2006 Minnesota Statutes

CHAPTER 145A. LOCAL PUBLIC HEALTH BOARDS

145A.01 CITATION.
This chapter may be cited as the "Local Public Health Act."
History: 1987 c 309 s 1

145A.02 DEFINITIONS.
    Subdivision 1. Applicability. Definitions in this section apply to this chapter.
    Subd. 2. Board of health. "Board of health" or "board" means an administrative authority
established under section 145A.03 or 145A.07.
    Subd. 3. City. "City" means a statutory city or home rule charter city as defined in section
410.015.
    Subd. 4. Commissioner. "Commissioner" means the Minnesota commissioner of health.
    Subd. 5. Community health board. "Community health board" means a board of health
established, operating, and eligible for a local public health grant under sections 145A.09 to
145A.131.
    Subd. 6. Community health services. "Community health services" means activities
designed to protect and promote the health of the general population within a community health
service area by emphasizing the prevention of disease, injury, disability, and preventable death
through the promotion of effective coordination and use of community resources, and by
extending health services into the community.
    Subd. 7. Community health service area. "Community health service area" means a city,
county, or multicounty area that is organized as a community health board under section 145A.09
and for which a local public health grant is received under sections 145A.09 to 145A.131.
    Subd. 8. County board. "County board" or "county" means a county board of commissioners
as defined in chapter 375.
    Subd. 9.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 10.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 11.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 12.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 13.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 14.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 15. Medical consultant. "Medical consultant" means a physician licensed to practice
medicine in Minnesota who is working under a written agreement with, employed by, or on
contract with a board of health to provide advice and information, to authorize medical procedures
through standing orders, and to assist a board of health and its staff in coordinating their activities
with local medical practitioners and health care institutions.
    Subd. 16. Population. "Population" means the total number of residents of the state or any
city or county as established by the last federal census, by a special census taken by the United
States Bureau of the Census, by the state demographer under section 4A.02, or by an estimate
of city population prepared by the Metropolitan Council, whichever is the most recent as to
the stated date of count or estimate.
    Subd. 17. Public health nuisance. "Public health nuisance" means any activity or failure to
act that adversely affects the public health.
    Subd. 18. Public health nurse. "Public health nurse" means a person who is licensed as a
registered nurse by the Minnesota Board of Nursing under sections 148.171 to 148.285 and who
meets the voluntary registration requirements established by the Board of Nursing.
History: 1987 c 309 s 2; 1989 c 194 s 2; 1991 c 345 art 2 s 43; 1997 c 199 s 14; 1999 c
245 art 9 s 47; 1Sp2003 c 14 art 8 s 12-14

BOARD OF HEALTH

145A.03 ESTABLISHMENT AND ORGANIZATION.
    Subdivision 1. Establishment; assignment of responsibilities. (a) The governing body of
a city or county must undertake the responsibilities of a board of health or establish a board of
health and assign to it the powers and duties of a board of health.
(b) A city council may ask a county or joint powers board of health to undertake the
responsibilities of a board of health for the city's jurisdiction.
(c) A county board or city council within the jurisdiction of a community health board
operating under sections 145A.09 to 145A.131 is preempted from forming a board of health
except as specified in section 145A.10, subdivision 2.
    Subd. 2. Joint powers board of health. Except as preempted under section 145A.10,
subdivision 2 , a county may establish a joint board of health by agreement with one or more
contiguous counties, or a city may establish a joint board of health with one or more contiguous
cities in the same county, or a city may establish a joint board of health with the county or counties
within which it is located. The agreements must be established according to section 471.59.
    Subd. 3. Withdrawal from joint powers board of health. A county or city may withdraw
from a joint powers board of health by resolution of its governing body not less than one year
after the effective date of the initial joint powers agreement. The withdrawing county or city
must notify the commissioner and the other parties to the agreement at least one year before the
beginning of the calendar year in which withdrawal takes effect.
    Subd. 4. Membership; duties of chair. A board of health must have at least five members,
one of whom must be elected by the members as chair and one as vice-chair. The chair, or in
the chair's absence, the vice-chair, must preside at meetings of the board of health and sign
or authorize an agent to sign contracts and other documents requiring signature on behalf of
the board of health.
    Subd. 5. Meetings. A board of health must hold meetings at least twice a year and as
determined by its rules of procedure. The board must adopt written procedures for transacting
business and must keep a public record of its transactions, findings, and determinations. Members
may receive a per diem plus travel and other eligible expenses while engaged in official duties.
    Subd. 6. Duplicate licensing. A local board of health must work with the commissioner of
agriculture to eliminate duplicate licensing and inspection of grocery and convenience stores by
no later than March 1, 1992.
History: 1987 c 309 s 3; 1991 c 52 s 3; 1Sp2003 c 14 art 8 s 31

