1.1                          A bill for an act 
  1.2             relating to health; requesting that the University of 
  1.3             Minnesota establish and administer a rural 
  1.4             preventative health care program; requesting that the 
  1.5             University of Minnesota operate a rural medical 
  1.6             community information resource system for health care 
  1.7             providers in rural areas; appropriating money; 
  1.8             proposing coding for new law in Minnesota Statutes, 
  1.9             chapter 137. 
  1.10  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.11     Section 1.  [137.44] [RURAL PREVENTATIVE HEALTH CARE 
  1.12  PROGRAM.] 
  1.13     Subdivision 1.  [PROGRAM COMPONENTS.] The board of regents 
  1.14  of the University of Minnesota, through the academic health 
  1.15  center, is requested to establish and coordinate a rural 
  1.16  preventative health care program to increase access to health 
  1.17  screening and health information services and to educate people 
  1.18  in rural areas about long-term strategies for preventing or 
  1.19  reducing the risk of diseases, especially cardiovascular, 
  1.20  reproductive, and thyroid diseases and diabetes, through 
  1.21  lifestyle changes and health promotion programs.  The academic 
  1.22  health center is requested to operate this program in 
  1.23  cooperation with the commissioner of health, the Minnesota 
  1.24  extension service, health plan companies and nonprofit health 
  1.25  service plan corporations that wish to participate, rural family 
  1.26  practice programs, and primary care physicians operating 
  1.27  diabetes prevention programs.  The academic health center is 
  2.1   requested to coordinate this program with existing programs in 
  2.2   the office of rural health and primary care and the Minnesota 
  2.3   extension service. 
  2.4      Subd. 2.  [SITE DESIGNATION.] The academic health center, 
  2.5   in cooperation with the office of rural health and primary care 
  2.6   and the Minnesota extension service, is requested to designate 
  2.7   rural regions of the state or rural communities to participate 
  2.8   in the prevention program.  Sites may be chosen based on an 
  2.9   abnormally high incidence of preventable cardiovascular, 
  2.10  reproductive, and thyroid diseases and diabetes in the region or 
  2.11  community; projected significant declines in population 
  2.12  according to the Minnesota planning state demographic center; 
  2.13  other evidence demonstrating a region's or community's need for 
  2.14  targeted prevention services; interest in prevention programs 
  2.15  expressed by public health nurses, other public health 
  2.16  professionals, and extension service personnel in the region or 
  2.17  community; and other criteria established by the academic health 
  2.18  center. 
  2.19     Subd. 3.  [SCREENING AND HEALTH INFORMATION.] The academic 
  2.20  health center may establish programs to provide screening 
  2.21  services for cardiovascular, reproductive, and thyroid diseases 
  2.22  and diabetes and to create and disseminate health information on 
  2.23  these diseases.  Screening services may be provided and health 
  2.24  information disseminated in conjunction with training meetings 
  2.25  on farm crops and pesticide use offered by the extension service.
  2.26     Subd. 4.  [COORDINATION WITH RURAL PHYSICIANS.] The 
  2.27  academic health center may coordinate its screening programs 
  2.28  with rural family practice physicians in designated regions or 
  2.29  communities by: 
  2.30     (1) providing continuing education programs to rural family 
  2.31  practice physicians on the abnormally high incidence of 
  2.32  cardiovascular, reproductive, and thyroid diseases and diabetes 
  2.33  in the region or community and screening and prevention methods 
  2.34  for these diseases; and 
  2.35     (2) developing programs to refer individuals who have been 
  2.36  screened and who may need additional services to rural family 
  3.1   practice physicians. 
  3.2      Subd. 5.  [LONG-TERM HEALTH PROMOTION STRATEGIES.] The 
  3.3   academic health center is requested to implement long-term 
  3.4   health promotion strategies in designated regions or communities 
  3.5   by: 
  3.6      (1) providing nutrition education services and dietary 
  3.7   alternatives to rural families and children, in coordination 
  3.8   with nutrition education programs offered by the extension 
  3.9   service in schools and hospitals; and 
  3.10     (2) establishing a health promotion program to provide 
  3.11  information on preventing thyroid cancer and reproductive 
  3.12  cancers. 
