2006 Minnesota Statutes

62J.692 MEDICAL EDUCATION.
    Subdivision 1. Definitions. For purposes of this section, the following definitions apply:
(a) "Accredited clinical training" means the clinical training provided by a medical education
program that is accredited through an organization recognized by the Department of Education,
the Centers for Medicare and Medicaid Services, or another national body who reviews the
accrediting organizations for multiple disciplines and whose standards for recognizing accrediting
organizations are reviewed and approved by the commissioner of health in consultation with the
Medical Education and Research Advisory Committee.
(b) "Commissioner" means the commissioner of health.
(c) "Clinical medical education program" means the accredited clinical training of physicians
(medical students and residents), doctor of pharmacy practitioners, doctors of chiropractic,
dentists, advanced practice nurses (clinical nurse specialists, certified registered nurse anesthetists,
nurse practitioners, and certified nurse midwives), and physician assistants.
(d) "Sponsoring institution" means a hospital, school, or consortium located in Minnesota
that sponsors and maintains primary organizational and financial responsibility for a clinical
medical education program in Minnesota and which is accountable to the accrediting body.
(e) "Teaching institution" means a hospital, medical center, clinic, or other organization that
conducts a clinical medical education program in Minnesota.
(f) "Trainee" means a student or resident involved in a clinical medical education program.
(g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time
equivalent counts, that are at training sites located in Minnesota with a medical assistance
provider number where training occurs in either an inpatient or ambulatory patient care setting
and where the training is funded, in part, by patient care revenues.
    Subd. 2. Medical Education and Research Advisory Committee. The commissioner shall
appoint an advisory committee to provide advice and oversight on the distribution of funds
appropriated for distribution under this section. In appointing the members, the commissioner
shall:
(1) consider the interest of all stakeholders;
(2) appoint members that represent both urban and rural interests; and
(3) appoint members that represent ambulatory care as well as inpatient perspectives.
The commissioner shall appoint to the advisory committee representatives of the following
groups to ensure appropriate representation of all eligible provider groups and other stakeholders:
public and private medical researchers; public and private academic medical centers, including
representatives from academic centers offering accredited training programs for physicians,
pharmacists, chiropractors, dentists, nurses, and physician assistants; managed care organizations;
employers; consumers and other relevant stakeholders. The advisory committee is governed by
section 15.059.
    Subd. 3. Application process. (a) A clinical medical education program conducted in
Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners, dentists,
chiropractors, or physician assistants is eligible for funds under subdivision 4 if the program:
(1) is funded, in part, by patient care revenues;
(2) occurs in patient care settings that face increased financial pressure as a result of
competition with nonteaching patient care entities; and
(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
A clinical medical education program that trains pediatricians is requested to include in its
program curriculum training in case management and medication management for children
suffering from mental illness to be eligible for funds under subdivision 4.
(b) A clinical medical education program for advanced practice nursing is eligible for funds
under subdivision 4 if the program meets the eligibility requirements in paragraph (a), clauses
(1) to (3), and is sponsored by the University of Minnesota Academic Health Center, the Mayo
Foundation, or institutions that are part of the Minnesota State Colleges and Universities system
or members of the Minnesota Private College Council.
(c) Applications must be submitted to the commissioner by a sponsoring institution on behalf
of an eligible clinical medical education program and must be received by October 31 of each
year for distribution in the following year. An application for funds must contain the following
information:
(1) the official name and address of the sponsoring institution and the official name and site
address of the clinical medical education programs on whose behalf the sponsoring institution is
applying;
(2) the name, title, and business address of those persons responsible for administering
the funds;
(3) for each clinical medical education program for which funds are being sought; the type
and specialty orientation of trainees in the program; the name, site address, and medical assistance
provider number of each training site used in the program; the total number of trainees at each
training site; and the total number of eligible trainee FTEs at each site; and
(4) other supporting information the commissioner deems necessary to determine program
eligibility based on the criteria in paragraphs (a) and (b) and to ensure the equitable distribution
of funds.
(d) An application must include the information specified in clauses (1) to (3) for each
clinical medical education program on an annual basis for three consecutive years. After that
time, an application must include the information specified in clauses (1) to (3) when requested, at
the discretion of the commissioner:
(1) audited clinical training costs per trainee for each clinical medical education program
when available or estimates of clinical training costs based on audited financial data;
(2) a description of current sources of funding for clinical medical education costs, including
a description and dollar amount of all state and federal financial support, including Medicare
direct and indirect payments; and
(3) other revenue received for the purposes of clinical training.
