HF 3344

as introduced - 94th Legislature (2025 - 2026) Posted on 05/18/2025 01:45pm

A bill for an act
relating to human services; modifying rights and protections for residents of certain
long-term care settings; modifying rights and protections for clients receiving
home care services and rights and protections for home and community-based
services recipients; requiring training; prohibiting certain arbitration provisions;
requiring certain notices; authorizing civil actions; appropriating money; amending
Minnesota Statutes 2024, sections 144.651, subdivisions 2, 6, 12, 15, 16, 22, 26,
28, 29, by adding subdivisions; 144.652, subdivision 2, by adding a subdivision;
144A.43, by adding subdivisions; 144A.44, subdivision 1, by adding a subdivision;
144A.472, subdivision 1; 144A.474, subdivision 11; 144A.4791, subdivisions 1,
11, by adding a subdivision; 144A.4796, subdivisions 2, 6, 7, by adding a
subdivision; 144G.08, by adding subdivisions; 144G.31, subdivision 4; 144G.63,
subdivision 7; 144G.90, subdivision 1; 144G.91, subdivisions 4, 5, 10, 12, 13, 15,
17, by adding subdivisions; 245A.07, subdivision 3, as amended; 245D.02, by
adding subdivisions; 245D.04; 245D.09, subdivisions 4, 5, by adding a subdivision;
245D.095, subdivision 5; 245D.21, by adding a subdivision; 256.9742, by adding
a subdivision; proposing coding for new law in Minnesota Statutes, chapters 144;
144A; 144G.

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

ARTICLE 1

LGBTQIA2S+ AND HIV LONG-TERM CARE BILL OF RIGHTS

Section 1. new text begin TITLE.
new text end

new text begin This article may be cited as the LGBTQIA2S+ and HIV long-term care bill of rights.
new text end

Sec. 2. new text begin FINDINGS AND PURPOSE.
new text end

new text begin (a) LGBTQIA2S+ older people and older people living with HIV fear or face
discrimination in nearly all settings, but particularly in long-term care settings, where they
may be subject to a wide array of discriminatory acts and mistreatment.
new text end

new text begin (b) Discriminatory acts and mistreatment may include facilities and their staff forcing
residents to wear clothing contrary to their gender identity; refusing to use a resident's chosen
name or pronouns; imposing traumatic detransitions; restricting medical decision-making
to a resident's biological family against that resident's wishes; refusing to accept health care
power of attorney from a resident's spouse or partner; disregarding residents' rooming and
visitation preferences; imposing discriminatory restrictions on visitation; and wrongfully
discharging or refusing to admit residents based on sexual orientation, gender identity,
gender expression, intersex status, two-spirit identity, or actual or perceived HIV status.
new text end

new text begin (c) LGBTQIA2S+ residents and residents living with HIV may endure inadequate care
because staff lack the training and experience to provide sensitive, culturally competent
services. Additionally, staff may lack medical understanding of the medications and
treatments certain residents require, particularly those living with HIV, those who access
gender-affirming care, and those with particular medical needs related to an intersex variation.
new text end

new text begin (d) Residents in long-term care facilities are uniquely vulnerable to mistreatment and
abuse because of the inherent imbalance of power between residents and staff. Often residents
are socially isolated from friends and family and must rely heavily on facility staff for basic
needs like bathing, dressing, feeding, and medication administration. Residents may have
physical or mental disabilities that impede their ability to draw attention to or report
mistreatment or may not feel safe doing so.
new text end

new text begin (e) Discrimination against LGBT individuals in long-term care facilities is not always
addressed, according to "Stories from the Field: LGBT Older Adults in Long-Term Care
Facilities," a 2011 study published by the National Senior Citizens Law Center (now Justice
in Aging). In that study, 43 percent of respondents reported personally witnessing or
experiencing instances of mistreatment of LGBT seniors in a long-term care facility,
including verbal or physical harassment from other residents; being refused admission or
readmission or being abruptly discharged; verbal or physical harassment from staff; staff
refusal to accept health care power of attorney from the resident's spouse or partner;
discriminatory restrictions on visitation; and staff refusal to refer to a transgender resident
by the resident's chosen name or pronouns. Eighty-one percent of respondents believed that
other residents would discriminate against an LGBT elder in a long-term care facility; 89
percent of respondents believed that staff would discriminate against an LGBT elder in a
long-term care facility; and 53 percent believed that staff discrimination would rise to the
level of abuse or neglect.
new text end

new text begin (f) Despite existing protections, LGBTQIA2S+ older people and older people living
with HIV may fear that they may still face discrimination. This article rectifies this by
establishing affirmative requirements for long-term care facilities, prohibiting specific
discriminatory acts in long-term care settings, and providing information and remedies to
ensure that residents living with HIV know their rights and have the means to enforce them.
new text end

new text begin (g) It is the purpose of this article to expand, clarify, confirm, and create greater
consistency in the rights and protections of long-term care residents against discrimination
on the basis of the resident's actual or perceived sex, including sexual orientation, gender
identity, and sex characteristics, including intersex traits, or HIV status.
new text end

Sec. 3.

new text begin [144.505] TRAINING IN LGBTQIA2S+ AND HIV CULTURAL
COMPETENCY.
new text end

new text begin Subdivision 1. new text end

new text begin Training required. new text end

new text begin (a) All boarding care homes and supervised living
facilities must meet the training requirements in this section for LGBTQIA2S+ and HIV
cultural competency:
new text end

new text begin (1) supervisors of direct-care staff must have at least four hours of initial training on the
topics listed in subdivision 2 within six months of the employment start date and must have
at least two hours of training on the topics listed in subdivision 2 for every two years of
employment thereafter;
new text end

new text begin (2) direct-care staff must have at least four hours of initial training on the topics listed
in subdivision 2 within six months of the employment start date and must have at least four
hours of training on the topics listed in subdivision 2 for every two years of employment
thereafter; and
new text end

new text begin (3) non-direct-care staff must have at least two hours of initial training on the topics
listed in subdivision 2 within six months of the employment start date and must have at
least two hours of training on the topics listed in subdivision 2 for every two years of
employment thereafter.
new text end

new text begin (b) A boarding care home or supervised living facility must implement a schedule to
train existing staff on the content specified in subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Content. new text end

new text begin At a minimum, the training must address:
new text end

new text begin (1) the terms and language commonly used by members of the LGBTQIA2S+ community
and people living with HIV, including but not limited to sexual orientation, gender identity,
gender expression, intersex status, and HIV status, and using definitions from the National
Institute of Allergy and Infectious Diseases HIV Language Guide;
new text end

new text begin (2) the health and social challenges historically experienced by members of the
LGBTQIA2S+ community and people living with HIV, including discrimination when
seeking or receiving care and the physical and mental health effects associated with this
discrimination;
new text end

new text begin (3) best practices for communicating with or about the LGBTQIA2S+ community and
people living with HIV, including using an individual's chosen name and pronouns;
new text end

new text begin (4) strategies to create a safe, affirming environment for LGBTQIA2S+ community
members and people living with HIV, including suggested changes to policies and procedures
of the facility, forms, signage, communication between residents and family members,
activities, in-house services, and staff training;
new text end

new text begin (5) information on why people with a diverse sexual orientation, gender identity, gender
expression, intersex status, or two-spirit identity, or people living with HIV may hide their
identities;
new text end

new text begin (6) information on the unique needs of people with a diverse sexual orientation, gender
identity, gender expression, intersex status, or two-spirit identity, or of people living with
HIV;
new text end

new text begin (7) an overview of the rights and protections for people with a diverse sexual orientation,
gender identity, gender expression, intersex status, or two-spirit identity, and for people
living with HIV;
new text end

new text begin (8) how to respectfully ask questions about, and respond to questions and concerns
relating to, sexual orientation, gender identity, and gender expression, and information on
why these questions are important for long-term care facilities;
new text end

new text begin (9) basic information about HIV, transmission of HIV, the history of HIV, the stigma
and discrimination experienced by people living with HIV, and common myths about HIV,
and the role of facility staff in creating a respectful and inclusive environment for residents
living with HIV; and
new text end

new text begin (10) how to provide stigma-free care, respect the rights of residents living with HIV,
and use appropriate language when discussing HIV.
new text end

new text begin Subd. 3. new text end

new text begin Forms of training; other requirements. new text end

new text begin The training required under this
section may be in person or online. A staff person who completes in-person training must
obtain proof that the staff person completed the training in the form of a certificate signed
by the staff person and the staff person's supervisor. Online training must include controls
to ensure the full training is completed, use of a personal identification number or personal
identification information to confirm the identity of the staff person participating in the
training, and a printable certificate that verifies the staff person completed the training. A
staff person who completes online training must print and sign the certificate, and have the
certificate signed by the staff person's supervisor.
new text end

new text begin Subd. 4. new text end

new text begin Training provider. new text end

new text begin The training required under this section must be provided
by an entity:
new text end

new text begin (1) whose mission and work demonstrate a belief in the reality and authenticity of
LGBTQIA2S+ identities and HIV, including but not limited to an understanding that gender
identity is a spectrum, an understanding that individuals can and should be allowed to
transition genders if it is their choice, an understanding that HIV causes AIDS, and a belief
that all members of the LGBTQIA2S+ community and those living with HIV deserve equal
protection under the law;
new text end

new text begin (2) with expertise in identifying and addressing the legal and social challenges faced by
LGBTQIA2S+ individuals and individuals living with HIV as they age and those faced by
LGBTQIA2S+ residents and residents living with HIV in long-term care facilities; and
new text end

new text begin (3) that has a commitment to advancing quality of care for LGBTQIA2S+ residents and
residents living with HIV in the state.
new text end

new text begin Subd. 5. new text end

new text begin Approval of training program. new text end

new text begin The commissioner must establish a process
for the commissioner to review and approve a facility's proposed training program under
this section. The commissioner must approve a facility's proposed training program within
90 days after the facility requests approval if:
new text end

new text begin (1) the facility submits with the request for approval, a statement of the qualifications
and training experience of the individual or entity providing the training; the proposed
method of providing the training, either in person or online; an outline of the training; and
copies of the materials used in the training; and
new text end

new text begin (2) the training meets the requirements in subdivisions 1 to 4.
new text end

new text begin Subd. 6. new text end

new text begin Documentation of training. new text end

new text begin The boarding care home or supervised living
facility must retain evidence in the employee record of each staff person having completed
the training required by this section.
new text end

Sec. 4.

Minnesota Statutes 2024, section 144.651, subdivision 2, is amended to read:

Subd. 2.

Definitions.

new text begin (a) new text end For the purposes of this section, new text begin the following terms have the
meanings given.
new text end

new text begin (b) "Gender expression" means an individual's gender-related appearance and behavior,
whether or not these are stereotypically associated with the sex the individual was assigned
at birth.
new text end

new text begin (c) "Gender identity" has the meaning given in section 363A.03, subdivision 50.
new text end

new text begin (d) "Gender nonconforming" means having a gender expression that does not conform
to stereotypical expectations of an individual's gender.
new text end

new text begin (e) "Gender transition" means a process by which an individual begins to live according
to that individual's gender identity rather than the sex the individual was assigned at birth.
This process may include changing the individual's clothing, appearance, name, or
identification documents, or undergoing medical treatments.
new text end

new text begin (f) "Harass" or "harassment" means acting in a manner that is unwanted, unwelcome,
or uninvited; that demeans, threatens, or offends the individual; and that results in a hostile
environment for the individual. Harass or harassment includes acts such as requiring an
individual to show identity documents in order to gain entrance to a restroom or other area
of a facility that is available to other individuals of the same gender identity as the individual.
new text end

new text begin (g) "HIV" means the human immunodeficiency virus.
new text end

new text begin (h) "LGBTQIA2S+" means an individual who identifies as lesbian, gay, bisexual,
transgender, gender expansive, queer, intersex, asexual, or two-spirit.
new text end

new text begin (i) new text end "Patient" means a person who is admitted to an acute care inpatient facility for a
continuous period longer than 24 hours, for the purpose of diagnosis or treatment bearing
on the physical or mental health of that person. For purposes of subdivisions 4 to 9, 12, 13,
15, 16, and 18 to 20, "patient" also means a person who receives health care services at an
outpatient surgical center or at a birth center licensed under section 144.615. "Patient" also
means a minor who is admitted to a residential program as defined in section 253C.01. For
purposes of subdivisions 1, 3 to 16, 18, 20 and 30, "patient" also means any person who is
receiving mental health treatment on an outpatient basis or in a community support program
or other community-based program.

new text begin (j) new text end "Resident" means a person who is admitted to a nonacute care facility including
extended care facilities, nursing homes, and boarding care homes for care required because
of prolonged mental or physical illness or disability, recovery from injury or disease, or
advancing age. For purposes of all subdivisions except subdivisions 28 and 29, "resident"
also means a person who is admitted to a facility licensed as a board and lodging facility
under Minnesota Rules, parts 4625.0100 to 4625.2355, a boarding care home under sections
144.50 to 144.56, or a supervised living facility under Minnesota Rules, parts 4665.0100
to 4665.9900, and which operates a rehabilitation program licensed under chapter 245G or
245I, or Minnesota Rules, parts 9530.6510 to 9530.6590.

new text begin (k) "Sexual orientation" has the meaning given in section 363A.03, subdivision 44.
new text end

new text begin (l) "Transgender" is an umbrella term for an individual whose gender identity or gender
expression is different from cultural expectations based on the sex the individual was assigned
at birth.
new text end

Sec. 5.

