1.1 	A bill for an act
1.2 	relating to health; modifying provisions regulating home health care services;
1.3 	amending Minnesota Statutes 2008, sections 144A.45, subdivisions 2, 4; 
1.4 	144A.46, subdivisions 2, 3; Minnesota Statutes 2009 Supplement, section 
1.5 	144A.46, subdivision 1.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. Minnesota Statutes 2008, section 144A.45, subdivision 2, is amended to 
1.8 	read:
1.9 		Subd. 2.Regulatory functions. (a) The commissioner shall:
1.10 	(1) evaluate, monitor, and license home care providers in accordance with sections 
1.11 	144A.45 to 144A.47; 
1.12 	(2) inspect the office and records of a provider during regular business hours without 
1.13 	advance notice to the home care provider;
1.14 	(3) with the consent of the consumer, visit the home where services are being 
1.15 	provided;
1.16 	(4) issue correction orders and assess civil penalties in accordance with section 
1.17 	144.653, subdivisions 5 to 8, for violations of sections 144A.43 to 144A.47 or the rules 
1.18 	adopted under those sections; ~~and~~
1.19 	(5) take action as authorized in section 144A.46, subdivision 3; and
1.20 	(6) take other action reasonably required to accomplish the purposes of sections 
1.21 	144A.43 to 144A.47. 
1.22 	(b) In the exercise of the authority granted in sections 144A.43 to 144A.47, the 
1.23 	commissioner shall comply with the applicable requirements of section 144.122, the 
1.24 	Government Data Practices Act, and the Administrative Procedure Act. 

2.1 	Sec. 2. Minnesota Statutes 2008, section 144A.45, subdivision 4, is amended to read:
2.2 		Subd. 4.Medicaid reimbursement. Notwithstanding the provisions of section 
2.3 	~~256B.071~~ 256B.37 or state plan requirements to the contrary, certification by the federal 
2.4 	Medicare program must not be a requirement of Medicaid payment for services delivered 
2.5 	under section 144A.4605. 

2.6 	Sec. 3. Minnesota Statutes 2009 Supplement, section 144A.46, subdivision 1, is 
2.7 	amended to read:
2.8 		Subdivision 1. License required. (a) A home care provider may not operate in the 
2.9 	state without a current license issued by the commissioner of health. A home care provider 
2.10 	may hold a separate license for each class of home care licensure. 
2.11 	(b) Within ten days after receiving an application for a license, the commissioner 
2.12 	shall acknowledge receipt of the application in writing. The acknowledgment must 
2.13 	indicate whether the application appears to be complete or whether additional information 
2.14 	is required before the application will be considered complete. Within 90 days after 
2.15 	receiving a complete application, the commissioner shall either grant or deny the license. 
2.16 	If an applicant is not granted or denied a license within 90 days after submitting a 
2.17 	complete application, the license must be deemed granted. An applicant whose license has 
2.18 	been deemed granted must provide written notice to the commissioner before providing a 
2.19 	home care service. 
2.20 	(c) Each application for a home care provider license, or for a renewal of a license, 
2.21 	shall be accompanied by a fee to be set by the commissioner under section 144.122 and 
2.22 	information sufficient to show that the applicant meets the requirements of licensure. 
2.23 	~~(d) The commissioner of health, in consultation with the commissioner of human~~ 
2.24 	~~services, shall provide recommendations to the legislature by February 15, 2009, for~~ 
2.25 	~~provider standards for personal care assistant services as described in section 256B.0659.~~ 

2.26 	Sec. 4. Minnesota Statutes 2008, section 144A.46, subdivision 2, is amended to read:
2.27 		Subd. 2. Exemptions. The following individuals or organizations are exempt from 
2.28 	the requirement to obtain a home care provider license: 
2.29 	(1) a person who is licensed as a registered nurse under sections 148.171 to 148.285 
2.30 	and who independently provides nursing services in the home without any contractual or 
2.31 	employment relationship to a home care provider or other organization; 
2.32 	(2) a personal care assistant who provides services to only one individual under the 
2.33 	medical assistance program as authorized under sections 256B.0625, subdivision 19a, and 
2.34 	256B.04, subdivision 16; 
3.1 	(3) a person or organization that offers, provides, or arranges for personal care 
3.2 	assistant services under the medical assistance program as authorized under sections 
3.3 	256B.0625, subdivision 19a, ~~and~~256B.04, subdivision 16, ~~until provider standards are~~ 
3.4 	~~implemented based on the recommendations in section 144A.46, subdivision 1, paragraph~~ 
3.5 	~~(d)~~ and 256B.0659; 
3.6 	(4) a person who is licensed under sections 148.65 to 148.78 and who independently 
3.7 	provides physical therapy services in the home without any contractual or employment 
3.8 	relationship to a home care provider or other organization; 
3.9 	(5) a provider that is licensed by the commissioner of human services to provide 
3.10 	semi-independent living services under Minnesota Rules, parts 9525.0500 to 9525.0660 
3.11 	when providing home care services to a person with a developmental disability; 
3.12 	(6) a provider that is licensed by the commissioner of human services to provide 
3.13 	home and community-based services under Minnesota Rules, parts 9525.2000 to 
3.14 	9525.2140 when providing home care services to a person with a developmental disability; 
3.15 	(7) a person or organization that provides only home management services, if the 
3.16 	person or organization is registered under section 144A.461; or 
3.17 	(8) a person who is licensed as a social worker under chapter 148D and who 
3.18 	provides social work services in the home independently and not through any contractual 
3.19 	or employment relationship with a home care provider or other organization. 
