SF 981

as introduced - 92nd Legislature (2021 - 2022) Posted on 07/30/2021 11:18am

A bill for an act
relating to health; appropriating money for the Department of Health, health
operations, and health-related boards, councils, and ombudsman; making health
policy changes to electronic health records, health care information exchange,
radiation hazard application fees, tests for infants for medical conditions, maternal
morbidity and death studies, fetal and infant death studies, and asbestos abatement;
amending Minnesota Statutes 2020, sections 62J.495, subdivisions 1, 2, 3, 4;
62J.498; 62J.4981; 62J.4982; 144.1205, subdivisions 2, 4, 8, 9, by adding a
subdivision; 144.125, subdivision 1; 145.901; 326.71, subdivision 4; 326.75,
subdivisions 1, 2, 3; Laws 2019, First Special Session chapter 9, article 14, section
3, as amended; proposing coding for new law in Minnesota Statutes, chapter 145.

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

ARTICLE 1

HEALTH AND HEALTH-BOARD APPROPRIATIONS

Section 1. new text begin 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 "2022" and "2023" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2022, or June 30, 2023, respectively.
"The first year" is fiscal year 2022. "The second year" is fiscal year 2023. "The biennium"
is fiscal years 2022 and 2023.
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 2022 new text end		new text begin 2023 new text end

Sec. 2. new text begin COMMISSIONER OF HEALTH 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 250,023,000 new text end

new text begin $ new text end

new text begin 249,704,000 new text end

new text begin Appropriations by Fund new text end
	new text begin 2022 new text end	new text begin 2023 new text end
new text begin General new text end	new text begin 132,347,000 new text end	new text begin 132,324,000 new text end
new text begin State Government Special Revenue new text end	new text begin 68,451,000 new text end	new text begin 68,835,000 new text end
new text begin Health Care Access new text end	new text begin 37,512,000 new text end	new text begin 36,832,000 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 The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end

new text begin Subd. 2. new text end new text begin Health Improvement new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 95,690,000 new text end	new text begin 95,877,000 new text end
new text begin State Government Special Revenue new text end	new text begin 9,140,000 new text end	new text begin 9,140,000 new text end
new text begin Health Care Access new text end	new text begin 37,512,000 new text end	new text begin 36,832,000 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) TANF Appropriations. (1) $3,579,000 in
fiscal year 2022 and $3,579,000 in fiscal year
2023 are from the TANF fund for home
visiting and nutritional services listed under
Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7). Funds must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1;
new text end

new text begin (2) $2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;
new text end

new text begin (3) $4,978,000 in fiscal year 2022 and
$4,978,000 in fiscal year 2023 are from the
TANF fund for the family home visiting grant
program according to Minnesota Statutes,
section 145A.17. $4,000,000 of the funding
in each fiscal year must be distributed to
community health boards according to
Minnesota Statutes, section 145A.131,
subdivision 1. $978,000 of the funding in each
fiscal year must be distributed to tribal
governments according to Minnesota Statutes,
section 145A.14, subdivision 2a;
new text end

new text begin (4) $1,156,000 in fiscal year 2022 and
$1,156,000 in fiscal year 2023 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and
new text end

new text begin (5) the commissioner may use up to 6.23
percent of the funds appropriated from the
TANF fund each fiscal year to conduct the
ongoing evaluations required under Minnesota
Statutes, section 145A.17, subdivision 7, and
training and technical assistance as required
under Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
new text end

new text begin (b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.
new text end

new text begin (c) new text begin Fetal and Infant Mortality Review. new text end
$311,000 in fiscal year 2022 and $311,000 in
fiscal year 2023 are appropriated from the
general fund to the commissioner of health to
be used to conduct fetal and infant mortality
reviews under Minnesota Statutes, section
145.9011.
new text end

new text begin (d) Maternal Morbidity and Death Studies.
$198,000 in fiscal year 2022 and $198,000 in
fiscal year 2023 are appropriated from the
general fund to the commissioner of health to
be used to conduct maternal morbidity and
death studies under Minnesota Statutes,
section 145.901.
new text end

new text begin (e) Transfer. The $77,000 transfer each year
from the state government special revenue
fund to the general fund as required by Laws
2008, chapter 364, section 17, paragraph (b),
is canceled effective June 30, 2021.
new text end

new text begin (f) MERC Program. The general fund
appropriation for distribution via the Medical
Education and Research Cost formula under
Minnesota Statutes, section 62J.692,
subdivision 4, is $0 in fiscal years 2022 and
2023.
new text end

new text begin (g) Base Level Adjustments. The general
fund base is $94,877,000 in fiscal year 2024
and $94,877,000 in fiscal year 2025. The state
government special revenue fund base is
$9,140,000 in fiscal year 2024 and $9,140,000
in fiscal year 2025. The health care access
fund base is $37,432,000 in fiscal year 2024
and $36,832,000 in fiscal year 2025.
new text end

new text begin Subd. 3. new text end new text begin Health Protection new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 25,087,000 new text end	new text begin 24,868,000 new text end
new text begin State Government Special Revenue new text end	new text begin 59,311,000 new text end	new text begin 59,695,000 new text end

new text begin Base Level Adjustments. The general fund
base is $24,868,000 in fiscal year 2024 and
$24,868,000 in fiscal year 2025. The state
government special revenue fund base is
$59,695,000 in fiscal year 2024 and
$59,695,000 in fiscal year 2025.
new text end

new text begin Subd. 4. new text end new text begin Health Operations new text end

new text begin 11,570,000 new text end

new text begin 11,579,000 new text end

Sec. 3. new text begin HEALTH-RELATED BOARDS 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 27,507,000 new text end

new text begin $ new text end

new text begin 26,943,000 new text end

new text begin Appropriations by Fund new text end
new text begin State Government Special Revenue new text end	new text begin 27,431,000 new text end	new text begin 26,867,000 new text end
new text begin Health Care Access new text end	new text begin 76,000 new text end	new text begin 76,000 new text end

new text begin This appropriation is from the state
government special revenue fund unless
specified otherwise. The amounts that may be
spent for each purpose are specified in the
following subdivisions.
new text end

new text begin Subd. 2. new text end new text begin Board of Chiropractic Examiners new text end

new text begin 666,000 new text end

new text begin 666,000 new text end

new text begin Subd. 3. new text end new text begin Board of Dentistry new text end

new text begin 4,228,000 new text end

new text begin 3,753,000 new text end

new text begin (a) Administrative Services Unit - Operating
Costs. Of this appropriation, $2,738,000 in
fiscal year 2022 and $2,263,000 in fiscal year
2023 are for operating costs of the
administrative services unit. The
administrative services unit may receive and
expend reimbursements for services it
performs for other agencies.
new text end

new text begin (b) Administrative Services Unit - Volunteer
Health Care Provider Program. Of this
appropriation, $150,000 in fiscal year 2022
and $150,000 in fiscal year 2023 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end

new text begin (c) Administrative Services Unit -
Retirement Costs. Of this appropriation,
$475,000 in fiscal year 2022 is a onetime
appropriation to the administrative services
unit to pay for the retirement costs of
health-related board employees. This funding
may be transferred to the health board
incurring retirement costs. Any board that has
an unexpended balance for an amount
transferred under this paragraph shall transfer
the unexpended amount to the administrative
services unit. These funds are available either
year of the biennium.
new text end

new text begin (d) Administrative Services Unit - Contested
Cases and Other Legal Proceedings. Of this
appropriation, $200,000 in fiscal year 2022
and $200,000 in fiscal year 2023 are for costs
of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards funded under
this section. Upon certification by a
health-related board to the administrative
services unit that costs will be incurred and
that there is insufficient money available to
pay for the costs out of money currently
available to that board, the administrative
services unit is authorized to transfer money
from this appropriation to the board for
payment of those costs with the approval of
the commissioner of management and budget.
The commissioner of management and budget
must require any board that has an unexpended
balance for an amount transferred under this
paragraph to transfer the unexpended amount
to the administrative services unit to be
deposited in the state government special
revenue fund.
new text end

new text begin Subd. 4. new text end new text begin Board of Dietetics and Nutrition Practice new text end

new text begin 164,000 new text end

new text begin 164,000 new text end

new text begin Subd. 5. new text end new text begin Board of Marriage and Family Therapy new text end

new text begin 406,000 new text end

new text begin 406,000 new text end

new text begin Subd. 6. new text end new text begin Board of Medical Practice new text end

new text begin 5,912,000 new text end

new text begin 5,868,000 new text end

new text begin Health Professional Services Program. This
appropriation includes $1,002,000 in fiscal
year 2022 and $1,002,000 in fiscal year 2023
for the health professional services program.
new text end

new text begin Subd. 7. new text end new text begin Board of Nursing new text end

new text begin 5,345,000 new text end

new text begin 5,355,000 new text end

new text begin Subd. 8. new text end new text begin Board of Executives for Long Term Services and Supports new text end

new text begin 693,000 new text end

new text begin 635,000 new text end

new text begin Subd. 9. new text end new text begin Board of Optometry new text end

new text begin 238,000 new text end

new text begin 238,000 new text end

new text begin Subd. 10. new text end new text begin Board of Pharmacy new text end

new text begin 4,479,000 new text end

new text begin 4,479,000 new text end

new text begin Appropriations by Fund new text end
new text begin State Government Special Revenue new text end	new text begin 4,403,000 new text end	new text begin 4,403,000 new text end
new text begin Health Care Access new text end	new text begin 76,000 new text end	new text begin 76,000 new text end

new text begin The base for this appropriation in the health
care access fund is $76,000 in fiscal year 2024,
$38,000 in fiscal year 2025, and $0 in fiscal
year 2026.
new text end

new text begin Subd. 11. new text end new text begin Board of Physical Therapy new text end

new text begin 564,000 new text end

new text begin 564,000 new text end

new text begin Subd. 12. new text end new text begin Board of Podiatric Medicine new text end

new text begin 214,000 new text end

new text begin 214,000 new text end

new text begin Subd. 13. new text end new text begin Board of Psychology new text end

new text begin 1,355,000 new text end

new text begin 1,355,000 new text end

new text begin Subd. 14. new text end new text begin Board of Social Work new text end

new text begin 1,556,000 new text end

new text begin 1,559,000 new text end

new text begin Subd. 15. new text end new text begin Board of Veterinary Medicine new text end

new text begin 363,000 new text end

new text begin 363,000 new text end

new text begin Subd. 16. new text end new text begin Board of Behavioral Health and Therapy new text end

