2006 Minnesota Statutes

CHAPTER 144. DEPARTMENT OF HEALTH

144.001 APPLICATION OF LAWS 2005, CHAPTER 56, TERMINOLOGY CHANGES.
State agencies shall use the terminology changes specified in Laws 2005, chapter 56, section
1, when printed material and signage are replaced and new printed material and signage are
obtained. State agencies do not have to replace existing printed material and signage to comply
with Laws 2005, chapter 56, sections 1 and 2. Language changes made according to Laws 2005,
chapter 56, sections 1 and 2, shall not expand or exclude eligibility to services.
History: 2005 c 56 s 3

STATE COMMISSIONER OF HEALTH

144.01 [Repealed, 1977 c 305 s 46]

144.011 DEPARTMENT OF HEALTH.
    Subdivision 1. Commissioner. The Department of Health shall be under the control and
supervision of the commissioner of health who shall be appointed by the governor under the
provisions of section 15.06. The State Board of Health is abolished and all powers and duties of the
board are transferred to the commissioner of health. The commissioner shall be selected without
regard to political affiliation but with regard to ability and experience in matters of public health.
    Subd. 2. State Health Advisory Task Force. The commissioner of health may appoint a
State Health Advisory Task Force. If appointed, members of the task force shall be broadly
representative of the licensed health professions and shall also include public members as defined
by section 214.02. The task force shall expire, and the terms, compensation, and removal of
members shall be as provided in section 15.059.
History: 1977 c 305 s 39; 1983 c 260 s 30

144.02 [Repealed, 1977 c 305 s 46]

144.03 [Repealed, 1977 c 305 s 46]

144.04 [Repealed, 1977 c 305 s 46]

144.05 GENERAL DUTIES OF COMMISSIONER; REPORTS.
    Subdivision 1. General duties. The state commissioner of health shall have general authority
as the state's official health agency and shall be responsible for the development and maintenance
of an organized system of programs and services for protecting, maintaining, and improving the
health of the citizens. This authority shall include but not be limited to the following:
(a) Conduct studies and investigations, collect and analyze health and vital data, and identify
and describe health problems;
(b) Plan, facilitate, coordinate, provide, and support the organization of services for the
prevention and control of illness and disease and the limitation of disabilities resulting therefrom;
(c) Establish and enforce health standards for the protection and the promotion of the public's
health such as quality of health services, reporting of disease, regulation of health facilities,
environmental health hazards and personnel;
(d) Affect the quality of public health and general health care services by providing
consultation and technical training for health professionals and paraprofessionals;
(e) Promote personal health by conducting general health education programs and
disseminating health information;
(f) Coordinate and integrate local, state and federal programs and services affecting the
public's health;
(g) Continually assess and evaluate the effectiveness and efficiency of health service systems
and public health programming efforts in the state; and
(h) Advise the governor and legislature on matters relating to the public's health.
    Subd. 2. Mission; efficiency. It is part of the department's mission that within the
department's resources the commissioner shall endeavor to:
(1) prevent the waste or unnecessary spending of public money;
(2) use innovative fiscal and human resource practices to manage the state's resources and
operate the department as efficiently as possible;
(3) coordinate the department's activities wherever appropriate with the activities of other
governmental agencies;
(4) use technology where appropriate to increase agency productivity, improve customer
service, increase public access to information about government, and increase public participation
in the business of government;
(5) utilize constructive and cooperative labor-management practices to the extent otherwise
required by chapters 43A and 179A;
(6) report to the legislature on the performance of agency operations and the accomplishment
of agency goals in the agency's biennial budget according to section 16A.10, subdivision 1; and
(7) recommend to the legislature appropriate changes in law necessary to carry out the
mission and improve the performance of the department.
    Subd. 3. Appropriation transfers to be reported. When the commissioner transfers
operational money between programs under section 16A.285, in addition to the requirements of
that section the commissioner must provide the chairs of the legislative committees that have
jurisdiction over the agency's budget with sufficient detail to identify the account to which the
money was originally appropriated, and the account to which the money is being transferred.
    Subd. 4. Identification of deceased individuals. Upon receiving notice under section
149A.90, subdivision 1, of the death of an individual who cannot be identified, the commissioner
must post on the department's Web site information regarding the individual for purposes of
obtaining information that may aid in identifying the individual and for purposes of notifying
relatives who may be seeking the individual. The information must remain on the Web site
continuously until the person's identity is determined.
History: (5339) RL s 2130; 1973 c 356 s 2; 1977 c 305 s 45; 1986 c 444; 1995 c 248 art 11 s
11; 1998 c 366 s 57; 1999 c 245 art 1 s 14; 2002 c 375 art 3 s 4

144.0505 COOPERATION WITH COMMISSIONER OF HUMAN SERVICES.
The commissioner shall promptly provide to the commissioner of human services upon
request information on hospital revenues, nursing home licensure, and health maintenance
organization revenues specifically required by the commissioner of human services to operate the
provider surcharge program.
History: 1992 c 513 art 7 s 1

144.0506 AGENCY WEB SITES.
    Subdivision 1. Information to be posted. The commissioner of health may post the
following information on agency Web sites, including minnesotahealthinfo.com:
(1) healthy lifestyle and preventive health care information, organized by sex and age, with
procedures and treatments categorized by level of effectiveness and reliability of the supporting
evidence on effectiveness;
(2) health plan company administrative efficiency report cards;
(3) health care provider charges for common procedures, based on information available
under section 62J.052;
(4) evidence-based medicine guidelines and related information for use as resources by
health care professionals, and summaries of the guidelines and related information for use by
patients and consumers;
(5) resources and Web links related to improving efficiency in medical clinics and health care
professional practices; and
(6) lists of nonprofit and charitable entities that accept donations of used medical equipment
and supplies, such as crutches and walkers.
    Subd. 2. Other Internet resources. The commissioner of health, in implementing
subdivision 1, shall include relevant Web links and materials from private sector and other
government sources in order to avoid duplication and reduce state administrative costs.
    Subd. 3. Cooperation with commissioner of commerce. The commissioner of health shall
consult and work in cooperation with the commissioner of commerce when posting on the Web site
information collected from health plan companies regulated by the commissioner of commerce.
History: 2006 c 267 art 1 s 2

144.051 DATA RELATING TO LICENSED AND REGISTERED PERSONS.
    Subdivision 1. Purpose. The legislature finds that accurate information pertaining to the
numbers, distribution and characteristics of health-related personnel is required in order that
there exist an adequate information resource at the state level for purposes of making decisions
pertaining to health personnel.
    Subd. 2. Information system. The commissioner of health shall establish a system for
the collection, analysis and reporting of data on individuals licensed or registered by the
commissioner or the health-related licensing boards as defined in section 214.01, subdivision 2.
Individuals licensed or registered by the commissioner or the health-related licensing boards shall
provide information to the commissioner of health that the commissioner may, pursuant to section
144.052, require. The commissioner shall publish at least biennially, a report which indicates the
type of information available and methods for requesting the information.
History: 1978 c 759 s 1; 1986 c 444

144.052 USE OF DATA.
    Subdivision 1. Rules. The commissioner, after consultation with the health-related licensing
boards as defined in section 214.01, subdivision 2, shall promulgate rules in accordance with
chapter 14 regarding the types of information collected and the forms used for collection. The
types of information collected shall include licensure or registration status, name, address, birth
date, sex, professional activity status, and educational background or similar information needed
in order to make decisions pertaining to health personnel.
    Subd. 2. Coordination with licensure renewal. In order that the collection of the
information specified in this section not impose an unnecessary burden on the licensed or
registered individual or require additional administrative cost to the state, the commissioner of
health shall, whenever possible, collect the information at the time of the individual's licensure
or registration renewal. The health-related licensing boards shall include the request for the
information that the commissioner may require pursuant to subdivision 1 with the licensure
renewal application materials, provided, however, that the collection of health personnel data
by the commissioner shall not cause the licensing boards to incur additional costs or delays
with regard to the license renewal process.
History: 1978 c 759 s 2; 1982 c 424 s 130; 1986 c 444

144.0525 EPIDEMIOLOGIC STUDIES; HEALTH HAZARDS; HEALTH
SURVEILLANCE.
All data collected by the commissioner of health under sections 176.234, 268.19, and
270B.14, subdivision 11, shall be used only for the purposes of epidemiologic investigations,
notification of persons exposed to health hazards as a result of employment, and surveillance
of occupational health and safety.
History: 1991 c 202 s 5; 1992 c 569 s 7; 1994 c 483 s 1; 1997 c 66 s 79

144.053 RESEARCH STUDIES CONFIDENTIAL.
    Subdivision 1. Status of data collected by commissioner. All information, records of
interviews, written reports, statements, notes, memoranda, or other data procured by the state
commissioner of health, in connection with studies conducted by the state commissioner of health,
or carried on by the said commissioner jointly with other persons, agencies or organizations,
or procured by such other persons, agencies or organizations, for the purpose of reducing the
morbidity or mortality from any cause or condition of health shall be confidential and shall be
used solely for the purposes of medical or scientific research.
    Subd. 2. Limits on use and disclosure. Such information, records, reports, statements, notes,
memoranda, or other data shall not be admissible as evidence in any action of any kind in any
court or before any other tribunal, board, agency or person. Such information, records, reports,
statements, notes, memoranda, or other data shall not be exhibited nor their contents disclosed in
any way, in whole or in part, by any representative of the state commissioner of health, nor by any
other person, except as may be necessary for the purpose of furthering the research project to
which they relate. No person participating in such research project shall disclose, in any manner,
the information so obtained except in strict conformity with such research project. No employee
of said commissioner shall interview any patient named in any such report, nor a relative of any
such patient, unless the consent of the attending physician and surgeon is first obtained.
    Subd. 3. No liability for giving information. The furnishing of such information to the state
commissioner of health or an authorized representative, or to any other cooperating agency in
such research project, shall not subject any person, hospital, sanitarium, nursing home or other
person or agency furnishing such information, to any action for damages or other relief.
    Subd. 4. Violation a misdemeanor. Any disclosure other than is provided for in this section,
is hereby declared to be a misdemeanor and punishable as such.
    Subd. 5. Personally identifying information. The commissioner of health or the
commissioner's agent is not required to solicit information that personally identifies persons
selected to participate in an epidemiologic study if the commissioner determines that:
(1) the study monitors incidence or prevalence of a serious disease to detect potential health
problems and predict risks, provides specific information to develop public health strategies to
prevent serious disease, enables the targeting of intervention resources for communities, patients,
or groups at risk of the disease, and informs health professionals about risks, early detection,
or treatment of the disease;
(2) the personally identifying information is not necessary to validate the quality, accuracy,
or completeness of the study; or
(3) the collection of personally identifying information may seriously jeopardize the validity
of study results, as demonstrated by an epidemiologic study.
History: 1955 c 769 s 1-4; 1976 c 173 s 31; 1977 c 305 s 45; 1986 c 444; 1988 c 689
art 2 s 29

144.0535 ENTRY FOR INSPECTION.
For the purposes of performing their official duties, all officers and employees of the state
Department of Health shall have the right to enter any building, conveyance, or place where
contagion, infection, filth, or other source or cause of preventable disease exists or is reasonably
suspected.
History: 1989 c 282 art 2 s 7

144.054 SUBPOENA POWER.
    Subdivision 1. Generally. The commissioner may, as part of an investigation to determine
whether a serious health threat exists or to locate persons who may have been exposed to an agent
which can seriously affect their health, issue subpoenas to require the attendance and testimony of
witnesses and production of books, records, correspondence, and other information relevant to
any matter involved in the investigation. The commissioner or the commissioner's designee may
administer oaths to witnesses or take their affirmation. The subpoenas may be served upon any
person named therein anywhere in the state by any person authorized to serve subpoenas or other
processes in civil actions of the district courts. If a person to whom a subpoena is issued does not
comply with the subpoena, the commissioner may apply to the district court in any district and
the court shall order the person to comply with the subpoena. Failure to obey the order of the
court may be punished by the court as contempt of court. Except as provided in subdivision 2,
no person may be compelled to disclose privileged information as described in section 595.02,
subdivision 1 . All information pertaining to individual medical records obtained under this section
shall be considered health data under section 13.3805, subdivision 1. The fees for the service of a
subpoena must be paid in the same manner as prescribed by law for a service of process issued
out of a district court. Witnesses must receive the same fees and mileage as in civil actions.
    Subd. 2. HIV; HBV. The commissioner may subpoena privileged medical information of
patients who may have been exposed by a licensed dental hygienist, dentist, physician, nurse,
podiatrist, a registered dental assistant, or a physician's assistant who is infected with the human
immunodeficiency virus (HIV) or hepatitis B virus (HBV) when the commissioner has determined
that it may be necessary to notify those patients that they may have been exposed to HIV or HBV.
History: 1988 c 579 s 1; 1992 c 559 art 1 s 1; 1999 c 227 s 22

144.055 HOME SAFETY PROGRAMS.
    Subdivision 1. Preventing home accidents; working with local boards. The state
commissioner of health is authorized to develop and conduct by exhibit, demonstration and by
health education or public health engineering activity, or by any other means or methods which
the commissioner may determine to be suitable and practicable for the purpose, a program in
home safety designed to prevent accidents and fatalities resulting therefrom. The commissioner
shall cooperate with boards of health as defined in section 145A.02, subdivision 2, the Minnesota
Safety Council, and other interested voluntary groups in its conduct of such programs.
    Subd. 2. Sharing equipment and staff. For the purpose of assisting boards of health to
develop community home safety programs and to conduct such surveys of safety hazards in
municipalities and counties, the commissioner may loan or furnish exhibit, demonstration, and
educational materials, and may assign personnel for a limited period to such boards of health.
History: 1957 c 290 s 1; 1977 c 305 s 45; 1987 c 309 s 24

144.056 PLAIN LANGUAGE IN WRITTEN MATERIALS.
(a) To the extent reasonable and consistent with the goals of providing easily understandable
and readable materials and complying with federal and state laws governing the program, all
written materials relating to determinations of eligibility for or amounts of benefits that will be
given to applicants for or recipients of assistance under a program administered or supervised by
the commissioner of health must be understandable to a person who reads at the seventh-grade
level, using the Flesch scale analysis readability score as determined under section 72C.09.
(b) All written materials relating to services and determinations of eligibility for or amounts
of benefits that will be given to applicants for or recipients of assistance under programs
administered or supervised by the commissioner of health must be developed to satisfy the plain
language requirements of the Plain Language Contract Act under sections 325G.29 to 325G.36.
Materials may be submitted to the attorney general for review and certification. Notwithstanding
section 325G.35, subdivision 1, the attorney general shall review submitted materials to determine
whether they comply with the requirements of section 325G.31. The remedies available pursuant
to sections 8.31 and 325G.33 to 325G.36 do not apply to these materials. Failure to comply with
this section does not provide a basis for suspending the implementation or operation of other laws
governing programs administered by the commissioner.
(c) The requirements of this section apply to all materials modified or developed by the
commissioner on or after July 1, 1988. The requirements of this section do not apply to materials
that must be submitted to a federal agency for approval to the extent that application of the
requirements prevents federal approval.
(d) Nothing in this section may be construed to prohibit a lawsuit brought to require
the commissioner to comply with this section or to affect individual appeal rights under the
special supplemental food program for women, infants, and children granted pursuant to federal
regulations under the Code of Federal Regulations, chapter 7, section 246.
History: 1988 c 689 art 2 s 30; 1997 c 7 art 2 s 13

144.057 BACKGROUND STUDIES ON LICENSEES AND OTHER PERSONNEL.
    Subdivision 1. Background studies required. The commissioner of health shall contract
with the commissioner of human services to conduct background studies of:
(1) individuals providing services which have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes, outpatient
surgical centers licensed under sections 144.50 to 144.58; nursing homes and home care agencies
licensed under chapter 144A; residential care homes licensed under chapter 144B, and board and
lodging establishments that are registered to provide supportive or health supervision services
under section 157.17;
(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact
services in a nursing home or a home care agency licensed under chapter 144A or a boarding
care home licensed under sections 144.50 to 144.58, and if the individual under study resides
outside Minnesota, the study must be at least as comprehensive as that of a Minnesota resident
and include a search of information from the criminal justice data communications network in the
state where the subject of the study resides;
(3) beginning July 1, 1999, all other employees in nursing homes licensed under chapter
144A, and boarding care homes licensed under sections 144.50 to 144.58. A disqualification
of an individual in this section shall disqualify the individual from positions allowing direct
contact or access to patients or residents receiving services. "Access" means physical access to
a client or the client's personal property without continuous, direct supervision as defined in
section 245C.02, subdivision 8, when the employee's employment responsibilities do not include
providing direct contact services;
(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; and
(5) controlling persons of a supplemental nursing services agency, as defined under section
144A.70.
If a facility or program is licensed by the Department of Human Services and subject to
the background study provisions of chapter 245C and is also licensed by the Department of
Health, the Department of Human Services is solely responsible for the background studies of
individuals in the jointly licensed programs.
    Subd. 2. Responsibilities of Department of Human Services. The Department of Human
Services shall conduct the background studies required by subdivision 1 in compliance with the
provisions of chapter 245C. For the purpose of this section, the term "residential program" shall
include all facilities described in subdivision 1. The Department of Human Services shall provide
necessary forms and instructions, shall conduct the necessary background studies of individuals,
and shall provide notification of the results of the studies to the facilities, supplemental nursing
services agencies, individuals, and the commissioner of health. Individuals shall be disqualified
under the provisions of chapter 245C. If an individual is disqualified, the Department of Human
Services shall notify the facility, the supplemental nursing services agency, and the individual
and shall inform the individual of the right to request a reconsideration of the disqualification by
submitting the request to the Department of Health.
    Subd. 3. Reconsiderations. The commissioner of health shall review and decide
reconsideration requests, including the granting of variances, in accordance with the procedures
and criteria contained in chapter 245C. The commissioner's decision shall be provided to the
individual and to the Department of Human Services. The commissioner's decision to grant or
deny a reconsideration of disqualification is the final administrative agency action, except for the
provisions under sections 245C.25, 245C.27, and 245C.28, subdivision 3.
    Subd. 4. Responsibilities of facilities and agencies. Facilities and agencies described in
subdivision 1 shall be responsible for cooperating with the departments in implementing the
provisions of this section. The responsibilities imposed on applicants and licensees under chapters
245A and 245C shall apply to these facilities and supplemental nursing services agencies. The
provision of section 245C.09, shall apply to applicants, licensees, registrants, or an individual's
refusal to cooperate with the completion of the background studies. Supplemental nursing
services agencies subject to the registration requirements in section 144A.71 must maintain
records verifying compliance with the background study requirements under this section.
History: 1995 c 229 art 3 s 4; 1996 c 305 art 1 s 35; 1996 c 408 art 10 s 1-3; 1997 c 248 s
1; 1Sp2001 c 9 art 7 s 1; art 14 s 2; 2002 c 379 art 1 s 49,113; 2003 c 15 art 1 s 33

144.06 STATE COMMISSIONER OF HEALTH TO PROVIDE INSTRUCTION.
The state commissioner of health, hereinafter referred to as the commissioner, is hereby
authorized to provide instruction and advice to expectant mothers and fathers during pregnancy
and to mothers, fathers, and their infants after childbirth; and to employ such persons as may be
necessary to carry out the requirements of sections 144.06 and 144.07. The instruction, advice,
and care shall be given only to applicants residing within the state. No person receiving aid under
this section and sections 144.07 and 144.09 shall for this reason be affected thereby in any civil
or political rights, nor shall the person's identity be disclosed except upon written order of the
commissioner.
History: (5340, 5341, 5342) 1921 c 392 s 1-3; 1977 c 305 s 45; 1981 c 31 s 2

144.062 VACCINE COST REDUCTION PROGRAM.
The commissioner of administration, after consulting with the commissioner of health, shall
negotiate discounts or rebates on vaccine or may purchase vaccine at reduced prices. Vaccines may
be offered for sale to medical care providers at the department's cost plus a fee for administrative
costs. As a condition of receiving the vaccine at reduced cost, a medical care provider must agree
to pass on the savings to patients. The commissioner of health may transfer money appropriated
for other Department of Health programs to the commissioner of administration for the initial
cost of purchasing vaccine, provided the money is repaid by the end of each state fiscal year
and the commissioner of finance approves the transfer. Proceeds from the sale of vaccines to
medical care providers, including fees collected for administrative costs, are appropriated to the
commissioner of administration. If the commissioner of administration, in consultation with the
commissioner of health, determines that a vaccine cost reduction program is not economically
feasible or cost-effective, the commissioner may elect not to implement the program.
History: 1990 c 568 art 2 s 5; 1997 c 7 art 2 s 14

144.065 PREVENTION AND TREATMENT OF SEXUALLY TRANSMITTED
INFECTIONS.
The state commissioner of health shall assist local health agencies and organizations
throughout the state with the development and maintenance of services for the detection and
treatment of sexually transmitted infections. These services shall provide for research, screening
and diagnosis, treatment, case finding, investigation, and the dissemination of appropriate
educational information. The state commissioner of health shall determine the composition of
such services and shall establish a method of providing funds to boards of health as defined
in section 145A.02, subdivision 2, state agencies, state councils, and nonprofit corporations,
which offer such services. The state commissioner of health shall provide technical assistance
to such agencies and organizations in accordance with the needs of the local area. Planning and
implementation of services and technical assistance may be conducted in collaboration with
boards of health; state agencies, including the University of Minnesota and the Department of
Education; state councils; nonprofit organizations; and representatives of affected populations.
History: 1974 c 575 s 6; 1977 c 305 s 45; 1985 c 248 s 70; 1999 c 245 art 2 s 15; 2003
c 130 s 12

144.07 POWERS OF COMMISSIONER.
The commissioner may:
(1) make all reasonable rules necessary to carry into effect the provisions of this section and
sections 144.06 and 144.09, and may amend, alter, or repeal such rules;
(2) accept private gifts for the purpose of carrying out the provisions of those sections;
(3) cooperate with agencies, whether city, state, federal, or private, which carry on work for
maternal and infant hygiene;
(4) make investigations and recommendations for the purpose of improving maternity care;
(5) promote programs and services available in Minnesota for parents and families of victims
of sudden infant death syndrome; and
(6) collect and report to the legislature the most current information regarding the frequency
and causes of sudden infant death syndrome.
The commissioner shall include in the report to the legislature a statement of the operation of
those sections.
History: (5343) 1921 c 392 s 4; 1977 c 305 s 45; 1984 c 637 s 1; 1985 c 248 s 70; 1986 c 444

144.071 MERIT SYSTEM FOR LOCAL EMPLOYEES.
The commissioner may establish a merit system for employees of county or municipal
health departments or public health nursing services or health districts, and may promulgate rules
governing the administration and operation thereof. In the establishment and administration
of the merit system authorized by this section, the commissioner may utilize facilities and
personnel of any state department or agency with the consent of such department or agency. The
commissioner may also, by rule, cooperate with the federal government in any manner necessary
to qualify for federal aid.
History: 1969 c 1073 s 1; 1977 c 305 s 45; 1985 c 248 s 70

144.072 IMPLEMENTATION OF SOCIAL SECURITY AMENDMENTS OF 1972.
    Subdivision 1. Rules. The state commissioner of health shall implement by rule, pursuant to
the Administrative Procedure Act, those provisions of the Social Security Amendments of 1972
(Public Law 92-603) required of state health agencies, including rules which:
(a) establish a plan, consistent with regulations prescribed by the secretary of health,
education, and welfare, for the review by appropriate professional health personnel, of the
appropriateness and quality of care and services furnished to recipients of medical assistance; and
(b) provide for the determination as to whether institutions and agencies meet the
requirements for participation in the medical assistance program, and the certification that those
requirements, including utilization review, are being met.
    Subd. 2. Existing procedures. The policies and procedures, including survey forms,
reporting forms, and other documents developed by the commissioner of health for the purpose of
conducting the inspections of care required under Code of Federal Regulations, title 42, sections
456.600 to 456.614, in effect on March 1, 1984, have the force and effect of law and shall remain
in effect and govern inspections of care until June 30, 1987, unless otherwise superseded by
rules adopted by the commissioner of health.
History: 1973 c 717 s 1; 1977 c 305 s 45; 1984 c 641 s 10; 1986 c 316 s 1

144.0721 ASSESSMENTS OF CARE AND SERVICES TO NURSING HOME
RESIDENTS.
    Subdivision 1. Appropriateness and quality. Until the date of implementation of the
revised case mix system based on the minimum data set, the commissioner of health shall
assess the appropriateness and quality of care and services furnished to private paying residents
in nursing homes and boarding care homes that are certified for participation in the medical
assistance program under United States Code, title 42, sections 1396-1396p. These assessments
shall be conducted until the date of implementation of the revised case mix system based on the
minimum data set, in accordance with section 144.072, with the exception of provisions requiring
recommendations for changes in the level of care provided to the private paying residents.
    Subd. 2. Access to data. With the exception of summary data, data on individuals that is
collected, maintained, used, or disseminated by the commissioner of health under subdivision 1 is
private data on individuals and shall not be disclosed to others except:
(1) under section 13.05;
(2) under a valid court order;
(3) to the nursing home or boarding care home in which the individual resided at the time the
assessment was completed;
(4) to the commissioner of human services; or
(5) to county home care staff for the purpose of assisting the individual to be discharged
from a nursing home or boarding care home and returned to the community.
    Subd. 3.[Repealed, 1998 c 407 art 4 s 69]
    Subd. 3a.[Repealed, 1998 c 407 art 4 s 69]
History: 1984 c 641 s 11; 1984 c 654 art 5 s 58; 1995 c 207 art 6 s 1,2; 1995 c 259 art 1 s
31; 1997 c 203 art 4 s 3; 1Sp2001 c 9 art 5 s 1; 2002 c 379 art 1 s 113

144.0722 RESIDENT REIMBURSEMENT CLASSIFICATIONS.
    Subdivision 1. Resident reimbursement classifications. The commissioner of health
shall establish resident reimbursement classifications based upon the assessments of residents
of nursing homes and boarding care homes conducted under sections 144.072 and 144.0721,
or under rules established by the commissioner of human services under sections 256B.41 to
256B.48. The reimbursement classifications established by the commissioner must conform to
the rules established by the commissioner of human services.
    Subd. 2. Notice of resident reimbursement classification. The commissioner of health shall
notify each resident, and the nursing home or boarding care home in which the resident resides,
of the reimbursement classification established under subdivision 1. The notice must inform the
resident of the classification that was assigned, the opportunity to review the documentation
supporting the classification, the opportunity to obtain clarification from the commissioner,
and the opportunity to request a reconsideration of the classification. The notice of resident
classification must be sent by first-class mail. The individual resident notices may be sent to the
resident's nursing home or boarding care home for distribution to the resident. The nursing home
or boarding care home is responsible for the distribution of the notice to each resident, to the
person responsible for the payment of the resident's nursing home expenses, or to another person
designated by the resident. This notice must be distributed within three working days after the
facility's receipt of the notices from the department.
    Subd. 2a. Semiannual assessment by nursing facilities. Notwithstanding Minnesota Rules,
part 9549.0059, subpart 2, item B, the individual dependencies items 21 to 24 and 28 are required
to be completed in accordance with the Facility Manual for Completing Case Mix Requests for
Classification, July 1987, issued by the Minnesota Department of Health.
    Subd. 3. Request for reconsideration. The resident or the nursing home or boarding care
home may request that the commissioner reconsider the assigned reimbursement classification.
The request for reconsideration must be submitted in writing to the commissioner within 30 days
of the receipt of the notice of resident classification. For reconsideration requests submitted by
or on behalf of the resident, the time period for submission of the request begins as of the date
the resident or the resident's representative receives the classification notice. The request for
reconsideration must include the name of the resident, the name and address of the facility in
which the resident resides, the reasons for the reconsideration, the requested classification changes,
and documentation supporting the requested classification. The documentation accompanying the
reconsideration request is limited to documentation establishing that the needs of the resident at
the time of the assessment resulting in the disputed classification justify a change of classification.
    Subd. 3a. Access to information. Upon written request, the nursing home or boarding care
home must give the resident or the resident's representative a copy of the assessment form and the
other documentation that was given to the department to support the assessment findings. The
nursing home or boarding care home shall also provide access to and a copy of other information
from the resident's record that has been requested by or on behalf of the resident to support a
resident's reconsideration request. A copy of any requested material must be provided within three
working days of receipt of a written request for the information. If a facility fails to provide the
material within this time, it is subject to the issuance of a correction order and penalty assessment
under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order
issued under this subdivision must require that the facility immediately comply with the request
for information and that as of the date of the issuance of the correction order, the facility shall
forfeit to the state a $100 fine the first day of noncompliance, and an increase in the $100 fine
by $50 increments for each day the noncompliance continues. For the purposes of this section,
"representative" includes the resident's guardian or conservator, the person authorized to pay the
nursing home expenses of the resident, a representative of the nursing home ombudsman's office
whose assistance has been requested, or any other individual designated by the resident.
    Subd. 3b. Facility's request for reconsideration. In addition to the information required
in subdivision 3, a reconsideration request from a nursing home or boarding care home
must contain the following information: the date the resident reimbursement classification
notices were received by the facility; the date the classification notices were distributed to the
resident or the resident's representative; and a copy of a notice sent to the resident or to the
resident's representative. This notice must tell the resident or the resident's representative that a
reconsideration of the resident's classification is being requested, the reason for the request, that
the resident's rate will change if the request is approved by the department and the extent of the
change, that copies of the facility's request and supporting documentation are available for review,
and that the resident also has the right to request a reconsideration. If the facility fails to provide
this information with the reconsideration request, the request must be denied, and the facility may
not make further reconsideration requests on that specific reimbursement classification.
    Subd. 4. Reconsideration. The commissioner's reconsideration must be made by individuals
not involved in reviewing the assessment that established the disputed classification. The
reconsideration must be based upon the initial assessment and upon the information provided to
the commissioner under subdivision 3. If necessary for evaluating the reconsideration request,
the commissioner may conduct on-site reviews. In its discretion, the commissioner may review
the reimbursement classifications assigned to all residents in the facility. Within 15 working
days of receiving the request for reconsideration, the commissioner shall affirm or modify the
original resident classification. The original classification must be modified if the commissioner
determines that the assessment resulting in the classification did not accurately reflect the needs of
the resident at the time of the assessment. The resident and the nursing home or boarding care
home shall be notified within five working days after the decision is made. The commissioner's
decision under this subdivision is the final administrative decision of the agency.
    Subd. 5. Audit authority. The Department of Health may audit assessments of nursing home
and boarding care home residents. These audits may be in addition to the assessments completed
by the department under section 144.0721. The audits may be conducted at the facility, and the
department may conduct the audits on an unannounced basis.
History: 1Sp1985 c 3 s 1; 1987 c 209 s 2; 1996 c 451 art 5 s 3

144.0723 [Repealed, 1999 c 245 art 3 s 51]

144.0724 RESIDENT REIMBURSEMENT CLASSIFICATION.
    Subdivision 1. Resident reimbursement classifications. The commissioner of health shall
establish resident reimbursement classifications based upon the assessments of residents of
nursing homes and boarding care homes conducted under this section and according to section
256B.438. The reimbursement classifications established under this section shall be implemented
after June 30, 2002, but no later than January 1, 2003.
    Subd. 2. Definitions. For purposes of this section, the following terms have the meanings
given.
(a) Assessment reference date. "Assessment reference date" means the last day of the
minimum data set observation period. The date sets the designated endpoint of the common
observation period, and all minimum data set items refer back in time from that point.
(b) Case mix index. "Case mix index" means the weighting factors assigned to the RUG-III
classifications.
(c) Index maximization. "Index maximization" means classifying a resident who could be
assigned to more than one category, to the category with the highest case mix index.
(d) Minimum data set. "Minimum data set" means the assessment instrument specified by
the Centers for Medicare and Medicaid Services and designated by the Minnesota Department
of Health.
(e) Representative. "Representative" means a person who is the resident's guardian
or conservator, the person authorized to pay the nursing home expenses of the resident, a
representative of the nursing home ombudsman's office whose assistance has been requested, or
any other individual designated by the resident.
(f) Resource utilization groups or RUG. "Resource utilization groups" or "RUG" means
the system for grouping a nursing facility's residents according to their clinical and functional
status identified in data supplied by the facility's minimum data set.
    Subd. 3. Resident reimbursement classifications. (a) Resident reimbursement
classifications shall be based on the minimum data set, version 2.0 assessment instrument, or its
successor version mandated by the Centers for Medicare and Medicaid Services that nursing
facilities are required to complete for all residents. The commissioner of health shall establish
resident classes according to the 34 group, resource utilization groups, version III or RUG-III
model. Resident classes must be established based on the individual items on the minimum data
set and must be completed according to the facility manual for case mix classification issued by
the Minnesota Department of Health. The facility manual for case mix classification shall be
drafted by the Minnesota Department of Health and presented to the chairs of health and human
services legislative committees by December 31, 2001.
(b) Each resident must be classified based on the information from the minimum data set
according to general domains in clauses (1) to (7):
(1) extensive services where a resident requires intravenous feeding or medications,
suctioning, or tracheostomy care, or is on a ventilator or respirator;
(2) rehabilitation where a resident requires physical, occupational, or speech therapy;
(3) special care where a resident has cerebral palsy; quadriplegia; multiple sclerosis; pressure
ulcers; ulcers; fever with vomiting, weight loss, pneumonia, or dehydration; surgical wounds with
treatment; or tube feeding and aphasia; or is receiving radiation therapy;
(4) clinically complex status where a resident has tube feeding, burns, coma, septicemia,
pneumonia, internal bleeding, chemotherapy, dialysis, oxygen, transfusions, foot infections or
lesions with treatment, hemiplegia/hemiparesis, physician visits or order changes, or diabetes
with injections and order changes;
(5) impaired cognition where a resident has poor cognitive performance;
(6) behavior problems where a resident exhibits wandering or socially inappropriate or
disruptive behavior, has hallucinations or delusions, is physically or verbally abusive toward
others, or resists care, unless the resident's other condition would place the resident in other
categories; and
(7) reduced physical functioning where a resident has no special clinical conditions.
(c) The commissioner of health shall establish resident classification according to a 34 group
model based on the information on the minimum data set and within the general domains listed in
paragraph (b), clauses (1) to (7). Detailed descriptions of each resource utilization group shall be
defined in the facility manual for case mix classification issued by the Minnesota Department of
Health. The 34 groups are described as follows:
(1) SE3: requires four or five extensive services;
(2) SE2: requires two or three extensive services;
(3) SE1: requires one extensive service;
(4) RAD: requires rehabilitation services and is dependent in activity of daily living (ADL)
at a count of 17 or 18;
(5) RAC: requires rehabilitation services and ADL count is 14 to 16;
(6) RAB: requires rehabilitation services and ADL count is ten to 13;
(7) RAA: requires rehabilitation services and ADL count is four to nine;
(8) SSC: requires special care and ADL count is 17 or 18;
(9) SSB: requires special care and ADL count is 15 or 16;
(10) SSA: requires special care and ADL count is seven to 14;
(11) CC2: clinically complex with depression and ADL count is 17 or 18;
(12) CC1: clinically complex with no depression and ADL count is 17 or 18;
(13) CB2: clinically complex with depression and ADL count is 12 to 16;
(14) CB1: clinically complex with no depression and ADL count is 12 to 16;
(15) CA2: clinically complex with depression and ADL count is four to 11;
(16) CA1: clinically complex with no depression and ADL count is four to 11;
(17) IB2: impaired cognition with nursing rehabilitation and ADL count is six to ten;
(18) IB1: impaired cognition with no nursing rehabilitation and ADL count is six to ten;
(19) IA2: impaired cognition with nursing rehabilitation and ADL count is four or five;
(20) IA1: impaired cognition with no nursing rehabilitation and ADL count is four or five;
(21) BB2: behavior problems with nursing rehabilitation and ADL count is six to ten;
(22) BB1: behavior problems with no nursing rehabilitation and ADL count is six to ten;
(23) BA2: behavior problems with nursing rehabilitation and ADL count is four to five;
(24) BA1: behavior problems with no nursing rehabilitation and ADL count is four to five;
(25) PE2: reduced physical functioning with nursing rehabilitation and ADL count is 16
to 18;
(26) PE1: reduced physical functioning with no nursing rehabilitation and ADL count is
16 to 18;
(27) PD2: reduced physical functioning with nursing rehabilitation and ADL count is 11
to 15;
(28) PD1: reduced physical functioning with no nursing rehabilitation and ADL count is
11 to 15;
(29) PC2: reduced physical functioning with nursing rehabilitation and ADL count is nine
or ten;
(30) PC1: reduced physical functioning with no nursing rehabilitation and ADL count is
nine or ten;
(31) PB2: reduced physical functioning with nursing rehabilitation and ADL count is six to
eight;
(32) PB1: reduced physical functioning with no nursing rehabilitation and ADL count is
six to eight;
(33) PA2: reduced physical functioning with nursing rehabilitation and ADL count is four
or five; and
(34) PA1: reduced physical functioning with no nursing rehabilitation and ADL count is
four or five.
    Subd. 4. Resident assessment schedule. (a) A facility must conduct and electronically
submit to the commissioner of health case mix assessments that conform with the assessment
schedule defined by Code of Federal Regulations, title 42, section 483.20, and published by the
United States Department of Health and Human Services, Centers for Medicare and Medicaid
Services, in the Long Term Care Assessment Instrument User's Manual, version 2.0, October
1995, and subsequent clarifications made in the Long-Term Care Assessment Instrument
Questions and Answers, version 2.0, August 1996. The commissioner of health may substitute
successor manuals or question and answer documents published by the United States Department
of Health and Human Services, Centers for Medicare and Medicaid Services, to replace or
supplement the current version of the manual or document.
(b) The assessments used to determine a case mix classification for reimbursement include
the following:
(1) a new admission assessment must be completed by day 14 following admission;
(2) an annual assessment must be completed within 366 days of the last comprehensive
assessment;
(3) a significant change assessment must be completed within 14 days of the identification
of a significant change; and
(4) the second quarterly assessment following either a new admission assessment, an annual
assessment, or a significant change assessment, and all quarterly assessments beginning October
1, 2006. Each quarterly assessment must be completed within 92 days of the previous assessment.
    Subd. 5. Short stays. (a) A facility must submit to the commissioner of health an initial
admission assessment for all residents who stay in the facility less than 14 days.
(b) Notwithstanding the admission assessment requirements of paragraph (a), a facility may
elect to accept a default rate with a case mix index of 1.0 for all facility residents who stay less
than 14 days in lieu of submitting an initial assessment. Facilities may make this election to be
effective on the day of implementation of the revised case mix system.
(c) After implementation of the revised case mix system, nursing facilities must elect one of
the options described in paragraphs (a) and (b) by reporting to the commissioner of health, as
prescribed by the commissioner. The election is effective on July 1.
(d) For residents who are admitted or readmitted and leave the facility on a frequent basis
and for whom readmission is expected, the resident may be discharged on an extended leave
status. This status does not require reassessment each time the resident returns to the facility
unless a significant change in the resident's status has occurred since the last assessment. The case
mix classification for these residents is determined by the facility election made in paragraphs
(a) and (b).
    Subd. 6. Penalties for late or nonsubmission. A facility that fails to complete or submit an
assessment for a RUG-III classification within seven days of the time requirements in subdivisions
4 and 5 is subject to a reduced rate for that resident. The reduced rate shall be the lowest rate for
that facility. The reduced rate is effective on the day of admission for new admission assessments
or on the day that the assessment was due for all other assessments and continues in effect until
the first day of the month following the date of submission of the resident's assessment.
    Subd. 7. Notice of resident reimbursement classification. (a) A facility must elect
between the options in clauses (1) and (2) to provide notice to a resident of the resident's case
mix classification.
(1) The commissioner of health shall provide to a nursing facility a notice for each resident
of the reimbursement classification established under subdivision 1. The notice must inform the
resident of the classification that was assigned, the opportunity to review the documentation
supporting the classification, the opportunity to obtain clarification from the commissioner, and the
opportunity to request a reconsideration of the classification. The commissioner must send notice
of resident classification by first class mail. A nursing facility is responsible for the distribution of
the notice to each resident, to the person responsible for the payment of the resident's nursing
home expenses, or to another person designated by the resident. This notice must be distributed
within three working days after the facility's receipt of the notice from the commissioner of health.
(2) A facility may choose to provide a classification notice, as prescribed by the commissioner
of health, to a resident upon receipt of the confirmation of the case mix classification calculated by
a facility or a corrected case mix classification as indicated on the final validation report from the
commissioner. A nursing facility is responsible for the distribution of the notice to each resident,
to the person responsible for the payment of the resident's nursing home expenses, or to another
person designated by the resident. This notice must be distributed within three working days after
the facility's receipt of the validation report from the commissioner. If a facility elects this option,
the commissioner of health shall provide the facility with a list of residents and their case mix
classifications as determined by the commissioner. A nursing facility may make this election to be
effective on the day of implementation of the revised case mix system.
(3) After implementation of the revised case mix system, a nursing facility shall elect a notice
of resident reimbursement classification procedure as described in clause (1) or (2) by reporting to
the commissioner of health, as prescribed by the commissioner. The election is effective July 1.
(b) If a facility submits a correction to the most recent assessment used to establish a case
mix classification conducted under subdivision 3 that results in a change in case mix classification,
the facility shall give written notice to the resident or the resident's representative about the
item that was corrected and the reason for the correction. The notice of corrected assessment
may be provided at the same time that the resident or resident's representative is provided the
resident's corrected notice of classification.
    Subd. 8. Request for reconsideration of resident classifications. (a) The resident, or
resident's representative, or the nursing facility or boarding care home may request that the
commissioner of health reconsider the assigned reimbursement classification. The request for
reconsideration must be submitted in writing to the commissioner within 30 days of the day the
resident or the resident's representative receives the resident classification notice. The request
for reconsideration must include the name of the resident, the name and address of the facility
in which the resident resides, the reasons for the reconsideration, the requested classification
changes, and documentation supporting the requested classification. The documentation
accompanying the reconsideration request is limited to documentation which establishes that the
needs of the resident at the time of the assessment justify a classification which is different than
the classification established by the commissioner of health.
(b) Upon request, the nursing facility must give the resident or the resident's representative a
copy of the assessment form and the other documentation that was given to the commissioner of
health to support the assessment findings. The nursing facility shall also provide access to and a
copy of other information from the resident's record that has been requested by or on behalf of the
resident to support a resident's reconsideration request. A copy of any requested material must be
provided within three working days of receipt of a written request for the information. If a facility
fails to provide the material within this time, it is subject to the issuance of a correction order and
penalty assessment under sections 144.653 and 144A.10. Notwithstanding those sections, any
correction order issued under this subdivision must require that the nursing facility immediately
comply with the request for information and that as of the date of the issuance of the correction
order, the facility shall forfeit to the state a $100 fine for the first day of noncompliance, and an
increase in the $100 fine by $50 increments for each day the noncompliance continues.
(c) In addition to the information required under paragraphs (a) and (b), a reconsideration
request from a nursing facility must contain the following information: (i) the date the
reimbursement classification notices were received by the facility; (ii) the date the classification
notices were distributed to the resident or the resident's representative; and (iii) a copy of a
notice sent to the resident or to the resident's representative. This notice must inform the resident
or the resident's representative that a reconsideration of the resident's classification is being
requested, the reason for the request, that the resident's rate will change if the request is approved
by the commissioner, the extent of the change, that copies of the facility's request and supporting
documentation are available for review, and that the resident also has the right to request a
reconsideration. If the facility fails to provide the required information with the reconsideration
request, the request must be denied, and the facility may not make further reconsideration requests
on that specific reimbursement classification.
(d) Reconsideration by the commissioner must be made by individuals not involved in
reviewing the assessment, audit, or reconsideration that established the disputed classification.
The reconsideration must be based upon the initial assessment and upon the information provided
to the commissioner under paragraphs (a) and (b). If necessary for evaluating the reconsideration
request, the commissioner may conduct on-site reviews. Within 15 working days of receiving
the request for reconsideration, the commissioner shall affirm or modify the original resident
classification. The original classification must be modified if the commissioner determines that
the assessment resulting in the classification did not accurately reflect the needs or assessment
characteristics of the resident at the time of the assessment. The resident and the nursing facility
or boarding care home shall be notified within five working days after the decision is made. A
decision by the commissioner under this subdivision is the final administrative decision of the
agency for the party requesting reconsideration.
(e) The resident classification established by the commissioner shall be the classification that
applies to the resident while the request for reconsideration is pending.
(f) The commissioner may request additional documentation regarding a reconsideration
necessary to make an accurate reconsideration determination.
    Subd. 9. Audit authority. (a) The commissioner shall audit the accuracy of resident
assessments performed under section 256B.438 through desk audits, on-site review of residents
and their records, and interviews with staff and families. The commissioner shall reclassify a
resident if the commissioner determines that the resident was incorrectly classified.
(b) The commissioner is authorized to conduct on-site audits on an unannounced basis.
(c) A facility must grant the commissioner access to examine the medical records relating to
the resident assessments selected for audit under this subdivision. The commissioner may also
observe and speak to facility staff and residents.
(d) The commissioner shall consider documentation under the time frames for coding items
on the minimum data set as set out in the Resident Assessment Instrument Manual published by
the Centers for Medicare and Medicaid Services.
(e) The commissioner shall develop an audit selection procedure that includes the following
factors:
(1) The commissioner may target facilities that demonstrate an atypical pattern of scoring
minimum data set items, nonsubmission of assessments, late submission of assessments, or a
previous history of audit changes of greater than 35 percent. The commissioner shall select at least
20 percent, with a minimum of ten assessments, of the most current assessments submitted to the
state for audit. Audits of assessments selected in the targeted facilities must focus on the factors
leading to the audit. If the number of targeted assessments selected does not meet the threshold
of 20 percent of the facility residents, then a stratified sample of the remainder of assessments
shall be drawn to meet the quota. If the total change exceeds 35 percent, the commissioner may
conduct an expanded audit up to 100 percent of the remaining current assessments.
(2) Facilities that are not a part of the targeted group shall be placed in a general pool from
which facilities will be selected on a random basis for audit. Every facility shall be audited
annually. If a facility has two successive audits in which the percentage of change is five percent
or less and the facility has not been the subject of a targeted audit in the past 36 months, the
facility may be audited biannually. A stratified sample of 15 percent, with a minimum of ten
assessments, of the most current assessments shall be selected for audit. If more than 20 percent
of the RUGS-III classifications after the audit are changed, the audit shall be expanded to a
second 15 percent sample, with a minimum of ten assessments. If the total change between the
first and second samples exceed 35 percent, the commissioner may expand the audit to all of
the remaining assessments.
(3) If a facility qualifies for an expanded audit, the commissioner may audit the facility again
within six months. If a facility has two expanded audits within a 24-month period, that facility
will be audited at least every six months for the next 18 months.
(4) The commissioner may conduct special audits if the commissioner determines that
circumstances exist that could alter or affect the validity of case mix classifications of residents.
These circumstances include, but are not limited to, the following:
(i) frequent changes in the administration or management of the facility;
(ii) an unusually high percentage of residents in a specific case mix classification;
(iii) a high frequency in the number of reconsideration requests received from a facility;
(iv) frequent adjustments of case mix classifications as the result of reconsiderations or audits;
(v) a criminal indictment alleging provider fraud; or
(vi) other similar factors that relate to a facility's ability to conduct accurate assessments.
(f) Within 15 working days of completing the audit process, the commissioner shall mail
the written results of the audit to the facility, along with a written notice for each resident
affected to be forwarded by the facility. The notice must contain the resident's classification and
a statement informing the resident, the resident's authorized representative, and the facility of
their right to review the commissioner's documents supporting the classification and to request
a reconsideration of the classification. This notice must also include the address and telephone
number of the area nursing home ombudsman.
    Subd. 10. Transition. After implementation of this section, reconsiderations requested for
classifications made under section 144.0722, subdivision 1, shall be determined under section
144.0722, subdivision 3.
History: 1Sp2001 c 9 art 5 s 2; 2002 c 276 s 1-4; 2002 c 277 s 32; 2002 c 379 art 1 s
113; 2006 c 282 art 20 s 1,2

144.073 [Repealed, 2001 c 205 art 2 s 3]

144.074 FUNDS RECEIVED FROM OTHER SOURCES.
The state commissioner of health may receive and accept money, property, or services from
any person, agency, or other source for any public health purpose within the scope of statutory
authority. All money so received is annually appropriated for those purposes in the manner and
subject to the provisions of law applicable to appropriations of state funds.
History: 1975 c 310 s 9; 1977 c 305 s 45; 1986 c 444

144.0741 [Expired]

144.0742 CONTRACTS FOR PROVISION OF PUBLIC HEALTH SERVICES.
The commissioner of health is authorized to enter into contractual agreements with any
public or private entity for the provision of statutorily prescribed public health services by the
department. The contracts shall specify the services to be provided and the amount and method
of reimbursement therefor. Funds generated in a contractual agreement made pursuant to this
section are appropriated to the department for purposes of providing the services specified in the
contracts. All such contractual agreements shall be processed in accordance with the provisions
of chapter 16C.
History: 1981 c 360 art 1 s 15; 1984 c 544 s 89; 1998 c 386 art 2 s 56

144.075 [Repealed, 1984 c 503 s 6]

144.0751 HEALTH STANDARDS.
(a) Safe drinking water or air quality standards established or revised by the commissioner
of health must:
(1) be based on scientifically acceptable, peer-reviewed information; and
(2) include a reasonable margin of safety to adequately protect the health of infants,
children, and adults by taking into consideration risks to each of the following health outcomes:
reproductive development and function, respiratory function, immunologic suppression or
hypersensitization, development of the brain and nervous system, endocrine (hormonal) function,
cancer, general infant and child development, and any other important health outcomes identified
by the commissioner.
(b) For purposes of this section, "peer-reviewed" means a scientifically based review
conducted by individuals with substantial knowledge and experience in toxicology, health risk
assessment, or other related fields as determined by the commissioner.
History: 1Sp2001 c 9 art 1 s 27; 2002 c 379 art 1 s 113

144.076 MOBILE HEALTH CLINIC.
The state commissioner of health may establish, equip, and staff with the commissioner's
own members or volunteers from the healing arts, or may contract with a public or private
nonprofit agency or organization to establish, equip, and staff a mobile unit, or units to travel in
and around poverty stricken areas and Indian reservations of the state on a prescribed course and
schedule for diagnostic and general health counseling, including counseling on and distribution of
dietary information, to persons residing in such areas. For this purpose the state commissioner
of health may purchase and equip suitable motor vehicles, and furnish a driver and such other
personnel as the department deems necessary to effectively carry out the purposes for which
these mobile units were established or may contract with a public or private nonprofit agency or
organization to provide the service.
History: 1971 c 940 s 1; 1975 c 310 s 3; 1977 c 305 s 45; 1986 c 444

144.077 MOBILE HEALTH CARE PROVIDERS.
    Subdivision 1. Definition. "Mobile health evaluation and screening provider" means any
provider who is transported in a vehicle mounted unit, either motorized or trailered, and readily
movable without disassembling, and who regularly provides evaluation and screening services
in more than one geographic location. "Mobile health evaluation and screening provider" does
not include any ambulance medical transportation type services or any mobile health service
provider affiliated, owned and operated, or under contract with a licensed health care facility
or provider, managed care entity licensed under chapter 62D or 62N or Minnesota licensed
physician or dentist, nor does it include fixed location providers who transfer or move during the
calendar year. All mobile health evaluation and screening providers must be directly supervised
by a physician licensed under chapter 147.
    Subd. 2. Licensure requirements. A mobile health evaluation and screening provider
shall be required to comply with all licensing reporting and certification, sanitation, and other
requirements and regulations that apply to a health care provider supplying similar services as a
fixed location provider. A mobile health evaluation and screening provider shall be subject to
regulation and order of the Department of Health.
    Subd. 3. Registration requirements. A mobile health evaluation and screening provider
shall register with the commissioner and file the anticipated locations of practice, schedules, and
routes annually no later than January 15. The mobile health evaluation and screening provider
shall also include the name and address of the supervising physician. A mobile health evaluation
and screening provider shall provide at least 30 days' written notice to the populations they
intend to serve.
History: 1995 c 135 s 1

144.08 [Repealed, 2001 c 205 art 2 s 3]

144.09 COOPERATION WITH FEDERAL AUTHORITIES.
The state of Minnesota, through its legislative authority:
(1) accepts the provisions of any act of Congress providing for cooperation between the
government of the United States and the several states in public protection of maternity and
infancy;
(2) empowers and directs the commissioner to cooperate with the federal Children's Bureau
to carry out the purposes of such acts; and
(3) appoints the commissioner of finance as custodian of all moneys given to the state by the
United States under the authority of such acts and such money shall be paid out in the manner
provided by such acts for the purposes therein specified.
History: (5344) 1921 c 392 s 5; 1977 c 305 s 45; 2003 c 112 art 2 s 50

144.092 COORDINATED NUTRITION DATA COLLECTION.
The commissioner of health may develop and coordinate a reporting system to improve the
state's ability to document inadequate nutrient and food intake of Minnesota's children and adults
and to identify problems and determine the most appropriate strategies for improving inadequate
nutritional status. The Board on Aging may develop a method to evaluate the nutritional status
and requirements of the elderly in Minnesota.
History: 1986 c 404 s 6; 1987 c 209 s 3; 1997 c 7 art 2 s 15

144.10 FEDERAL AID FOR MATERNAL AND CHILD WELFARE SERVICES.
The commissioner of finance is hereby appointed as the custodian of all moneys received, or
which may hereafter be received, by the state by reason of any federal aid granted for maternal
and child welfare service and for public health services, including the purposes as declared in
Public Law 725 enacted by the 79th Congress of the United States, Chapter 958-2d Session
and all amendments thereto, which moneys shall be expended in accordance with the purposes
expressed in the acts of Congress granting such aid and solely in accordance with plans to be
prepared by the state commissioner. The plans so to be prepared by the commissioner for maternal
and child health service shall be approved by the United States Children's Bureau; and the plans of
the commissioner for public health service shall be approved by the United States Public Health
Service. Such plans shall include the training of personnel for both state and local health work
and conform with all the requirements governing federal aid for these purposes. Such plans shall
be designed to secure for the state the maximum amount of federal aid which is possible to be
secured on the basis of the available state, county, and local appropriations for such purposes.
The commissioner shall make reports, which shall be in such form and contain such information
as may be required by the United States Children's Bureau or the United States Public Health
Service, as the case may be; and comply with all the provisions, rules, and regulations which
may be prescribed by these federal authorities in order to secure the correction and verification
of such reports.
History: (5391-1) Ex1936 c 70 s 1; 1947 c 485 s 1; 1977 c 305 s 45; 2003 c 112 art 2 s 50

144.11 RULES.
The commissioner may make such reasonable rules as may be necessary to carry into effect
the provisions of section 144.10 and alter, amend, suspend, or repeal any of such rules.
History: (5391-2) Ex1936 c 70 s 2; 1977 c 305 s 45; 1985 c 248 s 70

144.12 REGULATION, ENFORCEMENT, LICENSES, FEES.
    Subdivision 1. Rules. The commissioner may adopt reasonable rules pursuant to chapter
14 for the preservation of the public health. The rules shall not conflict with the charter or
ordinance of a city of the first class upon the same subject. The commissioner may control, by
rule, by requiring the taking out of licenses or permits, or by other appropriate means, any of
the following matters:
(1) The manufacture into articles of commerce, other than food, of diseased, tainted, or
decayed animal or vegetable matter;
(2) The business of scavengering and the disposal of sewage;
(3) The location of mortuaries and cemeteries and the removal and burial of the dead;
(4) The management of boarding places for infants and the treatment of infants in them;
(5) The pollution of streams and other waters and the distribution of water by persons for
drinking or domestic use;
(6) The construction and equipment, in respect to sanitary conditions, of schools, hospitals,
almshouses, prisons, and other public institutions, and of lodging houses and other public sleeping
places kept for gain;
(7) The treatment, in hospitals and elsewhere, of persons suffering from communicable
diseases, including all manner of venereal disease and infection, the disinfection and quarantine of
persons and places in case of those diseases, and the reporting of sicknesses and deaths from them;
Neither the commissioner nor any board of health as defined in section 145A.02, subdivision
2 , nor director of public health may adopt any rule or regulation for the treatment in any penal
or correctional institution of any person suffering from any communicable disease or venereal
disease or infection, which requires the involuntary detention of any person after the expiration
of the period of sentence to the penal or correctional institution, or after the expiration of the
period to which the sentence may be reduced by good time allowance or by the lawful order of
any judge or the Department of Corrections;
(8) The prevention of infant blindness and infection of the eyes of the newly born by the
designation, from time to time, of one or more prophylactics to be used in those cases and in the
manner that the commissioner directs, unless specifically objected to by a parent of the infant;
(9) The furnishing of vaccine matter; the assembling, during epidemics of smallpox, with
other persons not vaccinated, but no rule of the board or of any public board or officer shall at any
time compel the vaccination of a child, or exclude, except during epidemics of smallpox and when
approved by the local board of education, a child from the public schools for the reason that the
child has not been vaccinated; any person required to be vaccinated may select for that purpose
any licensed physician and no rule shall require the vaccination of any child whose physician
certifies that by reason of the child's physical condition vaccination would be dangerous;
(10) The accumulation of filthy and unwholesome matter to the injury of the public health
and its removal;
(11) The collection, recording, and reporting of vital statistics by public officers and the
furnishing of information to them by physicians, undertakers, and others of births, deaths, causes
of death, and other pertinent facts;
(12) The construction, equipment, and maintenance, in respect to sanitary conditions, of
lumber camps, migratory or migrant labor camps, and other industrial camps;
(13) The general sanitation of tourist camps, summer hotels, and resorts in respect to
water supplies, disposal of sewage, garbage, and other wastes and the prevention and control of
communicable diseases; and, to that end, may prescribe the respective duties of agents of a
board of health as authorized under section 145A.04; and all boards of health shall make such
investigations and reports and obey such directions as the commissioner may require or give and,
under the supervision of the commissioner, enforce the rules;
(14) Atmospheric pollution which may be injurious or detrimental to public health;
(15) Sources of radiation, and the handling, storage, transportation, use and disposal of
radioactive isotopes and fissionable materials; and
(16) The establishment, operation and maintenance of all clinical laboratories not owned,
or functioning as a component of a licensed hospital. These laboratories shall not include
laboratories owned or operated by five or less licensed practitioners of the healing arts, unless
otherwise provided by federal law or regulation, and in which these practitioners perform tests or
procedures solely in connection with the treatment of their patients. Rules promulgated under
the authority of this clause, which shall not take effect until federal legislation relating to the
regulation and improvement of clinical laboratories has been enacted, may relate at least to
minimum requirements for external and internal quality control, equipment, facility environment,
personnel, administration and records. These rules may include the establishment of a fee
schedule for clinical laboratory inspections. The provisions of this clause shall expire 30 days
after the conclusion of any fiscal year in which the federal government pays for less than 45
percent of the cost of regulating clinical laboratories.
    Subd. 2. Mass gatherings. The commissioner may regulate the general sanitation of
mass gatherings by promulgation of rules in respect to, but not limited to, the following areas:
water supply, disposal of sewage, garbage and other wastes, the prevention and control of
communicable diseases, the furnishing of suitable and adequate sanitary accommodations, and
all other reasonable and necessary precautions to protect and insure the health, comfort and
safety of those in attendance. No permit, license, or other prior approval shall be required of the
commissioner for a mass gathering. A "mass gathering" shall mean an actual or reasonably
anticipated assembly of more than 1,500 persons which will continue, or may reasonably be
expected to continue, for a period of more than ten consecutive hours and which is held in an
open space or temporary structure especially constructed, erected or assembled for the gathering.
For purposes of this subdivision, "mass gatherings" shall not include public gatherings sponsored
by a political subdivision or a nonprofit organization.
    Subd. 3. Licenses; permits. Applications for licenses or permits issued pursuant to this
section shall be submitted with a fee prescribed by the commissioner pursuant to section 144.122.
Licenses or permits shall expire and be renewed as prescribed by the commissioner pursuant to
section 144.122.
History: (5345) RL s 2131; 1917 c 345 s 1; 1923 c 227 s 1; 1951 c 537 s 1; 1953 c 134 s 1;
1957 c 361 s 1; 1975 c 310 s 4; 1975 c 351 s 1; 1977 c 66 s 10; 1977 c 305 s 45; 1977 c 406 s 1;
1983 c 359 s 9; 1985 c 248 s 70; 1986 c 444; 1987 c 309 s 24

RADIATION HAZARDS PROGRAM

144.1201 DEFINITIONS.
    Subdivision 1. Applicability. For purposes of sections 144.1201 to 144.1204, the terms
defined in this section have the meanings given to them.
    Subd. 2. By-product nuclear material. "By-product nuclear material" means a radioactive
material, other than special nuclear material, yielded in or made radioactive by exposure to
radiation created incident to the process of producing or utilizing special nuclear material.
    Subd. 3. Radiation. "Radiation" means ionizing radiation and includes alpha rays; beta rays;
gamma rays; x-rays; high energy neutrons, protons, or electrons; and other atomic particles.
    Subd. 4. Radioactive material. "Radioactive material" means a matter that emits radiation.
Radioactive material includes special nuclear material, source nuclear material, and by-product
nuclear material.
    Subd. 5. Source nuclear material. "Source nuclear material" means uranium or thorium, or
a combination thereof, in any physical or chemical form; or ores that contain by weight 1/20 of
one percent (0.05 percent) or more of uranium, thorium, or a combination thereof. Source nuclear
material does not include special nuclear material.
    Subd. 6. Special nuclear material. "Special nuclear material" means:
(1) plutonium, uranium enriched in the isotope 233 or in the isotope 235, and any other
material that the Nuclear Regulatory Commission determines to be special nuclear material
according to United States Code, title 42, section 2071, except that source nuclear material is
not included; and
(2) a material artificially enriched by any of the materials listed in clause (1), except that
source nuclear material is not included.
History: 1999 c 245 art 2 s 16

144.1202 UNITED STATES NUCLEAR REGULATORY COMMISSION AGREEMENT.
    Subdivision 1. Agreement authorized. In order to have a comprehensive program to protect
the public from radiation hazards, the governor, on behalf of the state, is authorized to enter into
agreements with the United States Nuclear Regulatory Commission under the Atomic Energy
Act of 1954, section 274b, as amended. The agreement shall provide for the discontinuance of
portions of the Nuclear Regulatory Commission's licensing and related regulatory authority over
by-product, source, and special nuclear materials, and the assumption of regulatory authority over
these materials by the state.
    Subd. 2. Health Department designated lead. The Department of Health is designated as
the lead agency to pursue an agreement on behalf of the governor and for any assumption of
specified licensing and regulatory authority from the Nuclear Regulatory Commission under
an agreement with the commission. The commissioner of health shall establish an advisory
group to assist in preparing the state to meet the requirements for reaching an agreement. The
commissioner may adopt rules to allow the state to assume regulatory authority under an
agreement under this section, including the licensing and regulation of radioactive materials. Any
regulatory authority assumed by the state includes the ability to set and collect fees.
    Subd. 3. Transition. A person who, on the effective date of an agreement under this section,
possesses a Nuclear Regulatory Commission license that is subject to the agreement is deemed to
possess a similar license issued by the Department of Health. A Department of Health license
obtained under this subdivision expires on the expiration date specified in the federal license.
    Subd. 4.[Repealed, 2004 c 236 s 7]
History: 1999 c 245 art 2 s 17; 1Sp2001 c 9 art 1 s 28; 2002 c 379 art 1 s 113; 2003 c 111 s 1

144.1203 TRAINING; RULEMAKING.
The commissioner shall adopt rules to ensure that individuals handling or utilizing radioactive
materials under the terms of a license issued by the commissioner under section 144.1202 have
proper training and qualifications to do so. The rules adopted must be at least as stringent as
federal regulations on proper training and qualifications adopted by the Nuclear Regulatory
Commission. Rules adopted under this section may incorporate federal regulations by reference.
History: 1999 c 245 art 2 s 18

144.1204 SURETY REQUIREMENTS.
    Subdivision 1. Financial assurance required. The commissioner may require an applicant
for a license under section 144.1202, or a person who was formerly licensed by the Nuclear
Regulatory Commission and is now subject to sections 144.1201 to 144.1204, to post financial
assurances to ensure the completion of all requirements established by the commissioner for the
decontamination, closure, decommissioning, and reclamation of sites, structures, and equipment
used in conjunction with activities related to licensure. The financial assurances posted must
be sufficient to restore the site to unrestricted future use and must be sufficient to provide for
surveillance and care when radioactive materials remain at the site after the licensed activities
cease. The commissioner may establish financial assurance criteria by rule. In establishing such
criteria, the commissioner may consider:
(1) the chemical and physical form of the licensed radioactive material;
(2) the quantity of radioactive material authorized;
(3) the particular radioisotopes authorized and their subsequent radiotoxicity;
(4) the method in which the radioactive material is held, used, stored, processed, transferred,
or disposed of; and
(5) the potential costs of decontamination, treatment, or disposal of a licensee's equipment
and facilities.
    Subd. 2. Acceptable financial assurances. The commissioner may, by rule, establish types
of financial assurances that meet the requirements of this section. Such financial assurances may
include bank letters of credit, deposits of cash, or deposits of government securities.
    Subd. 3. Trust agreements. Financial assurances must be established together with trust
agreements. Both the financial assurances and the trust agreements must be in a form and
substance that meet requirements established by the commissioner.
    Subd. 4. Exemptions. The commissioner is authorized to exempt from the requirements of
this section, by rule, any category of licensee upon a determination by the commissioner that an
exemption does not result in a significant risk to the public health or safety or to the environment
and does not pose a financial risk to the state.
    Subd. 5. Other remedies unaffected. Nothing in this section relieves a licensee of a civil
liability incurred, nor may this section be construed to relieve the licensee of obligations to prevent
or mitigate the consequences of improper handling or abandonment of radioactive materials.
History: 1999 c 245 art 2 s 19

144.1205 RADIOACTIVE MATERIAL; SPECIAL NUCLEAR MATERIAL.
    Subdivision 1. Application and license renewal fee. When a license is required for
radioactive material or source or special nuclear material by a rule adopted under section
144.1202, subdivision 2, an application fee according to subdivision 4 must be paid upon initial
application for a license. The licensee must renew the license 60 days before the expiration date of
the license by paying a license renewal fee equal to the application fee under subdivision 4. The
expiration date of a license is the date set by the United States Nuclear Regulatory Commission
before transfer of the licensing program under section 144.1202 and thereafter as specified by
rule of the commissioner of health.
    Subd. 2. Annual fee. A licensee must pay an annual fee at least 60 days before the
anniversary date of the issuance of the license. The annual fee is as follows:

TYPE

ANNUAL FEE

	Academic broad scope - type A		$19,920
	Academic broad scope - type B		19,920
	Academic broad scope - type C		19,920
	Medical broad scope - type A		19,920
	Medical institution - diagnostic and therapeutic		3,680
	Medical institution - diagnostic (no written directives)		3,680
	Medical private practice - diagnostic and therapeutic		3,680
	Medical private practice - diagnostic (no written directives)		3,680
	Eye applicators		3,680
	Nuclear medical vans		3,680
	High dose rate afterloader		3,680
	Mobile high dose rate afterloader		3,680
	Medical therapy - other emerging technology		3,680
	Teletherapy		8,960
	Gamma knife		8,960
	Veterinary medicine		2,000
	In vitro testing lab		2,000
	Nuclear pharmacy		8,800
	Radiopharmaceutical distribution (10 CFR 32.72)		3,840
	Radiopharmaceutical processing and distribution (10 CFR 32.72)		8,800
	Medical sealed sources - distribution (10 CFR 32.74)		3,840
	Medical sealed sources - processing and distribution (10 CFR 32.74)		8,800
	Well logging - sealed sources		3,760
	Measuring systems - fixed gauge		2,000
	Measuring systems - portable gauge		2,000
	X-ray fluorescent analyzer		1,520
	Measuring systems - gas chromatograph		2,000
	Measuring systems - other		2,000
	Broad scope manufacturing and distribution - type A		19,920
	Broad scope manufacturing and distribution - type B		17,600
	Broad scope manufacturing and distribution - type C		17,600
	Manufacturing and distribution - other		5,280
	Nuclear laundry		18,640
	Decontamination services		4,960
	Leak test services only		2,000
	Instrument calibration service only, less than 100 curies		2,000
	Instrument calibration service only, 100 curies or more		2,000
	Service, maintenance, installation, source changes, etc.		4,960
	Waste disposal service, prepackaged only		6,000
	Waste disposal		8,320
	Distribution - general licensed devices (sealed sources)		1,760
	Distribution - general licensed material (unsealed sources)		1,120
	Industrial radiography - fixed location		9,840
	Industrial radiography - temporary job sites		9,840
	Irradiators, self-shielding, less than 10,000 curies		2,880
	Irradiators, other, less than 10,000 curies		5,360
	Irradiators, self-shielding, 10,000 curies or more		2,880
	Research and development - type A broad scope		9,520
	Research and development - type B broad scope		9,520
	Research and development - type C broad scope		9,520
	Research and development - other		4,480
	Storage - no operations		2,000
	Source material - shielding		584
	Special nuclear material plutonium - neutron source in device		3,680
	Pacemaker by-product and/or special nuclear material - medical (institution)		3,680
	Pacemaker by-product and/or special nuclear material - manufacturing and distribution		5,280
	Accelerator-produced radioactive material		3,840
	Nonprofit educational institutions		300
	General license registration		150

    Subd. 3. Fee categories; incorporation of federal licensing categories. (a) Fee categories
under this section are equivalent to the licensing categories used by the United States Nuclear
Regulatory Commission under Code of Federal Regulations, title 10, parts 30 to 36, 39, 40, 70,
71, and 150, except as provided in paragraph (b).
(b) The category of "Academic, small" is the type of license required for the use of
radioactive materials in a teaching institution. Radioactive materials are limited to ten
radionuclides not to exceed a total activity amount of one curie.
    Subd. 4. Application fee. A licensee must pay an application fee as follows:

TYPE

APPLICATION FEE

	Academic broad scope - type A		$ 5,920
	Academic broad scope - type B		5,920
	Academic broad scope - type C		5,920
	Medical broad scope - type A		3,920
	Medical institution - diagnostic and therapeutic		1,520
	Medical institution - diagnostic (no written directives)		1,520
	Medical private practice - diagnostic and therapeutic		1,520
	Medical private practice - diagnostic (no written directives)		1,520
	Eye applicators		1,520
	Nuclear medical vans		1,520
	High dose rate afterloader		1,520
	Mobile high dose rate afterloader		1,520
	Medical therapy - other emerging technology		1,520
	Teletherapy		5,520
	Gamma knife		5,520
	Veterinary medicine		960
	In vitro testing lab		960
	Nuclear pharmacy		4,880
	Radiopharmaceutical distribution (10 CFR 32.72)		2,160
	Radiopharmaceutical processing and distribution (10 CFR 32.72)		4,880
	Medical sealed sources - distribution (10 CFR 32.74)		2,160
	Medical sealed sources - processing and distribution (10 CFR 32.74)		4,880
	Well logging - sealed sources		1,600
	Measuring systems - fixed gauge		960
	Measuring systems - portable gauge		960
	X-ray fluorescent analyzer		584
	Measuring systems - gas chromatograph		960
	Measuring systems - other		960
	Broad scope manufacturing and distribution - type A		5,920
	Broad scope manufacturing and distribution - type B		5,920
	Broad scope manufacturing and distribution - type C		5,920
	Manufacturing and distribution - other		2,320
	Nuclear laundry		10,080
	Decontamination services		2,640
	Leak test services only		960
	Instrument calibration service only, less than 100 curies		960
	Instrument calibration service only, 100 curies or more		960
	Service, maintenance, installation, source changes, etc.		2,640
	Waste disposal service, prepackaged only		2,240
	Waste disposal		1,520
	Distribution - general licensed devices (sealed sources)		880
	Distribution - general licensed material (unsealed sources)		520
	Industrial radiography - fixed location		2,640
	Industrial radiography - temporary job sites		2,640
	Irradiators, self-shielding, less than 10,000 curies		1,440
	Irradiators, other, less than 10,000 curies		2,960
	Irradiators, self-shielding, 10,000 curies or more		1,440
	Research and development - type A broad scope		4,960
	Research and development - type B broad scope		4,960
	Research and development - type C broad scope		4,960
	Research and development - other		2,400
	Storage - no operations		960
	Source material - shielding		136
	Special nuclear material plutonium - neutron source in device		1,200
	Pacemaker by-product and/or special nuclear material - medical (institution)		1,200
	Pacemaker by-product and/or special nuclear material - manufacturing and distribution		2,320
	Accelerator-produced radioactive material		4,100
	Nonprofit educational institutions		300
	General license registration		0
	Industrial radiographer certification		150

    Subd. 5. Penalty for late payment. An annual fee or a license renewal fee submitted to the
commissioner after the due date specified by rule must be accompanied by an additional amount
equal to 25 percent of the fee due.
    Subd. 6. Inspections. The commissioner of health shall make periodic safety inspections of
the radioactive material and source and special nuclear material of a licensee. The commissioner
shall prescribe the frequency of safety inspections by rule.
    Subd. 7. Recovery of reinspection cost. If the commissioner finds serious violations of
public health standards during an inspection under subdivision 6, the licensee must pay all costs
associated with subsequent reinspection of the source. The costs shall be the actual costs incurred
by the commissioner and include, but are not limited to, labor, transportation, per diem, materials,
legal fees, testing, and monitoring costs.
    Subd. 8. Reciprocity fee. A licensee submitting an application for reciprocal recognition of
a materials license issued by another agreement state or the United States Nuclear Regulatory
Commission for a period of 180 days or less during a calendar year must pay $1,200. For a period
of 181 days or more, the licensee must obtain a license under subdivision 4.
    Subd. 9. Fees for license amendments. A licensee must pay a fee of $300 to amend
a license as follows:
(1) to amend a license requiring review including, but not limited to, addition of isotopes,
procedure changes, new authorized users, or a new radiation safety officer; and
(2) to amend a license requiring review and a site visit including, but not limited to, facility
move or addition of processes.
History: 1Sp2001 c 9 art 1 s 29; 2002 c 379 art 1 s 113; 2004 c 236 s 1-4

144.121 X-RAY MACHINES; OTHER SOURCES OF IONIZING RADIATION.
    Subdivision 1. Registration; fees. The fee for the registration for x-ray machines and
other sources of ionizing radiation required to be registered under rules adopted by the state
commissioner of health pursuant to section 144.12, shall be in an amount as described in
subdivision 1a pursuant to section 144.122. The registration shall expire and be renewed as
prescribed by the commissioner pursuant to section 144.122.
    Subd. 1a. Fees for x-ray machines and other sources of ionizing radiation. A facility with
x-ray machines or other sources of ionizing radiation must biennially pay an initial or biennial
renewal registration fee consisting of a base facility fee of $132 and an additional fee for each
x-ray machine or other source of ionizing radiation as follows:

	(1)	medical or veterinary equipment		$ 106
	(2)	dental x-ray equipment		$ 66
	(3)	accelerator		$ 132
	(4)	radiation therapy equipment		$ 132
	(5)	x-ray equipment not used on humans or animals		$ 106
	(6)	devices with sources of ionizing radiation not used on humans or animals		$ 106
	(7)	sources of radium		$ 198

    Subd. 1b. Penalty fee for late registration. Applications for initial or renewal registrations
submitted to the commissioner after the time specified by the commissioner shall be accompanied
by a penalty fee of $20 in addition to the fees prescribed in subdivision 1a.
    Subd. 1c. Fee for x-ray machines and other sources of ionizing radiation. The initial
registration fee of x-ray machines or other sources of radiation required to be registered during the
last 12 months of a biennial registration period will be 50 percent of the applicable registration fee
prescribed in subdivision 1a.
    Subd. 2. Inspections. Periodic radiation safety inspections of the sources of ionizing
radiation shall be made by the state commissioner of health. The frequency of safety inspections
shall be prescribed by the commissioner on the basis of the frequency of use of the source of
ionizing radiation; provided that each source shall be inspected at least once every four years.
    Subd. 3. Exemption. Notwithstanding rules adopted by the commissioner under section
144.12, subdivision 1, clause (15), practitioners of veterinary medicine are not required to conduct
densitometry and sensitometry tests as part of any ionizing radiation quality assurance program.
    Subd. 4. Radiation monitoring. Whenever involved in radiation procedures, practitioners
of veterinary medicine and staff shall wear film-based radiation monitoring badges to monitor
individual exposure. The badges must be submitted periodically to a dosimetry service for
individual exposure determination.
    Subd. 5. Examination for individual operating x-ray equipment. After January 1, 1997,
an individual in a facility with x-ray equipment for use on humans that is registered under
subdivision 1 may not operate, nor may the facility allow the individual to operate, x-ray
equipment unless the individual has passed an examination approved by the commissioner of
health, or an examination determined to the satisfaction of the commissioner of health to be an
equivalent national, state, or regional examination, that demonstrates the individual's knowledge
of basic radiation safety, proper use of x-ray equipment, darkroom and film processing, and
quality assurance procedures. The commissioner shall establish by rule criteria for the approval of
examinations required for an individual operating an x-ray machine in Minnesota.
    Subd. 6. Inspection. At the time a facility with x-ray equipment is inspected by the
commissioner of health in accordance with subdivision 2, an individual operating x-ray equipment
in the facility must be able to show compliance with the requirements of subdivision 5.
    Subd. 7.[Repealed, 1999 c 86 art 2 s 6]
    Subd. 8. Exemption from examination requirements; operators of certain bone
densitometers. (a) This subdivision applies to a bone densitometer that is used on humans to
estimate bone mineral content and bone mineral density in a region of a finger on a person's
nondominant hand, gives an x-ray dose equivalent of less than 0.001 microsieverts per scan, and
has an x-ray leakage exposure rate of less than two milliroentgens per hour at a distance of
one meter, provided that the bone densitometer is operating in accordance with manufacturer
specifications.
(b) An individual who operates a bone densitometer that satisfies the definition in paragraph
(a) and the facility in which an individual operates such a bone densitometer are exempt from the
requirements of subdivisions 5 and 6.
History: 1974 c 81 s 1; 1975 c 310 s 35; 1977 c 305 s 45; 1985 c 248 s 70; 1993 c 188 s 1,2;
1995 c 146 s 1-3; 1997 c 203 art 2 s 7-10; 1999 c 245 art 2 s 20

144.1211 [Repealed, 1993 c 206 s 25]

144.122 LICENSE, PERMIT, AND SURVEY FEES.
(a) The state commissioner of health, by rule, may prescribe procedures and fees for filing
with the commissioner as prescribed by statute and for the issuance of original and renewal
permits, licenses, registrations, and certifications issued under authority of the commissioner. The
expiration dates of the various licenses, permits, registrations, and certifications as prescribed by
the rules shall be plainly marked thereon. Fees may include application and examination fees and
a penalty fee for renewal applications submitted after the expiration date of the previously issued
permit, license, registration, and certification. The commissioner may also prescribe, by rule,
reduced fees for permits, licenses, registrations, and certifications when the application therefor
is submitted during the last three months of the permit, license, registration, or certification
period. Fees proposed to be prescribed in the rules shall be first approved by the Department of
Finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be in an
amount so that the total fees collected by the commissioner will, where practical, approximate
the cost to the commissioner in administering the program. All fees collected shall be deposited
in the state treasury and credited to the state government special revenue fund unless otherwise
specifically appropriated by law for specific purposes.
(b) The commissioner may charge a fee for voluntary certification of medical laboratories
and environmental laboratories, and for environmental and medical laboratory services provided
by the department, without complying with paragraph (a) or chapter 14. Fees charged for
environment and medical laboratory services provided by the department must be approximately
equal to the costs of providing the services.
(c) The commissioner may develop a schedule of fees for diagnostic evaluations conducted
at clinics held by the services for children with disabilities program. All receipts generated by
the program are annually appropriated to the commissioner for use in the maternal and child
health program.
(d) The commissioner shall set license fees for hospitals and nursing homes that are not
boarding care homes at the following levels:

	Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and American Osteopathic Association (AOA) hospitals	$7,555 plus $13 per bed
	Non-JCAHO and non-AOA hospitals	$5,180 plus $247 per bed
	Nursing home	$183 plus $91 per bed

The commissioner shall set license fees for outpatient surgical centers, boarding care homes,
and supervised living facilities at the following levels:

	Outpatient surgical centers	$3,349
	Boarding care homes	$183 plus $91 per bed
	Supervised living facilities	$183 plus $91 per bed.

