SF 2475

2nd Engrossment - 89th Legislature (2015 - 2016) Posted on 05/18/2016 08:54am

A bill for an act
relating to health; amending provisions for the statewide trauma system,
home care, hearing instrument dispensers, and food, beverage, and lodging
establishments; amending Minnesota Statutes 2014, sections 144.605,
subdivision 5; 144.608, subdivision 1; 144A.473, subdivision 2; 144A.475,
subdivisions 3, 3b, by adding a subdivision; 144A.4792, subdivision 13;
144A.4799, subdivision 1; 144A.482; 153A.14, subdivisions 2d, 2h; 153A.15,
subdivision 2a; 157.15, subdivision 14; 157.16, subdivision 4.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2014, section 144.605, subdivision 5, is amended to read:

Subd. 5.

Level IV designation.

(a) The commissioner shall grant the appropriate
level IV trauma hospital designation to a hospital that successfully completes the
designation process under paragraph (b).

(b) The hospital must complete and submit a self-reported survey and application to
the Trauma Advisory Council for review, verifying that the hospital meets the criteria as a
level IV trauma hospital. When the Trauma Advisory Council is satisfied the application
is complete, the deleted text begin council shall review the application and, if the council approves the
application, send a letter of recommendation to the commissioner for final approval and
designation. The commissioner shall grant a level IV designation and shall arrange a site
review visit within three years of the designation and every three years thereafter, to
coincide with the three-year reverification process. deleted text end new text begin commissioner shall arrange a site
review visit. Upon successful completion of the site review, the review team shall make
written recommendations to the Trauma Advisory Council. If approved by the Trauma
Advisory Council, a letter of recommendation shall be sent to the commissioner for final
approval and designation.
new text end

Sec. 2.

Minnesota Statutes 2014, section 144.608, subdivision 1, is amended to read:

Subdivision 1.

Trauma Advisory Council established.

(a) A Trauma Advisory
Council is established to advise, consult with, and make recommendations to the
commissioner on the development, maintenance, and improvement of a statewide trauma
system.

(b) The council shall consist of the following members:

(1) a trauma surgeon certified by the American Board of Surgery or the American
Osteopathic Board of Surgery who practices in a level I or II trauma hospital;

(2) a general surgeon certified by the American Board of Surgery or the American
Osteopathic Board of Surgery whose practice includes trauma and who practices in a
designated rural area as defined under section 144.1501, subdivision 1, paragraph (b);

(3) a neurosurgeon certified by the American Board of Neurological Surgery who
practices in a level I or II trauma hospital;

(4) a trauma program nurse manager or coordinator practicing in a level I or II
trauma hospital;

(5) an emergency physician certified by the American Board of Emergency Medicine
or the American Osteopathic Board of Emergency Medicine whose practice includes
emergency room care in a level I, II, III, or IV trauma hospital;

(6) a trauma program manager or coordinator who practices in a level III or IV
trauma hospital;

(7) a physician certified by the American Board of Family Medicine or the American
Osteopathic Board of Family Practice whose practice includes emergency department care
in a level III or IV trauma hospital located in a designated rural area as defined under
section 144.1501, subdivision 1, paragraph (b);

(8) a nurse practitioner, as defined under section 144.1501, subdivision 1, paragraph
(h), or a physician assistant, as defined under section 144.1501, subdivision 1, paragraph
(j), whose practice includes emergency room care in a level IV trauma hospital located in
a designated rural area as defined under section 144.1501, subdivision 1, paragraph (b);

(9) a deleted text begin pediatrician deleted text end new text begin physician new text end certified new text begin in pediatric emergency medicine new text end by the
American Board of Pediatrics or new text begin certified in pediatric emergency medicine by the American
Board of Emergency Medicine or certified by new text end the American Osteopathic Board of Pediatrics
whose practice new text begin primarily new text end includes emergency department new text begin medical new text end care in a level I, II, III,
or IV trauma hospital new text begin , or a surgeon certified in pediatric surgery by the American Board of
Surgery whose practice involves the care of pediatric trauma patients in a trauma hospital new text end ;

