HF 4275

as introduced - 90th Legislature (2017 - 2018) Posted on 03/28/2018 10:48am

A bill for an act
relating to health; making changes to statutory provisions affecting older and
vulnerable adults; modifying the Minnesota Health Records Act and the health
care bill of rights; modifying regulation of nursing homes, home care providers,
housing with services establishments, and assisted living services; modifying
requirements for reporting maltreatment of vulnerable adults; establishing an
advisory task force; providing for access to information and data sharing; requiring
reports; imposing civil and criminal penalties; amending Minnesota Statutes 2016,
sections 144.291, subdivision 2; 144.6501, subdivision 3, by adding a subdivision;
144.651, subdivisions 1, 2, 4, 6, 14, 16, 17, 20, 21, by adding subdivisions;
144A.10, subdivision 1; 144A.44; 144A.441; 144A.442; 144A.45, subdivisions
1, 2; 144A.474, subdivisions 1, 8, 9; 144A.4791, subdivision 10; 144A.53,
subdivisions 1, 4; 144D.01, subdivision 1; 144D.02; 144D.04, by adding a
subdivision; 144D.09; 144G.01, subdivision 1; 325F.71; 573.02, subdivision 2;
609.2231, subdivision 8; 626.557, subdivisions 3, 4, 9, 9a, 9b, 9c, 9d, 10b, 12b,
14, 17; 626.5572, by adding a subdivision; Minnesota Statutes 2017 Supplement,
sections 144A.474, subdivision 11; 144D.04, subdivision 2; 256.045, subdivisions
3, 4; proposing coding for new law in Minnesota Statutes, chapters 144; 144D;
144G; repealing Minnesota Statutes 2016, sections 144G.03, subdivision 6; 256.021.

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

Section 1. new text begin CITATION.
new text end

new text begin Sections 1 to 60 may be cited as the "Older and Vulnerable Adults Rights and Protection
Act of 2018."
new text end

Sec. 2.

Minnesota Statutes 2016, section 144.291, subdivision 2, is amended to read:

Subd. 2.

Definitions.

For the purposes of sections 144.291 to 144.298, the following
terms have the meanings given.

(a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.

(b) "Health information exchange" means a legal arrangement between health care
providers and group purchasers to enable and oversee the business and legal issues involved
in the electronic exchange of health records between the entities for the delivery of patient
care.

(c) "Health record" means any information, whether oral or recorded in any form or
medium, that relates to the past, present, or future physical or mental health or condition of
a patient; the provision of health care to a patient; or the past, present, or future payment
for the provision of health care to a patient.

(d) "Identifying information" means the patient's name, address, date of birth, gender,
parent's or guardian's name regardless of the age of the patient, and other nonclinical data
which can be used to uniquely identify a patient.

(e) "Individually identifiable form" means a form in which the patient is or can be
identified as the subject of the health records.

(f) "Medical emergency" means medically necessary care which is immediately needed
to preserve life, prevent serious impairment to bodily functions, organs, or parts, or prevent
placing the physical or mental health of the patient in serious jeopardy.

(g) "Patient" means new text begin :
new text end

new text begin (1) new text end a natural person who has received health care services from a provider for treatment
or examination of a medical, psychiatric, or mental condition deleted text begin , deleted text end new text begin ;
new text end

new text begin (2) new text end the surviving spouse new text begin , children, sibling, guardian, conservator, new text end and parents of a
deceased patient, deleted text begin or deleted text end new text begin unless the authority of the surviving spouse, children, sibling, guardian,
conservator, or parents has been restricted by either a court or the deceased person who
received health care services;
new text end

new text begin (3) new text end a person the patient appoints in writing as a representative, including a health care
agent acting according to chapter 145C, unless the authority of the agent has been limited
by the principal in the principal's health care directive deleted text begin . deleted text end new text begin ; and
new text end

new text begin (4) new text end except for minors who have received health care services under sections 144.341 to
144.347, in the case of a minor, patient includes a parent or guardian, or a person acting as
a parent or guardian in the absence of a parent or guardian.

(h) "Patient information service" means a service providing the following query options:
a record locator service as defined in paragraph (j) or a master patient index or clinical data
repository as defined in section 62J.498, subdivision 1.

(i) "Provider" means:

(1) any person who furnishes health care services and is regulated to furnish the services
under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148D, 148F, 150A, 151, 153, or
153A;

(2) a home care provider licensed under section 144A.471;

(3) a health care facility licensed under this chapter or chapter 144A; and

(4) a physician assistant registered under chapter 147A.

(j) "Record locator service" means an electronic index of patient identifying information
that directs providers in a health information exchange to the location of patient health
records held by providers and group purchasers.

(k) "Related health care entity" means an affiliate, as defined in section 144.6521,
subdivision 3, paragraph (b), of the provider releasing the health records.

Sec. 3.

Minnesota Statutes 2016, section 144.6501, subdivision 3, is amended to read:

Subd. 3.

Contracts of admission.

(a) A facility shall make complete unsigned copies
of its admission contract available to potential applicants and to the state or local long-term
care ombudsman immediately upon request.

(b) A facility shall post conspicuously within the facility, in a location accessible to
public view, either a complete copy of its admission contract or notice of its availability
from the facility.

(c) An admission contract must be printed in black type of at least ten-point type size.
The facility shall give a complete copy of the admission contract to the resident or the
resident's legal representative promptly after it has been signed by the resident or legal
representative.

new text begin (d) The admission contract must contain the name, address, and contact information of
the current owner, manager, and if different from the owner, license holder of the facility,
and the name and physical mailing address, which may not be a public or private post office
box, of at least one natural person who is authorized to accept service of process.
new text end

deleted text begin (d) deleted text end new text begin (e) new text end An admission contract is a consumer contract under sections 325G.29 to 325G.37.

deleted text begin (e) deleted text end new text begin (f) new text end All admission contracts must state in bold capital letters the following notice to
applicants for admission: "NOTICE TO APPLICANTS FOR ADMISSION. READ YOUR
ADMISSION CONTRACT. ORAL STATEMENTS OR COMMENTS MADE BY THE
FACILITY OR YOU OR YOUR REPRESENTATIVE ARE NOT PART OF YOUR
ADMISSION CONTRACT UNLESS THEY ARE ALSO IN WRITING. DO NOT RELY
ON ORAL STATEMENTS OR COMMENTS THAT ARE NOT INCLUDED IN THE
WRITTEN ADMISSION CONTRACT."

Sec. 4.

Minnesota Statutes 2016, section 144.6501, is amended by adding a subdivision
to read:

new text begin Subd. 3a. new text end

new text begin Changes to contracts of admission. new text end

new text begin The facility must provide prompt written
notice to the resident or resident's legal representative of a new owner, manager, and if
different from the owner, license holder of the facility, and the name and physical mailing
address, which may not be a public or private post office box of any new or additional
natural person not identified in the admission contract who is authorized to accept service
of process.
new text end

Sec. 5.

Minnesota Statutes 2016, section 144.651, subdivision 1, is amended to read:

Subdivision 1.

Legislative intent.

It is the intent of the legislature and the purpose of
this section to promote the interests and well being of the patients and residents of health
care facilities. new text begin It is the intent of this section that every patient's and resident's civil and
religious liberties, including the right to independent personal decisions and knowledge of
available choices, must not be infringed and that the facility must encourage and assist in
the fullest possible exercise of these rights. The rights provided under this section are
established for the benefit of patients and residents. new text end No health care facility may require new text begin or
request new text end a patient or resident to waive new text begin any of new text end these rights new text begin at any time or for any reason
including new text end as a condition of admission to the facility. deleted text begin Any guardian or conservator of a patient
or resident or, in the absence of a guardian or conservator, deleted text end An interested person deleted text begin , deleted text end may seek
enforcement of these rights on behalf of a patient or resident new text begin , as provided under section
144.6512 new text end . deleted text begin An interested person may also seek enforcement of these rights on behalf of a
patient or resident who has a guardian or conservator through administrative agencies or in
district court having jurisdiction over guardianships and conservatorships. deleted text end Pending the
outcome of an enforcement proceeding the health care facility may, in good faith, comply
with the instructions of a guardian or conservator. deleted text begin It is the intent of this section that every
patient's civil and religious liberties, including the right to independent personal decisions
and knowledge of available choices, shall not be infringed and that the facility shall encourage
and assist in the fullest possible exercise of these rights.
deleted text end

Sec. 6.

Minnesota Statutes 2016, 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 and sections 144.6511 and
144.6512 new text end , new text begin the terms defined in this subdivision have the meanings given them.
new text end

new text begin (b) new text end "Patient" means new text begin :
new text end

new text begin (1) new text end 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 deleted text begin . deleted text end new text begin ;
new text end

new text begin (2) a minor who is admitted to a residential program as defined in section 253C.01;
new text end

new text begin (3) new text end for purposes of subdivisions new text begin 1, new text end 4 to 9, 12, 13, 15, 16, and 18 to 20, deleted text begin "patient" also
means deleted text end a person who receives health care services at an outpatient surgical center or at a
birth center licensed under section 144.615 deleted text begin . "Patient" also means a minor who is admitted
to a residential program as defined in section 253C.01. deleted text end new text begin ; and
new text end

new text begin (4) new text end for purposes of subdivisions 1, 3 to 16, 18, 20 and 30, deleted text begin "patient" also means deleted text end 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 (c) new text end "Resident" means a person who is admitted to new text begin , resides in, or receives services from:
new text end

new text begin (1) new text end a nonacute care facility including extended care facilities deleted text begin , deleted text end new text begin ;
new text end

new text begin (2) a housing with services establishment operating under assisted living title protection
under chapter 144G;
new text end

new text begin (3) a home care service provider required to be licensed under chapter 144A that provides
services in a living unit registered as a housing with services establishment under chapter
144D;
new text end

new text begin (4) a new text end nursing deleted text begin homes, and deleted text end new text begin home;
new text end

new text begin (5) a new text end boarding care deleted text begin homes deleted text end new text begin home new text end for care required because of prolonged mental or physical
illness or disability, recovery from injury or disease, or advancing age deleted text begin . deleted text end new text begin ; and
new text end

new text begin (6) new text end for purposes of deleted text begin all subdivisions except deleted text end subdivisions deleted text begin 28 and 29 deleted text end new text begin 1 to 27 new text end , deleted text begin "resident"
also means a person who is admitted to deleted text end new text begin and 30 to 34, new text end a facility licensed as a board and
lodging facility under Minnesota Rules, parts 4625.0100 to 4625.2355, or a supervised
living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which operates
a rehabilitation program licensed under Minnesota Rules, parts deleted text begin 9530.6405 deleted text end new text begin 9530.6510 new text end to
9530.6590.

new text begin (d) "Health care facility" or "facility" means:
new text end

new text begin (1) an acute care inpatient facility;
new text end

new text begin (2) a residential program as defined in section 253C.01;
new text end

new text begin (3) for the purposes of subdivisions 1, 4 to 9, 12, 13, 15, 16, and 18 to 20, an outpatient
surgical center or a birth center licensed under section 144.615;
new text end

new text begin (4) for the purposes of subdivisions 1, 3 to 16, 18, 20, and 30, a setting in which outpatient
mental health services are provided, or a community support program or other
community-based program providing mental health treatment;
new text end

new text begin (5) a nonacute care facility, including extended care facilities;
new text end

new text begin (6) a housing with services establishment operating under assisted living title protection
under chapter 144G;
new text end

new text begin (7) any living unit of a housing with services establishment registered under chapter
144D, in which home care services are provided to a resident by a home care provider
licensed under chapter 144A;
new text end

new text begin (8) a nursing home;
new text end

new text begin (9) a boarding care home for care required because of prolonged mental or physical
illness or disability, recovery from injury or disease, or advancing age; or
new text end

new text begin (10) for the purposes of subdivisions 1 to 27 and 30 to 34, a facility licensed as a board
and lodging facility under Minnesota Rules, chapter 4625, or a supervised living facility
under Minnesota Rules, chapter 4665, and which operates a rehabilitation program licensed
under Minnesota Rules, parts 9530.6410 to 9530.6590.
new text end

new text begin (e) "Interested person" has the meaning given under section 524.5-102, subdivision 7.
An interested person does not include a person whose authority has been restricted by the
patient or resident, or by a court.
new text end

Sec. 7.

Minnesota Statutes 2016, section 144.651, subdivision 4, is amended to read:

Subd. 4.

Information about rights.

new text begin (a) new text end Patients and residents shall, at admission, be
told that there are legal rights for their protection during their stay at the facility or throughout
their course of treatment and maintenance in the community and that these are described
in an accompanying written statement new text begin in plain language and in terms patients and residents
can understand new text end of the applicable rights and responsibilities set forth in this section. new text begin The
written statement must also include the name and address of the state or county agency to
contact for additional information or assistance. new text end In the case of patients admitted to residential
programs as defined in section 253C.01, the written statement shall also describe the right
of a person 16 years old or older to request release as provided in section 253B.04,
subdivision 2, and shall list the names and telephone numbers of individuals and organizations
that provide advocacy and legal services for patients in residential programs.

new text begin (b) new text end Reasonable accommodations shall be made for people who have communication
disabilities and those who speak a language other than English.

new text begin (c) new text end Current facility policies, inspection findings of state and local health authorities, and
further explanation of the written statement of rights shall be available to patients, residents,
their guardians or their chosen representatives upon reasonable request to the administrator
or other designated staff person, consistent with chapter 13, the Data Practices Act, and
section 626.557, relating to vulnerable adults.

Sec. 8.

Minnesota Statutes 2016, section 144.651, subdivision 6, is amended to read:

Subd. 6.

Appropriate health care.

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 . deleted text end new text begin , provided with reasonable regularity and continuity of staff
assignment as far as facility policy allows by persons who are properly trained and competent
to perform their duties. new text end This right is limited where the service is not reimbursable by public
or private resources.

Sec. 9.

Minnesota Statutes 2016, section 144.651, subdivision 14, is amended to read:

Subd. 14.

Freedom from maltreatment.

new text begin (a) new text end Patients and residents shall be free from
maltreatment as defined in the Vulnerable Adults Protection Act. "Maltreatment" means
conduct described in section 626.5572, subdivision 15, or the intentional and nontherapeutic
infliction of physical pain or injury, or any persistent course of conduct intended to produce
mental or emotional distress. new text begin Every patient and resident has the right to immediate notification
by a facility of alleged maltreatment, including the details of any report submitted by the
facility under section 626.557 to the common entry point, as defined in section 626.5572,
subdivision 5. An interested person, as defined in section 626.5572, subdivision 12a, also
has the right to information about maltreatment and the details of a report.
new text end

new text begin (b) new text end Every patient and resident shall also be free from nontherapeutic chemical and
physical restraints, except in fully documented emergencies, or as authorized in writing
after examination by a patient's or resident's physician for a specified and limited period of
time, and only when necessary to protect the resident from self-injury or injury to others.

Sec. 10.

Minnesota Statutes 2016, section 144.651, is amended by adding a subdivision
to read:

new text begin Subd. 14a. new text end

new text begin Placement of cameras in private space. new text end

new text begin (a) For purposes of this subdivision:
new text end

new text begin (1) "resident representative" has the meaning given in Code of Federal Regulations, title
42, section 483.5; and
new text end

new text begin (2) "camera" includes other electronic monitoring devices.
new text end

new text begin (b) Every resident has the right to place a camera in the resident's private space. A facility
shall not interfere with the placement. The resident may define when, where, and under
what circumstances the camera may be temporarily turned off and has the right to change
these preferences at any time.
new text end

new text begin (c) If the resident resides in shared space, the resident must document a discussion
regarding placement of a camera with any roommate or the roommate's guardian or health
care agent. If consent from the roommate or the roommate's guardian or health care agent
cannot be obtained, the facility must make a reasonable accommodation to either provide
a private room or another shared room in which the roommate consents to placement of a
camera.
new text end

new text begin (d) Costs for placement of a camera are incurred by the resident, except that the resident
may utilize the facility's Internet service if otherwise made available to the resident.
new text end

new text begin (e) A health care agent or guardian may place a camera in the resident's private space
on behalf of the resident after documenting a discussion with the resident, which includes
informing the resident of the resident's right to privacy and a right to be free from
maltreatment, and confirming that the resident does not object to the placement of a camera
in the resident's private space.
new text end

new text begin (f) A resident representative who is not the health care agent or guardian may place a
camera in the resident's private space on behalf of the resident after documenting a discussion
with any health care agent or guardian of the resident regarding the placement, and
confirming that the resident and any health care agent or guardian do not object to the
placement.
new text end

new text begin (g) An interested person who is not the health care agent, guardian, or resident
representative may place a camera in the resident's private space on behalf of the resident
after documenting a discussion with any health care agent, guardian, or resident representative
of the resident regarding the placement, and confirming that any health care agent, guardian,
or resident representative does not object to the placement. Where there is no health care
agent, guardian, or resident representative of the resident, an interested person must document
a discussion with the ombudsman for long-term care regarding the placement, and must
confirm that the ombudsman does not object to the placement.
new text end

new text begin If conflict arises between multiple interested parties, the ombudsman for long-term care
shall be consulted.
new text end

new text begin (h) The health care agent, guardian, resident representative, or interested person who
has placed the camera, after discussion with the resident, may define when, where, and
under what circumstances the camera may be temporarily turned off and has the right to
change these preferences at any time.
new text end

new text begin (i) No one may seek placement of a camera in the resident's private space on behalf of
a resident if the placement has been restricted or rescinded in writing by a resident or a
court.
new text end

new text begin (j) The facility may not tamper with or remove any camera placed in the resident's private
space or attempt to persuade, coerce, or influence the resident not to place a camera in the
resident's private space. The facility shall not retaliate against the resident for placement of
a camera. A facility does not violate Minnesota law or rules if a camera for which the facility
was unaware is found during a survey or investigation by the Department of Health.
new text end

Sec. 11.

