1.1                          A bill for an act 
  1.2             relating to health; modifying provisions relating to 
  1.3             access to patients and residents; amending Minnesota 
  1.4             Statutes 1994, sections 144.6501, subdivisions 1 and 
  1.5             4; 144.651, subdivisions 21 and 26; and 253B.03, 
  1.6             subdivisions 3 and 4. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 1994, section 144.6501, 
  1.9   subdivision 1, is amended to read: 
  1.10     Subdivision 1.  [DEFINITIONS.] For purposes of this 
  1.11  section, the following terms have the meanings given them. 
  1.12     (a) "Facility" means a nursing home licensed under chapter 
  1.13  144A or a boarding care facility licensed under sections 144.50 
  1.14  to 144.58. 
  1.15     (b) "Contract of admission," "admission contract," or 
  1.16  "admission agreement," includes, but is not limited to, all 
  1.17  documents that a resident or resident's representative must sign 
  1.18  at the time of, or as a condition of, admission to the 
  1.19  facility.  Oral representations and statements between the 
  1.20  facility and the resident or resident's representative are not 
  1.21  part of the contract of admission unless expressly contained in 
  1.22  writing in those documents.  The contract of admission must 
  1.23  specify the obligations of the resident or the responsible party.
  1.24     (c) "Legal representative" means an attorney-in-fact under 
  1.25  a valid power of attorney executed by the prospective resident, 
  1.26  or a conservator or guardian of the person or of the estate, or 
  2.1   a representative payee appointed for the prospective resident, 
  2.2   or other agent of limited powers. 
  2.3      (d) "Responsible party" means a person who has access to 
  2.4   the resident's income and assets and who agrees to apply the 
  2.5   resident's income and assets to pay for the resident's care or 
  2.6   who agrees to make and complete an application for medical 
  2.7   assistance on behalf of the resident. 
  2.8      Sec. 2.  Minnesota Statutes 1994, section 144.6501, 
  2.9   subdivision 4, is amended to read: 
  2.10     Subd. 4.  [RESIDENTS' SIGNATURES RESIDENT AND FACILITY 
  2.11  OBLIGATIONS.] (a) Before or at the time of admission, the 
  2.12  facility shall make reasonable efforts to communicate the 
  2.13  content of the admission contract to, and obtain on the 
  2.14  admission contract the signature of, the person who is to be 
  2.15  admitted to the facility and the responsible party.  The 
  2.16  admission contract must be signed by the prospective resident 
  2.17  unless the resident is legally incompetent or cannot understand 
  2.18  or sign the admission contract because of the resident's medical 
  2.19  condition.  
  2.20     (b) If the resident cannot sign the admission contract, the 
  2.21  reason must be documented in the resident's medical record by 
  2.22  the admitting physician. 
  2.23     (c) If the determination under paragraph (b) has been made, 
  2.24  the facility may request the signature of another person on 
  2.25  behalf of the applicant, subject to the provisions of paragraph 
  2.26  (d).  The facility must not require the person to disclose any 
  2.27  information regarding the person's personal financial assets, 
  2.28  liabilities, or income, unless the person voluntarily chooses to 
  2.29  become financially responsible for the resident's care.  The 
  2.30  facility must issue timely billing, respond to questions, and 
  2.31  monitor timely payment.  
  2.32     (d) A person who desires to assume financial responsibility 
  2.33  for the resident's care may contract with the facility to do so. 
  2.34  A person other than the resident or a financially responsible 
  2.35  spouse who is financially responsible for the resident who signs 
  2.36  an admission contract must not be required by the facility to 
  3.1   assume personal financial responsibility liability for the 
  3.2   resident's care.  A person who desires to assume financial 
  3.3   responsibility for the resident's care may contract with the 
  3.4   facility to do so.  However, if the responsible party has signed 
  3.5   the admission contract and fails to make timely payment of the 
  3.6   facility obligation, or knowingly fails to spenddown the 
  3.7   resident's assets appropriately for the purpose of obtaining 
  3.8   medical assistance, then the responsible party shall be liable 
  3.9   to the facility for the resident's costs of care which are not 
  3.10  paid for by medical assistance.  A responsible party shall be 
  3.11  personally liable only to the extent the resident's income or 
  3.12  assets were misapplied. 