(10) an orthopedic surgeon certified by the American Board of Orthopaedic Surgery
or the American Osteopathic Board of Orthopedic Surgery whose practice includes trauma
and who practices in a level I, II, or III trauma hospital;

(11) the state emergency medical services medical director appointed by the
Emergency Medical Services Regulatory Board;

(12) a hospital administrator of a level III or IV trauma hospital located in a
designated rural area as defined under section 144.1501, subdivision 1, paragraph (b);

(13) a rehabilitation specialist whose practice includes rehabilitation of patients
with major trauma injuries or traumatic brain injuries and spinal cord injuries as defined
under section 144.661;

(14) an attendant or ambulance director who is an EMT, EMT-I, or EMT-P within
the meaning of section 144E.001 and who actively practices with a licensed ambulance
service in a primary service area located in a designated rural area as defined under section
144.1501, subdivision 1, paragraph (b); and

(15) the commissioner of public safety or the commissioner's designee.

Sec. 3.

Minnesota Statutes 2014, section 144A.473, subdivision 2, is amended to read:

Subd. 2.

Temporary license.

(a) For new license applicants, the commissioner
shall issue a temporary license for either the basic or comprehensive home care level. A
temporary license is effective for new text begin up to new text end one year from the date of issuance. Temporary
licensees must comply with sections 144A.43 to 144A.482.

(b) During the temporary license year, the commissioner shall survey the temporary
licensee after the commissioner is notified or has evidence that the temporary licensee
is providing home care services.

(c) Within five days of beginning the provision of services, the temporary
licensee must notify the commissioner that it is serving clients. The notification to the
commissioner may be mailed or e-mailed to the commissioner at the address provided by
the commissioner. If the temporary licensee does not provide home care services during
the temporary license year, then the temporary license expires at the end of the year and
the applicant must reapply for a temporary home care license.

(d) A temporary licensee may request a change in the level of licensure prior to
being surveyed and granted a license by notifying the commissioner in writing and
providing additional documentation or materials required to update or complete the
changed temporary license application. The applicant must pay the difference between
the application fees when changing from the basic level to the comprehensive level of
licensure. No refund will be made if the provider chooses to change the license application
to the basic level.

(e) If the temporary licensee notifies the commissioner that the licensee has clients
within 45 days prior to the temporary license expiration, the commissioner may extend the
temporary license for up to 60 days in order to allow the commissioner to complete the
on-site survey required under this section and follow-up survey visits.

Sec. 4.

Minnesota Statutes 2014, section 144A.475, subdivision 3, is amended to read:

Subd. 3.

Notice.

new text begin (a) new text end 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 new text begin , or issue a
conditional license new text end if the commissioner determines that there are level 3 deleted text begin or 4 deleted text end violations deleted text begin as
defined in section 144A.474, subdivision 11, paragraph (b), deleted text end new text begin that do not pose an imminent
risk of harm to the health or safety of persons on the provider's care, new text end 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.

new text begin (b) If the commissioner determines there are (1) level 4 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 3" and "level
4" have the meanings given in section 144A.474, subdivision 11, paragraph (b).
new text end

Sec. 5.

Minnesota Statutes 2014, section 144A.475, subdivision 3b, is amended to read:

Subd. 3b.

deleted text begin Temporary suspension deleted text end Expedited hearing.

(a) Within five business
days of receipt of the license holder's timely appeal of a temporary suspension new text begin or issuance
of a conditional license new text end , 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 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 new text begin or conditional license new text end 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 3 or 4 violations as defined in
section 144A.474, subdivision 11, paragraph (b) new text begin , or that there were violations that posed
an imminent risk of harm to the health and safety of the persons within the provider's care new text end .

(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 new text begin or conditional
license new text end is withdrawn or dismissed, the commissioner shall issue a final order affirming the
temporary immediate suspension new text begin or conditional license new text end 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.

new text begin (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.
new text end

Sec. 6.