Minnesota Statutes 2016, section 144.651, subdivision 16, is amended to read:

Subd. 16.

Confidentiality of records.

Patients and residents shall be assured confidential
treatment of their personal new text begin , financial, new text end 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.
new text begin Patients and residents have a right to access their own records and written information from
those records. new text end 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.

Sec. 12.

Minnesota Statutes 2016, section 144.651, subdivision 17, is amended to read:

Subd. 17.

Disclosure of services available.

Patients and residents shall be informed,
prior to or at the time of admission and during their stay, of services which are included in
the facility's basic per diem or daily room rate and that other services are available at
additional charges. new text begin Patients and residents have the right to reasonable advance notice of
changes in services or charges. A facility may not collect a nonrefundable deposit, unless
it is applied to the first month's charges. new text end Facilities shall make every effort to assist patients
and residents in obtaining information regarding whether the Medicare or medical assistance
program will pay for any or all of the aforementioned services.

Sec. 13.

Minnesota Statutes 2016, section 144.651, subdivision 20, is amended to read:

Subd. 20.

Grievances.

new text begin (a) new text end Patients and residents shall be encouraged and assisted,
throughout their stay in a facility or their course of treatment, to understand and exercise
their rights as patients, residents, and citizens. Patients and residents may voice grievances new text begin ,
assert the rights granted under this section personally, or have these rights asserted by an
interested person, new text end and recommend changes in policies and services to facility staff and
others of their choice, free from restraint, interference, coercion, discrimination, new text begin retaliation,
new text end or reprisal, including threat of discharge. deleted text begin Notice of the grievance procedure of the facility
or program, as well as addresses and telephone numbers for the Office of Health Facility
Complaints and the area nursing home ombudsman pursuant to the Older Americans Act,
section 307(a)(12) shall be posted in a conspicuous place.
deleted text end

new text begin (b) Patients, residents, and interested persons have the right to complain about services
that are provided, services that are not being provided, and the lack of courtesy or respect
to the patient or resident or the patient's or resident's property. The facility must investigate
and attempt resolution of the complaint or grievance. The patient or resident has the right
to be informed of the name of the individual who is responsible for handling grievances.
new text end

new text begin (c) Notice must be posted in a conspicuous place of the facility's or program's grievance
procedure, as well as telephone numbers and, where applicable, addresses for the common
entry point, defined in section 626.5572, subdivision 5, a protection and advocacy agency,
and the area nursing home ombudsman pursuant to the Older Americans Act, section
307(a)(12).
new text end

new text begin (d) new text end Every acute care inpatient facility, every residential program as defined in section
253C.01, every nonacute care facility, and every facility employing more than two people
that provides outpatient mental health services shall have a written internal grievance
procedure that, at a minimum, sets forth the process to be followed; specifies time limits,
including time limits for facility response; provides for the patient or resident to have the
assistance of an advocate; requires a written response to written grievances; and provides
for a timely decision by an impartial decision maker if the grievance is not otherwise resolved.
Compliance by hospitals, residential programs as defined in section 253C.01 which are
hospital-based primary treatment programs, and outpatient surgery centers with section
144.691 and compliance by health maintenance organizations with section 62D.11 is deemed
to be compliance with the requirement for a written internal grievance procedure.

Sec. 14.

Minnesota Statutes 2016, section 144.651, subdivision 21, is amended to read:

Subd. 21.

Communication privacy.

Patients and residents may associate and
communicate privately with persons of their choice and enter and, except as provided by
the Minnesota Commitment Act, leave the facility as they choose. Patients and residents
shall have access, at their new text begin own new text end expense new text begin , unless provided by the facility new text end , to writing instruments,
stationery, deleted text begin and deleted text end postage new text begin , and Internet service new text end . Personal mail shall be sent without interference
and received unopened unless medically or programmatically contraindicated and
documented by the physician in the medical record. There shall be access to a telephone
where patients and residents can make and receive calls as well as speak privately. Facilities
which are unable to provide a private area shall make reasonable arrangements to
accommodate the privacy of patients' or residents' calls. 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. This right is limited where medically
inadvisable, as documented by the attending physician in a patient's or resident's care record.
Where programmatically limited by a facility abuse prevention plan pursuant to section
626.557, subdivision 14, paragraph (b), this right shall also be limited accordingly.

Sec. 15.

Minnesota Statutes 2016, section 144.651, is amended by adding a subdivision
to read:

new text begin Subd. 34. new text end

new text begin Retaliation prohibited. new text end

new text begin (a) A facility or person must not retaliate against a
patient, resident, employee, or interested person who:
new text end

new text begin (1) files a complaint or grievance or asserts any rights on behalf of the patient or resident
as provided under subdivision 20;
new text end

new text begin (2) submits a maltreatment report, whether mandatory or voluntary, on behalf of the
patient or resident under section 626.557, subdivision 3, 4, or 4a;
new text end

new text begin (3) advocates on behalf of the patient or resident for necessary or improved care and
services or enforcement of rights under this section or other law;
new text end

new text begin (4) contracts to receive services from a service provider of the resident's choice; or
new text end

new text begin (5) places a camera or electronic monitoring device in the resident's private space as
provided in subdivision 14a.
new text end

new text begin (b) There is a rebuttable presumption that adverse action is retaliatory if taken against
a patient, resident, employee, or interested person within 90 days of a patient, resident,
employee, or interested person filing a grievance as provided in paragraph (a), submitting
a maltreatment report, or otherwise advocating on behalf of a patient or resident.
new text end

new text begin (c) For purposes of this section, "adverse action" means any action taken by a facility
or person against the patient, resident, employee, or interested person that includes but is
not limited to:
new text end

new text begin (1) discharge or transfer from the facility;
new text end

new text begin (2) discharge from or termination of employment;
new text end

new text begin (3) demotion or reduction in remuneration for services;
new text end

new text begin (4) restriction or prohibition of access either to the facility or to the patient or resident;
new text end

new text begin (5) any restriction of any of the rights set forth in state or federal law;
new text end

new text begin (6) any restriction of access to or use of amenities or services;
new text end

new text begin (7) termination of a services or lease agreement, or both;
new text end

new text begin (8) a sudden increase in costs for services not already contemplated at the time of the
action taken;
new text end

new text begin (9) removal, tampering with, or deprivation of technology, communication, or electronic
monitoring devices of the patient or resident;
new text end

new text begin (10) reporting maltreatment in bad faith; or
new text end

new text begin (11) making any oral or written communication of false information about a person
advocating on behalf of the patient or resident.
new text end

Sec. 16.

new text begin [144.6511] DECEPTIVE MARKETING AND BUSINESS PRACTICES.
new text end

new text begin (a) Deceptive marketing and business practices are prohibited.
new text end

new text begin (b) For the purposes of this section, it is a deceptive practice for a facility to:
new text end

new text begin (1) make any false, fraudulent, deceptive, or misleading statements in marketing,
advertising, or any other oral or written description or representation of care or services,
whether in oral, written, or electronic form;
new text end

new text begin (2) arrange for or provide health care or services that are inferior to, substantially different
from, or substantially more expensive than those offered, promised, marketed, or advertised;
new text end

new text begin (3) fail to deliver any care or services the provider or facility promised or represented
that the facility was able to provide;
new text end

new text begin (4) fail to inform the patient or resident in writing of any limitations to care services
available prior to executing a contract for admission;
new text end

new text begin (5) fail to fulfill a written or oral promise that the facility shall continue the same services
and the same lease terms if a private pay resident converts to the elderly waiver program;
new text end

new text begin (6) fail to disclose and clearly explain the purpose of a nonrefundable community fee
or other fee prior to contracting for services with a patient or resident;
new text end

new text begin (7) advertise or represent, orally or in writing, that the facility is or has a special care
unit, such as for dementia or memory care, without complying with training and disclosure
requirements under sections 144D.065 and 325F.72, and any other applicable law; or
new text end

new text begin (8) define the terms "facility," "contract of admission," "admission contract," "admission
agreement," "legal representative," or "responsible party" to mean anything other than the
meanings of those terms under section 144.6501.
new text end

Sec. 17.

new text begin [144.6512] ENFORCEMENT OF THE HEALTH CARE BILL OF RIGHTS.
new text end

new text begin In addition to the remedies otherwise provided by or available under law, a patient or
resident, or an interested person on behalf of the patient or resident, may bring a civil action
against a facility to recover actual, incidental, and consequential damages or $5,000,
whichever is greater, costs and disbursements, including costs of investigation, and reasonable
attorney fees, and receive other equitable relief as determined by the court for a violation
of sections 144.6501, subdivision 2, or 144.651 and 144.6511.
new text end

Sec. 18.

Minnesota Statutes 2016, section 144A.10, subdivision 1, is amended to read:

Subdivision 1.

Enforcement authority.

The commissioner of health is the exclusive
state agency charged with the responsibility and duty of inspecting all facilities required to
be licensed under section 144A.02 new text begin , and issuing correction orders and imposing fines as
provided in this section, Minnesota Rules, chapter 4658, or any other applicable law new text end . The
commissioner of health shall enforce the rules established pursuant to sections 144A.01 to
144A.155, subject only to the authority of the Department of Public Safety respecting the
enforcement of fire and safety standards in nursing homes and the responsibility of the
commissioner of human services under sections 245A.01 to 245A.16 or 252.28.

The commissioner may request and must be given access to relevant information, records,
incident reports, or other documents in the possession of a licensed facility if the
commissioner considers them necessary for the discharge of responsibilities. For the purposes
of inspections and securing information to determine compliance with the licensure laws
and rules, the commissioner need not present a release, waiver, or consent of the individual.
new text begin A nursing home's refusal to cooperate in providing lawfully requested information is grounds
for a correction order or fine. new text end The identities of patients or residents must be kept private as
defined by section 13.02, subdivision 12.

Sec. 19.

Minnesota Statutes 2016, section 144A.44, is amended to read:

144A.44 HOME CARE BILL OF RIGHTS.

Subdivision 1.

Statement of rights.

new text begin (a) All home care providers, and individuals or
organizations exempt from home care licensure by section 144A.471, subdivision 8, must
comply with this section. new text end A person who receives home care services has deleted text begin these rights deleted text end new text begin the
right to new text end :

(1) deleted text begin the right to deleted text end receive written information about rights before receiving services,
including what to do if rights are violated;

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

(3) deleted text begin the right to deleted text end be told before receiving services the type and disciplines of staff who
will be providing the services, 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;

(4) deleted text begin the right to deleted 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;

(5) deleted text begin the right to deleted text end refuse services or treatment;

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

(7) deleted text begin the right to deleted 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; and what charges the client may be responsible for paying;

(8) deleted text begin the right to deleted 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;

(9) deleted text begin the right to deleted 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, or other health programs;

(10) deleted text begin the right to deleted text end have personal, financial, and medical information kept private, and to
be advised of the provider's policies and procedures regarding disclosure of such information;

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

(12) deleted text begin the right to deleted text end be served by people who are properly trained and competent to perform
their duties;

(13) deleted text begin the right to deleted text end be treated with courtesy and respect, and to have the client's property
treated with respect;

(14) deleted text begin the right to deleted 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;

(15) deleted text begin the right to deleted text end reasonable, advance notice of changes in services or charges;

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

(17) deleted text begin the right to deleted text end at least deleted text begin ten deleted text end new text begin 30 new text end days' advance notice of the termination of a service by a
provider, except 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;

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

(19) deleted text begin the right to deleted text end complain about services that are provided, or fail to be provided, and
the lack of courtesy or respect to the client or the client's property;

(20) deleted text begin the right to deleted 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;

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

(22) deleted text begin the right to deleted 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 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (23) reasonable access at reasonable times to available legal or advocacy services so
that the client may receive assistance in understanding, exercising, and protecting the rights
in this section and other law.
new text end

new text begin (b) A home care provider shall:
new text end

new text begin (1) encourage and assist in the fullest possible exercise of these rights;
new text end

new text begin (2) provide the names and telephone numbers of individuals and organizations that
provide advocacy and legal services for clients;
new text end

new text begin (3) make every effort to assist clients in obtaining information regarding whether the
Medicare or medical assistance program will pay for services;
new text end

new text begin (4) make reasonable accommodations for people who have communication disabilities
and those who speak a language other than English; and
new text end

new text begin (5) provide all information and notices in plain language and in terms the client can
understand.
new text end

Subd. 2.

Interpretation and enforcement of rights.

deleted text begin These rights are established for
the benefit of clients who receive home care services. All home care providers, including
those exempted under section 144A.471, must comply with this section. The commissioner
shall enforce this section and the home care bill of rights requirement against home care
providers exempt from licensure in the same manner as for licensees. A home care provider
may not request or require a client to surrender any of these rights as a condition of receiving
services. This statement of deleted text end new text begin The new text end rights deleted text begin does deleted text end new text begin provided under this section are established for
the benefit of clients who receive home care services, do new text end not replace or diminish other rights
and liberties that may exist relative to clients receiving home care services, persons providing
home care services, or providers licensed under sections 144A.43 to 144A.482 new text begin , and may
not be waived. Any oral or written waiver of the rights provided under this section is void
and unenforceable new text end .

new text begin Subd. 3. new text end

new text begin Deceptive marketing and business practices. new text end

new text begin (a) Deceptive marketing and
business practices are prohibited.
new text end

new text begin (b) For the purposes of this section, it is a deceptive marketing and business practice to:
new text end

new text begin (1) engage in any conduct listed in section 144.6511;
new text end

new text begin (2) seek or collect a nonrefundable deposit, unless the deposit is applied to the first
month's charges;
new text end

new text begin (3) fail to disclose and clearly explain the purpose of a nonrefundable community fee
or other fee prior to contracting for services with a client; or
new text end

new text begin (4) make any oral or written statement or representation, either directly or in marketing
or advertising materials that contradict, conflict with, or otherwise are inconsistent with the
provisions set forth in the admissions agreement, service agreement, contract, lease, or
Uniform Consumer Information Guide under section 144G.06.
new text end

new text begin Subd. 4. new text end

new text begin Enforcement of rights. new text end

new text begin The commissioner shall enforce this section and the
requirements in the home care bill of rights against home care providers exempt from
licensure in the same manner as for licensees.
new text end

new text begin Subd. 5. new text end

new text begin Private enforcement of rights. new text end

new text begin In addition to the remedies otherwise available
under law, a person who receives home care services, an assisted living client, or an interested
person on behalf of the person who receives home care services may bring a civil action
against a home care provider and recover actual, incidental, and consequential damages or
$5,000, whichever is greater, costs and disbursements, including costs of investigation, and
reasonable attorney fees, and receive other equitable relief as determined by the court for
a violation of this section or section 144A.441. For purposes of this section, an interested
person has the meaning given in section 144.651, subdivision 2, except that an interested
person does not include a person whose authority has been restricted by the person receiving
home care services or assisted living, or by a court.
new text end

Sec. 20.

Minnesota Statutes 2016, section 144A.441, is amended to read:

144A.441 ASSISTED LIVING BILL OF RIGHTS ADDENDUM.

