Legislative Update

March 16, 2009

MAFP President-Elect Testifies on Preventive Dental Bill
MAFP President-Elect Pat Fontaine, M.D., testified before the Senate Health and Family Security Committee on March 9 to raise major concerns with legislation to mandate that physicians provide preventive dental services as part of a child and teen checkup.  SF 633 (Berglin, Minneapolis) would require a preventive dental assessment and the application of a fluoride varnish for at-risk children on public programs.

There is a frustration among many family physicians that dentists in many parts of the state are not serving patients on public programs.  Fontaine told the committee that family physicians share the concern that low income children are not receiving necessary preventive dental care, but that the answer is not mandating that service on physicians. 

Many family medicine and pediatric clinics have voluntarily begun to offer these services and have had success with it.  However, many others do not believe they are trained to do dental work and are uncomfortable with the mandate. 

The bill passed out of the Health and Family Security Committee on a voice vote and is awaiting hearing in the Senate Finance Committee.  The House companion bill HF 984 (Norton, Rochester) is scheduled to be heard in the House Health and Human Services Policy Committee on Tuesday, March 17.  Dr. Fontaine will be meeting with the House author to see if there is a chance for compromise language this coming week.

Senate Democrats Release Budget Outline
The Senate Democratic Caucus released their outline for solving the budget shortfall on March 12.  Their proposal stresses the need for structural changes to balance the budget for the next four years, not just the two-year period the Governor recommended.  They recommend a 7 percent across the board cut to all state agencies, resulting in $5.1 billion in cuts over four years.  This budget includes nearly $1 billion in cuts to K-12 education, the largest part of the state’s budget.  The Governor recommended no cuts to education.

Their budget maintains the Health Care Access Fund as a dedicated fund for health care and helps preserve coverage for low-income Minnesotans.  They do recommend $719 million in cuts to the health and human services areas.

Their budget document also calls for $2 billion in new revenues without details on what kind of taxes.  When asked, Sen. Tom Baak, chair of the Senate Tax Committee, said he was leaning towards income tax increases, and not expanding the sales tax to clothing or services.

Governor Pawlenty will be releasing supplemental budget  recommendations within the next two weeks to incorporate the $1.8 billion of new federal stimulus money.

APN Bill Introduced
Legislation was introduced this past week to address changes recommended for advance practice nurses (APNs) as the result of the report from the Healthcare Work Force Shortage Task Force that met this past fall.  The legislation, drafted by the Minnesota Nurses Association, HF 1668 (Murphy, St. Paul) seems to go beyond what the task force recommended.

MAFP Past President Dave Thorson, MD, served on the task force representing the MAFP.  The task force recommended removing the requirement for APNs to have a written delegated prescribing protocol as long as the requirement for APNs to have a collaborative plan is strengthened.  The task force envisioned that the collaborative plan be written and articulate practice limitations, referral patterns, and APN and physician roles.

HF 1668 does not require a collaborative plan for all APNs and does not require that the physician have any say in what is included in the plan.

This bill is scheduled for hearing this coming week.

Independent Birthing Centers
Legislation to license independent birthing centers is scheduled for hearing in the Senate Health and Family Security Committee this week.   SF 780 (Berglin, Minneapolis) would license facilities that are not in a hospital, that have the primary purpose of performing low-risk deliveries.  They can be staffed by physicians, certified nurse midwives, or licensed traditional midwives.  They must have an emergency plan to transfer a patient within 30 minutes from the time of diagnosis of the emergency to an acute care hospital and have an obstetrician and pediatrician on-call at all times.

This is being proposed as a cost saving measure to allow mothers with “low-risk” pregnancies to utilize birthing centers.  This bill will be heard in the Senate health and Family Security Committee this week.

Booster Seat Legislation Passes Another Hurdle
Legislation to mandate that children under age 8 or shorter than 4 feet-9 inches use booster seats in vehicles passed the House Public Safety Finance Division on March 12.   HF 267 (Hortman, Brooklyn Park) would expand our current child restraint law beyond car seats for children up to age 4.  Children from 4 to 8 currently are required to wear seat belts, but not be in any type of booster seat.  Children this age are too small to for seat belts to fit safely.

The bill will next be heard in the House Finance Committee.

House Introductions

Ruud; Abeler; Hayden; Hosch; Murphy, E., and Fritz introduced:
H. F. 1211, A bill for an act relating to health; requiring coverage for interpreter services; establishing an interpreter services work group; requiring reports; proposing coding for new law in Minnesota Statutes, chapter 62Q.

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

Abeler and Atkins introduced:
H. F. 1232, A bill for an act relating to health; prohibiting certain factors for evaluating health care provider performance; adding a statement to health plan issued identification cards; amending Minnesota Statutes 2008, sections 62J.60, by adding a subdivision; 62Q.101.