Minnesota Statutes 2024, section 144.651, is amended by adding a subdivision to
read:

new text begin Subd. 4a. new text end

new text begin Nondiscrimination notice. new text end

new text begin Residents must be provided with the following
notice when residents are provided with the statement of rights under subdivision 4:
new text end

new text begin "[Name of provider] will not discriminate against residents, and does not permit
discrimination against residents, including but not limited to bullying, abuse, or harassment,
on the basis of actual or perceived sexual orientation, gender identity, gender expression,
intersex status, two-spirit identity, or actual or perceived HIV status, or based on association
with another individual on account of that individual's actual or perceived sexual orientation,
gender identity, gender expression, intersex status, two-spirit identity, or actual or perceived
HIV status. You may file a complaint with the Office of Health Facility Complaints or the
Office of Ombudsman for Long-Term Care if you believe that you have experienced this
kind of discrimination."
new text end

Sec. 6.

Minnesota Statutes 2024, section 144.651, is amended by adding a subdivision to
read:

new text begin Subd. 5a. new text end

new text begin Chosen name and pronouns; gender identity. new text end

new text begin A resident has the right to be
free from having others repeatedly, knowingly, and willfully refuse to use the resident's
chosen name or pronouns after being reasonably informed of the resident's chosen name
and pronouns. The facility and facility staff must not refuse to use a resident's chosen name
and pronouns based on the resident's actual or perceived sexual orientation, gender identity,
gender expression, intersex status, or two-spirit identity. A resident has the right to have
the resident's oral or written attestation of the resident's gender identity accepted by a facility
and facility staff, and a facility or facility staff must not require a resident to provide proof
of the resident's gender identity using any form of identification.
new text end

Sec. 7.

Minnesota Statutes 2024, section 144.651, subdivision 6, is amended to read:

Subd. 6.

Appropriate health care new text begin and personal care new text end .

new text begin (a) new text end Patients and residents shall
have the right to appropriate medical and personal care based on individual needs.
Appropriate care for residents means care designed to enable residents to achieve their
highest level of physical and mental functioning. deleted text begin This right is
deleted text end

new text begin (b) Residents have the right to health care and personal care, including medication, that
is appropriate to the resident's organs and bodily needs and have the right to not be provided
with medical care or personal care that, to a similarly situated, reasonable person, unduly
demeans the resident's dignity or causes avoidable discomfort. A facility must not refuse
or willfully fail to provide any health care, personal care, or reasonable accommodation to
a resident based on the resident's actual or perceived sexual orientation, gender identity,
gender expression, intersex status, two-spirit identity, or actual or perceived HIV status.
new text end

new text begin (c) Transgender residents have the right to be provided with access to any assessments,
therapies, and treatments that are recommended by the resident's health care provider,
including but not limited to transgender-related medical care, hormone therapy, and
supportive counseling.
new text end

new text begin (d) The rights in this subdivision are new text end limited where the service is not reimbursable by
public or private resources.

Sec. 8.

Minnesota Statutes 2024, section 144.651, subdivision 12, is amended to read:

Subd. 12.

Right to refuse care.

Competent patients and residents shall have the right
to refuse treatment based on the information required in subdivision 9. new text begin LGBTQIA2S+
residents, residents living with HIV, and residents receiving treatment for HIV have the
right to refuse to be examined, observed, or treated by facility staff when the primary purpose
is educational or informational rather than therapeutic, and this refusal shall not diminish
the resident's ability to access care for diagnosis or treatment. new text end Residents who refuse treatment,
medication, or dietary restrictions shall be informed of the likely medical or major
psychological results of the refusal, with documentation in the individual medical record.
In cases where a patient or resident is incapable of understanding the circumstances but has
not been adjudicated incompetent, or when legal requirements limit the right to refuse
treatment, the conditions and circumstances shall be fully documented by the attending
physician, advanced practice registered nurse, or physician assistant in the patient's or
resident's medical record.

Sec. 9.

Minnesota Statutes 2024, section 144.651, is amended by adding a subdivision to
read:

new text begin Subd. 14a. new text end

new text begin Reasonable action to prevent discrimination or harassment. new text end

new text begin A facility
must take reasonable actions within the facility's control to prevent discrimination or
harassment against a resident by all individuals present in the facility, including but not
limited to staff, contractors, and other residents, based on the resident's actual or perceived
sexual orientation, gender identity, gender expression, intersex status, two-spirit identity,
or actual or perceived HIV status, when the facility knows or should know about the
discrimination or harassment.
new text end

Sec. 10.

Minnesota Statutes 2024, section 144.651, subdivision 15, is amended to read:

Subd. 15.

Treatment privacy.

Patients and residents shall have the right to respectfulness
and privacy as it relates to their medical and personal care program. Case discussion,
consultation, examination, and treatment are confidential and shall be conducted discreetly.
new text begin Persons not directly involved in providing personal care, medical care, social support, or
administrative support to a transgender resident, gender-nonconforming resident, resident
living with HIV, or resident receiving treatment for HIV must not be present during case
discussions, physical examinations, treatment, or personal care for that resident without the
resident's express permission. new text end Privacy shall be respected during toileting, bathing, and other
activities of personal hygiene, except as needed for patient or resident safety or assistance. new text begin
A facility must use doors, curtains, screens, or other effective visual barriers to provide
bodily privacy to transgender residents, gender-nonconforming residents, residents living
with HIV, and residents receiving treatment for HIV whenever the residents are partially
or fully unclothed.
new text end

Sec. 11.

Minnesota Statutes 2024, section 144.651, subdivision 16, is amended to read:

Subd. 16.

Confidentiality of records.

new text begin (a) new text end Patients and residents shall be assured
confidential treatment of their personal and medical records, and may approve or refuse
their release to any individual outside the facility. Residents shall be notified when personal
records are requested by any individual outside the facility and may select someone to
accompany them when the records or information are the subject of a personal interview.
Copies of records and written information from the records shall be made available in
accordance with this subdivision and sections 144.291 to 144.298. This right does not apply
to complaint investigations and inspections by the Department of Health, where required
by third-party payment contracts, or where otherwise provided by law.

new text begin (b) Residents have the right to have the facility not disclose any personally identifiable
information regarding whether a resident is LGBTQIA2S+, a resident's gender transition
status, or a resident's HIV status or perceived HIV status. A facility must take appropriate
steps to minimize the likelihood of inadvertent or accidental disclosure of this information
to other residents, visitors, or staff, except to the minimum extent necessary for staff to
perform their duties.
new text end

Sec. 12.

Minnesota Statutes 2024, section 144.651, subdivision 22, is amended to read:

Subd. 22.

Personal property.

Patients and residents may retain and use their personal
clothing and possessions as space permits, unless to do so would infringe upon rights of
other patients or residents, and unless medically or programmatically contraindicated for
documented medical, safety, or programmatic reasons. new text begin Residents have the right to wear
clothing, accessories, and cosmetics and engage in grooming practices that are permitted
for any other resident and a facility and facility staff must not limit these rights based on
the resident's actual or perceived sexual orientation, gender identity, gender expression,
intersex status, or two-spirit identity. new text end The facility must either maintain a central locked
depository or provide individual locked storage areas in which residents may store their
valuables for safekeeping. The facility may, but is not required to, provide compensation
for or replacement of lost or stolen items.

Sec. 13.

Minnesota Statutes 2024, section 144.651, subdivision 26, is amended to read:

Subd. 26.

Right to associate.

(a) Residents may meet with and receive visitors and
participate in activities of commercial, religious, political, as defined in section 203B.11
and community groups without interference at their discretion if the activities do not infringe
on the right to privacy of other residents or are not programmatically contraindicated. This
includes:

(1) the right to join with other individuals within and outside the facility to work for
improvements in long-term care;

(2) the right to visitation by an individual the patient has appointed as the patient's health
care agent under chapter 145C;

(3) the right to visitation and health care decision making by an individual designated
by the patient under paragraph (c).

(b) Upon admission to a facility where federal law prohibits unauthorized disclosure of
patient or resident identifying information to callers and visitors, the patient or resident, or
the legal guardian or conservator of the patient or resident, shall be given the opportunity
to authorize disclosure of the patient's or resident's presence in the facility to callers and
visitors who may seek to communicate with the patient or resident. To the extent possible,
the legal guardian or conservator of a patient or resident shall consider the opinions of the
patient or resident regarding the disclosure of the patient's or resident's presence in the
facility.

(c) Upon admission to a facility, the patient or resident, or the legal guardian or
conservator of the patient or resident, must be given the opportunity to designate a person
who is not related who will have the status of the patient's next of kin with respect to
visitation and making a health care decision. A designation must be included in the patient's
health record. With respect to making a health care decision, a health care directive or
appointment of a health care agent under chapter 145C prevails over a designation made
under this paragraph. The unrelated person may also be identified as such by the patient or
by the patient's family.

new text begin (d) A resident has the right to associate with other residents or visitors, including the
right to consensual sexual relations or to displays of physical affection, unless the restriction
is uniformly applied to all residents in a nondiscriminatory manner. A resident living with
HIV or perceived to be living with HIV must not be isolated by facility staff due to the
resident's actual or perceived HIV status, including but not limited to limiting the resident
to the resident's room, limiting areas of the facility where the resident is permitted to go, or
limiting the restrooms the resident is permitted to use.
new text end

Sec. 14.

Minnesota Statutes 2024, section 144.651, is amended by adding a subdivision
to read:

new text begin Subd. 26a. new text end

new text begin Restrooms. new text end

new text begin A resident has the right to use any restroom that is available for
use by other residents of the same gender identity as the resident, regardless of whether the
resident is making a gender transition, has taken or is taking hormones, has undergone
gender affirmation surgery, or presents as gender nonconforming. A resident has the right
to not be harassed for seeking to use or using a restroom that is available for use by other
residents of the same gender identity as the resident.
new text end

Sec. 15.

Minnesota Statutes 2024, section 144.651, subdivision 28, is amended to read:

Subd. 28.

Married residents new text begin ; sharing a room new text end .

new text begin (a) new text end Residents, if married, shall be assured
privacy for visits by their spouses and, if both spouses are residents of the facility, they shall
be permitted to share a room, unless medically contraindicated and documented by their
physicians in the medical records.

new text begin (b) Two consenting residents shall be permitted to share a room.
new text end

new text begin (c) If rooms are assigned by gender, a transgender resident or LGBTQIA2S+ resident
must not be reassigned to a room or be refused a room assignment other than in accordance
with the resident's gender identity, unless so requested by the resident or required by federal
law.
new text end

Sec. 16.

Minnesota Statutes 2024, section 144.651, subdivision 29, is amended to read:

Subd. 29.

new text begin Admissions, new text end transfers new text begin , new text end and discharges.

Residents shall not be arbitrarily
transferred or discharged. new text begin Residents shall not be denied admission, transferred, refused a
transfer, or discharged based on the resident's actual or perceived sexual orientation, gender
identity, gender expression, intersex status, two-spirit identity, or actual or perceived HIV
status. new text end Residents must be notified, in writing, of the proposed discharge or transfer and its
justification no later than 30 days before discharge from the facility and seven days before
transfer to another room within the facility. This notice shall include the resident's right to
contest the proposed action, with the address and telephone number of the area nursing
home ombudsman pursuant to the Older Americans Act, section 307(a)(12). The resident,
informed of this right, may choose to relocate before the notice period ends. The notice
period may be shortened in situations outside the facility's control, such as a determination
by utilization review, the accommodation of newly admitted residents, a change in the
resident's medical or treatment program, the resident's own or another resident's welfare,
or nonpayment for stay unless prohibited by the public program or programs paying for the
resident's care, as documented in the medical record. Facilities shall make a reasonable
effort to accommodate new residents without disrupting room assignments.

Sec. 17.

Minnesota Statutes 2024, section 144.652, subdivision 2, is amended to read:

Subd. 2.