new text begin 868,000 new text end

new text begin 868,000 new text end

new text begin Subd. 17. new text end new text begin Board of Occupational Therapy Practice new text end

new text begin 456,000 new text end

new text begin 456,000 new text end

Sec. 4. new text begin EMERGENCY MEDICAL SERVICES REGULATORY BOARD new text end

new text begin $ new text end

new text begin 3,803,000 new text end

new text begin $ new text end

new text begin 3,829,000 new text end

new text begin (a) Cooper/Sams Volunteer Ambulance
Program. $950,000 in fiscal year 2022 and
$950,000 in fiscal year 2023 are for the
Cooper/Sams volunteer ambulance program
under Minnesota Statutes, section 144E.40.
new text end

new text begin (1) Of this amount, $861,000 in fiscal year
2022 and $861,000 in fiscal year 2023 are for
the ambulance service personnel longevity
award and incentive program under Minnesota
Statutes, section 144E.40.
new text end

new text begin (2) Of this amount, $89,000 in fiscal year 2022
and $89,000 in fiscal year 2023 are for the
operations of the ambulance service personnel
longevity award and incentive program under
Minnesota Statutes, section 144E.40.
new text end

new text begin (b) EMSRB Operations. $1,880,000 in fiscal
year 2022 and $1,880,000 in fiscal year 2023
are for board operations.
new text end

new text begin (c) Regional Grants. $585,000 in fiscal year
2022 and $585,000 in fiscal year 2023 are for
regional emergency medical services
programs, to be distributed equally to the eight
emergency medical service regions under
Minnesota Statutes, section 144E.52.
new text end

new text begin (d) Ambulance Training Grant. $361,000
in fiscal year 2022 and $361,000 in fiscal year
2023 are for training grants under Minnesota
Statutes, section 144E.35.
new text end

Sec. 5. new text begin COUNCIL ON DISABILITY new text end

new text begin $ new text end

new text begin 1,022,000 new text end

new text begin $ new text end

new text begin 1,038,000 new text end

Sec. 6. new text begin OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES new text end

new text begin $ new text end

new text begin 2,487,000 new text end

new text begin $ new text end

new text begin 2,536,000 new text end

new text begin Department of Psychiatry Monitoring.
$100,000 in fiscal year 2022 and $100,000 in
fiscal year 2023 are for monitoring the
Department of Psychiatry at the University of
Minnesota.
new text end

Sec. 7. new text begin OMBUDSPERSONS FOR FAMILIES new text end

new text begin $ new text end

new text begin 733,000 new text end

new text begin $ new text end

new text begin 744,000 new text end

Sec. 8.

Laws 2019, First Special Session chapter 9, article 14, section 3, as amended by
Laws 2019, First Special Session chapter 12, section 6, is amended to read:

Sec. 3. COMMISSIONER OF HEALTH

Subdivision 1. Total Appropriation

$

231,829,000

$

deleted text begin 236,188,000 deleted text end new text begin 233,979,000 new text end

Appropriations by Fund
	2020	2021
General	124,381,000	126,276,000
State Government Special Revenue	58,450,000	deleted text begin 61,367,000 deleted text end new text begin 59,158,000 new text end
Health Care Access	37,285,000	36,832,000
Federal TANF	11,713,000	11,713,000

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2. Health Improvement

Appropriations by Fund
General	94,980,000	96,117,000
State Government Special Revenue	7,614,000	deleted text begin 7,558,000 deleted text end new text begin 6,924,000 new text end
Health Care Access	37,285,000	36,832,000
Federal TANF	11,713,000	11,713,000

(a) TANF Appropriations. (1) $3,579,000 in
fiscal year 2020 and $3,579,000 in fiscal year
2021 are from the TANF fund for home
visiting and nutritional services under
Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7). Funds must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1;

(2) $2,000,000 in fiscal year 2020 and
$2,000,000 in fiscal year 2021 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;

(3) $4,978,000 in fiscal year 2020 and
$4,978,000 in fiscal year 2021 are from the
TANF fund for the family home visiting grant
program under Minnesota Statutes, section
145A.17. $4,000,000 of the funding in each
fiscal year must be distributed to community
health boards according to Minnesota Statutes,
section 145A.131, subdivision 1. $978,000 of
the funding in each fiscal year must be
distributed to tribal governments according to
Minnesota Statutes, section 145A.14,
subdivision 2a;

(4) $1,156,000 in fiscal year 2020 and
$1,156,000 in fiscal year 2021 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and

(5) The commissioner may use up to 6.23
percent of the amounts appropriated from the
TANF fund each year to conduct the ongoing
evaluations required under Minnesota Statutes,
section 145A.17, subdivision 7, and training
and technical assistance as required under
Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.

(b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.

(c) Comprehensive Suicide Prevention.
$2,730,000 in fiscal year 2020 and $2,730,000
in fiscal year 2021 are from the general fund
for a comprehensive, community-based suicide
prevention strategy. The funds are allocated
as follows:

(1) $955,000 in fiscal year 2020 and $955,000
in fiscal year 2021 are for community-based
suicide prevention grants authorized in
Minnesota Statutes, section 145.56,
subdivision 2. Specific emphasis must be
placed on those communities with the greatest
disparities. The base for this appropriation is
$1,291,000 in fiscal year 2022 and $1,291,000
in fiscal year 2023;

(2) $683,000 in fiscal year 2020 and $683,000
in fiscal year 2021 are to support
evidence-based training for educators and
school staff and purchase suicide prevention
curriculum for student use statewide, as
authorized in Minnesota Statutes, section
145.56, subdivision 2. The base for this
appropriation is $913,000 in fiscal year 2022
and $913,000 in fiscal year 2023;

(3) $137,000 in fiscal year 2020 and $137,000
in fiscal year 2021 are to implement the Zero
Suicide framework with up to 20 behavioral
and health care organizations each year to treat
individuals at risk for suicide and support
those individuals across systems of care upon
discharge. The base for this appropriation is
$205,000 in fiscal year 2022 and $205,000 in
fiscal year 2023;

(4) $955,000 in fiscal year 2020 and $955,000
in fiscal year 2021 are to develop and fund a
Minnesota-based network of National Suicide
Prevention Lifeline, providing statewide
coverage. The base for this appropriation is
$1,321,000 in fiscal year 2022 and $1,321,000
in fiscal year 2023; and

(5) the commissioner may retain up to 18.23
percent of the appropriation under this
paragraph to administer the comprehensive
suicide prevention strategy.

(d) 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.

(e) Health Care Access Survey. $225,000 in
fiscal year 2020 and $225,000 in fiscal year
2021 are from the health care access fund to
continue and improve the Minnesota Health
Care Access Survey. These appropriations
may be used in either year of the biennium.

(f) Community Solutions for Healthy Child
Development Grant Program. $1,000,000
in fiscal year 2020 and $1,000,000 in fiscal
year 2021 are for the community solutions for
healthy child development grant program to
promote health and racial equity for young
children and their families under article 11,
section 107. The commissioner may use up to
23.5 percent of the total appropriation for
administration. The base for this appropriation
is $1,000,000 in fiscal year 2022, $1,000,000
in fiscal year 2023, and $0 in fiscal year 2024.

(g) Domestic Violence and Sexual Assault
Prevention Program. $375,000 in fiscal year
2020 and $375,000 in fiscal year 2021 are
from the general fund for the domestic
violence and sexual assault prevention
program under article 11, section 108. This is
a onetime appropriation.

(h) Skin Lightening Products Public
Awareness Grant Program. $100,000 in
fiscal year 2020 and $100,000 in fiscal year
2021 are from the general fund for a skin
lightening products public awareness and
education grant program. This is a onetime
appropriation.

(i) Cannabinoid Products Workgroup.
$8,000 in fiscal year 2020 is from the state
government special revenue fund for the
cannabinoid products workgroup. This is a
onetime appropriation.

(j) Base Level Adjustments. The general fund
base is $96,742,000 in fiscal year 2022 and
$96,742,000 in fiscal year 2023. The health
care access fund base is $37,432,000 in fiscal
year 2022 and $36,832,000 in fiscal year 2023.

Subd. 3. Health Protection

Appropriations by Fund
General	18,803,000	19,774,000
State Government Special Revenue	50,836,000	deleted text begin 53,809,000 deleted text end new text begin 52,234,000 new text end

(a) 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.

(b) Base Level Adjustment. The general fund
base is $19,119,000 in fiscal year 2022 and
$19,119,000 in fiscal year 2023. The state
government special revenue fund base is
$53,782,000 in fiscal year 2022 and
$53,782,000 in fiscal year 2023.

Subd. 4. Health Operations

10,598,000

10,385,000

Base Level Adjustment. The general fund
base is $10,912,000 in fiscal year 2022 and
$10,912,000 in fiscal year 2023.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment and
the reductions in subdivisions 1 to 3 are onetime reductions.
new text end

Sec. 9. new text begin TRANSFERS; HEALTH.
new text end

new text begin Positions, salary money, and nonsalary administrative money may be transferred within
the Department of Health as the commissioner considers necessary, with the advance
approval of the commissioner of management and budget. The commissioner shall inform
the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services finance quarterly about transfers made under this section.
new text end

Sec. 10. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end

new text begin The commissioner of health shall not use indirect cost allocations to pay for the
operational costs of any program for which they are responsible.
new text end

Sec. 11. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2023, unless a
different expiration date is explicit.
new text end

Sec. 12. new text begin EFFECTIVE DATE.
new text end

new text begin This article is effective July 1, 2021, unless a different effective date is specified.
new text end

ARTICLE 2

HEALTH POLICY

Section 1.

Minnesota Statutes 2020, section 62J.495, subdivision 1, is amended to read:

Subdivision 1.

Implementation.

The commissioner of health, in consultation with the
e-Health Advisory Committee, shall develop uniform standards to be used for the
interoperable electronic health records 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. deleted text begin The commissioner
shall include an update on standards development as part of an annual report to the legislature. deleted text end
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.

Sec. 2.

Minnesota Statutes 2020, section 62J.495, subdivision 2, is amended to read:

Subd. 2.

E-Health Advisory Committee.