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

Abeler; Loeffler; Norton; Murphy, E., and Peterson introduced:
H. F. 1234, A bill for an act relating to health; requiring medication therapy management services under certain conditions; proposing coding for new law in Minnesota Statutes, chapter 62Q.

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

Murphy, E.; Thao; Fritz; Brod; Otremba; Greiling; Hosch; Abeler; Loeffler and Hayden introduced:
H. F. 1249, 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.

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

Norton, Thissen, Gottwalt, Abeler, Huntley and Murphy, E. introduced:
H. F. 1308, A bill for an act relating to health; requiring uniform technology and data standards for local public health agencies; appropriating money from American Recovery and Reinvestment Act of 2009; amending Minnesota Statutes 2008, section 62J.495, subdivision 1.

The bill was read for the first time and referred to the Committee on Finance.

Thissen introduced:
H. F. 1322, A bill for an act relating to health information technology; creating certain requirements for the use of federal funding; requiring legislative approval of a plan; limiting the appropriation of federal funds.

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

Thissen, Gottwalt, Abeler and Kahn introduced:
H. F. 1341, A bill for an act relating to health; changing provisions in the newborn screening program; amending Minnesota Statutes 2008, sections 13.386, subdivision 3; 144.125, subdivision 3, by adding subdivisions.

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

Abeler and Thissen introduced:
H. F. 1346, A bill for an act relating to health; requiring the commissioners of health and human services to develop and implement certification standards for obstetric health care homes; requiring the commissioners to provide payments for the coordination of obstetric services; authorizing rulemaking; amending Minnesota Statutes 2008, sections 256B.0751, subdivisions 3, 7, by adding a subdivision; 256B.0752, subdivision 2; 256B.0753, subdivisions 1, 2.

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

Clark, Rukavina, Persell, Laine and Hayden introduced:
H. F. 1352, A bill for an act relating to health; modifying provisions of the cancer surveillance system; amending Minnesota Statutes 2008, sections 13.3806, subdivision 14; 144.671.

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

Dean introduced: 
H. F. 1363, A bill for an act relating to civil actions; regulating the liability of certain health care providers for providing emergency care and treatment; regulating affidavits of expert review in malpractice actions against health care providers; amending Minnesota Statutes 2008, sections 145.682, subdivisions 2, 3, 6; 604A.01, subdivision 2.

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

Murphy, E.; Thissen; Norton; Kelliher; Clark; Abeler; Ruud; Loeffler; Davnie; Wagenius; Hornstein; Brynaert; Champion; Knuth; Huntley; Hausman; Anzelc; Hayden and Laine introduced:
H. F. 1424, A bill for an act relating to public health; creating a public health improvement account; modifying provisions of the statewide health improvement program; establishing a program to provide funding for health impact assessments; appropriating money; amending Minnesota Statutes 2008, section 145.986, subdivisions 1, 5; proposing coding for new law in Minnesota Statutes, chapters 16A; 145.

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

Huntley introduced:
H. F. 1454, A bill for an act relating to health; requiring commissioner of health to develop a uniform formulary exception document; amending Minnesota Statutes 2008, section 62J.497, 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.

Huntley introduced:
H. F. 1564, A bill for an act relating to health care reform; increasing affordability and eligibility for state health care programs; establishing the Minnesota Health Insurance Exchange; continuing payment reform; creating an affordability standard; establishing goals for universal coverage and a contingent individual responsibility mandate; amending Minnesota Statutes 2008, sections 13.46, subdivision 2; 62E.141; 62L.12, subdivisions 2, 4; 62U.04, subdivisions 3, 8; 62U.05; 62U.07, by adding a subdivision; 62U.08, subdivision 2; 256.01, by adding a subdivision; 256B.056, subdivision 10; 256B.057, subdivision 8; 256L.03, subdivisions 3, 5; 256L.04, subdivisions 1, 7; 256L.05, by adding a subdivision; 256L.07, subdivisions 1, 3; 256L.15, by adding a subdivision; proposing coding for new law in Minnesota Statutes, chapter 62U.

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

Huntley introduced:
H. F. 1567, A bill for an act relating to health; making technical changes to electronic prescription drug program; amending Minnesota Statutes 2008, section 62J.497, subdivisions 1, 2.

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

Liebling, Loeffler, Ruud and Laine introduced:
H. F. 1640, 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.

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

Murphy, E.; Thao; Ruud and Abeler introduced:
H. F. 1668, A bill for an act relating to health occupations; modifying practice requirements for advanced practice registered nurses; amending Minnesota Statutes 2008, sections 148.171, subdivisions 5, 10, 11, 13, 21; 148.235, subdivisions 2a, 4a, 4b; 151.01, subdivisions 23, 27; 151.37, subdivision 2; repealing Minnesota Statutes 2008, sections 148.171, subdivision 6; 148.235, subdivisions 1, 2, 4, 6.