Assisted living clients, as defined in section 144G.01, subdivision 3, shall be provided
with the home care bill of rights required by section 144A.44, except that the home care
bill of rights provided to these clients must include the following provision in place of the
provision in section 144A.44, subdivision 1, new text begin paragraph (a), new text end clause (17):

"(17) the right to reasonable, advance notice of changes in services or charges, including
at least 30 days' advance notice of the termination of a service by a provider, except in cases
where:

(i) the recipient of services deleted text begin engages in conduct that alters the conditions of employment
as specified in the employment contract between the home care provider and the individual
providing home care services, or deleted text end creates new text begin and the home care provider can document new text end an
abusive or unsafe work environment for the individual providing home care services;

(ii) new text begin a doctor or treating physician documents that new text end an emergency deleted text begin for the informal caregiver deleted text end
or a significant change in the recipient's condition has resulted in service needs that exceed
the current service provider agreement and that cannot be safely met by the home care
provider; or

(iii) the provider has not received payment for services, for which at least ten days'
advance notice of the termination of a service shall be provided."

Sec. 21.

Minnesota Statutes 2016, section 144A.442, is amended to read:

144A.442 deleted text begin ASSISTED LIVING CLIENTS; SERVICE deleted text end new text begin ARRANGED HOME CARE
PROVIDER RESPONSIBILITIES; new text end TERMINATION new text begin OF SERVICES new text end .

new text begin Subdivision 1. new text end

new text begin Legislative intent. new text end

new text begin It is the intent of the legislature to ensure to the greatest
extent possible stability of services for persons residing in housing with services
establishments.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin For the purposes of this section, "arranged home care provider"
has the meaning given in section 144D.01, subdivision 2a, and "assisted living client" has
the meaning given in section 144G.01, subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Notice; permissible reasons to terminate services. new text end

new text begin (a) Except as provided in
paragraph (b), an arranged home care provider must provide at least 30 days' notice prior
to terminating a service contract. Notwithstanding any other provision of law, an arranged
home care provider may terminate services only if the assisted living client:
new text end

new text begin (1) engages in conduct that significantly alters the terms of the service plan with the
arranged home care provider and does not cure the alteration within 30 days of receiving
written notice of the conduct; or
new text end

new text begin (2) breaches the services agreement, which includes failure to pay for services, and has
not cured the breach within 30 days of receiving written notice of the nonpayment.
new text end

new text begin (b) Notwithstanding paragraph (a), the arranged home care provider may terminate
services with ten days' notice if the assisted living client:
new text end

new text begin (1) creates, and the arranged home care provider can document, an abusive or unsafe
work environment for the individual providing home care services; or
new text end

new text begin (2) has service needs that exceed the current service plan and cannot be safely met by
the arranged home care provider and a doctor or treating physician documents that an
emergency or a significant change in the assisted living client's condition has occurred.
new text end

new text begin Subd. 4. new text end

new text begin Contents of service termination notice. new text end

If an arranged home care provider deleted text begin ,
as defined in section 144D.01, subdivision 2a, who is not also Medicare certified deleted text end terminates
a service agreement or service plan with an assisted living client, deleted text begin as defined in section
144G.01, subdivision 3, deleted text end the new text begin arranged new text end home care provider shall provide the assisted living
client and the legal or designated representatives of the client, if any, with deleted text begin a deleted text end new text begin an advance new text end
written notice of new text begin service new text end termination new text begin as provided under subdivision 3, new text end which deleted text begin includes deleted text end new text begin must
include new text end the following information:

(1) the effective date of new text begin service new text end termination;

(2) the reason for new text begin service new text end termination;

(3) without extending the termination notice period, an affirmative offer to meet with
the assisted living client or deleted text begin client representatives deleted text end new text begin client's representative new text end within no more than
five business days of the date of the new text begin service new text end termination notice to discuss the termination;

(4) contact information for a reasonable number of other home care providers in the
geographic area of the assisted living client, as required by section 144A.4791, subdivision
10;

(5) a statement that the new text begin arranged home care new text end provider will participate in a coordinated
transfer of the care of the client to another provider or caregiver, as required by section
144A.44, subdivision 1, new text begin paragraph (a), new text end clause (18);

(6) new text begin a statement that the assisted living client has the right to a meeting at the client's
request with a representative of the arranged home care provider to discuss and attempt to
avoid the service termination;
new text end

new text begin (7) new text end the name and contact information of a representative of the new text begin arranged new text end home care
provider with whom the new text begin assisted living new text end client may discuss the notice of new text begin service new text end termination;

deleted text begin (7) deleted text end new text begin (8) new text end a copy of the home care bill of rights; deleted text begin and
deleted text end

deleted text begin (8) deleted text end new text begin (9) new text end a statement that the notice of new text begin service new text end termination of home care services by the
new text begin arranged new text end home care provider does not constitute notice of termination of the deleted text begin housing with
services contract with a housing with services establishment. deleted text end new text begin lease; and
new text end

new text begin (10) a statement that the assisted living client has the right to appeal the service
termination to the Office of Administrative Hearings and that includes the contact information
for the Office of Administrative Hearings.
new text end

new text begin Subd. 5. new text end

new text begin Right to appeal service termination. new text end

new text begin (a) At any time prior to the expiration
of the notice period provided under subdivision 3 and section 144A.441, an assisted living
client may appeal the service termination by making a written request for a hearing to the
Office of Administrative Hearings. The Office of Administrative Hearings must conduct
the hearing no later than 14 days after the office receives the appeal request from the assisted
living client. The hearing must be held in the housing with services establishment where
the client resides, unless it is impractical or the parties agree to a different place.
new text end

new text begin (b) The arranged home care provider may not discontinue services to an assisted living
client who makes a timely appeal of a notice of service termination unless the Office of
Administrative Hearings has made a final determination on the appeal in favor of the arranged
home care provider.
new text end

new text begin (c) Assisted living clients are not required to request a meeting as available under
subdivision 4, clause (6), prior to submitting an appeal hearing request.
new text end

new text begin (d) The commissioner of health may order the arranged home care provider to rescind
the service contract termination if the proposed termination is in violation of state or federal
law.
new text end

new text begin (e) Nothing in this section limits the right of an assisted living client or the client's
representative to request or receive assistance from the Office of Ombudsman for Long-Term
Care and a protection and advocacy agency concerning the proposed service termination.
new text end

new text begin Subd. 6. new text end

new text begin Discontinuation of services. new text end

new text begin An arranged home care provider's responsibilities
when voluntarily discontinuing services to all clients are governed by section 144A.4791,
subdivision 10.
new text end

Sec. 22.

Minnesota Statutes 2016, section 144A.45, subdivision 1, is amended to read:

Subdivision 1.

Regulations.

The commissioner shall regulate home care providers
pursuant to sections 144A.43 to 144A.482. The regulations shall include the following:

(1) provisions to assure, to the extent possible, the health, safety, well-being, and
appropriate treatment of persons who receive home care services while respecting a client's
autonomy and choice;

(2) requirements that home care providers furnish the commissioner with specified
information necessary to implement sections 144A.43 to 144A.482;

(3) standards of training of home care provider personnel;

(4) standards for provision of home care services;

(5) standards for medication management;

(6) standards for supervision of home care services;

(7) standards for client evaluation or assessment;

(8) requirements for the involvement of a client's health care provider, the documentation
of health care providers' orders, if required, and the client's service plan;

(9) new text begin standards for new text end the maintenance of accurate, current client records;

(10) the establishment of basic and comprehensive levels of licenses based on services
provided; and

(11) provisions to enforce these regulations and the home care bill of rights new text begin , including
provisions for issuing penalties and fines as allowed under law new text end .

Sec. 23.

Minnesota Statutes 2016, section 144A.45, subdivision 2, is amended to read:

Subd. 2.

Regulatory functions.

The commissioner shall:

(1) license, survey, and monitor without advance notice, home care providers in
accordance with sections 144A.43 to 144A.482;

(2) survey every temporary licensee within one year of the temporary license issuance
date subject to the temporary licensee providing home care services to a client or clients;

(3) survey all licensed home care providers deleted text begin on an interval that will promote the health
and safety of clients deleted text end new text begin annually new text end ;

(4) with the consent of the client, visit the home where services are being provided;

(5) issue correction orders and assess civil penalties in accordance with deleted text begin section deleted text end new text begin sections new text end
144.653, subdivisions 5 to 8 new text begin , 144A.474, and 144A.475 new text end , for violations of sections 144A.43
to 144A.482;

(6) take action as authorized in section 144A.475; and

(7) take other action reasonably required to accomplish the purposes of sections 144A.43
to 144A.482.

Sec. 24.

Minnesota Statutes 2016, section 144A.474, subdivision 1, is amended to read:

Subdivision 1.

Surveys.

The commissioner shall conduct surveys of each home care
provider. deleted text begin By June 30, 2016, deleted text end The commissioner shall conduct a survey of home care providers
deleted text begin on a frequency of at least once every three years. Survey frequency may be based on the
license level, the provider's compliance history, the number of clients served, or other factors
as determined by the department deemed necessary to ensure the health, safety, and welfare
of clients and compliance with the law deleted text end new text begin annually new text end .

Sec. 25.

Minnesota Statutes 2016, section 144A.474, subdivision 8, is amended to read:

Subd. 8.

Correction orders.

(a) A correction order may be issued whenever the
commissioner finds upon survey or during a complaint investigation that a home care
provider, a managerial official, or an employee of the provider is not in compliance with
sections 144A.43 to 144A.482. The correction order shall cite the specific statute and
document areas of noncompliance and the time allowed for correction. new text begin In addition to issuing
a correction order, the commissioner may impose an immediate fine. The home care provider
must submit a correction plan to the commissioner.
new text end

(b) The commissioner shall mail copies of any correction order to the last known address
of the home care provider, or electronically scan the correction order and e-mail it to the
last known home care provider e-mail address, within 30 calendar days after the survey exit
date. A copy of each correction order new text begin , the amount of any immediate fine issued, the correction
plan, new text end and copies of any documentation supplied to the commissioner shall be kept on file
by the home care provider, and public documents shall be made available for viewing by
any person upon request. Copies may be kept electronically.

(c) By the correction order date, the home care provider must document in the provider's
records new text begin and submit in writing to the commissioner new text end any action taken to comply with the
correction order. deleted text begin The commissioner may request a copy of this documentation and the home
care provider's action to respond to the correction order in future surveys, upon a complaint
investigation, and as otherwise needed.
deleted text end

Sec. 26.

Minnesota Statutes 2016, section 144A.474, subdivision 9, is amended to read:

Subd. 9.

Follow-up surveys.

For providers that have Level 3 or Level 4 violations under
subdivision 11, or any violations determined to be widespread, the department shall conduct
a follow-up survey within 90 calendar days of the survey. When conducting a follow-up
survey, the surveyor will focus on whether the previous violations have been corrected and
may also address any new violations that are observed while evaluating the corrections that
have been made. If a new violation is identified on a follow-up survey, deleted text begin no fine will be
imposed unless it is not corrected on the next follow-up survey deleted text end new text begin the surveyor shall issue a
correction order for the new violation and may impose an immediate fine for the new
violation new text end .

Sec. 27.

Minnesota Statutes 2017 Supplement, 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 (c) as follows:

(1) new text begin Level 0, fines ranging from $0 to $500, using as a guide relevant or comparable
penalty schedules in Minnesota Rules, chapter 4658;
new text end

new text begin (2) new text end Level 1, no fines or enforcement;

deleted text begin (2) deleted text end new text begin (3) new text end Level 2, fines ranging from $0 to deleted text begin $500 deleted text end new text begin $....... new text end , in addition to any of the enforcement
mechanisms authorized in section 144A.475 for widespread violations;

deleted text begin (3) deleted text end new text begin (4) new text end Level 3, fines ranging from $500 to deleted text begin $1,000 deleted text end new text begin $....... new text end , in addition to any of the
enforcement mechanisms authorized in section 144A.475; and

deleted text begin (4) deleted text end new text begin (5) new text end Level 4, fines ranging from $1,000 to deleted text begin $5,000 deleted text end new text begin $....... new text end , in addition to any of the
enforcement mechanisms authorized in section 144A.475.

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

(1) level of violation:

(i) new text begin Level 0 is a violation of sections 144.6501, 144.651 to 144.6512, 144A.44, 144A.441,
or 626.557;
new text end

new text begin (ii) new text end 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;

deleted text begin (ii) deleted text end new text begin (iii) new text end 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;

deleted text begin (iii) deleted text end new text begin (iv) new text end 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

deleted text begin (iv) deleted text end new text begin (v) new text end 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 required to be
licensed under sections 144A.43 to 144A.482 has not corrected violations by the date
specified in the correction order or conditional license resulting from a survey or complaint
investigation, the commissioner may impose deleted text begin a deleted text end new text begin an additional new text end fine new text begin for noncompliance with
a correction order new text end . A notice of noncompliance with a correction order must be mailed to
the applicant's or provider's last known address. The deleted text begin noncompliance deleted text end notice new text begin of noncompliance
with a correction order new text end must list the violations not corrected new text begin and any fines imposed new text end .

(d) The license holder must pay the fines assessed on or before the payment date specified new text begin
on a correction order or on a notice of noncompliance with a correction order new text end . If the license
holder fails to deleted text begin fully comply with the order deleted text end new text begin pay a fine by the specified date new text end , the commissioner
may issue a deleted text begin second deleted text end new text begin late payment new text end fine or suspend the license until the license holder deleted text begin complies
by paying the fine deleted text end new text begin pays all outstanding fines new text end . A timely appeal shall stay payment of the new text begin late
payment new text end fine until the commissioner issues a final order.

(e) A license holder shall promptly notify the commissioner in writing when a violation
specified in deleted text begin the order deleted text end new text begin a notice of noncompliance with a correction order new text end is corrected. If upon
reinspection the commissioner determines that a violation has not been corrected as indicated
by the deleted text begin order deleted text end new text begin notice of noncompliance with a correction order new text end , the commissioner may issue
deleted text begin a second deleted text end new text begin an additional new text end fine new text begin for noncompliance with a notice of noncompliance with a
correction order new text end . The commissioner shall notify the license holder by mail to the last known
address in the licensing record that deleted text begin a second deleted text end new text begin an additional new text end fine has been assessed. The license
holder may appeal the deleted text begin second deleted text end new text begin additional new text end fine as provided under this subdivision.

(f) A home care provider that has been assessed a fine under this subdivision new text begin or
subdivision 8 new text end has a right to a reconsideration or a hearing under this section and chapter 14.

(g) 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.

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

(i) Fines collected under this subdivision shall be deposited in the state government
special revenue fund and credited to an account separate from the revenue collected under
section 144A.472. Subject to an appropriation by the legislature, the revenue from the fines
collected must be used by the commissioner for special projects to improve home care in
Minnesota as recommended by the advisory council established in section 144A.4799.

Sec. 28.

Minnesota Statutes 2016, section 144A.4791, subdivision 10, is amended to read:

Subd. 10.

Termination of service plan.

(a) new text begin Except as provided in section 144A.442, new text end if
a home care provider terminates a service plan with a client, and the client continues to need
home care services, the home care provider shall provide the client and the client's
representative, if any, with a written notice of termination which includes the following
information:

(1) the effective date of termination;

(2) the reason for termination;

(3) a list of known licensed home care providers in the client's immediate geographic
area;

(4) a statement that the home care provider will participate in a coordinated transfer of
care of the client to another home care provider, health care provider, or caregiver, as
required by the home care bill of rights, section 144A.44, subdivision 1, new text begin paragraph (a),
new text end clause (17);

(5) the name and contact information of a person employed by the home care provider
with whom the client may discuss the notice of termination; and

(6) if applicable, a statement that the notice of termination of home care services does
not constitute notice of termination of the housing with services contract with a housing
with services establishment.

(b) When the home care provider voluntarily discontinues services to all clients, the
home care provider must notify the commissioner, lead agencies, and ombudsman for
long-term care about its clients and comply with the requirements in this subdivision.

Sec. 29.

Minnesota Statutes 2016, section 144A.53, subdivision 1, is amended to read:

Subdivision 1.

Powers.

The director may:

(a) Promulgate by rule, pursuant to chapter 14, and within the limits set forth in
subdivision 2, the methods by which complaints against health facilities, health care
providers, home care providers, or residential care homes, or administrative agencies are
to be made, reviewed, investigated, and acted upon; provided, however, that a fee may not
be charged for filing a complaint.

(b) Recommend legislation and changes in rules to the state commissioner of health,
governor, administrative agencies or the federal government.

(c) Investigate, upon a complaint or upon initiative of the director, any action or failure
to act by a health care provider, home care provider, residential care home, or a health
facility.

(d) Request and receive access to relevant information, records, incident reports, or
documents in the possession of an administrative agency, a health care provider, a home
care provider, a residential care home, or a health facility, and issue investigative subpoenas
to individuals and facilities for oral information and written information, including privileged
information which the director deems necessary for the discharge of responsibilities. For
purposes of investigation and securing information to determine violations, the director
need not present a release, waiver, or consent of an individual. The identities of patients or
residents must be kept private as defined by section 13.02, subdivision 12.