3.20 	An exemption under this subdivision does not excuse the individual from complying 
3.21 	with applicable provisions of the home care bill of rights. 

3.22 	Sec. 5. Minnesota Statutes 2008, section 144A.46, subdivision 3, is amended to read:
3.23 		Subd. 3.Enforcement. (a) The commissioner may refuse to grant or renew a 
3.24 	license, ~~or~~ may suspend or revoke a license, or may impose a conditional license for 
3.25 	violation of statutes or rules relating to home care services or for conduct detrimental to the 
3.26 	welfare of the consumer. A suspension may include terms that must be completed before a 
3.27 	suspension is lifted. Terms for a suspension or conditional license may include one or 
3.28 	more of the following and the scope of each will be determined by the commissioner:
3.29 	(1) requiring a consultant to review, evaluate, and make recommended changes to 
3.30 	the provider's practices and submit reports to the commissioner at the cost of the provider;
3.31 	(2) requiring supervision of the provider's practices at the cost of the provider by an 
3.32 	unrelated person who has sufficient knowledge and qualifications to oversee the practices 
3.33 	and who will submit reports to the commissioner;
3.34 	(3) requiring the provider or the provider's employees to obtain training at the cost 
3.35 	of the provider;
4.1 	(4) requiring the provider to submit reports to the commissioner;
4.2 	(5) prohibiting the provider from taking any new clients for a period of time; or
4.3 	(6) any other action reasonably required to accomplish the purpose of section 
4.4 	144A.45, subdivision 2, and this subdivision.
4.5 	(b) Prior to any suspension, revocation, or refusal to renew a license, the home care 
4.6 	provider shall be entitled to notice and a hearing as provided by sections 14.57 to 14.69. 
4.7 	In addition to any other remedy provided by law, the commissioner may, without a prior 
4.8 	contested case hearing, temporarily suspend a license or prohibit delivery of services by 
4.9 	a provider for not more than 60 days if the commissioner determines that the health or 
4.10 	safety of a consumer is in imminent danger, provided: (1) advance notice is given to the 
4.11 	provider; (2) after notice, the provider fails to correct the problem; (3) the commissioner 
4.12 	has reason to believe that other administrative remedies are not likely to be effective; and 
4.13 	(4) there is an opportunity for a contested case hearing within the 60 days. 
4.14 	(c) The process of suspending or revoking a license must include a plan for 
4.15 	transferring affected clients to other providers~~.~~ by the provider, which will be monitored 
4.16 	by the commissioner. Within three business days of being notified of the final revocation 
4.17 	or suspension action, the provider shall provide the commissioner, the lead agencies as 
4.18 	defined in section 256B.0911, and the ombudsman for long-term care with the following 
4.19 	information: (1) a list of all clients, including full names and all contact information 
4.20 	on file; (2) a list of each client's contact person, including full names and all contact 
4.21 	information on file; (3) the location of each client; (4) the payor sources for each client, 
4.22 	including payor source identification numbers; and (5) for each client, a copy of the client's 
4.23 	service agreement, and a list of the types of services being provided. The revocation or 
4.24 	suspension notification requirement is satisfied by mailing the notice to the address in the 
4.25 	license record. The provider shall cooperate with the commissioner and the lead agencies 
4.26 	during the process of transferring care of clients to qualified providers. Within three 
4.27 	business days of being notified of the final revocation or suspension action, the provider 
4.28 	must notify and disclose to each of the provider's clients or the client's contact persons that 
4.29 	the commissioner is taking action against the provider's license by providing a copy of the 
4.30 	revocation or suspension notice issued by the commissioner. When the home care provider 
4.31 	voluntarily discontinues services, the provider will notify the commissioner, lead agencies, 
4.32 	and the ombudsman for long-term care about its clients as required in this section.
