1.1    .................... moves to amend H. F. No. 297, the delete everything amendment
1.2(A07-0645), as follows:
1.3Page 57, delete section 3 and insert:

1.4    "Sec. 3. Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:
1.5    Subdivision 1. Definitions. For purposes of this section, the following definitions
1.6apply:
1.7    (a) "Accredited clinical training" means the clinical training provided by a
1.8medical education program that is accredited through an organization recognized by the
1.9Department of Education, the Centers for Medicare and Medicaid Services, or another
1.10national body who reviews the accrediting organizations for multiple disciplines and
1.11whose standards for recognizing accrediting organizations are reviewed and approved by
1.12the commissioner of health in consultation with the Medical Education and Research
1.13Advisory Committee.
1.14    (b) "Commissioner" means the commissioner of health.
1.15    (c) "Clinical medical education program" means the accredited clinical training of
1.16physicians (medical students and residents), doctor of pharmacy practitioners, doctors
1.17of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
1.18registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
1.19physician assistants.
1.20    (d) "Sponsoring institution" means a hospital, school, or consortium located in
1.21Minnesota that sponsors and maintains primary organizational and financial responsibility
1.22for a clinical medical education program in Minnesota and which is accountable to the
1.23accrediting body.
1.24    (e) "Teaching institution" means a hospital, medical center, clinic, or other
1.25organization that conducts a clinical medical education program in Minnesota.
1.26    (f) "Trainee" means a student or resident involved in a clinical medical education
1.27program.
2.1    (g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time
2.2equivalent counts, that are at training sites located in Minnesota with a currently
2.3active medical assistance provider number enrollment status and a National Provider
2.4Identification (NPI) number where training occurs in either an inpatient or ambulatory
2.5patient care setting and where the training is funded, in part, by patient care revenues.

2.6    Sec. 4. Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:
2.7    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute
2.890 percent of available medical education funds transferred according to section
2.9256B.69, subdivision 5c, paragraph (a), clause (1), to all qualifying applicants based on a
2.10distribution formula that reflects a summation of two factors:
2.11    (1) an education factor, which is determined by the total number of eligible trainee
2.12FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical
2.13medical education program; and
2.14    (2) a public program volume factor, which is determined by the total volume of
2.15public program revenue received by each training site as a percentage of all public
2.16program revenue received by all training sites in the fund pool.
2.17    In this formula, the education factor is weighted at 67 percent and the public program
2.18volume factor is weighted at 33 percent.
2.19    Public program revenue for the distribution formula includes revenue from medical
2.20assistance, prepaid medical assistance, general assistance medical care, and prepaid
2.21general assistance medical care. Training sites that receive no public program revenue
2.22are ineligible for funds available under this paragraph. Total statewide average costs per
2.23trainee for medical residents is based on audited clinical training costs per trainee in
2.24primary care clinical medical education programs for medical residents. Total statewide
2.25average costs per trainee for dental residents is based on audited clinical training costs
2.26per trainee in clinical medical education programs for dental students. Total statewide
2.27average costs per trainee for pharmacy residents is based on audited clinical training costs
2.28per trainee in clinical medical education programs for pharmacy students.
2.29    (b) The commissioner shall annually distribute ten percent of total available medical
2.30education funds transferred according to section 256B.69, subdivision 5c, paragraph (a),
2.31clause (1), to all qualifying applicants based on the percentage received by each applicant
2.32under paragraph (a). These funds are to be used to offset clinical education costs at
2.33eligible clinical training sites based on criteria developed by the clinical medical education
2.34program. Applicants may choose to distribute funds allocated under this paragraph based
2.35on the distribution formula described in paragraph (a).
3.1    (c) The commissioner shall annually distribute $5,000,000 of the funds dedicated
3.2to the commissioner under section 297F.10, subdivision 1, clause (2), plus any federal
3.3financial participation on these funds and on funds transferred under subdivision 10, to all
3.4qualifying applicants based on a distribution formula that gives 100 percent weight to a
3.5public program volume factor, which is determined by the total volume of public program
3.6revenue received by each training site as a percentage of all public program revenue
3.7received by all training sites in the fund pool. If federal approval is not obtained for
3.8federal financial participation on any portion of funds distributed under this paragraph,
3.990 percent of the unmatched funds shall be distributed by the commissioner based on
3.10the formula described in paragraph (a) and ten percent of the unmatched funds shall be
3.11distributed by the commissioner based on the formula described in paragraph (b).
3.12    (d) The commissioner shall annually distribute $3,060,000 of funds dedicated to the
3.13commissioner under section 297F.10, subdivision 1, clause (2), through a formula giving
3.14100 percent weight to an education factor, which is determined by the total number of
3.15eligible trainee full-time equivalents and the total statewide average costs per trainee, by
3.16type of trainee, in each clinical medical education program. If no matching funds are
3.17received on funds distributed under paragraph (c), funds distributed under this paragraph
3.18shall be distributed by the commissioner based on the formula described in paragraph (a).
3.19    (e) The commissioner shall annually distribute $340,000 of funds dedicated to the
3.20commissioner under section 297F.10, subdivision 1, clause (2), to all qualifying applicants
3.21based on the percentage received by each applicant under paragraph (a). These funds are
3.22to be used to offset clinical education costs at eligible clinical training sites based on
3.23criteria developed by the clinical medical education program. Applicants may choose to
3.24distribute funds allocated under this paragraph based on the distribution formula described
3.25in paragraph (a). If no matching funds are received on funds distributed under paragraph
3.26(c), funds distributed under this paragraph shall be distributed by the commissioner based
3.27on the formula described in paragraph (b).
3.28    (c) (f) Funds distributed shall not be used to displace current funding appropriations
3.29from federal or state sources.
3.30    (d) (g) Funds shall be distributed to the sponsoring institutions indicating the amount
3.31to be distributed to each of the sponsor's clinical medical education programs based on
3.32the criteria in this subdivision and in accordance with the commissioner's approval letter.
3.33Each clinical medical education program must distribute funds allocated under paragraph
3.34(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
3.35institutions, which are accredited through an organization recognized by the Department
3.36of Education or the Centers for Medicare and Medicaid Services, may contract directly
4.1with training sites to provide clinical training. To ensure the quality of clinical training,
4.2those accredited sponsoring institutions must:
4.3    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
4.4training conducted at sites; and
4.5    (2) take necessary action if the contract requirements are not met. Action may
4.6include the withholding of payments under this section or the removal of students from
4.7the site.
4.8    (e) (h) Any funds not distributed in accordance with the commissioner's approval
4.9letter must be returned to the medical education and research fund within 30 days of
4.10receiving notice from the commissioner. The commissioner shall distribute returned funds
4.11to the appropriate training sites in accordance with the commissioner's approval letter.
4.12    (f) (i) The commissioner shall distribute by June 30 of each year an amount equal to
4.13the funds transferred under subdivision 10, plus five percent interest to the University of
4.14Minnesota Board of Regents for the instructional costs of health professional programs
4.15at the Academic Health Center and for interdisciplinary academic initiatives within the
4.16Academic Health Center.
4.17    (g) (j) A maximum of $150,000 of the funds dedicated to the commissioner
4.18under section 297F.10, subdivision 1, paragraph (b), clause (2), may be used by the
4.19commissioner for administrative expenses associated with implementing this section.

