Legislative Update

February 27, 2009

A Slow Two Weeks at the Legislature
The Legislature seems to be in a bit of a holding pattern as they wait for the next steps on the budget shortfall.  With the passage of the federal stimulus package by Congress providing new money to state governments, there is a lot of behind-the-scenes work going on to determine the exact impact that it will have on Minnesota’s budget.  Also, many committees seemed to lose steam in the weeks leading up to the next budget forecast which will be released on March 3rd. 

Most committees held hearings but few bills were heard and many of them were hearings at which no action was taken.  Near the end of last week, many hearings at the Capitol were cancelled so Legislators could go on the road and hold “Hearing Sessions” on the Governor’s Budget Proposal throughout the state.  For the past two weeks, these hearings have been held large turnouts of citizens pleading with legislators not to follow the Governor’s plan to cut the budget.  At most of the hearings over 100 people signed up to testify and in many locations there was not enough room for all of the people interested to fit into the hearing rooms.  Democrats are trying to make the point that the Governor is cutting essential services.

Most are expecting the next budget forecast on March 3 to show that the state deficit has grown.  The current $4.8 billion shortfall could be as high as $7 billion in the new forecast.  As the economy continues to struggle and employers announce more layoffs, tax revenues decrease and the need for more safety net funding increases.

Federal Stimulus Provides Opportunities for Health Programs
Congress recently passed the American Recovery and Reinvestment Act of 2009 (HR1) to address the severe economic crisis in our country.  A large portion of the new spending will go to states to assist with health care costs.  It is estimated that Minnesota will receive $2.03 billion over the next two years through an increase in the federal Medicaid matching money.  Currently in Minnesota, the state pays 50% of the Medical Assistance costs and the federal government pays 50%.  HR 1 increases the federal match by 6.2%.

HR 1 also provides new money to help providers invest in health information technology (HIT).  The Minnesota Department of Health updated the Senate Health and Human Services Finance Division on the Minnesota’s investments in HIT and opportunities for federal funding.  The state requires all providers, group purchasers, prescribers and dispensers to have an electronic prescription drug program in place by January 2011.  In addition, all healthcare providers and hospitals must have interoperable electronic health records (EHR) in place by 2015.  The state has already provided $14.6 million in grants and loans to support adoption of EHR with targeted funds to rural and safety net providers.  There have been over $27 million in requests.

According to MDH, the federal stimulus package invests $31 billion in HIT and incentives to encourage doctors and hospitals to use HIT to exchange patient’s health information.  No specifics were provided on what portion of the federal stimulus Minnesota would receive.  State match would be required for implementation grants.  Assistance would be provided to higher education to expand medical health information programs.  Physicians using EHR in 2011 can receive up to $44,000 through increased Medicare payments over 5 years and hospitals can receive up to $16 million over 4 years.

Safe Patient Handling Legislation Moves Forward
Legislation requiring all clinics that regularly move patients to develop a written safe patient handling plan by July 1, 2010 has passed the Senate Business, Industry, and Jobs Committee with no opposition.  SF 594 (Higgins-Minneapolis) states that the plan must have a goal of  January 1, 2012, “ensuring the safe handling of patients by minimizing manual lifting of patients by direct patient care workers and by utilizing safe patient handling equipment.”  The plan shall address:

1. assessment of risks with regard to patient handling that considers the patient population and environment of care;
       

2. the acquisition of an adequate supply of appropriate safe patient handling equipment;
     
3. initial and ongoing training of direct patient care workers on the use of this equipment;
       
4. procedures to ensure that physical plant modifications and major construction projects are consistent with plan goals; and
       
5. periodic evaluations of the safe patient handling plan.

MAFP reviewed drafts of this legislation in 2008 and was comfortable with what it was asking.  This bill would not require a clinic to purchase any specific equipment or lifts, but only to have a plan in place that was appropriate for the specific needs of that clinic.

Changes to APN Delegation
Legislation is being drafted by the Minnesota Nurses Association (MNA) to implement the recommendations from the Healthcare Workforce Shortage Task Force.  This task force was established by the Legislature last year to review state laws or regulations that may be a burden to allowing practitioners to practice at the top of their license.  MAFP past Presidents Dave Thorson, MD, and Randy Rice, MD, both served on this task force.

