to the user's
size and complexity, and the sensitivity of the personal information obtained. The permissible
user shall identify reasonably foreseeable internal and external risks to the security,
confidentiality, and integrity of personal information that could result in the unauthorized
disclosure, misuse, or other compromise of the information and assess the sufficiency of
any safeguards in place to control the risks.

(e) The board shall not release data submitted under subdivision 4 unless it is provided
with evidence, satisfactory to the board, that the person requesting the information is entitled
to receive the data.

(f) The board shall maintain a log of all persons who access the data for a period of at
least three years and shall ensure that any permissible user complies with paragraph deleted text begin (c) deleted text end new text begin (d) new text end
prior to attaining direct access to the data.

(g) Section 13.05, subdivision 6, shall apply to any contract the board enters into pursuant
to subdivision 2. A vendor shall not use data collected under this section for any purpose
not specified in this section.

(h) The board may participate in an interstate prescription monitoring program data
exchange system provided that permissible users in other states have access to the data only
as allowed under this section, and that section 13.05, subdivision 6, applies to any contract
or memorandum of understanding that the board enters into under this paragraph.

(i) With available appropriations, the commissioner of human services shall establish
and implement a system through which the Department of Human Services shall routinely
access the data for the purpose of determining whether any client enrolled in an opioid
treatment program licensed according to chapter 245A has been prescribed or dispensed a
controlled substance in addition to that administered or dispensed by the opioid treatment
program. When the commissioner determines there have been multiple prescribers or multiple
prescriptions of controlled substances, the commissioner shall:

(1) inform the medical director of the opioid treatment program only that the
commissioner determined the existence of multiple prescribers or multiple prescriptions of
controlled substances; and

(2) direct the medical director of the opioid treatment program to access the data directly,
review the effect of the multiple prescribers or multiple prescriptions, and document the
review.

If determined necessary, the commissioner of human services shall seek a federal waiver
of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section
2.34, paragraph (c), prior to implementing this paragraph.

(j) The board shall review the data submitted under subdivision 4 on at least a quarterly
basis and shall establish criteria, in consultation with the advisory task force, for referring
information about a patient to prescribers and dispensers who prescribed or dispensed the
prescriptions in question if the criteria are met.

new text begin (k) The board shall conduct random audits, on at least a quarterly basis, of electronic
access by permissible users, as identified in paragraph (b), clauses (1), (2), (3), (6), (7), (9),
and (10), to the data in subdivision 4, to ensure compliance with permissible use as defined
in this section. A permissible user whose account has been selected for a random audit shall
respond to an inquiry by the board, no later than 30 days after receipt of notice that an audit
is being conducted. Failure to respond may result in deactivation of access to the electronic
system and referral to the appropriate health licensing board, or the commissioner of human
services, for further action.
new text end

new text begin (l) A permissible user who has delegated the task of accessing the data in subdivision 4
to an agent or employee shall audit the use of the electronic system by delegated agents or
employees on at least a quarterly basis to ensure compliance with permissible use as defined
in this section. When a delegated agent or employee has been identified as inappropriately
accessing data, the permissible user must immediately remove access for that individual
and notify the board within seven days. The board shall notify all permissible users associated
with the delegated agent or employee of the alleged violation.
new text end

Sec. 5.

Minnesota Statutes 2018, section 525A.11, is amended to read:

525A.11 PERSONS THAT MAY RECEIVE ANATOMICAL GIFT; PURPOSE
OF ANATOMICAL GIFT.

(a) An anatomical gift may be made to the following persons named in the document
of gift:

(1) a hospital; accredited medical school, dental school, college, or university; organ
procurement organization; or nonprofit organization in medical education or research, for
research or education;

(2) subject to paragraph (b), an individual designated by the person making the anatomical
gift if the individual is the recipient of the part; and

(3) an eye bank or tissue bank.

(b) If an anatomical gift to an individual under paragraph (a), clause (2), cannot be
transplanted into the individual, the part passes in accordance with paragraph (g) in the
absence of an express, contrary indication by the person making the anatomical gift.

