Subd. 6.

Fees for variances.

The commissioner shall charge a nonrefundable application fee of deleted text begin $275deleted text end new text begin $325new text end to cover the deleted text begin administrativedeleted text end cost of processing a request for a variance or modification of rules adopted by the commissioner under this chapter.

Subdivision 1.

Well notification fee.

The well notification fee to be paid by a property owner is:

(1) for construction of a water supply well, deleted text begin $275deleted text end new text begin $325new text end , which includes the state core function fee;

(2) for a well sealing, deleted text begin $75deleted text end new text begin $125new text end for each well or temporary boring, which includes the state core function fee, except that: (i) a single notification and fee of deleted text begin $75deleted text end new text begin $125new text end is required for all temporary borings on a single property and sealed within 72 hours of start of construction; and (ii) temporary borings less than 25 feet in depth are exempt from the notification and fee requirements in this chapter;

(3) for construction of a dewatering well, deleted text begin $275deleted text end new text begin $330new text end , which includes the state core function fee, for each dewatering wellnew text begin ,new text end except a dewatering project comprising five or more dewatering wells shall be assessed a single fee of deleted text begin $1,375deleted text end new text begin $1,620new text end for the dewatering wells recorded on the notification; and

(4) for construction of an environmental well, deleted text begin $275deleted text end new text begin $330new text end , which includes the state core function fee, deleted text begin except that a single fee of $275 is required for all environmental wells recorded on the notification that are located on a single property, and except that no fee is required for construction of a temporary boringdeleted text end new text begin for each environmental well, except an environmental well site project comprising five or more environmental wells shall be assessed a single fee of $1,620 for the environmental wells recorded on the notificationnew text end .

Subd. 1a.

State core function fee.

The state core function fee to be collected by the state and delegated community health boards and used to support state core functions is:

(1) for a new well, deleted text begin $20deleted text end new text begin $40new text end ; and

(2) for a well sealing, deleted text begin $5deleted text end new text begin $15new text end .

Subd. 2.

Permit fee.

new text begin (a) new text end The permit fee to be paid by a property owner is:

(1) for a water supply well that is not in use under a maintenance permit, deleted text begin $175deleted text end new text begin $225new text end annually;

(2) for an environmental well that is unsealed under a maintenance permit, deleted text begin $175 annually exceptdeleted text end no fee is required for an environmental well owned by a federal agency, state agency, or local unit of government that is unsealed under a maintenance permit. "Local unit of government" means a statutory or home rule charter city, town, county, or soil and water conservation district, new text begin a new text end watershed district, an organization formed for the joint exercise of powers under section 471.59, a community health board, or other special purpose district or authority with local jurisdiction in water and related land resources management;

(3) for environmental wellsnew text begin on an environmental well sitenew text end that are unsealed under a maintenance permitdeleted text begin ,deleted text end new text begin :new text end

deleted text begin $175deleted text end new text begin (i) $225new text end annuallynew text begin for one to ten environmental wellsnew text end per site deleted text begin regardless of the number of environmental wells located on sitedeleted text end ;

new text begin (ii) $325 annually for 11 to 20 environmental wells per site; and new text end

new text begin (iii) $425 annually for 21 or more environmental wells per site; new text end

(4) for a groundwater thermal exchange device, in addition to the notification fee for water supply wells, deleted text begin $275deleted text end new text begin $350 for systems using 20 gallons per minute or less and $590 for systems using over 20 gallons per minutenew text end , which includes the state core function fee;

(5) for a bored geothermal heat exchanger with less than ten tons of heating/cooling capacity, deleted text begin $275deleted text end new text begin $350new text end ;

(6) for a bored geothermal heat exchanger with ten to 50 tons of heating/cooling capacity, deleted text begin $515deleted text end new text begin $590new text end ;

(7) for a bored geothermal heat exchanger with greater than 50 tons of heating/cooling capacity, deleted text begin $740deleted text end new text begin $815new text end ;

(8) for a dewatering well that is unsealed under a maintenance permit, deleted text begin $175deleted text end new text begin $330new text end annually for each dewatering well, except a dewatering project comprising deleted text begin more thandeleted text end fivenew text begin or morenew text end dewatering wells shall be issued a single permit for deleted text begin $875deleted text end new text begin $1,620new text end annually for dewatering wells recorded on the permit;

(9) for an elevator boring, deleted text begin $275deleted text end new text begin $325new text end for each boring; and

(10) for a submerged closed loop heat exchanger system, in addition to the notification fee for water supply wells, $3,250, which includes the state core function fee.

new text begin (b) For purposes of this subdivision, an environmental well site includes all of the environmental wells on a single property. A single property is considered one tax parcel or multiple contiguous parcels with the same owner. new text end

Subdivision 1.

Disclosure of wells to buyer.

(a) Before signing an agreement to sell or transfer real property, the seller must disclose in writing to the buyer information about the status and location of all known wells on the property, by delivering to the buyer either a statement by the seller that the seller does not know of any wells on the property, or a disclosure statement indicating the legal description and county, and a map drawn from available information showing the location of each well to the extent practicable. In the disclosure statement, the seller must indicate, for each well, whether the well is in use, not in use, or sealed.

(b) At the time of closing of the sale, the disclosure statement information, name and mailing address of the buyer, and the quartile, section, township, and range in which each well is located must be provided on a well disclosure certificate signed by the seller or a person authorized to act on behalf of the seller.

(c) A well disclosure certificate need not be provided if the seller does not know of any wells on the property and the deed or other instrument of conveyance contains the statement: "The Seller certifies that the Seller does not know of any wells on the described real property."

(d) If a deed is given pursuant to a contract for deed, the well disclosure certificate required by this subdivision shall be signed by the buyer or a person authorized to act on behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure certificate is not required if the following statement appears on the deed followed by the signature of the grantee or, if there is more than one grantee, the signature of at least one of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the described real property." The statement and signature of the grantee may be on the front or back of the deed or on an attached sheet and an acknowledgment of the statement by the grantee is not required for the deed to be recordable.

(e) This subdivision does not apply to the sale, exchange, or transfer of real property:

(1) that consists solely of a sale or transfer of severed mineral interests; or

(2) that consists of an individual condominium unit as described in chapters 515 and 515B.

(f) For an area owned in common under chapter 515 or 515B the association or other responsible person must report to the commissioner by July 1, 1992, the location and status of all wells in the common area. The association or other responsible person must notify the commissioner within 30 days of any change in the reported status of wells.

(g) If the seller fails to provide a required well disclosure certificate, the buyer, or a person authorized to act on behalf of the buyer, may sign a well disclosure certificate based on the information provided on the disclosure statement required by this section or based on other available information.

(h) A county recorder or registrar of titles may not record a deed or other instrument of conveyance dated after October 31, 1990, for which a certificate of value is required under section 272.115, or any deed or other instrument of conveyance dated after October 31, 1990, from a governmental body exempt from the payment of state deed tax, unless the deed or other instrument of conveyance contains the statement made in accordance with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all the information required by paragraph (b) or (d). The county recorder or registrar of titles must not accept a certificate unless it contains all the required information. The county recorder or registrar of titles shall note on each deed or other instrument of conveyance accompanied by a well disclosure certificate that the well disclosure certificate was received. The notation must include the statement "No wells on property" if the disclosure certificate states there are no wells on the property. The well disclosure certificate shall not be filed or recorded in the records maintained by the county recorder or registrar of titles. After noting "No wells on property" on the deed or other instrument of conveyance, the county recorder or registrar of titles shall destroy or return to the buyer the well disclosure certificate. The county recorder or registrar of titles shall collect from the buyer or the person seeking to record a deed or other instrument of conveyance, a fee of deleted text begin $50deleted text end new text begin $54new text end for receipt of a completed well disclosure certificate. By the tenth day of each month, the county recorder or registrar of titles shall transmit the well disclosure certificates to the commissioner of health. By the tenth day after the end of each calendar quarter, the county recorder or registrar of titles shall transmit to the commissioner of health deleted text begin $42.50deleted text end new text begin $46.50new text end of the fee for each well disclosure certificate received during the quarter. The commissioner shall maintain the well disclosure certificate for at least six years. The commissioner may store the certificate as an electronic image. A copy of that image shall be as valid as the original.

(i) No new well disclosure certificate is required under this subdivision if the buyer or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed or other instrument of conveyance that the status and number of wells on the property have not changed since the last previously filed well disclosure certificate. The following statement, if followed by the signature of the person making the statement, is sufficient to comply with the certification requirement of this paragraph: "I am familiar with the property described in this instrument and I certify that the status and number of wells on the described real property have not changed since the last previously filed well disclosure certificate." The certification and signature may be on the front or back of the deed or on an attached sheet and an acknowledgment of the statement is not required for the deed or other instrument of conveyance to be recordable.

(j) The commissioner in consultation with county recorders shall prescribe the form for a well disclosure certificate and provide well disclosure certificate forms to county recorders and registrars of titles and other interested persons.

(k) Failure to comply with a requirement of this subdivision does not impair:

(1) the validity of a deed or other instrument of conveyance as between the parties to the deed or instrument or as to any other person who otherwise would be bound by the deed or instrument; or

(2) the record, as notice, of any deed or other instrument of conveyance accepted for filing or recording contrary to the provisions of this subdivision.

Subd. 2.

Certification fee.

(a) The application fee for certification as a representative of a well contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not act on an application until the application fee is paid.

(b) The renewal fee for certification as a representative of a well contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not renew a certification until the renewal fee is paid.

(c) A certified representative must file an application and a renewal application fee to renew the certification by the date stated in the certification. The renewal application must include information that the certified representative has met continuing education requirements established by the commissioner by rule.

Subd. 6.

License fee.

The fee for a well contractor's license is deleted text begin $250deleted text end new text begin $300new text end .

Subd. 8.

Renewal.

(a) A licensee must file an application and a renewal application fee to renew the license by the date stated in the license.

(b) The renewal application fee for a well contractor's license is deleted text begin $250deleted text end new text begin $300new text end .

(c) The renewal application must include information that the certified representative of the applicant has met continuing education requirements established by the commissioner by rule.

(d) At the time of the renewal, the commissioner must have on file all properly completed well and boring construction reports, well and boring sealing reports, reports of elevator borings, water sample analysis reports, well and boring permits, and well notifications for work conducted by the licensee since the last license renewal.

Subd. 2.

Certification fee.

(a) The application fee for certification as a representative of a limited well/boring contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not act on an application until the application fee is paid.

(b) The renewal fee for certification as a representative of a limited well/boring contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not renew a certification until the renewal fee is paid.

(c) The fee for three or more limited well/boring contractor certifications is deleted text begin $225deleted text end new text begin $275new text end .

(d) A certified representative must file an application and a renewal application fee to renew the certification by the date stated in the certification. The renewal application must include information that the certified representative has met continuing education requirements established by the commissioner by rule.

Subd. 6.

License fee.

The fee for a limited well/boring contractor's license is deleted text begin $75deleted text end new text begin $100new text end . The fee for three or more limited well/boring contractor licenses is deleted text begin $225deleted text end new text begin $275new text end .

Subd. 8.

Renewal.

(a) A person must file an application and a renewal application fee to renew the limited well/boring contractor's license by the date stated in the license.

(b) The renewal application fee for a limited well/boring contractor's license is deleted text begin $75deleted text end new text begin $100new text end .

(c) The renewal application must include information that the certified representative of the applicant has met continuing education requirements established by the commissioner by rule.

(d) At the time of the renewal, the commissioner must have on file all properly completed well and boring construction reports, well and boring sealing reports, well and boring permits, water quality sample reports, and well notifications for work conducted by the licensee since the last license renewal.

Subd. 2.

Certification fee.

(a) The application fee for certification as a representative of an elevator boring contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not act on an application until the application fee is paid.

(b) The renewal fee for certification as a representative of an elevator boring contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not renew a certification until the renewal fee is paid.

(c) A certified representative must file an application and a renewal application fee to renew the certification by the date stated in the certification. The renewal application must include information that the certified representative has met continuing education requirements established by the commissioner by rule.

Subd. 6.

License fee.

The fee for an elevator boring contractor's license is deleted text begin $75deleted text end new text begin $100new text end .

Subd. 8.

Renewal.

(a) A person must file an application and a renewal application fee to renew the license by the date stated in the license.

(b) The renewal application fee for an elevator boring contractor's license is deleted text begin $75deleted text end new text begin $100new text end .

(c) The renewal application must include information that the certified representative of the applicant has met continuing education requirements established by the commissioner by rule.

(d) At the time of renewal, the commissioner must have on file all reports and permits for elevator boring work conducted by the licensee since the last license renewal.

Subd. 2b.

Issuance of license.

If a person employs a certified representative, submits the bond under subdivision 3, and pays the license fee of deleted text begin $75deleted text end new text begin $100new text end for an environmental well contractor license, the commissioner shall issue an environmental well contractor license to the applicant. The fee for an individual registration is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not act on an application until the application fee is paid.

Subd. 2c.

Certification fee.

(a) The application fee for certification as a representative of an environmental well contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not act on an application until the application fee is paid.

(b) The renewal fee for certification as a representative of an environmental well contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not renew a certification until the renewal fee is paid.

(c) A certified representative must file an application and a renewal application fee to renew the certification by the date stated in the certification. The renewal application must include information that the certified representative has met continuing education requirements established by the commissioner by rule.

Subd. 4.

License renewal.

(a) A person must file an application and a renewal application fee to renew the license by the date stated in the license.

(b) The renewal application fee for an environmental well contractor's license is deleted text begin $75deleted text end new text begin $100new text end .

(c) The renewal application must include information that the certified representative of the applicant has met continuing education requirements established by the commissioner by rule.

(d) At the time of the renewal, the commissioner must have on file all well and boring construction reports, well and boring sealing reports, well permits, and notifications for work conducted by the licensed person since the last license renewal.

Subdivision 1.

Drilling machine.

(a) A person may not use a drilling machine such as a cable tool, rotary tool, hollow rod tool, or auger for a drilling activity requiring a license under this chapter unless the drilling machine is registered with the commissioner.

(b) A person must apply for the registration on forms prescribed by the commissioner and submit a deleted text begin $75deleted text end new text begin $125new text end registration fee.

(c) A registration is valid for one year.

Subd. 2.

Hoist.

(a) A person may not use a machine such as a hoist for an activity requiring a license under this chapter to repair wells or borings, seal wells or borings, or install pumps unless the machine is registered with the commissioner.

(b) A person must apply for the registration on forms prescribed by the commissioner and submit a deleted text begin $75deleted text end new text begin $125new text end registration fee.

(c) A registration is valid for one year.

Subd. 2.

License required to make borings.

(a) Except as provided in paragraph (d), a person must not make an exploratory boring without an explorer's license. The fee for an explorer's license is deleted text begin $75deleted text end new text begin $100new text end . The explorer's license is valid until the date prescribed in the license by the commissioner.

(b) A person must file an application and renewal application fee to renew the explorer's license by the date stated in the license. The renewal application fee is deleted text begin $75deleted text end new text begin $100new text end .

(c) If the licensee submits an application fee after the required renewal date, the licensee:

(1) must include a late fee of $75; and

(2) may not conduct activities authorized by an explorer's license until the renewal application, renewal application fee, late fee, and sealing reports required in subdivision 9 are submitted.

(d) An explorer must designate a responsible individual to supervise and oversee the making of exploratory borings.

(1) Before an individual supervises or oversees an exploratory boring, the individual must file an application and application fee of deleted text begin $75deleted text end new text begin $100new text end to qualify as a certified responsible individual.

(2) The individual must take and pass an examination relating to construction, location, and sealing of exploratory borings. A professional engineer or geoscientist licensed under sections 326.02 to 326.15 or a professional geologist certified by the American Institute of Professional Geologists is not required to take the examination required in this subdivision, but must be certified as a responsible individual to supervise an exploratory boring.

(3) The individual must file an application and a renewal fee of deleted text begin $75deleted text end new text begin $100new text end to renew the responsible individual's certification by the date stated in the certification. If the certified responsible individual submits an application fee after the renewal date, the certified responsible individual must include a late fee of $75 and may not supervise or oversee exploratory borings until the renewal application, application fee, and late fee are submitted.