(e) Unless prohibited by federal law, the commissioner of health shall charge applicants
the following fees to cover the cost of any initial certification surveys required to determine a
provider's eligibility to participate in the Medicare or Medicaid program:

	Prospective payment surveys for hospitals	$900
	Swing bed surveys for nursing homes	$1,200
	Psychiatric hospitals	$1,400
	Rural health facilities	$1,100
	Portable x-ray providers	$500
	Home health agencies	$1,800
	Outpatient therapy agencies	$800
	End stage renal dialysis providers	$2,100
	Independent therapists	$800
	Comprehensive rehabilitation outpatient facilities	$1,200
	Hospice providers	$1,700
	Ambulatory surgical providers	$1,800
	Hospitals	$4,200
	Other provider categories or additional resurveys required to complete initial certification	Actual surveyor costs: average surveyor cost x number of hours for the survey process.

These fees shall be submitted at the time of the application for federal certification and shall
not be refunded. All fees collected after the date that the imposition of fees is not prohibited by
federal law shall be deposited in the state treasury and credited to the state government special
revenue fund.
(f) The commissioner shall charge the following fees for examinations, registrations,
licenses, and inspections:

	Plumbing examination		$ 50
	Water conditioning examination		$ 50
	Plumbing bond registration fee		$ 40
	Water conditioning bond registration fee		$ 40
	Master plumber's license		$120
	Journeyman plumber's license		$ 55
	Apprentice registration		$ 25
	Water conditioning contractor license		$ 70
	Water conditioning installer license		$ 35
	Residential inspection fee (each visit)		$ 50
	Public, commercial, and industrial inspections		Inspection fee
	25 or fewer drainage fixture units		$ 300
	26 to 50 drainage fixture units		$ 900
	51 to 150 drainage fixture units		$1,200
	151 to 249 drainage fixture units		$1,500
	250 or more drainage fixture units		$1,800
	Callback fee (each visit)		$100

History: 1974 c 471 s 1; 1975 c 310 s 36; 1977 c 305 s 45; 1985 c 248 s 70; 1986 c 444;
1987 c 403 art 2 s 7; 1989 c 209 art 1 s 14; 1989 c 282 art 1 s 16; 1992 c 513 art 6 s 1; 1Sp1993 c
1 art 9 s 18; 1995 c 207 art 9 s 4; 1996 c 451 art 4 s 5; 1Sp2001 c 9 art 1 s 30; 2002 c 379 art
1 s 113; 2005 c 56 s 1; 2005 c 85 s 1; 1Sp2005 c 4 art 6 s 7

144.1222 PUBLIC POOLS; ENCLOSED SPORTS ARENAS.
    Subdivision 1. Public pools. The commissioner of health shall be responsible for the
adoption of rules and enforcement of applicable laws and rules relating to the operation,
maintenance, design, installation, and construction of public pools and facilities related to them.
The commissioner shall adopt rules governing the collection of fees under section 144.122 to
cover the cost of pool construction plan review, monitoring, and inspections.
    Subd. 1a. Fees. All plans and specifications for public swimming pool and spa construction,
installation, or alteration or requests for a variance that are submitted to the commissioner
according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate fees.
If the commissioner determines, upon review of the plans, that inadequate fees were paid, the
necessary additional fees shall be paid before plan approval. For purposes of determining fees, a
project is defined as a proposal to construct or install a public pool, spa, special purpose pool,
or wading pool and all associated water treatment equipment and drains, gutters, decks, water
recreation features, spray pads, and those design and safety features that are within five feet of
any pool or spa. The commissioner shall charge the following fees for plan review and inspection
of public pools and spas and for requests for variance from the public pool and spa rules:
(1) each spa pool, $500;
(2) projects valued at $250,000 or less, a minimum of $800 per pool plus:
(i) for each slide, an additional $400; and
(ii) for each spa pool, an additional $500;
(3) projects valued at $250,000 or more, 0.5 percent of documented estimated project cost to
a maximum fee of $10,000;
(4) alterations to an existing pool without changing the size or configuration of the pool, $400;
(5) removal or replacement of pool disinfection equipment only, $75; and
(6) request for variance from the public pool and spa rules, $500.
    Subd. 2. Pools used for treatment or therapy. A pool used by a medical or rehabilitation
facility to facilitate treatment or therapy, to which only authorized access is allowed and which
is not open for any other public use, is exempt from the requirements of Minnesota Rules, part
4717.1050, regarding warning signs, and Minnesota Rules, part 4717.1650, subpart 1, regarding
placards.
    Subd. 2a. Portable wading pools at family day care or group family day care homes. A
portable wading pool that is located at a family day care or group family day care home licensed
under Minnesota Rules, chapter 9502, or at a home at which child care services are provided
under section 245A.03, subdivision 2, clause (2), shall be defined as a private residential pool and
not as a public pool for purposes of public swimming pool regulations under Minnesota Rules,
chapter 4717, provided that the portable wading pool has a maximum depth of 24 inches and is
capable of being manually emptied and moved.
    Subd. 2b. Swimming pools at family day care or group family day care homes.
Notwithstanding Minnesota Rules, part 4717.0250, subpart 8, a swimming pool that is located at a
family day care or group family day care home licensed under Minnesota Rules, chapter 9502,
shall not be considered a public pool, and is exempt from the requirements for public pools in
Minnesota Rules, parts 4717.0150 to 4717.3975. If the provider chooses to allow children cared
for at the family day care or group family day care home to use the swimming pool located at the
home, the provider must satisfy the requirements in section 245A.14, subdivision 11.
    Subd. 2c. Pools used for adult-only recreation. Notwithstanding Minnesota Rules, part
4717.1850, a pool with a zero-depth area may be used without a lifeguard present if access to
the pool area is prohibited to individuals under the age of 18 years during the time a lifeguard
is not present.
    Subd. 2d. Hot tubs on rental houseboats. (a) A hot water pool intended for seated
recreational use, including a hot tub or whirlpool, that is located on a houseboat that is rented
to the public is not a public pool and is exempt from the requirements for public pools under
Minnesota Rules, chapter 4717.
(b) A hot water pool under this subdivision must be conspicuously posted with the following
notice to renters:

"NOTICE

This spa is exempt from state and local sanitary requirements that prevent disease
transmission.

USE AT YOUR OWN RISK

This notice is required under Minnesota Statutes, section 144.1222, subdivision 2d."
    Subd. 3. Enclosed sports arenas. The commissioner of health shall be responsible for the
adoption of rules and enforcement of applicable laws and rules relating to indoor air quality in the
operation and maintenance of enclosed sports arenas.
History: 1995 c 165 s 1; 2002 c 279 s 5; 2002 c 333 s 1; 1Sp2003 c 14 art 7 s 25; 2005 c 50
s 1; 2005 c 130 s 1

144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES; EXCEPTIONS.
    Subdivision 1. Who must pay. Except for the limitation contained in this section, the
commissioner of health shall charge a handling fee for each specimen submitted to the Department
of Health for analysis for diagnostic purposes by any hospital, private laboratory, private clinic,
or physician. No fee shall be charged to any entity which receives direct or indirect financial
assistance from state or federal funds administered by the Department of Health, including any
public health department, nonprofit community clinic, venereal disease clinic, family planning
clinic, or similar entity. The commissioner of health may establish by rule other exceptions to
the handling fee as may be necessary to gather information for epidemiologic purposes. All fees
collected pursuant to this section shall be deposited in the state treasury and credited to the state
government special revenue fund.
    Subd. 2. Rules for fee amounts. The commissioner of health shall promulgate rules, in
accordance with chapter 14, which shall specify the amount of the handling fee prescribed in
subdivision 1. The fee shall approximate the costs to the department of handling specimens
including reporting, postage, specimen kit preparation, and overhead costs. The fee prescribed in
subdivision 1 shall be $15 per specimen until the commissioner promulgates rules pursuant to
this subdivision.
History: 1979 c 49 s 1; 1982 c 424 s 130; 1987 c 403 art 2 s 8; 1992 c 513 art 6 s 2;
1Sp1993 c 1 art 9 s 19

144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL DISORDERS.
    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative officer or
other person in charge of each institution caring for infants 28 days or less of age, (2) the person
required in pursuance of the provisions of section 144.215, to register the birth of a child, or (3)
the nurse midwife or midwife in attendance at the birth, to arrange to have administered to every
infant or child in its care tests for heritable and congenital disorders according to subdivision 2
and rules prescribed by the state commissioner of health. Testing and the recording and reporting
of test results shall be performed at the times and in the manner prescribed by the commissioner
of health. The commissioner shall charge laboratory service fees so that the total of fees collected
will approximate the costs of conducting the tests and implementing and maintaining a system to
follow-up infants with heritable or congenital disorders. The laboratory service fee is $61 per
specimen. Costs associated with capital expenditures and the development of new procedures
may be prorated over a three-year period when calculating the amount of the fees.
    Subd. 2. Determination of tests to be administered. The commissioner shall periodically
revise the list of tests to be administered for determining the presence of a heritable or congenital
disorder. Revisions to the list shall reflect advances in medical science, new and improved testing
methods, or other factors that will improve the public health. In determining whether a test must be
administered, the commissioner shall take into consideration the adequacy of laboratory methods
to detect the heritable or congenital disorder, the ability to treat or prevent medical conditions
caused by the heritable or congenital disorder, and the severity of the medical conditions caused
by the heritable or congenital disorder. The list of tests to be performed may be revised if the
changes are recommended by the advisory committee established under section 144.1255,
approved by the commissioner, and published in the State Register. The revision is exempt from
the rulemaking requirements in chapter 14, and sections 14.385 and 14.386 do not apply.
    Subd. 3. Objection of parents to test. Persons with a duty to perform testing under
subdivision 1 shall advise parents of infants (1) that the blood or tissue samples used to perform
testing thereunder as well as the results of such testing may be retained by the Department of
Health, (2) the benefit of retaining the blood or tissue sample, and (3) that the following options
are available to them with respect to the testing: (i) to decline to have the tests, or (ii) to elect to
have the tests but to require that all blood samples and records of test results be destroyed within
24 months of the testing. If the parents of an infant object in writing to testing for heritable and
congenital disorders or elect to require that blood samples and test results be destroyed, the
objection or election shall be recorded on a form that is signed by a parent or legal guardian
and made part of the infant's medical record. A written objection exempts an infant from the
requirements of this section and section 144.128.
History: 1965 c 205 s 1; 1977 c 305 s 45; 1Sp1981 c 4 art 1 s 75; 1985 c 248 s 70; 1986
c 444; 1988 c 689 art 2 s 31; 1994 c 636 art 2 s 2; 1997 c 203 art 2 s 11; 1997 c 205 s 19;
1Sp2003 c 14 art 7 s 26

144.1255 HERITABLE AND CONGENITAL DISORDERS.
    Subdivision 1. Creation and membership. (a) By July 1, 2003, the commissioner of health
shall appoint an advisory committee to provide advice and recommendations to the commissioner
concerning tests and treatments for heritable and congenital disorders found in newborn children.
Membership of the committee shall include, but not be limited to, at least one member from
each of the following representative groups:
(1) parents and other consumers;
(2) primary care providers;
(3) clinicians and researchers specializing in newborn diseases and disorders;
(4) genetic counselors;
(5) birth hospital representatives;
(6) newborn screening laboratory professionals;
(7) nutritionists; and
(8) other experts as needed representing related fields such as emerging technologies and
health insurance.
(b) The terms and removal of members are governed by section 15.059. Members shall
not receive per diems but shall be compensated for expenses. Notwithstanding section 15.059,
subdivision 5 , the advisory committee does not expire.
    Subd. 2. Function and objectives. The committee's activities include, but are not limited to:
(1) collection of information on the efficacy and reliability of various tests for heritable
and congenital disorders;
(2) collection of information on the availability and efficacy of treatments for heritable
and congenital disorders;
(3) collection of information on the severity of medical conditions caused by heritable
and congenital disorders;
(4) discussion and assessment of the benefits of performing tests for heritable and congenital
disorders as compared to the costs, treatment limitations, or other potential disadvantages of
requiring the tests;
(5) discussion and assessment of ethical considerations surrounding the testing, treatment,
and handling of data and specimens generated by the testing requirements of sections 144.125
to 144.128; and
(6) providing advice and recommendations to the commissioner concerning tests and
treatments for heritable and congenital disorders found in newborn children.
History: 1Sp2003 c 14 art 7 s 27

144.126 [Repealed, 1Sp2003 c 14 art 7 s 89]

144.128 COMMISSIONER'S DUTIES.
The commissioner shall:
(1) notify the physicians of newborns tested of the results of the tests performed;
(2) make referrals for the necessary treatment of diagnosed cases of heritable and congenital
disorders when treatment is indicated;
(3) maintain a registry of the cases of heritable and congenital disorders detected by the
screening program for the purpose of follow-up services;
(4) prepare a separate form for use by parents or by adults who were tested as minors to
direct that blood samples and test results be destroyed;
(5) comply with a destruction request within 45 days after receiving it;
(6) notify individuals who request destruction of samples and test results that the samples
and test results have been destroyed; and
(7) adopt rules to carry out sections 144.125 to 144.128.
History: 1Sp1985 c 9 art 2 s 10; 1991 c 36 s 2; 1Sp2003 c 14 art 7 s 28; 2006 c 253 s 9

144.13 RULES, NOTICE PUBLISHED.
Three weeks' published notice of such rules, if of general application throughout the state,
shall be given at the seat of government; if of local application only, as near such locality as
practicable. Special rules applicable to particular cases shall be sufficiently noticed when posted
in a conspicuous place upon or near the premises affected. Fines collected for violations of
rules adopted by the commissioner shall be paid into the state treasury; and of local boards
and officers, into the county treasury.
History: (5346) RL s 2132; 1977 c 305 s 45; 1985 c 248 s 70

144.14 QUARANTINE OF INTERSTATE CARRIERS.
When necessary the commissioner may establish and enforce a system of quarantine against
the introduction into the state of any plague or other communicable disease by common carriers
doing business across its borders. Its members, officers, and agents may board any conveyance
used by such carriers to inspect the same and, if such conveyance be found infected, may detain
the same and isolate and quarantine any or all persons found thereon, with their luggage, until
all danger of communication of disease therefrom is removed.
History: (5347) RL s 2133; 1977 c 305 s 45

144.145 FLUORIDATION OF MUNICIPAL WATER SUPPLIES.
For the purpose of promoting public health through prevention of tooth decay, the person,
firm, corporation, or municipality having jurisdiction over a municipal water supply, whether
publicly or privately owned or operated, shall control the quantities of fluoride in the water
so as to maintain a fluoride content prescribed by the state commissioner of health. In the
manner provided by law, the state commissioner of health shall promulgate rules relating to the
fluoridation of public water supplies which shall include, but not be limited to the following: (1)
The means by which fluoride is controlled; (2) the methods of testing the fluoride content; and (3)
the records to be kept relating to fluoridation. The state commissioner of health shall enforce the
provisions of this section. In so doing the commissioner shall require the fluoridation of water in
all municipal water supplies on or before January 1, 1970. The state commissioner of health shall
not require the fluoridation of water in any municipal water supply where such water supply in the
state of nature contains sufficient fluorides to conform with the rules of such commissioner.
History: 1967 c 603 s 1; 1977 c 305 s 45; 1985 c 248 s 70; 1986 c 444

144.146 TREATMENT OF CYSTIC FIBROSIS.
    Subdivision 1. Program. The commissioner of health shall develop and conduct a program
including medical care and hospital treatment for persons aged 21 or over who are suffering
from cystic fibrosis.
    Subd. 2.[Repealed, 1978 c 762 s 9]
History: 1975 c 409 s 1,2; 1977 c 305 s 45

SUMMER HEALTH CARE INTERNS

144.1464 SUMMER HEALTH CARE INTERNS.
    Subdivision 1. Summer internships. The commissioner of health, through a contract with a
nonprofit organization as required by subdivision 4, shall award grants to hospitals, clinics,
nursing facilities, and home care providers to establish a secondary and postsecondary summer
health care intern program. The purpose of the program is to expose interested secondary and
postsecondary pupils to various careers within the health care profession.
    Subd. 2. Criteria. (a) The commissioner, through the organization under contract, shall
award grants to hospitals, clinics, nursing facilities, and home care providers that agree to:
(1) provide secondary and postsecondary summer health care interns with formal exposure
to the health care profession;
(2) provide an orientation for the secondary and postsecondary summer health care interns;
(3) pay one-half the costs of employing the secondary and postsecondary summer health
care intern;
(4) interview and hire secondary and postsecondary pupils for a minimum of six weeks
and a maximum of 12 weeks; and
(5) employ at least one secondary student for each postsecondary student employed, to the
extent that there are sufficient qualifying secondary student applicants.
(b) In order to be eligible to be hired as a secondary summer health intern by a hospital,
clinic, nursing facility, or home care provider, a pupil must:
(1) intend to complete high school graduation requirements and be between the junior and
senior year of high school; and
(2) be from a school district in proximity to the facility.
(c) In order to be eligible to be hired as a postsecondary summer health care intern by
a hospital or clinic, a pupil must:
(1) intend to complete a health care training program or a two-year or four-year degree
program and be planning on enrolling in or be enrolled in that training program or degree
program; and
(2) be enrolled in a Minnesota educational institution or be a resident of the state of
Minnesota; priority must be given to applicants from a school district or an educational institution
in proximity to the facility.
(d) Hospitals, clinics, nursing facilities, and home care providers awarded grants may employ
pupils as secondary and postsecondary summer health care interns beginning on or after June 15,
1993, if they agree to pay the intern, during the period before disbursement of state grant money,
with money designated as the facility's 50 percent contribution towards internship costs.
    Subd. 3. Grants. The commissioner, through the organization under contract, shall award
separate grants to hospitals, clinics, nursing facilities, and home care providers meeting
the requirements of subdivision 2. The grants must be used to pay one-half of the costs of
employing secondary and postsecondary pupils in a hospital, clinic, nursing facility, or home
care setting during the course of the program. No more than 50 percent of the participants may
be postsecondary students, unless the program does not receive enough qualified secondary
applicants per fiscal year. No more than five pupils may be selected from any secondary or
postsecondary institution to participate in the program and no more than one-half of the number
of pupils selected may be from the seven-county metropolitan area.
    Subd. 4. Contract. The commissioner shall contract with a statewide, nonprofit organization
representing facilities at which secondary and postsecondary summer health care interns will
serve, to administer the grant program established by this section. Grant funds that are not used in
one fiscal year may be carried over to the next fiscal year. The organization awarded the grant
shall provide the commissioner with any information needed by the commissioner to evaluate the
program, in the form and at the times specified by the commissioner.
History: 1992 c 499 art 7 s 9; 1993 c 345 art 11 s 1; 1993 c 366 s 28,29; 1994 c 625 art 12 s
2; 1995 c 234 art 8 s 29-31; 1Sp2001 c 9 art 1 s 31; 2002 c 370 art 1 s 113

RURAL HOSPITAL GRANTS

144.1465 FINDING AND PURPOSE.
The legislature finds that rural hospitals are an integral part of the health care delivery
system and are fundamental to the development of a sound rural economy. The legislature further
finds that access to rural health care must be assured to all Minnesota residents. The rural health
care system is undergoing a restructuring that threatens to jeopardize access in rural areas to
quality health services. To assure continued rural health care access the legislature proposes to
establish a grant program to assist rural hospitals and their communities with the development
of strategic plans and transition projects, provide subsidies for geographically isolated hospitals
facing closure, and examine the problem of recruitment and retention of rural physicians, nurses,
and other allied health care professionals.
History: 1990 c 568 art 2 s 6

144.147 RURAL HOSPITAL PLANNING AND TRANSITION GRANT PROGRAM.
    Subdivision 1. Definition. "Eligible rural hospital" means any nonfederal, general acute
care hospital that:
(1) is either located in a rural area, as defined in the federal Medicare regulations, Code of
Federal Regulations, title 42, section 405.1041, or located in a community with a population of
less than 15,000, according to United States Census Bureau statistics, outside the seven-county
metropolitan area;
(2) has 50 or fewer beds; and
(3) is not for profit.
    Subd. 2. Grants authorized. The commissioner shall establish a program of grants to assist
eligible rural hospitals. The commissioner shall award grants to hospitals and communities for the
purposes set forth in paragraphs (a) and (b).
(a) Grants may be used by hospitals and their communities to develop strategic plans for
preserving or enhancing access to health services. At a minimum, a strategic plan must consist of:
(1) a needs assessment to determine what health services are needed and desired by the
community. The assessment must include interviews with or surveys of area health professionals,
local community leaders, and public hearings;
(2) an assessment of the feasibility of providing needed health services that identifies
priorities and timeliness for potential changes; and
(3) an implementation plan.
The strategic plan must be developed by a committee that includes representatives from the
hospital, local public health agencies, other health providers, and consumers from the community.
(b) The grants may also be used by eligible rural hospitals that have developed strategic
plans to implement transition projects to modify the type and extent of services provided, in order
to reflect the needs of that plan. Grants may be used by hospitals under this paragraph to develop
hospital-based physician practices that integrate hospital and existing medical practice facilities
that agree to transfer their practices, equipment, staffing, and administration to the hospital. The
grants may also be used by the hospital to establish a health provider cooperative, a telemedicine
system, an electronic health records system, or a rural health care system or to cover expenses
associated with being designated as a critical access hospital for the Medicare rural hospital
flexibility program. Not more than one-third of any grant shall be used to offset losses incurred
by physicians agreeing to transfer their practices to hospitals.
    Subd. 3. Consideration of grants. In determining which hospitals will receive grants under
this section, the commissioner shall take into account:
(1) improving community access to hospital or health services;
(2) changes in service populations;
(3) availability and upgrading of ambulatory and emergency services;
(4) the extent that the health needs of the community are not currently being met by other
providers in the service area;
(5) the need to recruit and retain health professionals;
(6) the extent of community support;
(7) the integration of health care services and the coordination with local community
organizations, such as community development and public health agencies; and
(8) the financial condition of the hospital.
    Subd. 4. Allocation of grants. (a) Eligible hospitals must apply to the commissioner no
later than September 1 of each fiscal year for grants awarded for that fiscal year. A grant may
be awarded upon signing of a grant contract.
(b) The commissioner must make a final decision on the funding of each application within
60 days of the deadline for receiving applications.
(c) Each relevant community health board has 30 days in which to review and comment to
the commissioner on grant applications from hospitals in their community health service area.
(d) In determining which hospitals will receive grants under this section, the commissioner
shall consider the following factors:
(1) Description of the problem, description of the project, and the likelihood of successful
outcome of the project. The applicant must explain clearly the nature of the health services
problems in their service area, how the grant funds will be used, what will be accomplished, and
the results expected. The applicant should describe achievable objectives, a timetable, and roles
and capabilities of responsible individuals and organizations.
(2) The extent of community support for the hospital and this proposed project. The
applicant should demonstrate support for the hospital and for the proposed project from other
local health service providers and from local community and government leaders. Evidence
of such support may include past commitments of financial support from local individuals,
organizations, or government entities; and commitment of financial support, in-kind services or
cash, for this project.
(3) The comments, if any, resulting from a review of the application by the community health
board in whose community health service area the hospital is located.
(e) In evaluating applications, the commissioner shall score each application on a 100 point
scale, assigning the maximum of 70 points for an applicant's understanding of the problem,
description of the project, and likelihood of successful outcome of the project; and a maximum of
30 points for the extent of community support for the hospital and this project. The commissioner
may also take into account other relevant factors.
(f) Any single grant to a hospital, including hospitals that submit applications as consortia,
may not exceed $50,000 a year and may not exceed a term of two years. Prior to the receipt of any
grant, the hospital must certify to the commissioner that at least one-half of the amount of the total
cost of the planning or transition project, which may include in-kind services, is available for the
same purposes from nonstate sources. A hospital receiving a grant under this section may use the
grant for any expenses incurred in the development of strategic plans or the implementation of
transition projects with respect to which the grant is made. Project grants may not be used to retire
debt incurred with respect to any capital expenditure made prior to the date on which the project
is initiated. Hospitals may apply to the program each year they are eligible.
(g) The commissioner may adopt rules to implement this section.
    Subd. 5. Evaluation. The commissioner shall evaluate the overall effectiveness of the grant
program. The commissioner may collect, from the hospital, and communities receiving grants,
quarterly progress reports to evaluate the grant program. Information related to the financial
condition of individual hospitals shall be classified as nonpublic data.
History: 1990 c 568 art 2 s 7; 1992 c 549 art 5 s 4-6; 1993 c 247 art 5 s 11; 1993 c 345
art 10 s 1; 1995 c 234 art 8 s 32; 1997 c 225 art 2 s 48-51; 1999 c 247 s 2-5; 2001 c 171 s
2; 1Sp2005 c 4 art 6 s 8,9

RURAL HOSPITAL DEMONSTRATION PROJECT

144.1475 RURAL HOSPITAL DEMONSTRATION PROJECT.
    Subdivision 1. Establishment. The commissioner of health, for the biennium ending June
30, 1999, shall establish at least three demonstration projects per fiscal year to assist rural
hospitals in the planning and implementation process to either consolidate or cooperate with
another existing hospital in its service area to provide better quality health care to its community.
A demonstration project must include at least two eligible hospitals. For purposes of this section,
an "eligible hospital" means a hospital that:
(1) is located outside the seven-county metropolitan area;
(2) has 50 or fewer licensed beds; and
(3) is located within a 25-mile radius of another hospital.
At least one of the eligible hospitals in a demonstration project must have had a negative
operating margin during one of the two years prior to application.
    Subd. 2. Application. (a) An eligible hospital seeking to be a participant in a demonstration
project must submit an application to the commissioner of health detailing the hospital's efforts to
consolidate health care delivery in its service area, cooperate with another hospital in the delivery
of health care, or both consolidate and cooperate. Applications must be submitted by October
15 of each fiscal year for grants awarded for that fiscal year.
(b) Applications must:
(1) describe the problem that the proposed consolidation or cooperation will address, the
consolidation or cooperation project, how the grant funds will be used, what will be accomplished,
and the results expected;
(2) describe achievable objectives, a timetable, and the roles and capabilities of responsible
individuals and organizations;
(3) include written commitments from the applicant hospital and at least one other hospital
that will participate in the consolidation or cooperation demonstration project, that specify the
activities the organization will undertake during the project, the resources the organization will
contribute to the demonstration project, and the expected role and nature of the organization's
involvement in proposed consolidation or cooperation activities; and
(4) provide evidence of support for the proposed project from other local health service
providers and from local community and government leaders.
    Subd. 3. Grants. The commissioner of health shall allocate a grant of up to $100,000 to the
highest scoring applicants each year until available funding is expended. Grants may be used by
eligible hospitals to:
(1) conduct consolidation or cooperation negotiations;
(2) develop consolidation or cooperation plans, including financial plans and architectural
designs;
(3) seek community input and conduct community education on proposed or planned
consolidations or cooperative activities; and
(4) implement consolidation or cooperation plans.
    Subd. 4. Consideration of grants. In evaluating applications, the commissioner shall score
each application on a 100 point scale, assigning: a maximum of 40 points for an applicant's
understanding of the problem, description of the project, and likelihood of successful outcome
of the project; a maximum of 30 points for explicit and unequivocal written commitments
from organizations participating in the project; a maximum of 20 points for matching funds or
in-kind services committed by the applicant or others to the project; and a maximum of ten
points for the extent of community support for the project. The commissioner shall consider the
comments, if any, resulting from a review of the application by the community health board in
whose community health service area the applicant is located. The commissioner may also take
into account other relevant factors.
    Subd. 5. Evaluation. The commissioner of health shall evaluate the overall effectiveness of
the demonstration projects and report to the legislature by September 1, 2000. The commissioner
may collect, from the hospitals receiving grants, any information necessary to evaluate the
demonstration project.
History: 1997 c 225 art 2 s 52

RURAL PHARMACY PLANNING AND TRANSITION GRANT PROGRAM

144.1476 RURAL PHARMACY PLANNING AND TRANSITION GRANT PROGRAM.
    Subdivision 1. Definitions. (a) For the purposes of this section, the following definitions
apply.
(b) "Eligible rural community" means:
(1) a Minnesota community that is located in a rural area, as defined in the federal Medicare
regulations, Code of Federal Regulations, title 42, section 405.1041; or
(2) a Minnesota community that has a population of less than 10,000, according to the United
States Bureau of Statistics, and that is outside the seven-county metropolitan area, excluding the
cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.
(c) "Health care provider" means a hospital, clinic, pharmacy, long-term care institution, or
other health care facility that is licensed, certified, or otherwise authorized by the laws of this
state to provide health care.
(d) "Pharmacist" means an individual with a valid license issued under chapter 151 to
practice pharmacy.
(e) "Pharmacy" has the meaning given under section 151.01, subdivision 2.
    Subd. 2. Grants authorized; eligibility. (a) The commissioner of health shall establish a
program to award grants to eligible rural communities or health care providers in eligible rural
communities for planning, establishing, keeping in operation, or providing health care services
that preserve access to prescription medications and the skills of a pharmacist according to
sections 151.01 to 151.40.
(b) To be eligible for a grant, an applicant must develop a strategic plan for preserving or
enhancing access to prescription medications and the skills of a pharmacist. At a minimum, a
strategic plan must consist of:
(1) a needs assessment to determine what pharmacy services are needed and desired by the
community. The assessment must include interviews with or surveys of area and local health
professionals, local community leaders, and public officials;
(2) an assessment of the feasibility of providing needed pharmacy services that identifies
priorities and timelines for potential changes; and
(3) an implementation plan.
(c) A grant may be used by a recipient that has developed a strategic plan to implement
transition projects to modify the type and extent of pharmacy services provided, in order to reflect
the needs of the community. Grants may also be used by recipients:
(1) to develop pharmacy practices that integrate pharmacy and existing health care provider
facilities; or
(2) to establish a pharmacy provider cooperative or initiatives that maintain local access to
prescription medications and the skills of a pharmacist.
    Subd. 3. Consideration of grants. In determining which applicants shall receive grants
under this section, the commissioner of health shall appoint a committee comprised of members
with experience and knowledge about rural pharmacy issues including, but not limited to, two
rural pharmacists with a community pharmacy background, two health care providers from rural
communities, one representative from a statewide pharmacist organization, and one representative
of the Board of Pharmacy. A representative of the commissioner may serve on the committee in an
ex officio status. In determining who shall receive a grant, the committee shall take into account:
(1) improving or maintaining access to prescription medications and the skills of a
pharmacist;
(2) changes in service populations;
(3) the extent community pharmacy needs are not currently met by other providers in the area;
(4) the financial condition of the applicant;
(5) the integration of pharmacy services into existing health care services; and
(6) community support.
The commissioner may also take into account other relevant factors.
    Subd. 4. Allocation of grants. (a) The commissioner shall establish a deadline for receiving
applications and must make a final decision on the funding of each application within 60 days
of the deadline. An applicant must apply no later than March 1 of each fiscal year for grants
awarded for that fiscal year.
(b) Any grant awarded must not exceed $50,000 a year. Notwithstanding any law to the
contrary, funds awarded to grantees in a grant agreement do not lapse until expended by the
grantee.
(c) Applicants may apply to the program each year they are eligible.
(d) Project grants may not be used to retire debt incurred with respect to any capital
expenditure made prior to the date on which the project is initiated.
    Subd. 5. Evaluation. The commissioner shall evaluate the overall effectiveness of the grant
program and may collect progress reports and other information from grantees needed for program
evaluation. An academic institution that has the expertise in evaluating rural pharmacy outcomes
may participate in the program evaluation if asked by a grantee or the commissioner. The
commissioner shall compile summaries of successful grant projects and other model community
efforts to preserve access to prescription medications and the skills of a pharmacist, and make this
information available to Minnesota communities seeking to address local pharmacy issues.
History: 1Sp2005 c 4 art 6 s 10; 2006 c 282 art 16 s 2

RURAL HOSPITAL GRANT PROGRAM

144.148 RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT PROGRAM.
    Subdivision 1. Definition. (a) For purposes of this section, the following definitions apply.
(b) "Eligible rural hospital" means any nonfederal, general acute care hospital that:
(1) is either located in a rural area, as defined in the federal Medicare regulations, Code of
Federal Regulations, title 42, section 405.1041, or located in a community with a population of
less than 15,000, according to United States Census Bureau statistics, outside the seven-county
metropolitan area;
(2) has 50 or fewer beds; and
(3) is not for profit.
(c) "Eligible project" means a modernization project to update, remodel, or replace aging
hospital facilities and equipment necessary to maintain the operations of a hospital, including
establishing an electronic health records system.
    Subd. 2. Program. (a) The commissioner of health shall award rural hospital capital
improvement grants to eligible rural hospitals. Except as provided in paragraph (b), a grant shall
not exceed $500,000 per hospital. Prior to the receipt of any grant, the hospital must certify to the
commissioner that at least one-quarter of the grant amount, which may include in-kind services, is
available for the same purposes from nonstate resources. Notwithstanding any law to the contrary,
funds awarded to grantees in a grant agreement do not lapse until expended by the grantee.
(b) A grant shall not exceed $1,500,000 per eligible rural hospital that also satisfies the
following criteria:
(1) is the only hospital in a county;
(2) has 25 or fewer licensed hospital beds with a net hospital operating margin not greater
than an average of two percent over the three fiscal years prior to application;
(3) is located in a medically underserved community (MUC) or a health professional
shortage area (HPSA);
(4) is located near a migrant worker employment site and regularly treats significant numbers
of migrant workers and their families; and
(5) has not previously received a grant under this section prior to July 1, 1999.
    Subd. 3. Applications. Eligible hospitals seeking a grant shall apply to the commissioner.
Applications must include a description of the problem that the proposed project will address,
a description of the project including construction and remodeling drawings or specifications,
sources of funds for the project, uses of funds for the project, the results expected, and a plan
to maintain or operate any facility or equipment included in the project. The applicant must
describe achievable objectives, a timetable, and roles and capabilities of responsible individuals
and organization. Applicants must submit to the commissioner evidence that competitive bidding
was used to select contractors for the project.
    Subd. 4. Consideration of applications. The commissioner shall review each application
to determine whether or not the hospital's application is complete and whether the hospital and
the project are eligible for a grant. In evaluating applications, the commissioner shall score each
application on a 100 point scale, assigning: a maximum of 40 points for an applicant's clarity
and thoroughness in describing the problem and the project; a maximum of 40 points for the
extent to which the applicant has demonstrated that it has made adequate provisions to assure
proper and efficient operation of the facility once the project is completed; and a maximum of
20 points for the extent to which the proposed project is consistent with the hospital's capital
improvement plan or strategic plan. The commissioner may also take into account other relevant
factors. During application review, the commissioner may request additional information about
a proposed project, including information on project cost. Failure to provide the information
requested disqualifies an applicant.
    Subd. 5. Program oversight. The commissioner shall determine the amount of a grant
to be given to an eligible rural hospital based on the relative score of each eligible hospital's
application and the funds available to the commissioner. The grant shall be used to update,
remodel, or replace aging facilities and equipment necessary to maintain the operations of the
hospital. The commissioner may collect, from the hospitals receiving grants, any information
necessary to evaluate the program.
    Subd. 6.[Repealed by amendment, 1999 c 245 art 2 s 21]
    Subd. 7.[Repealed by amendment, 1999 c 245 art 2 s 21]
    Subd. 8.[Repealed, 1Sp2001 c 9 art 1 s 62]
    Subd. 9. Status of previous awards. The commissioner must regard grants or loans awarded
to eligible rural hospitals before August 1, 1999, as grants subject to the conditions of this section
and not subject to repayment as loans under Minnesota Statutes 1998, section 144.148.
History: 1997 c 225 art 2 s 53; 1999 c 245 art 2 s 21; 2001 c 171 s 3; 1Sp2001 c 9 art 1 s
32; 2002 c 375 art 3 s 5; 2002 c 379 art 1 s 113; 2004 c 231 s 1; 1Sp2005 c 4 art 6 s 11

RURAL HEALTH

144.1481 RURAL HEALTH ADVISORY COMMITTEE.
    Subdivision 1. Establishment; membership. The commissioner of health shall establish
a 15-member Rural Health Advisory Committee. The committee shall consist of the following
members, all of whom must reside outside the seven-county metropolitan area, as defined in
section 473.121, subdivision 2:
(1) two members from the house of representatives of the state of Minnesota, one from the
majority party and one from the minority party;
(2) two members from the senate of the state of Minnesota, one from the majority party and
one from the minority party;
(3) a volunteer member of an ambulance service based outside the seven-county metropolitan
area;
(4) a representative of a hospital located outside the seven-county metropolitan area;
(5) a representative of a nursing home located outside the seven-county metropolitan area;
(6) a medical doctor or doctor of osteopathy licensed under chapter 147;
(7) a midlevel practitioner;
(8) a registered nurse or licensed practical nurse;
(9) a licensed health care professional from an occupation not otherwise represented on
the committee;
(10) a representative of an institution of higher education located outside the seven-county
metropolitan area that provides training for rural health care providers; and
(11) three consumers, at least one of whom must be an advocate for persons who are
mentally ill or developmentally disabled.
The commissioner will make recommendations for committee membership. Committee
members will be appointed by the governor. In making appointments, the governor shall ensure
that appointments provide geographic balance among those areas of the state outside the
seven-county metropolitan area. The chair of the committee shall be elected by the members. The
advisory committee is governed by section 15.059, except that the members do not receive per
diem compensation. Notwithstanding section 15.059, the advisory committee does not expire.
    Subd. 2. Duties. The advisory committee shall:
(1) advise the commissioner and other state agencies on rural health issues;
(2) provide a systematic and cohesive approach toward rural health issues and rural health
care planning, at both a local and statewide level;
(3) develop and evaluate mechanisms to encourage greater cooperation among rural
communities and among providers;
(4) recommend and evaluate approaches to rural health issues that are sensitive to the needs
of local communities; and
(5) develop methods for identifying individuals who are underserved by the rural health
care system.
    Subd. 3. Staffing; office space; equipment. The commissioner shall provide the advisory
committee with staff support, office space, and access to office equipment and services.
History: 1992 c 549 art 5 s 7; 1993 c 247 art 5 s 12; 2001 c 161 s 20; 1Sp2003 c 14 art 7 s 29

144.1482 OFFICE OF RURAL HEALTH.
    Subdivision 1. Duties. The Office of Rural Health in conjunction with the University of
Minnesota medical schools and other organizations in the state which are addressing rural health
care problems shall:
(1) establish and maintain a clearinghouse for collecting and disseminating information on
rural health care issues, research findings, and innovative approaches to the delivery of rural
health care;
(2) coordinate the activities relating to rural health care that are carried out by the state to
avoid duplication of effort;
(3) identify federal and state rural health programs and provide technical assistance to
public and nonprofit entities, including community and migrant health centers, to assist them
in participating in these programs;
(4) assist rural communities in improving the delivery and quality of health care in rural
areas and in recruiting and retaining health professionals; and
(5) carry out the duties assigned in section 144.1483.
    Subd. 2. Contracts. To carry out these duties, the office may contract with or provide grants
to public and private, nonprofit entities.
History: 1992 c 549 art 5 s 8

144.1483 RURAL HEALTH INITIATIVES.
The commissioner of health, through the Office of Rural Health, and consulting as necessary
with the commissioner of human services, the commissioner of commerce, the Minnesota Office
of Higher Education, and other state agencies, shall:
(1) develop a detailed plan regarding the feasibility of coordinating rural health care services
by organizing individual medical providers and smaller hospitals and clinics into referral networks
with larger rural hospitals and clinics that provide a broader array of services;
(2) develop recommendations regarding health education and training programs in rural
areas, including but not limited to a physician assistants' training program, continuing education
programs for rural health care providers, and rural outreach programs for nurse practitioners
within existing training programs;
(3) develop a statewide, coordinated recruitment strategy for health care personnel and
maintain a database on health care personnel as required under section 144.1485;
(4) develop and administer technical assistance programs to assist rural communities in: (i)
planning and coordinating the delivery of local health care services; and (ii) hiring physicians,
nurse practitioners, public health nurses, physician assistants, and other health personnel;
(5) study and recommend changes in the regulation of health care personnel, such as nurse
practitioners and physician assistants, related to scope of practice, the amount of on-site physician
supervision, and dispensing of medication, to address rural health personnel shortages;
(6) support efforts to ensure continued funding for medical and nursing education programs
that will increase the number of health professionals serving in rural areas;
(7) support efforts to secure higher reimbursement for rural health care providers from the
Medicare and medical assistance programs;
(8) coordinate the development of a statewide plan for emergency medical services, in
cooperation with the Emergency Medical Services Advisory Council;
(9) establish a Medicare rural hospital flexibility program pursuant to section 1820 of the
federal Social Security Act, United States Code, title 42, section 1395i-4, by developing a state
rural health plan and designating, consistent with the rural health plan, rural nonprofit or public
hospitals in the state as critical access hospitals. Critical access hospitals shall include facilities
that are certified by the state as necessary providers of health care services to residents in the area.
Necessary providers of health care services are designated as critical access hospitals on the basis
of being more than 20 miles, defined as official mileage as reported by the Minnesota Department
of Transportation, from the next nearest hospital, being the sole hospital in the county, being a
hospital located in a county with a designated medically underserved area or health professional
shortage area, or being a hospital located in a county contiguous to a county with a medically
underserved area or health professional shortage area. A critical access hospital located in a
county with a designated medically underserved area or a health professional shortage area or in a
county contiguous to a county with a medically underserved area or health professional shortage
area shall continue to be recognized as a critical access hospital in the event the medically
underserved area or health professional shortage area designation is subsequently withdrawn; and
(10) carry out other activities necessary to address rural health problems.
History: 1992 c 549 art 5 s 9; 1995 c 212 art 3 s 59; 1998 c 257 s 1; 1999 c 245 art 2 s 22;
2001 c 171 s 4; 1Sp2003 c 14 art 7 s 30; 2005 c 107 art 2 s 60; 1Sp2005 c 4 art 6 s 12

144.1484 [Repealed, 1Sp2003 c 14 art 7 s 89]

144.1485 DATABASE ON HEALTH PERSONNEL.
(a) The commissioner of health shall develop and maintain a database on health services
personnel. The commissioner shall use this information to assist local communities and units
of state government to develop plans for the recruitment and retention of health personnel.
Information collected in the database must include, but is not limited to, data on levels of
educational preparation, specialty, and place of employment. The commissioner may collect
information through the registration and licensure systems of the state health licensing boards.
(b) Health professionals who report their practice or place of employment address to the
commissioner of health under section 144.052 may request in writing that their practice or
place of employment address be classified as private data on individuals, as defined in section
13.02, subdivision 12. The commissioner shall grant the classification upon receipt of a signed
statement by the health professional that the classification is required for the safety of the health
professional, if the statement also provides a valid, existing address where the health professional
consents to receive service of process. The commissioner shall use the mailing address in place
of the practice or place of employment address in all documents available to the general public.
The practice or place of employment address and any information provided in the classification
request, other than the mailing address, are private data on individuals and may be provided
to other state agencies. The practice or place of employment address may be used to develop
summary reports that show in aggregate the distribution of health care providers in Minnesota.
History: 1992 c 549 art 5 s 11; 1994 c 625 art 8 s 39

144.1486 [Repealed, 1Sp2005 c 4 art 6 s 58]

NATIONAL HEALTH SERVICES CORPS

STATE LOAN REPAYMENT PROGRAM

144.1487 LOAN REPAYMENT PROGRAM FOR HEALTH PROFESSIONALS.
    Subdivision 1. Definition. (a) For purposes of sections 144.1487 to 144.1492, the following
definition applies.
(b) "Health professional shortage area" means an area designated as such by the federal
Secretary of Health and Human Services, as provided under Code of Federal Regulations, title 42,
part 5, and United States Code, title 42, section 254E.
    Subd. 2. Establishment and purpose. The commissioner shall establish a National Health
Services Corps state loan repayment program authorized by section 388I of the Public Health
Service Act, United States Code, title 42, section 254q-1, as amended by Public Law 101-597.
The purpose of the program is to assist communities with the recruitment and retention of health
professionals in federally designated health professional shortage areas.
History: 1993 c 345 art 11 s 16; 1995 c 212 art 3 s 44; 1995 c 234 art 8 s 35

144.1488 PROGRAM ADMINISTRATION AND ELIGIBILITY.
    Subdivision 1. Duties of commissioner of health. The commissioner shall administer the
state loan repayment program. The commissioner shall:
(1) ensure that federal funds are used in accordance with program requirements established
by the federal National Health Services Corps;
(2) notify potentially eligible loan repayment sites about the program;
(3) develop and disseminate application materials to sites;
(4) review and rank applications using the scoring criteria approved by the federal
Department of Health and Human Services as part of the Minnesota Department of Health's
National Health Services Corps state loan repayment program application;
(5) select sites that qualify for loan repayment based upon the availability of federal and
state funding;
(6) carry out other activities necessary to implement and administer sections 144.1487 to
144.1492;
(7) verify the eligibility of program participants;
(8) sign a contract with each participant that specifies the obligations of the participant and
the state;
(9) arrange for loan repayment of qualifying educational loans for program participants;
(10) monitor the obligated service of program participants;
(11) waive or suspend service or payment obligations of participants in appropriate situations;
(12) place participants who fail to meet their obligations in default; and
(13) enforce penalties for default.
    Subd. 2.[Repealed, 1995 c 212 art 3 s 60; 1995 c 234 art 8 s 57]
    Subd. 3. Eligible loan repayment sites. Nonprofit private and public entities located in and
providing health care services in federally designated primary care health professional shortage
areas are eligible to apply for the program. The commissioner shall develop a list of Minnesota
health professional shortage areas in greatest need of health care professionals and shall select
loan repayment sites from that list. The commissioner shall ensure, to the greatest extent possible,
that the geographic distribution of sites within the state reflects the percentage of the population
living in rural and urban health professional shortage areas.
    Subd. 4. Eligible health professionals. (a) To be eligible to apply to the commissioner for
the loan repayment program, health professionals must be citizens or nationals of the United
States, must not have any unserved obligations for service to a federal, state, or local government,
or other entity, must have a current and unrestricted Minnesota license to practice, and must be
ready to begin full-time clinical practice upon signing a contract for obligated service.
(b) Eligible providers are those specified by the federal Bureau of Health Professions in the
policy information notice for the state's current federal grant application. A health professional
selected for participation is not eligible for loan repayment until the health professional has an
employment agreement or contract with an eligible loan repayment site and has signed a contract
for obligated service with the commissioner.
History: 1993 c 345 art 11 s 17; 1995 c 212 art 3 s 45,46; 1995 c 234 art 8 s 36,37; 1999 c
247 s 10-12; 1Sp2003 c 14 art 7 s 31

144.1489 OBLIGATIONS OF PARTICIPANTS.
    Subdivision 1. Contract required. Before starting the period of obligated service, a
participant must sign a contract with the commissioner that specifies the obligations of the
participant and the commissioner.
    Subd. 2. Obligated service. A participant shall agree in the contract to fulfill the period of
obligated service by providing primary health care services in full-time clinical practice. The
service must be provided in a nonprofit private or public entity that is located in and providing
services to a federally designated health professional shortage area and that has been designated
as an eligible site by the commissioner under the state loan repayment program.
    Subd. 3. Length of service. Participants must agree to provide obligated service for a
minimum of two years. A participant may extend a contract to provide obligated service for a
third and fourth year, subject to approval by the commissioner and the availability of federal
and state funding.
    Subd. 4. Affidavit of service required. Before receiving loan repayment, annually
thereafter, and as requested by the commissioner, a participant shall submit an affidavit to the
commissioner stating that the participant is providing the obligated service and which is signed by
a representative of the organizational entity in which the service is provided. Participants must
provide written notice to the commissioner within 30 days of: a change in name or address, a
decision not to fulfill a service obligation, or cessation of clinical practice.
    Subd. 5. Tax responsibility. The participant is responsible for reporting on federal income
tax returns any amount paid by the state on designated loans, if required to do so under federal law.
    Subd. 6. Nondiscrimination requirements. Participants are prohibited from charging
a higher rate for professional services than the usual and customary rate prevailing in the area
where the services are provided. If a patient is unable to pay this charge, a participant shall charge
the patient a reduced rate or not charge the patient. Participants must agree not to discriminate
on the basis of ability to pay or status as a Medicare or medical assistance enrollee. Participants
must agree to accept assignment under the Medicare program and to serve as an enrolled provider
under medical assistance.
History: 1993 c 345 art 11 s 18; 1995 c 212 art 3 s 47-49; 1995 c 234 art 8 s 38-40;
1999 c 247 s 13,14

144.1490 RESPONSIBILITIES OF LOAN REPAYMENT PROGRAM.
    Subdivision 1. Loan repayment. Subject to the availability of federal and state funds for the
loan repayment program, the commissioner shall pay all or part of the qualifying education loans
up to $20,000 annually for each primary care physician participant that fulfills the required service
obligation. For purposes of this provision, "qualifying educational loans" are government and
commercial loans for actual costs paid for tuition, reasonable education expenses, and reasonable
living expenses related to the graduate or undergraduate education of a health care professional.
    Subd. 2. Procedure for loan repayment. Program participants, at the time of signing a
contract, shall designate the qualifying loan or loans for which the commissioner is to make
payments. The participant shall submit to the commissioner proof that all payments made by the
commissioner have been applied toward the designated qualifying loans. The commissioner shall
make payments in accordance with the terms and conditions of the state loan repayment grant
agreement or contract, in an amount not to exceed $20,000 when annualized. If the amount paid
by the commissioner is less than $20,000 during a 12-month period, the commissioner shall pay
during the 12th month an additional amount towards a loan or loans designated by the participant,
to bring the total paid to $20,000. The total amount paid by the commissioner must not exceed the
amount of principal and accrued interest of the designated loans.
History: 1993 c 345 art 11 s 19; 1995 c 212 art 3 s 50; 1995 c 234 art 8 s 41; 1999 c 247 s 15

144.1491 FAILURE TO COMPLETE OBLIGATED SERVICE.
    Subdivision 1. Penalties for breach of contract. A program participant who fails to
complete the required years of obligated service shall repay the amount paid, as well as a financial
penalty specified by the federal Bureau of Health Professions in the policy information notice
for the state's current federal grant application. The commissioner shall report to the appropriate
health-related licensing board a participant who fails to complete the service obligation and fails
to repay the amount paid or fails to pay any financial penalty owed under this subdivision.
    Subd. 2. Suspension or waiver of obligation. Payment or service obligations cancel in the
event of a participant's death. The commissioner may waive or suspend payment or service
obligations in case of total and permanent disability or long-term temporary disability lasting
for more than two years. The commissioner shall evaluate all other requests for suspension
or waivers on a case-by-case basis.
History: 1993 c 345 art 11 s 20; 1995 c 212 art 3 s 51; 1995 c 234 art 8 s 42; 1Sp2001 c
9 art 13 s 1; 2002 c 379 art 1 s 113; 1Sp2003 c 14 art 7 s 32

144.1492 STATE RURAL HEALTH NETWORK REFORM INITIATIVE.
    Subdivision 1. Purpose and matching funds. The commissioner of health shall apply for
federal grant funding under the State Rural Health Network Reform Initiative, a Health Care
Financing Administration program to provide grant funds to states to encourage innovations in
rural health financing and delivery systems. The commissioner may use state funds appropriated
to the Department of Health for the provision of technical assistance for community integrated
service network development as matching funds for the federal grant.
    Subd. 2. Use of federal funds. If the Department of Health receives federal funding under
the State Rural Health Network Reform Initiative, the department shall use these funds to
implement a program to provide technical assistance and grants to rural communities to establish
health care networks and to develop and test a rural health network reform model.
    Subd. 3. Eligible applicants and criteria for awarding of grants to rural communities.
(a) Funding which the department receives to award grants to rural communities to establish
health care networks shall be awarded through a request for proposals process. Planning grant
funds may be used for community facilitation and initial network development activities including
incorporation as a nonprofit organization or cooperative, assessment of network models, and
determination of the best fit for the community. Implementation grant funds can be used to enable
incorporated nonprofit organizations and cooperatives to purchase technical services needed for
further network development such as legal, actuarial, financial, marketing, and administrative
services.
(b) In order to be eligible to apply for a planning or implementation grant under the
federally funded health care network reform program, an organization must be located in a
rural area of Minnesota excluding the seven-county Twin Cities metropolitan area and the
census-defined urbanized areas of Duluth, Rochester, St. Cloud, and Moorhead. The proposed
network organization must also meet or plan to meet the criteria for a community integrated
service network.
(c) In determining which organizations will receive grants, the commissioner may consider
the following factors:
(1) the applicant's description of their plans for health care network development, their need
for technical assistance, and other technical assistance resources available to the applicant. The
applicant must clearly describe the service area to be served by the network, how the grant funds
will be used, what will be accomplished, and the expected results. The applicant should describe
achievable objectives, a timetable, and roles and capabilities of responsible individuals and
organizations;
(2) the extent of community support for the applicant and the health care network. The
applicant should demonstrate support from private and public health care providers in the service
area and local community and government leaders. Evidence of such support may include a
commitment of financial support, in-kind services, or cash, for development of the network;
(3) the size and demographic characteristics of the population in the service area for the
proposed network and the distance of the service area from the nearest metropolitan area; and
(4) the technical assistance resources available to the applicant from nonstate sources and the
financial ability of the applicant to purchase technical assistance services with nonstate funds.
History: 1994 c 625 art 8 s 41; 1999 c 245 art 2 s 23

144.1493 NURSING GRANT PROGRAM.
    Subdivision 1. Establishment. A nursing grant program is established under the supervision
of the commissioner of health and the administration of the Metropolitan Healthcare Foundation's
Project LINC to provide grants to Minnesota health care facility employees seeking to complete a
baccalaureate or master's degree in nursing.
    Subd. 2. Responsibility of Metropolitan Healthcare Foundation's Project LINC. The
Metropolitan Healthcare Foundation's Project LINC shall administer the grant program and award
grants to eligible health care facility employees. To be eligible to receive a grant, a person must be:
(1) an employee of a health care facility located in Minnesota, whom the facility has
recommended to the Metropolitan Healthcare Foundation's Project LINC for consideration;
(2) working part time, up to 32 hours per pay period, for the health care facility, while
maintaining full salary and benefits;
(3) enrolled full time in a Minnesota school or college of nursing to complete a baccalaureate
or master's degree in nursing; and
(4) a resident of the state of Minnesota.
The grant must be awarded for one academic year but is renewable for a maximum of six
semesters or nine quarters of full-time study, or their equivalent. The grant must be used for
tuition, fees, and books. Priority in awarding grants shall be given to persons with the greatest
financial need. The health care facility may require its employee to commit to a reasonable
postprogram completion of employment at the health care facility as a condition for the financial
support the facility provides.
    Subd. 3. Responsibility of commissioner. The commissioner shall distribute money each
year to the Metropolitan Healthcare Foundation's Project LINC to be used to award grants under
this section, provided that the commissioner shall not distribute the money unless the Metropolitan
Healthcare Foundation's Project LINC matches the money with an equal amount from nonstate
sources. The Metropolitan Healthcare Foundation's Project LINC shall expend nonstate money
prior to expending state money and shall return to the commissioner all state money not used
each year for nursing program grants to be redistributed under this section. The Metropolitan
Healthcare Foundation's Project LINC shall report to the commissioner on its program activity
as requested by the commissioner.
History: 1995 c 234 art 8 s 43

144.1494 [Repealed, 1Sp2003 c 14 art 7 s 89]

144.1495 [Repealed, 1Sp2003 c 14 art 7 s 89]

144.1496 [Repealed, 1Sp2003 c 14 art 7 s 89]

144.1497 [Repealed, 1Sp2003 c 14 art 7 s 89]

144.1499 PROMOTION OF HEALTH CARE AND LONG-TERM CARE CAREERS.
The commissioner of health, in consultation with an organization representing health
care employers, long-term care employers, and educational institutions, may make grants to
qualifying consortia as defined in section 116L.11, subdivision 4, for intergenerational programs
to encourage middle and high school students to work and volunteer in health care and long-term
care settings. To qualify for a grant under this section, a consortium shall:
(1) develop a health and long-term care careers curriculum that provides career exploration
and training in national skill standards for health care and long-term care and that is consistent
with Minnesota graduation standards and other related requirements;
(2) offer programs for high school students that provide training in health and long-term care
careers with credits that articulate into postsecondary programs; and
(3) provide technical support to the participating health care and long-term care employer to
enable the use of the employer's facilities and programs for kindergarten to grade 12 health and
long-term care careers education.
History: 1Sp2001 c 9 art 1 s 33; 2002 c 379 art 1 s 113

144.15 [Repealed, 1945 c 512 s 37]

144.1501 HEALTH PROFESSIONAL EDUCATION LOAN FORGIVENESS PROGRAM.
    Subdivision 1. Definitions. (a) For purposes of this section, the following definitions apply.
(b) "Dentist" means an individual who is licensed to practice dentistry.
(c) "Designated rural area" means:
(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin, Ramsey,
Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St.
Cloud; or
(2) a municipal corporation, as defined under section 471.634, that is physically located, in
whole or in part, in an area defined as a designated rural area under clause (1).
(d) "Emergency circumstances" means those conditions that make it impossible for the
participant to fulfill the service commitment, including death, total and permanent disability, or
temporary disability lasting more than two years.
(e) "Medical resident" means an individual participating in a medical residency in family
practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse anesthetist,
advanced clinical nurse specialist, or physician assistant.
(g) "Nurse" means an individual who has completed training and received all licensing or
certification necessary to perform duties as a licensed practical nurse or registered nurse.
(h) "Nurse-midwife" means a registered nurse who has graduated from a program of study
designed to prepare registered nurses for advanced practice as nurse-midwives.
(i) "Nurse practitioner" means a registered nurse who has graduated from a program of study
designed to prepare registered nurses for advanced practice as nurse practitioners.
(j) "Pharmacist" means an individual with a valid license issued under chapter 151.
(k) "Physician" means an individual who is licensed to practice medicine in the areas of
family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
(l) "Physician assistant" means a person registered under chapter 147A.
(m) "Qualified educational loan" means a government, commercial, or foundation loan for
actual costs paid for tuition, reasonable education expenses, and reasonable living expenses
related to the graduate or undergraduate education of a health care professional.
(n) "Underserved urban community" means a Minnesota urban area or population included
in the list of designated primary medical care health professional shortage areas (HPSAs),
medically underserved areas (MUAs), or medically underserved populations (MUPs) maintained
and updated by the United States Department of Health and Human Services.
    Subd. 2. Creation of account. (a) A health professional education loan forgiveness program
account is established. The commissioner of health shall use money from the account to establish
a loan forgiveness program:
(1) for medical residents agreeing to practice in designated rural areas or underserved urban
communities or specializing in the area of pediatric psychiatry;
(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach for at
least 20 hours per week in the nursing field in a postsecondary program;
(3) for nurses who agree to practice in a Minnesota nursing home or intermediate care
facility for persons with developmental disability or to teach for at least 20 hours per week in
the nursing field in a postsecondary program;
(4) for other health care technicians agreeing to teach for at least 20 hours per week in
their designated field in a postsecondary program. The commissioner, in consultation with the
Healthcare Education-Industry Partnership, shall determine the health care fields where the need
is the greatest, including, but not limited to, respiratory therapy, clinical laboratory technology,
radiologic technology, and surgical technology;
(5) for pharmacists who agree to practice in designated rural areas; and
(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient encounters
to state public program enrollees or patients receiving sliding fee schedule discounts through a
formal sliding fee schedule meeting the standards established by the United States Department of
Health and Human Services under Code of Federal Regulations, title 42, section 51, chapter 303.
(b) Appropriations made to the account do not cancel and are available until expended,
except that at the end of each biennium, any remaining balance in the account that is not
committed by contract and not needed to fulfill existing commitments shall cancel to the fund.
    Subd. 3. Eligibility. (a) To be eligible to participate in the loan forgiveness program, an
individual must:
(1) be a medical or dental resident, a licensed pharmacist or be enrolled in a dentist, midlevel
practitioner, registered nurse, or a licensed practical nurse training program; and
(2) submit an application to the commissioner of health. If fewer applications are submitted
by dental students or residents than there are dentist participant slots available, the commissioner
may consider applications submitted by dental program graduates who are licensed dentists.
(b) An applicant selected to participate must sign a contract to agree to serve a minimum
three-year full-time service obligation according to subdivision 2, which shall begin no later than
March 31 following completion of required training.
    Subd. 4. Loan forgiveness. The commissioner of health may select applicants each year
for participation in the loan forgiveness program, within the limits of available funding. The
commissioner shall distribute available funds for loan forgiveness proportionally among the
eligible professions according to the vacancy rate for each profession in the required geographic
area, facility type, teaching area, patient group, or specialty type specified in subdivision 2. The
commissioner shall allocate funds for physician loan forgiveness so that 75 percent of the funds
available are used for rural physician loan forgiveness and 25 percent of the funds available
are used for underserved urban communities and pediatric psychiatry loan forgiveness. If the
commissioner does not receive enough qualified applicants each year to use the entire allocation
of funds for any eligible profession, the remaining funds may be allocated proportionally
among the other eligible professions according to the vacancy rate for each profession in the
required geographic area, patient group, or facility type specified in subdivision 2. Applicants
are responsible for securing their own qualified educational loans. The commissioner shall select
participants based on their suitability for practice serving the required geographic area or facility
type specified in subdivision 2, as indicated by experience or training. The commissioner shall
give preference to applicants closest to completing their training. For each year that a participant
meets the service obligation required under subdivision 3, up to a maximum of four years, the
commissioner shall make annual disbursements directly to the participant equivalent to 15 percent
of the average educational debt for indebted graduates in their profession in the year closest to
the applicant's selection for which information is available, not to exceed the balance of the
participant's qualifying educational loans. Before receiving loan repayment disbursements and as
requested, the participant must complete and return to the commissioner an affidavit of practice
form provided by the commissioner verifying that the participant is practicing as required under
subdivisions 2 and 3. The participant must provide the commissioner with verification that the full
amount of loan repayment disbursement received by the participant has been applied toward the
designated loans. After each disbursement, verification must be received by the commissioner
and approved before the next loan repayment disbursement is made. Participants who move
their practice remain eligible for loan repayment as long as they practice as required under
subdivision 2.
    Subd. 5. Penalty for nonfulfillment. If a participant does not fulfill the required minimum
commitment of service according to subdivision 3, the commissioner of health shall collect from
the participant the total amount paid to the participant under the loan forgiveness program plus
interest at a rate established according to section 270C.40. The commissioner shall deposit the
money collected in the health care access fund to be credited to the health professional education
loan forgiveness program account established in subdivision 2. The commissioner shall allow
waivers of all or part of the money owed the commissioner as a result of a nonfulfillment penalty
if emergency circumstances prevented fulfillment of the minimum service commitment.
    Subd. 6. Rules. The commissioner may adopt rules to implement this section.
History: 1Sp2003 c 14 art 7 s 33; 2005 c 56 s 1; 2005 c 151 art 2 s 17; 1Sp2005 c 4 art
6 s 13-16

144.1502 [Repealed, 1Sp2005 c 4 art 6 s 58]

    Subdivision 1.[Repealed, 1978 c 699 s 17]
    Subd. 2.[Repealed, 1978 c 699 s 17]
    Subd. 3.[Repealed, 1978 c 699 s 17]
    Subd. 4.[Repealed, 1978 c 699 s 17]
    Subd. 5.[Repealed, 1978 c 699 s 17]
    Subd. 6.[Repealed, 1978 c 699 s 17]
    Subd. 7.[Repealed, 1978 c 699 s 17]
    Subd. 8.[Repealed, 1978 c 699 s 17; 1978 c 790 s 4]
    Subd. 9.[Repealed, 1978 c 699 s 17; 1978 c 790 s 4]

144.152 [Repealed, 1978 c 699 s 17]

144.153 [Repealed, 1978 c 699 s 17]

144.154 [Repealed, 1978 c 699 s 17]

144.155 [Repealed, 1978 c 699 s 17]

144.156 [Repealed, 1978 c 699 s 17]

144.157 [Repealed, 1978 c 699 s 17]

144.158 [Repealed, 1978 c 699 s 17]

144.159 [Repealed, 1978 c 699 s 17]

144.16 [Repealed, 1945 c 512 s 37]

144.161 [Repealed, 1978 c 699 s 17]

144.162 [Repealed, 1978 c 699 s 17]

144.163 [Repealed, 1978 c 699 s 17]

144.164 [Repealed, 1978 c 699 s 17]

144.165 [Repealed, 1978 c 699 s 17]

144.166 [Repealed, 1978 c 699 s 17]

144.167 [Repealed, 1978 c 699 s 17]

144.168 [Repealed, 1978 c 699 s 17]

144.169 [Repealed, 1978 c 699 s 17]

144.17 [Repealed, 1945 c 512 s 37]

144.171 [Repealed, 1978 c 699 s 17]

144.172 [Repealed, 1978 c 699 s 17]

144.173 [Repealed, 1978 c 699 s 17]

144.174 [Repealed, 1978 c 699 s 17]

    Subdivision 1.[Repealed, 1978 c 699 s 17]
    Subd. 2.[Repealed, 1978 c 699 s 17; 1978 c 790 s 4]
    Subd. 3.[Repealed, 1947 c 517 s 8; 1978 c 699 s 17]
    Subd. 4.[Repealed, 1978 c 699 s 17]
    Subd. 5.[Repealed, 1978 c 699 s 17]

144.176 [Repealed, 1978 c 699 s 17]

144.1761 [Repealed, 1Sp2001 c 9 art 15 s 33]

144.177 [Repealed, 1978 c 699 s 17]

144.178 [Repealed, 1978 c 699 s 17]

144.18 [Repealed, 1945 c 512 s 37]

144.181 [Repealed, 1978 c 699 s 17]

144.182 [Repealed, 1978 c 699 s 17]

144.183 [Repealed, 1978 c 699 s 17]

144.19 [Repealed, 1945 c 512 s 37]

144.191 [Repealed, 1978 c 699 s 17]

144.20 [Repealed, 1945 c 512 s 37]

144.201 [Repealed, 1978 c 699 s 17]

144.202 [Repealed, 1978 c 699 s 17]

144.203 [Repealed, 1978 c 699 s 17]

144.204 [Repealed, 1978 c 699 s 17]

144.205 [Repealed, 1978 c 699 s 17]

144.21 [Repealed, 1945 c 512 s 37]