(a) The commissioner shall establish an
e-Health Advisory Committee governed by section 15.059 to advise the commissioner on
the following matters:

(1) assessment of the adoption and effective use of health information technology by
the state, licensed health care providers and facilities, and local public health agencies;

(2) recommendations for implementing a statewide interoperable health information
infrastructure, to include estimates of necessary resources, and for determining standards
for clinical data exchange, clinical support programs, patient privacy requirements, and
maintenance of the security and confidentiality of individual patient data;

(3) recommendations for encouraging use of innovative health care applications using
information technology and systems to improve patient care and reduce the cost of care,
including applications relating to disease management and personal health management
that enable remote monitoring of patients' conditions, especially those with chronic
conditions; and

(4) other related issues as requested by the commissioner.

(b) The members of the e-Health Advisory Committee shall include the commissioners,
or commissioners' designees, of health, human services, administration, and commerce and
additional members to be appointed by the commissioner to include persons representing
Minnesota's local public health agencies, licensed hospitals and other licensed facilities and
providers, private purchasers, the medical and nursing professions, health insurers and health
plans, the state quality improvement organization, academic and research institutions,
consumer advisory organizations with an interest and expertise in health information
technology, and other stakeholders as identified by the commissioner to fulfill the
requirements of section 3013, paragraph (g), of the HITECH Act.

(c) deleted text begin The commissioner shall prepare and issue an annual report not later than January 30
of each year outlining progress to date in implementing a statewide health information
infrastructure and recommending action on policy and necessary resources to continue the
promotion of adoption and effective use of health information technology.
deleted text end

deleted text begin (d) deleted text end This subdivision expires June 30, 2021.

Sec. 3.

Minnesota Statutes 2020, section 62J.495, subdivision 3, is amended to read:

Subd. 3.

Interoperable electronic health record requirements.

(a) 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 deleted text begin state-certified deleted text end
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.

Sec. 4.

Minnesota Statutes 2020, section 62J.495, subdivision 4, is amended to read:

Subd. 4.

Coordination with national HIT activities.

(a) The commissioner, in
consultation with the e-Health Advisory Committee, shall update the statewide
implementation plan required under subdivision 2 and released June 2008, to be consistent
with the updated federal deleted text begin HIT Strategic Plan released by the Office of the National Coordinator
in accordance with section 3001 of the HITECH Act. The statewide plan shall meet the
requirements for a plan required under section 3013 of the HITECH Act deleted text end new text begin plans new text end .

(b) The commissioner, in consultation with the e-Health Advisory Committee, shall
work to ensure coordination between state, regional, and national efforts to support and
accelerate efforts to effectively use health information technology to improve the quality
and coordination of health care and the continuity of patient care among health care providers,
to reduce medical errors, to improve population health, to reduce health disparities, and to
reduce chronic disease. The commissioner's coordination efforts shall include but not be
limited to:

deleted text begin (1) assisting in the development and support of health information technology regional
extension centers established under section 3012(c) of the HITECH Act to provide technical
assistance and disseminate best practices;
deleted text end

deleted text begin (2) providing supplemental information to the best practices gathered by regional centers
to ensure that the information is relayed in a meaningful way to the Minnesota health care
community;
deleted text end

deleted text begin (3) deleted text end new text begin (1) new text end providing financial and technical support to Minnesota health care providers to
encourage implementation of admission, discharge and transfer alerts, and care summary
document exchange transactions and to evaluate the impact of health information technology
on cost and quality of care. Communications about available financial and technical support
shall include clear information about the interoperable health record requirements in
subdivision 1, including a separate statement in bold-face type clarifying the exceptions to
those requirements;

deleted text begin (4) deleted text end new text begin (2) new text end providing educational resources and technical assistance to health care providers
and patients related to state and national privacy, security, and consent laws governing
clinical health information, including the requirements in sections 144.291 to 144.298. In
carrying out these activities, the commissioner's technical assistance does not constitute
legal advice;

deleted text begin (5) deleted text end new text begin (3) new text end assessing Minnesota's legal, financial, and regulatory framework for health
information exchange, including the requirements in sections 144.291 to 144.298, and
making recommendations for modifications that would strengthen the ability of Minnesota
health care providers to securely exchange data in compliance with patient preferences and
in a way that is efficient and financially sustainable; and

deleted text begin (6) deleted text end new text begin (4) new text end seeking public input on both patient impact and costs associated with requirements
related to patient consent for release of health records for the purposes of treatment, payment,
and health care operations, as required in section 144.293, subdivision 2. The commissioner
shall provide a report to the legislature on the findings of this public input process no later
than February 1, 2017.

(c) The commissioner, in consultation with the e-Health Advisory Committee, shall
monitor national activity related to health information technology and shall coordinate
statewide input on policy development. The commissioner shall coordinate statewide
responses to proposed federal health information technology regulations in order to ensure
that the needs of the Minnesota health care community are adequately and efficiently
addressed in the proposed regulations. The commissioner's responses may include, but are
not limited to:

(1) reviewing and evaluating any standard, implementation specification, or certification
criteria proposed by the national HIT standards deleted text begin committee deleted text end new text begin committees new text end ;

(2) reviewing and evaluating policy proposed by deleted text begin the deleted text end national HIT policy deleted text begin committee deleted text end new text begin
committees new text end relating to the implementation of a nationwide health information technology
infrastructure; new text begin and
new text end

(3) deleted text begin monitoring and responding to activity related to the development of quality measures
and other measures as required by section 4101 of the HITECH Act. Any response related
to quality measures shall consider and address the quality efforts required under chapter
62U; and
deleted text end

deleted text begin (4) deleted text end monitoring and responding to national activity related to privacy, security, and data
stewardship of electronic health information and individually identifiable health information.

(d) To the extent that the state is either required or allowed to apply, or designate an
entity to apply for or carry out activities and programs deleted text begin under section 3013 of the HITECH
Act deleted text end , the commissioner of health, in consultation with the e-Health Advisory Committee
and the commissioner of human services, shall be the lead applicant or sole designating
authority. The commissioner shall make such designations consistent with the goals and
objectives of sections 62J.495 to 62J.497 and 62J.50 to 62J.61.

(e) The commissioner of human services shall apply for funding necessary to administer
the incentive payments to providers authorized under title IV of the American Recovery
and Reinvestment Act.

deleted text begin (f) The commissioner shall include in the report to the legislature information on the
activities of this subdivision and provide recommendations on any relevant policy changes
that should be considered in Minnesota.
deleted text end

Sec. 5.

Minnesota Statutes 2020, section 62J.498, is amended to read:

62J.498 HEALTH INFORMATION EXCHANGE.

Subdivision 1.

Definitions.

(a) The following definitions apply to sections 62J.498 to
62J.4982:

(b) "Clinical data repository" means a real time database that consolidates data from a
variety of clinical sources to present a unified view of a single patient and is used by a
deleted text begin state-certified deleted text end health information exchange service provider to enable health information
exchange among health care providers that are not related health care entities as defined in
section 144.291, subdivision 2, paragraph (k). This does not include clinical data that are
submitted to the commissioner for public health purposes required or permitted by law,
including any rules adopted by the commissioner.

(c) "Clinical transaction" means any meaningful use transaction or other health
information exchange transaction that is not covered by section 62J.536.

(d) "Commissioner" means the commissioner of health.

(e) "Health care provider" or "provider" means a health care provider or provider as
defined in section 62J.03, subdivision 8.

(f) "Health data intermediary" means an entity that provides the technical capabilities
or related products and services to enable health information exchange among health care
providers that are not related health care entities as defined in section 144.291, subdivision
2, paragraph (k). This includes but is not limited to health information service providers
(HISP), electronic health record vendors, and pharmaceutical electronic data intermediaries
as defined in section 62J.495.

(g) "Health information exchange" means the electronic transmission of health-related
information between organizations according to nationally recognized standards.

(h) "Health information exchange service provider" means a health data intermediary
or health information organization.

(i) "Health information organization" means an organization that oversees, governs, and
facilitates health information exchange among health care providers that are not related
health care entities as defined in section 144.291, subdivision 2, paragraph (k), to improve
coordination of patient care and the efficiency of health care delivery.

deleted text begin (j) "HITECH Act" means the Health Information Technology for Economic and Clinical
Health Act as defined in section 62J.495.
deleted text end

deleted text begin (k) deleted text end new text begin (j) new text end "Major participating entity" means:

(1) a participating entity that receives compensation for services that is greater than 30
percent of the health information organization's gross annual revenues from the health
information exchange service provider;

(2) a participating entity providing administrative, financial, or management services to
the health information organization, if the total payment for all services provided by the
participating entity exceeds three percent of the gross revenue of the health information
organization; and

(3) a participating entity that nominates or appoints 30 percent or more of the board of
directors or equivalent governing body of the health information organization.

deleted text begin (l) deleted text end new text begin (k) new text end "Master patient index" means an electronic database that holds unique identifiers
of patients registered at a care facility and is used by a deleted text begin state-certified deleted text end health information
exchange service provider to enable health information exchange among health care providers
that are not related health care entities as defined in section 144.291, subdivision 2, paragraph
(k). This does not include data that are submitted to the commissioner for public health
purposes required or permitted by law, including any rules adopted by the commissioner.

deleted text begin (m) "Meaningful use" means use of certified electronic health record technology to
improve quality, safety, and efficiency and reduce health disparities; engage patients and
families; improve care coordination and population and public health; and maintain privacy
and security of patient health information as established by the Centers for Medicare and
Medicaid Services and the Minnesota Department of Human Services pursuant to sections
4101, 4102, and 4201 of the HITECH Act.
deleted text end

deleted text begin (n) "Meaningful use transaction" means an electronic transaction that a health care
provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare
penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
deleted text end

deleted text begin (o) deleted text end new text begin (l) new text end "Participating entity" means any of the following persons, health care providers,
companies, or other organizations with which a health information organization deleted text begin or health
data intermediary deleted text end has contracts or other agreements for the provision of health information
exchange services:

(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home
licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise
licensed under the laws of this state or registered with the commissioner;

(2) a health care provider, and any other health care professional otherwise licensed
under the laws of this state or registered with the commissioner;

(3) a group, professional corporation, or other organization that provides the services of
individuals or entities identified in clause (2), including but not limited to a medical clinic,
a medical group, a home health care agency, an urgent care center, and an emergent care
center;

(4) a health plan as defined in section 62A.011, subdivision 3; and

(5) a state agency as defined in section 13.02, subdivision 17.

deleted text begin (p) deleted text end new text begin (m) new text end "Reciprocal agreement" means an arrangement in which two or more health
information exchange service providers agree to share in-kind services and resources to
allow for the pass-through of clinical transactions.

deleted text begin (q) "State-certified health data intermediary" means a health data intermediary that has
been issued a certificate of authority to operate in Minnesota.
deleted text end

deleted text begin (r) deleted text end new text begin (n) new text end "State-certified health information organization" means a health information
organization that has been issued a certificate of authority to operate in Minnesota.