Subd. 4.

Notification and map of borings.

(a) By ten days before beginning exploratory boring, an explorer must submit to the commissioner of health a notification of the proposed boring map and a fee of deleted text begin $275deleted text end new text begin $325 for each boring constructednew text end .

(b) By ten days before beginning exploratory boring, an explorer must submit to the commissioners of health and natural resources a county road map on a single sheet of paper that is 8-1/2 by 11 inches in size and having a scale of one-half inch equal to one mile, as prepared by the Department of Transportation, or a 7.5 minute series topographic map (1:24,000 scale), as prepared by the United States Geological Survey, showing the location of each proposed exploratory boring to the nearest estimated 40 acre parcel. Exploratory boring that is proposed on the map may not be commenced later than 180 days after submission of the map, unless a new map is submitted.

Subd. 3.

Commissioner duties.

(a) The commissioner shall make available to health care practitioners, women who may become pregnant, expectant parents, and parents of infants up-to-date and evidence-based information about congenital CMV that has been reviewed by experts with knowledge of the disease. The information shall include the following:

(1) the recommendation to consider testing for congenital CMV if the parent or legal guardian of the infant elected not to have newborn screening performed under section 144.125, the infant failed a newborn hearing screening, or pregnancy history suggests increased risk for congenital CMV infection;

(2) the incidence of CMV;

(3) the transmission of CMV to pregnant women and women who may become pregnant;

(4) birth defects caused by congenital CMV;

(5) available preventative measures to avoid the infection of women who are pregnant or may become pregnant; and

(6) resources available for families of children born with congenital CMV.

(b) The commissioner shall follow existing department practice, inclusive of community engagement, to ensure that the information in paragraph (a) is culturally and linguistically appropriate for all recipients.

(c) The commissioner shall establish an outreach program to:

(1) educate women who may become pregnant, expectant parents, and parents of infants about CMV; and

(2) raise awareness for CMV among health care practitioners.

(d) The Advisory Committee on Heritable and Congenital Disorders established under section 144.1255 shall review congenital CMV for inclusion on the list of tests to be performed under section 144.125. If the committee recommends and the commissioner approves the recommendation of adding congenital CMV to the newborn screening panel, the commissioner shall publish the addition in the State Register and the per specimen fee for screening under section 144.125, subdivision 1, paragraph (c), shall be increased by $43deleted text begin , for a total of $220 per specimen,deleted text end effective upon publication in the State Register.

Subd. 3.

Eligible grantees.

new text begin (a) new text end Organizations eligible to receive grant funding under this section are Minnesota's Tribal Nationsnew text begin in accordance with paragraph (b)new text end and urban American Indian community-based organizationsnew text begin in accordance with paragraph (c)new text end .

new text begin (b) Minnesota's Tribal Nations may choose to receive funding under this section according to a noncompetitive funding formula specified by the commissioner. new text end

new text begin (c) Urban American Indian community-based organizations are eligible to apply for funding under this section by submitting a proposal for consideration by the commissioner. new text end

Subd. 2.

Initial and annual fee.

(a) A licensee must pay an initial fee that is equivalent to the annual fee upon issuance of the initial license.

(b) A licensee must pay an annual fee at least 60 days before the anniversary date of the issuance of the license. The annual fee is as follows:

Subd. 4.

Initial and renewal application fee.

A licensee must pay an initial and a renewal application fee according to this subdivision.

Subd. 8.

Reciprocity fee.

A licensee submitting an application for reciprocal recognition of a materials license issued by another agreement state or the United States Nuclear Regulatory Commission for a period of 180 days or less during a calendar year must pay deleted text begin $2,400deleted text end new text begin $3,200new text end . For a period of 181 days or more, the licensee must obtain a license under subdivision 4.

Subd. 9.

Fees for license amendments.

A licensee must pay a fee of deleted text begin $600deleted text end new text begin $800new text end to amend a license as follows:

(1) to amend a license requiring review including, but not limited to, addition of isotopes, procedure changes, new authorized users, or a new radiation safety officer; or

(2) to amend a license requiring review and a site visit including, but not limited to, facility move or addition of processes.

Subd. 10.

Fees for general license registrations.

A person required to register generally licensed devices according to Minnesota Rules, part 4731.3215, must pay an annual registration fee of deleted text begin $450deleted text end new text begin $600new text end .

Subd. 1a.

Fees for ionizing radiation-producing equipment.

(a) A facility with ionizing radiation-producing equipment and other sources of ionizing radiation must pay an initial or annual renewal registration fee consisting of a base facility fee of deleted text begin $100deleted text end new text begin $155new text end and an additional fee for each x-ray tube, as follows:

deleted text begin (b) A facility with radiation therapy and accelerator equipment must pay an initial or annual registration fee of $500. A facility with an industrial accelerator must pay an initial or annual registration fee of $150. deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end Electron microscopy equipment is exempt from the registration fee requirements of this section.

deleted text begin (d)deleted text end new text begin (c)new text end For purposes of this section, a security screening system means ionizing radiation-producing equipment designed and used for security screening of humans who are in the custody of a correctional or detention facility, and used by the facility to image and identify contraband items concealed within or on all sides of a human body. For purposes of this section, a correctional or detention facility is a facility licensed under section 241.021 and operated by a state agency or political subdivision charged with detection, enforcement, or incarceration in respect to state criminal and traffic laws.new text begin The commissioner shall adopt rules to establish requirements for the use of security screening systems. Notwithstanding section 14.125, the authority to adopt these rules does not expire.new text end

Subd. 2.

Inspections.

Periodic radiation safety inspections of the x-ray equipment and other sources of ionizing radiation shall be made by the commissioner of health. The frequency of safety inspections shall be prescribed by the commissioner deleted text begin on the basis ofdeleted text end new text begin based onnew text end the deleted text begin frequency ofdeleted text end new text begin radiation exposure risk to occupational and public health fromnew text end use of deleted text begin thedeleted text end x-ray equipment and other source of ionizing radiationdeleted text begin , provided that each source shall be inspected at least once every four yearsdeleted text end .

Subd. 5.

Examination for individual operating x-ray systems.

(a) An individual in a facility with x-ray systems for use on living humans that is registered under subdivision 1 may not operate, nor may the facility allow the individual to operate, x-ray systems unless the individual has passed a national or state examination.

(b) Individuals who may operate x-ray systems include:

(1) an individual who has passed the American Registry of Radiologic Technologists (ARRT) registry for radiography examination;

(2) an individual who has passed the American Chiropractic Registry of Radiologic Technologists (ACRRT) registry examination and is limited to radiography of spines and extremities;

(3) a registered limited scope x-ray operator and a registered bone densitometry equipment operator who passed the examination requirements in paragraphs (d) and (e) and practices according to subdivision 5a;

(4) an x-ray operator who has the original certificate or the original letter of passing the examination that was required before January 1, 2008, under Minnesota Statutes 2008, section 144.121, subdivision 5a, paragraph (b), clause (1);

(5) an individual who has passed the American Registry of Radiologic Technologists (ARRT) registry for radiation therapy examination according to subdivision 5e;

(6) a cardiovascular technologist according to subdivision 5c;

(7) a nuclear medicine technologist according to subdivision 5d;

(8) an individual who has passed the examination for a dental hygienist under section 150A.06 and only operates dental x-ray systems;

(9) an individual who has passed the examination for a dental therapist under section 150A.06 and only operates dental x-ray systems;

(10) an individual who has passed the examination for a dental assistant under section 150A.06 and only operates dental x-ray systems;

(11) an individual who has passed the examination under Minnesota Rules, part deleted text begin 3100.8500, subpart 3deleted text end new text begin 3100.1320new text end , and only operates dental x-ray systems; and

(12) a qualified practitioner who is licensed by a health-related licensing board with active practice authority and is working within the practitioner's scope of practice.

(c) Except for individuals under clauses (3) and (4), an individual who is participating in a training or educational program in any of the occupations listed in paragraph (b) is exempt from the examination requirement within the scope and for the duration of the training or educational program.

(d) The Minnesota examination for limited scope x-ray operators must include:

(1) radiation protection, radiation physics and radiobiology, equipment operation and quality assurance, image acquisition and technical evaluation, and patient interactions and management; and

(2) at least one of the following regions of the human anatomy: chest, extremities, skull and sinus, spine, or podiatry. The examinations must include the anatomy of, and radiographic positions and projections for, the specific regions.

(e) The examination for bone densitometry equipment operators must include:

(1) osteoporosis, bone physiology, bone health and patient education, patient preparation, fundamental principals, biological effects of radiation, units of measurements, radiation protection in bone densitometry, fundamentals of x-ray production, quality control, measuring bone mineral testing, determining quality in bone mineral testing, file and database management; and

(2) dual x-ray absorptiometry scanning of the lumbar spine, proximal femur, and forearm. The examination must include the anatomy, scan acquisition, and scan analysis for these three procedures.

(f) A limited scope x-ray operator, and a bone densitometry equipment operator, who are required to take an examination under this subdivision must submit to the commissioner a registration application for the examination and a $25 processing fee. The processing fee shall be deposited in the state treasury and credited to the state government special revenue fund.

Subd. 1a.

Fees.

All plans and specifications for public pool and spa construction, installation, or alteration or requests for a variance that are submitted to the commissioner according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate fees. All public pool construction plans submitted for review after January 1, 2009, must be certified by a professional engineer registered in the state of Minnesota. If the commissioner determines, upon review of the plans, that inadequate fees were paid, the necessary additional fees shall be paid before plan approval. For purposes of determining fees, a project is defined as a proposal to construct or install a public pool, spa, special purpose pool, or wading pool and all associated water treatment equipment and drains, gutters, decks, water recreation features, spray pads, and those design and safety features that are within five feet of any pool or spa.new text begin Plans submitted less than 30 days prior to construction are subject to an additional late fee equal to 50 percent of the original plan review fee.new text end The commissioner shall charge the following fees for plan review and inspection of public pools and spas and for requests for variance from the public pool and spa rules:

(1) each pool, deleted text begin $1,500deleted text end new text begin $1,600new text end ;

(2) each spa pool, deleted text begin $800deleted text end new text begin $900new text end ;

(3) each slide, deleted text begin $600deleted text end new text begin $650new text end ;

(4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses (1), (2), and (3) or 0.5 percent of the documented estimated project cost to a maximum fee of $15,000;

(5) alterations to an existing pool without changing the size or configuration of the pool, deleted text begin $600deleted text end new text begin $700new text end ;

(6) removal or replacement of pool disinfection equipment only, deleted text begin $100deleted text end new text begin $200new text end ; and

(7) request for variance from the public pool and spa rules, deleted text begin $500deleted text end new text begin $550new text end .

Subd. 2d.

deleted text begin Hot tubsdeleted text end new text begin Spa poolsnew text end on rental deleted text begin houseboatsdeleted text end new text begin propertynew text end .

new text begin (a) For the purposes of this subdivision, "spa pool" has the meaning given in Minnesota Rules, part 4717.0250, subpart 9. new text end

deleted text begin (a)deleted text end new text begin (b) Except as provided in paragraph (c), new text end a deleted text begin hot waterdeleted text end new text begin spanew text end pool intended for seated recreational use, including a hot tub or whirlpool, that is located on deleted text begin a houseboat that is rented to the publicdeleted text end new text begin the property of a stand-alone, single-unit rental property, offered for rent by the property owner or through a resort, and that is only intended to be used by the occupants of the rental property:new text end

new text begin (1)new text end is not a public pool deleted text begin anddeleted text end new text begin ;new text end

new text begin (2)new text end is exempt from the requirements for public pools under new text begin subdivisions 1 to 2c, 4, and 5 and new text end Minnesota Rules, chapter 4717deleted text begin .deleted text end new text begin , except as otherwise provided in this paragraph; andnew text end

new text begin (3) may be used by renters so long as: new text end

new text begin (i) the water temperature in the spa pool does not exceed 106 degrees Fahrenheit; and new text end

new text begin (ii) prior to check-in by each new rental party, the resort or property owner tests the water in the spa pool for the concentration of chlorine or bromine, pH, and alkalinity, and the water in the spa pool meets the requirements for disinfection residual, pH, and alkalinity in Minnesota Rules, part 4717.1750, subparts 4, 5, and 6. new text end

deleted text begin (b) deleted text end new text begin (c) A spa pool intended for seated recreational use, including a hot tub or whirlpool, that is located on a houseboat that is rented to the public: new text end

new text begin (1) is not a public pool; new text end

new text begin (2) is exempt from the requirements for public pools under subdivisions 1 to 2c, 4, and 5 and Minnesota Rules, chapter 4717; and new text end

new text begin (3) is exempt from the requirements under paragraph (b), clause (3). new text end

new text begin (d) A political subdivision must not adopt a local law, rule, or ordinance that prohibits the operation of, or establishes additional requirements for, a spa pool that meets the criteria in paragraph (b) or (c). new text end

new text begin (e)new text end A deleted text begin hot waterdeleted text end new text begin spanew text end pool under this subdivision must be conspicuously posted with the following noticenew text begin and must be providednew text end to rentersnew text begin upon check innew text end :

"NOTICE

This spa is exempt from state and local new text begin anti-entrapment and new text end sanitary requirements that prevent deleted text begin disease transmissiondeleted text end new text begin waterborne diseases such as Legionnaires' disease, Pseudomonas folliculitis (hot tub rash), and chemical burns and is not subject to inspectionnew text end .

USE AT YOUR OWN RISK

This notice is required under Minnesota Statutes, section 144.1222, subdivision 2d."

Subdivision 1.

Duty to perform testing.

(a) It is the duty of (1) the administrative officer or other person in charge of each institution caring for infants 28 days or less of age, (2) the person required in pursuance of the provisions of section 144.215, to register the birth of a child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have administered to every infant or child in its care tests for heritable and congenital disorders according to subdivision 2 and rules prescribed by the state commissioner of health.

(b) Testing, recording of test results, reporting of test results, and follow-up of infants with heritable congenital disorders, including hearing loss detected through the early hearing detection and intervention program in section 144.966, shall be performed at the times and in the manner prescribed by the commissioner of health.

(c) The fee to support the newborn screening program, including tests administered under this section and section 144.966, shall be deleted text begin $177deleted text end new text begin $184new text end per specimen. This fee amount shall be deposited in the state treasury and credited to the state government special revenue fund.

(d) The fee to offset the cost of the support services provided under section 144.966, subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury and credited to the general fund.

Subdivision 1.

Fee setting.

The commissioner of health may assess an annual fee of deleted text begin $9.72deleted text end new text begin $15.22new text end for every service connection to a public water supply that is owned or operated by a home rule charter city, a statutory city, a city of the first class, or a town. The commissioner of health may also assess an annual fee for every service connection served by a water user district defined in section 110A.02.

Subd. 1a.

License fee.

The annual license fee for outpatient surgical centers is deleted text begin $1,512deleted text end new text begin $1,966new text end .

Subd. 2.

Eligibility for license condition.

(a) A hospital is not eligible to receive a license condition for swing beds unless (1) it either has a licensed bed capacity of less than 50 beds defined in the federal Medicare regulations, Code of Federal Regulations, title 42, section 482.66, or it has a licensed bed capacity of 50 beds or more and has swing beds that were approved for Medicare reimbursement before May 1, 1985, or it has a licensed bed capacity of less than 65 beds and the available nursing homes within 50 miles have had, in the aggregate, an average occupancy rate of 96 percent or higher in the most recent two years as documented on the statistical reports to the Department of Health; and (2) it is located in a rural area as defined in the federal Medicare regulations, Code of Federal Regulations, title 42, section 482.66.

(b) Except for those critical access hospitals established under section 144.1483, clause (9), and section 1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that have an attached nursing home or that owned a nursing home located in the same municipality as of May 1, 2005, eligible hospitals are allowed a total number of days of swing bed use per year as provided in paragraph (c). Critical access hospitals that have an attached nursing home or that owned a nursing home located in the same municipality as of May 1, 2005, are allowed swing bed use as provided in federal law.new text begin A critical access hospital described in section 144.5621 is allowed an unlimited number of days of swing bed use per year.new text end

(c) An eligible hospital is allowed a total of 3,000 days of swing bed use in calendar year 2020. Beginning in calendar year 2021, and for each subsequent calendar year until calendar year 2027, the total number of days of swing bed use per year is increased by 200 swing bed use days. Beginning in calendar year 2028, an eligible hospital is allowed a total of 4,500 days of swing bed use per year.