  3.13     (e) The admission contract must include written notice in 
  3.14  the signature block, in bold capital letters, that a person 
  3.15  other than the resident or financially responsible spouse may 
  3.16  not be required by the facility to assume personal financial 
  3.17  responsibility liability for the resident's care.  
  3.18     (f) This subdivision does not preclude the facility from 
  3.19  obtaining the signature of a legal representative, if applicable.
  3.20     Sec. 3.  Minnesota Statutes 1994, section 144.651, 
  3.21  subdivision 21, is amended to read: 
  3.22     Subd. 21.  [COMMUNICATION PRIVACY.] Patients and residents 
  3.23  may associate and communicate privately with persons of their 
  3.24  choice and enter and, except as provided by the Minnesota 
  3.25  Commitment Act, leave the facility as they choose.  Patients and 
  3.26  residents shall have access, at their expense, to writing 
  3.27  instruments, stationery, and postage.  Personal mail shall be 
  3.28  sent without interference and received unopened unless medically 
  3.29  or programmatically contraindicated and documented by the 
  3.30  physician in the medical record.  There shall be access to a 
  3.31  telephone where patients and residents can make and receive 
  3.32  calls as well as speak privately.  Facilities which are unable 
  3.33  to provide a private area shall make reasonable arrangements to 
  3.34  accommodate the privacy of patients' or residents' calls.  Upon 
  3.35  admission to a facility, a patient or resident, or the patient's 
  3.36  or resident's legal guardian or conservator, shall be given the 
  4.1   opportunity to authorize disclosure of the patient's or 
  4.2   resident's presence in the facility, to callers or visitors who 
  4.3   may seek to communicate with the patient or resident.  This 
  4.4   disclosure option must be made available in all cases where 
  4.5   federal law prohibits unauthorized disclosure of patient or 
  4.6   resident identifying information to callers and visitors, the 
  4.7   patient or resident, or the legal guardian or conservator of the 
  4.8   patient or resident, shall be given the opportunity to authorize 
  4.9   disclosure of the patient's or resident's presence in the 
  4.10  facility to callers and visitors who may seek to communicate 
  4.11  with the patient or resident.  To the extent possible, the legal 
  4.12  guardian or conservator of a patient or resident shall consider 
  4.13  the opinions of the patient or resident regarding the disclosure 
  4.14  of the patient's or resident's presence in the facility.  This 
  4.15  right is limited where medically inadvisable, as documented by 
  4.16  the attending physician in a patient's or resident's care 
  4.17  record.  Where programmatically limited by a facility abuse 
  4.18  prevention plan pursuant to section 626.557, subdivision 14, 
  4.19  clause 2, this right shall also be limited accordingly.  
  4.20     Sec. 4.  Minnesota Statutes 1994, section 144.651, 
  4.21  subdivision 26, is amended to read: 
  4.22     Subd. 26.  [RIGHT TO ASSOCIATE.] Residents may meet with 
  4.23  visitors and participate in activities of commercial, religious, 
  4.24  political, as defined in section 203B.11 and community groups 
  4.25  without interference at their discretion if the activities do 
  4.26  not infringe on the right to privacy of other residents or are 
  4.27  not programmatically contraindicated.  This includes the right 
  4.28  to join with other individuals within and outside the facility 
  4.29  to work for improvements in long-term care.  Upon admission to a 
  4.30  facility, a patient or resident, or the patient's or resident's 
  4.31  legal guardian or conservator, shall be given the opportunity to 
  4.32  authorize disclosure of the patient's or resident's presence in 
  4.33  the facility, to callers or visitors who may seek to communicate 
  4.34  with the patient or resident.  This disclosure option must be 
  4.35  made available in all cases where federal law prohibits 
  4.36  unauthorized disclosure of patient or resident identifying 
  5.1   information to callers and visitors, the patient or resident, or 
  5.2   the legal guardian or conservator of the patient or resident, 
  5.3   shall be given the opportunity to authorize disclosure of the 
  5.4   patient's or resident's presence in the facility to callers and 
  5.5   visitors who may seek to communicate with the patient or 
  5.6   resident.  To the extent possible, the legal guardian or 
  5.7   conservator of a patient or resident shall consider the opinions 
  5.8   of the patient or resident regarding the disclosure of the 
  5.9   patient's or resident's presence in the facility. 
