Bill Text: MN SF2123 | 2013-2014 | 88th Legislature | Introduced
Bill Title: Dental therapists and advanced dental therapists health professional loan forgiveness program addition; dental screenings by dental therapists or dental hygienists in collaborative practices coverage; telehealth oral health services coverage
Spectrum: Slight Partisan Bill (Democrat 2-1)
Status: (Introduced - Dead) 2014-03-03 - Referred to Health, Human Services and Housing [SF2123 Detail]
Download: Minnesota-2013-SF2123-Introduced.html
1.2relating to oral health; adding dental therapists and advanced dental therapists to
1.3the health professional education loan forgiveness program; covering basic dental
1.4screenings performed by dental therapists or dental hygienists in collaborative
1.5practices; covering oral health services provided by telehealth;amending
1.6Minnesota Statutes 2012, sections 144.1501, subdivisions 1, 2, 3; 256B.0625,
1.7subdivision 14, by adding a subdivision.
1.8BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.9 Section 1. Minnesota Statutes 2012, section 144.1501, subdivision 1, is amended to read:
1.10 Subdivision 1. Definitions. (a) For purposes of this section, the following definitions
1.11apply.
1.12(b) "Dentist" means an individual who is licensed to practice dentistry.
1.13(c) "Designated rural area" means an area defined as a small rural area or isolated rural
1.14area according to the four category classifications of the Rural Urban Commuting Area
1.15system developed for the United States Health Resources and Services Administration.
1.16(d) "Emergency circumstances" means those conditions that make it impossible for
1.17the participant to fulfill the service commitment, including death, total and permanent
1.18disability, or temporary disability lasting more than two years.
1.19(e) "Medical resident" means an individual participating in a medical residency in
1.20family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
1.21(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
1.22anesthetist, advanced clinical nurse specialist, or physician assistant.
1.23(g) "Nurse" means an individual who has completed training and received all
1.24licensing or certification necessary to perform duties as a licensed practical nurse or
1.25registered nurse.
2.1(h) "Nurse-midwife" means a registered nurse who has graduated from a program of
2.2study designed to prepare registered nurses for advanced practice as nurse-midwives.
2.3(i) "Nurse practitioner" means a registered nurse who has graduated from a program
2.4of study designed to prepare registered nurses for advanced practice as nurse practitioners.
2.5(j) "Pharmacist" means an individual with a valid license issued under chapter 151.
2.6(k) "Physician" means an individual who is licensed to practice medicine in the areas
2.7of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
2.8(l) "Physician assistant" means a person licensed under chapter 147A.
2.9(m) "Qualified educational loan" means a government, commercial, or foundation
2.10loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
2.11expenses related to the graduate or undergraduate education of a health care professional.
2.12(n) "Underserved urban community" means a Minnesota urban area or population
2.13included in the list of designated primary medical care health professional shortage areas
2.14(HPSAs), medically underserved areas (MUAs), or medically underserved populations
2.15(MUPs) maintained and updated by the United States Department of Health and Human
2.16Services.
2.17(o) "Dental therapist" means a dental therapist licensed under section 150A.105.
2.18(p) "Advanced dental therapist" means an advanced dental therapist certified under
2.19section 150A.106.
2.20 Sec. 2. Minnesota Statutes 2012, section 144.1501, subdivision 2, is amended to read:
2.21 Subd. 2. Creation of account. (a) A health professional education loan forgiveness
2.22program account is established. The commissioner of health shall use money from the
2.23account to establish a loan forgiveness program:
2.24 (1) for medical residents agreeing to practice in designated rural areas or underserved
2.25urban communities or specializing in the area of pediatric psychiatry;
2.26 (2) for midlevel practitioners agreeing to practice in designated rural areas or to
2.27teach at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary
2.28program at the undergraduate level or the equivalent at the graduate level;
2.29 (3) for nurses who agree to practice in a Minnesota nursing home or intermediate
2.30care facility for persons with developmental disability or to teach at least 12 credit hours,
2.31or 720 hours per year in the nursing field in a postsecondary program at the undergraduate
2.32level or the equivalent at the graduate level;
2.33 (4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
2.34hours per year in their designated field in a postsecondary program at the undergraduate
2.35level or the equivalent at the graduate level. The commissioner, in consultation with
3.1the Healthcare Education-Industry Partnership, shall determine the health care fields
3.2where the need is the greatest, including, but not limited to, respiratory therapy, clinical
3.3laboratory technology, radiologic technology, and surgical technology;
3.4 (5) for pharmacists who agree to practice in designated rural areas;and
3.5 (6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
3.6encounters to state public program enrollees or patients receiving sliding fee schedule
3.7discounts through a formal sliding fee schedule meeting the standards established by
3.8the United States Department of Health and Human Services under Code of Federal
3.9Regulations, title 42, section 51, chapter 303; and
3.10 (7) for dental therapists or advanced dental therapists.