Correction order; emergencies.

new text begin (a) new text end A substantial violation of the rights of
any patient or resident as defined in section 144.651, shall be grounds for issuance of a
correction order pursuant to section 144.653 or 144A.10.

new text begin (b) new text end The issuance or nonissuance of a correction order shall not preclude, diminish,
enlarge, or otherwise alter private action by or on behalf of a patient or resident to enforce
any unreasonable violation of the patient's or resident's rights.

new text begin (c) Notwithstanding paragraph (a), a substantial violation of the rights of a resident
related to the resident's actual or perceived sexual orientation, gender identity, gender
expression, intersex status, two-spirit identity, or actual or perceived HIV status shall be
grounds for issuance of a correction order and imposition of a fine under section 144.653
or 144A.10. Notwithstanding section 144.653, subdivisions 5 and 6, or 144A.10, subdivisions
5 and 6, the commissioner must immediately impose a fine for a violation described in this
paragraph without first providing the facility with an opportunity to correct the violation or
issuing a notice of noncompliance.
new text end

new text begin (d) new text end Compliance with the provisions of section 144.651 shall not be required whenever
emergency conditions, as documented by the attending physician, advanced practice
registered nurse, or physician assistant in a patient's medical record or a resident's care
record, indicate immediate medical treatment, including but not limited to surgical
procedures, is necessary and it is impossible or impractical to comply with the provisions
of section 144.651 because delay would endanger the patient's or resident's life, health, or
safety.

Sec. 18.

Minnesota Statutes 2024, section 144.652, is amended by adding a subdivision
to read:

new text begin Subd. 3. new text end

new text begin Civil action. new text end

new text begin A resident injured by a violation of a right listed in section 144.651
based on the resident's actual or perceived sexual orientation, gender identity, gender
expression, intersex status, two-spirit identity, or actual or perceived HIV status may bring
a civil action to recover damages and costs and reasonable attorney fees.
new text end

Sec. 19.

new text begin [144A.045] TRAINING IN LGBTQIA2S+ AND HIV CULTURAL
COMPETENCY.
new text end

new text begin Subdivision 1. new text end

new text begin Training required. new text end

new text begin (a) All nursing homes must meet the training
requirements in this section for LGBTQIA2S+ and HIV cultural competency:
new text end

new text begin (1) supervisors of direct-care staff must have at least four hours of initial training on the
topics listed in section 144.505, subdivision 2, within six months of the employment start
date, and must have at least two hours of training on the topics listed in section 144.505,
subdivision 2, for every two years of employment thereafter;
new text end

new text begin (2) direct-care staff must have at least four hours of initial training on the topics listed
in section 144.505, subdivision 2, within six months of the employment start date, and must
have at least four hours of training on the topics listed in section 144.505, subdivision 2,
for every two years of employment thereafter; and
new text end

new text begin (3) non-direct-care staff must have at least two hours of initial training on the topics
listed in section 144.505, subdivision 2, within six months of the employment start date,
and must have at least two hours of training on the topics listed in section 144.505,
subdivision 2, for every two years of employment thereafter.
new text end

new text begin (b) A nursing home must implement a schedule to train existing staff on the topics listed
in section 144.505, subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Forms of training; other requirements. new text end

new text begin The training required under this
section may be in person or online and must satisfy the requirements in section 144.505,
subdivision 3. A staff person who completes in-person training or online training must
comply with the requirements for in-person training or online training, as applicable, in
section 144.505, subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Training provider. new text end

new text begin The training required under this section must be provided
by an entity that meets the requirements in section 144.505, subdivision 4.
new text end

new text begin Subd. 4. new text end

new text begin Approval of training program. new text end

new text begin The commissioner must establish a process
for the commissioner to review and approve a nursing home's proposed training program
under this section. The commissioner must approve a nursing home's proposed training
program within 90 days after the nursing home requests approval if:
new text end

new text begin (1) the nursing home submits with the request for approval, a statement of the
qualifications and training experience of the individual or entity providing the training; the
proposed method of providing the training, either in person or online; an outline of the
training; and copies of the materials used in the training; and
new text end

new text begin (2) the training meets the requirements in subdivisions 1 to 3.
new text end

new text begin Subd. 5. new text end

new text begin Documentation of training. new text end

new text begin The nursing home must retain evidence in the
employee record of each staff person having completed the training required by this section.
new text end

Sec. 20.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision
to read:

new text begin Subd. 24a. new text end

new text begin Gender expression. new text end

new text begin "Gender expression" has the meaning given in section
144.651, subdivision 2.
new text end

Sec. 21.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision
to read:

new text begin Subd. 24b. new text end

new text begin Gender identity. new text end

new text begin "Gender identity" has the meaning given in section 363A.03,
subdivision 50.
new text end

Sec. 22.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision
to read:

new text begin Subd. 24c. new text end

new text begin Gender nonconforming. new text end

new text begin "Gender nonconforming" has the meaning given
in section 144.651, subdivision 2.
new text end

Sec. 23.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision
to read:

new text begin Subd. 24d. new text end

new text begin Gender transition. new text end

new text begin "Gender transition" has the meaning given in section
144.651, subdivision 2.
new text end

Sec. 24.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision
to read:

new text begin Subd. 25a. new text end

new text begin Harass or harassment. new text end

new text begin "Harass" or "harassment" has the meaning given in
section 144.651, subdivision 2.
new text end

Sec. 25.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision
to read:

new text begin Subd. 25b. new text end

new text begin HIV. new text end

new text begin "HIV" has the meaning given in section 144.651, subdivision 2.
new text end

Sec. 26.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision
to read:

new text begin Subd. 28a. new text end

new text begin LGBTQIA2S+. new text end

new text begin "LGBTQIA2S+" has the meaning given in section 144.651,
subdivision 2.
new text end

Sec. 27.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision
to read:

new text begin Subd. 63a. new text end

new text begin Sexual orientation. new text end

new text begin "Sexual orientation" has the meaning given in section
363A.03, subdivision 44.
new text end

Sec. 28.

Minnesota Statutes 2024, section 144G.08, is amended by adding a subdivision
to read:

new text begin Subd. 70a. new text end

new text begin Transgender. new text end

new text begin "Transgender" has the meaning given in section 144.651,
subdivision 2.
new text end

Sec. 29.

Minnesota Statutes 2024, section 144G.31, subdivision 4, is amended to read:

Subd. 4.

Fine amounts.

(a) Fines and enforcement actions under this subdivision may
be assessed based on the level and scope of the violations described in subdivisions 2 and
3 as follows and new text begin , except as provided in clause (6), new text end may be imposed immediately with no
opportunity to correct the violation prior to imposition:

(1) Level 1, no fines or enforcement;

(2) Level 2, a fine of $500 per violation, in addition to any enforcement mechanism
authorized in section 144G.20 for widespread violations;

(3) Level 3, a fine of $3,000 per violation, in addition to any enforcement mechanism
authorized in section 144G.20;

(4) Level 4, a fine of $5,000 per violation, in addition to any enforcement mechanism
authorized in section 144G.20; deleted text begin and
deleted text end

(5) for maltreatment violations for which the licensee was determined to be responsible
for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000
per incident. A fine of $5,000 per incident may be imposed if the commissioner determines
the licensee is responsible for maltreatment consisting of sexual assault, death, or abuse
resulting in serious injury deleted text begin . deleted text end new text begin ; and
new text end

new text begin (6) for a substantial violation of a resident's rights in section 144G.90 related to the
resident's actual or perceived sexual orientation, gender identity, gender expression, intersex
status, two-spirit identity, or actual or perceived HIV status, or a substantial violation of a
resident's rights in section 144G.565, a fine of $1,000 per incident. The commissioner must
immediately impose a fine for a violation described in this clause without first providing
the facility with an opportunity to correct the violation.
new text end

(b) When a fine is assessed against a facility for substantiated maltreatment, the
commissioner shall not also impose an immediate fine under this chapter for the same
circumstance.

Sec. 30.

new text begin [144G.565] DENIAL OF ADMISSION, TRANSFER, DISCHARGE, OR
EVICTION ON CERTAIN GROUNDS PROHIBITED.
new text end

new text begin An assisted living facility must not refuse to admit an individual to a facility, transfer a
resident within the facility or to another facility, refuse to transfer a resident within the
facility or to another facility, or discharge or evict a resident based in whole or in part on
the resident's actual or perceived sexual orientation, gender identity, gender expression,
intersex status, two-spirit identity, or actual or perceived HIV status.
new text end

Sec. 31.

Minnesota Statutes 2024, section 144G.63, subdivision 7, is amended to read:

Subd. 7.

Verification and documentation of orientation and training.

The assisted
living facility shall retain evidence in the employee record of each staff person having
completed the orientation and training required by this section new text begin and section 144G.65 new text end .

Sec. 32.

new text begin [144G.65] TRAINING IN LGBTQIA2S+ AND HIV CULTURAL
COMPETENCY.
new text end

new text begin Subdivision 1. new text end

new text begin Training required. new text end

new text begin (a) All assisted living facilities must meet the training
requirements in this section for LGBTQIA2S+ and HIV cultural competency:
new text end

new text begin (1) supervisors of direct-care staff must have at least four hours of initial training on the
topics listed in section 144.505, subdivision 2, within six months of the employment start
date, and must have at least two hours of training on the topics listed in section 144.505,
subdivision 2, for every two years of employment thereafter;
new text end

new text begin (2) direct-care staff must have at least four hours of initial training on the topics listed
in section 144.505, subdivision 2, within six months of the employment start date, and must
have at least four hours of training on the topics listed in section 144.505, subdivision 2,
for every two years of employment thereafter; and
new text end

new text begin (3) non-direct-care staff must have at least two hours of initial training on the topics
listed in section 144.505, subdivision 2, within six months of the employment start date,
and must have at least two hours of training on the topics listed in section 144.505,
subdivision 2, for every two years of employment thereafter.
new text end

new text begin (b) An assisted living facility must implement a schedule to train existing staff on the
topics listed in section 144.505, subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Forms of training; other requirements. new text end

new text begin The training required under this
section may be in person or online and must satisfy the requirements in section 144.505,
subdivision 3. A staff person who completes in-person training or online training must
comply with the requirements for in-person training or online training, as applicable, in
section 144.505, subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Training provider. new text end

new text begin The training required under this section must be provided
by an entity that meets the requirements in section 144.505, subdivision 4.
new text end

new text begin Subd. 4. new text end

new text begin Approval of training program. new text end

new text begin The commissioner must establish a process
for the commissioner to review and approve a facility's proposed training program under
this section. The commissioner must approve a facility's proposed training program within
90 days after the facility requests approval if:
new text end

new text begin (1) the facility submits with the request for approval, a statement of the qualifications
and training experience of the individual or entity providing the training; the proposed
method of providing the training, either in person or online; an outline of the training; and
copies of the materials used in the training; and
new text end

new text begin (2) the training meets the requirements in subdivisions 1 to 3.
new text end

Sec. 33.

Minnesota Statutes 2024, section 144G.90, subdivision 1, is amended to read:

Subdivision 1.

Assisted living bill of rights; new text begin nondiscrimination notice; new text end notification
to resident.

(a) An assisted living facility must provide the resident a written notice of the
rights under section 144G.91 before the initiation of services to that resident. The facility
shall make all reasonable efforts to provide notice of the rights to the resident in a language
the resident can understand.

(b) In addition to the text of the assisted living bill of rights in section 144G.91, the
notice shall also contain the following statement describing how to file a complaint or report
suspected abuse:

"If you want to report suspected abuse, neglect, or financial exploitation, you may contact
the Minnesota Adult Abuse Reporting Center (MAARC). If you have a complaint about
the facility or person providing your services, you may contact the Office of Health Facility
Complaints, Minnesota Department of Health. If you would like to request advocacy services,
you may contact the Office of Ombudsman for Long-Term Care or the Office of Ombudsman
for Mental Health and Developmental Disabilities."

new text begin (c) The notice must also contain the following statement regarding nondiscrimination:
new text end

new text begin "[Name of provider] will not discriminate against residents, and does not permit
discrimination against residents, including but not limited to bullying, abuse, or harassment,
on the basis of actual or perceived sexual orientation, gender identity, gender expression,
intersex status, two-spirit identity, or actual or perceived HIV status, or based on association
with another individual on account of that individual's actual or perceived sexual orientation,
gender identity, gender expression, intersex status, two-spirit identity, or actual or perceived
HIV status. You may file a complaint with the Office of Health Facility Complaints or the
Office of Ombudsman for Long-Term Care if you believe that you have experienced this
kind of discrimination."
new text end

deleted text begin (c) deleted text end new text begin (d) new text end The statement must include contact information for the Minnesota Adult Abuse
Reporting Center and the telephone number, website address, email address, mailing address,
and street address of the Office of Health Facility Complaints at the Minnesota Department
of Health, the Office of Ombudsman for Long-Term Care, and the Office of Ombudsman
for Mental Health and Developmental Disabilities. The statement must include the facility's
name, address, email, telephone number, and name or title of the person at the facility to
whom problems or complaints may be directed. It must also include a statement that the
facility will not retaliate because of a complaint.

deleted text begin (d) deleted text end new text begin (e) new text end A facility must obtain written acknowledgment from the resident of the resident's
receipt of the assisted living bill of rights or shall document why an acknowledgment cannot
be obtained. Acknowledgment of receipt shall be retained in the resident's record.

Sec. 34.

Minnesota Statutes 2024, section 144G.91, subdivision 4, is amended to read:

Subd. 4.

Appropriate care and services.