(e) Enter and inspect, at any time, a health facility or residential care home and be
permitted to interview staff; provided that the director shall not unduly interfere with or
disturb the provision of care and services within the facility or home or the activities of a
patient or resident unless the patient or resident consents.

(f) Issue correction orders and assess civil fines pursuant to deleted text begin section deleted text end new text begin sections new text end 144.653 new text begin ,
144A.10, 144A.45, and 144A.474; Minnesota Rules, chapters 4655, 4658, 4664, and 4665; new text end
or any other law deleted text begin which deleted text end new text begin that new text end provides for the issuance of correction orders new text begin or fines new text end to health
facilities or home care provider deleted text begin , or under section 144A.45 deleted text end . A facility's or home's refusal to
cooperate in providing lawfully requested information may also be grounds for a correction
order new text begin or fine new text end .

(g) Recommend the certification or decertification of health facilities pursuant to Title
XVIII or XIX of the United States Social Security Act.

(h) Assist patients or residents of health facilities or residential care homes in the
enforcement of their rights under Minnesota law.

(i) Work with administrative agencies, health facilities, home care providers, residential
care homes, and health care providers and organizations representing consumers on programs
designed to provide information about health facilities to the public and to health facility
residents.

Sec. 30.

Minnesota Statutes 2016, section 144A.53, subdivision 4, is amended to read:

Subd. 4.

Referral of complaints.

new text begin (a) new text end If a complaint received by the director relates to
a matter more properly within the jurisdiction of new text begin law enforcement; new text end an occupational licensing
board new text begin , new text end or other governmental agency, the director shall forward the complaint deleted text begin to that agency deleted text end new text begin
appropriately new text end and shall inform the complaining party of the forwarding. deleted text begin The
deleted text end

new text begin (b) An new text end agency shall promptly act in respect to the complaint, and shall inform the
complaining party and the director of its disposition. If a governmental agency receives a
complaint which is more properly within the jurisdiction of the director, it shall promptly
forward the complaint to the director, and shall inform the complaining party of the
forwarding.

new text begin (c) new text end If the director has reason to believe that an official or employee new text begin , or client or resident new text end
of an administrative agency, a home care provider, residential care home, or health facility
has acted in a manner warranting criminal or disciplinary proceedings, the director shall
refer the matter to the state commissioner of health, the commissioner of human services,
an appropriate prosecuting authority, or other appropriate agency.

Sec. 31.

Minnesota Statutes 2016, section 144D.01, subdivision 1, is amended to read:

Subdivision 1.

Scope.

As used in sections 144D.01 to deleted text begin 144D.06 deleted text end new text begin 144D.11 new text end , the following
terms have the meanings given them.

Sec. 32.

Minnesota Statutes 2016, section 144D.02, is amended to read:

144D.02 REGISTRATION REQUIRED.

No entity may establish, operate, conduct, or maintain a housing with services
establishment in this state without registering and operating as required in sections 144D.01
to deleted text begin 144D.06 deleted text end new text begin 144D.11 new text end .

Sec. 33.

Minnesota Statutes 2017 Supplement, section 144D.04, subdivision 2, is amended
to read:

Subd. 2.

Contents of contract.

A housing with services contract, which need not be
entitled as such to comply with this section, shall include at least the following elements in
itself or through supporting documents or attachments:

(1) the name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners is not a natural person, identification of the type of business entity of
the owner or owners;

(3) the name and mailing address of the managing agent, through management agreement
or lease agreement, of the establishment, if different from the owner or owners;

(4) the name and new text begin physical mailing new text end address new text begin , which may not be a public or private post
office box, new text end of at least one natural person who is authorized to accept service of process on
behalf of the owner or owners and managing agent;

(5) a statement describing the registration and licensure status of the establishment and
any provider providing health-related or supportive services under an arrangement with the
establishment;

(6) the term of the contract;

(7) a description of the services to be provided to the resident in the base rate to be paid
by the resident, including a delineation of the portion of the base rate that constitutes rent
and a delineation of charges for each service included in the base rate;

(8) a description of any additional services, including home care services, available for
an additional fee from the establishment directly or through arrangements with the
establishment, and a schedule of fees charged for these services;

(9) a conspicuous notice informing the tenant of the policy concerning the conditions
under which and the process through which the contract may be modified, amended, or
terminated, including whether a move to a different room or sharing a room would be
required in the event that the tenant can no longer pay the current rent;

(10) a description of the establishment's complaint resolution process available to residents
including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;

(11) the resident's designated representative, if any;

(12) the establishment's referral procedures if the contract is terminated;

(13) requirements of residency used by the establishment to determine who may reside
or continue to reside in the housing with services establishment;

(14) billing and payment procedures and requirements;

(15) a statement regarding the ability of a resident to receive services from service
providers with whom the establishment does not have an arrangement;

(16) a statement regarding the availability of public funds for payment for residence or
services in the establishment new text begin and the fact that at least ten percent of the rooms or beds in
the housing with services establishment are to be used by residents whose payments are
made under the medical assistance elderly waiver program new text end ; deleted text begin and
deleted text end

(17) a statement regarding the availability of and contact information for long-term care
consultation services under section 256B.0911 in the county in which the establishment is
located deleted text begin . deleted text end new text begin ;
new text end

new text begin (18) a statement that a resident has the right to request a reasonable accommodation;
and
new text end

new text begin (19) a statement describing the conditions under which a contract may be amended.
new text end

Sec. 34.

Minnesota Statutes 2016, section 144D.04, is amended by adding a subdivision
to read:

new text begin Subd. 2b. new text end

new text begin Changes to contract. new text end

new text begin The housing with services establishment must provide
prompt written notice to the resident or resident's legal representative of a new owner,
manager, and if different from the owner, license holder of the housing with services
establishment, and the name and physical mailing address, which may not be a public or
private post office box of any new or additional natural person not identified in the admission
contract who is authorized to accept service of process.
new text end

Sec. 35.

new text begin [144D.061] ELDERLY WAIVER BEDS REQUIRED.
new text end

new text begin All registered housing with services establishments must designate at least ten percent
of rooms or beds for residents receiving medical assistance elderly waiver services.
new text end

Sec. 36.

new text begin [144D.085] RELOCATION WITHIN FACILITY.
new text end

new text begin Subdivision 1. new text end

new text begin Notification prior to relocation. new text end

new text begin A housing with services establishment
must:
new text end

new text begin (1) notify a resident and the resident's representative at least five days prior to a proposed
nonemergency relocation within the facility; and
new text end

new text begin (2) obtain consent from the resident or the resident's representative to the relocation.
new text end

new text begin Subd. 2. new text end

new text begin Restriction on relocation. new text end

new text begin A person who has been a private pay resident for
at least one year, resides in a private room, and whose payments subsequently will be made
under the medical assistance elderly waiver program may not be relocated to a shared room
without the consent of the resident or the resident's representative.
new text end

Sec. 37.

Minnesota Statutes 2016, section 144D.09, is amended to read:

144D.09 TERMINATION OF LEASE.

new text begin Subdivision 1. new text end

new text begin Legislative intent. new text end

deleted text begin The housing with services establishment shall include
with notice of termination of lease information about how to contact the ombudsman for
long-term care, including the address and telephone number along with a statement of how
to request problem-solving assistance. deleted text end new text begin It is the intent of the legislature to ensure to the
greatest extent possible stability of housing for persons residing in housing with services
establishments.
new text end

new text begin Subd. 2. new text end

new text begin Permissible reasons to terminate lease. new text end

new text begin (a) Notwithstanding chapter 504B, a
housing with services establishment may terminate a resident's lease only if:
new text end

new text begin (1) the resident breaches the lease, which includes failure to pay rent as required, and
has not cured the breach within 30 days of receipt of the notice required under subdivision
3. A breach of a services contract does not constitute a breach of a lease;
new text end

new text begin (2) the resident holds over beyond the date to vacate mutually agreed upon in writing
by the resident and the housing with services establishment; or
new text end

new text begin (3) the resident holds over beyond the date provided by the resident in a notice of
voluntary termination of the lease provided to the housing with services establishment.
new text end

new text begin (b) Notwithstanding paragraph (a), a housing with services establishment may
immediately commence an eviction if the breach involves any of the acts listed in section
504B.171, subdivision 1.
new text end

new text begin Subd. 3. new text end

new text begin Notice of lease termination. new text end

new text begin A housing with services establishment must
provide at least 30 days' notice prior to terminating a residential lease, unless the resident
commits a breach of the lease involving any of the acts listed in section 504B.171, subdivision
1.
new text end

new text begin Subd. 4. new text end

new text begin Contents of notice. new text end

new text begin The notice of lease termination required under subdivision
3 must include:
new text end

new text begin (1) the reason for the termination;
new text end

new text begin (2) the date termination shall occur;
new text end

new text begin (3) a statement that a lease cannot be terminated without providing the resident an
opportunity to cure the breach of lease, including failure to pay rent, prior to expiration of
30 days after receipt of the notice;
new text end

new text begin (4) information on how to contact the Office of Ombudsman for Long-Term Care and
a protection and advocacy agency, including the address and telephone number of both
offices, along with a statement of how to request problem-solving assistance;
new text end

new text begin (5) a statement that the resident has the right to a meeting at the resident's request with
the owner or manager of the housing with services establishment to discuss and attempt to
resolve the alleged breach to avoid termination; and
new text end

new text begin (6) a statement that the resident has the right to appeal the termination of the lease to
the Office of Administrative Hearings and provide the contact information for the Office
of Administrative Hearings.
new text end

new text begin Subd. 5. new text end

new text begin Right to appeal termination of lease. new text end

new text begin (a) At any time prior to the expiration
of the notice period provided under subdivision 3, a resident may appeal the termination by
making a written request for a hearing to the Office of Administrative Hearings. The Office
of Administrative Hearings must conduct the hearing no later than 14 days after the office
receives the appeal request from the resident. The hearing must be held in the establishment
in which the resident resides, unless it is impractical or the parties agree to a different place.
new text end

new text begin (b) A resident who makes a timely appeal of a notice of lease termination may not be
evicted by the housing with services establishment unless the Office of Administrative
Hearings has made a final determination on the appeal in favor of the housing with services
establishment.
new text end

new text begin (c) The commissioner of health may order the housing with services establishment to
rescind the lease termination or readmit the resident if the lease termination was in violation
of state or federal law.
new text end

new text begin (d) The housing with services establishment must readmit the resident if the resident is
hospitalized for medical necessity before resolution of the appeal.
new text end

new text begin (e) Residents are not required to request a meeting under subdivision 4, clause (6), prior
to submitting an appeal hearing request.
new text end

new text begin (f) Nothing in this section limits the right of a resident or the resident's representative
to request or receive assistance from the Office of Ombudsman for Long-Term Care and
the protection and advocacy agency concerning the proposed lease termination.
new text end

new text begin Subd. 6. new text end

new text begin Discharge plan and transfer of information to new residence. new text end

new text begin (a) For the
purposes of this subdivision and subdivision 7, "discharge" means the involuntary relocation
of a resident due to a termination of a lease.
new text end

new text begin (b) A housing with services establishment discharging a resident must prepare an adequate
discharge plan that proposes a safe discharge location, is based on the resident's discharge
goals, includes the resident and the resident's case manager and representative, if any, in
discharge planning, and contains a plan for appropriate and sufficient postdischarge care.
A housing with services establishment may not discharge a resident if the resident will
become homeless upon discharge, as that term is defined in section 116L.361, subdivision
5.
new text end

new text begin (c) A housing with services establishment that proposes to discharge a resident must
assist the resident with applying for and locating a new housing with services establishment
or skilled nursing facility in which to live, including coordinating with the case manager,
if any.
new text end

new text begin (d) Prior to discharge, a housing with services establishment must provide to the receiving
facility or establishment all information known to the housing with services establishment
related to the resident that is necessary to ensure continuity of care and services, including,
at a minimum:
new text end

new text begin (1) the resident's full name, date of birth, and insurance information;
new text end

new text begin (2) the name, telephone number, and address of the resident's representative, if any;
new text end

new text begin (3) the resident's current documented diagnoses;
new text end

new text begin (4) the resident's known allergies, if any;
new text end

new text begin (5) the name and telephone number of the resident's physician and current physician
orders;
new text end

new text begin (6) medication administration records;
new text end

new text begin (7) the most recent resident assessment; and
new text end

new text begin (8) copies of health care directives, "do not resuscitate" orders, and guardianship orders
or powers of attorney, if any.
new text end

new text begin Subd. 7. new text end

new text begin Final accounting; return of money and property. new text end

new text begin Within 30 days of the date
of discharge, the housing with services establishment shall:
new text end

new text begin (1) provide to the resident or the resident's representative a final statement of account;
new text end

new text begin (2) provide any refunds due; and
new text end

new text begin (3) return any money, property, or valuables held in trust or custody by the establishment.
new text end

Sec. 38.

new text begin [144D.095] TERMINATION OF SERVICES.
new text end

new text begin A termination of services initiated by an arranged home care provider is governed by
section 144A.442.
new text end

Sec. 39.

Minnesota Statutes 2016, section 144G.01, subdivision 1, is amended to read:

Subdivision 1.

Scope; other definitions.

For purposes of sections 144G.01 to deleted text begin 144G.05 deleted text end new text begin
144G.08 new text end , the following definitions apply. In addition, the definitions provided in section
144D.01 also apply to sections 144G.01 to deleted text begin 144G.05 deleted text end new text begin 144G.08 new text end .

Sec. 40.

new text begin [144G.07] TERMINATION OF LEASE.
new text end

new text begin A lease termination initiated by a registered housing with services establishment using
"assisted living" is governed by section 144D.09.
new text end

Sec. 41.

new text begin [144G.08] TERMINATION OF SERVICES.
new text end

new text begin A termination of services initiated by an arranged home care provider as defined in
section 144D.01, subdivision 2a, is governed by section 144A.442.
new text end

Sec. 42.

Minnesota Statutes 2017 Supplement, section 256.045, subdivision 3, is amended
to read:

Subd. 3.

State agency hearings.

(a) State agency hearings are available for the following:

(1) any person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county agency or the
federal Food Stamp Act whose application for assistance is denied, not acted upon with
reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed
to have been incorrectly paid;

(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;

(3) a party aggrieved by a ruling of a prepaid health plan;

(4) except as provided under chapter 245C deleted text begin , deleted text end new text begin :
new text end

new text begin (i) new text end any individual or facility determined by a lead investigative agency to have maltreated
a vulnerable adult under section 626.557 after they have exercised their right to administrative
reconsideration under section 626.557; new text begin and
new text end

new text begin (ii) any vulnerable adult who is the subject of a maltreatment investigation under section
626.557 or unless restricted by the vulnerable adult or by a court, an interested person as
defined in section 524.5-102, subdivision 7, after the right to administrative reconsideration
under section 626.557, subdivision 9d, has been exercised;
new text end

(5) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under section 626.556 is denied or not
acted upon with reasonable promptness, regardless of funding source;

(6) any person to whom a right of appeal according to this section is given by other
provision of law;

(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
under section 256B.15;

(8) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;

(9) except as provided under chapter 245A, an individual or facility determined to have
maltreated a minor under section 626.556, after the individual or facility has exercised the
right to administrative reconsideration under section 626.556;

(10) except as provided under chapter 245C, an individual disqualified under sections
245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
individual has committed an act or acts that meet the definition of any of the crimes listed
in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
626.556, subdivision 3, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) or (9) and a disqualification under this clause in which the
basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
a single fair hearing. In such cases, the scope of review by the human services judge shall
include both the maltreatment determination and the disqualification. The failure to exercise
the right to an administrative reconsideration shall not be a bar to a hearing under this section
if federal law provides an individual the right to a hearing to dispute a finding of
maltreatment;

(11) any person with an outstanding debt resulting from receipt of public assistance,
medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A against
the debt;

(12) a person issued a notice of service termination under section 245D.10, subdivision
3a, from residential supports and services as defined in section 245D.03, subdivision 1,
paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a;

(13) an individual disability waiver recipient based on a denial of a request for a rate
exception under section 256B.4914; or

(14) a person issued a notice of service termination under section 245A.11, subdivision
11, that is not otherwise subject to appeal under subdivision 4a.

(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
is the only administrative appeal to the final agency determination specifically, including
a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
available when there is no district court action pending. If such action is filed in district
court while an administrative review is pending that arises out of some or all of the events
or circumstances on which the appeal is based, the administrative review must be suspended
until the judicial actions are completed. If the district court proceedings are completed,
dismissed, or overturned, the matter may be considered in an administrative hearing.