145A.04 POWERS AND DUTIES OF BOARD OF HEALTH.
    Subdivision 1. Jurisdiction; enforcement. A county or multicounty board of health has
the powers and duties of a board of health for all territory within its jurisdiction not under the
jurisdiction of a city board of health. Under the general supervision of the commissioner, the
board shall enforce laws, regulations, and ordinances pertaining to the powers and duties of a
board of health within its jurisdictional area.
    Subd. 2. Appointment of agent. A board of health must appoint, employ, or contract with
a person or persons to act on its behalf. The board shall notify the commissioner of the agent's
name, address, and phone number where the agent may be reached between board meetings and
submit a copy of the resolution authorizing the agent to act on the board's behalf.
    Subd. 3. Employment; medical consultant. (a) A board of health may establish a health
department or other administrative agency and may employ persons as necessary to carry out
its duties.
(b) Except where prohibited by law, employees of the board of health may act as its agents.
(c) Employees of the board of health are subject to any personnel administration rules
adopted by a city council or county board forming the board of health unless the employees of the
board are within the scope of a statewide personnel administration system.
(d) The board of health may appoint, employ, or contract with a medical consultant to receive
appropriate medical advice and direction.
    Subd. 4. Acquisition of property; request for and acceptance of funds; collection of fees.
(a) A board of health may acquire and hold in the name of the county or city the lands, buildings,
and equipment necessary for the purposes of sections 145A.03 to 145A.131. It may do so by any
lawful means, including gifts, purchase, lease, or transfer of custodial control.
(b) A board of health may accept gifts, grants, and subsidies from any lawful source, apply
for and accept state and federal funds, and request and accept local tax funds.
(c) A board of health may establish and collect reasonable fees for performing its duties and
providing community health services.
(d) With the exception of licensing and inspection activities, access to community health
services provided by or on contract with the board of health must not be denied to an individual or
family because of inability to pay.
    Subd. 5. Contracts. To improve efficiency, quality, and effectiveness, avoid unnecessary
duplication, and gain cost advantages, a board of health may contract to provide, receive, or
ensure provision of services.
    Subd. 6. Investigation; reporting and control of communicable diseases. A board of
health shall make investigations and reports and obey instructions on the control of communicable
diseases as the commissioner may direct under section 144.12, 145A.06, subdivision 2, or
145A.07. Boards of health must cooperate so far as practicable to act together to prevent and
control epidemic diseases.
    Subd. 7. Entry for inspection. To enforce public health laws, ordinances or rules, a member
or agent of a board of health may enter a building, conveyance, or place where contagion,
infection, filth, or other source or cause of preventable disease exists or is reasonably suspected.
    Subd. 8. Removal and abatement of public health nuisances. (a) If a threat to the public
health such as a public health nuisance, source of filth, or cause of sickness is found on any
property, the board of health or its agent shall order the owner or occupant of the property to
remove or abate the threat within a time specified in the notice but not longer than ten days.
Action to recover costs of enforcement under this subdivision must be taken as prescribed
in section 145A.08.
(b) Notice for abatement or removal must be served on the owner, occupant, or agent of the
property in one of the following ways:
(1) by registered or certified mail;
(2) by an officer authorized to serve a warrant; or
(3) by a person aged 18 years or older who is not reasonably believed to be a party to any
action arising from the notice.
(c) If the owner of the property is unknown or absent and has no known representative upon
whom notice can be served, the board of health or its agent shall post a written or printed notice
on the property stating that, unless the threat to the public health is abated or removed within a
period not longer than ten days, the board will have the threat abated or removed at the expense of
the owner under section 145A.08 or other applicable state or local law.
(d) If the owner, occupant, or agent fails or neglects to comply with the requirement of the
notice provided under paragraphs (b) and (c), then the board of health or its agent shall remove or
abate the nuisance, source of filth, or cause of sickness described in the notice from the property.
    Subd. 9. Injunctive relief. In addition to any other remedy provided by law, the board of
health may bring an action in the court of appropriate jurisdiction to enjoin a violation of statute,
rule, or ordinance that the board has power to enforce, or to enjoin as a public health nuisance any
activity or failure to act that adversely affects the public health.
    Subd. 10. Hindrance of enforcement prohibited; penalty. It is a misdemeanor deliberately
to hinder a member of a board of health or its agent from entering a building, conveyance, or
place where contagion, infection, filth, or other source or cause of preventable disease exists
or is reasonably suspected, or otherwise to interfere with the performance of the duties of the
board of health.
    Subd. 11. Neglect of enforcement prohibited; penalty. It is a misdemeanor for a member or
agent of a board of health to refuse or neglect to perform a duty imposed on a board of health by
statute or ordinance.
    Subd. 12. Other powers and duties established by law. This section does not limit powers
and duties of a board of health prescribed in other sections.
History: 1987 c 309 s 4; 1Sp2003 c 14 art 8 s 31

