HF 3142

1st Unofficial Engrossment - 89th Legislature (2015 - 2016)

Posted on 05/19/2016 02:27 p.m.

1.1A bill for an act 1.2relating to health; amending provisions for the all-payer claims data, statewide 1.3trauma system, home care, hearing instrument dispensers, Zika preparedness, 1.4food, beverage, and lodging establishments, and body art technician license; 1.5allowing electronic monitoring devices in residential care or services; requiring a 1.6health carrier to update its Web site; adopting requirements for a medical faculty 1.7license; changing provisions in the medical cannabis program; approving positive 1.8support strategies and restrictive interventions in Minnesota Rules and making 1.9conforming statutory changes; appropriating money and canceling a specific 1.10appropriation;amending Minnesota Statutes 2014, sections 144.605, subdivision 1.115; 144.608, subdivision 1; 144A.473, subdivision 2; 144A.475, subdivisions 3, 1.123b, by adding a subdivision; 144A.4791, by adding a subdivision; 144A.4792, 1.13subdivision 13; 144A.4799, subdivisions 1, 3; 144A.482; 144D.01, subdivision 1.142a; 144G.03, subdivisions 2, 4; 146B.01, subdivision 28; 146B.03, subdivisions 1.154, 6, 7, by adding a subdivision; 146B.07, subdivisions 1, 2; 152.22, subdivision 1.1614; 152.25, subdivisions 3, 4; 152.29, subdivision 3, by adding a subdivision; 1.17152.36, subdivision 2, by adding a subdivision; 153A.14, subdivisions 2d, 1.182h; 153A.15, subdivision 2a; 157.15, subdivision 14; 157.16, subdivision 4; 1.19245.8251, subdivision 2, by adding a subdivision; 252.275, subdivision 1a; 1.20253B.03, subdivisions 1, 6a; 256B.0659, subdivision 3; 256B.0951, subdivision 1.215; 256B.097, subdivision 4; 256B.77, subdivision 17; 626.5572, subdivision 2; 1.22Minnesota Statutes 2015 Supplement, sections 62U.04, subdivision 11; 626.556, 1.23subdivision 2; proposing coding for new law in Minnesota Statutes, chapters 1.2462K; 144; 144D; 147; repealing Minnesota Statutes 2014, section 245.825, 1.25subdivisions 1, 1b. 1.26BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.27    Section 1. new text begin [62K.075] PROVIDER NETWORK NOTIFICATIONS. new text end 1.28 new text begin A health carrier must update the carrier's Web site regarding any change in a new text end 1.29 new text begin provider's network status within 24 hours of the change. new text end 1.30    Sec. 2. Minnesota Statutes 2015 Supplement, section 62U.04, subdivision 11, is 1.31amended to read: 2.1    Subd. 11. Restricted uses of the all-payer claims data. (a) Notwithstanding 2.2subdivision 4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the 2.3commissioner's designee shall only use the data submitted under subdivisions 4 and 5 for 2.4the following purposes: 2.5(1) to evaluate the performance of the health care home program as authorized under 2.6sections 256B.0751, subdivision 6, and 256B.0752, subdivision 2; 2.7(2) to study, in collaboration with the reducing avoidable readmissions effectively 2.8(RARE) campaign, hospital readmission trends and rates; 2.9(3) to analyze variations in health care costs, quality, utilization, and illness burden 2.10based on geographical areas or populations; 2.11(4) to evaluate the state innovation model (SIM) testing grant received by the 2.12Departments of Health and Human Services, including the analysis of health care cost, 2.13quality, and utilization baseline and trend information for targeted populations and 2.14communities; and 2.15(5) to compile one or more public use files of summary data or tables that must: 2.16(i) be available to the public for no or minimal cost by March 1, 2016, and available 2.17by Web-based electronic data download by June 30, 2019; 2.18(ii) not identify individual patients, payers, or providers; 2.19(iii) be updated by the commissioner, at least annually, with the most current data 2.20available; 2.21(iv) contain clear and conspicuous explanations of the characteristics of the data, 2.22such as the dates of the data contained in the files, the absence of costs of care for uninsured 2.23patients or nonresidents, and other disclaimers that provide appropriate context; and 2.24(v) not lead to the collection of additional data elements beyond what is authorized 2.25under this section as of June 30, 2015. 2.26(b) The commissioner may publish the results of the authorized uses identified 2.27in paragraph (a) so long as the data released publicly do not contain information or 2.28descriptions in which the identity of individual hospitals, clinics, or other providers may 2.29be discerned. 2.30(c) Nothing in this subdivision shall be construed to prohibit the commissioner from 2.31using the data collected under subdivision 4 to complete the state-based risk adjustment 2.32system assessment due to the legislature on October 1, 2015. 2.33(d) The commissioner or the commissioner's designee may use the data submitted 2.34under subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until 2.35July 1, 2016 new text begin 2019 new text end . 3.1(e) The commissioner shall consult with the all-payer claims database work group 3.2established under subdivision 12 regarding the technical considerations necessary to create 3.3the public use files of summary data described in paragraph (a), clause (5). 3.4    Sec. 3. Minnesota Statutes 2014, section 144.605, subdivision 5, is amended to read: 3.5    Subd. 5. Level IV designation. (a) The commissioner shall grant the appropriate 3.6level IV trauma hospital designation to a hospital that successfully completes the 3.7designation process under paragraph (b). 3.8(b) The hospital must complete and submit a self-reported survey and application to 3.9the Trauma Advisory Council for review, verifying that the hospital meets the criteria as a 3.10level IV trauma hospital. When the Trauma Advisory Council is satisfied the application 3.11is complete, the council shall review the application and, if the council approves the 3.12application, send a letter of recommendation to the commissioner for final approval and 3.13designation. The commissioner shall grant a level IV designation and shall arrange a site 3.14review visit within three years of the designation and every three years thereafter, to 3.15coincide with the three-year reverification process. new text begin commissioner shall arrange a site new text end 3.16 new text begin review visit. Upon successful completion of the site review, the review team shall make new text end 3.17 new text begin written recommendations to the Trauma Advisory Council. If approved by the Trauma new text end 3.18 new text begin Advisory Council, a letter of recommendation shall be sent to the commissioner for final new text end 3.19 new text begin approval and designation. new text end 3.20 new text begin EFFECTIVE DATE. new text end new text begin This section is effective October 1, 2016. new text end 3.21    Sec. 4. Minnesota Statutes 2014, section 144.608, subdivision 1, is amended to read: 3.22    Subdivision 1. Trauma Advisory Council established. (a) A Trauma Advisory 3.23Council is established to advise, consult with, and make recommendations to the 3.24commissioner on the development, maintenance, and improvement of a statewide trauma 3.25system. 3.26(b) The council shall consist of the following members: 3.27(1) a trauma surgeon certified by the American Board of Surgery or the American 3.28Osteopathic Board of Surgery who practices in a level I or II trauma hospital; 3.29(2) a general surgeon certified by the American Board of Surgery or the American 3.30Osteopathic Board of Surgery whose practice includes trauma and who practices in a 3.31designated rural area as defined under section 144.1501, subdivision 1, paragraph (b); 3.32(3) a neurosurgeon certified by the American Board of Neurological Surgery who 3.33practices in a level I or II trauma hospital; 4.1(4) a trauma program nurse manager or coordinator practicing in a level I or II 4.2trauma hospital; 4.3(5) an emergency physician certified by the American Board of Emergency Medicine 4.4or the American Osteopathic Board of Emergency Medicine whose practice includes 4.5emergency room care in a level I, II, III, or IV trauma hospital; 4.6(6) a trauma program manager or coordinator who practices in a level III or IV 4.7trauma hospital; 4.8(7) a physician certified by the American Board of Family Medicine or the American 4.9Osteopathic Board of Family Practice whose practice includes emergency department care 4.10in a level III or IV trauma hospital located in a designated rural area as defined under 4.11section 144.1501, subdivision 1, paragraph (b); 4.12(8) a nurse practitioner, as defined under section 144.1501, subdivision 1, paragraph 4.13(h), or a physician assistant, as defined under section 144.1501, subdivision 1, paragraph 4.14(j), whose practice includes emergency room care in a level IV trauma hospital located in 4.15a designated rural area as defined under section 144.1501, subdivision 1, paragraph (b); 4.16(9) a pediatrician new text begin physician new text end certified new text begin in pediatric emergency medicine new text end by the 4.17American Board of Pediatrics or new text begin certified in pediatric emergency medicine by the American new text end 4.18 new text begin Board of Emergency Medicine or certified by new text end the American Osteopathic Board of Pediatrics 4.19whose 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, 4.20or IV trauma hospital new text begin , or a surgeon certified in pediatric surgery by the American Board of new text end 4.21 new text begin Surgery whose practice involves the care of pediatric trauma patients in a trauma hospital new text end ; 4.22(10) an orthopedic surgeon certified by the American Board of Orthopaedic Surgery 4.23or the American Osteopathic Board of Orthopedic Surgery whose practice includes trauma 4.24and who practices in a level I, II, or III trauma hospital; 4.25(11) the state emergency medical services medical director appointed by the 4.26Emergency Medical Services Regulatory Board; 4.27(12) a hospital administrator of a level III or IV trauma hospital located in a 4.28designated rural area as defined under section 144.1501, subdivision 1, paragraph (b); 4.29(13) a rehabilitation specialist whose practice includes rehabilitation of patients 4.30with major trauma injuries or traumatic brain injuries and spinal cord injuries as defined 4.31under section 144.661; 4.32(14) an attendant or ambulance director who is an EMT, EMT-I, or EMT-P within 4.33the meaning of section 144E.001 and who actively practices with a licensed ambulance 4.34service in a primary service area located in a designated rural area as defined under section 4.35144.1501, subdivision 1 , paragraph (b); and 4.36(15) the commissioner of public safety or the commissioner's designee. 5.1    Sec. 5. new text begin [144.945] ZIKA PREPAREDNESS AND RESPONSE. new text end 5.2 new text begin (a) To the extent funds are available, the commissioner of health shall undertake new text end 5.3 new text begin the following statewide planning, coordination, preparation, and response activities new text end 5.4 new text begin related to the Zika virus: new text end 5.5 new text begin (1) maintain state and local public health readiness to address Zika-related public new text end 5.6 new text begin health threats; new text end 5.7 new text begin (2) conduct diagnostic tests of patients who meet criteria for Zika testing and new text end 5.8 new text begin maintain enhanced laboratory surveillance activities related to Zika; new text end 5.9 new text begin (3) engage in Zika surveillance activities, including evaluating patients for testing new text end 5.10 new text begin based on criteria, advising health care providers on Zika virus research, providing new text end 5.11 new text begin recommendations and interpretations of test results, and conducting Zika-related public new text end 5.12 new text begin awareness and prevention activities; and new text end 5.13 new text begin (4) conduct mosquito surveillance activities under section 144.95 to enhance new text end 5.14 new text begin monitoring of areas where mosquitoes carrying the Zika virus may be found in Minnesota, new text end 5.15 new text begin notwithstanding section 144.95, subdivision 10. new text end 5.16 new text begin (b) The commissioner shall seek authority from the United States Centers for new text end 5.17 new text begin Disease Control and Prevention to use federal Public Health Emergency Preparedness new text end 5.18 new text begin grant funds for costs associated with Zika preparedness and response activities under this new text end 5.19 new text begin section and shall seek additional federal funds for this purpose. new text end 5.20    Sec. 6. Minnesota Statutes 2014, section 144A.473, subdivision 2, is amended to read: 5.21    Subd. 2. Temporary license. (a) For new license applicants, the commissioner 5.22shall issue a temporary license for either the basic or comprehensive home care level. A 5.23temporary license is effective for new text begin up to new text end one year from the date of issuance. Temporary 5.24licensees must comply with sections 144A.43 to 144A.482. 5.25(b) During the temporary license year, the commissioner shall survey the temporary 5.26licensee after the commissioner is notified or has evidence that the temporary licensee 5.27is providing home care services. 5.28(c) Within five days of beginning the provision of services, the temporary 5.29licensee must notify the commissioner that it is serving clients. The notification to the 5.30commissioner may be mailed or e-mailed to the commissioner at the address provided by 5.31the commissioner. If the temporary licensee does not provide home care services during 5.32the temporary license year, then the temporary license expires at the end of the year and 5.33the applicant must reapply for a temporary home care license. 