(d) Days of swing bed use for medical care that an eligible hospital has determined are charity care shall not count toward the applicable limit in paragraph (b) or (c). For purposes of this paragraph, "charity care" means care that an eligible hospital provided for free or at a discount to persons who cannot afford to pay and for which the eligible hospital did not expect payment.

(e) Days of swing bed use for care of a person who has been denied admission to every Medicare-certified skilled nursing facility within 25 miles of the eligible hospital shall not count toward the applicable limit in paragraphs (b) and (c). Eligible hospitals must maintain documentation that they have contacted each skilled nursing facility within 25 miles to determine if any skilled nursing facility beds are available and if the skilled nursing facilities are willing to admit the patient. Skilled nursing facilities that are contacted must admit the patient or deny admission within 24 hours of being contacted by the eligible hospital. Failure to respond within 24 hours is deemed a denial of admission.

deleted text begin (f) Except for critical access hospitals that have an attached nursing home or that owned a nursing home located in the same municipality as of May 1, 2005, the commissioner of health may approve swing bed use beyond 2,000 days as long as there are no Medicare certified skilled nursing facility beds available within 25 miles of that hospital that are willing to admit the patient and the patient agrees to the referral being sent to the skilled nursing facility. Critical access hospitals exceeding 2,000 swing bed days must maintain documentation that they have contacted skilled nursing facilities within 25 miles to determine if any skilled nursing facility beds are available that are willing to admit the patient and the patient agrees to the referral being sent to the skilled nursing facility. This paragraph expires January 1, 2020. deleted text end

deleted text begin (g) After reaching 2,000 days of swing bed use in a year, an eligible hospital to which this limit applies may admit six additional patients to swing beds each year without seeking approval from the commissioner or being in violation of this subdivision. These six swing bed admissions are exempt from the limit of 2,000 annual swing bed days for hospitals subject to this limit. This paragraph expires January 1, 2020. deleted text end

deleted text begin (h) A health care system that is in full compliance with this subdivision may allocate its total limit of swing bed days among the hospitals within the system, provided that no hospital in the system without an attached nursing home may exceed 2,000 swing bed days per year. This paragraph expires January 1, 2020. deleted text end

Subd. 3.

Approval of license condition.

(a) The commissioner of health shall approve a license condition for swing beds if the hospital meets all of the criteria of this subdivision.

(b) The hospital must meet the eligibility criteria in subdivision 2.

(c) The hospital must be in compliance with the Medicare conditions of participation for swing beds under Code of Federal Regulations, title 42, section 482.66.

(d)new text begin Except as provided in section 144.5621,new text end the hospital must agree, in writing, to limit the length of stay of a patient receiving services in a swing bed to not more than 40 days, or the duration of Medicare eligibility, unless the commissioner of health approves a greater length of stay in an emergency situation. To determine whether an emergency situation exists, the commissioner shall require the hospital to provide documentation that continued services in the swing bed are required by the patient; that no skilled nursing facility beds are available within 25 miles from the patient's home, or in some more remote facility of the resident's choice, that can provide the appropriate level of services required by the patient; and that other alternative services are not available to meet the needs of the patient. If the commissioner approves a greater length of stay, the hospital shall develop a plan providing for the discharge of the patient upon the availability of a nursing home bed or other services that meet the needs of the patient. Permission to extend a patient's length of stay must be requested by the hospital at least ten days prior to the end of the maximum length of stay.

(e)new text begin Except as provided in section 144.5621,new text end the hospital must agree, in writing, to limit admission to a swing bed only to (1) patients who have been hospitalized and not yet discharged from the facility, or (2) patients who are transferred directly from an acute care hospital.

(f) The hospital must agree, in writing, to report to the commissioner of health by December 1, 1985, and annually thereafter, in a manner required by the commissioner (1) the number of patients readmitted to a swing bed within 60 days of a patient's discharge from the facility, (2) the hospital's charges for care in a swing bed during the reporting period with a description of the care provided for the rate charged, and (3) the number of beds used by the hospital for transitional care and similar subacute inpatient care.

(g) The hospital must agree, in writing, to report statistical data on the utilization of the swing beds on forms supplied by the commissioner. The data must include the number of swing beds, the number of admissions to and discharges from swing beds, Medicare reimbursed patient days, total patient days, and other information required by the commissioner to assess the utilization of swing beds.

Subd. 2.

Council administration.

(a) The council must meet at least twice a year but may meet more frequently at the call of the chair, a majority of the council members, or the commissioner.

(b) The terms, compensation, and removal of members of the council are governed by section 15.059. The council expires June 30, deleted text begin 2025deleted text end new text begin 2035new text end .

(c) The council may appoint subcommittees and work groups. Subcommittees shall consist of council members. Work groups may include noncouncil members. Noncouncil members shall be compensated for work group activities under section 15.059, subdivision 3, but shall receive expenses only.

Subd. 8.

Fees.

(a) The biennial license fee for a birth center is deleted text begin $365deleted text end new text begin $438new text end .

(b) The temporary license fee is deleted text begin $365deleted text end new text begin $438new text end .

(c) Fees shall be collected and deposited according to section 144.122.

Subd. 9.

Follow-up surveys.

For providers that have Level 3 deleted text begin ordeleted text end new text begin ,new text end Level 4new text begin , or Level 5new text end violations under subdivision 11, the department shall conduct a follow-up survey within 90 calendar days of the survey. When conducting a follow-up survey, the surveyor will focus on whether the previous violations have been corrected and may also address any new violations that are observed while evaluating the corrections that have been made.

Subd. 11.

Fines.

(a) Fines and enforcement actions under this subdivision may be assessed based on the level and scope of the violations described in paragraph (b) and imposed immediately with no opportunity to correct the violation first as follows:

(1) Level 1, no fines or enforcement;

(2) Level 2, a fine of $500 per violation, in addition to any of the enforcement mechanisms authorized in section 144A.475 deleted text begin for widespread violationsdeleted text end ;

(3) Level 3, a fine of deleted text begin $3,000deleted text end new text begin $1,000new text end per incident, in addition to any of the enforcement mechanisms authorized in section 144A.475;

(4) Level 4, a fine of deleted text begin $5,000deleted text end new text begin $3,000new text end per incident, in addition to any of the enforcement mechanisms authorized in section 144A.475;

new text begin (5) Level 5, a fine of $5,000 per violation, in addition to any enforcement mechanism authorized in section 144A.475; and new text end

deleted text begin (5)deleted text end new text begin (6)new text end for maltreatment violations for which the licensee was determined to be responsible for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000. A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible for maltreatment consisting of sexual assault, death, or abuse resulting in serious injurydeleted text begin ; anddeleted text end new text begin .new text end

deleted text begin (6)deleted text end The fines in clauses (1) to deleted text begin (4)deleted text end new text begin (5)new text end are increased and immediate fine imposition is authorized for both surveys and investigations conducted.

When a fine is assessed against a facility for substantiated maltreatment, the commissioner shall not also impose an immediate fine under this chapter for the same circumstance.

(b) Correction orders for violations are categorized by both level and scope and fines shall be assessed as follows:

(1) level of violation:

(i) Level 1 is a violation that deleted text begin has no potential to cause more than adeleted text end new text begin will cause onlynew text end minimal impact on the client and does not affect health or safety;

(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential to have harmed a client's health or safety, but was not likely to cause serious injury, impairment, or death;

(iii) Level 3 is a violation that harmed a client's health or safety, deleted text begin not including serious injury, impairment, or death, or a violation that has the potential to lead to serious injury, impairment, or deathdeleted text end new text begin or a violation that had the potential to cause more than minimal harm to the clientnew text end ; deleted text begin anddeleted text end

(iv) Level 4 is a violation that deleted text begin results in serious injury, impairment, or deathdeleted text end new text begin harmed a client's health or safety, not including serious injury or death, or a violation that was likely to lead to serious injury or deathnew text end ;new text begin andnew text end

new text begin (v) Level 5 is a violation that results in serious injury or death; and new text end

(2) scope of violation:

(i) isolated, when one or a limited number of clients are affected or one or a limited number of staff are involved or the situation has occurred only occasionally;

(ii) pattern, when more than a limited number of clients are affected, more than a limited number of staff are involved, or the situation has occurred repeatedly but is not found to be pervasive; and

(iii) widespread, when problems are pervasive or represent a systemic failure that has affected or has the potential to affect a large portion or all of the clients.

(c) If the commissioner finds that the applicant or a home care provider has not corrected violations by the date specified in the correction order or conditional license resulting from a survey or complaint investigation, the commissioner shall provide a notice of noncompliance with a correction order by email to the applicant's or provider's last known email address. The noncompliance notice must list the violations not corrected.

(d) For every violation identified by the commissioner, the commissioner shall issue an immediate fine pursuant to paragraph (a)deleted text begin , clause (6)deleted text end . The license holder must still correct the violation in the time specified. The issuance of an immediate fine can occur in addition to any enforcement mechanism authorized under section 144A.475. The immediate fine may be appealed as allowed under this subdivision.

(e) The license holder must pay the fines assessed on or before the payment date specified. If the license holder fails to fully comply with the order, the commissioner may issue a second fine or suspend the license until the license holder complies by paying the fine. A timely appeal shall stay payment of the fine until the commissioner issues a final order.

(f) A license holder shall promptly notify the commissioner in writing when a violation specified in the order is corrected. If upon reinspection the commissioner determines that a violation has not been corrected as indicated by the order, the commissioner may issue a second fine. The commissioner shall notify the license holder by mail to the last known address in the licensing record that a second fine has been assessed. The license holder may appeal the second fine as provided under this subdivision.

(g) A home care provider that has been assessed a fine under this subdivision has a right to a reconsideration or a hearing under this section and chapter 14.

(h) When a fine has been assessed, the license holder may not avoid payment by closing, selling, or otherwise transferring the licensed program to a third party. In such an event, the license holder shall be liable for payment of the fine.

(i) In addition to any fine imposed under this section, the commissioner may assess a penalty amount based on costs related to an investigation that results in a final order assessing a fine or other enforcement action authorized by this chapter.

(j) Fines collected under paragraph (a)deleted text begin , clauses (1) to (4),deleted text end shall be deposited in a dedicated special revenue account. On an annual basis, the balance in the special revenue account shall be appropriated to the commissioner to implement the recommendations of the advisory council established in section 144A.4799.

deleted text begin (k) Fines collected under paragraph (a), clause (5), shall be deposited in a dedicated special revenue account and appropriated to the commissioner to provide compensation according to subdivision 14 to clients subject to maltreatment. A client may choose to receive compensation from this fund, not to exceed $5,000 for each substantiated finding of maltreatment, or take civil action. This paragraph expires July 31, 2021. deleted text end

Subd. 3.

Notice.

(a) Prior to any suspension, revocation, or refusal to renew a license, the home care provider shall be entitled to notice and a hearing as provided by sections 14.57 to 14.69. In addition to any other remedy provided by law, the commissioner may, without a prior contested case hearing, temporarily suspend a license or prohibit delivery of services by a provider for not more than 90 days, or issue a conditional license if the commissioner determines that there are level deleted text begin 3deleted text end new text begin 4new text end violations that do not pose an imminent risk of harm to the health or safety of persons in the provider's care, provided:

(1) advance notice is given to the home care provider;

(2) after notice, the home care provider fails to correct the problem;

(3) the commissioner has reason to believe that other administrative remedies are not likely to be effective; and

(4) there is an opportunity for a contested case hearing within the 30 days unless there is an extension granted by an administrative law judge pursuant to subdivision 3b.

(b) If the commissioner determines there are:

(1) level deleted text begin 4deleted text end new text begin 5new text end violations; or

(2) violations that pose an imminent risk of harm to the health or safety of persons in the provider's care,

the commissioner may immediately temporarily suspend a license, prohibit delivery of services by a provider, or issue a conditional license without meeting the requirements of paragraph (a), clauses (1) to (4).

For the purposes of this subdivision, "level deleted text begin 3deleted text end new text begin 4new text end " and "level deleted text begin 4deleted text end new text begin 5new text end " have the meanings given in section 144A.474, subdivision 11, paragraph (b).

Subd. 3a.

Hearing.

Within 15 business days of receipt of the licensee's timely appeal of a sanction under this section, other than for a temporary suspension, the commissioner shall request assignment of an administrative law judge. The commissioner's request must include a proposed date, time, and place of hearing. A hearing must be conducted by an administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within 90 calendar days of the request for assignment, unless an extension is requested by either party and granted by the administrative law judge for good cause or for purposes of discussing settlement. In no case shall one or more extensions be granted for a total of more than 90 calendar days unless there is a criminal action pending against the licensee. If, while a licensee continues to operate pending an appeal of an order for revocation, suspension, or refusal to renew a license, the commissioner identifies one or more new violations of law that meet the requirements of level deleted text begin 3deleted text end new text begin 4new text end or deleted text begin 4deleted text end new text begin 5new text end violations as defined in section 144A.474, subdivision 11, paragraph (b), the commissioner shall act immediately to temporarily suspend the license under the provisions in subdivision 3.

Subd. 3b.

Expedited hearing.

(a) Within five business days of receipt of the license holder's timely appeal of a temporary suspension or issuance of a conditional license, the commissioner shall request assignment of an administrative law judge. The request must include a proposed date, time, and place of a hearing. A hearing must be conducted by an administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within 30 calendar days of the request for assignment, unless an extension is requested by either party and granted by the administrative law judge for good cause. The commissioner shall issue a notice of hearing by certified mail or personal service at least ten business days before the hearing. Certified mail to the last known address is sufficient. The scope of the hearing shall be limited solely to the issue of whether the temporary suspension or issuance of a conditional license should remain in effect and whether there is sufficient evidence to conclude that the licensee's actions or failure to comply with applicable laws are level deleted text begin 3deleted text end new text begin 4new text end or deleted text begin 4deleted text end new text begin 5new text end violations as defined in section 144A.474, subdivision 11, paragraph (b), or that there were violations that posed an imminent risk of harm to the health and safety of persons in the provider's care.

(b) The administrative law judge shall issue findings of fact, conclusions, and a recommendation within ten business days from the date of hearing. The parties shall have ten calendar days to submit exceptions to the administrative law judge's report. The record shall close at the end of the ten-day period for submission of exceptions. The commissioner's final order shall be issued within ten business days from the close of the record. When an appeal of a temporary immediate suspension or conditional license is withdrawn or dismissed, the commissioner shall issue a final order affirming the temporary immediate suspension or conditional license within ten calendar days of the commissioner's receipt of the withdrawal or dismissal. The license holder is prohibited from operation during the temporary suspension period.

(c) When the final order under paragraph (b) affirms an immediate suspension, and a final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that sanction, the licensee is prohibited from operation pending a final commissioner's order after the contested case hearing conducted under chapter 14.

(d) A licensee whose license is temporarily suspended must comply with the requirements for notification and transfer of clients in subdivision 5. These requirements remain if an appeal is requested.

Subd. 3c.

Immediate temporary suspension.

(a) In addition to any other remedies provided by law, the commissioner may, without a prior contested case hearing, immediately temporarily suspend a license or prohibit delivery of services by a provider for not more than 90 days, or issue a conditional license, if the commissioner determines that there are:

(1) level deleted text begin 4deleted text end new text begin 5new text end violations; or

(2) violations that pose an imminent risk of harm to the health or safety of persons in the provider's care.

(b) For purposes of this subdivision, "level deleted text begin 4deleted text end new text begin 5new text end " has the meaning given in section 144A.474, subdivision 11, paragraph (b).

(c) A notice stating the reasons for the immediate temporary suspension or conditional license and informing the license holder of the right to an expedited hearing under subdivision 3b must be delivered by personal service to the address shown on the application or the last known address of the license holder. The license holder may appeal an order immediately temporarily suspending a license or issuing a conditional license. The appeal must be made in writing by certified mail or personal service. If mailed, the appeal must be postmarked and sent to the commissioner within five calendar days after the license holder receives notice. If an appeal is made by personal service, it must be received by the commissioner within five calendar days after the license holder received the order.