(c) If an anatomical gift of one or more specific parts or of all parts is made in a document
of gift that does not name a person described in paragraph (a) but identifies the purpose for
which an anatomical gift may be used, the following rules apply:

(1) if the part is an eye and the gift is for the purpose of transplantation or therapy, the
gift passes to the appropriate eye bank;

(2) if the part is tissue and the gift is for the purpose of transplantation or therapy, the
gift passes to the appropriate tissue bank;

(3) if the part is an organ and the gift is for the purpose of transplantation or therapy,
the gift passes to the appropriate organ procurement organization as custodian of the organ;
and

(4) if the part is an organ, an eye, or tissue and the gift is for the purpose of research or
education, the gift passes to the appropriate procurement organization.

(d) For the purpose of paragraph (c), if there is more than one purpose of an anatomical
gift set forth in the document of gift but the purposes are not set forth in any priority, the
gift must be used for transplantation or therapy, if suitable. If the gift cannot be used for
transplantation or therapy, the gift may be used for research or education.

(e) If an anatomical gift of one or more specific parts is made in a document of gift that
does not name a person described in paragraph (a) and does not identify the purpose of the
gift, the gift may be used only for transplantation or therapy, and the gift passes in accordance
with paragraph (g).

(f) If a document of gift specifies only a general intent to make an anatomical gift by
words such as "donor," "organ donor," or "body donor," or by a symbol or statement of
similar import, the gift may be used only for transplantation or therapy, and the gift passes
in accordance with paragraph (g).

(g) For purposes of paragraphs (b), (e), and (f), the following rules apply:

(1) if the part is an eye, the gift passes to the appropriate eye bank;

(2) if the part is tissue, the gift passes to the appropriate tissue bank; and

(3) if the part is an organ, the gift passes to the appropriate organ procurement
organization as custodian of the organ.

(h) An anatomical gift of an organ for transplantation or therapy, other than an anatomical
gift under paragraph (a), clause (2), passes to the organ procurement organization as custodian
of the organ.

(i) If an anatomical gift does not pass pursuant to paragraphs (a) to (h) or the decedent's
body or part is not used for transplantation, therapy, research, or education, custody of the
body or part passes to the person under obligation to dispose of the body or part.

(j) A person may not accept an anatomical gift if the person knows that the gift was not
effectively made under section 525A.05 or 525A.10 or if the person knows that the decedent
made a refusal under section 525A.07 that was not revoked. For purposes of this paragraph,
if a person knows that an anatomical gift was made on a document of gift, the person is
deemed to know of any amendment or revocation of the gift or any refusal to make an
anatomical gift on the same document of gift.

(k) Except as otherwise provided in paragraph (a), clause (2), nothing in this chapter
affects the allocation of organs for transplantation or therapy.

new text begin (l) For purposes of paragraphs (c), clauses (1) and (4), and (g), no gift of an eye or a part
of an eye shall be directly or indirectly processed by or distributed to a for profit entity, and
no gift shall be sold or distributed for profit.
new text end

Sec. 6. new text begin GUIDELINES AUTHORIZING PATIENT-ASSISTED MEDICATION
ADMINISTRATION IN EMERGENCIES.
new text end

new text begin (a) Within the limits of the board's available appropriation, the Emergency Medical
Services Regulatory Board shall propose guidelines authorizing EMTs, AEMTs, and
paramedics certified under Minnesota Statutes, section 144E.28, to assist a patient in
emergency situations with administering prescription medications that are:
new text end

new text begin (1) carried by a patient;
new text end

new text begin (2) intended to treat adrenal insufficiency or other rare conditions that require emergency
treatment with a previously prescribed medication;
new text end

new text begin (3) intended to treat a specific life-threatening condition; and
new text end

new text begin (4) administered via routes of delivery that are within the scope of training of the EMT,
AEMT, or paramedic.
new text end

new text begin (b) The Emergency Medical Services Regulatory Board shall submit the proposed
guidelines and draft legislation as necessary to the chairs and ranking minority members of
the legislative committees with jurisdiction over health care by January 1, 2020.
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 6