5.34(d) A temporary licensee may request a change in the level of licensure prior to 5.35being surveyed and granted a license by notifying the commissioner in writing and 6.1providing additional documentation or materials required to update or complete the 6.2changed temporary license application. The applicant must pay the difference between 6.3the application fees when changing from the basic level to the comprehensive level of 6.4licensure. No refund will be made if the provider chooses to change the license application 6.5to the basic level. 6.6(e) If the temporary licensee notifies the commissioner that the licensee has clients 6.7within 45 days prior to the temporary license expiration, the commissioner may extend the 6.8temporary license for up to 60 days in order to allow the commissioner to complete the 6.9on-site survey required under this section and follow-up survey visits. 6.10    Sec. 7. Minnesota Statutes 2014, section 144A.475, subdivision 3, is amended to read: 6.11    Subd. 3. Notice. new text begin (a) new text end Prior to any suspension, revocation, or refusal to renew a 6.12license, the home care provider shall be entitled to notice and a hearing as provided 6.13by sections 14.57 to 14.69. In addition to any other remedy provided by law, the 6.14commissioner may, without a prior contested case hearing, temporarily suspend a license 6.15or prohibit delivery of services by a provider for not more than 90 days new text begin , or issue a new text end 6.16 new text begin conditional license new text end if the commissioner determines that there are level 3 or 4 violations as 6.17defined in section 144A.474, subdivision 11, paragraph (b), new text begin that do not pose an imminent new text end 6.18 new text begin risk of harm to the health or safety of persons in the provider's care, new text end provided: 6.19(1) advance notice is given to the home care provider; 6.20(2) after notice, the home care provider fails to correct the problem; 6.21(3) the commissioner has reason to believe that other administrative remedies are not 6.22likely to be effective; and 6.23(4) there is an opportunity for a contested case hearing within the 30 days unless 6.24there is an extension granted by an administrative law judge pursuant to subdivision 3b. 6.25 new text begin (b) If the commissioner determines there are: new text end 6.26 new text begin (1) level 4 violations; or new text end 6.27 new text begin (2) violations that pose an imminent risk of harm to the health or safety of persons in new text end 6.28 new text begin the provider's care, new text end 6.29 new text begin the commissioner may immediately temporarily suspend a license, prohibit delivery of new text end 6.30 new text begin services by a provider, or issue a conditional license without meeting the requirements of new text end 6.31 new text begin paragraph (a), clauses (1) to (4). new text end 6.32 new text begin For the purposes of this subdivision, "level 3" and "level 4" have the meanings given in new text end 6.33 new text begin section 144A.474, subdivision 11, paragraph (b). new text end 6.34    Sec. 8. Minnesota Statutes 2014, section 144A.475, subdivision 3b, is amended to read: 7.1    Subd. 3b. Temporary suspension Expedited hearing. (a) Within five business 7.2days of receipt of the license holder's timely appeal of a temporary suspension new text begin or issuance new text end 7.3 new text begin of a conditional license new text end , the commissioner shall request assignment of an administrative 7.4law judge. The request must include a proposed date, time, and place of a hearing. A 7.5hearing must be conducted by an administrative law judge within 30 calendar days of the 7.6request for assignment, unless an extension is requested by either party and granted by the 7.7administrative law judge for good cause. The commissioner shall issue a notice of hearing 7.8by certified mail or personal service at least ten business days before the hearing. Certified 7.9mail to the last known address is sufficient. The scope of the hearing shall be limited solely 7.10to the issue of whether the temporary suspension new text begin or issuance of a conditional license new text end should 7.11remain in effect and whether there is sufficient evidence to conclude that the licensee's 7.12actions or failure to comply with applicable laws are level 3 or 4 violations as defined in 7.13section 144A.474, subdivision 11, paragraph (b) new text begin , or that there were violations that posed new text end 7.14 new text begin an imminent risk of harm to the health and safety of persons in the provider's care new text end . 7.15(b) The administrative law judge shall issue findings of fact, conclusions, and a 7.16recommendation within ten business days from the date of hearing. The parties shall 7.17have ten calendar days to submit exceptions to the administrative law judge's report. 7.18The record shall close at the end of the ten-day period for submission of exceptions. 7.19The commissioner's final order shall be issued within ten business days from the close 7.20of the record. When an appeal of a temporary immediate suspension new text begin or conditional new text end 7.21 new text begin license new text end is withdrawn or dismissed, the commissioner shall issue a final order affirming the 7.22temporary immediate suspension new text begin or conditional license new text end within ten calendar days of the 7.23commissioner's receipt of the withdrawal or dismissal. The license holder is prohibited 7.24from operation during the temporary suspension period. 7.25(c) When the final order under paragraph (b) affirms an immediate suspension, and a 7.26final licensing sanction is issued under subdivisions 1 and 2 and the licensee appeals that 7.27sanction, the licensee is prohibited from operation pending a final commissioner's order 7.28after the contested case hearing conducted under chapter 14. 7.29 new text begin (d) A licensee whose license is temporarily suspended must comply with the new text end 7.30 new text begin requirements for notification and transfer of clients in subdivision 5. These requirements new text end 7.31 new text begin remain if an appeal is requested. new text end 7.32    Sec. 9. Minnesota Statutes 2014, section 144A.475, is amended by adding a 7.33subdivision to read: 7.34     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 new text end 7.35 new text begin remedies provided by law, the commissioner may, without a prior contested case hearing, new text end 8.1 new text begin immediately temporarily suspend a license or prohibit delivery of services by a provider new text end 8.2 new text begin for not more than 90 days, or issue a conditional license, if the commissioner determines new text end 8.3 new text begin that there are: new text end 8.4 new text begin (1) level 4 violations; or new text end 8.5 new text begin (2) violations that pose an imminent risk of harm to the health or safety of persons in new text end 8.6 new text begin the provider's care. new text end 8.7 new text begin (b) For purposes of this subdivision, "level 4" has the meaning given in section new text end 8.8 new text begin 144A.474, subdivision 11, paragraph (b). new text end 8.9 new text begin (c) A notice stating the reasons for the immediate temporary suspension or new text end 8.10 new text begin conditional license and informing the license holder of the right to an expedited hearing new text end 8.11 new text begin under subdivision 3b, must be delivered by personal services to the address shown on the new text end 8.12 new text begin application or the last known address of the license holder. The license holder may appeal new text end 8.13 new text begin an order immediately temporarily suspending a license or issuing a conditional license. new text end 8.14 new text begin The appeal must be made in writing by certified mail or personal service. If mailed, the new text end 8.15 new text begin appeal must be postmarked and sent to the commissioner within five calendar days after the new text end 8.16 new text begin license holder receives notice. If an appeal is made by personal service, it must be received new text end 8.17 new text begin by the commissioner within five calendar days after the license holder received the order. new text end 8.18 new text begin (d) A license holder whose license is immediately temporarily suspended must new text end 8.19 new text begin comply with the requirements for notification and transfer of clients in subdivision 5. new text end 8.20 new text begin These requirements remain if an appeal is requested. new text end 8.21    Sec. 10. Minnesota Statutes 2014, section 144A.4791, is amended by adding a 8.22subdivision to read: 8.23     new text begin Subd. 14. new text end new text begin Application of other law. new text end new text begin Home care providers may exercise the new text end 8.24 new text begin authority and are subject to the protections in section 152.34. new text end 8.25    Sec. 11. Minnesota Statutes 2014, section 144A.4792, subdivision 13, is amended to 8.26read: 8.27    Subd. 13. Prescriptions. There must be a current written or electronically recorded 8.28prescription as defined in Minnesota Rules, part 6800.0100, subpart 11a new text begin section 151.01, new text end 8.29 new text begin subdivision 16a new text end , for all prescribed medications that the comprehensive home care provider 8.30is managing for the client. 8.31    Sec. 12. Minnesota Statutes 2014, section 144A.4799, subdivision 1, is amended to 8.32read: 9.1    Subdivision 1. Membership. The commissioner of health shall appoint eight 9.2persons to a home care provider new text begin home care and assisted living program new text end advisory council 9.3consisting of the following: 9.4(1) three public members as defined in section 214.02 who shall be either persons 9.5who are currently receiving home care services or have family members receiving home 9.6care services, or persons who have family members who have received home care services 9.7within five years of the application date; 9.8(2) three Minnesota home care licensees representing basic and comprehensive 9.9levels of licensure who may be a managerial official, an administrator, a supervising 9.10registered nurse, or an unlicensed personnel performing home care tasks; 9.11(3) one member representing the Minnesota Board of Nursing; and 9.12(4) one member representing the ombudsman for long-term care. 9.13    Sec. 13. Minnesota Statutes 2014, section 144A.4799, subdivision 3, is amended to 9.14read: 9.15    Subd. 3. Duties. new text begin (a) new text end At the commissioner's request, the advisory council shall 9.16provide advice regarding regulations of Department of Health licensed home care 9.17providers in this chapter, including advice on the following: 9.18(1) community standards for home care practices; 9.19(2) enforcement of licensing standards and whether certain disciplinary actions 9.20are appropriate; 9.21(3) ways of distributing information to licensees and consumers of home care; 9.22(4) training standards; 9.23(5) identify new text begin identifying new text end emerging issues and opportunities in the home care field, 9.24including the use of technology in home and telehealth capabilities; 9.25(6) allowable home care licensing modifications and exemptions, including a method 9.26for an integrated license with an existing license for rural licensed nursing homes to 9.27provide limited home care services in an adjacent independent living apartment building 9.28owned by the licensed nursing home; and 9.29 new text begin (7) recommendations for studies using the data in section 62U.04, subdivision 4, new text end 9.30 new text begin including but not limited to studies concerning costs related to dementia and chronic new text end 9.31 new text begin disease among an elderly population over 60 and additional long-term care costs, as new text end 9.32 new text begin described in section 62U.10, subdivision 6. new text end 9.33(7) new text begin (b) The advisory council shall new text end perform other duties as directed by the 9.34commissioner. 10.1    Sec. 14. Minnesota Statutes 2014, section 144A.482, is amended to read: 10.2144A.482 REGISTRATION OF HOME MANAGEMENT PROVIDERS. 10.3(a) For purposes of this section, a home management provider is a person or 10.4organization that provides at least two of the following services: housekeeping, meal 10.5preparation, and shopping to a person who is unable to perform these activities due to 10.6illness, disability, or physical condition. 10.7(b) A person or organization that provides only home management services may not 10.8operate in the state without a current certificate of registration issued by the commissioner 10.9of health. To obtain a certificate of registration, the person or organization must annually 10.10submit to the commissioner the name, mailing and physical addresses, e-mail address, and 10.11telephone number of the person or organization and a signed statement declaring that the 10.12person or organization is aware that the home care bill of rights applies to their clients and 10.13that the person or organization will comply with the home care bill of rights provisions 10.14contained in section 144A.44. A person or organization applying for a certificate must 10.15also provide the name, business address, and telephone number of each of the persons 10.16responsible for the management or direction of the organization. 10.17(c) The commissioner shall charge an annual registration fee of $20 for persons and 10.18$50 for organizations. The registration fee shall be deposited in the state treasury and 10.19credited to the state government special revenue fund. 10.20(d) A home care provider that provides home management services and other home 10.21care services must be licensed, but licensure requirements other than the home care bill of 10.22rights do not apply to those employees or volunteers who provide only home management 10.23services to clients who do not receive any other home care services from the provider. 