VITAL STATISTICS

144.211 CITATION.
Sections 144.211 to 144.227 may be cited as the "Vital Statistics Act."
History: 1978 c 699 s 1

144.212 DEFINITIONS.
    Subdivision 1. Scope. As used in sections 144.211 to 144.227, the following terms have
the meanings given:
    Subd. 1a. Amendment. "Amendment" means completion or correction of a vital record.
    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
    Subd. 2a. Delayed registration. "Delayed registration" means registration of a record of
birth or death filed one or more years after the date of birth or death.
    Subd. 3. File. "File" means to present a vital record or report for registration to the Office of
the State Registrar and to have the vital record or report accepted for registration by the Office
of the State Registrar.
    Subd. 4. Final disposition. "Final disposition" means the burial, interment, cremation,
removal from the state, or other authorized disposition of a dead body or dead fetus.
    Subd. 4a. Institution. "Institution" means a public or private establishment that:
(1) provides inpatient or outpatient medical, surgical, or diagnostic care or treatment; or
(2) provides nursing, custodial, or domiciliary care, or to which persons are committed
by law.
    Subd. 5. Registration. "Registration" means the process by which vital records are
completed, filed, and incorporated into the official records of the Office of the State Registrar.
    Subd. 6. State registrar. "State registrar" means the commissioner of health or a designee.
    Subd. 7. System of vital statistics. "System of vital statistics" includes the registration,
collection, preservation, amendment, and certification of vital records, the collection of other
reports required by sections 144.211 to 144.227, and related activities including the tabulation,
analysis, publication, and dissemination of vital statistics.
    Subd. 8. Vital record. "Vital record" means a record or report of birth, stillbirth, death,
marriage, dissolution and annulment, and data related thereto. The birth record is not a medical
record of the mother or the child.
    Subd. 9. Vital statistics. "Vital statistics" means the data derived from records and reports
of birth, death, fetal death, induced abortion, marriage, dissolution and annulment, and related
reports.
    Subd. 10. Local registrar. "Local registrar" means an individual designated under section
144.214, subdivision 1, to perform the duties of a local registrar.
    Subd. 11. Consent to disclosure. "Consent to disclosure" means an affidavit filed with the
state registrar which sets forth the following information:
(1) the current name and address of the affiant;
(2) any previous name by which the affiant was known;
(3) the original and adopted names, if known, of the adopted child whose original birth
record is to be disclosed;
(4) the place and date of birth of the adopted child;
(5) the biological relationship of the affiant to the adopted child; and
(6) the affiant's consent to disclosure of information from the original birth record of the
adopted child.
History: 1978 c 699 s 2; 1986 c 444; 1997 c 228 s 3-5; 1Sp2001 c 9 art 15 s 1-7; 2002 c 379
art 1 s 113; 2005 c 60 s 2

144.213 OFFICE OF THE STATE REGISTRAR.
    Subdivision 1. Creation; State Registrar. The commissioner shall establish an Office of
the State Registrar under the supervision of the state registrar. The commissioner shall furnish to
local registrars the forms necessary for correct reporting of vital statistics, and shall instruct the
local registrars in the collection and compilation of the data. The commissioner shall promulgate
rules for the collection, filing, and registering of vital statistics information by state and local
registrars, physicians, morticians, and others. Except as otherwise provided in sections 144.211
to 144.227, rules previously promulgated by the commissioner relating to the collection, filing
and registering of vital statistics shall remain in effect until repealed, modified or superseded
by a rule promulgated by the commissioner.
    Subd. 2. General duties. The state registrar shall coordinate the work of local registrars
to maintain a statewide system of vital statistics. The state registrar is responsible for the
administration and enforcement of sections 144.211 to 144.227, and shall supervise local
registrars in the enforcement of sections 144.211 to 144.227 and the rules promulgated thereunder.
    Subd. 3. Record keeping. To preserve vital records the state registrar is authorized to
prepare typewritten, photographic, electronic or other reproductions of original records and
files in the Office of the State Registrar. The reproductions when certified by the state or local
registrar shall be accepted as the original records.
History: 1978 c 699 s 3; 1Sp2001 c 9 art 15 s 32

144.214 LOCAL REGISTRARS OF VITAL STATISTICS.
    Subdivision 1. Districts. The counties of the state shall constitute the 87 registration
districts of the state. A local registrar in each county shall be designated by the county board of
commissioners. The local registrar in any city which maintains local registration of vital statistics
shall be the agent of a board of health as authorized under section 145A.04. In addition, the state
registrar may establish registration districts on United States government reservations and may
appoint a local registrar for each registration district so established.
    Subd. 2. Failure of duty. A local registrar who neglects or fails to discharge duties as
provided by sections 144.211 to 144.227 may be relieved of the duties as local registrar by the
state registrar after notice and hearing. The state registrar may appoint a successor to serve as
local registrar. If a local registrar fails to file or transmit birth or death records, the state registrar
shall obtain them by other means.
    Subd. 3. Duties. The local registrar shall enforce the provisions of sections 144.211 to
144.227 and the rules promulgated thereunder within the registration district and shall promptly
report violations of the laws or rules to the state registrar.
    Subd. 4.[Repealed, 2005 c 106 s 68]
History: 1978 c 699 s 4; 1986 c 444; 1986 c 473 s 1; 1Sp1986 c 3 art 1 s 82; 1987 c 309 s
24; 1Sp2001 c 9 art 15 s 8-10, 32; 2002 c 379 art 1 s 113

144.215 BIRTH REGISTRATION.
    Subdivision 1. When and where to file. A record of birth for each live birth which occurs in
this state shall be filed with the state registrar within five days after the birth.
    Subd. 2. Rules governing birth registration. The commissioner shall establish by rule an
orderly mechanism for the registration of births including at least a designation for who must file
the birth record, a procedure for registering births which occur in moving conveyances, and a
provision governing the names of the parent or parents to be entered on the birth record.
    Subd. 3. Father's name; child's name. In any case in which paternity of a child is
determined by a court of competent jurisdiction, a declaration of parentage is executed under
section 257.34, or a recognition of parentage is executed under section 257.75, the name of the
father shall be entered on the birth record. If the order of the court declares the name of the child,
it shall also be entered on the birth record. If the order of the court does not declare the name of
the child, or there is no court order, then upon the request of both parents in writing, the surname
of the child shall be defined by both parents.
    Subd. 4. Social Security number registration. (a) Parents of a child born within this state
shall give the parents' Social Security numbers to the Office of the State Registrar at the time of
filing the birth record, but the numbers shall not appear on the record.
(b) The Social Security numbers are classified as private data, as defined in section 13.02,
subdivision 12 , on individuals, but the Office of the State Registrar shall provide a Social
Security number to the public authority responsible for child support services upon request by
the public authority for use in the establishment of parentage and the enforcement of child
support obligations.
    Subd. 5. Births occurring in an institution. When a birth occurs in an institution or en route
to an institution, the person in charge of the institution or that person's authorized designee shall
obtain the personal data required under this section and shall prepare the record of birth. For
purposes of this section, "institution" means a hospital or other facility that provides childbirth
services.
    Subd. 6. Births occurring outside an institution. When a birth occurs outside of an
institution as defined in subdivision 5, the record of birth shall be filed by one of the following
persons, in the indicated order of preference:
(1) the physician present at the time of the birth or immediately thereafter;
(2) in the absence of a physician, a person, other than the mother, present at the time of
the birth or immediately thereafter;
(3) the father of the child;
(4) the mother of the child; or
(5) in the absence of the father and if the mother is unable, the person with primary
responsibility for the premises where the child was born.
    Subd. 7. Evidence required to register a noninstitution birth within the first year of
birth. When a birth occurs in this state outside of an institution, as defined in subdivision 5, and
the birth record is filed before the first birthday, evidence in support of the facts of birth shall be
required. Evidence shall be presented by the individual responsible for filing the vital record under
subdivision 6. Evidence shall consist of proof that the child was born alive, proof of pregnancy,
and evidence of the mother's presence in this state on the date of the birth. If the evidence is not
acceptable, the state registrar shall advise the applicant of the reason for not filing a birth record
and shall further advise the applicant of the right of appeal to a court of competent jurisdiction.
History: 1978 c 699 s 5; 1980 c 589 s 28; 1Sp1993 c 1 art 6 s 1,2; 1997 c 205 s 20; 1997 c
228 s 6-8; 1Sp2001 c 9 art 15 s 11-15,32; 2002 c 379 art 1 s 113

144.2151 RECORD OF BIRTH RESULTING IN STILLBIRTH.
    Subdivision 1. Filing. A record of birth for each birth resulting in a stillbirth in this state,
on or after August 1, 2005, for which a fetal death report is required under section 144.222,
subdivision 1 , shall be filed with the state registrar within five days after the birth if the parent or
parents of the stillbirth request to have a record of birth resulting in stillbirth prepared.
    Subd. 2. Information to parents. The party responsible for filing a fetal death report under
section 144.222, subdivision 1, shall advise the parent or parents of a stillbirth:
(1) that they may request preparation of a record of birth resulting in stillbirth;
(2) that preparation of the record is optional; and
(3) how to obtain a certified copy of the record if one is requested and prepared.
    Subd. 3. Preparation. (a) Within five days after delivery of a stillbirth, the parent or parents
of the stillbirth may prepare and file the record with the state registrar if the parent or parents
of the stillbirth, after being advised as provided in subdivision 2, request to have a record of
birth resulting in stillbirth prepared.
(b) If the parent or parents of the stillbirth do not choose to provide a full name for the
stillbirth, the parent or parents may choose to file only a last name.
(c) Either parent of the stillbirth or, if neither parent is available, another person with
knowledge of the facts of the stillbirth shall attest to the accuracy of the personal data entered on
the record in time to permit the filing of the record within five days after delivery.
    Subd. 4. Retroactive application. Notwithstanding subdivisions 1 to 3, if a birth that
occurred in this state at any time resulted in a stillbirth for which a fetal death report was required
under section 144.222, subdivision 1, but a record of birth resulting in stillbirth was not prepared
under subdivision 3, a parent of the stillbirth may submit to the state registrar, on or after August
1, 2005, a written request for preparation of a record of birth resulting in stillbirth and evidence of
the facts of the stillbirth in the form and manner specified by the state registrar. The state registrar
shall prepare and file the record of birth resulting in stillbirth within 30 days after receiving
satisfactory evidence of the facts of the stillbirth.
    Subd. 5. Responsibilities of state registrar. The state registrar shall:
(1) prescribe the form of and information to be included on a record of birth resulting in
stillbirth, which shall be as similar as possible to the form of and information included on a
record of birth;
(2) prescribe the form of and information to be provided by the parent of a stillbirth
requesting a record of birth resulting in stillbirth under subdivisions 3 and 4 and make this form
available on the Department of Health's Web site;
(3) issue a certified copy of a record of birth resulting in stillbirth to a parent of the stillbirth
that is the subject of the record if:
(i) a record of birth resulting in stillbirth has been prepared and filed under subdivision 3
or 4; and
(ii) the parent requesting a certified copy of the record submits the request in writing; and
(4) create and implement a process for entering, preparing, and handling stillbirth records
identical or as close as possible to the processes for birth and fetal death records when feasible,
but no later than the date on which the next reprogramming of the Department of Health's
database for vital records is completed.
History: 2005 c 60 s 1

144.216 FOUNDLING REGISTRATION.
    Subdivision 1. Reporting a foundling. Whoever finds a live born infant of unknown
parentage shall report within five days to the Office of the State Registrar such information as the
commissioner may by rule require to identify the foundling.
    Subd. 2. Status of foundling reports. A report registered under subdivision 1 shall
constitute the record of birth for the child. If the child is identified and a record of birth is found or
obtained, the report registered under subdivision 1 shall be confidential pursuant to section 13.02,
subdivision 3 , and shall not be disclosed except pursuant to court order.
History: 1978 c 699 s 6; 1981 c 311 s 39; 1982 c 545 s 24; 1Sp2001 c 9 art 15 s 32

144.217 DELAYED RECORDS OF BIRTH.
    Subdivision 1. Evidence required for filing. Before a delayed record of birth is registered,
the person presenting the delayed vital record for registration shall offer evidence of the facts
contained in the vital record, as required by the rules of the commissioner. In the absence of the
evidence required, the delayed vital record shall not be registered. No delayed record of birth shall
be registered for a deceased person.
    Subd. 2. Court petition. If a delayed record of birth is rejected under subdivision 1, a person
may petition the appropriate court for an order establishing a record of the date and place of the
birth and the parentage of the person whose birth is to be registered. The petition shall state:
(1) that the person for whom a delayed record of birth is sought was born in this state;
(2) that no record of birth can be found in the Office of the State Registrar;
(3) that diligent efforts by the petitioner have failed to obtain the evidence required in
subdivision 1;
(4) that the state registrar has refused to register a delayed record of birth; and
(5) other information as may be required by the court.
    Subd. 3. Court order. The court shall fix a time and place for a hearing on the petition
and shall give the state registrar ten days' notice of the hearing. The state registrar may appear
and testify in the proceeding. If the court is satisfied from the evidence received at the hearing
of the truth of the statements in the petition, the court shall order the registration of the delayed
vital record.
    Subd. 4.[Repealed, 1Sp2001 c 9 art 15 s 16,33]
History: 1978 c 699 s 7; 1Sp2001 c 9 art 15 s 16; 2002 c 379 art 1 s 113

144.218 REPLACEMENT BIRTH RECORDS.
    Subdivision 1. Adoption. Upon receipt of a certified copy of an order, decree, or certificate
of adoption, the state registrar shall register a replacement vital record in the new name of the
adopted person. The original record of birth is confidential pursuant to section 13.02, subdivision
3 , and shall not be disclosed except pursuant to court order or section 144.2252. The information
contained on the original birth record, except for the registration number, shall be provided on
request to a parent who is named on the original birth record. Upon the receipt of a certified
copy of a court order of annulment of adoption the state registrar shall restore the original vital
record to its original place in the file.
    Subd. 2. Adoption of foreign persons. In proceedings for the adoption of a person who
was born in a foreign country, the court, upon evidence presented by the commissioner of human
services from information secured at the port of entry or upon evidence from other reliable
sources, may make findings of fact as to the date and place of birth and parentage. Upon receipt of
certified copies of the court findings and the order or decree of adoption, a certificate of adoption,
or a certified copy of a decree issued under section 259.60, the state registrar shall register a birth
record in the new name of the adopted person. The certified copies of the court findings and the
order or decree of adoption, certificate of adoption, or decree issued under section 259.60 are
confidential, pursuant to section 13.02, subdivision 3, and shall not be disclosed except pursuant
to court order or section 144.2252. The birth record shall state the place of birth as specifically as
possible and that the vital record is not evidence of United States citizenship.
    Subd. 3. Subsequent marriage of birth parents. If, in cases in which a record of birth has
been registered pursuant to section 144.215 and the birth parents of the child marry after the birth
of the child, a replacement record of birth shall be registered upon presentation of a certified copy
of the marriage certificate of the birth parents, and either a recognition of parentage or court
adjudication of paternity. The original record of birth is confidential, pursuant to section 13.02,
subdivision 3 , and shall not be disclosed except pursuant to court order.
    Subd. 4. Incomplete, incorrect, and modified vital records. If a court finds that a birth
record is incomplete, inaccurate, or false or if it is being issued pursuant to section 259.10,
subdivision 2 , the court may order the registration of a replacement vital record, and, if necessary,
set forth the correct information in the order. Upon receipt of the order, the registrar shall register
a replacement vital record containing the findings of the court. The prior vital record shall be
confidential pursuant to section 13.02, subdivision 3, and shall not be disclosed except pursuant
to court order.
    Subd. 5. Replacement of vital records. Upon the order of a court of this state, upon the
request of a court of another state, upon the filing of a declaration of parentage under section
257.34, or upon the filing of a recognition of parentage with a registrar, a replacement birth record
must be registered consistent with the findings of the court, the declaration of parentage, or the
recognition of parentage.
History: 1978 c 699 s 8; 1980 c 561 s 1; 1981 c 311 s 24; 1982 c 545 s 24; 1984 c 654 art 5
s 58; 1994 c 465 art 1 s 62; 1994 c 631 s 31; 1995 c 259 art 1 s 32; 1997 c 205 s 21; 1998 c 406
art 1 s 1,37; 1998 c 407 art 9 s 1; 1Sp2001 c 9 art 15 s 17; 2002 c 379 art 1 s 113

144.219 [Repealed, 1Sp2001 c 9 art 15 s 33]

144.22 [Repealed, 1945 c 512 s 37]

144.221 DEATH REGISTRATION.
    Subdivision 1. When and where to file. A death record for each death which occurs in the
state shall be filed with the state registrar within five days after death and prior to final disposition.
    Subd. 2. Rules governing death registration. The commissioner of health shall establish
in rule an orderly mechanism for the registration of deaths including at least a designation for
who must file the death record, a procedure for the registration of deaths in moving conveyances,
and provision to include cause and certification of death and assurance of registration prior to
final disposition.
    Subd. 3. When no body is found. When circumstances suggest that a death has occurred
although a dead body cannot be produced to confirm the fact of death, a death record shall not be
registered until a court has adjudicated the fact of death.
History: 1978 c 699 s 10; 1Sp2001 c 9 art 15 s 18,19,32; 2002 c 379 art 1 s 113; 2005
c 106 s 56

144.2215 MINNESOTA BIRTH DEFECTS INFORMATION SYSTEM.
    Subdivision 1. Establishment. The commissioner of health shall establish and maintain
an information system containing data on the cause, treatment, prevention, and cure of major
birth defects. The commissioner shall consult with representatives and experts in epidemiology,
medicine, insurance, health maintenance organizations, genetics, consumers, and voluntary
organizations in developing the system and may phase in the implementation of the system.
    Subd. 2. Duties of commissioner. The commissioner of health shall design a system that
allows the commissioner to:
(1) monitor incidence trends of birth defects to detect potential public health problems,
predict risks, and assist in responding to birth defects clusters;
(2) more accurately target intervention, prevention, and services for communities, patients,
and their families;
(3) inform health professionals and citizens of the prevalence of and risks for birth defects;
(4) conduct scientific investigation and surveys of the causes, mortality, methods of
treatment, prevention, and cure for birth defects;
(5) modify, as necessary, the birth defects information system through demonstration projects;
(6) remove identifying information about a child whose parent or legal guardian has chosen
not to participate in the system as permitted by section 144.2216, subdivision 4;
(7) protect the individually identifiable information as required by section 144.2217;
(8) limit the dissemination of identifying information as required by sections 144.2218 and
144.2219; and
(9) use the birth defects coding scheme defined by the Centers for Disease Control and
Prevention (CDC) of the United States Public Health Service.
History: 1996 c 451 art 4 s 6; 2004 c 288 art 6 s 11; 2004 c 290 s 25

144.2216 BIRTH DEFECTS RECORDS AND REPORTS REQUIRED.
    Subdivision 1. Hospitals and similar institutions. With the informed consent of a parent or
guardian, as provided in subdivision 4, a hospital, medical clinic, medical laboratory, or other
institution for the hospitalization, clinical or laboratory diagnosis, or care of human beings shall
provide the commissioner of health with access to information on each birth defect case in the
manner and at the times that the commissioner designates.
    Subd. 2. Other information repositories. With the informed consent of a parent or
guardian, as provided in subdivision 4, other repositories of information on the diagnosis or care
of infants may provide the commissioner with access to information on each case of birth defects
in the manner and at the times that the commissioner designates.
    Subd. 3. Reporting without liability. Furnishing information in good faith in compliance
with this section does not subject the person, hospital, medical clinic, medical laboratory, data
repository, or other institution furnishing the information to any action for damages or relief.
    Subd. 4. Opt out. A parent or legal guardian must be informed by the commissioner at
the time of the initial data collection that they may request removal at any time of personal
identifying information concerning a child from the birth defects information system using a
written form prescribed by the commissioner. The commissioner shall advise parents or legal
guardians of infants:
(1) that the information on birth defects may be retained by the Department of Health;
(2) the benefit of retaining birth defects records;
(3) that they may elect to have the birth defects information collected once, within one year
of birth, but to require that all personally identifying information be destroyed immediately upon
the commissioner receiving the information.
If the parents of an infant object in writing to the maintaining of birth defects information, the
objection or election shall be recorded on a form that is signed by a parent or legal guardian and
submitted to the commissioner of health; and
(4) that if the parent or legal guardian chooses to opt-out, the commissioner will not be
able to inform the parent or legal guardian of a child of information related to the prevention,
treatment, or cause of a particular birth defect.
History: 2004 c 288 art 6 s 12; 2004 c 290 s 26

144.2217 CLASSIFICATION OF BIRTH DEFECTS INFORMATION.
Information collected on individuals for the birth defects information system are private
data on individuals as defined in section 13.02, subdivision 12, and may only be used for the
purposes in sections 144.2215 to 144.2219. Any disclosure other than one provided for in sections
144.2215 to 144.2219 is a misdemeanor.
History: 2004 c 288 art 6 s 13; 2004 c 290 s 27

144.2218 TRANSFERS OF INFORMATION TO OTHER GOVERNMENT AGENCIES.
Information collected by the birth defects information system may be disseminated to a state
or local government agency in Minnesota or another state solely for purposes consistent with
sections 144.2215 to 144.2219, provided that the state or local government agency agrees to
maintain the classification of the information as provided under section 144.2217. Information
collected by other states consistent with sections 144.2215 to 144.2219 may be received by the
commissioner of health and must be maintained according to section 144.2217.
History: 2004 c 288 art 6 s 14; 2004 c 290 s 28

144.2219 TRANSFERS OF INFORMATION TO RESEARCH ENTITIES.
Information from the birth defects information system that does not contain identifying
information may be shared with research entities upon request for studies approved by the
commissioner and appropriate institutional review boards. For studies approved by the
commissioner that require identifying information about a child or a parent or legal guardian of
the child, the commissioner shall contact the parent or legal guardian to obtain informed consent
to share identifying information with the research entity. Notwithstanding section 144.335,
subdivision 3a, paragraph (d) , the parent or legal guardian must provide informed consent before
the information may be shared. The commissioner must collect all reasonable costs of locating
and obtaining consent from the research entity.
History: 2004 c 288 art 6 s 15; 2004 c 290 s 29

144.222 REPORTS OF FETAL OR INFANT DEATH.
    Subdivision 1. Fetal death report required. A fetal death report must be filed within five
days of the death of a fetus for whom 20 or more weeks of gestation have elapsed, except for
abortions defined under section 145.4241. A fetal death report must be prepared in a format
prescribed by the state registrar and filed in accordance with Minnesota Rules, parts 4601.0100 to
4601.2600 by:
(1) a person in charge of an institution or that person's authorized designee if a fetus is
delivered in the institution or en route to the institution;
(2) a physician, certified nurse midwife, or other licensed medical personnel in attendance at
or immediately after the delivery if a fetus is delivered outside an institution; or
(3) a parent or other person in charge of the disposition of the remains if a fetal death
occurred without medical attendance at or immediately after the delivery.
    Subd. 2. Sudden infant death. Each infant death which is diagnosed as sudden infant death
syndrome shall be reported within five days to the state registrar.
History: 1978 c 699 s 11; 1984 c 637 s 2; 1Sp2001 c 9 art 15 s 20; 2002 c 379 art 1
s 113; 2005 c 60 s 3

144.223 REPORT OF MARRIAGE.
Data relating to certificates of marriage registered shall be reported to the state registrar
by the local registrar or designee of the county board in each of the 87 registration districts
pursuant to the rules of the commissioner. The information in clause (1) necessary to compile
the report shall be furnished by the applicant prior to the issuance of the marriage license. The
report shall contain the following:
(1) personal information on bride and groom:
(i) name;
(ii) residence;
(iii) date and place of birth;
(iv) race;
(v) if previously married, how terminated; and
(vi) signature of applicant, date signed, and Social Security number; and
(2) information concerning the marriage:
(i) date of marriage;
(ii) place of marriage; and
(iii) civil or religious ceremony.
History: 1977 c 305 s 45; 1978 c 699 s 12; 1997 c 203 art 6 s 4; 1Sp2001 c 9 art 15 s
21; 2002 c 379 art 1 s 113

144.224 [Repealed, 2000 c 372 s 3]

144.225 DISCLOSURE OF INFORMATION FROM VITAL RECORDS.
    Subdivision 1. Public information; access to vital records. Except as otherwise provided
for in this section and section 144.2252, information contained in vital records shall be public
information. Physical access to vital records shall be subject to the supervision and regulation of
state and local registrars and their employees pursuant to rules promulgated by the commissioner
in order to protect vital records from loss, mutilation or destruction and to prevent improper
disclosure of vital records which are confidential or private data on individuals, as defined in
section 13.02, subdivisions 3 and 12.
    Subd. 2. Data about births. (a) Except as otherwise provided in this subdivision, data
pertaining to the birth of a child to a woman who was not married to the child's father when the
child was conceived nor when the child was born, including the original record of birth and the
certified vital record, are confidential data. At the time of the birth of a child to a woman who
was not married to the child's father when the child was conceived nor when the child was born,
the mother may designate demographic data pertaining to the birth as public. Notwithstanding
the designation of the data as confidential, it may be disclosed:
(1) to a parent or guardian of the child;
(2) to the child when the child is 16 years of age or older;
(3) under paragraph (b) or (e); or
(4) pursuant to a court order. For purposes of this section, a subpoena does not constitute a
court order.
(b) Unless the child is adopted, data pertaining to the birth of a child that are not accessible
to the public become public data if 100 years have elapsed since the birth of the child who is the
subject of the data, or as provided under section 13.10, whichever occurs first.
(c) If a child is adopted, data pertaining to the child's birth are governed by the provisions
relating to adoption records, including sections 13.10, subdivision 5; 144.218, subdivision
1 ; 144.2252; and 259.89.
(d) The name and address of a mother under paragraph (a) and the child's date of birth
may be disclosed to the county social services or public health member of a family services
collaborative for purposes of providing services under section 124D.23.
(e) The commissioner of human services shall have access to birth records for:
(1) the purposes of administering medical assistance, general assistance medical care, and
the MinnesotaCare program;
(2) child support enforcement purposes; and
(3) other public health purposes as determined by the commissioner of health.
    Subd. 2a. Health data associated with birth registration. Information from which an
identification of risk for disease, disability, or developmental delay in a mother or child can
be made, that is collected in conjunction with birth registration or fetal death reporting, is
private data as defined in section 13.02, subdivision 12. The commissioner may disclose to a
local board of health, as defined in section 145A.02, subdivision 2, health data associated with
birth registration which identifies a mother or child at high risk for serious disease, disability,
or developmental delay in order to assure access to appropriate health, social, or educational
services. Notwithstanding the designation of the private data, the commissioner of human services
shall have access to health data associated with birth registration for:
(1) purposes of administering medical assistance, general assistance medical care, and the
MinnesotaCare program; and
(2) for other public health purposes as determined by the commissioner of health.
    Subd. 2b. Commissioner of health; duties. Notwithstanding the designation of certain of
this data as confidential under subdivision 2 or private under subdivision 2a, the commissioner
shall give the commissioner of human services access to birth record data and data contained
in recognitions of parentage prepared according to section 257.75 necessary to enable the
commissioner of human services to identify a child who is subject to threatened injury, as defined
in section 626.556, subdivision 2, paragraph (l), by a person responsible for the child's care, as
defined in section 626.556, subdivision 2, paragraph (b), clause (1). The commissioner shall be
given access to all data included on official birth records.
    Subd. 3. Laws and rules for preparing vital records. No person shall prepare or issue any
vital record which purports to be an original, certified copy, or copy of a vital record except as
authorized in sections 144.211 to 144.227 or the rules of the commissioner.
    Subd. 4. Access to records for research purposes. The state registrar may permit persons
performing medical research access to the information restricted in subdivision 2 if those persons
agree in writing not to disclose private or confidential data on individuals.
    Subd. 5. Residents of other states. When a resident of another state is born or dies in this
state, the state registrar shall send a report of the birth or death to the state of residence.
    Subd. 6. Group purchaser identity; nonpublic data; disclosure. (a) Except as otherwise
provided in this subdivision, the named identity of a group purchaser as defined in section
62J.03, subdivision 6, collected in association with birth registration is nonpublic data as defined
in section 13.02.
(b) The commissioner may publish, or by other means release to the public, the named
identity of a group purchaser as part of an analysis of information collected from the birth
registration process. Analysis means the identification of trends in prenatal care and birth
outcomes associated with group purchasers. The commissioner may not reveal the named identity
of the group purchaser until the group purchaser has had 21 days after receipt of the analysis to
review the analysis and comment on it. In releasing data under this subdivision, the commissioner
shall include comments received from the group purchaser related to the scientific soundness and
statistical validity of the methods used in the analysis. This subdivision does not authorize the
commissioner to make public any individual identifying data except as permitted by law.
(c) A group purchaser may contest whether an analysis made public under paragraph (b)
is based on scientifically sound and statistically valid methods in a contested case proceeding
under sections 14.57 to 14.62, subject to appeal under sections 14.63 to 14.68. To obtain a
contested case hearing, the group purchaser must present a written request to the commissioner
before the end of the time period for review and comment. Within ten days of the assignment
of an administrative law judge, the group purchaser must demonstrate by clear and convincing
evidence the group purchaser's likelihood of succeeding on the merits. If the judge determines
that the group purchaser has made this demonstration, the data may not be released during the
contested case proceeding and through appeal. If the judge finds that the group purchaser has not
made this demonstration, the commissioner may immediately publish, or otherwise make public,
the nonpublic group purchaser data, with comments received as set forth in paragraph (b).
(d) The contested case proceeding and subsequent appeal is not an exclusive remedy and
any person may seek a remedy pursuant to section 13.08, subdivisions 1 to 4, or as otherwise
authorized by law.
    Subd. 7. Certified birth or death record. (a) The state or local registrar shall issue a
certified birth or death record or a statement of no vital record found to an individual upon the
individual's proper completion of an attestation provided by the commissioner:
(1) to a person who has a tangible interest in the requested vital record. A person who has
a tangible interest is:
(i) the subject of the vital record;
(ii) a child of the subject;
(iii) the spouse of the subject;
(iv) a parent of the subject;
(v) the grandparent or grandchild of the subject;
(vi) if the requested record is a death record, a sibling of the subject;
(vii) the party responsible for filing the vital record;
(viii) the legal custodian or guardian or conservator of the subject;
(ix) a personal representative, by sworn affidavit of the fact that the certified copy is required
for administration of the estate;
(x) a successor of the subject, as defined in section 524.1-201, if the subject is deceased, by
sworn affidavit of the fact that the certified copy is required for administration of the estate;
(xi) if the requested record is a death record, a trustee of a trust by sworn affidavit of the fact
that the certified copy is needed for the proper administration of the trust;
(xii) a person or entity who demonstrates that a certified vital record is necessary for the
determination or protection of a personal or property right, pursuant to rules adopted by the
commissioner; or
(xiii) adoption agencies in order to complete confidential postadoption searches as required
by section 259.83;
(2) to any local, state, or federal governmental agency upon request if the certified vital
record is necessary for the governmental agency to perform its authorized duties. An authorized
governmental agency includes the Department of Human Services, the Department of Revenue,
and the United States Immigration and Naturalization Service;
(3) to an attorney upon evidence of the attorney's license;
(4) pursuant to a court order issued by a court of competent jurisdiction. For purposes of
this section, a subpoena does not constitute a court order; or
(5) to a representative authorized by a person under clauses (1) to (4).
(b) The state or local registrar shall also issue a certified death record to an individual
described in paragraph (a), clause (1), items (ii) to (viii), if, on behalf of the individual, a licensed
mortician furnishes the registrar with a properly completed attestation in the form provided by
the commissioner within 180 days of the time of death of the subject of the death record. This
paragraph is not subject to the requirements specified in Minnesota Rules, part 4601.2600, subpart
5, item B.
    Subd. 8. Standardized format for certified birth and death records. No later than July
1, 2000, the commissioner shall develop a standardized format for certified birth records and
death records issued by state and local registrars. The format shall incorporate security features
in accordance with this section. The standardized format must be implemented on a statewide
basis by July 1, 2001.
History: 1978 c 699 s 14; 1980 c 509 s 42; 1980 c 561 s 2; 1981 c 311 s 39; 1982 c 545 s
24; 1983 c 7 s 2; 1983 c 243 s 5 subd 2; 1984 c 654 art 5 s 58; 1986 c 444; 1991 c 203 s 1,2;
1994 c 631 s 31; 1995 c 259 art 1 s 33; 1996 c 440 art 1 s 34,35; 1997 c 228 s 9-11; 1998 c 397
art 11 s 3; 2000 c 267 s 1; 2001 c 15 s 1; 2001 c 178 art 1 s 1; 1Sp2001 c 9 art 15 s 22-26,32;
2002 c 379 art 1 s 113; 2005 c 23 s 1; 2005 c 106 s 57; 2006 c 212 art 3 s 10

144.2252 ACCESS TO ORIGINAL BIRTH RECORD AFTER ADOPTION.
(a) Whenever an adopted person requests the state registrar to disclose the information on the
adopted person's original birth record, the state registrar shall act according to section 259.89.
(b) The state registrar shall provide a transcript of an adopted person's original birth record to
an authorized representative of a federally recognized American Indian tribe for the sole purpose
of determining the adopted person's eligibility for enrollment or membership. Information
contained in the birth record may not be used to provide the adopted person information about the
person's birth parents, except as provided in this section or section 259.83.
History: 1Sp2001 c 9 art 15 s 27; 2002 c 379 art 1 s 113

144.226 FEES.
    Subdivision 1. Which services are for fee. The fees for the following services shall be the
following or an amount prescribed by rule of the commissioner:
(a) The fee for the issuance of a certified vital record or a certification that the vital record
cannot be found is $9. No fee shall be charged for a certified birth, stillbirth, or death record that
is reissued within one year of the original issue, if an amendment is made to the vital record and if
the previously issued vital record is surrendered. The fee is nonrefundable.
(b) The fee for processing a request for the replacement of a birth record for all events,
except when filing a recognition of parentage pursuant to section 257.73, subdivision 1, is $40.
The fee is payable at the time of application and is nonrefundable.
(c) The fee for processing a request for the filing of a delayed registration of birth, stillbirth, or
death is $40. The fee is payable at the time of application and is nonrefundable. This fee includes
one subsequent review of the request if the request is not acceptable upon the initial receipt.
(d) The fee for processing a request for the amendment of any vital record when requested
more than 45 days after the filing of the vital record is $40. No fee shall be charged for an
amendment requested within 45 days after the filing of the vital record. The fee is payable at the
time of application and is nonrefundable. This fee includes one subsequent review of the request
if the request is not acceptable upon the initial receipt.
(e) The fee for processing a request for the verification of information from vital records
is $9 when the applicant furnishes the specific information to locate the vital record. When the
applicant does not furnish specific information, the fee is $20 per hour for staff time expended.
Specific information includes the correct date of the event and the correct name of the registrant.
Fees charged shall approximate the costs incurred in searching and copying the vital records. The
fee is payable at the time of application and is nonrefundable.
(f) The fee for processing a request for the issuance of a copy of any document on file
pertaining to a vital record or statement that a related document cannot be found is $9. The fee is
payable at the time of application and is nonrefundable.
    Subd. 2. Fees to state government special revenue fund. Fees collected under this section
by the state registrar shall be deposited to the state government special revenue fund.
    Subd. 3. Birth record surcharge. In addition to any fee prescribed under subdivision 1,
there shall be a nonrefundable surcharge of $3 for each certified birth or stillbirth record and for a
certification that the vital record cannot be found. The local or state registrar shall forward this
amount to the commissioner of finance for deposit into the account for the children's trust fund
for the prevention of child abuse established under section 256E.22. This surcharge shall not be
charged under those circumstances in which no fee for a certified birth or stillbirth record is
permitted under subdivision 1, paragraph (a). Upon certification by the commissioner of finance
that the assets in that fund exceed $20,000,000, this surcharge shall be discontinued.
    Subd. 4. Vital records surcharge. (a) In addition to any fee prescribed under subdivision 1,
there is a nonrefundable surcharge of $2 for each certified and noncertified birth, stillbirth, or
death record, and for a certification that the record cannot be found. The local or state registrar
shall forward this amount to the commissioner of finance to be deposited into the state government
special revenue fund. This surcharge shall not be charged under those circumstances in which no
fee for a birth, stillbirth, or death record is permitted under subdivision 1, paragraph (a).
(b) Effective August 1, 2005, to June 30, 2009, the surcharge in paragraph (a) shall be $4.
    Subd. 5. Electronic verification. A fee for the electronic verification of a vital event,
when the information being verified is obtained from a certified birth or death record, shall be
established through contractual or interagency agreements with interested local, state, or federal
government agencies.
    Subd. 6. Alternative payment methods. Notwithstanding subdivision 1, alternative
payment methods may be approved and implemented by the state registrar or a local registrar.
History: 1977 c 305 s 45; 1978 c 699 s 15; 1984 c 654 art 5 s 58; 1986 c 423 s 8; 1986
c 444; 1987 c 358 s 108; 1991 c 292 art 8 s 25; 1Sp1993 c 1 art 9 s 20; 1995 c 207 art 9 s 5;
1997 c 203 art 2 s 12,13; 1998 c 406 art 1 s 2,3,37; 1998 c 407 art 9 s 2,3; 1Sp2001 c 9 art 1 s
35; art 15 s 28,29; 2002 c 379 art 1 s 113; 2003 c 112 art 2 s 50; 2005 c 60 s 4-6; 2005 c 98 art
1 s 24; 1Sp2005 c 4 art 6 s 17-20

144.227 PENALTIES.
    Subdivision 1. False statements. A person who intentionally makes a false statement in a
certificate, vital record, or report required to be filed under sections 144.211 to 144.214 or 144.216
to 144.227, or in an application for an amendment thereof, or in an application for a certified vital
record or who supplies false information intending that the information be used in the preparation
of a report, vital record, certificate, or amendment thereof, is guilty of a misdemeanor.
    Subd. 2. Fraud. A person who, without lawful authority and with the intent to deceive,
willfully and knowingly makes, counterfeits, alters, obtains, possesses, uses, or sells a certificate,
vital record, or report required to be filed under sections 144.211 to 144.227 or a certified
certificate, vital record, or report, is guilty of a gross misdemeanor.
    Subd. 3. Birth registration. A person who intentionally makes a false statement in a
registration required under section 144.215 or in an application for an amendment to such a
registration or who intentionally supplies false information intending that the information be used
in the preparation of a registration under section 144.215 is guilty of a gross misdemeanor. This
offense shall be prosecuted by the county attorney.
History: 1978 c 699 s 16; 1994 c 631 s 1,2; 1Sp2001 c 9 art 15 s 30; 2002 c 379 art 1 s 113

144.23-144.28 [Repealed, 1945 c 512 s 37]

HEALTH RECORDS AND REPORTS

144.29 HEALTH RECORDS; CHILDREN OF SCHOOL AGE.
It shall be the duty of every school nurse, school physician, school attendance officer,
superintendent of schools, principal, teacher, and of the persons charged with the duty of
compiling and keeping the school census records, to cause a health record to be kept for each child
of school age. Such record shall be kept in such form that it may be transferred with the child to
any school which the child shall attend within the state. It shall contain a record of such student
health data as defined in section 13.32, subdivision 2, paragraph (a), and shall be classified as
private data as defined in section 13.32, subdivision 3. Nothing in sections 144.29 to 144.32 shall
be construed to require any child whose parent or guardian objects in writing thereto to undergo a
physical or medical examination or treatment. A copy shall be forwarded to the proper department
of any state to which the child shall remove. Each district shall assign a teacher, school nurse, or
other professional person to review, at the beginning of each school year, the health record of all
pupils under the assignee's direction. Growth, results of vision and hearing screening, and findings
obtained from health assessments must be entered periodically on the pupil's health record.
History: (5356-1) 1929 c 277 s 1; 1977 c 305 s 45; 1993 c 224 art 12 s 30; 1Sp1997 c 3 s
23; 1Sp1997 c 4 art 6 s 16

144.30 COPIES OF RECORDS EVIDENCE IN JUVENILE COURT.
When any child shall be brought into juvenile court the court shall request, and the custodian
of the record shall furnish, a complete certified copy of such record to the court, which copy shall
be received as evidence in the case; and no decision or disposition of the pending matter shall be
finally made until such record, if existing, shall be considered.
History: (5356-2) 1929 c 277 s 2

144.31 [Repealed, 1969 c 1082 s 2]

144.32 FALSE STATEMENTS TO BE CAUSE FOR DISCHARGE.
Any intentionally false statement in such certificate and any act or omission of a
superintendent or superior officer to connive at or permit the same shall be deemed good cause for
summary discharge of the person at fault regardless of any contract.
History: (5356-4) 1929 c 277 s 4

144.33 [Repealed, 1961 c 27 s 1]

144.334 RIGHT TO REQUEST PATIENT INFORMATION.
Upon an oral or written request by a spouse, parent, child, or sibling for information about
a patient who is being evaluated for or diagnosed with mental illness, a provider must notify
the requesting individual of the right under section 144.335, subdivision 3a, paragraph (f), to
have the provider request the patient's authorization to release information about the patient
to a designated individual.
History: 2000 c 316 s 1

144.3345 INTERCONNECTED ELECTRONIC HEALTH RECORD GRANTS.
    Subdivision 1. Definitions. The following definitions are used for the purposes of this section.
(a) "Eligible community e-health collaborative" means an existing or newly established
collaborative to support the adoption and use of interoperable electronic health records. A
collaborative must consist of at least three or more eligible health care entities in at least two of
the categories listed in paragraph (b) and have a focus on interconnecting the members of the
collaborative for secure and interoperable exchange of health care information.
(b) "Eligible health care entity" means one of the following:
(1) community clinics, as defined under section 145.9268;
(2) hospitals eligible for rural hospital capital improvement grants, as defined in section
144.148;
(3) physician clinics located in a community with a population of less than 50,000 according
to United States Census Bureau statistics and outside the seven-county metropolitan area;
(4) nursing facilities licensed under sections 144A.01 to 144A.27;
(5) community health boards as established under chapter 145A;
(6) nonprofit entities with a purpose to provide health information exchange coordination
governed by a representative, multi-stakeholder board of directors; and
(7) other providers of health or health care services approved by the commissioner for
which interoperable electronic health record capability would improve quality of care, patient
safety, or community health.
    Subd. 2. Grants authorized. The commissioner of health shall award grants to eligible
community e-health collaborative projects to improve the implementation and use of interoperable
electronic health records including but not limited to the following projects:
(1) collaborative efforts to host and support fully functional interoperable electronic health
records in multiple care settings;
(2) electronic medication history and electronic patient registration information;
(3) electronic personal health records for persons with chronic diseases and for prevention
services;
(4) rural and underserved community models for electronic prescribing; and
(5) enabling local public health systems to rapidly and electronically exchange information
needed to participate in community e-health collaboratives or for public health emergency
preparedness and response.
Grant funds may not be used for construction of health care or other buildings or facilities.
    Subd. 3. Allocation of grants. (a) To receive a grant under this section, an eligible
community e-health collaborative must submit an application to the commissioner of health by
the deadline established by the commissioner. A grant may be awarded upon the signing of a
grant contract. In awarding grants, the commissioner shall give preference to projects benefiting
providers located in rural and underserved areas of Minnesota which the commissioner has
determined have an unmet need for the development and funding of electronic health records.
Applicants may apply for and the commissioner may award grants for one-year, two-year,
or three-year periods.
(b) An application must be on a form and contain information as specified by the
commissioner but at a minimum must contain:
(1) a description of the purpose or project for which grant funds will be used;
(2) a description of the problem or problems the grant funds will be used to address,
including an assessment likelihood of the project occurring absent grant funding;
(3) a description of achievable objectives, a workplan, budget, budget narrative, a project
communications plan, a timeline for implementation and completion of processes or projects
enabled by the grant, and an assessment of privacy and security issues and a proposed approach to
address these issues;
(4) a description of the health care entities and other groups participating in the project,
including identification of the lead entity responsible for applying for and receiving grant funds;
(5) a plan for how patients and consumers will be involved in development of policies and
procedures related to the access to and interchange of information;
(6) evidence of consensus and commitment among the health care entities and others who
developed the proposal and are responsible for its implementation; and
(7) a plan for documenting and evaluating results of the grant.
(c) The commissioner shall review each application to determine whether the application
is complete and whether the applicant and the project are eligible for a grant. In evaluating
applications, the commissioner shall take into consideration factors, including but not limited to,
the following:
(1) the degree to which the proposal interconnects the various providers of care in the
applicant's geographic community;
(2) the degree to which the project provides for the interoperability of electronic health
records or related health information technology between the members of the collaborative,
and presence and scope of a description of how the project intends to interconnect with other
providers not part of the project into the future;
(3) the degree to which the project addresses current unmet needs pertaining to interoperable
electronic health records in a geographic area of Minnesota and the likelihood that the needs
would not be met absent grant funds;
(4) the applicant's thoroughness and clarity in describing the project, how the project will
improve patient safety, quality of care, and consumer empowerment, and the role of the various
collaborative members;
(5) the recommendations of the Health Information and Technology Infrastructure Advisory
Committee; and
(6) other factors that the commissioner deems relevant.
(d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall be required
to provide $1 in the form of cash or in-kind staff or services for each $3 provided under the
grant program.
(e) Grants shall not exceed $900,000 per grant. The commissioner has discretion over the
size and number of grants awarded.
    Subd. 4. Evaluation and report. The commissioner of health shall evaluate the overall
effectiveness of the grant program. The commissioner shall collect progress and expenditure
reports to evaluate the grant program from the eligible community collaboratives receiving grants.
History: 2006 c 282 art 16 s 3

144.335 ACCESS TO HEALTH RECORDS.
    Subdivision 1. Definitions. For the purposes of this section, the following terms have the
meanings given them:
(a) "Patient" means a natural person who has received health care services from a provider
for treatment or examination of a medical, psychiatric, or mental condition, the surviving spouse
and parents of a deceased patient, or a person the patient appoints in writing as a representative,
including a health care agent acting pursuant to chapter 145C, unless the authority of the agent
has been limited by the principal in the principal's health care directive. Except for minors who
have received health care services pursuant to sections 144.341 to 144.347, in the case of a minor,
patient includes a parent or guardian, or a person acting as a parent or guardian in the absence of
a parent or guardian.
(b) "Provider" means (1) any person who furnishes health care services and is regulated to
furnish the services pursuant to chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D,
150A, 151, 153, or 153A; (2) a home care provider licensed under section 144A.46; (3) a health
care facility licensed pursuant to this chapter or chapter 144A; (4) a physician assistant registered
under chapter 147A; and (5) an unlicensed mental health practitioner regulated pursuant to
sections 148B.60 to 148B.71.
(c) "Individually identifiable form" means a form in which the patient is or can be identified
as the subject of the health records.
    Subd. 2. Patient access. (a) Upon request, a provider shall supply to a patient complete and
current information possessed by that provider concerning any diagnosis, treatment and prognosis
of the patient in terms and language the patient can reasonably be expected to understand.
(b) Except as provided in paragraph (e), upon a patient's written request, a provider, at
a reasonable cost to the patient, shall promptly furnish to the patient (1) copies of the patient's
health record, including but not limited to laboratory reports, x-rays, prescriptions, and other
technical information used in assessing the patient's health condition, or (2) the pertinent portion
of the record relating to a condition specified by the patient. With the consent of the patient, the
provider may instead furnish only a summary of the record. The provider may exclude from the
health record written speculations about the patient's health condition, except that all information
necessary for the patient's informed consent must be provided.
(c) If a provider, as defined in subdivision 1, clause (b)(1), reasonably determines that the
information is detrimental to the physical or mental health of the patient, or is likely to cause the
patient to inflict self harm, or to harm another, the provider may withhold the information from
the patient and may supply the information to an appropriate third party or to another provider,
as defined in subdivision 1, clause (b)(1). The other provider or third party may release the
information to the patient.
(d) A provider as defined in subdivision 1, clause (b)(3), shall release information upon
written request unless, prior to the request, a provider as defined in subdivision 1, clause (b)(1),
has designated and described a specific basis for withholding the information as authorized by
paragraph (c).
(e) A provider may not release a copy of a videotape of a child victim or alleged victim of
physical or sexual abuse without a court order under section 13.03, subdivision 6, or as provided
in section 611A.90. This paragraph does not limit the right of a patient to view the videotape.
    Subd. 3. Provider transfers and loans. A patient's health record, including but not limited
to, laboratory reports, x-rays, prescriptions, and other technical information used in assessing
the patient's condition, or the pertinent portion of the record relating to a specific condition, or a
summary of the record, shall promptly be furnished to another provider upon the written request
of the patient. The written request shall specify the name of the provider to whom the health
record is to be furnished. The provider who furnishes the health record or summary may retain a
copy of the materials furnished. The patient shall be responsible for the reasonable costs of
furnishing the information.
    Subd. 3a. Patient consent to release of records; liability. (a) A provider, or a person
who receives health records from a provider, may not release a patient's health records to a
person without a signed and dated consent from the patient or the patient's legally authorized
representative authorizing the release, unless the release is specifically authorized by law. Except
as provided in paragraph (c) or (d), a consent is valid for one year or for a lesser period specified
in the consent or for a different period provided by law.
(b) This subdivision does not prohibit the release of health records:
(1) for a medical emergency when the provider is unable to obtain the patient's consent due
to the patient's condition or the nature of the medical emergency; or
(2) to other providers within related health care entities when necessary for the current
treatment of the patient.
(c) Notwithstanding paragraph (a), if a patient explicitly gives informed consent to the
release of health records for the purposes and pursuant to the restrictions in clauses (1) and (2),
the consent does not expire after one year for:
(1) the release of health records to a provider who is being advised or consulted with in
connection with the current treatment of the patient;
(2) the release of health records to an accident and health insurer, health service plan
corporation, health maintenance organization, or third-party administrator for purposes of
payment of claims, fraud investigation, or quality of care review and studies, provided that:
(i) the use or release of the records complies with sections 72A.49 to 72A.505;
(ii) further use or release of the records in individually identifiable form to a person other
than the patient without the patient's consent is prohibited; and
(iii) the recipient establishes adequate safeguards to protect the records from unauthorized
disclosure, including a procedure for removal or destruction of information that identifies the
patient.
(d) Notwithstanding paragraph (a), health records may be released to an external researcher
solely for purposes of medical or scientific research only as follows:
(1) health records generated before January 1, 1997, may be released if the patient has not
objected or does not elect to object after that date;
(2) for health records generated on or after January 1, 1997, the provider must:
(i) disclose in writing to patients currently being treated by the provider that health records,
regardless of when generated, may be released and that the patient may object, in which case
the records will not be released; and
(ii) use reasonable efforts to obtain the patient's written general authorization that describes
the release of records in item (i), which does not expire but may be revoked or limited in writing
at any time by the patient or the patient's authorized representative;
(3) authorization may be established if an authorization is mailed at least two times to the
patient's last known address with a postage prepaid return envelope and a conspicuous notice that
the patient's medical records may be released if the patient does not object, and at least 60 days
have expired since the second notice was sent; and the provider must advise the patient of the
rights specified in clause (4); and
(4) the provider must, at the request of the patient, provide information on how the patient
may contact an external researcher to whom the health record was released and the date it was
released.
In making a release for research purposes the provider shall make a reasonable effort to
determine that:
(i) the use or disclosure does not violate any limitations under which the record was collected;
(ii) the use or disclosure in individually identifiable form is necessary to accomplish the
research or statistical purpose for which the use or disclosure is to be made;
(iii) the recipient has established and maintains adequate safeguards to protect the records
from unauthorized disclosure, including a procedure for removal or destruction of information
that identifies the patient; and
(iv) further use or release of the records in individually identifiable form to a person other
than the patient without the patient's consent is prohibited.
(e) A person who negligently or intentionally releases a health record in violation of this
subdivision, or who forges a signature on a consent form, or who obtains under false pretenses the
consent form or health records of another person, or who, without the person's consent, alters
a consent form, is liable to the patient for compensatory damages caused by an unauthorized
release, plus costs and reasonable attorney's fees.
(f) Upon the written request of a spouse, parent, child, or sibling of a patient being evaluated
for or diagnosed with mental illness, a provider shall inquire of a patient whether the patient
wishes to authorize a specific individual to receive information regarding the patient's current
and proposed course of treatment. If the patient so authorizes, the provider shall communicate to
the designated individual the patient's current and proposed course of treatment. Paragraph (a)
applies to consents given under this paragraph.
(g) Notwithstanding paragraph (a), a provider must disclose health records relating to a
patient's mental health to a law enforcement agency if the law enforcement agency provides the
name of the patient and communicates that the:
(1) patient is currently involved in an emergency interaction with the law enforcement
agency; and
(2) disclosure of the records is necessary to protect the health or safety of the patient or of
another person.
The scope of disclosure under this paragraph is limited to the minimum necessary for law
enforcement to respond to the emergency. A law enforcement agency that obtains health records
under this paragraph shall maintain a record of the requestor, the provider of the information, and
the patient's name. Health records obtained by a law enforcement agency under this paragraph are
private data on individuals as defined in section 13.02 and must not be used by law enforcement
for any other purpose.
(h) In cases where a provider releases health records without patient consent as authorized by
law, the release must be documented in the patient's health record. In the case of a release under
paragraph (g), the documentation must include the date and circumstances under which the release
was made, the person or agency to whom the release was made, and the records that were released.
    Subd. 3b. Release of records to commissioner of health or Health Data Institute.
Subdivision 3a does not apply to the release of health records to the commissioner of health or
the Health Data Institute under chapter 62J, provided that the commissioner encrypts the patient
identifier upon receipt of the data.
    Subd. 3c. Independent medical examination. This section applies to the subject and
provider of an independent medical examination requested by or paid for by a third party.
Notwithstanding subdivision 3a, a provider may release health records created as part of an
independent medical examination to the third party who requested or paid for the examination.
    Subd. 3d. Release of records for family and caretaker involvement in mental health
care. (a) Notwithstanding subdivision 3a, a provider providing mental health care and treatment
may disclose health record information described in paragraph (b) about a patient to a family
member of the patient or other person who requests the information if:
(1) the request for information is in writing;
    (2) the family member or other person lives with, provides care for, or is directly involved in
monitoring the treatment of the patient;
    (3) the involvement under clause (2) is verified by the patient's mental health care provider,
the patient's attending physician, or a person other than the person requesting the information, and
is documented in the patient's medical record;
(4) before the disclosure, the patient is informed in writing of the request, the name of
the person requesting the information, the reason for the request, and the specific information
being requested;
    (5) the patient agrees to the disclosure, does not object to the disclosure, or is unable to
consent or object, and the patient's decision or inability to make a decision is documented in the
patient's medical record; and
    (6) the disclosure is necessary to assist in the provision of care or monitoring of the patient's
treatment.
    (b) The information disclosed under this subdivision is limited to diagnosis, admission to
or discharge from treatment, the name and dosage of the medications prescribed, side effects of
the medication, consequences of failure of the patient to take the prescribed medication, and
a summary of the discharge plan.
    (c) If a provider reasonably determines that providing information under this subdivision
would be detrimental to the physical or mental health of the patient or is likely to cause the patient
to inflict self harm or to harm another, the provider must not disclose the information.
(d) This subdivision does not apply to disclosures for a medical emergency or to family
members as authorized or required under subdivision 3a, paragraph (b), clause (1), or paragraph
(f).
    Subd. 4. Additional patient rights. The rights set forth in this section are in addition to the
rights set forth in sections 144.651 and 144.652 and any other provision of law relating to the
access of a patient to the patient's health records.
    Subd. 5. Costs. (a) When a patient requests a copy of the patient's record for purposes of
reviewing current medical care, the provider must not charge a fee.
(b) When a provider or its representative makes copies of patient records upon a patient's
request under this section, the provider or its representative may charge the patient or the patient's
representative no more than 75 cents per page, plus $10 for time spent retrieving and copying
the records, unless other law or a rule or contract provide for a lower maximum charge. This
limitation does not apply to x-rays. The provider may charge a patient no more than the actual cost
of reproducing x-rays, plus no more than $10 for the time spent retrieving and copying the x-rays.
(c) The respective maximum charges of 75 cents per page and $10 for time provided in this
subdivision are in effect for calendar year 1992 and may be adjusted annually each calendar year
as provided in this subdivision. The permissible maximum charges shall change each year by an
amount that reflects the change, as compared to the previous year, in the Consumer Price Index
for all Urban Consumers, Minneapolis-St. Paul (CPI-U), published by the Department of Labor.
(d) A provider or its representative must not charge a fee to provide copies of records
requested by a patient or the patient's authorized representative if the request for copies of records
is for purposes of appealing a denial of Social Security disability income or Social Security
disability benefits under title II or title XVI of the Social Security Act. For the purpose of further
appeals, a patient may receive no more than two medical record updates without charge, but
only for medical record information previously not provided. For purposes of this paragraph, a
patient's authorized representative does not include units of state government engaged in the
adjudication of Social Security disability claims.
    Subd. 5a. Notice of rights; information on release. A provider shall provide to patients, in
a clear and conspicuous manner, a written notice concerning practices and rights with respect to
access to health records. The notice must include an explanation of:
(1) disclosures of health records that may be made without the written consent of the patient,
including the type of records and to whom the records may be disclosed; and
(2) the right of the patient to have access to and obtain copies of the patient's health records
and other information about the patient that is maintained by the provider.
The notice requirements of this paragraph are satisfied if the notice is included with the
notice and copy of the patient and resident bill of rights under section 144.652 or if it is displayed
prominently in the provider's place of business. The commissioner of health shall develop the
notice required in this subdivision and publish it in the State Register.
    Subd. 6. Violation. A violation of this section may be grounds for disciplinary action against
a provider by the appropriate licensing board or agency.
History: 1977 c 380 s 1; 1985 c 298 s 40; 1986 c 444; 1987 c 347 art 1 s 18; 1987 c 378
s 1; 1988 c 670 s 8; 1989 c 64 s 1,2; 1989 c 175 s 3; 1989 c 209 art 1 s 15; 1990 c 573 s 20;
1991 c 292 art 2 s 3; 1991 c 319 s 15; 1992 c 569 s 8-11; 1993 c 345 art 12 s 7; 1993 c 351 s
24,25; 1994 c 618 art 1 s 19; 1994 c 625 art 8 s 42,43; 1995 c 205 art 2 s 3; 1995 c 234 art 5 s
23; 1995 c 259 art 1 s 34; art 4 s 5; 1996 c 440 art 1 s 36; 1Sp1997 c 3 s 24; 1998 c 317 s 1;
1998 c 399 s 1; 2001 c 211 s 2; 2002 c 375 art 3 s 6; 2004 c 290 s 30; 2005 c 147 art 1 s 3; 2006
c 212 art 3 s 11; 2006 c 253 s 10

144.3351 IMMUNIZATION DATA.
Providers as defined in section 144.335, subdivision 1, group purchasers as defined in section
62J.03, subdivision 6, elementary or secondary schools or child care facilities as defined in section
121A.15, subdivision 9, public or private postsecondary educational institutions as defined in
section 135A.14, subdivision 1, paragraph (b), a board of health as defined in section 145A.02,
subdivision 2 , community action agencies as defined in section 256E.31, subdivision 1, and the
commissioner of health may exchange immunization data with one another, without the patient's
consent, if the person requesting access provides services on behalf of the patient. For purposes
of this section immunization data includes:
(1) patient's name, address, date of birth, gender, parent or guardian's name; and
(2) date vaccine was received, vaccine type, lot number, and manufacturer of all
immunizations received by the patient, and whether there is a contraindication or an adverse
reaction indication.
This section applies to all immunization data, regardless of when the immunization occurred.
History: 1992 c 569 s 12; 1995 c 259 art 1 s 35; 1Sp1995 c 3 art 16 s 13; 1998 c 397 art
11 s 3; 2005 c 98 art 1 s 24

144.3352 HEPATITIS B MATERNAL CARRIER DATA; INFANT IMMUNIZATION.
The commissioner of health or a local board of health may inform the physician attending a
newborn of the hepatitis B infection status of the biological mother.
History: 1994 c 618 art 1 s 20

144.336 REGISTRY OF PERSONS TYPED FOR HUMAN LEUKOCYTE ANTIGENS.
    Subdivision 1. Release restricted. No person, including the state, a state agency, or a
political subdivision, that maintains or operates a registry of the names of persons, their human
leukocyte antigen types, and their willingness to be a tissue donor shall reveal the identity of the
person or the person's human leukocyte antigen type without the person's consent. If the data
are maintained by a governmental entity, the data are classified as private data on individuals
as defined in section 13.02, subdivision 12.
    Subd. 2. Duties. Persons that maintain or operate a registry described in subdivision 1 have
no responsibility for any search beyond their own records to identify potential donors for the
benefit of any person seeking a tissue transplant and have no duty to encourage potential donors
to assist persons seeking a tissue transplant, and are not liable for their failure to do so.
History: 1984 c 436 s 33; 1986 c 444

144.34 INVESTIGATION AND CONTROL OF OCCUPATIONAL DISEASES.
Any physician having under professional care any person whom the physician believes to
be suffering from poisoning from lead, phosphorus, arsenic, brass, silica dust, carbon monoxide
gas, wood alcohol, or mercury, or their compounds, or from anthrax or from compressed-air
illness or any other disease contracted as a result of the nature of the employment of such person
shall within five days mail to the Department of Health a report stating the name, address, and
occupation of such patient, the name, address, and business of the patient's employer, the nature
of the disease, and such other information as may reasonably be required by the department. The
department shall prepare and furnish the physicians of this state suitable blanks for the reports
herein required. No report made pursuant to the provisions of this section shall be admissible
as evidence of the facts therein stated in any action at law or in any action under the Workers'
Compensation Act against any employer of such diseased person. The Department of Health
is authorized to investigate and to make recommendations for the elimination or prevention
of occupational diseases which have been reported to it, or which shall be reported to it, in
accordance with the provisions of this section. The department is also authorized to study and
provide advice in regard to conditions that may be suspected of causing occupational diseases.
Information obtained upon investigations made in accordance with the provisions of this section
shall not be admissible as evidence in any action at law to recover damages for personal injury or
in any action under the Workers' Compensation Act. Nothing herein contained shall be construed
to interfere with or limit the powers of the Department of Labor and Industry to make inspections
of places of employment or issue orders for the protection of the health of the persons therein
employed. When upon investigation the commissioner of health reaches a conclusion that a
condition exists which is dangerous to the life and health of the workers in any industry or factory
or other industrial institutions the commissioner shall file a report thereon with the Department of
Labor and Industry.
History: (4327-1) 1939 c 322; 1975 c 359 s 23; 1977 c 305 s 45; 1986 c 444

CONSENT OF MINORS FOR

HEALTH SERVICES

144.341 LIVING APART FROM PARENTS AND MANAGING FINANCIAL AFFAIRS.
Notwithstanding any other provision of law, any minor who is living separate and apart
from parents or legal guardian, whether with or without the consent of a parent or guardian and
regardless of the duration of such separate residence, and who is managing personal financial
affairs, regardless of the source or extent of the minor's income, may give effective consent to
personal medical, dental, mental and other health services, and the consent of no other person is
required.
History: 1971 c 544 s 1; 1986 c 444

144.342 MARRIAGE OR GIVING BIRTH, CONSENT FOR HEALTH SERVICE FOR
SELF OR CHILD.
Any minor who has been married or has borne a child may give effective consent to personal
medical, mental, dental and other health services, or to services for the minor's child, and the
consent of no other person is required.
History: 1971 c 544 s 2; 1986 c 444

144.343 PREGNANCY, VENEREAL DISEASE, ALCOHOL OR DRUG ABUSE,
ABORTION.
    Subdivision 1. Minor's consent valid. Any minor may give effective consent for medical,
mental and other health services to determine the presence of or to treat pregnancy and conditions
associated therewith, venereal disease, alcohol and other drug abuse, and the consent of no other
person is required.
    Subd. 2. Notification concerning abortion. Notwithstanding the provisions of section
13.02, subdivision 8, no abortion operation shall be performed upon an unemancipated minor
or upon a woman for whom a guardian has been appointed pursuant to sections 524.5-101 to
524.5-502 because of a finding of incapacity, until at least 48 hours after written notice of the
pending operation has been delivered in the manner specified in subdivisions 2 to 4.
(a) The notice shall be addressed to the parent at the usual place of abode of the parent and
delivered personally to the parent by the physician or an agent.
(b) In lieu of the delivery required by clause (a), notice shall be made by certified mail
addressed to the parent at the usual place of abode of the parent with return receipt requested and
restricted delivery to the addressee which means postal employee can only deliver the mail to the
authorized addressee. Time of delivery shall be deemed to occur at 12 o'clock noon on the next
day on which regular mail delivery takes place, subsequent to mailing.
    Subd. 3. Parent, abortion; definitions. For purposes of this section, "parent" means both
parents of the pregnant woman if they are both living, one parent of the pregnant woman if only
one is living or if the second one cannot be located through reasonably diligent effort, or the
guardian or conservator if the pregnant woman has one.
For purposes of this section, "abortion" means the use of any means to terminate the
pregnancy of a woman known to be pregnant with knowledge that the termination with those
means will, with reasonable likelihood, cause the death of the fetus and "fetus" means any
individual human organism from fertilization until birth.
    Subd. 4. Limitations. No notice shall be required under this section if:
(a) The attending physician certifies in the pregnant woman's medical record that the
abortion is necessary to prevent the woman's death and there is insufficient time to provide the
required notice; or
(b) The abortion is authorized in writing by the person or persons who are entitled to
notice; or
(c) The pregnant minor woman declares that she is a victim of sexual abuse, neglect, or
physical abuse as defined in section 626.556. Notice of that declaration shall be made to the
proper authorities as provided in section 626.556, subdivision 3.
    Subd. 5. Penalty. Performance of an abortion in violation of this section shall be a
misdemeanor and shall be grounds for a civil action by a person wrongfully denied notification. A
person shall not be held liable under this section if the person establishes by written evidence
that the person relied upon evidence sufficient to convince a careful and prudent person that
the representations of the pregnant woman regarding information necessary to comply with
this section are bona fide and true, or if the person has attempted with reasonable diligence to
deliver notice, but has been unable to do so.
    Subd. 6. Substitute notification provisions. If subdivision 2 of this law is ever temporarily
or permanently restrained or enjoined by judicial order, subdivision 2 shall be enforced as
though the following paragraph were incorporated as paragraph (c) of that subdivision; provided,
however, that if such temporary or permanent restraining order or injunction is ever stayed or
dissolved, or otherwise ceases to have effect, subdivision 2 shall have full force and effect,
without being modified by the addition of the following substitute paragraph which shall have no
force or effect until or unless an injunction or restraining order is again in effect.
(c)(i) If such a pregnant woman elects not to allow the notification of one or both of
her parents or guardian or conservator, any judge of a court of competent jurisdiction shall,
upon petition, or motion, and after an appropriate hearing, authorize a physician to perform
the abortion if said judge determines that the pregnant woman is mature and capable of giving
informed consent to the proposed abortion. If said judge determines that the pregnant woman
is not mature, or if the pregnant woman does not claim to be mature, the judge shall determine
whether the performance of an abortion upon her without notification of her parents, guardian,
or conservator would be in her best interests and shall authorize a physician to perform the
abortion without such notification if said judge concludes that the pregnant woman's best interests
would be served thereby.
(ii) Such a pregnant woman may participate in proceedings in the court on her own behalf,
and the court may appoint a guardian ad litem for her. The court shall, however, advise her that she
has a right to court appointed counsel, and shall, upon her request, provide her with such counsel.
(iii) Proceedings in the court under this section shall be confidential and shall be given such
precedence over other pending matters so that the court may reach a decision promptly and
without delay so as to serve the best interests of the pregnant woman. A judge of the court who
conducts proceedings under this section shall make in writing specific factual findings and legal
conclusions supporting the decision and shall order a record of the evidence to be maintained
including the judge's own findings and conclusions.
(iv) An expedited confidential appeal shall be available to any such pregnant woman for
whom the court denies an order authorizing an abortion without notification. An order authorizing
an abortion without notification shall not be subject to appeal. No filing fees shall be required of
any such pregnant woman at either the trial or the appellate level. Access to the trial court for
the purposes of such a petition or motion, and access to the appellate courts for purposes of
making an appeal from denial of the same, shall be afforded such a pregnant woman 24 hours
a day, seven days a week.
    Subd. 7. Severability. If any provision, word, phrase or clause of this section or the
application thereof to any person or circumstance shall be held invalid, such invalidity shall not
affect the provisions, words, phrases, clauses or application of this section which can be given
effect without the invalid provision, word, phrase, clause, or application, and to this end the
provisions, words, phrases, and clauses of this section are declared to be severable.
History: 1971 c 544 s 3; 1981 c 228 s 1; 1981 c 311 s 39; 1982 c 545 s 24; 1986 c 444;
2004 c 146 art 3 s 1

144.344 EMERGENCY TREATMENT.
Medical, dental, mental and other health services may be rendered to minors of any age
without the consent of a parent or legal guardian when, in the professional's judgment, the risk to
the minor's life or health is of such a nature that treatment should be given without delay and the
requirement of consent would result in delay or denial of treatment.
History: 1971 c 544 s 4

144.3441 HEPATITIS B VACCINATION.
A minor may give effective consent for a hepatitis B vaccination. The consent of no other
person is required.
History: 1993 c 167 s 1

144.345 REPRESENTATIONS TO PERSONS RENDERING SERVICE.
The consent of a minor who claims to be able to give effective consent for the purpose of
receiving medical, dental, mental or other health services but who may not in fact do so, shall
be deemed effective without the consent of the minor's parent or legal guardian, if the person
rendering the service relied in good faith upon the representations of the minor.
History: 1971 c 544 s 5; 1986 c 444

144.346 INFORMATION TO PARENTS.
The professional may inform the parent or legal guardian of the minor patient of any
treatment given or needed where, in the judgment of the professional, failure to inform the parent
or guardian would seriously jeopardize the health of the minor patient.
History: 1971 c 544 s 6

144.347 FINANCIAL RESPONSIBILITY.
A minor so consenting for such health services shall thereby assume financial responsibility
for the cost of said services.
History: 1971 c 544 s 7

WATER POLLUTION

144.35 POLLUTION OF WATER.
No sewage or other matter that will impair the healthfulness of water shall be deposited
where it will fall or drain into any pond or stream used as a source of water supply for domestic
use. The commissioner shall have general charge of all springs, wells, ponds, and streams so used
and take all necessary and proper steps to preserve the same from such pollution as may endanger
the public health. In case of violation of any of the provisions of this section, the commissioner
may, with or without a hearing, order any person to desist from causing such pollution and to
comply with such direction as the commissioner may deem proper and expedient in the premises.
Such order shall be served forthwith upon the person found to have violated such provisions.
History: (5375) RL s 2147; 1977 c 305 s 45; 1986 c 444

144.36 APPEAL TO DISTRICT COURT.
Within five days after service of the order, any person aggrieved thereby may appeal to the
district court of the county in which such polluted source of water supply is situated. During
the pendency of the appeal the pollution against which the order has been issued shall not be
continued and, upon violation of such order, the appeal shall forthwith be dismissed.
History: (5376) RL s 2148; 1987 c 309 s 16

144.37 OTHER REMEDIES PRESERVED.
Nothing in section 144.36 shall curtail the power of the courts to administer the usual legal
and equitable remedies in cases of nuisances or of improper interference with private rights.
History: (5377) RL s 2149; 1987 c 309 s 17

144.371 [Renumbered 115.01]

144.372 [Renumbered 115.02]

144.373 [Renumbered 115.03]

144.374 [Renumbered 115.04]

144.375 [Renumbered 115.05]

144.376 [Renumbered 115.06]

144.377 [Renumbered 115.07]

144.378 [Renumbered 115.08]

144.379 [Renumbered 115.09]

144.38 [Repealed, 1967 c 882 s 11]

SAFE DRINKING WATER ACT

144.381 CITATION.
Sections 144.381 to 144.387 may be cited as the "Safe Drinking Water Act of 1977."
History: 1977 c 66 s 1

144.382 DEFINITIONS.
    Subdivision 1. Scope. For the purposes of sections 144.381 to 144.387, the following terms
have the meanings given.
    Subd. 2. Commissioner. "Commissioner" means the state commissioner of health.
    Subd. 3. Federal regulations. "Federal regulations" means rules promulgated by the federal
environmental protection agency, or its successor agencies.
    Subd. 4. Public water supply. "Public water supply" has the meaning given to "public
water system" in the federal Safe Drinking Water Act, United States Code, title 42, section 300f,
clause (4).
    Subd. 5. Supplier. "Supplier" means a person who owns, manages or operates a public
water supply.
History: 1977 c 66 s 2; 1977 c 305 s 45; 1999 c 18 s 1

144.383 AUTHORITY OF COMMISSIONER.
In order to insure safe drinking water in all public water supplies, the commissioner has
the following powers:
(a) To approve the site, design, and construction and alteration of all public water supplies
and, for community and nontransient noncommunity water systems as defined in Code of Federal
Regulations, title 40, section 141.2, to approve documentation that demonstrates the technical,
managerial, and financial capacity of those systems to comply with rules adopted under this
section;
(b) To enter the premises of a public water supply, or part thereof, to inspect the facilities and
records kept pursuant to rules promulgated by the commissioner, to conduct sanitary surveys and
investigate the standard of operation and service delivered by public water supplies;
(c) To contract with boards of health as defined in section 145A.02, subdivision 2, created
pursuant to section 145A.09, for routine surveys, inspections, and testing of public water supply
quality;
(d) To develop an emergency plan to protect the public when a decline in water quality or
quantity creates a serious health risk, and to issue emergency orders if a health risk is imminent;
(e) To promulgate rules, pursuant to chapter 14 but no less stringent than federal regulation,
which may include the granting of variances and exemptions.
History: 1977 c 66 s 3; 1977 c 305 s 45; 1982 c 424 s 130; 1987 c 309 s 24; 1989 c 209 art
2 s 1; 1998 c 261 s 1

