1997 MERC Legislative Summary
The 1997 legislature allocated $8.5 million to the Medical Education and Research Costs (MERC) Trust Fund to fund medical education activities in Minnesota. This was a one-time appropriation from the General Revenues ($5 million) and Health Care Access Fund ($3.5 million) which was distributed in the Spring of 1998. These dollars were matched with approximately $9.3 million federal Medicaid funds, for a total of approximately $17.8 million. These dollars will be distributed to all qualifying applicants based on the following criteria: 1) total dollars in the trust fund; 2) total eligible trainees in each eligible education program; and 3) statewide average cost per trainee, by type of trainee, in each medical education program. This one-time appropriation does not meet the ongoing needs of medical education and research programs in the state; therefore, an ongoing base appropriation was requested in the 1998 legislative session to maintain the high quality medical education infrastructure in Minnesota.
The 1997 legislature also approved removal of the current medical education dollars included in the capitated rates of the Prepaid Medical Assistance Program (PMAP) and Prepaid General Assistance Medical Care (PGAMC). These medical education dollars will be transferred to the MERC Trust Fund for distribution beginning in 1999. These dollars from the public programs are not new dollars for medical education. Rather, they are existing dollars that will be targeted more effectively by distribution through the MERC Trust Fund.
Text of 1997 MERC Legislation--Unofficial Version
This page contains the laws enacted by the 1997 legislature relating to the Medical Education and Research Trust Fund. These laws were revised in the 1998 legislative session. The 1998 legislation will be effective August 1, 1998.
stricken= old language to be removed
- underscored = new language to be added
MINNESOTA STATUTE 62J.69 MEDICAL EDUCATION AND RESEARCH TRUST FUND.
Subdivision 1. Definitions. For purposes of this section, the following definitions apply:
(a) "Medical education" means the accredited clinical training of physicians (medical students and residents), doctor of pharmacy practitioners, dentists, advanced practice nurses (clinical nurse specialist, certified registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and physician assistants.
(b) "Clinical training" means accredited training that is funded and was historically funded in part by inpatient care revenues and that occurs in both inpatient and ambulatory care settings.
(c) "Trainee" means students involved in an accredited clinical training program for medical education as defined in paragraph (a).
(d) "Health care research" means approved clinical, outcomes, and health services investigations that are funded by patient out-of-pocket expenses or a third-party payer.
(e) "Commissioner" means the commissioner of health.
(f) "Teaching institutions" means any hospital, medical center, clinic, or other organization that currently sponsors or conducts accredited medical education programs or clinical research in Minnesota.
Subd. 2. Allocation and funding for medical education and research. (a) The commissioner may establish a trust fund for the purposes of funding medical education and research activities in the state of Minnesota.
(b) By January 1, 1997, the commissioner may appoint an advisory committee to provide advice and oversight on the distribution of funds from the medical education and research trust fund. If a committee is appointed, the commissioner shall: (1) consider the interest of all stakeholders when selecting committee members; (2) select members that represent both urban and rural interest; and (3) select members that include ambulatory care as well as inpatient perspectives. The commissioner shall appoint to the advisory committee representatives of the following groups: medical researchers, public and private academic medical centers, managed care organizations, Blue Cross and Blue Shield of Minnesota, commercial carriers, Minnesota Medical Association, Minnesota Nurses Association, medical product manufacturers, employers, and other relevant stakeholders, including consumers. The advisory committee is governed by section 15.059, for membership terms and removal of members and will sunset on June 30, 1999.
(c) Eligible applicants for funds are accredited medical education teaching institutions, consortia, and programs operating in Minnesota. Applications must be submitted by the sponsoring institution on behalf of the teaching program, and must be received by September 30 of each year for distribution
by in January 1 of the following year. An application for funds must include the following:
(1) the official name and address of the sponsoring institution
, facility, and the official name and address of the facility or program that is applying for funding program on whose behalf the institution is applying for funding;
(2) the name, title, and business address of those persons responsible for administering the funds;
(3) the total number, type and specialty orientation of eligible Minnesota-based trainees in each accredited medical education program
applying for which funds are being sought;
(4) audited clinical training costs per trainee for each medical education program;
(5) a description of current sources of funding for medical education costs including a description and dollar amount of all state and federal financial support;
(6) other revenue received for the purposes of clinical training;
(7) a statement identifying unfunded costs; and
(8) other supporting information the commissioner, with advice from the advisory committee, determines is necessary for the equitable distribution of funds.