10.24A licensed home care provider need not be registered as a home management service 10.25provider but must provide an orientation on the home care bill of rights to its employees 10.26or volunteers who provide home management services. 10.27(e) An individual who provides home management services under this section must, 10.28within 120 days after beginning to provide services, attend an orientation session approved 10.29by the commissioner that provides training on the home care bill of rights and an orientation 10.30on the aging process and the needs and concerns of elderly and disabled persons. 10.31(f) The commissioner may suspend or revoke a provider's certificate of registration 10.32or assess fines for violation of the home care bill of rights. Any fine assessed for a 10.33violation of the home care bill of rights by a provider registered under this section shall be 10.34in the amount established in the licensure rules for home care providers. As a condition 10.35of registration, a provider must cooperate fully with any investigation conducted by the 10.36commissioner, including providing specific information requested by the commissioner on 11.1clients served and the employees and volunteers who provide services. Fines collected 11.2under this paragraph shall be deposited in the state treasury and credited to the fund 11.3specified in the statute or rule in which the penalty was established. 11.4(g) The commissioner may use any of the powers granted in sections 144A.43 to 11.5144A.4798 to administer the registration system and enforce the home care bill of rights 11.6under this section. 11.7    Sec. 15. Minnesota Statutes 2014, section 144D.01, subdivision 2a, is amended to read: 11.8    Subd. 2a. Arranged home care provider. "Arranged home care provider" means 11.9a home care provider licensed under Minnesota Rules, chapter 4668, new text begin chapter 144A new text end that 11.10provides services to some or all of the residents of a housing with services establishment 11.11and that is either the establishment itself or another entity with which the establishment 11.12has an arrangement. 11.13    Sec. 16. new text begin [144D.12] HOME CARE AND HOUSING SERVICES ELECTRONIC new text end 11.14 new text begin MONITORING. new text end 11.15     new text begin Subdivision 1. new text end new text begin Definitions. new text end new text begin (a) The definitions in this subdivision apply to this new text end 11.16 new text begin section. new text end 11.17 new text begin (b) "Electronic monitoring device" means a video or audio broadcasting or recording new text end 11.18 new text begin device that broadcasts or records activity or sounds occurring in a residence. new text end 11.19 new text begin (c) "Home care provider" has the meaning given in section 144A.43, subdivision 4. new text end 11.20 new text begin (d) "Housing with services establishment" has the meaning given in section new text end 11.21 new text begin 144D.01, subdivision 4, and includes an establishment providing assisted living services new text end 11.22 new text begin under chapter 144G. new text end 11.23 new text begin (e) "Legal representative" means a court-appointed guardian or individual with new text end 11.24 new text begin current legal authority to make decisions about health services for a resident under a new text end 11.25 new text begin health care directive or power of attorney. new text end 11.26 new text begin (f) "Resident" means an individual receiving home care services from a home care new text end 11.27 new text begin provider or health-related, supportive, or assisted living services from a housing with new text end 11.28 new text begin services establishment. Resident includes a legal representative of a resident. new text end 11.29 new text begin (g) "Residential care or services provider" or "provider" means a home care provider new text end 11.30 new text begin or housing with services establishment. new text end 11.31     new text begin Subd. 2. new text end new text begin Electronic monitoring must be permitted. new text end new text begin A residential care or services new text end 11.32 new text begin provider must allow a resident to install or use an electronic monitoring device that may new text end 11.33 new text begin broadcast or record care or services given to the resident by the provider and that occur new text end 11.34 new text begin within the private home, room, or unit of the resident in which the resident does not share new text end 12.1 new text begin a home, room, or unit with another resident who does not consent to the installation or use new text end 12.2 new text begin of an electronic monitoring device. The resident may elect whether to install the device in new text end 12.3 new text begin plain view or in a manner where it is partially or fully hidden. new text end 12.4     new text begin Subd. 3. new text end new text begin Resident protections. new text end new text begin (a) A residential care or services provider must not: new text end 12.5 new text begin (1) refuse to provide care or services to a potential resident, or change the terms of new text end 12.6 new text begin or terminate care or services to a resident, based on the installation or use of an electronic new text end 12.7 new text begin monitoring device as provided for under subdivision 2; or new text end 12.8 new text begin (2) prevent or interfere with the permissible installation or use of an electronic new text end 12.9 new text begin monitoring device by a resident as provided for under subdivision 2. new text end 12.10 new text begin (b) A residential care or services provider must not require a resident to install or use new text end 12.11 new text begin an electronic monitoring device or otherwise install or use an electronic monitoring device new text end 12.12 new text begin in the private home, room, or unit of the resident without the written consent of the resident. new text end 12.13     new text begin Subd. 4. new text end new text begin Cost and installation. new text end new text begin (a) A resident who conducts electronic monitoring new text end 12.14 new text begin must do so at the resident's own expense, including paying purchase, installation, new text end 12.15 new text begin maintenance, and removal costs. new text end 12.16 new text begin (b) If a resident installs an electronic monitoring device as provided for under new text end 12.17 new text begin subdivision 2 that uses Internet technology for visual or audio monitoring, the resident new text end 12.18 new text begin is responsible for contracting with an Internet service provider. A housing with services new text end 12.19 new text begin establishment must make a reasonable attempt to accommodate the resident's installation new text end 12.20 new text begin needs, including allowing access to the establishment's telecommunications or equipment new text end 12.21 new text begin room. An establishment must not charge the resident a fee for the cost of electricity used by new text end 12.22 new text begin an electronic monitoring device. Electronic monitoring device installations and supporting new text end 12.23 new text begin services in a housing with services establishment must comply with the requirements of new text end 12.24 new text begin the National Fire Protection Association (NFPA) 101 Life Safety Code (2015 edition). new text end 12.25    Sec. 17. Minnesota Statutes 2014, section 144G.03, subdivision 2, is amended to read: 12.26    Subd. 2. Minimum requirements for assisted living. (a) Assisted living shall 12.27be provided or made available only to individuals residing in a registered housing with 12.28services establishment. Except as expressly stated in this chapter, a person or entity 12.29offering assisted living may define the available services and may offer assisted living to 12.30all or some of the residents of a housing with services establishment. The services that 12.31comprise assisted living may be provided or made available directly by a housing with 12.32services establishment or by persons or entities with which the housing with services 12.33establishment has made arrangements. 12.34(b) A person or entity entitled to use the phrase "assisted living," according to 12.35section 144G.02, subdivision 1, shall do so only with respect to a housing with services 13.1establishment, or a service, service package, or program available within a housing with 13.2services establishment that, at a minimum: 13.3(1) provides or makes available health-related services under a class A or class F 13.4home care license. At a minimum, health-related services must include: 13.5(i) assistance with self-administration of medication new text begin , new text end as defined in Minnesota Rules, 13.6part 4668.0003, subpart 2a, new text begin medication management, new text end or medication administration as 13.7defined in Minnesota Rules, part 4668.0003, subpart 21a new text begin in section 144A.43 new text end ; and 13.8(ii) assistance with at least three of the following seven activities of daily living: 13.9bathing, dressing, grooming, eating, transferring, continence care, and toileting. 13.10All health-related services shall be provided in a manner that complies with applicable 13.11home care licensure requirements in chapter 144A, new text begin and new text end sections 148.171 to 148.285, and 13.12Minnesota Rules, chapter 4668; 13.13(2) provides necessary assessments of the physical and cognitive needs of assisted 13.14living clients by a registered nurse, as required by applicable home care licensure 13.15requirements in chapter 144A, new text begin and new text end sections 148.171 to 148.285, and Minnesota Rules, 13.16chapter 4668; 13.17(3) has and maintains a system for delegation of health care activities to unlicensed 13.18assistive health care personnel by a registered nurse, including supervision and evaluation 13.19of the delegated activities as required by applicable home care licensure requirements in 13.20chapter 144A, new text begin and new text end sections 148.171 to 148.285, and Minnesota Rules, chapter 4668; 13.21(4) provides staff access to an on-call registered nurse 24 hours per day, seven 13.22days per week; 13.23(5) has and maintains a system to check on each assisted living client at least daily; 13.24(6) provides a means for assisted living clients to request assistance for health and 13.25safety needs 24 hours per day, seven days per week, from the establishment or a person or 13.26entity with which the establishment has made arrangements; 13.27(7) has a person or persons available 24 hours per day, seven days per week, who 13.28is responsible for responding to the requests of assisted living clients for assistance with 13.29health or safety needs, who shall be: 13.30(i) awake; 13.31(ii) located in the same building, in an attached building, or on a contiguous campus 13.32with the housing with services establishment in order to respond within a reasonable 13.33amount of time; 13.34(iii) capable of communicating with assisted living clients; 13.35(iv) capable of recognizing the need for assistance; 14.1(v) capable of providing either the assistance required or summoning the appropriate 14.2assistance; and 14.3(vi) capable of following directions; 14.4(8) offers to provide or make available at least the following supportive services 14.5to assisted living clients: 14.6(i) two meals per day; 14.7(ii) weekly housekeeping; 14.8(iii) weekly laundry service; 14.9(iv) upon the request of the client, reasonable assistance with arranging for 14.10transportation to medical and social services appointments, and the name of or other 14.11identifying information about the person or persons responsible for providing this 14.12assistance; 14.13(v) upon the request of the client, reasonable assistance with accessing community 14.14resources and social services available in the community, and the name of or other 14.15identifying information about the person or persons responsible for providing this 14.16assistance; and 14.17(vi) periodic opportunities for socialization; and 14.18(9) makes available to all prospective and current assisted living clients information 14.19consistent with the uniform format and the required components adopted by the 14.20commissioner under section 144G.06. This information must be made available beginning 14.21no later than six months after the commissioner makes the uniform format and required 14.22components available to providers according to section 144G.06. 14.23    Sec. 18. Minnesota Statutes 2014, section 144G.03, subdivision 4, is amended to read: 14.24    Subd. 4. Nursing assessment. (a) A housing with services establishment offering or 14.25providing assisted living shall: 14.26(1) offer to have the arranged home care provider conduct a nursing assessment by 14.27a registered nurse of the physical and cognitive needs of the prospective resident and 14.28propose a service agreement or service plan prior to the date on which a prospective 14.29resident executes a contract with a housing with services establishment or the date on 14.30which a prospective resident moves in, whichever is earlier; and 14.31(2) inform the prospective resident of the availability of and contact information for 14.32long-term care consultation services under section 256B.0911, prior to the date on which a 14.33prospective resident executes a contract with a housing with services establishment or the 14.34date on which a prospective resident moves in, whichever is earlier. 15.1(b) An arranged home care provider is not obligated to conduct a nursing assessment 15.2by a registered nurse when requested by a prospective resident if either the geographic 15.3distance between the prospective resident and the provider, or urgent or unexpected 15.4circumstances, do not permit the assessment to be conducted prior to the date on which 15.5the prospective resident executes a contract or moves in, whichever is earlier. When such 15.6circumstances occur, the arranged home care provider shall offer to conduct a telephone 15.7conference whenever reasonably possible. 