(d) A license holder whose license is immediately temporarily suspended must comply with the requirements for notification and transfer of clients in subdivision 5. These requirements remain if an appeal is requested.

Subd. 2.

Application information and fee.

The commissioner shall establish forms and procedures for processing each supplemental nursing services agency registration application. An application for a supplemental nursing services agency registration must include at least the following:

(1) the names and addresses of all owners and controlling persons of the supplemental nursing services agency;

(2) if the owner is a corporation, copies of its articles of incorporation and current bylaws, together with the names and addresses of its officers and directors;

(3) if the owner is a limited liability company, copies of its articles of organization and operating agreement, together with the names and addresses of its officers and directors;

(4) documentation that the supplemental nursing services agency has medical malpractice insurance to insure against the loss, damage, or expense of a claim arising out of the death or injury of any person as the result of negligence or malpractice in the provision of health care services by the supplemental nursing services agency or by any employee of the agency;

(5) documentation that the supplemental nursing services agency has an employee dishonesty bond in the amount of $10,000;

(6) documentation that the supplemental nursing services agency has insurance coverage for workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies provided or procured by the agency;

(7) documentation that the supplemental nursing services agency filed with the commissioner of revenue: (i) the name and address of the bank, savings bank, or savings association in which the supplemental nursing services agency deposits all employee income tax withholdings; and (ii) the name and address of any nurse, nursing assistant, nurse aide, or orderly whose income is derived from placement by the agency, if the agency purports the income is not subject to withholding;

(8) any other relevant information that the commissioner determines is necessary to properly evaluate an application for registration;

(9) a policy and procedure that describes how the supplemental nursing services agency's records will be immediately available at all times to the commissioner and facility; and

(10) a nonrefundable registration fee of deleted text begin $2,035deleted text end new text begin $2,442new text end .

If a supplemental nursing services agency fails to provide the items in this subdivision to the department, the commissioner shall immediately suspend or refuse to issue the supplemental nursing services agency registration. The supplemental nursing services agency may appeal the commissioner's findings according to section 144A.475, subdivisions 3a and 7, except that the hearing must be conducted by an administrative law judge within 60 calendar days of the request for hearing assignment.

Subdivision 1.

License required; application.

(a) A hospice provider may not operate in the state without a valid license issued by the commissioner.

(b) Within ten days after receiving an application for a license, the commissioner shall acknowledge receipt of the application in writing. The acknowledgment must indicate whether the application appears to be complete or whether additional information is required before the application is considered complete. Within 90 days after receiving a complete application, the commissioner shall either grant or deny the license. If an applicant is not granted or denied a license within 90 days after submitting a complete application, the license must be deemed granted. An applicant whose license has been deemed granted must provide written notice to the commissioner before providing hospice care.

(c) Each application for a hospice provider license, or for a renewal of a license, shall be accompanied by a fee as follows:

(1) for revenues no more than $25,000, deleted text begin $125deleted text end new text begin $150new text end ;

(2) for revenues greater than $25,000 and no more than $100,000, deleted text begin $312.50deleted text end new text begin $375new text end ;

(3) for revenues greater than $100,000 and no more than $250,000, deleted text begin $625deleted text end new text begin $750new text end ;

(4) for revenues greater than $250,000 and no more than $350,000, deleted text begin $937.50deleted text end new text begin $1,125new text end ;

(5) for revenues greater than $350,000 and no more than $450,000, deleted text begin $1,250deleted text end new text begin $1,500new text end ;

(6) for revenues greater than $450,000 and no more than $550,000, deleted text begin $1,562.50deleted text end new text begin $1,875new text end ;

(7) for revenues greater than $550,000 and no more than $650,000, deleted text begin $1,875deleted text end new text begin $2,250new text end ;

(8) for revenues greater than $650,000 and no more than $750,000, deleted text begin $2,187.50deleted text end new text begin $2,625new text end ;

(9) for revenues greater then $750,000 and no more than $850,000, deleted text begin $2,500deleted text end new text begin $3,000new text end ;

(10) for revenues greater than $850,000 and no more than $950,000, deleted text begin $2,812.50deleted text end new text begin $3,375new text end ;

(11) for revenues greater than $950,000 and no more than $1,100,000, deleted text begin $3,125deleted text end new text begin $3,750new text end ;

(12) for revenues greater than $1,100,000 and no more than $1,275,000, deleted text begin $3,750deleted text end new text begin $4,500new text end ;

(13) for revenues greater than $1,275,000 and no more than $1,500,000, deleted text begin $4,375deleted text end new text begin $5,250new text end ; and

(14) for revenues greater than $1,500,000, deleted text begin $5,000deleted text end new text begin $6,000new text end .

Subd. 3.

Immediate temporary suspension.

(a) In addition to any other remedies provided by law, the commissioner may, without a prior contested case hearing, immediately temporarily suspend a license or prohibit delivery of housing or services by a facility for not more than 90 calendar days or issue a conditional license, if the commissioner determines that there are:

(1) Level deleted text begin 4deleted text end new text begin 5new text end violations; or

(2) violations that pose an imminent risk of harm to the health or safety of residents.

(b) For purposes of this subdivision, "Level deleted text begin 4deleted text end new text begin 5new text end " has the meaning given in section 144G.31.

(c) A notice stating the reasons for the immediate temporary suspension or conditional license and informing the licensee of the right to an expedited hearing under subdivision 17 must be delivered by personal service to the address shown on the application or the last known address of the licensee. The licensee may appeal an order immediately temporarily suspending a license or issuing a conditional license. The appeal must be made in writing by certified mail or personal service. If mailed, the appeal must be postmarked and sent to the commissioner within five calendar days after the licensee receives notice. If an appeal is made by personal service, it must be received by the commissioner within five calendar days after the licensee received the order.

(d) A licensee whose license is immediately temporarily suspended must comply with the requirements for notification and transfer of residents in subdivision 15. The requirements in subdivision 9 remain if an appeal is requested.

Subd. 13.

Notice to facility.

(a) Prior to any suspension, revocation, or refusal to renew a license, the facility shall be entitled to notice and a hearing as provided by sections 14.57 to 14.69. The hearing must commence within 60 calendar days after the proceedings are initiated. In addition to any other remedy provided by law, the commissioner may, without a prior contested case hearing, temporarily suspend a license or prohibit delivery of services by a provider for not more than 90 calendar days, or issue a conditional license if the commissioner determines that there are Level deleted text begin 3deleted text end new text begin 4new text end violations that do not pose an imminent risk of harm to the health or safety of the facility residents, provided:

(1) advance notice is given to the facility;

(2) after notice, the facility fails to correct the problem;

(3) the commissioner has reason to believe that other administrative remedies are not likely to be effective; and

(4) there is an opportunity for a contested case hearing within 30 calendar days unless there is an extension granted by an administrative law judge.

(b) If the commissioner determines there are Level deleted text begin 4deleted text end new text begin 5new text end violations or violations that pose an imminent risk of harm to the health or safety of the facility residents, the commissioner may immediately temporarily suspend a license, prohibit delivery of services by a facility, or issue a conditional license without meeting the requirements of paragraph (a), clauses (1) to (4).

For the purposes of this subdivision, "Level deleted text begin 3deleted text end new text begin 4new text end " and "Level deleted text begin 4deleted text end new text begin 5new text end " have the meanings given in section 144G.31.

Subd. 16.

Hearing.

Within 15 business days of receipt of the licensee's timely appeal of a sanction under this section, other than for a temporary suspension, the commissioner shall request assignment of an administrative law judge. The commissioner's request must include a proposed date, time, and place of hearing. A hearing must be conducted by an administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within 90 calendar days of the request for assignment, unless an extension is requested by either party and granted by the administrative law judge for good cause or for purposes of discussing settlement. In no case shall one or more extensions be granted for a total of more than 90 calendar days unless there is a criminal action pending against the licensee. If, while a licensee continues to operate pending an appeal of an order for revocation, suspension, or refusal to renew a license, the commissioner identifies one or more new violations of law that meet the requirements of Level deleted text begin 3deleted text end new text begin 4new text end or Level deleted text begin 4deleted text end new text begin 5new text end violations as defined in section 144G.31, the commissioner shall act immediately to temporarily suspend the license.

Subd. 17.

Expedited hearing.

(a) Within five business days of receipt of the licensee's timely appeal of a temporary suspension or issuance of a conditional license, the commissioner shall request assignment of an administrative law judge. The request must include a proposed date, time, and place of a hearing. A hearing must be conducted by an administrative law judge pursuant to Minnesota Rules, parts 1400.8505 to 1400.8612, within 30 calendar days of the request for assignment, unless an extension is requested by either party and granted by the administrative law judge for good cause. The commissioner shall issue a notice of hearing by certified mail or personal service at least ten business days before the hearing. Certified mail to the last known address is sufficient. The scope of the hearing shall be limited solely to the issue of whether the temporary suspension or issuance of a conditional license should remain in effect and whether there is sufficient evidence to conclude that the licensee's actions or failure to comply with applicable laws are Level deleted text begin 3deleted text end new text begin 4new text end or Level deleted text begin 4deleted text end new text begin 5new text end violations as defined in section 144G.31, or that there were violations that posed an imminent risk of harm to the resident's health and safety.

(b) The administrative law judge shall issue findings of fact, conclusions, and a recommendation within ten business days from the date of hearing. The parties shall have ten calendar days to submit exceptions to the administrative law judge's report. The record shall close at the end of the ten-day period for submission of exceptions. The commissioner's final order shall be issued within ten business days from the close of the record. When an appeal of a temporary immediate suspension or conditional license is withdrawn or dismissed, the commissioner shall issue a final order affirming the temporary immediate suspension or conditional license within ten calendar days of the commissioner's receipt of the withdrawal or dismissal. The licensee is prohibited from operation during the temporary suspension period.

(c) When the final order under paragraph (b) affirms an immediate suspension, and a final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that sanction, the licensee is prohibited from operation pending a final commissioner's order after the contested case hearing conducted under chapter 14.

(d) A licensee whose license is temporarily suspended must comply with the requirements for notification and transfer of residents under subdivision 15. These requirements remain if an appeal is requested.

Subd. 7.

Required follow-up surveys.

For assisted living facilities that have Level 3 deleted text begin ordeleted text end new text begin ,new text end Level 4new text begin , or Level 5new text end violations under section 144G.31, the commissioner shall conduct a follow-up survey within 90 calendar days of the survey. When conducting a follow-up survey, the surveyor shall focus on whether the previous violations have been corrected and may also address any new violations that are observed while evaluating the corrections that have been made.

Subd. 2.

Levels of violations.

Correction orders for violations are categorized by level as follows:

(1) Level 1 is a violation that deleted text begin has no potential to cause more than a minimal impact on the residentdeleted text end new text begin will cause only minimal impact on the residentnew text end and does not affect health or safety;

(2) Level 2 is a violation that did not harm a resident's health or safety but had the potential to have harmed a resident's health or safety, but was not likely to cause serious injury, impairment, or death;

(3) Level 3 is a violation that harmed a resident's health or safety, deleted text begin not including serious injury, impairment, or death, or a violation that has the potential to lead to serious injury, impairment, or deathdeleted text end new text begin or a violation that had the potential to cause more than minimal harm to the residentnew text end ; deleted text begin anddeleted text end

(4) Level 4 is a violation that deleted text begin results in serious injury, impairment, or death.deleted text end new text begin harmed a resident's health or safety, not including serious injury or death, or a violation that was likely to lead to serious injury or death; andnew text end

new text begin (5) Level 5 is a violation that results in serious injury or death. new text end

Subd. 4.

Fine amounts.

(a) Fines and enforcement actions under this subdivision may be assessed based on the level and scope of the violations described in subdivisions 2 and 3 as follows and may be imposed immediately with no opportunity to correct the violation prior to imposition:

(1) Level 1, no fines or enforcement;

(2) Level 2, a fine of $500 per violation, in addition to any enforcement mechanism authorized in section 144G.20 deleted text begin for widespread violationsdeleted text end ;

(3) Level 3, a fine of deleted text begin $3,000deleted text end new text begin $1,000new text end per violation, in addition to any enforcement mechanism authorized in section 144G.20;

(4) Level 4, a fine of deleted text begin $5,000deleted text end new text begin $3,000new text end per violation, in addition to any enforcement mechanism authorized in section 144G.20; deleted text begin anddeleted text end

new text begin (5) Level 5, a fine of $5,000 per violation, in addition to any enforcement mechanism authorized in section 144G.20; and new text end

deleted text begin (5)deleted text end new text begin (6)new text end for maltreatment violations for which the licensee was determined to be responsible for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000 per incident. A fine of $5,000 per incident may be imposed if the commissioner determines the licensee is responsible for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury.

(b) When a fine is assessed against a facility for substantiated maltreatment, the commissioner shall not also impose an immediate fine under this chapter for the same circumstance.

Subd. 5.

Immediate fine; payment.

(a) For every Level 3 deleted text begin ordeleted text end new text begin ,new text end Level 4new text begin , or Level 5new text end violation, the commissioner may issue an immediate fine. The licensee must still correct the violation in the time specified. The issuance of an immediate fine may occur in addition to any enforcement mechanism authorized under section 144G.20. The immediate fine may be appealed as allowed under this chapter.

(b) The licensee must pay the fines assessed on or before the payment date specified. If the licensee fails to fully comply with the order, the commissioner may issue a second fine or suspend the license until the licensee complies by paying the fine. A timely appeal shall stay payment of the fine until the commissioner issues a final order.

(c) A licensee shall promptly notify the commissioner in writing when a violation specified in the order is corrected. If upon reinspection the commissioner determines that a violation has not been corrected as indicated by the order, the commissioner may issue an additional fine. The commissioner shall notify the licensee by mail to the last known address in the licensing record that a second fine has been assessed. The licensee may appeal the second fine as provided under this subdivision.

(d) A facility that has been assessed a fine under this section has a right to a reconsideration or hearing under this chapter and chapter 14.

Subd. 6.

New construction; plans.

(a) For all new licensure and construction beginning on or after August 1, 2021, the following must be provided to the commissioner:

(1) architectural and engineering plans and specifications for new construction must be prepared and signed by architects and engineers who are registered in Minnesota. Final working drawings and specifications for proposed construction must be submitted to the commissioner for review and approval;

(2) final architectural plans and specifications must include elevations and sections through the building showing types of construction, and must indicate dimensions and assignments of rooms and areas, room finishes, door types and hardware, elevations and details of nurses' work areas, utility rooms, toilet and bathing areas, and large-scale layouts of dietary and laundry areas. Plans must show the location of fixed equipment and sections and details of elevators, chutes, and other conveying systems. Fire walls and smoke partitions must be indicated. The roof plan must show all mechanical installations. The site plan must indicate the proposed and existing buildings, topography, roadways, walks and utility service lines; and

(3) final mechanical and electrical plans and specifications must address the complete layout and type of all installations, systems, and equipment to be provided. Heating plans must include heating elements, piping, thermostatic controls, pumps, tanks, heat exchangers, boilers, breeching, and accessories. Ventilation plans must include room air quantities, ducts, fire and smoke dampers, exhaust fans, humidifiers, and air handling units. Plumbing plans must include the fixtures and equipment fixture schedule; water supply and circulating piping, pumps, tanks, riser diagrams, and building drains; the size, location, and elevation of water and sewer services; and the building fire protection systems. Electrical plans must include fixtures and equipment, receptacles, switches, power outlets, circuits, power and light panels, transformers, and service feeders. Plans must show location of nurse call signals, cable lines, fire alarm stations, and fire detectors and emergency lighting.

(b) Unless construction is begun within one year after approval of the final working drawing and specifications, the drawings must be resubmitted for review and approval.

(c) The commissioner must be notified within 30 days before completion of construction so that the commissioner can make arrangements for a final inspection by the commissioner.

(d) At least one set of complete life safety plans, including changes resulting from remodeling or alterations, must be kept on file in the facility.

new text begin (e) For new construction beginning on or after July 1, 2025, the licensee must comply with section 144.554 to submit applicable construction plans and fees to the commissioner. new text end

Subd. 2.

Allocation of subsidies.

