1.1 	A bill for an act
1.2 	relating to health; modifying best practices
1.3 	guidelines; establishing a quality improvement
1.4 	investment program; appropriating money; amending
1.5 	Minnesota Statutes 2004, section 62J.43.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. Minnesota Statutes 2004, section 62J.43, is
1.8 	amended to read:
1.9 	62J.43  ~~BEST PRACTICES~~ EVIDENCE-BASED HEALTH CARE
1.10 	GUIDELINES AND QUALITY IMPROVEMENT.
1.11 	~~(a)~~ Subdivision 1.[ADOPTION OF BEST PRACTICES.] To
1.12 	improve quality and reduce health care costs, state agencies
1.13 	shall encourage the ~~adoption~~ use of ~~best practice~~ evidence-based
1.14 	health care guidelines and participation in best practices
1.15 	measurement activities by physicians, other health care
1.16 	providers, and health plan companies.  The commissioner of
1.17 	health shall facilitate access to ~~best practice~~ evidence-based
1.18 	health care guidelines and quality of care measurement
1.19 	information to providers, purchasers, and consumers by:
1.20 	(1) identifying and promoting local community-based,
1.21 	physician-designed ~~best practices care~~ , evidence-based health
1.22 	care guidelines across the Minnesota health care system;
1.23 	(2) disseminating information available to the commissioner
1.24 	on adherence to ~~best practices~~ evidence-based guidelines care by
1.25 	physicians and other health care providers in Minnesota;
2.1 	(3) educating consumers and purchasers on how to
2.2 	effectively use this information in choosing their providers and
2.3 	in making purchasing decisions; and
2.4 	(4) making ~~best practices~~ evidence-based health care
2.5 	guidelines and quality care measurement information available to
2.6 	enrollees and program participants through the Department of
2.7 	Health's Web site.  The commissioner may convene an advisory
2.8 	committee to ensure that the Web site is designed to provide
2.9 	user friendly and easy accessibility.
2.10 	~~(b)~~ Subd. 2.[COLLABORATION WITH MINNESOTA NONPROFIT
2.11 	ORGANIZATION.] The commissioner of health shall collaborate with
2.12 	a nonprofit Minnesota quality improvement organization
2.13 	specializing in best practices and quality of care measurements
2.14 	to provide ~~best practices~~ evidence-based health care guidelines 
2.15 	criteria and assist in the collection of the data.
2.16 	~~(c)~~ Subd. 3.[CRITERIA FOR EVIDENCE-BASED
2.17 	GUIDELINES.] Guidelines identified under this section must meet
2.18 	the following criteria:
2.19 	(1) the scope and application are clear;
2.20 	(2) authorship is stated and any conflicts of interest
2.21 	disclosed;
2.22 	(3) authors represent all pertinent clinical fields or
2.23 	other means of input have been used;
2.24 	(4) the development process is explicitly stated;
2.25 	(5) the guideline is grounded in evidence;
2.26 	(6) the evidence is cited and graded;
2.27 	(7) the document itself is clear and practical;
2.28 	(8) the document is flexible in use, with exceptions noted
2.29 	or provided for with general statements;
2.30 	(9) measures are included for use in systems improvement;
2.31 	and 
2.32 	(10) the guideline has scheduled reviews and updating.
2.33 		Subd. 4.Initial evidence-based health care guidelines.
 2.34 	The initial ~~best practices~~ evidence-based health care guidelines 
2.35 	and quality of care measurement criteria developed shall include
2.36 	asthma, diabetes, and at least two other preventive health
3.1 	measures.  Hypertension and coronary artery disease shall be
3.2 	included within one year following availability.
3.3 	~~(d)~~ Subd. 5.[USE IN STATE CONTRACTS WITH HEALTH PLANS.]
3.4 	The commissioners of human services and employee relations may
3.5 	use the data to make decisions about contracts they enter into
3.6 	with health plan companies.
3.7 	~~(e)~~ Subd. 6.[LIMITATIONS.] This section does not apply if
3.8 	the ~~best practices~~ evidence-based health care guidelines
3.9 	authorize or recommend denial of treatment, food, or fluids
3.10 	necessary to sustain life on the basis of the patient's age or
3.11 	expected length of life or the patient's present or predicted
3.12 	disability, degree of medical dependency, or quality of life.
3.13 	~~(f) The commissioner of health, human services, and~~
3.14 	~~employee relations shall report to the legislature by January~~
3.15 	~~15, 2005, on the status of best practices and quality of care~~
3.16 	~~initiatives, and shall present recommendations to the~~
3.17 	~~legislature on any statutory changes needed to increase the~~
3.18 	~~effectiveness of these initiatives.~~
3.19 	~~(g) This section expires June 30, 2006.~~

3.20 	Sec. 2. QUALITY IMPROVEMENT INVESTMENT PROGRAM.
 3.21 	The commissioner of health, in consultation with the
3.22 	commissioners of finance and administration, shall submit
3.23 	recommendations to the legislature by December 15, 2005, to
3.24 	establish a quality improvement investment program to provide
3.25 	technical assistance, grants, and low-interest loans to health
3.26 	care organizations and health professional associations to
3.27 	support establishing or updating electronic information systems
3.28 	in all health care settings to support the efficient and
3.29 	effective delivery of safe, evidence-based health care services
3.30 	and to reduce administrative costs.

3.31 	Sec. 3. APPROPRIATION.
 3.32 	$....... is appropriated from the general fund to the
3.33 	commissioner of health for the fiscal year ending June 30, 2006,
3.34 	for the report required under section 2.

3.35 	Sec. 4. EFFECTIVE DATE.
 3.36 	Sections 1 to 3 are effective July 1, 2005.