(a) Residents have the right to care and assisted
living services that are appropriate based on the resident's needs and according to an
up-to-date service plan subject to accepted health care standards.

(b) Residents have the right to receive health care and other assisted living services with
continuity from people who are properly trained and competent to perform their duties and
in sufficient numbers to adequately provide the services agreed to in the assisted living
contract and the service plan.

new text begin (c) Residents have the right to health care and personal care, including medication, that
is appropriate to the resident's organs and bodily needs and have the right to not be provided
with medical care or personal care that, to a similarly situated, reasonable person, unduly
demeans the resident's dignity or causes avoidable discomfort. A facility must not refuse
or willfully fail to provide any health care, personal care, or reasonable accommodation to
a resident based on the resident's actual or perceived sexual orientation, gender identity,
gender expression, intersex status, two-spirit identity, or actual or perceived HIV status.
new text end

new text begin (d) Transgender residents have the right to be provided with access to any assessments,
therapies, and treatments that are recommended by the resident's health care provider,
including but not limited to transgender-related medical care, hormone therapy, and
supportive counseling.
new text end

Sec. 35.

Minnesota Statutes 2024, section 144G.91, subdivision 5, is amended to read:

Subd. 5.

Refusal of care or services.

Residents have the right to refuse care or assisted
living services and to be informed by the facility of the medical, health-related, or
psychological consequences of refusing care or services. new text begin LGBTQIA2S+ residents, residents
living with HIV, and residents receiving treatment for HIV have the right to refuse to be
examined, observed, or treated by facility staff when the primary purpose is educational or
informational rather than therapeutic, and this refusal shall not diminish the resident's ability
to access care for diagnosis or treatment.
new text end

Sec. 36.

Minnesota Statutes 2024, section 144G.91, is amended by adding a subdivision
to read:

new text begin Subd. 7a. new text end

new text begin Chosen name and pronouns; gender identity. new text end

new text begin A resident has the right to be
free from having others repeatedly, knowingly, and willfully refuse to use the resident's
chosen name or pronouns after being reasonably informed of the resident's chosen name
and pronouns. The facility and facility staff must not refuse to use a resident's chosen name
and pronouns based on the resident's actual or perceived sexual orientation, gender identity,
gender expression, intersex status, or two-spirit identity. A resident has the right to have
the resident's oral or written attestation of the resident's gender identity accepted by a facility
and facility staff, and a facility or facility staff must not require a resident to provide proof
of the resident's gender identity using any form of identification.
new text end

Sec. 37.

Minnesota Statutes 2024, section 144G.91, is amended by adding a subdivision
to read:

new text begin Subd. 8a. new text end

new text begin Reasonable action to prevent discrimination or harassment. new text end

new text begin A facility
must take reasonable actions within the facility's control to prevent discrimination or
harassment against a resident by all individuals present in the facility, including but not
limited to staff, contractors, and other residents, based on the resident's actual or perceived
sexual orientation, gender identity, gender expression, intersex status, two-spirit identity,
or actual or perceived HIV status, when the facility knows or should know about the
discrimination or harassment.
new text end

Sec. 38.

Minnesota Statutes 2024, section 144G.91, subdivision 10, is amended to read:

Subd. 10.

Individual autonomy.

new text begin (a) new text end Residents have the right to individual autonomy,
initiative, and independence in making life choices, including establishing a daily schedule
and choosing with whom to interact. new text begin A facility must not, based on the resident's actual or
perceived sexual orientation, gender identity, gender expression, intersex status, two-spirit
identity, or actual or perceived HIV status, restrict a resident's right to associate with other
residents or visitors, including the right to consensual sexual relations or to displays of
physical affection, unless the restriction is uniformly applied to all residents in a
nondiscriminatory manner.
new text end

new text begin (b) Residents have the right to wear clothing, accessories, and cosmetics and engage in
grooming practices that are permitted to any other resident and a facility and facility staff
must not limit these rights based on the resident's actual or perceived sexual orientation,
gender identity, gender expression, intersex status, or two-spirit identity.
new text end

Sec. 39.

Minnesota Statutes 2024, section 144G.91, subdivision 12, is amended to read:

Subd. 12.

Visitors and social participation.

(a) Residents have the right to meet with
or receive visits at any time by the resident's family, guardian, conservator, health care
agent, attorney, advocate, or religious or social work counselor, or any person of the resident's
choosing. deleted text begin This right deleted text end new text begin A resident living with HIV or perceived to be living with HIV must
not be isolated by facility staff due to the resident's actual or perceived HIV status, including
but not limited to limiting the resident to the resident's unit, limiting areas of the facility
where the resident is permitted to go, or limiting which restrooms the resident is permitted
to use. The rights in this paragraph new text end may be restricted in certain circumstances if necessary
for the resident's health and safety and if documented in the resident's service plan.

(b) Residents have the right to engage in community life and in activities of their choice.
This includes the right to participate in commercial, religious, social, community, and
political activities without interference and at their discretion if the activities do not infringe
on the rights of other residents.

Sec. 40.

Minnesota Statutes 2024, section 144G.91, is amended by adding a subdivision
to read:

new text begin Subd. 12a. new text end

new text begin Restrooms. new text end

new text begin A resident has the right to use any restroom that is available for
use by other residents of the same gender identity as the resident, regardless of whether the
resident is making a gender transition, has taken or is taking hormones, has undergone
gender affirmation surgery, or presents as gender nonconforming. A resident has the right
to not be harassed for seeking to use or using a restroom that is available for use by other
residents of the same gender identity as the resident.
new text end

Sec. 41.

Minnesota Statutes 2024, section 144G.91, subdivision 13, is amended to read:

Subd. 13.

Personal and treatment privacy.

(a) Residents have the right to consideration
of their privacy, individuality, and cultural identity as related to their social, religious, and
psychological well-being. Staff must respect the privacy of a resident's space by knocking
on the door and seeking consent before entering, except in an emergency or unless otherwise
documented in the resident's service plan.

(b) Residents have the right to have and use a lockable door to the resident's unit. The
facility shall provide locks on the resident's unit. Only a staff member with a specific need
to enter the unit shall have keys. This right may be restricted in certain circumstances if
necessary for a resident's health and safety and documented in the resident's service plan.

(c) Residents have the right to respect and privacy regarding the resident's service plan.
Case discussion, consultation, examination, and treatment are confidential and must be
conducted discreetly. new text begin Persons not directly involved in providing personal care, medical care,
social support, or administrative support to a transgender resident, gender-nonconforming
resident, resident living with HIV, or resident receiving treatment for HIV must not be
present during case discussions, physical examinations, treatment, or personal care for that
resident without the resident's express permission. new text end Privacy must be respected during toileting,
bathing, and other activities of personal hygiene, except as needed for resident safety or
assistance. new text begin A facility must use doors, curtains, screens, or other effective visual barriers to
provide bodily privacy to transgender residents, gender-nonconforming residents, residents
living with HIV, and residents receiving treatment for HIV whenever the residents are
partially or fully unclothed.
new text end

Sec. 42.

Minnesota Statutes 2024, section 144G.91, subdivision 15, is amended to read:

Subd. 15.

Confidentiality of records.

(a) Residents have the right to have personal,
financial, health, and medical information kept private, to approve or refuse release of
information to any outside party, and to be advised of the assisted living facility's policies
and procedures regarding disclosure of the information. Residents must be notified when
personal records are requested by any outside party.

(b) Residents have the right to access their own records.

new text begin (c) Residents have the right to have the facility not disclose any personally identifiable
information regarding whether a resident is LGBTQIA2S+, a resident's gender transition
status, or a resident's HIV status or perceived HIV status. A facility must take appropriate
steps to minimize the likelihood of inadvertent or accidental disclosure of this information
to other residents, visitors, or staff, except to the minimum extent necessary for staff to
perform their duties.
new text end

Sec. 43.

Minnesota Statutes 2024, section 144G.91, subdivision 17, is amended to read:

Subd. 17.

Right to choose roommate new text begin ; room and unit assignments new text end .

new text begin (a) new text end Residents have
the right to choose a roommate if sharing a unit new text begin , and two consenting residents shall be
permitted to share a room new text end .

new text begin (b) If units or rooms are assigned by gender, a transgender resident or LGBTQIA2S+
resident must not be reassigned to a room or unit or be refused a room or unit assignment
other than in accordance with the resident's gender identity, unless so requested by the
resident or required by federal law.
new text end

Sec. 44.

new text begin [144G.915] CIVIL ACTION.
new text end

new text begin A resident injured by a violation of a right listed in section 144G.91 based on the resident's
actual or perceived sexual orientation, gender identity, gender expression, intersex status,
two-spirit identity, or actual or perceived HIV status may bring a civil action to recover
damages and costs and reasonable attorney fees.
new text end

Sec. 45.

Minnesota Statutes 2024, section 256.9742, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Training. new text end

new text begin The ombudsman and representatives of the office must complete
LGBTQIA2S+ and HIV cultural competency training within six months after appointment
or the employment start date and every two years thereafter. Initial training completed by
the ombudsman and representatives of the office must address at least the topics listed in
section 144.505, subdivision 2, and subsequent trainings must at least address the topics
listed in section 144.505, subdivision 2, clauses (3) and (5). The ombudsman must implement
a schedule to train the current ombudsman and existing representatives of the office on at
least the topics listed in section 144.505, subdivision 2.
new text end

Sec. 46. new text begin APPROPRIATIONS; TRAINING IN LGBTQIA2S+ AND HIV CULTURAL
COMPETENCY.
new text end

new text begin (a) $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the
general fund to the commissioner of health for grants to eligible organizations to develop
and provide LGBTQIA2S+ and HIV cultural competency training under Minnesota Statutes,
sections 144.505, 144A.045, and 144G.65.
new text end

new text begin (b) $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the
general fund to the commissioner of human services for a grant to an eligible organization
to develop and provide LGBTQIA2S+ and HIV cultural competency training under
Minnesota Statutes, section 256.9742, subdivision 7.
new text end

ARTICLE 2

LGBTQIA2S+ AND HIV HOME AND COMMUNITY-BASED SERVICES BILL
OF RIGHTS

Section 1. new text begin TITLE.
new text end

new text begin This article may be cited as the LGBTQIA2S+ and HIV home and community-based
services bill of rights.
new text end

Sec. 2.

Minnesota Statutes 2024, section 144A.43, is amended by adding a subdivision to
read:

new text begin Subd. 2f. new text end

new text begin Gender-affirming care. new text end

new text begin "Gender-affirming care" has the meaning given in
section 62Q.585, subdivision 3.
new text end

Sec. 3.

Minnesota Statutes 2024, section 144A.43, is amended by adding a subdivision to
read:

new text begin Subd. 2g. new text end

new text begin Gender expression. new text end

new text begin "Gender expression" has the meaning given in section
144.651, subdivision 2.
new text end

Sec. 4.

Minnesota Statutes 2024, section 144A.43, is amended by adding a subdivision to
read:

new text begin Subd. 2h. new text end

new text begin Gender identity. new text end

new text begin "Gender identity" has the meaning given in section 363A.03,
subdivision 50.
new text end

Sec. 5.

Minnesota Statutes 2024, section 144A.43, is amended by adding a subdivision to
read:

new text begin Subd. 2i. new text end

new text begin HIV. new text end

new text begin "HIV" means the human immunodeficiency virus.
new text end

Sec. 6.

Minnesota Statutes 2024, section 144A.43, is amended by adding a subdivision to
read:

new text begin Subd. 5a. new text end

new text begin LGBTQIA2S+. new text end

new text begin "LGBTQIA2S+" has the meaning given in section 144.651,
subdivision 2.
new text end

Sec. 7.

Minnesota Statutes 2024, section 144A.43, is amended by adding a subdivision to
read:

new text begin Subd. 27a. new text end

new text begin Sexual orientation. new text end

new text begin "Sexual orientation" has the meaning given in section
363A.03, subdivision 44.
new text end

Sec. 8.

Minnesota Statutes 2024, section 144A.43, is amended by adding a subdivision to
read:

new text begin Subd. 34a. new text end

new text begin Transgender. new text end

new text begin "Transgender" has the meaning given in section 144.651,
subdivision 2.
new text end

Sec. 9.

Minnesota Statutes 2024, section 144A.44, subdivision 1, is amended to read:

Subdivision 1.

Statement of rights.