FORECAST ADJUSTMENT

Section 1. new text begin DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT. new text end

new text begin The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2017, First Special
Session chapter 6, article 18, from the general fund, or any other fund named, to the
commissioner of human services for the purposes specified in this article, to be available
for the fiscal year indicated for each purpose. The figure "2019" used in this article means
that the appropriations listed are available for the fiscal year ending June 30, 2019.
new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2019 new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin (318,423,000) new text end

new text begin Appropriations by Fund new text end
	new text begin 2019 new text end
new text begin General new text end	new text begin (317,538,000) new text end
new text begin Health Care Access new text end	new text begin 8,410,000 new text end
new text begin Federal TANF new text end	new text begin (9,295,000) new text end

new text begin Subd. 2. new text end new text begin Forecasted Programs new text end
new text begin (a) Minnesota Family Investment Program (MFIP)/Diversionary Work Program (DWP) new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin (19,361,000) new text end
new text begin Federal TANF new text end	new text begin (8,893,000) new text end

new text begin (b) MFIP Child Care Assistance new text end

new text begin (16,789,000) new text end

new text begin (c) General Assistance new text end

new text begin (7,928,000) new text end

new text begin (d) Minnesota Supplemental Aid new text end

new text begin (549,000) new text end

new text begin (e) Housing Support new text end

new text begin (13,836,000) new text end

new text begin (f) Northstar Care for Children new text end

new text begin (19,027,000) new text end

new text begin (g) MinnesotaCare new text end

new text begin 8,410,000 new text end

new text begin This appropriation is from the health care
access fund.
new text end

new text begin (h) Medical Assistance new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin (222,176,000) new text end
new text begin Health Care Access new text end	new text begin -0- new text end

new text begin (i) Alternative Care new text end

new text begin -0- new text end

new text begin (j) Consolidated Chemical Dependency Treatment Fund (CCDTF) Entitlement new text end

new text begin (17,872,000) new text end

new text begin Subd. 3. new text end new text begin Technical Activities new text end

new text begin (402,000) new text end

new text begin This appropriation is from the federal TANF
fund.
new text end

Sec. 3. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 and 2 are effective the day following final enactment.
new text end

ARTICLE 7

APPROPRIATIONS

Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS. new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the agencies
and for the purposes specified in this article. The appropriations are from the general fund,
or another named fund, and are available for the fiscal years indicated for each purpose.
The figures "2020" and "2021" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2020, or June 30, 2021, respectively.
"The first year" is fiscal year 2020. "The second year" is fiscal year 2021. "The biennium"
is fiscal years 2020 and 2021.
new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2020 new text end		new text begin 2021 new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin $ new text end

new text begin 8,039,269,000 new text end

new text begin $ new text end

new text begin 8,076,725,000 new text end

new text begin Appropriations by Fund new text end
	new text begin 2020 new text end	new text begin 2021 new text end
new text begin General new text end	new text begin 7,249,360,000 new text end	new text begin 7,282,307,000 new text end
new text begin State Government Special Revenue new text end	new text begin 4,299,000 new text end	new text begin 4,299,000 new text end
new text begin Health Care Access new text end	new text begin 513,192,000 new text end	new text begin 516,231,000 new text end
new text begin Federal TANF new text end	new text begin 270,522,000 new text end	new text begin 271,992,000 new text end
new text begin Lottery Prize new text end	new text begin 1,896,000 new text end	new text begin 1,896,000 new text end

new text begin (a) Office of Ombudsman for Long-Term
Care. $1,312,000 in fiscal year 2020 and
$1,501,000 in fiscal year 2021 are from the
general fund for nine additional regional
ombudsmen and one deputy director in the
Office of Ombudsman for Long-Term Care,
to perform the duties in Minnesota Statutes,
section 256.9742.
new text end

new text begin (b) Transfer to Office of Legislative
Auditor. $300,000 in fiscal year 2020 and
$300,000 in fiscal year 2021 are from the
general fund for transfer to the Office of the
Legislative Auditor for audit activities under
Minnesota Statutes, section 3.972, subdivision
2b.
new text end

new text begin (c) Transfer to Office of Legislative Auditor.
$400,000 in fiscal year 2020 and $400,000 in
fiscal year 2021 are from the general fund for
transfer to the Office of the Legislative
Auditor for audit activities under Minnesota
Statutes, section 3.972, subdivision 2a.
new text end

new text begin (d) Fetal Alcohol Spectrum Disorders
Grants. $250,000 in fiscal year 2020 and
$250,000 in fiscal year 2021 are from the
general fund for a grant under Minnesota
Statutes, section 254A.21, to a statewide
organization that focuses solely on prevention
of and intervention with fetal alcohol spectrum
disorders.
new text end