145A.05 LOCAL ORDINANCES.
    Subdivision 1. Generally. A county board may adopt ordinances for all or a part of its
jurisdiction to regulate actual or potential threats to the public health under this section and
section 375.51, unless the ordinances are preempted by, in conflict with, or less restrictive than
standards in state law or rule.
    Subd. 2. Animal control. In addition to powers under sections 35.67 to 35.69, a county board
may adopt ordinances to issue licenses or otherwise regulate the keeping of animals, to restrain
animals from running at large, to authorize the impounding and sale or summary destruction of
animals, and to establish pounds.
    Subd. 3. Control of unwholesome substances. Unless preempted by or in conflict with
sections 394.21 to 394.37, a county board may adopt ordinances to prevent bringing, depositing,
or leaving within the county any unwholesome substance and to require the owners or occupants
of lands to remove unwholesome substances or to provide for removal at the expense of the
owner or occupant.
    Subd. 4. Regulation of waste. A county board may adopt ordinances to provide for or
regulate the disposal of sewage, garbage, and other refuse.
    Subd. 5. Regulation of water. A county board may adopt ordinances to provide for cleaning
and removal of obstructions from waters in the county and to prevent their obstruction or pollution.
    Subd. 6. Regulation of offensive trades. A county board may adopt ordinances to regulate
offensive trades, unless the ordinances are preempted by, in conflict with, or less restrictive than
standards under sections 394.21 to 394.37. In this subdivision, "offensive trade" means a trade or
employment that is hurtful to inhabitants within any county, city, or town, dangerous to the public
health, injurious to neighboring property, or from which offensive odors arise.
    Subd. 7. Control of public health nuisances. A county board may adopt ordinances to
define public health nuisances and to provide for their prevention or abatement.
    Subd. 7a. Curfew. A county board may adopt an ordinance establishing a countywide
curfew for unmarried persons under 18 years of age. If the county board of a county located in the
seven-county metropolitan area adopts a curfew ordinance under this subdivision, the ordinance
shall contain an earlier curfew for children under the age of 12 than for older children.
    Subd. 8. Enforcement of delegated powers. A county board may adopt ordinances
consistent with this section to administer and enforce the powers and duties delegated by
agreement with the commissioner under section 145A.07.
    Subd. 9. Relation to cities and towns. The governing body of a city or town may adopt
ordinances relating to the public health authorized by law or agreement with the commissioner
under section 145A.07. The ordinances must not conflict with or be less restrictive than ordinances
adopted by the county board within whose jurisdiction the city or town is located.
History: 1987 c 309 s 5; 1994 c 636 art 9 s 10; 1995 c 226 art 2 s 1

145A.06 COMMISSIONER; POWERS AND DUTIES.
    Subdivision 1. Generally. In addition to other powers and duties provided by law, the
commissioner has the powers listed in subdivisions 2 to 5.
    Subd. 2. Supervision of local enforcement. (a) In the absence of provision for a board
of health, the commissioner may appoint three or more persons to act as a board until one is
established. The commissioner may fix their compensation, which the county or city must pay.
(b) The commissioner by written order may require any two or more boards of health to act
together to prevent or control epidemic diseases.
(c) If a board fails to comply with section 145A.04, subdivision 6, the commissioner may
employ medical and other help necessary to control communicable disease at the expense of the
board of health involved.
(d) If the commissioner has reason to believe that the provisions of this chapter have been
violated, the commissioner shall inform the attorney general and submit information to support
the belief. The attorney general shall institute proceedings to enforce the provisions of this chapter
or shall direct the county attorney to institute proceedings.
    Subd. 3.[Repealed, 1989 c 194 s 22]
    Subd. 4. Assistance to boards of health. The commissioner shall help and advise boards
of health that ask for help in developing, administering, and carrying out public health services
and programs.
    Subd. 5. Deadly infectious diseases. The commissioner shall promote measures aimed at
preventing businesses from facilitating sexual practices that transmit deadly infectious diseases
by providing technical advice to boards of health to assist them in regulating these practices or
closing establishments that constitute a public health nuisance.
History: 1987 c 309 s 6; 1988 c 689 art 2 s 47; 1Sp2003 c 14 art 8 s 15

145A.07 DELEGATION OF POWERS AND DUTIES.
    Subdivision 1. Agreements to perform duties of commissioner. (a) The commissioner
of health may enter into an agreement with any board of health to delegate all or part of the
licensing, inspection, reporting, and enforcement duties authorized under sections 144.12;
144.381 to 144.387; 144.411 to 144.417; 144.71 to 144.74; 145A.04, subdivision 6; provisions
of chapter 103I pertaining to construction, repair, and abandonment of water wells; chapter
157; and sections 327.14 to 327.28.
(b) Agreements are subject to subdivision 3.
(c) This subdivision does not affect agreements entered into under Minnesota Statutes 1986,
section 145.031, 145.55, or 145.918, subdivision 2.
    Subd. 2. Agreements to perform duties of board of health. A board of health may
authorize a township board, city council, or county board within its jurisdiction to establish
a board of health under section 145A.03 and delegate to the board of health by agreement any
powers or duties under sections 145A.04, 145A.07, subdivision 2, and 145A.08. An agreement
to delegate powers and duties of a board of health must be approved by the commissioner and
is subject to subdivision 3.
    Subd. 3. Terms of agreements. (a) Agreements authorized under this section must be in
writing and signed by the delegating authority and the designated agent.
(b) The agreement must list criteria the delegating authority will use to determine if
the designated agent's performance meets appropriate standards and is sufficient to replace
performance by the delegating authority.
(c) The agreement may specify minimum staff requirements and qualifications, set
procedures for the assessment of costs, and provide for termination procedures if the delegating
authority finds that the designated agent fails to comply with the agreement.
(d) A designated agent must not perform licensing, inspection, or enforcement duties under
the agreement in territory outside its jurisdiction unless approved by the governing body for
that territory through a separate agreement.
(e) The scope of agreements established under this section is limited to duties and
responsibilities agreed upon by the parties. The agreement may provide for automatic renewal and
for notice of intent to terminate by either party.
(f) During the life of the agreement, the delegating authority shall not perform duties that
the designated agent is required to perform under the agreement, except inspections necessary to
determine compliance with the agreement and this section or as agreed to by the parties.
(g) The delegating authority shall consult with, advise, and assist a designated agent in the
performance of its duties under the agreement.
(h) This section does not alter the responsibility of the delegating authority for the
performance of duties specified in law.
History: 1987 c 309 s 7; 1989 c 209 art 2 s 18; 1990 c 426 art 2 s 1; 1993 c 206 s 12;
1995 c 186 s 43