Subd. 2.

Health information exchange oversight.

(a) The commissioner shall protect
the public interest on matters pertaining to health information exchange. The commissioner
shall:

(1) review and act on applications from deleted text begin health data intermediaries and deleted text end health information
organizations for certificates of authority to operate in Minnesota;

new text begin (2) require information to be provided as needed from health information exchange
service providers in order to meet requirements established under sections 62J.498 to
62J.4982;
new text end

deleted text begin (2) deleted text end new text begin (3) new text end provide ongoing monitoring to ensure compliance with criteria established under
sections 62J.498 to 62J.4982;

deleted text begin (3) deleted text end new text begin (4) new text end respond to public complaints related to health information exchange services;

deleted text begin (4) deleted text end new text begin (5) new text end take enforcement actions as necessary, including the imposition of fines,
suspension, or revocation of certificates of authority as outlined in section 62J.4982;

deleted text begin (5) deleted text end new text begin (6) new text end provide a biennial report on the status of health information exchange services
that includes but is not limited to:

(i) recommendations on actions necessary to ensure that health information exchange
services are adequate to meet the needs of Minnesota citizens and providers statewide;

(ii) recommendations on enforcement actions to ensure that health information exchange
service providers act in the public interest without causing disruption in health information
exchange services;

(iii) recommendations on updates to criteria for obtaining certificates of authority under
this section; and

(iv) recommendations on standard operating procedures for health information exchange,
including but not limited to the management of consumer preferences; and

deleted text begin (6) deleted text end new text begin (7) new text end other duties necessary to protect the public interest.

(b) As part of the application review process for certification under paragraph (a), prior
to issuing a certificate of authority, the commissioner shall:

(1) make all portions of the application classified as public data available to the public
for at least ten days while an application is under consideration. At the request of the
commissioner, the applicant shall participate in a public hearing by presenting an overview
of their application and responding to questions from interested parties; and

(2) consult with hospitals, physicians, and other providers prior to issuing a certificate
of authority.

(c) When the commissioner is actively considering a suspension or revocation of a
certificate of authority as described in section 62J.4982, subdivision 3, all investigatory data
that are collected, created, or maintained related to the suspension or revocation are classified
as confidential data on individuals and as protected nonpublic data in the case of data not
on individuals.

(d) The commissioner may disclose data classified as protected nonpublic or confidential
under paragraph (c) if disclosing the data will protect the health or safety of patients.

(e) After the commissioner makes a final determination regarding a suspension or
revocation of a certificate of authority, all minutes, orders for hearing, findings of fact,
conclusions of law, and the specification of the final disciplinary action, are classified as
public data.

Sec. 6.

Minnesota Statutes 2020, section 62J.4981, is amended to read:

62J.4981 CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH
INFORMATION EXCHANGE SERVICES.

Subdivision 1.

Authority to require organizations to apply.

The commissioner shall
require deleted text begin a health data intermediary or deleted text end a health information organization to apply for a
certificate of authority under this section. An applicant may continue to operate until the
commissioner acts on the application. If the application is denied, the applicant is considered
a health information exchange service provider whose certificate of authority has been
revoked under section 62J.4982, subdivision 2, paragraph (d).

deleted text begin Subd. 2. deleted text end

deleted text begin Certificate of authority for health data intermediaries. deleted text end

deleted text begin (a) A health data
intermediary must be certified by the state and comply with requirements established in this
section.
deleted text end

deleted text begin (b) Notwithstanding any law to the contrary, any corporation organized to do so may
apply to the commissioner for a certificate of authority to establish and operate as a health
data intermediary in compliance with this section. No person shall establish or operate a
health data intermediary in this state, nor sell or offer to sell, or solicit offers to purchase
or receive advance or periodic consideration in conjunction with a health data intermediary
contract unless the organization has a certificate of authority or has an application under
active consideration under this section.
deleted text end

deleted text begin (c) In issuing the certificate of authority, the commissioner shall determine whether the
applicant for the certificate of authority has demonstrated that the applicant meets the
following minimum criteria:
deleted text end

deleted text begin (1) hold reciprocal agreements with at least one state-certified health information
organization to access patient data, and for the transmission and receipt of clinical
transactions. Reciprocal agreements must meet the requirements established in subdivision
5; and
deleted text end

deleted text begin (2) participate in statewide shared health information exchange services as defined by
the commissioner to support interoperability between state-certified health information
organizations and state-certified health data intermediaries.
deleted text end

Subd. 3.

Certificate of authority for health information organizations.

(a) A health
information organization must obtain a certificate of authority from the commissioner and
demonstrate compliance with the criteria in paragraph (c).

(b) Notwithstanding any law to the contrary, an organization may apply for a certificate
of authority to establish and operate a health information organization under this section.
No person shall establish or operate a health information organization in this state, nor sell
or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in
conjunction with a health information organization or health information contract unless
the organization has a certificate of authority under this section.

(c) In issuing the certificate of authority, the commissioner shall determine whether the
applicant for the certificate of authority has demonstrated that the applicant meets the
following minimum criteria:

(1) the entity is a legally established organization;

(2) appropriate insurance, including liability insurance, for the operation of the health
information organization is in place and sufficient to protect the interest of the public and
participating entities;

(3) strategic and operational plans address governance, technical infrastructure, legal
and policy issues, finance, and business operations in regard to how the organization will
expand to support providers in achieving health information exchange goals over time;

(4) the entity addresses the parameters to be used with participating entities and other
health information exchange service providers for clinical transactions, compliance with
Minnesota law, and interstate health information exchange trust agreements;

(5) the entity's board of directors or equivalent governing body is composed of members
that broadly represent the health information organization's participating entities and
consumers;

(6) the entity maintains a professional staff responsible to the board of directors or
equivalent governing body with the capacity to ensure accountability to the organization's
mission;

(7) the organization is compliant with national certification and accreditation programs
designated by the commissioner;

(8) the entity maintains the capability to query for patient information based on national
standards. The query capability may utilize a master patient index, clinical data repository,
or record locator service as defined in section 144.291, subdivision 2, paragraph (j). The
entity must be compliant with the requirements of section 144.293, subdivision 8, when
conducting clinical transactions;

(9) the organization demonstrates interoperability with all other state-certified health
information organizations using nationally recognized standards;

(10) the organization demonstrates compliance with all privacy and security requirements
required by state and federal law; and

(11) the organization uses financial policies and procedures consistent with generally
accepted accounting principles and has an independent audit of the organization's financials
on an annual basis.

(d) Health information organizations that have obtained a certificate of authority must:

(1) meet the requirements established for connecting to the National eHealth Exchange;

(2) annually submit strategic and operational plans for review by the commissioner that
address:

(i) progress in achieving objectives included in previously submitted strategic and
operational plans across the following domains: business and technical operations, technical
infrastructure, legal and policy issues, finance, and organizational governance;

(ii) plans for ensuring the necessary capacity to support clinical transactions;

(iii) approach for attaining financial sustainability, including public and private financing
strategies, and rate structures;

(iv) rates of adoption, utilization, and transaction volume, and mechanisms to support
health information exchange; and

(v) an explanation of methods employed to address the needs of community clinics,
critical access hospitals, and free clinics in accessing health information exchange services;

(3) enter into reciprocal agreements with all other state-certified health information
organizations deleted text begin and state-certified health data intermediaries deleted text end to enable access to patient data,
and for the transmission and receipt of clinical transactions. Reciprocal agreements must
meet the requirements in subdivision 5;

(4) participate in statewide shared health information exchange services as defined by
the commissioner to support interoperability deleted text begin between state-certified health information
organizations and state-certified health data intermediaries deleted text end ; and

(5) comply with additional requirements for the certification or recertification of health
information organizations that may be established by the commissioner.

Subd. 4.

Application for certificate of authority for health information deleted text begin exchange
service providers deleted text end new text begin organizations new text end .

(a) Each application for a certificate of authority shall
be in a form prescribed by the commissioner and verified by an officer or authorized
representative of the applicant. Each application shall include the following in addition to
information described in the criteria in deleted text begin subdivisions 2 and deleted text end new text begin subdivision new text end 3:

(1) deleted text begin for health information organizations only, deleted text end a copy of the basic organizational document,
if any, of the applicant and of each major participating entity, such as the articles of
incorporation, or other applicable documents, and all amendments to it;

(2) deleted text begin for health information organizations only, deleted text end a list of the names, addresses, and official
positions of the following:

(i) all members of the board of directors or equivalent governing body, and the principal
officers and, if applicable, shareholders of the applicant organization; and

(ii) all members of the board of directors or equivalent governing body, and the principal
officers of each major participating entity and, if applicable, each shareholder beneficially
owning more than ten percent of any voting stock of the major participating entity;

(3) deleted text begin for health information organizations only, deleted text end the name and address of each participating
entity and the agreed-upon duration of each contract or agreement if applicable;

(4) a copy of each standard agreement or contract intended to bind the participating
entities and the health information deleted text begin exchange service provider deleted text end new text begin organization new text end . Contractual
provisions shall be consistent with the purposes of this section, in regard to the services to
be performed under the standard agreement or contract, the manner in which payment for
services is determined, the nature and extent of responsibilities to be retained by the health
information organization, and contractual termination provisions;

(5) a statement generally describing the health information deleted text begin exchange service provider deleted text end new text begin
organization new text end , its health information exchange contracts, facilities, and personnel, including
a statement describing the manner in which the applicant proposes to provide participants
with comprehensive health information exchange services;

(6) a statement reasonably describing the geographic area or areas to be served and the
type or types of participants to be served;

(7) a description of the complaint procedures to be used as required under this section;

(8) a description of the mechanism by which participating entities will have an opportunity
to participate in matters of policy and operation;

(9) a copy of any pertinent agreements between the health information organization and
insurers, including liability insurers, demonstrating coverage is in place;

(10) a copy of the conflict of interest policy that applies to all members of the board of
directors or equivalent governing body and the principal officers of the health information
organization; and

(11) other information as the commissioner may reasonably require to be provided.

(b) Within 45 days after the receipt of the application for a certificate of authority, the
commissioner shall determine whether or not the application submitted meets the
requirements for completion in paragraph (a), and notify the applicant of any further
information required for the application to be processed.