(e) An applicant that does not provide information requested by the commissioner shall not
be eligible for funds for the current funding cycle.
    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute 90 percent of
available medical education funds to all qualifying applicants based on a distribution formula that
reflects a summation of two factors:
(1) an education factor, which is determined by the total number of eligible trainee FTEs
and the total statewide average costs per trainee, by type of trainee, in each clinical medical
education program; and
(2) a public program volume factor, which is determined by the total volume of public
program revenue received by each training site as a percentage of all public program revenue
received by all training sites in the fund pool.
In this formula, the education factor is weighted at 67 percent and the public program
volume factor is weighted at 33 percent.
Public program revenue for the distribution formula includes revenue from medical
assistance, prepaid medical assistance, general assistance medical care, and prepaid general
assistance medical care. Training sites that receive no public program revenue are ineligible
for funds available under this paragraph. Total statewide average costs per trainee for medical
residents is based on audited clinical training costs per trainee in primary care clinical medical
education programs for medical residents. Total statewide average costs per trainee for dental
residents is based on audited clinical training costs per trainee in clinical medical education
programs for dental students. Total statewide average costs per trainee for pharmacy residents is
based on audited clinical training costs per trainee in clinical medical education programs for
pharmacy students.
(b) The commissioner shall annually distribute ten percent of total available medical
education funds to all qualifying applicants based on the percentage received by each applicant
under paragraph (a). These funds are to be used to offset clinical education costs at eligible
clinical training sites based on criteria developed by the clinical medical education program.
Applicants may choose to distribute funds allocated under this paragraph based on the distribution
formula described in paragraph (a).
(c) Funds distributed shall not be used to displace current funding appropriations from
federal or state sources.
(d) Funds shall be distributed to the sponsoring institutions indicating the amount to be
distributed to each of the sponsor's clinical medical education programs based on the criteria in
this subdivision and in accordance with the commissioner's approval letter. Each clinical medical
education program must distribute funds allocated under paragraph (a) to the training sites as
specified in the commissioner's approval letter. Sponsoring institutions, which are accredited
through an organization recognized by the Department of Education or the Centers for Medicare
and Medicaid Services, may contract directly with training sites to provide clinical training. To
ensure the quality of clinical training, those accredited sponsoring institutions must:
(1) develop contracts specifying the terms, expectations, and outcomes of the clinical
training conducted at sites; and
(2) take necessary action if the contract requirements are not met. Action may include the
withholding of payments under this section or the removal of students from the site.
(e) Any funds not distributed in accordance with the commissioner's approval letter must be
returned to the medical education and research fund within 30 days of receiving notice from the
commissioner. The commissioner shall distribute returned funds to the appropriate training sites
in accordance with the commissioner's approval letter.
(f) The commissioner shall distribute by June 30 of each year an amount equal to the funds
transferred under subdivision 10, plus five percent interest to the University of Minnesota Board
of Regents for the instructional costs of health professional programs at the Academic Health
Center and for interdisciplinary academic initiatives within the Academic Health Center.
(g) A maximum of $150,000 of the funds dedicated to the commissioner under section
297F.10, subdivision 1, paragraph (b), clause (2), may be used by the commissioner for
administrative expenses associated with implementing this section.
    Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section must sign and
submit a medical education grant verification report (GVR) to verify that the correct grant amount
was forwarded to each eligible training site. If the sponsoring institution fails to submit the GVR
by the stated deadline, or to request and meet the deadline for an extension, the sponsoring
institution is required to return the full amount of funds received to the commissioner within 30
days of receiving notice from the commissioner. The commissioner shall distribute returned funds
to the appropriate training sites in accordance with the commissioner's approval letter.
(b) The reports must provide verification of the distribution of the funds and must include:
(1) the total number of eligible trainee FTEs in each clinical medical education program;
(2) the name of each funded program and, for each program, the dollar amount distributed
to each training site;
(3) documentation of any discrepancies between the initial grant distribution notice included
in the commissioner's approval letter and the actual distribution;
(4) a statement by the sponsoring institution describing the distribution of funds allocated
under subdivision 4, paragraph (b), including information on which clinical training sites received
funding and the rationale used for determining funding priorities;
(5) a statement by the sponsoring institution stating that the completed grant verification
report is valid and accurate; and
(6) other information the commissioner, with advice from the advisory committee, deems
appropriate to evaluate the effectiveness of the use of funds for medical education.