The commissioner of health shall distribute subsidies to federally qualified health centers operating in Minnesota to continue, expand, and improve federally qualified health center services to low-income populations. The commissioner shall distribute the funds appropriated under this section to federally qualified health centers operating in Minnesota as of January 1, 2007. The amount of each subsidy shall be in proportion to each federally qualified health center's amount of discounts granted to patients during the most recent calendar year as reported on the federal Uniform Data System report in conformance with the Bureau of Primary Health Care Program Expectations Policy Information Notice 98-23, except that each eligible federally qualified health center shall receive at least deleted text begin twodeleted text end new text begin fivenew text end percent but no more than 30 percent of the total amount of money available under this section.

Subd. 2.

License renewal.

Initial and renewal licenses for all food and beverage service establishments, youth camps, hotels, motels, lodging establishments, public pools, and resorts shall be issued on an annual basis. Any person who operates a place of business after the expiration date of a license or without having submitted an application and paid the fee shall be deemed to have violated the provisions of this chapter and shall be subject to enforcement action, as provided in the Health Enforcement Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of deleted text begin $60deleted text end new text begin $100new text end shall be added to the total of the license fee for any food and beverage service establishment operating without a license as a mobile food unit, a seasonal temporary or seasonal permanent food stand, or a special event food stand, and a penalty of deleted text begin $120deleted text end new text begin $200new text end shall be added to the total of the license fee for all restaurants, food carts, hotels, motels, lodging establishments, youth camps, public pools, and resorts operating without a license for a period of up to 30 days. A late fee of deleted text begin $360deleted text end new text begin $450new text end shall be added to the license fee for establishments operating more than 30 days without a license.

Subd. 2a.

Food manager certification.

An applicant for certification or certification renewal as a food manager must submit to the commissioner a deleted text begin $35deleted text end new text begin $45new text end nonrefundable certification fee payable to the Department of Health. The commissioner shall issue a duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant submits a completed application on a form provided by the commissioner for a duplicate certificate and pays deleted text begin $20deleted text end new text begin $25new text end to the department for the cost of duplication.new text begin In addition, a $5 technology fee must be paid with the initial certification, certification renewal, or duplicate certificate application.new text end

Subd. 3.

Establishment fees; definitions.

(a) The following fees are required for food and beverage service establishments, youth camps, hotels, motels, lodging establishments, public pools, and resorts licensed under this chapter. Food and beverage service establishments must pay the highest applicable fee under paragraph (d), clause (1), (2), (3), or (4). The license fee for new operators previously licensed under this chapter for the same calendar year is one-half of the appropriate annual license fee, plus any penalty that may be required. The license fee for operators opening on or after October 1 is one-half of the appropriate annual license fee, plus any penalty that may be required.

(b) All food and beverage service establishments, except special event food stands, and all hotels, motels, lodging establishments, public pools, and resorts shall pay an annual base fee of deleted text begin $165deleted text end new text begin $300new text end .

(c) A special event food stand shall pay a flat fee of deleted text begin $55deleted text end new text begin $75new text end annually. "Special event food stand" means a fee category where food is prepared or served in conjunction with celebrations, county fairs, or special events from a special event food stand as defined in section 157.15.

(d) In addition to the base fee in paragraph (b), each food and beverage service establishment, other than a special event food stand and a school concession stand, and each hotel, motel, lodging establishment, public pool, and resort shall pay an additional annual fee for each fee category, additional food service, or required additional inspection specified in this paragraph:

(1) Category 1 establishment, deleted text begin $110deleted text end new text begin $185new text end . "Category 1 establishment" means a fee category that provides one or more of the following items or is one of the listed establishments or facilities:

(i) serves prepackaged food that is served in the package;

(ii) serves a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;

(iii) serves soft drinks, coffee, or nonalcoholic beverages;

(iv) provides cleaning for eating, drinking, or cooking utensils, when the only food served is prepared off site;

(v) a food establishment where the method of food preparation meets the definition of a low-risk establishment in section 157.20; or

(vi) operates as a child care facility licensed under section 142B.05 and Minnesota Rules, chapter 9503.

(2) Category 2 establishment, deleted text begin $245deleted text end new text begin $430new text end . "Category 2 establishment" means an establishment that is not a Category 1 establishment and is either:

(i) a food establishment where the method of food preparation meets the definition of a medium-risk establishment in section 157.20; or

(ii) an elementary or secondary school as defined in section 120A.05.

(3) Category 3 establishment, deleted text begin $385deleted text end new text begin $670new text end . "Category 3 establishment" means an establishment that is not a Category 1 or Category 2 establishment and is either:

(i) a food establishment where the method of food preparation meets the definition of a high-risk establishment in section 157.20; or

(ii) an establishment where 500 or more meals are prepared per day and served at one or more separate locations.

(4) Other food and beverage service, including food carts, mobile food units, seasonal temporary food stands, and seasonal permanent food stands, deleted text begin $85deleted text end new text begin $150new text end .

(5) Lodging per sleeping accommodation unit, deleted text begin $11deleted text end new text begin $15new text end , including hotels, motels, lodging establishments, and resorts, up to a maximum of deleted text begin $1,100deleted text end new text begin $1,500new text end . "Lodging per sleeping accommodation unit" means a fee category including the number of guest rooms, cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the number of beds in a dormitory.

(6) First public pool, deleted text begin $355deleted text end new text begin $455new text end ; each additional public pool, deleted text begin $200deleted text end new text begin $300new text end . "Public pool" means a fee category that has the meaning given in section 144.1222, subdivision 4.

(7) First spa, deleted text begin $200deleted text end new text begin $300new text end ; each additional spa, deleted text begin $110deleted text end new text begin $200new text end . "Spa pool" means a fee category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.

(8) Private sewer or water, deleted text begin $60deleted text end new text begin $85new text end . "Individual private water" means a fee category with a water supply other than a community public water supply as defined in Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an individual sewage treatment system which uses subsurface treatment and disposal.

(9) Additional food service, deleted text begin $175deleted text end new text begin $250new text end . "Additional food service" means a location at a food service establishment, other than the primary food preparation and service area, used to prepare or serve beverages or food to the public. Additional food service does not apply to school concession stands.

(10) Additional inspection fee, deleted text begin $250deleted text end new text begin $350new text end . "Additional inspection fee" means a fee to conduct the second inspection each year for elementary and secondary education facility school lunch programs when required by the Richard B. Russell National School Lunch Act.

(11) HACCP verification, deleted text begin $175deleted text end new text begin $225new text end . "HACCP verification" means an annual fee category for a business that performs one or more specialized process that requires an HACCP plan as required in chapter 31 and Minnesota Rules, chapter 4626.

(e) A fee for review of construction plans must accompany the initial license application for restaurants, hotels, motels, lodging establishments, resorts, seasonal food stands, and mobile food units.new text begin Plans submitted less than 30 days prior to construction are subject to an additional late fee equal to 50 percent of the original plan review fee.new text end A fee for review of an HACCP plan for specialized processing must be submitted and approved prior to preparing and serving the specialized processed food for human consumption. The fees for construction plan reviews and HACCP plan reviews are as follows:

(f) When existing food and beverage service establishments, hotels, motels, lodging establishments, resorts, seasonal food stands, and mobile food units are extensively remodeled, a fee must be submitted with the remodeling plans. The fee for this construction plan review is as follows:

(g) Special event food stands are not required to submit construction or remodeling plans for review.

(h) Youth camps shall pay an annual single fee for food and lodging as follows:

(1) camps with up to 99 campers, deleted text begin $325deleted text end new text begin $375new text end ;

(2) camps with 100 to 199 campers, deleted text begin $550deleted text end new text begin $600new text end ; and

(3) camps with 200 or more campers, deleted text begin $750deleted text end new text begin $800new text end .

(i) A youth camp which pays fees under paragraph (d) is not required to pay fees under paragraph (h).

Subd. 3a.

Statewide hospitality fee.

Every person, firm, or corporation that operates a licensed boarding establishment, food and beverage service establishment, seasonal temporary or permanent food stand, special event food stand, mobile food unit, food cart, resort, hotel, motel, or lodging establishment in Minnesota must submit to the commissioner a deleted text begin $40deleted text end new text begin $50new text end annual statewide hospitality fee for each licensed activity. The fee for establishments licensed by the Department of Health is required at the same time the licensure fee is due. For establishments licensed by local governments, the fee is due by July 1 of each year.

Subd. 2.

Skilled and intermediate nursing care.

deleted text begin (a)deleted text end Medical assistance covers skilled nursing home services and services of intermediate care facilities, including training and habilitation services, as defined in section 252.41, subdivision 3, for persons with developmental disabilities who are residing in intermediate care facilities for persons with developmental disabilities. deleted text begin Medical assistance must not be used to pay the costs of nursing care provided to a patient in a swing bed as defined in section 144.562, unless (1) the facility in which the swing bed is located is eligible as a sole community provider, as defined in Code of Federal Regulations, title 42, section 412.92, or the facility is a public hospital owned by a governmental entity with 15 or fewer licensed acute care beds; (2) the Centers for Medicare and Medicaid Services approves the necessary state plan amendments; (3) the patient was screened as provided by law; (4) the patient no longer requires acute care services; and (5) no nursing home beds are available within 25 miles of the facility. The commissioner shall exempt a facility from compliance with the sole community provider requirement in clause (1) if, as of January 1, 2004, the facility had an agreement with the commissioner to provide medical assistance swing bed services.deleted text end

deleted text begin (b) Medical assistance also covers up to ten days of nursing care provided to a patient in a swing bed if: (1) the patient's physician, advanced practice registered nurse, or physician assistant certifies that the patient has a terminal illness or condition that is likely to result in death within 30 days and that moving the patient would not be in the best interests of the patient and patient's family; (2) no open nursing home beds are available within 25 miles of the facility; and (3) no open beds are available in any Medicare hospice program within 50 miles of the facility. The daily medical assistance payment for nursing care for the patient in the swing bed is the statewide average medical assistance skilled nursing care per diem as computed annually by the commissioner on July 1 of each year. deleted text end

Subd. 2.

Duties of commissioner of health.

(a) Notwithstanding chapters 62D and 62N, a county that elects to purchase medical assistance in return for a fixed sum without regard to the frequency or extent of services furnished to any particular enrollee is not required to obtain a certificate of authority under chapter 62D or 62N. The county board of commissioners is the governing body of a county-based purchasing program. In a multicounty arrangement, the governing body is a joint powers board established under section 471.59.

(b) A county that elects to purchase medical assistance services under this section must satisfy the commissioner of health that the requirements for assurance of consumer protection, provider protection, and fiscal solvency of chapter 62D, applicable to health maintenance organizations will be met according to the following schedule:

(1) for a county-based purchasing plan approved on or before June 30, 2008, the plan must have in reserve:

(i) at least 50 percent of the minimum amount required under chapter 62D as of January 1, 2010;

(ii) at least 75 percent of the minimum amount required under chapter 62D as of January 1, 2011;

(iii) at least 87.5 percent of the minimum amount required under chapter 62D as of January 1, 2012; and

(iv) at least 100 percent of the minimum amount required under chapter 62D as of January 1, 2013; and

(2) for a county-based purchasing plan first approved after June 30, 2008, the plan must have in reserve:

(i) at least 50 percent of the minimum amount required under chapter 62D at the time the plan begins enrolling enrollees;

(ii) at least 75 percent of the minimum amount required under chapter 62D after the first full calendar year;

(iii) at least 87.5 percent of the minimum amount required under chapter 62D after the second full calendar year; and

(iv) at least 100 percent of the minimum amount required under chapter 62D after the third full calendar year.

(c) Until a plan is required to have reserves equaling at least 100 percent of the minimum amount required under chapter 62D, the plan may demonstrate its ability to cover any losses by satisfying the requirements of chapter 62N. A county-based purchasing plan must also assure the commissioner of health that the requirements of sections 62J.041; 62J.48; 62J.71 to 62J.73; all applicable provisions of chapter 62Q, including sections 62Q.075; 62Q.1055; 62Q.106; 62Q.12; 62Q.135; 62Q.14; 62Q.19; 62Q.23, paragraph (c); 62Q.43; 62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.68 to 62Q.72; and 72A.201 will be met.

(d) All enforcement and rulemaking powers available under chapters 62D, 62J, 62N, and 62Q are hereby granted to the commissioner of health with respect to counties that purchase medical assistance services under this section.

(e) The commissioner, in consultation with county government, shall develop administrative and financial reporting requirements for county-based purchasing programs relating to sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 62N.31, and other sections as necessary, that are specific to county administrative, accounting, and reporting systems and consistent with other statutory requirements of counties.

(f) The commissioner shall collect from a county-based purchasing plan under this section the following fees:

(1) fees attributable to the costs of audits and other examinations of plan financial operations. These fees are subject to the provisions of Minnesota Rules, part 4685.2800, subpart 1, item F; and

(2) an annual fee of deleted text begin $21,500deleted text end new text begin $30,000new text end , to be paid by June 15 of each calendar year.

All fees collected under this paragraph shall be deposited in the state government special revenue fund.

Subdivision 1.

When license required.

deleted text begin A person within the state intending to directly perform or cause to be performed through subcontracting or similar delegation any asbestos-related work either for financial gain or with respect to the person's own property shall first apply for and obtain a license from the commissioner. The license shall be in writing, be dated when issued, contain an expiration date, be signed by the commissioner, and give the name and address of the person to whom it is issued. deleted text end

deleted text begin The domiciled owner of a single family residence is not required to hold a license or pay a project permit fee to conduct asbestos-related work in the domiciled residence. deleted text end

new text begin Any person performing any asbestos-related work within the state must be licensed by the commissioner, whether directly performing asbestos work or causing it to be performed through subcontracting or similar delegation. A domiciled owner of a single-family residence is not required to hold a license or pay a project permit fee to conduct asbestos-related work in the domiciled residence. new text end

Subd. 3.

Permit fee.

Five calendar days before beginning asbestos-related work, a person shall pay a project permit fee to the commissioner equal to deleted text begin twodeleted text end new text begin threenew text end percent of the total costs of the asbestos-related work. For asbestos-related work performed in single or multifamily residences, of greater than ten but less than 260 linear feet of asbestos-containing material on pipes, or greater than six but less than 160 square feet of asbestos-containing material on other facility components, a person shall pay a project permit fee of $35 to the commissioner.

Subd. 3a.

Asbestos-related training course permit fee.

deleted text begin The commissioner shall establish by rule a permit fee to be paid bydeleted text end A training course providernew text begin shall pay the commissioner a fee of $500new text end on application for a training course permit deleted text begin ordeleted text end new text begin and $250 for thenew text end renewal of a permit of each asbestos-related training course required for certification or registration.

Subd. 2.

License renewal.

Initial and renewal licenses for all manufactured home parks and recreational camping areas shall be issued annually and shall have an expiration date included on the license. Any person who operates a manufactured home park or recreational camping area after the expiration date of a license or without having submitted an application and paid the fee shall be deemed to have violated the provisions of this chapter and shall be subject to enforcement action, as provided in the Health Enforcement Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of deleted text begin $120deleted text end new text begin $200new text end shall be added to the total of the license fee for any manufactured home park or recreational camping area operating without a license for a period of up to 30 days. A late fee of deleted text begin $360deleted text end new text begin $450new text end shall be added to the license fee for any manufactured home park or recreational camping area operating more than 30 days without a license.

Subd. 3.

Fees, manufactured home parks and recreational camping areas.

(a) The following fees are required for manufactured home parks and recreational camping areas licensed under this chapter. Fees collected under this section shall be deposited in the state government special revenue fund. Recreational camping areas and manufactured home parks shall pay the highest applicable base fee under paragraph (b). The license fee for new operators of a manufactured home park or recreational camping area previously licensed under this chapter for the same calendar year is one-half of the appropriate annual license fee, plus any penalty that may be required. The license fee for operators opening on or after October 1 is one-half of the appropriate annual license fee, plus any penalty that may be required.

(b) All manufactured home parks and recreational camping areas shall pay the following annual base fee:

(1) a manufactured home park, deleted text begin $165deleted text end new text begin $280new text end ; and

(2) a recreational camping area with:

(i) 24 or less sites, deleted text begin $55deleted text end new text begin $100new text end ;

(ii) 25 to 99 sites, deleted text begin $230deleted text end new text begin $410new text end ; and

(iii) 100 or more sites, deleted text begin $330deleted text end new text begin $610new text end .