4.20    Sec. 5. Minnesota Statutes 2006, section 62J.692, subdivision 7a, is amended to read:
4.21    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner
4.22shall award grants to teaching institutions and clinical training sites for projects that
4.23increase dental access for underserved populations and promote innovative clinical
4.24training of dental professionals.
4.25    (b) The commissioner shall award grants to teaching institutions and clinical training
4.26sites for projects that increase mental health access for underserved populations, promote
4.27innovative clinical training of mental health professionals, increase the number of mental
4.28health providers in rural or underserved areas, and promote the incorporation of patient
4.29safety principles into clinical medical education programs.
4.30    (c) In awarding the grants, the commissioner, in consultation with the commissioner
4.31of human services, shall consider the following:
4.32    (1) potential to successfully increase access to an underserved population;
4.33    (2) the long-term viability of the project to improve access beyond the period
4.34of initial funding;
4.35    (3) evidence of collaboration between the applicant and local communities;
4.36    (4) the efficiency in the use of the funding; and
5.1    (5) the priority level of the project in relation to state clinical education, access,
5.2patient safety, and workforce goals.; and
5.3    (6) the potential of the project to impact the number or distribution of the health
5.4care workforce.
5.5    (b) (d) The commissioner shall periodically evaluate the priorities in awarding the
5.6innovations grants in order to ensure that the priorities meet the changing workforce
5.7needs of the state.

5.8    Sec. 6. Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:
5.9    Subd. 8. Federal financial participation. (a) The commissioner of human
5.10services shall seek to maximize federal financial participation in payments for medical
5.11education and research costs. If the commissioner of human services determines that
5.12federal financial participation is available for the medical education and research, the
5.13commissioner of health shall transfer to the commissioner of human services the amount
5.14of state funds necessary to maximize the federal funds available. The amount transferred
5.15to the commissioner of human services, plus the amount of federal financial participation,
5.16shall be distributed to medical assistance providers in accordance with the distribution
5.17methodology described in subdivision 4.
5.18    (b) For the purposes of paragraph (a), the commissioner shall use physician clinic
5.19rates where possible to maximize federal financial participation.

5.20    Sec. 7. Minnesota Statutes 2006, section 62J.692, subdivision 10, is amended to read:
5.21    Subd. 10. Transfers from University of Minnesota. Of the funds dedicated to the
5.22Academic Health Center under section 297F.10, subdivision 1, clause (1), $4,850,000
5.23shall be transferred annually to the commissioner of health no later than April 15 of each
5.24year for distribution under subdivision 4, paragraph (f) (i)."
5.25Renumber the sections in sequence and correct the internal references
5.26Amend the title accordingly