144.3831 FEES.
    Subdivision 1. Fee setting. The commissioner of health may assess an annual fee of $6.36
for every service connection to a public water supply that is owned or operated by a home rule
charter city, a statutory city, a city of the first class, or a town. The commissioner of health may
also assess an annual fee for every service connection served by a water user district defined
in section 110A.02.
    Subd. 2. Collection and payment of fee. The public water supply described in subdivision 1
shall:
(1) collect the fees assessed on its service connections;
(2) pay the Department of Health an amount equivalent to the fees based on the total number
of service connections. The service connections for each public water supply described in
subdivision 1 shall be verified every four years by the Department of Health; and
(3) pay one-fourth of the total yearly fee to the Department of Health each calendar quarter.
In lieu of quarterly payments, a public water supply described in subdivision 1 with fewer than
50 service connections may make a single annual payment by June 30 each year. The fees
payable to the Department of Health shall be deposited in the state treasury as nondedicated state
government special revenue fund revenues.
    Subd. 3. Late fee. The public water supply described in subdivision 1 shall pay a late fee in
the amount of five percent of the amount of the fees due from the public water supply if the fees
due from the public water supply are not paid within 30 days of the payment dates in subdivision
2, clause (3). The late fee that the public water supply shall pay shall be assessed only on the
actual amount collected by the public water supply through fees on service connections.
History: 1992 c 513 art 6 s 3; 1Sp1993 c 1 art 9 s 21; 1995 c 186 s 42; 1Sp2001 c 5 art 7 s
3; 1Sp2005 c 4 art 6 s 21

144.384 NOTICE OF VIOLATION.
Upon discovery of a violation of a maximum contaminant level or treatment technique,
the commissioner shall promptly notify the supplier of the violation, state the rule violated,
and state a date by which the violation must be corrected or by which a request for variance or
exemption must be submitted.
History: 1977 c 66 s 4; 1977 c 305 s 45

144.385 PUBLIC NOTICE.
If a public water system has violated a rule of the commissioner, has a variance or exemption
granted, or fails to comply with the terms of the variance or exemption, the supplier shall provide
public notice of the fact pursuant to the rules of the commissioner.
History: 1977 c 66 s 5; 1977 c 305 s 45

144.386 PENALTIES.
    Subdivision 1. Basic fine. A person who violates a rule of the commissioner, fails to comply
with the terms of a variance or exemption, or fails to request a variance or exemption by the
date specified in the notice from the commissioner, may be fined up to $1,000 for each day the
offense continues, in a civil action brought by the commissioner in district court. All fines shall be
deposited in the general fund of the state treasury.
    Subd. 2. Gross misdemeanor fine. A person who intentionally or repeatedly violates a
rule of the commissioner, or fails to comply with an emergency order of the commissioner, is
guilty of a gross misdemeanor, and may be fined not more than $10,000, imprisoned not more
than one year, or both.
    Subd. 3. Drinking water notice; fine. A supplier who fails to comply with the provisions of
section 144.385, or disseminates false or misleading information relating to the notice required in
section 144.385, is subject to the penalties described in subdivision 2.
    Subd. 4.[Repealed, 1993 c 206 s 25]
History: 1977 c 66 s 6; 1977 c 305 s 45; 1984 c 628 art 3 s 11

144.387 COSTS.
If the state prevails in any civil action under section 144.386, the court may award reasonable
costs and expenses to the state.
History: 1977 c 66 s 7

144.3871 [Repealed, 1996 c 418 s 18]

FEMALE GENITAL MUTILATION;

EDUCATION AND OUTREACH

144.3872 FEMALE GENITAL MUTILATION; EDUCATION AND OUTREACH.
The commissioner of health shall carry out appropriate education, prevention, and outreach
activities in communities that traditionally practice female circumcision, excision, or infibulation
to inform people in those communities about the health risks and emotional trauma inflicted by
those practices and to inform them and the medical community of the criminal penalties contained
in section 609.2245. The commissioner shall work with culturally appropriate groups to obtain
private funds to help finance these prevention and outreach activities.
History: 1994 c 636 art 9 s 9

144.388 [Repealed, 1988 c 689 art 2 s 269]

144.39 [Repealed, 1967 c 882 s 11]

PROMOTION OF NONSMOKING

144.391 PUBLIC POLICY.
The legislature finds that:
(1) smoking causes premature death, disability, and chronic disease, including cancer and
heart disease, and lung disease;
(2) smoking related diseases result in excess medical care costs; and
(3) smoking initiation occurs primarily in adolescence.
The legislature desires to prevent young people from starting to smoke, to encourage and
assist smokers to quit, and to promote clean indoor air.
History: 1Sp1985 c 14 art 19 s 13

144.392 DUTIES OF COMMISSIONER.
The commissioner of health shall:
(1) provide assistance to workplaces to develop policies that promote nonsmoking and are
consistent with the Minnesota Clean Indoor Air Act;
(2) provide technical assistance, including design and evaluation methods, materials, and
training to local health departments, communities, and other organizations that undertake
community programs for the promotion of nonsmoking;
(3) collect and disseminate information and materials for smoking prevention;
(4) evaluate new and existing nonsmoking programs on a statewide and regional basis
using scientific evaluation methods;
(5) conduct surveys in school-based populations regarding the epidemiology of smoking
behavior, knowledge, and attitudes related to smoking, and the penetration of statewide smoking
control programs; and
(6) report to the legislature each biennium on activities undertaken, smoking rates in the
population and subgroups of the total population, evaluation activities and results of those
activities, and recommendations for further action.
History: 1Sp1985 c 14 art 19 s 14

144.393 PUBLIC COMMUNICATIONS PROGRAM.
The commissioner may conduct a long-term coordinated public information program that
includes public service announcements, public education forums, mass media, and written
materials. The program must promote nonsmoking and include background survey research
and evaluation. The program must be designed to run over at least five years, subject to the
availability of money.
History: 1Sp1985 c 14 art 19 s 15

144.394 HEALTH PROMOTION AND EDUCATION.
The commissioner may sell at market value all health promotion and health education
materials. Proceeds from the sale of the materials are appropriated to the Department of Health
for the program that developed the material.
History: 1995 c 207 art 9 s 6; 1997 c 203 art 2 s 14

TOBACCO USE PREVENTION AND LOCAL

PUBLIC HEALTH ENDOWMENT FUND

144.395 [Repealed, 2006 c 282 art 14 s 15]

144.396 TOBACCO USE PREVENTION.
    Subdivision 1. Purpose. The legislature finds that it is important to reduce the prevalence of
tobacco use among the youth of this state. It is a goal of the state to reduce tobacco use among
youth by 25 percent by the year 2005, and to promote statewide and local tobacco use prevention
activities to achieve this goal.
    Subd. 2. Measurable outcomes. The commissioner, in consultation with other public,
private, or nonprofit organizations involved in tobacco use prevention efforts, shall establish
measurable outcomes to determine the effectiveness of the grants receiving funds under this
section in reducing the use of tobacco among youth.
    Subd. 3. Statewide assessment. The commissioner of health shall conduct a statewide
assessment of tobacco-related behaviors and attitudes among youth to establish a baseline to
measure the statewide effect of tobacco use prevention activities. The commissioner of education
must provide any information requested by the commissioner of health as part of conducting the
assessment. To the extent feasible, the commissioner of health should conduct the assessment so
that the results may be compared to nationwide data.
    Subd. 4. Process. (a) The commissioner shall develop the criteria and procedures to allocate
the grants under this section. In developing the criteria, the commissioner shall establish an
administrative cost limit for grant recipients. The outcomes established under subdivision 2 must
be specified to the grant recipients receiving grants under this section at the time the grant is
awarded.
(b) A recipient of a grant under this section must coordinate its tobacco use prevention
activities with other entities performing tobacco use prevention activities within the recipient's
service area.
    Subd. 5. Statewide tobacco prevention grants. (a) To the extent funds are appropriated
for the purposes of this subdivision, the commissioner of health shall award competitive grants
to eligible applicants for projects and initiatives directed at the prevention of tobacco use. The
project areas for grants include:
(1) statewide public education and information campaigns which include implementation at
the local level; and
(2) coordinated special projects, including training and technical assistance, a resource
clearinghouse, and contracts with ethnic and minority communities.
(b) Eligible applicants may include, but are not limited to, nonprofit organizations, colleges
and universities, professional health associations, community health boards, and other health care
organizations. Applicants must submit proposals to the commissioner. The proposals must specify
the strategies to be implemented to target tobacco use among youth, and must take into account
the need for a coordinated statewide tobacco prevention effort.
(c) The commissioner must give priority to applicants who demonstrate that the proposed
project:
(1) is research based or based on proven effective strategies;
(2) is designed to coordinate with other activities and education messages related to other
health initiatives;
(3) utilizes and enhances existing prevention activities and resources; or
(4) involves innovative approaches preventing tobacco use among youth.
    Subd. 6. Local tobacco prevention grants. (a) The commissioner shall award grants to
eligible applicants for local and regional projects and initiatives directed at tobacco prevention in
coordination with other health areas aimed at reducing high-risk behaviors in youth that lead to
adverse health-related problems. The project areas for grants include:
(1) school-based tobacco prevention programs aimed at youth and parents;
(2) local public awareness and education projects aimed at tobacco prevention in
coordination with locally assessed community public health needs pursuant to chapter 145A; or
(3) local initiatives aimed at reducing high-risk behavior in youth associated with tobacco
use and the health consequences of these behaviors.
(b) Eligible applicants may include, but are not limited to, community health boards,
school districts, community clinics, Indian tribes, nonprofit organizations, and other health care
organizations. Applicants must submit proposals to the commissioner. The proposals must specify
the strategies to be implemented to target tobacco use among youth, and must be targeted to
achieve the outcomes established in subdivision 2.
(c) The commissioner must give priority to applicants who demonstrate that the proposed
project or initiative is:
(1) supported by the community in which the applicant serves;
(2) is based on research or on proven effective strategies;
(3) is designed to coordinate with other community activities related to other health
initiatives;
(4) incorporates an understanding of the role of community in influencing behavioral changes
among youth regarding tobacco use and other high-risk health-related behaviors; or
(5) addresses disparities among populations of color related to tobacco use and other
high-risk health-related behaviors.
(d) The commissioner shall divide the state into specific geographic regions and allocate
a percentage of the money available for distribution to projects or initiatives aimed at that
geographic region. If the commissioner does not receive a sufficient number of grant proposals
from applicants that serve a particular region or the proposals submitted do not meet the criteria
developed by the commissioner, the commissioner shall provide technical assistance and expertise
to ensure the development of adequate proposals aimed at addressing the public health needs of
that region. In awarding the grants, the commissioner shall consider locally assessed community
public health needs pursuant to chapter 145A.
    Subd. 7. Local public health promotion and protection. The commissioner shall
distribute funds appropriated for the purpose of local health promotion and protection activities
to community health boards for local health initiatives other than tobacco prevention aimed at
high risk health behaviors among youth. The commissioner shall distribute these funds to the
community health boards based on demographics and other need-based factors relating to health.
    Subd. 8. Coordination. The commissioner shall coordinate the projects and initiatives
funded under this section with the tobacco use prevention efforts of the Minnesota partnership
for action against tobacco, community health boards, and other public, private, and nonprofit
organizations and the tobacco prevention efforts that are being conducted on the national level.
    Subd. 9. Evaluation. (a) Using the outcome measures established in subdivision 2, the
commissioner of health shall conduct a biennial evaluation of the statewide and local tobacco
use prevention projects and community health board activities funded under this section. The
evaluation must include:
(1) the effect of these activities on the amount of tobacco use by youth and rates at which
youth start to use tobacco products; and
(2) a longitudinal tracking of outcomes for youth.
Grant recipients and community health boards shall cooperate with the commissioner in
the evaluation and provide the commissioner with the information necessary to conduct the
evaluation. Beginning January 15, 2003, the results of each evaluation must be submitted to the
chairs and members of the house Health and Human Services Finance Committee and the senate
Health and Family Security Budget Division.
(b) A maximum of $150,000 of the annual appropriation described in section 144.395,
subdivision 2 , paragraph (c), that is appropriated on July 1, 2000, and in every odd-numbered year
thereafter, may be used by the commissioner to establish and maintain tobacco use monitoring
systems and to conduct the evaluations. This appropriation is in addition to the appropriation in
section 144.395, subdivision 2, paragraph (d).
    Subd. 10. Report. The commissioner of health shall submit a biennial report to the chairs
and members of the house Health and Human Services Finance Committee and the senate Health
and Family Security Budget Division on the statewide and local projects and community health
board prevention activities funded under this section. These reports must include information
on grant recipients, activities that were conducted using grant funds, and evaluation data and
outcome measures, if available. These reports are due by January 15 of the odd-numbered
years, beginning in 2001.
    Subd. 11. Audits. The legislative auditor may audit tobacco use prevention and local public
health expenditures to ensure that the money is spent for tobacco use prevention measures and
public health initiatives.
    Subd. 12. Funds not to supplant existing funding. Funds appropriated to the statewide
tobacco prevention grants, local tobacco prevention grants, or the local public health promotion
and prevention must not be used as a substitute for traditional sources of funding tobacco use
prevention activities or public health initiatives. Any local unit of government receiving money
under this section must ensure that existing local financial efforts remain in place.
    Subd. 13.[Repealed, 2000 c 488 art 11 s 12]
History: 1999 c 245 art 11 s 5; 2000 c 488 art 11 s 5,6; 2003 c 130 s 12; 1Sp2003 c 14 art
7 s 35-40

144.40 [Repealed, 1967 c 882 s 11]

    Subdivision 1.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 2.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 3.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 4.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 5.[Repealed, 1Sp2003 c 9 art 8 s 8; 1Sp2003 c 14 art 8 s 32]

144.41 [Repealed, 1967 c 882 s 11]

CLEAN INDOOR AIR ACT

144.411 CITATION.
Sections 144.411 to 144.417 may be cited as the Minnesota Clean Indoor Air Act.
History: 1975 c 211 s 1

144.412 PUBLIC POLICY.
The purpose of sections 144.411 to 144.417 is to protect the public health, comfort and
environment by prohibiting smoking in areas where children or ill or injured persons are present,
and by limiting smoking in public places and at public meetings to designated smoking areas.
History: 1975 c 211 s 2; 1987 c 399 s 1

144.413 DEFINITIONS.
    Subdivision 1. Scope. As used in sections 144.411 to 144.416, the terms defined in this
section have the meanings given them.
    Subd. 2. Public place. "Public place" means any enclosed, indoor area used by the general
public or serving as a place of work, including, but not limited to, restaurants, retail stores, offices
and other commercial establishments, public conveyances, educational facilities other than public
schools, as defined in section 120A.05, subdivisions 9, 11, and 13, hospitals, nursing homes,
auditoriums, arenas, meeting rooms, and common areas of rental apartment buildings, but
excluding private, enclosed offices occupied exclusively by smokers even though such offices
may be visited by nonsmokers.
    Subd. 3. Public meeting. "Public meeting" includes all meetings open to the public pursuant
to section 13D.01.
    Subd. 4. Smoking. "Smoking" includes carrying a lighted cigar, cigarette, pipe, or any
other lighted smoking equipment.
History: 1975 c 211 s 3; 1992 c 576 s 1; 1994 c 520 s 1; 1998 c 397 art 11 s 3; 1999 c
245 art 2 s 24

144.414 PROHIBITIONS.
    Subdivision 1. Public places. No person shall smoke in a public place or at a public meeting
except in designated smoking areas. This prohibition does not apply in cases in which an entire
room or hall is used for a private social function and seating arrangements are under the control of
the sponsor of the function and not of the proprietor or person in charge of the place. Furthermore,
this prohibition shall not apply to places of work not usually frequented by the general public,
except that the state commissioner of health shall establish rules to restrict or prohibit smoking
in factories, warehouses, and those places of work where the close proximity of workers or
the inadequacy of ventilation causes smoke pollution detrimental to the health and comfort of
nonsmoking employees.
    Subd. 2. Day care premises. Smoking is prohibited in a day care center licensed under
Minnesota Rules, parts 9503.0005 to 9503.0175, or in a family home or in a group family day
care provider home licensed under Minnesota Rules, parts 9502.0300 to 9502.0445, during
its hours of operation.
    Subd. 3. Health care facilities and clinics. (a) Smoking is prohibited in any area of a
hospital, health care clinic, doctor's office, or other health care-related facility, other than a nursing
home, boarding care facility, or licensed residential facility, except as allowed in this subdivision.
(b) Smoking by participants in peer reviewed scientific studies related to the health effects
of smoking may be allowed in a separated room ventilated at a rate of 60 cubic feet per minute
per person pursuant to a policy that is approved by the commissioner and is established by the
administrator of the program to minimize exposure of nonsmokers to smoke.
History: 1975 c 211 s 4; 1977 c 305 s 45; 1984 c 654 art 2 s 113; 1987 c 399 s 2; 1992 c 576
s 2; 1993 c 14 s 1; 1995 c 165 s 2; 1999 c 245 art 2 s 25; 1Sp2003 c 14 art 7 s 41

144.415 DESIGNATION OF SMOKING AREAS.
Smoking areas may be designated by proprietors or other persons in charge of public places,
except in places in which smoking is prohibited by the fire marshal or by other law, ordinance or
rule.
Where smoking areas are designated, existing physical barriers and ventilation systems shall
be used to minimize the toxic effect of smoke in adjacent nonsmoking areas. In the case of public
places consisting of a single room, the provisions of this law shall be considered met if one side of
the room is reserved and posted as a no smoking area. No public place other than a bar shall be
designated as a smoking area in its entirety. If a bar is designated as a smoking area in its entirety,
this designation shall be posted conspicuously on all entrances normally used by the public.
History: 1975 c 211 s 5; 1985 c 248 s 70

144.416 RESPONSIBILITIES OF PROPRIETORS.
The proprietor or other person in charge of a public place shall make reasonable efforts to
prevent smoking in the public place by
(a) posting appropriate signs;
(b) arranging seating to provide a smoke-free area;
(c) asking smokers to refrain from smoking upon request of a client or employee suffering
discomfort from the smoke; or
(d) any other means which may be appropriate.
History: 1975 c 211 s 6

144.4165 TOBACCO PRODUCTS PROHIBITED IN PUBLIC SCHOOLS.
No person shall at any time smoke, chew, or otherwise ingest tobacco or a tobacco product
in a public school, as defined in section 120A.05, subdivisions 9, 11, and 13. This prohibition
extends to all facilities, whether owned, rented, or leased, and all vehicles that a school district
owns, leases, rents, contracts for, or controls. Nothing in this section shall prohibit the lighting of
tobacco by an adult as a part of a traditional Indian spiritual or cultural ceremony. For purposes
of this section, an Indian is a person who is a member of an Indian tribe as defined in section
260.755 subdivision 12.
History: 1992 c 576 s 3; 1993 c 224 art 9 s 42; 1996 c 412 art 13 s 30; 1998 c 397 art 11 s
3; 1999 c 139 art 4 s 2; 1999 c 245 art 2 s 26

144.417 COMMISSIONER OF HEALTH, ENFORCEMENT, PENALTIES.
    Subdivision 1. Rules. (a) The state commissioner of health shall adopt rules necessary
and reasonable to implement the provisions of sections 144.411 to 144.417, except as provided
for in section 144.414.
(b) Rules implementing sections 144.411 to 144.417 adopted after January 1, 2002, may
not take effect until approved by a law enacted after January 1, 2002. This paragraph does not
apply to a rule or severable portion of a rule governing smoking in office buildings, factories,
warehouses, or similar places of work, or in health care facilities. This paragraph does not apply
to a rule changing the definition of "restaurant" to make it the same as the definition in section
157.15, subdivision 12.
    Subd. 2. Penalties. Any person who violates section 144.414 or 144.4165 is guilty of a
petty misdemeanor.
    Subd. 3. Injunction. The state commissioner of health, a board of health as defined in
section 145A.02, subdivision 2, or any affected party may institute an action in any court with
jurisdiction to enjoin repeated violations of section 144.416 or 144.4165.
History: 1975 c 211 s 7; 1977 c 305 s 45; 1985 c 248 s 70; 1986 c 444; 1987 c 309 s 24;
1992 c 576 s 4,5; 1995 c 165 s 3; 2002 c 375 art 3 s 7

HEALTH THREAT PROCEDURES

144.4171 SCOPE.
    Subdivision 1. Authority. Under the powers and duties assigned to the commissioner in
sections 144.05 and 144.12, the commissioner shall proceed according to sections 144.4171
to 144.4186 with respect to persons who pose a health threat to others or who engage in
noncompliant behavior.
    Subd. 2. Preemption. Sections 144.4171 to 144.4186 preempt and supersede any local
ordinance or rule concerning persons who pose a health threat to others or who engage in
noncompliant behavior.
History: 1987 c 209 s 4

144.4172 DEFINITIONS.
    Subdivision 1. Carrier. "Carrier" means a person who serves as a potential source of
infection and who harbors or who the commissioner reasonably believes to be harboring a specific
infectious agent whether or not there is present discernible clinical disease. In the absence of a
medically accepted test, the commissioner may reasonably believe an individual to be a carrier
only when a determination based upon specific facts justifies an inference that the individual
harbors a specific infectious agent.
    Subd. 2. Communicable disease. "Communicable disease" means a disease or condition
that causes serious illness, serious disability, or death, the infectious agent of which may pass or
be carried, directly or indirectly, from the body of one person to the body of another.
    Subd. 3. Commissioner. "Commissioner" means the commissioner of health.
    Subd. 4. Contact notification program. "Contact notification program" means an ongoing
program established by the commissioner to encourage carriers of a communicable disease
whose primary route of transmission is through an exchange of blood, semen, or vaginal
secretions, such as treponema pallidum, neisseria gonorrhea, chlamydia trachomatis, and human
immunodeficiency virus, to identify others who may be at risk by virtue of contact with the carrier.
    Subd. 5. Directly transmitted. "Directly transmitted" means predominately:
(1) sexually transmitted;
(2) bloodborne; or
(3) transmitted through direct or intimate skin contact.
    Subd. 6. Health directive. "Health directive" means a written statement, or, in urgent
circumstances, an oral statement followed by a written statement within three days, from the
commissioner, or board of health as defined in section 145A.02, subdivision 2, with delegated
authority from the commissioner, issued to a carrier who constitutes a health threat to others.
A health directive must be individual, specific, and cannot be issued to a class of persons.
The directive may require a carrier to cooperate with health authorities in efforts to prevent or
control transmission of communicable disease, including participation in education, counseling,
or treatment programs, and undergoing medical tests necessary to verify the person's carrier
status. The written directive shall be served in the same manner as a summons and complaint
under the Minnesota Rules of Civil Procedure.
    Subd. 7. Licensed health professional. "Licensed health professional" means a person
licensed in Minnesota to practice those professions described in section 214.01, subdivision 2.
    Subd. 8. Health threat to others. "Health threat to others" means that a carrier demonstrates
an inability or unwillingness to act in such a manner as to not place others at risk of exposure
to infection that causes serious illness, serious disability, or death. It includes one or more of
the following:
(1) with respect to an indirectly transmitted communicable disease:
(a) behavior by a carrier which has been demonstrated epidemiologically to transmit or
which evidences a careless disregard for the transmission of the disease to others; or
(b) a substantial likelihood that a carrier will transmit a communicable disease to others as is
evidenced by a carrier's past behavior, or by statements of a carrier that are credible indicators of
a carrier's intention.
(2) With respect to a directly transmitted communicable disease:
(a) repeated behavior by a carrier which has been demonstrated epidemiologically to transmit
or which evidences a careless disregard for the transmission of the disease to others;
(b) a substantial likelihood that a carrier will repeatedly transmit a communicable disease to
others as is evidenced by a carrier's past behavior, or by statements of a carrier that are credible
indicators of a carrier's intention;
(c) affirmative misrepresentation by a carrier of the carrier's status prior to engaging in any
behavior which has been demonstrated epidemiologically to transmit the disease; or
(d) the activities referenced in clause (1) if the person whom the carrier places at risk is:
(i) a minor, (ii) of diminished capacity by reason of mood altering chemicals, including alcohol,
(iii) has been diagnosed as having significantly subaverage intellectual functioning, (iv) has an
organic disorder of the brain or a psychiatric disorder of thought, mood, perception, orientation,
or memory which substantially impairs judgment, behavior, reasoning, or understanding; (v)
adjudicated as an incompetent; or (vi) a vulnerable adult as defined in section 626.5572.
(3) Violation by a carrier of any part of a court order issued pursuant to this chapter.
    Subd. 9. Indirectly transmitted. "Indirectly transmitted" means any transmission not
defined by subdivision 5.
    Subd. 10. Noncompliant behavior. "Noncompliant behavior" means a failure or refusal by
a carrier to comply with a health directive.
    Subd. 11. Respondent. "Respondent" means any person against whom an action is
commenced under sections 144.4171 to 144.4186.
History: 1986 c 444; 1987 c 209 s 5; 1987 c 309 s 24; 1995 c 229 art 4 s 4

144.4173 CAUSE OF ACTION.
    Subdivision 1. Compliance with directive. Failure or refusal of a carrier to comply with a
health directive is grounds for proceeding under subdivision 2.
    Subd. 2. Commencement of action. The commissioner, or a board of health as defined in
section 145A.02, subdivision 2, with express delegated authority from the commissioner, may
commence legal action against a carrier who is a health threat to others and, unless a court order is
sought under section 144.4182, who engages in noncompliant behavior, by filing with the district
court in the county in which respondent resides, and serving upon respondent, a petition for
relief and notice of hearing.
History: 1987 c 209 s 6; 1987 c 309 s 24

144.4174 STANDING.
Only the commissioner, or a board of health as defined in section 145A.02, subdivision 2,
with express delegated authority from the commissioner, may commence an action under sections
144.4171 to 144.4186.
History: 1987 c 209 s 7; 1987 c 309 s 24

144.4175 REPORTING.
    Subdivision 1. Voluntary reporting. Any licensed health professional or other human
services professional regulated by the state who has knowledge or reasonable cause to believe that
a person is a health threat to others or has engaged in noncompliant behavior, as defined in section
144.4172, may report that information to the commissioner.
    Subd. 2. Liability for reporting. A licensed health professional or other human services
professional regulated by the state who has knowledge or reasonable cause to believe that a
person is a health threat to others or has engaged in noncompliant behavior, and who makes a
report in good faith under subdivision 1, is not subject to liability for reporting in any civil,
administrative, disciplinary, or criminal action.
    Subd. 3. Falsified reports. Any person who knowingly or recklessly makes a false report
under the provisions of this section shall be liable in a civil suit for any actual damages suffered
by the person or persons so reported and for any punitive damages set by the court or jury.
    Subd. 4. Waiver of privilege. Any privilege otherwise created in section 595.02, clauses
(d), (e), (g), and (j), with respect to persons who make a report under subdivision 1, is waived
regarding any information about a carrier as a health threat to others or about a carrier's
noncompliant behavior in any investigation or action under sections 144.4171 to 144.4186.
History: 1987 c 209 s 8

144.4176 PETITION; NOTICE.
    Subdivision 1. Petition. The petition must set forth the following:
(1) the grounds and underlying facts that demonstrate that the respondent is a health threat
to others and, unless an emergency court order is sought under section 144.4182, has engaged
in noncompliant behavior;
(2) the petitioner's efforts to alleviate the health threat to others prior to the issuance of a
health directive, unless an emergency court order is sought under section 144.4182;
(3) the petitioner's efforts to issue the health directive to the respondent in person, unless
an emergency court order is sought under section 144.4182;
(4) the type of relief sought; and
(5) a request for a court hearing on the allegations contained in the petition.
    Subd. 2. Hearing notice. The notice must contain the following information:
(1) the time, date, and place of the hearing;
(2) respondent's right to appear at the hearing;
(3) respondent's right to present and cross-examine witnesses; and
(4) respondent's right to counsel, including the right, if indigent, to representation by counsel
designated by the court or county of venue.
History: 1987 c 209 s 9

144.4177 TIME OF HEARING AND DUTIES OF COUNSEL.
    Subdivision 1. Time of hearing. A hearing on the petition must be held before the district
court in the county in which respondent resides as soon as possible, but no later than 14 days
from service of the petition and hearing notice.
    Subd. 2. Duties of counsel. In all proceedings under this section, counsel for the respondent
shall (1) consult with the person prior to any hearing; (2) be given adequate time to prepare for
all hearings; (3) continue to represent the person throughout any proceedings under this charge
unless released as counsel by the court; and (4) be a vigorous advocate on behalf of the client.
History: 1987 c 209 s 10

144.4178 CRIMINAL IMMUNITY.
In accordance with section 609.09, subdivision 2, no person shall be excused in an action
under sections 144.4171 to 144.4186 from giving testimony or producing any documents, books,
records, or correspondence, tending to be self-incriminating; but the testimony or evidence, or
other testimony or evidence derived from it, must not be used against the person in any criminal
case, except for perjury committed in the testimony.
History: 1987 c 209 s 11

144.4179 STANDARD OF PROOF; EVIDENCE.
    Subdivision 1. Clear and convincing. The commissioner must prove the allegations in
the petition by clear and convincing evidence.
    Subd. 2. All relevant evidence. The court shall admit all reliable relevant evidence. Medical
and epidemiologic data must be admitted if it otherwise comports with section 145.30, chapter
600, Minnesota Rules of Evidence 803(6), or other statutes or rules that permit reliable evidence
to be admitted in civil cases.
    Subd. 3. Carrier status. Upon a finding by the court that the commissioner's suspicion of
carrier status is reasonable as established by presentation of facts justifying an inference that the
respondent harbors a specific infectious agent, there shall exist a rebuttable presumption that
the respondent is a carrier. This presumption may be rebutted if the respondent demonstrates
noncarrier status after undergoing medically accepted tests.
    Subd. 4. Failure to appear. If a party fails to appear at the hearing without prior court
approval, the hearing may proceed without the absent party and the court may make its
determination on the basis of all reliable evidence submitted at the hearing.
    Subd. 5. Records. The court shall take and preserve an accurate stenographic record of
the proceedings.
History: 1987 c 209 s 12

144.4180 REMEDIES.
    Subdivision 1. Remedies available. Upon a finding by the court that the commissioner has
proven the allegations set forth in the petition, the court may order that the respondent must:
(1) participate in a designated education program;
(2) participate in a designated counseling program;
(3) participate in a designated treatment program;
(4) undergo medically accepted tests to verify carrier status or for diagnosis, or undergo
treatment that is consistent with standard medical practice as necessary to make respondent
noninfectious;
(5) notify or appear before designated health officials for verification of status, testing, or
other purposes consistent with monitoring;
(6) cease and desist the conduct which constitutes a health threat to others;
(7) live part time or full time in a supervised setting for the period and under the conditions
set by the court;
(8) subject to the provisions of subdivision 2, be committed to an appropriate institutional
facility for the period and under the conditions set by the court, but not longer than six months,
until the respondent is made noninfectious, or until the respondent completes a course of treatment
prescribed by the court, whichever occurs first, unless the commissioner shows good cause for
continued commitment; and
(9) comply with any combination of the remedies in clauses (1) to (8), or other remedies
considered just by the court. In no case may a respondent be committed to a correctional facility.
    Subd. 2. Commitment review panel. The court may not order the remedy specified in
subdivision 1, clause (8), unless it first considers the recommendation of a commitment review
panel appointed by the commissioner to review the need for commitment of the respondent
to an institutional facility.
The duties of the commitment review panel shall be to:
(1) review the record of the proceeding;
(2) interview the respondent. If the respondent is not interviewed, the reasons must be
documented; and
(3) identify, explore, and list the reasons for rejecting or recommending alternatives to
commitment.
    Subd. 3. Construction. This section shall be construed so that the least restrictive alternative
is used to achieve the desired purpose of preventing or controlling communicable disease.
    Subd. 4. Additional requirements. If commitment or supervised living is ordered, the
court shall require the head of the institutional facility or the person in charge of supervision to
submit: (a) a plan of treatment within ten days of initiation of commitment or supervised living;
and (b) a written report, with a copy to both the commissioner and the respondent, at least 60
days, but not more than 90 days, from the start of respondent's commitment or supervised living
arrangement, setting forth the following:
(1) the types of support or therapy groups, if any, respondent is attending and how often
respondent attends;
(2) the type of care or treatment respondent is receiving, and what future care or treatment is
necessary;
(3) whether respondent has been cured or made noninfectious, or otherwise no longer poses
a threat to public health;
(4) whether continued commitment or supervised living is necessary; and
(5) other information the court considers necessary.
History: 1987 c 209 s 13

144.4181 APPEAL.
The petitioner or respondent may appeal the decision of the district court. The Court of
Appeals shall hear the appeal within 30 days after service of the notice of appeal. However,
respondent's status as determined by the district court remains unchanged, and any remedy
ordered by the district court remains in effect while the appeal is pending.
History: 1987 c 209 s 14

144.4182 TEMPORARY EMERGENCY HOLD.
    Subdivision 1. Apprehend and hold. To protect the public health in an emergency, the
court may order an agent of a board of health as authorized under section 145A.04 or peace
officer to take a person into custody and transport the person to an appropriate emergency care
or treatment facility for observation, examination, testing, diagnosis, care, treatment, and, if
necessary, temporary detention. If the person is already institutionalized, the court may order the
institutional facility to hold the person. These orders may be issued in an ex parte proceeding
upon an affidavit of the commissioner or a designee of the commissioner. An order shall issue
upon a determination by the court that reasonable cause exists to believe that the person is: (a) for
indirectly transmitted diseases, an imminent health threat to others; or (b) for directly transmitted
diseases, a substantial likelihood of an imminent health threat to others.
The affidavit must set forth the specific facts upon which the order is sought and must be
served on the person immediately upon apprehension or detention. An order under this section
may be executed on any day and at any time.
    Subd. 2. Duration of hold. No person may be held under subdivision 1 longer than 72 hours,
exclusive of Saturdays, Sundays, and legal holidays, without a court hearing to determine if the
emergency hold should continue.
History: 1987 c 209 s 15; 1987 c 309 s 24

144.4183 EMERGENCY HOLD HEARING.
    Subdivision 1. Time of notice. Notice of the emergency hold hearing must be served upon
the person held under section 144.4182, subdivision 1, at least 24 hours before the hearing.
    Subd. 2. Contents of notice. The notice must contain the following information:
(1) the time, date, and place of the hearing;
(2) the grounds and underlying facts upon which continued detention is sought;
(3) the person's right to appear at the hearing;
(4) the person's right to present and cross-examine witnesses; and
(5) the person's right to counsel, including the right, if indigent, to representation by counsel
designated by the court or county of venue.
    Subd. 3. Order for continued emergency hold. The court may order the continued holding
of the person if it finds, by a preponderance of the evidence, that the person would pose an
imminent health threat to others if released. However, in no case may the emergency hold
continue longer than five days, unless a petition is filed under section 144.4173. If a petition is
filed, the emergency hold must continue until a hearing on the petition is held under section
144.4177. That hearing must occur within five days of the filing of the petition, exclusive of
Saturdays, Sundays, and legal holidays.
History: 1987 c 209 s 16

144.4184 CONTACT DATA.
Identifying information voluntarily given to the commissioner, or an agent of the
commissioner, by a carrier through a contact notification program must not be used as evidence in
a court proceeding to determine noncompliant behavior.
History: 1987 c 209 s 17

144.4185 COSTS.
    Subdivision 1. Costs of care. The court shall determine what part of the cost of care or
treatment ordered by the court, if any, the respondent can pay. The respondent shall provide the
court documents and other information necessary to determine financial ability. If the respondent
cannot pay the full cost of care, the rest must be paid by the county in which respondent resides. If
the respondent provides inaccurate or misleading information, or later becomes able to pay the
full cost of care, the respondent becomes liable to the county for costs paid by the county.
    Subd. 2. Court-appointed counsel. If the court appoints counsel to represent respondent
free of charge, counsel must be compensated by the county in which respondent resides, except to
the extent that the court finds that the respondent is financially able to pay for counsel's services.
In these situations, the rate of compensation for counsel shall be determined by the court.
    Subd. 3. Report. The commissioner shall report any recommendations for appropriate
changes in the modes of financing of services provided under subdivision 1 by January 15, 1988.
History: 1987 c 209 s 18

144.4186 DATA PRIVACY.
    Subdivision 1. Nonpublic data. Data contained in a health directive are classified as
protected nonpublic data under section 13.02, subdivision 13, in the case of data not on
individuals, and private under section 13.02, subdivision 12, in the case of data on individuals.
Investigative data shall have the classification accorded it under section 13.39.
    Subd. 2. Protective order. Once an action is commenced, any party may seek a protective
order to protect the disclosure of portions of the court record identifying individuals or entities.
    Subd. 3. Records retention. A records retention schedule for records developed under
sections 144.4171 to 144.4186 shall be established pursuant to section 138.17, subdivision 7.
History: 1987 c 209 s 19

ISOLATION AND QUARANTINE

144.419 ISOLATION AND QUARANTINE OF PERSONS.
    Subdivision 1. Definitions. For purposes of sections 144.419 to 144.4196, the following
definitions apply:
(1) "bioterrorism" means the intentional use of any microorganism, virus, infectious
substance, or biological product that may be engineered as a result of biotechnology, or any
naturally occurring or bioengineered component of any such microorganism, virus, infectious
substance, or biological product, to cause death, disease, or other biological malfunction in a
human, an animal, a plant, or another living organism in order to influence the conduct of
government or to intimidate or coerce a civilian population;
(2) "communicable disease" means a disease caused by a living organism or virus and
believed to be caused by bioterrorism or a new or novel or previously controlled or eradicated
infectious agent or biological toxin that can be transmitted person to person and for which
isolation or quarantine is an effective control strategy, excluding a disease that is directly
transmitted as defined under section 144.4172, subdivision 5;
(3) "isolation" means separation, during the period of communicability, of a person infected
with a communicable disease, in a place and under conditions so as to prevent direct or indirect
transmission of an infectious agent to others; and
(4) "quarantine" means restriction, during a period of communicability, of activities or travel
of an otherwise healthy person who likely has been exposed to a communicable disease to prevent
disease transmission during the period of communicability in the event the person is infected.
    Subd. 2. General requirements. (a) The commissioner of health or any person acting
under the commissioner's authority shall comply with paragraphs (b) to (h) when isolating or
quarantining individuals or groups of individuals.
(b) Isolation and quarantine must be by the least restrictive means necessary to prevent the
spread of a communicable or potentially communicable disease to others and may include, but are
not limited to, confinement to private homes or other private or public premises.
(c) Isolated individuals must be confined separately from quarantined individuals.
(d) The health status of isolated and quarantined individuals must be monitored regularly to
determine if they require continued isolation or quarantine. To adequately address emergency
health situations, isolated and quarantined individuals shall be given a reliable means to
communicate 24 hours a day with health officials and to summon emergency health services.
(e) If a quarantined individual subsequently becomes infectious or is reasonably believed to
have become infectious with a communicable or potentially communicable disease, the individual
must be isolated according to section 144.4195.
(f) Isolated and quarantined individuals must be immediately released when they pose no
known risk of transmitting a communicable or potentially communicable disease to others.
(g) The needs of persons isolated and quarantined shall be addressed in a systematic and
competent fashion, including, but not limited to, providing adequate food, clothing, shelter, means
of communication between those in isolation or quarantine and those outside these settings,
medication, and competent medical care.
(h) Premises used for isolation and quarantine shall be maintained in a safe and hygienic
manner and be designed to minimize the likelihood of further transmission of infection or other
harms to persons isolated and quarantined.
    Subd. 3. Termination. The isolation or quarantine of a person must terminate automatically
on the expiration date of a court order authorizing isolation or quarantine that is issued according
to section 144.4195, or before the expiration date if the commissioner of health determines that
isolation or quarantine of the person is no longer necessary to protect the public.
    Subd. 4. Right to refuse treatment. Any person who is isolated or quarantined according
to this section and section 144.4195 has a fundamental right to refuse medical treatment,
testing, physical or mental examination, vaccination, participation in experimental procedures
and protocols, collection of specimens, and preventive treatment programs. A person who has
been directed by the commissioner of health or any person acting under the commissioner's
authority to submit to medical procedures and protocols because the person is infected with or
reasonably believed by the commissioner or by the person acting under the commissioner's
authority to be infected with or exposed to a communicable disease and who refuses to submit
to them may be subject to continued isolation or quarantine according to the parameters set
forth in section 144.4195.
    Subd. 5. Restricted entry. (a) No person, other than a person authorized by the commissioner
of health or authorized by any person acting under the commissioner's authority, shall enter an
isolation or quarantine area. If, by reason of an unauthorized entry into an isolation or quarantine
area, a person poses a danger to public health, the person may be subject to isolation or quarantine
according to this section and section 144.4195.
(b) A family member of a person isolated or quarantined has a right to choose to enter into
an isolation or quarantine area. The commissioner of health must permit the family member
entry into the isolation or quarantine area if the family member signs a consent form stating that
the family member has been informed of the potential health risks, isolation and quarantine
guidelines, and the consequences of entering the area. The family member may not hold the
Department of Health, the commissioner of health, or the state responsible for any consequences
of entering the isolation or quarantine area. If, by reason of entry into an isolation or quarantine
area under this paragraph, a person poses a danger to public health, the person may be subject to
isolation or quarantine according to this section and section 144.4195.
History: 2002 c 402 s 18; 2005 c 149 s 1

144.4195 DUE PROCESS FOR ISOLATION OR QUARANTINE OF PERSONS.
    Subdivision 1. Ex parte order for isolation or quarantine. (a) Before isolating or
quarantining a person or group of persons, the commissioner of health shall obtain a written, ex
parte order authorizing the isolation or quarantine from the District Court of Ramsey County, the
county where the person or group of persons is located, or a county adjoining the county where
the person or group of persons is located. The evidence or testimony in support of an application
may be made or taken by telephone, facsimile transmission, video equipment, or other electronic
communication. The court shall grant the order upon a finding that probable cause exists to
believe isolation or quarantine is warranted to protect the public health.
(b) The order must state the specific facts justifying isolation or quarantine, must state that
the person being isolated or quarantined has a right to a court hearing under this section and a
right to be represented by counsel during any proceeding under this section, and must be provided
immediately to each person isolated or quarantined. The commissioner of health shall provide a
copy of the authorizing order to the commissioner of public safety and other peace officers known
to the commissioner to have jurisdiction over the site of the isolation or quarantine. If feasible, the
commissioner of health shall give each person being isolated or quarantined an estimate of the
expected period of the person's isolation or quarantine.
(c) If it is impracticable to provide individual orders to a group of persons isolated or
quarantined, one order shall suffice to isolate or quarantine a group of persons believed to have
been commonly infected with or exposed to a communicable disease. A copy of the order and
notice shall be posted in a conspicuous place:
(1) in the isolation or quarantine premises, but only if the persons to be isolated or
quarantined are already at the isolation or quarantine premises and have adequate access to
the order posted there; or
(2) in another location where the group of persons to be isolated or quarantined is located,
such that the persons have adequate access to the order posted there.
If the court determines that posting the order according to clause (1) or (2) is impractical due to
the number of persons to be isolated or quarantined or the geographical area affected, the court
must use the best means available to ensure that the affected persons are fully informed of the
order and notice.
(d) Any peace officer, as defined in section 144.4803, subdivision 16, may use force as
described by sections 609.06 and 609.066 to apprehend, hold, transport, quarantine, or isolate a
person subject to the order if the person flees or forcibly resists the officer. This subdivision is
authority to carry out enforcement duties under this section. The commissioner or an agent of a
local board of health authorized under section 145A.04 shall advise the peace officer on request
of protective measures recommended to protect the officer from possible transmission of the
communicable disease. The peace officer may act upon telephone, facsimile, or other electronic
notification of the order from the court, commissioner of health, agent of a local board of health,
or commissioner of public safety. This paragraph expires August 1, 2009.
(e) No person may be isolated or quarantined pursuant to an order issued under this
subdivision for longer than 21 days without a court hearing under subdivision 3 to determine
whether isolation or quarantine should continue. A person who is isolated or quarantined may
request a court hearing under subdivision 3 at any time before the expiration of the order.
    Subd. 2. Temporary hold upon commissioner's directive. (a) Notwithstanding subdivision
1, the commissioner of health may by directive isolate or quarantine a person or group of
persons without first obtaining a written, ex parte order from the court if a delay in isolating or
quarantining the person or group of persons would significantly jeopardize the commissioner
of health's ability to prevent or limit the transmission of a communicable or potentially
communicable life-threatening disease to others. The directive shall specify the known period of
incubation or communicability or the estimated period under the commissioner's best medical
judgment when the disease is unknown. The directive remains in effect for the period specified
unless amended by the commissioner or superseded by a court order. The commissioner must
provide the person or group of persons subject to the temporary hold with notice that the person
has a right to request a court hearing under this section and a right to be represented by counsel
during a proceeding under this section. If it is impracticable to provide individual notice to each
person subject to the temporary hold, notice of these rights may be posted in the same manner as
the posting of orders under subdivision 1, paragraph (c). Immediately upon executing the directive
and initiating notice of the parties subject to it, the commissioner shall initiate the process to apply
for a written, ex parte order pursuant to subdivision 1 authorizing the isolation or quarantine. The
court must rule within 24 hours of receipt of the application or sooner if practicable or necessary.
If the person is under a temporary hold, the person may not be held in isolation or quarantine after
the temporary hold expires unless the court issues an ex parte order under subdivision 1. If the
court does not rule within 36 hours after the execution of the directive, the directive shall expire.
(b) At the same time the commissioner initiates the process to apply for a written, ex parte
order under paragraph (a), the commissioner shall notify the governor, the majority and minority
leaders of the senate, the speaker and majority and minority leaders of the house, and the chairs
and the ranking minority members of the senate and house committees having jurisdiction over
health policy that a directive for a temporary hold has been issued under this subdivision. Notice
under this paragraph is governed by the data privacy provisions of subdivision 6.
(c) Any peace officer, as defined in section 144.4803, subdivision 16, may assist a public
health official to apprehend, hold, transport, quarantine, or isolate a person subject to the
commissioner's directive. The peace officer may use force as described by sections 609.06 and
609.066. The commissioner or an agent of a local board of health authorized under section
145A.04 shall advise the peace officer on request of protective measures recommended to protect
the officer from possible transmission of the communicable disease. The peace officer may act
upon telephone, facsimile, or other electronic notification of the commissioner's directive or upon
the request of an agent of a local board of health.
(d) If a person subject to a commissioner's directive under paragraph (a) is already
institutionalized in an appropriate health care facility, the commissioner of health may direct the
facility to continue to hold the person. The facility shall take all reasonable measures to prevent
the person from exposing others to the communicable disease.
(e) This subdivision expires August 1, 2009.
    Subd. 3. Court hearing. (a) A person isolated or quarantined under an order issued pursuant
to subdivision 1 or a temporary hold under subdivision 2 or the person's representative may
petition the court to contest the court order or temporary hold at any time prior to the expiration
of the order or temporary hold. If a petition is filed, the court must hold a hearing within 72
hours from the date of the filing. A petition for a hearing does not stay the order of isolation
or quarantine. At the hearing, the commissioner of health must show by clear and convincing
evidence that the isolation or quarantine is warranted to protect the public health.
(b) If the commissioner of health wishes to extend the order for isolation or quarantine past
the period of time stated in subdivision 1, paragraph (d), the commissioner must petition the court
to do so. Notice of the hearing must be served upon the person or persons who are being isolated
or quarantined at least three days before the hearing. If it is impracticable to provide individual
notice to large groups who are isolated or quarantined, a copy of the notice may be posted in the
same manner as described under subdivision 1, paragraph (c).
(c) The notice must contain the following information:
(1) the time, date, and place of the hearing;
(2) the grounds and underlying facts upon which continued isolation or quarantine is sought;
(3) the person's right to appear at the hearing; and
(4) the person's right to counsel, including the right, if indigent, to be represented by counsel
designated by the court or county of venue.
(d) The court may order the continued isolation or quarantine of the person or group of
persons if it finds by clear and convincing evidence that the person or persons would pose an
imminent health threat to others if isolation or quarantine was lifted. In no case may the isolation
or quarantine continue longer than 30 days from the date of the court order issued under this
subdivision unless the commissioner petitions the court for an extension. Any hearing to extend
an order is governed by this subdivision.
    Subd. 4. Hearing on conditions of isolation or quarantine. A person isolated or
quarantined may request a hearing in district court for remedies regarding the treatment during
and the terms and conditions of isolation or quarantine. Upon receiving a request for a hearing
under this subdivision, the court shall fix a date for a hearing that is within seven days of the
receipt of the request by the court. The request for a hearing does not alter the order for isolation or
quarantine. If the court finds that the isolation or quarantine of the individual is not in compliance
with section 144.419, the court may fashion remedies appropriate to the circumstances of the
emergency and in keeping with this chapter.
    Subd. 5. Judicial procedures and decisions. (a) Court orders issued pursuant to subdivision
3 or 4 shall be based upon clear and convincing evidence and a written record of the disposition of
the case shall be made and retained.
(b) Any person subject to isolation or quarantine has the right to be represented by counsel.
Persons not otherwise represented may request the court to appoint counsel at the expense of the
Department of Health or of a local public health board that has entered into a written delegation
agreement with the commissioner under subdivision 7. The court shall appoint counsel when
so requested and may have one counsel represent a group of persons similarly situated. The
appointments shall be only for representation under subdivisions 3 and 4 and for appeals of
orders under subdivisions 3 and 4. On counsel's request, the commissioner or an agent of a local
board of health authorized under section 145A.04 shall advise counsel of protective measures
recommended to protect counsel from possible transmission of the communicable disease.
Appointments shall be made and counsel compensated according to procedures developed by the
Supreme Court. The procedures shall provide standards for determining indigency for purposes
of appeal. A person seeking an appeal who does not meet the indigency standard may, upon
motion by the commissioner of health or local public health board and subsequent court order,
reimburse the Department of Health or local public health board for the attorney fees and costs
incurred in the person's appeal. Counsel appointed for a respondent must be allowed to withdraw
from representation and is not required to pursue an appeal if, in the opinion of counsel, there
is insufficient basis for proceeding.
(c) The court may choose to conduct a hearing under subdivision 3 or 4 by telephonic,
interactive video, or other electronic means to maintain isolation or quarantine precautions and
reduce the risk of spread of a communicable disease. Otherwise, the manner in which the request
for a hearing is filed and acted upon shall be in accordance with the existing laws and rules
of the courts of this state or, if the isolation or quarantine occurs during a national security or
peacetime emergency, any rules that are developed by the courts for use during a national
security or peacetime emergency.
    Subd. 6. Data privacy. Data on individuals contained in the commissioner's directive under
subdivision 2 are health data under section 13.3805, subdivision 1.
    Subd. 7. Delegation. The commissioner may delegate any authority prescribed in subdivision
1 or 3 to the local public health board, according to chapter 145A.
History: 2002 c 402 s 19; 2005 c 149 s 2-4

144.4196 EMPLOYEE PROTECTION.
    Subdivision 1. Definitions. For purposes of this section:
(1) "qualifying employee" means a person who performs services for hire in Minnesota and
who has been subject to isolation or quarantine for a communicable disease as defined in section
144.419, subdivision 1, clause (2). The term applies to persons who comply with isolation or
quarantine restrictions because of:
(i) a commissioner's directive;
(ii) an order of a federal quarantine officer;
(iii) a state or federal court order; or
(iv) a written recommendation of the commissioner or designee that the person enter
isolation or quarantine; and
(2) "employer" means any person having one or more employees in Minnesota and includes
the state and any political subdivision of the state.
    Subd. 2. Protections. (a) An employer shall not discharge, discipline, threaten, or penalize
a qualifying employee, or otherwise discriminate in the work terms, conditions, location, or
privileges of the employee, because the employee has been in isolation or quarantine.
(b) A qualifying employee claiming a violation of paragraph (a) may bring a civil action
for recovery of lost wages or benefits, for reinstatement, or for other relief within 180 days of
the claimed violation or 180 days of the end of the isolation or quarantine, whichever is later. A
qualifying employee who prevails shall be allowed reasonable attorney fees fixed by the court.
(c) Nothing in this subdivision is intended to alter sick leave or sick pay terms of the
employment relationship.
    Subd. 3. Limitations. The protections of subdivision 2 do not apply to work absences due to
isolation or quarantine for periods longer than 21 consecutive work days. However, absences due
to isolation or quarantine for periods longer than 21 consecutive work days resulting in loss of
employment shall be treated for purposes of unemployment compensation in the same manner as
loss of employment due to a serious illness.
History: 2005 c 149 s 5

144.4197 EMERGENCY VACCINE ADMINISTRATION; LEGEND DRUG.
(a) When a mayor, county board chair, or legal successor to such official has declared a
local emergency under section 12.29 or the governor has declared an emergency under section
12.31, subdivision 1 or 2, the commissioner of health may authorize any person, including, but
not limited to, any person licensed or otherwise credentialed under chapters 144E, 147 to 148,
150A, 151, 153, or 156, to administer vaccinations or dispense legend drugs if the commissioner
determines that such action is necessary to protect the health and safety of the public. The
authorization shall be in writing and shall contain the categories of persons included in the
authorization, any additional training required before performance of the vaccination or drug
dispensing by such persons, any supervision required for performance of the vaccination or drug
dispensing, and the duration of the authorization. The commissioner may, in writing, extend the
scope and duration of the authorization as the emergency warrants. Any person authorized by
the commissioner under this section shall not be subject to criminal liability, administrative
penalty, professional discipline, or other administrative sanction for good faith performance of the
vaccination or drug dispensing duties assigned according to this section.
(b) This section expires August 1, 2009.
History: 2005 c 149 s 6

TUBERCULOSIS

144.42 [Repealed, 1980 c 357 s 22]

144.421 [Repealed, 1980 c 357 s 22]

144.422 [Repealed, 1987 c 209 s 40]

144.423 [Repealed, 1951 c 314 s 8]

144.424 [Repealed, 1987 c 209 s 40]

144.425 [Repealed, 1987 c 209 s 40]

144.426 [Repealed, 1951 c 314 s 8]

144.427 [Repealed, 1980 c 357 s 22]

144.428 [Repealed, 1980 c 357 s 22]

144.429 [Repealed, 1980 c 357 s 22]

144.43 [Repealed, 1980 c 357 s 22]

144.44 [Renumbered 144.423]

144.441 TUBERCULOSIS SCREENING IN SCHOOLS.
    Subdivision 1. Definitions. As used in sections 144.441 to 144.444, the following terms have
the meanings given them:
(a) "Person employed by a school or school district" means a person employed by a school,
school district, or by a service cooperative as a member of the instructional, supervisory, or support
staff including, but not limited to, superintendents, principals, supervisors, teachers, librarians,
counselors, school psychologists, school nurses, school social workers, audiovisual directors or
coordinators, recreation personnel, media generalists or supervisors, speech therapists, athletic
coaches, teachers' aids, clerical workers, custodians, school bus drivers, and food service workers.
(b) "Person enrolled in a school" means a person enrolled in grades kindergarten through 12
and a disabled child receiving special instruction and services in a school.
(c) "School" includes any public elementary, middle, secondary, or vocational center school
as defined in section 120A.05, subdivisions 9, 11, 13, and 17, or nonpublic school, church, or
religious organization in which a child is provided instruction in compliance with sections
120A.22 and 120A.24.
    Subd. 2. Designation of schools. Based on the occurrence of active tuberculosis or evidence
of a higher than expected prevalence of tuberculosis infection in the population attending or
employed by one or more schools in a school district, the commissioner of health may designate
schools or a school district in which screening of some or all persons enrolled in or employed
by the school or school district for tuberculosis is a necessary public health measure. In making
the designation, the commissioner shall also determine the frequency with which proof of
screening must be submitted. In determining whether the population attending or employed by
a school or school district has a higher than expected prevalence of tuberculosis infection, the
commissioner shall consider factors such as race or ethnicity, age, and the geographic location
of residence of the student population; the expected background prevalence of tuberculosis
infection in the community; and currently accepted public health standards pertaining to the
control of tuberculosis.
    Subd. 3. Screening of students. As determined by the commissioner under subdivision 2, no
person may enroll or remain enrolled in any school which the commissioner has designated under
subdivision 2 until the person has submitted to the administrator or other person having general
control and supervision of the school, one of the following statements:
(1) a statement from a physician or public clinic stating that the person has had a negative
Mantoux test reaction within the past year, provided that the person has no symptoms suggestive
of tuberculosis or evidence of a new exposure to active tuberculosis;
(2) a statement from a physician or public clinic stating that a person who has a positive
Mantoux test reaction has had a negative chest roentgenogram (X-ray) for tuberculosis within the
past year, provided that the person has no symptoms suggestive of tuberculosis or evidence of a
new exposure to active tuberculosis;
(3) a statement from a physician or public health clinic stating that the person (i) has a
history of adequately treated active tuberculosis; (ii) is currently receiving tuberculosis preventive
therapy; (iii) is currently undergoing therapy for active tuberculosis and the person's presence in a
school building will not endanger the health of other people; or (iv) has completed a course of
tuberculosis preventive therapy or was intolerant to preventive therapy, provided the person has
no symptoms suggestive of tuberculosis or evidence of a new exposure to active tuberculosis; or
(4) a notarized statement signed by the minor child's parent or guardian or by the emancipated
person stating that the person has not submitted the proof of tuberculosis screening as required by
this subdivision because of the conscientiously held beliefs of the parent or guardian of the minor
child or of the emancipated person. This statement must be forwarded to the commissioner.
    Subd. 4. Screening of employees. As determined by the commissioner under subdivision 2,
a person employed by the designated school or school district shall submit to the administrator or
other person having general control and supervision of the school one of the following:
(1) a statement from a physician or public clinic stating that the person has had a negative
Mantoux test reaction within the past year, provided that the person has no symptoms suggestive
of tuberculosis or evidence of a new exposure to active tuberculosis;
(2) a statement from a physician or public clinic stating that a person who has a positive
Mantoux test reaction has had a negative chest roentgenogram (X-ray) for tuberculosis within the
past year, provided that the person has no symptoms suggestive of tuberculosis or evidence of a
new exposure to active tuberculosis;
(3) a statement from a physician or public health clinic stating that the person (i) has a
history of adequately treated active tuberculosis; (ii) is currently receiving tuberculosis preventive
therapy; (iii) is currently undergoing therapy for active tuberculosis and the person's presence in a
school building will not endanger the health of other people; or (iv) has completed a course of
preventive therapy or was intolerant to preventive therapy, provided the person has no symptoms
suggestive of tuberculosis or evidence of a new exposure to active tuberculosis; or
(4) a notarized statement signed by the person stating that the person has not submitted the
proof of tuberculosis screening as required by this subdivision because of conscientiously held
beliefs. This statement must be forwarded to the commissioner of health.
    Subd. 5. Exceptions. Subdivisions 3 and 4 do not apply to:
(1) a person with a history of either a past positive Mantoux test reaction or active
tuberculosis who has a documented history of completing a course of tuberculosis therapy or
preventive therapy when the school or school district holds a statement from a physician or public
health clinic indicating that such therapy was provided to the person and that the person has no
symptoms suggestive of tuberculosis or evidence of a new exposure to active tuberculosis; and
(2) a person with a history of a past positive Mantoux test reaction who has not completed a
course of preventive therapy. This determination shall be made by the commissioner based on
currently accepted public health standards and the person's health status.
    Subd. 6. Programs using school facilities. The commissioner may require the statements
described in subdivisions 3 and 4 to be submitted by participants or staff of a program or activity
that uses the facilities of a school or school district on a regular and ongoing basis, if the
commissioner has determined that tuberculosis screening is necessary.
    Subd. 7. Implementation. The administrator or other person having general control and
supervision of the school or school district designated by the commissioner under subdivision 2
shall take the measures that are necessary, including the exclusion of persons from the premises of
a school, to obtain the proof of screening required by subdivisions 3 and 4.
    Subd. 8. Access to records. The commissioner shall have access to any school or school
district records, including health records of persons enrolled in or employed by a school or school
district, that are needed to determine whether a tuberculosis screening program is necessary, or
to administer a screening program.
    Subd. 9. Reports. The administrator or other person having general control and supervision
of a school or school district that the commissioner has designated under subdivision 2 shall
provide the commissioner with any reports determined by the commissioner to be necessary
to implement a screening or control program or to evaluate the need for further tuberculosis
screening or control efforts in a school.
    Subd. 10. Waiver. The commissioner may waive any portion of the requirements of
subdivisions 3 to 9 if the commissioner determines that it is not necessary in order to protect
the public health.
History: 1993 c 167 s 2; 1996 c 305 a 1 s 138; 1998 c 397 art 11 s 3; 2005 c 56 s 1

144.442 TESTING IN SCHOOL CLINICS.
    Subdivision 1. Administration; notification. In the event that the commissioner designates
a school or school district under section 144.441, subdivision 2, the school or school district or
board of health may administer Mantoux screening tests to some or all persons enrolled in or
employed by the designated school or school district. Any Mantoux screening provided under
this section shall be under the direction of a licensed physician.
Prior to administering the Mantoux test to such persons, the school or school district or board
of health shall inform in writing such persons and parents or guardians of minor children to whom
the test may be administered, of the following:
(1) that there has been an occurrence of active tuberculosis or evidence of a higher than
expected prevalence of tuberculosis infection in that school or school district;
(2) that screening is necessary to avoid the spread of tuberculosis;
(3) the manner by which tuberculosis is transmitted;
(4) the risks and possible side effects of the Mantoux test;
(5) the risks from untreated tuberculosis to the infected person and others;
(6) the ordinary course of further diagnosis and treatment if the Mantoux test is positive;
(7) that screening has been scheduled; and
(8) that no person will be required to submit to the screening if the person submits a
statement of objection due to the conscientiously held beliefs of the person employed or of the
parent or guardian of a minor child.
    Subd. 2. Consent of minors. Minors may give consent for testing as set forth in sections
144.341 to 144.347.
    Subd. 3. Screening of minors. Prior to administering a Mantoux test to a minor, the school
or school district or board of health shall prepare a form for signature in which the parent or
guardian shall consent or submit a statement of objection to the test. The parent or guardian
of a minor child shall return a signed form to the school or school district or board of health
which is conducting the screening indicating receipt of the notice and consent or objection to
the administration of the test. In the event that the form with a signed consent or objection is
not returned, the school or school district or board of health may undertake such steps as are
reasonable to secure such consent or objection. If after such steps the school or school district or
board of health chooses to screen the minor without consent, it shall send a notice of intent to
test by certified mail, restricted delivery with return receipt, to the address given to the school or
school district by the parent or guardian for emergency contact of the parent or guardian. The
accuracy of the address shall be checked with the person enrolled, if possible. Placing notice as
specified in this subdivision shall constitute service. Reasonable efforts shall be made to provide
this notice in a language understood by the parent or guardian. If this notice cannot be delivered
or a form with a signed consent or objection is not returned, the school or school district or board
of health shall check the permanent medical record required by section 144.29 to determine if
the parent or guardian previously withheld consent to immunizations or other medical treatment
because of conscientiously held beliefs. If there is such a statement on file or if the school district
otherwise has notice of such a statement, the school or school district or board of health shall not
administer the Mantoux test unless the consent of the parent or guardian is obtained. If there is no
such statement in the permanent medical record or known to exist otherwise, the school or school
district or board of health may administer the Mantoux test at the time and place specified in the
notice unless medically contraindicated. The school or school district or board of health shall
document in the permanent medical record its efforts to notify the parent or guardian of the minor
child, and its efforts to check the permanent medical records.
    Subd. 4. Consent for subsequent testing or treatment. In the event the Mantoux test is
positive, no further diagnosis of or treatment for tuberculosis in a minor child shall be undertaken
without the signed consent of the parent or guardian of the minor child.
History: 1986 c 444; 1993 c 167 s 3

144.443 TUBERCULOSIS HEALTH THREAT TO OTHERS.
A "health threat to others" as defined in section 144.4172, subdivision 8, includes a person
who, although not currently infectious, has failed to complete a previously prescribed course of
tuberculosis therapy, demonstrates an inability or unwillingness to initiate or complete, or shows
an intent to fail to complete, a prescribed course of tuberculosis drug therapy, if that failure
could lead to future infectiousness.
History: 1993 c 167 s 4

144.444 TUBERCULOSIS EMERGENCY HOLD.
A temporary emergency hold under section 144.4182 may be placed on a person who
is a health threat to others when there is reasonable cause to believe that the person may be
unlocatable for the purposes of applying the procedures described in sections 144.4171 to
144.4186, or when medical or epidemiologic evidence suggests that the person is or may become
infectious before the conclusion of court proceedings and appeals.
History: 1993 c 167 s 5

144.445 TUBERCULOSIS SCREENING IN CORRECTIONAL INSTITUTIONS.
    Subdivision 1. Screening of inmates. (a) All persons detained or confined for 14 consecutive
days or more in facilities operated, licensed, or inspected by the Department of Corrections
shall be screened for tuberculosis with either a Mantoux test or a chest roentgenogram (x-ray)
as consistent with screening and follow-up practices recommended by the United States Public
Health Service or the Department of Health, as determined by the commissioner of health.
Administration of the Mantoux test or chest roentgenogram (x-ray) must take place on or before
the 14th day of detention or confinement.
(b) If an inmate refuses to submit to an annual test as specified in paragraph (a), the
commissioner of corrections may order the inmate to be tested.
    Subd. 2. Screening of employees. All employees of facilities operated, licensed, or inspected
by the Department of Corrections shall be screened for tuberculosis before employment in the
facility and annually thereafter, with either a Mantoux test or a chest roentgenogram (X-ray) as
consistent with screening and follow-up practices recommended by the United States Public
Health Service or the Department of Health, as determined by the commissioner of health.
    Subd. 3. Exceptions. Subdivisions 1 and 2 do not apply to:
(1) a person who is detained or confined in a juvenile temporary holdover facility, provided
that the person has no symptoms suggestive of tuberculosis, evidence of a new exposure to
active tuberculosis, or other health condition that may require a chest roentgenogram (x-ray)
be performed to rule out active tuberculosis;
(2) a person who is detained or confined in a facility operated, licensed, or inspected by the
Department of Corrections where the facility holds a written record of a negative Mantoux test
performed on the person (i) within three months prior to intake into the facility; or (ii) within
12 months prior to intake into the facility if the person has remained under the continuing
jurisdiction of a correctional facility since the negative Mantoux test, provided that the person has
no symptoms suggestive of tuberculosis, evidence of a new exposure to active tuberculosis, or
other health condition that may require a chest roentgenogram (x-ray) be performed to rule out
active tuberculosis;
(3) a person who is detained or confined in a facility operated, licensed, or inspected by the
Department of Corrections where the facility has a written record of (i) a history of adequately
treated active tuberculosis; (ii) compliance with currently prescribed tuberculosis therapy or
preventive therapy; or (iii) completion of a course of preventive therapy, provided the person has
no symptoms suggestive of tuberculosis, evidence of a new exposure to active tuberculosis,
or other health condition that may require a chest roentgenogram (x-ray) to rule out active
tuberculosis;
(4) a person who is detained or confined in a facility operated, licensed, or inspected by
the Department of Corrections where the facility holds a written record of a negative chest
roentgenogram (x-ray) (i) within six months; or (ii) within 12 months prior to intake in the facility
if the person has remained under the continuing jurisdiction of a correctional facility since the
negative chest roentgenogram (x-ray), provided that the person has no symptoms suggestive of
tuberculosis, evidence of a new exposure to active tuberculosis, or other health condition that may
require a new chest roentgenogram (x-ray) to rule out active tuberculosis;
(5) an employee with a record of either a past positive Mantoux test reaction or active
tuberculosis who is currently completing or has a documented history of completing a course of
tuberculosis therapy or preventive therapy, provided the employee has no symptoms suggestive of
tuberculosis, evidence of a new exposure to active tuberculosis, or other health condition that may
require a chest roentgenogram (x-ray) be performed to rule out active tuberculosis;
(6) an employee with either a record of a past positive Mantoux test reaction or a positive or
significant Mantoux test reaction in preemployment screening who does not complete a course
of preventive therapy may be exempt from annual Mantoux testing or other screening if the
employee has a documented negative chest roentgenogram (x-ray) performed at any time since the
initial positive Mantoux test, provided the employee has no symptoms suggestive of tuberculosis,
evidence of a new exposure to active tuberculosis, or other health condition that may require a
chest roentgenogram (x-ray) be performed to rule out active tuberculosis; and
(7) the commissioner may exempt additional employees or persons detained or confined in
facilities operated, licensed, or inspected by the Department of Corrections based on currently
accepted public health standards or the person's health status.
    Subd. 4. Reports. The administrator or other person having general control and supervision
of a facility operated, licensed, or inspected by the Department of Corrections shall provide the
commissioner with any reports determined by the commissioner of health to be necessary to
evaluate the need for further tuberculosis screening or control efforts in a facility or facilities.
    Subd. 5. Waiver. The commissioner may waive any portion of the requirements of
subdivisions 1 to 4 if the commissioner of health determines that it is not necessary to protect the
public health or if the screening may have a detrimental effect on a person's health status.
History: 1993 c 167 s 6; 1997 c 164 s 1,2; 2006 c 260 art 4 s 2

144.45 TUBERCULOSIS IN SCHOOLS; CERTIFICATE.
No person with active tuberculosis shall remain in or near a school building unless the person
has a certificate issued by a physician stating that the person's presence in a school building
will not endanger the health of other people.
History: (5384) 1913 c 434 s 4; 1949 c 471 s 10; 1980 c 357 s 9

144.46 [Repealed, 1980 c 357 s 22]

144.47 [Repealed, 1980 c 357 s 22]

144.471 [Repealed, 1987 c 209 s 40]

144.48 [Renumbered 144.427]

TUBERCULOSIS HEALTH THREAT

144.4801 TITLE.
Sections 144.4801 to 144.4813 may be cited as the "Tuberculosis Health Threat Act."
History: 1997 c 164 s 3

144.4802 AUTHORITY.
    Subdivision 1. Authority to commit. Under the powers and duties assigned to the
commissioner in this chapter and chapter 145, the commissioner may proceed under sections
144.4801 to 144.4813 whenever the commissioner has probable cause to believe that a person
who has active tuberculosis or is clinically suspected of having active tuberculosis is an
endangerment to the public health.
    Subd. 2. Preemption. Sections 144.4801 to 144.4813 preempt and supersede sections
144.4171 to 144.4186, 144.443, and 144.444 with regard to a tuberculosis health threat. Nothing
in sections 144.4801 to 144.4813 restricts the commissioner's authority to seek injunctive relief
pursuant to section 145.075, or any other relief under other statutes or at common law.
    Subd. 3. Reliance on spiritual means in lieu of medical treatment. Nothing in sections
144.4801 to 144.4813 shall be construed to abridge the right of a carrier to refuse medical
treatment for tuberculosis if the carrier opposes medical treatment on the basis of sincere religious
beliefs and complies with a monitoring plan developed by the commissioner for the isolation of
the carrier as defined in section 144.4803, subdivision 14. A carrier who meets the requirements
of this subdivision is not considered an endangerment under section 144.4803, subdivision 10,
clauses (2) to (6) and (8). Nothing in this subdivision shall be construed to limit the authority
of the commissioner to take necessary actions to protect the public health according to sections
144.4801 to 144.4813.
History: 1997 c 164 s 4

144.4803 DEFINITIONS.
    Subdivision 1. Active tuberculosis. "Active tuberculosis" includes infectious and
noninfectious tuberculosis and means:
(1) a condition evidenced by a positive culture for mycobacterium tuberculosis taken from
a pulmonary or laryngeal source;
(2) a condition evidenced by a positive culture for mycobacterium tuberculosis taken
from an extrapulmonary source when there is clinical evidence such as a positive skin test for
tuberculosis infection, coughing, sputum production, fever, or other symptoms compatible with
pulmonary tuberculosis; or
(3) a condition in which clinical specimens are not available for culture, but there is
radiographic evidence of tuberculosis such as an abnormal chest x-ray, and clinical evidence such
as a positive skin test for tuberculosis infection, coughing, sputum production, fever, or other
symptoms compatible with pulmonary tuberculosis, that lead a physician to reasonably diagnose
active tuberculosis according to currently accepted standards of medical practice and to initiate
treatment for tuberculosis.
    Subd. 2. Board of health. "Board of health" means an administrative authority established
under section 145A.03.
    Subd. 3. Carrier. "Carrier" means a person who has active tuberculosis or is clinically
suspected of having active tuberculosis.
    Subd. 4. Clinically suspected of having active tuberculosis. "Clinically suspected of having
active tuberculosis" means presenting a reasonable possibility of having active tuberculosis based
upon epidemiologic, clinical, or radiographic evidence, laboratory test results, or other reliable
evidence as determined by a physician using currently accepted standards of medical practice.
    Subd. 5. Commissioner. "Commissioner" means the commissioner of health.
    Subd. 6. Contagion precautions for tuberculosis. "Contagion precautions for tuberculosis"
means those measures under currently accepted standards of medical practice that prevent a
carrier from exposing others to tuberculosis.
    Subd. 7. Department. "Department" means the Department of Health.
    Subd. 8. Directly observed therapy. "Directly observed therapy" means a method for
ensuring compliance with medication directions in which a licensed health professional or
designee observes a person ingesting prescribed medications or administers the prescribed
medication to the person.
    Subd. 9. Disease prevention officer. "Disease prevention officer" means a designated agent
of the commissioner, or a designated agent of a board of health that has express delegated
authority from the commissioner to proceed under sections 144.4801 to 144.4813.
    Subd. 10. Endangerment to the public health. "Endangerment to the public health" means
a carrier who may transmit tuberculosis to another person or persons because the carrier has
engaged or is engaging in any of the following conduct:
(1) refuses or fails to submit to a diagnostic tuberculosis examination that is ordered by a
physician and is reasonable according to currently accepted standards of medical practice;
(2) refuses or fails to initiate or complete treatment for tuberculosis that is prescribed by a
physician and is reasonable according to currently accepted standards of medical practice;
(3) refuses or fails to keep appointments for treatment of tuberculosis;
(4) refuses or fails to provide the commissioner, upon request, with evidence showing the
completion of a course of treatment for tuberculosis that is prescribed by a physician and is
reasonable according to currently accepted standards of medical practice;
(5) refuses or fails to initiate or complete a course of directly observed therapy that is
prescribed by a physician and is reasonable according to currently accepted standards of medical
practice;
(6) misses at least 20 percent of scheduled appointments for directly observed therapy, or
misses at least two consecutive appointments for directly observed therapy;
(7) refuses or fails to follow contagion precautions for tuberculosis after being instructed on
the precautions by a licensed health professional or by the commissioner;
(8) based on evidence of the carrier's past or present behavior, may not complete a course
of treatment for tuberculosis that is reasonable according to currently accepted standards of
medical practice; or
(9) may expose other persons to tuberculosis based on epidemiological, medical, or other
reliable evidence.
    Subd. 11. Epidemiological data or epidemiological evidence. "Epidemiological data" or
"epidemiological evidence" means data or evidence relating to the occurrence, distribution,
clinical characteristics, and control of disease within a group of people or within a specified
population.
    Subd. 12. Health order. "Health order" means an order issued by the commissioner or a
board of health with express delegated authority from the commissioner.
    Subd. 13. Infectious tuberculosis. "Infectious tuberculosis" means the stage of tuberculosis
where mycobacterial organisms are capable of being expelled into the air by a person, as
determined by laboratory, epidemiological, or clinical findings.
    Subd. 14. Isolation. "Isolation" means placing a carrier who has infectious tuberculosis in:
(1) a hospital or other treatment facility;
(2) the carrier's residence or current location; or
(3) any other place approved by the commissioner, provided that the place of isolation
prevents or limits the transmission of the infectious tuberculosis agent to others during the period
of infectiousness.
    Subd. 15. Licensed health professional. "Licensed health professional" means a person
licensed by one of the health-related licensing boards listed in section 214.01, subdivision 2.
    Subd. 16. Peace officer. "Peace officer" means an employee or an elected or appointed
official of a political subdivision or law enforcement agency who is licensed by the Board of
Peace Officer Standards and Training, is charged with the prevention and detection of crime and
the enforcement of the general criminal laws of the state, and has the full power of arrest. "Peace
officer" includes an officer of the Minnesota State Patrol.
    Subd. 17. Physician. "Physician" means a person who is licensed by the Board of Medical
Practice under chapter 147 to practice medicine.
    Subd. 18. Respondent. "Respondent" means a person or group of persons to whom the
commissioner has issued a health order, excluding the carrier.
    Subd. 19. Treatment facility. "Treatment facility" means a hospital or other treatment
provider that is qualified to provide care, treatment, and appropriate contagion precautions for
tuberculosis.
History: 1997 c 164 s 5