In addition to the base fee, manufactured home parks and recreational camping areas shall pay deleted text begin $5deleted text end new text begin $8new text end for each licensed site. This paragraph does not apply to special event recreational camping areas. Operators of a manufactured home park or a recreational camping area also licensed under section 157.16 for the same location shall pay only one base fee, whichever is the highest of the base fees found in this section or section 157.16.

(c) In addition to the fee in paragraph (b), each manufactured home park or recreational camping area shall pay an additional annual fee for each fee category specified in this paragraph:

(1) Manufactured home parks and recreational camping areas with public swimming pools and spas shall pay the appropriate fees specified in section 157.16.

(2) Individual private sewer or water, deleted text begin $60deleted text end new text begin $85new text end . "Individual private water" means a fee category with a water supply other than a community public water supply as defined in Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with a subsurface sewage treatment system which uses subsurface treatment and disposal.

(d) The following fees must accompany a plan review application for initial construction of a manufactured home park or recreational camping area:

(1) for initial construction of less than 25 sites, deleted text begin $375deleted text end new text begin $400new text end ;

(2) for initial construction of 25 to 99 sites, deleted text begin $400deleted text end new text begin $425new text end ; and

(3) for initial construction of 100 or more sites, deleted text begin $500deleted text end new text begin $525new text end .

(e) The following fees must accompany a plan review application when an existing manufactured home park or recreational camping area is expanded:

(1) for expansion of less than 25 sites, deleted text begin $250deleted text end new text begin $300new text end ;

(2) for expansion of 25 to 99 sites, deleted text begin $300deleted text end new text begin $350new text end ; and

(3) for expansion of 100 or more sites, deleted text begin $450deleted text end new text begin $500new text end .

new text begin (f) Plan review applications submitted less than 30 days prior to construction are subject to an additional late fee equal to 50 percent of the original plan review fee. new text end

Subd. 4.

Fees, special event recreational camping areas.

(a) The following fees are required for special event recreational camping areas licensed under this chapter.

(b) All special event recreational camping areas shall pay an annual fee of deleted text begin $150deleted text end new text begin $250new text end plus deleted text begin $1deleted text end new text begin $4new text end for each licensed site.

(c) A special event recreational camping area shall pay a late fee of deleted text begin $360deleted text end new text begin $450new text end for failing to obtain a license prior to operating.

(d) The following fees must accompany a plan review application for initial construction of a special event recreational camping area:

(1) for initial construction of less than 25 special event recreational camping sites, deleted text begin $375deleted text end new text begin $475new text end ;

(2) for initial construction of 25 to 99 sites, deleted text begin $400deleted text end new text begin $500new text end ; and

(3) for initial construction of 100 or more sites, deleted text begin $500deleted text end new text begin $600new text end .

(e) The following fees must accompany a plan review application for expansion of a special event recreational camping area:

(1) for expansion of less than 25 sites, deleted text begin $250deleted text end new text begin $300new text end ;

(2) for expansion of 25 to 99 sites, deleted text begin $300deleted text end new text begin $350new text end ; and

(3) for expansion of 100 or more sites, deleted text begin $450deleted text end new text begin $500new text end .

new text begin (f) Plan review applications submitted less than 30 days prior to construction are subject to an additional late fee equal to 50 percent of the original plan review fee. new text end

Subd. 3.

Reporting by covered entities to the commissioner.

(a) Each 340B covered entity shall report to the commissioner by April 1 of each year the following information for transactions conducted by the 340B covered entity or on its behalf, and related to its participation in the federal 340B program for the previous calendar year:

(1) the aggregated acquisition cost for prescription drugs obtained under the 340B program;

(2) the aggregated payment amount received for drugs obtained under the 340B program and dispensed or administered to patientsdeleted text begin ;deleted text end new text begin :new text end

new text begin (i) that are net of the contracted price for insurance claims payments; and new text end

new text begin (ii) that reflect the portion of payment received from grants, cash, or other payment types that relate to the dispensing or administering of drugs obtained under the 340B program; new text end

(3) the number of pricing units dispensed or administered for prescription drugs described in clause (2); and

(4) the aggregated payments made:

(i) to contract pharmacies to dispense drugs obtained under the 340B program;

(ii) to any other entity that is not the covered entity and is not a contract pharmacy for managing any aspect of the covered entity's 340B program; and

(iii) for deleted text begin alldeleted text end other new text begin internal, direct new text end expenses related to administering the 340B programnew text begin with a detailed description of the direct costs includednew text end .

The information under clauses (2) and (3) must be reported by payer type, including but not limited to commercial insurance, medical assistance, MinnesotaCare, and Medicare, in the form and manner prescribed by the commissioner.

(b) For covered entities that are hospitals, the information required under paragraph (a), clauses (1) to (3), must also be reported at the national drug code level for the 50 most frequently dispensed or administered drugs by the facility under the 340B program.

(c) Data submitted to the commissioner under paragraphs (a) and (b) are classified as nonpublic data, as defined in section 13.02, subdivision 9.

Subd. 4.

Enforcement and exceptions.

(a) Any deleted text begin health caredeleted text end new text begin coverednew text end entity subject to reporting under this section that fails to provide data in the form and manner prescribed by the commissioner is subject tonew text begin the levy ofnew text end a fine deleted text begin paid to the commissionerdeleted text end of up to $500 for each day the data are past due. Any fine levied against the entity under this subdivision is subject to the contested case and judicial review provisions of sections 14.57 deleted text begin anddeleted text end new text begin tonew text end 14.69.

(b) The commissioner may grant an entity an extension of or exemption from the reporting obligations under this deleted text begin subdivisiondeleted text end new text begin sectionnew text end , upon a showing of good cause by the entity.

Subd. 5.

Reports to the legislature.

By November 15, 2024, and by November 15 of each year thereafter, the commissioner shall submit to the chairs and ranking minority members of the legislative committees with jurisdiction over health care finance and policy, a report that aggregates the data submitted under subdivision 3, paragraphs (a) and (b). deleted text begin The following information must be included in the reportdeleted text end For all 340B entities whose net 340B revenue constitutes a significant share, as determined by the commissioner, of all net 340B revenue across all 340B covered entities in Minnesotanew text begin , the following information must also be included in the reportnew text end :

(1) the information submitted under subdivision 2; and

(2) for each 340B entity identified in subdivision 2, that entity's 340B net revenue as calculated using the data submitted under subdivision 3, paragraph (a), with net revenue being subdivision 3, paragraph (a), clause (2), less the sum of subdivision 3, paragraph (a), clauses (1) and (4).

For all other entities, the data in the report must be aggregated to the entity type or groupings of entity types in a manner that prevents the identification of an individual entity and any entity's specific data value reported for an individual data element.

Subd. 19a.

Uniform explanation of benefits deleted text begin documentdeleted text end .

"Uniform explanation of benefits deleted text begin documentdeleted text end " means new text begin either new text end the document associated with and explaining the details of a group purchaser's claim adjudication for services renderednew text begin or its electronic equivalent under section 62J.581new text end , which is sent to a patient.

Subd. 2.

Definitions.

(a) For purposes of this section, the terms defined in this subdivision have the meanings given.

(b) "Biosimilar" means a drug that is produced or distributed pursuant to a biologics license application approved under United States Code, title 42, section 262(K)(3).

(c) "Brand name drug" means a drug that is produced or distributed pursuant to:

(1) a new drug application approved under United States Code, title 21, section 355(c), except for a generic drug as defined under Code of Federal Regulations, title 42, section 447.502; or

(2) a biologics license application approved under United States Code, title 42, section 262(a)(c).

(d) "Commissioner" means the commissioner of health.

(e) "Generic drug" means a drug that is marketed or distributed pursuant to:

(1) an abbreviated new drug application approved under United States Code, title 21, section 355(j);

(2) an authorized generic as defined under Code of Federal Regulations, title 42, section 447.502; or

(3) a drug that entered the market the year before 1962 and was not originally marketed under a new drug application.

(f) "Manufacturer" means a drug manufacturer licensed under section 151.252.

(g) "New prescription drug" or "new drug" means a prescription drug approved for marketing by the United States Food and Drug Administration (FDA) for which no previous wholesale acquisition cost has been established for comparison.

(h) "Patient assistance program" means a program that a manufacturer offers to the public in which a consumer may reduce the consumer's out-of-pocket costs for prescription drugs by using coupons, discount cards, prepaid gift cards, manufacturer debit cards, or by other means.

(i) "Prescription drug" or "drug" has the meaning provided in section 151.441, subdivision 8.

(j) "Price" means the wholesale acquisition cost as defined in United States Code, title 42, section 1395w-3a(c)(6)(B).

(k) "30-day supply" means the total daily dosage units of a prescription drug recommended by the prescribing label approved by the FDA for 30 days. If the FDA-approved prescribing label includes more than one recommended daily dosage, the 30-day supply is based on the maximum recommended daily dosage on the FDA-approved prescribing label.

(l) "Course of treatment" means the total dosage of a single prescription for a prescription drug recommended by the FDA-approved prescribing label. If the FDA-approved prescribing label includes more than one recommended dosage for a single course of treatment, the course of treatment is the maximum recommended dosage on the FDA-approved prescribing label.

(m) "Drug product family" means a group of one or more prescription drugs that share a unique generic drug description or nontrade name and dosage form.

deleted text begin (n) "Individual salable unit" means the smallest container of product introduced into commerce by the manufacturer or repackager that is intended by the manufacturer or repackager for individual sale to a dispenser. deleted text end

deleted text begin (o)deleted text end new text begin (n)new text end "National drug code" means the three-segment code maintained by the federal Food and Drug Administration that includes a labeler code, a product code, and a package code for a drug product and that has been converted to an 11-digit format consisting of five digits in the first segment, four digits in the second segment, and two digits in the third segment. A three-segment code shall be considered converted to an 11-digit format when, as necessary, at least one "0" has been added to the front of each segment containing less than the specified number of digits such that each segment contains the specified number of digits.

deleted text begin (p)deleted text end new text begin (o)new text end "Pharmacy" or "pharmacy provider" means a community/outpatient pharmacy as defined in Minnesota Rules, part 6800.0100, subpart 2, that is also licensed as a pharmacy by the Board of Pharmacy under section 151.19.

deleted text begin (q)deleted text end new text begin (p)new text end "Pharmacy benefit manager" or "PBM" means an entity licensed to act as a pharmacy benefit manager under section 62W.03.

deleted text begin (r)deleted text end new text begin (q)new text end "Pricing unit" means the smallest dispensable amount of a prescription drug product that could be dispensednew text begin or administerednew text end .

deleted text begin (s)deleted text end new text begin (r)new text end "Rebate" means a discount, chargeback, or other price concession that affects the price of a prescription drug product, regardless of whether conferred through regular aggregate payments, on a claim-by-claim basis at the point of sale, as part of retrospective financial reconciliations, including reconciliations that also reflect other contractual arrangements, or by any other method. "Rebate" does not mean a bona fide service fee as defined in Code of Federal Regulations, title 42, section 447.502.

deleted text begin (t)deleted text end new text begin (s)new text end "Reporting entity" means any manufacturer, pharmacy, pharmacy benefit manager, wholesale drug distributor, or any other entity required to submit data under this section.

deleted text begin (u)deleted text end new text begin (t)new text end "Wholesale drug distributor" or "wholesaler" means an entity thatdeleted text begin :deleted text end

deleted text begin (1)deleted text end is licensed to act as a wholesale drug distributor under section 151.47deleted text begin ; anddeleted text end new text begin .new text end

deleted text begin (2) distributes prescription drugs, for which it is not the manufacturer, to persons or entities, or both, other than a consumer or patient in the state. deleted text end

Subd. 3.

Prescription drug price increases reporting.

(a) Beginning January 1, 2022, a drug manufacturer must submit to the commissioner the information described in paragraph (b) for each prescription drug for which the price was $100 or greater for a 30-day supply or for a course of treatment lasting less than 30 days and:

(1) for brand name drugs where there is an increase of ten percent or greater in the price over the previous 12-month period or an increase of 16 percent or greater in the price over the previous 24-month period; and

(2) for generic or biosimilar drugs where there is an increase of 50 percent or greater in the price over the previous 12-month period.

(b) For each of the drugs described in paragraph (a), the manufacturer shall submit to the commissioner no later than 60 days after the price increase goes into effect, in the form and manner prescribed by the commissioner, the following information, if applicable:

(1) the description and price of the drug and the net increase, expressed as a percentage, with the following listed separately:

(i) the national drug code;

(ii) the product name;

(iii) the dosage form;

(iv) the strength; and

(v) the package size;

(2) the factors that contributed to the price increase;

(3) the name of any generic version of the prescription drug available on the market;

new text begin (4) the year the prescription drug was introduced for sale in the United States; new text end

deleted text begin (4)deleted text end new text begin (5)new text end the introductory price of the prescription drug when it was introduced for sale in the United States and the price of the drug on the last day of each of the five calendar years preceding the price increase;

deleted text begin (5)deleted text end new text begin (6)new text end the direct costs incurred during the previous 12-month period by the manufacturer that are associated with the prescription drug, listed separately:

(i) to manufacture the prescription drug;

(ii) to market the prescription drug, including advertising costs; and

(iii) to distribute the prescription drug;

new text begin (7) the number of units of the prescription drug sold during the previous 12-month period; new text end

deleted text begin (6)deleted text end new text begin (8)new text end the total sales revenue for the prescription drug during the previous 12-month period;

new text begin (9) the total rebate payable amount accrued for the prescription drug during the previous 12-month period; new text end

deleted text begin (7)deleted text end new text begin (10)new text end the manufacturer's net profit attributable to the prescription drug during the previous 12-month period;

deleted text begin (8)deleted text end new text begin (11)new text end the total amount of financial assistance the manufacturer has provided through patient prescription assistance programs during the previous 12-month period, if applicable;

deleted text begin (9)deleted text end new text begin (12)new text end any agreement between a manufacturer and another entity contingent upon any delay in offering to market a generic version of the prescription drug;

deleted text begin (10)deleted text end new text begin (13)new text end the patent expiration date of the prescription drug if it is under patent;

deleted text begin (11)deleted text end new text begin (14)new text end the name and location of the company that manufactured the drug;

deleted text begin (12)deleted text end new text begin (15)new text end if a brand name prescription drug, the highest price paid for the prescription drug during the previous calendar year in the ten countries, excluding the United States, that charged the highest single price for the prescription drug; and

deleted text begin (13)deleted text end new text begin (16)new text end if the prescription drug was acquired by the manufacturer during the previous 12-month period, all of the following information:

(i) price at acquisition;

(ii) price in the calendar year prior to acquisition;

(iii) name of the company from which the drug was acquired;

(iv) date of acquisition; and

(v) acquisition price.

(c) The manufacturer may submit any documentation necessary to support the information reported under this subdivision.

Subd. 6.

Public posting of prescription drug price information.

(a) The commissioner shall post on the department's website, or may contract with a private entity or consortium that satisfies the standards of section 62U.04, subdivision 6, to meet this requirement, the following information:

(1) a list of the prescription drugs reported under subdivisions 3, 4, and 11 to 14 and the manufacturers of those prescription drugs; deleted text begin anddeleted text end

new text begin (2) a list of reporting entities that reported prescription drug price information under subdivisions 3, 4, and 11 to 14; and new text end

deleted text begin (2)deleted text end new text begin (3)new text end information reported to the commissioner under subdivisions 3, 4, and 11 to 14new text begin , aggregated on a per-drug basis in a manner that does not allow the identification of a reporting entity that is not the manufacturer of the drugnew text end .

(b) The information must be published in an easy-to-read format and in a manner that identifies the information that is disclosed on a per-drug basis and must not be aggregated in a manner that prevents the identification of the prescription drug.

