1.1                          A bill for an act 
  1.2             relating to health; modifying provisions for 
  1.3             application for and distribution of medical education 
  1.4             funds; amending Minnesota Statutes 1999 Supplement, 
  1.5             section 62J.692, subdivisions 1, 3, and 4. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Minnesota Statutes 1999 Supplement, section 
  1.8   62J.692, subdivision 1, is amended to read: 
  1.9      Subdivision 1.  [DEFINITIONS.] For purposes of this 
  1.10  section, the following definitions apply: 
  1.11     (a) "Accredited clinical training" means the clinical 
  1.12  training provided by a medical education program that is 
  1.13  accredited through an organization recognized by the department 
  1.14  of education ~~or~~, the health care financing administration ~~as the~~ 
  1.15  ~~official accrediting body for that program~~, or another body 
  1.16  whose standards for recognizing accrediting organizations are 
  1.17  reviewed and approved by the commissioner of health in 
  1.18  consultation with the medical education and research advisory 
  1.19  committee. 
  1.20     (b) "Commissioner" means the commissioner of health. 
  1.21     (c) "Clinical medical education program" means the 
  1.22  accredited clinical training of physicians (medical students and 
  1.23  residents), doctor of pharmacy practitioners, doctors of 
  1.24  chiropractic, dentists, advanced practice nurses (clinical nurse 
  1.25  specialists, certified registered nurse anesthetists, nurse 
  2.1   practitioners, and certified nurse midwives), and physician 
  2.2   assistants. 
  2.3      (d) "Sponsoring institution" means a hospital, school, or 
  2.4   consortium located in Minnesota that sponsors and maintains 
  2.5   primary organizational and financial responsibility for a 
  2.6   clinical medical education program in Minnesota and which is 
  2.7   accountable to the accrediting body. 
  2.8      (e) "Teaching institution" means a hospital, medical 
  2.9   center, clinic, or other organization that conducts a clinical 
  2.10  medical education program in Minnesota. 
  2.11     (f) "Trainee" means a student or resident involved in a 
  2.12  clinical medical education program.  
  2.13     (g) "Eligible trainee FTEs" means the number of trainees, 
  2.14  as measured by full-time equivalent counts, that are at training 
  2.15  sites located in Minnesota with a medical assistance provider 
  2.16  number where training occurs in either an inpatient or 
  2.17  ambulatory patient care setting and where the training is 
  2.18  funded, in part, by patient care revenues. 
  2.19     Sec. 2.  Minnesota Statutes 1999 Supplement, section 
  2.20  62J.692, subdivision 3, is amended to read: 
  2.21     Subd. 3.  [APPLICATION PROCESS.] (a) A clinical medical 
  2.22  education program conducted in Minnesota by a teaching 
  2.23  institution is eligible for funds under subdivision 4 if the 
  2.24  program: 
  2.25     (1) is funded, in part, by patient care revenues; 
  2.26     (2) occurs in patient care settings that face increased 
  2.27  financial pressure as a result of competition with nonteaching 
  2.28  patient care entities; and 
  2.29     (3) emphasizes primary care or specialties that are in 
  2.30  undersupply in Minnesota. 
  2.31     (b) Applications must be submitted to the commissioner by a 
  2.32  sponsoring institution on behalf of an eligible clinical medical 
  2.33  education program and must be received by ~~September 30~~ October 
  2.34  31 of each year for distribution in the following year.  An 
  2.35  application for funds must contain the following information: 
  2.36     (1) the official name and address of the sponsoring 
  3.1   institution and the official name and site address of the 
  3.2   clinical medical education programs on whose behalf the 
  3.3   sponsoring institution is applying; 
  3.4      (2) the name, title, and business address of those persons 
  3.5   responsible for administering the funds; 
  3.6      (3) for each clinical medical education program for which 
  3.7   funds are being sought; the type and specialty orientation of 
  3.8   trainees in the program; the name, site address, and medical 
  3.9   assistance provider number of each training site used in the 
  3.10  program; the total number of trainees at each training site; and 
  3.11  the total number of eligible trainee FTEs at each site; and 
  3.12     (4) ~~audited clinical training costs per trainee for each~~ 
  3.13  ~~clinical medical education program where available or estimates~~ 
  3.14  ~~of clinical training costs based on audited financial data;~~ 
  3.15     ~~(5) a description of current sources of funding for~~ 
  3.16  ~~clinical medical education costs, including a description and~~ 
  3.17  ~~dollar amount of all state and federal financial support,~~ 
  3.18  ~~including Medicare direct and indirect payments;~~ 
  3.19     ~~(6) other revenue received for the purposes of clinical~~ 
  3.20  ~~training; and~~ 
  3.21     ~~(7)~~ other supporting information the commissioner deems 
  3.22  necessary to determine program eligibility based on the criteria 
  3.23  in paragraph (a) and to ensure the equitable distribution of 
  3.24  funds.  