Sec. 3. new text begin COMMISSIONER OF HEALTH new text end

new text begin $ new text end

new text begin 222,424,000 new text end

new text begin $ new text end

new text begin 225,132,000 new text end

new text begin Appropriations by Fund new text end
	new text begin 2020 new text end	new text begin 2021 new text end
new text begin General new text end	new text begin 155,213,000 new text end	new text begin 155,946,000 new text end
new text begin State Government Special Revenue new text end	new text begin 56,290,000 new text end	new text begin 58,252,000 new text end
new text begin Health Care Access new text end	new text begin (792,000) new text end	new text begin (779,000) new text end
new text begin Federal TANF new text end	new text begin 11,713,000 new text end	new text begin 11,713,000 new text end

new text begin (a) Perinatal Hospice Grants. $500,000 in
fiscal year 2020 is from the general fund for
perinatal hospice development, training, and
awareness grants. Eligible entities may apply
for multiple grants. This is a onetime
appropriation and is available until June 30,
2023.
new text end

new text begin (b) Public Health Laboratory Equipment.
$840,000 in fiscal year 2020 and $655,000 in
fiscal year 2021 are from the general fund for
equipment for the public health laboratory.
This is a onetime appropriation and is
available until June 30, 2023.
new text end

new text begin (c) Statewide Tobacco Cessation. $1,598,000
in fiscal year 2020 and $2,748,000 in fiscal
year 2021 are from the general fund for
statewide tobacco cessation services under
Minnesota Statutes, section 144.397. The base
for this appropriation is $2,878,000 in fiscal
year 2022 and $2,878,000 in fiscal year 2023.
new text end

new text begin (d) Safe Harbor for Sexually Exploited
Youth. $470,000 in fiscal year 2020 and
$470,000 in fiscal year 2021 are from the
general fund for grants for comprehensive
services, including trauma-informed, culturally
specific services for sexually exploited youth
under Minnesota Statutes, section 145.4716.
new text end

new text begin (e) Safe Harbor for Sexually Exploited
Youth Evaluation. $5,000 in fiscal year 2020
and $5,000 in fiscal year 2021 are from the
general fund to the commissioner of health for
evaluation activities under Minnesota Statutes,
section 145.4718. The base appropriation
includes $45,000 in fiscal year 2020 and
$45,000 in fiscal year 2021 for evaluation
activities under Minnesota Statutes, section
145.4718.
new text end

new text begin (f) Safe Harbor for Sexually Exploited
Youth Training and Protocol
Implementation. $25,000 in fiscal year 2020
and $25,000 in fiscal year 2021 are from the
general fund to the commissioner of health for
training and protocol implementation.
new text end

new text begin (g) Study on Breastfeeding Disparities.
$79,000 in fiscal year 2020 is from the general
fund for a study on breastfeeding disparities.
The commissioner shall engage community
stakeholders in Minnesota including but not
limited to the Minnesota Breastfeeding
Coalition; the women, infants, and children
program; hospitals and clinics; local public
health professionals and organizations;
community-based organizations; and
representatives of populations with low
breastfeeding rates to carry out a study
identifying barriers, challenges, and successes
affecting initiation, duration, and exclusivity
of breastfeeding. The study shall address
policy, systemic, and environmental factors
that support and create barriers to
breastfeeding. The study shall identify and
make recommendations regarding culturally
appropriate practices that have been shown to
increase breastfeeding rates in populations that
have the greatest breastfeeding disparity rates.
A report on the study must be completed and
submitted to the chairs and ranking minority
members of the legislative committees with
jurisdiction over health care policy and finance
on or before September 15, 2020. This is a
onetime appropriation.
new text end

new text begin (h) Palliative Care Advisory Council.
$44,000 in fiscal year 2020 and $44,000 in
fiscal year 2021 are from the general fund for
the Palliative Care Advisory Council under
Minnesota Statutes, section 144.059. This is
a onetime appropriation.
new text end

new text begin (i) Study on the Increase in Abortions after
20 Weeks. $42,000 in fiscal year 2020 is from
the general fund for an evaluation of the
increase in abortions occurring after the
gestational age of 20 weeks and the reasons
for the increase. The commissioner shall report
the findings to the chairs and ranking minority
members of the legislative committees with
jurisdiction over health care policy and finance
by February 15, 2020. This is a onetime
appropriation.
new text end

new text begin (j) Positive Abortion Alternatives Grants.
$336,000 in fiscal year 2020 and $336,000 in
fiscal year 2021 are from the general fund for
the positive abortion alternatives grants under
Minnesota Statutes, section 145.4235.
new text end