15.8(c) The arranged home care provider shall comply with applicable home care 15.9licensure requirements in chapter 144A, new text begin and new text end sections 148.171 to 148.285, and Minnesota 15.10Rules, chapter 4668, with respect to the provision of a nursing assessment prior to the 15.11delivery of nursing services and the execution of a home care service plan or service 15.12agreement. 15.13    Sec. 19. Minnesota Statutes 2014, section 146B.01, subdivision 28, is amended to read: 15.14    Subd. 28. Supervision. "Supervision" means the physical presence of a technician 15.15licensed under this chapter while a body art procedure is being performed new text begin and includes: new text end 15.16 new text begin (1) "direct supervision" where a licensed technician is physically present in the new text end 15.17 new text begin establishment, and is within five feet and is in the line of sight of the temporary licensee new text end 15.18 new text begin who is performing a body art procedure while the procedure is being performed; and new text end 15.19 new text begin (2) "indirect supervision" where a licensed technician is physically present in the new text end 15.20 new text begin establishment while a body art procedure is being performed by the temporary licensee new text end . 15.21    Sec. 20. Minnesota Statutes 2014, section 146B.03, subdivision 4, is amended to read: 15.22    Subd. 4. Licensure requirements. new text begin (a) new text end An applicant for licensure under this section 15.23shall new text begin must new text end submit to the commissioner on a form provided by the commissioner: 15.24(1) proof that the applicant is over the age of 18; 15.25    (2) the type of license the applicant is applying for; 15.26(3) all fees required under section 146B.10; 15.27(4) proof of completing a minimum of 200 hours of supervised experience within 15.28each area for which the applicant is seeking a license, and must include an affidavit from 15.29the supervising licensed technician; 15.30(5) proof of having satisfactorily completed coursework within the year preceding 15.31application and approved by the commissioner on bloodborne pathogens, the prevention 15.32of disease transmission, infection control, and aseptic technique. Courses to be considered 15.33for approval by the commissioner may include, but are not limited to, those administered 15.34by one of the following: 16.1(i) the American Red Cross; 16.2(ii) United States Occupational Safety and Health Administration (OSHA); or 16.3(iii) the Alliance of Professional Tattooists; and 16.4(6) any other relevant information requested by the commissioner. 16.5 new text begin The licensure requirements in this paragraph are effective for all applications for new text end 16.6 new text begin new licenses received before January 1, 2017. new text end 16.7 new text begin (b) An applicant for licensure under this section must submit to the commissioner new text end 16.8 new text begin on a form provided by the commissioner: new text end 16.9 new text begin (1) proof that the applicant is over the age of 18; new text end 16.10 new text begin (2) the type of license the applicant is applying for; new text end 16.11 new text begin (3) all fees required under section 146B.10; new text end 16.12 new text begin (4) a log showing the completion of the required supervised experience described new text end 16.13 new text begin under subdivision 12 that includes a list of each licensed technician who provided the new text end 16.14 new text begin required supervision; new text end 16.15 new text begin (5) a signed affidavit from each licensed technician who the applicant listed in new text end 16.16 new text begin the log described in clause (4); new text end 16.17 new text begin (6) proof of having satisfactorily completed a minimum of five hours of coursework, new text end 16.18 new text begin within the year preceding application and approval by the commissioner, on bloodborne new text end 16.19 new text begin pathogens, the prevention of disease transmission, infection control, and aseptic technique. new text end 16.20 new text begin Courses to be considered for approval by the commissioner may include, but are not new text end 16.21 new text begin limited to, those administered by one of the following: new text end 16.22 new text begin (i) the American Red Cross; new text end 16.23 new text begin (ii) the United States Occupational Safety and Health Administration (OSHA); or new text end 16.24 new text begin (iii) the Alliance of Professional Tattooists; and new text end 16.25 new text begin (7) any other relevant information requested by the commissioner. new text end 16.26 new text begin The licensure requirements in this paragraph are effective for all applications for new text end 16.27 new text begin new licenses received on or after January 1, 2017. new text end 16.28    Sec. 21. Minnesota Statutes 2014, section 146B.03, subdivision 6, is amended to read: 16.29    Subd. 6. Licensure term; renewal. (a) A technician's license is valid for two 16.30years from the date of issuance and may be renewed upon payment of the renewal fee 16.31established under section 146B.10. 16.32(b) At renewal, a licensee must submit proof of continuing education approved by 16.33the commissioner in the areas identified in subdivision 4, clause (5). 16.34 new text begin (c) The commissioner shall notify the technician of the pending expiration of a new text end 16.35 new text begin technician license at least 60 days prior to license expiration. new text end 17.1    Sec. 22. Minnesota Statutes 2014, section 146B.03, subdivision 7, is amended to read: 17.2    Subd. 7. Temporary licensure. (a) The commissioner may issue a temporary license 17.3to an applicant who submits to the commissioner on a form provided by the commissioner: 17.4(1) proof that the applicant is over the age of 18; 17.5(2) all fees required under section 148B.10; and 17.6(3) a letter from a licensed technician who has agreed to provide the supervision to 17.7meet the supervised experience requirement under subdivision 4, clause (4). 17.8(b) Upon completion of the required supervised experience, the temporary 17.9licensee shall submit documentation of satisfactorily completing the requirements under 17.10subdivision 4, clauses (3) and (4), and the applicable fee under section 146B.10. The 17.11commissioner shall issue a new license in accordance with subdivision 4. 17.12(c) A temporary license issued under this subdivision is valid for one year and 17.13may be renewed for one additional year. 17.14    Sec. 23. Minnesota Statutes 2014, section 146B.03, is amended by adding a 17.15subdivision to read: 17.16     new text begin Subd. 12. new text end new text begin Required supervised experience. new text end new text begin An applicant for a body art technician new text end 17.17 new text begin license must complete the following minimum supervised experience for licensure: new text end 17.18 new text begin (1) for a tattoo technician license an applicant must complete a minimum of 200 new text end 17.19 new text begin hours of tattoo experience under supervision; new text end 17.20 new text begin (2) for a body piercing technician license an applicant must perform 250 body new text end 17.21 new text begin piercings under direct supervision and 250 body piercings under indirect supervision; and new text end 17.22 new text begin (3) for a dual body art technician license an applicant must complete a minimum of new text end 17.23 new text begin 200 hours of tattoo experience under supervision and perform 250 body piercings under new text end 17.24 new text begin direct supervision and 250 body piercings under indirect supervision. new text end 17.25    Sec. 24. Minnesota Statutes 2014, section 146B.07, subdivision 1, is amended to read: 17.26    Subdivision 1. Proof of age. (a) A technician shall require proof of age new text begin from clients new text end 17.27 new text begin who state they are 18 years of age or older new text end before performing any body art procedure on a 17.28client. Proof of age must be established by one of the following methods: 17.29(1) a valid driver's license or identification card issued by the state of Minnesota or 17.30another state that includes a photograph and date of birth of the individual; 17.31(2) a valid military identification card issued by the United States Department of 17.32Defense; 17.33(3) a valid passport; 17.34(4) a resident alien card; or 18.1(5) a tribal identification card. 18.2(b) Before performing any body art procedure, the technician must provide the client 18.3with a disclosure and authorization form that indicates whether the client has: 18.4(1) diabetes; 18.5(2) a history of hemophilia; 18.6(3) a history of skin diseases, skin lesions, or skin sensitivities to soap or disinfectants; 18.7(4) a history of epilepsy, seizures, fainting, or narcolepsy; 18.8(5) any condition that requires the client to take medications such as anticoagulants 18.9that thin the blood or interfere with blood clotting; or 18.10(6) any other information that would aid the technician in the body art procedure 18.11process evaluation. 18.12(c) The form must include a statement informing the client that the technician shall 18.13not perform a body art procedure if the client fails to complete or sign the disclosure and 18.14authorization form, and the technician may decline to perform a body art procedure if the 18.15client has any identified health conditions. 18.16    (d) The technician shall ask the client to sign and date the disclosure and 18.17authorization form confirming that the information listed on the form is accurate. 18.18(e) Before performing any body art procedure, the technician shall offer and make 18.19available to the client personal draping, as appropriate. 18.20    Sec. 25. Minnesota Statutes 2014, section 146B.07, subdivision 2, is amended to read: 18.21    Subd. 2. Parent or legal guardian consent; prohibitions. (a) A technician may 18.22perform body piercings on an individual under the age of 18 if new text begin : new text end 18.23     new text begin (1) new text end the individual's parent or legal guardian is present and new text begin ; new text end 18.24     new text begin (2) the individual's parent or legal guardian provides personal identification by new text end 18.25 new text begin using one of the methods described in subdivision 1, paragraph (a), clauses (1) to (5), and new text end 18.26 new text begin provides documentation that reasonably establishes that the individual is the parent or new text end 18.27 new text begin legal guardian of the individual who is seeking the body piercing; new text end 18.28     new text begin (3) the individual seeking the body piercing provides proof of identification by new text end 18.29 new text begin using one of the methods described in subdivision 1, paragraph (a), clauses (1) to (5), new text end 18.30 new text begin a current student identification, or another official source that includes the name and new text end 18.31 new text begin a photograph of the individual; new text end 18.32     new text begin (4) new text end a consent form and the authorization form under subdivision 1, paragraph (b) is 18.33signed by the parent or legal guardian in the presence of the technician, new text begin ; new text end and 18.34     new text begin (5) new text end the piercing is not prohibited under paragraph (c). 19.1    (b) No technician shall tattoo any individual under the age of 18 regardless of 19.2parental or guardian consent. 19.3    (c) No nipple or genital piercing, branding, scarification, suspension, subdermal 19.4implantation, microdermal, or tongue bifurcation shall be performed by any technician on 19.5any individual under the age of 18 regardless of parental or guardian consent. 19.6    (d) No technician shall perform body art procedures on any individual who appears 19.7to be under the influence of alcohol, controlled substances as defined in section 152.01, 19.8subdivision 4, or hazardous substances as defined in rules adopted under chapter 182. 19.9    (e) No technician shall perform body art procedures while under the influence of 19.10alcohol, controlled substances as defined under section 152.01, subdivision 4, or hazardous 19.11substances as defined in the rules adopted under chapter 182. 19.12    (f) No technician shall administer anesthetic injections or other medications. 