(c) Within 90 days after the receipt of a complete application for a certificate of authority,
the commissioner shall issue a certificate of authority to the applicant if the commissioner
determines that the applicant meets the minimum criteria requirements of subdivision 2 deleted text begin for
health data intermediaries or subdivision 3 for health information organizations deleted text end . If the
commissioner determines that the applicant is not qualified, the commissioner shall notify
the applicant and specify the reasons for disqualification.

(d) Upon being granted a certificate of authority to operate as a state-certified health
information organization deleted text begin or state-certified health data intermediary deleted text end , the organization must
operate in compliance with the provisions of this section. Noncompliance may result in the
imposition of a fine or the suspension or revocation of the certificate of authority according
to section 62J.4982.

Subd. 5.

Reciprocal agreements between health information deleted text begin exchange entities deleted text end new text begin
organizations new text end .

(a) Reciprocal agreements between two health information organizations
deleted text begin or between a health information organization and a health data intermediary deleted text end must include
a fair and equitable model for charges between the entities that:

(1) does not impede the secure transmission of clinical transactions;

(2) does not charge a fee for the exchange of deleted text begin meaningful use deleted text end transactions transmitted
according to nationally recognized standards where no additional value-added service is
rendered to the sending or receiving health information organization deleted text begin or health data
intermediary deleted text end either directly or on behalf of the client;

(3) is consistent with fair market value and proportionately reflects the value-added
services accessed as a result of the agreement; and

(4) prevents health care stakeholders from being charged multiple times for the same
service.

(b) Reciprocal agreements must include comparable quality of service standards that
ensure equitable levels of services.

(c) Reciprocal agreements are subject to review and approval by the commissioner.

(d) Nothing in this section precludes a state-certified health information organization deleted text begin or
state-certified health data intermediary deleted text end from entering into contractual agreements for the
provision of value-added services deleted text begin beyond meaningful use transactions deleted text end .

Sec. 7.

Minnesota Statutes 2020, section 62J.4982, is amended to read:

62J.4982 ENFORCEMENT AUTHORITY; COMPLIANCE.

Subdivision 1.

Penalties and enforcement.

(a) The commissioner may, for any violation
of statute or rule applicable to a health information deleted text begin exchange service provider deleted text end new text begin organization new text end ,
levy an administrative penalty in an amount up to $25,000 for each violation. In determining
the level of an administrative penalty, the commissioner shall consider the following factors:

(1) the number of participating entities affected by the violation;

(2) the effect of the violation on participating entities' access to health information
exchange services;

(3) if only one participating entity is affected, the effect of the violation on the patients
of that entity;

(4) whether the violation is an isolated incident or part of a pattern of violations;

(5) the economic benefits derived by the health information organization deleted text begin or a health data
intermediary deleted text end by virtue of the violation;

(6) whether the violation hindered or facilitated an individual's ability to obtain health
care;

(7) whether the violation was intentional;

(8) whether the violation was beyond the direct control of the health information deleted text begin exchange
service provider deleted text end new text begin organization new text end ;

(9) any history of prior compliance with the provisions of this section, including
violations;

(10) whether and to what extent the health information deleted text begin exchange service provider deleted text end new text begin
organization new text end attempted to correct previous violations;

(11) how the health information deleted text begin exchange service provider deleted text end new text begin organization new text end responded to
technical assistance from the commissioner provided in the context of a compliance effort;
and

(12) the financial condition of the health information deleted text begin exchange service provider deleted text end new text begin
organization new text end including deleted text begin , deleted text end but not limited to deleted text begin , deleted text end whether the health information deleted text begin exchange service
provider deleted text end new text begin organization new text end had financial difficulties that affected its ability to comply or whether
the imposition of an administrative monetary penalty would jeopardize the ability of the
health information deleted text begin exchange service provider deleted text end new text begin organization new text end to continue to deliver health
information exchange services.

The commissioner shall give reasonable notice in writing to the health information
deleted text begin exchange service provider deleted text end new text begin organization new text end of the intent to levy the penalty and the reasons for
it. A health information deleted text begin exchange service provider deleted text end new text begin organization new text end may have 15 days within
which to contest whether the facts found constitute a violation of sections 62J.4981 and
62J.4982, according to the contested case and judicial review provisions of sections 14.57
to 14.69.

(b) If the commissioner has reason to believe that a violation of section 62J.4981 or
62J.4982 has occurred or is likely, the commissioner may confer with the persons involved
before commencing action under subdivision 2. The commissioner may notify the health
information deleted text begin exchange service provider deleted text end new text begin organization new text end and the representatives, or other persons
who appear to be involved in the suspected violation, to arrange a voluntary conference
with the alleged violators or their authorized representatives. The purpose of the conference
is to attempt to learn the facts about the suspected violation and, if it appears that a violation
has occurred or is threatened, to find a way to correct or prevent it. The conference is not
governed by any formal procedural requirements, and may be conducted as the commissioner
considers appropriate.

(c) The commissioner may issue an order directing a health information deleted text begin exchange service
provider deleted text end new text begin organization new text end or a representative of a health information deleted text begin exchange service provider deleted text end new text begin
organization new text end to cease and desist from engaging in any act or practice in violation of sections
62J.4981 and 62J.4982.

(d) Within 20 days after service of the order to cease and desist, a health information
deleted text begin exchange service provider deleted text end new text begin organization new text end may contest whether the facts found constitute a
violation of sections 62J.4981 and 62J.4982 according to the contested case and judicial
review provisions of sections 14.57 to 14.69.

(e) In the event of noncompliance with a cease and desist order issued under this
subdivision, the commissioner may institute a proceeding to obtain injunctive relief or other
appropriate relief in Ramsey County District Court.

Subd. 2.

Suspension or revocation of certificates of authority.

(a) The commissioner
may suspend or revoke a certificate of authority issued to a deleted text begin health data intermediary or deleted text end
health information organization under section 62J.4981 if the commissioner finds that:

(1) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end is operating
significantly in contravention of its basic organizational document, or in a manner contrary
to that described in and reasonably inferred from any other information submitted under
section 62J.4981, unless amendments to the submissions have been filed with and approved
by the commissioner;

(2) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end is unable to fulfill its
obligations to furnish comprehensive health information exchange services as required
under its health information exchange contract;

(3) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end is no longer financially
solvent or may not reasonably be expected to meet its obligations to participating entities;

(4) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end has failed to implement
the complaint system in a manner designed to reasonably resolve valid complaints;

(5) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end , or any person acting
with its sanction, has advertised or merchandised its services in an untrue, misleading,
deceptive, or unfair manner;

(6) the continued operation of the health information deleted text begin exchange service provider deleted text end new text begin
organization new text end would be hazardous to its participating entities or the patients served by the
participating entities; or

(7) the health information deleted text begin exchange service provider deleted text end new text begin organization new text end has otherwise failed
to substantially comply with section 62J.4981 or with any other statute or administrative
rule applicable to health information exchange service providers, or has submitted false
information in any report required under sections 62J.498 to 62J.4982.

(b) A certificate of authority shall be suspended or revoked only after meeting the
requirements of subdivision 3.

(c) If the certificate of authority of a health information deleted text begin exchange service provider deleted text end new text begin
organization new text end is suspended, the health information deleted text begin exchange service provider deleted text end new text begin organization new text end
shall not, during the period of suspension, enroll any additional participating entities, and
shall not engage in any advertising or solicitation.

(d) If the certificate of authority of a health information deleted text begin exchange service provider deleted text end new text begin
organization new text end is revoked, the organization shall proceed, immediately following the effective
date of the order of revocation, to wind up its affairs, and shall conduct no further business
except as necessary to the orderly conclusion of the affairs of the organization. The
organization shall engage in no further advertising or solicitation. The commissioner may,
by written order, permit further operation of the organization as the commissioner finds to
be in the best interest of participating entities, to the end that participating entities will be
given the greatest practical opportunity to access continuing health information exchange
services.

Subd. 3.

Denial, suspension, and revocation; administrative procedures.

(a) When
the commissioner has cause to believe that grounds for the denial, suspension, or revocation
of a certificate of authority exist, the commissioner shall notify the health information
deleted text begin exchange service provider deleted text end new text begin organization new text end in writing stating the grounds for denial, suspension,
or revocation and setting a time within 20 days for a hearing on the matter.

(b) After a hearing before the commissioner at which the health information deleted text begin exchange
service provider deleted text end new text begin organization new text end may respond to the grounds for denial, suspension, or
revocation, or upon the failure of the health information exchange service provider to appear
at the hearing, the commissioner shall take action as deemed necessary and shall issue
written findings and mail them to the health information deleted text begin exchange service provider deleted text end new text begin
organization new text end .

(c) If suspension, revocation, or administrative penalty is proposed according to this
section, the commissioner must deliver, or send by certified mail with return receipt
requested, to the health information deleted text begin exchange service provider deleted text end new text begin organization new text end written notice
of the commissioner's intent to impose a penalty. This notice of proposed determination
must include:

(1) a reference to the statutory basis for the penalty;

(2) a description of the findings of fact regarding the violations with respect to which
the penalty is proposed;

(3) the nature and amount of the proposed penalty;

(4) any circumstances described in subdivision 1, paragraph (a), that were considered
in determining the amount of the proposed penalty;

(5) instructions for responding to the notice, including a statement of the health
information deleted text begin exchange service provider's deleted text end new text begin organization's new text end right to a contested case proceeding
and a statement that failure to request a contested case proceeding within 30 calendar days
permits the imposition of the proposed penalty; and

(6) the address to which the contested case proceeding request must be sent.

Subd. 4.

Coordination.

The commissioner shall, to the extent possible, seek the advice
of the Minnesota e-Health Advisory Committee, in the review and update of criteria for the
certification and recertification of health information deleted text begin exchange service providers deleted text end new text begin
organizations new text end when implementing sections 62J.498 to 62J.4982.

Subd. 5.

Fees and monetary penalties.

(a) The commissioner shall assess fees on every
health information deleted text begin exchange service provider deleted text end new text begin organization new text end subject to sections 62J.4981 and
62J.4982 as follows:

(1) filing an application for certificate of authority to operate as a health information
organization, $7,000; new text begin and
new text end

(2) deleted text begin filing an application for certificate of authority to operate as a health data intermediary,
$7,000;
deleted text end

deleted text begin (3) deleted text end annual health information organization certificate fee, $7,000 deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (4) annual health data intermediary certificate fee, $7,000.
deleted text end

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

(c) Administrative monetary penalties imposed under this subdivision shall be credited
to an account in the special revenue fund and are appropriated to the commissioner for the
purposes of sections 62J.498 to 62J.4982.