(c) The commissioner shall not post to the department's website or a private entity contracting with the commissioner shall not post any information described in this section if the information is not public data under section 13.02, subdivision 8a; or is trade secret information under section 13.37, subdivision 1, paragraph (b); or is trade secret information pursuant to the Defend Trade Secrets Act of 2016, United States Code, title 18, section 1836, as amended. If a reporting entity believes information should be withheld from public disclosure pursuant to this paragraph, the reporting entity must clearly and specifically identify that information and describe the legal basis in writing when the reporting entity submits the information under this section. If the commissioner disagrees with the reporting entity's request to withhold information from public disclosure, the commissioner shall provide the reporting entity written notice that the information will be publicly posted 30 days after the date of the notice.

(d) If the commissioner withholds any information from public disclosure pursuant to this subdivision, the commissioner shall post to the department's website a report describing the nature of the information and the commissioner's basis for withholding the information from disclosure.

(e) To the extent the information required to be posted under this subdivision is collected and made available to the public by another state, by the University of Minnesota, or through an online drug pricing reference and analytical tool, the commissioner may reference the availability of this drug price data from another source including, within existing appropriations, creating the ability of the public to access the data from the source for purposes of meeting the reporting requirements of this subdivision.

Subd. 10.

Notice of prescription drugs of substantial public interest.

(a) No later than January 31, 2024, and quarterly thereafter, the commissioner shall produce and post on the department's website a list of prescription drugs that the commissioner determines to represent a substantial public interest and for which the commissioner intends to request data under subdivisions 11 to 14, subject to paragraph (c). The commissioner shall base its inclusion of prescription drugs on any information the commissioner determines is relevant to providing greater consumer awareness of the factors contributing to the cost of prescription drugs in the state, and the commissioner shall consider drug product families that include prescription drugs:

(1) that triggered reporting under subdivision 3 or 4 during the previous calendar quarter;

(2) for which average claims paid amounts exceeded 125 percent of the price as of the claim incurred date during the most recent calendar quarter for which claims paid amounts are available; or

(3) that are identified by members of the public during a public comment process.

(b) Not sooner than 30 days after publicly posting the list of prescription drugs under paragraph (a), the department shall notify, via email, reporting entities registered with the department ofnew text begin :new text end

new text begin (1)new text end the requirement to report under subdivisions 11 to 14deleted text begin .deleted text end new text begin ; and new text end

new text begin (2) the reporting period for which data must be provided. new text end

(c) The commissioner must not designate more than 500 prescription drugs as having a substantial public interest in any one notice.

(d) Notwithstanding subdivision 16, the commissioner is exempt from chapter 14, including section 14.386, in implementing this subdivision.

Subd. 11.

Manufacturer prescription drug substantial public interest reporting.

(a) Beginning January 1, 2024, a manufacturer must submit to the commissioner the information described in paragraph (b) for any prescription drug:

(1) included in a notification to report issued to the manufacturer by the department under subdivision 10;

(2) which the manufacturer manufactures or repackages;

(3) for which the manufacturer sets the wholesale acquisition cost; and

(4) for which the manufacturer has not submitted data under subdivision 3 during the 120-day period prior to the date of the notification to report.

(b) For each of the drugs described in paragraph (a), the manufacturer shall submit to the commissioner no later than 60 days after the date of the notification to report, in the form and manner prescribed by the commissioner, the following information, if applicable:

(1) a description of the drug with the following listed separately:

(i) the national drug code;

(ii) the product name;

(iii) the dosage form;

(iv) the strength; and

(v) the package size;

(2) the price of the drug product on the later of:

(i) the day one year prior to the date of the notification to report;

(ii) the introduced to market date; or

(iii) the acquisition date;

(3) the price of the drug product on the date of the notification to report;

new text begin (4) the year the prescription drug was introduced for sale in the United States; new text end

deleted text begin (4)deleted text end new text begin (5)new text end the introductory price of the prescription drug when it was introduced for sale in the United States and the price of the drug on the last day of each of the five calendar years preceding the date of the notification to report;

deleted text begin (5)deleted text end new text begin (6)new text end the direct costs incurred during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report by the manufacturers that are associated with the prescription drug, listed separately:

(i) to manufacture the prescription drug;

(ii) to market the prescription drug, including advertising costs; and

(iii) to distribute the prescription drug;

deleted text begin (6)deleted text end new text begin (7)new text end the number of units of the prescription drug sold during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

deleted text begin (7)deleted text end new text begin (8)new text end the total sales revenue for the prescription drug during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

deleted text begin (8)deleted text end new text begin (9)new text end the total rebate payable amount accrued for the prescription drug during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

deleted text begin (9)deleted text end new text begin (10)new text end the manufacturer's net profit attributable to the prescription drug during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

deleted text begin (10)deleted text end new text begin (11)new text end the total amount of financial assistance the manufacturer has provided through patient prescription assistance programs during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report, if applicable;

deleted text begin (11)deleted text end new text begin (12)new text end any agreement between a manufacturer and another entity contingent upon any delay in offering to market a generic version of the prescription drug;

deleted text begin (12)deleted text end new text begin (13)new text end the patent expiration date of the prescription drug if the prescription drug is under patent;

deleted text begin (13)deleted text end new text begin (14)new text end the name and location of the company that manufactured the drug;

deleted text begin (14)deleted text end new text begin (15)new text end if the prescription drug is a brand name prescription drug, the ten countries other than the United States that paid the highest prices for the prescription drug during the previous calendar year and their prices; and

deleted text begin (15)deleted text end new text begin (16)new text end if the prescription drug was acquired by the manufacturer within deleted text begin a 12-month period prior to the date ofdeleted text end new text begin the reporting period specified innew text end the notification to report, all of the following information:

(i) the price at acquisition;

(ii) the price in the calendar year prior to acquisition;

(iii) the name of the company from which the drug was acquired;

(iv) the date of acquisition; and

(v) the acquisition price.

(c) The manufacturer may submit any documentation necessary to support the information reported under this subdivision.

Subd. 12.

Pharmacy prescription drug substantial public interest reporting.

(a) Beginning January 1, 2024, a pharmacy must submit to the commissioner the information described in paragraph (b) for any prescription drugnew text begin : new text end

new text begin (1)new text end included in a notification to report issued to the pharmacy by the department under subdivision 10deleted text begin .deleted text end new text begin ; andnew text end

new text begin (2) that the pharmacy dispensed in Minnesota or mailed to a Minnesota address. new text end

(b) For each of the drugs described in paragraph (a), the pharmacy shall submit to the commissioner no later than 60 days after the date of the notification to report, in the form and manner prescribed by the commissioner, the following information, if applicable:

(1) a description of the drug with the following listed separately:

(i) the national drug code;

(ii) the product name;

(iii) the dosage form;

(iv) the strength; and

(v) the package size;

(2) the number of units of the drug acquired during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(3) the total spent before rebates by the pharmacy to acquire the drug during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(4) the total rebate receivable amount accrued by the pharmacy for the drug during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(5) the number of pricing units of the drug dispensed by the pharmacy during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(6) the total payment receivable by the pharmacy for dispensing the drug including ingredient cost, dispensing fee, and administrative fees during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(7) the total rebate payable amount accrued by the pharmacy for the drug during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report; and

(8) the average cash price paid by consumers per pricing unit for prescriptions dispensed where no claim was submitted to a health care service plan or health insurer during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report.

(c) The pharmacy may submit any documentation necessary to support the information reported under this subdivision.

(d) The commissioner may grant extensions, exemptions, or both to compliance with the requirements of paragraphs (a) and (b) by small or independent pharmacies, if compliance with paragraphs (a) and (b) would represent a hardship or undue burden to the pharmacy. The commissioner may establish procedures for small or independent pharmacies to request extensions or exemptions under this paragraph.

Subd. 13.

PBM prescription drug substantial public interest reporting.

(a) Beginning January 1, 2024, a PBM must submit to the commissioner the information described in paragraph (b) for any prescription drugnew text begin : new text end

new text begin (1)new text end included in a notification to report issued to the PBM by the department under subdivision 10deleted text begin .deleted text end new text begin ; andnew text end

new text begin (2) for which the PBM fulfilled pharmacy benefit management duties for Minnesota residents. new text end

(b) For each of the drugs described in paragraph (a), the PBM shall submit to the commissioner no later than 60 days after the date of the notification to report, in the form and manner prescribed by the commissioner, the following information, if applicable:

(1) a description of the drug with the following listed separately:

(i) the national drug code;

(ii) the product name;

(iii) the dosage form;

(iv) the strength; and

(v) the package size;

(2) the number of pricing units of the drug product filled deleted text begin for which the PBM administered claimsdeleted text end during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(3) the total reimbursement amount accrued and payable to pharmacies for pricing units of the drug product filled deleted text begin for which the PBM administered claimsdeleted text end during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(4) the total reimbursement deleted text begin or administrative feedeleted text end amountdeleted text begin , or both,deleted text end accrued and receivable from payers for pricing units of the drug product filled deleted text begin for which the PBM administered claimsdeleted text end during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

new text begin (5) the total administrative fee amount accrued and receivable from payers for pricing units of the drug product filled during the reporting period specified in the notification to report; new text end

deleted text begin (5)deleted text end new text begin (6)new text end the total rebate receivable amount accrued by the PBM for the drug product during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report; and

deleted text begin (6)deleted text end new text begin (7)new text end the total rebate payable amount accrued by the PBM for the drug product during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report.

(c) The PBM may submit any documentation necessary to support the information reported under this subdivision.

Subd. 14.

Wholesale drug distributor prescription drug substantial public interest reporting.

(a) Beginning January 1, 2024, a wholesale drug distributornew text begin that distributes prescription drugs, for which it is not the manufacturer, to persons or entities, or both, other than a consumer or patient in the state,new text end must submit to the commissioner the information described in paragraph (b) for any prescription drugnew text begin : new text end

new text begin (1)new text end included in a notification to report issued to the wholesale drug distributor by the department under subdivision 10deleted text begin .deleted text end new text begin ; andnew text end

new text begin (2) that the wholesale drug distributor distributed within or into Minnesota. new text end

(b) For each of the drugs described in paragraph (a), the wholesale drug distributor shall submit to the commissioner no later than 60 days after the date of the notification to report, in the form and manner prescribed by the commissioner, the following information, if applicable:

(1) a description of the drug with the following listed separately:

(i) the national drug code;

(ii) the product name;

(iii) the dosage form;

(iv) the strength; and

(v) the package size;

(2) the number of units of the drug product acquired by the wholesale drug distributor during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(3) the total spent before rebates by the wholesale drug distributor to acquire the drug product during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(4) the total rebate receivable amount accrued by the wholesale drug distributor for the drug product during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(5) the number of units of the drug product sold by the wholesale drug distributor during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;

(6) gross revenue from sales in the United States generated by the wholesale drug distributor for deleted text begin thisdeleted text end new text begin thenew text end drug product during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report; and

(7) total rebate payable amount accrued by the wholesale drug distributor for the drug product during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report.

(c) The wholesale drug distributor may submit any documentation necessary to support the information reported under this subdivision.

Subd. 15.

Registration requirements.

deleted text begin Beginning January 1, 2024,deleted text end A reporting entity subject to this chapter shall registernew text begin , or update existing registration information,new text end with the department in a form and manner prescribed by the commissionernew text begin by January 30 each yearnew text end .

Subd. 2.

deleted text begin Primary care; mental health services; general hospital servicesdeleted text end new text begin Time and distance standardsnew text end .

deleted text begin The maximum travel distance or time shall be the lesser of 30 miles or 30 minutes to the nearest provider of each of the following services: primary care services, mental health services, and general hospital servicesdeleted text end new text begin Health carriers must meet the time and distance standards under Code of Federal Regulations, title 45, section 155.1050new text end .

Subd. 5.

Waiver.

(a) A health carrier may apply to the commissioner of health for a waiver of the requirements in subdivision 2 deleted text begin or 3deleted text end if it is unable to meet the statutory requirements. A waiver application must be submitted on a form provided by the commissioner, must be accompanied by an application fee of $500 for each application to waive the requirements in subdivision 2 deleted text begin or 3deleted text end for one or more provider types per county, and must:

(1) demonstrate with specific data that the requirement of subdivision 2 deleted text begin or 3deleted text end is not feasible in a particular service area or part of a service area; and

(2) include specific information as to the steps that were and will be taken to address the network inadequacy, and, for steps that will be taken prospectively to address network inadequacy, the time frame within which those steps will be taken.

(b) The commissioner shall establish guidelines for evaluating waiver applications, standards governing approval or denial of a waiver application, and standards for steps that health carriers must take to address the network inadequacy and allow the health carrier to meet network adequacy requirements within a reasonable time period. The commissioner shall review each waiver application using these guidelines and standards and shall approve a waiver application only if:

(1) the standards for approval established by the commissioner are satisfied; and

(2) the steps that were and will be taken to address the network inadequacy and the time frame for taking these steps satisfy the standards established by the commissioner.

(c) If, in its waiver application, a health carrier demonstrates to the commissioner that there are no providers of a specific type or specialty in a county, the commissioner may approve a waiver in which the health carrier is allowed to address network inadequacy in that county by providing for patient access to providers of that type or specialty via telehealth, as defined in section 62A.673, subdivision 2.

(d) The waiver shall automatically expire after one year. Upon or prior to expiration of a waiver, a health carrier unable to meet the requirements in subdivision 2 deleted text begin or 3deleted text end must submit a new waiver application under paragraph (a) and must also submit evidence of steps the carrier took to address the network inadequacy. When the commissioner reviews a waiver application for a network adequacy requirement which has been waived for the carrier for the most recent one-year period, the commissioner shall also examine the steps the carrier took during that one-year period to address network inadequacy, and shall only approve a subsequent waiver application that satisfies the requirements in paragraph (b), demonstrates that the carrier took the steps it proposed to address network inadequacy, and explains why the carrier continues to be unable to satisfy the requirements in subdivision 2 deleted text begin or 3deleted text end .

(e) Application fees collected under this subdivision shall be deposited in the state government special revenue fund in the state treasury.

Subd. 6.

Referral centers.

deleted text begin Subdivisionsdeleted text end new text begin Subdivisionnew text end 2 deleted text begin and 3deleted text end shall not apply if an enrollee is referred to a referral center for health care services. A referral center is a medical facility that provides highly specialized medical care, including but not limited to organ transplants. A health carrier or preferred provider organization may consider the volume of services provided annually, case mix, and severity adjusted mortality and morbidity rates in designating a referral center.

Subd. 17b.

Temporary boring.

"Temporary boring" means an excavation that is 15 feet or more in depth, is sealed within 72 hours of the time of construction, and is drilled, cored, washed, driven, dug, jetted, or otherwise constructed to:

(1) conduct physical, chemical, or biological testing of groundwater, including groundwater quality monitoring;

(2) monitor or measure physical, chemical, radiological, or biological parameters of earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or resistance;

(3) measure groundwater levels, including use of a piezometer; deleted text begin anddeleted text end new text begin ornew text end

(4) determine groundwater flow direction or velocity.

Subd. 2.

Duties.

The commissioner shall:

(1) regulate the drilling, construction, modification, repair, and sealing of wells and borings;

(2) examine and license:

(i) well contractors;

(ii) persons constructing, repairing, and sealing bored geothermal heat exchangers;

(iii) persons modifying or repairing well casings above the pitless unit or adaptor, well screens, well diameters, and installing well pumps or pumping equipment;

(iv) persons constructing, repairing, and sealing dewatering wells;

(v) persons sealing wells or borings; deleted text begin anddeleted text end

(vi) persons excavating or drilling holes for the installation of elevator borings;new text begin andnew text end

new text begin (vii) persons installing, removing, or maintaining groundwater thermal exchange devices and submerged closed loop heat exchangers; new text end

(3) examine and license environmental well contractors;

(4) license explorers engaged in exploratory boring and examine individuals who supervise or oversee exploratory boring;

(5) after consultation with the commissioner of natural resources and the Pollution Control Agency, establish standards for the design, location, construction, repair, and sealing of wells and borings within the state; and

(6) issue permits for wells, groundwater thermal devices, bored geothermal heat exchangers,new text begin installation of submerged closed loop heat exchanger systems,new text end and elevator borings.

Subd. 5.

Commissioner to adopt rules.