19.13    Sec. 26. new text begin [147.0375] MEDICAL FACULTY LICENSE. new text end 19.14     new text begin Subdivision 1. new text end new text begin Requirements. new text end new text begin The board shall issue a license to practice medicine new text end 19.15 new text begin to any person who satisfies the requirements in paragraphs (a) to (g). new text end 19.16     new text begin (a) The applicant must satisfy all the requirements established in section new text end new text begin 147.02, new text end 19.17 new text begin subdivision 1 new text end new text begin , paragraphs (a), (e), (f), (g), and (h). new text end 19.18     new text begin (b) The applicant must present evidence satisfactory to the board that the applicant new text end 19.19 new text begin is a graduate of a medical or osteopathic school approved by the board as equivalent new text end 19.20 new text begin to accredited United States or Canadian schools based upon its faculty, curriculum, new text end 19.21 new text begin facilities, accreditation, or other relevant data. If the applicant is a graduate of a medical or new text end 19.22 new text begin osteopathic program that is not accredited by the Liaison Committee for Medical Education new text end 19.23 new text begin or the American Osteopathic Association, the applicant may use the Federation of State new text end 19.24 new text begin Medical Boards' Federation Credentials Verification Service (FCVS) or its successor. If new text end 19.25 new text begin the applicant uses this service as allowed under this paragraph, the physician application new text end 19.26 new text begin fee may be less than $200 but must not exceed the cost of administering this paragraph. new text end 19.27     new text begin (c) The applicant must present evidence satisfactory to the board of the completion new text end 19.28 new text begin of two years of graduate, clinical medical training in a program located in the United new text end 19.29 new text begin States, its territories, or Canada and accredited by a national accrediting organization new text end 19.30 new text begin approved by the board. This requirement does not apply: new text end 19.31     new text begin (1) to an applicant who is admitted as a permanent immigrant to the United States on new text end 19.32 new text begin or before October 1, 1991, as a person of exceptional ability in the sciences according to new text end 19.33 new text begin Code of Federal Regulations, title 20, section 656.22(d); new text end 19.34     new text begin (2) to an applicant holding a valid license to practice medicine in another state or new text end 19.35 new text begin country and issued a permanent immigrant visa after October 1, 1991, as a person of new text end 20.1 new text begin extraordinary ability in the field of science or as an outstanding professor or researcher new text end 20.2 new text begin according to Code of Federal Regulations, title 8, section 204.5(h) and (i), or a temporary new text end 20.3 new text begin nonimmigrant visa or status as a person of extraordinary ability in the field of science new text end 20.4 new text begin according to Code of Federal Regulations, title 8, section 214.2(o); or new text end 20.5     new text begin (3) to an applicant who is licensed in another state, has practiced five years without new text end 20.6 new text begin disciplinary action in the United States, its territories, or Canada, has completed one year new text end 20.7 new text begin of the graduate, clinical medical training required by this paragraph, and has passed the new text end 20.8 new text begin Special Purpose Examination of the Federation of State Medical Boards within three new text end 20.9 new text begin attempts in the 24 months before licensing. new text end 20.10     new text begin (d) The applicant must present evidence satisfactory to the board that the applicant new text end 20.11 new text begin has been appointed to serve as a faculty member of a medical school accredited by the new text end 20.12 new text begin Liaison Committee of Medical Education or an osteopathic medical school accredited new text end 20.13 new text begin by the American Osteopathic Association. new text end 20.14     new text begin Subd. 2. new text end new text begin Medical school review. new text end new text begin The board may contract with any qualified person new text end 20.15 new text begin or organization for the performance of a review or investigation, including site visits new text end 20.16 new text begin if necessary, of any medical or osteopathic school prior to approving the school under new text end 20.17 new text begin section new text end new text begin 147.02, subdivision 1 new text end new text begin , paragraph (b), or subdivision 1, paragraph (b), of this new text end 20.18 new text begin section. To the extent possible, the board shall require the school being reviewed to pay new text end 20.19 new text begin the costs of the review or investigation. new text end 20.20     new text begin Subd. 3. new text end new text begin Resignation or termination for the medical faculty position. new text end new text begin If a person new text end 20.21 new text begin holding a license issued under this section resigns or is terminated from the academic new text end 20.22 new text begin medical center in which the licensee is employed as a faculty member, the licensee new text end 20.23 new text begin must notify the board in writing no later than 30 days after the date of termination or new text end 20.24 new text begin resignation. Upon notification of resignation or termination, the board shall terminate new text end 20.25 new text begin the medical license. new text end 20.26     new text begin Subd. 4. new text end new text begin Reporting obligation. new text end new text begin A person holding a license issued under this section new text end 20.27 new text begin is subject to the reporting obligations of section 147.111. new text end 20.28     new text begin Subd. 5. new text end new text begin Limitation of practice. new text end new text begin A person issued a license under this section may new text end 20.29 new text begin only practice medicine within the clinical setting of the academic medical center where new text end 20.30 new text begin the licensee is an appointed faculty member or within a physician group practice affiliated new text end 20.31 new text begin with the academic medical center. new text end 20.32     new text begin Subd. 6. new text end new text begin Continuing education. new text end new text begin The licensee must meet the continuing education new text end 20.33 new text begin requirements under Minnesota Rules, chapter 5605. new text end 20.34     new text begin Subd. 7. new text end new text begin Expiration. new text end new text begin This section expires July 1, 2018. new text end 20.35    Sec. 27. Minnesota Statutes 2014, section 152.22, subdivision 14, is amended to read: 21.1    Subd. 14. Qualifying medical condition. "Qualifying medical condition" means a 21.2diagnosis of any of the following conditions: 21.3(1) cancer, if the underlying condition or treatment produces one or more of the 21.4following: 21.5(i) severe or chronic pain; 21.6(ii) nausea or severe vomiting; or 21.7(iii) cachexia or severe wasting; 21.8(2) glaucoma; 21.9(3) human immunodeficiency virus or acquired immune deficiency syndrome; 21.10(4) Tourette's syndrome; 21.11(5) amyotrophic lateral sclerosis; 21.12(6) seizures, including those characteristic of epilepsy; 21.13(7) severe and persistent muscle spasms, including those characteristic of multiple 21.14sclerosis; 21.15(8) new text begin inflammatory bowel disease, including new text end Crohn's disease; 21.16(9) terminal illness, with a probable life expectancy of under one year, if the illness 21.17or its treatment produces one or more of the following: 21.18(i) severe or chronic pain; 21.19(ii) nausea or severe vomiting; or 21.20(iii) cachexia or severe wasting; or 21.21(10) any other medical condition or its treatment approved by the commissioner. 21.22    Sec. 28. Minnesota Statutes 2014, section 152.25, subdivision 3, is amended to read: 21.23    Subd. 3. Deadlines. (a) The commissioner shall adopt rules necessary for the 21.24manufacturer to begin distribution of medical cannabis to patients under the registry 21.25program by July 1, 2015, and have notice of proposed rules published in the State Register 21.26prior to January 1, 2015. 21.27(b) The commissioner shall, by November 1, 2014, advise the public and the cochairs 21.28of the task force on medical cannabis therapeutic research established under section 21.29 if the commissioner is unable to register two manufacturers by the December 1, 21.302014, deadline. The commissioner shall provide a written statement as to the reason or 21.31reasons the deadline will not be met. Upon request of the commissioner, the task force 21.32shall extend the deadline by six months, but may not extend the deadline more than once. 21.33(c) If notified by a manufacturer that distribution to patients may not begin by 21.34the July 1, 2015, deadline, the commissioner shall advise the public and the cochairs 21.35of the task force on medical cannabis therapeutic research. Upon notification by the 22.1commissioner, the task force shall extend the deadline by six months, but may not extend 22.2the deadline more than once. 22.3    Sec. 29. Minnesota Statutes 2014, section 152.25, subdivision 4, is amended to read: 22.4    Subd. 4. Reports. (a) The commissioner shall provide regular updates to the task 22.5force new text begin and to the chairs and ranking minority members of the legislative committees with new text end 22.6 new text begin jurisdiction over health and human services, public safety, judiciary, and civil law new text end on 22.7medical cannabis therapeutic research regarding any changes in federal law or regulatory 22.8restrictions regarding the use of medical cannabis. 22.9(b) The commissioner may submit medical research based on the data collected 22.10under sections 152.22 to 152.37 to any federal agency with regulatory or enforcement 22.11authority over medical cannabis to demonstrate the effectiveness of medical cannabis for 22.12treating a qualifying medical condition. 22.13    Sec. 30. Minnesota Statutes 2014, section 152.29, subdivision 3, is amended to read: 22.14    Subd. 3. Manufacturer; distribution. (a) A manufacturer shall require that 22.15employees licensed as pharmacists pursuant to chapter 151 be the only employees to 22.16distribute new text begin give final approval for new text end the new text begin distribution of new text end medical cannabis to a patient. 22.17(b) A manufacturer may dispense medical cannabis products, whether or not the 22.18products have been manufactured by the manufacturer, but is not required to dispense 22.19medical cannabis products. 22.20(c) Prior to distribution of any medical cannabis, the manufacturer shall: 22.21(1) verify that the manufacturer has received the registry verification from the 22.22commissioner for that individual patient; 22.23(2) verify that the person requesting the distribution of medical cannabis is the patient, 22.24the patient's registered designated caregiver, or the patient's parent or legal guardian listed 22.25in the registry verification using the procedures described in section 152.11, subdivision 2d; 22.26(3) assign a tracking number to any medical cannabis distributed from the 22.27manufacturer; 22.28(4) ensure that any employee of the manufacturer licensed as a pharmacist pursuant to 22.29chapter 151 has consulted with the patient to determine the proper dosage for the individual 22.30patient after reviewing the ranges of chemical compositions of the medical cannabis and 22.31the ranges of proper dosages reported by the commissioner new text begin . For purposes of this clause, a new text end 22.32 new text begin consultation may be conducted remotely using a videoconference, so long as the employee new text end 22.33 new text begin providing the consultation is able to confirm the identity of the patient, the consultation new text end 23.1 new text begin occurs while the patient is at a distribution facility, and the consultation adheres to patient new text end 23.2 new text begin privacy requirements that apply to health care services delivered through telemedicine new text end ; 23.3(5) properly package medical cannabis in compliance with the United States 23.4Poison Prevention Packing Act regarding child-resistant packaging and exemptions for 23.5packaging for elderly patients, and label distributed medical cannabis with a list of all 23.6active ingredients and individually identifying information, including: 23.7(i) the patient's name and date of birth; 23.8(ii) the name and date of birth of the patient's registered designated caregiver or, 23.9if listed on the registry verification, the name of the patient's parent or legal guardian, 23.10if applicable; 23.11(iii) the patient's registry identification number; 23.12(iv) the chemical composition of the medical cannabis; and 23.13(v) the dosage; and 23.14(6) ensure that the medical cannabis distributed contains a maximum of a 30-day 23.15supply of the dosage determined for that patient. 23.16(d) A manufacturer shall require any employee of the manufacturer who is 23.17transporting medical cannabis or medical cannabis products to a distribution facility to 23.18carry identification showing that the person is an employee of the manufacturer. 23.19    Sec. 31. Minnesota Statutes 2014, section 152.29, is amended by adding a subdivision 23.20to read: 23.21     new text begin Subd. 3a. new text end new text begin Transportation of medical cannabis; staffing. new text end new text begin A medical cannabis new text end 23.22 new text begin manufacturer may staff a transport motor vehicle with only one employee if the medical new text end 23.23 new text begin cannabis manufacturer is transporting medical cannabis to either a certified laboratory for new text end 23.24 new text begin the purpose of testing or a facility for the purpose of disposal. If the medical cannabis new text end 23.25 new text begin manufacturer is transporting medical cannabis for any other purpose or destination, the new text end 23.26 new text begin transport motor vehicle must be staffed with a minimum of two employees as required by new text end 23.27 new text begin rules adopted by the commissioner. new text end 23.28    Sec. 32. Minnesota Statutes 2014, section 152.36, is amended by adding a subdivision 23.29to read: 23.30     new text begin Subd. 1a. new text end new text begin Administration. new text end new text begin The commissioner of health shall provide administrative new text end 23.31 new text begin and technical support to the task force. new text end 23.32    Sec. 33. Minnesota Statutes 2014, section 152.36, subdivision 2, is amended to read: 24.1    Subd. 2. Impact assessment. The task force shall hold hearings to conduct an 24.2assessment that evaluates new text begin evaluate new text end the impact of the use of medical cannabis and evaluates 24.3Minnesota's activities and other states' activities involving medical cannabis, and offer 24.4analysis of new text begin including, but not limited to new text end : 24.5    (1) program design and implementation; 24.6    (2) the impact on the health care provider community; 24.7    (3) patient experiences; 24.8    (4) the impact on the incidence of substance abuse; 24.9    (5) access to and quality of medical cannabis and medical cannabis products; 24.10    (6) the impact on law enforcement and prosecutions; 24.11    (7) public awareness and perception; and 24.12    (8) any unintended consequences. 