(c) By February 15 of each year, the commissioner, with advice from the advisory committee,
shall provide an annual summary report to the legislature on the implementation of this section.
    Subd. 6. Other available funds. The commissioner is authorized to distribute, in accordance
with subdivision 4, funds made available through:
(1) voluntary contributions by employers or other entities;
(2) allocations for the commissioner of human services to support medical education and
research; and
(3) other sources as identified and deemed appropriate by the legislature for inclusion in
the fund.
    Subd. 7. Transfers from the commissioner of human services. (a) The amount transferred
according to section 256B.69, subdivision 5c, paragraph (a), clause (1), shall be distributed by the
commissioner annually to clinical medical education programs that meet the qualifications of
subdivision 3 based on the formula in subdivision 4, paragraph (a).
(b) Fifty percent of the amount transferred according to section 256B.69, subdivision 5c,
paragraph (a), clause (2), shall be distributed by the commissioner to the University of Minnesota
Board of Regents for the purposes described in sections 137.38 to 137.40. Of the remaining
amount transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (2), 24
percent of the amount shall be distributed by the commissioner to the Hennepin County Medical
Center for clinical medical education. The remaining 26 percent of the amount transferred shall
be distributed by the commissioner in accordance with subdivision 7a. If the federal approval
is not obtained for the matching funds under section 256B.69, subdivision 5c, paragraph (a),
clause (2), 100 percent of the amount transferred under this paragraph shall be distributed by the
commissioner to the University of Minnesota Board of Regents for the purposes described in
sections 137.38 to 137.40.
(c) The amount transferred according to section 256B.69, subdivision 5c, paragraph (a),
clauses (3) and (4), shall be distributed by the commissioner upon receipt to the University of
Minnesota Board of Regents for the purposes of clinical graduate medical education.
    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner shall
award grants to teaching institutions and clinical training sites for projects that increase
dental access for underserved populations and promote innovative clinical training of dental
professionals. In awarding the grants, the commissioner, in consultation with the commissioner of
human services, shall consider the following:
(1) potential to successfully increase access to an underserved population;
(2) the long-term viability of the project to improve access beyond the period of initial
funding;
(3) evidence of collaboration between the applicant and local communities;
(4) the efficiency in the use of the funding; and
(5) the priority level of the project in relation to state clinical education, access, and
workforce goals.
(b) The commissioner shall periodically evaluate the priorities in awarding the innovations
grants in order to ensure that the priorities meet the changing workforce needs of the state.
    Subd. 8. Federal financial participation. (a) The commissioner of human services shall
seek to maximize federal financial participation in payments for medical education and research
costs. If the commissioner of human services determines that federal financial participation
is available for the medical education and research, the commissioner of health shall transfer
to the commissioner of human services the amount of state funds necessary to maximize the
federal funds available. The amount transferred to the commissioner of human services, plus the
amount of federal financial participation, shall be distributed to medical assistance providers in
accordance with the distribution methodology described in subdivision 4.
(b) For the purposes of paragraph (a), the commissioner shall use physician clinic rates
where possible to maximize federal financial participation.
    Subd. 9. Review of eligible providers. The commissioner and the Medical Education and
Research Costs Advisory Committee may review provider groups included in the definition of
a clinical medical education program to assure that the distribution of the funds continue to be
consistent with the purpose of this section. The results of any such reviews must be reported to the
Legislative Commission on Health Care Access.
    Subd. 10. Transfers from University of Minnesota. Of the funds dedicated to the Academic
Health Center under section 297F.10, subdivision 1, clause (1), $4,850,000 shall be transferred
annually to the commissioner of health no later than April 15 of each year for distribution under
subdivision 4, paragraph (f).
History: 1999 c 245 art 2 s 10; 2000 c 494 s 1-3; 2001 c 161 s 14; 1Sp2001 c 9 art 2 s 2,3;
2002 c 220 art 15 s 1,2; 2002 c 277 s 32; 2002 c 375 art 3 s 1; 2002 c 379 art 1 s 113; 1Sp2003 c
14 art 7 s 16-19; art 12 s 1; 1Sp2003 c 21 art 9 s 1,2; 2004 c 228 art 1 s 16; 2005 c 10 art 1 s
81; 2005 c 84 s 1-3; 1Sp2005 c 4 art 2 s 1