(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.

(d) The scope of hearings involving claims to foster care payments under paragraph (a),
clause (5), shall be limited to the issue of whether the county is legally responsible for a
child's placement under court order or voluntary placement agreement and, if so, the correct
amount of foster care payment to be made on the child's behalf and shall not include review
of the propriety of the county's child protection determination or child placement decision.

(e) The scope of hearings under paragraph (a), clauses (12) and (14), shall be limited to
whether the proposed termination of services is authorized under section 245D.10,
subdivision 3a, paragraph (b), or 245A.11, subdivision 11, and whether the requirements
of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision 2a,
paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of
termination of services, the scope of the hearing shall also include whether the case
management provider has finalized arrangements for a residential facility, a program, or
services that will meet the assessed needs of the recipient by the effective date of the service
termination.

(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing under this section, except if assisting a recipient as provided in subdivision
4.

(g) An applicant or recipient is not entitled to receive social services beyond the services
prescribed under chapter 256M or other social services the person is eligible for under state
law.

(h) The commissioner may summarily affirm the county or state agency's proposed
action without a hearing when the sole issue is an automatic change due to a change in state
or federal law.

(i) Unless federal or Minnesota law specifies a different time frame in which to file an
appeal, an individual or organization specified in this section may contest the specified
action, decision, or final disposition before the state agency by submitting a written request
for a hearing to the state agency within 30 days after receiving written notice of the action,
decision, or final disposition, or within 90 days of such written notice if the applicant,
recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
13, why the request was not submitted within the 30-day time limit. The individual filing
the appeal has the burden of proving good cause by a preponderance of the evidence.

Sec. 43.

Minnesota Statutes 2017 Supplement, section 256.045, subdivision 4, is amended
to read:

Subd. 4.

Conduct of hearings.

(a) All hearings held pursuant to subdivision 3, 3a, 3b,
or 4a shall be conducted according to the provisions of the federal Social Security Act and
the regulations implemented in accordance with that act to enable this state to qualify for
federal grants-in-aid, and according to the rules and written policies of the commissioner
of human services. County agencies shall install equipment necessary to conduct telephone
hearings. A state human services judge may schedule a telephone conference hearing when
the distance or time required to travel to the county agency offices will cause a delay in the
issuance of an order, or to promote efficiency, or at the mutual request of the parties. Hearings
may be conducted by telephone conferences unless the applicant, recipient, former recipient,
person, or facility contesting maltreatment objects. A human services judge may grant a
request for a hearing in person by holding the hearing by interactive video technology or
in person. The human services judge must hear the case in person if the person asserts that
either the person or a witness has a physical or mental disability that would impair the
person's or witness's ability to fully participate in a hearing held by interactive video
technology. The hearing shall not be held earlier than five days after filing of the required
notice with the county or state agency. The state human services judge shall notify all
interested persons of the time, date, and location of the hearing at least five days before the
date of the hearing. Interested persons may be represented by legal counsel or other
representative of their choice, including a provider of therapy services, at the hearing and
may appear personally, testify and offer evidence, and examine and cross-examine witnesses.
The applicant, recipient, former recipient, person, or facility contesting maltreatment shall
have the opportunity to examine the contents of the case file and all documents and records
to be used by the county or state agency at the hearing at a reasonable time before the date
of the hearing and during the hearing. In hearings under subdivision 3, paragraph (a), clauses
(4), (9), and (10), either party may subpoena the private data relating to the investigation
prepared by the agency under section 626.556 or 626.557 that is not otherwise accessible
under section 13.04, provided the identity of the reporter may not be disclosed.

(b) The private data obtained by subpoena in a hearing under subdivision 3, paragraph
(a), clause (4), (9), or (10), must be subject to a protective order which prohibits its disclosure
for any other purpose outside the hearing provided for in this section without prior order of
the district court. Disclosure without court order is punishable by a sentence of not more
than 90 days imprisonment or a fine of not more than $1,000, or both. These restrictions on
the use of private data do not prohibit access to the data under section 13.03, subdivision
6. Except for appeals under subdivision 3, paragraph (a), clauses (4), (5), (9), and (10), upon
request, the county agency shall provide reimbursement for transportation, child care,
photocopying, medical assessment, witness fee, and other necessary and reasonable costs
incurred by the applicant, recipient, or former recipient in connection with the appeal. All
evidence, except that privileged by law, commonly accepted by reasonable people in the
conduct of their affairs as having probative value with respect to the issues shall be submitted
at the hearing and such hearing shall not be "a contested case" within the meaning of section
14.02, subdivision 3. The agency must present its evidence prior to or at the hearing, and
may not submit evidence after the hearing except by agreement of the parties at the hearing,
provided the petitioner has the opportunity to respond.

(c) In hearings under subdivision 3, paragraph (a), clauses (4), (9), and (10), involving
determinations of maltreatment or disqualification made by more than one county agency,
by a county agency and a state agency, or by more than one state agency, the hearings may
be consolidated into a single fair hearing upon the consent of all parties and the state human
services judge.

(d) For hearings under subdivision 3, paragraph (a), clause (4) or (10), involving a
vulnerable adult, the human services judge shall notify the vulnerable adult who is the
subject of the maltreatment determination and new text begin an interested person, as defined in section
524.5-102, subdivision 7 new text end , if known, deleted text begin a guardian of the vulnerable adult appointed under
section 524.5-310, or a health care agent designated by the vulnerable adult in a health care
directive that is currently effective under section 145C.06 and whose authority to make
health care decisions is not suspended under section 524.5-310, of the hearing deleted text end new text begin and whose
authority has not been restricted by the vulnerable adult or by a court, and shall notify the
facility or individual who is the alleged perpetrator of maltreatment new text end . The notice must be
sent by certified mail and inform the vulnerable adult new text begin or the alleged perpetrator new text end of the right
to file a signed written statement in the proceedings. A guardian or health care agent who
prepares or files a written statement for the vulnerable adult must indicate in the statement
that the person is the vulnerable adult's guardian or health care agent and sign the statement
in that capacity. The vulnerable adult, the guardian, or the health care agent may file a
written statement with the human services judge hearing the case no later than five business
days before commencement of the hearing. The human services judge shall include the
written statement in the hearing record and consider the statement in deciding the appeal.
This subdivision does not limit, prevent, or excuse the vulnerable adult new text begin or alleged perpetrator
new text end from being called as a witness testifying at the hearing or grant the vulnerable adult, the
guardian, or health care agent a right to participate in the proceedings or appeal the human
services judge's decision in the case. The lead investigative agency must consider including
the vulnerable adult victim of maltreatment as a witness in the hearing. If the lead
investigative agency determines that participation in the hearing would endanger the
well-being of the vulnerable adult or not be in the best interests of the vulnerable adult, the
lead investigative agency shall inform the human services judge of the basis for this
determination, which must be included in the final order. If the human services judge is not
reasonably able to determine the address of the vulnerable adult, the guardian, new text begin the alleged
perpetrator, new text end or the health care agent, the human services judge is not required to send a
hearing notice under this subdivision.

Sec. 44.

Minnesota Statutes 2016, section 325F.71, is amended to read:

325F.71 SENIOR CITIZENS new text begin , VULNERABLE ADULTS, new text end AND deleted text begin DISABLED deleted text end
PERSONS new text begin WITH DISABILITIES new text end ; ADDITIONAL CIVIL PENALTY FOR
DECEPTIVE ACTS.

Subdivision 1.

Definitions.

For the purposes of this section, the following words have
the meanings given them:

(a) "Senior citizen" means a person who is 62 years of age or older.

(b) " deleted text begin Disabled deleted text end Person new text begin with a disability new text end " means a person who has an impairment of physical
or mental function or emotional status that substantially limits one or more major life
activities.

(c) "Major life activities" means functions such as caring for one's self, performing
manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working.

new text begin (d) "Vulnerable adult" has the meaning given in section 626.5572, subdivision 21.
new text end

Subd. 2.

Supplemental civil penalty.

(a) In addition to any liability for a civil penalty
pursuant to sections 325D.43 to 325D.48, regarding deceptive trade practices; 325F.67,
regarding false advertising; and 325F.68 to 325F.70, regarding consumer fraud; a person
who engages in any conduct prohibited by those statutes, and whose conduct is perpetrated
against one or more senior citizens new text begin , vulnerable adults, new text end or deleted text begin disabled deleted text end persons new text begin with a disability new text end ,
is liable for an additional civil penalty not to exceed $10,000 for each violation, if one or
more of the factors in paragraph (b) are present.

(b) In determining whether to impose a civil penalty pursuant to paragraph (a), and the
amount of the penalty, the court shall consider, in addition to other appropriate factors, the
extent to which one or more of the following factors are present:

(1) whether the defendant knew or should have known that the defendant's conduct was
directed to one or more senior citizens new text begin , vulnerable adults, new text end or deleted text begin disabled deleted text end persons new text begin with a
disability new text end ;

(2) whether the defendant's conduct caused new text begin one or more new text end senior citizens new text begin , vulnerable adults, new text end
or deleted text begin disabled deleted text end persons new text begin with a disability new text end to suffer: loss or encumbrance of a primary residence,
principal employment, or source of income; substantial loss of property set aside for
retirement or for personal or family care and maintenance; substantial loss of payments
received under a pension or retirement plan or a government benefits program; or assets
essential to the health or welfare of the senior citizen new text begin , vulnerable adult, new text end or deleted text begin disabled deleted text end person new text begin
with a disability new text end ;

(3) whether one or more senior citizens new text begin , vulnerable adults, new text end or deleted text begin disabled deleted text end persons new text begin with a
disability new text end are more vulnerable to the defendant's conduct than other members of the public
because of age, poor health or infirmity, impaired understanding, restricted mobility, or
disability, and actually suffered physical, emotional, or economic damage resulting from
the defendant's conduct; deleted text begin or
deleted text end

(4) whether the defendant's conduct caused senior citizens new text begin , vulnerable adults, new text end or deleted text begin disabled deleted text end
persons new text begin with a disability new text end to make an uncompensated asset transfer that resulted in the person
being found ineligible for medical assistance deleted text begin . deleted text end new text begin ; or
new text end

new text begin (5) whether the defendant provided or arranged for health care or services that are inferior
to, substantially different than, or substantially more expensive than offered, promised,
marketed, or advertised.
new text end

Subd. 3.

Restitution to be given priority.

Restitution ordered pursuant to the statutes
listed in subdivision 2 shall be given priority over imposition of civil penalties designated
by the court under this section.

Subd. 4.

Private remedies.

A person injured by a violation of this section may bring a
civil action and recover damages, together with costs and disbursements, including costs
of investigation and reasonable attorney's fees, and receive other equitable relief as
determined by the court.

Sec. 45.

Minnesota Statutes 2016, section 573.02, subdivision 2, is amended to read:

Subd. 2.

Injury action.

new text begin (a) new text end When injury is caused to a person by the wrongful act or
omission of any person or corporation and the person thereafter dies from a cause unrelated
to those injuries, the trustee appointed in subdivision 3 may maintain an action for special
damages arising out of such injury if the decedent might have maintained an action therefor
had the decedent lived.

new text begin (b) When the injury is caused to a person who was a vulnerable adult, prior to the injury,
the next of kin may maintain an action on behalf of the decedent for damages for pain and
suffering, in addition to special damages as provided under paragraph (a). For purposes of
this paragraph, "vulnerable adult" has the meaning given in section 626.5572, subdivision
21.
new text end

Sec. 46.

Minnesota Statutes 2016, section 609.2231, subdivision 8, is amended to read:

Subd. 8.

Vulnerable adults.

(a) As used in this subdivision, "vulnerable adult" has the
meaning given in section 609.232, subdivision 11.

(b) Whoever assaults deleted text begin and inflicts demonstrable bodily harm on deleted text end a vulnerable adult,
knowing or having reason to know that the person is a vulnerable adult, is guilty of a gross
misdemeanor.

Sec. 47.

Minnesota Statutes 2016, section 626.557, subdivision 3, is amended to read:

Subd. 3.

Timing of report.

(a) A mandated reporter who has reason to believe that a
vulnerable adult is being or has been maltreated, or who has knowledge that a vulnerable
adult has sustained a physical injury which is not reasonably explained shall deleted text begin immediately deleted text end
report the information to the common entry point new text begin as soon as possible but in no event longer
than 24 hours new text end . If an individual is a vulnerable adult solely because the individual is admitted
to a facility, a mandated reporter is not required to report suspected maltreatment of the
individual that occurred prior to admission, unless:

(1) the individual was admitted to the facility from another facility and the reporter has
reason to believe the vulnerable adult was maltreated in the previous facility; or

(2) the reporter knows or has reason to believe that the individual is a vulnerable adult
as defined in section 626.5572, subdivision 21, paragraph (a), clause (4).

(b) A person not required to report under the provisions of this section may voluntarily
report as described above.

(c) Nothing in this section requires a report of known or suspected maltreatment, if the
reporter knows or has reason to know that a report has been made to the common entry
point.

(d) Nothing in this section shall preclude a reporter from also reporting to a law
enforcement agency.

(e) A mandated reporter who knows or has reason to believe that an error under section
626.5572, subdivision 17, paragraph (c), clause (5), occurred must make a report under this
subdivision. If the reporter or a facility, at any time believes that an investigation by a lead
investigative agency will determine or should determine that the reported error was not
neglect according to the criteria under section 626.5572, subdivision 17, paragraph (c),
clause (5), the reporter or facility may provide to the common entry point or directly to the
lead investigative agency information explaining how the event meets the criteria under
section 626.5572, subdivision 17, paragraph (c), clause (5). The lead investigative agency
shall consider this information when making an initial disposition of the report under
subdivision 9c.

Sec. 48.

Minnesota Statutes 2016, section 626.557, subdivision 4, is amended to read:

Subd. 4.

Reporting.

(a) Except as provided in paragraph (b), a mandated reporter shall
immediately make an oral report to the common entry point. The common entry point may
accept electronic reports submitted through a Web-based reporting system established by
the commissioner. Use of a telecommunications device for the deaf or other similar device
shall be considered an oral report. The common entry point may not require written reports.
To the extent possible, the report must be of sufficient content to identify the vulnerable
adult, the caregiver, the nature and extent of the suspected maltreatment, any evidence of
previous maltreatment, the name and address of the reporter, the time, date, and location of
the incident, and any other information that the reporter believes might be helpful in
investigating the suspected maltreatment. new text begin The common entry point must provide a method
for the reporter to electronically submit evidence to support the maltreatment report, including
but not limited to uploading photographs, videos, or documents. new text end A mandated reporter may
disclose not public data, as defined in section 13.02, and medical records under sections
144.291 to 144.298, to the extent necessary to comply with this subdivision.

(b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified
under Title 19 of the Social Security Act, a nursing home that is licensed under section
144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a hospital
that is licensed under sections 144.50 to 144.58 and has swing beds certified under Code
of Federal Regulations, title 42, section 482.66, may submit a report electronically to the
common entry point instead of submitting an oral report. deleted text begin The report may be a duplicate of
the initial report the facility submits electronically to the commissioner of health to comply
with the reporting requirements under Code of Federal Regulations, title 42, section 483.13. deleted text end
The commissioner of health may modify these reporting requirements to include items
required under paragraph (a) that are not currently included in the electronic reporting form.

new text begin (c) All reports must be directed to the common entry point, including reports from
federally licensed facilities, vulnerable adults, and interested persons.
new text end

Sec. 49.

Minnesota Statutes 2016, section 626.557, subdivision 9, is amended to read:

Subd. 9.

Common entry point designation.

(a) Each county board shall designate a
common entry point for reports of suspected maltreatment, for use until the commissioner
of human services establishes a common entry point. Two or more county boards may
jointly designate a single common entry point. The commissioner of human services shall
establish a common entry point effective July 1, 2015. The common entry point is the unit
responsible for receiving the report of suspected maltreatment under this section.

(b) The common entry point must be available 24 hours per day to take calls from
reporters of suspected maltreatment. new text begin The common entry point staff must receive training
on how to screen and dispatch reports efficiently and in accordance with this section. new text end The
common entry point shall use a standard intake form that includes:

(1) the time and date of the report;

(2) the name, address, and telephone number of the person reporting;

(3) the time, date, and location of the incident;

(4) the names of the persons involved, including but not limited to, perpetrators, alleged
victims, and witnesses;

(5) whether there was a risk of imminent danger to the alleged victim;

(6) a description of the suspected maltreatment;

(7) the disability, if any, of the alleged victim;

(8) the relationship of the alleged perpetrator to the alleged victim;

(9) whether a facility was involved and, if so, which agency licenses the facility;

(10) any action taken by the common entry point;

(11) whether law enforcement has been notified;

(12) whether the reporter wishes to receive notification of the initial and final reports;
and

(13) if the report is from a facility with an internal reporting procedure, the name, mailing
address, and telephone number of the person who initiated the report internally.