24.13    Sec. 34. Minnesota Statutes 2014, section 153A.14, subdivision 2d, is amended to read: 24.14    Subd. 2d. Certification renewal notice. Certification must be renewed annually. 24.15The commissioner shall mail a renewal notice to the dispenser's last known address new text begin on new text end 24.16 new text begin record with the commissioner new text end by September 1 of each year. The notice must include a 24.17renewal application and notice of fees required for renewal. A dispenser is not relieved 24.18from meeting the renewal deadline on the basis that the dispenser did not receive the 24.19renewal notice. In renewing a certificate, a dispenser shall follow the procedures for 24.20applying for a certificate specified in subdivision 1. 24.21    Sec. 35. Minnesota Statutes 2014, section 153A.14, subdivision 2h, is amended to read: 24.22    Subd. 2h. Certification by examination. An applicant must achieve a passing score, 24.23as determined by the commissioner, on an examination according to paragraphs (a) to (c). 24.24(a) The examination must include, but is not limited to: 24.25(1) A written examination approved by the commissioner covering the following 24.26areas as they pertain to hearing instrument selling: 24.27(i) basic physics of sound; 24.28(ii) the anatomy and physiology of the ear; 24.29(iii) the function of hearing instruments; and 24.30(iv) the principles of hearing instrument selection. 24.31(2) Practical tests of proficiency in the following techniques as they pertain to 24.32hearing instrument selling: 24.33(i) pure tone audiometry, including air conduction testing and bone conduction 24.34testing; 25.1(ii) live voice or recorded voice speech audiometry including speech recognition 25.2(discrimination) testing, most comfortable loudness level, and uncomfortable loudness 25.3measurements of tolerance thresholds; 25.4(iii) masking when indicated; 25.5(iv) recording and evaluation of audiograms and speech audiometry to determine 25.6proper selection and fitting of a hearing instrument; 25.7(v) taking ear mold impressions; 25.8(vi) using an otoscope for the visual observation of the entire ear canal; and 25.9(vii) state and federal laws, rules, and regulations. 25.10(b) The new text begin practical new text end examination shall be administered by the commissioner at least 25.11twice a year. 25.12(c) An applicant must achieve a passing score on all portions of the examination 25.13within a two-year period. An applicant who does not achieve a passing score on all 25.14portions of the examination within a two-year period must retake the entire examination 25.15and achieve a passing score on each portion of the examination. An applicant who does not 25.16apply for certification within one year of successful completion of the examination must 25.17retake the examination and achieve a passing score on each portion of the examination. 25.18An applicant may not take any part of the new text begin practical new text end examination more than three times in 25.19a two-year period. 25.20    Sec. 36. Minnesota Statutes 2014, section 153A.15, subdivision 2a, is amended to read: 25.21    Subd. 2a. Hearings. If the commissioner proposes to take action against the 25.22dispenser as described in subdivision 2, the commissioner must first notify the person 25.23against whom the action is proposed to be taken and provide the person with an 25.24opportunity to request a hearing under the contested case provisions of chapter 14. new text begin Service new text end 25.25 new text begin of a notice of disciplinary action may be made personally or by certified mail, return new text end 25.26 new text begin receipt requested. new text end If the person does not request a hearing by notifying the commissioner 25.27within 30 days after service of the notice of the proposed action, the commissioner may 25.28proceed with the action without a hearing. 25.29    Sec. 37. Minnesota Statutes 2014, section 157.15, subdivision 14, is amended to read: 25.30    Subd. 14. Special event food stand. "Special event food stand" means a food and 25.31beverage service establishment which is used in conjunction with celebrations and special 25.32events, and which operates no more than three times annually for no more than ten total 25.33days new text begin within the applicable license period new text end . 26.1    Sec. 38. Minnesota Statutes 2014, section 157.16, subdivision 4, is amended to read: 26.2    Subd. 4. Posting requirements. Every food and beverage service establishment, 26.3for-profit youth camp, hotel, motel, lodging establishment, public pool, or resort must 26.4have the new text begin original new text end license posted in a conspicuous place at the establishment. Mobile food 26.5units, food carts, and seasonal temporary food stands shall be issued decals with the 26.6initial license and each calendar year with license renewals. The current license year 26.7decal must be placed on the unit or stand in a location determined by the commissioner. 26.8Decals are not transferable. 26.9    Sec. 39. Minnesota Statutes 2014, section 245.8251, is amended by adding a 26.10subdivision to read: 26.11     new text begin Subd. 1a. new text end new text begin Legislative approval. new text end new text begin Minnesota Rules, chapter 9544, positive support new text end 26.12 new text begin strategies and restrictive interventions is approved. new text end 26.13 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 26.14    Sec. 40. Minnesota Statutes 2014, section 245.8251, subdivision 2, is amended to read: 26.15    Subd. 2. Data collection. (a) The commissioner shall, with stakeholder input, 26.16identify data elements specific to incidents of emergency use of manual restraint and 26.17positive support transition plans for persons receiving services from licensed facilities 26.18and licensed services under chapter 245D and in licensed facilities and licensed services 26.19serving persons with a developmental disability or related condition as defined in 26.20Minnesota Rules, part 9525.0016, subpart 2, effective January 1, 2014. Licensed facilities 26.21and licensed services shall report the data in a format and at a frequency determined by the 26.22commissioner of human services to the commissioner and the Office of the Ombudsman 26.23for Mental Health and Developmental Disabilities. 26.24(b) Beginning July 1, 2013, licensed facilities and licensed services regulated under 26.25Minnesota Rules, parts 9525.2700 to 9525.2810, shall submit data regarding the use of all 26.26controlled procedures identified in Minnesota Rules, part 9525.2740, in a format and at 26.27a frequency determined by the commissioner to the commissioner and the Office of the 26.28Ombudsman for Mental Health and Developmental Disabilities. 26.29 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 26.30    Sec. 41. Minnesota Statutes 2014, section 252.275, subdivision 1a, is amended to read: 26.31    Subd. 1a. Service requirements. The methods, materials, and settings used to 26.32provide semi-independent living services to a person must be designed to: 27.1(1) increase the person's independence in performing tasks and activities by teaching 27.2skills that reduce dependence on caregivers; 27.3(2) provide training in an environment where the skill being taught is typically used; 27.4(3) increase the person's opportunities to interact with nondisabled individuals who 27.5are not paid caregivers; 27.6(4) increase the person's opportunities to use community resources and participate in 27.7community activities, including recreational, cultural, and educational resources, stores, 27.8restaurants, religious services, and public transportation; 27.9(5) increase the person's opportunities to develop decision-making skills and to make 27.10informed choices in all aspects of daily living, including: 27.11(i) selection of service providers; 27.12(ii) goals and methods; 27.13(iii) location and decor of residence; 27.14(iv) roommates; 27.15(v) daily routines; 27.16(vi) leisure activities; and 27.17(vii) personal possessions; 27.18(6) provide daily schedules, routines, environments and interactions similar to those 27.19of nondisabled individuals of the same chronological age; and 27.20(7) comply with section 245.825, subdivision 1 new text begin 245.8251 and the rules promulgated new text end 27.21 new text begin pursuant to section 245.8251, subdivision 1 new text end . 27.22 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 27.23    Sec. 42. Minnesota Statutes 2014, section 253B.03, subdivision 1, is amended to read: 27.24    Subdivision 1. Restraints. (a) A patient has the right to be free from restraints. 27.25Restraints shall not be applied to a patient in a treatment facility unless the head of the 27.26treatment facility, a member of the medical staff, or a licensed peace officer who has custody 27.27of the patient determines that they are necessary for the safety of the patient or others. 27.28(b) Restraints shall not be applied to patients with developmental disabilities except 27.29as permitted under section new text begin 245.8251 new text end and rules of the commissioner of human 27.30services. Consent must be obtained from the person or person's guardian except for 27.31emergency procedures as permitted under rules of the commissioner adopted under 27.32section new text begin 245.8251 new text end . 27.33(c) Each use of a restraint and reason for it shall be made part of the clinical record 27.34of the patient under the signature of the head of the treatment facility. 28.1 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 28.2    Sec. 43. Minnesota Statutes 2014, section 253B.03, subdivision 6a, is amended to read: 28.3    Subd. 6a. Consent for treatment for developmental disability. A patient with 28.4a developmental disability, or the patient's guardian, has the right to give or withhold 28.5consent before: 28.6(1) the implementation of any aversive or deprivation procedure new text begin restrictive new text end 28.7 new text begin interventions new text end except for emergency procedures new text begin use of manual restraint new text end permitted in rules 28.8of the commissioner adopted under section new text begin 245.8251 new text end ; or 28.9(2) the administration of psychotropic medication. 28.10 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 28.11    Sec. 44. Minnesota Statutes 2014, section 256B.0659, subdivision 3, is amended to read: 28.12    Subd. 3. Noncovered personal care assistance services. (a) Personal care assistance 28.13services are not eligible for medical assistance payment under this section when provided: 28.14    (1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal 28.15guardian, licensed foster provider, except as allowed under section 256B.0652, subdivision 28.1610 , or responsible party; 28.17    (2) in order to meet staffing or license requirements in a residential or child care 28.18setting; 28.19    (3) solely as a child care or babysitting service; or 28.20    (4) without authorization by the commissioner or the commissioner's designee. 28.21    (b) The following personal care services are not eligible for medical assistance 28.22payment under this section when provided in residential settings: 28.23    (1) when the provider of home care services who is not related by blood, marriage, 28.24or adoption owns or otherwise controls the living arrangement, including licensed or 28.25unlicensed services; or 28.26    (2) when personal care assistance services are the responsibility of a residential or 28.27program license holder under the terms of a service agreement and administrative rules. 28.28    (c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible 28.29for medical assistance reimbursement for personal care assistance services under this 28.30section include: 28.31    (1) sterile procedures; 28.32    (2) injections of fluids and medications into veins, muscles, or skin; 28.33    (3) home maintenance or chore services; 29.1    (4) homemaker services not an integral part of assessed personal care assistance 29.2services needed by a recipient; 29.3    (5) application of restraints or implementation of procedures new text begin restrictive interventions new text end 29.4under section new text begin 245.8251 new text end ; 29.5    (6) instrumental activities of daily living for children under the age of 18, except 29.6when immediate attention is needed for health or hygiene reasons integral to the personal 29.7care services and the need is listed in the service plan by the assessor; and 29.8    (7) assessments for personal care assistance services by personal care assistance 29.9provider agencies or by independently enrolled registered nurses. 29.10 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 29.11    Sec. 45. Minnesota Statutes 2014, section 256B.0951, subdivision 5, is amended to read: 29.12    Subd. 5. Variance of certain standards prohibited. The safety standards, rights, 29.13or procedural protections under chapter 245C and sections new text begin 245.8251 new text end ; 245.91 to 29.14245.97 ; 245A.09, subdivision 2, paragraph (c), clauses (2) and (5); 245A.12; 245A.13; 29.15252.41, subdivision 9 ; 256B.092, subdivisions 1b, clause (7), and 10; 626.556; 626.557, 29.16and procedures for the monitoring of psychotropic medications shall not be varied 29.17under the alternative quality assurance licensing system. The commission may make 29.18recommendations to the commissioners of human services and health or to the legislature 29.19regarding alternatives to or modifications of the rules and procedures referenced in this 29.20subdivision. 