Sec. 8.

Minnesota Statutes 2020, section 144.1205, subdivision 2, is amended to read:

Subd. 2.

new text begin Initial and new text end annual fee.

new text begin (a) A licensee must pay an initial fee that is equivalent
to the annual fee upon issuance of the initial license.
new text end

new text begin (b) new text end A licensee must pay an annual fee at least 60 days before the anniversary date of the
issuance of the license. The annual fee is as follows:

TYPE		deleted text begin ANNUAL deleted text end new text begin LICENSE new text end FEE
Academic broad scope - type A new text begin , B, or C new text end		deleted text begin $19,920 deleted text end new text begin $25,896 new text end
deleted text begin Academic broad scope - type B deleted text end		deleted text begin 19,920 deleted text end
deleted text begin Academic broad scope - type C deleted text end		deleted text begin 19,920 deleted text end
new text begin Academic broad scope - type A, B, or C (4-8 locations) new text end		new text begin $31,075 new text end
new text begin Academic broad scope - type A, B, or C (9 or more locations) new text end		new text begin $36,254 new text end
Medical broad scope - type A		deleted text begin 19,920 deleted text end new text begin $25,896 new text end
new text begin Medical broad scope- type A (4-8 locations) new text end		new text begin $31,075 new text end
new text begin Medical broad scope- type A (9 or more locations) new text end		new text begin $36,254 new text end
deleted text begin Medical institution - diagnostic and therapeutic deleted text end		deleted text begin 3,680 deleted text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies new text end		new text begin $4,784 new text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies (4-8 locations) new text end		new text begin $5,740 new text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies (9 or more locations) new text end		new text begin $6,697 new text end
deleted text begin Medical institution - diagnostic (no written directives) deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Medical private practice - diagnostic and therapeutic deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Medical private practice - diagnostic (no written directives) deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Eye applicators deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Nuclear medical vans deleted text end		deleted text begin 3,680 deleted text end
deleted text begin High dose rate afterloader deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Mobile high dose rate afterloader deleted text end		deleted text begin 3,680 deleted text end
deleted text begin Medical therapy - other emerging technology deleted text end		deleted text begin 3,680 deleted text end
Teletherapy		deleted text begin 8,960 deleted text end new text begin $11,648 new text end
Gamma knife		deleted text begin 8,960 deleted text end new text begin $11,648 new text end
Veterinary medicine		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
In vitro testing lab		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
Nuclear pharmacy		deleted text begin 8,800 deleted text end new text begin $11,440 new text end
new text begin Nuclear pharmacy (5 or more locations) new text end		new text begin $13,728 new text end
Radiopharmaceutical distribution (10 CFR 32.72)		deleted text begin 3,840 deleted text end new text begin $4,992 new text end
Radiopharmaceutical processing and distribution (10 CFR 32.72)		deleted text begin 8,800 deleted text end new text begin $11,440 new text end
new text begin Radiopharmaceutical processing and distribution (10 CFR 32.72) (5 or more locations) new text end		new text begin $13,728 new text end
Medical sealed sources - distribution (10 CFR 32.74)		deleted text begin 3,840 deleted text end new text begin $4,992 new text end
Medical sealed sources - processing and distribution (10 CFR 32.74)		deleted text begin 8,800 deleted text end new text begin $11,440 new text end
new text begin Medical sealed sources - processing and distribution (10 CFR 32.74) (5 or more locations) new text end		new text begin $13,728 new text end
Well logging - sealed sources		deleted text begin 3,760 deleted text end new text begin $4,888 new text end
Measuring systems - new text begin ( new text end fixed gauge new text begin , portable gauge, gas chromatograph, other) new text end		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
deleted text begin Measuring systems - portable gauge deleted text end		deleted text begin 2,000 deleted text end
new text begin Measuring systems - (fixed gauge, portable gauge, gas chromatograph, other) (4-8 locations) new text end		new text begin $3,120 new text end
new text begin Measuring systems - (fixed gauge, portable gauge, gas chromatograph, other) (9 or more locations) new text end		new text begin $3,640 new text end
X-ray fluorescent analyzer		deleted text begin 1,520 deleted text end new text begin $1,976 new text end
deleted text begin Measuring systems - gas chromatograph deleted text end		deleted text begin 2,000 deleted text end
deleted text begin Measuring systems - other deleted text end		deleted text begin 2,000 deleted text end
deleted text begin Broad scope deleted text end Manufacturing and distribution - type A new text begin broad scope new text end		deleted text begin 19,920 deleted text end new text begin $25,896 new text end
new text begin Manufacturing and distribution - type A broad scope (4-8 locations) new text end		new text begin $31,075 new text end
new text begin Manufacturing and distribution - type A broad scope (9 or more locations) new text end		new text begin $36,254 new text end
deleted text begin Broad scope deleted text end Manufacturing and distribution - type B new text begin or C broad scope new text end		deleted text begin 17,600 deleted text end new text begin $22,880 new text end
deleted text begin Broad scope Manufacturing and distribution - type C deleted text end		deleted text begin 17,600 deleted text end
new text begin Manufacturing and distribution - type B or C broad scope (4-8 locations) new text end		new text begin $27,456 new text end
new text begin Manufacturing and distribution - type B or C broad scope (9 or more locations) new text end		new text begin $32,032 new text end
Manufacturing and distribution - other		deleted text begin 5,280 deleted text end new text begin $6,864 new text end
new text begin Manufacturing and distribution - other (4-8 locations) new text end		new text begin $8,236 new text end
new text begin Manufacturing and distribution - other (9 or more locations) new text end		new text begin $9,609 new text end
Nuclear laundry		deleted text begin 18,640 deleted text end new text begin $24,232 new text end
Decontamination services		deleted text begin 4,960 deleted text end new text begin $6,448 new text end
Leak test services only		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
Instrument calibration service only deleted text begin , less than 100 curies deleted text end		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
deleted text begin Instrument calibration service only, 100 curies or more deleted text end		deleted text begin 2,000 deleted text end
Service, maintenance, installation, source changes, etc.		deleted text begin 4,960 deleted text end new text begin $6,448 new text end
Waste disposal service, prepackaged only		deleted text begin 6,000 deleted text end new text begin $7,800 new text end
Waste disposal		deleted text begin 8,320 deleted text end new text begin $10,816 new text end
Distribution - general licensed devices (sealed sources)		deleted text begin 1,760 deleted text end new text begin $2,288 new text end
Distribution - general licensed material (unsealed sources)		deleted text begin 1,120 deleted text end new text begin $1,456 new text end
Industrial radiography - fixed new text begin or temporary new text end location		deleted text begin 9,840 deleted text end new text begin $12,792 new text end
deleted text begin Industrial radiography - temporary job sites deleted text end		deleted text begin 9,840 deleted text end
new text begin Industrial radiography - fixed or temporary location (5 or more locations) new text end		new text begin $16,629 new text end
Irradiators, self-shielding deleted text begin , less than 10,000 curies deleted text end		deleted text begin 2,880 deleted text end new text begin $3,744 new text end
Irradiators, other, less than 10,000 curies		deleted text begin 5,360 deleted text end new text begin $6,968 new text end
deleted text begin Irradiators, self-shielding, 10,000 curies or more deleted text end		deleted text begin 2,880 deleted text end
Research and development - type A new text begin , B, or C new text end broad scope		deleted text begin 9,520 deleted text end new text begin $12,376 new text end
deleted text begin Research and development - type B broad scope deleted text end		deleted text begin 9,520 deleted text end
deleted text begin Research and development - type C broad scope deleted text end		deleted text begin 9,520 deleted text end
new text begin Research and development - type A, B, or C broad scope (4-8 locations) new text end		new text begin $14,851 new text end
new text begin Research and development - type A, B, or C broad scope (9 or more locations) new text end		new text begin $17,326 new text end
Research and development - other		deleted text begin 4,480 deleted text end new text begin $5,824 new text end
Storage - no operations		deleted text begin 2,000 deleted text end new text begin $2,600 new text end
Source material - shielding		deleted text begin 584 deleted text end new text begin $759 new text end
Special nuclear material plutonium - neutron source in device		deleted text begin 3,680 deleted text end new text begin $4,784 new text end
Pacemaker by-product and/or special nuclear material - medical (institution)		deleted text begin 3,680 deleted text end new text begin $4,784 new text end
Pacemaker by-product and/or special nuclear material - manufacturing and distribution		deleted text begin 5,280 deleted text end new text begin $6,864 new text end
Accelerator-produced radioactive material		deleted text begin 3,840 deleted text end new text begin $4,992 new text end
Nonprofit educational institutions		deleted text begin 300 deleted text end new text begin $500 new text end
deleted text begin General license registration deleted text end		deleted text begin 150 deleted text end

Sec. 9.

Minnesota Statutes 2020, section 144.1205, subdivision 4, is amended to read:

Subd. 4.

new text begin Initial and renewal new text end application fee.