The recommendations related to advanced practice nurses included elimination of the current delegated prescribing requirements that include a written prescribing agreement with a physician, and replacing that with a requirement for a written collaboration plan for nurse practitioners and clinical nurse specialists.  The task force report did not include specifics for what should be included in the collaboration plan.

Staff met with representatives of the MNA last week to review draft legislation on this topic.  Based on direction from the MAFP Legislative Committee, we told them that the collaboration plan must be written and mutually agreed to by any physicians, clinics, or hospitals mentioned in the plan.  The plan as drafted by the MNA would include information for patients on whom the nurse would refer to if the needs of the patient exceeded the nurse’s expertise, to what hospital the nurse had privileges, and the type of services the nurse was not qualified to perform.

The MAFP Legislative Committee has not taken a position on this legislation because we have not yet seen final language.

Booster Seat Legislation Passes House Public Safety Committee
Tom Hellmich, M.D., a pediatrician in Emergency Medicine at Children’s Hospitals and Clinics in the Twin Cities, testified Tuesday before the House Public Safety Policy and Oversight Committee in support of  child passenger safety legislation (HF267/SF99).  The bill updates Minnesota traffic safety law to require that children be in proper restraints until they reach the age of 8 or are 4’9” tall.  Minnesota’s current law only requires that children under the age of four must be buckled in a child restraint system.  44 states have stronger child passenger restraint laws than Minnesota.  Even our neighbors in Wisconsin, Iowa and North Dakota have enacted requirements that children be properly restrained for their age.

The bill was referred to the House Public Safety Finance Committee where it could be heard as early as next week. Please contact your legislators to let them know the importance of passing this bill.

House Introductions
 

Murphy, E. introduced:

H. F. 802, A bill for an act relating to human services; prohibiting hospital payment for certain hospital-acquired conditions and certain treatments; amending Minnesota Statutes 2008, section 256.969, by adding a subdivision.

The bill was read for the first time and referred to the Committee on Health Care and Human Services Policy and Oversight.
 

Norton; Juhnke; Jackson; Severson; Huntley; Dean; Ruud; Fritz; Murphy, E.; Solberg; Thao; Davids; Peppin; Otremba; Slawik and Holberg introduced:

H. F. 823, A bill for an act relating to health; establishing licensure and practice limitations for dental therapist; establishing fees for dental therapist; amending Minnesota Statutes 2008, sections 150A.01, by adding a subdivision; 150A.05, subdivision 2, by adding a subdivision; 150A.06, subdivisions 2d, 5, 6, by adding a subdivision; 150A.08, subdivisions 1, 3a, 5; 150A.09, subdivisions 1, 3; 150A.091, subdivisions 2, 3, 5, 8, 10; 150A.10, subdivisions 1, 2, 3; 150A.11, subdivision 4; 150A.12; 151.01, subdivision 23; proposing coding for new law in Minnesota Statutes, chapter 150A; repealing Minnesota Statutes 2008, section 150A.061.

The bill was read for the first time and referred to the Committee on Health Care and Human Services Policy and Oversight.
 

Thissen introduced:

H. F. 884, A bill for an act relating to health; creating a medical supplies and equipment purchasing alliance; proposing coding for new law in Minnesota Statutes, chapter 16B.

The bill was read for the first time and referred to the Committee on Health Care and Human Services Policy and Oversight.
 

Fritz, Ruud, Haws, Clark and Thissen introduced:

H. F. 921, A bill for an act relating to occupational safety and health; requiring safe patient handling plans in clinical settings; amending Minnesota Statutes 2008, sections 182.6551; 182.6552, by adding a subdivision; proposing coding for new law in Minnesota Statutes, chapter 182.

The bill was read for the first time and referred to the Committee on Health Care and Human Services Policy and Oversight.
 

Atkins and Thissen introduced:

H. F. 969, A bill for an act relating to health; modifying provisions governing patient access to health records and costs; amending Minnesota Statutes 2008, sections 144.292, subdivisions 5, 6; 144.293, subdivisions 4, 6.

The bill was read for the first time and referred to the Committee on Health Care and Human Services Policy and Oversight.
 

Norton; Huntley; Murphy, E.; Abeler; Liebling; Ruud; Brod and Thao introduced:

H. F. 984, A bill for an act relating to human services; authorizing medical assistance coverage of primary care health care providers performing primary caries prevention services as part of the child and teen checkup program; amending Minnesota Statutes 2008, section 256B.0625, subdivision 14.

The bill was read for the first time and referred to the Committee on Health Care and Human Services Policy and Oversight.
 