144.4804 REPORTING RELATING TO TUBERCULOSIS.
    Subdivision 1. Mandatory reporting. A licensed health professional must report to the
commissioner or a disease prevention officer within 24 hours of obtaining knowledge of a
reportable person as specified in subdivision 3, unless the licensed health professional is aware
that the facts causing the person to be a reportable person have previously been reported. Within
72 hours of making a report, excluding Saturdays, Sundays, and legal holidays, the licensed health
professional shall submit to the commissioner or to the disease prevention officer a certified copy
of the reportable person's medical records relating to the carrier's tuberculosis and status as an
endangerment to the public health if the person is reportable under subdivision 3, clause (3), (4),
or (5). A reporting facility may designate an infection control practitioner to make reports and to
send certified medical records relating to the carrier's tuberculosis and status as an endangerment
to the public health under this subdivision.
    Subd. 2. Voluntary reporting. A person other than a licensed health professional may
report to the commissioner or a disease prevention officer if the person has knowledge of a
reportable person as specified in subdivision 3, or has probable cause to believe that a person
should be reported under subdivision 3.
    Subd. 3. Reportable persons. A licensed health professional must report to the
commissioner or a disease prevention officer if the licensed health professional has knowledge of:
(1) a person who has been diagnosed with active tuberculosis;
(2) a person who is clinically suspected of having active tuberculosis;
(3) a person who refuses or fails to submit to a diagnostic tuberculosis examination when the
person is clinically suspected of having tuberculosis;
(4) a carrier who has refused or failed to initiate or complete treatment for tuberculosis,
including refusal or failure to take medication for tuberculosis or keep appointments for directly
observed therapy or other treatment of tuberculosis; or
(5) a person who refuses or fails to follow contagion precautions for tuberculosis after being
instructed on the precautions by a licensed health professional or by the commissioner.
    Subd. 4. Reporting information. The report by a licensed health professional under
subdivision 1 or by a person under subdivision 2 must contain the following information, to the
extent known:
(1) the reportable person's name, birth date, address or last known location, and telephone
number;
(2) the date and specific circumstances that cause the person to be a reportable person;
(3) the reporting person's name, title, address, and telephone number; and
(4) any other information relevant to the reportable person's case of tuberculosis.
    Subd. 5. Immunity for reporting. A licensed health professional who is required to report
under subdivision 1 or a person who voluntarily reports in good faith under subdivision 2 is
immune from liability in a civil, administrative, disciplinary, or criminal action for reporting
under this section.
    Subd. 6. Falsified reports. A person who knowingly or recklessly makes a false report
under this section is liable in a civil suit for actual damages suffered by the person or persons
reported and for punitive damages.
    Subd. 7. Waiver of privilege. A person who is the subject of a report under subdivision 1 is
deemed to have waived any privilege created in section 595.02, subdivision 1, paragraphs (d), (e),
(g), (i), (j), and (k), with respect to any information provided under this section.
    Subd. 8. Tuberculosis notification. If an emergency medical services person, as defined
in section 144.7401, subdivision 4, is exposed to a person with active tuberculosis during the
performance of duties, the treatment facility's designated infection control coordinator shall
notify the emergency medical services agency's exposure control officer by telephone and by
written correspondence. The facility's designated infection control coordinator shall provide the
emergency medical services person with information about screening and, if indicated, follow-up.
History: 1997 c 164 s 6; 2000 c 422 s 4

144.4805 HEALTH ORDER; RIGHTS OF CARRIER AND RESPONDENT.
    Subdivision 1. Authority. Only the commissioner, or a board of health with express
delegated authority from the commissioner, may issue a health order under this section.
    Subd. 2. Grounds for health order. Whenever the commissioner has probable cause to
believe that a carrier is an endangerment to the public health, the commissioner may issue a health
order that the commissioner deems necessary to protect the public health. The commissioner may
petition the court for enforcement of the health order. In a court proceeding for enforcement of the
health order, the commissioner shall demonstrate the particularized circumstances constituting
the necessity for the health order. The health order may be issued to any person, including a
carrier, physician, licensed health professional, or treatment facility. The health order may be in
the form of a subpoena by the commissioner for certified medical records relating to the carrier's
tuberculosis and status as an endangerment to the public health.
    Subd. 3. Contents of health order. A health order must include:
(1) a citation to this section as the legal authority under which the order is issued;
(2) a summary of evidence upon which the person is alleged to be a carrier;
(3) a description of the alleged conduct of the carrier that makes the carrier an endangerment
to the public health;
(4) a description of less restrictive alternatives that the commissioner considered and
rejected, together with the reasons for the rejection, or a description of less restrictive alternatives
that the commissioner used and that were unsuccessful;
(5) the preventive measure ordered; and
(6) a notice advising the carrier or respondent that:
(i) a hearing will be held if the carrier or respondent petitions the court for a hearing or if the
commissioner determines that the carrier has not complied with the health order;
(ii) the carrier or respondent has the right to appear at the hearing;
(iii) the carrier or respondent has the right to present and cross-examine witnesses at the
hearing;
(iv) the carrier has the right to court-appointed counsel in a proceeding under sections
144.4801 to 144.4813; and
(v) the carrier or respondent has the right to the assistance of an interpreter in a proceeding
under sections 144.4801 to 144.4813.
    Subd. 4. Right to counsel. (a) The carrier or respondent has the right to counsel in any
proceeding under sections 144.4801 to 144.4813. The court shall promptly appoint counsel for a
carrier if the carrier does not have counsel:
(1) at the time the court issues an order under section 144.4807, subdivision 7, authorizing
the continued detention of the carrier;
(2) at the time the court issues an order under section 144.4808, subdivision 2, authorizing
the carrier to be apprehended and held; or
(3) in all other cases, at the time either party files a notice for a preliminary hearing under
section 144.4810, subdivision 2.
The court shall appoint counsel for the carrier. The cost of court-appointed counsel shall
be paid by the court.
(b) Upon being notified of the name and address of counsel for the carrier, the commissioner
shall promptly forward to the carrier and the carrier's counsel the following:
(1) a copy of the health order;
(2) a certified copy of relevant portions of the carrier's medical records; and
(3) the name and address of the licensed health professional, including the carrier's attending
physician or nurse, or the public health physician or nurse whom the commissioner intends to
have testify at the preliminary hearing, and a summary of the witness' testimony, including a
copy of the witness' affidavit, if any.
    Subd. 5. Duty to communicate. The commissioner's counsel and the carrier's counsel
shall make every effort to communicate prior to any hearing and to stipulate as to undisputed
facts, witnesses, and exhibits.
    Subd. 6. Right to interpreter. The carrier or respondent has the right to the assistance of an
interpreter in a proceeding under sections 144.4801 to 144.4813.
    Subd. 7. Service of order. A health order may be served by a disease prevention officer
or peace officer.
History: 1997 c 164 s 7

144.4806 PREVENTIVE MEASURES UNDER HEALTH ORDER.
A health order may include, but need not be limited to, an order:
(1) requiring the carrier's attending physician or treatment facility to isolate and detain the
carrier for treatment or for a diagnostic examination for tuberculosis, pursuant to section 144.4807,
subdivision 1 , if the carrier is an endangerment to the public health and is in a treatment facility;
(2) requiring a carrier who is an endangerment to the public health to submit to diagnostic
examination for tuberculosis and to remain in the treatment facility until the commissioner
receives the results of the examination;
(3) requiring a carrier who is an endangerment to the public health to remain in or present
at a treatment facility until the carrier has completed a course of treatment for tuberculosis
that is prescribed by a physician and is reasonable according to currently accepted standards
of medical practice;
(4) requiring a carrier who is an endangerment to the public health to complete a course
of treatment for tuberculosis that is prescribed by a physician and is reasonable according to
currently accepted standards of medical practice and, if necessary, to follow contagion precautions
for tuberculosis;
(5) requiring a carrier who is an endangerment to the public health to follow a course
of directly observed therapy that is prescribed by a physician and is reasonable according to
currently accepted standards of medical practice;
(6) excluding a carrier who is an endangerment to the public health from the carrier's place
of work or school, or from other premises if the commissioner determines that exclusion is
necessary because contagion precautions for tuberculosis cannot be maintained in a manner
adequate to protect others from being exposed to tuberculosis;
(7) requiring a licensed health professional or treatment facility to provide to the
commissioner certified copies of all medical and epidemiological data relevant to the carrier's
tuberculosis and status as an endangerment to the public health;
(8) requiring the diagnostic examination for tuberculosis of other persons in the carrier's
household, workplace, or school, or other persons in close contact with the carrier if the
commissioner has probable cause to believe that the persons may have active tuberculosis or
may have been exposed to tuberculosis based on epidemiological, medical, or other reliable
evidence; or
(9) requiring a carrier or other persons to follow contagion precautions for tuberculosis.
History: 1997 c 164 s 8

144.4807 NOTICE OF OBLIGATION TO ISOLATE OR EXAMINE.
    Subdivision 1. Obligation to isolate. If the carrier is in a treatment facility, the commissioner
or a carrier's attending physician, after obtaining approval from the commissioner, may issue a
notice of obligation to isolate to a treatment facility if the commissioner or attending physician
has probable cause to believe that a carrier is an endangerment to the public health.
    Subd. 2. Obligation to examine. If the carrier is clinically suspected of having active
tuberculosis, the commissioner may issue a notice of obligation to examine to the carrier's
attending physician to conduct a diagnostic examination for tuberculosis on the carrier.
    Subd. 3. Precautions to avoid exposure. Upon receiving a notice of obligation to isolate
or notice of obligation to examine, a treatment facility shall immediately take all reasonable
precautions to prevent the carrier from exposing other persons to tuberculosis, including the use
of guards or locks, if appropriate.
    Subd. 4. Service of health order on carrier. When issuing a notice of obligation to isolate
or examine to the carrier's physician or a treatment facility, the commissioner shall simultaneously
serve a health order on the carrier ordering the carrier to remain in the treatment facility for
treatment or examination.
    Subd. 5. Duration of detention. No carrier may be detained under subdivision 1 or 2 longer
than 72 hours, excluding Saturdays, Sundays, and legal holidays, unless the court issues an
order authorizing continued detention of the carrier pursuant to subdivision 7. A carrier may
not be released prior to the expiration of the 72-hour hold without the express consent of the
commissioner.
    Subd. 6. Application for extension of 72-hour hold. The commissioner may seek an order
extending the hold under subdivision 5 by filing an ex parte application with the probate division
of the district court of the county in which the carrier resides. The application may be filed
orally by telephone or by facsimile, provided that a written application is filed within 72 hours,
excluding Saturdays, Sundays, and legal holidays.
    Subd. 7. Court order extending 72-hour hold. The court may extend the hold under
subdivision 5 by up to six days, excluding Saturdays, Sundays, and legal holidays, if the court
finds that there is probable cause to believe that the carrier is an endangerment to the public
health. The court may find probable cause to detain, examine, and isolate the carrier based upon a
written statement by facsimile or upon an oral statement by telephone from the carrier's attending
physician or nurse, a public health physician or nurse, other licensed health professional, or
disease prevention officer, stating the grounds and facts that demonstrate that the carrier is an
endangerment to the public health, provided that an affidavit from such witness is filed with the
court within 72 hours, excluding Saturdays, Sundays, and legal holidays. The order may be issued
orally by telephone, or by facsimile, provided that a written order is issued within 72 hours,
excluding Saturdays, Sundays, and legal holidays. The oral and written order shall contain a
notice of the carrier's rights contained in section 144.4805, subdivision 3, clause (6). A carrier
may not be released prior to the hold extended under this subdivision without the express consent
of the commissioner.
    Subd. 8. Appointment of counsel. If the carrier does not have counsel at the time the court
issues an order to extend the hold under subdivision 7, the court shall promptly appoint counsel
for the carrier.
    Subd. 9. Immunity. A disease prevention officer, peace officer, physician, licensed health
professional, or treatment facility that acts in good faith under this section is immune from
liability in any civil, administrative, disciplinary, or criminal action for acting under this section.
History: 1997 c 164 s 9

144.4808 APPREHEND AND HOLD ORDER.
    Subdivision 1. Application for apprehend and hold order. The commissioner may make
an ex parte application for an order to apprehend and hold a carrier who is not in a treatment
facility if the commissioner has probable cause to believe that a carrier is:
(1) an endangerment to the public health; and
(2) either in imminent danger of exposing another person or persons to tuberculosis, or may
flee or become unlocatable.
The commissioner shall file the application in the probate division of the district court of
the county in which the carrier resides. The application may be filed orally by telephone or
by facsimile, provided that a written application is filed within 72 hours, excluding Saturdays,
Sundays, and legal holidays.
    Subd. 2. Court order to apprehend and hold. The court may find probable cause to
apprehend and hold the carrier based upon a written statement by facsimile or oral statement by
telephone from the carrier's attending physician or nurse, a public health physician or nurse, other
licensed health professional, or disease prevention officer, stating the grounds and facts that
demonstrate that the carrier is an endangerment to the public health, provided that an affidavit
from such witness is filed with the court within 72 hours, excluding Saturdays, Sundays, and
legal holidays. The court may issue an order to a peace officer or to a disease prevention officer,
or both to:
(1) apprehend and transport the carrier to a designated treatment facility, and detain the
carrier until the carrier is admitted to the treatment facility; or
(2) apprehend and isolate the carrier.
The order may be issued orally by telephone, or by facsimile, provided that a written order is
issued within 72 hours, excluding Saturdays, Sundays, and legal holidays. The oral and written
order shall contain a notice of the carrier's rights contained in section 144.4805, subdivision 3,
clause (6).
    Subd. 3. Duration of detention. A carrier may be detained under this subdivision up to six
days, excluding Saturdays, Sundays, and legal holidays. A carrier may not be released prior
to the expiration of the hold authorized under this section without the express consent of the
commissioner.
    Subd. 4. Apprehension of carrier. If the carrier flees or forcibly resists the peace officer
or disease prevention officer, the officer may use all necessary and lawful means to apprehend,
hold, transport, or isolate the carrier. This subdivision is authority for the officer to carry out the
duties specified in this section. The commissioner shall provide any information and equipment
necessary to protect the officer from becoming exposed to tuberculosis.
    Subd. 5. Appointment of counsel. If the carrier does not have counsel at the time the court
issues an apprehend and hold order under subdivision 2, the court shall promptly appoint counsel
for the carrier.
    Subd. 6. Immunity. A disease prevention officer, peace officer, physician, licensed health
professional, or treatment facility that acts in good faith under this section is immune from
liability in any civil, administrative, disciplinary, or criminal action for acting under this section.
History: 1997 c 164 s 10

144.4809 PRELIMINARY HEARING.
    Subdivision 1. Grounds for hearing. A party may petition the court for an order for
enforcement of or relief from a health order or judicial order.
    Subd. 2. Petition for preliminary hearing. The petitioning party shall serve on the
commissioner and file in the probate division of the district court of the county in which the
carrier or respondent resides a petition and notice of preliminary hearing. The court shall hold a
preliminary hearing no later than 15 days from the date of the filing and service of the petition for
a preliminary hearing. If a carrier detained under section 144.4807 or 144.4808 files a petition for
a preliminary hearing, the hearing must be held no later than five days from the date of the filing
and service of the petition, excluding Saturdays, Sundays, and legal holidays.
    Subd. 3. Commissioner's notice of hearing. If the commissioner petitions the court to
enforce the health order, the notice of the preliminary hearing must contain the following
information:
(1) the date, time, and place of the hearing;
(2) the right of the carrier to be represented by court-appointed counsel during any
proceeding under sections 144.4801 to 144.4813;
(3) the right of the carrier or respondent to the assistance of an interpreter in any proceeding
under sections 144.4801 to 144.4813;
(4) the right of the carrier or respondent to appear at the hearing;
(5) the right of the carrier or respondent to present and cross-examine witnesses;
(6) a statement of any disputed facts, or a statement of the nature of any other disputed
matter; and
(7) the name and address of any witness that the petitioning party intends to call to testify
at the hearing, and a brief summary of the witness' testimony.
    Subd. 4. Carrier's or respondent's notice of hearing. If the carrier or respondent petitions
the court for relief from the health order or court order, the notice of preliminary hearing must
contain the information in subdivision 3, clauses (1), (6), and (7).
    Subd. 5. Duty to communicate. (a) At least five days before the date of the preliminary
hearing, excluding Saturdays, Sundays, and legal holidays, the nonpetitioning party shall respond
to the petition for hearing by filing and serving on the petitioning party:
(1) a statement of any disputed facts, or a statement of the nature of any other disputed
matter; and
(2) the name and address of any witness that the nonpetitioning party intends to call to testify
at the hearing, and a brief summary of the witness' testimony.
If the carrier seeks release from an emergency hold ordered under section 144.4807,
subdivision 7 , or under section 144.4808, subdivision 2, the commissioner shall file and serve
on the carrier's counsel the items in clauses (1) and (2) at least 48 hours prior to the preliminary
hearing, excluding Saturdays, Sundays, and legal holidays.
(b) At the hearing, the parties shall identify the efforts they made to resolve the matter prior
to the preliminary hearing.
    Subd. 6. Hearing room in treatment facility. If the carrier is infectious, the treatment
facility in which the carrier is sought to be detained or to which the carrier is sought to be removed
shall make reasonable accommodations to provide a room where the hearing may be held that
minimizes the risk of exposing persons attending the hearing to tuberculosis. If a room is not
available at the treatment facility, the court may designate another location for the hearing.
    Subd. 7. Standard of proof. The commissioner must prove by a preponderance of the
evidence that the carrier is an endangerment to the public health.
    Subd. 8. Rules of evidence. The court shall admit all reliable relevant evidence. Medical
and epidemiological data must be admitted if it conforms with section 145.31, chapter 600,
Minnesota Rules of Evidence, rule 803(6), or other statutes or rules that permit reliable evidence
to be admitted in civil cases. The court may rely on medical and epidemiological data, including
hearsay, if it finds that physicians and other licensed health professionals rely on the data in the
regular course of providing health care and treatment.
    Subd. 9. Sufficiency of evidence. It is a sufficient basis for the court to order continued
confinement of the carrier or other preventive measures requested by the commissioner if reliable
testimony is provided solely by the carrier's attending physician or nurse, a public health physician
or nurse, other licensed health professional, or disease prevention officer.
    Subd. 10. Failure to appear at hearing. If the carrier or respondent fails to appear at the
hearing without prior court approval, the hearing may proceed without the carrier or respondent
and the court may make its determination on the basis of all reliable evidence submitted at the
hearing.
History: 1997 c 164 s 11

144.4810 FINAL HEARING.
    Subdivision 1. Grounds for hearing. After the preliminary hearing, the commissioner,
carrier, or respondent may petition the court for relief from or enforcement of the court order
issued pursuant to the preliminary hearing. The commissioner may petition the court for additional
preventive measures if the carrier or respondent has not complied with the court order issued
pursuant to the preliminary hearing. The petitioning party shall serve and file a petition and notice
of hearing with the probate division of the district court. The court shall hold the final hearing no
later than 15 days from the date of the filing and service of the petition for a final hearing.
    Subd. 2. Notice of hearing. The notice of the final hearing must contain the same information
as for the preliminary hearing in section 144.4809, subdivision 3 or 4.
    Subd. 3. Duty to communicate. The parties have a duty to communicate and exchange
information as provided in section 144.4809, subdivision 5.
    Subd. 4. Hearing room in treatment facility. The hearing room for the final hearing is
governed by section 144.4809, subdivision 6.
    Subd. 5. Standard of proof. The commissioner must prove by clear and convincing
evidence that the carrier is an endangerment to the public health.
    Subd. 6. Rules of evidence. The rules of evidence are governed by section 144.4809,
subdivision 8 .
    Subd. 7. Sufficiency of evidence. The sufficiency of evidence is governed by section
144.4809, subdivision 9.
    Subd. 8. Failure to appear at hearing. The failure of the carrier or respondent to appear at
the hearing is governed by section 144.4809, subdivision 10.
    Subd. 9. Right of appeal. The commissioner, carrier, or respondent may appeal the decision
of the district court. The Court of Appeals shall hear the appeal within 60 days after filing and
service of the notice of appeal.
    Subd. 10. Right of commissioner to issue subsequent order. Notwithstanding any ruling
by the district court, the commissioner may issue a subsequent health order if the commissioner
has probable cause to believe that a health order is necessary based on additional facts not known
or present at the time of the district court hearing.
History: 1997 c 164 s 12

144.4811 PERIODIC REVIEW AND RELEASE FROM DETENTION.
    Subdivision 1. Periodic review. If the carrier has been detained in a treatment facility or
has been isolated pursuant to a court order, the commissioner shall submit a report to the court,
the carrier, and the carrier's counsel within 90 days of the date of the court-ordered detention
and every 90 days thereafter, until the carrier is released. The report must state the treatment
the carrier receives, whether the carrier is cured or noninfectious, and whether the carrier will
continue to be detained. If the carrier contests the commissioner's determination for continued
detention, the carrier may request a hearing. The hearing on continued detention is governed by
the provisions for a final hearing under section 144.4810, excluding subdivision 5 of that section.
The court shall order continued detention of the carrier if it finds that such detention is reasonable.
This subdivision does not apply to consent orders or other confinement that has been voluntarily
agreed upon by the parties.
    Subd. 2. Carrier's petition for release. If the carrier is detained in a treatment facility or
isolated pursuant to a court order, the carrier may make a good faith request for release from
confinement prior to the 90-day review under subdivision 1 by filing a petition and notice of
hearing with the court that ordered the confinement and by serving the petition and notice on the
commissioner. The hearing on continued confinement is governed by the provisions for a final
hearing under section 144.4810, excluding subdivision 5 of that section. The court shall order
continued detention of the carrier if it finds that such detention is reasonable.
    Subd. 3. Release from detention based on order to compel examination. A carrier who
has been detained in a treatment facility under a court order to compel the carrier to submit to a
diagnostic tuberculosis examination shall be released only after:
(1) the commissioner determines that the carrier does not have active tuberculosis; or
(2) the commissioner determines that the carrier is not an endangerment to the public health.
    Subd. 4. Release from detention based on endangerment. A carrier who is detained in
a treatment facility or isolated under a court order because the carrier is an endangerment to
the public health shall be released only after:
(1) the commissioner determines that the carrier is cured; or
(2) the commissioner determines that the carrier is no longer an endangerment to the public
health.
History: 1997 c 164 s 13

144.4812 COSTS OF CARE.
The costs incurred by the treatment facility and other providers of services to diagnose or
treat the carrier for tuberculosis must be borne by the carrier, the carrier's health plan, or public
programs. During the period of insurance coverage, a health plan may direct the implementation
of the care required by the health order or court order and shall pay at the contracted rate of
payment, which shall be considered payment in full. Inpatient hospital services required by the
health order or court order and covered by medical assistance or general assistance medical care
are not billable to any other governmental entity. If the carrier cannot pay for treatment, and the
carrier does not have public or private health insurance coverage, the carrier shall apply for
financial assistance with the aid of the county. For persons not otherwise eligible for public
assistance, the commissioner of human services shall determine what, if any, costs the carrier
shall pay. The commissioner of human services shall make payments at the general assistance
medical care rate, which will be considered payment in full.
History: 1997 c 164 s 14

144.4813 DATA PRIVACY.
    Subdivision 1. Nonpublic data. Data on individuals contained in the health order are
health data under section 13.3805, subdivision 1. Other data on individuals collected by the
commissioner as part of an investigation of a carrier under sections 144.4801 to 144.4813 are
investigative data under section 13.39.
    Subd. 2. Protective order. After a judicial action is commenced, a party may seek a
protective order to protect the disclosure of portions of the court record identifying individuals
or entities.
    Subd. 3. Records retention. A records retention schedule for records developed under
sections 144.4801 to 144.4813 must be established pursuant to section 138.17, subdivision 7.
History: 1997 c 164 s 15; 1999 c 227 s 22

144.49 VIOLATIONS; PENALTIES.
    Subdivision 1. Violating rules or board directions. Any person violating any rule of
the commissioner or any lawful direction of a board of health as defined in section 145A.02,
subdivision 2 , or an agent of a board of health as authorized under section 145A.04 is guilty of
a misdemeanor.
    Subd. 2.[Repealed, 1979 c 50 s 14]
    Subd. 3.[Repealed, 1979 c 50 s 14]
    Subd. 4.[Repealed, 1979 c 50 s 14]
    Subd. 5.[Repealed, 1987 c 209 s 40]
    Subd. 6. Operating without license. Any person, partnership, association, or corporation
establishing, conducting, managing, or operating any hospital, sanitarium, or other institution
in accordance with the provisions of sections 144.50 to 144.56, without first obtaining a license
therefor is guilty of a misdemeanor.
    Subd. 7. Operating outside law or rules. Any person, partnership, association, or
corporation which establishes, conducts, manages or operates any hospital, sanitarium or other
institution required to be licensed under sections 144.50 to 144.56, in violation of any provision
of sections 144.50 to 144.56 or any rule established thereunder, is guilty of a misdemeanor.
    Subd. 8. False statements in reports. Any person lawfully engaged in the practice of
healing who willfully makes any false statement in any report required to be made pursuant
to section 144.45 is guilty of a misdemeanor.
History: (5346, 5356, 5367, 5388) RL s 2132; 1913 c 434 s 8; 1913 c 579; 1917 c 220 s 6;
1939 c 89 s 1; 1941 c 549 s 10; 1943 c 649 s 1; 1945 c 512 s 35,37; 1949 c 471 s 14; 1976 c 173
s 32,33; 1977 c 305 s 45; 1980 c 357 s 11,12; 1985 c 248 s 70; 1986 c 444; 1987 c 309 s 24;
1987 c 384 art 2 s 1; 1991 c 199 art 2 s 15

144.491 [Repealed, 1998 c 407 art 2 s 109]

FORMALDEHYDE GASES IN

BUILDING MATERIALS

144.495 FORMALDEHYDE RULES.
The legislature finds that building materials containing urea formaldehyde may emit unsafe
levels of formaldehyde in newly constructed housing units. The product standards prescribed in
section 325F.181 are intended to provide indoor air levels of formaldehyde that do not exceed
0.4 parts per million. If the commissioner of health determines that the standards prescribed in
section 325F.181 result in indoor air levels of formaldehyde that exceed 0.4 parts per million,
the commissioner may adopt different building materials product standards to ensure that the 0.4
parts per million level is not exceeded. The commissioner may adopt rules under chapter 14 to
establish product standards as provided in this section. The rules of the commissioner governing
ambient air levels of formaldehyde, Minnesota Rules, parts 4620.1600 to 4620.2100, are repealed,
except that the rule of the commissioner relating to new installations of urea formaldehyde foam
insulation in residential housing units remains in effect.
History: 1980 c 594 s 1; 1982 c 424 s 130; 1985 c 216 s 1

HOSPITALS

144.50 HOSPITALS, LICENSES; DEFINITIONS.
    Subdivision 1. License required. (a) No person, partnership, association, or corporation, nor
any state, county, or local governmental units, nor any division, department, board, or agency
thereof, shall establish, operate, conduct, or maintain in the state any hospital, sanitarium or
other institution for the hospitalization or care of human beings without first obtaining a license
therefor in the manner provided in sections 144.50 to 144.56. No person or entity shall advertise a
facility providing services required to be licensed under sections 144.50 to 144.56 without first
obtaining a license.
(b) A violation of this subdivision is a misdemeanor punishable by a fine of not more than
$300. The commissioner may seek an injunction in the district court against the continuing
operation of the unlicensed institution. Proceedings for securing an injunction may be brought
by the attorney general or by the appropriate county attorney.
(c) The sanctions in this subdivision do not restrict other available sanctions.
    Subd. 2. Hospital, sanitarium, other institution; definition. Hospital, sanitarium or other
institution for the hospitalization or care of human beings, within the meaning of sections 144.50
to 144.56 shall mean any institution, place, building, or agency, in which any accommodation is
maintained, furnished, or offered for five or more persons for: the hospitalization of the sick or
injured; the provision of care in a swing bed authorized under section 144.562; elective outpatient
surgery for preexamined, prediagnosed low risk patients; emergency medical services offered
24 hours a day, seven days a week, in an ambulatory or outpatient setting in a facility not a part
of a licensed hospital; or the institutional care of human beings. Nothing in sections 144.50 to
144.56 shall apply to a clinic, a physician's office or to hotels or other similar places that furnish
only board and room, or either, to their guests.
    Subd. 3. Hospitalization. "Hospitalization" means the reception and care of persons for a
continuous period longer than 24 hours, for the purpose of diagnosis or treatment bearing on
the physical or mental health of such persons.
    Subd. 4.[Repealed, 1980 c 357 s 22]
    Subd. 5. Separate licensing for healing; medicine. Nothing in sections 144.50 to 144.56
shall authorize any person, partnership, association, or corporation, nor any state, county, or local
governmental units, nor any division, department, board, or agency thereof, to engage, in any
manner, in the practice of healing, or the practice of medicine, as defined by law.
    Subd. 6. Supervised living facility licenses. (a) The commissioner may license as a
supervised living facility a facility seeking medical assistance certification as an intermediate
care facility for persons with developmental disability for four or more persons as authorized
under section 252.291.
(b) Class B supervised living facilities shall be classified as follows for purposes of the
State Building Code:
(1) Class B supervised living facilities for six or less persons must meet Group R, Division 3,
occupancy requirements; and
(2) Class B supervised living facilities for seven to 16 persons must meet Group R, Division
1, occupancy requirements.
(c) Class B facilities classified under paragraph (b), clauses (1) and (2), must meet the fire
protection provisions of chapter 21 of the 1985 Life Safety Code, NFPA 101, for facilities housing
persons with impractical evacuation capabilities, except that Class B facilities licensed prior to
July 1, 1990, need only continue to meet institutional fire safety provisions. Class B supervised
living facilities shall provide the necessary physical plant accommodations to meet the needs and
functional disabilities of the residents. For Class B supervised living facilities licensed after July
1, 1990, and housing nonambulatory or nonmobile persons, the corridor access to bedrooms,
common spaces, and other resident use spaces must be at least five feet in clear width, except that
a waiver may be requested in accordance with Minnesota Rules, part 4665.0600.
(d) The commissioner may license as a Class A supervised living facility a residential
program for chemically dependent individuals that allows children to reside with the parent
receiving treatment in the facility. The licensee of the program shall be responsible for the health,
safety, and welfare of the children residing in the facility. The facility in which the program is
located must be provided with a sprinkler system approved by the state fire marshal. The licensee
shall also provide additional space and physical plant accommodations appropriate for the number
and age of children residing in the facility. For purposes of license capacity, each child residing in
the facility shall be considered to be a resident.
    Subd. 7. Residents with aids or hepatitis. Boarding care homes and supervised living
facilities licensed by the commissioner of health must accept as a resident a person who is infected
with the human immunodeficiency virus or the hepatitis B virus unless the facility cannot meet
the needs of the person under Minnesota Rules, part 4665.0200, subpart 5, or 4655.1500, subpart
2, or the person is otherwise not eligible for admission to the facility under state laws or rules.
History: 1941 c 549 s 1; 1943 c 649 s 1; 1951 c 304 s 1; 1969 c 358 s 1; 1976 c 173 s 34;
1977 c 218 s 1; 1981 c 95 s 1; 1Sp1985 c 3 s 2; 1987 c 209 s 20,21; 1988 c 689 art 2 s 32; 1989 c
282 art 2 s 8; art 3 s 4; 1990 c 568 art 3 s 3; 1991 c 286 s 3; 1992 c 513 art 6 s 4; 2005 c 56 s 1

144.51 LICENSE APPLICATIONS.
Before a license shall be issued under sections 144.50 to 144.56, the person applying
shall submit evidence satisfactory to the state commissioner of health that the person is not
less than 18 years of age and of reputable and responsible character; in the event the applicant
is an association or corporation or governmental unit like evidence shall be submitted as to the
members thereof and the persons in charge. All applicants shall, in addition, submit satisfactory
evidence of their ability to comply with the provisions of sections 144.50 to 144.56 and all rules
and minimum standards adopted thereunder.
History: 1941 c 549 s 2; 1943 c 649 s 2; 1951 c 304 s 2; 1973 c 725 s 7; 1976 c 173 s 35;
1977 c 305 s 45; 1985 c 248 s 70; 1986 c 444

144.52 APPLICATION.
Any person, partnership, association, or corporation, including state, county, or local
governmental units, or any division, department, board, or agency thereof, desiring a license under
sections 144.50 to 144.56 shall file with the state commissioner of health a verified application
containing the name of the applicant desiring said license; whether such persons so applying are
18 years of age; the type of institution to be operated; the location thereof; the name of the person
in charge thereof, and such other information pertinent thereto as the state commissioner of health
by rule may require. Application on behalf of a corporation or association or other governmental
unit shall be made by any two officers thereof or by its managing agents.
History: 1941 c 549 s 3; 1943 c 649 s 3; 1951 c 304 s 3; 1973 c 725 s 8; 1977 c 305 s
45; 1985 c 248 s 70

144.53 FEES.
Each application for a license, or renewal thereof, to operate a hospital, sanitarium or
other institution for the hospitalization or care of human beings, within the meaning of sections
144.50 to 144.56, except applications by the Minnesota Veterans Home, the commissioner of
human services for the licensing of state institutions or by the administrator for the licensing of
the University of Minnesota hospitals, shall be accompanied by a fee to be prescribed by the
state commissioner of health pursuant to section 144.122. No fee shall be refunded. Licenses
shall expire and shall be renewed as prescribed by the commissioner of health pursuant to
section 144.122.
No license granted hereunder shall be assignable or transferable.
History: 1941 c 549 s 4; 1945 c 192 s 1; 1951 c 304 s 4; 1959 c 466 s 1; 1974 c 471 s 3; 1975
c 63 s 1; 1975 c 310 s 5; 1976 c 173 s 36; 1976 c 239 s 69; 1977 c 305 s 45; 1984 c 654 art 5 s 58

144.54 INSPECTIONS.
Every building, institution, or establishment for which a license has been issued shall be
periodically inspected by a duly appointed representative of the state commissioner of health
under the rules to be established by the state commissioner of health. No institution of any kind
licensed pursuant to the provisions of sections 144.50 to 144.56 shall be required to be licensed
or inspected under the laws of this state relating to hotels, restaurants, lodging houses, boarding
houses, and places of refreshment.
History: 1941 c 549 s 5; 1951 c 304 s 5; 1977 c 305 s 45; 1985 c 248 s 70

144.55 LICENSES; ISSUANCE, SUSPENSION AND REVOCATION.
    Subdivision 1. Issuance. The state commissioner of health is hereby authorized to issue
licenses to operate hospitals, sanitariums, outpatient surgical centers, or other institutions for
the hospitalization or care of human beings, which are found to comply with the provisions
of sections 144.50 to 144.56 and any reasonable rules promulgated by the commissioner. The
commissioner shall not require an outpatient surgical center licensed as part of a hospital to obtain
a separate outpatient surgical center license. All decisions of the commissioner thereunder may be
reviewed in the district court in the county in which the institution is located or contemplated.
    Subd. 1a. License fee. The annual license fee for outpatient surgical centers is $1,512.
    Subd. 1b. Standards for nursing care. As a condition of licensure, outpatient surgical
centers must provide nursing care consistent with nationally accepted nursing clinical standards
for perioperative nursing, including, but not limited to Association of Operating Room Nurses
and American Nurses Association standards, which are generally accepted in the professional
nursing community.
    Subd. 2. Definitions. For the purposes of this section, the following terms have the meanings
given:
(a) "Outpatient surgical center" or "center" means a freestanding facility organized for the
specific purpose of providing elective outpatient surgery for preexamined, prediagnosed, low-risk
patients. Admissions are limited to procedures that utilize general anesthesia or conscious sedation
and that do not require overnight inpatient care. An outpatient surgical center is not organized to
provide regular emergency medical services and does not include a physician's or dentist's office
or clinic for the practice of medicine, the practice of dentistry, or the delivery of primary care.
(b) "Approved accrediting organization" means the Joint Commission on Accreditation of
Health Care Organizations or the American Osteopathic Association.
    Subd. 3. Standards for licensure. (a) Notwithstanding the provisions of section 144.56, for
the purpose of hospital licensure, the commissioner of health shall use as minimum standards
the hospital certification regulations promulgated pursuant to Title XVIII of the Social Security
Act, United States Code, title 42, section 1395, et seq. The commissioner may use as minimum
standards changes in the federal hospital certification regulations promulgated after May 7, 1981,
if the commissioner finds that such changes are reasonably necessary to protect public health
and safety. The commissioner shall also promulgate in rules additional minimum standards
for new construction.
(b) Each hospital and outpatient surgical center shall establish policies and procedures to
prevent the transmission of human immunodeficiency virus and hepatitis B virus to patients and
within the health care setting. The policies and procedures shall be developed in conformance
with the most recent recommendations issued by the United States Department of Health and
Human Services, Public Health Service, Centers for Disease Control. The commissioner of health
shall evaluate a hospital's compliance with the policies and procedures according to subdivision 4.
    Subd. 4. Routine inspections; presumption. Any hospital surveyed and accredited under
the standards of the hospital accreditation program of an approved accrediting organization that
submits to the commissioner within a reasonable time copies of (a) its currently valid accreditation
certificate and accreditation letter, together with accompanying recommendations and comments
and (b) any further recommendations, progress reports and correspondence directly related to
the accreditation is presumed to comply with application requirements of subdivision 1 and
the standards requirements of subdivision 3 and no further routine inspections or accreditation
information shall be required by the commissioner to determine compliance. Notwithstanding
the provisions of sections 144.54 and 144.653, subdivisions 2 and 4, hospitals shall be inspected
only as provided in this section. The provisions of section 144.653 relating to the assessment and
collection of fines shall not apply to any hospital. The commissioner of health shall annually
conduct, with notice, validation inspections of a selected sample of the number of hospitals
accredited by an approved accrediting organization, not to exceed ten percent of accredited
hospitals, for the purpose of determining compliance with the provisions of subdivision 3. If a
validation survey discloses a failure to comply with subdivision 3, the provisions of section
144.653 relating to correction orders, reinspections, and notices of noncompliance shall apply.
The commissioner shall also conduct any inspection necessary to determine whether hospital
construction, addition, or remodeling projects comply with standards for construction promulgated
in rules pursuant to subdivision 3. Pursuant to section 144.653, the commissioner shall inspect any
hospital that does not have a currently valid hospital accreditation certificate from an approved
accrediting organization. Nothing in this subdivision shall be construed to limit the investigative
powers of the Office of Health Facility Complaints as established in sections 144A.51 to 144A.54.
    Subd. 5. Coordination of inspections. Prior to conducting routine inspections of hospitals
and outpatient surgical centers, a state agency shall notify the commissioner of its intention to
inspect. The commissioner shall then determine whether the inspection is necessary in light of
any previous inspections conducted by the commissioner, any other state agency, or an approved
accrediting organization. The commissioner shall notify the agency of the determination and
may authorize the agency to conduct the inspection. No state agency may routinely inspect any
hospital without the authorization of the commissioner. The commissioner shall coordinate,
insofar as is possible, routine inspections conducted by state agencies, so as to minimize the
number of inspections to which hospitals are subject.
    Subd. 6. Suspension, revocation, and refusal to renew. (a) The commissioner may refuse
to grant or renew, or may suspend or revoke, a license on any of the following grounds:
(1) violation of any of the provisions of sections 144.50 to 144.56 or the rules or standards
issued pursuant thereto, or Minnesota Rules, chapters 4650 and 4675;
(2) permitting, aiding, or abetting the commission of any illegal act in the institution;
(3) conduct or practices detrimental to the welfare of the patient; or
(4) obtaining or attempting to obtain a license by fraud or misrepresentation; or
(5) with respect to hospitals and outpatient surgical centers, if the commissioner determines
that there is a pattern of conduct that one or more physicians who have a "financial or economic
interest," as defined in section 144.6521, subdivision 3, in the hospital or outpatient surgical
center, have not provided the notice and disclosure of the financial or economic interest required
by section 144.6521.
(b) The commissioner shall not renew a license for a boarding care bed in a resident room
with more than four beds.
    Subd. 7. Hearing. Prior to any suspension, revocation or refusal to renew a license, the
licensee shall be entitled to notice and a hearing as provided by sections 14.57 to 14.69. At each
hearing, the commissioner shall have the burden of establishing that a violation described in
subdivision 6 has occurred.
If a license is revoked, suspended, or not renewed, a new application for license may be
considered by the commissioner if the conditions upon which revocation, suspension, or refusal to
renew was based have been corrected and evidence of this fact has been satisfactorily furnished.
A new license may then be granted after proper inspection has been made and all provisions of
sections 144.50 to 144.56 and any rules promulgated thereunder, or Minnesota Rules, chapters
4650 and 4675, have been complied with and recommendation has been made by the inspector as
an agent of the commissioner.
    Subd. 8. Rules. The commissioner may promulgate rules necessary to implement the
provisions of this section, except that the standards described in subdivision 3 shall constitute
the sole minimum quality standards for licensure of hospitals.
    Subd. 9. Expiration of presently valid licenses. All licenses presently in effect shall remain
valid following May 7, 1981 and shall expire on the dates specified on the licenses unless
suspended or revoked.
    Subd. 10. Evaluation report. On November 15, 1983, the commissioner shall provide the
legislature and the governor with a written report evaluating the utilization of the accreditation
program, paying particular attention to its effect upon the public health and safety.
    Subd. 11. State hospitals not affected. Subdivisions 3, 4 and 5 do not apply to state hospitals
and other facilities operated under the direction of the commissioner of human services.
History: 1941 c 549 s 6; 1951 c 304 s 6; 1976 c 173 s 37; 1977 c 305 s 45; 1978 c 674 s 60;
1981 c 95 s 2; 1982 c 424 s 130; 1984 c 654 art 5 s 58; 1985 c 248 s 70; 1986 c 444; 1987 c 384
art 2 s 1; 1987 c 403 art 4 s 1; 1992 c 559 art 1 s 2; 2004 c 198 s 1-8; 2005 c 85 s 2-4

144.5509 RADIATION THERAPY FACILITY CONSTRUCTION.
(a) A radiation therapy facility may be constructed only by an entity owned, operated,
or controlled by a hospital licensed according to sections 144.50 to 144.56 either alone or
in cooperation with another entity.
(b) This section expires August 1, 2013.
History: 1Sp2003 c 14 art 7 s 42; 2006 c 190 s 1

144.551 HOSPITAL CONSTRUCTION MORATORIUM.
    Subdivision 1. Restricted construction or modification. (a) The following construction or
modification may not be commenced:
(1) any erection, building, alteration, reconstruction, modernization, improvement,
extension, lease, or other acquisition by or on behalf of a hospital that increases the bed capacity
of a hospital, relocates hospital beds from one physical facility, complex, or site to another, or
otherwise results in an increase or redistribution of hospital beds within the state; and
(2) the establishment of a new hospital.
(b) This section does not apply to:
(1) construction or relocation within a county by a hospital, clinic, or other health care
facility that is a national referral center engaged in substantial programs of patient care, medical
research, and medical education meeting state and national needs that receives more than 40
percent of its patients from outside the state of Minnesota;
(2) a project for construction or modification for which a health care facility held an approved
certificate of need on May 1, 1984, regardless of the date of expiration of the certificate;
(3) a project for which a certificate of need was denied before July 1, 1990, if a timely
appeal results in an order reversing the denial;
(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200,
section 2;
(5) a project involving consolidation of pediatric specialty hospital services within the
Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number of
pediatric specialty hospital beds among the hospitals being consolidated;
(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds
to an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
pediatric-orthopedic hospital on an existing site and that will not result in a net increase in the
number of hospital beds. Upon completion of the reconstruction, the licenses of both hospitals
must be reinstated at the capacity that existed on each site before the relocation;
(7) the relocation or redistribution of hospital beds within a hospital building or identifiable
complex of buildings provided the relocation or redistribution does not result in: (i) an increase
in the overall bed capacity at that site; (ii) relocation of hospital beds from one physical site or
complex to another; or (iii) redistribution of hospital beds within the state or a region of the state;
(8) relocation or redistribution of hospital beds within a hospital corporate system that
involves the transfer of beds from a closed facility site or complex to an existing site or complex
provided that: (i) no more than 50 percent of the capacity of the closed facility is transferred; (ii)
the capacity of the site or complex to which the beds are transferred does not increase by more
than 50 percent; (iii) the beds are not transferred outside of a federal health systems agency
boundary in place on July 1, 1983; and (iv) the relocation or redistribution does not involve
the construction of a new hospital building;
(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice
County that primarily serves adolescents and that receives more than 70 percent of its patients
from outside the state of Minnesota;
(10) a project to replace a hospital or hospitals with a combined licensed capacity of 130
beds or less if: (i) the new hospital site is located within five miles of the current site; and (ii) the
total licensed capacity of the replacement hospital, either at the time of construction of the initial
building or as the result of future expansion, will not exceed 70 licensed hospital beds, or the
combined licensed capacity of the hospitals, whichever is less;
(11) the relocation of licensed hospital beds from an existing state facility operated by the
commissioner of human services to a new or existing facility, building, or complex operated by
the commissioner of human services; from one regional treatment center site to another; or from
one building or site to a new or existing building or site on the same campus;
(12) the construction or relocation of hospital beds operated by a hospital having a statutory
obligation to provide hospital and medical services for the indigent that does not result in a net
increase in the number of hospital beds, notwithstanding section 144.552, 27 beds, of which 12
serve mental health needs, may be transferred from Hennepin County Medical Center to Regions
Hospital under this clause;
(13) a construction project involving the addition of up to 31 new beds in an existing
nonfederal hospital in Beltrami County;
(14) a construction project involving the addition of up to eight new beds in an existing
nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
(15) a construction project involving the addition of 20 new hospital beds used for
rehabilitation services in an existing hospital in Carver County serving the southwest suburban
metropolitan area. Beds constructed under this clause shall not be eligible for reimbursement
under medical assistance, general assistance medical care, or MinnesotaCare;
(16) a project for the construction or relocation of up to 20 hospital beds for the operation of
up to two psychiatric facilities or units for children provided that the operation of the facilities or
units have received the approval of the commissioner of human services;
(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation
services in an existing hospital in Itasca County;
(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County that
closed 20 rehabilitation beds in 2002, provided that the beds are used only for rehabilitation in the
hospital's current rehabilitation building. If the beds are used for another purpose or moved to
another location, the hospital's licensed capacity is reduced by 20 beds;
(19) a critical access hospital established under section 144.1483, clause (9), and section
1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that
delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, to
the extent that the critical access hospital does not seek to exceed the maximum number of
beds permitted such hospital under federal law;
(20) notwithstanding section 144.552, a project for the construction of a new hospital in the
city of Maple Grove with a licensed capacity of up to 300 beds provided that:
(i) the project, including each hospital or health system that will own or control the entity
that will hold the new hospital license, is approved by a resolution of the Maple Grove City
Council as of March 1, 2006;
(ii) the entity that will hold the new hospital license will be owned or controlled by one or
more not-for-profit hospitals or health systems that have previously submitted a plan or plans for a
project in Maple Grove as required under section 144.552, and the plan or plans have been found
to be in the public interest by the commissioner of health as of April 1, 2005;
(iii) the new hospital's initial inpatient services must include, but are not limited to, medical
and surgical services, obstetrical and gynecological services, intensive care services, orthopedic
services, pediatric services, noninvasive cardiac diagnostics, behavioral health services, and
emergency room services;
(iv) the new hospital:
(A) will have the ability to provide and staff sufficient new beds to meet the growing needs
of the Maple Grove service area and the surrounding communities currently being served by the
hospital or health system that will own or control the entity that will hold the new hospital license;
(B) will provide uncompensated care;
(C) will provide mental health services, including inpatient beds;
(D) will be a site for workforce development for a broad spectrum of health-care-related
occupations and have a commitment to providing clinical training programs for physicians and
other health care providers;
(E) will demonstrate a commitment to quality care and patient safety;
(F) will have an electronic medical records system, including physician order entry;
(G) will provide a broad range of senior services;
(H) will provide emergency medical services that will coordinate care with regional
providers of trauma services and licensed emergency ambulance services in order to enhance the
continuity of care for emergency medical patients; and
(I) will be completed by December 31, 2009, unless delayed by circumstances beyond the
control of the entity holding the new hospital license; and
(v) as of 30 days following submission of a written plan, the commissioner of health has not
determined that the hospitals or health systems that will own or control the entity that will hold
the new hospital license are unable to meet the criteria of this clause;
(21) a project approved under section 144.553;
(22) a project for the construction of a hospital with up to 25 beds in Cass County within
a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder is
approved by the Cass County Board; or
(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity
from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing a
separately licensed 13-bed skilled nursing facility.
    Subd. 2. Emergency waiver. The commissioner shall grant an emergency waiver from
the provisions of this section if the need for the project is a result of fire, tornado, flood, storm
damage, or other similar disaster, if adequate health care facilities are not available for the people
who previously used the applicant facility, and if the request for an emergency waiver is limited in
nature and scope only to those repairs necessitated by the natural disaster.
    Subd. 3. Enforcement. The district court in Ramsey County has jurisdiction to enjoin an
alleged violation of subdivision 1. At the request of the commissioner of health, the attorney
general may bring an action to enjoin an alleged violation. The commissioner of health shall
not issue a license for any portion of a hospital in violation of subdivision 1. No hospital in
violation of subdivision 1 may apply for or receive public funds under chapters 245 to 256B,
or from any other source.
    Subd. 4. Definitions. Except as indicated in this subdivision, the terms used in this section
have the meanings given them under Minnesota Statutes 1982, sections 145.832 to 145.845,
and the rules adopted under those sections.
The term "hospital" has the meaning given it in section 144.50.
History: 1990 c 500 s 1; 1990 c 568 art 2 s 8; 1993 c 243 s 1; 2000 c 488 art 9 s 1; 1Sp2001
c 9 art 1 s 37; 2002 c 379 art 1 s 113; 1Sp2003 c 14 art 7 s 43; 2004 c 187 s 1; 1Sp2005 c
4 art 6 s 22; 2006 c 172 s 1; 2006 c 249 s 1

144.552 PUBLIC INTEREST REVIEW.
(a) The following entities must submit a plan to the commissioner:
(1) a hospital seeking to increase its number of licensed beds; or
(2) an organization seeking to obtain a hospital license and notified by the commissioner
under section 144.553, subdivision 1, paragraph (c), that it is subject to this section.
The plan must include information that includes an explanation of how the expansion will
meet the public's interest. When submitting a plan to the commissioner, an applicant shall pay
the commissioner for the commissioner's cost of reviewing the plan, as determined by the
commissioner and notwithstanding section 16A.1283. Money received by the commissioner under
this section is appropriated to the commissioner for the purpose of administering this section.
(b) Plans submitted under this section shall include detailed information necessary for the
commissioner to review the plan and reach a finding. The commissioner may request additional
information from the hospital submitting a plan under this section and from others affected by the
plan that the commissioner deems necessary to review the plan and make a finding.
(c) The commissioner shall review the plan and, within 90 days, but no more than six months
if extenuating circumstances apply, issue a finding on whether the plan is in the public interest. In
making the recommendation, the commissioner shall consider issues including but not limited to:
(1) whether the new hospital or hospital beds are needed to provide timely access to care or
access to new or improved services;
(2) the financial impact of the new hospital or hospital beds on existing acute-care hospitals
that have emergency departments in the region;
(3) how the new hospital or hospital beds will affect the ability of existing hospitals in
the region to maintain existing staff;
(4) the extent to which the new hospital or hospital beds will provide services to nonpaying
or low-income patients relative to the level of services provided to these groups by existing
hospitals in the region; and
(5) the views of affected parties.
Prior to making a recommendation, the commissioner shall conduct a public hearing in the
affected hospital service area to take testimony from interested persons.
(d) Upon making a recommendation under paragraph (c), the commissioner shall provide a
copy of the recommendation to the chairs of the house and senate committees having jurisdiction
over health and human services policy and finance.
History: 2004 c 231 s 2; 2006 c 249 s 2

144.553 ALTERNATIVE APPROVAL PROCESS.
    Subdivision 1. Letter of intent; publication; acceptance of additional proposals. (a) An
organization seeking to obtain a hospital license must submit a letter of intent to the commissioner,
specifying the community in which the proposed hospital would be located and the number of
beds proposed for the new hospital. When multiple letters of intent are received, the commissioner
shall determine whether they constitute requests for separate projects or are competing proposals
to serve the same or a similar service area.
(b) Upon receipt of a letter under paragraph (a), the commissioner shall publish a notice in
the State Register that includes the information received from the organization under paragraph
(a). The notice must state that another organization interested in seeking a hospital license to serve
the same or a similar service area must notify the commissioner within 30 days.
(c) If no responses are received from additional organizations under paragraph (b), the
commissioner shall notify the entity seeking a license that it is required to submit a plan under
section 144.552 and shall notify the chairs of the house of representatives and senate committees
having jurisdiction over health and human services policy and finance that the project is subject to
sections 144.551 and 144.552.
    Subd. 2. Needs assessment. (a) If one or more responses are received by the commissioner
under subdivision 1, paragraph (b), the commissioner shall complete within 90 days a needs
assessment to determine if a new hospital is needed in the proposed service area.
(b) The organizations that have filed or responded to a letter of intent under subdivision 1
shall provide to the commissioner within 30 days of a request from the commissioner a statement
justifying the need for a new hospital in the service area and sufficient information, as determined
by the commissioner, to allow the commissioner to determine the need for a new hospital. The
information may include, but is not limited to, a demographic analysis of the proposed service
area, the number of proposed beds, the types of hospital services to be provided, and distances
and travel times to existing hospitals currently providing services in the service area.
(c) The commissioner shall make a determination of need for the new hospital. If the
commissioner determines that a new hospital in the service area is not justified, the commissioner
shall notify the applicants in writing, stating the reasons for the decision.
    Subd. 3. Process when hospital need is determined. (a) If the commissioner determines
that a new hospital is needed in the proposed service area, the commissioner shall notify the
applicants of that finding and shall select the applicant determined under the process established in
this subdivision to be best able to provide services consistent with the review criteria established
in this subdivision.
(b) The commissioner shall:
(1) determine market-specific criteria that shall be used to evaluate all proposals. The criteria
must include standards regarding:
(i) access to care;
(ii) quality of care;
(iii) cost of care; and
(iv) overall project feasibility;
(2) establish additional criteria at the commissioner's discretion. In establishing the criteria,
the commissioner shall consider the need for:
(i) mental health services in the service area, including both inpatient and outpatient services
for adults, adolescents, and children;
(ii) a significant commitment to providing uncompensated care, including discounts for
uninsured patients and coordination with other providers of care to low-income uninsured
persons; and
(iii) coordination with other hospitals so that specialized services are not unnecessarily
duplicated and are provided in sufficient volume to ensure the maintenance of high-quality
care; and
(3) define a service area for the proposed hospital. The service area shall consist of:
(i) in the 11-county metropolitan area, in St. Cloud, and in Duluth, the zip codes located
within a 20-mile radius of the proposed new hospital location; and
(ii) in the remainder of the state, the zip codes within a 30-mile radius of the proposed
new hospital location.
(c) The commissioner shall publish the criteria determined under paragraph (b) in the State
Register within 60 days of the determination under subdivision 2. Once published, the criteria
shall not be modified with respect to the particular project and applicants to which they apply.
The commissioner shall publish with the criteria guidelines for a proposal and submission
review process.
(d) For 60 days after the publication under paragraph (c), the commissioner shall accept
proposals to construct a hospital from organizations that have submitted a letter of intent under
subdivision 1, paragraph (a), or have notified the commissioner under subdivision 1, paragraph
(b). The proposal must include a plan for the new hospital and evidence of compliance with the
criteria specified under paragraph (b). Once submitted, the proposal may not be revised except:
(1) to submit corrections of material facts; or
(2) in response to a request from the commissioner to provide clarification or further
information.
(e) The commissioner shall determine within 90 days of the deadline for applications under
paragraph (d), which applicant has demonstrated that it is best able to provide services consistent
with the published criteria. The commissioner shall make this determination by order following
a hearing according to this paragraph. The hearing shall not constitute or be considered to be a
contested case hearing under chapter 14 and shall be conducted solely under the procedures
specified in this paragraph. The hearing shall commence upon at least 30 days' notice to the
applicants by the commissioner. The hearing may be conducted by the commissioner or by a
person designated by the commissioner. The designee may be an administrative law judge. The
purpose of the hearing shall be to receive evidence to assist the commissioner in determining
which applicant has demonstrated that it best meets the published criteria.
The parties to the hearing shall consist only of those applicants who have submitted a
completed application. Each applicant shall have the right to be represented by counsel, to present
evidence deemed relevant by the commissioner, and to examine and cross-examine witnesses.
Persons who are not parties to the proceeding but who wish to present comments or submit
information may do so in the manner determined by the commissioner or the commissioner's
designee. Any person who is not a party shall have no right to examine or cross-examine
witnesses. The commissioner may participate as an active finder of fact in the hearing and may
ask questions to elicit information or clarify answers or responses.
(f) Prior to making a determination selecting an application, the commissioner shall hold
a public hearing in the proposed hospital service area to accept comments from members of
the public. The commissioner shall take this information into consideration in making the
determination. The commissioner may appoint an advisory committee, including legislators
and local elected officials who represent the service area and outside experts to assist in the
recommendation process. The commissioner shall issue an order selecting an application
following the closing of the record of the hearing as determined by the hearing officer. The
commissioner's order shall include a statement of the reasons the selected application best meets
the published criteria.
(g) Within 30 days following the determination under paragraph (e), the commissioner shall
recommend the selected proposal to the legislature.
    Subd. 4. Payment of commissioner's expenses. Notwithstanding section 16A.1283,
applicants who are a party at any stage of the administrative process established in this section
shall pay the cost of that stage of the process, as determined by the commissioner. The cost of
the needs assessment, criteria development, and hearing shall be divided equally among the
applicants. Money received by the commissioner under this subdivision is appropriated to the
commissioner for the purpose of administering this section.
History: 2006 c 249 s 3
NOTE: This section as added by Laws 2006, chapter 249, section 3, expires January 1, 2009.
Laws 2006, chapter 249, section 6.

144.555 HOSPITAL CLOSINGS; PATIENT RELOCATIONS.
    Subdivision 1. Notice of closing or curtailing service. If a facility licensed under sections
144.50 to 144.56 voluntarily plans to cease operations or to curtail operations to the extent
that patients or residents must be relocated, the controlling persons of the facility must notify
the commissioner of health at least 90 days before the scheduled cessation or curtailment. The
commissioner shall cooperate with the controlling persons and advise them about relocating the
patients or residents.
    Subd. 2. Penalty. Failure to notify the commissioner under subdivision 1 may result in
issuance of a correction order under section 144.653, subdivision 5.
History: 1987 c 209 s 22

144.56 STANDARDS.
    Subdivision 1. Commissioner's powers. The state commissioner of health shall, in the
manner prescribed by law, adopt and enforce reasonable rules and standards under sections
144.50 to 144.56 which the commissioner finds to be necessary and in the public interests and
may rescind or modify them from time to time as may be in the public interest, insofar as such
action is not in conflict with any provision thereof.
    Subd. 2. Content of rules and standards. In the public interest the commissioner of health,
by such rules and standards, may regulate and establish minimum standards as to the construction,
equipment, maintenance, and operation of the institutions insofar as they relate to sanitation and
safety of the buildings and to the health, treatment, comfort, safety, and well-being of the persons
accommodated for care. Construction as used in this subdivision means the erection of new
buildings or the alterations of or additions to existing buildings commenced after the passage
of this act.
    Subd. 2a. Double beds in boarding care homes. The commissioner shall not adopt any rule
which unconditionally prohibits double beds in a boarding care home. The commissioner may
adopt rules setting criteria for when double beds will be allowed.
    Subd. 2b. Boarding care homes. The commissioner shall not adopt or enforce any rule
that limits:
(1) a certified boarding care home from providing nursing services in accordance with
the home's Medicaid certification; or
(2) a noncertified boarding care home registered under chapter 144D from providing home
care services in accordance with the home's registration.
    Subd. 3. Maternity patients. The commissioner of health shall, with the advice of the
commissioner of human services, prescribe such general rules for the conduct of all institutions
receiving maternity patients as shall be necessary to effect the purposes of all laws of the state
relating to maternity patients and newborn infants so far as the same are applicable.
    Subd. 4. Classes of institutions. The commissioner of health may classify the institutions
licensed under sections 144.50 to 144.56 on the basis of the type of care provided and may
prescribe separate rules and minimum standards for each class.
History: 1941 c 549 s 7; 1943 c 649 s 7; 1951 c 304 s 7; 1977 c 305 s 45; 1981 c 23 s 2;
1984 c 654 art 5 s 58; 1985 c 248 s 70; 1986 c 444; 1995 c 207 art 7 s 6; 1999 c 245 art 2 s 27

144.561 DESCRIPTION OF CERTAIN MEDICAL FACILITIES.
    Subdivision 1. Definitions. For purposes of this section, the following words have the
meanings given to them:
(a) "Person" means an individual, partnership, association, corporation, state, county or local
governmental unit or a division, department, board or agency of a governmental unit.
(b) "Medical facility" means an institution, office, clinic, or building, not attached to a
licensed hospital, where medical services for the diagnosis or treatment of illness or injury or the
maintenance of health are offered in an outpatient or ambulatory setting.
    Subd. 2. Prohibition. No person shall use the words "emergency," "emergent," "trauma,"
"critical," or any form of these words which suggest, offer, or imply the availability of immediate
care for any medical condition likely to cause death, disability or serious illness in the name of
any medical facilities, or in advertising, publications or signs identifying the medical facility
unless the facility is licensed under the provisions of section 144.50.
History: 1984 c 534 s 2

144.562 SWING BED APPROVAL; ISSUANCE OF LICENSE CONDITIONS.
    Subdivision 1. Definition. For the purposes of this section, "swing bed" means a hospital
bed licensed under sections 144.50 to 144.56 that has been granted a license condition under
this section and which has been certified to participate in the federal Medicare program under
United States Code, title 42, section 1395 (tt).
    Subd. 2. Eligibility for license condition. (a) A hospital is not eligible to receive a license
condition for swing beds unless (1) it either has a licensed bed capacity of less than 50 beds
defined in the federal Medicare regulations, Code of Federal Regulations, title 42, section 482.66,
or it has a licensed bed capacity of 50 beds or more and has swing beds that were approved for
Medicare reimbursement before May 1, 1985, or it has a licensed bed capacity of less than 65 beds
and the available nursing homes within 50 miles have had, in the aggregate, an average occupancy
rate of 96 percent or higher in the most recent two years as documented on the statistical reports
to the Department of Health; and (2) it is located in a rural area as defined in the federal Medicare
regulations, Code of Federal Regulations, title 42, section 482.66.
(b) Except for those critical access hospitals established under section 144.1483, clause (9),
and section 1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4,
that have an attached nursing home or that owned a nursing home located in the same municipality
as of May 1, 2005, eligible hospitals are allowed a total of 2,000 days of swing bed use per year.
Critical access hospitals that have an attached nursing home or that owned a nursing home located
in the same municipality as of May 1, 2005, are allowed swing bed use as provided in federal law.
(c) Except for critical access hospitals that have an attached nursing home or that owned a
nursing home located in the same municipality as of May 1, 2005, the commissioner of health
may approve swing bed use beyond 2,000 days as long as there are no Medicare certified skilled
nursing facility beds available within 25 miles of that hospital that are willing to admit the patient.
Critical access hospitals exceeding 2,000 swing bed days must maintain documentation that
they have contacted skilled nursing facilities within 25 miles to determine if any skilled nursing
facility beds are available that are willing to admit the patient.
(d) After reaching 2,000 days of swing bed use in a year, an eligible hospital to which this
limit applies may admit six additional patients to swing beds each year without seeking approval
from the commissioner or being in violation of this subdivision. These six swing bed admissions
are exempt from the limit of 2,000 annual swing bed days for hospitals subject to this limit.
(e) A health care system that is in full compliance with this subdivision may allocate its total
limit of swing bed days among the hospitals within the system, provided that no hospital in the
system without an attached nursing home may exceed 2,000 swing bed days per year.
    Subd. 3. Approval of license condition. The commissioner of health shall approve a license
condition for swing beds if the hospital meets all of the criteria of this subdivision:
(a) The hospital must meet the eligibility criteria in subdivision 2.
(b) The hospital must be in compliance with the Medicare conditions of participation for
swing beds under Code of Federal Regulations, title 42, section 482.66.
(c) The hospital must agree, in writing, to limit the length of stay of a patient receiving
services in a swing bed to not more than 40 days, or the duration of Medicare eligibility, unless the
commissioner of health approves a greater length of stay in an emergency situation. To determine
whether an emergency situation exists, the commissioner shall require the hospital to provide
documentation that continued services in the swing bed are required by the patient; that no skilled
nursing facility beds are available within 25 miles from the patient's home, or in some more
remote facility of the resident's choice, that can provide the appropriate level of services required
by the patient; and that other alternative services are not available to meet the needs of the patient.
If the commissioner approves a greater length of stay, the hospital shall develop a plan providing
for the discharge of the patient upon the availability of a nursing home bed or other services that
meet the needs of the patient. Permission to extend a patient's length of stay must be requested by
the hospital at least ten days prior to the end of the maximum length of stay.
(d) The hospital must agree, in writing, to limit admission to a swing bed only to (1) patients
who have been hospitalized and not yet discharged from the facility, or (2) patients who are
transferred directly from an acute care hospital.
(e) The hospital must agree, in writing, to report to the commissioner of health by December
1, 1985, and annually thereafter, in a manner required by the commissioner (1) the number of
patients readmitted to a swing bed within 60 days of a patient's discharge from the facility, (2) the
hospital's charges for care in a swing bed during the reporting period with a description of the care
provided for the rate charged, and (3) the number of beds used by the hospital for transitional care
and similar subacute inpatient care.
(f) The hospital must agree, in writing, to report statistical data on the utilization of the swing
beds on forms supplied by the commissioner. The data must include the number of swing beds,
the number of admissions to and discharges from swing beds, Medicare reimbursed patient days,
total patient days, and other information required by the commissioner to assess the utilization
of swing beds.
    Subd. 4. Issuance of license condition; renewals. The commissioner of health shall issue a
license condition to a hospital that complies with subdivisions 2 and 3. The license condition must
be granted when the license is first issued, when it is renewed, or during the hospital's licensure
year. The condition is valid for the hospital's licensure year. The license condition can be renewed
at the time of the hospital's license renewal if the hospital complies with subdivisions 2 and 3.
    Subd. 5. Inspections. Notwithstanding section 144.55, subdivision 4, the commissioner of
health may conduct inspections of a hospital granted a condition under this section to assess
compliance with this section.
    Subd. 6. Violations. Notwithstanding section 144.55, subdivision 4, if the hospital fails
to comply with subdivision 2 or 3, the commissioner of health shall issue a correction order
and penalty assessment under section 144.653 or may suspend, revoke, or refuse to renew the
license condition under section 144.55, subdivision 6. The penalty assessment for a violation of
subdivision 2 or 3 is $500.
    Subd. 7.[Obsolete]
History: 1Sp1985 c 3 s 3; 1986 c 420 s 1; 1989 c 282 art 2 s 9,10; 1995 c 207 art 7 s
7; 1Sp2005 c 4 art 6 s 23

144.563 NURSING SERVICES PROVIDED IN A HOSPITAL; PROHIBITED
PRACTICES.
A hospital that has been granted a license condition under section 144.562 must not provide
to patients not reimbursed by Medicare or medical assistance the types of services that would
be usually and customarily provided and reimbursed under medical assistance or Medicare as
services of a skilled nursing facility or intermediate care facility for more than 42 days and only
for patients who have been hospitalized and no longer require an acute level of care. Permission to
extend a patient's length of stay may be granted by the commissioner if requested by the physician
at least ten days prior to the end of the maximum length of stay.
History: 1Sp1985 c 3 s 4

144.564 MONITORING OF SUBACUTE OR TRANSITIONAL CARE SERVICES.
    Subdivision 1. Hospital data. The commissioner of health shall monitor the provision of
subacute or transitional care services provided in hospitals. All hospitals providing these services
must report statistical data on the extent and utilization of these services on forms supplied by the
commissioner. The data must include the following information: the number of admissions to and
discharges from subacute or transitional care beds, charges for services in these beds, the length
of stay and total patient days, admission origin and discharge destination, and other information
required by the commissioner to assess the utilization of these services. For purposes of this
subdivision, subacute or transitional care services is care provided in a hospital bed to patients
who have been hospitalized and no longer meet established acute care criteria, and care provided
to patients who are admitted for respite care.
    Subd. 2. Nursing home data. Nursing homes which provide services to individuals whose
length of stay in the facility is less than 42 days shall report the data required by subdivision 1 on
forms supplied by the commissioner of health.
    Subd. 3. Annual report. The commissioner shall monitor the provision of services described
in this section and shall report annually to the legislature concerning these services, including
recommendations on the need for legislation.
History: 1986 c 420 s 2

144.565 DIAGNOSTIC IMAGING FACILITIES.
    Subdivision 1. Utilization and services data; economic and financial interests. The
commissioner shall require diagnostic imaging facilities to annually report to the commissioner,
in the form and manner specified by the commissioner:
(1) utilization data for each health plan company and each public program, including
workers' compensation, as follows:
(i) the number of computerized tomography (CT) procedures performed;
(ii) the number of magnetic resonance imaging (MRI) procedures performed; and
(iii) the number of positron emission tomography (PET) procedures performed; and
(2) the names of all individuals with a financial or economic interest in the facility.
    Subd. 2. Commissioner's right to inspect records. If the report is not filed or the
commissioner of health has reason to believe the report is incomplete or false, the commissioner
shall have the right to inspect diagnostic imaging facility books, audits, and records.
    Subd. 3. Separate reports. For a diagnostic imaging facility that is not attached or not
contiguous to a hospital or a hospital affiliate, the commissioner shall require the information
in subdivision 1 be reported separately for each detached diagnostic imaging facility as part of
the report required under section 144.702. If any entity owns more than one diagnostic imaging
facility, that entity must report by individual facility.
    Subd. 4. Definitions. For purposes of this section, the following terms have the meanings
given:
(a) "Diagnostic imaging facility" means a health care facility that provides diagnostic
imaging services through the use of ionizing radiation or other imaging technique including,
but not limited to magnetic resonance imaging (MRI) or computerized tomography (CT) scan
on a freestanding or mobile basis.
(b) "Financial or economic interest" means a direct or indirect:
(1) equity or debt security issued by an entity, including, but not limited to, shares of stock
in a corporation, membership in a limited liability company, beneficial interest in a trust, units
or other interests in a partnership, bonds, debentures, notes or other equity interests or debt
instruments, or any contractual arrangements;
(2) membership, proprietary interest, or co-ownership with an individual, group, or
organization to which patients, clients, or customers are referred to; or
(3) employer-employee or independent contractor relationship, including, but not limited
to, those that may occur in a limited partnership, profit-sharing arrangement, or other similar
arrangement with any facility to which patients are referred, including any compensation between
a facility and a health care provider, the group practice of which the provider is a member or
employee or a related party with respect to any of them.
(c) "Freestanding" means a diagnostic imaging facility that is not located within a:
(1) hospital;
(2) location licensed as a hospital; or
(3) physician's office or clinic where the professional practice of medicine by licensed
physicians is the primary purpose and not the provision of ancillary services such as diagnostic
imaging.
(d) "Mobile" means a diagnostic imaging facility that is transported to various sites not
including movement within a hospital or a physician's office or clinic.
History: 2004 c 198 s 9

144.57 [Repealed, 1951 c 304 s 8]

144.571 [Repealed, 1983 c 260 s 68]

144.572 INSTITUTIONS EXCEPTED.
No rule nor requirement shall be made, nor standard established under sections 144.50
to 144.56 for any sanitarium conducted by and for the adherents of any recognized church or
religious denomination for the purpose of providing care and treatment for those who select and
depend upon spiritual means through prayer alone, in lieu of medical care, for healing, except
as to the sanitary and safe condition of the premises, cleanliness of operation, and its physical
equipment.
History: 1951 c 304 s 10; 1976 c 173 s 39; 1985 c 248 s 70; 1996 c 451 art 4 s 7

144.573 PETS IN CERTAIN INSTITUTIONS.
Facilities for the institutional care of human beings licensed under section 144.50, may keep
pet animals on the premises subject to reasonable rules as to the care, type and maintenance
of the pet.
History: 1979 c 38 s 2

144.574 DANGERS OF SHAKING INFANTS AND YOUNG CHILDREN.
    Subdivision 1. Education by hospitals. (a) A hospital licensed under sections 144.50 to
144.56 shall make available for viewing by the parents of each newborn baby delivered in the
hospital a video presentation on the dangers associated with shaking infants and young children.
(b) A hospital shall use a video obtained from the commissioner or approved by the
commissioner. The commissioner shall provide to a hospital and any interested individuals, at
cost, copies of an approved video. The commissioner shall review other video presentations for
possible approval upon the request of a hospital. The commissioner shall not require a hospital to
use videos that would require the hospital to pay royalties for use of the video, restrict viewing
in order to comply with public viewing or other restrictions, or be subject to other costs or
restrictions associated with copyrights.
(c) A hospital shall, whenever possible, request both parents to view the video.
(d) The showing or distribution of the video shall not subject any person or facility to any
action for damages or other relief provided the person or facility acted in good faith.
    Subd. 2. Education by health care providers. The commissioner shall establish a protocol
for health care providers to educate parents and primary caregivers about the dangers associated
with shaking infants and young children. The commissioner shall request family practice
physicians, pediatricians, and other pediatric health care providers to review these dangers with
the parents and primary caregivers of infants and young children up to the age of three at each
well-baby visit.
History: 1Sp2005 c 4 art 6 s 24

144.58 INFORMATION, CONFIDENTIAL.
Information of a confidential nature received by the state commissioner of health through
inspections and authorized under sections 144.50 to 144.56 shall not be disclosed except in a
proceeding involving the question of licensure.
History: 1941 c 549 s 9; 1951 c 304 s 11; 1977 c 305 s 45

144.581 HOSPITAL AUTHORITIES.
    Subdivision 1. Nonprofit corporation powers. A municipality, political subdivision, state
agency, or other governmental entity that owns or operates a hospital authorized, organized, or
operated under chapters 158, 250, 376, and 397, or under sections 246A.01 to 246A.27, 412.221,
447.05 to 447.13, 447.31, or 471.59, or under any special law authorizing or establishing a
hospital or hospital district shall, relative to the delivery of health care services, have, in addition
to any authority vested by law, the authority and legal capacity of a nonprofit corporation under
chapter 317A, including authority to
(a) enter shared service and other cooperative ventures,
(b) join or sponsor membership in organizations intended to benefit the hospital or hospitals
in general,
(c) enter partnerships,
(d) incorporate other corporations,
(e) have members of its governing authority or its officers or administrators serve as
directors, officers, or employees of the ventures, associations, or corporations,
(f) own shares of stock in business corporations,
(g) offer, directly or indirectly, products and services of the hospital, organization,
association, partnership, or corporation to the general public, and
(h) expend funds, including public funds in any form, or devote the resources of the hospital
or hospital district to recruit or retain physicians whose services are necessary or desirable for
meeting the health care needs of the population, and for successful performance of the hospital
or hospital district's public purpose of the promotion of health. Allowable uses of funds and
resources include the retirement of medical education debt, payment of one-time amounts in
consideration of services rendered or to be rendered, payment of recruitment expenses, payment
of moving expenses, and the provision of other financial assistance necessary for the recruitment
and retention of physicians, provided that the expenditures in whatever form are reasonable under
the facts and circumstances of the situation.
    Subd. 2. Use of hospital funds for corporate projects. In the event that the municipality,
political subdivision, state agency, or other governmental entity provides direct financial subsidy
to the hospital from tax revenue at the time an undertaking authorized under subdivision 1, clauses
(a) to (g), is established or funded, the hospital may not contribute funds to the undertaking for
more than three years and thereafter all funds must be repaid, with interest in no more than
ten years.
    Subd. 3. Converting public funds for individual benefit. The conversion of public funds
for the benefit of any individual shall constitute grounds for review and action by the attorney
general or the county attorney under section 609.54.
    Subd. 4. Other laws governing hospital board. The execution of the functions of the board
of directors of a hospital by an organization established under this section shall be subject to the
public purchasing requirements of section 471.345, the Open Meeting Law, chapter 13D, and
the Data Practices Act, chapter 13.
    Subd. 5. Closed meetings; recording. (a) Notwithstanding subdivision 4 or chapter 13D, a
public hospital or an organization established under this section may hold a closed meeting
to discuss specific marketing activity and contracts that might be entered into pursuant to the
marketing activity in cases where the hospital or organization is in competition with health care
providers that offer similar goods or services, and where disclosure of information pertaining
to those matters would cause harm to the competitive position of the hospital or organization,
provided that the goods or services do not require a tax levy. No contracts referred to in this
paragraph may be entered into earlier than 15 days after the proposed contract has been described
at a public meeting and the description entered in the minutes, except for contracts for consulting
services or with individuals for personal services.
(b) A meeting may not be closed under paragraph (a) except by a majority vote of the board
of directors in a public meeting. The time and place of the closed meeting must be announced at
the public meeting. A written roll of members present at the closed meeting must be available to
the public after the closed meeting. The proceedings of a closed meeting must be tape-recorded
and preserved by the board of directors for two years. The data on the tape are nonpublic data
under section 13.02, subdivision 9. However, the data become public data under section 13.02,
subdivision 14 , two years after the meeting, or when the hospital or organization takes action
on matters referred to in paragraph (a), except for contracts for consulting services. In the case
of personal service contracts, the data become public when the contract is signed. For entities
subject to section 471.345, a contract entered into by the board is subject to the requirements
of section 471.345.
(c) The board of directors may not discuss a tax levy, bond issuance, or other expenditure
of money unless the expenditure is directly related to specific marketing activities and contracts
described in paragraph (a) at a closed meeting.
History: 1984 c 554 s 1; 1984 c 655 art 2 s 15 subd 1; 1987 c 384 art 2 s 1; 1989 c 304
s 137; 1989 c 351 s 15; 1990 c 568 art 2 s 9; 1992 c 549 art 5 s 13; 1994 c 618 art 1 s 21;
1994 c 625 art 8 s 44

144.583 [Repealed, 1973 c 139 s 2]

144.584 [Repealed, 1976 c 173 s 64]

144.59 [Repealed, 1980 c 567 s 2]

144.60 [Repealed, 1980 c 567 s 2]

STATEWIDE TRAUMA SYSTEM

144.602 DEFINITIONS.
    Subdivision 1. Applicability. For purposes of sections 144.602 to 144.608, the terms defined
in this section have the meanings given them.
    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
    Subd. 3. Major trauma. "Major trauma" means a sudden severe injury or damage to the
body caused by an external force that results in potentially life-threatening injuries or that could
result in the following disabilities:
(1) impairment of cognitive or mental abilities;
(2) impairment of physical functioning; or
(3) disturbance of behavioral or emotional functioning.
    Subd. 4. Trauma hospital. "Trauma hospital" means a hospital that voluntarily meets the
commissioner's criteria under section 144.603 and that has been designated as a trauma hospital
under section 144.605.
History: 1Sp2005 c 4 art 6 s 25; 2006 c 212 art 3 s 12

144.603 STATEWIDE TRAUMA SYSTEM CRITERIA.
    Subdivision 1. Criteria established. The commissioner shall adopt criteria to ensure that
severely injured people are promptly transported and treated at trauma hospitals appropriate to
the severity of injury. Minimum criteria shall address emergency medical service trauma triage
and transportation guidelines as approved under section 144E.101, subdivision 14, designation
of hospitals as trauma hospitals, interhospital transfers, a trauma registry, and a trauma system
governance structure.
    Subd. 2. Basis; verification. The commissioner shall base the establishment, implementation,
and modifications to the criteria under subdivision 1 on the department-published Minnesota
comprehensive statewide trauma system plan. The commissioner shall seek the advice of
the Trauma Advisory Council in implementing and updating the criteria, using accepted and
prevailing trauma transport, treatment, and referral standards of the American College of
Surgeons, the American College of Emergency Physicians, the Minnesota Emergency Medical
Services Regulatory Board, the national Trauma Resources Network, and other widely recognized
trauma experts. The commissioner shall adapt and modify the standards as appropriate to
accommodate Minnesota's unique geography and the state's hospital and health professional
distribution and shall verify that the criteria are met by each hospital voluntarily participating in
the statewide trauma system.
    Subd. 3. Rule exemption and report to legislature. In developing and adopting the criteria
under this section, the commissioner of health is exempt from chapter 14, including section
14.386. By September 1, 2009, the commissioner must report to the legislature on implementation
of the voluntary trauma system, including recommendations on the need for including the trauma
system criteria in rule.
History: 1Sp2005 c 4 art 6 s 26

144.604 TRAUMA TRIAGE AND TRANSPORTATION.
    Subdivision 1. Transport requirement. Unless the Emergency Medical Services Regulatory
Board has approved a licensed ambulance service's deviation from the guidelines under section
144E.101, subdivision 14, the ambulance service must transport major trauma patients from the
scene to the highest state-designated trauma hospital within 30 minutes' transport time.
    Subd. 2. Ground ambulance exceptions. Notwithstanding subdivision 1, ground
ambulances must comply with the following:
(1) patients with compromised airways must be transported immediately to the nearest
designated trauma hospital; and
(2) level II trauma hospitals capable of providing definitive trauma care must not be bypassed
to reach a level I trauma hospital.
    Subd. 3. Undesignated hospitals. No major trauma patient shall be transported to a hospital
not participating in the statewide trauma system unless no trauma hospital is available within
30 minutes' transport time.
History: 1Sp2005 c 4 art 6 s 27

NOTE: This section, as added by Laws 2005, First Special Session chapter 4, article 6,
section 27, is effective July 1, 2009. Laws 2005, First Special Session chapter 4, article 6, section
27, the effective date.