  5.10     Sec. 5.  Minnesota Statutes 1994, section 253B.03, 
  5.11  subdivision 3, is amended to read: 
  5.12     Subd. 3.  [VISITORS AND PHONE CALLS.] Subject to the 
  5.13  general rules of the treatment facility, a patient has the right 
  5.14  to receive visitors and make phone calls.  The head of the 
  5.15  treatment facility may restrict visits and phone calls on 
  5.16  determining that the medical welfare of the patient requires 
  5.17  it.  Any limitation imposed on the exercise of the patient's 
  5.18  visitation and phone call rights and the reason for it shall be 
  5.19  made a part of the clinical record of the patient.  Upon 
  5.20  admission to a facility, a patient or resident, or the patient's 
  5.21  or resident's legal guardian or conservator, shall be given the 
  5.22  opportunity to authorize disclosure of the patient's or 
  5.23  resident's presence in the facility, to callers or visitors who 
  5.24  may seek to communicate with the patient or resident.  This 
  5.25  disclosure option must be made available in all cases where 
  5.26  federal law prohibits unauthorized disclosure of patient or 
  5.27  resident identifying information to callers and visitors, the 
  5.28  patient or resident, or the legal guardian or conservator of the 
  5.29  patient or resident, shall be given the opportunity to authorize 
  5.30  disclosure of the patient's or resident's presence in the 
  5.31  facility to callers and visitors who may seek to communicate 
  5.32  with the patient or resident.  To the extent possible, the legal 
  5.33  guardian or conservator of a patient or resident shall consider 
  5.34  the opinions of the patient or resident regarding the disclosure 
  5.35  of the patient's or resident's presence in the facility. 
  5.36     Sec. 6.  Minnesota Statutes 1994, section 253B.03, 
  6.1   subdivision 4, is amended to read: 
  6.2      Subd. 4.  [SPECIAL VISITATION; RELIGION.] A patient has the 
  6.3   right to meet with or call a personal physician, spiritual 
  6.4   advisor, and counsel at all reasonable times.  Upon admission to 
  6.5   a facility, a patient or resident, or the patient's or 
  6.6   resident's legal guardian or conservator, shall be given the 
  6.7   opportunity to authorize disclosure of the patient's or 
  6.8   resident's presence in the facility, to callers or visitors who 
  6.9   may seek to communicate with the patient or resident.  This 
  6.10  disclosure option must be made available in all cases where 
  6.11  federal law prohibits unauthorized disclosure of patient or 
  6.12  resident identifying information to callers and visitors, the 
  6.13  patient or resident, or the legal guardian or conservator of the 
  6.14  patient or resident, shall be given the opportunity to authorize 
  6.15  disclosure of the patient's or resident's presence in the 
  6.16  facility to callers and visitors who may seek to communicate 
  6.17  with the patient or resident.  To the extent possible, the legal 
  6.18  guardian or conservator of a patient or resident shall consider 
  6.19  the opinions of the patient or resident regarding the disclosure 
  6.20  of the patient's or resident's presence in the facility.  The 
  6.21  patient has the right to continue the practice of religion.