29.21 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 29.22    Sec. 46. Minnesota Statutes 2014, section 256B.097, subdivision 4, is amended to read: 29.23    Subd. 4. Regional quality councils. (a) The commissioner shall establish, as 29.24selected by the State Quality Council, regional quality councils of key stakeholders, 29.25including regional representatives of: 29.26    (1) disability service recipients and their family members; 29.27    (2) disability service providers; 29.28    (3) disability advocacy groups; and 29.29    (4) county human services agencies and staff from the Department of Human 29.30Services and Ombudsman for Mental Health and Developmental Disabilities. 29.31    (b) Each regional quality council shall: 29.32    (1) direct and monitor the community-based, person-directed quality assurance 29.33system in this section; 30.1    (2) approve a training program for quality assurance team members under clause (13); 30.2    (3) review summary reports from quality assurance team reviews and make 30.3recommendations to the State Quality Council regarding program licensure; 30.4    (4) make recommendations to the State Quality Council regarding the system; 30.5    (5) resolve complaints between the quality assurance teams, counties, providers, 30.6persons receiving services, their families, and legal representatives; 30.7    (6) analyze and review quality outcomes and critical incident data reporting 30.8incidents of life safety concerns immediately to the Department of Human Services 30.9licensing division; 30.10    (7) provide information and training programs for persons with disabilities and their 30.11families and legal representatives on service options and quality expectations; 30.12    (8) disseminate information and resources developed to other regional quality 30.13councils; 30.14    (9) respond to state-level priorities; 30.15    (10) establish regional priorities for quality improvement; 30.16    (11) submit an annual report to the State Quality Council on the status, outcomes, 30.17improvement priorities, and activities in the region; 30.18    (12) choose a representative to participate on the State Quality Council and assume 30.19other responsibilities consistent with the priorities of the State Quality Council; and 30.20    (13) recruit, train, and assign duties to members of quality assurance teams, taking 30.21into account the size of the service provider, the number of services to be reviewed, 30.22the skills necessary for the team members to complete the process, and ensure that no 30.23team member has a financial, personal, or family relationship with the facility, program, 30.24or service being reviewed or with anyone served at the facility, program, or service. 30.25Quality assurance teams must be comprised of county staff, persons receiving services 30.26or the person's families, legal representatives, members of advocacy organizations, 30.27providers, and other involved community members. Team members must complete 30.28the training program approved by the regional quality council and must demonstrate 30.29performance-based competency. Team members may be paid a per diem and reimbursed 30.30for expenses related to their participation in the quality assurance process. 30.31    (c) The commissioner shall monitor the safety standards, rights, and procedural 30.32protections for the monitoring of psychotropic medications and those identified under 30.33sections new text begin 245.8251 new text end ; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), 30.34clauses (2) and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, 30.35clause (7); 626.556; and 626.557. 31.1    (d) The regional quality councils may hire staff to perform the duties assigned in 31.2this subdivision. 31.3    (e) The regional quality councils may charge fees for their services. 31.4    (f) The quality assurance process undertaken by a regional quality council consists of 31.5an evaluation by a quality assurance team of the facility, program, or service. The process 31.6must include an evaluation of a random sample of persons served. The sample must be 31.7representative of each service provided. The sample size must be at least five percent but 31.8not less than two persons served. All persons must be given the opportunity to be included 31.9in the quality assurance process in addition to those chosen for the random sample. 31.10    (g) A facility, program, or service may contest a licensing decision of the regional 31.11quality council as permitted under chapter 245A. 31.12 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 31.13    Sec. 47. Minnesota Statutes 2014, section 256B.77, subdivision 17, is amended to read: 31.14    Subd. 17. Approval of alternatives. The commissioner may approve alternatives to 31.15administrative rules if the commissioner determines that appropriate alternative measures 31.16are in place to protect the health, safety, and rights of enrollees and to assure that services 31.17are of sufficient quality to produce the outcomes described in the personal support plans. 31.18Prior approved waivers, if needed by the demonstration project, shall be extended. The 31.19commissioner shall not waive the rights or procedural protections under sections 245.825 31.20 new text begin 245.8251 new text end ; 245.91 to 245.97; 252.41, subdivision 9; 256B.092, subdivision 10; 626.556; 31.21and 626.557; or procedures for the monitoring of psychotropic medications. Prohibited 31.22practices as defined in statutes and rules governing service delivery to eligible individuals 31.23are applicable to services delivered under this demonstration project. 31.24 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 31.25    Sec. 48. Minnesota Statutes 2015 Supplement, section 626.556, subdivision 2, is 31.26amended to read: 31.27    Subd. 2. Definitions. As used in this section, the following terms have the meanings 31.28given them unless the specific content indicates otherwise: 31.29    (a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected 31.30occurrence or event which: 31.31    (1) is not likely to occur and could not have been prevented by exercise of due 31.32care; and 32.1    (2) if occurring while a child is receiving services from a facility, happens when the 32.2facility and the employee or person providing services in the facility are in compliance 32.3with the laws and rules relevant to the occurrence or event. 32.4    (b) "Commissioner" means the commissioner of human services. 32.5    (c) "Facility" means: 32.6    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital, 32.7sanitarium, or other facility or institution required to be licensed under sections 144.50 to 32.8144.58 , 241.021, or 245A.01 to 245A.16, or chapter 245D; 32.9    (2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 32.10124E; or 32.11    (3) a nonlicensed personal care provider organization as defined in section 32.12256B.0625, subdivision 19a . 32.13    (d) "Family assessment" means a comprehensive assessment of child safety, risk of 32.14subsequent child maltreatment, and family strengths and needs that is applied to a child 32.15maltreatment report that does not allege sexual abuse or substantial child endangerment. 32.16Family assessment does not include a determination as to whether child maltreatment 32.17occurred but does determine the need for services to address the safety of family members 32.18and the risk of subsequent maltreatment. 32.19    (e) "Investigation" means fact gathering related to the current safety of a child 32.20and the risk of subsequent maltreatment that determines whether child maltreatment 32.21occurred and whether child protective services are needed. An investigation must be used 32.22when reports involve sexual abuse or substantial child endangerment, and for reports of 32.23maltreatment in facilities required to be licensed under chapter 245A or 245D; under 32.24sections 144.50 to 144.58 and 241.021; in a school as defined in section 120A.05, 32.25subdivisions 9 , 11, and 13, and chapter 124E; or in a nonlicensed personal care provider 32.26association as defined in section 256B.0625, subdivision 19a. 32.27    (f) "Mental injury" means an injury to the psychological capacity or emotional 32.28stability of a child as evidenced by an observable or substantial impairment in the child's 32.29ability to function within a normal range of performance and behavior with due regard to 32.30the child's culture. 32.31    (g) "Neglect" means the commission or omission of any of the acts specified under 32.32clauses (1) to (9), other than by accidental means: 32.33    (1) failure by a person responsible for a child's care to supply a child with necessary 32.34food, clothing, shelter, health, medical, or other care required for the child's physical or 32.35mental health when reasonably able to do so; 33.1    (2) failure to protect a child from conditions or actions that seriously endanger the 33.2child's physical or mental health when reasonably able to do so, including a growth delay, 33.3which may be referred to as a failure to thrive, that has been diagnosed by a physician and 33.4is due to parental neglect; 33.5    (3) failure to provide for necessary supervision or child care arrangements 33.6appropriate for a child after considering factors as the child's age, mental ability, physical 33.7condition, length of absence, or environment, when the child is unable to care for the 33.8child's own basic needs or safety, or the basic needs or safety of another child in their care; 33.9    (4) failure to ensure that the child is educated as defined in sections 120A.22 and 33.10260C.163, subdivision 11 , which does not include a parent's refusal to provide the parent's 33.11child with sympathomimetic medications, consistent with section 125A.091, subdivision 5; 33.12    (5) nothing in this section shall be construed to mean that a child is neglected solely 33.13because the child's parent, guardian, or other person responsible for the child's care in 33.14good faith selects and depends upon spiritual means or prayer for treatment or care of 33.15disease or remedial care of the child in lieu of medical care; except that a parent, guardian, 33.16or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report 33.17if a lack of medical care may cause serious danger to the child's health. This section does 33.18not impose upon persons, not otherwise legally responsible for providing a child with 33.19necessary food, clothing, shelter, education, or medical care, a duty to provide that care; 33.20    (6) prenatal exposure to a controlled substance, as defined in section 253B.02, 33.21subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal 33.22symptoms in the child at birth, results of a toxicology test performed on the mother at 33.23delivery or the child at birth, medical effects or developmental delays during the child's 33.24first year of life that medically indicate prenatal exposure to a controlled substance, or the 33.25presence of a fetal alcohol spectrum disorder; 33.26    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5); 33.27    (8) chronic and severe use of alcohol or a controlled substance by a parent or 33.28person responsible for the care of the child that adversely affects the child's basic needs 33.29and safety; or 33.30    (9) emotional harm from a pattern of behavior which contributes to impaired 33.31emotional functioning of the child which may be demonstrated by a substantial and 33.32observable effect in the child's behavior, emotional response, or cognition that is not 33.33within the normal range for the child's age and stage of development, with due regard to 33.34the child's culture. 33.35(h) "Nonmaltreatment mistake" means: 34.1(1) at the time of the incident, the individual was performing duties identified in the 34.2center's child care program plan required under Minnesota Rules, part 9503.0045; 34.3(2) the individual has not been determined responsible for a similar incident that 34.4resulted in a finding of maltreatment for at least seven years; 34.5(3) the individual has not been determined to have committed a similar 34.6nonmaltreatment mistake under this paragraph for at least four years; 34.7(4) any injury to a child resulting from the incident, if treated, is treated only with 34.8remedies that are available over the counter, whether ordered by a medical professional or 34.9not; and 34.10(5) except for the period when the incident occurred, the facility and the individual 34.11providing services were both in compliance with all licensing requirements relevant to the 34.12incident. 34.13This definition only applies to child care centers licensed under Minnesota 34.14Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of 34.15substantiated maltreatment by the individual, the commissioner of human services shall 34.16determine that a nonmaltreatment mistake was made by the individual. 34.17    (i) "Operator" means an operator or agency as defined in section 245A.02. 34.18    (j) "Person responsible for the child's care" means (1) an individual functioning 34.19within the family unit and having responsibilities for the care of the child such as a 34.20parent, guardian, or other person having similar care responsibilities, or (2) an individual 34.21functioning outside the family unit and having responsibilities for the care of the child 34.22such as a teacher, school administrator, other school employees or agents, or other lawful 34.23custodian of a child having either full-time or short-term care responsibilities including, 34.24but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching, 34.25and coaching. 