1.1                          A bill for an act
  1.2             relating to health; expanding the University of 
  1.3             Minnesota-Duluth medical education program; requesting 
  1.4             the University of Minnesota-Duluth School of Medicine 
  1.5             to apply for a federal area health education center 
  1.6             program grant; establishing a physician substitute 
  1.7             demonstration project for rural communities; expanding 
  1.8             the size of the rural physician associate program; 
  1.9             appropriating money; proposing coding for new law in 
  1.10            Minnesota Statutes, chapter 137.  
  1.11  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.12     Section 1.  [137.42] [UNIVERSITY OF MINNESOTA-DULUTH SCHOOL 
  1.13  OF MEDICINE.] 
  1.14     Subdivision 1.  [PURPOSE.] The legislature finds that there 
  1.15  is a continuing need to increase the number of rural family 
  1.16  physicians practicing in Minnesota, and to prepare future rural 
  1.17  family physicians to meet the unique and evolving health care 
  1.18  needs of the rural patients and rural Minnesota communities 
  1.19  which they will serve.  The legislature further finds that the 
  1.20  University of Minnesota-Duluth School of Medicine is nationally 
  1.21  recognized for the percentage of its medical students who choose 
  1.22  family practice careers and who choose to practice in rural 
  1.23  settings.  It is therefore the intent of the legislature to meet 
  1.24  these needs for access to quality care in rural areas of the 
  1.25  state by expanding the University of Minnesota-Duluth School of 
  1.26  Medicine from a two-year to a four-year program. 
  1.27     Subd. 2.  [PROGRAM EXPANSION.] The board of regents, 
  1.28  through the University of Minnesota academic health center, is 
  2.1   requested to expand the medical education program at the 
  2.2   University of Minnesota-Duluth School of Medicine from a 
  2.3   two-year to a four-year program.  The academic health center is 
  2.4   requested to include in this expanded program the following: 
  2.5      (1) interdisciplinary community-based education in rural 
  2.6   sites for medical students and other health professional 
  2.7   students such as, nurse practitioner, pharmacy, and physician 
  2.8   assistant students, through which students will continue to 
  2.9   provide ongoing care in rural communities after completion of a 
  2.10  practice rotation; 
  2.11     (2) distance education technologies to link and maximize 
  2.12  resources and incorporate telecommunication technology into the 
  2.13  students' skill base; and 
  2.14     (3) interdisciplinary, community-based, public health 
  2.15  projects to teach team collaboration and preventive medicine 
  2.16  strategies for enhancing health and reducing costs. 
  2.17     The academic health center is requested to develop and 
  2.18  implement an expansion plan that provides for program 
  2.19  development through the 1997-1998 school year, with the first 
  2.20  students being accepted into the four-year program beginning 
  2.21  with the 1997-1998 school year. 
  2.22     Sec. 2.  [137.43] [GRANTS FOR AREA HEALTH EDUCATION CENTER 
  2.23  PROGRAMS.] 
  2.24     Subdivision 1.  [GRANT APPLICATION.] The board of regents 
  2.25  of the University of Minnesota, through the academic health 
  2.26  center and the University of Minnesota-Duluth School of 
  2.27  Medicine, is requested to apply for a federal area health 
  2.28  education center program grant.  If awarded a grant, the 
  2.29  University of Minnesota-Duluth School of Medicine, in 
  2.30  cooperation with public or private, nonprofit area health 
  2.31  education centers, is requested to plan, develop, and operate 
  2.32  area health education center programs.  The University of 
  2.33  Minnesota-Duluth School of Medicine is requested to develop 
  2.34  cooperative arrangements with two area health education centers 
  2.35  in year two of the grant, and develop cooperative arrangements 
  2.36  with an additional two centers in year three of the grant. 
  3.1      Subd. 2.  [PROGRAM REQUIREMENTS.] Each program must: 
  3.2      (1) provide preceptorship educational experiences for 
  3.3   health science students; 
  3.4      (2) maintain community-based primary care residency 
  3.5   programs, or be affiliated with such programs; 
  3.6      (3) maintain continuing education programs for health 
  3.7   professionals, or coordinate its activities with such programs; 
  3.8      (4) maintain learning resources and dissemination systems; 
  3.9      (5) have agreements with community-based organizations for 
  3.10  educating and training health professionals; 
  3.11     (6) train health professionals, including nurses and allied 
  3.12  health professionals; and 
  3.13     (7) carry out recruitment and health career awareness 
  3.14  programs among minority and other students in medically 
  3.15  underserved areas of the state. 