145A.08 ASSESSMENT OF COSTS; TAX LEVY AUTHORIZED.
    Subdivision 1. Cost of care. A person who has or whose dependent or spouse has a
communicable disease that is subject to control by the board of health is financially liable to the
unit or agency of government that paid for the reasonable cost of care provided to control the
disease under section 145A.04, subdivision 6.
    Subd. 2. Assessment of costs of enforcement. (a) If costs are assessed for enforcement of
section 145A.04, subdivision 8, and no procedure for the assessment of costs has been specified
in an agreement established under section 145A.07, the enforcement costs must be assessed as
prescribed in this subdivision.
(b) A debt or claim against an individual owner or single piece of real property resulting
from an enforcement action authorized by section 145A.04, subdivision 8, must not exceed
the cost of abatement or removal.
(c) The cost of an enforcement action under section 145A.04, subdivision 8, may be assessed
and charged against the real property on which the public health nuisance, source of filth, or cause
of sickness was located. The auditor of the county in which the action is taken shall extend the
cost so assessed and charged on the tax roll of the county against the real property on which
the enforcement action was taken.
(d) The cost of an enforcement action taken by a town or city board of health under section
145A.04, subdivision 8, may be recovered from the county in which the town or city is located if
the city clerk or other officer certifies the costs of the enforcement action to the county auditor
as prescribed in this section. Taxes equal to the full amount of the enforcement action but not
exceeding the limit in paragraph (b) must be collected by the county treasurer and paid to the city
or town as other taxes are collected and paid.
    Subd. 3. Tax levy authorized. A city council or county board that has formed or is a member
of a board of health may levy taxes on all taxable property in its jurisdiction to pay the cost
of performing its duties under this chapter.
History: 1987 c 309 s 8; 1Sp1989 c 1 art 5 s 6

COMMUNITY HEALTH BOARDS

145A.09 PURPOSE; FORMATION; ELIGIBILITY; WITHDRAWAL.
    Subdivision 1. General purpose. The purpose of sections 145A.09 to 145A.14 is to develop
and maintain an integrated system of community health services under local administration and
within a system of state guidelines and standards.
    Subd. 2. Community health board; eligibility. A board of health that meets the
requirements of sections 145A.09 to 145A.131 is a community health board and is eligible for a
local public health grant under section 145A.131.
    Subd. 3. Population requirement. A board of health must include within its jurisdiction a
population of 30,000 or more persons or be composed of three or more contiguous counties to be
eligible to form a community health board.
    Subd. 4. Cities. A city that meets the requirements of sections 145A.09 to 145A.131 is
eligible for a local public health grant under section 145A.131.
    Subd. 5. Human services board. A county board or a joint powers board of health that
establishes a community health board and has or establishes an operational human services
board under chapter 402 must assign the powers and duties of a community health board to
the human services board.
    Subd. 6.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 7. Withdrawal. (a) A county or city that has established or joined a community
health board may withdraw from the local public health grant program authorized by sections
145A.09 to 145A.131 by resolution of its governing body in accordance with section 145A.03,
subdivision 3 , and this subdivision.
(b) A county or city may not withdraw from a joint powers community health board during
the first two calendar years following that county's or city's initial adoption of the joint powers
agreement.
(c) The withdrawal of a county or city from a community health board does not affect the
eligibility for the local public health grant of any remaining county or city for one calendar year
following the effective date of withdrawal.
(d) The local public health grant for a county that chooses to withdraw from a multicounty
community health board shall be reduced by the amount of the local partnership incentive under
section 145A.131, subdivision 2, paragraph (c).
History: 1987 c 186 s 15; 1987 c 309 s 9,25; 1991 c 345 art 2 s 44; 1Sp2003 c 14 art 8 s
16-18; 2006 c 212 art 3 s 13