Sec. 4. new text begin HEALTH-RELATED BOARDS new text end

new text begin $ new text end

new text begin 19,992,000 new text end

new text begin $ new text end

new text begin 20,092,000 new text end

new text begin $25,000 in fiscal year 2020 is appropriated
from the state government special revenue to
the Board of Pharmacy to implement the
random audits under Minnesota Statutes,
section 152.126, subdivision 6, paragraph (k).
This is a onetime appropriation.
new text end

Sec. 5. new text begin EMERGENCY MEDICAL SERVICES REGULATORY BOARD new text end

new text begin $ new text end

new text begin 4,588,000 new text end

new text begin $ new text end

new text begin 4,588,000 new text end

new text begin Regional Emergency Medical Services
Programs. $985,000 in fiscal year 2020 and
$985,000 in fiscal year 2021 are to be
deposited in the emergency medical services
system fund and distributed by the Emergency
Medical Services Regulatory Board according
to Minnesota Statutes, section 144E.50.
new text end

Sec. 6. new text begin COUNCIL ON DISABILITY new text end

new text begin $ new text end

new text begin 858,000 new text end

new text begin $ new text end

new text begin 860,000 new text end

Sec. 7. new text begin OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES new text end

new text begin $ new text end

new text begin 2,438,000 new text end

new text begin $ new text end

new text begin 2,438,000 new text end

Sec. 8. new text begin OMBUDSPERSONS FOR FAMILIES new text end

new text begin $ new text end

new text begin 467,000 new text end

new text begin $ new text end

new text begin 467,000 new text end

Sec. 9. new text begin COMMISSIONER OF MANAGEMENT AND BUDGET new text end

new text begin $ new text end

new text begin 498,000 new text end

new text begin $ new text end

new text begin 498,000 new text end

new text begin (a) By June 30, 2019, the commissioner shall
transfer $399,000,000 from the general fund
to the health care access fund. This is a
onetime transfer.
new text end

new text begin (b) By June 30, 2020, the commissioner shall
transfer $236,580,000 from the general fund
to the health care access fund. This is a
onetime transfer.
new text end

new text begin (c) By June 30, 2022, the commissioner shall
transfer $47,451,000 from the general fund to
the health care access fund. This is a onetime
transfer.
new text end

new text begin (d) Proven-Effective Practices Evaluation
Activities. $498,000 in fiscal year 2020 and
$498,000 in fiscal year 2021 are from the
general fund for evaluation activities under
article ..., section ....
new text end

Sec. 10. new text begin TRANSFERS.
new text end

new text begin Subdivision 1. new text end

new text begin Forecasted programs. new text end

new text begin The commissioner of human services, with the
approval of the commissioner of management and budget, may transfer unencumbered
appropriation balances for the biennium ending June 30, 2021, within fiscal years among
the MFIP, general assistance, medical assistance, MinnesotaCare, MFIP child care assistance
under Minnesota Statutes, section 119B.05, Minnesota supplemental aid program, housing
support, the entitlement portion of Northstar Care for Children under Minnesota Statutes,
chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment
fund, and between fiscal years of the biennium. The commissioner shall inform the chairs
and ranking minority members of the senate Health and Human Services Finance Committee
and the house of representatives Health and Human Services Finance Committee quarterly
about transfers made under this subdivision.
new text end

new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin Positions, salary money, and nonsalary administrative money
may be transferred within the Departments of Health and Human Services only to set up
and maintain accounting and budget systems with the advance approval of the commissioner
of management and budget. The commissioner shall inform the chairs and ranking minority
members of the senate Health and Human Services Finance Committee and the house of
representatives Health and Human Services Finance Committee quarterly about the transfers
made under this subdivision.
new text end

APPENDIX

Repealed Minnesota Statutes: S2452-1

16A.724 HEALTH CARE ACCESS FUND.

Subd. 2.

Transfers.

(a) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund, effective for the biennium beginning July 1, 2007, the commissioner of management and budget shall transfer the excess funds from the health care access fund to the general fund on June 30 of each year, provided that the amount transferred in fiscal year 2016 shall not exceed $48,000,000, the amount in fiscal year 2017 shall not exceed $122,000,000, and the amount in any fiscal biennium thereafter shall not exceed $244,000,000. The purpose of this transfer is to meet the rate increase required under Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision 6.