34.26    (k) "Physical abuse" means any physical injury, mental injury, or threatened injury, 34.27inflicted by a person responsible for the child's care on a child other than by accidental 34.28means, or any physical or mental injury that cannot reasonably be explained by the child's 34.29history of injuries, or any aversive or deprivation procedures, or regulated interventions, 34.30that have not been authorized under section 125A.0942 or new text begin 245.8251 new text end . 34.31    Abuse does not include reasonable and moderate physical discipline of a child 34.32administered by a parent or legal guardian which does not result in an injury. Abuse does 34.33not include the use of reasonable force by a teacher, principal, or school employee as 34.34allowed by section 121A.582. Actions which are not reasonable and moderate include, but 34.35are not limited to, any of the following: 34.36    (1) throwing, kicking, burning, biting, or cutting a child; 35.1    (2) striking a child with a closed fist; 35.2    (3) shaking a child under age three; 35.3    (4) striking or other actions which result in any nonaccidental injury to a child 35.4under 18 months of age; 35.5    (5) unreasonable interference with a child's breathing; 35.6    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6; 35.7    (7) striking a child under age one on the face or head; 35.8    (8) striking a child who is at least age one but under age four on the face or head, 35.9which results in an injury; 35.10    (9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 35.11substances which were not prescribed for the child by a practitioner, in order to control or 35.12punish the child; or other substances that substantially affect the child's behavior, motor 35.13coordination, or judgment or that results in sickness or internal injury, or subjects the 35.14child to medical procedures that would be unnecessary if the child were not exposed 35.15to the substances; 35.16    (10) unreasonable physical confinement or restraint not permitted under section 35.17609.379 , including but not limited to tying, caging, or chaining; or 35.18    (11) in a school facility or school zone, an act by a person responsible for the child's 35.19care that is a violation under section 121A.58. 35.20    (l) "Practice of social services," for the purposes of subdivision 3, includes but is 35.21not limited to employee assistance counseling and the provision of guardian ad litem and 35.22parenting time expeditor services. 35.23    (m) "Report" means any communication received by the local welfare agency, 35.24police department, county sheriff, or agency responsible for child protection pursuant to 35.25this section that describes neglect or physical or sexual abuse of a child and contains 35.26sufficient content to identify the child and any person believed to be responsible for the 35.27neglect or abuse, if known. 35.28    (n) "Sexual abuse" means the subjection of a child by a person responsible for the 35.29child's care, by a person who has a significant relationship to the child, as defined in 35.30section 609.341, or by a person in a position of authority, as defined in section 609.341, 35.31subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual 35.32conduct in the first degree), 609.343 (criminal sexual conduct in the second degree), 35.33609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct 35.34in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual 35.35abuse also includes any act which involves a minor which constitutes a violation of 35.36prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes 36.1threatened sexual abuse which includes the status of a parent or household member 36.2who has committed a violation which requires registration as an offender under section 36.3243.166, subdivision 1b, paragraph (a) or (b), or required registration under section 36.4243.166, subdivision 1b, paragraph (a) or (b). 36.5    (o) "Substantial child endangerment" means a person responsible for a child's care, 36.6by act or omission, commits or attempts to commit an act against a child under their 36.7care that constitutes any of the following: 36.8    (1) egregious harm as defined in section 260C.007, subdivision 14; 36.9    (2) abandonment under section 260C.301, subdivision 2; 36.10    (3) neglect as defined in paragraph (g), clause (2), that substantially endangers the 36.11child's physical or mental health, including a growth delay, which may be referred to as 36.12failure to thrive, that has been diagnosed by a physician and is due to parental neglect; 36.13    (4) murder in the first, second, or third degree under section 609.185, 609.19, or 36.14609.195 ; 36.15    (5) manslaughter in the first or second degree under section 609.20 or 609.205; 36.16    (6) assault in the first, second, or third degree under section 609.221, 609.222, or 36.17609.223 ; 36.18    (7) solicitation, inducement, and promotion of prostitution under section 609.322; 36.19    (8) criminal sexual conduct under sections 609.342 to 609.3451; 36.20    (9) solicitation of children to engage in sexual conduct under section 609.352; 36.21    (10) malicious punishment or neglect or endangerment of a child under section 36.22609.377 or 609.378; 36.23    (11) use of a minor in sexual performance under section 617.246; or 36.24    (12) parental behavior, status, or condition which mandates that the county attorney 36.25file a termination of parental rights petition under section 260C.503, subdivision 2. 36.26    (p) "Threatened injury" means a statement, overt act, condition, or status that 36.27represents a substantial risk of physical or sexual abuse or mental injury. Threatened 36.28injury includes, but is not limited to, exposing a child to a person responsible for the 36.29child's care, as defined in paragraph (j), clause (1), who has: 36.30    (1) subjected a child to, or failed to protect a child from, an overt act or condition 36.31that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a 36.32similar law of another jurisdiction; 36.33    (2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph 36.34(b), clause (4), or a similar law of another jurisdiction; 36.35    (3) committed an act that has resulted in an involuntary termination of parental rights 36.36under section 260C.301, or a similar law of another jurisdiction; or 37.1    (4) committed an act that has resulted in the involuntary transfer of permanent 37.2legal and physical custody of a child to a relative under Minnesota Statutes 2010, section 37.3260C.201, subdivision 11 , paragraph (d), clause (1), section 260C.515, subdivision 4, or a 37.4similar law of another jurisdiction. 37.5A child is the subject of a report of threatened injury when the responsible social 37.6services agency receives birth match data under paragraph (q) from the Department of 37.7Human Services. 37.8(q) Upon receiving data under section 144.225, subdivision 2b, contained in a 37.9birth record or recognition of parentage identifying a child who is subject to threatened 37.10injury under paragraph (p), the Department of Human Services shall send the data to the 37.11responsible social services agency. The data is known as "birth match" data. Unless the 37.12responsible social services agency has already begun an investigation or assessment of the 37.13report due to the birth of the child or execution of the recognition of parentage and the 37.14parent's previous history with child protection, the agency shall accept the birth match 37.15data as a report under this section. The agency may use either a family assessment or 37.16investigation to determine whether the child is safe. All of the provisions of this section 37.17apply. If the child is determined to be safe, the agency shall consult with the county 37.18attorney to determine the appropriateness of filing a petition alleging the child is in need 37.19of protection or services under section 260C.007, subdivision 6, clause (16), in order to 37.20deliver needed services. If the child is determined not to be safe, the agency and the county 37.21attorney shall take appropriate action as required under section 260C.503, subdivision 2. 37.22    (r) Persons who conduct assessments or investigations under this section shall take 37.23into account accepted child-rearing practices of the culture in which a child participates 37.24and accepted teacher discipline practices, which are not injurious to the child's health, 37.25welfare, and safety. 37.26 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 37.27    Sec. 49. Minnesota Statutes 2014, section 626.5572, subdivision 2, is amended to read: 37.28    Subd. 2. Abuse. "Abuse" means: 37.29(a) An act against a vulnerable adult that constitutes a violation of, an attempt to 37.30violate, or aiding and abetting a violation of: 37.31(1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224; 37.32(2) the use of drugs to injure or facilitate crime as defined in section 609.235; 37.33(3) the solicitation, inducement, and promotion of prostitution as defined in section 37.34609.322 ; and 38.1(4) criminal sexual conduct in the first through fifth degrees as defined in sections 38.2609.342 to 609.3451. 38.3A violation includes any action that meets the elements of the crime, regardless of 38.4whether there is a criminal proceeding or conviction. 38.5(b) Conduct which is not an accident or therapeutic conduct as defined in this 38.6section, which produces or could reasonably be expected to produce physical pain or 38.7injury or emotional distress including, but not limited to, the following: 38.8(1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a 38.9vulnerable adult; 38.10(2) use of repeated or malicious oral, written, or gestured language toward a 38.11vulnerable adult or the treatment of a vulnerable adult which would be considered by a 38.12reasonable person to be disparaging, derogatory, humiliating, harassing, or threatening; 38.13(3) use of any aversive or deprivation procedure, unreasonable confinement, or 38.14involuntary seclusion, including the forced separation of the vulnerable adult from other 38.15persons against the will of the vulnerable adult or the legal representative of the vulnerable 38.16adult; and 38.17(4) use of any aversive or deprivation procedures for persons with developmental 38.18disabilities or related conditions not authorized under section new text begin 245.8251 new text end . 38.19(c) Any sexual contact or penetration as defined in section 609.341, between a 38.20facility staff person or a person providing services in the facility and a resident, patient, 38.21or client of that facility. 38.22(d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against 38.23the vulnerable adult's will to perform services for the advantage of another. 38.24(e) For purposes of this section, a vulnerable adult is not abused for the sole reason 38.25that the vulnerable adult or a person with authority to make health care decisions for 38.26the vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C or 252A, or 38.27section 253B.03 or 524.5-313, refuses consent or withdraws consent, consistent with that 38.28authority and within the boundary of reasonable medical practice, to any therapeutic 38.29conduct, including any care, service, or procedure to diagnose, maintain, or treat the 38.30physical or mental condition of the vulnerable adult or, where permitted under law, to 38.31provide nutrition and hydration parenterally or through intubation. This paragraph does 38.32not enlarge or diminish rights otherwise held under law by: 38.33(1) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an 38.34involved family member, to consent to or refuse consent for therapeutic conduct; or 38.35(2) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct. 39.1(f) For purposes of this section, a vulnerable adult is not abused for the sole reason 39.2that the vulnerable adult, a person with authority to make health care decisions for the 39.3vulnerable adult, or a caregiver in good faith selects and depends upon spiritual means 39.4or prayer for treatment or care of disease or remedial care of the vulnerable adult in lieu 39.5of medical care, provided that this is consistent with the prior practice or belief of the 39.6vulnerable adult or with the expressed intentions of the vulnerable adult. 39.7(g) For purposes of this section, a vulnerable adult is not abused for the sole reason 39.8that the vulnerable adult, who is not impaired in judgment or capacity by mental or 39.9emotional dysfunction or undue influence, engages in consensual sexual contact with: 39.10(1) a person, including a facility staff person, when a consensual sexual personal 39.11relationship existed prior to the caregiving relationship; or 39.12(2) a personal care attendant, regardless of whether the consensual sexual personal 39.13relationship existed prior to the caregiving relationship. 39.14 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 39.15    Sec. 50. new text begin APPROPRIATION. new text end 39.16 new text begin $24,000 is appropriated in fiscal year 2017 to the commissioner of health to new text end 39.17 new text begin administer the task force on medical cannabis therapeutic research under Minnesota new text end 39.18 new text begin Statutes, section 152.36, and for the task force to conduct the impact assessment on the new text end 39.19 new text begin use of cannabis for medicinal purposes. new text end 39.20    Sec. 51. new text begin APPROPRIATION CANCELLATION. new text end 39.21 new text begin Effective July 1, 2016, the appropriation in Laws 2014, chapter 311, section 21, new text end 39.22 new text begin subdivision 2, of $24,000 to the Legislative Coordinating Commission is canceled to the new text end 39.23 new text begin general fund. new text end 39.24    Sec. 52. new text begin REPEALER. new text end 39.25 new text begin Minnesota Statutes 2014, section 245.825, subdivisions 1 and 1b, new text end new text begin are repealed. new text end 39.26 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end