Bill Text: MN SF2309 | 2013-2014 | 88th Legislature | Introduced


Bill Title: Local public health system provisions modifications

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2014-03-19 - Second reading [SF2309 Detail]

Download: Minnesota-2013-SF2309-Introduced.html

1.1A bill for an act
1.2relating to health; making changes to the local public health system;amending
1.3Minnesota Statutes 2012, sections 145A.02, subdivisions 5, 15, by adding
1.4subdivisions; 145A.03, subdivisions 1, 2, 4, 5, by adding a subdivision; 145A.04,
1.5as amended; 145A.05, subdivision 2; 145A.06, subdivisions 2, 5, 6, by adding
1.6subdivisions; 145A.07, subdivisions 1, 2; 145A.08; 145A.11, subdivision 2;
1.7145A.131; Minnesota Statutes 2013 Supplement, section 145A.06, subdivision
1.87; repealing Minnesota Statutes 2012, sections 145A.02, subdivision 2; 145A.03,
1.9subdivisions 3, 6; 145A.09, subdivisions 1, 2, 3, 4, 5, 7; 145A.10, subdivisions 1,
1.102, 3, 4, 5a, 7, 9, 10; 145A.12, subdivisions 1, 2, 7.
1.11BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.12    Section 1. Minnesota Statutes 2012, section 145A.02, is amended by adding a
1.13subdivision to read:
1.14    Subd. 1a. Areas of public health responsibility. "Areas of public health
1.15responsibility" means:
1.16(1) assuring an adequate local public health infrastructure;
1.17(2) promoting healthy communities and healthy behaviors;
1.18(3) preventing the spread of communicable disease;
1.19(4) protecting against environmental health hazards;
1.20(5) preparing for and responding to emergencies; and
1.21(6) assuring health services.

1.22    Sec. 2. Minnesota Statutes 2012, section 145A.02, subdivision 5, is amended to read:
1.23    Subd. 5. Community health board. "Community health board" means a board of
1.24health established, operating, and eligible for a the governing body for local public health
1.25grant under sections 145A.09 to 145A.131. in Minnesota. The community health board
1.26may be comprised of a single county, multiple contiguous counties, or in a limited number
2.1of cases, a single city as specified in section 145A.03, subdivision 1. CHBs have the
2.2responsibilities and authority under this chapter.

2.3    Sec. 3. Minnesota Statutes 2012, section 145A.02, is amended by adding a subdivision
2.4to read:
2.5    Subd. 6a. Community health services administrator. "Community health services
2.6administrator" means a person who meets personnel standards for the position established
2.7under section 145A.06, subdivision 3b, and is working under a written agreement with,
2.8employed by, or under contract with a community health board to provide public health
2.9leadership and to discharge the administrative and program responsibilities on behalf of
2.10the board.

2.11    Sec. 4. Minnesota Statutes 2012, section 145A.02, is amended by adding a subdivision
2.12to read:
2.13    Subd. 8a. Local health department. "Local health department" means an
2.14operational entity that is responsible for the administration and implementation of
2.15programs and services to address the areas of public health responsibility. It is governed
2.16by a community health board.

2.17    Sec. 5. Minnesota Statutes 2012, section 145A.02, is amended by adding a subdivision
2.18to read:
2.19    Subd. 8b. Essential public health services. "Essential public health services"
2.20means the public health activities that all communities should undertake. These services
2.21serve as the framework for the National Public Health Performance Standards. In
2.22Minnesota they refer to activities that are conducted to accomplish the areas of public
2.23health responsibility. The ten essential public health services are to:
2.24(1) monitor health status to identify and solve community health problems;
2.25(2) diagnose and investigate health problems and health hazards in the community;
2.26(3) inform, educate, and empower people about health issues;
2.27(4) mobilize community partnerships and action to identify and solve health
2.28problems;
2.29(5) develop policies and plans that support individual and community health efforts;
2.30(6) enforce laws and regulations that protect health and ensure safety;
2.31(7) link people to needed personal health services and assure the provision of health
2.32care when otherwise unavailable;
2.33(8) maintain a competent public health workforce;
3.1(9) evaluate the effectiveness, accessibility, and quality of personal and
3.2population-based health services; and
3.3(10) contribute to research seeking new insights and innovative solutions to health
3.4problems.

3.5    Sec. 6. Minnesota Statutes 2012, section 145A.02, subdivision 15, is amended to read:
3.6    Subd. 15. Medical consultant. "Medical consultant" means a physician licensed
3.7to practice medicine in Minnesota who is working under a written agreement with,
3.8employed by, or on contract with a community health board of health to provide advice
3.9and information, to authorize medical procedures through standing orders protocols, and
3.10to assist a community health board of health and its staff in coordinating their activities
3.11with local medical practitioners and health care institutions.

3.12    Sec. 7. Minnesota Statutes 2012, section 145A.02, is amended by adding a subdivision
3.13to read:
3.14    Subd. 15a. Performance management. "Performance management" means the
3.15systematic process of using data for decision making by identifying outcomes and
3.16standards; measuring, monitoring, and communicating progress; and engaging in quality
3.17improvement activities in order to achieve desired outcomes.

3.18    Sec. 8. Minnesota Statutes 2012, section 145A.02, is amended by adding a subdivision
3.19to read:
3.20    Subd. 15b. Performance measures. "Performance measures" means quantitative
3.21ways to define and measure performance.