144.605 DESIGNATING TRAUMA HOSPITALS.
    Subdivision 1. Naming privileges. Unless it has been designated a trauma hospital by the
commissioner, no hospital shall use the term trauma center or trauma hospital in its name or its
advertising or shall otherwise indicate it has trauma treatment capabilities.
    Subd. 2. Designation; reverification. The commissioner shall designate four levels of
trauma hospitals. A hospital that voluntarily meets the criteria for a particular level of trauma
hospital shall apply to the commissioner for designation and, upon the commissioner's verifying
the hospital meets the criteria, be designated a trauma hospital at the appropriate level for a
three-year period. Prior to the expiration of the three-year designation, a hospital seeking to
remain part of the voluntary system must apply for and successfully complete a reverification
process, be awaiting the site visit for the reverification, or be awaiting the results of the site
visit. The commissioner may extend a hospital's existing designation for up to 18 months on a
provisional basis if the hospital has applied for reverification in a timely manner but has not yet
completed the reverification process within the expiration of the three-year designation and the
extension is in the best interest of trauma system patient safety. To be granted a provisional
extension, the hospital must be:
(1) scheduled and awaiting the site visit for reverification;
(2) awaiting the results of the site visit; or
(3) responding to and correcting identified deficiencies identified in the site visit.
    Subd. 3. ACS verification. The commissioner shall grant the appropriate level I, II, or III
trauma hospital designation to a hospital that successfully completes and passes the American
College of Surgeons (ACS) verification standards at the hospital's cost, submits verification
documentation to the Trauma Advisory Council, and formally notifies the Trauma Advisory
Council of ACS verification.
    Subd. 4. Level III designation; not ACS verified. (a) The commissioner shall grant the
appropriate level III trauma hospital designation to a hospital that is not ACS verified but that
successfully completes the designation process under paragraph (b).
(b) The hospital must complete and submit a self-reported survey and application to the
Trauma Advisory Council for review, verifying that the hospital meets the criteria as a level III
trauma hospital. When the Trauma Advisory Council is satisfied the application is complete, the
commissioner shall arrange a site review visit. Upon successful completion of the site review, the
review team shall make written recommendations to the Trauma Advisory Council. If approved
by the Trauma Advisory Council, a letter of recommendation shall be sent to the commissioner
for final approval and designation.
    Subd. 5. Level IV designation. (a) The commissioner shall grant the appropriate level IV
trauma hospital designation to a hospital that successfully completes the designation process
under paragraph (b).
(b) The hospital must complete and submit a self-reported survey and application to the
Trauma Advisory Council for review, verifying that the hospital meets the criteria as a level IV
trauma hospital. When the Trauma Advisory Council is satisfied the application is complete, the
council shall review the application and, if the council approves the application, send a letter of
recommendation to the commissioner for final approval and designation. The commissioner
shall grant a level IV designation and shall arrange a site review visit within three years of the
designation and every three years thereafter, to coincide with the three-year reverification process.
    Subd. 6. Changes in designation. Changes in a trauma hospital's ability to meet the criteria
for the hospital's level of designation must be self-reported to the Trauma Advisory Council and
to other regional hospitals and local emergency medical services providers and authorities. If the
hospital cannot correct its ability to meet the criteria for its level within six months, the hospital
may apply for redesignation at a different level.
    Subd. 7. Higher designation. A trauma hospital may apply for a higher trauma hospital
designation one time during the hospital's three-year designation by completing the designation
process for that level of trauma hospital.
    Subd. 8. Loss of designation. The commissioner may refuse to designate or redesignate
or may revoke a previously issued trauma hospital designation if a hospital does not meet the
criteria of the statewide trauma plan, in the interests of patient safety, or if a hospital denies
or refuses a reasonable request by the commissioner or the commissioner's designee to verify
information by correspondence or an on-site visit.
History: 1Sp2005 c 4 art 6 s 28

144.606 INTERHOSPITAL TRANSFERS.
    Subdivision 1. Written procedures required. A level III or IV trauma hospital must have
predetermined, written procedures that direct the internal process for rapidly and efficiently
transferring a major trauma patient to definitive care, including:
(1) clearly identified anatomic and physiologic criteria that, if met, will immediately initiate
transfer to definitive care;
(2) a listing of appropriate ground and air transport services, including primary and
secondary telephone contact numbers; and
(3) immediately available supplies, records, or other necessary resources that will accompany
a patient.
    Subd. 2. Transfer agreements. (a) A level III or IV trauma hospital may transfer patients to
a hospital with which the trauma hospital has a written transfer agreement.
(b) Each agreement must be current and with a trauma hospital or trauma hospitals capable
of caring for major trauma injuries.
(c) A level III or IV trauma hospital must have a current transfer agreement with a hospital
that has special capabilities in the treatment of burn injuries and a transfer agreement with a
second hospital that has special capabilities in the treatment of burn injuries, should the primary
transfer hospital be unable to accept a burn patient.
History: 1Sp2005 c 4 art 6 s 29

144.607 TRAUMA REGISTRY.
    Subdivision 1. Registry participation required. A trauma hospital must participate in the
statewide trauma registry.
    Subd. 2. Trauma reporting. A trauma hospital must report major trauma injuries as part of
the reporting for the traumatic brain injury and spinal cord injury registry required in sections
144.661 to 144.665.
    Subd. 3. Application of other law. Sections 144.661 to 144.665 apply to a major trauma
reported to the statewide trauma registry, with the exception of sections 144.662, clause (2),
and 144.664, subdivision 3.
History: 1Sp2005 c 4 art 6 s 30

144.608 TRAUMA ADVISORY COUNCIL.
    Subdivision 1. Trauma Advisory Council established. (a) A Trauma Advisory Council
is established to advise, consult with, and make recommendations to the commissioner on the
development, maintenance, and improvement of a statewide trauma system.
(b) The council shall consist of the following members:
(1) a trauma surgeon certified by the American College of Surgeons who practices in a
level I or II trauma hospital;
(2) a general surgeon certified by the American College of Surgeons whose practice
includes trauma and who practices in a designated rural area as defined under section 144.1501,
subdivision 1 , paragraph (b);
(3) a neurosurgeon certified by the American Board of Neurological Surgery who practices
in a level I or II trauma hospital;
(4) a trauma program nurse manager or coordinator practicing in a level I or II trauma
hospital;
(5) an emergency physician certified by the American College of Emergency Physicians
whose practice includes emergency room care in a level I, II, III, or IV trauma hospital;
(6) an emergency room nurse manager who practices in a level III or IV trauma hospital;
(7) a family practice physician whose practice includes emergency room care in a level
III or IV trauma hospital located in a designated rural area as defined under section 144.1501,
subdivision 1 , paragraph (b);
(8) a nurse practitioner, as defined under section 144.1501, subdivision 1, paragraph (h),
or a physician assistant, as defined under section 144.1501, subdivision 1, paragraph (j), whose
practice includes emergency room care in a level IV trauma hospital located in a designated rural
area as defined under section 144.1501, subdivision 1, paragraph (b);
(9) a pediatrician certified by the American Academy of Pediatrics whose practice includes
emergency room care in a level I, II, III, or IV trauma hospital;
(10) an orthopedic surgeon certified by the American Board of Orthopaedic Surgery whose
practice includes trauma and who practices in a level I, II, or III trauma hospital;
(11) the state emergency medical services medical director appointed by the Emergency
Medical Services Regulatory Board;
(12) a hospital administrator of a level III or IV trauma hospital located in a designated rural
area as defined under section 144.1501, subdivision 1, paragraph (b);
(13) a rehabilitation specialist whose practice includes rehabilitation of patients with major
trauma injuries or traumatic brain injuries and spinal cord injuries as defined under section
144.661;
(14) an attendant or ambulance director who is an EMT, EMT-I, or EMT-P within the
meaning of section 144E.001 and who actively practices with a licensed ambulance service in
a primary service area located in a designated rural area as defined under section 144.1501,
subdivision 1 , paragraph (b); and
(15) the commissioner of public safety or the commissioner's designee.
(c) Council members whose appointment is dependent on practice in a level III or IV trauma
hospital may be appointed to an initial term based upon their statements that the hospital intends
to become a level III or IV facility by July 1, 2009.
    Subd. 2. Council administration. (a) The council must meet at least twice a year but
may meet more frequently at the call of the chair, a majority of the council members, or the
commissioner.
(b) The terms, compensation, and removal of members of the council are governed by
section 15.059, except that the council expires June 30, 2015.
(c) The council may appoint subcommittees and workgroups. Subcommittees shall consist of
council members. Workgroups may include noncouncil members. Noncouncil members shall
be compensated for workgroup activities under section 15.059, subdivision 3, but shall receive
expenses only.
    Subd. 3. Regional trauma advisory councils. (a) Up to eight regional trauma advisory
councils may be formed as needed.
(b) Regional trauma advisory councils shall advise, consult with, and make recommendation
to the state Trauma Advisory Council on suggested regional modifications to the statewide trauma
criteria that will improve patient care and accommodate specific regional needs.
(c) Each regional advisory council must have no more than 15 members. The commissioner,
in consultation with the Emergency Medical Services Regulatory Board, shall name the council
members.
(d) Regional council members may receive expenses in the same manner and amount as
authorized by the plan adopted under section 43A.18, subdivision 2.
History: 1Sp2005 c 4 art 6 s 31

144.61 [Repealed, 1980 c 567 s 2]

144.62 [Repealed, 1980 c 567 s 2]

144.63 [Repealed, 1980 c 567 s 2]

144.64 [Repealed, 1980 c 567 s 2]

144.65 [Repealed, 1980 c 567 s 2]

NURSING HOME ADMISSION CONTRACTS

144.6501 NURSING HOME ADMISSION CONTRACTS.
    Subdivision 1. Definitions. For purposes of this section, the following terms have the
meanings given them.
(a) "Facility" means a nursing home licensed under chapter 144A or a boarding care facility
licensed under sections 144.50 to 144.58.
(b) "Contract of admission," "admission contract," or "admission agreement," includes, but
is not limited to, all documents that a resident or resident's representative must sign at the time of,
or as a condition of, admission to the facility. Oral representations and statements between the
facility and the resident or resident's representative are not part of the contract of admission unless
expressly contained in writing in those documents. The contract of admission must specify the
obligations of the resident or the responsible party.
(c) "Legal representative" means an attorney-in-fact under a valid power of attorney executed
by the prospective resident, or a conservator or guardian appointed for the prospective resident, or
a representative payee appointed for the prospective resident, or other agent of limited powers.
(d) "Responsible party" means a person who has access to the resident's income and assets
and who agrees to apply the resident's income and assets to pay for the resident's care or who
agrees to make and complete an application for medical assistance on behalf of the resident.
    Subd. 2. Waivers of liability prohibited. An admission contract must not include a waiver
of facility liability for the health and safety or personal property of a resident while the resident
is under the facility's supervision. An admission contract must not include a provision that the
facility knows or should know to be deceptive, unlawful, or unenforceable under state or federal
law, nor any provision that requires or implies a lesser standard of care or responsibility than is
required by law.
    Subd. 3. Contracts of admission. (a) A facility shall make complete unsigned copies of
its admission contract available to potential applicants and to the state or local long-term care
ombudsman immediately upon request.
(b) A facility shall post conspicuously within the facility, in a location accessible to public
view, either a complete copy of its admission contract or notice of its availability from the facility.
(c) An admission contract must be printed in black type of at least ten-point type size. The
facility shall give a complete copy of the admission contract to the resident or the resident's legal
representative promptly after it has been signed by the resident or legal representative.
(d) An admission contract is a consumer contract under sections 325G.29 to 325G.37.
(e) All admission contracts must state in bold capital letters the following notice to applicants
for admission: "NOTICE TO APPLICANTS FOR ADMISSION. READ YOUR ADMISSION
CONTRACT. ORAL STATEMENTS OR COMMENTS MADE BY THE FACILITY OR YOU
OR YOUR REPRESENTATIVE ARE NOT PART OF YOUR ADMISSION CONTRACT
UNLESS THEY ARE ALSO IN WRITING. DO NOT RELY ON ORAL STATEMENTS OR
COMMENTS THAT ARE NOT INCLUDED IN THE WRITTEN ADMISSION CONTRACT."
    Subd. 4. Resident and facility obligations. (a) Before or at the time of admission, the
facility shall make reasonable efforts to communicate the content of the admission contract to,
and obtain on the admission contract the signature of, the person who is to be admitted to the
facility and the responsible party. The admission contract must be signed by the prospective
resident unless the resident is legally incompetent or cannot understand or sign the admission
contract because of the resident's medical condition.
(b) If the resident cannot sign the admission contract, the reason must be documented in the
resident's medical record by the admitting physician.
(c) If the determination under paragraph (b) has been made, the facility may request the
signature of another person on behalf of the applicant, subject to the provisions of paragraph
(d). The facility must not require the person to disclose any information regarding the person's
personal financial assets, liabilities, or income, unless the person voluntarily chooses to become
financially responsible for the resident's care. The facility must issue timely billing, respond to
questions, and monitor timely payment.
(d) A person who desires to assume financial responsibility for the resident's care may
contract with the facility to do so. A person other than the resident or a financially responsible
spouse who signs an admission contract must not be required by the facility to assume personal
financial liability for the resident's care. However, if the responsible party has signed the
admission contract and fails to make timely payment of the facility obligation, or knowingly fails
to spend down the resident's assets appropriately for the purpose of obtaining medical assistance,
then the responsible party shall be liable to the facility for the resident's costs of care which are
not paid for by medical assistance. A responsible party shall be personally liable only to the extent
the resident's income or assets were misapplied.
(e) The admission contract must include written notice in the signature block, in bold capital
letters, that a person other than the resident or financially responsible spouse may not be required
by the facility to assume personal financial liability for the resident's care.
(f) This subdivision does not preclude the facility from obtaining the signature of a legal
representative, if applicable.
    Subd. 5. Public benefits eligibility. An admission contract must clearly and explicitly state
whether the facility participates in the Medicare, medical assistance, or Veterans Administration
programs. If the facility's participation in any of those programs is limited for any reason, the
admission contract must clearly state the limitation and whether the facility is eligible to receive
payment from the program for the person who is considering admission or who has been admitted
to the facility.
    Subd. 6. Medical assistance payment. (a) An admission contract for a facility that is
certified for participation in the medical assistance program must state that neither the prospective
resident, nor anyone on the resident's behalf, is required to pay privately any amount for which the
resident's care at the facility has been approved for payment by medical assistance or to make any
kind of donation, voluntary or otherwise. Except as permitted under section 6015 of the Deficit
Reduction Act of 2005, Public Law 109-171, an admission contract must state that the facility does
not require as a condition of admission, either in its admission contract or by oral promise before
signing the admission contract, that residents remain in private pay status for any period of time.
(b) The admission contract must state that upon presentation of proof of eligibility, the
facility will submit a medical assistance claim for reimbursement and will return any and all
payments made by the resident, or by any person on the resident's behalf, for services covered by
medical assistance, upon receipt of medical assistance payment.
(c) A facility that participates in the medical assistance program shall not charge for the day
of the resident's discharge from the facility or subsequent days.
(d) If a facility's charges incurred by the resident are delinquent for 30 days, and no person
has agreed to apply for medical assistance for the resident, the facility may petition the court
under chapter 525 to appoint a representative for the resident in order to apply for medical
assistance for the resident.
(e) The remedy provided in this subdivision does not preclude a facility from seeking any
other remedy available under other laws of this state.
    Subd. 7. Consent to treatment. An admission contract must not include a clause requiring a
resident to sign a consent to all treatment ordered by any physician. An admission contract may
require consent only for routine nursing care or emergency care. An admission contract must
contain a clause that informs the resident of the right to refuse treatment.
    Subd. 8. Written acknowledgment. An admission contract must contain a written
acknowledgment that the resident has been informed of the patient's bill of rights, as required in
section 144.652.
    Subd. 9. Violations; penalties. (a) Violation of this section is grounds for issuance of a
correction order, and if uncorrected, a penalty assessment issued by the commissioner of health,
under section 144A.10. The civil fine for noncompliance with a correction order issued under
this section is $250 per day.
(b) Unless otherwise expressly provided, the remedies or penalties provided by this
subdivision do not preclude a resident from seeking any other remedy and penalty available
under other laws of this state.
    Subd. 10. Applicability. This section applies to new admissions to facilities on and after
October 1, 1989. This section does not require the execution of a new admission contract for a
resident who was residing in a facility before June 1, 1989. However, provisions of the admission
contract that are inconsistent with or in conflict with this section are voidable at the sole option of
the resident. Residents must be given notice of the changes in admission contracts according to
this section and must be given the opportunity to execute a new admission contract that conforms
to this section.
History: 1989 c 285 s 2; 1990 c 426 art 1 s 19; 1995 c 136 s 1,2; 2005 c 10 art 4 s 1;
2006 c 282 art 17 s 23

144.6503 FACILITIES FOR ALZHEIMER'S DISEASE OR RELATED DISORDER.
(a) If a nursing facility markets or otherwise promotes services for persons with Alzheimer's
disease or related disorders, whether in a segregated or general unit, the facility's direct care staff
and their supervisors must be trained in dementia care.
(b) Areas of required training include:
(1) an explanation of Alzheimer's disease and related disorders;
(2) assistance with activities of daily living;
(3) problem solving with challenging behaviors; and
(4) communication skills.
(c) The facility shall provide to consumers in written or electronic form a description of the
training program, the categories of employees trained, the frequency of training, and the basic
topics covered.
History: 2003 c 37 s 1

SUBACUTE CARE WAIVERS

144.6505 SUBACUTE CARE WAIVERS.
    Subdivision 1. Subacute care; waiver from state and federal rules and regulations. The
commissioners of health and human services shall work with providers to examine state and
federal rules and regulations governing the provision of care in nursing facilities and apply for
federal waivers and pursue state law changes to any impediments to the provision of subacute
care in skilled nursing facilities.
    Subd. 2. Definition of subacute care. (a) For the purpose of this section, "subacute care"
means comprehensive inpatient care, as further defined in this subdivision, designed for persons
who:
(1) have or have had an acute illness or accident, or an acute exacerbation of a chronic
illness, and who require a moderate level of service intensity;
(2) do not require, or no longer require, technologically intensive diagnosis or management;
(3) have concurrent medical, nursing, and discharge and/or nondischarge oriented
rehabilitation objectives that are expected to be achieved within a specified time; and
(4) require interdisciplinary management.
(b) Subacute care includes goal-oriented treatment rendered immediately after, or as an
appropriate alternative to, acute hospitalization with the goal of transitioning patients towards
increased independence or lower acuity level in a cost-effective environment, to treat one or more
specific active complex medical conditions or to administer one or more technically complex
treatments, in the context of a patient's underlying long-term conditions and overall situation.
(c) Subacute care does not generally depend heavily on high technology monitoring or
complex diagnostic procedures.
(d) Subacute care requires the coordinated services of an interdisciplinary team including
physicians, nurses, and other relevant professional disciplines, who are trained and knowledgeable
to assess and manage these specific conditions and perform the necessary procedures.
(e) Subacute care is provided as part of a specifically defined program.
(f) Subacute care includes more intensive care than traditional nursing facility care and less
intensive care than acute care and may be provided at a variety of sites, including hospitals
and skilled nursing facilities.
(g) Subacute care requires recurrent patient assessment on a daily to weekly basis and review
of the clinical course and treatment plan for a limited time period ranging from several days to
several months, until the condition is stabilized or a predetermined treatment course is completed.
History: 1995 c 207 art 7 s 8; 1995 c 263 s 14

PATIENTS BILL OF RIGHTS

144.651 HEALTH CARE BILL OF RIGHTS.
    Subdivision 1. Legislative intent. It is the intent of the legislature and the purpose of this
section to promote the interests and well being of the patients and residents of health care
facilities. No health care facility may require a patient or resident to waive these rights as a
condition of admission to the facility. Any guardian or conservator of a patient or resident or, in
the absence of a guardian or conservator, an interested person, may seek enforcement of these
rights on behalf of a patient or resident. An interested person may also seek enforcement of these
rights on behalf of a patient or resident who has a guardian or conservator through administrative
agencies or in district court having jurisdiction over guardianships and conservatorships. Pending
the outcome of an enforcement proceeding the health care facility may, in good faith, comply with
the instructions of a guardian or conservator. It is the intent of this section that every patient's
civil and religious liberties, including the right to independent personal decisions and knowledge
of available choices, shall not be infringed and that the facility shall encourage and assist in
the fullest possible exercise of these rights.
    Subd. 2. Definitions. For the purposes of this section, "patient" means a person who is
admitted to an acute care inpatient facility for a continuous period longer than 24 hours, for the
purpose of diagnosis or treatment bearing on the physical or mental health of that person. For
purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, "patient" also means a person who
receives health care services at an outpatient surgical center. "Patient" also means a minor who is
admitted to a residential program as defined in section 253C.01. For purposes of subdivisions 1, 3
to 16, 18, 20 and 30, "patient" also means any person who is receiving mental health treatment
on an outpatient basis or in a community support program or other community-based program.
"Resident" means a person who is admitted to a nonacute care facility including extended care
facilities, nursing homes, and boarding care homes for care required because of prolonged
mental or physical illness or disability, recovery from injury or disease, or advancing age. For
purposes of all subdivisions except subdivisions 28 and 29, "resident" also means a person who
is admitted to a facility licensed as a board and lodging facility under Minnesota Rules, parts
4625.0100 to 4625.2355, or a supervised living facility under Minnesota Rules, parts 4665.0100
to 4665.9900, and which operates a rehabilitation program licensed under Minnesota Rules, parts
9530.4100 to 9530.4450.
    Subd. 3. Public policy declaration. It is declared to be the public policy of this state that
the interests of each patient and resident be protected by a declaration of a patients' bill of rights
which shall include but not be limited to the rights specified in this section.
    Subd. 4. Information about rights. Patients and residents shall, at admission, be told that
there are legal rights for their protection during their stay at the facility or throughout their course
of treatment and maintenance in the community and that these are described in an accompanying
written statement of the applicable rights and responsibilities set forth in this section. In the case
of patients admitted to residential programs as defined in section 253C.01, the written statement
shall also describe the right of a person 16 years old or older to request release as provided in
section 253B.04, subdivision 2, and shall list the names and telephone numbers of individuals
and organizations that provide advocacy and legal services for patients in residential programs.
Reasonable accommodations shall be made for those with communication impairments and those
who speak a language other than English. Current facility policies, inspection findings of state
and local health authorities, and further explanation of the written statement of rights shall be
available to patients, residents, their guardians or their chosen representatives upon reasonable
request to the administrator or other designated staff person, consistent with chapter 13, the Data
Practices Act, and section 626.557, relating to vulnerable adults.
    Subd. 5. Courteous treatment. Patients and residents have the right to be treated with
courtesy and respect for their individuality by employees of or persons providing service in a
health care facility.
    Subd. 6. Appropriate health care. Patients and residents shall have the right to appropriate
medical and personal care based on individual needs. Appropriate care for residents means care
designed to enable residents to achieve their highest level of physical and mental functioning.
This right is limited where the service is not reimbursable by public or private resources.
    Subd. 7. Physician's identity. Patients and residents shall have or be given, in writing, the
name, business address, telephone number, and specialty, if any, of the physician responsible for
coordination of their care. In cases where it is medically inadvisable, as documented by the
attending physician in a patient's or resident's care record, the information shall be given to
the patient's or resident's guardian or other person designated by the patient or resident as a
representative.
    Subd. 8. Relationship with other health services. Patients and residents who receive
services from an outside provider are entitled, upon request, to be told the identity of the provider.
Residents shall be informed, in writing, of any health care services which are provided to those
residents by individuals, corporations, or organizations other than their facility. Information shall
include the name of the outside provider, the address, and a description of the service which may
be rendered. In cases where it is medically inadvisable, as documented by the attending physician
in a patient's or resident's care record, the information shall be given to the patient's or resident's
guardian or other person designated by the patient or resident as a representative.
    Subd. 9. Information about treatment. Patients and residents shall be given by their
physicians complete and current information concerning their diagnosis, treatment, alternatives,
risks, and prognosis as required by the physician's legal duty to disclose. This information shall
be in terms and language the patients or residents can reasonably be expected to understand.
Patients and residents may be accompanied by a family member or other chosen representative.
This information shall include the likely medical or major psychological results of the treatment
and its alternatives. In cases where it is medically inadvisable, as documented by the attending
physician in a patient's or resident's medical record, the information shall be given to the patient's
or resident's guardian or other person designated by the patient or resident as a representative.
Individuals have the right to refuse this information.
Every patient or resident suffering from any form of breast cancer shall be fully informed,
prior to or at the time of admission and during her stay, of all alternative effective methods of
treatment of which the treating physician is knowledgeable, including surgical, radiological, or
chemotherapeutic treatments or combinations of treatments and the risks associated with each of
those methods.
    Subd. 10. Participation in planning treatment; notification of family members. (a)
Patients and residents shall have the right to participate in the planning of their health care. This
right includes the opportunity to discuss treatment and alternatives with individual caregivers,
the opportunity to request and participate in formal care conferences, and the right to include a
family member or other chosen representative. In the event that the patient or resident cannot
be present, a family member or other representative chosen by the patient or resident may be
included in such conferences.
(b) If a patient or resident who enters a facility is unconscious or comatose or is unable to
communicate, the facility shall make reasonable efforts as required under paragraph (c) to notify
either a family member or a person designated in writing by the patient as the person to contact in
an emergency that the patient or resident has been admitted to the facility. The facility shall allow
the family member to participate in treatment planning, unless the facility knows or has reason
to believe the patient or resident has an effective advance directive to the contrary or knows the
patient or resident has specified in writing that they do not want a family member included in
treatment planning. After notifying a family member but prior to allowing a family member
to participate in treatment planning, the facility must make reasonable efforts, consistent with
reasonable medical practice, to determine if the patient or resident has executed an advance
directive relative to the patient or resident's health care decisions. For purposes of this paragraph,
"reasonable efforts" include:
(1) examining the personal effects of the patient or resident;
(2) examining the medical records of the patient or resident in the possession of the facility;
(3) inquiring of any emergency contact or family member contacted under this section
whether the patient or resident has executed an advance directive and whether the patient or
resident has a physician to whom the patient or resident normally goes for care; and
(4) inquiring of the physician to whom the patient or resident normally goes for care, if
known, whether the patient or resident has executed an advance directive. If a facility notifies
a family member or designated emergency contact or allows a family member to participate in
treatment planning in accordance with this paragraph, the facility is not liable to the patient or
resident for damages on the grounds that the notification of the family member or emergency
contact or the participation of the family member was improper or violated the patient's privacy
rights.
(c) In making reasonable efforts to notify a family member or designated emergency contact,
the facility shall attempt to identify family members or a designated emergency contact by
examining the personal effects of the patient or resident and the medical records of the patient or
resident in the possession of the facility. If the facility is unable to notify a family member or
designated emergency contact within 24 hours after the admission, the facility shall notify the
county social service agency or local law enforcement agency that the patient or resident has been
admitted and the facility has been unable to notify a family member or designated emergency
contact. The county social service agency and local law enforcement agency shall assist the
facility in identifying and notifying a family member or designated emergency contact. A county
social service agency or local law enforcement agency that assists a facility in implementing this
subdivision is not liable to the patient or resident for damages on the grounds that the notification
of the family member or emergency contact or the participation of the family member was
improper or violated the patient's privacy rights.
    Subd. 11. Continuity of care. Patients and residents shall have the right to be cared for with
reasonable regularity and continuity of staff assignment as far as facility policy allows.
    Subd. 12. Right to refuse care. Competent patients and residents shall have the right to
refuse treatment based on the information required in subdivision 9. Residents who refuse
treatment, medication, or dietary restrictions shall be informed of the likely medical or major
psychological results of the refusal, with documentation in the individual medical record. In cases
where a patient or resident is incapable of understanding the circumstances but has not been
adjudicated incompetent, or when legal requirements limit the right to refuse treatment, the
conditions and circumstances shall be fully documented by the attending physician in the patient's
or resident's medical record.
    Subd. 13. Experimental research. Written, informed consent must be obtained prior to a
patient's or resident's participation in experimental research. Patients and residents have the right
to refuse participation. Both consent and refusal shall be documented in the individual care record.
    Subd. 14. Freedom from maltreatment. Patients and residents shall be free from
maltreatment as defined in the Vulnerable Adults Protection Act. "Maltreatment" means conduct
described in section 626.5572, subdivision 15, or the intentional and nontherapeutic infliction
of physical pain or injury, or any persistent course of conduct intended to produce mental or
emotional distress. Every patient and resident shall also be free from nontherapeutic chemical
and physical restraints, except in fully documented emergencies, or as authorized in writing after
examination by a patient's or resident's physician for a specified and limited period of time, and
only when necessary to protect the resident from self-injury or injury to others.
    Subd. 15. Treatment privacy. Patients and residents shall have the right to respectfulness
and privacy as it relates to their medical and personal care program. Case discussion, consultation,
examination, and treatment are confidential and shall be conducted discreetly. Privacy shall be
respected during toileting, bathing, and other activities of personal hygiene, except as needed for
patient or resident safety or assistance.
    Subd. 16. Confidentiality of records. Patients and residents shall be assured confidential
treatment of their personal and medical records, and may approve or refuse their release to any
individual outside the facility. Residents shall be notified when personal records are requested by
any individual outside the facility and may select someone to accompany them when the records
or information are the subject of a personal interview. Copies of records and written information
from the records shall be made available in accordance with this subdivision and section 144.335.
This right does not apply to complaint investigations and inspections by the Department of Health,
where required by third party payment contracts, or where otherwise provided by law.
    Subd. 17. Disclosure of services available. Patients and residents shall be informed,
prior to or at the time of admission and during their stay, of services which are included in the
facility's basic per diem or daily room rate and that other services are available at additional
charges. Facilities shall make every effort to assist patients and residents in obtaining information
regarding whether the Medicare or medical assistance program will pay for any or all of the
aforementioned services.
    Subd. 18. Responsive service. Patients and residents shall have the right to a prompt and
reasonable response to their questions and requests.
    Subd. 19. Personal privacy. Patients and residents shall have the right to every consideration
of their privacy, individuality, and cultural identity as related to their social, religious, and
psychological well-being. Facility staff shall respect the privacy of a resident's room by knocking
on the door and seeking consent before entering, except in an emergency or where clearly
inadvisable.
    Subd. 20. Grievances. Patients and residents shall be encouraged and assisted, throughout
their stay in a facility or their course of treatment, to understand and exercise their rights as
patients, residents, and citizens. Patients and residents may voice grievances and recommend
changes in policies and services to facility staff and others of their choice, free from restraint,
interference, coercion, discrimination, or reprisal, including threat of discharge. Notice of the
grievance procedure of the facility or program, as well as addresses and telephone numbers for
the Office of Health Facility Complaints and the area nursing home ombudsman pursuant to the
Older Americans Act, section 307(a)(12) shall be posted in a conspicuous place.
Every acute care inpatient facility, every residential program as defined in section 253C.01,
every nonacute care facility, and every facility employing more than two people that provides
outpatient mental health services shall have a written internal grievance procedure that, at a
minimum, sets forth the process to be followed; specifies time limits, including time limits for
facility response; provides for the patient or resident to have the assistance of an advocate;
requires a written response to written grievances; and provides for a timely decision by an
impartial decision maker if the grievance is not otherwise resolved. Compliance by hospitals,
residential programs as defined in section 253C.01 which are hospital-based primary treatment
programs, and outpatient surgery centers with section 144.691 and compliance by health
maintenance organizations with section 62D.11 is deemed to be compliance with the requirement
for a written internal grievance procedure.
    Subd. 21. Communication privacy. Patients and residents may associate and communicate
privately with persons of their choice and enter and, except as provided by the Minnesota
Commitment Act, leave the facility as they choose. Patients and residents shall have access, at
their expense, to writing instruments, stationery, and postage. Personal mail shall be sent without
interference and received unopened unless medically or programmatically contraindicated and
documented by the physician in the medical record. There shall be access to a telephone where
patients and residents can make and receive calls as well as speak privately. Facilities which
are unable to provide a private area shall make reasonable arrangements to accommodate the
privacy of patients' or residents' calls. Upon admission to a facility where federal law prohibits
unauthorized disclosure of patient or resident identifying information to callers and visitors,
the patient or resident, or the legal guardian or conservator of the patient or resident, shall
be given the opportunity to authorize disclosure of the patient's or resident's presence in the
facility to callers and visitors who may seek to communicate with the patient or resident. To
the extent possible, the legal guardian or conservator of a patient or resident shall consider the
opinions of the patient or resident regarding the disclosure of the patient's or resident's presence in
the facility. This right is limited where medically inadvisable, as documented by the attending
physician in a patient's or resident's care record. Where programmatically limited by a facility
abuse prevention plan pursuant to section 626.557, subdivision 14, paragraph (b), this right shall
also be limited accordingly.
    Subd. 22. Personal property. Patients and residents may retain and use their personal
clothing and possessions as space permits, unless to do so would infringe upon rights of other
patients or residents, and unless medically or programmatically contraindicated for documented
medical, safety, or programmatic reasons. The facility must either maintain a central locked
depository or provide individual locked storage areas in which residents may store their valuables
for safekeeping. The facility may, but is not required to, provide compensation for or replacement
of lost or stolen items.
    Subd. 23. Services for the facility. Patients and residents shall not perform labor or services
for the facility unless those activities are included for therapeutic purposes and appropriately
goal-related in their individual medical record.
    Subd. 24. Choice of supplier. Residents may purchase or rent goods or services not included
in the per diem rate from a supplier of their choice unless otherwise provided by law. The
supplier shall ensure that these purchases are sufficient to meet the medical or treatment needs
of the residents.
    Subd. 25. Financial affairs. Competent residents may manage their personal financial
affairs, or shall be given at least a quarterly accounting of financial transactions on their behalf
if they delegate this responsibility in accordance with the laws of Minnesota to the facility for
any period of time.
    Subd. 26. Right to associate. Residents may meet with visitors and participate in activities
of commercial, religious, political, as defined in section 203B.11 and community groups without
interference at their discretion if the activities do not infringe on the right to privacy of other
residents or are not programmatically contraindicated. This includes the right to join with other
individuals within and outside the facility to work for improvements in long-term care. Upon
admission to a facility where federal law prohibits unauthorized disclosure of patient or resident
identifying information to callers and visitors, the patient or resident, or the legal guardian or
conservator of the patient or resident, shall be given the opportunity to authorize disclosure of the
patient's or resident's presence in the facility to callers and visitors who may seek to communicate
with the patient or resident. To the extent possible, the legal guardian or conservator of a patient
or resident shall consider the opinions of the patient or resident regarding the disclosure of the
patient's or resident's presence in the facility.
    Subd. 27. Advisory councils. Residents and their families shall have the right to organize,
maintain, and participate in resident advisory and family councils. Each facility shall provide
assistance and space for meetings. Council meetings shall be afforded privacy, with staff or
visitors attending only upon the council's invitation. A staff person shall be designated the
responsibility of providing this assistance and responding to written requests which result from
council meetings. Resident and family councils shall be encouraged to make recommendations
regarding facility policies.
    Subd. 28. Married residents. Residents, if married, shall be assured privacy for visits by
their spouses and, if both spouses are residents of the facility, they shall be permitted to share
a room, unless medically contraindicated and documented by their physicians in the medical
records.
    Subd. 29. Transfers and discharges. Residents shall not be arbitrarily transferred or
discharged. Residents must be notified, in writing, of the proposed discharge or transfer and its
justification no later than 30 days before discharge from the facility and seven days before transfer
to another room within the facility. This notice shall include the resident's right to contest the
proposed action, with the address and telephone number of the area nursing home ombudsman
pursuant to the Older Americans Act, section 307(a)(12). The resident, informed of this right, may
choose to relocate before the notice period ends. The notice period may be shortened in situations
outside the facility's control, such as a determination by utilization review, the accommodation of
newly-admitted residents, a change in the resident's medical or treatment program, the resident's
own or another resident's welfare, or nonpayment for stay unless prohibited by the public program
or programs paying for the resident's care, as documented in the medical record. Facilities shall
make a reasonable effort to accommodate new residents without disrupting room assignments.
    Subd. 30. Protection and advocacy services. Patients and residents shall have the right of
reasonable access at reasonable times to any available rights protection services and advocacy
services so that the patient may receive assistance in understanding, exercising, and protecting
the rights described in this section and in other law. This right shall include the opportunity for
private communication between the patient and a representative of the rights protection service
or advocacy service.
    Subd. 31. Isolation and restraints. A minor patient who has been admitted to a residential
program as defined in section 253C.01 has the right to be free from physical restraint and isolation
except in emergency situations involving a likelihood that the patient will physically harm the
patient's self or others. These procedures may not be used for disciplinary purposes, to enforce
program rules, or for the convenience of staff. Isolation or restraint may be used only upon the
prior authorization of a physician, psychiatrist, or licensed psychologist, only when less restrictive
measures are ineffective or not feasible and only for the shortest time necessary.
    Subd. 32. Treatment plan. A minor patient who has been admitted to a residential program
as defined in section 253C.01 has the right to a written treatment plan that describes in behavioral
terms the case problems, the precise goals of the plan, and the procedures that will be utilized to
minimize the length of time that the minor requires inpatient treatment. The plan shall also state
goals for release to a less restrictive facility and follow-up treatment measures and services, if
appropriate. To the degree possible, the minor patient and the minor patient's parents or guardian
shall be involved in the development of the treatment and discharge plan.
    Subd. 33. Restraints. (a) Competent nursing home residents, family members of residents
who are not competent, and legally appointed conservators, guardians, and health care agents
as defined under section 145C.01, have the right to request and consent to the use of a physical
restraint in order to treat the medical symptoms of the resident.
(b) Upon receiving a request for a physical restraint, a nursing home shall inform the
resident, family member, or legal representative of alternatives to and the risks involved with
physical restraint use. The nursing home shall provide a physical restraint to a resident only upon
receipt of a signed consent form authorizing restraint use and a written order from the attending
physician that contains statements and determinations regarding medical symptoms and specifies
the circumstances under which restraints are to be used.
(c) A nursing home providing a restraint under paragraph (b) must:
(1) document that the procedures outlined in that paragraph have been followed;
(2) monitor the use of the restraint by the resident; and
(3) periodically, in consultation with the resident, the family, and the attending physician,
reevaluate the resident's need for the restraint.
(d) A nursing home shall not be subject to fines, civil money penalties, or other state or
federal survey enforcement remedies solely as the result of allowing the use of a physical restraint
as authorized in this subdivision. Nothing in this subdivision shall preclude the commissioner
from taking action to protect the health and safety of a resident if:
(1) the use of the restraint has jeopardized the health and safety of the resident; and
(2) the nursing home failed to take reasonable measures to protect the health and safety
of the resident.
(e) For purposes of this subdivision, "medical symptoms" include:
(1) a concern for the physical safety of the resident; and
(2) physical or psychological needs expressed by a resident. A resident's fear of falling may
be the basis of a medical symptom.
A written order from the attending physician that contains statements and determinations regarding
medical symptoms is sufficient evidence of the medical necessity of the physical restraint.
(f) When determining nursing facility compliance with state and federal standards for the use
of physical restraints, the commissioner of health is bound by the statements and determinations
contained in the attending physician's order regarding medical symptoms. For purposes of this
order, "medical symptoms" include the request by a competent resident, family member of a
resident who is not competent, or legally appointed conservator, guardian, or health care agent as
defined under section 145C.01, that the facility provide a physical restraint in order to enhance
the physical safety of the resident.
History: 1973 c 688 s 1; 1976 c 274 s 1; 1982 c 504 s 1; 1983 c 248 s 1; 1984 c 654 art 5
s 8; 1984 c 657 s 1; 1986 c 326 s 1-6; 1986 c 444; 1989 c 186 s 1; 1989 c 282 art 3 s 5; 1991
c 255 s 19; 1993 c 54 s 1-3; 1995 c 136 s 3,4; 1995 c 189 s 8; 1995 c 229 art 4 s 5,6; 1996 c
277 s 1; 1998 c 254 art 2 s 10; 1999 c 83 s 1; 2004 c 198 s 10

144.652 BILL OF RIGHTS NOTICE TO PATIENT OR RESIDENT; VIOLATION.
    Subdivision 1. Distribution; posting. Except as provided below, section 144.651 shall be
posted conspicuously in a public place in all facilities licensed under the provisions of sections
144.50 to 144.58, or 144A.02. Copies of the law shall be furnished the patient or resident and the
patient or resident's guardian or conservator upon admittance to the facility. Facilities providing
services to patients may delete section 144.651, subdivisions 24 to 29, and those portions of
other subdivisions that apply only to residents, from copies posted or distributed to patients with
appropriate notation that residents have additional rights under law. The policy statement shall
include the address and telephone number of the Board of Medical Practice and/or the name and
phone number of the person within the facility to whom inquiries about the medical care received
may be directed. The notice shall include a brief statement describing how to file a complaint with
the Office of Health Facility Complaints established pursuant to section 144A.52 concerning a
violation of section 144.651 or any other state statute or rule. This notice shall include the address
and phone number of the Office of Health Facility Complaints.
    Subd. 2. Correction order; emergencies. A substantial violation of the rights of any patient
or resident as defined in section 144.651, shall be grounds for issuance of a correction order
pursuant to section 144.653 or 144A.10. The issuance or nonissuance of a correction order shall
not preclude, diminish, enlarge, or otherwise alter private action by or on behalf of a patient or
resident to enforce any unreasonable violation of the patient's or resident's rights. Compliance
with the provisions of section 144.651 shall not be required whenever emergency conditions,
as documented by the attending physician in a patient's medical record or a resident's care
record, indicate immediate medical treatment, including but not limited to surgical procedures, is
necessary and it is impossible or impractical to comply with the provisions of section 144.651
because delay would endanger the patient's or resident's life, health, or safety.
History: 1973 c 688 s 2; 1976 c 173 s 41; 1976 c 222 s 28; 1976 c 274 s 2; 1977 c 326 s 1;
1983 c 248 s 2; 1986 c 444; 1991 c 106 s 6

144.6521 DISCLOSURE OF FINANCIAL INTEREST.
    Subdivision 1. Disclosure. No health care provider with a financial or economic interest
in, or an employment or contractual arrangement that limits referral options with, a hospital,
outpatient surgical center or diagnostic imaging facility, or an affiliate of one of these entities,
shall refer a patient to that hospital, center, or facility, or an affiliate of one of these entities, unless
the health care provider discloses in writing to the patient, in advance of the referral, the existence
of such an interest, employment, or arrangement.
The written disclosure form must be printed in letters of at least 12-point boldface type and
must read as follows: "Your health care provider is referring you to a facility or service in which
your health care provider has a financial or economic interest."
Hospitals, outpatient surgical centers, and diagnostic imaging facilities shall promptly report
to the commissioner of health any suspected violations of this section by a health care provider
who has made a referral to such hospital, outpatient surgical center, or diagnostic imaging facility
without providing the written notice.
    Subd. 2. Posting of notice. In addition to the requirement in subdivision 1, each health care
provider who makes referrals to a hospital, outpatient surgical center or diagnostic imaging
facility, or an affiliate of one of these entities in which the health care provider has a financial or
economic interest, or has an employment or contractual arrangement with one of these entities that
limits referral options, shall post a notice of this interest, employment, or arrangement in a patient
reception area or waiting room or other conspicuous public location within the provider's facility.
    Subd. 3. Definition. (a) For purposes of this section, the following definitions apply.
(b) "Affiliate" means an entity that controls, is controlled by, or is under common control
with another entity.
(c) "Diagnostic imaging facility" has the meaning provided in section 144.565, subdivision 4.
(d) "Employment or contractual arrangement that limits referral options" means a
requirement of, or a financial incentive, provided to a health care provider to refer a patient to a
specific hospital, outpatient surgical center or diagnostic imaging facility, or an affiliate of one of
these entities even if other options exist for the patient.
(e) "Freestanding" has the meaning provided in section 144.565, subdivision 4.
(f) "Financial or economic interest" means a direct or indirect:
(1) equity or debt security issued by an entity, including, but not limited to, shares of stock
in a corporation, membership in a limited liability company, beneficial interest in a trust, units
or other interests in a partnership, bonds, debentures, notes or other equity interests or debt
instruments, or any contractual arrangements;
(2) membership, proprietary interest, or co-ownership with an individual, group, or
organization to which patients, clients, or customers are referred to; or
(3) employer-employee or independent contractor relationship, including, but not limited
to, those that may occur in a limited partnership, profit-sharing arrangement, or other similar
arrangement with any facility to which patients are referred, including any compensation between
a facility and a health care provider, the group practice of which the provider is a member or
employee or a related party with respect to any of them.
(g) "Health care provider" means an individual licensed by a health licensing board as
defined in section 214.01, subdivision 2, who has the authority, within the individual's scope of
practice, to make referrals to a hospital, outpatient surgical center, or diagnostic imaging facility.
(h) "Mobile" has the meaning provided in section 144.565, subdivision 4.
History: 2004 c 198 s 11

144.653 RULES; PERIODIC INSPECTIONS; ENFORCEMENT.
    Subdivision 1. Rules. The state commissioner of health is the exclusive state agency charged
with the responsibility and duty of inspecting all facilities required to be licensed under the
provisions of sections 144.50 to 144.58. The state commissioner of health shall enforce its rules
subject only to the authority of the Department of Public Safety respecting the enforcement of fire
and safety standards in licensed health care facilities and the responsibility of the commissioner of
human services pursuant to sections 245A.01 to 245A.16 and 252.28.
    Subd. 2. Periodic inspection. All facilities required to be licensed under the provisions of
sections 144.50 to 144.58 shall be periodically inspected by the state commissioner of health to
ensure compliance with rules and standards. Inspections shall occur at different times throughout
the calendar year. The commissioner of health may enter into agreements with political
subdivisions providing for the inspection of such facilities by locally employed inspectors.
The commissioner of health shall conduct inspections and reinspections of facilities licensed
under the provisions of sections 144.50 to 144.56 with a frequency and in a manner calculated
to produce the greatest benefit to residents within the limits of the resources available to the
commissioner. In performing this function, the commissioner may devote proportionately more
resources to the inspection of those facilities in which conditions present the most serious
concerns with respect to resident health, treatment, comfort, safety, and well-being.
These conditions include but are not limited to: change in ownership; frequent change
in administration in excess of normal turnover rates; complaints about care, safety, or rights;
where previous inspections or reinspections have resulted in correction orders related to care,
safety, or rights; and, where persons involved in ownership or administration of the facility have
been indicted for alleged criminal activity. Any health care facility that has none of the above
conditions or any other condition established by the commissioner that poses a risk to resident
care, safety, or rights shall be inspected once every two years.
    Subd. 3. Enforcement. With the exception of the Department of Public Safety which has the
exclusive jurisdiction to enforce state fire and safety standards, the state commissioner of health
is the exclusive state agency charged with the responsibility and duty of inspecting facilities
required to be licensed under the provisions of sections 144.50 to 144.58 and enforcing the
rules and standards prescribed by it.
The commissioner may request and must be given access to relevant information, records,
incident reports, or other documents in the possession of a licensed facility if the commissioner
considers them necessary for the discharge of responsibilities. For the purposes of inspections and
securing information to determine compliance with the licensure laws and rules, the commissioner
need not present a release, waiver, or consent of the individual. The identities of patients or
residents must be kept private as defined by section 13.02, subdivision 12.
    Subd. 4. Without notice. One or more unannounced inspections of each facility required
to be licensed under the provisions of sections 144.50 to 144.58 or Minnesota Rules, chapter
4675, shall be made annually.
    Subd. 5. Correction orders. Whenever a duly authorized representative of the state
commissioner of health finds upon inspection of a facility required to be licensed under the
provisions of sections 144.50 to 144.58 that the licensee of such facility is not in compliance
with sections 144.411 to 144.417, 144.50 to 144.58, 144.651, or 626.557, or the applicable
rules promulgated under those sections, a correction order shall be issued to the licensee. The
correction order shall state the deficiency, cite the specific rule violated, and specify the time
allowed for correction.
    Subd. 6. Reinspections; fines. If upon reinspection it is found that the licensee of a facility
required to be licensed under the provisions of sections 144.50 to 144.58 has not corrected
deficiencies specified in the correction order, a notice of noncompliance with a correction
order shall be issued stating all deficiencies not corrected. Unless a hearing is requested under
subdivision 8, the licensee shall forfeit to the state within 15 days after receipt by the licensee
of such notice of noncompliance with a correction order up to $1,000 for each deficiency not
corrected. For each subsequent reinspection, the licensee may be fined an additional amount for
each deficiency which has not been corrected. All forfeitures shall be paid into the general fund.
The commissioner of health shall promulgate by rule a schedule of fines applicable for each type
of uncorrected deficiency.
    Subd. 7. Recovery. Any unpaid forfeitures may be recovered by the attorney general.
    Subd. 8. Hearings. A licensee of a facility required to be licensed under the provisions
of sections 144.50 to 144.58 is entitled to a hearing on any notice of noncompliance with a
correction order issued to the licensee as a result of a reinspection, provided that the licensee
makes a written request therefor within 15 days of receipt by the licensee of the notice of
noncompliance with a correction order. Failure to request a hearing shall result in the forfeiture
of a penalty as determined by the commissioner of health in accordance with subdivision 6. A
request for a hearing shall operate as a stay during the hearing and review process of the payment
of any forfeiture provided for in this section. Upon receipt of the request for a hearing, a hearing
officer, who shall not be an employee of the state commissioner of health, shall be appointed
by the state commissioner of health, and the hearing officer shall promptly schedule a hearing
on the matter, giving at least ten days' notice of the date, time, and place of the hearing to the
licensee. Upon determining that the licensee of a facility required to be licensed under sections
144.50 to 144.58 has not corrected the deficiency specified in the correction order, the hearing
officer shall impose a penalty as determined by the commissioner of health in accordance with
subdivision 6. The hearing and review thereof shall be in accordance with the relevant provisions
of the Administrative Procedure Act.
    Subd. 9. Nonlimiting. Nothing in this section shall be construed to limit the powers granted
to the state commissioner of health in section 144.55.
History: 1973 c 688 s 3; 1975 c 310 s 6,7,37; 1976 c 173 s 42; 1977 c 305 s 45; 1Sp1981 c 4
art 1 s 76; 1983 c 312 art 1 s 16; 1984 c 654 art 5 s 58; 1985 c 248 s 70; 1986 c 444; 1987 c
209 s 23; 1989 c 209 art 2 s 1; 1991 c 286 s 4; 2004 c 198 s 12

144.6535 VARIANCE OR WAIVER.
    Subdivision 1. Request for variance or waiver. A hospital may request that the
commissioner grant a variance or waiver from the provisions of Minnesota Rules, chapter 4640
or 4645. A request for a variance or waiver must be submitted to the commissioner in writing.
Each request must contain:
(1) the specific rule or rules for which the variance or waiver is requested;
(2) the reasons for the request;
(3) the alternative measures that will be taken if a variance or waiver is granted;
(4) the length of time for which the variance or waiver is requested; and
(5) other relevant information deemed necessary by the commissioner to properly evaluate
the request for the variance or waiver.
    Subd. 2. Criteria for evaluation. The decision to grant or deny a variance or waiver must be
based on the commissioner's evaluation of the following criteria:
(1) whether the variance or waiver will adversely affect the health, treatment, comfort,
safety, or well-being of a patient;
(2) whether the alternative measures to be taken, if any, are equivalent to or superior to those
prescribed in Minnesota Rules, chapter 4640 or 4645; and
(3) whether compliance with the rule or rules would impose an undue burden upon the
applicant.
    Subd. 3. Notification of variance. The commissioner must notify the applicant in writing of
the decision. If a variance or waiver is granted, the notification must specify the period of time
for which the variance or waiver is effective and the alternative measures or conditions, if any,
to be met by the applicant.
    Subd. 4. Effect of alternative measures or conditions. (a) Alternative measures or
conditions attached to a variance or waiver have the same force and effect as the rules under
Minnesota Rules, chapter 4640 or 4645, and are subject to the issuance of correction orders and
penalty assessments in accordance with section 144.55.
(b) Fines for a violation of this section shall be in the same amount as that specified for the
particular rule for which the variance or waiver was requested.
    Subd. 5. Renewal. A request for renewal of a variance or waiver must be submitted in
writing at least 45 days before its expiration date. Renewal requests must contain the information
specified in subdivision 1. A variance or waiver must be renewed by the commissioner if the
applicant continues to satisfy the criteria in subdivision 2 and the alternative measures or
conditions, if any, specified under subdivision 3 and demonstrates compliance with the alternative
measures or conditions imposed at the time the original variance or waiver was granted.
    Subd. 6. Denial, revocation, or refusal to renew. The commissioner must deny, revoke,
or refuse to renew a variance or waiver if it is determined that the criteria in subdivision 2 or
the alternative measures or conditions, if any, specified under subdivision 3 are not met. The
applicant must be notified in writing of the reasons for the decision and informed of the right to
appeal the decision.
    Subd. 7. Appeal procedure. An applicant may contest the denial, revocation, or refusal to
renew a variance or waiver by requesting a contested case hearing under chapter 14. The applicant
must submit, within 15 days of the receipt of the commissioner's decision, a written request for a
hearing. The request for hearing must set forth in detail the reasons why the applicant contends
the decision of the commissioner should be reversed or modified. At the hearing, the applicant
has the burden of proving that it satisfied the criteria specified in subdivision 2 or the alternative
measures or conditions, if any, specified under subdivision 3, except in a proceeding challenging
the revocation of a variance or waiver.
History: 2001 c 29 s 1

144.654 EXPERTS MAY BE EMPLOYED.
The state commissioner of health may employ experts in the field of health care to assist the
staffs of facilities required to be licensed under the provisions of sections 144.50 to 144.58, or
144A.02, in programming and providing adequate care of the patients and residents of the facility.
Alternate methods of care for patients and residents of the facilities shall be researched by the
state commissioner of health using the knowledge and experience of experts employed therefor.
History: 1973 c 688 s 4; 1976 c 173 s 43; 1977 c 305 s 45

144.655 PROGRAM FOR VOLUNTARY MEDICAL AID.
Licensed physicians may visit a facility required to be licensed under the provisions of
sections 144.50 to 144.58, or 144A.02, and examine patients and residents thereof under a
program which shall be established by the state commissioner of health and regulated and
governed by rules promulgated by the state commissioner of health pursuant to the Administrative
Procedure Act. The rules shall protect the privacy of patients and residents of facilities. No patient
or resident of any facility shall be required to submit to an examination under the program.
The state commissioner of health shall consult with medical schools and other experts for the
purpose of establishing the program. The state commissioner of health shall encourage the active
participation of all licensed physicians on a voluntary basis in the program.
History: 1973 c 688 s 5; 1976 c 173 s 44; 1977 c 305 s 45

144.656 EMPLOYEES TO BE COMPENSATED.
All employees of facilities required to be licensed under the provisions of sections 144.50 to
144.58, or 144A.02, participating in orientation programs or in in-service training provided by the
facility shall be compensated therefor at their regular rate of pay, provided, however, that this
section will be effective only to the extent that facilities are reimbursed for the compensation by
the commissioner of human services in the proportion of welfare to total residents and patients in
the facility.
History: 1973 c 688 s 6; 1976 c 173 s 45; 1984 c 654 art 5 s 58

144.657 VOLUNTEER EFFORTS ENCOURAGED.
The state commissioner of health, through the dissemination of information to appropriate
organizations, shall encourage citizens to promote improved care in facilities required to be
licensed under the provisions of sections 144.50 to 144.58, or 144A.02, throughout the state.
History: 1973 c 688 s 7; 1976 c 173 s 46; 1977 c 305 s 45

144.658 EPIDEMIOLOGIC DATA DISCOVERY.
Notwithstanding any law to the contrary, health data on an individual collected by public
health officials conducting an epidemiologic investigation to reduce morbidity or mortality is not
subject to discovery in a legal action.
History: 1985 c 298 s 41

144.6581 DETERMINATION OF WHETHER DATA IDENTIFIES INDIVIDUALS.
The commissioner of health may: (1) withhold access to health or epidemiologic data if
the commissioner determines the data are data on an individual, as defined in section 13.02,
subdivision 5 ; or (2) grant access to health or epidemiologic data, if the commissioner determines
the data are summary data as defined in section 13.02, subdivision 19. In the exercise of this
discretion, the commissioner shall consider whether the data requested, alone or in combination,
may constitute information from which an individual subject of data may be identified using
epidemiologic methods. In making this determination, the commissioner shall consider disease
incidence, associated risk factors for illness, and similar factors unique to the data by which
it could be linked to a specific subject of the data. This discretion is limited to health or
epidemiologic data maintained by the commissioner of health or a board of health, as defined
in section 145A.02.
History: 1993 c 351 s 26

144.6585 IDENTIFICATION OF HEALTH CARE PROVIDERS.
Any health care provider who is licensed, credentialed, or registered by a health-related
licensing board as defined under section 214.01, subdivision 2, must wear a name tag that
indicates by words, letters, abbreviations, or insignia the profession or occupation of the
individual. The name tag must be worn whenever the health care provider is rendering health
services to a patient, unless wearing the name tag would create a safety or health risk to the
patient. The failure to wear a name tag is not reportable under chapter 214.
History: 1997 c 237 s 15

144.659 [Repealed, 1982 c 419 s 2]

144.66 [Repealed, 1987 c 403 art 2 s 164]

TRAUMATIC BRAIN AND SPINAL CORD INJURIES

144.661 DEFINITIONS.
    Subdivision 1. Scope. For purposes of sections 144.661 to 144.665, the following terms have
the meanings given them.
    Subd. 2. Traumatic brain injury. "Traumatic brain injury" means a sudden insult or damage
to the brain or its coverings caused by an external physical force which may produce a diminished
or altered state of consciousness and which results in the following disabilities:
(1) impairment of cognitive or mental abilities;
(2) impairment of physical functioning; or
(3) disturbance of behavioral or emotional functioning.
These disabilities may be temporary or permanent and may result in partial or total loss of
function. "Traumatic brain injury" does not include injuries of a degenerative or congenital nature.
    Subd. 3. Spinal cord injury. "Spinal cord injury" means an injury that occurs as a result of
trauma which may involve spinal vertebral fracture and where the injured person suffers an acute,
traumatic lesion of neural elements in the spinal canal, resulting in any degree of temporary or
permanent sensory deficit, motor deficit, or bladder or bowel dysfunction. "Spinal cord injury"
does not include intervertebral disc disease.
History: 1991 c 292 art 2 s 5

144.662 TRAUMATIC BRAIN INJURY AND SPINAL CORD INJURY REGISTRY.
The commissioner of health shall establish and maintain a central registry of persons who
sustain traumatic brain injury or spinal cord injury. The purpose of the registry is to:
(1) collect information to facilitate the development of injury prevention, treatment, and
rehabilitation programs; and
(2) ensure the provision to persons with traumatic brain injury or spinal cord injury of
information regarding appropriate public or private agencies that provide rehabilitative services
so that injured persons may obtain needed services to alleviate injuries and avoid secondary
problems, such as mental illness and chemical dependency.
History: 1991 c 292 art 2 s 6

144.663 DUTY TO REPORT.
    Subdivision 1. Establishment of reporting system. The commissioner shall design and
establish a reporting system which designates either the treating hospital, medical facility, or
physician to report to the department within a reasonable period of time after the identification
of a person with traumatic brain injury or spinal cord injury. The consent of the injured person
is not required.
    Subd. 2. Information. The report must be submitted on forms provided by the department
and must include the following information:
(1) the name, age, and residence of the injured person;
(2) the date and cause of the injury;
(3) the initial diagnosis; and
(4) other information required by the commissioner.
    Subd. 3. Reporting without liability. The furnishing of information required by the
commissioner shall not subject any person or facility required to report to any action for damages
or other relief, provided that the person or facility is acting in good faith.
History: 1991 c 292 art 2 s 7

144.664 DUTIES OF COMMISSIONER.
    Subdivision 1. Studies. The commissioner shall collect injury incidence information,
analyze the information, and conduct special studies regarding traumatic brain injury and spinal
cord injury.
    Subd. 2. Provision of data. The commissioner shall provide summary registry data to public
and private entities to conduct studies using data collected by the registry. The commissioner
may charge a fee under section 13.03, subdivision 3, for all out-of-pocket expenses associated
with the provision of data or data analysis.
    Subd. 3. Notification. Within five days of receiving a report of traumatic brain injury or
spinal cord injury, the commissioner shall notify the injured person or the injured person's family
of resources and services available in Minnesota, pursuant to section 144.662, clause (2).
    Subd. 4.[Repealed, 1999 c 86 art 2 s 6]
    Subd. 5. Rules. The commissioner shall adopt rules to administer the registry, collect
information, and distribute data. The rules must include, but are not limited to, the following:
(1) the specific ICD-9 procedure codes included in the definitions of "traumatic brain injury"
and "spinal cord injury";
(2) the type of data to be reported;
(3) standards for reporting specific types of data;
(4) the persons and facilities required to report and the time period in which reports must be
submitted;
(5) criteria relating to the use of registry data by public and private entities engaged in
research; and
(6) specification of fees to be charged under section 13.03, subdivision 3, for out-of-pocket
expenses.
History: 1991 c 292 art 2 s 8; 1994 c 483 s 1; 1997 c 205 s 22

144.665 TRAUMATIC BRAIN INJURY AND SPINAL CORD INJURY DATA.
Data on individuals collected by the commissioner of health under sections 144.662 to
144.664 are private data on individuals as defined in section 13.02, subdivision 12, and may be
used only for the purposes set forth in sections 144.662 to 144.664 in accordance with the rules
adopted by the commissioner.
History: 1991 c 292 art 2 s 9; 1994 c 483 s 1; 1997 c 205 s 23

144.67 [Repealed, 1987 c 403 art 2 s 164]

CANCER SURVEILLANCE SYSTEM

144.671 CANCER SURVEILLANCE SYSTEM; PURPOSE.
The commissioner of health shall establish a statewide population-based cancer surveillance
system. The purpose of this system is to:
(1) monitor incidence trends of cancer to detect potential public health problems, predict
risks, and assist in investigating cancer clusters;
(2) more accurately target intervention resources for communities and patients and their
families;
(3) inform health professionals and citizens about risks, early detection, and treatment of
cancers known to be elevated in their communities; and
(4) promote high quality research to provide better information for cancer control and to
address public concerns and questions about cancer.
History: 1987 c 403 art 2 s 9

144.672 DUTIES OF COMMISSIONER; RULES.
    Subdivision 1. Rule authority. The commissioner of health shall collect cancer incidence
information, analyze the information, and conduct special studies designed to determine the
potential public health significance of an increase in cancer incidence.
The commissioner shall adopt rules to administer the system, collect information, and
distribute data. The rules must include, but not be limited to, the following:
(1) the type of data to be reported;
(2) standards for reporting specific types of data;
(3) payments allowed to hospitals, pathologists, and registry systems to defray their costs in
providing information to the system;
(4) criteria relating to contracts made with outside entities to conduct studies using data
collected by the system. The criteria may include requirements for a written protocol outlining
the purpose and public benefit of the study, the description, methods, and projected results of the
study, peer review by other scientists, the methods and facilities to protect the privacy of the data,
and the qualifications of the researcher proposing to undertake the study; and
(5) specification of fees to be charged under section 13.03, subdivision 3, for all out-of-pocket
expenses for data summaries or specific analyses of data requested by public and private agencies,
organizations, and individuals, and which are not otherwise included in the commissioner's
annual summary reports. Fees collected are appropriated to the commissioner to offset the cost
of providing the data.
    Subd. 2. Biennial report required. The commissioner of health shall prepare and transmit
to the governor and to members of the legislature under section 3.195, a biennial report on the
incidence of cancer in Minnesota and a compilation of summaries and reports from special studies
and investigations performed to determine the potential public health significance of an increase
in cancer incidence, together with any findings and recommendations. The first report shall be
delivered by February 1989, with subsequent reports due in February of each of the following
odd-numbered years.
History: 1987 c 403 art 2 s 10; 1988 c 629 s 37; 1994 c 411 s 1; 1997 c 192 s 24; 2001
c 161 s 21

