1.1                          A bill for an act 
  1.2             relating to health; extending certain enforcement 
  1.3             authority related to the provision of funeral goods 
  1.4             and services; modifying provisions for public health 
  1.5             collaboration plans; modifying rural hospital programs 
  1.6             eligibility; repealing professional boxing regulation; 
  1.7             amending Minnesota Statutes 2000, sections 62Q.075; 
  1.8             144.147, subdivision 1; 144.148, subdivision 1; 
  1.9             144.1483; 149A.01, by adding a subdivision; 149A.02, 
  1.10            subdivision 14, by adding a subdivision; 149A.11; 
  1.11            149A.62; 149A.71, subdivision 4; 149A.97, subdivision 
  1.12            8; repealing Minnesota Statutes 2000, section 144.994; 
  1.13            Laws 2000, chapter 488, article 2, section 26. 
  1.14  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.15     Section 1.  Minnesota Statutes 2000, section 62Q.075, is 
  1.16  amended to read: 
  1.17     62Q.075 [LOCAL PUBLIC ACCOUNTABILITY AND COLLABORATION 
  1.18  PLAN.] 
  1.19     Subdivision 1.  [DEFINITION.] For purposes of this section, 
  1.20  "managed care organization" means a health maintenance 
  1.21  organization or community integrated service network. 
  1.22     Subd. 2.  [REQUIREMENT.] Beginning October 31, 1997 2004, 
  1.23  all managed care health maintenance organizations shall file 
  1.24  biennially with the action plans required under section 62Q.07 a 
  1.25  plan every four years with the commissioner of health describing 
  1.26  the actions the managed care health maintenance organization has 
  1.27  taken and those it intends to take to contribute to 
  1.28  achieving one or more high priority public health goals for each 
  1.29  service area in which an enrollee of the managed care 
  2.1   organization resides.  This plan must be jointly developed in 
  2.2   collaboration with the local public health units, and other 
  2.3   community organizations providing health services within the 
  2.4   same service area as the managed care health maintenance 
  2.5   organization.  Local government units with responsibilities and 
  2.6   authority defined under chapters 145A and 256E may designate 
  2.7   individuals to participate in the collaborative planning with 
  2.8   the managed care health maintenance organization to provide 
  2.9   expertise and represent community needs and goals as identified 
  2.10  under chapters 145A and 256E.  Every other year, beginning 
  2.11  October 31, 2002, all health maintenance organizations shall 
  2.12  file reports updating progress on the four-year collaboration 
  2.13  plan. 
  2.14     Subd. 3.  [CONTENTS.] The plan must address the following: 
  2.15     (a) (1) specific measurement strategies and a description 
  2.16  of any activities which contribute to one or more high priority 
  2.17  public health goals and needs of high risk and special needs 
  2.18  populations as defined and developed under chapters 145A and 
  2.19  256E; 
  2.20     (b) (2) description of the process by which the managed 
  2.21  care health maintenance organization will coordinate its 
  2.22  activities with the community health boards, and other relevant 
  2.23  community organizations servicing the same area; 
  2.24     (c) (3) documentation indicating that local public health 
  2.25  units and local government unit designees were involved in the 
  2.26  development of the plan; and 
  2.27     (d) (4) documentation of compliance with the plan filed the 
  2.28  previous year previously, including data on the previously 
  2.29  identified progress measures. 
  2.30     Subd. 4.  [REVIEW.] Upon receipt of the plan, the 
  2.31  appropriate commissioner of health shall provide a copy to the 
  2.32  local community health boards, and other relevant community 
  2.33  organizations within the managed care health maintenance 
  2.34  organization's service area.  After reviewing the plan, these 
  2.35  community groups may submit written comments on the plan 
  2.36  to either the commissioner of health or commerce, as applicable, 
  3.1   and may advise the commissioner of the managed care health 
  3.2   maintenance organization's effectiveness in assisting to achieve 
  3.3   regional high priority public health goals.  The plan may be 
  3.4   reviewed by the county boards, or city councils acting as a 
  3.5   local board of health in accordance with chapter 145A, within 
  3.6   the managed care health maintenance organization's service area 
  3.7   to determine whether the plan is consistent with the goals and 
  3.8   objectives of the plans required under chapters 145A and 256E 
  3.9   and whether the plan meets the needs of the community.  The 
  3.10  county board, or applicable city council, may also review and 
  3.11  make recommendations on the availability and accessibility of 
  3.12  services provided by the managed care health maintenance 
  3.13  organization.  The county board, or applicable city council, may 
  3.14  submit written comments to the appropriate commissioner of 
  3.15  health, and may advise the commissioner of the managed care 
  3.16  health maintenance organization's effectiveness in assisting to 
  3.17  meet the needs and goals as defined under the responsibilities 
  3.18  of chapters 145A and 256E.  The commissioner of health shall 
  3.19  develop recommendations to utilize the written comments 
  3.20  submitted as part of the licensure process to ensure local 
  3.21  public accountability.  These recommendations shall be reported 
  3.22  to the legislative commission on health care access by January 
  3.23  15, 1996.  Copies of these written comments must be provided to 
  3.24  the managed care health maintenance organization.  The plan and 
  3.25  any comments submitted must be filed with the information 
  3.26  clearinghouse to be distributed to the public. 