(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if necessary, the commissioner shall reduce these transfers from the health care access fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer sufficient funds from the general fund to the health care access fund to meet annual MinnesotaCare expenditures.

144.1464 SUMMER HEALTH CARE INTERNS.

Subdivision 1.

Summer internships.

The commissioner of health, through a contract with a nonprofit organization as required by subdivision 4, shall award grants, within available appropriations, to hospitals, clinics, nursing facilities, and home care providers to establish a secondary and postsecondary summer health care intern program. The purpose of the program is to expose interested secondary and postsecondary pupils to various careers within the health care profession.

Subd. 2.

Criteria.

(a) The commissioner, through the organization under contract, shall award grants to hospitals, clinics, nursing facilities, and home care providers that agree to:

(1) provide secondary and postsecondary summer health care interns with formal exposure to the health care profession;

(2) provide an orientation for the secondary and postsecondary summer health care interns;

(3) pay one-half the costs of employing the secondary and postsecondary summer health care intern;

(4) interview and hire secondary and postsecondary pupils for a minimum of six weeks and a maximum of 12 weeks; and

(5) employ at least one secondary student for each postsecondary student employed, to the extent that there are sufficient qualifying secondary student applicants.

(b) In order to be eligible to be hired as a secondary summer health intern by a hospital, clinic, nursing facility, or home care provider, a pupil must:

(1) intend to complete high school graduation requirements and be between the junior and senior year of high school; and

(2) be from a school district in proximity to the facility.

(c) In order to be eligible to be hired as a postsecondary summer health care intern by a hospital or clinic, a pupil must:

(1) intend to complete a health care training program or a two-year or four-year degree program and be planning on enrolling in or be enrolled in that training program or degree program; and

(2) be enrolled in a Minnesota educational institution or be a resident of the state of Minnesota; priority must be given to applicants from a school district or an educational institution in proximity to the facility.

(d) Hospitals, clinics, nursing facilities, and home care providers awarded grants may employ pupils as secondary and postsecondary summer health care interns beginning on or after June 15, 1993, if they agree to pay the intern, during the period before disbursement of state grant money, with money designated as the facility's 50 percent contribution towards internship costs.

Subd. 3.

Grants.

The commissioner, through the organization under contract, shall award separate grants to hospitals, clinics, nursing facilities, and home care providers meeting the requirements of subdivision 2. The grants must be used to pay one-half of the costs of employing secondary and postsecondary pupils in a hospital, clinic, nursing facility, or home care setting during the course of the program. No more than 50 percent of the participants may be postsecondary students, unless the program does not receive enough qualified secondary applicants per fiscal year. No more than five pupils may be selected from any secondary or postsecondary institution to participate in the program and no more than one-half of the number of pupils selected may be from the seven-county metropolitan area.

Subd. 4.

Contract.

The commissioner shall contract with a statewide, nonprofit organization representing facilities at which secondary and postsecondary summer health care interns will serve, to administer the grant program established by this section. Grant funds that are not used in one fiscal year may be carried over to the next fiscal year. The organization awarded the grant shall provide the commissioner with any information needed by the commissioner to evaluate the program, in the form and at the times specified by the commissioner.

144.1911 INTERNATIONAL MEDICAL GRADUATES ASSISTANCE PROGRAM.

Subdivision 1.

Establishment.

The international medical graduates assistance program is established to address barriers to practice and facilitate pathways to assist immigrant international medical graduates to integrate into the Minnesota health care delivery system, with the goal of increasing access to primary care in rural and underserved areas of the state.

Subd. 2.

Definitions.

(a) For the purposes of this section, the following terms have the meanings given.

(b) "Commissioner" means the commissioner of health.

(c) "Immigrant international medical graduate" means an international medical graduate who was born outside the United States, now resides permanently in the United States, and who did not enter the United States on a J1 or similar nonimmigrant visa following acceptance into a United States medical residency or fellowship program.

(d) "International medical graduate" means a physician who received a basic medical degree or qualification from a medical school located outside the United States and Canada.

(e) "Minnesota immigrant international medical graduate" means an immigrant international medical graduate who has lived in Minnesota for at least two years.

(f) "Rural community" means a statutory and home rule charter city or township that is outside the seven-county metropolitan area as defined in section 473.121, subdivision 2, excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.