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 Doll, Scheid, Lourey, Sheran and Jungbauer introduced--
S.F. No. 1044: A bill for an act relating to health; requiring prescription information be kept confidential; proposing coding for new law in Minnesota Statutes, chapter 151.

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

Senator Prettner Solon introduced--
S.F. No. 1099: A bill for an act relating to health; requiring commissioner of health to develop a uniform formulary exception document; amending Minnesota Statutes 2008, section 62J.497, by adding a subdivision.

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

Senators Carlson, Berglin, Marty, Torres Ray and Moua introduced--
S.F. No. 1187: A bill for an act relating to health occupations; removing the number of attempts allowed to pass the medical licensing examination; amending Minnesota Statutes 2008, section 147.02, subdivision 1.

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

Senators Marty, Berglin and Doll introduced--
S.F. No. 1237: A bill for an act relating to health; preventing conflicts of interest; banning gifts from drug or medical device manufacturers or distributors to physicians and formulary committee members; amending Minnesota Statutes 2008, sections 151.461; 151.47, subdivision 1; 256B.0625, subdivision 13c; proposing coding for new law in Minnesota Statutes, chapter 62J.

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

Senators Prettner Solon, Marty and Doll introduced--
S.F. No. 1238: A bill for an act relating to health; enforcing Minnesota unfair price discrimination law for prescription drugs; requiring disclosure of all financial transactions related to prescription drug pricing; requiring certificate of authority for a pharmacy benefits manager; requiring rulemaking; providing civil penalties; amending Minnesota Statutes 2008, section 151.061, subdivision 2; proposing coding for new law as Minnesota Statutes, chapter 151A.

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

Senators Hann, Ingebrigtsen, Koch and Michel introduced--
S.F. No. 1280: A bill for an act relating to health; permitting Minnesota residents to buy health coverage approved in other states; creating a Physician’s Council on Health Care Policy to analyze health coverage mandates; providing a tax credit for persons without access to employer-based coverage; amending Minnesota Statutes 2008, sections 62A.02, by adding a subdivision; 290.06, by adding a subdivision; proposing coding for new law in Minnesota Statutes, chapter 62J.

Referred to the Committee on Commerce and Consumer Protection.

Senators Marty, Prettner Solon and Pappas introduced--
S.F. No. 1468: A bill for an act relating to health; regulating hospital policies on cesarean section under certain circumstances; proposing coding for new law in Minnesota Statutes, chapter 144.

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

Senator Berglin introduced--
S.F. No. 1473: A bill for an act relating to health care reform; increasing affordability and eligibility for state health care programs; establishing the Minnesota Health Insurance Exchange; continuing payment reform; creating an affordability standard; establishing goals for universal coverage and a contingent individual responsibility mandate; amending Minnesota Statutes 2008, sections 13.46, subdivision 2; 62E.141; 62L.12, subdivisions 2, 4; 62U.04, subdivisions 3, 8; 62U.05; 62U.07, by adding a subdivision; 62U.08, subdivision 2; 256.01, by adding a subdivision; 256B.056, subdivision 10; 256B.057, subdivision 8; 256L.03, subdivisions 3, 5; 256L.04, subdivisions 1, 7; 256L.05, by adding a subdivision; 256L.07, subdivisions 1, 3; 256L.15, by adding a subdivision; proposing coding for new law in Minnesota Statutes, chapter 62U.

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

Senators Scheid and Rosen introduced--
S.F. No. 1478: A bill for an act relating to health; changing provisions in the newborn screening program; amending Minnesota Statutes 2008, sections 13.386, subdivision 3; 144.125, subdivision 3, by adding subdivisions.

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

Senator Doll introduced--
S.F. No. 1479: A bill for an act relating to health; making technical changes to electronic prescription drug program; amending Minnesota Statutes 2008, section 62J.497, subdivisions 1, 2.

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

Senators Sheran, Berglin, Lourey, Marty and Erickson Ropes introduced--
S.F. No. 1532: A bill for an act relating to health occupations; modifying practice requirements for advanced practice registered nurses; amending Minnesota Statutes 2008, sections 148.171, subdivisions 5, 10, 11, 13, 21; 148.235, subdivisions 2a, 4a, 4b; 151.01, subdivisions 23, 27; 151.37, subdivision 2; repealing Minnesota Statutes 2008, sections 148.171, subdivision 6; 148.235, subdivisions 1, 2, 4, 6.
Referred to the Committee on Health, Housing and Family Security.

Senator Prettner Solon introduced--
S.F. No. 1533: A bill for an act relating to public health; requiring information on meningococcal disease, human papilloma virus, and other diseases and vaccines to be provided; proposing coding for new law in Minnesota Statutes, chapter 144.

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)