  3.25     (c) An application must include the information specified 
  3.26  in clauses (1) to (3) for each clinical medical education 
  3.27  program on an annual basis for three consecutive years.  After 
  3.28  that time, an application must include the information specified 
  3.29  in clauses (1) to (3) in the first year of each biennium:  
  3.30     (1) audited clinical training costs per trainee for each 
  3.31  clinical medical education program when available or estimates 
  3.32  of clinical training costs based on audited financial data; 
  3.33     (2) a description of current sources of funding for 
  3.34  clinical medical education costs, including a description and 
  3.35  dollar amount of all state and federal financial support, 
  3.36  including Medicare direct and indirect payments; and 
  4.1      (3) other revenue received for the purposes of clinical 
  4.2   training.  
  4.3      (d) An applicant that does not provide information 
  4.4   requested by the commissioner shall not be eligible for funds 
  4.5   for the current funding cycle. 
  4.6      Sec. 3.  Minnesota Statutes 1999 Supplement, section 
  4.7   62J.692, subdivision 4, is amended to read: 
  4.8      Subd. 4.  [DISTRIBUTION OF FUNDS.] (a) The commissioner 
  4.9   shall annually distribute medical education funds to all 
  4.10  qualifying applicants based on the following criteria:  
  4.11     (1) total medical education funds available for 
  4.12  distribution; 
  4.13     (2) total number of eligible trainee FTEs in each clinical 
  4.14  medical education program; and 
  4.15     (3) the statewide average cost per trainee as determined by 
  4.16  the application information provided in the first year of the 
  4.17  biennium, by type of trainee, in each clinical medical education 
  4.18  program.  
  4.19     (b) Funds distributed shall not be used to displace current 
  4.20  funding appropriations from federal or state sources.  
  4.21     (c) Funds shall be distributed to the sponsoring 
  4.22  institutions indicating the amount to be distributed to each of 
  4.23  the sponsor's clinical medical education programs based on the 
  4.24  criteria in this subdivision and in accordance with the 
  4.25  commissioner's approval letter.  Each clinical medical education 
  4.26  program must distribute funds to the training sites as specified 
  4.27  in the commissioner's approval letter.  Sponsoring institutions, 
  4.28  which are accredited through an organization recognized by the 
  4.29  department of education or the health care financing 
  4.30  administration, may contract directly with training sites to 
  4.31  provide clinical training.  To ensure the quality of clinical 
  4.32  training, those accredited sponsoring institutions must: 
  4.33     (1) develop contracts specifying the terms, expectations, 
  4.34  and outcomes of the clinical training conducted at sites; and 
  4.35     (2) take necessary action if the contract requirements are 
  4.36  not met.  Action may include the withholding of payments under 
  5.1   this section or the removal of students from the site.  
  5.2      (d) Any funds not distributed in accordance with the 
  5.3   commissioner's approval letter must be returned to the medical 
  5.4   education and research fund within 30 days of receiving notice 
  5.5   from the commissioner.  The commissioner shall distribute 
  5.6   returned funds to the appropriate training sites in accordance 
  5.7   with the commissioner's approval letter.  
  5.8      Sec. 4.  [EFFECTIVE DATE.] 
  5.9      Section 1 is effective the day following final enactment.