4.33 	~~(b)~~ (d) The owner and managerial officials, as defined in the home care licensure 
4.34 	rules, Minnesota Rules, chapter 4668, of a home care provider whose Minnesota license 
4.35 	has not been renewed or has been revoked because of noncompliance with applicable law 
4.36 	or rule shall not be eligible to apply for nor will be granted a home care license, including 
5.1 	other licenses in this chapter, or be given status as an enrolled personal care assistance 
5.2 	provider agency or personal care assistant by the Department of Human Services pursuant 
5.3 	to section 256B.0659 for five years following the effective date of the nonrenewal or 
5.4 	revocation. If the owner and managerial officials already have enrollment status, their 
5.5 	enrollment will be terminated by the Department of Human Services.
5.6 	~~(c)~~ (e) The commissioner shall not issue a license to a home care provider if an 
5.7 	owner or managerial official includes any individual who was an owner or managerial 
5.8 	official of a home care provider whose Minnesota license was not renewed or was revoked 
5.9 	as described in paragraph ~~(b)~~ (d) for five years following the effective date of nonrenewal 
5.10 	or revocation.
5.11 	~~(d)~~ (f) Notwithstanding the provisions of paragraph (a), the commissioner shall not 
5.12 	renew, or shall suspend or revoke the license of any home care provider which includes 
5.13 	any individual as an owner or managerial official who was an owner or managerial official 
5.14 	of a home care provider whose Minnesota license was not renewed or was revoked as 
5.15 	described in paragraph ~~(b)~~ (d) for five years following the effective date of the nonrenewal 
5.16 	or revocation. The commissioner shall notify the home care provider 30 days in advance 
5.17 	of the date of nonrenewal, suspension, or revocation of the license. Within ten days after 
5.18 	the receipt of this notification, the home care provider may request, in writing, that the 
5.19 	commissioner stay the nonrenewal, revocation, or suspension of the license. The home 
5.20 	care provider shall specify the reasons for requesting the stay; the steps that will be taken 
5.21 	to attain or maintain compliance with the licensure laws and regulations; any limits on the 
5.22 	authority or responsibility of the owners or managerial officials whose actions resulted in 
5.23 	the notice of nonrenewal, revocation, or suspension; and any other information to establish 
5.24 	that the continuing affiliation with these individuals will not jeopardize client health, safety, 
5.25 	or well being. The commissioner shall determine whether the stay will be granted within 
5.26 	30 days of receiving the provider's request. The commissioner may propose additional 
5.27 	restrictions or limitations on the provider's license and require that the granting of the stay 
5.28 	be contingent upon compliance with those provisions. The commissioner shall take into 
5.29 	consideration the following factors when determining whether the stay should be granted:
5.30 	(1) the threat that continued involvement of the owners and managerial officials in 
5.31 	the home care provider poses to client health, safety, and well being;
5.32 	(2) the compliance history of the home care provider; and
5.33 	(3) the appropriateness of any limits suggested by the home care provider.
5.34 	If the commissioner grants the stay, the order shall include any restrictions or limitation 
5.35 	on the provider's license. The failure of the provider to comply with any restrictions or 
6.1 	limitations shall result in the immediate removal of the stay and the commissioner shall 
6.2 	take immediate action to suspend, revoke, or not renew the license.
6.3 	~~(e)~~ (g) The provisions contained in paragraphs ~~(b)~~ (d) and ~~(c)~~ (e) shall apply to 
6.4 	any nonrenewal or revocation of a home care license occurring after June 1, 1993, the 
6.5 	effective date of the home care licensure rules.
6.6 	~~(f)~~ (h) For the purposes of this subdivision, owners of a home care provider are those 
6.7 	individuals whose ownership interest provides sufficient authority or control to affect or 
6.8 	change decisions related to the operation of the home care provider. An owner includes 
6.9 	a sole proprietor, a general partner, or any other individual whose individual ownership 
6.10 	interest can affect the management and direction of the policies of the home care provider. 
6.11 	For the purposes of this subdivision, managerial officials are those individuals who had 
6.12 	the responsibility for the ongoing management or direction of the policies, services, or 
6.13 	employees of the home care provider relating to the areas of noncompliance which led 
6.14 	to the license revocation or nonrenewal.