(a) A client who receives home care services in the
community or in an assisted living facility licensed under chapter 144G has these rights:

(1) receive new text begin oral and new text end written information, in plain language new text begin and in a language the client
understands new text end , about rights before receiving services, including what to do if rights are violated;

(2) receive care and services according to a suitable and up-to-date plan, and subject to
accepted health care, medical or nursing standards and person-centered care, to take an
active part in developing, modifying, and evaluating the plan and services;

(3) new text begin receive HIV-related treatment as prescribed, gender-affirming care, gender-affirming
mental health care, and medical and nonmedical care that is appropriate to a client's organs
and bodily needs; not have the client's dignity demeaned or cause the client avoidable
discomfort; and not have medical or nonmedical care denied or curtailed because of the
client's actual or perceived sexual orientation, gender identity, gender expression, intersex
status, two-spirit identity, or actual or perceived HIV status;
new text end

new text begin (4) new text end be told before receiving services the type and disciplines of staff who will be providing
the services, new text begin whether the staff who will provide the services completed the required
LGBTQIA2S+ and HIV cultural competency training, new text end the frequency of visits proposed to
be furnished, other choices that are available for addressing home care needs, and the
potential consequences of refusing these services;

deleted text begin (4) deleted text end new text begin (5) new text end be told in advance of any recommended changes by the provider in the service
plan and to take an active part in any decisions about changes to the service plan;

deleted text begin (5) deleted text end new text begin (6) new text end refuse services or treatment new text begin , including experimental HIV treatment or
gender-affirming care new text end ;

deleted text begin (6) deleted text end new text begin (7) new text end know, before receiving services or during the initial visit, any limits to the services
available from a home care provider;

deleted text begin (7) deleted text end new text begin (8) new text end be told before services are initiated what the provider charges for the services;
to what extent payment may be expected from health insurance, public programs, or other
sources, if known; deleted text begin and deleted text end what charges the client may be responsible for paying; new text begin and whether
charges and payments may be impacted by the client's sexual orientation, gender identity,
gender expression, intersex status, two-spirit identity, or actual or perceived HIV status;
new text end

deleted text begin (8) deleted text end new text begin (9) new text end know that there may be other services available in the community, including
other home care services and providers, and to know where to find information about these
services;

deleted text begin (9) deleted text end new text begin (10) new text end choose freely among available providers and to change providers after services
have begun, within the limits of health insurance, long-term care insurance, medical
assistance, other health programs, or public programs;

deleted text begin (10) deleted text end new text begin (11) new text end have personal, financial, and medical information new text begin , including but not limited
to information on the client's sexual orientation, gender identity, gender expression, intersex
status, two-spirit identity, or HIV status, new text end kept private, and to be advised of the provider's
policies and procedures regarding disclosure of such information;

deleted text begin (11) deleted text end new text begin (12) new text end access the client's own records and written information from those records in
accordance with sections 144.291 to 144.298;

deleted text begin (12) deleted text end new text begin (13) new text end be served by people who are properly trained new text begin , have completed the training
required under section 144A.4796, new text end and new text begin are new text end competent to perform their duties;

deleted text begin (13) deleted text end new text begin (14) new text end be treated with courtesy and respect, new text begin to be free from having others repeatedly,
knowingly, and willfully refuse to use the client's chosen name and pronouns after being
reasonably informed of the client's chosen name and pronouns, new text end and to have the client's
property treated with respect;

deleted text begin (14) deleted text end new text begin (15) new text end be free from physical and verbal abuse, neglect, financial exploitation, and all
forms of maltreatment covered under the Vulnerable Adults Act and the Maltreatment of
Minors Act;

new text begin (16) be free from discrimination based on race; color; religion; sex; gender identity;
gender expression; two-spirit identity; intersex status; actual or perceived sexual orientation;
marital status; medical condition, including actual or perceived HIV status; military or
veteran status; national origin; ancestry; disability; genetic information; age; receipt of
HIV-related treatment; or receipt of gender-affirming care or gender-affirming mental health
care;
new text end

new text begin (17) be free from discrimination based on private and personal items belonging to the
client, including but not limited to photographs, letters, mail, clothing, toiletries, and décor;
and be free to wear clothing, accessories, and cosmetics of the client's choosing;
new text end

new text begin (18) be free to have visitors of the client's choice; to restrict or prohibit visitors, including
members of the client's biological family; to have the client's visitors be free from
discrimination as provided in clause (16); and to have consensual sexual relations;
new text end

new text begin (19) be free to have privacy, with or without visitors, at times of the client's choosing;
new text end

deleted text begin (15) deleted text end new text begin (20) new text end reasonable, advance notice of changes in services or charges;

deleted text begin (16) deleted text end new text begin (21) new text end know the provider's reason for termination of services;

deleted text begin (17) deleted text end new text begin (22) new text end at least ten calendar days' advance notice of the termination of a service by a
home care provider, except at least 30 calendar days' advance notice of the service termination
shall be given by a home care provider for services provided to a client residing in an assisted
living facility as defined in section 144G.08, subdivision 7. This clause does not apply in
cases where:

(i) the client engages in conduct that significantly alters the terms of the service plan
with the home care provider;

(ii) the client, person who lives with the client, or others create an abusive or unsafe
work environment for the person providing home care services; or

(iii) an emergency or a significant change in the client's condition has resulted in service
needs that exceed the current service plan and that cannot be safely met by the home care
provider;

deleted text begin (18) deleted text end new text begin (23) new text end a coordinated transfer when there will be a change in the provider of services;

deleted text begin (19) deleted text end new text begin (24) new text end complain to staff and others of the client's choice about services that are
provided, or fail to be provided, new text begin discrimination experienced by the client, new text end and the lack of
courtesy or respect to the client or the client's property and the right to recommend changes
in policies and services, free from retaliation including the threat of termination of services;

deleted text begin (20) deleted text end new text begin (25) new text end know how to contact an individual associated with the home care provider
who is responsible for handling problems and to have the home care provider investigate
and attempt to resolve the grievance or complaint;

deleted text begin (21) deleted text end new text begin (26) new text end know the name and address of the state or county agency to contact for
additional information or assistance;

deleted text begin (22) deleted text end new text begin (27) new text end assert these rights personally, or have them asserted by the client's representative
or by anyone on behalf of the client, without retaliation; and

deleted text begin (23) deleted text end new text begin (28) new text end place an electronic monitoring device in the client's or resident's space in
compliance with state requirements.

(b) When providers violate the rights in this section, they are subject to the fines and
license actions in sections 144A.474, subdivision 11, and 144A.475.

(c) Providers must do all of the following:

(1) encourage and assist in the fullest possible exercise of these rights;

(2) provide the names and telephone numbers of individuals and organizations that
provide advocacy and legal services for clients and residents seeking to assert their rights;

(3) make every effort to assist clients or residents in obtaining information regarding
whether Medicare, medical assistance, other health programs, or public programs will pay
for services;

(4) make reasonable accommodations for people who have communication disabilities,
or those who speak a language other than English; and

(5) provide all information and notices in plain language and in terms the client or
resident can understand.

(d) No provider may require or request a client or resident to waive any of the rights
listed in this section at any time or for any reasons, including as a condition of initiating
services or entering into an assisted living contract.

Sec. 10.

Minnesota Statutes 2024, section 144A.44, is amended by adding a subdivision
to read:

new text begin Subd. 3. new text end

new text begin Civil action. new text end

new text begin A client injured by a violation of this section, based on the client's
actual or perceived sexual orientation, gender identity, gender expression, intersex status,
two-spirit identity, or actual or perceived HIV status, may bring a civil action to recover
damages and costs and reasonable attorney fees.
new text end

Sec. 11.

Minnesota Statutes 2024, section 144A.472, subdivision 1, is amended to read:

Subdivision 1.

License applications.

Each application for a home care provider license
must include information sufficient to show that the applicant meets the requirements of
licensure, including:

(1) the applicant's name, email address, physical address, and mailing address, including
the name of the county in which the applicant resides and has a principal place of business;

(2) the initial license fee in the amount specified in subdivision 7;

(3) the email address, physical address, mailing address, and telephone number of the
principal administrative office;

(4) the email address, physical address, mailing address, and telephone number of each
branch office, if any;

(5) the names, email and mailing addresses, and telephone numbers of all owners and
managerial officials;

(6) documentation of compliance with the background study requirements of section
144A.476 for all persons involved in the management, operation, or control of the home
care provider;

(7) documentation of a background study as required by section 144.057 for any
individual seeking employment, paid or volunteer, with the home care provider;

(8) evidence of workers' compensation coverage as required by sections 176.181 and
176.182;

(9) documentation of liability coverage, if the provider has it;

(10) identification of the license level the provider is seeking;

(11) documentation that identifies the managerial official who is in charge of day-to-day
operations and attestation that the person has reviewed and understands the home care
provider regulations;

(12) documentation that the applicant has designated one or more owners, managerial
officials, or employees as an agent or agents, which shall not affect the legal responsibility
of any other owner or managerial official under this chapter;

(13) the signature of the officer or managing agent on behalf of an entity, corporation,
association, or unit of government;

(14) verification that the applicant has the following policies and procedures in place so
that if a license is issued, the applicant will implement the policies and procedures and keep
them current:

(i) requirements in chapter 260E, reporting of maltreatment of minors, and section
626.557, reporting of maltreatment of vulnerable adults;

(ii) conducting and handling background studies on employees;

(iii) orientation, training, and competency evaluations of home care staff, and a process
for evaluating staff performance;

(iv) handling complaints from clients, family members, or client representatives regarding
staff or services provided by staff;

(v) conducting initial evaluation of clients' needs and the providers' ability to provide
those services;

(vi) conducting initial and ongoing client evaluations and assessments and how changes
in a client's condition are identified, managed, and communicated to staff and other health
care providers as appropriate;

(vii) orientation to and implementation of the home care client bill of rights;

(viii) infection control practices;

(ix) reminders for medications, treatments, or exercises, if provided; and

(x) conducting appropriate screenings, or documentation of prior screenings, to show
that staff are free of tuberculosis, consistent with current United States Centers for Disease
Control and Prevention standards; deleted text begin and
deleted text end

new text begin (15) for an applicant with 25 or more employees, the name of the applicant's chief
diversity officer; and
new text end

deleted text begin (15) deleted text end new text begin (16) new text end other information required by the department.

Sec. 12.

Minnesota Statutes 2024, section 144A.474, subdivision 11, is amended to read:

Subd. 11.

Fines.

(a) Fines and enforcement actions under this subdivision may be assessed
based on the level and scope of the violations described in paragraph (b) and new text begin , except as
provided in clause (7), new text end imposed immediately with no opportunity to correct the violation
first as follows:

(1) Level 1, no fines or enforcement;

(2) Level 2, a fine of $500 per violation, in addition to any of the enforcement
mechanisms authorized in section 144A.475 for widespread violations;

(3) Level 3, a fine of $3,000 per incident, in addition to any of the enforcement
mechanisms authorized in section 144A.475;

(4) Level 4, a fine of $5,000 per incident, in addition to any of the enforcement
mechanisms authorized in section 144A.475;

(5) for maltreatment violations for which the licensee was determined to be responsible
for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000.
A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible
for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury;
deleted text begin and
deleted text end

(6) the fines in clauses (1) to (4) are increased and immediate fine imposition is authorized
for both surveys and investigations conducted deleted text begin . deleted text end new text begin ; and
new text end

new text begin (7) for a substantial violation of a client's rights in section 144A.44 related to the client's
actual or perceived sexual orientation, gender identity, gender expression, intersex status,
two-spirit identity, or actual or perceived HIV status, a fine of $1,000 per incident. The
commissioner must immediately impose a fine for a violation described in this clause without
first providing the home care provider with an opportunity to correct the violation.
new text end

When a fine is assessed against a facility for substantiated maltreatment, the commissioner
shall not also impose an immediate fine under this chapter for the same circumstance.

(b) Correction orders for violations are categorized by both level and scope and fines
shall be assessed as follows:

(1) level of violation:

(i) Level 1 is a violation that has no potential to cause more than a minimal impact on
the client and does not affect health or safety;

(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential
to have harmed a client's health or safety, but was not likely to cause serious injury,
impairment, or death;

(iii) Level 3 is a violation that harmed a client's health or safety, not including serious
injury, impairment, or death, or a violation that has the potential to lead to serious injury,
impairment, or death; and

(iv) Level 4 is a violation that results in serious injury, impairment, or death;

(2) scope of violation:

(i) isolated, when one or a limited number of clients are affected or one or a limited
number of staff are involved or the situation has occurred only occasionally;

(ii) pattern, when more than a limited number of clients are affected, more than a limited
number of staff are involved, or the situation has occurred repeatedly but is not found to be
pervasive; and

(iii) widespread, when problems are pervasive or represent a systemic failure that has
affected or has the potential to affect a large portion or all of the clients.

(c) If the commissioner finds that the applicant or a home care provider has not corrected
violations by the date specified in the correction order or conditional license resulting from
a survey or complaint investigation, the commissioner shall provide a notice of
noncompliance with a correction order by email to the applicant's or provider's last known
email address. The noncompliance notice must list the violations not corrected.

(d) For every violation identified by the commissioner, the commissioner shall issue an
immediate fine pursuant to paragraph (a), clause (6). The license holder must still correct
the violation in the time specified. The issuance of an immediate fine can occur in addition
to any enforcement mechanism authorized under section 144A.475. The immediate fine
may be appealed as allowed under this subdivision.

(e) The license holder must pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies by paying the fine. A
timely appeal shall stay payment of the fine until the commissioner issues a final order.