(g) "Underserved community" means a Minnesota area or population included in the list of designated primary medical care health professional shortage areas, medically underserved areas, or medically underserved populations (MUPs) maintained and updated by the United States Department of Health and Human Services.

Subd. 3.

Program administration.

In administering the international medical graduates assistance program, the commissioner shall:

(1) provide overall coordination for the planning, development, and implementation of a comprehensive system for integrating qualified immigrant international medical graduates into the Minnesota health care delivery system, particularly those willing to serve in rural or underserved communities of the state;

(2) develop and maintain, in partnership with community organizations working with international medical graduates, a voluntary roster of immigrant international medical graduates interested in entering the Minnesota health workforce to assist in planning and program administration, including making available summary reports that show the aggregate number and distribution, by geography and specialty, of immigrant international medical graduates in Minnesota;

(3) work with graduate clinical medical training programs to address barriers faced by immigrant international medical graduates in securing residency positions in Minnesota, including the requirement that applicants for residency positions be recent graduates of medical school. The annual report required in subdivision 10 shall include any progress in addressing these barriers;

(4) develop a system to assess and certify the clinical readiness of eligible immigrant international medical graduates to serve in a residency program. The system shall include assessment methods, an operating plan, and a budget. Initially, the commissioner may develop assessments for clinical readiness for practice of one or more primary care specialties, and shall add additional assessments as resources are available. The commissioner may contract with an independent entity or another state agency to conduct the assessments. In order to be assessed for clinical readiness for residency, an eligible international medical graduate must have obtained a certification from the Educational Commission of Foreign Medical Graduates. The commissioner shall issue a Minnesota certificate of clinical readiness for residency to those who pass the assessment;

(5) explore and facilitate more streamlined pathways for immigrant international medical graduates to serve in nonphysician professions in the Minnesota workforce; and

(6) study, in consultation with the Board of Medical Practice and other stakeholders, changes necessary in health professional licensure and regulation to ensure full utilization of immigrant international medical graduates in the Minnesota health care delivery system. The commissioner shall include recommendations in the annual report required under subdivision 10, due January 15, 2017.

Subd. 4.

Career guidance and support services.

(a) The commissioner shall award grants to eligible nonprofit organizations to provide career guidance and support services to immigrant international medical graduates seeking to enter the Minnesota health workforce. Eligible grant activities include the following:

(1) educational and career navigation, including information on training and licensing requirements for physician and nonphysician health care professions, and guidance in determining which pathway is best suited for an individual international medical graduate based on the graduate's skills, experience, resources, and interests;

(2) support in becoming proficient in medical English;

(3) support in becoming proficient in the use of information technology, including computer skills and use of electronic health record technology;

(4) support for increasing knowledge of and familiarity with the United States health care system;

(5) support for other foundational skills identified by the commissioner;

(6) support for immigrant international medical graduates in becoming certified by the Educational Commission on Foreign Medical Graduates, including help with preparation for required licensing examinations and financial assistance for fees; and

(7) assistance to international medical graduates in registering with the program's Minnesota international medical graduate roster.

(b) The commissioner shall award the initial grants under this subdivision by December 31, 2015.

Subd. 5.

Clinical preparation.

(a) The commissioner shall award grants to support clinical preparation for Minnesota international medical graduates needing additional clinical preparation or experience to qualify for residency. The grant program shall include:

(1) proposed training curricula;

(2) associated policies and procedures for clinical training sites, which must be part of existing clinical medical education programs in Minnesota; and

(3) monthly stipends for international medical graduate participants. Priority shall be given to primary care sites in rural or underserved areas of the state, and international medical graduate participants must commit to serving at least five years in a rural or underserved community of the state.

(b) The policies and procedures for the clinical preparation grants must be developed by December 31, 2015, including an implementation schedule that begins awarding grants to clinical preparation programs beginning in June of 2016.

Subd. 6.

International medical graduate primary care residency grant program and revolving account.