  3.27     Sec. 2.  Minnesota Statutes 2000, section 144.147, 
  3.28  subdivision 1, is amended to read: 
  3.29     Subdivision 1.  [DEFINITION.] "Eligible rural hospital" 
  3.30  means any nonfederal, general acute care hospital that: 
  3.31     (1) is either located in a rural area, as defined in the 
  3.32  federal Medicare regulations, Code of Federal Regulations, title 
  3.33  42, section 405.1041, or located in a community with a 
  3.34  population of less than 5,000 10,000, according to United States 
  3.35  Census Bureau statistics, outside the seven-county metropolitan 
  3.36  area; 
  4.1      (2) has 50 or fewer beds; and 
  4.2      (3) is not for profit. 
  4.3      Sec. 3.  Minnesota Statutes 2000, section 144.148, 
  4.4   subdivision 1, is amended to read: 
  4.5      Subdivision 1.  [DEFINITION.] (a) For purposes of this 
  4.6   section, the following definitions apply. 
  4.7      (b) "Eligible rural hospital" means any nonfederal, general 
  4.8   acute care hospital that: 
  4.9      (1) is either located in a rural area, as defined in the 
  4.10  federal Medicare regulations, Code of Federal Regulations, title 
  4.11  42, section 405.1041, or located in a community with a 
  4.12  population of less than 5,000 10,000, according to United States 
  4.13  Census Bureau Statistics, outside the seven-county metropolitan 
  4.14  area; 
  4.15     (2) has 50 or fewer beds; and 
  4.16     (3) is not for profit. 
  4.17     (c) "Eligible project" means a modernization project to 
  4.18  update, remodel, or replace aging hospital facilities and 
  4.19  equipment necessary to maintain the operations of a hospital. 
  4.20     Sec. 4.  Minnesota Statutes 2000, section 144.1483, is 
  4.21  amended to read: 
  4.22     144.1483 [RURAL HEALTH INITIATIVES.] 
  4.23     The commissioner of health, through the office of rural 
  4.24  health, and consulting as necessary with the commissioner of 
  4.25  human services, the commissioner of commerce, the higher 
  4.26  education services office, and other state agencies, shall: 
  4.27     (1) develop a detailed plan regarding the feasibility of 
  4.28  coordinating rural health care services by organizing individual 
  4.29  medical providers and smaller hospitals and clinics into 
  4.30  referral networks with larger rural hospitals and clinics that 
  4.31  provide a broader array of services; 
  4.32     (2) develop and implement a program to assist rural 
  4.33  communities in establishing community health centers, as 
  4.34  required by section 144.1486; 
  4.35     (3) administer the program of financial assistance 
  4.36  established under section 144.1484 for rural hospitals in 
  5.1   isolated areas of the state that are in danger of closing 
  5.2   without financial assistance, and that have exhausted local 
  5.3   sources of support; 
  5.4      (4) develop recommendations regarding health education and 
  5.5   training programs in rural areas, including but not limited to a 
  5.6   physician assistants' training program, continuing education 
  5.7   programs for rural health care providers, and rural outreach 
  5.8   programs for nurse practitioners within existing training 
  5.9   programs; 
  5.10     (5) develop a statewide, coordinated recruitment strategy 
  5.11  for health care personnel and maintain a database on health care 
  5.12  personnel as required under section 144.1485; 
  5.13     (6) develop and administer technical assistance programs to 
  5.14  assist rural communities in:  (i) planning and coordinating the 
  5.15  delivery of local health care services; and (ii) hiring 
  5.16  physicians, nurse practitioners, public health nurses, physician 
  5.17  assistants, and other health personnel; 
  5.18     (7) study and recommend changes in the regulation of health 
  5.19  care personnel, such as nurse practitioners and physician 
  5.20  assistants, related to scope of practice, the amount of on-site 
  5.21  physician supervision, and dispensing of medication, to address 
  5.22  rural health personnel shortages; 
  5.23     (8) support efforts to ensure continued funding for medical 
  5.24  and nursing education programs that will increase the number of 
  5.25  health professionals serving in rural areas; 
  5.26     (9) support efforts to secure higher reimbursement for 
  5.27  rural health care providers from the Medicare and medical 
  5.28  assistance programs; 
  5.29     (10) coordinate the development of a statewide plan for 
  5.30  emergency medical services, in cooperation with the emergency 
  5.31  medical services advisory council; 
  5.32     (11) establish a Medicare rural hospital flexibility 