3.11 (b) Appropriations made to the account do not cancel and are available until
3.12expended, except that at the end of each biennium, any remaining balance in the account
3.13that is not committed by contract and not needed to fulfill existing commitments shall
3.14cancel to the fund.
3.15 Sec. 3. Minnesota Statutes 2012, section 144.1501, subdivision 3, is amended to read:
3.16 Subd. 3. Eligibility. (a) To be eligible to participate in the loan forgiveness program,
3.17an individual must:
3.18(1) be a medical or dental resident, a licensed pharmacist or be enrolled in a dentist,
3.19dental therapist, advanced dental therapist, midlevel practitioner, registered nurse, or a
3.20licensed practical nurse training program; and
3.21(2) submit an application to the commissioner of health. If fewer applications are
3.22submitted by dental students or residents than there are dentist participant slots available,
3.23the commissioner may consider applications submitted by dental program graduates
3.24who are licensed dentists.
3.25(b) An applicant selected to participate must sign a contract to agree to serve a
3.26minimum three-year full-time service obligation according to subdivision 2, which shall
3.27begin no later than March 31 following completion of required training.
3.28 Sec. 4. Minnesota Statutes 2012, section 256B.0625, subdivision 14, is amended to read:
3.29 Subd. 14. Diagnostic, screening, and preventive services. (a) Medical assistance
3.30covers diagnostic, screening, and preventive services.
3.31(b) "Preventive services" include services related to pregnancy, including:
3.32(1) services for those conditions which may complicate a pregnancy and which may
3.33be available to a pregnant woman determined to be at risk of poor pregnancy outcome;
3.34(2) prenatal HIV risk assessment, education, counseling, and testing; and
4.1(3) alcohol abuse assessment, education, and counseling on the effects of alcohol
4.2usage while pregnant. Preventive services available to a woman at risk of poor pregnancy
4.3outcome may differ in an amount, duration, or scope from those available to other
4.4individuals eligible for medical assistance.
4.5(c) "Screening services" include, but are not limited to,:
4.6(1) blood lead tests.; and
4.7(2) oral health screenings conducted by a licensed dental provider in collaborative
4.8practice under section 150A.10, subdivision 1a, or 150A.106, to determine an enrollee's
4.9need to be seen by a dentist for diagnosis and assessment to identify possible signs
4.10of oral or systemic disease, malformation, or injury, and the potential need for referral
4.11for diagnosis and treatment. This clause includes oral health screenings conducted by a
4.12licensed dental provider as part of a state or federally mandated screening.
4.13(d) The commissioner shall encourage, at the time of the child and teen checkup or
4.14at an episodic care visit, the primary care health care provider to perform primary caries
4.15preventive services. Primary caries preventive services include, at a minimum:
4.16(1) a general visual examination of the child's mouth without using probes or other
4.17dental equipment or taking radiographs;
4.18(2) a risk assessment using the factors established by the American Academies
4.19of Pediatrics and Pediatric Dentistry; and
4.20(3) the application of a fluoride varnish beginning at age one to those children
4.21assessed by the provider as being high risk in accordance with best practices as defined by
4.22the Department of Human Services. The provider must obtain parental or legal guardian
4.23consent before a fluoride varnish is applied to a minor child's teeth.
4.24At each checkup, if primary caries preventive services are provided, the provider must
4.25provide to the child's parent or legal guardian: information on caries etiology and
4.26prevention; and information on the importance of finding a dental home for their child
4.27by the age of one. The provider must also advise the parent or legal guardian to contact
4.28the child's managed care plan or the Department of Human Services in order to secure a
4.29dental appointment with a dentist. The provider must indicate in the child's medical record
4.30that the parent or legal guardian was provided with this information and document any
4.31primary caries prevention services provided to the child.
4.32 Sec. 5. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
4.33subdivision to read:
4.34 Subd. 64. Oral health telehealth. Medical assistance covers dental and oral health
4.35services that are otherwise covered by medical assistance as direct face-to-face services
5.1provided via telecommunications equipment, including, but not limited to, store and
5.2forward technology. Reimbursement is at the same rates and under the same requirements
5.3that would otherwise apply to the service.