3.22    Sec. 9. Minnesota Statutes 2012, section 145A.03, subdivision 1, is amended to read:
3.23    Subdivision 1. Establishment; assignment of responsibilities. (a) The governing
3.24body of a city or county must undertake the responsibilities of a community health board
3.25of health or establish a board of health by establishing or joining a community health
3.26board according to paragraphs (b) to (f) and assign assigning to it the powers and duties of
3.27a board of health specified under section 145A.04.
3.28(b) A city council may ask a county or joint powers board of health to undertake
3.29the responsibilities of a board of health for the city's jurisdiction. A community health
3.30board must include within its jurisdiction a population of 30,000 or more persons or be
3.31composed of three or more contiguous counties.
4.1(c) A county board or city council within the jurisdiction of a community health
4.2board operating under sections 145A.09 to 145A.131 is preempted from forming a board of
4.3 community health board except as specified in section 145A.10, subdivision 2 145A.131.
4.4(d) A county board or a joint powers board that establishes a community health
4.5board and has or establishes an operational human services board under chapter 402 may
4.6assign the powers and duties of a community health board to a human services board.
4.7Eligibility for funding from the commissioner will be maintained if all requirements of
4.8sections 145A.03 and 145A.04 are met.
4.9(e) Community health boards established prior to January 1, 2014, including city
4.10community health boards, are eligible to maintain their status as community health boards
4.11as outlined in this subdivision.
4.12(f) A community health board may authorize, by resolution, the community
4.13health service administrator or other designated agent or agents to act on behalf of the
4.14community health board.

4.15    Sec. 10. Minnesota Statutes 2012, section 145A.03, subdivision 2, is amended to read:
4.16    Subd. 2. Joint powers community health board of health. Except as preempted
4.17under section 145A.10, subdivision 2, A county may establish a joint community health
4.18board of health by agreement with one or more contiguous counties, or a an existing city
4.19community health board may establish a joint community health board of health with one
4.20or more contiguous cities in the same county, or a city may establish a joint board of health
4.21with the existing city community health boards in the same county or counties within in
4.22 which it is located. The agreements must be established according to section 471.59.

4.23    Sec. 11. Minnesota Statutes 2012, section 145A.03, subdivision 4, is amended to read:
4.24    Subd. 4. Membership; duties of chair. A community health board of health must
4.25have at least five members, one of whom must be elected by the members as chair and one
4.26as vice-chair. The chair, or in the chair's absence, the vice-chair, must preside at meetings
4.27of the community health board of health and sign or authorize an agent to sign contracts and
4.28other documents requiring signature on behalf of the community health board of health.

4.29    Sec. 12. Minnesota Statutes 2012, section 145A.03, subdivision 5, is amended to read:
4.30    Subd. 5. Meetings. A community health board of health must hold meetings at least
4.31twice a year and as determined by its rules of procedure. The board must adopt written
4.32procedures for transacting business and must keep a public record of its transactions,
5.1findings, and determinations. Members may receive a per diem plus travel and other
5.2eligible expenses while engaged in official duties.

5.3    Sec. 13. Minnesota Statutes 2012, section 145A.03, is amended by adding a
5.4subdivision to read:
5.5    Subd. 7. Community health board; eligibility for funding. A community health
5.6board that meets the requirements of this section is eligible to receive the local public
5.7health grant under section 145A.131 and for other funds that the commissioner grants to
5.8community health boards to carry out public health activities.