Liebling and Norton introduced:

H. F. 1027, A bill for an act relating to health care; repealing the prohibition of balance billing for Medicare-covered services; repealing Minnesota Statutes 2008, section 62J.25.

The bill was read for the first time and referred to the Committee on Health Care and Human Services Policy and Oversight.
 

Abeler; Gottwalt; Murphy, E., and Loeffler introduced:

H. F. 1076, A bill for an act relating to health; prohibiting billing for correcting adverse health care events; proposing coding for new law in Minnesota Statutes, chapter 62J.

The bill was read for the first time and referred to the Committee on Health Care and Human Services Policy and Oversight.
 

Murphy, E.; Anzelc and Slawik introduced:

H. F. 1077, A bill for an act relating to health occupation; licensing respiratory therapists; amending Minnesota Statutes 2008, sections 147C.01; 147C.05; 147C.10; 147C.15; 147C.20; 147C.25; 147C.30; 147C.35; 147C.40.

The bill was read for the first time and referred to the Committee on Health Care and Human Services Policy and Oversight.

Howes and Thao introduced:

H. F. 1084, A bill for an act relating to health occupations; requiring licensure for clinical perfusionist; establishing fees; requiring rulemaking; providing penalties; proposing coding for new law in Minnesota Statutes, chapter 147A.

The bill was read for the first time and referred to the Committee on Health Care and Human Services Policy and Oversight.
 

Senate Introductions

Senators Berglin and Pappas introduced--

S.F. No. 780: A bill for an act relating to health; establishing licensure for birthing centers; limiting reimbursement for uncomplicated births; designating licensed birthing centers as essential community providers; amending Minnesota Statutes 2008, section 62Q.19, subdivision 1; proposing coding for new law in Minnesota Statutes, chapters 144; 256B.

Referred to the Committee on Health, Housing and Family Security.
 

Senators Berglin, Marty, Torres Ray, Dahle and Koering introduced--

S.F. No. 815: A bill for an act relating to health; creating a medical supplies and equipment purchasing alliance; proposing coding for new law in Minnesota Statutes, chapter 16B.

Referred to the Committee on State and Local Government Operations and Oversight.
 

Senators Olson, M.; Betzold; Scheid and Moua introduced--

S.F. No. 857: A bill for an act relating to health; modifying provisions governing patient access to health records and costs; amending Minnesota Statutes 2008, sections 144.292, subdivisions 5, 6; 144.293, subdivisions 4, 6.

Referred to the Committee on Health, Housing and Family Security.
 

Senators Sheran, Marty, Doll, Dibble and Berglin introduced--

S.F. No. 895: A bill for an act relating to health; establishing an academic detailing program for prescription drugs; allowing rulemaking; appropriating money; proposing coding for new law in Minnesota Statutes, chapter 62U.

Referred to the Committee on Health, Housing and Family Security.
 

Senators Tomassoni, Day, Vandeveer and Sparks introduced--

S.F. No. 898: A bill for an act relating to health; creating an exception to the Clean Indoor Air Act; allowing employee smoking rooms under certain conditions; amending Minnesota Statutes 2008, section 144.4167, by adding a subdivision.

Referred to the Committee on Health, Housing and Family Security.
 

Senators Sheran and Erickson Ropes introduced--

S.F. No. 957: A bill for an act relating to health; expanding the definition of licensed health care professional; allowing use of physical agent modalities by occupational therapists under certain circumstances; amending Minnesota Statutes 2008, sections 148.6402, subdivision 13; 148.6440, subdivision 2.

Referred to the Committee on Health, Housing and Family Security.
 

Senators Lynch and Rosen introduced--

S.F. No. 962: A bill for an act relating to health care; repealing the prohibition of balance billing for Medicare-covered services; repealing Minnesota Statutes 2008, section 62J.25.

Referred to the Committee on Finance.
 

Senators Kubly, Marty, Berglin, Erickson Ropes and Fischbach introduced--

S.F. No. 999: A bill for an act relating to health occupations; establishing licensure for medical laboratory science professionals; creating the Board of Medical Laboratory Science; establishing fees; proposing coding for new law as Minnesota Statutes, chapter 148F.

Referred to the Committee on Health, Housing and Family Security.
 

- Dave Renner, MAFP Legislative Representative
(drenner@mnmed.org, 612-362-3750, 1-800-342-5662)