(d) The commissioner shall distribute medical education funds to all qualifying applicants based on the following basic criteria: (1) total medical education funds available; (2) total eligible trainees in each eligible education program; and (3) the statewide average cost per trainee, by type of trainee, in each medical education program. Funds distributed shall not be used to displace current funding appropriations from federal or state sources. Funds shall be distributed to the sponsoring institutions indicating the amount to be paid to each of the sponsor's medical education programs based on the criteria in this paragraph. Sponsoring institutions which receive funds from the trust fund must distribute approved funds to the medical education program according to the commissioner's approval letter. Further, programs must distribute funds among the sites of training based on the percentage of total program training performed at each site.
(e) Medical education programs receiving funds from the trust fund must submit annual cost and program reports through the sponsoring institution based on criteria established by the commissioner. The reports must include:
(1) the total number of eligible trainees in the program;
type of programs and residencies funded, the amounts of trust fund payments to each program, and within each program, the percentage distributed to each training site;
(3) the average cost per trainee and a detailed breakdown of the components of those costs;
(4) other state or federal appropriations received for the purposes of clinical training;
(5) other revenue received for the purposes of clinical training; and
(6) other information the commissioner, with advice from the advisory committee, deems appropriate to evaluate the effectiveness of the use of funds for clinical training.
The commissioner, with advice from the advisory committee, will provide an annual summary report to the legislature on program implementation due February 15 of each year.
(f) The commissioner is authorized to distribute funds made available through:
(1) voluntary contributions by employers or other entities;
(2) allocations for the department of human services to support medical education and research; and
(3) other sources as identified and deemed appropriate by the legislature for inclusion in the trust fund.
(g) The advisory committee shall continue to study and make recommendations on:
(1) the funding of medical research consistent with work currently mandated by the legislature and under way at the department of health; and
(2) the costs and benefits associated with medical education and research.
Subd. 3. Medical assistance and general assistance service. The commissioner of health, in consultation with the medical education and research costs advisory committee, shall develop a system to recognize those teaching programs which serve higher numbers or high proportions of public program recipients and shall report to the legislative commission on health care access by January 15, 1998, on an allocation formula to implement this system.1997 MINNESOTA LAWS CHAPTER 225, ARTICLE 7, SECTION 2
Subdivision 1. Medical education. Of the fiscal year 1998 health care access fund appropriation, $3,500,000 is for medical education research costs. This appropriation, plus the federal financial participation amount shall be distributed to medical assistance providers according to the distribution methodology of the medical education research trust fund established under Minnesota Statutes, section 62J.69. Any unspent funds in this appropriation do not cancel but may carry forward and be available in fiscal year 1999.1997 MINNESOTA LAWS CHAPTER 203, ARTICLE 1, SECTION 2
Subd. 5. Distribution to medical assistance providers.(a) Of the amount appropriated to the medical assistance account in fiscal year 1998, $5,000,000 plus the federal financial participation amount shall be distributed to medical assistance providers according to the distribution methodology of the medical education research trust fund established under Minnesota Statutes, section 62J.69. (b) In fiscal year 1999, the prepaid medical assistance and prepaid general assistance medical capitation rate reduction amounts under Minnesota Statutes, section 256B.69, subdivision 5c, and the federal financial participation amount associated with the medical assistance reduction, shall be distributed to medical assistance providers according to the distribution methodology of the trust fund.
MINNESOTA STATUTE 256B.69 PREPAYMENT DEMONSTRATION PROJECT
Subd. 5c. Medical education and research trust fund. (a) Beginning in January 1999 and each year thereafter:
(1) the commissioner of human services shall transfer an amount equal to the reduction in the prepaid medical assistance and prepaid general assistance medical care payments resulting from clause (2), excluding nursing facility and elderly waiver payments, to the medical education and research trust fund established under section 62J.69;
(2) the county medical assistance and general assistance medical care capitation base rate prior to plan specific adjustments shall be reduced 6.3 percent for Hennepin county, two percent for the remaining metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties; and
(3) the amount calculated under clause (1) shall not be adjusted for subsequent changes to the capitation payments for periods already paid.
(b) This subdivision shall be effective upon approval of a federal waiver which allows federal financial participation in the medical education and research trust fund.
1997 MINNESOTA LAWS CHAPTER 203, ARTICLE 2, SECTION 31
Funding sources for the medical education and research trust fund. (a) The commissioner of health, in consultation with the medical education and research costs advisory committee, shall continue to consider additional broad-based funding sources, and shall recommend potential sources of funding to the legislature by February 15, 1998.
(b) The commissioner of health, in consultation with the commissioner of human services, shall examine the appropriateness of transferring an educational component from the MinnesotaCare rates to the medical education and research trust fund, and the appropriate amount and timing of any such transfer. The commissioner shall report recommendations on the feasibility of including MinnesotaCare funding in the trust fund to the legislature by February 15, 1998.