145A.10 POWERS AND DUTIES OF COMMUNITY HEALTH BOARDS.
    Subdivision 1. General. A community health board has the powers and duties of a board of
health prescribed in sections 145A.03, 145A.04, 145A.07, and 145A.08, as well as the general
responsibility for development and maintenance of an integrated system of community health
services as prescribed in sections 145A.09 to 145A.131.
    Subd. 2. Preemption. (a) Not later than 365 days after the formation of a community health
board, any other board of health within the community health service area for which the plan
has been prepared must cease operation, except as authorized in a joint powers agreement under
section 145A.03, subdivision 2, or delegation agreement under section 145A.07, subdivision 2,
or as otherwise allowed by this subdivision.
(b) This subdivision does not preempt or otherwise change the powers and duties of any city
or county eligible for a local public health grant under section 145A.09.
(c) This subdivision does not preempt the authority to operate a community health services
program of any city of the first or second class operating an existing program of community
health services located within a county with a population of 300,000 or more persons until the city
council takes action to allow the county to preempt the city's powers and duties.
    Subd. 3. Medical consultant. The community health board must appoint, employ, or
contract with a medical consultant to ensure appropriate medical advice and direction for the
board of health and assist the board and its staff in the coordination of community health services
with local medical care and other health services.
    Subd. 4. Employees. Persons employed by a county, city, or the state whose functions
and duties are assumed by a community health board shall become employees of the board
without loss in benefits, salaries, or rights. Failure to comply with this subdivision does not affect
eligibility under section 145A.09.
    Subd. 5.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 5a. Duties. (a) Consistent with the guidelines and standards established under section
145A.12, and with input from the community, the community health board shall:
(1) establish local public health priorities based on an assessment of community health
needs and assets; and
(2) determine the mechanisms by which the community health board will address the
local public health priorities established under clause (1) and achieve the statewide outcomes
established under sections 145.8821 and 145A.12, subdivision 7, within the limits of available
funding. In determining the mechanisms to address local public health priorities and achieve
statewide outcomes, the community health board shall seek public input or consider the
recommendations of the community health advisory committee and the following essential public
health services:
(i) monitor health status to identify community health problems;
(ii) diagnose and investigate problems and health hazards in the community;
(iii) inform, educate, and empower people about health issues;
(iv) mobilize community partnerships to identify and solve health problems;
(v) develop policies and plans that support individual and community health efforts;
(vi) enforce laws and regulations that protect health and ensure safety;
(vii) link people to needed personal health care services;
(viii) ensure a competent public health and personal health care workforce;
(ix) evaluate effectiveness, accessibility, and quality of personal and population-based
health services; and
(x) research for new insights and innovative solutions to health problems.
(b) By February 1, 2005, and every five years thereafter, each community health board that
receives a local public health grant under section 145A.131 shall notify the commissioner in
writing of the statewide outcomes established under sections 145.8821 and 145A.12, subdivision
7 , that the board will address and the local priorities established under paragraph (a) that the
board will address.
(c) Each community health board receiving a local public health grant under section
145A.131 must submit an annual report to the commissioner documenting progress toward the
achievement of statewide outcomes established under sections 145.8821 and 145A.12, subdivision
7 , and the local public health priorities established under paragraph (a), using reporting standards
and procedures established by the commissioner and in compliance with all applicable federal
requirements. If a community health board has identified additional local priorities for use of the
local public health grant since the last notification of outcomes and priorities under paragraph
(b), the community health board shall notify the commissioner of the additional local public
health priorities in the annual report.
    Subd. 6.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 7. Equal access to services. The community health board must ensure that community
health services are accessible to all persons on the basis of need. No one shall be denied
services because of race, color, sex, age, language, religion, nationality, inability to pay, political
persuasion, or place of residence.
    Subd. 8.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 9. Recommended legislation. The community health board may recommend local
ordinances pertaining to community health services to any county board or city council within
its jurisdiction and advise the commissioner on matters relating to public health that require
assistance from the state, or that may be of more than local interest.
    Subd. 10. State and local advisory committees. (a) A State Community Health Advisory
Committee is established to advise, consult with, and make recommendations to the commissioner
on the development, maintenance, funding, and evaluation of community health services. Each
community health board may appoint a member to serve on the committee. The committee
must meet at least quarterly, and special meetings may be called by the committee chair or a
majority of the members. Members or their alternates may be reimbursed for travel and other
necessary expenses while engaged in their official duties. Notwithstanding section 15.059, the
State Community Health Advisory Committee does not expire.
(b) The city councils or county boards that have established or are members of a community
health board may appoint a community health advisory committee to advise, consult with, and
make recommendations to the community health board on the duties under subdivision 5a.
History: 1987 c 309 s 10; 2001 c 161 s 25; 1Sp2003 c 14 art 7 s 46; art 8 s 19-21,31

145A.11 POWERS AND DUTIES OF CITY AND COUNTY.
    Subdivision 1. Generally. In addition to the powers and duties prescribed elsewhere in law
and in section 145A.05, a city council or county board that has formed or is a member of a
community health board has the powers and duties prescribed in this section.
    Subd. 2. Levying taxes. In levying taxes authorized under section 145A.08, subdivision 3,
a city council or county board that has formed or is a member of a community health board
must consider the income and expenditures required to meet local public health priorities
established under section 145A.10, subdivision 5a, and statewide outcomes established under
section 145A.12, subdivision 7.
    Subd. 3.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 4. Ordinances relating to community health services. A city council or county board
that has established or is a member of a community health board may by ordinance adopt and
enforce minimum standards for services provided according to sections 145A.02 and 145A.10.
An ordinance must not conflict with state law or with more stringent standards established either
by rule of an agency of state government or by the provisions of the charter or ordinances of any
city organized under section 145A.09, subdivision 4.
History: 1987 c 309 s 11; 1Sp2003 c 14 art 8 s 22,23