(a) The commissioner shall award grants to support primary care residency positions designated for Minnesota immigrant physicians who are willing to serve in rural or underserved areas of the state. No grant shall exceed $150,000 per residency position per year. Eligible primary care residency grant recipients include accredited family medicine, internal medicine, obstetrics and gynecology, psychiatry, and pediatric residency programs. Eligible primary care residency programs shall apply to the commissioner. Applications must include the number of anticipated residents to be funded using grant funds and a budget. Notwithstanding any law to the contrary, funds awarded to grantees in a grant agreement do not lapse until the grant agreement expires. Before any funds are distributed, a grant recipient shall provide the commissioner with the following:

(1) a copy of the signed contract between the primary care residency program and the participating international medical graduate;

(2) certification that the participating international medical graduate has lived in Minnesota for at least two years and is certified by the Educational Commission on Foreign Medical Graduates. Residency programs may also require that participating international medical graduates hold a Minnesota certificate of clinical readiness for residency, once the certificates become available; and

(3) verification that the participating international medical graduate has executed a participant agreement pursuant to paragraph (b).

(b) Upon acceptance by a participating residency program, international medical graduates shall enter into an agreement with the commissioner to provide primary care for at least five years in a rural or underserved area of Minnesota after graduating from the residency program and make payments to the revolving international medical graduate residency account for five years beginning in their second year of postresidency employment. Participants shall pay $15,000 or ten percent of their annual compensation each year, whichever is less.

(c) A revolving international medical graduate residency account is established as an account in the special revenue fund in the state treasury. The commissioner of management and budget shall credit to the account appropriations, payments, and transfers to the account. Earnings, such as interest, dividends, and any other earnings arising from fund assets, must be credited to the account. Funds in the account are appropriated annually to the commissioner to award grants and administer the grant program established in paragraph (a). Notwithstanding any law to the contrary, any funds deposited in the account do not expire. The commissioner may accept contributions to the account from private sector entities subject to the following provisions:

(1) the contributing entity may not specify the recipient or recipients of any grant issued under this subdivision;

(2) the commissioner shall make public the identity of any private contributor to the account, as well as the amount of the contribution provided; and

(3) a contributing entity may not specify that the recipient or recipients of any funds use specific products or services, nor may the contributing entity imply that a contribution is an endorsement of any specific product or service.

Subd. 7.

Voluntary hospital programs.

A hospital may establish residency programs for foreign-trained physicians to become candidates for licensure to practice medicine in the state of Minnesota. A hospital may partner with organizations, such as the New Americans Alliance for Development, to screen for and identify foreign-trained physicians eligible for a hospital's particular residency program.

Subd. 8.

Board of Medical Practice.

Nothing in this section alters the authority of the Board of Medical Practice to regulate the practice of medicine.

Subd. 9.

Consultation with stakeholders.

The commissioner shall administer the international medical graduates assistance program, including the grant programs described under subdivisions 4, 5, and 6, in consultation with representatives of the following sectors:

(1) state agencies:

(i) Board of Medical Practice;

(ii) Office of Higher Education; and

(iii) Department of Employment and Economic Development;

(2) health care industry:

(i) a health care employer in a rural or underserved area of Minnesota;

(ii) a health plan company;

(iii) the Minnesota Medical Association;

(iv) licensed physicians experienced in working with international medical graduates; and

(v) the Minnesota Academy of Physician Assistants;

(3) community-based organizations:

(i) organizations serving immigrant and refugee communities of Minnesota;

(ii) organizations serving the international medical graduate community, such as the New Americans Alliance for Development and Women's Initiative for Self Empowerment; and

(iii) the Minnesota Association of Community Health Centers;

(4) higher education:

(i) University of Minnesota;

(ii) Mayo Clinic School of Health Professions;

(iii) graduate medical education programs not located at the University of Minnesota or Mayo Clinic School of Health Professions; and

(iv) Minnesota physician assistant education programs; and

(5) two international medical graduates.

Subd. 10.

Report.

The commissioner shall submit an annual report to the chairs and ranking minority members of the legislative committees with jurisdiction over health care and higher education on the progress of the integration of international medical graduates into the Minnesota health care delivery system. The report shall include recommendations on actions needed for continued progress integrating international medical graduates. The report shall be submitted by January 15 each year, beginning January 15, 2016.

256B.0625 COVERED SERVICES.

Subd. 31c.

Preferred incontinence product program.

The commissioner shall implement a preferred incontinence product program by July 1, 2018. The program shall require the commissioner to volume purchase incontinence products and related supplies in accordance with section 256B.04, subdivision 14. Medical assistance coverage for incontinence products and related supplies shall conform to the limitations established under the program.