The commissioner shall adopt rules including:

(1) issuance of licenses for:

(i) qualified well contractors;

(ii) persons constructing, repairing, and sealing dewatering wells;

(iii) persons sealing wells or borings;

(iv) persons installing, modifying, or repairing well casings, well screens, well diameters, and well pumps or pumping equipment;

(v) persons constructing, repairing, and sealing bored geothermal heat exchangers;

(vi) persons constructing, repairing, and sealing elevator borings; deleted text begin anddeleted text end

(vii) persons constructing, repairing, and sealing environmental wells;new text begin andnew text end

new text begin (viii) persons installing, removing, or maintaining groundwater thermal exchange devices and submerged closed loop heat exchangers; new text end

(2) establishment of conditions for examination and review of applications for license and certification;

(3) establishment of conditions for revocation and suspension of license and certification;

(4) establishment of minimum standards for design, location, construction, repair, and sealing of wells and borings to implement the purpose and intent of this chapter;

(5) establishment of a system for reporting on wells and borings drilled and sealed;

(6) establishment of standards for the construction, maintenance, sealing, and water quality monitoring of wells in areas of known or suspected contamination;

(7) establishment of wellhead protection measures for wells serving public water supplies;

(8) establishment of procedures to coordinate collection of well and boring data with other state and local governmental agencies;

(9) establishment of criteria and procedures for submission of well and boring logs, formation samples or well or boring cuttings, water samples, or other special information required for and water resource mapping; and

(10) establishment of minimum standards for design, location, construction, maintenance, repair, sealing, safety, and resource conservation related to borings, including exploratory borings as defined in section 103I.005, subdivision 9.

Subdivision 1.

Establishment.

The healthy eating, here at home program is established to provide incentives for low-income Minnesotans to use federal Supplemental Nutrition Assistance Program (SNAP)new text begin or SUN bucks (Summer EBT)new text end benefits for healthy purchases at Minnesota-based farmers' markets, mobile markets, and direct-farmer sales, including community-supported agriculture shares.

Subd. 2.

Definitions.

(a) The definitions in this subdivision apply to this section.

(b) "Healthy eating, here at home" means a program administered by the deleted text begin Minnesota Humanities Centerdeleted text end new text begin Department of Healthnew text end to provide incentives for low-income Minnesotans to use SNAPnew text begin or SUN bucks (Summer EBT)new text end benefits for healthy purchases at Minnesota-based farmers' markets.

(c) "Healthy purchases" means SNAP-eligible foods.

(d) "Minnesota-based farmers' market" means a physical market as defined in section 28A.151, subdivision 1, paragraph (b), and also includes mobile markets and direct-farmer sales, including through a community-supported agriculture model.

(e) "Voucher" means a physical or electronic credit.

(f) "Eligible household" means an individual or family that is determined to be a recipient of SNAPnew text begin or SUN bucks (Summer EBT)new text end .

Subd. 3.

Grants.

The deleted text begin Minnesota Humanities Centerdeleted text end new text begin commissionernew text end shall allocate grant funds to nonprofit organizations that work with Minnesota-based farmers' markets to provide up to $10 vouchers to SNAPnew text begin or SUN bucks (Summer EBT)new text end participants who use electronic benefits transfer (EBT) cards for healthy purchases. Funds may also be provided for vouchers distributed through nonprofit organizations engaged in healthy cooking and food education outreach to eligible households for use at farmers' markets. Funds appropriated under this section may not be used for healthy cooking classes or food education outreach. When awarding grants, the deleted text begin Minnesota Humanities Centerdeleted text end new text begin commissionernew text end must consider how the nonprofit organizations will achieve geographic balance, including specific efforts to reach eligible households across the state, and the organizations' capacity to manage the programming and outreach.

Subd. 4.

Household eligibility; participation.

To be eligible for a healthy eating, here at home voucher, an eligible household must meet the Minnesota SNAPnew text begin or SUN bucks (Summer EBT)new text end eligibility requirements deleted text begin under section deleted text end deleted text begin 142F.10deleted text end .

Subd. 6.

Program reporting.

The nonprofit organizations that receive grant funds must report annually to the deleted text begin Minnesota Humanities Centerdeleted text end new text begin commissionernew text end with information regarding the operation of the program, including the number of vouchers issued and the number of people served. To the extent practicable, the nonprofit organizations must report on the usage of the vouchers and evaluate the program's effectiveness.

Subd. 1a.

Notice of closing, curtailing operations, relocating services, or ceasing to offer certain services; hospitals.

(a) The controlling persons of a hospital licensed under sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health, the public, and others at least 182 days before the hospital or hospital campus voluntarily plans to implement one of the scheduled actions listed in paragraph (b), unless the controlling persons can demonstrate to the commissioner that meeting the advanced notice requirement is not feasible and the commissioner approves a shorter advanced notice.

(b) The following scheduled actions require advanced notice under paragraph (a):

(1) ceasing operations;

(2) curtailing operations to the extent that new text begin emergency department services ornew text end patientsnew text begin receiving inpatient health servicesnew text end must be relocated;

(3) relocating the provision of new text begin inpatient new text end health services new text begin or emergency department services new text end to another hospital or deleted text begin anotherdeleted text end hospital campus; or

(4) ceasing to offer new text begin inpatient new text end maternity care and new text begin inpatient new text end newborn care services, new text begin inpatient new text end intensive care unit services, inpatient mental health services, or inpatient substance use disorder treatment services.

(c) A notice required under this subdivision must comply with the requirements in subdivision 1d.

(d) The commissioner shall cooperate with the controlling persons and advise them about relocating the patients.

new text begin (e) For purposes of this subdivision, "inpatient" means services that are provided to a person who has been admitted to a hospital for bed occupancy. new text end

Subd. 1b.

Public hearing.

Within 30 days after receiving notice under subdivision 1a, the commissioner shall conduct a public hearing on the scheduled cessation of operations, curtailment of operations, relocation of health services, or cessation in offering health services. The commissioner must provide adequate public notice of the hearing in a time and manner determined by the commissioner. new text begin The commissioner must ensure that video conferencing technology is used at the public hearing to allow members of the public to view and participate in the hearing. new text end The controlling persons of the hospital or hospital campus must participate in the public hearing. The public hearing must be held at a location that is within ten miles of the hospital or hospital campus or with the commissioner's approval as close as is practicable, new text begin that can accommodate the hearing's anticipated public attendance, new text end and that is provided or arranged by the hospital or hospital campus. deleted text begin Video conferencing technology must be used to allow members of the public to view and participate in the hearing.deleted text end The public hearing must include:

(1) an explanation by the controlling persons of the reasons for ceasing or curtailing operations, relocating health services, or ceasing to offer any of the listed health services;

(2) a description of the actions that controlling persons will take to ensure that residents in the hospital's or campus's service area have continued access to the health services being eliminated, curtailed, or relocated;

(3) an opportunity for new text begin at least one hour of new text end public testimony on the scheduled cessation or curtailment of operations, relocation of health services, or cessation in offering any of the listed health services, and on the hospital's or campus's plan to ensure continued access to those health services being eliminated, curtailed, or relocated; and

(4) an opportunity for the controlling persons to respond to questions from interested persons.

Subdivision 1.

Establishment; composition of advisory council.

The health equity advisory and leadership (HEAL) council consists of 18 members appointed by the commissioner of healthnew text begin , including but not limited to membersnew text end who will provide representation from the following groups:

(1) African American and African heritage communities;

(2) Asian American and Pacific Islander communities;

(3) Latina/o/x communities;

(4) American Indian communities and Tribal governments and nations;

(5) disability communities;

(6) lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities; and

(7) representatives who reside outside the seven-county metropolitan area.

Subd. 2.

Organization and meetings.

(a) Terms, compensation, and removal of members of the advisory council shall be as provided in section 15.059, subdivisions 2 to 4, except that terms for advisory council members shall be for two years. Members may be reappointed to serve up to two additional terms. Notwithstanding section 15.059, subdivision 6, the advisory council shall not expire. deleted text begin The commissioner shall recommend appointments to replace members vacating their positions in a timely manner, no more than three months after the advisory council reviews panel recommendations.deleted text end

(b) The commissioner must convene meetings at least quarterly and must provide meeting space and administrative support to the advisory council. Subcommittees may be convened as necessary. Advisory council meetings are subject to the Open Meeting Law under chapter 13D.

Subdivision 1.

Remedies available.

The provisions of chapters 103I and 157 and sections 115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14), and (15); 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385; 144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98; 144.992; new text begin 147.037, subdivision 1b, paragraph (d); new text end 326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all rules, orders, stipulation agreements, settlements, compliance agreements, licenses, registrations, certificates, and permits adopted or issued by the department or under any other law now in force or later enacted for the preservation of public health may, in addition to provisions in other statutes, be enforced under this section.

Subd. 15.

Occupational therapist.

"Occupational therapist" deleted text begin means a person who is licensed under sections 148.6401 to 148.6449deleted text end new text begin has the meaning given in section 148.6402, subdivision 14new text end .

Subd. 45.

Occupational therapist.

"Occupational therapist" deleted text begin means a person who is licensed under sections 148.6401 to 148.6449deleted text end new text begin has the meaning given in section 148.6402, subdivision 14new text end .

Subd. 7.

Physician application and license fees.

(a) The board may charge the following nonrefundable application and license fees processed pursuant to sections 147.02, 147.03, 147.037, 147.0375, and 147.38:

(1) physician application fee, $200;

(2) physician annual registration renewal fee, $192;

(3) physician endorsement to other states, $40;

(4) physician emeritus license, $50;

(5) physician late fee, $60;

new text begin (6) nonrenewable 24-month limited license, $392; new text end

new text begin (7) initial physician license for limited license holder, $192; new text end

deleted text begin (6)deleted text end new text begin (8)new text end duplicate license fee, $20;

deleted text begin (7)deleted text end new text begin (9)new text end certification letter fee, $25;

deleted text begin (8)deleted text end new text begin (10)new text end education or training program approval fee, $100;

deleted text begin (9)deleted text end new text begin (11)new text end report creation and generation fee, $60 per hour;

deleted text begin (10)deleted text end new text begin (12)new text end examination administration fee (half day), $50;

deleted text begin (11)deleted text end new text begin (13)new text end examination administration fee (full day), $80;

deleted text begin (12)deleted text end new text begin (14)new text end fees developed by the Interstate Commission for determining physician qualification to register and participate in the interstate medical licensure compact, as established in rules authorized in and pursuant to section 147.38, not to exceed $1,000; and

deleted text begin (13)deleted text end new text begin (15)new text end verification fee, $25.

(b) The board may prorate the initial annual license fee. All licensees are required to pay the full fee upon license renewal. The revenue generated from the fee must be deposited in an account in the state government special revenue fund.

Subdivision 1.

General.

Within the meaning of sections 147D.01 to 147D.27, a person who shall publicly profess to be a traditional midwife and who, for a fee, shall assist or attend to a woman in pregnancy, childbirth outside a hospital, and postpartum, shall be regarded as practicing traditional midwifery.new text begin A certified midwife licensed by the Board of Nursing under chapter 148G is not subject to the provisions of this chapter.new text end

Subdivision 1.

Fees.

deleted text begin In addition to the fees established in Minnesota Rules, chapter 2500,deleted text end The board is authorized to charge the fees in this section.

Subd. 2.

Powers.

(a) The board is authorized to adopt and, from time to time, revise rules not inconsistent with the law, as may be necessary to enable it to carry into effect the provisions of sections 148.171 to 148.285new text begin and chapter 148Gnew text end . The board shall prescribe by rule curricula and standards for schools and courses preparing persons for licensure under sections 148.171 to 148.285new text begin and 148G.12new text end . It shall conduct or provide for surveys of such schools and courses at such times as it may deem necessary. It shall approve such schools and courses as meet the requirements of sections 148.171 to 148.285new text begin or section 148G.12,new text end and board rules. It shall examine, license, and renew the license of duly qualified applicants. It shall hold examinations at least once in each year at such time and place as it may determine. It shall by rule adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for registration and renewal of registration as defined in section 148.231new text begin and chapter 148Gnew text end . It shall maintain a record of all persons licensed by the board to practice advanced practice, professional, or practical nursingnew text begin , or certified as a midwifenew text end . It shall cause the prosecution of all persons violating sections 148.171 to 148.285new text begin or chapter 148G,new text end and have power to incur such necessary expense therefor. It shall register public health nurses who meet educational and other requirements established by the board by rule, including payment of a fee. It shall have power to issue subpoenas, and to compel the attendance of witnesses and the production of all necessary documents and other evidentiary material. Any board member may administer oaths to witnesses, or take their affirmation. It shall keep a record of all its proceedings.

(b) The board shall have access to hospital, nursing home, and other medical records of a patient cared for by a nursenew text begin or certified midwifenew text end under review. If the board does not have a written consent from a patient permitting access to the patient's records, the nursenew text begin , certified midwife,new text end or facility shall delete any data in the record that identifies the patient before providing it to the board. The board shall have access to such other records as reasonably requested by the board to assist the board in its investigation. Nothing herein may be construed to allow access to any records protected by section 145.64. The board shall maintain any records obtained pursuant to this paragraph as investigative data under chapter 13.

(c) The board may accept and expend grants or gifts of money or in-kind services from a person, a public or private entity, or any other source for purposes consistent with the board's role and within the scope of its statutory authority.

(d) The board may accept registration fees for meetings and conferences conducted for the purposes of board activities that are within the scope of its authority.

Subd. 17a.

Speech-language pathology assistant.

"Speech-language pathology assistant" means a person who meets the qualifications under section 148.5181 and provides speech-language pathology services under the supervision of a licensed speech-language pathologistnew text begin under sections 122A.183 and 122A.184 ornew text end in accordance with section 148.5192.

Subd. 3.

Supervision requirements.

(a) A supervising speech-language pathologist shall authorize and accept full responsibility for the performance, practice, and activity of a speech-language pathology assistant. The amount and type of supervision required must be based on the skills and experience of the speech-language pathology assistant. A minimum of one hour every 30 days of consultative supervision time must be documented for each speech-language pathology assistant.

(b) A supervising speech-language pathologist must:

(1) be licensed under sections new text begin 122A.183, 122A.184, or new text end 148.511 to 148.5198;

(2) hold a certificate of clinical competence from the American Speech-Language-Hearing Association or its equivalent as approved by the commissioner; and

(3) have completed at least ten hours of continuing education in supervision.

(c) Once every 60 days, the supervising speech-language pathologist must treat or cotreat with the speech-language pathology assistant each client on the speech-language pathology assistant's caseload.

(d) For purposes of this section, "direct supervision" means observation and guidance by the supervising speech-language pathologist during the performance of a delegated duty that occurs either on-site and in-view or through the use of real-time, two-way interactive audio and visual communication. The supervision requirements described in this section are minimum requirements. Additional supervision requirements may be imposed at the discretion of the supervising speech-language pathologist.

(e) A supervising speech-language pathologist must be available to communicate with a speech-language pathology assistant at any time the assistant is in direct contact with a client.

(f) A supervising speech-language pathologist must document activities performed by the assistant that are directly supervised by the supervising speech-language pathologist. At a minimum, the documentation must include:

(1) information regarding the quality of the speech-language pathology assistant's performance of the delegated duties; and

(2) verification that any delegated clinical activity was limited to duties authorized to be performed by the speech-language pathology assistant under this section.

(g) A supervising speech-language pathologist must review and cosign all informal treatment notes signed or initialed by the speech-language pathology assistant.

(h) A full-time, speech-language pathologist may supervise no more than two full-time, speech-language pathology assistants or the equivalent of two full-time assistants.

new text begin (i) If the commissioner determines that a speech-language pathology assistant licensed under section 148.5181 violates any part of sections 148.511 to 148.5198 and is supervised by a speech-language pathologist licensed by the Professional Educator Licensing and Standards Board (PELSB), the commissioner must immediately notify PELSB. Upon such notification, PELSB must initiate an investigation of the supervising speech-language pathologist. PELSB must share the result of the investigation with the commissioner. new text end

Subd. 3b.

Speech-language pathology assistant licensure fees.

The fee for initial licensure as a speech-language pathology assistant deleted text begin is $493deleted text end new text begin must not exceed $220new text end . The fee for licensure renewal for a speech-language pathology assistant deleted text begin is $493deleted text end new text begin must not exceed $220new text end .

Subdivision 1.

Scope.

For the purpose of sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end , the following terms have the meanings given them.