5.9    Sec. 14. Minnesota Statutes 2012, section 145A.04, as amended by Laws 2013, chapter
5.1043, section 21, is amended to read:
5.11145A.04 POWERS AND DUTIES OF COMMUNITY HEALTH BOARD OF
5.12HEALTH.
5.13    Subdivision 1. Jurisdiction; enforcement. (a) A county or multicounty community
5.14health board of health has the powers and duties of a board of health for all territory within
5.15its jurisdiction not under the jurisdiction of a city board of health. Under the general
5.16supervision of the commissioner, the board shall enforce laws, regulations, and ordinances
5.17pertaining to the powers and duties of a board of health within its jurisdictional area
5.18 general responsibility for development and maintenance of a system of community health
5.19services under local administration and within a system of state guidelines and standards.
5.20(b) Under the general supervision of the commissioner, the community health board
5.21shall recommend the enforcement of laws, regulations, and ordinances pertaining to the
5.22powers and duties within its jurisdictional area. In the case of a multicounty or city
5.23community health board, the joint powers agreement under section 145A.03, subdivision
5.242, or delegation agreement under section 145A.07 shall clearly specify enforcement
5.25authorities.
5.26(c) A member of a community health board may not withdraw from a joint powers
5.27community health board during the first two calendar years following the effective
5.28date of the initial joint powers agreement. The withdrawing member must notify the
5.29commissioner and the other parties to the agreement at least one year before the beginning
5.30of the calendar year in which withdrawal takes effect.
5.31(d) The withdrawal of a county or city from a community health board does not
5.32effect the eligibility for the local public health grant of any remaining county or city for
5.33one calendar year following the effective date of withdrawal.
6.1(e) The local public health grant for a county or city that chooses to withdraw from
6.2a multicounty community health board shall be reduced by the amount of the local
6.3partnership incentive.
6.4    Subd. 1a. Duties. Consistent with the guidelines and standards established under
6.5section 145A.06, the community health board shall:
6.6(1) identify local public health priorities and implement activities to address the
6.7priorities and the areas of public health responsibility, which include:
6.8(i) assuring an adequate local public health infrastructure by maintaining the basic
6.9foundational capacities to a well-functioning public health system that includes data
6.10analysis and utilization; health planning; partnership development and community
6.11mobilization; policy development, analysis, and decision support; communication; and
6.12public health research, evaluation, and quality improvement;
6.13(ii) promoting healthy communities and healthy behavior through activities
6.14that improve health in a population, such as investing in healthy families; engaging
6.15communities to change policies, systems, or environments to promote positive health or
6.16prevent adverse health; providing information and education about healthy communities
6.17or population health status; and addressing issues of health equity, health disparities, and
6.18the social determinants to health;
6.19(iii) preventing the spread of communicable disease by preventing diseases that are
6.20caused by infectious agents through detecting acute infectious diseases, ensuring the
6.21reporting of infectious diseases, preventing the transmission of infectious diseases, and
6.22implementing control measures during infectious disease outbreaks;
6.23(iv) protecting against environmental health hazards by addressing aspects of the
6.24environment that pose risks to human health, such as monitoring air and water quality;
6.25developing policies and programs to reduce exposure to environmental health risks and
6.26promote healthy environments; and identifying and mitigating environmental risks such as
6.27food and waterborne diseases, radiation, occupational health hazards, and public health
6.28nuisances;
6.29(v) preparing and responding to emergencies by engaging in activities that prepare
6.30public health departments to respond to events and incidents and assist communities in
6.31recovery, such as providing leadership for public health preparedness activities with
6.32a community; developing, exercising, and periodically reviewing response plans for
6.33public health threats; and developing and maintaining a system of public health workforce
6.34readiness, deployment, and response; and
6.35(vi) assuring health services by engaging in activities such as assessing the
6.36availability of health-related services and health care providers in local communities,
7.1identifying gaps and barriers in services; convening community partners to improve
7.2community health systems; and providing services identified as priorities by the local
7.3assessment and planning process; and
7.4(2) submit to the commissioner of health, at least every five years, a community
7.5health assessment and community health improvement plan, which shall be developed
7.6with input from the community and take into consideration the statewide outcomes, the
7.7areas of responsibility, and essential public health services;
7.8(3) implement a performance management process in order to achieve desired
7.9outcomes; and
7.10(4) annually report to the commissioner on a set of performance measures and be
7.11prepared to provide documentation of ability to meet the performance measures.
7.12    Subd. 2. Appointment of agent community health service (CHS) administrator.
7.13A community health board of health must appoint, employ, or contract with a person or
7.14persons CHS administrator to act on its behalf. The board shall notify the commissioner
7.15of the agent's name, address, and phone number where the agent may be reached between
7.16board meetings CHS administrator's contact information and submit a copy of the
7.17resolution authorizing the agent CHS administrator to act as an agent on the board's behalf.
7.18 The resolution must specify the types of action or actions that the CHS administrator is
7.19authorized to take on behalf of the board.
7.20    Subd. 2a. Appointment of medical consultant. The community health board shall
7.21appoint, employ, or contract with a medical consultant to ensure appropriate medical
7.22advice and direction for the community health board and assist the board and its staff in
7.23the coordination of community health services with local medical care and other health
7.24services.
7.25    Subd. 3. Employment; medical consultant employees. (a) A community health
7.26board of health may establish a health department or other administrative agency and may
7.27employ persons as necessary to carry out its duties.
7.28(b) Except where prohibited by law, employees of the community health board
7.29of health may act as its agents.
7.30(c) Employees of the board of health are subject to any personnel administration
7.31rules adopted by a city council or county board forming the board of health unless the
7.32employees of the board are within the scope of a statewide personnel administration
7.33system. Persons employed by a county, city, or the state whose functions and duties are
7.34assumed by a community health board shall become employees of the board without
7.35loss in benefits, salaries, or rights.
8.1(d) The board of health may appoint, employ, or contract with a medical consultant
8.2to receive appropriate medical advice and direction.
8.3    Subd. 4. Acquisition of property; request for and acceptance of funds;
8.4collection of fees. (a) A community health board of health may acquire and hold in the
8.5name of the county or city the lands, buildings, and equipment necessary for the purposes
8.6of sections 145A.03 to 145A.131. It may do so by any lawful means, including gifts,
8.7purchase, lease, or transfer of custodial control.
8.8(b) A community health board of health may accept gifts, grants, and subsidies from
8.9any lawful source, apply for and accept state and federal funds, and request and accept
8.10local tax funds.
8.11(c) A community health board of health may establish and collect reasonable fees
8.12for performing its duties and providing community health services.
8.13(d) With the exception of licensing and inspection activities, access to community
8.14health services provided by or on contract with the community health board of health must
8.15not be denied to an individual or family because of inability to pay.
8.16    Subd. 5. Contracts. To improve efficiency, quality, and effectiveness, avoid
8.17unnecessary duplication, and gain cost advantages, a community health board of health
8.18 may contract to provide, receive, or ensure provision of services.
8.19    Subd. 6. Investigation; reporting and control of communicable diseases. A
8.20community health board of health shall make investigations, or coordinate with any county
8.21board or city council within its jurisdiction to make investigations and reports and obey
8.22instructions on the control of communicable diseases as the commissioner may direct under
8.23section 144.12, 145A.06, subdivision 2, or 145A.07. Community health boards of health
8.24 must cooperate so far as practicable to act together to prevent and control epidemic diseases.
8.25    Subd. 6a. Minnesota Responds Medical Reserve Corps; planning. A community
8.26health board of health receiving funding for emergency preparedness or pandemic
8.27influenza planning from the state or from the United States Department of Health and
8.28Human Services shall participate in planning for emergency use of volunteer health
8.29professionals through the Minnesota Responds Medical Reserve Corps program of the
8.30Department of Health. A community health board of health shall collaborate on volunteer
8.31planning with other public and private partners, including but not limited to local or
8.32regional health care providers, emergency medical services, hospitals, tribal governments,
8.33state and local emergency management, and local disaster relief organizations.
8.34    Subd. 6b. Minnesota Responds Medical Reserve Corps; agreements. A
8.35community health board of health, county, or city participating in the Minnesota Responds
8.36Medical Reserve Corps program may enter into written mutual aid agreements for
9.1deployment of its paid employees and its Minnesota Responds Medical Reserve Corps
9.2volunteers with other community health boards of health, other political subdivisions
9.3within the state, or with tribal governments within the state. A community health board
9.4of health may also enter into agreements with the Indian Health Services of the United
9.5States Department of Health and Human Services, and with boards of health, political
9.6subdivisions, and tribal governments in bordering states and Canadian provinces.
9.7    Subd. 6c. Minnesota Responds Medical Reserve Corps; when mobilized. When
9.8a community health board of health, county, or city finds that the prevention, mitigation,
9.9response to, or recovery from an actual or threatened public health event or emergency
9.10exceeds its local capacity, it shall use available mutual aid agreements. If the event or
9.11emergency exceeds mutual aid capacities, a community health board of health, county, or
9.12city may request the commissioner of health to mobilize Minnesota Responds Medical
9.13Reserve Corps volunteers from outside the jurisdiction of the community health board
9.14of health, county, or city.
9.15    Subd. 6d. Minnesota Responds Medical Reserve Corps; liability coverage.
9.16A Minnesota Responds Medical Reserve Corps volunteer responding to a request for
9.17training or assistance at the call of a community health board of health, county, or city
9.18 must be deemed an employee of the jurisdiction for purposes of workers' compensation,
9.19tort claim defense, and indemnification.
9.20    Subd. 7. Entry for inspection. To enforce public health laws, ordinances or rules, a
9.21member or agent of a community health board of health, county, or city may enter a
9.22building, conveyance, or place where contagion, infection, filth, or other source or cause
9.23of preventable disease exists or is reasonably suspected.
9.24    Subd. 8. Removal and abatement of public health nuisances. (a) If a threat to the
9.25public health such as a public health nuisance, source of filth, or cause of sickness is found
9.26on any property, the community health board of health, county, city, or its agent shall order
9.27the owner or occupant of the property to remove or abate the threat within a time specified
9.28in the notice but not longer than ten days. Action to recover costs of enforcement under
9.29this subdivision must be taken as prescribed in section 145A.08.
9.30(b) Notice for abatement or removal must be served on the owner, occupant, or agent
9.31of the property in one of the following ways:
9.32(1) by registered or certified mail;
9.33(2) by an officer authorized to serve a warrant; or
9.34(3) by a person aged 18 years or older who is not reasonably believed to be a party to
9.35any action arising from the notice.
10.1(c) If the owner of the property is unknown or absent and has no known representative
10.2upon whom notice can be served, the community health board of health, county, or city,
10.3 or its agent, shall post a written or printed notice on the property stating that, unless the
10.4threat to the public health is abated or removed within a period not longer than ten days,
10.5the community health board, county, or city will have the threat abated or removed at the
10.6expense of the owner under section 145A.08 or other applicable state or local law.
10.7(d) If the owner, occupant, or agent fails or neglects to comply with the requirement
10.8of the notice provided under paragraphs (b) and (c), then the community health board of
10.9health, county, city, or its a designated agent of the board, county, or city shall remove or
10.10abate the nuisance, source of filth, or cause of sickness described in the notice from the
10.11property.
10.12    Subd. 9. Injunctive relief. In addition to any other remedy provided by law, the
10.13community health board of health, county, or city may bring an action in the court of
10.14appropriate jurisdiction to enjoin a violation of statute, rule, or ordinance that the board
10.15has power to enforce, or to enjoin as a public health nuisance any activity or failure to
10.16act that adversely affects the public health.
10.17    Subd. 10. Hindrance of enforcement prohibited; penalty. It is a misdemeanor
10.18deliberately to deliberately hinder a member of a community health board of health,
10.19county or city, or its agent from entering a building, conveyance, or place where contagion,
10.20infection, filth, or other source or cause of preventable disease exists or is reasonably
10.21suspected, or otherwise to interfere with the performance of the duties of the board of
10.22health responsible jurisdiction.
10.23    Subd. 11. Neglect of enforcement prohibited; penalty. It is a misdemeanor for
10.24a member or agent of a community health board of health, county, or city to refuse or
10.25neglect to perform a duty imposed on a board of health an applicable jurisdiction by
10.26statute or ordinance.
10.27    Subd. 12. Other powers and duties established by law. This section does not limit
10.28powers and duties of a community health board of health, county, or city prescribed in
10.29other sections.
10.30    Subd. 13. Recommended legislation. The community health board may recommend
10.31local ordinances pertaining to community health services to any county board or city
10.32council within its jurisdiction and advise the commissioner on matters relating to public
10.33health that require assistance from the state, or that may be of more than local interest.
10.34    Subd. 14. Equal access to services. The community health board must ensure that
10.35community health services are accessible to all persons on the basis of need. No one shall
11.1be denied services because of race, color, sex, age, language, religion, nationality, inability
11.2to pay, political persuasion, or place of residence.
11.3    Subd. 15. State and local advisory committees. (a) A state community
11.4health services advisory committee is established to advise, consult with, and make
11.5recommendations to the commissioner on the development, maintenance, funding, and
11.6evaluation of local public health services. Each community health board may appoint a
11.7member to serve on the committee. The committee must meet at least quarterly, and
11.8special meetings may be called by the committee chair or a majority of the members.
11.9Members or their alternates may be reimbursed for travel and other necessary expenses
11.10while engaged in their official duties.
11.11(b) Notwithstanding section 15.059, the State Community Health Services Advisory
11.12Committee does not expire.
11.13(c) The city boards or county boards that have established or are members of a
11.14community health board may appoint a community health advisory to advise, consult
11.15with, and make recommendations to the community health board on the duties under
11.16subdivision 1a.