145A.12 POWERS AND DUTIES OF COMMISSIONER.
    Subdivision 1. Administrative and program support. The commissioner must assist
community health boards in the development, administration, and implementation of community
health services. This assistance may consist of but is not limited to:
(1) informational resources, consultation, and training to help community health boards plan,
develop, integrate, provide and evaluate community health services; and
(2) administrative and program guidelines and standards, developed with the advice of the
State Community Health Advisory Committee.
    Subd. 2. Personnel standards. In accordance with chapter 14, and in consultation with the
State Community Health Advisory Committee, the commissioner may adopt rules to set standards
for administrative and program personnel to ensure competence in administration and planning.
    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 14 art 8 s 32]
    Subd. 6.[Repealed, 1997 c 7 art 2 s 67]
    Subd. 7. Statewide outcomes. (a) The commissioner, in consultation with the State
Community Health Advisory Committee established under section 145A.10, subdivision 10,
paragraph (a), shall establish statewide outcomes for local public health grant funds allocated to
community health boards between January 1, 2004, and December 31, 2005.
(b) At least one statewide outcome must be established in each of the following public
health areas:
(1) preventing diseases;
(2) protecting against environmental hazards;
(3) preventing injuries;
(4) promoting healthy behavior;
(5) responding to disasters; and
(6) ensuring access to health services.
(c) The commissioner shall use Minnesota's public health goals established under section
62J.212 and the essential public health services under section 145A.10, subdivision 5a, as a basis
for the development of statewide outcomes.
(d) The statewide maternal and child health outcomes established under section 145.8821
shall be included as statewide outcomes under this section.
(e) By December 31, 2004, and every five years thereafter, the commissioner, in consultation
with the State Community Health Advisory Committee established under section 145A.10,
subdivision 10 , paragraph (a), and the Maternal and Child Health Advisory Task Force established
under section 145.881, shall develop statewide outcomes for the local public health grant
established under section 145A.131, based on state and local assessment data regarding the health
of Minnesota residents, the essential public health services under section 145A.10, and current
Minnesota public health goals established under section 62J.212.
History: 1987 c 309 s 12; 1Sp2003 c 14 art 8 s 24-26

145A.13 MS 2003 Supp [Expired]