(f) A license holder shall promptly notify the commissioner in writing when a violation
specified in the order is corrected. If upon reinspection the commissioner determines that
a violation has not been corrected as indicated by the order, the commissioner may issue a
second fine. The commissioner shall notify the license holder by mail to the last known
address in the licensing record that a second fine has been assessed. The license holder may
appeal the second fine as provided under this subdivision.

(g) A home care provider that has been assessed a fine under this subdivision has a right
to a reconsideration or a hearing under this section and chapter 14.

(h) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder shall be liable for payment of the fine.

(i) In addition to any fine imposed under this section, the commissioner may assess a
penalty amount based on costs related to an investigation that results in a final order assessing
a fine or other enforcement action authorized by this chapter.

(j) Fines collected under paragraph (a), clauses (1) to (4), shall be deposited in a dedicated
special revenue account. On an annual basis, the balance in the special revenue account
shall be appropriated to the commissioner to implement the recommendations of the advisory
council established in section 144A.4799.

(k) Fines collected under paragraph (a), clause (5), shall be deposited in a dedicated
special revenue account and appropriated to the commissioner to provide compensation
according to subdivision 14 to clients subject to maltreatment. A client may choose to receive
compensation from this fund, not to exceed $5,000 for each substantiated finding of
maltreatment, or take civil action. This paragraph expires July 31, 2021.

Sec. 13.

Minnesota Statutes 2024, section 144A.4791, subdivision 1, is amended to read:

Subdivision 1.

Home care bill of rights; notification to client.

(a) The home care
provider shall provide the client or the client's representative a written notice of the rights
under section 144A.44 before the date that services are first provided to that client. The
provider deleted text begin shall make all reasonable efforts to deleted text end new text begin must new text end provide notice of the rights to the client
or the client's representative in a language the client or client's representative can understand.

(b) In addition to the text of the home care bill of rights in section 144A.44, subdivision
1, the notice shall also contain the following statement describing how to file a complaint
with these offices.

"If you have a complaint about the provider or the person providing your home care
services, you may call, write, or visit the Office of Health Facility Complaints, Minnesota
Department of Health. You may also contact the Office of Ombudsman for Long-Term
Care or the Office of Ombudsman for Mental Health and Developmental Disabilities."

The statement should include the telephone number, website address, email address,
mailing address, and street address of the Office of Health Facility Complaints at the
Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care, and
the Office of the Ombudsman for Mental Health and Developmental Disabilities. The
statement should also include the home care provider's name, address, email, telephone
number, and name or title of the person at the provider to whom problems or complaints
may be directed. It must also include a statement that the home care provider will not retaliate
because of a complaint.

new text begin (c) The notice must also contain the following statement regarding nondiscrimination:
new text end

new text begin "[Name of provider] will not discriminate against clients, and does not permit
discrimination against clients, including but not limited to bullying, abuse, or harassment,
on the basis of actual or perceived sexual orientation, gender identity, gender expression,
intersex status, two-spirit identity, or actual or perceived HIV status, or based on association
with another individual on account of that individual's actual or perceived sexual orientation,
gender identity, gender expression, intersex status, two-spirit identity, or actual or perceived
HIV status. You may file a complaint with the Office of Health Facility Complaints at the
Minnesota Department of Health, Office of Ombudsman for Long-Term Care, or Office of
Ombudsman for Mental Health and Developmental Disabilities if you believe that you have
experienced this kind of discrimination."
new text end

new text begin The statement must include the contact information for the departments and offices to
which complaints may be filed.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end The home care provider shall obtain written acknowledgment of the client's receipt
of the home care bill of rights new text begin and the statements required under paragraphs (b) and (c) new text end or
shall document why an acknowledgment cannot be obtained. The acknowledgment may be
obtained from the client or the client's representative. Acknowledgment of receipt shall be
retained in the client's record.

Sec. 14.

Minnesota Statutes 2024, section 144A.4791, subdivision 11, is amended to read:

Subd. 11.

Client complaint and investigative process.

(a) The home care provider
must have a written policy and system for receiving, investigating, reporting, and attempting
to resolve complaints from its clients or clients' representatives new text begin , and communicating with
clients about how the home care provider will resolve complaints new text end . The policy should clearly
identify the process by which clients may file a complaint or concern about home care
services and an explicit statement that the home care provider will not discriminate or
retaliate against a client for expressing concerns or complaints. A home care provider must
have a process in place to conduct investigations of complaints made by the client or the
client's representative about the services in the client's plan that are or are not being provided
or other items covered in the client's home care bill of rights. This complaint system must
provide reasonable accommodations for any special needs of the client or client's
representative if requested. new text begin Within seven days after receiving a complaint from a client or
client representative, the home care provider must provide the client or client representative
with written information on how the home care provider plans to resolve the complaint.
new text end

(b) The home care provider must document the complaint, name of the client,
investigation, and resolution of each complaint filed. The home care provider must maintain
a record of all activities regarding complaints received, including the date the complaint
was received, and the home care provider's investigation and resolution of the complaint.
This complaint record must be kept for each event for at least two years after the date of
entry and must be available to the commissioner for review.

(c) The required complaint system must provide for written notice to each client or
client's representative that includes:

(1) the client's right to complain to the home care provider about the services received;

(2) the name or title of the person or persons with the home care provider to contact with
complaints;

(3) the method of submitting a complaint to the home care provider; and

(4) a statement that the provider is prohibited against retaliation according to paragraph
(d).

(d) A home care provider must not take any action that negatively affects a client in
retaliation for a complaint made or a concern expressed by the client or the client's
representative.

Sec. 15.

Minnesota Statutes 2024, section 144A.4791, is amended by adding a subdivision
to read:

new text begin Subd. 15. new text end

new text begin Arbitration. new text end

new text begin No home care provider may include an arbitration provision in
a contract for home care services or otherwise require a client or prospective client, as a
condition of initiating or continuing home care services, to agree to arbitration to address
disputes regarding home care services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2025, and applies to contracts
entered into on or after that date.
new text end

Sec. 16.

Minnesota Statutes 2024, section 144A.4796, subdivision 2, is amended to read:

Subd. 2.

Content.

(a) The orientation must contain the following topics:

(1) an overview of sections 144A.43 to 144A.4798;

(2) introduction and review of all the provider's policies and procedures related to the
provision of home care services by the individual staff person;

(3) handling of emergencies and use of emergency services;

(4) compliance with and reporting of the maltreatment of minors or vulnerable adults
under section 626.557 and chapter 260E;

(5) home care bill of rights under section 144A.44;

(6) handling of clients' complaints, reporting of complaints, and where to report
complaints including information on the Office of Health Facility Complaints and the
Common Entry Point;

(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
Ombudsman at the Department of Human Services, county managed care advocates, or
other relevant advocacy services; deleted text begin and
deleted text end

(8) review of the types of home care services the employee will be providing and the
provider's scope of licensure deleted text begin . deleted text end new text begin ; and
new text end

new text begin (9) LGBTQIA2S+ and HIV cultural competency according to subdivision 5a.
new text end

(b) In addition to the topics listed in paragraph (a), orientation may also contain training
on providing services to clients with hearing loss. Any training on hearing loss provided
under this subdivision must be high quality and research-based, may include online training,
and must include training on one or more of the following topics:

(1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
and challenges it poses to communication;

(2) health impacts related to untreated age-related hearing loss, such as increased
incidence of dementia, falls, hospitalizations, isolation, and depression; or

(3) information about strategies and technology that may enhance communication and
involvement, including communication strategies, assistive listening devices, hearing aids,
visual and tactile alerting devices, communication access in real time, and closed captions.

Sec. 17.

Minnesota Statutes 2024, section 144A.4796, is amended by adding a subdivision
to read:

new text begin Subd. 5a. new text end

new text begin LGBTQIA2S+ and HIV cultural competency training. new text end

new text begin (a) A home care
provider's employees and contractors must complete LGBTQIA2S+ and HIV cultural
competency training. At a minimum, this training must address:
new text end

new text begin (1) terms and language commonly used by members of the LGBTQIA2S+ community
and people living with HIV, including but not limited to sexual orientation, gender identity,
gender expression, intersex status, and HIV status;
new text end

new text begin (2) the health and social challenges historically experienced by members of the
LGBTQIA2S+ community and people living with HIV, including discrimination when
seeking or receiving care and the physical and mental health effects associated with this
discrimination;
new text end

new text begin (3) best practices for communicating with or about the LGBTQIA2S+ community and
people living with HIV, including using an individual's chosen name and pronouns;
new text end

new text begin (4) strategies to create a safe and affirming environment for LGBTQIA2S+ community
members and people living with HIV, including suggested changes to home care policies
and procedures, forms, signage, communication between clients and family members,
activities, in-house services, and staff training;
new text end

new text begin (5) information on why people with a diverse sexual orientation, gender identity, gender
expression, intersex status, or two-spirit identity, or people living with HIV may hide their
identities;
new text end

new text begin (6) information on the unique needs of people with a diverse sexual orientation, gender
identity, gender expression, intersex status, or two-spirit identity, or of people living with
HIV;
new text end

new text begin (7) an overview of the rights and protections for people with a diverse sexual orientation,
gender identity, gender expression, intersex status, or two-spirit identity, and of people
living with HIV;
new text end

new text begin (8) how to respectfully ask questions about, and respond to questions and concerns
relating to, sexual orientation, gender identity, gender expression, intersex status, two-spirit
identity, or actual or perceived HIV status; and
new text end

new text begin (9) basic information about HIV, transmission of HIV, the history of HIV, the stigma
and discrimination experienced by people living with HIV, and common myths about HIV.
new text end

new text begin (b) The training required under paragraph (a) must be provided by an entity:
new text end

new text begin (1) whose mission and work demonstrate a belief in the reality and authenticity of
LGBTQIA2S+ identities and HIV, including but not limited to an understanding that gender
identity is a spectrum, an understanding that individuals can and should be allowed to
transition genders if it is their choice, an understanding that HIV causes AIDS, and a belief
that all members of the LGBTQIA2S+ community and those living with HIV deserve equal
protection under the law; and
new text end

new text begin (2) with expertise in identifying and addressing the legal and social challenges faced by
LGBTQIA2S+ individuals and individuals living with HIV as they age and those faced by
LGBTQIA2S+ individuals and individuals living with HIV who are receiving home care
services.
new text end

new text begin (c) The training required under paragraph (a) may be in person or online. An individual
who completes in-person training must obtain proof that the individual completed the training
in the form of a certificate signed by the individual and the individual's supervisor. Online
training must include controls to ensure the full training is completed, use of a personal
identification number or personal identification information to confirm the identity of the
individual participating in the training, and a printable certificate that verifies the individual
completed the training. An individual who completes online training must print and sign
the certificate and have the certificate signed by the individual's supervisor.
new text end

new text begin (d) An entity providing training under this subdivision must maintain records of the
training, including, for each training provided, the name and title of the presenter, date of
training, title of training, description of the training's content, and, if applicable, signatures
of those who completed the training.
new text end

Sec. 18.

Minnesota Statutes 2024, section 144A.4796, subdivision 6, is amended to read:

Subd. 6.

Required annual training.

(a) All staff that perform direct home care services
must complete at least eight hours of annual training for each 12 months of employment.
The training may be obtained from the home care provider or another source and must
include topics relevant to the provision of home care services. The annual training must
include:

(1) training on reporting of maltreatment of minors under chapter 260E and maltreatment
of vulnerable adults under section 626.557, whichever is applicable to the services provided;

(2) review of the home care bill of rights in section 144A.44;

(3) review of infection control techniques used in the home and implementation of
infection control standards including a review of hand-washing techniques; the need for
and use of protective gloves, gowns, and masks; appropriate disposal of contaminated
materials and equipment, such as dressings, needles, syringes, and razor blades; disinfecting
reusable equipment; disinfecting environmental surfaces; and reporting of communicable
diseases; and

(4) review of the provider's policies and procedures relating to the provision of home
care services and how to implement those policies and procedures.

(b) In addition to the topics listed in paragraph (a), annual training may also contain
training on providing services to clients with hearing loss. Any training on hearing loss
provided under this subdivision must be high quality and research-based, may include online
training, and must include training on one or more of the following topics:

(1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
and challenges it poses to communication;

(2) health impacts related to untreated age-related hearing loss, such as increased
incidence of dementia, falls, hospitalizations, isolation, and depression; or

(3) information about strategies and technology that may enhance communication and
involvement, including communication strategies, assistive listening devices, hearing aids,
visual and tactile alerting devices, communication access in real time, and closed captions.

new text begin (c) In addition to the topics listed in paragraph (a), a home care provider's employees
and contractors who perform direct home care services must complete, every two years, at
least four hours of LGBTQIA2S+ and HIV cultural competency training according to
subdivision 5a.
new text end

new text begin (d) A home care provider's employees and contractors who do not perform direct home
care services must complete, every two years, at least two hours of LGBTQIA2S+ and HIV
cultural competency training according to subdivision 5a.
new text end

Sec. 19.