11.17    Sec. 15. Minnesota Statutes 2012, section 145A.05, subdivision 2, is amended to read:
11.18    Subd. 2. Animal control. In addition to powers under sections 35.67 to 35.69, a
11.19county board, city council, or municipality may adopt ordinances to issue licenses or
11.20otherwise regulate the keeping of animals, to restrain animals from running at large, to
11.21authorize the impounding and sale or summary destruction of animals, and to establish
11.22pounds.

11.23    Sec. 16. Minnesota Statutes 2012, section 145A.06, subdivision 2, is amended to read:
11.24    Subd. 2. Supervision of local enforcement. (a) In the absence of provision for a
11.25community health board of health, the commissioner may appoint three or more persons
11.26to act as a board until one is established. The commissioner may fix their compensation,
11.27which the county or city must pay.
11.28(b) The commissioner by written order may require any two or more community
11.29health boards of health, counties, or cities to act together to prevent or control epidemic
11.30diseases.
11.31(c) If a community health board, county, or city fails to comply with section 145A.04,
11.32subdivision 6
, the commissioner may employ medical and other help necessary to control
11.33communicable disease at the expense of the board of health jurisdiction involved.
12.1(d) If the commissioner has reason to believe that the provisions of this chapter have
12.2been violated, the commissioner shall inform the attorney general and submit information
12.3to support the belief. The attorney general shall institute proceedings to enforce the
12.4provisions of this chapter or shall direct the county attorney to institute proceedings.