144.68 RECORDS AND REPORTS REQUIRED.
    Subdivision 1. Person practicing healing arts. Every person licensed to practice the healing
arts in any form, upon request of the commissioner of health, shall prepare and forward to the
commissioner, in the manner and at such times as the commissioner designates, a detailed record
of each case of cancer treated or seen by the person professionally.
    Subd. 2. Hospitals and similar institutions. Every hospital, medical clinic, medical
laboratory, or other institution for the hospitalization, clinical or laboratory diagnosis, or care of
human beings, upon request of the commissioner of health, shall prepare and forward to the
commissioner, in the manner and at the times designated by the commissioner, a detailed record
of each case of cancer.
    Subd. 3. Reporting without liability. The furnishing of the information required under
subdivisions 1 and 2 shall not subject the person, hospital, medical clinic, medical laboratory, or
other institution furnishing the information, to any action for damages or other relief.
History: 1949 c 350 s 3; 1976 c 173 s 47,48; 1977 c 305 s 45; 1986 c 444; 1987 c 403
art 2 s 11

144.69 CLASSIFICATION OF DATA ON INDIVIDUALS.
Notwithstanding any law to the contrary, including section 13.05, subdivision 9, data
collected on individuals by the cancer surveillance system, including the names and personal
identifiers of persons required in section 144.68 to report, shall be private and may only be
used for the purposes set forth in this section and sections 144.671, 144.672, and 144.68. Any
disclosure other than is provided for in this section and sections 144.671, 144.672, and 144.68, is
declared to be a misdemeanor and punishable as such. Except as provided by rule, and as part
of an epidemiologic investigation, an officer or employee of the commissioner of health may
interview patients named in any such report, or relatives of any such patient, only after the consent
of the attending physician or surgeon is obtained.
History: 1949 c 350 s 4; 1987 c 403 art 2 s 12

144.6905 [Repealed, 2002 c 220 art 16 s 3]

144.691 GRIEVANCE PROCEDURES.
    Subdivision 1. Facilities. Every hospital licensed as such pursuant to sections 144.50 to
144.56, and every outpatient surgery center shall establish a grievance or complaint mechanism
designed to process and resolve promptly and effectively grievances by patients or their
representatives related to billing, inadequacies of treatment, and other factors which may have an
impact on the incidence of malpractice claims and suits.
For the purposes of sections 144.691 to 144.693, "outpatient surgery center" shall mean a
free standing facility organized for the specific purpose of providing elective outpatient surgery
for preexamined prediagnosed low risk patients. Services provided at an outpatient surgery center
shall be limited to surgical procedures which utilize local or general anesthesia and which do not
require overnight inpatient care. "Outpatient surgery center" does not mean emergency medical
services, or physician or dentist offices.
    Subd. 2. Patient notice. Each patient receiving treatment at a hospital or an outpatient surgery
center shall be notified of the grievance or complaint mechanism which is available to the patient.
    Subd. 3. Rules. The state commissioner of health shall, by January 1, 1977, establish by rule
promulgated pursuant to chapter 15:
(a) Minimum standards and procedural requirements for grievance and complaint
mechanism;
(b) A list of patient complaints which may be processed through a complaint or grievance
mechanism;
(c) The form and manner in which patient notices shall be made; and
(d) A schedule of fines, not to exceed $200 per offense, for the failure of a hospital or
outpatient surgery center to comply with the provisions of this section.
    Subd. 4.[Repealed, 1996 c 451 art 4 s 71]
History: 1976 c 325 s 8; 1977 c 305 s 45; 1981 c 311 s 39; 1982 c 545 s 24; 1986 c 444

144.692 [Repealed, 1987 c 209 s 40]

144.693 MEDICAL MALPRACTICE CLAIMS; REPORTS.
    Subdivision 1. Insurers' reports to commissioner. On or before September 1, 1976, and on
or before March 1 and September 1 of each year thereafter, each insurer providing professional
liability insurance to one or more hospitals, outpatient surgery centers, or health maintenance
organizations, shall submit to the state commissioner of health a report listing by facility or
organization all claims which have been closed by or filed with the insurer during the period
ending December 31 of the previous year or June 30 of the current year. The report shall contain,
but not be limited to, the following information:
(a) The total number of claims made against each facility or organization which were filed or
closed during the reporting period;
(b) The date each new claim was filed with the insurer;
(c) The allegations contained in each claim filed during the reporting period;
(d) The disposition and closing date of each claim closed during the reporting period;
(e) The dollar amount of the award or settlement for each claim closed during the reporting
period; and
(f) Any other information the commissioner of health may, by rule, require.
Any hospital, outpatient surgery center, or health maintenance organization which is self
insured shall be considered to be an insurer for the purposes of this section and shall comply
with the reporting provisions of this section.
A report from an insurer submitted pursuant to this section is private data, as defined in
section 13.02, subdivision 12, accessible to the facility or organization which is the subject of the
data, and to its authorized agents. Any data relating to patient records which is reported to the
state commissioner of health pursuant to this section shall be reported in the form of summary
data, as defined in section 13.02, subdivision 19.
    Subd. 2. Report to legislature. The state commissioner of health shall collect and review the
data reported pursuant to subdivision 1. On December 1, 1976, and on January 2 of each year
thereafter, the state commissioner of health shall report to the legislature the findings related to
the incidence and size of malpractice claims against hospitals, outpatient surgery centers, and
health maintenance organizations, and shall make any appropriate recommendations to reduce the
incidence and size of the claims. Data published by the state commissioner of health pursuant to
this subdivision with respect to malpractice claims information shall be summary data within
the meaning of section 13.02, subdivision 19.
    Subd. 3. Access to insurers' records. The state commissioner of health shall have access
to the records of any insurer relating to malpractice claims made against hospitals, outpatient
surgery centers, and health maintenance organizations in years prior to 1976 if the commissioner
determines the records are necessary to fulfill the duties of the commissioner under Laws 1976,
chapter 325.
History: 1976 c 325 s 10; 1977 c 305 s 45; 1981 c 311 s 39; 1982 c 545 s 24; 1986 c 444

HEALTH CARE COST INFORMATION

144.695 CITATION.
Sections 144.695 to 144.703 may be cited as the Minnesota Health Care Cost Information
Act of 1984.
History: 1976 c 296 art 2 s 1; 1984 c 534 s 3

144.696 DEFINITIONS.
    Subdivision 1. Scope. Unless the context clearly indicates otherwise, for the purposes of
sections 144.695 to 144.703, the terms defined in this section have the meanings given them.
    Subd. 2. Commissioner of health. "Commissioner of health" means the state commissioner
of health.
    Subd. 3. Hospital. "Hospital" means any acute care institution licensed pursuant to sections
144.50 to 144.58, but does not include any health care institution conducted for those who rely
primarily upon treatment by prayer or spiritual means in accordance with the creed or tenets of
any church or denomination.
    Subd. 4. Outpatient surgical center. "Outpatient surgical center" means a facility other
than a hospital offering elective outpatient surgery under a license issued under sections 144.50
to 144.58.
History: 1976 c 296 art 2 s 2; 1977 c 305 s 45; 1984 c 534 s 4

144.697 GENERAL POWERS AND DUTIES OF STATE COMMISSIONER OF HEALTH.
    Subdivision 1. Contracts. The commissioner of health may contract with third parties for
services necessary to carry out the commissioner's activities where this will promote economy,
avoid duplication of effort, and make best use of available expertise.
    Subd. 2. Grants; gifts. The commissioner of health may apply for and receive grants and
gifts from any governmental agency, private entity or other person.
    Subd. 3. Committees. To further the purposes of sections 144.695 to 144.703, the
commissioner of health may create committees from the membership and may appoint ad hoc
advisory committees.
    Subd. 4. Coordinating rules and inspections. The commissioner of health shall coordinate
regulation and inspection of hospitals to avoid, to the extent possible, conflicting rules and
duplicative inspections.
History: 1976 c 296 art 2 s 3; 1977 c 305 s 45; 1986 c 444

144.698 REPORTING REQUIREMENTS.
    Subdivision 1. Yearly reports. Each hospital and each outpatient surgical center, which has
not filed the financial information required by this section with a voluntary, nonprofit reporting
organization pursuant to section 144.702, shall file annually with the commissioner of health after
the close of the fiscal year:
(1) a balance sheet detailing the assets, liabilities, and net worth of the hospital or outpatient
surgical center;
(2) a detailed statement of income and expenses;
(3) a copy of its most recent cost report, if any, filed pursuant to requirements of Title XVIII
of the United States Social Security Act;
(4) a copy of all changes to articles of incorporation or bylaws;
(5) information on services provided to benefit the community, including services provided
at no cost or for a reduced fee to patients unable to pay, teaching and research activities, or other
community or charitable activities;
(6) information required on the revenue and expense report form set in effect on July 1, 1989,
or as amended by the commissioner in rule;
(7) information on changes in ownership or control; and
(8) other information required by the commissioner in rule.
    Subd. 2. Separate reports for facilities. If more than one licensed hospital or outpatient
surgical center is operated by the reporting organization, the commissioner of health may require
that the information be reported separately for each hospital and each outpatient surgical center.
    Subd. 3. Attestation. The commissioner of health may require attestation by responsible
officials of the hospital or outpatient surgical center that the contents of the reports are true.
    Subd. 4. Reports open to public inspection. All reports, except privileged medical
information, filed pursuant to this section, section 144.701 or section 144.702, subdivision 3 or 4
shall be open to public inspection.
    Subd. 5. Commissioner's right to inspect records. If the report is not filed or the
commissioner of health has reason to believe the report is incomplete or false, the commissioner
shall have the right to inspect hospital and outpatient surgical center books, audits, and records.
History: 1976 c 296 art 2 s 4; 1977 c 305 s 45; 1984 c 534 s 5; 1989 c 282 art 2 s 11;
1991 c 202 s 7; 2004 c 198 s 13,14

144.699 CONTINUING ANALYSIS.
    Subdivision 1. Acute care costs. The commissioner of health may:
(a) Undertake analyses and studies relating to acute care costs and to the financial status
of any hospital or outpatient surgical center subject to the provisions of sections 144.695 to
144.703; and
(b) Publish and disseminate the information relating to acute care costs.
    Subd. 2. Fostering price competition. The commissioner of health shall:
(a) Encourage hospitals, outpatient surgical centers, home care providers, and professionals
regulated by the health related licensing boards as defined in section 214.01, subdivision 2, and by
the commissioner of health under section 214.13, to publish prices for procedures and services that
are representative of the diagnoses and conditions for which citizens of this state seek treatment.
(b) Analyze and disseminate available price information and analyses so as to foster the
development of price competition among hospitals, outpatient surgical centers, home care
providers, and health professionals.
    Subd. 3. Cooperation with attorney general. Upon request of the attorney general, the
commissioner of health shall make available to the attorney general all requested information
provided under sections 144.695 to 144.703 in order to assist the attorney general in discharging
the responsibilities of section 8.31.
    Subd. 4. Other reports or costs. The commissioner of health shall prepare and file
summaries and compilations or other supplementary reports based on the information filed with
or made available to the commissioner of health, which reports will advance the purposes of
sections 144.695 to 144.703.
History: 1976 c 296 art 2 s 5; 1977 c 305 s 45; 1984 c 534 s 6; 1987 c 378 s 2

144.70 BIENNIAL REPORT.
    Subdivision 1. Content. The commissioner of health shall prepare a report every two years
concerning the status and operations of the health care markets in Minnesota. The commissioner
of health shall transmit the reports to the governor, and to the members of the legislature under
section 3.195. The first report must be submitted on January 15, 1987, and succeeding reports
on January 15 every two years. Each report must contain information, analysis, and appropriate
recommendations concerning the following issues associated with Minnesota health care markets:
(1) the overall status of the health care cost problem, including the costs faced by employers
and individuals, and prospects for the problem's improving or getting worse;
(2) the status of competitive forces in the market for health services and the market for health
plans, and the effect of the forces on the health care cost problem;
(3) the feasibility and cost-effectiveness of facilitating development of strengthened
competitive forces through state initiatives;
(4) the feasibility of limiting health care costs by means other than competitive forces,
including direct forms of government intervention such as price regulation; the commissioner of
health may exclude this issue from the report if the report concludes that the overall status of the
health care cost problem is improving, or that competitive forces are contributing significantly to
health care cost containment;
(5) the overall status of access to adequate health services by citizens of Minnesota, the
scope of financial and geographic barriers to access, the effect of competitive forces on access,
and prospects for access improving or getting worse;
(6) the feasibility and cost-effectiveness of enhancing access to adequate health services by
citizens of Minnesota through state initiatives; and
(7) the commissioner of health's operations and activities for the preceding two years as they
relate to the duties imposed on the commissioner of health by sections 144.695 to 144.703.
    Subd. 2. Interagency cooperation. In completing the report required by subdivision 1, in
fulfilling the requirements of sections 144.695 to 144.703, and in undertaking other initiatives
concerning health care costs, access, or quality, the commissioner of health shall cooperate with
and consider potential benefits to other state agencies that have a role in the market for health
services or the market for health plans. Other agencies include the Department of Employee
Relations, as administrator of the state employee health benefits program; the Department
of Human Services, as administrator of health services entitlement programs; the Department
of Commerce, in its regulation of health plans; the Department of Labor and Industry, in its
regulation of health service costs under workers' compensation.
History: 1976 c 296 art 2 s 6; 1977 c 305 s 45; 1Sp1985 c 9 art 2 s 11; 1991 c 345 art 2
s 37; 1994 c 411 s 2

144.701 RATE DISCLOSURE.
    Subdivision 1. Consumer information. The commissioner of health shall ensure that
the total costs, total revenues, overall utilization, and total services of each hospital and each
outpatient surgical center are reported to the public in a form understandable to consumers.
    Subd. 2. Data for policy making. The commissioner of health shall compile relevant
financial and accounting, utilization, and services data concerning hospitals and outpatient
surgical centers in order to have statistical information available for legislative policy making.
    Subd. 3. Rate schedule. The commissioner of health shall obtain from each hospital and
outpatient surgical center a current rate schedule. Any subsequent amendments or modifications
of that schedule shall be filed with the commissioner of health on or before their effective date.
    Subd. 4. Filing fees. Each report which is required to be submitted to the commissioner of
health under sections 144.695 to 144.703 and which is not submitted to a voluntary, nonprofit
reporting organization in accordance with section 144.702 shall be accompanied by a filing
fee in an amount prescribed by rule of the commissioner of health. Upon the withdrawal of
approval of a reporting organization, or the decision of the commissioner to not renew a reporting
organization, fees collected under section 144.702 shall be submitted to the commissioner. Fees
received under this subdivision shall be deposited in a revolving fund and are appropriated to
the commissioner of health for the purposes of sections 144.695 to 144.703. The commissioner
shall report the termination or nonrenewal of the voluntary reporting organization to the chair of
the Health and Human Services Finance Committee of the house of representatives, to the chair
of the Health and Human Services Division of the Finance Committee of the senate, and the
commissioner of finance.
History: 1976 c 296 art 2 s 7; 1977 c 305 s 45; 1982 c 424 s 130; 1984 c 534 s 7; 1989 c
282 art 2 s 12; 1998 c 407 art 2 s 27-29; 2004 c 284 art 2 s 15

144.702 HOSPITAL AND OUTPATIENT SURGICAL CENTER COSTS.
    Subdivision 1. Reporting through a reporting organization. A hospital or outpatient
surgical center may agree to submit its financial, utilization, and services reports to a voluntary,
nonprofit reporting organization whose reporting procedures have been approved by the
commissioner of health in accordance with this section. Each report submitted to the voluntary,
nonprofit reporting organization under this section shall be accompanied by a filing fee.
    Subd. 2. Approval of organization's reporting procedures. The commissioner of health
may approve voluntary reporting procedures consistent with written operating requirements
for the voluntary, nonprofit reporting organization which shall be established annually by the
commissioner. These written operating requirements shall specify reports, analyses, and other
deliverables to be produced by the voluntary, nonprofit reporting organization, and the dates
on which those deliverables must be submitted to the commissioner. These written operating
requirements shall specify deliverable dates sufficient to enable the commissioner of health
to process and report health care cost information system data to the commissioner of human
services by August 15 of each year. The commissioner of health shall, by rule, prescribe standards
for submission of data by hospitals and outpatient surgical centers to the voluntary, nonprofit
reporting organization or to the commissioner. These standards shall provide for:
(a) the filing of appropriate financial, utilization, and services information with the reporting
organization;
(b) adequate analysis and verification of that financial, utilization, and services information;
and
(c) timely publication of the costs, revenues, and rates of individual hospitals and outpatient
surgical centers prior to the effective date of any proposed rate increase. The commissioner of
health shall annually review the procedures approved pursuant to this subdivision.
    Subd. 3. Cost and rate information; time limits on filing. Any voluntary, nonprofit
reporting organization which collects information on costs, revenues, and rates of a hospital or
outpatient surgical center located in this state shall file a copy of the information received for
each hospital and outpatient surgical center with the commissioner of health within 30 days
of completion of the information collection process, together with a summary of the financial
information acquired by the organization during the course of its review.
    Subd. 4. Making information available to commissioner. Any voluntary, nonprofit
reporting organization which receives the financial information required by sections 144.695 to
144.703 shall make the information and all summaries and analyses of the information available
to the commissioner of health in accordance with procedures prescribed by the commissioner
of health.
    Subd. 5. Laws governing restraint of trade. If the reporting and procedures of a voluntary,
nonprofit reporting organization have been approved by the commissioner of health those
reporting activities of the organization shall be exempt from the provisions of sections 325D.49 to
325D.66.
    Subd. 6. Reporting organization; definition. For the purposes of this section "reporting
organization" means an association or other organization which has as one of its primary functions
the collection and dissemination of acute care cost information.
    Subd. 7. Staff support. The commissioner may require as part of the written operating
requirements for the voluntary, nonprofit reporting organization that the organization provide
sufficient funds to cover the costs of one professional staff position who will directly administer
the health care cost information system.
    Subd. 8. Termination or nonrenewal of reporting organization. The commissioner
may withdraw approval of any voluntary, nonprofit reporting organization for failure on the
part of the voluntary, nonprofit reporting organization to comply with the written operating
requirements under subdivision 2. Upon the effective date of the withdrawal, all funds collected
by the voluntary, nonprofit reporting organization under subdivision 1, but not expended shall
be deposited in a revolving fund and are appropriated to the commissioner of health for the
purposes of sections 144.695 to 144.703.
The commissioner may choose not to renew approval of a voluntary, nonprofit reporting
organization if the organization has failed to perform its obligations satisfactorily under the
written operating requirements under subdivision 2.
History: 1976 c 296 art 2 s 8; 1977 c 305 s 45; 1984 c 534 s 8; 1989 c 282 art 2 s 13-15;
1995 c 207 art 6 s 3; 1998 c 407 art 2 s 30-32

144.7021 [Repealed, 1984 c 534 s 33]

144.7022 REPORTING ORGANIZATIONS; PENALTY ORDERS.
    Subdivision 1. Authorization. The commissioner may issue an order to the voluntary,
nonprofit reporting organization requiring violations to be corrected and administratively assess
monetary penalties for violations of sections 144.695 to 144.703 or rules, written operating
requirements, orders, stipulation agreements, settlements, or compliance agreements adopted,
enforced, or issued by the commissioner.
    Subd. 2. Contents of order. An order assessing an administrative penalty under this section
must include:
(1) a concise statement of the facts alleged to constitute a violation;
(2) a reference to the section of law, rule, written operating requirement, order, stipulation
agreement, settlement, or compliance agreement that has been violated;
(3) a statement of the amount of the administrative penalty to be imposed and the factors
upon which the penalty is based;
(4) a statement of the corrective actions necessary to correct the violation; and
(5) a statement of the right to request a hearing according to sections 14.57 to 14.62.
    Subd. 3. Concurrent corrective order. The commissioner may issue an order assessing
an administrative penalty and requiring the violations cited in the order be corrected within
30 calendar days from the date the order is received. Before the 31st day after the order was
received, the voluntary, nonprofit reporting organization that is subject to the order shall provide
the commissioner with information demonstrating that the violation has been corrected or that
a corrective plan acceptable to the commissioner has been developed. The commissioner shall
determine whether the violation has been corrected and notify the voluntary, nonprofit reporting
organization of the commissioner's determination.
    Subd. 4. Penalty. If the commissioner determines that the violation has been corrected or an
acceptable corrective plan has been developed, the penalty may be forgiven, except where there
are repeated or serious violations. The commissioner may issue an order with a penalty that will
not be forgiven after corrective action is taken. Unless there is a request for review of the order
under subdivision 6 before the penalty is due, the penalty is due and payable:
(1) on the 31st calendar day after the order was received, if the voluntary, nonprofit reporting
organization fails to provide information to the commissioner showing that the violation has been
corrected or that appropriate steps have been taken toward correcting the violation;
(2) on the 20th day after the voluntary, nonprofit reporting organization receives the
commissioner's determination that the information provided is not sufficient to show that either
the violation has been corrected or that appropriate steps have been taken toward correcting
the violation; or
(3) on the 31st day after the order was received where the penalty is for repeated or serious
violations and according to the order issued, the penalty will not be forgiven after corrective
action is taken.
All penalties due under this section are payable to the commissioner of finance, state of
Minnesota, and shall be deposited in the general fund.
    Subd. 5. Amount of penalty; considerations. (a) The maximum amount of an administrative
penalty order is $5,000 for each specific violation identified in an inspection, investigation, or
compliance review, up to an annual maximum total for all violations of ten percent of the fees
collected by the voluntary, nonprofit reporting organization under section 144.702, subdivision 1.
The annual maximum is based on a reporting year.
(b) In determining the amount of the administrative penalty, the commissioner shall consider
the following:
(1) the willfulness of the violation;
(2) the gravity of the violation;
(3) the history of past violations;
(4) the number of violations;
(5) the economic benefit gained by the person allowing or committing the violation; and
(6) other factors as justice may require, if the commissioner specifically identifies the
additional factors in the commissioner's order.
(c) In determining the amount of a penalty for a violation subsequent to an initial violation
under paragraph (a), the commissioner shall also consider:
(1) the similarity of the most recent previous violation and the violation to be penalized;
(2) the time elapsed since the last violation; and
(3) the response of the voluntary, nonprofit reporting organization to the most recent previous
violation.
    Subd. 6. Request for hearing; hearing; and final order. A request for hearing must be in
writing, delivered to the commissioner by certified mail within 20 calendar days after the receipt
of the order, and specifically state the reasons for seeking review of the order. The commissioner
must initiate a hearing within 30 calendar days from the date of receipt of the written request for
hearing. The hearing shall be conducted pursuant to the contested case procedures in sections
14.57 to 14.62. No earlier than ten calendar days after and within 30 calendar days of receipt of
the presiding administrative law judge's report, the commissioner shall, based on all relevant
facts, issue a final order modifying, vacating, or making the original order permanent. If, within
20 calendar days of receipt of the original order, the voluntary, nonprofit reporting organization
fails to request a hearing in writing, the order becomes the final order of the commissioner.
    Subd. 7. Review of final order and payment of penalty. Once the commissioner issues a
final order, any penalty due under that order shall be paid within 30 calendar days after the date of
the final order, unless review of the final order is requested. The final order of the commissioner
may be appealed in the manner prescribed in sections 14.63 to 14.69. If the final order is reviewed
and upheld, the penalty shall be paid 30 calendar days after the date of the decision of the
reviewing court. Failure to request an administrative hearing pursuant to subdivision 6 shall
constitute a waiver of the right to further agency or judicial review of the final order.
    Subd. 8. Reinspections and effect of noncompliance. If, upon reinspection, or in the
determination of the commissioner, it is found that any deficiency specified in the order has
not been corrected or an acceptable corrective plan has not been developed, the voluntary,
nonprofit reporting organization is in noncompliance. The commissioner shall issue a notice of
noncompliance and may impose any additional remedy available under this chapter.
    Subd. 9. Enforcement. The attorney general may proceed on behalf of the commissioner
to enforce penalties that are due and payable under this section in any manner provided by law
for the collection of debts.
    Subd. 10. Termination or nonrenewal of reporting organization. The commissioner may
withdraw or not renew approval of any voluntary, nonprofit reporting organization for failure on
the part of the voluntary, nonprofit reporting organization to pay penalties owed under this section.
    Subd. 11. Cumulative remedy. The authority of the commissioner to issue an administrative
penalty order is in addition to other lawfully available remedies.
    Subd. 12. Mediation. In addition to review under subdivision 6, the commissioner
is authorized to enter into mediation concerning an order issued under this section if the
commissioner and the voluntary, nonprofit reporting organization agree to mediation.
History: 1998 c 407 art 2 s 33; 2003 c 112 art 2 s 50

144.703 ADDITIONAL POWERS.
    Subdivision 1. Rulemaking. In addition to the other powers granted to the commissioner of
health by law, the commissioner of health may:
(a) Adopt, amend, and repeal rules in accordance with chapter 14;
(b) Adopt in rule a schedule of fines, ranging from $100 to $1,000, for failure of a hospital or
an outpatient surgical center to submit, or to make a timely submission of, information called
for by sections 144.695 to 144.703.
    Subd. 2. Contested cases. Any person aggrieved by a final determination of the
commissioner of health as to any rule or determination under sections 144.695 to 144.703 shall
be entitled to an administrative hearing and judicial review in accordance with the contested
case provisions of chapter 14.
History: 1976 c 296 art 2 s 9; 1977 c 305 s 45; 1982 c 424 s 130; 1984 c 534 s 9

144.704 [Repealed, 1984 c 534 s 33]

144.705 [Repealed, 1984 c 534 s 33]

ADVERSE HEALTH CARE EVENTS REPORTING

144.706 CITATION.
Sections 144.706 to 144.7069 may be cited as the Minnesota Adverse Health Care Events
Reporting Act of 2003.
History: 2003 c 99 s 1

144.7063 DEFINITIONS.
    Subdivision 1. Scope. Unless the context clearly indicates otherwise, for the purposes of
sections 144.706 to 144.7069, the terms defined in this section have the meanings given them.
    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
    Subd. 3. Facility. "Facility" means a hospital or outpatient surgical center licensed under
sections 144.50 to 144.58.
    Subd. 4. Serious disability. "Serious disability" means (1) a physical or mental impairment
that substantially limits one or more of the major life activities of an individual or a loss of bodily
function, if the impairment or loss lasts more than seven days or is still present at the time of
discharge from an inpatient health care facility, or (2) loss of a body part.
    Subd. 5. Surgery. "Surgery" means the treatment of disease, injury, or deformity by manual
or operative methods. Surgery includes endoscopies and other invasive procedures.
History: 2003 c 99 s 2; 1Sp2003 c 14 art 7 s 84; 2004 c 198 s 15

NOTE: Subdivision 3, as amended by Laws 2004, chapter 198, section 15, is effective on
the date of full implementation of the adverse health care events reporting system as provided in
Laws 2003, chapter 99, section 7, provided the commissioner of health has secured sufficient
funds from nonstate sources to operate the adverse health care events reporting system in fiscal
year 2005. Laws 2004, chapter 198, section 15, the effective date.

144.7065 FACILITY REQUIREMENTS TO REPORT, ANALYZE, AND CORRECT.
    Subdivision 1. Reports of adverse health care events required. Each facility shall report to
the commissioner the occurrence of any of the adverse health care events described in subdivisions
2 to 7 as soon as is reasonably and practically possible, but no later than 15 working days after
discovery of the event. The report shall be filed in a format specified by the commissioner and
shall identify the facility but shall not include any identifying information for any of the health
care professionals, facility employees, or patients involved. The commissioner may consult with
experts and organizations familiar with patient safety when developing the format for reporting
and in further defining events in order to be consistent with industry standards.
    Subd. 2. Surgical events. Events reportable under this subdivision are:
(1) surgery performed on a wrong body part that is not consistent with the documented
informed consent for that patient. Reportable events under this clause do not include situations
requiring prompt action that occur in the course of surgery or situations whose urgency precludes
obtaining informed consent;
(2) surgery performed on the wrong patient;
(3) the wrong surgical procedure performed on a patient that is not consistent with the
documented informed consent for that patient. Reportable events under this clause do not include
situations requiring prompt action that occur in the course of surgery or situations whose urgency
precludes obtaining informed consent;
(4) retention of a foreign object in a patient after surgery or other procedure, excluding
objects intentionally implanted as part of a planned intervention and objects present prior to
surgery that are intentionally retained; and
(5) death during or immediately after surgery of a normal, healthy patient who has no organic,
physiologic, biochemical, or psychiatric disturbance and for whom the pathologic processes for
which the operation is to be performed are localized and do not entail a systemic disturbance.
    Subd. 3. Product or device events. Events reportable under this subdivision are:
(1) patient death or serious disability associated with the use of contaminated drugs, devices,
or biologics provided by the facility when the contamination is the result of generally detectable
contaminants in drugs, devices, or biologics regardless of the source of the contamination or
the product;
(2) patient death or serious disability associated with the use or function of a device in patient
care in which the device is used or functions other than as intended. "Device" includes, but is not
limited to, catheters, drains, and other specialized tubes, infusion pumps, and ventilators; and
(3) patient death or serious disability associated with intravascular air embolism that occurs
while being cared for in a facility, excluding deaths associated with neurosurgical procedures
known to present a high risk of intravascular air embolism.
    Subd. 4. Patient protection events. Events reportable under this subdivision are:
(1) an infant discharged to the wrong person;
(2) patient death or serious disability associated with patient disappearance for more than
four hours, excluding events involving adults who have decision-making capacity; and
(3) patient suicide or attempted suicide resulting in serious disability while being cared for in
a facility due to patient actions after admission to the facility, excluding deaths resulting from
self-inflicted injuries that were the reason for admission to the facility.
    Subd. 5. Care management events. Events reportable under this subdivision are:
(1) patient death or serious disability associated with a medication error, including, but not
limited to, errors involving the wrong drug, the wrong dose, the wrong patient, the wrong time,
the wrong rate, the wrong preparation, or the wrong route of administration, excluding reasonable
differences in clinical judgment on drug selection and dose;
(2) patient death or serious disability associated with a hemolytic reaction due to the
administration of ABO-incompatible blood or blood products;
(3) maternal death or serious disability associated with labor or delivery in a low-risk
pregnancy while being cared for in a facility, including events that occur within 42 days
postdelivery and excluding deaths from pulmonary or amniotic fluid embolism, acute fatty liver
of pregnancy, or cardiomyopathy;
(4) patient death or serious disability directly related to hypoglycemia, the onset of which
occurs while the patient is being cared for in a facility;
(5) death or serious disability, including kernicterus, associated with failure to identify and
treat hyperbilirubinemia in neonates during the first 28 days of life. "Hyperbilirubinemia" means
bilirubin levels greater than 30 milligrams per deciliter;
(6) stage 3 or 4 ulcers acquired after admission to a facility, excluding progression from
stage 2 to stage 3 if stage 2 was recognized upon admission; and
(7) patient death or serious disability due to spinal manipulative therapy.
    Subd. 6. Environmental events. Events reportable under this subdivision are:
(1) patient death or serious disability associated with an electric shock while being cared for
in a facility, excluding events involving planned treatments such as electric countershock;
(2) any incident in which a line designated for oxygen or other gas to be delivered to a patient
contains the wrong gas or is contaminated by toxic substances;
(3) patient death or serious disability associated with a burn incurred from any source while
being cared for in a facility;
(4) patient death associated with a fall while being cared for in a facility; and
(5) patient death or serious disability associated with the use or lack of restraints or bedrails
while being cared for in a facility.
    Subd. 7. Criminal events. Events reportable under this subdivision are:
(1) any instance of care ordered by or provided by someone impersonating a physician,
nurse, pharmacist, or other licensed health care provider;
(2) abduction of a patient of any age;
(3) sexual assault on a patient within or on the grounds of a facility; and
(4) death or significant injury of a patient or staff member resulting from a physical assault
that occurs within or on the grounds of a facility.
    Subd. 8. Root cause analysis; corrective action plan. Following the occurrence of an
adverse health care event, the facility must conduct a root cause analysis of the event. Following
the analysis, the facility must: (1) implement a corrective action plan to implement the findings
of the analysis or (2) report to the commissioner any reasons for not taking corrective action. If
the root cause analysis and the implementation of a corrective action plan are complete at the
time an event must be reported, the findings of the analysis and the corrective action plan must
be included in the report of the event. The findings of the root cause analysis and a copy of the
corrective action plan must otherwise be filed with the commissioner within 60 days of the event.
    Subd. 9. Electronic reporting. The commissioner must design the reporting system so that a
facility may file by electronic means the reports required under this section. The commissioner
shall encourage a facility to use the electronic filing option when that option is feasible for the
facility.
    Subd. 10. Relation to other law; data classification. (a) Adverse health events described
in subdivisions 2 to 6 do not constitute "maltreatment," "neglect," or "a physical injury that is
not reasonably explained" under section 626.556 or 626.557 and are excluded from the reporting
requirements of sections 626.556 and 626.557, provided the facility makes a determination within
24 hours of the discovery of the event that this section is applicable and the facility files the
reports required under this section in a timely fashion.
(b) A facility that has determined that an event described in subdivisions 2 to 6 has occurred
must inform persons who are mandated reporters under section 626.556, subdivision 3, or
626.5572, subdivision 16, of that determination. A mandated reporter otherwise required to
report under section 626.556, subdivision 3, or 626.557, subdivision 3, paragraph (e), is relieved
of the duty to report an event that the facility determines under paragraph (a) to be reportable
under subdivisions 2 to 6.
(c) The protections and immunities applicable to voluntary reports under sections 626.556
and 626.557 are not affected by this section.
(d) Notwithstanding section 626.556, 626.557, or any other provision of Minnesota statute or
rule to the contrary, neither a lead agency under section 626.556, subdivision 3c, or 626.5572,
subdivision 13 , the commissioner of health, nor the director of the Office of Health Facility
Complaints is required to conduct an investigation of or obtain or create investigative data or
reports regarding an event described in subdivisions 2 to 6. If the facility satisfies the requirements
described in paragraph (a), the review or investigation shall be conducted and data or reports
shall be obtained or created only under sections 144.706 to 144.7069, except as permitted or
required under sections 144.50 to 144.564, or as necessary to carry out the state's certification
responsibility under the provisions of sections 1864 and 1867 of the Social Security Act.
(e) Data contained in the following records are nonpublic and, to the extent they contain data
on individuals, confidential data on individuals, as defined in section 13.02:
(1) reports provided to the commissioner under sections 147.155, 147A.155, 148.267,
151.301, and 153.255;
(2) event reports, findings of root cause analyses, and corrective action plans filed by a
facility under this section; and
(3) records created or obtained by the commissioner in reviewing or investigating the reports,
findings, and plans described in clause (2).
For purposes of the nonpublic data classification contained in this paragraph, the reporting
facility shall be deemed the subject of the data.
History: 2003 c 99 s 3; 1Sp2003 c 14 art 7 s 85; 2004 c 186 s 1

144.7067 COMMISSIONER DUTIES AND RESPONSIBILITIES.
    Subdivision 1. Establishment of reporting system. (a) The commissioner shall establish an
adverse health event reporting system designed to facilitate quality improvement in the health care
system. The reporting system shall not be designed to punish errors by health care practitioners
or health care facility employees.
(b) The reporting system shall consist of:
(1) mandatory reporting by facilities of 27 adverse health care events;
(2) mandatory completion of a root cause analysis and a corrective action plan by the facility
and reporting of the findings of the analysis and the plan to the commissioner or reporting of
reasons for not taking corrective action;
(3) analysis of reported information by the commissioner to determine patterns of systemic
failure in the health care system and successful methods to correct these failures;
(4) sanctions against facilities for failure to comply with reporting system requirements; and
(5) communication from the commissioner to facilities, health care purchasers, and the
public to maximize the use of the reporting system to improve health care quality.
(c) The commissioner is not authorized to select from or between competing alternate
acceptable medical practices.
    Subd. 2. Duty to analyze reports; communicate findings. The commissioner shall:
(1) analyze adverse event reports, corrective action plans, and findings of the root cause
analyses to determine patterns of systemic failure in the health care system and successful
methods to correct these failures;
(2) communicate to individual facilities the commissioner's conclusions, if any, regarding an
adverse event reported by the facility;
(3) communicate with relevant health care facilities any recommendations for corrective
action resulting from the commissioner's analysis of submissions from facilities; and
(4) publish an annual report:
(i) describing, by institution, adverse events reported;
(ii) outlining, in aggregate, corrective action plans and the findings of root cause analyses; and
(iii) making recommendations for modifications of state health care operations.
    Subd. 3. Sanctions. (a) The commissioner shall take steps necessary to determine if adverse
event reports, the findings of the root cause analyses, and corrective action plans are filed in a
timely manner. The commissioner may sanction a facility for:
(1) failure to file a timely adverse event report under section 144.7065, subdivision 1; or
(2) failure to conduct a root cause analysis, to implement a corrective action plan, or to
provide the findings of a root cause analysis or corrective action plan in a timely fashion under
section 144.7065, subdivision 8.
(b) If a facility fails to develop and implement a corrective action plan or report to the
commissioner why corrective action is not needed, the commissioner may suspend, revoke, fail to
renew, or place conditions on the license under which the facility operates.
History: 2003 c 99 s 4

144.7068 REPORTS FROM LICENSING BOARDS.
(a) Effective upon full implementation of the adverse health care events reporting system,
the records maintained under sections 147.155, 147A.155, 148.267, 151.301, and 153.255, shall
be reported to the commissioner on the schedule established in those sections.
(b) The commissioner shall forward these reports to the facility named in the report.
(c) The facility shall determine whether the event has been previously reported under
section 144.7065. The facility shall notify the commissioner whether the event has been reported
previously. If the event has not been previously reported, the facility shall make a determination
whether the event was reportable under section 144.7065. If the facility determines the event was
reportable, the date of discovery of the event for the purposes of section 144.7065, subdivision 10,
paragraph (d), shall be as follows:
(1) if the commissioner determines that the facility knew or reasonably should have known
about the occurrence of the event, the date the event occurred shall be the date of discovery.
The facility shall be considered out of compliance with the reporting act, and the event shall be
subject to sections 626.556 and 626.557; or
(2) if the commissioner determines that the facility did not know about the occurrence
of the event, the date the facility receives the report from the commissioner shall serve as the
date of discovery.
If the facility determines that the event was not reportable under section 144.7065, the facility
shall notify the commissioner of that determination.
History: 2004 c 186 s 2

144.7069 INTERSTATE COORDINATION; REPORTS.
The commissioner shall report the definitions and the list of reportable events adopted in this
act to the National Quality Forum and, working in coordination with the National Quality Forum,
to the other states. The commissioner shall monitor discussions by the National Quality Forum of
amendments to the forum's list of reportable events and shall report to the legislature whenever
the list is modified. The commissioner shall also monitor implementation efforts in other states to
establish a list of reportable events and shall make recommendations to the legislature as necessary
for modifications in the Minnesota list or in the other components of the Minnesota reporting
system to keep the system as nearly uniform as possible with similar systems in other states.
History: 2003 c 99 s 5

CHILDREN'S CAMPS

144.71 PURPOSE; DEFINITIONS.
    Subdivision 1. Health and safety. The purpose of sections 144.71 to 144.74 is to protect
the health and safety of persons in attendance at youth camps.
    Subd. 2. Definition. For the purpose of such sections, a youth camp is defined as a parcel or
parcels of land with permanent buildings, tents or other structures together with appurtenances
thereon, established or maintained as living quarters where both food and beverage service and
lodging or the facilities therefor are provided for ten or more people, operated continuously for a
period of five days or more each year for educational, recreational or vacation purposes, and the
use of the camp is offered to minors free of charge or for payment of a fee.
    Subd. 3. What not included in definition. This definition does not include cabin and
trailer camps, fishing and hunting camps, resorts, penal and correctional camps, industrial and
construction camps, nor does it include homes operated for care or treatment of children and for
the operation of which a license is required under the provisions of chapter 257.
History: 1951 c 285 s 1; 1974 c 406 s 21; 1993 c 206 s 6; 1996 c 451 art 4 s 8,9

144.72 OPERATION.
    Subdivision 1. Permits. The state commissioner of health is authorized to issue permits for
the operation of youth camps which are required to obtain the permits.
    Subd. 2. Application. On or before June first annually, every person, partnership, limited
liability company or corporation, operating or seeking to operate a youth camp, shall make
application in writing to the commissioner for a permit to conduct a youth camp. Such application
shall be in such form and shall contain such information as the commissioner may find necessary
to determine that the youth camp will be operated and maintained in such a manner as to protect
and preserve the health and safety of the persons using the camp. Where a person, partnership,
limited liability company or corporation operates or is seeking to operate more than one youth
camp, a separate application shall be made for each camp.
    Subd. 3. Issuance of permits. If the commissioner should determine from the application
that the health and safety of the persons using the camp will be properly safeguarded, the
commissioner may, prior to actual inspection of the camp, issue the permit in writing. No fee
shall be charged for the permit. The permit shall be posted in a conspicuous place on the premises
occupied by the camp.
History: 1951 c 285 s 2; 1977 c 305 s 45; 1986 c 444; 1996 c 451 art 4 s 10,11

144.73 STATE COMMISSIONER OF HEALTH, DUTIES.
    Subdivision 1. Inspection of camps. It shall be the duty of the state commissioner of health
to make an annual inspection of each youth camp, and where, upon inspection it is found that there
is a failure to protect the health and safety of the persons using the camp, or a failure to comply
with the camp rules prescribed by the commissioner, the commissioner shall give notice to the
camp operator of such failure, which notice shall set forth the reason or reasons for such failure.
    Subd. 2.[Repealed, 1993 c 206 s 25]
    Subd. 3.[Repealed, 1993 c 206 s 25]
    Subd. 4.[Repealed, 1993 c 206 s 25]
History: 1951 c 285 s 3; 1977 c 305 s 45; 1978 c 674 s 60; 1985 c 248 s 70; 1986 c 444;
1993 c 286 s 2; 1994 c 465 art 3 s 68; 1996 c 451 art 4 s 12

144.74 RULES, STANDARDS.
The state commissioner of health is authorized to adopt and enforce such reasonable
rules and standards as the commissioner determines necessary to protect the health and safety
of persons in attendance at youth camps. Such rules and standards may include reasonable
restrictions and limitations on the following:
(1) Camp sites and buildings, including location, layout, lighting, ventilation, heating,
plumbing, drainage and sleeping quarters;
(2) Sanitary facilities, including water supply, toilet and shower facilities, sewage and excreta
disposal, waste and garbage disposal, and the control of insects and rodents, and
(3) Food service, including storage, refrigeration, sanitary preparation and handling of food,
the cleanliness of kitchens and the proper functioning of equipment.
History: 1951 c 285 s 4; 1977 c 305 s 45; 1985 c 248 s 70; 1986 c 444; 1996 c 451 art 4 s 13

BLOODBORNE PATHOGENS; EMERGENCY MEDICAL SERVICES PERSON

144.7401 DEFINITIONS.
    Subdivision 1. Scope of definitions. For purposes of sections 144.7401 to 144.7415, the
following terms have the meanings given them.
    Subd. 2. Bloodborne pathogens. "Bloodborne pathogens" means pathogenic
microorganisms that are present in human blood and can cause disease in humans. These
pathogens include, but are not limited to, hepatitis B virus (HBV), hepatitis C virus (HCV),
and human immunodeficiency virus (HIV).
    Subd. 3. Emergency medical services agency. "Emergency medical services agency" means
an agency, entity, or organization that employs or uses emergency medical services persons as
employees or volunteers.
    Subd. 4. Emergency medical services person. "Emergency medical services person" means:
(1) an individual employed or receiving compensation to provide out-of-hospital emergency
medical services such as a firefighter, paramedic, emergency medical technician, licensed nurse,
rescue squad person, or other individual who serves as an employee or volunteer of an ambulance
service as defined under chapter 144E or a member of an organized first responder squad that
is formally recognized by a political subdivision in the state, who provides out-of-hospital
emergency medical services during the performance of the individual's duties;
(2) an individual employed as a licensed peace officer under section 626.84, subdivision 1;
(3) an individual employed as a crime laboratory worker while working outside the
laboratory and involved in a criminal investigation;
(4) any individual who renders emergency care or assistance at the scene of an emergency
or while an injured person is being transported to receive medical care and who is acting as a
Good Samaritan under section 604A.01; and
(5) any individual who, in the process of executing a citizen's arrest under section 629.30,
may have experienced a significant exposure to a source individual.
    Subd. 5. Source individual. "Source individual" means an individual, living or dead, whose
blood, tissue, or potentially infectious body fluids may be a source of bloodborne pathogen
exposure to an emergency medical services person. Examples include, but are not limited to, a
victim of an accident, injury, or illness or a deceased person.
    Subd. 6. Significant exposure. "Significant exposure" means contact likely to transmit a
bloodborne pathogen, in a manner supported by the most current guidelines and recommendations
of the United States Public Health Service at the time an evaluation takes place, that includes:
(1) percutaneous injury, contact of mucous membrane or nonintact skin, or prolonged
contact of intact skin; and
(2) contact, in a manner that may transmit a bloodborne pathogen, with blood, tissue, or
potentially infectious body fluids.
    Subd. 7. Facility. "Facility" means a hospital licensed under sections 144.50 to 144.56 or
a freestanding emergency medical care facility licensed under Laws 1988, chapter 467, that
receives an emergency medical services person for evaluation for significant exposure or a source
individual cared for by an emergency medical services person.
    Subd. 8. Peace officer; applicability. An individual licensed as a peace officer under
section 626.84, subdivision 1, is considered an emergency medical services person for purposes
of sections 144.7401 to 144.7415 regardless of whether the officer is engaged in performing
emergency services.
History: 2000 c 422 s 5; 2006 c 260 art 3 s 4

144.7402 CONDITIONS FOR APPLICABILITY OF PROCEDURES.
    Subdivision 1. Request for procedures. An emergency medical services person or
emergency medical services agency may request that a facility follow the procedures of sections
144.7401 to 144.7415 when an emergency medical services person may have experienced a
significant exposure to a source individual.
    Subd. 2. Conditions. A facility shall follow the procedures outlined in sections 144.7401 to
144.7415 when all of the following conditions are met:
(1) the facility determines that significant exposure has occurred, following the protocol
under section 144.7414;
(2) the licensed physician for the emergency medical services person needs the source
individual's bloodborne pathogen test results to begin, continue, modify, or discontinue treatment,
in accordance with the most current guidelines of the United States Public Health Service,
because of possible exposure to a bloodborne pathogen; and
(3) the emergency medical services person consents to provide a blood sample for testing for
a bloodborne pathogen. If the emergency medical services person consents to blood collection,
but does not consent at that time to bloodborne pathogen testing, the facility shall preserve the
sample for at least 90 days. If the emergency medical services person elects to have the sample
tested within 90 days, the testing shall be done as soon as feasible.
    Subd. 3. Locating source individual. If the source individual is not received by a facility
but the facility is providing treatment to the emergency medical services person, the emergency
medical services agency shall make reasonable efforts to locate the source individual and inform
the facility of the source individual's identity and location. The facility shall make a reasonable
effort to contact the source individual in order to follow the procedures in sections 144.7401 to
144.7415. The emergency medical services agency and facilities may exchange private data
about the source individual as necessary to fulfill their responsibilities under this subdivision,
notwithstanding any provision of law to the contrary.
History: 2000 c 422 s 6

144.7403 INFORMATION REQUIRED TO BE GIVEN TO INDIVIDUALS.
    Subdivision 1. Information to source individual. (a) Before seeking any consent required
by the procedures under sections 144.7401 to 144.7415, a facility shall inform the source
individual that the source individual's bloodborne pathogen test results, without the individual's
name, address, or other uniquely identifying information, shall be reported to the emergency
medical services person if requested, and that test results collected under sections 144.7401
to 144.7415 are for medical purposes as set forth in section 144.7409 and may not be used as
evidence in any criminal proceedings or civil proceedings, except for procedures under sections
144.4171 to 144.4186.
(b) The facility shall inform the source individual of the insurance protections in section
72A.20, subdivision 29.
(c) The facility shall inform the source individual that the individual may refuse to provide a
blood sample and that the source individual's refusal may result in a request for a court order to
require the source individual to provide a blood sample.
(d) The facility shall inform the source individual that the facility will advise the emergency
medical services person of the confidentiality requirements and penalties before disclosing any
test information.
    Subd. 2. Information to EMS person. (a) Before disclosing any information about the
source individual, the facility shall inform the emergency medical services person of the
confidentiality requirements of section 144.7411 and that the person may be subject to penalties
for unauthorized release of information about the source individual under section 144.7412.
(b) The facility shall inform the emergency medical services person of the insurance
protections in section 72A.20, subdivision 29.
History: 2000 c 422 s 7

144.7404 DISCLOSURE OF POSITIVE BLOODBORNE PATHOGEN TEST RESULTS.
If the conditions of sections 144.7402 and 144.7403 are met, the facility shall ask the source
individual and the emergency medical services person if they have ever had a positive test for
a bloodborne pathogen. The facility must attempt to get existing test results under this section
before taking any steps to obtain a blood sample or to test for bloodborne pathogens. The facility
shall disclose the source individual's bloodborne pathogen test results to the emergency medical
services person without the source individual's name, address, or other uniquely identifying
information.
History: 2000 c 422 s 8

144.7405 CONSENT PROCEDURES GENERALLY.
(a) For purposes of sections 144.7401 to 144.7415, whenever the facility is required to seek
consent, the facility shall follow its usual procedure for obtaining consent from an individual or
an individual's representative consistent with other law applicable to consent.
(b) Consent from a source individual's representative for bloodborne pathogen testing of an
existing blood sample obtained from the source individual is not required if the facility has made
reasonable efforts to obtain the representative's consent and consent cannot be obtained within
24 hours of a significant exposure.
(c) If testing of the source individual's blood occurs without consent because the source
individual is unable to provide consent or has left the facility and cannot be located, and the source
individual's representative cannot be located, the facility shall provide the information required in
section 144.7403 to the source individual or representative whenever it is possible to do so.
(d) If a source individual dies before an opportunity to consent to blood collection or testing
under sections 144.7401 to 144.7415, the facility does not need consent of the deceased person's
representative for purposes of sections 144.7401 to 144.7415.
History: 2000 c 422 s 9

144.7406 TESTING OF AVAILABLE BLOOD.
    Subdivision 1. Procedures with consent. If the source individual is or was under the care or
custody of the facility and a sample of the source individual's blood is available with the consent of
the source individual, the facility shall test that blood for bloodborne pathogens with the consent
of the source individual, provided the conditions in sections 144.7402 and 144.7403 are met.
    Subd. 2. Procedures without consent. If the source individual has provided a blood sample
with consent but does not consent to bloodborne pathogen testing, the facility shall test for
bloodborne pathogens if the emergency medical services person or emergency medical services
agency requests the test, provided all of the following criteria are met:
(1) the emergency medical services person or emergency medical services agency has
documented exposure to blood or body fluids during performance of that person's occupation or
while acting as a Good Samaritan under section 604A.01 or executing a citizen's arrest under
section 629.30;
(2) the facility has determined that a significant exposure has occurred and a licensed
physician for the emergency medical services person has documented in the emergency medical
services person's medical record that bloodborne pathogen test results are needed for beginning,
modifying, continuing, or discontinuing medical treatment for the emergency medical services
person under section 144.7414, subdivision 2;
(3) the emergency medical services person provides a blood sample for testing for
bloodborne pathogens as soon as feasible;
(4) the facility asks the source individual to consent to a test for bloodborne pathogens
and the source individual does not consent;
(5) the facility has provided the source individual with all of the information required by
section 144.7403; and
(6) the facility has informed the emergency medical services person of the confidentiality
requirements of section 144.7411 and the penalties for unauthorized release of source information
under section 144.7412.
    Subd. 3. Follow-up. The facility shall inform the source individual and the emergency
medical services person of their own test results. The facility shall inform the emergency medical
services person of the source individual's test results without the source individual's name,
address, or other uniquely identifying information.
History: 2000 c 422 s 10

144.7407 BLOOD SAMPLE COLLECTION FOR TESTING.
    Subdivision 1. Procedures with consent. (a) If a blood sample is not otherwise available, the
facility shall obtain consent from the source individual before collecting a blood sample for testing
for bloodborne pathogens. The consent process shall include informing the source individual that
the individual may refuse to provide a blood sample and that the source individual's refusal
may result in a request for a court order under subdivision 2 to require the source individual
to provide a blood sample.
(b) If the source individual consents to provide a blood sample, the facility shall collect a
blood sample and test the sample for bloodborne pathogens.
(c) The facility shall inform the emergency medical services person about the source
individual's test results without the individual's name, address, or other uniquely identifying
information. The facility shall inform the source individual of the test results.
(d) If the source individual refuses to provide a blood sample for testing, the facility shall
inform the emergency medical services person of the source individual's refusal.
    Subd. 2. Procedures without consent. (a) An emergency medical services agency, or, if
there is no agency, an emergency medical services person, may bring a petition for a court order
to require a source individual to provide a blood sample for testing for bloodborne pathogens. The
petition shall be filed in the district court in the county where the source individual resides or is
hospitalized. The petitioner shall serve the petition on the source individual at least three days
before a hearing on the petition. The petition shall include one or more affidavits attesting that:
(1) the facility followed the procedures in sections 144.7401 to 144.7415 and attempted to
obtain bloodborne pathogen test results according to those sections;
(2) it has been determined under section 144.7414, subdivision 2, that a significant exposure
has occurred to the emergency medical services person; and
(3) a physician with specialty training in infectious diseases, including HIV, has documented
that the emergency medical services person has provided a blood sample and consented to
testing for bloodborne pathogens and bloodborne pathogen test results are needed for beginning,
continuing, modifying, or discontinuing medical treatment for the emergency medical services
person.
(b) Facilities shall cooperate with petitioners in providing any necessary affidavits to the
extent that facility staff can attest under oath to the facts in the affidavits.
(c) The court may order the source individual to provide a blood sample for bloodborne
pathogen testing if:
(1) there is probable cause to believe the emergency medical services person has experienced
a significant exposure to the source individual;
(2) the court imposes appropriate safeguards against unauthorized disclosure that must
specify the persons who have access to the test results and the purposes for which the test
results may be used;
(3) a licensed physician for the emergency medical services person needs the test results
for beginning, continuing, modifying, or discontinuing medical treatment for the emergency
medical services person; and
(4) the court finds a compelling need for the test results. In assessing compelling need,
the court shall weigh the need for the court-ordered blood collection and test results against
the interests of the source individual, including, but not limited to, privacy, health, safety, or
economic interests. The court shall also consider whether the involuntary blood collection and
testing would serve the public interest.
(d) The court shall conduct the proceeding in camera unless the petitioner or the source
individual requests a hearing in open court and the court determines that a public hearing is
necessary to the public interest and the proper administration of justice.
(e) The source individual has the right to counsel in any proceeding brought under this
subdivision.
History: 2000 c 422 s 11

144.7408 NO DISCRIMINATION.
A facility shall not base decisions about admission to a facility or the provision of care or
treatment on any requirement that the source individual consent to bloodborne pathogen testing
under sections 144.7401 to 144.7415.
History: 2000 c 422 s 12

144.7409 USE OF TEST RESULTS.
Bloodborne pathogen test results of a source individual obtained under sections 144.7401 to
144.7415 are for diagnostic purposes and to determine the need for treatment or medical care
specific to a bloodborne pathogen-related illness of an emergency medical services person. The
test results may not be used as evidence in any criminal proceedings or civil proceedings, except
for procedures under sections 144.4171 to 144.4186.
History: 2000 c 422 s 13

144.7411 TEST INFORMATION CONFIDENTIALITY.
    Subdivision 1. Private data. Information concerning test results obtained under sections
144.7401 to 144.7415 is information protected from disclosure without consent under section
144.335 with respect to private facilities and private data as defined in section 13.02, subdivision
12 , with respect to public facilities.
    Subd. 2. Consent to release information. No facility, individual, or employer shall disclose
to an emergency medical services person the name, address, or other uniquely identifying
information about a source individual without a written release signed by the source individual or
the source individual's legally authorized representative. The facility shall not record the name,
address, or other uniquely identifying information about the source individual's test results in the
emergency medical services person's medical records.
History: 2000 c 422 s 14

144.7412 PENALTY FOR UNAUTHORIZED RELEASE OF INFORMATION.
Unauthorized release by an individual, facility, or agency of a source individual's name,
address, or other uniquely identifying information under sections 144.7401 to 144.7415 is subject
to the remedies and penalties under sections 13.08 and 13.09. This section does not preclude
private causes of action against an individual, state agency, statewide system, political subdivision,
or person responsible for releasing private data or information protected from disclosure.
History: 2000 c 422 s 15

144.7413 RESPONSIBILITY FOR TESTING AND TREATMENT; COSTS.
(a) The facility shall ensure that tests under sections 144.7401 to 144.7415 are performed
if requested by the emergency medical services person or emergency medical services agency,
provided the conditions set forth in sections 144.7401 to 144.7415 are met.
(b) The emergency medical services agency that employs the emergency medical services
person who requests testing under sections 144.7401 to 144.7415 must pay or arrange payment
for the cost of counseling, testing, and treatment of the emergency medical services person and
costs associated with the testing of the source individual.
(c) A facility shall have a protocol that states whether the facility will pay for the cost of
counseling, testing, or treatment of a person executing a citizen's arrest under section 629.30 or
acting as a Good Samaritan under section 604A.01.
History: 2000 c 422 s 16

144.7414 PROTOCOLS FOR EXPOSURE TO BLOODBORNE PATHOGENS.
    Subdivision 1. EMS agency requirements. The emergency medical services agency
shall have procedures for an emergency medical services person to notify a facility that the
person may have experienced a significant exposure from a source individual. The emergency
medical services agency shall also have a protocol to locate the source individual if the facility
has not received the source individual and the emergency medical services agency knows the
source individual's identity.
    Subd. 2. Facility protocol requirements. Every facility shall adopt and follow a
postexposure protocol for emergency medical services persons who have experienced a significant
exposure. The postexposure protocol must adhere to the most current recommendations of the
United States Public Health Service and include, at a minimum, the following:
(1) a process for emergency medical services persons to report an exposure in a timely
fashion;
(2) a process for an infectious disease specialist, or a licensed physician who is
knowledgeable about the most current recommendations of the United States Public Health
Service in consultation with an infectious disease specialist, (i) to determine whether a significant
exposure to one or more bloodborne pathogens has occurred and (ii) to provide, under the
direction of a licensed physician, a recommendation or recommendations for follow-up treatment
appropriate to the particular bloodborne pathogen or pathogens for which a significant exposure
has been determined;
(3) if there has been a significant exposure, a process to determine whether the source
individual has a bloodborne pathogen through disclosure of test results, or through blood
collection and testing as required by sections 144.7401 to 144.7415;
(4) a process for providing appropriate counseling prior to and following testing for a
bloodborne pathogen regarding the likelihood of bloodborne pathogen transmission and follow-up
recommendations according to the most current recommendations of the United States Public
Health Service, recommendations for testing, and treatment to the emergency medical services
person;
(5) a process for providing appropriate counseling under clause (4) to the emergency medical
services person and the source individual; and
(6) compliance with applicable state and federal laws relating to data practices,
confidentiality, informed consent, and the patient bill of rights.
History: 2000 c 422 s 17

144.7415 PENALTIES AND IMMUNITY.
    Subdivision 1. Penalties. Any facility or person who willfully violates the provisions of
sections 144.7401 to 144.7415 is guilty of a misdemeanor.
    Subd. 2. Immunity. A facility, licensed physician, and designated health care personnel are
immune from liability in any civil, administrative, or criminal action relating to the disclosure of
test results to an emergency medical services person or emergency medical services agency and
the testing of a blood sample from the source individual for bloodborne pathogens if a good faith
effort has been made to comply with sections 144.7401 to 144.7415.
History: 2000 c 422 s 18

144.75 [Repealed, 1973 c 250 s 2]

144.76 [Repealed, 1993 c 206 s 25]

144.761 [Repealed, 2000 c 422 s 55]

144.762 [Repealed, 2000 c 422 s 55]

144.763 [Repealed, 2000 c 422 s 55]

144.764 [Repealed, 2000 c 422 s 55]

144.765 [Repealed, 2000 c 422 s 55]

144.766 [Repealed, 2000 c 422 s 55]

144.767 [Repealed, 2000 c 422 s 55]

144.768 [Repealed, 2000 c 422 s 55]

144.769 [Repealed, 2000 c 422 s 55]

144.7691 [Repealed, 2000 c 422 s 55]

144.801 [Repealed, 1997 c 199 s 15]

144.802 [Repealed, 1997 c 199 s 15]

144.803 [Repealed, 1997 c 199 s 15]

144.804 [Repealed, 1997 c 199 s 15]

144.805 [Repealed, 1989 c 134 s 12]

144.806 [Repealed, 1997 c 199 s 15]

    Subdivision 1.[Renumbered 144E.17, subdivision 1]
    Subd. 2.[Renumbered 144E.17, subd 2]
    Subd. 3.[Repealed, 1989 c 134 s 12]

144.808 [Renumbered 144E.18]

144.809 [Renumbered 144E.25]

    Subdivision 1.[Renumbered 144E.35, subdivision 1]
    Subd. 2.[Renumbered 144E.35, subd 2]
    Subd. 3.[Repealed by amendment, 1989 c 134 s 11]

144.8092 [Repealed, 1989 c 134 s 12]

    Subdivision 1.[Renumbered 144E.50, subdivision 1]
    Subd. 2.[Renumbered 144E.50, subd 2]
    Subd. 2a.[Renumbered 144E.50, subd 3]
    Subd. 3.[Renumbered 144E.50, subd 4]
    Subd. 4.[Renumbered 144E.50, subd 5]

144.8095 [Renumbered 144E.52]

144.8097 [Repealed, 1995 c 207 art 9 s 61 subd 2]

ALCOHOLISM COUNSELOR

144.81 [Repealed, 1973 c 572 s 18]

144.82 [Repealed, 1973 c 572 s 18]

144.83 [Repealed, 1967 c 893 s 5]

144.831 [Repealed, 1973 c 572 s 18]

144.832 [Repealed, 1973 c 572 s 18]

144.833 [Repealed, 1973 c 572 s 18]

144.834 [Repealed, 1973 c 572 s 18]

144.84 CIVIL SERVICE CLASSIFICATION.
The commissioner of employee relations and the Civil Service Commission shall establish
a classification to be known as "counselor on alcoholism" the qualifications of which shall
give recognition to the value and desirability of recovered alcoholics in performing the duties
of their employment.
History: 1953 c 705 s 4; 1973 c 507 s 45; 1980 c 617 s 47

144.851 [Repealed, 1990 c 533 s 8]

144.852 [Repealed, 1990 c 533 s 8]

144.853 [Repealed, 1990 c 533 s 8]

144.854 [Repealed, 1990 c 533 s 8]

144.856 [Repealed, 1990 c 533 s 8]

144.860 [Repealed, 1990 c 533 s 8]

144.861 [Repealed, 1991 c 345 art 2 s 69]

144.862 [Repealed, 1990 c 533 s 8]

144.871 [Repealed, 1995 c 213 art 1 s 13]

144.872 [Repealed, 1995 c 213 art 1 s 13]

144.8721 [Repealed, 1993 c 286 s 34; 1Sp1993 c 1 art 9 s 75]

144.873 [Repealed, 1995 c 213 art 1 s 13]

144.874 [Repealed, 1995 c 213 art 1 s 13]

144.876 [Repealed, 1995 c 213 art 1 s 13]

    Subdivision 1.[Repealed, 1995 c 213 art 1 s 13]
    Subd. 2.[Repealed, 1995 c 213 art 1 s 13]
    Subd. 3.[Repealed, 1995 c 213 art 1 s 13]
    Subd. 4.[Repealed, 1995 c 213 art 1 s 13]
    Subd. 5.[Repealed, 1995 c 165 s 17; 1995 c 213 art 1 s 13]
    Subd. 6.[Repealed, 1995 c 213 art 1 s 13]
    Subd. 7.[Repealed, 1995 c 213 art 1 s 13]

144.8771 [Repealed, 1995 c 213 art 1 s 13]

144.878 [Repealed, 1995 c 213 art 1 s 13]

    Subdivision 1.[Repealed, 1994 c 567 s 24]
    Subd. 2.[Repealed, 1994 c 567 s 24]
    Subd. 3.[Repealed, 1994 c 567 s 24]
    Subd. 4.[Repealed, 1995 c 165 s 17; 1995 c 213 art 1 s 13]
    Subd. 5.[Repealed, 1994 c 567 s 24]
    Subd. 6.[Repealed, 1995 c 213 art 1 s 13]

144.8782 [Repealed, 1995 c 213 art 1 s 13]

144.879 [Repealed, 1995 c 213 art 1 s 13]

HUMAN GENETICS

144.91 POWERS AND DUTIES.
The state commissioner of health is authorized to develop and carry on a program in the field
of human genetics which shall include the collection and interpretation of data relating to human
hereditary diseases and pathologic conditions; the assembly, preparation and dissemination of
informational material on the subject for professional counselors and the lay public; the conduct
of such research studies as may stimulate reduction in the frequency of manifestation of various
deleterious genes, and the provision of counseling services to the public on problems of human
genetics. It shall consult and cooperate with the University of Minnesota, the Public Health
Service and the Children's Bureau of the Department of Health, Education and Welfare, and
with nationally recognized scientific and professional organizations engaged in studying the
problems of human genetics.
History: 1959 c 572 s 1; 1977 c 305 s 45

144.92 GRANTS OR GIFTS.
The board is authorized to receive and expend in accordance with approved plans such
funds as may be granted by the Public Health Service or any other federal agency which may
appropriate funds for this purpose, or such funds as may be received as gifts from private
organizations and individuals to the state for carrying out the purposes of section 144.91.
History: 1959 c 572 s 2; 1Sp1981 c 4 art 1 s 78

144.93 [Repealed, 1973 c 250 s 2]

144.94 [Repealed, 1987 c 209 s 40]

MOSQUITO RESEARCH PROGRAM

144.95 MOSQUITO RESEARCH PROGRAM.
    Subdivision 1. Research program. The commissioner of health shall establish and maintain
a long-range program of research to study:
(1) the basic biology, distribution, population ecology, and biosystematics of Minnesota
mosquitoes;
(2) the impact of mosquitoes on human and animal health and the economy, including such
areas as recreation, tourism, and livestock production;
(3) the baseline population and environmental status of organisms other than mosquitoes that
may be affected by mosquito management;
(4) the effects of mosquito management strategies on animals and plants that may result in
changes in ecology of specific areas;
(5) the development of mosquito management strategies that are effective, practical, and
environmentally safe;
(6) the costs and benefits of development of local and regional management and educational
programs.
    Subd. 2. Research facility and field stations. (a) The commissioner of health shall establish
and maintain mosquito management research and development facilities, including but not limited
to field research stations in the major mosquito ecologic regions and a center for basic mosquito
management research and development. The commissioner shall, to the extent possible, contract
with the University of Minnesota in establishing, maintaining, and staffing the research facilities.
(b) The commissioner of health shall establish and implement a program of contractual
research grants with public and private agencies and individuals in order to:
(1) undertake supplemental research studies on basic mosquito biology, physiology, and life
cycle history beyond those described in subdivision 1;
(2) undertake research into the effects of mosquitoes on human health, including vector-borne
diseases, and on animal health, including agricultural and wildlife effects;
(3) undertake studies of other economic factors including tourism and recreation;
(4) collect and analyze baseline data on the ecology and distribution of organisms other than
mosquitoes that may be affected as a result of mosquito management strategies;
(5) develop new, effective, practical, and biologically compatible control methods and
materials;
(6) conduct additional monitoring of the environmental effects of mosquito control methods
and materials;
(7) undertake demonstration, training, and education programs for development of local
and regional mosquito management programs.
    Subd. 3. Conduct research trials. The commissioner of health may develop and conduct
research trials of mosquito management methods and materials. Trials may be conducted, with
the agreement of the public or private landholder, wherever and whenever the commissioner
considers necessary to provide accurate data for determining the efficacy of a method or material
in controlling mosquitoes.
    Subd. 4. Research trials. Research trials of mosquito management methods and materials
are subject to the following laws and rules unless a specific written exemption, license, or waiver
is granted; sections 84.0895, 103G.615, 97A.045, subdivision 1, 103A.201, 103G.255, and
103G.275 to 103G.285; and Minnesota Rules, chapters 1505, 6115, 6120, 6134, and 6140.
    Subd. 5. General authority. (a) To carry out subdivisions 1 to 4, the commissioner of
health may:
(1) accept money, property, or services from any source;
(2) receive and hold lands;
(3) accept gifts;
(4) cooperate with city, state, federal, or private agencies whose research on mosquito control
or on other environmental matters may be affected by the commissioner's mosquito management
and research activities; and
(5) enter into contracts with any public or private entity.
(b) The contracts must specify the duties performed, services provided, and the amount and
method of reimbursement for them. Money collected by the commissioner under contracts made
under this subdivision is appropriated to the commissioner for the purposes specified in the
contracts. Contractual agreements must be processed under section 16C.08.
    Subd. 6. Authority to enter property. The commissioner of health, officers, employees, or
agents may, with express permission of the owner, enter upon any property at reasonable times to:
(1) determine whether mosquito breeding exists;
(2) examine, count, study, or collect laboratory samples to determine the property's
geographic, geologic, and biologic characteristics; or
(3) study and collect laboratory samples to determine the effect on animals and vegetation of
an insecticide, herbicide, or other method used to control mosquitoes.
    Subd. 7. Research plots. The commissioner of health may lease and maintain experimental
plots of land for mosquito research. The commissioner of health shall determine the locations
of the experimental plots and may enter into agreements with any public or private agency or
individual to lease the land. The commissioners of agriculture, natural resources, transportation,
and iron range resources and rehabilitation shall cooperate with the commissioner of health.
    Subd. 8. Emergencies. The commissioner may suspend or revoke a contract, agreement, or
delegated authority granted in this section at any time and without prior notice if an emergency,
accident, or hazard threatens the public health.
    Subd. 9.[Repealed, 1997 c 7 art 2 s 67]
    Subd. 10. Contingency. This section is effective only if the tax on cigarettes imposed by
United States Code, title 26, section 5701, as amended, is reduced after June 1, 1985, or if other
public or private funds sufficient to fund the program are made available to the commissioner for
the purposes of this program.
History: 1Sp1985 c 14 art 19 s 17; 1987 c 149 art 2 s 10; 1987 c 312 art 1 s 26 subd 2; 1990
c 391 art 8 s 29; art 10 s 3; 1993 c 163 art 1 s 25; 1998 c 386 art 2 s 57