  5.33  program pursuant to section 1820 of the federal Social Security 
  5.34  Act, United States Code, title 42, section 1395i-4, by 
  5.35  developing a state rural health plan and designating, consistent 
  5.36  with the rural health plan, rural nonprofit or public hospitals 
  6.1   in the state as critical access hospitals.  Critical access 
  6.2   hospitals shall include facilities that are certified by the 
  6.3   state as necessary providers of health care services to 
  6.4   residents in the area.  Necessary providers of health care 
  6.5   services are designated as critical access hospitals on the 
  6.6   basis of being more than 20 miles, defined as official mileage 
  6.7   as reported by the Minnesota department of transportation, from 
  6.8   the next nearest hospital or, being the sole hospital in the 
  6.9   county or, being a hospital located in a county with a 
  6.10  designated medical medically underserved area or health 
  6.11  professional shortage area, or being a hospital located in a 
  6.12  county contiguous to a county with a medically underserved area 
  6.13  or health professional shortage area.  A critical access 
  6.14  hospital located in a county with a designated medical medically 
  6.15  underserved area or a health professional shortage area or in a 
  6.16  county contiguous to a county with a medically underserved area 
  6.17  or health professional shortage area shall continue to be 
  6.18  recognized as a critical access hospital in the event the 
  6.19  medical medically underserved area or health professional 
  6.20  shortage area designation is subsequently withdrawn; and 
  6.21     (12) carry out other activities necessary to address rural 
  6.22  health problems. 
  6.23     Sec. 5.  Minnesota Statutes 2000, section 149A.01, is 
  6.24  amended by adding a subdivision to read: 
  6.25     Subd. 4.  [NONLIMITING.] Nothing in this chapter shall be 
  6.26  construed to limit the powers granted to the commissioner of 
  6.27  health, commissioner of commerce, state attorney general, or a 
  6.28  county attorney in any other statute, law, or rule. 
  6.29     Sec. 6.  Minnesota Statutes 2000, section 149A.02, 
  6.30  subdivision 14, is amended to read: 
  6.31     Subd. 14.  [DISCIPLINARY ACTION.] "Disciplinary action" 
  6.32  means any action taken by the commissioner regulatory agency 
  6.33  against any person subject to regulation under this chapter for 
  6.34  the violation of or the threatened violation of any law, rule, 
  6.35  order, stipulation agreement, settlement, compliance agreement, 
  6.36  license, or permit adopted, issued, or enforced by 
  7.1   the commissioner regulatory agency. 
  7.2      Sec. 7.  Minnesota Statutes 2000, section 149A.02, is 
  7.3   amended by adding a subdivision to read: 
  7.4      Subd. 37a.  [REGULATORY AGENCY.] "Regulatory agency" means: 
  7.5      (1) the commissioner of health for provisions related to a 
  7.6   funeral provider who is required to be licensed, registered, or 
  7.7   issued a permit under this chapter; and 
  7.8      (2) the commissioner of commerce for provisions related to 
  7.9   insurance policies purchased by a preneed consumer to arrange 
  7.10  for funeral goods, funeral services, burial site goods, or 
  7.11  burial services. 
  7.12     Sec. 8.  Minnesota Statutes 2000, section 149A.11, is 
  7.13  amended to read: 
  7.14     149A.11 [PUBLICATION OF DISCIPLINARY ACTIONS.] 
  7.15     The regulatory agencies shall report all disciplinary 
  7.16  measures or actions taken to the commissioner.  At least 
  7.17  annually, the commissioner shall publish and make available to 
  7.18  the public a description of all disciplinary measures or actions 
  7.19  taken by the commissioner regulatory agencies.  The publication 
  7.20  shall include, for each disciplinary measure or action taken, 
  7.21  the name and business address of the licensee or intern, the 
  7.22  nature of the misconduct, and the measure or action taken by the 
  7.23  commissioner regulatory agency. 
  7.24     Sec. 9.  Minnesota Statutes 2000, section 149A.62, is 
  7.25  amended to read: 
  7.26     149A.62 [IMMUNITY; REPORTING.] 
  7.27     Any person, private agency, organization, society, 
  7.28  association, licensee, or intern who, in good faith, submits 
  7.29  information to the commissioner a regulatory agency under 
  7.30  section 149A.61 or otherwise reports violations or alleged 
  7.31  violations of this chapter, is immune from civil liability or 
  7.32  criminal prosecution.  This section does not prohibit 
  7.33  disciplinary action taken by the commissioner against any 
  7.34  licensee or intern pursuant to a self report of a violation. 