12.5    Sec. 17. Minnesota Statutes 2012, section 145A.06, is amended by adding a
12.6subdivision to read:
12.7    Subd. 3a. Assistance to community health boards. The commissioner shall help
12.8and advise community health boards that ask for assistance in developing, administering,
12.9and carrying out public health services and programs. This assistance may consist of,
12.10but is not limited to:
12.11(1) informational resources, consultation, and training to assist community health
12.12boards plan, develop, integrate, provide, and evaluate community health services; and
12.13(2) administrative and program guidelines and standards developed with the advice
12.14of the State Community Health Services Advisory Committee.

12.15    Sec. 18. Minnesota Statutes 2012, section 145A.06, is amended by adding a
12.16subdivision to read:
12.17    Subd. 3b. Personnel standards. In accordance with chapter 14, and in consultation
12.18with the State Community Health Services Advisory Committee, the commissioner
12.19may adopt rules to set standards for administrative and program personnel to ensure
12.20competence in administration and planning.

12.21    Sec. 19. Minnesota Statutes 2012, section 145A.06, subdivision 5, is amended to read:
12.22    Subd. 5. Deadly infectious diseases. The commissioner shall promote measures
12.23aimed at preventing businesses from facilitating sexual practices that transmit deadly
12.24infectious diseases by providing technical advice to community health boards of health
12.25 to assist them in regulating these practices or closing establishments that constitute
12.26a public health nuisance.

12.27    Sec. 20. Minnesota Statutes 2012, section 145A.06, is amended by adding a
12.28subdivision to read:
12.29    Subd. 5a. System-level performance management. To improve public health
12.30and ensure the integrity and accountability of the statewide local public health system,
12.31the commissioner, in consultation with the State Community Health Services Advisory
13.1Committee, shall develop performance measures and implement a process to monitor
13.2statewide outcomes and performance improvement.

13.3    Sec. 21. Minnesota Statutes 2012, section 145A.06, subdivision 6, is amended to read:
13.4    Subd. 6. Health volunteer program. (a) The commissioner may accept grants from
13.5the United States Department of Health and Human Services for the emergency system
13.6for the advanced registration of volunteer health professionals (ESAR-VHP) established
13.7under United States Code, title 42, section 247d-7b. The ESAR-VHP program as
13.8implemented in Minnesota is known as the Minnesota Responds Medical Reserve Corps.
13.9(b) The commissioner may maintain a registry of volunteers for the Minnesota
13.10Responds Medical Reserve Corps and obtain data on volunteers relevant to possible
13.11deployments within and outside the state. All state licensing and certifying boards
13.12shall cooperate with the Minnesota Responds Medical Reserve Corps and shall verify
13.13volunteers' information. The commissioner may also obtain information from other states
13.14and national licensing or certifying boards for health practitioners.
13.15(c) The commissioner may share volunteers' data, including any data classified
13.16as private data, from the Minnesota Responds Medical Reserve Corps registry with
13.17community health boards of health, cities or counties, the University of Minnesota's
13.18Academic Health Center or other public or private emergency preparedness partners, or
13.19tribal governments operating Minnesota Responds Medical Reserve Corps units as needed
13.20for credentialing, organizing, training, and deploying volunteers. Upon request of another
13.21state participating in the ESAR-VHP or of a Canadian government administering a similar
13.22health volunteer program, the commissioner may also share the volunteers' data as needed
13.23for emergency preparedness and response.