Minnesota Statutes 2014, section 144A.475, is amended by adding a
subdivision to read:

new text begin Subd. 3c. new text end

new text begin Immediate temporary suspension. new text end

new text begin (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 4 violations; or (2) violations that pose an imminent risk of harm to
the health or safety of persons in the provider's care.
new text end

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

new text begin (b) 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 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 a request is made by personal service, it must be received by the
commissioner within five calendar days after the license holder received the order.
new text end

new text begin (c) A licensee 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.
new text end

Sec. 7.

Minnesota Statutes 2014, section 144A.4792, subdivision 13, is amended to
read:

Subd. 13.

Prescriptions.

There must be a current written or electronically recorded
prescription as defined in deleted text begin Minnesota Rules, part 6800.0100, subpart 11a deleted text end new text begin section 151.01,
subdivision 16a new text end , for all prescribed medications that the comprehensive home care provider
is managing for the client.

Sec. 8.

Minnesota Statutes 2014, section 144A.4799, subdivision 1, is amended to read:

Subdivision 1.

Membership.

The commissioner of health shall appoint eight
persons to a deleted text begin home care provider deleted text end new text begin home care and assisted living program new text end advisory council
consisting of the following:

(1) three public members as defined in section 214.02 who shall be either persons
who are currently receiving home care services or have family members receiving home
care services, or persons who have family members who have received home care services
within five years of the application date;

(2) three Minnesota home care licensees representing basic and comprehensive
levels of licensure who may be a managerial official, an administrator, a supervising
registered nurse, or an unlicensed personnel performing home care tasks;

(3) one member representing the Minnesota Board of Nursing; and

(4) one member representing the ombudsman for long-term care.

Sec. 9.

Minnesota Statutes 2014, section 144A.482, is amended to read:

144A.482 REGISTRATION OF HOME MANAGEMENT PROVIDERS.

(a) For purposes of this section, a home management provider is a person or
organization that provides at least two of the following services: housekeeping, meal
preparation, and shopping to a person who is unable to perform these activities due to
illness, disability, or physical condition.

(b) A person or organization that provides only home management services may not
operate in the state without a current certificate of registration issued by the commissioner
of health. To obtain a certificate of registration, the person or organization must annually
submit to the commissioner the name, mailing and physical addresses, e-mail address, and
telephone number of the person or organization and a signed statement declaring that the
person or organization is aware that the home care bill of rights applies to their clients and
that the person or organization will comply with the home care bill of rights provisions
contained in section 144A.44. A person or organization applying for a certificate must
also provide the name, business address, and telephone number of each of the persons
responsible for the management or direction of the organization.

(c) The commissioner shall charge an annual registration fee of $20 for persons and
$50 for organizations. The registration fee shall be deposited in the state treasury and
credited to the state government special revenue fund.

(d) A home care provider that provides home management services and other home
care services must be licensed, but licensure requirements other than the home care bill of
rights do not apply to those employees or volunteers who provide only home management
services to clients who do not receive any other home care services from the provider.
A licensed home care provider need not be registered as a home management service
provider but must provide an orientation on the home care bill of rights to its employees
or volunteers who provide home management services.

(e) An individual who provides home management services under this section must,
within 120 days after beginning to provide services, attend an orientation session deleted text begin approved
by the commissioner deleted text end that provides training on the home care bill of rights and an orientation
on the aging process and the needs and concerns of elderly and disabled persons.

(f) The commissioner may suspend or revoke a provider's certificate of registration
or assess fines for violation of the home care bill of rights. Any fine assessed for a
violation of the home care bill of rights by a provider registered under this section shall be
in the amount established in the licensure rules for home care providers. As a condition
of registration, a provider must cooperate fully with any investigation conducted by the
commissioner, including providing specific information requested by the commissioner on
clients served and the employees and volunteers who provide services. Fines collected
under this paragraph shall be deposited in the state treasury and credited to the fund
specified in the statute or rule in which the penalty was established.