Minnesota Statutes 2024, section 144A.4796, subdivision 7, is amended to read:

Subd. 7.

Documentation.

A home care provider must retain documentation in the
employee records of the staff who have satisfied the orientation and training requirements
of this section new text begin including, for training required under subdivision 5a, certificates of completion new text end .

Sec. 20.

Minnesota Statutes 2024, section 245A.07, subdivision 3, as amended by Laws
2025, chapter 20, section 200, is amended to read:

Subd. 3.

License suspension, revocation, or fine.

(a) The commissioner may suspend
or revoke a license, or impose a fine if:

(1) a license holder fails to comply fully with applicable laws or rules including but not
limited to the requirements of this chapter and chapter 245C;

(2) a license holder, a controlling individual, or an individual living in the household
where the licensed services are provided or is otherwise subject to a background study has
been disqualified and the disqualification was not set aside and no variance has been granted;

(3) a license holder knowingly withholds relevant information from or gives false or
misleading information to the commissioner in connection with an application for a license,
in connection with the background study status of an individual, during an investigation,
or regarding compliance with applicable laws or rules;

(4) a license holder is excluded from any program administered by the commissioner
under section 245.095;

(5) revocation is required under section 245A.04, subdivision 7, paragraph (d); deleted text begin or
deleted text end

(6) suspension is necessary under subdivision 2a, paragraph (b), clause (2) deleted text begin . deleted text end new text begin ; or
new text end

new text begin (7) a license holder under chapter 245D engages in a substantial violation of a service
recipient's rights related to the service recipient's actual or perceived sexual orientation,
gender identity, gender expression, intersex status, two-spirit identity, or actual or perceived
HIV status. The commissioner must immediately impose a fine for a violation described in
this clause without first providing the license holder with an opportunity to correct the
violation.
new text end

A license holder who has had a license issued under this chapter suspended, revoked,
or has been ordered to pay a fine must be given notice of the action by certified mail, by
personal service, or through the provider licensing and reporting hub. If mailed, the notice
must be mailed to the address shown on the application or the last known address of the
license holder. The notice must state in plain language the reasons the license was suspended
or revoked, or a fine was ordered.

(b) If the license was suspended or revoked, the notice must inform the license holder
of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
a license. The appeal of an order suspending or revoking a license must be made in writing
by certified mail, by personal service, or through the provider licensing and reporting hub.
If mailed, the appeal must be postmarked and sent to the commissioner within ten calendar
days after the license holder receives notice that the license has been suspended or revoked.
If a request is made by personal service, it must be received by the commissioner within
ten calendar days after the license holder received the order. If the order is issued through
the provider hub, the appeal must be received by the commissioner within ten calendar days
from the date the commissioner issued the order through the hub. Except as provided in
subdivision 2a, paragraph (c), if a license holder submits a timely appeal of an order
suspending or revoking a license, the license holder may continue to operate the program
as provided in section 245A.04, subdivision 7, paragraphs (i) and (j), until the commissioner
issues a final order on the suspension or revocation.

(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license
holder of the responsibility for payment of fines and the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an
order to pay a fine must be made in writing by certified mail, by personal service, or through
the provider licensing and reporting hub. If mailed, the appeal must be postmarked and sent
to the commissioner within ten calendar days after the license holder receives notice that
the fine has been ordered. If a request is made by personal service, it must be received by
the commissioner within ten calendar days after the license holder received the order. If the
order is issued through the provider hub, the appeal must be received by the commissioner
within ten calendar days from the date the commissioner issued the order through the hub.

(2) The license holder shall pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies. If the license holder
receives state funds, the state, county, or municipal agencies or departments responsible for
administering the funds shall withhold payments and recover any payments made while the
license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine
until the commissioner issues a final order.

(3) A license holder shall promptly notify the commissioner of human services, in writing,
when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the
commissioner determines that a violation has not been corrected as indicated by the order
to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify
the license holder by certified mail, by personal service, or through the provider licensing
and reporting hub that a second fine has been assessed. The license holder may appeal the
second fine as provided under this subdivision.

(4) Fines shall be assessed as follows:

(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a
child under chapter 260E or the maltreatment of a vulnerable adult under section 626.557
for which the license holder is determined responsible for the maltreatment under section
260E.30, subdivision 4, paragraphs (a) and (b), or 626.557, subdivision 9c, paragraph (c);

(ii) if the commissioner determines that a determination of maltreatment for which the
license holder is responsible is the result of maltreatment that meets the definition of serious
maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit
$5,000;

(iii) the license holder shall forfeit $200 for each occurrence of a violation of law or rule
governing matters of health, safety, or supervision, including but not limited to the provision
of adequate staff-to-child or adult ratios, and failure to comply with background study
requirements under chapter 245C; and

(iv) the license holder shall forfeit $100 for each occurrence of a violation of law or rule
other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iii).

For purposes of this section, "occurrence" means each violation identified in the
commissioner's fine order. Fines assessed against a license holder that holds a license to
provide home and community-based services, as identified in section 245D.03, subdivision
1, and a community residential setting or day services facility license under chapter 245D
where the services are provided, may be assessed against both licenses for the same
occurrence, but the combined amount of the fines shall not exceed the amount specified in
this clause for that occurrence.

(5) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder will be personally liable for payment. In the case of a corporation, each
controlling individual is personally and jointly liable for payment.

(d) Except for background study violations involving the failure to comply with an order
to immediately remove an individual or an order to provide continuous, direct supervision,
the commissioner shall not issue a fine under paragraph (c) relating to a background study
violation to a license holder who self-corrects a background study violation before the
commissioner discovers the violation. A license holder who has previously exercised the
provisions of this paragraph to avoid a fine for a background study violation may not avoid
a fine for a subsequent background study violation unless at least 365 days have passed
since the license holder self-corrected the earlier background study violation.

Sec. 21.

Minnesota Statutes 2024, section 245D.02, is amended by adding a subdivision
to read:

new text begin Subd. 8d. new text end

new text begin Gender-affirming care. new text end

new text begin "Gender-affirming care" has the meaning given in
section 62Q.585, subdivision 3.
new text end

Sec. 22.

Minnesota Statutes 2024, section 245D.02, is amended by adding a subdivision
to read:

new text begin Subd. 8e. new text end

new text begin Gender expression. new text end

new text begin "Gender expression" has the meaning given in section
144.651, subdivision 2.
new text end

Sec. 23.

Minnesota Statutes 2024, section 245D.02, is amended by adding a subdivision
to read:

new text begin Subd. 8f. new text end

new text begin Gender identity. new text end

new text begin "Gender identity" has the meaning given in section 363A.03,
subdivision 50.
new text end

Sec. 24.

Minnesota Statutes 2024, section 245D.02, is amended by adding a subdivision
to read:

new text begin Subd. 9a. new text end

new text begin HIV. new text end

new text begin "HIV" means the human immunodeficiency virus.
new text end

Sec. 25.

Minnesota Statutes 2024, section 245D.02, is amended by adding a subdivision
to read:

new text begin Subd. 12a. new text end

new text begin LGBTQIA2S+. new text end

new text begin "LGBTQIA2S+" has the meaning given in section 144.651,
subdivision 2.
new text end

Sec. 26.

Minnesota Statutes 2024, section 245D.02, is amended by adding a subdivision
to read:

new text begin Subd. 32b. new text end

new text begin Sexual orientation. new text end

new text begin "Sexual orientation" has the meaning given in section
363A.03, subdivision 44.
new text end

Sec. 27.

Minnesota Statutes 2024, section 245D.02, is amended by adding a subdivision
to read:

new text begin Subd. 34b. new text end

new text begin Transgender. new text end

new text begin "Transgender" has the meaning given in section 144.651,
subdivision 2.
new text end

Sec. 28.

Minnesota Statutes 2024, section 245D.04, is amended to read:

245D.04 SERVICE RECIPIENT RIGHTS.

Subdivision 1.

License holder responsibility for individual rights of persons served
by the program.

The license holder must:

(1) provide each person or each person's legal representative with deleted text begin a deleted text end new text begin an oral and new text end written
notice new text begin , in plain language and in a language the person understands, new text end that identifies the service
recipient rights in subdivisions 2 and 3, and an explanation of those rights within five
working days of service initiation and annually thereafter;

(2) make reasonable accommodations to provide this information in other formats or
languages as needed to facilitate understanding of the rights by the person and the person's
legal representative, if any;

(3) maintain documentation of the person's or the person's legal representative's receipt
of a copy and an explanation of the rights; and

(4) ensure the exercise and protection of the person's rights in the services provided by
the license holder and as authorized in the support plan.

Subd. 2.

Service-related rights.

A person's service-related rights include the right to:

(1) participate in the development and evaluation of the services provided to the person;

(2) have services and supports identified in the support plan and the support plan
addendum provided in a manner that respects and takes into consideration the person's
preferences according to the requirements in sections 245D.07 and 245D.071;

new text begin (3) receive HIV-related treatment as prescribed, gender-affirming care, gender-affirming
mental health care, and medical and nonmedical care that is appropriate to a person's organs
and bodily needs; not have the person's dignity demeaned or cause the person avoidable
discomfort; and not have medical or nonmedical care denied or curtailed because of the
person's actual or perceived sexual orientation, gender identity, gender expression, intersex
status, two-spirit identity, or actual or perceived HIV status;
new text end

deleted text begin (3) deleted text end new text begin (4) new text end refuse or terminate services new text begin , including experimental HIV treatment or
gender-affirming care, new text end and be informed of the consequences of refusing or terminating
services;

deleted text begin (4) deleted text end new text begin (5) new text end know, in advance, limits to the services available from the license holder, including
the license holder's knowledge, skill, and ability to meet the person's service and support
needs;

deleted text begin (5) deleted text end new text begin (6) new text end know conditions and terms governing the provision of services, including the
license holder's admission criteria and policies and procedures related to temporary service
suspension and service termination;

new text begin (7) know, in advance, whether the staff who will provide the services completed the
required LGBTQIA2S+ and HIV cultural competency training;
new text end

deleted text begin (6) deleted text end new text begin (8) new text end a coordinated transfer to ensure continuity of care when there will be a change
in the provider;

deleted text begin (7) deleted text end new text begin (9) new text end know what the charges are for services, regardless of who will be paying for the
services, and be notified of changes in those charges new text begin and whether charges and payments
may be impacted by the person's sexual orientation, gender identity, gender expression,
intersex status, two-spirit identity, or actual or perceived HIV status new text end ;

deleted text begin (8) deleted text end new text begin (10) new text end know, in advance, whether services are covered by insurance, government
funding, or other sources, and be told of any charges the person or other private party may
have to pay; and

deleted text begin (9) deleted text end new text begin (11) new text end receive services from an individual who is competent and trained, who has
professional certification or licensure, as required, and who meets additional qualifications
identified in the person's support plan or support plan addendum.

Subd. 3.

Protection-related rights.

(a) A person's protection-related rights include the
right to:

(1) have personal, financial, service, health, and medical information new text begin , including but not
limited to information on the person's sexual orientation, gender identity, gender expression,
intersex status, two-spirit identity, or HIV status, new text end kept private, and be advised of disclosure
of this information by the license holder;

(2) access records and recorded information about the person in accordance with
applicable state and federal law, regulation, or rule;

(3) be free from maltreatment;

(4) be free from restraint, time out, seclusion, restrictive intervention, or other prohibited
procedure identified in section 245D.06, subdivision 5, or successor provisions, except for:
(i) emergency use of manual restraint to protect the person from imminent danger to self
or others according to the requirements in section 245D.061 or successor provisions; or (ii)
the use of safety interventions as part of a positive support transition plan under section
245D.06, subdivision 8, or successor provisions;

(5) receive services in a clean and safe environment when the license holder is the owner,
lessor, or tenant of the service site;

(6) be treated with courtesy and respect new text begin , be free from having others repeatedly, knowingly,
and willfully refuse to use the person's chosen name and pronouns after being reasonably
informed of the person's chosen name and pronouns, new text end and receive respectful treatment of
the person's property;

(7) reasonable observance of cultural and ethnic practice and religion;

(8) be free from deleted text begin bias and harassment regarding deleted text end new text begin discrimination based on new text end race, deleted text begin gender deleted text end new text begin
color new text end , age, disability, spirituality, deleted text begin and deleted text end new text begin sex, gender identity, gender expression, two-spirit
identity, intersex status, actual or perceived new text end sexual orientation new text begin , marital status, medical
condition, including actual or perceived HIV status, military or veteran status, national
origin, ancestry, genetic information, receipt of HIV-related treatment, or receipt of
gender-affirming care or gender-affirming mental health care new text end ;

new text begin (9) be free from discrimination based on private and personal items belonging to the
person, including but not limited to photographs, letters, mail, clothing, toiletries, and décor,
and be free to wear clothing, accessories, and cosmetics of the person's choosing;
new text end

new text begin (10) be free to have visitors of the person's choice; to restrict or prohibit visitors, including
members of the person's biological family; to have the person's visitors be free from
discrimination as provided in clause (8); and to have consensual sexual relations;
new text end

deleted text begin (9) deleted text end new text begin (11) new text end be informed of and use the license holder's grievance policy and procedures,
including knowing how to contact persons responsible for addressing problems and to appeal
under section 256.045;

deleted text begin (10) deleted text end new text begin (12) new text end know the name, telephone number, and the website, email, and street addresses
of protection and advocacy services, including the appropriate state-appointed ombudsman,
and a brief description of how to file a complaint with these offices;

deleted text begin (11) deleted text end new text begin (13) new text end assert these rights personally, or have them asserted by the person's family,
authorized representative, or legal representative, without retaliation;

deleted text begin (12) deleted text end new text begin (14) new text end give or withhold written informed consent to participate in any research or
experimental treatment;

deleted text begin (13) deleted text end new text begin (15) new text end associate with other persons of the person's choice in the community;

deleted text begin (14) deleted text end new text begin (16) new text end personal privacy, new text begin with or without visitors, at times of the person's choosing, new text end
including the right to use the lock on the person's bedroom or unit door;

deleted text begin (15) deleted text end new text begin (17) new text end engage in chosen activities; and

deleted text begin (16) deleted text end new text begin (18) new text end access to the person's personal possessions at any time, including financial
resources.