13.24    Sec. 22. Minnesota Statutes 2013 Supplement, section 145A.06, subdivision 7, is
13.25amended to read:
13.26    Subd. 7. Commissioner requests for health volunteers. (a) When the
13.27commissioner receives a request for health volunteers from:
13.28(1) a local board of health community health board, county, or city according to
13.29section 145A.04, subdivision 6c;
13.30(2) the University of Minnesota Academic Health Center;
13.31(3) another state or a territory through the Interstate Emergency Management
13.32Assistance Compact authorized under section 192.89;
13.33(4) the federal government through ESAR-VHP or another similar program; or
13.34(5) a tribal or Canadian government;
14.1the commissioner shall determine if deployment of Minnesota Responds Medical Reserve
14.2Corps volunteers from outside the requesting jurisdiction is in the public interest. If so,
14.3the commissioner may ask for Minnesota Responds Medical Reserve Corps volunteers to
14.4respond to the request. The commissioner may also ask for Minnesota Responds Medical
14.5Reserve Corps volunteers if the commissioner finds that the state needs health volunteers.
14.6(b) The commissioner may request Minnesota Responds Medical Reserve Corps
14.7volunteers to work on the Minnesota Mobile Medical Unit (MMU), or on other mobile
14.8or temporary units providing emergency patient stabilization, medical transport, or
14.9ambulatory care. The commissioner may utilize the volunteers for training, mobilization
14.10or demobilization, inspection, maintenance, repair, or other support functions for the
14.11MMU facility or for other emergency units, as well as for provision of health care services.
14.12(c) A volunteer's rights and benefits under this chapter as a Minnesota Responds
14.13Medical Reserve Corps volunteer is not affected by any vacation leave, pay, or other
14.14compensation provided by the volunteer's employer during volunteer service requested by
14.15the commissioner. An employer is not liable for actions of an employee while serving as a
14.16Minnesota Responds Medical Reserve Corps volunteer.
14.17(d) If the commissioner matches the request under paragraph (a) with Minnesota
14.18Responds Medical Reserve Corps volunteers, the commissioner shall facilitate deployment
14.19of the volunteers from the sending Minnesota Responds Medical Reserve Corps units to
14.20the receiving jurisdiction. The commissioner shall track volunteer deployments and assist
14.21sending and receiving jurisdictions in monitoring deployments, and shall coordinate
14.22efforts with the division of homeland security and emergency management for out-of-state
14.23deployments through the Interstate Emergency Management Assistance Compact or
14.24other emergency management compacts.
14.25(e) Where the commissioner has deployed Minnesota Responds Medical Reserve
14.26Corps volunteers within or outside the state, the provisions of paragraphs (f) and (g) must
14.27apply. Where Minnesota Responds Medical Reserve Corps volunteers were deployed
14.28across jurisdictions by mutual aid or similar agreements prior to a commissioner's call,
14.29the provisions of paragraphs (f) and (g) must apply retroactively to volunteers deployed
14.30as of their initial deployment in response to the event or emergency that triggered a
14.31subsequent commissioner's call.
14.32(f)(1) A Minnesota Responds Medical Reserve Corps volunteer responding to a
14.33request for training or assistance at the call of the commissioner must be deemed an
14.34employee of the state for purposes of workers' compensation and tort claim defense and
14.35indemnification under section 3.736, without regard to whether the volunteer's activity is
14.36under the direction and control of the commissioner, the division of homeland security
15.1and emergency management, the sending jurisdiction, the receiving jurisdiction, or of a
15.2hospital, alternate care site, or other health care provider treating patients from the public
15.3health event or emergency.
15.4(2) For purposes of calculating workers' compensation benefits under chapter 176,
15.5the daily wage must be the usual wage paid at the time of injury or death for similar services
15.6performed by paid employees in the community where the volunteer regularly resides, or
15.7the wage paid to the volunteer in the volunteer's regular employment, whichever is greater.
15.8(g) The Minnesota Responds Medical Reserve Corps volunteer must receive
15.9reimbursement for travel and subsistence expenses during a deployment approved by the
15.10commissioner under this subdivision according to reimbursement limits established for
15.11paid state employees. Deployment begins when the volunteer leaves on the deployment
15.12until the volunteer returns from the deployment, including all travel related to the
15.13deployment. The Department of Health shall initially review and pay those expenses to
15.14the volunteer. Except as otherwise provided by the Interstate Emergency Management
15.15Assistance Compact in section 192.89 or agreements made thereunder, the department
15.16shall bill the jurisdiction receiving assistance and that jurisdiction shall reimburse the
15.17department for expenses of the volunteers.
15.18(h) In the event Minnesota Responds Medical Reserve Corps volunteers are
15.19deployed outside the state pursuant to the Interstate Emergency Management Assistance
15.20Compact, the provisions of the Interstate Emergency Management Assistance Compact
15.21must control over any inconsistent provisions in this section.
15.22(i) When a Minnesota Responds Medical Reserve Corps volunteer makes a claim
15.23for workers' compensation arising out of a deployment under this section or out of a
15.24training exercise conducted by the commissioner, the volunteer's workers compensation
15.25benefits must be determined under section 176.011, subdivision 9, clause (25), even if the
15.26volunteer may also qualify under other clauses of section 176.011, subdivision 9.

15.27    Sec. 23. Minnesota Statutes 2012, section 145A.07, subdivision 1, is amended to read:
15.28    Subdivision 1. Agreements to perform duties of commissioner. (a) The
15.29commissioner of health may enter into an agreement with any community health board of
15.30health, county, or city to delegate all or part of the licensing, inspection, reporting, and
15.31enforcement duties authorized under sections 144.12; 144.381 to 144.387; 144.411 to
15.32144.417 ; 144.71 to 144.74; 145A.04, subdivision 6; provisions of chapter 103I pertaining
15.33to construction, repair, and abandonment of water wells; chapter 157; and sections 327.14
15.34to 327.28.
15.35(b) Agreements are subject to subdivision 3.
16.1(c) This subdivision does not affect agreements entered into under Minnesota
16.2Statutes 1986, section 145.031, 145.55, or 145.918, subdivision 2.

16.3    Sec. 24. Minnesota Statutes 2012, section 145A.07, subdivision 2, is amended to read:
16.4    Subd. 2. Agreements to perform duties of community health board of health.
16.5A community health board of health may authorize a township board, city council, or
16.6county board within its jurisdiction to establish a board of health under section 145A.03
16.7 and delegate to the board of health by agreement any powers or duties under sections
16.8145A.04, 145A.07, subdivision 2, and 145A.08 carry out activities to fulfill community
16.9health board responsibilities. An agreement to delegate community health board powers
16.10and duties of a board of health to a county or city must be approved by the commissioner
16.11and is subject to subdivision 3.

16.12    Sec. 25. Minnesota Statutes 2012, section 145A.08, is amended to read:
16.13145A.08 ASSESSMENT OF COSTS; TAX LEVY AUTHORIZED.
16.14    Subdivision 1. Cost of care. A person who has or whose dependent or spouse has a
16.15communicable disease that is subject to control by the community health board of health is
16.16financially liable to the unit or agency of government that paid for the reasonable cost of
16.17care provided to control the disease under section 145A.04, subdivision 6.
16.18    Subd. 2. Assessment of costs of enforcement. (a) If costs are assessed for
16.19enforcement of section 145A.04, subdivision 8, and no procedure for the assessment
16.20of costs has been specified in an agreement established under section 145A.07, the
16.21enforcement costs must be assessed as prescribed in this subdivision.
16.22(b) A debt or claim against an individual owner or single piece of real property
16.23resulting from an enforcement action authorized by section 145A.04, subdivision 8, must
16.24not exceed the cost of abatement or removal.
16.25(c) The cost of an enforcement action under section 145A.04, subdivision 8, may be
16.26assessed and charged against the real property on which the public health nuisance, source
16.27of filth, or cause of sickness was located. The auditor of the county in which the action is
16.28taken shall extend the cost so assessed and charged on the tax roll of the county against the
16.29real property on which the enforcement action was taken.
16.30(d) The cost of an enforcement action taken by a town or city board of health under
16.31section 145A.04, subdivision 8, may be recovered from the county in which the town or
16.32city is located if the city clerk or other officer certifies the costs of the enforcement action
16.33to the county auditor as prescribed in this section. Taxes equal to the full amount of the
17.1enforcement action but not exceeding the limit in paragraph (b) must be collected by the
17.2county treasurer and paid to the city or town as other taxes are collected and paid.
17.3    Subd. 3. Tax levy authorized. A city council or county board that has formed or is
17.4a member of a community health board of health may levy taxes on all taxable property in
17.5its jurisdiction to pay the cost of performing its duties under this chapter.