(g) The commissioner may use any of the powers granted in sections 144A.43 to
144A.4798 to administer the registration system and enforce the home care bill of rights
under this section.

Sec. 10.

Minnesota Statutes 2014, section 153A.14, subdivision 2d, is amended to read:

Subd. 2d.

Certification renewal notice.

Certification must be renewed annually.
The commissioner shall mail a renewal notice to the dispenser's last known address new text begin on
record with the commissioner new text end by September 1 of each year. deleted text begin The notice must include a
renewal application and notice of fees required for renewal. deleted text end A dispenser is not relieved
from meeting the renewal deadline on the basis that the dispenser did not receive the
renewal notice. In renewing a certificate, a dispenser shall follow the procedures for
applying for a certificate specified in subdivision 1.

Sec. 11.

Minnesota Statutes 2014, section 153A.14, subdivision 2h, is amended to read:

Subd. 2h.

Certification by examination.

An applicant must achieve a passing score,
as determined by the commissioner, on an examination according to paragraphs (a) to (c).

(a) The examination must include, but is not limited to:

(1) A written examination approved by the commissioner covering the following
areas as they pertain to hearing instrument selling:

(i) basic physics of sound;

(ii) the anatomy and physiology of the ear;

(iii) the function of hearing instruments; and

(iv) the principles of hearing instrument selection.

(2) deleted text begin Practical tests deleted text end new text begin A practical examination new text end of proficiency in the following techniques
as they pertain to hearing instrument selling:

(i) pure tone audiometry, including air conduction testing and bone conduction
testing;

(ii) live voice or recorded voice speech audiometry including speech recognition
(discrimination) testing, most comfortable loudness level, and uncomfortable loudness
measurements of tolerance thresholds;

(iii) masking when indicated;

(iv) recording and evaluation of audiograms and speech audiometry to determine
proper selection and fitting of a hearing instrument;

(v) taking ear mold impressions;

(vi) using an otoscope for the visual observation of the entire ear canal; and

(vii) state and federal laws, rules, and regulations.

(b) The new text begin practical new text end examination shall be administered by the commissioner at least
twice a year.

(c) An applicant must achieve a passing score on all portions of the examination
within a two-year period. An applicant who does not achieve a passing score on all
portions of the examination within a two-year period must retake the entire examination
and achieve a passing score on each portion of the examination. An applicant who does not
apply for certification within one year of successful completion of the examination must
retake the examination and achieve a passing score on each portion of the examination.
An applicant may not take any part of the new text begin practical new text end examination more than three times in
a two-year period.

Sec. 12.

Minnesota Statutes 2014, section 153A.15, subdivision 2a, is amended to read:

Subd. 2a.

Hearings.

If the commissioner proposes to take action against the
dispenser as described in subdivision 2, the commissioner must first notify the person
against whom the action is proposed to be taken and provide the person with an
opportunity to request a hearing under the contested case provisions of chapter 14. new text begin Service
of a notice of disciplinary action may be made personally or by certified mail, return
receipt requested. new text end If the person does not request a hearing by notifying the commissioner
within 30 days after service of the notice of the proposed action, the commissioner may
proceed with the action without a hearing.

Sec. 13.

Minnesota Statutes 2014, section 157.15, subdivision 14, is amended to read:

Subd. 14.

Special event food stand.

"Special event food stand" means a food
and beverage service establishment which is used in conjunction with celebrations and
special events, and which operates deleted text begin no more than three times annually deleted text end for no more than
ten total days.

Sec. 14.

Minnesota Statutes 2014, section 157.16, subdivision 4, is amended to read:

Subd. 4.

Posting requirements.

Every food and beverage service establishment,
for-profit youth camp, hotel, motel, lodging establishment, public pool, or resort must
have the new text begin original new text end license posted in a conspicuous place at the establishment. deleted text begin Mobile food
units, food carts, and seasonal temporary food stands shall be issued decals with the
initial license and each calendar year with license renewals. The current license year
decal must be placed on the unit or stand in a location determined by the commissioner.
Decals are not transferable.
deleted text end