  7.35     Sec. 10.  Minnesota Statutes 2000, section 149A.71, 
  7.36  subdivision 4, is amended to read: 
  8.1      Subd. 4.  [CASKET, ALTERNATE CONTAINER, AND CREMATION 
  8.2   CONTAINER SALES; RECORDS; REQUIRED DISCLOSURES.] Any funeral 
  8.3   provider who sells or offers to sell a casket, alternate 
  8.4   container, or cremation container to the public must maintain a 
  8.5   record of each sale that includes the name of the purchaser, the 
  8.6   purchaser's mailing address, the name of the decedent, the date 
  8.7   of the decedent's death, and the place of death.  These records 
  8.8   shall be open to inspection by the commissioner regulatory 
  8.9   agency and reported to the commissioner.  Any funeral provider 
  8.10  selling a casket, alternate container, or cremation container to 
  8.11  the public, and not having charge of the final disposition of 
  8.12  the dead human body, shall enclose within the casket, alternate 
  8.13  container, or cremation container information provided by the 
  8.14  commissioner that includes a blank certificate of death, and a 
  8.15  copy of the statutes and rules controlling the removal, 
  8.16  preparation, transportation, arrangements for disposition, and 
  8.17  final disposition of a dead human body.  This subdivision does 
  8.18  not apply to morticians, funeral directors, funeral 
  8.19  establishments, crematories, or wholesale distributors of 
  8.20  caskets, alternate containers, or cremation containers. 
  8.21     Sec. 11.  Minnesota Statutes 2000, section 149A.97, 
  8.22  subdivision 8, is amended to read: 
  8.23     Subd. 8.  [INVESTIGATIONS BY STATE AUDITOR.] Upon 
  8.24  notification from the county auditor or the commissioner of 
  8.25  health a regulatory agency of indications of violations of this 
  8.26  chapter, or upon reliable written verification by any person, 
  8.27  the state auditor shall make an independent determination of 
  8.28  whether a violation of the provisions in this chapter is 
  8.29  occurring or is about to occur.  If the state auditor finds such 
  8.30  evidence, the state auditor shall conduct any examinations of 
  8.31  accounts and records of the entity that the state auditor 
  8.32  considers the public interest to demand and shall inform the 
  8.33  appropriate agency of any finding of misconduct.  The state 
  8.34  auditor may require the entity being examined to send all books, 
  8.35  accounts, and vouchers pertaining to the receipt, disbursement, 
  8.36  and custody of funds to the office of the state auditor for 
  9.1   examination.  The person, firm, partnership, association, or 
  9.2   corporation examined under this section by the state auditor 
  9.3   shall reimburse the state auditor for expenses incurred in 
  9.4   conducting the examination within 30 days after the state 
  9.5   auditor submits its expenses.  Interest at the rate established 
  9.6   in section 549.09 shall accrue on the outstanding balance 
  9.7   starting on the 31st day after the state auditor's office 
  9.8   submits its request for expenses. 
  9.9      Sec. 12.  [TRANSFER OF ENFORCEMENT AUTHORITY.] 
  9.10     (a) The terms used in this section have the meanings given 
  9.11  in Minnesota Statutes, section 149A.02. 
  9.12     (b) Except as otherwise provided in statute, enforcement 
  9.13  authority for Minnesota Statutes, sections 149A.70, 149A.71, 
  9.14  149A.72, 149A.73, 149A.74, 149A.745, 149A.75, and 149A.97, may 
  9.15  be exercised for provisions related to insurance policies 
  9.16  purchased by a preneed consumer to arrange for funeral goods, 
  9.17  funeral services, burial site goods, or burial services, 
  9.18  enforcement authority may be exercised by the commissioner of 
  9.19  commerce. 
  9.20     (c) The commissioner of health retains enforcement 
  9.21  authority for provisions of Minnesota Statutes, chapter 149A, 
  9.22  related to funeral providers that are required to be licensed, 
  9.23  registered, or issued a permit under that chapter. 
  9.24     Sec. 13.  [REVISOR'S INSTRUCTION.] 
  9.25     The revisor of statutes shall change the term 
  9.26  "commissioner" or "commissioner of health" to "regulatory 
  9.27  agency" wherever it appears in Minnesota Statutes, sections 
  9.28  149A.04; 149A.05; 149A.06; 149A.07; 149A.08; 149A.09; 149A.10; 
  9.29  149A.60; and 149A.61, subdivisions 1, 2, 3, 6, 7, and 8. 
  9.30     Sec. 14.  [REPEALER.] 
  9.31     Minnesota Statutes 2000, section 144.994, is repealed. 
  9.32     Laws 2000, chapter 488, article 2, section 26, is repealed.