5.4EFFECTIVE DATE.This section is effective January 1, 2015, or upon federal
5.5approval, whichever is later, and applies to services provided after the effective date.
1.3the health professional education loan forgiveness program; covering basic dental
1.4screenings performed by dental therapists or dental hygienists in collaborative
1.5practices; covering oral health services provided by telehealth;amending
1.6Minnesota Statutes 2012, sections 144.1501, subdivisions 1, 2, 3; 256B.0625,
1.7subdivision 14, by adding a subdivision.
1.8BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.9 Section 1. Minnesota Statutes 2012, section 144.1501, subdivision 1, is amended to read:
1.10 Subdivision 1. Definitions. (a) For purposes of this section, the following definitions
1.11apply.
1.12(b) "Dentist" means an individual who is licensed to practice dentistry.
1.13(c) "Designated rural area" means an area defined as a small rural area or isolated rural
1.14area according to the four category classifications of the Rural Urban Commuting Area
1.15system developed for the United States Health Resources and Services Administration.
1.16(d) "Emergency circumstances" means those conditions that make it impossible for
1.17the participant to fulfill the service commitment, including death, total and permanent
1.18disability, or temporary disability lasting more than two years.
1.19(e) "Medical resident" means an individual participating in a medical residency in
1.20family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
1.21(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
1.22anesthetist, advanced clinical nurse specialist, or physician assistant.
1.23(g) "Nurse" means an individual who has completed training and received all
1.24licensing or certification necessary to perform duties as a licensed practical nurse or
1.25registered nurse.
2.1(h) "Nurse-midwife" means a registered nurse who has graduated from a program of
2.2study designed to prepare registered nurses for advanced practice as nurse-midwives.
2.3(i) "Nurse practitioner" means a registered nurse who has graduated from a program
2.4of study designed to prepare registered nurses for advanced practice as nurse practitioners.
2.5(j) "Pharmacist" means an individual with a valid license issued under chapter 151.
2.6(k) "Physician" means an individual who is licensed to practice medicine in the areas
2.7of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
2.8(l) "Physician assistant" means a person licensed under chapter 147A.
2.9(m) "Qualified educational loan" means a government, commercial, or foundation
2.10loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
2.11expenses related to the graduate or undergraduate education of a health care professional.
2.12(n) "Underserved urban community" means a Minnesota urban area or population
2.13included in the list of designated primary medical care health professional shortage areas
2.14(HPSAs), medically underserved areas (MUAs), or medically underserved populations
2.15(MUPs) maintained and updated by the United States Department of Health and Human
2.16Services.
2.17(o) "Dental therapist" means a dental therapist licensed under section 150A.105.
2.18(p) "Advanced dental therapist" means an advanced dental therapist certified under
2.19section 150A.106.
2.20 Sec. 2. Minnesota Statutes 2012, section 144.1501, subdivision 2, is amended to read:
2.21 Subd. 2. Creation of account. (a) A health professional education loan forgiveness
2.22program account is established. The commissioner of health shall use money from the
2.23account to establish a loan forgiveness program:
2.24 (1) for medical residents agreeing to practice in designated rural areas or underserved
2.25urban communities or specializing in the area of pediatric psychiatry;
2.26 (2) for midlevel practitioners agreeing to practice in designated rural areas or to
2.27teach at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary
2.28program at the undergraduate level or the equivalent at the graduate level;
2.29 (3) for nurses who agree to practice in a Minnesota nursing home or intermediate
2.30care facility for persons with developmental disability or to teach at least 12 credit hours,
2.31or 720 hours per year in the nursing field in a postsecondary program at the undergraduate
2.32level or the equivalent at the graduate level;
2.33 (4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
2.34hours per year in their designated field in a postsecondary program at the undergraduate
2.35level or the equivalent at the graduate level. The commissioner, in consultation with
3.1the Healthcare Education-Industry Partnership, shall determine the health care fields
3.2where the need is the greatest, including, but not limited to, respiratory therapy, clinical
3.3laboratory technology, radiologic technology, and surgical technology;
3.4 (5) for pharmacists who agree to practice in designated rural areas;
3.5 (6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
3.6encounters to state public program enrollees or patients receiving sliding fee schedule
3.7discounts through a formal sliding fee schedule meeting the standards established by
3.8the United States Department of Health and Human Services under Code of Federal
3.9Regulations, title 42, section 51, chapter 303; and
3.10 (7) for dental therapists or advanced dental therapists.