(c) The common entry point is not required to complete each item on the form prior to
dispatching the report to the appropriate lead investigative agency.

(d) The common entry point shall immediately report to a law enforcement agency any
incident in which there is reason to believe a crime has been committed.

(e) If a report is initially made to a law enforcement agency or a lead investigative agency,
those agencies shall take the report on the appropriate common entry point intake forms
and immediately forward a copy to the common entry point.

(f) The common entry point deleted text begin staff deleted text end must deleted text begin receive training on how to screen and dispatch
reports efficiently and in accordance with this section. deleted text end new text begin cross-reference multiple complaints
to the lead investigative agency concerning:
new text end

new text begin (1) the same alleged perpetrator, facility, or licensee;
new text end

new text begin (2) the same vulnerable adult; or
new text end

new text begin (3) the same incident.
new text end

(g) The commissioner of human services shall maintain a centralized database for the
collection of common entry point data, lead investigative agency data including maltreatment
report disposition, and appeals data. The common entry point shall have access to the
centralized database and must log the reports into the database and immediately identify
and locate prior reports of abuse, neglect, or exploitation.

(h) When appropriate, the common entry point staff must refer calls that do not allege
the abuse, neglect, or exploitation of a vulnerable adult to other organizations that might
resolve the reporter's concerns.

(i) A common entry point must be operated in a manner that enables the commissioner
of human services to:

(1) track critical steps in the reporting, evaluation, referral, response, disposition, and
investigative process to ensure compliance with all requirements for all reports;

(2) maintain data to facilitate the production of aggregate statistical reports for monitoring
patterns of abuse, neglect, or exploitation;

(3) serve as a resource for the evaluation, management, and planning of preventative
and remedial services for vulnerable adults who have been subject to abuse, neglect, or
exploitation;

(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
of the common entry point; and

(5) track and manage consumer complaints related to the common entry point deleted text begin . deleted text end new text begin , including
tracking and cross-referencing multiple complaints concerning:
new text end

new text begin (i) the same alleged perpetrator, facility, or licensee;
new text end

new text begin (ii) the same vulnerable adult; and
new text end

new text begin (iii) the same incident.
new text end

(j) The commissioners of human services and health shall collaborate on the creation of
a system for referring reports to the lead investigative agencies. This system shall enable
the commissioner of human services to track critical steps in the reporting, evaluation,
referral, response, disposition, investigation, notification, determination, and appeal processes.

Sec. 50.

Minnesota Statutes 2016, section 626.557, subdivision 9a, is amended to read:

Subd. 9a.

Evaluation and referral of reports made to common entry point.

(a) The
common entry point must screen the reports of alleged or suspected maltreatment for
immediate risk and make all necessary referrals as follows:

(1) if the common entry point determines that there is an immediate need for emergency
adult protective services, the common entry point agency shall immediately notify the
appropriate county agency;

(2) new text begin if the common entry point determines immediate need exists for response by law
enforcement, including the urgent need to secure a crime scene, interview witnesses, remove
the alleged perpetrator, or safeguard the vulnerable adult's property, or new text end if the report contains
suspected criminal activity against a vulnerable adult, the common entry point shall
immediately notify the appropriate law enforcement agency;

(3) the common entry point shall refer all reports of alleged or suspected maltreatment
to the appropriate lead investigative agency as soon as possible, but in any event no longer
than two working days;

(4) if the report contains information about a suspicious death, the common entry point
shall immediately notify the appropriate law enforcement agencies, the local medical
examiner, and the ombudsman for mental health and developmental disabilities established
under section 245.92. Law enforcement agencies shall coordinate with the local medical
examiner and the ombudsman as provided by law; and

(5) for reports involving multiple locations or changing circumstances, the common
entry point shall determine the county agency responsible for emergency adult protective
services and the county responsible as the lead investigative agency, using referral guidelines
established by the commissioner.

(b) If the lead investigative agency receiving a report believes the report was referred
by the common entry point in error, the lead investigative agency shall immediately notify
the common entry point of the error, including the basis for the lead investigative agency's
belief that the referral was made in error. The common entry point shall review the
information submitted by the lead investigative agency and immediately refer the report to
the appropriate lead investigative agency.

Sec. 51.

Minnesota Statutes 2016, section 626.557, subdivision 9b, is amended to read:

Subd. 9b.

Response to reports.

Law enforcement is the primary agency to conduct
investigations of any incident in which there is reason to believe a crime has been committed.
Law enforcement shall initiate a response immediately. If the common entry point notified
a county agency for emergency adult protective services, law enforcement shall cooperate
with that county agency when both agencies are involved and shall exchange data to the
extent authorized in subdivision 12b, paragraph deleted text begin (g) deleted text end new text begin (k) new text end . County adult protection shall initiate
a response immediately. Each lead investigative agency shall complete the investigative
process for reports within its jurisdiction. A lead investigative agency, county, adult protective
agency, licensed facility, or law enforcement agency shall cooperate with other agencies in
the provision of protective services, coordinating its investigations, and assisting another
agency within the limits of its resources and expertise and shall exchange data to the extent
authorized in subdivision 12b, paragraph deleted text begin (g) deleted text end new text begin (k) new text end . The lead investigative agency shall obtain
the results of any investigation conducted by law enforcement officials new text begin , and law enforcement
shall obtain the results of any investigation conducted by the lead investigative agency to
determine if criminal action is warranted new text end . The lead investigative agency has the right to
enter facilities and inspect and copy records as part of investigations. The lead investigative
agency has access to not public data, as defined in section 13.02, and medical records under
sections 144.291 to 144.298, that are maintained by facilities to the extent necessary to
conduct its investigation. Each lead investigative agency shall develop guidelines for
prioritizing reports for investigation. new text begin Nothing in this subdivision alters the duty of the lead
investigative agency to serve as the agency responsible for investigating reports made under
section 626.557.
new text end

Sec. 52.

Minnesota Statutes 2016, section 626.557, subdivision 9c, is amended to read:

Subd. 9c.

Lead investigative agency; notifications, dispositions, determinations.

(a)
deleted text begin Upon request of the reporter, deleted text end The lead investigative agency shall notify the reporter that it
has received the report, and provide information on the initial disposition of the report within
five business days of receipt of the report, provided that the notification will not endanger
the vulnerable adult or hamper the investigation.

new text begin (b) The lead investigative agency must provide the following information to the vulnerable
adult or the vulnerable adult's interested person, if known, within five days of receipt of the
report:
new text end

new text begin (1) the nature of the maltreatment allegations, including the report of maltreatment as
allowed under law;
new text end

new text begin (2) the name of the facility or other location at which alleged maltreatment occurred;
new text end

new text begin (3) the name of the alleged perpetrator if the lead investigative agency believes disclosure
of the name is necessary to protect the vulnerable adult;
new text end

new text begin (4) protective measures that may be recommended or taken as a result of the maltreatment
report;
new text end

new text begin (5) contact information for the investigator or other information as requested and allowed
under law; and
new text end

new text begin (6) confirmation of whether the facility is investigating the matter and, if so:
new text end

new text begin (i) an explanation of the process and estimated timeline for the investigation; and
new text end

new text begin (ii) a statement that the lead investigative agency will provide an update on the
investigation approximately every three weeks upon request by the vulnerable adult or the
vulnerable adult's interested person and a report when the investigation is concluded.
new text end

new text begin (c) The lead investigative agency may assign multiple reports of maltreatment for the
same or separate incidences related to the same vulnerable adult to the same investigator,
as deemed appropriate. Reports related to the same vulnerable adult must, at a minimum,
be cross-referenced.
new text end

deleted text begin (b) deleted text end new text begin (d) new text end Upon conclusion of every investigation it conducts, the lead investigative agency
shall make a final disposition as defined in section 626.5572, subdivision 8.

deleted text begin (c) deleted text end new text begin (e) new text end When determining whether the facility or individual is the responsible party for
substantiated maltreatment or whether both the facility and the individual are responsible
for substantiated maltreatment, the lead investigative agency shall consider at least the
following mitigating factors:

(1) whether the actions of the facility or the individual caregivers were in accordance
with, and followed the terms of, an erroneous physician order, prescription, resident care
plan, or directive. This is not a mitigating factor when the facility or caregiver is responsible
for the issuance of the erroneous order, prescription, plan, or directive or knows or should
have known of the errors and took no reasonable measures to correct the defect before
administering care;

(2) the comparative responsibility between the facility, other caregivers, and requirements
placed upon the employee, including but not limited to, the facility's compliance with related
regulatory standards and factors such as the adequacy of facility policies and procedures,
the adequacy of facility training, the adequacy of an individual's participation in the training,
the adequacy of caregiver supervision, the adequacy of facility staffing levels, and a
consideration of the scope of the individual employee's authority; and

(3) whether the facility or individual followed professional standards in exercising
professional judgment.

deleted text begin (d) deleted text end new text begin (f) new text end When substantiated maltreatment is determined to have been committed by an
individual who is also the facility license holder, both the individual and the facility must
be determined responsible for the maltreatment, and both the background study
disqualification standards under section 245C.15, subdivision 4, and the licensing actions
under section 245A.06 or 245A.07 apply.

deleted text begin (e) deleted text end new text begin (g) new text end The lead investigative agency shall complete its final disposition within 60
calendar days. If the lead investigative agency is unable to complete its final disposition
within 60 calendar days, the lead investigative agency shall notify the following persons
provided that the notification will not endanger the vulnerable adult or hamper the
investigation: (1) the vulnerable adult or the vulnerable adult's deleted text begin guardian or health care agent deleted text end new text begin
interested person new text end , when known, if the lead investigative agency knows them to be aware of
the investigation; and (2) the facility, where applicable. The notice shall contain the reason
for the delay and the projected completion date. If the lead investigative agency is unable
to complete its final disposition by a subsequent projected completion date, the lead
investigative agency shall again notify the vulnerable adult or the vulnerable adult's deleted text begin guardian
or health care agent deleted text end new text begin interested person new text end , when known if the lead investigative agency knows
them to be aware of the investigation, and the facility, where applicable, of the reason for
the delay and the revised projected completion date provided that the notification will not
endanger the vulnerable adult or hamper the investigation. The lead investigative agency
must notify the health care agent of the vulnerable adult only if the health care agent's
authority to make health care decisions for the vulnerable adult is currently effective deleted text begin under
section 145C.06 deleted text end and not suspended under section 524.5-310 deleted text begin and the investigation relates
to a duty assigned to the health care agent by the principal deleted text end . A lead investigative agency's
inability to complete the final disposition within 60 calendar days or by any projected
completion date does not invalidate the final disposition.

deleted text begin (f) deleted text end new text begin (h) new text end Within ten calendar days of completing the final disposition, the lead investigative
agency shall provide a copy of the public investigation memorandum under subdivision
12b, paragraph deleted text begin (b), clause (1) deleted text end new text begin (d) new text end , when required to be completed under this section, to the
following persons:

(1) the vulnerable adult, or deleted text begin the vulnerable adult's guardian or health care agent deleted text end new text begin an
interested person new text end , if known, unless the lead investigative agency knows that the notification
would endanger the well-being of the vulnerable adult;

(2) the reporter, deleted text begin if deleted text end new text begin unless new text end the reporter requested deleted text begin notification deleted text end new text begin otherwise new text end when making the
report, provided this notification would not endanger the well-being of the vulnerable adult;

(3) the alleged perpetrator, if known;

(4) the facility; deleted text begin and
deleted text end

(5) the ombudsman for long-term care, or the ombudsman for mental health and
developmental disabilities, as appropriate deleted text begin . deleted text end new text begin ;
new text end

new text begin (6) law enforcement; and
new text end

new text begin (7) the county attorney, as appropriate.
new text end

deleted text begin (g) deleted text end new text begin (i) new text end If, as a result of a reconsideration, review, or hearing, the lead investigative agency
changes the final disposition, or if a final disposition is changed on appeal, the lead
investigative agency shall notify the parties specified in paragraph deleted text begin (f) deleted text end new text begin (h) new text end .

deleted text begin (h) deleted text end new text begin (j) new text end The lead investigative agency shall notify the vulnerable adult who is the subject
of the report or deleted text begin the vulnerable adult's guardian or health care agent deleted text end new text begin an interested person new text end , if
known, and any person or facility determined to have maltreated a vulnerable adult, of their
appeal or review rights under this section or section deleted text begin 256.021 deleted text end new text begin 256.045 new text end .

deleted text begin (i) deleted text end new text begin (k) new text end The lead investigative agency shall routinely provide investigation memoranda
for substantiated reports to the appropriate licensing boards. These reports must include the
names of substantiated perpetrators. The lead investigative agency may not provide
investigative memoranda for inconclusive or false reports to the appropriate licensing boards
unless the lead investigative agency's investigation gives reason to believe that there may
have been a violation of the applicable professional practice laws. If the investigation
memorandum is provided to a licensing board, the subject of the investigation memorandum
shall be notified and receive a summary of the investigative findings.

deleted text begin (j) deleted text end new text begin (l) new text end In order to avoid duplication, licensing boards shall consider the findings of the
lead investigative agency in their investigations if they choose to investigate. This does not
preclude licensing boards from considering other information.

deleted text begin (k) deleted text end new text begin (m) new text end The lead investigative agency must provide to the commissioner of human
services its final dispositions, including the names of all substantiated perpetrators. The
commissioner of human services shall establish records to retain the names of substantiated
perpetrators.

Sec. 53.

Minnesota Statutes 2016, section 626.557, subdivision 9d, is amended to read:

Subd. 9d.

Administrative reconsideration deleted text begin ; review panel deleted text end .

(a) Except as provided under
paragraph deleted text begin (e) deleted text end new text begin (d) new text end , any individual or facility which a lead investigative agency determines
has maltreated a vulnerable adult, or the vulnerable adult or an interested person acting on
behalf of the vulnerable adult, regardless of the lead investigative agency's determination,
who contests the lead investigative agency's final disposition of an allegation of maltreatment,
may request the lead investigative agency to reconsider its final disposition. The request
for reconsideration must be submitted in writing to the lead investigative agency within 15
calendar days after receipt of notice of final disposition or, if the request is made by an
interested person who is not entitled to notice, within 15 days after receipt of the notice by
the vulnerable adult or the vulnerable adult's guardian or health care agent. If mailed, the
request for reconsideration must be postmarked and sent to the lead investigative agency
within 15 calendar days of the individual's or facility's receipt of the final disposition. If the
request for reconsideration is made by personal service, it must be received by the lead
investigative agency within 15 calendar days of the individual's or facility's receipt of the
final disposition. An individual who was determined to have maltreated a vulnerable adult
under this section and who was disqualified on the basis of serious or recurring maltreatment
under sections 245C.14 and 245C.15, may request reconsideration of the maltreatment
determination and the disqualification. The request for reconsideration of the maltreatment
determination and the disqualification must be submitted in writing within 30 calendar days
of the individual's receipt of the notice of disqualification under sections 245C.16 and
245C.17. If mailed, the request for reconsideration of the maltreatment determination and
the disqualification must be postmarked and sent to the lead investigative agency within 30
calendar days of the individual's receipt of the notice of disqualification. If the request for
reconsideration is made by personal service, it must be received by the lead investigative
agency within 30 calendar days after the individual's receipt of the notice of disqualification.

(b) Except as provided under paragraphs new text begin (d) and new text end (e) deleted text begin and (f) deleted text end , if the lead investigative
agency denies the request or fails to act upon the request within 15 working days after
receiving the request for reconsideration, the person new text begin , including the vulnerable adult or an
interested person acting on behalf of the vulnerable adult, new text end or facility entitled to a fair hearing
under section 256.045, may submit to the commissioner of human services a written request
for a hearing under that statute. deleted text begin The vulnerable adult, or an interested person acting on
behalf of the vulnerable adult, may request a review by the Vulnerable Adult Maltreatment
Review Panel under section 256.021 if the lead investigative agency denies the request or
fails to act upon the request, or if the vulnerable adult or interested person contests a
reconsidered disposition. deleted text end The lead investigative agency shall notify persons who request
reconsideration of their rights under this paragraph. The request must be submitted in writing
to the review panel and a copy sent to the lead investigative agency within 30 calendar days
of receipt of notice of a denial of a request for reconsideration or of a reconsidered
disposition. The request must specifically identify the aspects of the lead investigative
agency determination with which the person is dissatisfied.