  3.13     Sec. 2.  [137.45] [RURAL MEDICAL COMMUNITY INFORMATION 
  3.14  RESOURCE SYSTEM.] 
  3.15     Subdivision 1.  [ESTABLISHMENT.] The board of regents of 
  3.16  the University of Minnesota, through the academic health center, 
  3.17  is requested to establish a rural medical community information 
  3.18  resource system to connect health care providers practicing in 
  3.19  rural areas with health care faculty and staff at the academic 
  3.20  health center and with a database of health care information 
  3.21  compiled and maintained by the academic health center.  The 
  3.22  information resource system should be designed so that rural 
  3.23  health care providers are able to correspond with academic 
  3.24  health center faculty and staff through Internet-based 
  3.25  electronic communications, including, but not limited to, 
  3.26  electronic mail, for consultations related to general health 
  3.27  care diagnosis and treatment issues, referral sources, and 
  3.28  environmental and occupational exposure to toxic substances, 
  3.29  including, but not limited to, pesticides.  The academic health 
  3.30  center may consult with teleconferencing and Internet 
  3.31  coordinators at the University of Minnesota in establishing the 
  3.32  system. 
  3.33     Subd. 2.  [PROGRAM ACTIVITIES.] Program activities may 
  3.34  include: 
  3.35     (1) compiling and maintaining a database of information on 
  3.36  general health care diagnosis and treatment issues, resources to 
  4.1   which rural health care providers can be referred for additional 
  4.2   information, and environmental and occupational exposure to 
  4.3   toxic substances, including, but not limited to, pesticides; 
  4.4      (2) establishing a system that allows rural health care 
  4.5   providers to correspond with academic health center faculty and 
  4.6   staff through Internet-based electronic communications, 
  4.7   including, but not limited to, electronic mail, for 
  4.8   consultations on general health care diagnosis and treatment 
  4.9   issues, referral sources, and environmental and occupational 
  4.10  exposure to toxic substances, including, but not limited to, 
  4.11  pesticides.  Staff with the information resource system may 
  4.12  respond to inquiries from rural health care providers by linking 
  4.13  providers with academic health center faculty and staff for 
  4.14  direct consultations using Internet-based electronic 
  4.15  communications or by searching for information in the system 
  4.16  database and forwarding information to providers; and 
  4.17     (3) developing procedures to allow rural health care 
  4.18  providers to obtain information in an expedited manner in 
  4.19  emergency situations.  Certain academic health center faculty 
  4.20  and staff may be designated as on-call for various medical 
  4.21  specializations and provided with alphanumeric pagers or other 
  4.22  similar technology that allows them to immediately receive 
  4.23  notice of incoming electronic mail messages.  Rural providers 
  4.24  may contact the on-call faculty and staff using electronic mail 
  4.25  accounts that are linked to on-call provider alphanumeric pagers 
  4.26  or other similar technology and may then receive emergency 
  4.27  consultation services from on-call faculty and staff. 
  4.28     Subd. 3.  [SITES DESIGNATED.] The academic health center is 
  4.29  requested to designate up to 20 clinics in rural communities to 
  4.30  participate in the information resource system.  For purposes of 
  4.31  this subdivision, "rural" means areas of the state that are 
  4.32  outside the seven-county metropolitan area, as defined in 
  4.33  section 473.121, subdivision 2, and outside of the Duluth, St. 
  4.34  Cloud, East Grand Forks, Moorhead, Rochester, and LaCrosse 
  4.35  census defined urbanized areas.  Each designated site shall 
  4.36  receive any equipment needed to contact academic health center 
  5.1   faculty and staff for consultations using Internet-based 
  5.2   electronic communication, including, but not limited to, 
  5.3   electronic mail, from that site. 
  5.4      Subd. 4.  [FEE SCHEDULE.] The academic health center may 
  5.5   establish a schedule of fees to be charged to participating 
  5.6   rural clinics for using faculty and staff resources and the 
  5.7   database of health care information through the information 
  5.8   resource system. 
  5.9      Sec. 3.  [APPROPRIATION.] 
  5.10     $....... is appropriated from the general fund to the board 
  5.11  of regents of the University of Minnesota for the biennium 
  5.12  ending June 30, 2001, for the rural preventative health care 
  5.13  program under section 1 and the rural medical community 
  5.14  information resource system under section 2.  Of this amount: 
  5.15     (1) $....... is for the rural preventative health care 
  5.16  program; and 
  5.17     (2) $....... is for the rural medical community information 
  5.18  resource system.