3.11 (b) Appropriations made to the account do not cancel and are available until
3.12expended, except that at the end of each biennium, any remaining balance in the account
3.13that is not committed by contract and not needed to fulfill existing commitments shall
3.14cancel to the fund.
3.15 Sec. 3. Minnesota Statutes 2012, section 144.1501, subdivision 3, is amended to read:
3.16 Subd. 3. Eligibility. (a) To be eligible to participate in the loan forgiveness program,
3.17an individual must:
3.18(1) be a medical or dental resident, a licensed pharmacist or be enrolled in a dentist,
3.19dental therapist, advanced dental therapist, midlevel practitioner, registered nurse, or a
3.20licensed practical nurse training program; and
3.21(2) submit an application to the commissioner of health. If fewer applications are
3.22submitted by dental students or residents than there are dentist participant slots available,
3.23the commissioner may consider applications submitted by dental program graduates
3.24who are licensed dentists.
3.25(b) An applicant selected to participate must sign a contract to agree to serve a
3.26minimum three-year full-time service obligation according to subdivision 2, which shall
3.27begin no later than March 31 following completion of required training.
3.28 Sec. 4. Minnesota Statutes 2012, section 256B.0625, subdivision 14, is amended to read:
3.29 Subd. 14. Diagnostic, screening, and preventive services. (a) Medical assistance
3.30covers diagnostic, screening, and preventive services.
3.31(b) "Preventive services" include services related to pregnancy, including:
3.32(1) services for those conditions which may complicate a pregnancy and which may
3.33be available to a pregnant woman determined to be at risk of poor pregnancy outcome;
3.34(2) prenatal HIV risk assessment, education, counseling, and testing; and
4.1(3) alcohol abuse assessment, education, and counseling on the effects of alcohol
4.2usage while pregnant. Preventive services available to a woman at risk of poor pregnancy
4.3outcome may differ in an amount, duration, or scope from those available to other
4.4individuals eligible for medical assistance.
4.5(c) "Screening services" include, but are not limited to
4.6(1) blood lead tests
4.7(2) oral health screenings conducted by a licensed dental provider in collaborative
4.8practice under section 150A.10, subdivision 1a, or 150A.106, to determine an enrollee's
4.9need to be seen by a dentist for diagnosis and assessment to identify possible signs
4.10of oral or systemic disease, malformation, or injury, and the potential need for referral
4.11for diagnosis and treatment. This clause includes oral health screenings conducted by a
4.12licensed dental provider as part of a state or federally mandated screening.
4.13(d) The commissioner shall encourage, at the time of the child and teen checkup or
4.14at an episodic care visit, the primary care health care provider to perform primary caries
4.15preventive services. Primary caries preventive services include, at a minimum:
4.16(1) a general visual examination of the child's mouth without using probes or other
4.17dental equipment or taking radiographs;
4.18(2) a risk assessment using the factors established by the American Academies
4.19of Pediatrics and Pediatric Dentistry; and
4.20(3) the application of a fluoride varnish beginning at age one to those children
4.21assessed by the provider as being high risk in accordance with best practices as defined by
4.22the Department of Human Services. The provider must obtain parental or legal guardian
4.23consent before a fluoride varnish is applied to a minor child's teeth.
4.24At each checkup, if primary caries preventive services are provided, the provider must
4.25provide to the child's parent or legal guardian: information on caries etiology and
4.26prevention; and information on the importance of finding a dental home for their child
4.27by the age of one. The provider must also advise the parent or legal guardian to contact
4.28the child's managed care plan or the Department of Human Services in order to secure a
4.29dental appointment with a dentist. The provider must indicate in the child's medical record
4.30that the parent or legal guardian was provided with this information and document any
4.31primary caries prevention services provided to the child.
4.32 Sec. 5. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
4.33subdivision to read:
4.34 Subd. 64. Oral health telehealth. Medical assistance covers dental and oral health
4.35services that are otherwise covered by medical assistance as direct face-to-face services
5.1provided via telecommunications equipment, including, but not limited to, store and
5.2forward technology. Reimbursement is at the same rates and under the same requirements
5.3that would otherwise apply to the service.
5.4EFFECTIVE DATE.This section is effective January 1, 2015, or upon federal
5.5approval, whichever is later, and applies to services provided after the effective date.