(b) For a person residing in a residential site licensed according to chapter 245A, or
where the license holder is the owner, lessor, or tenant of the residential service site,
protection-related rights also include the right to:

(1) have daily, private access to and use of a non-coin-operated telephone for local calls
and long-distance calls made collect or paid for by the person;

(2) receive and send, without interference, uncensored, unopened mail or electronic
correspondence or communication;

(3) have use of and free access to common areas in the residence and the freedom to
come and go from the residence at will;

(4) choose the person's visitors and time of visits and have privacy for visits with the
person's spouse, next of kin, legal counsel, religious adviser, or others, in accordance with
section 363A.09 of the Human Rights Act, including privacy in the person's bedroom;

(5) have access to three nutritionally balanced meals and nutritious snacks between
meals each day;

(6) have freedom and support to access food and potable water at any time;

(7) have the freedom to furnish and decorate the person's bedroom or living unit;

(8) a setting that is clean and free from accumulation of dirt, grease, garbage, peeling
paint, mold, vermin, and insects;

(9) a setting that is free from hazards that threaten the person's health or safety; and

(10) a setting that meets the definition of a dwelling unit within a residential occupancy
as defined in the State Fire Code.

deleted text begin (c) Restriction of a person's rights under paragraph (a), clauses (13) to (16), or paragraph
(b) is allowed only if determined necessary to ensure the health, safety, and well-being of
the person. Any restriction of those rights must be documented in the person's support plan
or support plan addendum. The restriction must be implemented in the least restrictive
alternative manner necessary to protect the person and provide support to reduce or eliminate
the need for the restriction in the most integrated setting and inclusive manner. The
documentation must include the following information:
deleted text end

deleted text begin (1) the justification for the restriction based on an assessment of the person's vulnerability
related to exercising the right without restriction;
deleted text end

deleted text begin (2) the objective measures set as conditions for ending the restriction;
deleted text end

deleted text begin (3) a schedule for reviewing the need for the restriction based on the conditions for
ending the restriction to occur semiannually from the date of initial approval, at a minimum,
or more frequently if requested by the person, the person's legal representative, if any, and
case manager; and
deleted text end

deleted text begin (4) signed and dated approval for the restriction from the person, or the person's legal
representative, if any. A restriction may be implemented only when the required approval
has been obtained. Approval may be withdrawn at any time. If approval is withdrawn, the
right must be immediately and fully restored.
deleted text end

new text begin Subd. 4. new text end

new text begin Restriction of a person's rights. new text end

new text begin Restriction of a person's rights under
subdivision 3, paragraph (a), clauses (15) to (18), or (b), is allowed only if determined
necessary to ensure the health, safety, and well-being of the person. Any restriction of those
rights must be documented in the person's support plan or support plan addendum. The
restriction must be implemented in the least restrictive alternative manner necessary to
protect the person and provide support to reduce or eliminate the need for the restriction in
the most integrated setting and inclusive manner. The documentation must include the
following information:
new text end

new text begin (1) the justification for the restriction based on an assessment of the person's vulnerability
related to exercising the right without restriction;
new text end

new text begin (2) the objective measures set as conditions for ending the restriction;
new text end

new text begin (3) a schedule for reviewing the need for the restriction based on the conditions for
ending the restriction to occur semiannually from the date of initial approval, at a minimum,
or more frequently if requested by the person, the person's legal representative, if any, and
the person's case manager; and
new text end

new text begin (4) signed and dated approval for the restriction from the person or the person's legal
representative, if any. A restriction may be implemented only when the required approval
has been obtained. Approval may be withdrawn at any time. If approval is withdrawn, the
right must be immediately and fully restored.
new text end

new text begin Subd. 5. new text end

new text begin Request to waive rights prohibited. new text end

new text begin No provider may require or request a
person to waive any of the rights listed in this section at any time, except as provided in
subdivision 4, including as a condition of initiating services or entering into a contract.
new text end

new text begin Subd. 6. new text end

new text begin Notice of nondiscrimination. new text end

new text begin The notice required under subdivision 1 must
also contain the following statement regarding nondiscrimination:
new text end

new text begin "[Name of license holder] will not discriminate against service recipients, and does not
permit discrimination against service recipients, including but not limited to bullying, abuse,
or harassment on the basis of actual or perceived sexual orientation, gender identity, gender
expression, intersex status, two-spirit identity, or actual or perceived HIV status, or based
on association with another individual on account of that individual's actual or perceived
sexual orientation, gender identity, gender expression, intersex status, two-spirit identity,
or actual or perceived HIV status. You may file a complaint with the Office of Ombudsman
for Long-Term Care or Office of Ombudsman for Mental Health and Developmental
Disabilities if you believe that you have experienced this kind of discrimination."
new text end

new text begin The statement must include the contact information for the department and offices to
which complaints may be filed.
new text end

new text begin Subd. 7. new text end

new text begin Arbitration. new text end

new text begin No license holder may include an arbitration provision in a contract
for home and community-based services or otherwise require a person, as a condition of
initiating or continuing home and community-based services, to agree to arbitration to
address disputes regarding home and community-based services.
new text end

new text begin Subd. 8. new text end

new text begin Civil action. new text end

new text begin A person injured by a violation of this section based on the person's
actual or perceived sexual orientation, gender identity, gender expression, intersex status,
two-spirit identity, or actual or perceived HIV status may bring a civil action to recover
damages and costs and reasonable attorney fees.
new text end

Sec. 29.

Minnesota Statutes 2024, section 245D.09, subdivision 4, is amended to read:

Subd. 4.

Orientation to program requirements.

Except for a license holder who does
not supervise any direct support staff, within 60 calendar days of hire, unless stated otherwise,
the license holder must provide and ensure completion of orientation sufficient to create
staff competency for direct support staff that combines supervised on-the-job training with
review of and instruction in the following areas:

(1) the job description and how to complete specific job functions, including:

(i) responding to and reporting incidents as required under section 245D.06, subdivision
1; and

(ii) following safety practices established by the license holder and as required in section
245D.06, subdivision 2;

(2) the license holder's current policies and procedures required under this chapter,
including their location and access, and staff responsibilities related to implementation of
those policies and procedures;

(3) data privacy requirements according to sections 13.01 to 13.10 and 13.46, the federal
Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff
responsibilities related to complying with data privacy practices;

(4) the service recipient rights and staff responsibilities related to ensuring the exercise
and protection of those rights according to the requirements in section 245D.04;

(5) sections 245A.65, 245A.66, and 626.557 and chapter 260E governing maltreatment
reporting and service planning for children and vulnerable adults, and staff responsibilities
related to protecting persons from maltreatment and reporting maltreatment. This orientation
must be provided within 72 hours of first providing direct contact services and annually
thereafter according to section 245A.65, subdivision 3;

(6) the principles of person-centered service planning and delivery as identified in section
245D.07, subdivision 1a, and how they apply to direct support service provided by the staff
person;

(7) the safe and correct use of manual restraint on an emergency basis according to the
requirements in section 245D.061 or successor provisions, and what constitutes the use of
restraints, time out, and seclusion, including chemical restraint;

(8) staff responsibilities related to prohibited procedures under section 245D.06,
subdivision 5, or successor provisions, why such procedures are not effective for reducing
or eliminating symptoms or undesired behavior, and why such procedures are not safe;

(9) basic first aid;

(10) strategies to minimize the risk of sexual violence, including concepts of healthy
relationships, consent, and bodily autonomy of people with disabilities; deleted text begin and
deleted text end

new text begin (11) LGBTQIA2S+ and HIV cultural competency according to subdivision 5b; and
new text end

deleted text begin (11) deleted text end new text begin (12) new text end other topics as determined necessary in the person's support plan by the case
manager or other areas identified by the license holder.

Sec. 30.

Minnesota Statutes 2024, section 245D.09, subdivision 5, is amended to read:

Subd. 5.

Annual training.

new text begin (a) new text end A license holder must provide annual training to direct
support staff on the topics identified in subdivision 4, clauses (3) to deleted text begin (11) deleted text end new text begin (10) and (12) new text end . If
the direct support staff has a first aid certification, annual training under subdivision 4,
clause (9), is not required as long as the certification remains current.

new text begin (b) In addition to the topics listed in paragraph (a), a license holder's employees,
subcontractors, and temporary staff who perform direct home care services must complete,
every two years, at least four hours of LGBTQIA2S+ and HIV cultural competency training
according to subdivision 5b.
new text end

new text begin (c) A license holder's employees, subcontractors, and temporary staff who do not perform
direct home care services must complete, every two years, at least two hours of
LGBTQIA2S+ and HIV cultural competency training according to subdivision 5b.
new text end

Sec. 31.

Minnesota Statutes 2024, section 245D.09, is amended by adding a subdivision
to read:

new text begin Subd. 5b. new text end

new text begin LGBTQIA2S+ and HIV cultural competency training. new text end

new text begin (a) A license holder's
employees, subcontractors, and temporary staff must complete cultural competency training
with regard to LGBTQIA2S+ and HIV topics.
new text end

new text begin (b) The training required under paragraph (a):
new text end

new text begin (1) must satisfy the requirements in section 144A.4796, subdivision 5a;
new text end

new text begin (2) must, at a minimum, address the topics listed in section 144A.4796, subdivision 5a;
new text end

new text begin (3) must be provided by an entity that meets the requirements in section 144A.4796,
subdivision 5a; and
new text end

new text begin (4) may be provided in person or online.
new text end

new text begin An individual who completes in-person training or online training must comply with the
requirements for in-person training or online training, as applicable, in section 144A.4796,
subdivision 5a.
new text end

new text begin (c) An entity providing training under this subdivision must maintain records of the
training, including, for each training provided, the name and title of the presenter, date of
training, title of training, description of the training's content, and, if applicable, signatures
of those who completed the training.
new text end

Sec. 32.

Minnesota Statutes 2024, section 245D.095, subdivision 5, is amended to read:

Subd. 5.

Personnel records.

(a) The license holder must maintain a personnel record
of each employee to document and verify staff qualifications, orientation, and training new text begin ,
including, for training required under section 245D.09, subdivision 5b, certificates of
completion new text end . The personnel record must include:

(1) the employee's date of hire, completed application, an acknowledgment signed by
the employee that job duties were reviewed with the employee and the employee understands
those duties, and documentation that the employee meets the position requirements as
determined by the license holder;

(2) documentation of staff qualifications, orientation, training, and performance
evaluations as required under section 245D.09, subdivisions 3 to 5, including the date the
training was completed, the number of hours per subject area, and the name of the trainer
or instructor; and

(3) a completed background study as required under chapter 245C.

(b) For employees hired after January 1, 2014, the license holder must maintain
documentation in the personnel record or elsewhere, sufficient to determine the date of the
employee's first supervised direct contact with a person served by the program, and the date
of first unsupervised direct contact with a person served by the program.

Sec. 33.

Minnesota Statutes 2024, section 245D.21, is amended by adding a subdivision
to read:

new text begin Subd. 3. new text end

new text begin Chief diversity officer. new text end

new text begin For an applicant with 25 or more employees, the
applicant must provide the commissioner with the name of the applicant's chief diversity
officer.
new text end

Sec. 34. new text begin APPROPRIATIONS.
new text end

new text begin (a) $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the
general fund to the commissioner of health for grants to eligible organizations to develop
and provide LGBTQIA2S+ and HIV cultural competency training under Minnesota Statutes,
section 144A.4796, subdivision 5a.
new text end

new text begin (b) $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the
general fund to the commissioner of human services for grants to eligible organizations to
develop and provide LGBTQIA2S+ and HIV cultural competency training under Minnesota
Statutes, section 245D.09, subdivision 5b.
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