17.6    Sec. 26. Minnesota Statutes 2012, section 145A.11, subdivision 2, is amended to read:
17.7    Subd. 2. Levying taxes. In levying taxes authorized under section 145A.08,
17.8subdivision 3
, a city council or county board that has formed or is a member of a
17.9community health board must consider the income and expenditures required to meet
17.10local public health priorities established under section 145A.10, subdivision 5a 145A.04,
17.11subdivision 1a, clause (2), and statewide outcomes established under section 145A.12,
17.12subdivision 7
145A.04, subdivision 1a, clause (1).

17.13    Sec. 27. Minnesota Statutes 2012, section 145A.131, is amended to read:
17.14145A.131 LOCAL PUBLIC HEALTH GRANT.
17.15    Subdivision 1. Funding formula for community health boards. (a) Base funding
17.16for each community health board eligible for a local public health grant under section
17.17145A.09, subdivision 2 145A.03, subdivision 7, shall be determined by each community
17.18health board's fiscal year 2003 allocations, prior to unallotment, for the following grant
17.19programs: community health services subsidy; state and federal maternal and child health
17.20special projects grants; family home visiting grants; TANF MN ENABL grants; TANF
17.21youth risk behavior grants; and available women, infants, and children grant funds in fiscal
17.22year 2003, prior to unallotment, distributed based on the proportion of WIC participants
17.23served in fiscal year 2003 within the CHS service area.
17.24(b) Base funding for a community health board eligible for a local public health grant
17.25under section 145A.09, subdivision 2 145A.03, subdivision 7, as determined in paragraph
17.26(a), shall be adjusted by the percentage difference between the base, as calculated in
17.27paragraph (a), and the funding available for the local public health grant.
17.28(c) Multicounty or multicity community health boards shall receive a local
17.29partnership base of up to $5,000 per year for each county or city in the case of a multicity
17.30community health board included in the community health board.
17.31(d) The State Community Health Advisory Committee may recommend a formula to
17.32the commissioner to use in distributing state and federal funds to community health boards
17.33organized and operating under sections 145A.09 145A.03 to 145A.131 to achieve locally
17.34identified priorities under section 145A.12, subdivision 7, by July 1, 2004 145A.04,
18.1subdivision 1a, for use in distributing funds to community health boards beginning
18.2January 1, 2006, and thereafter.
18.3    Subd. 2. Local match. (a) A community health board that receives a local public
18.4health grant shall provide at least a 75 percent match for the state funds received through
18.5the local public health grant described in subdivision 1 and subject to paragraphs (b) to (d).
18.6(b) Eligible funds must be used to meet match requirements. Eligible funds include
18.7funds from local property taxes, reimbursements from third parties, fees, other local funds,
18.8and donations or nonfederal grants that are used for community health services described
18.9in section 145A.02, subdivision 6.
18.10(c) When the amount of local matching funds for a community health board is less
18.11than the amount required under paragraph (a), the local public health grant provided for
18.12that community health board under this section shall be reduced proportionally.
18.13(d) A city organized under the provision of sections 145A.09 145A.03 to 145A.131
18.14that levies a tax for provision of community health services is exempt from any county
18.15levy for the same services to the extent of the levy imposed by the city.
18.16    Subd. 3. Accountability. (a) Community health boards accepting local public health
18.17grants must document progress toward the statewide outcomes established in section
18.18145A.12, subdivision 7, to maintain eligibility to receive the local public health grant.
18.19 meet all of the requirements and perform all of the duties described in sections 145A.03
18.20and 145A.04, to maintain eligibility to receive the local public health grant.
18.21(b) In determining whether or not the community health board is documenting
18.22progress toward statewide outcomes, the commissioner shall consider the following factors:
18.23(1) whether the community health board has documented progress to meeting
18.24essential local activities related to the statewide outcomes, as specified in the grant
18.25agreement;
18.26(2) the effort put forth by the community health board toward the selected statewide
18.27outcomes;
18.28(3) whether the community health board has previously failed to document progress
18.29toward selected statewide outcomes under this section;
18.30(4) the amount of funding received by the community health board to address the
18.31statewide outcomes; and
18.32(5) other factors as the commissioner may require, if the commissioner specifically
18.33identifies the additional factors in the commissioner's written notice of determination.
18.34(c) If the commissioner determines that a community health board has not by
18.35the applicable deadline documented progress toward the selected statewide outcomes
18.36established under section 145.8821 or 145A.12, subdivision 7, the commissioner shall
19.1notify the community health board in writing and recommend specific actions that the
19.2community health board should take over the following 12 months to maintain eligibility
19.3for the local public health grant.
19.4(d) During the 12 months following the written notification, the commissioner shall
19.5provide administrative and program support to assist the community health board in
19.6taking the actions recommended in the written notification.
19.7(e) If the community health board has not taken the specific actions recommended by
19.8the commissioner within 12 months following written notification, the commissioner may
19.9determine not to distribute funds to the community health board under section 145A.12,
19.10subdivision 2
, for the next fiscal year.
19.11(f) If the commissioner determines not to distribute funds for the next fiscal year, the
19.12commissioner must give the community health board written notice of this determination
19.13and allow the community health board to appeal the determination in writing.
19.14(g) If the commissioner determines not to distribute funds for the next fiscal year
19.15to a community health board that has not documented progress toward the statewide
19.16outcomes and not taken the actions recommended by the commissioner, the commissioner
19.17may retain local public health grant funds that the community health board would have
19.18otherwise received and directly carry out essential local activities to meet the statewide
19.19outcomes, or contract with other units of government or community-based organizations
19.20to carry out essential local activities related to the statewide outcomes.
19.21(h) If the community health board that does not document progress toward the
19.22statewide outcomes is a city, the commissioner shall distribute the local public health
19.23funds that would have been allocated to that city to the county in which the city is located,
19.24if that county is part of a community health board.
19.25(i) The commissioner shall establish a reporting system by which community health
19.26boards will document their progress toward statewide outcomes. This system will be
19.27developed in consultation with the State Community Health Services Advisory Committee
19.28established in section 145A.10, subdivision 10, paragraph (a).
19.29(b) By January 1 of each year, the commissioner shall notify community health
19.30boards of the performance-related accountability requirements of the local public health
19.31grant for that calendar year. Performance-related accountability requirements will be
19.32comprised of a subset of the annual performance measures and will be selected in
19.33consultation with the State Community Health Services Advisory Committee.
19.34(c) If the commissioner determines that a community health board has not met the
19.35accountability requirements, the commissioner shall notify the community health board in
20.1writing and recommend specific actions the community health board must take over the
20.2next six months in order to maintain eligibility for the Local Public Health Act grant.
20.3(d) Following the written notification in paragraph (c), the commissioner shall
20.4provide administrative and program support to assist the community health board as
20.5required in section 145A.06, subdivision 3a.
20.6(e) The commissioner shall provide the community health board two months
20.7following the written notification to appeal the determination in writing.
20.8(f) If the community health board has not submitted an appeal within two months
20.9or has not taken the specific actions recommended by the commissioner within six
20.10months following written notification, the commissioner may elect to not reimburse
20.11invoices for funds submitted after the six-month compliance period and shall reduce by
20.121/12 the community health board's annual award allocation for every successive month
20.13of noncompliance.
20.14(g) The commissioner may retain the amount of funding that would have been
20.15allocated to the community health board and assume responsibility for public health
20.16activities in the geographic area served by the community health board.
20.17    Subd. 4. Responsibility of commissioner to ensure a statewide public health
20.18system. If a county withdraws from a community health board and operates as a board of
20.19health or If a community health board elects not to accept the local public health grant,
20.20the commissioner may retain the amount of funding that would have been allocated to
20.21the community health board using the formula described in subdivision 1 and assume
20.22responsibility for public health activities to meet the statewide outcomes in the geographic
20.23area served by the board of health or community health board. The commissioner may
20.24elect to directly provide public health activities to meet the statewide outcomes or contract
20.25with other units of government or with community-based organizations. If a city that is
20.26currently a community health board withdraws from a community health board or elects
20.27not to accept the local public health grant, the local public health grant funds that would
20.28have been allocated to that city shall be distributed to the county in which the city is
20.29located, if the county is part of a community health board.
20.30    Subd. 5. Local public health priorities Use of funds. Community health boards
20.31may use their local public health grant to address local public health priorities identified
20.32under section 145A.10, subdivision 5a. funds to address the areas of public health
20.33responsibility and local priorities developed through the community health assessment and
20.34community health improvement planning process.