(c) If, as a result of a reconsideration or review, the lead investigative agency changes
the final disposition, it shall notify the parties specified in subdivision 9c, paragraph deleted text begin (f) deleted text end new text begin (h) new text end .

deleted text begin (d) For purposes of this subdivision, "interested person acting on behalf of the vulnerable
adult" means a person designated in writing by the vulnerable adult to act on behalf of the
vulnerable adult, or a legal guardian or conservator or other legal representative, a proxy
or health care agent appointed under chapter 145B or 145C, or an individual who is related
to the vulnerable adult, as defined in section 245A.02, subdivision 13.
deleted text end

deleted text begin (e) deleted text end new text begin (d) new text end If an individual was disqualified under sections 245C.14 and 245C.15, on the
basis of a determination of maltreatment, which was serious or recurring, and the individual
has requested reconsideration of the maltreatment determination under paragraph (a) and
reconsideration of the disqualification under sections 245C.21 to 245C.27, reconsideration
of the maltreatment determination and requested reconsideration of the disqualification
shall be consolidated into a single reconsideration. If reconsideration of the maltreatment
determination is denied and the individual remains disqualified following a reconsideration
decision, the individual may request a fair hearing under section 256.045. If an individual
requests a fair hearing on the maltreatment determination and the disqualification, the scope
of the fair hearing shall include both the maltreatment determination and the disqualification.

deleted text begin (f) deleted text end new text begin (e) new text end If a maltreatment determination or a disqualification based on serious or recurring
maltreatment is the basis for a denial of a license under section 245A.05 or a licensing
sanction under section 245A.07, the license holder has the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided for
under section 245A.08, the scope of the contested case hearing must include the maltreatment
determination, disqualification, and licensing sanction or denial of a license. In such cases,
a fair hearing must not be conducted under section 256.045. Except for family child care
and child foster care, reconsideration of a maltreatment determination under this subdivision,
and reconsideration of a disqualification under section 245C.22, must not be conducted
when:

(1) a denial of a license under section 245A.05, or a licensing sanction under section
245A.07, is based on a determination that the license holder is responsible for maltreatment
or the disqualification of a license holder based on serious or recurring maltreatment;

(2) the denial of a license or licensing sanction is issued at the same time as the
maltreatment determination or disqualification; and

(3) the license holder appeals the maltreatment determination or disqualification, and
denial of a license or licensing sanction.

Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
determination or disqualification, but does not appeal the denial of a license or a licensing
sanction, reconsideration of the maltreatment determination shall be conducted under sections
626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
disqualification shall be conducted under section 245C.22. In such cases, a fair hearing shall
also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
626.557, subdivision 9d.

If the disqualified subject is an individual other than the license holder and upon whom
a background study must be conducted under chapter 245C, the hearings of all parties may
be consolidated into a single contested case hearing upon consent of all parties and the
administrative law judge.

deleted text begin (g) deleted text end new text begin (f) new text end Until August 1, 2002, an individual or facility that was determined by the
commissioner of human services or the commissioner of health to be responsible for neglect
under section 626.5572, subdivision 17, after October 1, 1995, and before August 1, 2001,
that believes that the finding of neglect does not meet an amended definition of neglect may
request a reconsideration of the determination of neglect. The commissioner of human
services or the commissioner of health shall mail a notice to the last known address of
individuals who are eligible to seek this reconsideration. The request for reconsideration
must state how the established findings no longer meet the elements of the definition of
neglect. The commissioner shall review the request for reconsideration and make a
determination within 15 calendar days. The commissioner's decision on this reconsideration
is the final agency action.

deleted text begin (1) deleted text end new text begin (g) new text end For purposes of compliance with the data destruction schedule under subdivision
12b, paragraph deleted text begin (d) deleted text end new text begin (h) new text end , when a finding of substantiated maltreatment has been changed as
a result of a reconsideration under this paragraph, the date of the original finding of a
substantiated maltreatment must be used to calculate the destruction date.

deleted text begin (2) deleted text end new text begin (h) new text end For purposes of any background studies under chapter 245C, when a determination
of substantiated maltreatment has been changed as a result of a reconsideration under this
paragraph, any prior disqualification of the individual under chapter 245C that was based
on this determination of maltreatment shall be rescinded, and for future background studies
under chapter 245C the commissioner must not use the previous determination of
substantiated maltreatment as a basis for disqualification or as a basis for referring the
individual's maltreatment history to a health-related licensing board under section 245C.31.

Sec. 54.

Minnesota Statutes 2016, section 626.557, subdivision 10b, is amended to read:

Subd. 10b.

Investigations; guidelines.

new text begin (a) new text end Each lead investigative agency shall develop
guidelines for prioritizing reports for investigation. When investigating a report, the lead
investigative agency shall conduct the following activities, as appropriate:

(1) interview of the alleged victim;

(2) interview of the reporter and others who may have relevant information;

(3) interview of the alleged perpetrator;

(4) examination of the environment surrounding the alleged incident;

(5) review of pertinent documentation of the alleged incident; and

(6) consultation with professionals.

new text begin (b) The lead investigator must contact the alleged victim or, if known, an interested
person, within five days after initiation of an investigation to provide the investigator's name
and contact information, and communicate with the alleged victim or interested person
approximately every three weeks during the course of the investigation.
new text end

Sec. 55.

Minnesota Statutes 2016, section 626.557, subdivision 12b, is amended to read:

Subd. 12b.

Data management.

(a) In performing any of the duties of this section as a
lead investigative agency, the county social service agency shall maintain appropriate
records. Data collected by the county social service agency under this section are welfare
data under section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data
under this paragraph that are inactive investigative data on an individual who is a vendor
of services are private data on individuals, as defined in section 13.02. The identity of the
reporter may only be disclosed as provided in paragraph deleted text begin (c) deleted text end new text begin (g) new text end .

new text begin (b) new text end Data maintained by the common entry point are deleted text begin confidential deleted text end new text begin private new text end data on
individuals or deleted text begin protected deleted text end nonpublic data as defined in section 13.02. Notwithstanding section
138.163, the common entry point shall maintain data for three calendar years after date of
receipt and then destroy the data unless otherwise directed by federal requirements.

deleted text begin (b) deleted text end new text begin (c) new text end The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section. County
social service agencies must maintain private data on individuals but are not required to
prepare an investigation memorandum. During an investigation by the commissioner of
health or the commissioner of human services, data collected under this section are
confidential data on individuals or protected nonpublic data as defined in section 13.02 new text begin ,
provided that data may be shared with the vulnerable adult or the vulnerable adult's interested
person if both commissioners determine that sharing of the data is needed to protect the
vulnerable adult new text end . Upon completion of the investigation, the data are classified as provided
in deleted text begin clauses (1) to (3) and paragraph (c) deleted text end new text begin paragraphs (d) to (g) new text end .

deleted text begin (1) deleted text end new text begin (d) new text end The investigation memorandum must contain the following data, which are public:

deleted text begin (i) deleted text end new text begin (1) new text end the name of the facility investigated;

deleted text begin (ii) deleted text end new text begin (2) new text end a statement of the nature of the alleged maltreatment;

deleted text begin (iii) deleted text end new text begin (3) new text end pertinent information obtained from medical or other records reviewed;

deleted text begin (iv) deleted text end new text begin (4) new text end the identity of the investigator;

deleted text begin (v) deleted text end new text begin (5) new text end a summary of the investigation's findings;

deleted text begin (vi) deleted text end new text begin (6) new text end statement of whether the report was found to be substantiated, inconclusive,
false, or that no determination will be made;

deleted text begin (vii) deleted text end new text begin (7) new text end a statement of any action taken by the facility;

deleted text begin (viii) deleted text end new text begin (8) new text end a statement of any action taken by the lead investigative agency; and

deleted text begin (ix) deleted text end new text begin (9) new text end when a lead investigative agency's determination has substantiated maltreatment,
a statement of whether an individual, individuals, or a facility were responsible for the
substantiated maltreatment, if known.

The investigation memorandum must be written in a manner which protects the identity
of the reporter and of the vulnerable adult and may not contain the names or, to the extent
possible, data on individuals or private data new text begin or individuals new text end listed in deleted text begin clause (2) deleted text end new text begin paragraph (e) new text end .

deleted text begin (2) deleted text end new text begin (e) new text end Data on individuals collected and maintained in the investigation memorandum
are private data new text begin on individuals new text end , including:

deleted text begin (i) deleted text end new text begin (1) new text end the name of the vulnerable adult;

deleted text begin (ii) deleted text end new text begin (2) new text end the identity of the individual alleged to be the perpetrator;

deleted text begin (iii) deleted text end new text begin (3) new text end the identity of the individual substantiated as the perpetrator; and

deleted text begin (iv) deleted text end new text begin (4) new text end the identity of all individuals interviewed as part of the investigation.

deleted text begin (3) deleted text end new text begin (f) new text end Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.

deleted text begin (c) deleted text end new text begin (g) new text end After the assessment or investigation is completed, the name of the reporter must
be confidential deleted text begin . deleted text end new text begin , except:
new text end

new text begin (1) new text end the subject of the report may compel disclosure of the name of the reporter only with
the consent of the reporter deleted text begin or deleted text end new text begin ;
new text end

new text begin (2) new text end upon a written finding by a court that the report was false and there is evidence that
the report was made in bad faith new text begin ; or
new text end

new text begin (3) the mandated reporter may self-disclose to support a claim of retaliation that is
prohibited under law, including under sections 144.651, subdivision 34, and 626.557,
subdivisions 4a and 17 new text end .

This subdivision does not alter disclosure responsibilities or obligations under the Rules
of Criminal Procedure, except that where the identity of the reporter is relevant to a criminal
prosecution, the district court shall do an in-camera review prior to determining whether to
order disclosure of the identity of the reporter.

deleted text begin (d) deleted text end new text begin (h) new text end Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be maintained under the following
schedule and then destroyed unless otherwise directed by federal requirements:

(1) data from reports determined to be false, maintained for three years after the finding
was made;

(2) data from reports determined to be inconclusive, maintained for four years after the
finding was made;

(3) data from reports determined to be substantiated, maintained for seven years after
the finding was made; and

(4) data from reports which were not investigated by a lead investigative agency and for
which there is no final disposition, maintained for three years from the date of the report.

deleted text begin (e) deleted text end new text begin (i) new text end The commissioners of health and human services shall annually publish on their
Web sites the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigation under this section,
and the resolution of those investigations. On a biennial basis, the commissioners of health
and human services shall jointly report the following information to the legislature and the
governor:

(1) the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigations under this section,
the resolution of those investigations, and which of the two lead agencies was responsible;

(2) trends about types of substantiated maltreatment found in the reporting period;

(3) if there are upward trends for types of maltreatment substantiated, recommendations
for addressing and responding to them;

(4) efforts undertaken or recommended to improve the protection of vulnerable adults;

(5) whether and where backlogs of cases result in a failure to conform with statutory
time frames and recommendations for reducing backlogs if applicable;

(6) recommended changes to statutes affecting the protection of vulnerable adults; and

(7) any other information that is relevant to the report trends and findings.

deleted text begin (f) deleted text end new text begin (j) new text end Each lead investigative agency must have a record retention policy.

deleted text begin (g) deleted text end new text begin (k) new text end Lead investigative agencies, prosecuting authorities, and law enforcement agencies
may exchange not public data, as defined in section 13.02, if the agency or authority
requesting the data determines that the data are pertinent and necessary to the requesting
agency in initiating, furthering, or completing an investigation under this section. Data
collected under this section must be made available to prosecuting authorities and law
enforcement officials, local county agencies, and licensing agencies investigating the alleged
maltreatment under this section. deleted text begin The lead investigative agency shall exchange not public
data with the vulnerable adult maltreatment review panel established in section 256.021 if
the data are pertinent and necessary for a review requested under that section. deleted text end
Notwithstanding section 138.17, upon completion of the review, not public data received
by the review panel must be destroyed.

deleted text begin (h) deleted text end new text begin (l) new text end Each lead investigative agency shall keep records of the length of time it takes to
complete its investigations.

deleted text begin (i) deleted text end new text begin (m) Notwithstanding paragraph (a) or (b), new text end a lead investigative agency may new text begin share
common entry point or investigative data and may new text end notify other affected parties new text begin , including
the vulnerable adult new text end and their authorized representative new text begin , new text end if the lead investigative agency has
reason to believe maltreatment has occurred and determines the information will safeguard
the well-being of the affected parties or dispel widespread rumor or unrest in the affected
facility.

deleted text begin (j) deleted text end new text begin (n) new text end Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead investigative agency may
not provide any notice unless the vulnerable adult has consented to disclosure in a manner
which conforms to federal requirements.

Sec. 56.

Minnesota Statutes 2016, section 626.557, subdivision 14, is amended to read:

Subd. 14.

Abuse prevention plans.

(a) Each facility, except home health agencies and
personal care attendant services providers new text begin and including a housing with services establishment
under chapter 144D and an entity operating under assisted living title protection under
section 144G.02 new text end , shall establish and enforce an ongoing written abuse prevention plan. The
plan shall contain an assessment of the physical plant, its environment, and its population
identifying factors which may encourage or permit abuse, and a statement of specific
measures to be taken to minimize the risk of abuse. The plan shall comply with any rules
governing the plan promulgated by the licensing agency.

(b) Each facility, including a home health care agency and personal care attendant
services providers, shall develop an individual abuse prevention plan for each vulnerable
adult residing there or receiving services from them. The plan shall contain an individualized
assessment of: (1) the person's susceptibility to abuse by other individuals, including other
vulnerable adults; (2) the person's risk of abusing other vulnerable adults; and (3) statements
of the specific measures to be taken to minimize the risk of abuse to that person and other
vulnerable adults. For the purposes of this paragraph, the term "abuse" includes self-abuse.

(c) If the facility, except home health agencies and personal care attendant services
providers, knows that the vulnerable adult has committed a violent crime or an act of physical
aggression toward others, the individual abuse prevention plan must detail the measures to
be taken to minimize the risk that the vulnerable adult might reasonably be expected to pose
to visitors to the facility and persons outside the facility, if unsupervised. Under this section,
a facility knows of a vulnerable adult's history of criminal misconduct or physical aggression
if it receives such information from a law enforcement authority or through a medical record
prepared by another facility, another health care provider, or the facility's ongoing
assessments of the vulnerable adult.

new text begin (d) The commissioner of health must issue a correction order and fine upon a finding
that the facility has failed to comply with this subdivision.
new text end

Sec. 57.

Minnesota Statutes 2016, section 626.557, subdivision 17, is amended to read:

Subd. 17.

Retaliation prohibited.

(a) A facility or person shall not retaliate against any
person new text begin , including an interested person or an agent of the vulnerable adult, new text end who reports in
good faith new text begin , or who the facility or person believes reported, new text end suspected maltreatment pursuant
to this section, or against a vulnerable adult with respect to whom a report is made, because
of the report new text begin or presumed report, whether mandatory or voluntary new text end .

(b) In addition to any remedies allowed under sections 181.931 to 181.935, any facility
or person which retaliates against any person because of a report of suspected maltreatment
is liable to that person for actual damages, punitive damages up to $10,000, and attorney
fees. new text begin A claim of retaliation may be brought upon showing that the claimant has a good faith
reason to believe retaliation as described under this subdivision occurred. The claim may
be brought regardless of whether or not there is confirmation that the name of the mandated
reporter was known.
new text end

(c) There shall be a rebuttable presumption that any adverse action, as defined below,
within 90 days of a report, is retaliatory. For purposes of this deleted text begin clause deleted text end new text begin paragraph new text end , the term
"adverse action" refers to action taken by a facility or person involved in a report against
the person making the report or the person with respect to whom the report was made because
of the report, and includes, but is not limited to:

(1) discharge or transfer from the facility;

(2) discharge from or termination of employment;

(3) demotion or reduction in remuneration for services;

(4) restriction or prohibition of access new text begin of the vulnerable adult new text end to the facility or its residents;
deleted text begin or
deleted text end

(5) any restriction of rights set forth in section 144.651 deleted text begin . deleted text end new text begin ;
new text end

new text begin (6) any restriction of access to or use of amenities or services;
new text end

new text begin (7) termination of services or lease agreement;
new text end

new text begin (8) sudden increase in costs for services not already contemplated at the time of the
maltreatment report;
new text end

new text begin (9) removal, tampering with, or deprivation of technology, communication, or electronic
monitoring devices; and
new text end

new text begin (10) filing a maltreatment report in bad faith against the reporter; or
new text end

new text begin (11) oral or written communication of false information about the reporter.
new text end

Sec. 58.