  3.16     Sec. 3.  [137.44] [PHYSICIAN SUBSTITUTE DEMONSTRATION 
  3.17  PROJECT.] 
  3.18     Subdivision 1.  [ESTABLISHMENT.] The board of regents, 
  3.19  through the University of Minnesota academic health center, is 
  3.20  requested to establish and administer a physician substitute 
  3.21  (locum tenens and emergency room coverage) demonstration project 
  3.22  at up to four rural demonstration sites within the state.  The 
  3.23  academic health center is requested to coordinate the 
  3.24  administration of the project with the commissioner of health 
  3.25  and the office of rural health and primary health care. 
  3.26     Subd. 2.  [PROJECT ACTIVITIES.] The project must: 
  3.27     (1) encourage physicians to serve as substitute physicians 
  3.28  for the demonstration sites; 
  3.29     (2) provide a central register of physicians interested in 
  3.30  serving as physician substitutes at the demonstration sites; 
  3.31     (3) provide a referral service for requests from 
  3.32  demonstration sites for physician substitutes; and 
  3.33     (4) provide physician substitute services, at rates that 
  3.34  reflect the administrative savings resulting from centralized 
  3.35  referral and credentialing. 
  3.36     Subd. 3.  [CREDENTIALING; PROFESSIONAL EDUCATION.] The 
  4.1   academic health center is requested to credential persons 
  4.2   desiring to serve as physician substitutes.  The academic health 
  4.3   center may employ physician substitutes serving in the 
  4.4   demonstration project as temporary clinical faculty, and may 
  4.5   provide physician substitutes with additional opportunities for 
  4.6   professional education and interaction. 
  4.7      Subd. 4.  [DEMONSTRATION SITES.] The academic health center 
  4.8   is requested to designate up to four rural communities as 
  4.9   demonstration sites for the project.  The academic health center 
  4.10  is requested to choose sites based on a community's need for 
  4.11  physician substitute services and the willingness of the 
  4.12  community to work cooperatively with the academic health center 
  4.13  and participate in the demonstration project evaluation. 
  4.14     Subd. 5.  [EVALUATION.] The commissioner of health, through 
  4.15  the office of rural health and primary care, shall evaluate the 
  4.16  demonstration project and present an evaluation report to the 
  4.17  legislature by January 15, 1996.  The commissioner may contract 
  4.18  with a nonprofit rural health policy organization to evaluate 
  4.19  the demonstration project.  The evaluation must identify any 
  4.20  modifications necessary to improve the effectiveness of the 
  4.21  project.  The evaluation must also include a recommendation on 
  4.22  whether the demonstration project should be extended to other 
  4.23  areas of the state. 
  4.24     Sec. 4.  [APPROPRIATION.] 
  4.25     Subdivision 1.  [MEDICAL SCHOOL EXPANSION.] $....... is 
  4.26  appropriated from the general fund to the board of regents of 
  4.27  the University of Minnesota for the biennium ending June 30, 
  4.28  1997, as the first phase of development funding for the 
  4.29  expansion of the University of Minnesota-Duluth School of 
  4.30  Medicine from a two-year to a four-year program, as authorized 
  4.31  under section 137.42. 
  4.32     Subd. 2.  [AREA HEALTH EDUCATION CENTER GRANT.] $....... is 
  4.33  appropriated from the general fund to the board of regents of 
  4.34  the University of Minnesota for the biennium ending June 30, 
  4.35  1997, to be used as the state match for federal funding received 
  4.36  through the area health education center grant applied for under 
  5.1   section 137.43.  This appropriation is available to the board 
  5.2   only if the University of Minnesota-Duluth School of Medicine 
  5.3   receives a federal area health education center grant. 
  5.4      Subd. 3.  [RURAL PHYSICIAN ASSOCIATE PROGRAM.] $....... is 
  5.5   appropriated from the general fund to the board of regents of 
  5.6   the University of Minnesota for the biennium ending June 30, 
  5.7   1997, to expand the rural physician associate program 
  5.8   administered by the University of Minnesota academic health 
  5.9   center from 40 to 60 students over a two-year period. 
  5.10     Subd. 4.  [PHYSICIAN SUBSTITUTE DEMONSTRATION PROJECT.] (a) 
  5.11  $....... is appropriated from the general fund to the board of 
  5.12  regents of the University of Minnesota for the biennium ending 
  5.13  June 30, 1997, for costs incurred by the academic health center 
  5.14  in credentialing physician substitutes and employing physician 
  5.15  substitutes as temporary clinical faculty under section 137.44. 
  5.16     (b) $....... is appropriated from the general fund to the 
  5.17  commissioner of health for the biennium ending June 30, 1997, to 
  5.18  evaluate the physician substitute demonstration project 
  5.19  established under section 137.44.