20.35    Sec. 28. REVISOR'S INSTRUCTION.
21.1(a) The revisor shall change the terms "board of health" or "local board of health" or
21.2any derivative of those terms to "community health board" where it appears in Minnesota
21.3Statutes, sections 13.3805, subdivision 1, paragraph (b); 13.46, subdivision 2, paragraph
21.4(a), clause (24); 35.67; 35.68; 38.02, subdivision 1, paragraph (b), clause (1); 121A.15,
21.5subdivisions 7 and 8; 144.055, subdivision 1; 144.065; 144.12, subdivision 1; 144.255,
21.6subdivision 2a; 144.3351; 144.383; 144.417, subdivision 3; 144.4172, subdivision
21.76; 144.4173, subdivision 2; 144.4174; 144.49, subdivision 1; 144.6581; 144A.471,
21.8subdivision 9, clause (19); 145.9255, subdivision 2; 175.35; 308A.201, subdivision 14;
21.9375A.04, subdivision 1; and 412.221, subdivision 22, paragraph (c).
21.10(b) The revisor shall change the cross-reference from "145A.02, subdivision 2"
21.11to "145A.02, subdivision 5" where it appears in Minnesota Statutes, sections 13.3805,
21.12subdivision 1, paragraph (b); 13.46, subdivision 2, paragraph (a), clause (24); 35.67; 35.68;
21.1338.02, subdivision 1, paragraph (b), clause (1); 121A.15, subdivisions 7 and 8; 144.055,
21.14subdivision 1; 144.065; 144.12, subdivision 1; 144.225, subdivision 2a; 144.3351;
21.15144.383; 144.417, subdivision 3; 144.4172, subdivision 6; 144.4173, subdivision 2;
21.16144.4174; 144.49, subdivision 1; 144A.471, subdivision 9, clause (19); 175.35; 308A.201,
21.17subdivision 14; 375A.04, subdivision 1; and 412.221, subdivision 22, paragraph (c).

21.18    Sec. 29. REPEALER.
21.19Minnesota Statutes 2012, sections 145A.02, subdivision 2; 145A.03, subdivisions
21.203 and 6; 145A.09, subdivisions 1, 2, 3, 4, 5, and 7; 145A.10, subdivisions 1, 2, 3, 4,
21.215a, 7, 9, and 10; and 145A.12, subdivisions 1, 2, and 7, are repealed. The revisor shall
21.22remove cross-references to these repealed sections and make changes necessary to correct
21.23punctuation, grammar, or structure of the remaining text.
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