A licensee must pay an new text begin initial and a
renewal new text end application fee deleted text begin as follows: deleted text end new text begin according to this subdivision.
new text end

TYPE	APPLICATION FEE
Academic broad scope - type A new text begin , B, or C new text end		deleted text begin $ 5,920 deleted text end new text begin $6,808 new text end
deleted text begin Academic broad scope - type B deleted text end		deleted text begin 5,920 deleted text end
deleted text begin Academic broad scope - type C deleted text end		deleted text begin 5,920 deleted text end
Medical broad scope - type A		deleted text begin 3,920 deleted text end new text begin $4,508 new text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies new text end		new text begin $1,748 new text end
deleted text begin Medical institution - diagnostic and therapeutic deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Medical institution - diagnostic (no written directives) deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Medical private practice - diagnostic and therapeutic deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Medical private practice - diagnostic (no written directives) deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Eye applicators deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Nuclear medical vans deleted text end		deleted text begin 1,520 deleted text end
deleted text begin High dose rate afterloader deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Mobile high dose rate afterloader deleted text end		deleted text begin 1,520 deleted text end
deleted text begin Medical therapy - other emerging technology deleted text end		deleted text begin 1,520 deleted text end
Teletherapy		deleted text begin 5,520 deleted text end new text begin $6,348 new text end
Gamma knife		deleted text begin 5,520 deleted text end new text begin $6,348 new text end
Veterinary medicine		deleted text begin 960 deleted text end new text begin $1,104 new text end
In vitro testing lab		deleted text begin 960 deleted text end new text begin $1,104 new text end
Nuclear pharmacy		deleted text begin 4,880 deleted text end new text begin $5,612 new text end
Radiopharmaceutical distribution (10 CFR 32.72)		deleted text begin 2,160 deleted text end new text begin $2,484 new text end
Radiopharmaceutical processing and distribution (10 CFR 32.72)		deleted text begin 4,880 deleted text end new text begin $5,612 new text end
Medical sealed sources - distribution (10 CFR 32.74)		deleted text begin 2,160 deleted text end new text begin $2,484 new text end
Medical sealed sources - processing and distribution (10 CFR 32.74)		deleted text begin 4,880 deleted text end new text begin $5,612 new text end
Well logging - sealed sources		deleted text begin 1,600 deleted text end new text begin $1,840 new text end
Measuring systems - new text begin ( new text end fixed gauge new text begin , portable gauge, gas chromatograph, other) new text end		deleted text begin 960 deleted text end new text begin $1,104 new text end
deleted text begin Measuring systems - portable gauge deleted text end		deleted text begin 960 deleted text end
X-ray fluorescent analyzer		deleted text begin 584 deleted text end new text begin $671 new text end
deleted text begin Measuring systems - gas chromatograph deleted text end		deleted text begin 960 deleted text end
deleted text begin Measuring systems - other deleted text end		deleted text begin 960 deleted text end
deleted text begin Broad scope deleted text end Manufacturing and distribution - type A new text begin , B, and C broad scope new text end		deleted text begin 5,920 deleted text end new text begin $6,854 new text end
deleted text begin Broad scope manufacturing and distribution - type B deleted text end		deleted text begin 5,920 deleted text end
deleted text begin Broad scope manufacturing and distribution - type C deleted text end		deleted text begin 5,920 deleted text end
Manufacturing and distribution - other		deleted text begin 2,320 deleted text end new text begin $2,668 new text end
Nuclear laundry		deleted text begin 10,080 deleted text end new text begin $11,592 new text end
Decontamination services		deleted text begin 2,640 deleted text end new text begin $3,036 new text end
Leak test services only		deleted text begin 960 deleted text end new text begin $1,104 new text end
Instrument calibration service only deleted text begin , less than 100 curies deleted text end		deleted text begin 960 deleted text end new text begin $1,104 new text end
deleted text begin Instrument calibration service only, 100 curies or more deleted text end		deleted text begin 960 deleted text end
Service, maintenance, installation, source changes, etc.		deleted text begin 2,640 deleted text end new text begin $3,036 new text end
Waste disposal service, prepackaged only		deleted text begin 2,240 deleted text end new text begin $2,576 new text end
Waste disposal		deleted text begin 1,520 deleted text end new text begin $1,748 new text end
Distribution - general licensed devices (sealed sources)		deleted text begin 880 deleted text end new text begin $1,012 new text end
Distribution - general licensed material (unsealed sources)		deleted text begin 520 deleted text end new text begin $598 new text end
Industrial radiography - fixed new text begin or temporary new text end location		deleted text begin 2,640 deleted text end new text begin $3,036 new text end
deleted text begin Industrial radiography - temporary job sites deleted text end		deleted text begin 2,640 deleted text end
Irradiators, self-shielding deleted text begin , less than 10,000 curies deleted text end		deleted text begin 1,440 deleted text end new text begin $1,656 new text end
Irradiators, other, less than 10,000 curies		deleted text begin 2,960 deleted text end new text begin $3,404 new text end
deleted text begin Irradiators, self-shielding, 10,000 curies or more deleted text end		deleted text begin 1,440 deleted text end
Research and development - type A new text begin , B, or C new text end broad scope		deleted text begin 4,960 deleted text end new text begin $5,704 new text end
deleted text begin Research and development - type B broad scope deleted text end		deleted text begin 4,960 deleted text end
deleted text begin Research and development - type C broad scope deleted text end		deleted text begin 4,960 deleted text end
Research and development - other		deleted text begin 2,400 deleted text end new text begin $2,760 new text end
Storage - no operations		deleted text begin 960 deleted text end new text begin $1,104 new text end
Source material - shielding		deleted text begin 136 deleted text end new text begin $156 new text end
Special nuclear material plutonium - neutron source in device		deleted text begin 1,200 deleted text end new text begin $1,380 new text end
Pacemaker by-product and/or special nuclear material - medical (institution)		deleted text begin 1,200 deleted text end new text begin $1,380 new text end
Pacemaker by-product and/or special nuclear material - manufacturing and distribution		deleted text begin 2,320 deleted text end new text begin $2,668 new text end
Accelerator-produced radioactive material		deleted text begin 4,100 deleted text end new text begin $4,715 new text end
Nonprofit educational institutions		deleted text begin 300 deleted text end new text begin $345 new text end
deleted text begin General license registration deleted text end		deleted text begin 0 deleted text end
deleted text begin Industrial radiographer certification deleted text end		deleted text begin 150 deleted text end

Sec. 10.

Minnesota Statutes 2020, section 144.1205, subdivision 8, is amended to read:

Subd. 8.

Reciprocity fee.

A licensee submitting an application for reciprocal recognition
of a materials license issued by another agreement state or the United States Nuclear
Regulatory Commission for a period of 180 days or less during a calendar year must pay
deleted text begin $1,200 deleted text end new text begin $2,400 new text end . For a period of 181 days or more, the licensee must obtain a license under
subdivision 4.

Sec. 11.

Minnesota Statutes 2020, section 144.1205, subdivision 9, is amended to read:

Subd. 9.

Fees for license amendments.

A licensee must pay a fee of deleted text begin $300 deleted text end new text begin $600 new text end to
amend a license as follows:

(1) to amend a license requiring review including, but not limited to, addition of isotopes,
procedure changes, new authorized users, or a new radiation safety officer; and

(2) to amend a license requiring review and a site visit including, but not limited to,
facility move or addition of processes.

Sec. 12.

Minnesota Statutes 2020, section 144.1205, is amended by adding a subdivision
to read:

new text begin Subd. 10. new text end

new text begin Fees for general license registrations. new text end

new text begin A person required to register generally
licensed devices according to Minnesota Rules, part 4731.3215, must pay an annual
registration fee of $450.
new text end

Sec. 13.

Minnesota Statutes 2020, section 144.125, subdivision 1, is amended to read:

Subdivision 1.

Duty to perform testing.

(a) It is the duty of (1) the administrative officer
or other person in charge of each institution caring for infants 28 days or less of age, (2) the
person required in pursuance of the provisions of section 144.215, to register the birth of a
child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have
administered to every infant or child in its care tests for heritable and congenital disorders
according to subdivision 2 and rules prescribed by the state commissioner of health.

(b) Testing, recording of test results, reporting of test results, and follow-up of infants
with heritable congenital disorders, including hearing loss detected through the early hearing
detection and intervention program in section 144.966, shall be performed at the times and
in the manner prescribed by the commissioner of health.

(c) The fee to support the newborn screening program, including tests administered
under this section and section 144.966, shall be deleted text begin $135 deleted text end new text begin $177 new text end per specimen. This fee amount
shall be deposited in the state treasury and credited to the state government special revenue
fund.

(d) The fee to offset the cost of the support services provided under section 144.966,
subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
and credited to the general fund.

Sec. 14.

Minnesota Statutes 2020, section 145.901, is amended to read:

145.901 MATERNAL new text begin MORBIDITY AND new text end DEATH STUDIES.

Subdivision 1.

Purpose.

The commissioner of health may conduct maternal new text begin morbidity
and new text end death studies to assist the planning, implementation, and evaluation of medical, health,
and welfare service systems and to reduce the numbers of preventable new text begin adverse new text end maternal
new text begin outcomes and new text end deaths in Minnesota.

Subd. 2.

Access to data.

(a) The commissioner of health has access to medical data as
defined in section 13.384, subdivision 1, paragraph (b), medical examiner data as defined
in section 13.83, subdivision 1, and health records created, maintained, or stored by providers
as defined in section 144.291, subdivision 2, paragraph (i), without the consent of the subject
of the data, and without the consent of the parent, spouse, other guardian, or legal
representative of the subject of the data, when the subject of the data is a woman who died
new text begin or experienced morbidities new text end during a pregnancy or within 12 months of a fetal death, a live
birth, or other termination of a pregnancy.

The commissioner has access only to medical data and health records related to new text begin maternal
morbidity and new text end deaths that occur on or after July 1, 2000 new text begin , including the names of the providers;
clinics; or other health services, such as family home visiting, WIC, prescription drug
monitoring programs, and behavioral health services, where care was received before,
during, or relating to the pregnancy or death. The commissioner has access to records
maintained by the medical examiner, coroner, or hospitals or hospital discharge data for the
purpose of providing the name and location of any pre-pregnancy, prenatal, or other care
up to one year after the end of the pregnancy received by the subject of the data new text end .

new text begin The subject of the data or the subject's parent, spouse, other guardian, or legal
representative may voluntarily participate in an informant interview with staff on behalf of
the commissioner related to the maternal experience. If the subject of the data or the subject's
parent, spouse, other guardian, or legal representative agrees to an interview, the
commissioner may compensate the interviewee for time and other expenses related to the
interview.
new text end

(b) The provider or responsible authority that creates, maintains, or stores the data shall
furnish the data upon the request of the commissioner. The provider or responsible authority
may charge a fee for providing the data, not to exceed the actual cost of retrieving and
duplicating the data.

(c) The commissioner shall make a good faith reasonable effort to notify the new text begin subject of
the data, or the subject's new text end parent, spouse, other guardian, or legal representative deleted text begin of the subject
of the data deleted text end before collecting data on the subject. For purposes of this paragraph, "reasonable
effort" means one notice is sent by certified mail to the last known address of the new text begin subject
of the data, or the subject's new text end parent, spouse, guardian, or legal representative informing the
recipient of the data collection and offering a public health nurse support visit if desired.

(d) The commissioner does not have access to coroner or medical examiner data that
are part of an active investigation as described in section 13.83.

new text begin (e) The commissioner may request and receive from a coroner or medical examiner the
name of the health care provider that provided prenatal, postpartum, and other health services
to the subject of the data.
new text end

new text begin (f) The commissioner may access Department of Human Services data to identify sources
of care and services to assist with the evaluation of welfare systems, including housing and
Healthy Start, to reduce preventable maternal deaths.
new text end

new text begin (g) The commissioner may request and receive law enforcement reports or incident
reports related to the subject of the data.
new text end

Subd. 3.