Minnesota Statutes 2016, section 626.5572, is amended by adding a subdivision
to read:

new text begin Subd. 12a. new text end

new text begin Interested person. new text end

new text begin "Interested person" has the meaning given in section
524.5-102, subdivision 7. An interested person does not include a person whose authority
has been restricted by the vulnerable adult or by a court or a person who is the alleged
perpetrator of the maltreatment.
new text end

Sec. 59. new text begin ASSISTED LIVING LICENSURE.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For the purposes of this section:
new text end

new text begin (1) "commissioner" means the commissioner of health; and
new text end

new text begin (2) "multiunit residential dwelling" means a residential dwelling containing two or more
units intended for use as a residence.
new text end

new text begin Subd. 2. new text end

new text begin Requirement of license. new text end

new text begin (a) After January 1, 2020, no provider of assisted
living may operate without first having obtained a license.
new text end

new text begin (b) By February 1, 2019, the commissioner shall propose for codification assisted living
licensing standards, which may include licensing tiers that correspond to designated levels
of care and services to replace housing with services registration under Minnesota Statutes,
chapter 144D, and assisted living title protection under Minnesota Statutes, chapter 144G.
The commissioner shall recommend draft legislation to implement all proposed changes to
Minnesota Statutes. The draft legislation shall:
new text end

new text begin (1) replace in Minnesota Statutes the term "housing with services" with "assisted living"
and replace the term "assisted living client" with "assisted living resident";
new text end

new text begin (2) consolidate and recodify Minnesota Statutes, chapters 144D and 144G, and all other
associated and relevant statutes and rules; and
new text end

new text begin (3) add "assisted living" to the definition of facilities in Minnesota Statutes, sections
144.651, subdivision 2, and 626.5572, subdivision 6, and all other applicable statutes or
rules.
new text end

new text begin The commissioner shall solicit public comment on the proposed licensing standards and
provide a comment period of no less than 30 days.
new text end

new text begin Subd. 3. new text end

new text begin Collaboration and consultation. new text end

new text begin In developing the licensing structure, the
commissioner must:
new text end

new text begin (1) collaborate with the commissioner of human services and the ombudsman for
long-term care;
new text end

new text begin (2) consult with an equal number of service providers, consumer advocates, and assisted
living and housing with services residents and their families or agents; and
new text end

new text begin (3) review and evaluate other state's licensing systems related to assisted living.
new text end

new text begin Subd. 4. new text end

new text begin Single license for housing and services. new text end

new text begin (a) The commissioner must create a
single assisted living license for both housing and services offered in a multiunit residential
dwelling that is not otherwise licensed by the Department of Human Services or the
Department of Health that offers:
new text end

new text begin (1) services comparable to those of a comprehensive home care services provider under
Minnesota Statutes, section 144A.471, subdivision 7;
new text end

new text begin (2) health-related services under Minnesota Statutes, section 144D.01, subdivision 6;
or
new text end

new text begin (3) supportive services under Minnesota Statutes, section 144D.01, including daily life
checks, transportation, social work services, and dietary services.
new text end

new text begin (b) A multiunit residential dwelling must obtain an assisted living license if at least 30
percent of the residents receive home care, health-related services, or supportive care services.
new text end

new text begin Subd. 5. new text end

new text begin Single contract. new text end

new text begin (a) The commissioner must establish a single contract for the
provision of housing and care services in an assisted living facility. The provisions of
Minnesota Statutes, chapter 504B, apply.
new text end

new text begin (b) Nothing in this subdivision precludes a resident from separately contracting with a
provider other than the assisted living facility.
new text end

new text begin (c) Nothing in this subdivision precludes the assisted living facility from separating
housing costs from care costs when billing.
new text end

new text begin Subd. 6. new text end

new text begin Forms and procedures. new text end

new text begin The commissioner must establish forms and procedures
for the processing of assisted living license applications. An application for an assisted
living license must, at a minimum, include the following information:
new text end

new text begin (1) the names and addresses of all controlling persons and managerial employees of the
facility to be licensed, and any affiliated corporate entities;
new text end

new text begin (2) the address and legal property description of the facility;
new text end

new text begin (3) a copy of the architectural and engineering plans and specifications of the facility as
prepared and certified by an architect or engineer registered to practice in this state;
new text end

new text begin (4) whether the applicant's license or authority to provide assisted living in any other
state has ever been revoked or suspended; and
new text end

new text begin (5) any other relevant information the commissioner determines necessary, including
the number of beds and other data necessary to determine number and type of residents
being served.
new text end

new text begin Subd. 7. new text end

new text begin Appeals and reconsiderations. new text end

new text begin The commissioner must establish criteria and
a process for reconsideration and appeal under which a license may be denied, suspended,
nonrenewed, or revoked.
new text end

new text begin Subd. 8. new text end

new text begin Fines and penalties. new text end

new text begin The commissioner must establish a schedule of license
fees and penalties for compliance failures.
new text end

new text begin Subd. 9. new text end

new text begin Standards. new text end

new text begin The commissioner must establish licensing standards that must
include, at a minimum:
new text end

new text begin (1) building design;
new text end

new text begin (2) physical environment;
new text end

new text begin (3) dietary services, including both the type, appropriateness, and quality of food;
new text end

new text begin (4) support services, including social work and transportation;
new text end

new text begin (5) staffing guidelines, including establishing 24 hours a day, seven days a week awake
staff, taking into account:
new text end

new text begin (i) the acuity level of the residents;
new text end

new text begin (ii) the number of residents;
new text end

new text begin (iii) evening and weekend needs; and
new text end

new text begin (iv) existing requirements under Minnesota Statutes, section 144A.4795, and Code of
Federal Regulations, title 42, section 483.30;
new text end

new text begin (6) training for:
new text end

new text begin (i) owners, financial officers, administrators, and management on Minnesota Statutes,
section 626.557, and on best practices and standards for long-term care; and
new text end

new text begin (ii) all staff, management, and controlling persons in the best practices for courteous
treatment of residents, resolution of conflict, and collaboration with all staff positions,
assisted living residents, and families;
new text end

new text begin (7) admission criteria, including but not limited to:
new text end

new text begin (i) admission contract language or definitions; and
new text end

new text begin (ii) an assessment to be conducted prior to admission to best meet the needs of residents;
new text end

new text begin (8) retention criteria, including criteria based on the provisions of Minnesota Statutes,
section 144A.4791, subdivision 4, as to when a resident's needs are beyond the scope of
care and practice in an assisted living facility;
new text end

new text begin (9) care and services, including but not limited to centralized, core criteria for dementia
care and coordination of care among medical providers for residents, based on the needs of
the resident, including carrying out any medical orders;
new text end

new text begin (10) discharge criteria, including discharge planning to a safe location and appeal rights,
incorporating Minnesota Statutes, sections 144D.09, 144D.095, 144G.07, and 144G.08;
new text end

new text begin (11) resident rights in the assisted living setting, including those currently found in
Minnesota Statutes, sections 144.651, 144A.44, 144A.441, or other statement of rights
under law;
new text end

new text begin (12) establishment of resident or family councils, or both, based on Minnesota Statutes,
section 144A.33; and
new text end

new text begin (13) safety criteria, including abuse prevention plans under Minnesota Statutes, section
626.557, subdivision 14.
new text end

new text begin Subd. 10. new text end

new text begin Licensing tiers. new text end

new text begin The commissioner may establish separate licensing levels
and, if levels are established, the criteria for the licenses. Examples of levels include:
new text end

new text begin (1) Tier 1, basic level service offering any supportive service, including daily life checks,
transportation, dietary services, or social work services, or any health-related service or
supportive service in an independent unit within a continuing care campus model;
new text end

new text begin (2) Tier 2, medium level service offering, in addition to Tier 1 offerings, any
health-related service, including dementia care, assistance with two or fewer activities of
daily living that do not include a two-person transfer, and the ability to engage in
self-preservation; and
new text end

new text begin (3) Tier 3, high level service offering, in addition to Tier 1 and Tier 2 offerings, assistance
with three or more activities of daily living, two-person transfers, diagnoses requiring
specialty care, or the need for assistance with self-preservation.
new text end

new text begin Subd. 11. new text end

new text begin Other considerations and actions. new text end

new text begin The commissioner, in establishing a
licensing structure, must:
new text end

new text begin (1) consider federal home and community-based service requirements necessary to
preserve access to assisted living care and services for individuals who rely on the medical
assistance elderly waiver program, including the customized living rates and other waivered
programs;
new text end

new text begin (2) determine if any changes are required to the medical assistance elderly waiver benefit
program or group residential housing program to ensure, to the extent possible, the programs
cover the housing costs and meet the service needs of an assisted living resident, including
the customized living rates; and
new text end

new text begin (3) seek federal approval as necessary for the assisted living license developed by the
commissioner.
new text end

new text begin Subd. 12. new text end

new text begin Exceptions. new text end

new text begin The commissioner shall exclude providers and facilities currently
licensed by the Department of Human Services from the requirements of the new assisted
living license. Nothing may be construed to affect the governance under Minnesota Statutes,
sections 144A.43 to 144A.483, of home care providers who do not dedicate their services
to a particular multiunit residential dwelling.
new text end

new text begin Subd. 13. new text end

new text begin Licensing of executive directors and administrators. new text end

new text begin After January 1, 2020,
no person may serve as an executive director or administrator of an assisted living facility
without first obtaining a license from the commissioner. The commissioner shall establish
licensing criteria and a fee schedule in consultation with the Board of Examiners for Nursing
Home Administrators under Minnesota Statutes, section 144A.19.
new text end

new text begin Subd. 14. new text end

new text begin Enforcement authority. new text end

new text begin The commissioner has the authority to enforce any
statute or rule governing licensing of assisted living facilities.
new text end

Sec. 60. new text begin DEMENTIA CARE CERTIFICATION.
new text end

new text begin (a) For the purposes of this section, "commissioner" means the commissioner of health.
new text end

new text begin (b) By February 1, 2019, the commissioner shall establish core criteria in all care and
service settings for the provision of dementia care as well as criteria to operate a dementia
care unit, to recommend legislation to implement dementia care after first providing a 30-day
public comment period. In establishing the core criteria for dementia care in these settings,
the commissioner must:
new text end

new text begin (1) collaborate with the commissioner of human services and the ombudsman for
long-term care;
new text end

new text begin (2) consult with an equal number of service providers, consumer advocates, and residents
diagnosed with dementia and their families or agents;
new text end

new text begin (3) review and evaluate other state's dementia care systems; and
new text end

new text begin (4) meet standards based on best practice recommendations for dementia care developed
by the Alzheimer's Association and other state and national organizations providing services,
information, and advocacy regarding persons with dementia and their families.
new text end

new text begin (c) After January 1, 2020, all providers must meet core criteria for dementia care as
developed by the commissioner. After January 1, 2020, no provider may advertise, offer,
or use the term "memory care unit" or "dementia care unit" without having first obtained a
dementia care unit certification. If 30 percent or more of the residents in any particular unit
in the residential setting are diagnosed with dementia, the provider must obtain the dementia
care unit certification in order to serve the residents.
new text end

new text begin (d) In developing core criteria for dementia care across all settings, the commissioner
must, at a minimum:
new text end

new text begin (1) evaluate existing requirements under Minnesota Statutes, sections 144.6503,
144A.4795, 144A.4796, and 144D.065, and chapter 144G;
new text end

new text begin (2) propose a single statute that identifies minimum safety and quality of service standards
for dementia special care, including dementia training, assessment, care planning, therapeutic
activities, and a residential setting's physical design and environment by combining concepts
and provisions found in Minnesota Statutes, sections 144.6503, 144A.4791, 144A.4796,
144D.065, and 325F.72; and
new text end

new text begin (3) develop comprehensive dementia care training curriculum, including evaluation of
competency of the individual worker, continuing education, portability for workers across
employers, and minimum standards for trainers. The curriculum must incorporate principles
of person-centered dementia care, including thorough knowledge of the person and the
person's abilities and needs, advancement of optimal functioning and a high quality of life,
and use of problem-solving approaches to care. Training requirements and curriculum must
reflect cultural competency, both for the provider and the recipient of the care.
new text end

new text begin (e) The commissioner must establish additional requirements beyond core criteria for
facilities and providers operating a dementia care unit in the residential setting, including
but not limited to the following:
new text end

new text begin (1) criteria for certification for the provision of dementia care and training for all care
providers employed by any facility, provider, or program who are involved in the delivery
of care to, or have regular contact with, persons with Alzheimer's disease or related
dementias; and
new text end

new text begin (2) training on behavioral approaches.
new text end

new text begin (f) The commissioner may adopt rules to implement this section.
new text end

new text begin (g) The commissioner has the authority to monitor and enforce compliance with any
certification statutes enacted or rules adopted.
new text end

Sec. 61. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2016, sections 144G.03, subdivision 6; and 256.021, new text end new text begin are repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: 18-7227

144G.03 ASSISTED LIVING REQUIREMENTS.

Subd. 6.

Termination of housing with services contract.

If a housing with services establishment terminates a housing with services contract with an assisted living client, the establishment shall provide the assisted living client, and the legal or designated representative of the assisted living client, if any, with a written notice of termination which includes the following information:

(1) the effective date of termination;

(2) the section of the contract that authorizes the termination;

(3) without extending the termination notice period, an affirmative offer to meet with the assisted living client and, if applicable, client representatives, within no more than five business days of the date of the termination notice to discuss the termination;

(4) an explanation that:

(i) the assisted living client must vacate the apartment, along with all personal possessions, on or before the effective date of termination;

(ii) failure to vacate the apartment by the date of termination may result in the filing of an eviction action in court by the establishment, and that the assisted living client may present a defense, if any, to the court at that time; and

(iii) the assisted living client may seek legal counsel in connection with the notice of termination;

(5) a statement that, with respect to the notice of termination, reasonable accommodation is available for the disability of the assisted living client, if any; and

(6) the name and contact information of the representative of the establishment with whom the assisted living client or client representatives may discuss the notice of termination.

256.021 VULNERABLE ADULT MALTREATMENT REVIEW PANEL.

Subdivision 1.

Creation.

(a) The commissioner of human services shall establish a review panel for purposes of reviewing lead investigative agency determinations regarding maltreatment of a vulnerable adult in response to requests received under section 626.557, subdivision 9d, paragraph (b). The panel shall hold quarterly meetings for purposes of conducting reviews under this section.

(b) The review panel consists of:

(1) the commissioners of health and human services or their designees;

(2) the ombudsman for long-term care and ombudsman for mental health and developmental disabilities, or their designees;

(3) a member of the board on aging, appointed by the board; and

(4) a representative from the county human services administrators appointed by the commissioner of human services or the administrator's designee.

Subd. 2.

Review procedure.

(a) If a vulnerable adult or an interested person acting on behalf of the vulnerable adult requests a review under this section, the panel shall review the request at its next quarterly meeting. If the next quarterly meeting is within ten days of the panel's receipt of the request for review, the review may be delayed until the next subsequent meeting. The panel shall review the request and the investigation memorandum and may review any other data on the investigation maintained by the lead investigative agency that are pertinent and necessary to its review of the final disposition. If more than one person requests a review under this section with respect to the same final disposition, the review panel shall combine the requests into one review. The panel shall submit its written request for the case file and other documentation relevant to the review to the supervisor of the investigator conducting the investigation under review.

(b) Within 30 days of the review under this section, the panel shall notify the director or manager of the lead investigative agency and the vulnerable adult or interested person who requested the review as to whether the panel concurs with the final disposition or whether the lead investigative agency must reconsider the final disposition. If the panel determines that the lead investigative agency must reconsider the final disposition, the panel must make specific recommendations to the director or manager of the lead investigative agency. The recommendation must include an explanation of the factors that form the basis of the recommendation to reconsider the final disposition and must specifically identify the disputed facts, the disputed application of maltreatment definitions, the disputed application of responsibility for maltreatment, and the disputed weighing of evidence, whichever apply. Within 30 days the lead investigative agency shall conduct a review and report back to the panel with its determination and the specific rationale for its final disposition. At a minimum, the specific rationale must include a detailed response to each of the factors identified by the panel that formed the basis for the recommendations of the panel.

(c) Upon receiving the report of reconsideration from the lead investigative agency, the panel shall communicate the decision in writing to the vulnerable adult or interested person acting on behalf of the vulnerable adult who requested the review. The panel shall include the specific rationale provided by the lead investigative agency as part of the communication.

Subd. 3.

Report.

By January 15 of each year, the panel shall submit a report to the committees of the legislature with jurisdiction over section 626.557 regarding the number of requests for review it receives under this section, the number of cases where the panel requires the lead investigative agency to reconsider its final disposition, and the number of cases where the final disposition is changed, and any recommendations to improve the review or investigative process.

Subd. 4.

Data.

Data of the review panel created or received as part of a review under this section are private data on individuals as defined in section 13.02.