LEAD POISONING PREVENTION ACT

144.9501 DEFINITIONS.
    Subdivision 1. Citation. Sections 144.9501 to 144.9509 may be cited as the "Lead Poisoning
Prevention Act."
    Subd. 2. Applicability. The definitions in this section apply to sections 144.9501 to 144.9509.
    Subd. 3. Abatement. "Abatement" means any set of measures intended to eliminate known
or presumed lead hazards. Abatement includes:
(1) the removal of lead-based paint and lead-contaminated dust, the permanent enclosure or
encapsulation of lead-based paint, the replacement of lead-painted surfaces or fixtures, and the
removal or enclosure of lead-contaminated soil; and
(2) all preparation, cleanup, disposal, and postabatement clearance testing activities
associated with these measures.
    Subd. 4. Areas at high risk for toxic lead exposure. "Areas at high risk for toxic lead
exposure" means a census tract in a city of the first class or a county or area within a county
outside a city of the first class that has been determined to be at high risk for toxic lead exposure
under section 144.9503.
    Subd. 4a. Assessing agency. "Assessing agency" means the commissioner or a board of
health with authority and responsibility to conduct lead risk assessments in response to reports of
children or pregnant women with elevated blood lead levels.
    Subd. 5. Bare soil. "Bare soil" means any visible soil that is at least an area of 36 contiguous
square inches.
    Subd. 6. Board of health. "Board of health" means an administrative authority established
under section 145A.03.
    Subd. 6a. Child. "Child" means an individual up to 72 months of age.
    Subd. 6b. Clearance inspection. "Clearance inspection" means a visual identification of
deteriorated paint and bare soil and a resampling and analysis of interior dust lead concentrations
in a residence to ensure that the lead standards established in rules adopted under section
144.9508 are not exceeded.
    Subd. 6c. Capillary blood sample. "Capillary blood sample" means a quantity of blood
drawn from a capillary. The sample generally is collected by fingerstick.
    Subd. 6d. Certified lead firm. "Certified lead firm" means a person that employs individuals
to perform regulated lead work and that is certified by the commissioner under section 144.9505.
    Subd. 7. Commissioner. "Commissioner" means the commissioner of the Minnesota
Department of Health.
    Subd. 7a. Contracting entity. "Contracting entity" means a public or private body, board,
individual, corporation, partnership, proprietorship, joint venture, fund, authority, or similar entity
that contracts with a person to do regulated lead work.
    Subd. 8. Deteriorated paint. "Deteriorated paint" means paint that is chipped, peeled, or
otherwise separated from its substrate or that is attached to damaged substrate.
    Subd. 9. Elevated blood lead level. "Elevated blood lead level" means a diagnostic blood
lead test with a result that is equal to or greater than ten micrograms of lead per deciliter of whole
blood in any person, unless the commissioner finds that a lower concentration is necessary to
protect public health.
    Subd. 10. Encapsulation. "Encapsulation" means covering a surface coated with paint that
exceeds the standards under section 144.9508 with a liquid or solid material that adheres to the
surface, rather than mechanically attaches to it; or covering bare soil that exceeds the standards
under section 144.9508 with a permeable material such as vegetation, mulch, or soil that meets
the standards under section 144.9508.
    Subd. 11. Enclosure. "Enclosure" means covering a surface coated with paint that exceeds
the standards under section 144.9508 by mechanically fastening to the surface a durable, solid
material; or covering bare soil that exceeds the standards under section 144.9508 with an
impermeable material, such as asphalt or concrete.
    Subd. 12.[Repealed, 1998 c 407 art 2 s 109]
    Subd. 13. Intact paint. "Intact paint" means paint that is not chipped, peeled, or otherwise
separated from its substrate or attached to damaged substrate. Painted surfaces which may
generate dust but are not chipped, peeled, or otherwise separated from their substrate or attached
to damaged substrate are considered to be intact paint.
    Subd. 13a. Interim controls. "Interim controls" means a set of measures intended to
temporarily reduce human exposure or likely exposure to known or presumed lead hazards,
including specialized cleaning, repairs, maintenance, painting, temporary encapsulation, or
enclosure.
    Subd. 14.[Repealed, 1998 c 407 art 2 s 109]
    Subd. 15. Lead hazard. "Lead hazard" means a condition that causes exposure to lead
from dust, bare soil, drinking water, or deteriorated paint that exceeds the standards adopted
under section 144.9508.
    Subd. 16.[Repealed, 1998 c 407 art 2 s 109]
    Subd. 17. Lead hazard reduction. "Lead hazard reduction" means abatement or interim
controls undertaken to make a residence, child care facility, school, or playground lead-safe by
complying with the lead standards and methods adopted under section 144.9508.
    Subd. 17a. Lead hazard screen. "Lead hazard screen" means a limited risk assessment
activity that involves the visual identification of dust, paint, or bare soil and sampling and
analysis of dust.
    Subd. 17b. Lead interim control worker. "Lead interim control worker" means an
individual who is trained as specified by the commissioner to conduct interim control activities.
    Subd. 18. Lead inspection. "Lead inspection" means a surface by surface investigation to
determine the presence of lead content of paint and a visual identification of the existence and
location of bare soil.
    Subd. 19. Lead inspector. "Lead inspector" means a person who is licensed by the
commissioner to perform a lead inspection under section 144.9505.
    Subd. 19a. Lead project design. "Lead project design" means site-specific written project
specifications for a regulated lead work project. Lead project design includes written technical
project specifications incorporated into bidding documents.
    Subd. 20. Lead order. "Lead order" means a legal instrument to compel a property owner to
engage in lead hazard reduction according to the specifications given by the assessing agency.
    Subd. 20a. Lead project designer. "Lead project designer" means an individual who is
responsible for planning the site-specific performance of regulated lead work and who has been
licensed by the commissioner under section 144.9505.
    Subd. 20b. Lead risk assessment. "Lead risk assessment" means an investigation to
determine the existence, nature, severity, and location of lead hazards.
    Subd. 20c. Lead risk assessor. "Lead risk assessor" means an individual who performs lead
risk assessments or lead inspections and who has been licensed by the commissioner under
section 144.9505.
    Subd. 21. Lead-safe. "Lead-safe" means a condition in which:
(1) lead is not present;
(2) lead may be present at the residence, child care facility, school, or playground, if the lead
concentration in the dust, paint, soil, and water of a residence does not exceed the standards
adopted under section 144.9508; or
(3) if the lead concentrations in the paint or soil do exceed the standards, the paint is intact
and the soil is not bare soil.
    Subd. 22. Lead-safe practices. "Lead-safe practices" means methods for construction,
renovation, remodeling, or maintenance activities that are not regulated lead work and that are
performed so that they do not:
(1) violate the standards under section 144.9508;
(2) create lead dust through the use of prohibited practices;
(3) leave debris or a lead residue that can form a dust;
(4) provide a readily accessible source of lead dust, lead paint, lead paint chips, or lead
contaminated soil, after the use of containment methods; and
(5) result in improper disposal of lead contaminated debris, dust, or soil.
    Subd. 22a. Lead supervisor. "Lead supervisor" means an individual who is responsible
for the on-site performance of abatement or interim controls and who has been licensed by the
commissioner under section 144.9505.
    Subd. 22b. Lead sampling technician. "Lead sampling technician" means an individual who
performs clearance inspections for nonabatement or nonorder lead hazard reduction sites, lead
dust sampling in other settings, or visual assessment for deteriorated paint, and who is registered
with the commissioner under section 144.9505.
    Subd. 23. Lead worker. "Lead worker" means an individual who performs abatement or
interim control work and who has been licensed by the commissioner under section 144.9505.
    Subd. 24. Person. "Person" has the meaning given in section 326.71, subdivision 8.
    Subd. 25. Persons at high risk for elevated blood lead level. "Persons at high risk for
elevated blood lead level" means:
(1) a child between six and 72 months of age:
(a) who lives in or visits, at least weekly, a residence, child care facility, or school built before
1978 which has peeling or chipping paint, ongoing remodeling or renovation, or bare soil; or
(b) who has a sibling, housemate, or playmate who has been diagnosed with an elevated
blood lead level in the last 12 months; and
(2) a pregnant female or a child between six and 72 months of age:
(a) who lives in a census tract found to have a median foundation soil lead value exceeding
100 parts per million of lead;
(b) who lives near an industrial point source that emits lead;
(c) who lives near a road with an average daily traffic which exceeded 5,000 vehicles per
day in 1986 or earlier; or
(d) who lives with a person whose occupation or hobby involves exposure to lead.
    Subd. 25a. Play area. "Play area" means any established area where children play, or on
residential property, any established area where children play or bare soil is accessible to children.
    Subd. 26. Primary prevention. "Primary prevention" means preventing toxic lead exposure
before blood levels become elevated.
    Subd. 26a. Regulated lead work. (a) "Regulated lead work" means:
(1) abatement;
(2) interim controls;
(3) a clearance inspection;
(4) a lead hazard screen;
(5) a lead inspection;
(6) a lead risk assessment;
(7) lead project designer services;
(8) lead sampling technician services; or
(9) swab team services.
(b) Regulated lead work does not include:
(1) activities such as remodeling, renovation, installation, rehabilitation, or landscaping
activities, the primary intent of which is to remodel, repair, or restore a structure or dwelling,
rather than to permanently eliminate lead hazards, even though these activities may incidentally
result in a reduction in lead hazards; or
(2) interim control activities that are not performed as a result of a lead order and that do not
disturb painted surfaces that total more than:
(i) 20 square feet (two square meters) on exterior surfaces;
(ii) two square feet (0.2 square meters) in an interior room; or
(iii) ten percent of the total surface area on an interior or exterior type of component with
a small surface area.
    Subd. 27. Safe housing. "Safe housing" means a residence that is lead-safe.
    Subd. 28. Secondary prevention. "Secondary prevention" means intervention to mitigate
health effects on people with elevated blood lead levels.
    Subd. 28a. Standard. "Standard" means a quantitative assessment of lead in any
environmental media or consumer product.
    Subd. 29. Swab team services. "Swab team services" means activities that provide
protection from lead hazards primarily through the use of interim controls, such as:
(1) removing lead dust by washing, vacuuming with high efficiency particle accumulator
(HEPA) or wet vacuum cleaners, and cleaning the interior of residential property;
(2) removing loose paint and paint chips and repainting or installing guards to protect intact
paint;
(3) covering or replacing bare soil that has a lead concentration of 100 parts per million or
more;
(4) health education;
(5) advice and assistance to help residents locate and move to a temporary residence while
lead hazard reduction is being completed; or
(6) any other assistance necessary to meet the resident's immediate needs as a result of
the relocation.
    Subd. 30. Swab team worker. "Swab team worker" means an individual who performs swab
team services and who has been licensed by the commissioner as a lead worker under section
144.9505.
    Subd. 31. Venous blood sample. "Venous blood sample" means a quantity of blood drawn
from a vein.
    Subd. 32.[Repealed, 2001 c 205 art 1 s 43]
History: 1995 c 213 art 1 s 3; 1997 c 205 s 24,25; 1998 c 407 art 2 s 34-49; 2001 c 205
art 1 s 1-25

144.9502 STATEWIDE LEAD SURVEILLANCE SYSTEM.
    Subdivision 1. Surveillance. The commissioner of health shall establish a statewide lead
surveillance system. The purpose of this system is to:
(a) monitor blood lead levels in children and adults to identify trends and populations at high
risk for elevated blood lead levels;
(b) ensure that screening services are provided to populations at high risk for elevated blood
lead levels;
(c) ensure that medical and environmental follow-up services for children with elevated
blood lead levels are provided; and
(d) provide accurate and complete data for planning and implementing primary prevention
programs that focus on the populations at high risk for elevated blood lead levels.
    Subd. 2. Studies and surveys. The commissioner of health shall collect blood lead level and
exposure information, analyze the information, and conduct studies designed to determine the
potential for high risk for elevated blood lead levels among children and adults.
    Subd. 3. Reports of blood lead analysis required. (a) Every hospital, medical clinic,
medical laboratory, other facility, or individual performing blood lead analysis shall report the
results after the analysis of each specimen analyzed, for both capillary and venous specimens,
and epidemiologic information required in this section to the commissioner of health, within the
time frames set forth in clauses (1) and (2):
(1) within two working days by telephone, fax, or electronic transmission, with written or
electronic confirmation within one month, for a venous blood lead level equal to or greater than
15 micrograms of lead per deciliter of whole blood; or
(2) within one month in writing or by electronic transmission, for any capillary result or for a
venous blood lead level less than 15 micrograms of lead per deciliter of whole blood.
(b) If a blood lead analysis is performed outside of Minnesota and the facility performing
the analysis does not report the blood lead analysis results and epidemiological information
required in this section to the commissioner, the provider who collected the blood specimen must
satisfy the reporting requirements of this section. For purposes of this section, "provider" has the
meaning given in section 62D.02, subdivision 9.
(c) The commissioner shall coordinate with hospitals, medical clinics, medical laboratories,
and other facilities performing blood lead analysis to develop a universal reporting form and
mechanism.
    Subd. 4. Blood lead analyses and epidemiologic information. The blood lead analysis
reports required in this section must specify:
(1) whether the specimen was collected as a capillary or venous sample;
(2) the date the sample was collected;
(3) the results of the blood lead analysis;
(4) the date the sample was analyzed;
(5) the method of analysis used;
(6) the full name, address, and phone number of the laboratory performing the analysis;
(7) the full name, address, and phone number of the physician or facility requesting the
analysis;
(8) the full name, address, and phone number of the person with the blood lead level, and the
person's birthdate, gender, and race.
    Subd. 5. Follow-up epidemiologic information. The follow-up epidemiologic information
required in this section must specify:
(1) the name, address, and phone number of the agency or individual contacted to investigate
the environment of the person with the elevated blood lead level to determine the sources of
lead exposure; and
(2) the name, address, and phone number of all agencies or individuals to whom the person
or the person's guardian was referred for education about the sources, effects, and prevention of
lead exposure.
    Subd. 6.[Repealed, 2001 c 205 art 1 s 43]
    Subd. 7. Reporting without liability. The furnishing of the information required under
this section shall not subject the person, laboratory, or other facility furnishing the information
to any action for damages or relief.
    Subd. 8. Laboratory standards. (a) A laboratory performing blood lead analysis shall
use methods that:
(1) meet or exceed the proficiency standards established in the federal Clinical Laboratory
Improvement Regulations, Code of Federal Regulations, title 42, section 493, promulgated in
accordance with the Clinical Laboratory Improvement Act amendments of 1988, Public Law
100-578; or
(2) meet or exceed the Occupational Safety and Health Standards for Lead in General
Industries, Code of Federal Regulations, section 1910.1025, and Occupational Safety and Health
Standards for Lead in Construction, Code of Federal Regulations, section 1926.62.
(b) A laboratory performing lead analysis of paint, soil, or dust must be a laboratory
recognized by the United States Environmental Protection Agency under the Toxic Substances
Control Act, United States Code, title 15, section 2685, paragraph (b). Analysis of samples of
drinking water must be performed by a laboratory certified by the commissioner to analyze
lead in water.
    Subd. 9. Classification of data. Notwithstanding any law to the contrary, including section
13.05, subdivision 9, data collected by the commissioner of health about persons with blood lead
levels, including analytic results from samples of paint, soil, dust, and drinking water taken
from the individual's home and immediate property, shall be private and may only be used by
the commissioner of health, the commissioner of labor and industry, authorized agents of Indian
tribes, and authorized employees of local boards of health for the purposes set forth in this section.
History: 1995 c 213 art 1 s 4; 1998 c 407 art 2 s 50-52; 2001 c 205 art 1 s 26

144.9503 PRIMARY PREVENTION.
    Subdivision 1. Primary prevention program. The commissioner shall develop and
maintain a primary prevention program to reduce lead exposure in young children and pregnant
women. A board of health serving a city of the first class shall determine areas at high risk
for toxic lead exposure before doing primary prevention lead hazard reduction activities. The
program shall provide primary prevention lead education materials, promote primary prevention
swab team services, provide lead cleanup equipment and material grants as funding allows,
monitor regulated lead work, and develop and maintain lead-safe practices in cooperation with
the commissioner of administration.
    Subd. 2. Priorities for primary prevention. (a) The commissioner of health and boards of
health serving cities of the first class shall determine areas at high risk for toxic lead exposure.
(b) A board of health serving a city of the first class shall rank order census tracts by
awarding points as specified in this paragraph. The priority for primary prevention in census tracts
at high risk for toxic lead exposure shall be based on the cumulative points awarded to each
census tract. A greater number of points means a higher priority.
(1) One point may be awarded to a census tract for each ten percent of children who were
under six years old at the time they were screened for lead in blood and whose blood lead level
exceeds ten micrograms of lead per deciliter of whole blood, provided the commissioner has
determined that the data used to award the points are comprehensive and representative.
(2) One point may be awarded for every five percent of housing that is defined as
dilapidated or deteriorated by the planning department or similar agency of the city in which
the housing is located. Where data is available by neighborhood or section within a city, the
percent of dilapidated or deteriorated housing shall apply equally to each census tract within
the neighborhood or section.
(3) One point may be awarded for every 100 parts per million of lead in soil, based on the
median soil lead values of foundation soil samples, calculated on 100 parts per million intervals,
or fraction thereof. A board of health shall use data from its own soil survey conducted according
to rules adopted under section 144.9508, except that a board of health serving Minneapolis or
St. Paul that has not conducted its own soil survey shall use the June 1988 census tract version
of the houseside map titled "Distribution of Houseside Lead Content of Soil-Dust in the Twin
Cities," prepared by the Center for Urban and Regional Affairs, Humphrey Institute, University
of Minnesota, Publication 1989, Center for Urban and Regional Affairs 89-4. Where the map
displays a census tract that is crossed by two or more intervals, the board of health shall make a
reasoned determination of the median foundation soil lead value for that census tract.
(4) A board of health may award one point to each census tract for each of the following
factors based on cutoff criteria to be determined by the board of health:
(i) percent of minority population;
(ii) number of children less than six years of age;
(iii) percent of housing built before 1950; and
(iv) percent of population living in poverty.
(c) The commissioner may determine areas at high risk for toxic lead exposure at the county
level or within a county outside a city of the first class using one or more of the following criteria:
(1) blood lead levels greater than ten micrograms per deciliter of whole blood in children
under six years of age;
(2) percent of dilapidated or deteriorated housing;
(3) soil lead levels in excess of 100 parts per million;
(4) percent of minority population;
(5) percent of housing built before 1950;
(6) percent of children living in poverty; or
(7) other factors appropriate in preventing lead exposure, as determined by a federal agency
including the United States Centers for Disease Control and Prevention, the United States
Environmental Protection Agency, or the United States Department of Housing and Urban
Development.
    Subd. 3. Primary prevention lead education strategy. The commissioner of health shall
develop and maintain a primary prevention lead education strategy to prevent lead exposure.
The strategy includes:
(1) lead education materials that describe the health effects of lead exposure, safety measures,
and methods to be used in the lead hazard reduction process;
(2) providing lead education materials to the general public;
(3) providing lead education materials to property owners, landlords, and tenants by swab
team workers and public health professionals, such as nurses, sanitarians, health educators,
nonprofit organizations working on lead issues, and other public health professionals in areas at
high risk for toxic lead exposure; and
(4) promoting awareness of community, legal, and housing resources.
    Subd. 4. Swab team services. Primary prevention may include the use of swab team
services. The swab team services may be provided based on lead hazard screens whenever
possible and must at least include lead hazard reduction for deteriorated interior lead-based
paint, bare soil, and dust.
    Subd. 5.[Repealed, 1998 c 407 art 2 s 109]
    Subd. 6.[Repealed, 2001 c 205 art 1 s 27,43]
    Subd. 7. Lead-safe practices information. The commissioner shall develop and maintain
in cooperation with the commissioner of administration provisions and procedures to define
lead-safe practices information for residential remodeling, renovation, installation, and
rehabilitation activities that are not lead hazard reduction, but may disrupt lead-based paint
surfaces and guidance documents for the regulated industry.
    Subd. 8.[Repealed, 1998 c 407 art 2 s 109]
    Subd. 9.[Repealed, 1998 c 407 art 2 s 109]
History: 1995 c 213 art 1 s 5; 1996 c 451 art 4 s 14-16; 1998 c 407 art 2 s 53-55; 2001
c 205 art 1 s 27; 2004 c 206 s 28

144.9504 SECONDARY PREVENTION.
    Subdivision 1. Jurisdiction. (a) A board of health serving cities of the first class must
conduct lead risk assessments for purposes of secondary prevention, according to the provisions
of this section. A board of health not serving cities of the first class must conduct lead risk
assessments for the purposes of secondary prevention, unless they certified in writing to the
commissioner by January 1, 1996, that they desired to relinquish these duties back to the
commissioner. At the discretion of the commissioner, a board of health may, upon written request
to the commissioner, resume these duties.
(b) Lead risk assessments must be conducted by a board of health serving a city of the first
class. The commissioner must conduct lead risk assessments in any area not including cities of
the first class where a board of health has relinquished to the commissioner the responsibility
for lead risk assessments. The commissioner shall coordinate with the board of health to ensure
that the requirements of this section are met.
(c) The commissioner may assist boards of health by providing technical expertise,
equipment, and personnel to boards of health. The commissioner may provide laboratory or
field lead-testing equipment to a board of health or may reimburse a board of health for direct
costs associated with lead risk assessments.
    Subd. 2. Lead risk assessment. (a) An assessing agency shall conduct a lead risk assessment
of a residence according to the venous blood lead level and time frame set forth in clauses (1)
to (4) for purposes of secondary prevention:
(1) within 48 hours of a child or pregnant female in the residence being identified to the
agency as having a venous blood lead level equal to or greater than 60 micrograms of lead per
deciliter of whole blood;
(2) within five working days of a child or pregnant female in the residence being identified
to the agency as having a venous blood lead level equal to or greater than 45 micrograms of
lead per deciliter of whole blood;
(3) within ten working days of a child in the residence being identified to the agency as
having a venous blood lead level equal to or greater than 15 micrograms of lead per deciliter of
whole blood; or
(4) within ten working days of a pregnant female in the residence being identified to the
agency as having a venous blood lead level equal to or greater than ten micrograms of lead
per deciliter of whole blood.
(b) Within the limits of available local, state, and federal appropriations, an assessing agency
may also conduct a lead risk assessment for children with any elevated blood lead level.
(c) In a building with two or more dwelling units, an assessing agency shall assess the
individual unit in which the conditions of this section are met and shall inspect all common areas
accessible to a child. If a child visits one or more other sites such as another residence, or a
residential or commercial child care facility, playground, or school, the assessing agency shall
also inspect the other sites. The assessing agency shall have one additional day added to the time
frame set forth in this subdivision to complete the lead risk assessment for each additional site.
(d) Within the limits of appropriations, the assessing agency shall identify the known
addresses for the previous 12 months of the child or pregnant female with venous blood lead
levels of at least 15 micrograms per deciliter for the child or at least ten micrograms per deciliter
for the pregnant female; notify the property owners, landlords, and tenants at those addresses that
an elevated blood lead level was found in a person who resided at the property; and give them
primary prevention information. Within the limits of appropriations, the assessing agency may
perform a risk assessment and issue corrective orders in the properties, if it is likely that the
previous address contributed to the child's or pregnant female's blood lead level. The assessing
agency shall provide the notice required by this subdivision without identifying the child or
pregnant female with the elevated blood lead level. The assessing agency is not required to obtain
the consent of the child's parent or guardian or the consent of the pregnant female for purposes
of this subdivision. This information shall be classified as private data on individuals as defined
under section 13.02, subdivision 12.
(e) The assessing agency shall conduct the lead risk assessment according to rules adopted by
the commissioner under section 144.9508. An assessing agency shall have lead risk assessments
performed by lead risk assessors licensed by the commissioner according to rules adopted under
section 144.9508. If a property owner refuses to allow a lead risk assessment, the assessing agency
shall begin legal proceedings to gain entry to the property and the time frame for conducting
a lead risk assessment set forth in this subdivision no longer applies. A lead risk assessor or
assessing agency may observe the performance of lead hazard reduction in progress and shall
enforce the provisions of this section under section 144.9509. Deteriorated painted surfaces, bare
soil, and dust must be tested with appropriate analytical equipment to determine the lead content,
except that deteriorated painted surfaces or bare soil need not be tested if the property owner
agrees to engage in lead hazard reduction on those surfaces. The lead content of drinking water
must be measured if another probable source of lead exposure is not identified. Within a standard
metropolitan statistical area, an assessing agency may order lead hazard reduction of bare soil
without measuring the lead content of the bare soil if the property is in a census tract in which soil
sampling has been performed according to rules established by the commissioner and at least 25
percent of the soil samples contain lead concentrations above the standard in section 144.9508.
(f) Each assessing agency shall establish an administrative appeal procedure which allows
a property owner to contest the nature and conditions of any lead order issued by the assessing
agency. Assessing agencies must consider appeals that propose lower cost methods that make
the residence lead safe. The commissioner shall use the authority and appeal procedure granted
under sections 144.989 to 144.993.
(g) Sections 144.9501 to 144.9509 neither authorize nor prohibit an assessing agency from
charging a property owner for the cost of a lead risk assessment.
    Subd. 3. Lead education strategy. At the time of a lead risk assessment or following a
lead order, the assessing agency shall ensure that a family will receive a visit at their residence
by a swab team worker or public health professional, such as a nurse, sanitarian, public health
educator, or other public health professional. The swab team worker or public health professional
shall inform the property owner, landlord, and the tenant of the health-related aspects of lead
exposure; nutrition; safety measures to minimize exposure; methods to be followed before,
during, and after the lead hazard reduction process; and community, legal, and housing resources.
If a family moves to a temporary residence during the lead hazard reduction process, lead
education services should be provided at the temporary residence whenever feasible.
    Subd. 4.[Repealed, 2001 c 205 art 1 s 43]
    Subd. 5. Lead orders. (a) An assessing agency, after conducting a lead risk assessment, shall
order a property owner to perform lead hazard reduction on all lead sources that exceed a standard
adopted according to section 144.9508. If lead risk assessments and lead orders are conducted
at times when weather or soil conditions do not permit the lead risk assessment or lead hazard
reduction, external surfaces and soil lead shall be assessed, and lead orders complied with, if
necessary, at the first opportunity that weather and soil conditions allow.
(b) If the paint standard under section 144.9508 is violated, but the paint is intact, the
assessing agency shall not order the paint to be removed unless the intact paint is a known source
of actual lead exposure to a specific person. Before the assessing agency may order the intact
paint to be removed, a reasonable effort must be made to protect the child and preserve the intact
paint by the use of guards or other protective devices and methods.
(c) Whenever windows and doors or other components covered with deteriorated lead-based
paint have sound substrate or are not rotting, those components should be repaired, sent out for
stripping or planed down to remove deteriorated lead-based paint, or covered with protective
guards instead of being replaced, provided that such an activity is the least cost method. However,
a property owner who has been ordered to perform lead hazard reduction may choose any method
to address deteriorated lead-based paint on windows, doors, or other components, provided that
the method is approved in rules adopted under section 144.9508 and that it is appropriate to
the specific property.
(d) Lead orders must require that any source of damage, such as leaking roofs, plumbing,
and windows, be repaired or replaced, as needed, to prevent damage to lead-containing interior
surfaces.
(e) The assessing agency is not required to pay for lead hazard reduction. The assessing
agency shall enforce the lead orders issued to a property owner under this section.
    Subd. 6. Swab team services. After a lead risk assessment or after issuing lead orders, the
assessing agency, within the limits of appropriations and availability, shall offer the property
owner the services of a swab team free of charge and, if accepted, shall send a swab team within
ten working days to the residence to perform swab team services as defined in section 144.9501.
If the assessing agency provides swab team services after a lead risk assessment, but before the
issuance of a lead order, swab team services do not need to be repeated after the issuance of
the lead order if the swab team services fulfilled the lead order. Swab team services are not
considered completed until the clearance inspection required under this section shows that the
property is lead safe.
    Subd. 7. Relocation of residents. (a) Within the limits of appropriations, the assessing
agency shall ensure that residents are relocated from rooms or dwellings during a lead hazard
reduction process that generates leaded dust, such as removal or disruption of lead-based paint
or plaster that contains lead. Residents shall not remain in rooms or dwellings where the lead
hazard reduction process is occurring. An assessing agency is not required to pay for relocation
unless state or federal funding is available for this purpose. The assessing agency shall make an
effort to assist the resident in locating resources that will provide assistance with relocation costs.
Residents shall be allowed to return to the room or dwelling after completion of the lead hazard
reduction process. An assessing agency shall use grant funds under section 144.9507 if available,
in cooperation with local housing agencies, to pay for moving costs and rent for a temporary
residence for any low-income resident temporarily relocated during lead hazard reduction. For
purposes of this section, "low-income resident" means any resident whose gross household
income is at or below 185 percent of federal poverty level.
(b) A resident of rental property who is notified by an assessing agency to vacate the
premises during lead hazard reduction, notwithstanding any rental agreement or lease provisions:
(1) shall not be required to pay rent due the landlord for the period of time the tenant vacates
the premises due to lead hazard reduction;
(2) may elect to immediately terminate the tenancy effective on the date the tenant vacates
the premises due to lead hazard reduction; and
(3) shall not, if the tenancy is terminated, be liable for any further rent or other charges
due under the terms of the tenancy.
(c) A landlord of rental property whose tenants vacate the premises during lead hazard
reduction shall:
(1) allow a tenant to return to the dwelling unit after lead hazard reduction and clearance
inspection, required under this section, is completed, unless the tenant has elected to terminate the
tenancy as provided for in paragraph (b); and
(2) return any security deposit due under section 504B.178 within five days of the date the
tenant vacates the unit, to any tenant who terminates tenancy as provided for in paragraph (b).
    Subd. 8. Property owner notification responsibility. If the property owner does not hire a
person licensed by the commissioner under section 144.9505 for compliance with the lead orders,
the property owner shall submit a notice as to when regulated lead work will begin, according to
section 144.9505, subdivision 4, to the assessing agency within 30 days after receiving the orders.
    Subd. 9. Clearance inspection. After completion of swab team services and compliance
with the lead orders by the property owner, including any repairs ordered by a local housing
or building inspector, the assessing agency shall conduct a clearance inspection by visual
identification of deteriorated paint and bare soil and retest the dust lead concentration in the
residence to assure that violations of the lead standards under section 144.9508 no longer exist.
The assessing agency is not required to test a dwelling unit after lead hazard reduction that was
not ordered by the assessing agency.
    Subd. 10. Case closure. A lead risk assessment is completed and the responsibility of the
assessing agency ends when all of the following conditions are met:
(1) lead orders are written on all known sources of violations of lead standards under section
144.9508;
(2) compliance with all lead orders has been completed; and
(3) clearance inspections demonstrate that no deteriorated lead paint, bare soil, or lead dust
levels exist that exceed the standards adopted under section 144.9508.
    Subd. 11.[Repealed, 2001 c 205 art 1 s 43]
History: 1995 c 213 art 1 s 6; 1996 c 451 art 4 s 17-19; 1997 c 205 s 26; 1997 c 228 s 12;
1998 c 407 art 2 s 56-65; 1999 c 199 art 2 s 3; 2001 c 205 art 1 s 28-32; 1Sp2005 c 4 art 6 s 32

144.9505 LICENSING OF LEAD FIRMS AND PROFESSIONALS.
    Subdivision 1. Licensing and certification; generally. (a) All fees received shall be paid into
the state treasury and credited to the lead abatement licensing and certification account and are
appropriated to the commissioner to cover costs incurred under this section and section 144.9508.
(b) Persons shall not advertise or otherwise present themselves as lead supervisors, lead
workers, lead inspectors, lead risk assessors, lead sampling technicians, lead project designers,
or lead firms unless they have licenses or certificates issued by or are registered with the
commissioner under this section.
(c) The fees required in this section for inspectors, risk assessors, and certified lead firms are
waived for state or local government employees performing services for or as an assessing agency.
(d) An individual who is the owner of property on which regulated lead work is to be
performed or an adult individual who is related to the property owner, as defined under section
245A.02, subdivision 13, is exempt from the requirements to obtain a license and pay a fee
according to this section.
(e) A person that employs individuals to perform regulated lead work outside of the person's
property must obtain certification as a certified lead firm. An individual who performs regulated
lead work must be employed by a certified lead firm, unless the individual is a sole proprietor
and does not employ any other individual who performs regulated lead work, the individual is
employed by a person that does not perform regulated lead work outside of the person's property,
or the individual is employed by an assessing agency.
    Subd. 1a. Lead worker license. Before an individual performs regulated lead work as
a worker, the individual shall first obtain a license from the commissioner. No license shall be
issued unless the individual shows evidence of successfully completing a training course in lead
hazard control. The commissioner shall specify the course of training and testing requirements
and shall charge a $50 fee for the license. License fees are nonrefundable and must be submitted
with each application. The license must be carried by the individual and be readily available for
review by the commissioner and other public health officials charged with the health, safety,
and welfare of the state's citizens.
    Subd. 1b. Lead supervisor license. Before an individual performs regulated lead work as a
supervisor, the individual shall first obtain a license from the commissioner. No license shall be
issued unless the individual shows evidence of experience and successful completion of a training
course in lead hazard control. The commissioner shall specify the course of training, experience,
and testing requirements and shall charge a $50 fee for the license. License fees are nonrefundable
and must be submitted with each application. The license must be carried by the individual and be
readily available for review by the commissioner and other public health officials charged with
the health, safety, and welfare of the state's citizens.
    Subd. 1c. Lead inspector license. Before an individual performs lead inspection services,
the individual shall first obtain a license from the commissioner. No license shall be issued unless
the individual shows evidence of successfully completing a training course in lead inspection.
The commissioner shall specify the course of training and testing requirements and shall charge
a $50 fee for the license. License fees are nonrefundable and must be submitted with each
application. The license must be carried by the individual and be readily available for review by
the commissioner and other public health officials charged with the health, safety, and welfare
of the state's citizens.
    Subd. 1d. Lead risk assessor license. Before an individual performs lead risk assessor
services, the individual shall first obtain a license from the commissioner. No license shall
be issued unless the individual shows evidence of experience and successful completion of a
training course in lead risk assessment. The commissioner shall specify the course of training,
experience, and testing requirements and shall charge a $100 fee for the license. License fees
are nonrefundable and must be submitted with each application. The license must be carried by
the individual and be readily available for review by the commissioner and other public health
officials charged with the health, safety, and welfare of the state's citizens.
    Subd. 1e. Lead project designer license. Before an individual performs lead project
designer services, the individual shall first obtain a license from the commissioner. No license
shall be issued unless the individual shows evidence of experience and successful completion of
a training course in lead project design. The commissioner shall specify the course of training,
experience, and testing requirements and shall charge a $100 fee for the license. License fees
are nonrefundable and must be submitted with each application. The license must be carried by
the individual and be readily available for review by the commissioner and other public health
officials charged with the health, safety, and welfare of the state's citizens.
    Subd. 1f. Lead sampling technician. An individual performing lead sampling technician
services shall first register with the commissioner. The commissioner shall not register an
individual unless the individual shows evidence of successfully completing a training course in
lead sampling. The commissioner shall specify the course of training and testing requirements.
Proof of registration must be carried by the individual and be readily available for review by
the commissioner and other public health officials charged with the health, safety, and welfare
of the state's citizens.
    Subd. 1g. Certified lead firm. A person within the state intending to directly perform or
cause to be performed through subcontracting or similar delegation any regulated lead work shall
first obtain certification from the commissioner. The certificate must be in writing, contain an
expiration date, be signed by the commissioner, and give the name and address of the person
to whom it is issued. The certification fee is $100, is nonrefundable, and must be submitted
with each application. The certificate or a copy of the certificate must be readily available at the
worksite for review by the contracting entity, the commissioner, and other public health officials
charged with the health, safety, and welfare of the state's citizens.
    Subd. 2.[Repealed, 2001 c 205 art 1 s 33,43]
    Subd. 3. Licensed building contractor; information. The commissioner shall provide
health and safety information on lead abatement and lead hazard reduction to all residential
building contractors licensed under section 326.84. The information must include the lead-safe
practices and any other materials describing ways to protect the health and safety of both
employees and residents.
    Subd. 4. Notice of regulated lead work. (a) At least five working days before starting work
at each regulated lead worksite, the person performing the regulated lead work shall give written
notice to the commissioner and the appropriate board of health.
(b) This provision does not apply to lead hazard screen, lead inspection, lead risk assessment,
lead sampling technician, or lead project design activities.
    Subd. 5.[Repealed, 2001 c 205 art 1 s 33,43]
    Subd. 6. Duties of contracting entity. A contracting entity intending to have regulated
lead work performed for its benefit shall include in the specifications and contracts for the
work a requirement that the work be performed by contractors and subcontractors licensed by
the commissioner under sections 144.9501 to 144.9509 and according to rules adopted by the
commissioner related to regulated lead work. No contracting entity shall allow regulated lead
work to be performed for its benefit unless the contracting entity has seen that the person has a
valid license or certificate. A contracting entity's failure to comply with this subdivision does not
relieve a person from any responsibility under sections 144.9501 to 144.9509.
History: 1995 c 213 art 1 s 7; 1996 c 451 art 4 s 20; 1998 c 407 art 2 s 66-68; 2001 c
205 art 1 s 33

144.9506 [Repealed, 2001 c 205 art 1 s 43]

144.9507 LEAD-RELATED FUNDING.
    Subdivision 1. Lead education strategy contracts. The commissioner shall, within
available federal or state appropriations, contract with:
(1) boards of health to provide funds for lead education as provided for in sections 144.9503
and 144.9504; and
(2) swab team workers and community-based advocacy groups to provide funds for lead
education for primary prevention of toxic lead exposure in areas at high risk for toxic lead
exposure.
    Subd. 2. Lead risk assessment contracts. The commissioner shall, within available
federal or state appropriations, contract with boards of health to conduct lead risk assessments
to determine sources of lead contamination and to issue and enforce lead orders according
to section 144.9504.
    Subd. 3. Temporary lead-safe housing contracts. The commissioner shall, within the limits
of available appropriations, contract with boards of health for temporary housing, to be used in
meeting relocation requirements in section 144.9504, and award grants to boards of health for
the purposes of paying housing and relocation costs under section 144.9504. The commissioner
may use up to 15 percent of the available appropriations to provide temporary lead-safe housing
in areas of the state in which the commissioner has the duty under section 144.9504 to perform
secondary prevention.
    Subd. 4.[Repealed, 1999 c 245 art 2 s 45]
    Subd. 5. Federal lead-related funds. To the extent practicable under federal guidelines, the
commissioner of health may use federal funding to contract with boards of health for purposes
specified in this section, but only to the extent that the federal funds do not replace existing
funding for these lead services.
History: 1995 c 213 art 1 s 9; 1998 c 407 art 2 s 71-73; 2001 c 205 art 1 s 34

144.9508 RULES.
    Subdivision 1. Sampling and analysis. The commissioner shall adopt, by rule, methods for:
(1) lead inspections, lead hazard screens, lead risk assessments, and clearance inspections;
(2) environmental surveys of lead in paint, soil, dust, and drinking water to determine areas
at high risk for toxic lead exposure;
(3) soil sampling for soil used as replacement soil;
(4) drinking water sampling, which shall be done in accordance with lab certification
requirements and analytical techniques specified by Code of Federal Regulations, title 40,
section 141.89; and
(5) sampling to determine whether at least 25 percent of the soil samples collected from a
census tract within a standard metropolitan statistical area contain lead in concentrations that
exceed 100 parts per million.
    Subd. 2. Regulated lead work standards and methods. (a) The commissioner shall adopt
rules establishing regulated lead work standards and methods in accordance with the provisions of
this section, for lead in paint, dust, drinking water, and soil in a manner that protects public health
and the environment for all residences, including residences also used for a commercial purpose,
child care facilities, playgrounds, and schools.
(b) In the rules required by this section, the commissioner shall require lead hazard reduction
of intact paint only if the commissioner finds that the intact paint is on a chewable or lead-dust
producing surface that is a known source of actual lead exposure to a specific individual. The
commissioner shall prohibit methods that disperse lead dust into the air that could accumulate to a
level that would exceed the lead dust standard specified under this section. The commissioner
shall work cooperatively with the commissioner of administration to determine which lead
hazard reduction methods adopted under this section may be used for lead-safe practices
including prohibited practices, preparation, disposal, and cleanup. The commissioner shall work
cooperatively with the commissioner of the Pollution Control Agency to develop disposal
procedures. In adopting rules under this section, the commissioner shall require the best available
technology for regulated lead work methods, paint stabilization, and repainting.
(c) The commissioner of health shall adopt regulated lead work standards and methods for
lead in bare soil in a manner to protect public health and the environment. The commissioner
shall adopt a maximum standard of 100 parts of lead per million in bare soil. The commissioner
shall set a soil replacement standard not to exceed 25 parts of lead per million. Soil lead hazard
reduction methods shall focus on erosion control and covering of bare soil.
(d) The commissioner shall adopt regulated lead work standards and methods for lead in dust
in a manner to protect the public health and environment. Dust standards shall use a weight of
lead per area measure and include dust on the floor, on the window sills, and on window wells.
Lead hazard reduction methods for dust shall focus on dust removal and other practices which
minimize the formation of lead dust from paint, soil, or other sources.
(e) The commissioner shall adopt lead hazard reduction standards and methods for lead
in drinking water both at the tap and public water supply system or private well in a manner
to protect the public health and the environment. The commissioner may adopt the rules for
controlling lead in drinking water as contained in Code of Federal Regulations, title 40, part
141. Drinking water lead hazard reduction methods may include an educational approach of
minimizing lead exposure from lead in drinking water.
(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that
removal of exterior lead-based coatings from residences and steel structures by abrasive blasting
methods is conducted in a manner that protects health and the environment.
(g) All regulated lead work standards shall provide reasonable margins of safety that
are consistent with more than a summary review of scientific evidence and an emphasis on
overprotection rather than underprotection when the scientific evidence is ambiguous.
(h) No unit of local government shall have an ordinance or regulation governing regulated
lead work standards or methods for lead in paint, dust, drinking water, or soil that require a
different regulated lead work standard or method than the standards or methods established
under this section.
(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit of local
government of an innovative lead hazard reduction method which is consistent in approach
with methods established under this section.
(j) The commissioner shall adopt rules for issuing lead orders required under section
144.9504, rules for notification of abatement or interim control activities requirements, and other
rules necessary to implement sections 144.9501 to 144.9509.
    Subd. 2a. Lead standards for exterior surfaces and street dust. The commissioner may,
by rule, establish lead standards for exterior horizontal surfaces, concrete or other impervious
surfaces, and street dust on residential property to protect the public health and the environment.
    Subd. 3. Licensure and certification. The commissioner shall adopt rules to license lead
supervisors, lead workers, lead project designers, lead inspectors, and lead risk assessors. The
commissioner shall also adopt rules requiring certification of firms that perform regulated lead
work and rules requiring registration of lead sampling technicians. The commissioner shall require
periodic renewal of licenses, certificates, and registrations and shall establish the renewal periods.
    Subd. 4. Lead training course. The commissioner shall establish by rule requirements for
training course providers and the renewal period for each lead-related training course required for
certification or licensure. The commissioner shall establish criteria in rules for the content and
presentation of training courses intended to qualify trainees for licensure under subdivision 3. The
commissioner shall establish criteria in rules for the content and presentation of training courses
for lead interim control workers. Training course permit fees shall be nonrefundable and must be
submitted with each application in the amount of $500 for an initial training course, $250 for
renewal of a permit for an initial training course, $250 for a refresher training course, and $125
for renewal of a permit of a refresher training course.
    Subd. 5. Variances. In adopting the rules required under this section, the commissioner
shall provide variance procedures for any provision in rules adopted under this section, except
for the numerical standards for the concentrations of lead in paint, dust, bare soil, and drinking
water. A variance shall be considered only according to the procedures and criteria in Minnesota
Rules, parts 4717.7000 to 4717.7050.
    Subd. 6.[Repealed, 2001 c 205 art 1 s 43]
History: 1995 c 213 art 1 s 10; 1998 c 407 art 2 s 74-77; 2001 c 205 art 1 s 35-39

144.9509 ENFORCEMENT.
    Subdivision 1. Enforcement. When the commissioner exercises authority for enforcement,
the provisions of sections 144.9501 to 144.9509 shall be enforced under the provisions of sections
144.989 to 144.993. Boards of health shall enforce a lead order issued under section 144.9504
under a local ordinance or as a public health nuisance under chapter 145A.
    Subd. 2. Discrimination. A person who discriminates against or otherwise sanctions an
employee who complains to or cooperates with the assessing agency in administering sections
144.9501 to 144.9509 is guilty of a petty misdemeanor.
    Subd. 3. Enforcement and status report. The commissioner shall examine compliance with
Minnesota's existing lead standards and rules and report to the legislature biennially, beginning
February 15, 1997, including an evaluation of current lead program activities by the state and
boards of health, the need for any additional enforcement procedures, recommendations on
developing a method to enforce compliance with lead standards, and cost estimates for any
proposed enforcement procedure. The report shall also include a summary of lead surveillance
data collected by the commissioner.
History: 1995 c 213 art 1 s 11; 1998 c 407 art 2 s 78; 2001 c 205 art 1 s 40,41

144.951 [Repealed, 1976 c 173 s 64]

144.9511 [Repealed, 1999 c 245 art 2 s 45]

144.9512 LEAD ABATEMENT PROGRAM.
    Subdivision 1. Definitions. (a) The definitions in section 144.9501 and in this subdivision
apply to this section.
(b) "Eligible organization" means a lead contractor, city, board of health, community health
department, community action agency as defined in section 256E.30, or community development
corporation.
(c) "Commissioner" means the commissioner of health, or the commissioner of the
Minnesota Housing Finance Agency as authorized by section 462A.05, subdivision 15c.
    Subd. 2. Grants; administration. Within the limits of the available appropriation, the
commissioner must develop a swab team services program which may make demonstration and
training grants to eligible organizations to train workers to provide swab team services and swab
team services for residential property. Grants may be awarded to nonprofit organizations to
provide technical assistance and training to ensure quality and consistency within the statewide
program. Grants must be awarded to help ensure full-time employment to workers providing
swab team services and must be awarded for a two-year period.
Grants awarded under this section must be made in consultation with the commissioner of
the Housing Finance Agency and representatives of neighborhood groups from areas at high risk
for toxic lead exposure, a labor organization, the lead coalition, community action agencies, and
the legal aid society. The consulting team must review grant applications and recommend awards
to eligible organizations that meet requirements for receiving a grant under this section.
    Subd. 3. Applicants. (a) Interested eligible organizations may apply to the commissioner for
grants under this section. Two or more eligible organizations may jointly apply for a grant. Priority
shall be given to community action agencies in greater Minnesota and to either community action
agencies or neighborhood based nonprofit organizations in cities of the first class. Of the total
annual appropriation, 12.5 percent may be used for administrative purposes. The commissioner
may deviate from this percentage if a grantee can justify the need for a larger administrative
allowance. Of this amount, up to five percent may be used by the commissioner for state
administrative purposes. Applications must provide information requested by the commissioner,
including at least the information required to assess the factors listed in paragraph (d).
(b) The commissioner must consult with boards of health to provide swab team services
for purposes of secondary prevention. The priority for swab teams created by grants to eligible
organizations under this section must be work assigned by the commissioner of health, or by a
board of health if so designated by the commissioner of health, to provide secondary prevention
swab team services to fulfill the requirements of section 144.9504, subdivision 6, in response to a
lead order. Swab teams assigned work under this section by the commissioner, that are not engaged
daily in fulfilling the requirements of section 144.9504, subdivision 6, must deliver swab team
services in response to elevated blood lead levels as defined in section 144.9501, subdivision 9,
where lead orders were not issued, and for purposes of primary prevention in census tracts known
to be in areas at high risk for toxic lead exposure as described in section 144.9503, subdivision 2.
(c) Any additional money must be used for grants to establish swab teams for primary
prevention under section 144.9503, in census tracts in areas at high risk for toxic lead exposure as
determined under section 144.9503, subdivision 2.
(d) In evaluating grant applications, the commissioner must consider the following criteria:
(1) the use of lead contractors and lead workers for residential swab team services;
(2) the participation of neighborhood groups and individuals, as swab team workers, in areas
at high risk for toxic lead exposure;
(3) plans for the provision of swab team services for primary and secondary prevention as
required under subdivision 4;
(4) plans for supervision, training, career development, and postprogram placement of
swab team members;
(5) plans for resident and property owner education on lead safety;
(6) plans for distributing cleaning supplies to area residents and educating residents and
property owners on cleaning techniques;
(7) sources of other funding and cost estimates for training, lead inspections, swab team
services, equipment, monitoring, testing, and administration;
(8) measures of program effectiveness;
(9) coordination of program activities with other federal, state, and local public health, job
training, apprenticeship, and housing renovation programs including programs under sections
116L.86 to 116L.881; and
(10) prior experience in providing swab team services.
    Subd. 4. Lead supervisor or certified firm. (a) Eligible organizations and lead supervisors
or certified firms may participate in the swab team program. An eligible organization receiving a
grant under this section must assure that all participating lead supervisors or certified firms are
licensed and that all swab team workers are certified by the Department of Health under section
144.9505. Eligible organizations and lead supervisors or certified firms may distinguish between
interior and exterior services in assigning duties and may participate in the program by:
(1) providing on-the-job training for swab team workers;
(2) providing swab team services to meet the requirements of sections 144.9503, subdivision
4 , and 144.9504, subdivision 6;
(3) providing a removal and replacement component using skilled craft workers under
subdivision 7;
(4) providing lead testing according to subdivision 8;
(5) providing lead dust cleaning supplies, as described in section 144.9507, subdivision 4,
paragraph (c), to residents; or
(6) having a swab team worker instruct residents and property owners on appropriate lead
control techniques, including the lead-safe directives developed by the commissioner of health.
(b) Participating lead supervisors or certified firms must:
(1) demonstrate proof of workers' compensation and general liability insurance coverage;
(2) be knowledgeable about lead abatement requirements established by the Department of
Housing and Urban Development and the Occupational Safety and Health Administration and
lead hazard reduction requirements and lead-safe directives of the commissioner of health;
(3) demonstrate experience with on-the-job training programs;
(4) demonstrate an ability to recruit employees from areas at high risk for toxic lead
exposure; and
(5) demonstrate experience in working with low-income clients.
    Subd. 5. Swab team workers. Each worker engaged in swab team services established under
this section must have blood lead concentrations below 15 micrograms of lead per deciliter of
whole blood as determined by a baseline blood lead screening. Any organization receiving a grant
under this section is responsible for lead screening and must assure that all swab team workers
meet the standards established in this subdivision. Grantees must use appropriate workplace
procedures including following the lead-safe directives developed by the commissioner of health
to reduce risk of elevated blood lead levels. Grantees and participating contractors must report all
employee blood lead levels that exceed 15 micrograms of lead per deciliter of whole blood to
the commissioner of health.
    Subd. 6. On-the-job training component. (a) Programs established under this section must
provide on-the-job training for swab team workers.
(b) Swab team workers must receive monetary compensation equal to the prevailing wage
as defined in section 177.42, subdivision 6, for comparable jobs in the licensed contractor's
principal business.
    Subd. 7. Removal and replacement component. (a) Within the limits of the available
appropriation and if a need is identified by a lead inspector, the commissioner may establish a
component for removal and replacement of deteriorated paint in residential properties according
to the following criteria:
(1) components within a residence must have both deteriorated lead-based paint and substrate
damage beyond repair or rotting wooden framework to be eligible for removal and replacement;
(2) all removal and replacement must be done using least-cost methods and following
lead-safe directives;
(3) whenever windows and doors or other components covered with deteriorated lead-based
paint have sound substrate or are not rotting, those components should be repaired, sent out for
stripping, planed down to remove deteriorated lead-based paint, or covered with protective guards
instead of being replaced, provided that such an activity is the least-cost method of providing
the swab team service;
(4) removal and replacement or repair must be done by lead contractors using skilled craft
workers or trained swab team members; and
(5) all craft work that requires a state license must be supervised by a person with a state
license in the craft work being supervised. The grant recipient may contract for this supervision.
(b) The program design must:
(1) identify the need for on-the-job training of swab team workers to be removal and
replacement workers; and
(2) describe plans to involve appropriate groups in designing methods to meet the need for
training swab team workers.
    Subd. 8. Testing and evaluation. (a) Testing of the environment is not necessary by swab
teams whose work is assigned by the commissioner of health or a designated board of health
under section 144.9504. The commissioner of health or designated board of health must share the
analytical testing data collected on each residence for purposes of secondary prevention under
section 144.9504 with the swab team workers in order to provide constructive feedback on their
work and to the commissioner for the purposes set forth in paragraph (c).
(b) For purposes of primary prevention evaluation, the following samples must be collected:
pretesting and posttesting of one noncarpeted floor dust lead sample and a notation of the extent
and location of bare soil and of deteriorated lead-based paint. The analytical testing data collected
on each residence for purposes of primary prevention under section 144.9503 must be shared
with the swab team workers in order to provide constructive feedback on their work and to the
commissioner for the purposes set forth in paragraph (c).
(c) The commissioner of health must establish a program to collect appropriate data as
required under paragraphs (a) and (b), in order to conduct an ongoing evaluation of swab team
services for primary and secondary prevention. Within the limits of available appropriations, the
commissioner of health must conduct on up to 1,000 residences which have received primary or
secondary prevention swab team services, a postremediation evaluation, on at least a quarterly
basis for a period of at least two years for each residence. The evaluation must note the condition
of the paint within the residence, the extent of bare soil on the grounds, and collect and analyze
one noncarpeted floor dust lead sample. The data collected must be evaluated to determine
the efficacy of providing swab team services as a method of reducing lead exposure in young
children. In evaluating this data, the commissioner of health must consider city size, community
location, historic traffic flow, soil lead level of the property by area or census tract, distance to
industrial point sources that emit lead, season of the year, age of the housing, age and number of
children living at the residence, the presence of pets that move in and out of the residence, and
other relevant factors as the commissioner of health may determine.
    Subd. 9. Program benefits. As a condition of providing swab team services under this
section, an organization may require a property owner to not increase rents on a property solely as
a result of a substantial improvement made with public funds under the programs in this section.
    Subd. 10. Requirements of organizations receiving grants. An eligible organization that is
awarded a training and demonstration grant under this section must prepare and submit a quarterly
progress report to the commissioner beginning three months after receipt of the grant.
History: 1Sp1995 c 3 art 16 s 13; 1998 c 273 s 10; 1999 c 86 art 1 s 30; 2001 c 79 s 1; 2002 c
379 art 1 s 41; 2003 c 130 s 12; 2004 c 206 s 27,52; 2005 c 98 art 1 s 24; 1Sp2005 c 5 art 8 s 1-4, 7

    Subdivision 1.[Repealed, 1977 c 347 s 23]
    Subd. 2.[Repealed, 1976 c 173 s 64]
    Subd. 3.[Repealed, 1977 c 347 s 23]

144.953 [Repealed, 1976 c 173 s 64]

144.954 [Repealed, 1976 c 173 s 64]

144.955 [Repealed, 1976 c 173 s 64]

144.9555 [Repealed, 1976 c 173 s 64]

144.956 [Repealed, 1976 c 173 s 64; 1976 c 222 s 209]

144.957 [Repealed, 1976 c 173 s 64]

144.958 [Repealed, 1976 c 173 s 64; 1976 c 222 s 209]

144.959 [Repealed, 1976 c 173 s 64]

144.96 [Repealed, 1976 c 173 s 64; 1976 c 222 s 209]

144.961 [Repealed, 1976 c 173 s 64]

144.962 [Repealed, 1976 c 173 s 64]

144.963 [Repealed, 1976 c 173 s 64]

144.964 [Repealed, 1976 c 173 s 64]

144.965 [Repealed, 1976 c 173 s 64; 1976 c 222 s 209]

CERTIFICATION OF ENVIRONMENTAL LABORATORIES

144.97 DEFINITIONS.
    Subdivision 1. Scope. The definitions in this section apply to section 144.98.
    Subd. 2. Certification. "Certification" means written acknowledgment of a laboratory's
demonstrated capability to perform tests for a specific purpose.
    Subd. 3. Commissioner. "Commissioner" means the commissioner of health.
    Subd. 4. Contract laboratory. "Contract laboratory" means a laboratory that performs tests
on samples on a contract or fee-for-service basis.
    Subd. 5. Environmental sample. "Environmental sample" means a substance derived from
a nonhuman source and collected for the purpose of analysis.
    Subd. 6. Laboratory. "Laboratory" means the state, a person, corporation, or other entity,
including governmental, that examines, analyzes, or tests samples.
    Subd. 7. Sample. "Sample" means a substance derived from a nonhuman source and
collected for the purpose of analysis, or a tissue, blood, excretion, or other bodily fluid specimen
obtained from a human for the detection of a chemical, etiologic agent, or histologic abnormality.
History: 1988 c 689 art 2 s 33

144.98 CERTIFICATION OF ENVIRONMENTAL LABORATORIES.
    Subdivision 1. Authorization. The commissioner of health may certify laboratories that
test environmental samples.
    Subd. 2. Rules. The commissioner may adopt rules to implement this section, including:
(1) procedures, requirements, and fee adjustments for laboratory certification, including
provisional status and recertification;
(2) standards and fees for certificate approval, suspension, and revocation;
(3) standards for environmental samples;
(4) analysis methods that assure reliable test results;
(5) laboratory quality assurance, including internal quality control, proficiency testing,
and personnel training; and
(6) criteria for recognition of certification programs of other states and the federal
government.
    Subd. 3. Fees. (a) An application for certification under subdivision 1 must be accompanied
by the biennial fee specified in this subdivision. The fees are for:
(1) base certification fee, $1,600;
(2) sample preparation techniques fees, $100 per technique; and
(3) test category certification fees:

	Test Category	Certification Fee
	Clean water program bacteriology	$800
	Safe drinking water program bacteriology	$800
	Clean water program inorganic chemistry	$800
	Safe drinking water program inorganic chemistry	$800
	Clean water program chemistry metals	$1,200
	Safe drinking water program chemistry metals	$1,200
	Resource conservation and recovery program chemistry metals	$1,200
	Clean water program volatile organic compounds	$1,500
	Safe drinking water program volatile organic compounds	$1,500
	Resource conservation and recovery program volatile organic compounds	$1,500
	Underground storage tank program volatile organic compounds	$1,500
	Clean water program other organic compounds	$1,500
	Safe drinking water program other organic compounds	$1,500
	Resource conservation and recovery program other organic compounds	$1,500
	Clean water program radiochemistry	$2,500
	Safe drinking water program radiochemistry	$2,500
	Resource conservation and recovery program agricultural contaminants	$2,500
	Resource conservation and recovery program emerging contaminants	$2,500

(b) Laboratories located outside of this state that require an on-site inspection shall be
assessed an additional $3,750 fee.
(c) The total biennial certification fee includes the base fee, the sample preparation
techniques fees, the test category fees, and, when applicable, the on-site inspection fee.
(d) Fees must be set so that the total fees support the laboratory certification program. Direct
costs of the certification service include program administration, inspections, the agency's general
support costs, and attorney general costs attributable to the fee function.
(e) A change fee shall be assessed if a laboratory requests additional analytes or methods at
any time other than when applying for or renewing its certification. The change fee is equal to the
test category certification fee for the analyte.
(f) A variance fee shall be assessed if a laboratory requests and is granted a variance from a
rule adopted under this section. The variance fee is $500 per variance.
(g) Refunds or credits shall not be made for analytes or methods requested but not approved.
(h) Certification of a laboratory shall not be awarded until all fees are paid.
    Subd. 4. Fees for laboratory proficiency testing and technical training. The commissioner
of health may set fees for proficiency testing and technical training services under section
16A.1285. Fees must be set so that the total fees cover the direct costs of the proficiency testing
and technical training services, including salaries, supplies and equipment, travel expenses, and
attorney general costs attributable to the fee function.
    Subd. 5. State government special revenue fund. Fees collected under this section must be
deposited in the state government special revenue fund.
History: 1988 c 689 art 2 s 34; 1Sp1993 c 1 art 9 s 52; 1995 c 165 s 4; 1995 c 233 art 2
s 50; 1996 c 305 art 3 s 21; 1999 c 250 art 3 s 21; 1Sp2001 c 9 art 1 s 38; 2002 c 379 art 1 s
113; 1Sp2005 c 4 art 6 s 33

HEALTH ENFORCEMENT CONSOLIDATION ACT OF 1993

144.989 TITLE; CITATION.
Sections 144.989 to 144.993 may be cited as the "Health Enforcement Consolidation Act
of 1993."
History: 1993 c 206 s 7

144.99 ENFORCEMENT.
    Subdivision 1. Remedies available. The provisions of chapters 103I and 157 and sections
115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14), and
(15) ; 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 144.381 to 144.385; 144.411 to 144.417;
144.495; 144.71 to 144.74; 144.9501 to 144.9509; 144.992; 326.37 to 326.45; 326.57 to 326.785;
327.10 to 327.131; and 327.14 to 327.28 and all rules, orders, stipulation agreements, settlements,
compliance agreements, licenses, registrations, certificates, and permits adopted or issued by the
department or under any other law now in force or later enacted for the preservation of public
health may, in addition to provisions in other statutes, be enforced under this section.
    Subd. 2. Access to information and property. The commissioner or an employee or agent
authorized by the commissioner, upon presentation of credentials, may:
(1) examine and copy any books, papers, records, memoranda, or data of any person subject
to regulation under the statutes listed in subdivision 1; and
(2) enter upon any property, public or private, for the purpose of taking any action authorized
under statutes, rules, or other actions listed in subdivision 1 including obtaining information from
a person who has a duty to provide information under the statutes listed in subdivision 1, taking
steps to remedy violations, or conducting surveys or investigations.
    Subd. 3. Correction orders. (a) The commissioner may issue correction orders that require a
person to correct a violation of the statutes, rules, and other actions listed in subdivision 1. The
correction order must state the deficiencies that constitute the violation; the specific statute, rule,
or other action; and the time by which the violation must be corrected.
(b) If the person believes that the information contained in the commissioner's correction
order is in error, the person may ask the commissioner to reconsider the parts of the order that are
alleged to be in error. The request must be in writing, delivered to the commissioner by certified
mail within seven calendar days after receipt of the order, and:
(1) specify which parts of the order for corrective action are alleged to be in error;
(2) explain why they are in error; and
(3) provide documentation to support the allegation of error.
The commissioner must respond to requests made under this paragraph within 15 calendar
days after receiving a request. A request for reconsideration does not stay the correction order;
however, after reviewing the request for reconsideration, the commissioner may provide
additional time to comply with the order if necessary. The commissioner's disposition of a request
for reconsideration is final.
    Subd. 4. Administrative penalty orders. (a) The commissioner may issue an order requiring
violations to be corrected and administratively assessing monetary penalties for violations of the
statutes, rules, and other actions listed in subdivision 1. The procedures in section 144.991 must
be followed when issuing administrative penalty orders. Except in the case of repeated or serious
violations, the penalty assessed in the order must be forgiven if the person who is subject to the
order demonstrates in writing to the commissioner before the 31st day after receiving the order
that the person has corrected the violation or has developed a corrective plan acceptable to the
commissioner. The maximum amount of an administrative penalty order is $10,000 for each
violator for all violations by that violator identified in an inspection or review of compliance.
(b) Notwithstanding paragraph (a), the commissioner may issue to a large public water
supply, serving a population of more than 10,000 persons, an administrative penalty order
imposing a penalty of at least $1,000 per day per violation, not to exceed $10,000 for each
violation of sections 144.381 to 144.385 and rules adopted thereunder.
    Subd. 5. Injunctive relief. In addition to any other remedy provided by law, the
commissioner may bring an action for injunctive relief in the district court in Ramsey County or,
at the commissioner's discretion, in the district court in the county in which a violation of the
statutes, rules, or other actions listed in subdivision 1 has occurred to enjoin the violation.
    Subd. 6. Cease and desist. The commissioner, or an employee of the department designated
by the commissioner, may issue an order to cease an activity covered by subdivision 1 if
continuation of the activity would result in an immediate risk to public health. An order issued
under this paragraph is effective for a maximum of 72 hours. In conjunction with the issuance of
the cease and desist order, the commissioner may post a sign to cease an activity until the cease
and desist order is lifted and the sign is removed by the commissioner. The commissioner must
seek an injunction or take other administrative action authorized by law to restrain activities
for a period beyond 72 hours. The issuance of a cease and desist order does not preclude the
commissioner from pursuing any other enforcement action available to the commissioner.
    Subd. 7. Plan for use of administrative penalties and cease and desist authority. The
commissioner of health shall prepare a plan for using the administrative penalty and cease and
desist authority in this section. The commissioner shall provide a 30-day period for public
comment on the plan. The plan must be finalized by December 1, 1993.
    Subd. 8. Denial or refusal to reissue permits, licenses, registrations, or certificates. (a)
The commissioner may deny or refuse to renew an application for a permit, license, registration,
or certificate required under the statutes or rules cited in subdivision 1, if the applicant does not
meet or fails to maintain the minimum qualifications for holding a permit, license, registration, or
certificate or has any unresolved violations related to the activity for which the permit, license,
registration, or certificate was issued.
(b) The commissioner may also deny or refuse to renew a permit, license, registration, or
certificate required under the statutes or rules cited in subdivision 1 if the applicant has a persistent
pattern of violations related to the permit, license, registration, or certificate, or if the applicant
submitted false material information to the department in connection with the application.
(c) The commissioner may condition the grant or renewal of a permit, license, registration,
or certificate on a demonstration by the applicant that actions needed to ensure compliance with
the requirements of the statutes listed in subdivision 1 have been taken, or may place conditions
on or issue a limited permit, license, registration, or certificate as a result of previous violations
by the applicant.
    Subd. 9. Suspension or revocation of permits, licenses, registrations, or certificates. The
commissioner may suspend, place conditions on, or revoke a permit, license, registration, or
certificate issued under the statutes or rules cited in subdivision 1 for:
(1) serious or repeated violations of the requirements in the statutes, rules, or other actions
listed in subdivision 1 that apply to the permit, license, registration, or certificate;
(2) submitting false material information to the department in connection with activities for
which the permit, license, registration, or certificate is issued;
(3) allowing the alteration or use of one's own permit, license, registration, or certificate
by another; or
(4) within the previous five years, conviction of a crime in connection with activities for
which the permit, license, registration, or certificate was issued.
    Subd. 10. Contested case hearings; license, certificate, registration. If the commissioner
proposes to deny, refuses to renew, suspends, or revokes a permit, license, registration, or
certificate under subdivision 8 or 9, the commissioner must first notify, in writing, the person
against whom the action is proposed to be taken and provide the person an opportunity to request a
hearing under the contested case provisions of chapter 14. If the person does not request a hearing
by notifying the commissioner within 20 days after receipt of the notice of proposed action, the
commissioner may proceed with the action without a hearing. This subdivision does not apply to:
(1) the denial of or refusal to renew a permit, license, registration, or certificate based on
the applicant's failure to meet or maintain the minimum qualifications for holding the permit,
license, registration, or certificate; or
(2) the denial of, refusal to renew, suspension of, or revocation of a permit, license,
registration, or certificate if the person against whom the action is proposed to be taken has been
granted a hearing under this subdivision within the previous 12 months.
    Subd. 11. Misdemeanor penalties. A person convicted of violating a statute or rule listed
in subdivision 1 is guilty of a misdemeanor.
    Subd. 12. Securing radioactive materials. (a) In the event of an emergency that poses a
danger to the public health, the commissioner shall have the authority to impound radioactive
materials and the associated shielding in the possession of a person who fails to abide by the
provisions of the statutes, rules, and any other item listed in subdivision 1. If impounding the
source of these materials is impractical, the commissioner shall have the authority to lock or
otherwise secure a facility that contains the source of such materials, but only the portions of
the facility as is necessary to protect the public health. An action taken under this paragraph
is effective for up to 72 hours. The commissioner must seek an injunction or take other
administrative action to secure radioactive materials beyond the initial 72-hour period.
(b) The commissioner may release impounded radioactive materials and the associated
shielding to the owner of the radioactive materials and associated shielding, upon terms and
conditions that are in accordance with the provisions of statutes, rules, and other items listed in
subdivision 1. In the alternative, the commissioner may bring an action in a court of competent
jurisdiction for an order directing the disposal of impounded radioactive materials and associated
shielding or directing other disposition as necessary to protect the public health and safety and the
environment. The costs of decontamination, transportation, burial, disposal, or other disposition
shall be borne by the owner or licensee of the radioactive materials and shielding or by any other
person who has used the radioactive materials and shielding for business purposes.
History: 1993 c 206 s 8; 1Sp1993 c 6 s 33; 1994 c 465 art 2 s 1; 1995 c 165 s 5-9; 1995 c
180 s 13; 1995 c 213 art 1 s 12; 1997 c 205 s 29,30; 1998 c 261 s 2; 1998 c 407 art 2 s 80; 1999
c 245 art 2 s 28,29

144.991 ADMINISTRATIVE PENALTY ORDER PROCEDURE.
    Subdivision 1. Amount of penalty; considerations. (a) In determining the amount of a
penalty under section 144.99, subdivision 4, the commissioner may consider:
(1) the willfulness of the violation;
(2) the gravity of the violation, including damage to humans, animals, air, water, land, or
other natural resources of the state;
(3) the history of past violations;
(4) the number of violations;
(5) the economic benefit gained by the person by allowing or committing the violation; and
(6) other factors as justice may require, if the commissioner specifically identifies the
additional factors in the commissioner's order.
(b) For a violation after an initial violation, the commissioner shall, in determining the
amount of a penalty, consider the factors in paragraph (a) and the:
(1) similarity of the most recent previous violation and the violation to be penalized;
(2) time elapsed since the last violation;
(3) number of previous violations; and
(4) response of the person to the most recent previous violation identified.
    Subd. 2. Contents of order. An order assessing an administrative penalty under section
144.99, subdivision 4, must include:
(1) a concise statement of the facts alleged to constitute a violation;
(2) a reference to the section of the statute, rule, variance, order, stipulation agreement, or
term or condition of a permit that has been violated;
(3) a statement of the amount of the administrative penalty to be imposed and the factors
upon which the penalty is based; and
(4) a statement of the person's right to review of the order.
    Subd. 3. Corrective order. (a) The commissioner may issue an order assessing a penalty
and requiring the violations cited in the order to be corrected within 30 calendar days from the
date the order is received.
(b) The person to whom the order was issued shall provide information to the commissioner
before the 31st day after the order was received demonstrating that the violation has been
corrected or that the person has developed a corrective plan acceptable to the commissioner. The
commissioner shall determine whether the violation has been corrected and notify the person
subject to the order of the commissioner's determination.
    Subd. 4. Penalty. (a) Except as provided in paragraph (b), if the commissioner determines
that the violation has been corrected or the person to whom the order was issued has developed a
corrective plan acceptable to the commissioner, the penalty must be forgiven. Unless the person
requests review of the order under subdivision 5 before the penalty is due, the penalty in the
order is due and payable:
(1) on the 31st day after the order was received, if the person subject to the order fails to
provide information to the commissioner showing that the violation has been corrected or that
appropriate steps have been taken toward correcting the violation; or
(2) on the 20th day after the person receives the commissioner's determination under
paragraph (b), if the person subject to the order has provided information to the commissioner that
the commissioner determines is not sufficient to show the violation has been corrected or that
appropriate steps have been taken toward correcting the violation.
(b) For repeated or serious violations, the commissioner may issue an order with a penalty
that will not be forgiven after the corrective action is taken. The penalty is due by 31 days after
the order was received unless review of the order under subdivision 5 has been sought.
(c) Interest at the rate established in section 549.09 begins to accrue on penalties under this
subdivision on the 31st day after the order with the penalty was received.
    Subd. 5. Expedited administrative hearing. (a) Within 30 days after receiving an order
or within 20 days after receiving notice that the commissioner has determined that a violation
has not been corrected or appropriate steps have not been taken, the person subject to an order
under this section may request an expedited hearing, using the procedures of Minnesota Rules,
parts 1400.8510 to 1400.8612, to review the commissioner's action. The hearing request must
specifically state the reasons for seeking review of the order. The person to whom the order is
directed and the commissioner are the parties to the expedited hearing. The commissioner must
notify the person to whom the order is directed of the time and place of the hearing at least 15
days before the hearing. The expedited hearing must be held within 30 days after a request for
hearing has been filed with the commissioner unless the parties agree to a later date.
(b) All written arguments must be submitted within ten days following the close of the
hearing. The hearing shall be conducted under Minnesota Rules, parts 1400.8510 to 1400.8612, as
modified by this subdivision. The Office of Administrative Hearings may, in consultation with the
agency, adopt rules specifically applicable to cases under this section.
(c) The administrative law judge shall issue a report making recommendations about the
commissioner's action to the commissioner within 30 days following the close of the record. The
administrative law judge may not recommend a change in the amount of the proposed penalty
unless the administrative law judge determines that, based on the factors in subdivision 1, the
amount of the penalty is unreasonable.
(d) If the administrative law judge makes a finding that the hearing was requested solely for
purposes of delay or that the hearing request was frivolous, the commissioner may add to the
amount of the penalty the costs charged to the agency by the Office of Administrative Hearings
for the hearing.
(e) If a hearing has been held, the commissioner may not issue a final order until at least five
days after receipt of the report of the administrative law judge. The person to whom an order is
issued may, within those five days, comment to the commissioner on the recommendations and
the commissioner will consider the comments. The final order may be appealed in the manner
provided in sections 14.63 to 14.69.
(f) If a hearing has been held and a final order issued by the commissioner, the penalty
shall be paid by 30 days after the date the final order is received unless review of the final order
is requested under sections 14.63 to 14.69. If review is not requested or the order is reviewed
and upheld, the amount due is the penalty, together with interest accruing from 31 days after the
original order was received at the rate established in section 549.09.
    Subd. 6. Mediation. In addition to review under subdivision 5, the commissioner
is authorized to enter into mediation concerning an order issued under this section if the
commissioner and the person to whom the order is issued both agree to mediation.
    Subd. 7. Enforcement. (a) The attorney general may proceed on behalf of the state to
enforce penalties that are due and payable under this section in any manner provided by law
for the collection of debts.
(b) The attorney general may petition the district court to file the administrative order as an
order of the court. At any court hearing, the only issues parties may contest are procedural and
notice issues. Once entered, the administrative order may be enforced in the same manner as a
final judgment of the district court.
(c) If a person fails to pay the penalty, the attorney general may bring a civil action in district
court seeking payment of the penalties, injunctive, or other appropriate relief including monetary
damages, attorney fees, costs, and interest.
    Subd. 8. Revocation and suspension of permit, license, registration, or certificate. If a
person fails to pay a penalty owed under this section, the agency has grounds to revoke or refuse
to reissue or renew a permit, license, registration, or certificate issued by the department.
    Subd. 9. Cumulative remedy. The authority of the agency to issue a corrective order
assessing penalties is in addition to other remedies available under statutory or common law,
except that the state may not seek civil penalties under any other provision of law for the
violations covered by the administrative penalty order. The payment of a penalty does not
preclude the use of other enforcement provisions, under which penalties are not assessed, in
connection with the violation for which the penalty was assessed.
History: 1993 c 206 s 9; 1994 c 465 art 1 s 18,19; 1995 c 165 s 10

144.992 FALSE INFORMATION.
A person subject to any of the requirements listed in section 144.99, subdivision 1, may not
make a false material statement, representation, or certification in; omit material information
from; or alter, conceal, or fail to file or maintain a notice, application, record, report, plan, or other
document required under the statutes, rules, or other actions listed in section 144.99, subdivision 1.
History: 1993 c 206 s 10

144.993 RECOVERY OF LITIGATION COSTS AND EXPENSES.
In any judicial action brought by the attorney general for civil penalties, injunctive relief, or
an action to compel performance pursuant to the authority cited in section 144.99, subdivision
1 , if the state finally prevails, and if the proven violation was willful, the state, in addition to
other penalties provided by law, may be allowed an amount determined by the court to be the
reasonable value of all or part of the litigation expenses incurred by the state. In determining the
amount of the litigation expenses to be allowed, the court shall give consideration to the economic
circumstances of the defendant.
History: 1993 c 206 s 11

144.994 [Repealed, 2001 c 171 s 14]