Management of records.

After the commissioner has collected all data about
a subject of a new text begin morbidity or new text end maternal death study needed to perform the study, the data from
source records obtained under subdivision 2, other than data identifying the subject, must
be transferred to separate records to be maintained by the commissioner. Notwithstanding
section 138.17, after the data have been transferred, all source records obtained under
subdivision 2 possessed by the commissioner must be destroyed.

Subd. 4.

Classification of data.

(a) Data provided to the commissioner from source
records under subdivision 2, including identifying information on individual providers, data
subjects, or their children, and data derived by the commissioner under subdivision 3 for
the purpose of carrying out maternal new text begin morbidity and new text end death studies, are classified as confidential
data on individuals or confidential data on decedents, as defined in sections 13.02, subdivision
3, and 13.10, subdivision 1, paragraph (a).

(b) Information classified under paragraph (a) shall not be subject to discovery or
introduction into evidence in any administrative, civil, or criminal proceeding. Such
information otherwise available from an original source shall not be immune from discovery
or barred from introduction into evidence merely because it was utilized by the commissioner
in carrying out maternal new text begin morbidity and new text end death studies.

(c) Summary data on maternal new text begin morbidity and new text end death studies created by the commissioner,
which does not identify individual data subjects or individual providers, shall be public in
accordance with section 13.05, subdivision 7.

new text begin (d) Data provided by the commissioner of human services to the commissioner of health
under this section retains the same classification the data held when retained by the
commissioner of human services, as required under section 13.03, subdivision 4, paragraph
(c).
new text end

Sec. 15.

new text begin [145.9011] FETAL AND INFANT DEATH STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin The commissioner of health may conduct fetal and infant death
studies to assist the planning, implementation, and evaluation of medical, health, and welfare
service systems and to reduce the numbers of preventable fetal and infant deaths in
Minnesota.
new text end

new text begin Subd. 2. new text end

new text begin Access to data. new text end

new text begin (a) The commissioner of health has access to medical data as
defined in section 13.384, subdivision 1, paragraph (b), medical examiner data as defined
in section 13.83, subdivision 1, and health records created, maintained, or stored by providers
as defined in section 144.291, subdivision 2, paragraph (i), without the consent of the subject
of the data, and without the consent of the parent, other guardian, or legal representative of
the subject of the data, when the subject of the data is:
new text end

new text begin (1) a live-born infant that died within the first year of life;
new text end

new text begin (2) a fetal death which meets the criteria required for reporting as defined in section
144.222; or
new text end

new text begin (3) the biological mother of a fetus or infant as described in clause (1) or (2).
new text end

new text begin The commissioner has access only to medical data and health records related to fetal or
infant deaths that occur on or after July 1, 2000, including the names of the providers and
clinics where care was received before, during, or relating to the pregnancy or fetal death
or death of the infant. The commissioner has access to records maintained by the medical
examiner, coroner, or hospitals for the purpose of providing the name and location of any
pre-pregnancy, prenatal, postpartum, or pediatric care received by the subject of the data
and biological mother.
new text end

new text begin (b) The provider or responsible authority that creates, maintains, or stores the data shall
furnish the data upon the request of the commissioner. The provider or responsible authority
may charge a fee for providing the data, not to exceed the actual cost of retrieving and
duplicating the data.
new text end

new text begin (c) The commissioner shall make a good faith reasonable effort to notify the parent,
spouse, other guardian, or legal representative of the subject of the data before collecting
data on the subject. For purposes of this paragraph, "reasonable effort" means one notice
is sent by certified mail to the last-known address of the parent, guardian, or legal
representative informing the recipient of the data collection and offering a public health
nurse support visit if desired.
new text end

new text begin (d) The commissioner does not have access to coroner or medical examiner data that
are part of an active investigation as described in section 13.83.
new text end

new text begin (e) The commissioner may request and receive from the coroner or medical examiner
the name of the health care provider that provided prenatal, postpartum, pediatric, and other
health services to the subject of the data and biological mother.
new text end

new text begin (f) The commissioner shall have access to Department of Human Services data to identify
sources of care and services to assist with evaluation of welfare systems to reduce preventable
fetal and infant deaths.
new text end

new text begin Subd. 3. new text end

new text begin Management of records. new text end

new text begin After the commissioner has collected all data on a
subject of a fetal or infant death study that is needed to perform the study, the data from
source records obtained under subdivision 2, other than data identifying the subject, must
be transferred to separate records to be maintained by the commissioner. Notwithstanding
section 138.17, after the data have been transferred, all source records obtained under
subdivision 2 possessed by the commissioner must be destroyed.
new text end

new text begin Subd. 4. new text end

new text begin Classification of data. new text end

new text begin (a) Data provided to the commissioner from source
records under subdivision 2, including identifying information on individual providers, data
subjects, or their family, and data derived by the commissioner under subdivision 3 for the
purpose of carrying out fetal or infant death studies, are classified as confidential data on
individuals or confidential data on decedents, as defined in sections 13.02, subdivision 3;
and 13.10, subdivision 1, paragraph (a).
new text end

new text begin (b) Information classified under paragraph (a) shall not be subject to discovery or
introduction into evidence in any administrative, civil, or criminal proceeding. Such
information otherwise available from an original source shall not be immune from discovery
or barred from introduction into evidence merely because it was utilized by the commissioner
in carrying out fetal or infant death studies.
new text end

new text begin (c) Summary data on fetal and infant death studies created by the commissioner, which
do not identify individual data subjects or individual providers, shall be public in accordance
with section 13.05, subdivision 7.
new text end

new text begin (d) Data provided by the commissioner of human services to the commissioner of health
under this section retains the same classification the data held when retained by the
commissioner of human services, as required under section 13.03, subdivision 4, paragraph
(c).
new text end

new text begin Subd. 5. new text end

new text begin Fetal and infant mortality reviews. new text end

new text begin The commissioner of health shall convene
case review committees to conduct death study reviews, make recommendations, and
publicly share summary information, especially for racial and ethnic groups, including
American Indians and African Americans, that experience significantly disparate rates of
fetal and infant mortality. The case review committees may include but are not limited to
medical examiners or coroners, health care institutions that provide care to pregnant people
and infants, obstetric and pediatric practitioners, Medicaid representatives, state agency
women and infant program representatives, and individuals from the communities with
disparate rates and other subject matter experts as appropriate. The case review committees
shall review data from source records obtained under subdivision 2, other than data
identifying the subject or the provider. Every three years beginning December 1, 2022, the
case review committees shall provide findings and recommendations to the Maternal and
Child Health Advisory Task Force and the commissioner from review of fetal and infant
deaths and provide specific recommendations designed to reduce disparities in fetal and
infant deaths.
new text end

new text begin Subd. 6. new text end

new text begin Community action committees. new text end

new text begin (a) The commissioner shall convene
community action committees to implement the priority recommendations from the case
review committees.
new text end

new text begin (b) Members of the community action committees may include but are not limited to
local, tribal, and state government representatives; local hospital or health care administration;
local public health; nonprofit organizations serving the community's mothers, infants, and
fathers; state maternal and child health consultants; case review committee members;
representatives of communities disproportionately affected by fetal and infant death;
Minnesotans with lived experiences; and others based on recommendations.
new text end

Sec. 16.

Minnesota Statutes 2020, section 326.71, subdivision 4, is amended to read:

Subd. 4.

Asbestos-related work.

"Asbestos-related work" means the enclosure, removal,
or encapsulation of asbestos-containing material in a quantity that meets or exceeds 260
linear feet of friable asbestos-containing material on pipes, 160 square feet of friable
asbestos-containing material on other facility components, or, if linear feet or square feet
cannot be measured, a total of 35 cubic feet of friable asbestos-containing material on or
off all facility components in one facility. In the case of single or multifamily residences,
"asbestos-related work" also means the enclosure, removal, or encapsulation of greater than
ten but less than 260 linear feet of friable asbestos-containing material on pipes, greater
than six but less than 160 square feet of friable asbestos-containing material on other facility
components, or, if linear feet or square feet cannot be measured, greater than one cubic foot
but less than 35 cubic feet of friable asbestos-containing material on or off all facility
components in one facility. deleted text begin This provision excludes asbestos-containing floor tiles and
sheeting, roofing materials, siding, and all ceilings with asbestos-containing material in
single family residences and buildings with no more than four dwelling units. deleted text end
Asbestos-related work includes asbestos abatement area preparation; enclosure, removal,
or encapsulation operations; and an air quality monitoring specified in rule to assure that
the abatement and adjacent areas are not contaminated with asbestos fibers during the project
and after completion.

For purposes of this subdivision, the quantity of deleted text begin asbestos containing deleted text end material applies
separately for every project.

Sec. 17.

Minnesota Statutes 2020, section 326.75, subdivision 1, is amended to read:

Subdivision 1.

Licensing fee.

A person required to be licensed under section 326.72
shall, before receipt of the license and before causing asbestos-related work to be performed,
pay the commissioner an annual license fee of deleted text begin $100 deleted text end new text begin $105 new text end .

Sec. 18.

Minnesota Statutes 2020, section 326.75, subdivision 2, is amended to read:

Subd. 2.

Certification fee.

An individual required to be certified new text begin as an asbestos worker
or asbestos site supervisor new text end under section 326.73, subdivision 1, shall pay the commissioner
a certification fee of deleted text begin $50 deleted text end new text begin $52.50 new text end before the issuance of the certificate. deleted text begin The commissioner
may establish by rule fees required before the issuance of deleted text end new text begin An individual required to be
certified as an new text end asbestos inspector, asbestos management planner, and asbestos project
designer deleted text begin certificates required deleted text end under section 326.73, subdivisions 2, 3, and 4 new text begin , shall pay the
commissioner a certification fee of $105 before the issuance of the certificate new text end .

Sec. 19.

Minnesota Statutes 2020, section 326.75, subdivision 3, is amended to read:

Subd. 3.

Permit fee.

Five calendar days before beginning asbestos-related work, a person
shall pay a project permit fee to the commissioner equal to deleted text begin one deleted text end new text begin two new text end percent of the total costs
of the asbestos-related work. For asbestos-related work performed in single or multifamily
residences, of greater than ten but less than 260 linear feet of asbestos-containing material
on pipes, or greater than six but less than 160 square feet of asbestos-containing material
on other facility components, a person shall pay a project permit fee of $35 to the
commissioner.