145A.131 LOCAL PUBLIC HEALTH GRANT.
    Subdivision 1. Funding formula for community health boards. (a) Base funding for
each community health board eligible for a local public health grant under section 145A.09,
subdivision 2 , shall be determined by each community health board's fiscal year 2003 allocations,
prior to unallotment, for the following grant programs: community health services subsidy; state
and federal maternal and child health special projects grants; family home visiting grants; TANF
MN ENABL grants; TANF youth risk behavior grants; and available women, infants, and children
grant funds in fiscal year 2003, prior to unallotment, distributed based on the proportion of WIC
participants served in fiscal year 2003 within the CHS service area.
(b) Base funding for a community health board eligible for a local public health grant
under section 145A.09, subdivision 2, as determined in paragraph (a), shall be adjusted by the
percentage difference between the base, as calculated in paragraph (a), and the funding available
for the local public health grant.
(c) Multicounty community health boards shall receive a local partnership base of up to
$5,000 per year for each county included in the community health board.
(d) The State Community Health Advisory Committee may recommend a formula to the
commissioner to use in distributing state and federal funds to community health boards organized
and operating under sections 145A.09 to 145A.131 to achieve locally identified priorities under
section 145A.12, subdivision 7, by July 1, 2004, for use in distributing funds to community health
boards beginning January 1, 2006, and thereafter.
    Subd. 2. Local match. (a) A community health board that receives a local public health
grant shall provide at least a 75 percent match for the state funds received through the local public
health grant described in subdivision 1 and subject to paragraphs (b) to (d).
(b) Eligible funds must be used to meet match requirements. Eligible funds include funds
from local property taxes, reimbursements from third parties, fees, other local funds, and
donations or nonfederal grants that are used for community health services described in section
145A.02, subdivision 6.
(c) When the amount of local matching funds for a community health board is less than the
amount required under paragraph (a), the local public health grant provided for that community
health board under this section shall be reduced proportionally.
(d) A city organized under the provision of sections 145A.09 to 145A.131 that levies a tax
for provision of community health services is exempt from any county levy for the same services
to the extent of the levy imposed by the city.
    Subd. 3. Accountability. (a) Community health boards accepting local public health
grants must document progress toward the statewide outcomes established in section 145A.12,
subdivision 7 , to maintain eligibility to receive the local public health grant.
(b) In determining whether or not the community health board is documenting progress
toward statewide outcomes, the commissioner shall consider the following factors:
(1) whether the community health board has documented progress to meeting essential local
activities related to the statewide outcomes, as specified in the grant agreement;
(2) the effort put forth by the community health board toward the selected statewide
outcomes;
(3) whether the community health board has previously failed to document progress toward
selected statewide outcomes under this section;
(4) the amount of funding received by the community health board to address the statewide
outcomes; and
(5) other factors as the commissioner may require, if the commissioner specifically identifies
the additional factors in the commissioner's written notice of determination.
(c) If the commissioner determines that a community health board has not by the applicable
deadline documented progress toward the selected statewide outcomes established under section
145.8821 or 145A.12, subdivision 7, the commissioner shall notify the community health board in
writing and recommend specific actions that the community health board should take over the
following 12 months to maintain eligibility for the local public health grant.
(d) During the 12 months following the written notification, the commissioner shall provide
administrative and program support to assist the community health board in taking the actions
recommended in the written notification.
(e) If the community health board has not taken the specific actions recommended by the
commissioner within 12 months following written notification, the commissioner may determine
not to distribute funds to the community health board under section 145A.12, subdivision 2, for
the next fiscal year.
(f) If the commissioner determines not to distribute funds for the next fiscal year, the
commissioner must give the community health board written notice of this determination and
allow the community health board to appeal the determination in writing.
(g) If the commissioner determines not to distribute funds for the next fiscal year to a
community health board that has not documented progress toward the statewide outcomes and not
taken the actions recommended by the commissioner, the commissioner may retain local public
health grant funds that the community health board would have otherwise received and directly
carry out essential local activities to meet the statewide outcomes, or contract with other units
of government or community-based organizations to carry out essential local activities related
to the statewide outcomes.
(h) If the community health board that does not document progress toward the statewide
outcomes is a city, the commissioner shall distribute the local public health funds that would have
been allocated to that city to the county in which the city is located, if that county is part of a
community health board.
(i) The commissioner shall establish a reporting system by which community health boards
will document their progress toward statewide outcomes. This system will be developed in
consultation with the State Community Health Services Advisory Committee established in
section 145A.10, subdivision 10, paragraph (a), and the Maternal and Child Health Advisory
Committee established in section 145.881.
    Subd. 4. Responsibility of commissioner to ensure a statewide public health system. If
a county withdraws from a community health board and operates as a board of health or if a
community health board elects not to accept the local public health grant, the commissioner may
retain the amount of funding that would have been allocated to the community health board using
the formula described in subdivision 1 and assume responsibility for public health activities to
meet the statewide outcomes in the geographic area served by the board of health or community
health board. The commissioner may elect to directly provide public health activities to meet
the statewide outcomes or contract with other units of government or with community-based
organizations. If a city that is currently a community health board withdraws from a community
health board or elects not to accept the local public health grant, the local public health grant funds
that would have been allocated to that city shall be distributed to the county in which the city
is located, if the county is part of a community health board.
    Subd. 5. Local public health priorities. Community health boards may use their local
public health grant to address local public health priorities identified under section 145A.10,
subdivision 5a .
History: 1Sp2003 c 14 art 8 s 28

145A.14 SPECIAL GRANTS.
    Subdivision 1. Migrant health grants. (a) The commissioner may make special grants to
cities, counties, groups of cities or counties, or nonprofit corporations to establish, operate, or
subsidize clinic facilities and services, including mobile clinics, to furnish health services for
migrant agricultural workers and their families in areas of the state where significant numbers of
migrant workers are located. "Migrant agricultural worker" means any individual whose principal
employment is in agriculture on a seasonal basis, who has been so employed within the past 24
months, and who has established a temporary residence for the purpose of such employment.
(b) Applicants must submit for approval a plan and budget for the use of the funds in the
form and detail specified by the commissioner.
(c) Applicants must keep records, including records of expenditures to be audited, as the
commissioner specifies.
    Subd. 2. Indian health grants. (a) The commissioner may make special grants to establish,
operate, or subsidize clinic facilities and services to furnish health services for American Indians
who reside off reservations.
(b) Applicants must submit for approval a plan and budget for the use of the funds in the
form and detail specified by the commissioner.
(c) Applicants must keep records, including records of expenditures to be audited, as the
commissioner specifies.
    Subd. 2a. Tribal governments. (a) Of the funding available for local public health grants,
$1,500,000 per year is available to tribal governments for:
(1) maternal and child health activities under section 145.882, subdivision 7;
(2) activities to reduce health disparities under section 145.928, subdivision 10; and
(3) emergency preparedness.
(b) The commissioner, in consultation with tribal governments, shall establish a formula for
distributing the funds and developing the outcomes to be measured.
    Subd. 3.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 4.[Repealed, 1Sp2003 c 14 art 8 s 32]
History: 1Sp1985 c 14 art 19 s 24; 1987 c 309 s 13,19,25; 1989 c 120 s 1; 1Sp2003 c
14 art 8 s 29,30

145A.15 MS 2002 [Expired]

145A.16 MS 2002 [Expired]

145A.17 FAMILY HOME VISITING PROGRAMS.
    Subdivision 1. Establishment; goals. The commissioner shall establish a program to fund
family home visiting programs designed to foster a healthy beginning for children in families at
or below 200 percent of the federal poverty guidelines, prevent child abuse and neglect, reduce
juvenile delinquency, promote positive parenting and resiliency in children, and promote family
health and economic self-sufficiency. A program funded under this section must serve families
at or below 200 percent of the federal poverty guidelines, and other families determined to be
at risk, including but not limited to being at risk for child abuse, child neglect, or juvenile
delinquency. Programs must give priority for services to families considered to be in need of
services, including but not limited to families with:
(1) adolescent parents;
(2) a history of alcohol or other drug abuse;
(3) a history of child abuse, domestic abuse, or other types of violence;
(4) a history of domestic abuse, rape, or other forms of victimization;
(5) reduced cognitive functioning;
(6) a lack of knowledge of child growth and development stages;
(7) low resiliency to adversities and environmental stresses; or
(8) insufficient financial resources to meet family needs.
    Subd. 2.[Repealed, 1Sp2003 c 14 art 8 s 32]
    Subd. 3. Requirements for programs; process. (a) Before a community health board or
tribal government may receive an allocation under subdivision 2, a community health board or
tribal government must submit a proposal to the commissioner that includes identification, based
on a community assessment, of the populations at or below 200 percent of the federal poverty
guidelines that will be served and the other populations that will be served. Each program that
receives funds must:
(1) use either a broad community-based or selective community-based strategy to provide
preventive and early intervention home visiting services;
(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first home
visit must occur prenatally or as soon after birth as possible and must include a public health
nursing assessment by a public health nurse;
(3) offer, at a minimum, information on infant care, child growth and development, positive
parenting, preventing diseases, preventing exposure to environmental hazards, and support
services available in the community;
(4) provide information on and referrals to health care services, if needed, including
information on health care coverage for which the child or family may be eligible; and provide
information on preventive services, developmental assessments, and the availability of public
assistance programs as appropriate;
(5) provide youth development programs;
(6) recruit home visitors who will represent, to the extent possible, the races, cultures, and
languages spoken by families that may be served;
(7) train and supervise home visitors in accordance with the requirements established under
subdivision 4;
(8) maximize resources and minimize duplication by coordinating activities with local social
and human services organizations, education organizations, and other appropriate governmental
entities and community-based organizations and agencies; and
(9) utilize appropriate racial and ethnic approaches to providing home visiting services.
(b) Funds available under this section shall not be used for medical services. The
commissioner shall establish an administrative cost limit for recipients of funds. The outcome
measures established under subdivision 6 must be specified to recipients of funds at the time the
funds are distributed.
(c) Data collected on individuals served by the home visiting programs must remain
confidential and must not be disclosed by providers of home visiting services without a specific
informed written consent that identifies disclosures to be made. Upon request, agencies providing
home visiting services must provide recipients with information on disclosures, including the
names of entities and individuals receiving the information and the general purpose of the
disclosure. Prospective and current recipients of home visiting services must be told and informed
in writing that written consent for disclosure of data is not required for access to home visiting
services.
    Subd. 4. Training. The commissioner shall establish training requirements for home visitors
and minimum requirements for supervision by a public health nurse. The requirements for nurses
must be consistent with chapter 148. Training must include child development, positive parenting
techniques, screening and referrals for child abuse and neglect, and diverse cultural practices in
child rearing and family systems.
    Subd. 5. Technical assistance. The commissioner shall provide administrative and technical
assistance to each program, including assistance in data collection and other activities related to
conducting short- and long-term evaluations of the programs as required under subdivision 7. The
commissioner may request research and evaluation support from the University of Minnesota.
    Subd. 6. Outcome measures. The commissioner shall establish outcomes to determine the
impact of family home visiting programs funded under this section on the following areas:
(1) appropriate utilization of preventive health care;
(2) rates of substantiated child abuse and neglect;
(3) rates of unintentional child injuries;
(4) rates of children who are screened and who pass early childhood screening; and
(5) any additional qualitative goals and quantitative measures established by the
commissioner.
    Subd. 7. Evaluation. Using the qualitative goals and quantitative outcome measures
established under subdivisions 1 and 6, the commissioner shall conduct ongoing evaluations of
the programs funded under this section. Community health boards and tribal governments shall
cooperate with the commissioner in the evaluations and shall provide the commissioner with
the information necessary to conduct the evaluations. As part of the ongoing evaluations, the
commissioner shall rate the impact of the programs on the outcome measures listed in subdivision
6, and shall periodically determine whether home visiting programs are the best way to achieve
the qualitative goals established under subdivisions 1 and 6. If the commissioner determines that
home visiting programs are not the best way to achieve these goals, the commissioner shall
provide the legislature with alternative methods for achieving them.
    Subd. 8. Report. By January 15, 2002, and January 15 of each even-numbered year
thereafter, the commissioner shall submit a report to the legislature on the family home visiting
programs funded under this section and on the results of the evaluations conducted under
subdivision 7.
    Subd. 9. No supplanting of existing funds. Funding available under this section may be
used only to supplement, not to replace, nonstate funds being used for home visiting services as
of July 1, 2001.
History: 1Sp2001 c 9 art 1 s 53; 2002 c 379 art 1 s 113