SF 2355

as introduced - 91st Legislature (2019 - 2020) Posted on 03/12/2019 09:10am

A bill for an act
relating to human services; modifying provisions governing continuing care for
older adults; amending Minnesota Statutes 2018, sections 245A.07, subdivision
3; 245C.08, subdivision 1; 256.021, subdivision 2; 256R.02, subdivisions 4, 17,
18, 19, 29, 42a, 48a; 256R.07, subdivisions 1, 2; 256R.09, subdivision 2; 256R.10,
subdivision 1; 256R.13, subdivision 4; 256R.39; 626.557, subdivisions 3, 3a, 4,
4a, 6, 9, 9b, 9c, 9d, 10, 10b, 12b, 14, 17; 626.5572, subdivisions 2, 3, 4, 6, 8, 9,
16, 17, 20, 21, by adding a subdivision; repealing Minnesota Statutes 2018, sections
256R.08, subdivision 2; 256R.49.

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

Section 1.

Minnesota Statutes 2018, section 245A.07, subdivision 3, is amended to read:

Subd. 3.

License suspension, revocation, or fine.

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

(1) a license holder fails to comply fully with applicable laws or rules;

(2) a license holder, a controlling individual, or an individual living in the household
where the licensed services are provided or is otherwise subject to a background study has
a disqualification which has not been set aside under section 245C.22;

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

(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to
submit the information required of an applicant under section 245A.04, subdivision 1,
paragraph (f) or (g).

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

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

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

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

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

(4) Fines shall be assessed as follows:

(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a
child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557
for which the license holder is determined responsible for the maltreatment under section
626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph deleted text begin (c) deleted text end new text begin (f) new text end ;

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

(iii) for a program that operates out of the license holder's home and a program licensed
under Minnesota Rules, parts 9502.0300 to deleted text begin 9502.0495 deleted text end new text begin 9502.0445 new text end , the fine assessed against
the license holder shall not exceed $1,000 for each determination of maltreatment;

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 2.

Minnesota Statutes 2018, section 245C.08, subdivision 1, is amended to read:

Subdivision 1.

Background studies conducted by Department of Human Services.

(a)
For a background study conducted by the Department of Human Services, the commissioner
shall review:

(1) information related to names of substantiated perpetrators of maltreatment of
vulnerable adults that has been received by the commissioner as required under section
626.557, subdivision 9c, paragraph deleted text begin (j) deleted text end new text begin (n) new text end ;

(2) the commissioner's records relating to the maltreatment of minors in licensed
programs, and from findings of maltreatment of minors as indicated through the social
service information system;

(3) information from juvenile courts as required in subdivision 4 for individuals listed
in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;

(4) information from the Bureau of Criminal Apprehension, including information
regarding a background study subject's registration in Minnesota as a predatory offender
under section 243.166;

(5) except as provided in clause (6), information received as a result of submission of
fingerprints for a national criminal history record check, as defined in section 245C.02,
subdivision 13c, when the commissioner has reasonable cause for a national criminal history
record check as defined under section 245C.02, subdivision 15a, or as required under section
144.057, subdivision 1, clause (2);

(6) for a background study related to a child foster care application for licensure, a
transfer of permanent legal and physical custody of a child under sections 260C.503 to
260C.515, or adoptions, and for a background study required for family child care, certified
license-exempt child care, child care centers, and legal nonlicensed child care authorized
under chapter 119B, the commissioner shall also review:

(i) information from the child abuse and neglect registry for any state in which the
background study subject has resided for the past five years; and

(ii) when the background study subject is 18 years of age or older, or a minor under
section 245C.05, subdivision 5a, paragraph (c), information received following submission
of fingerprints for a national criminal history record check; and

(7) for a background study required for family child care, certified license-exempt child
care centers, licensed child care centers, and legal nonlicensed child care authorized under
chapter 119B, the background study shall also include, to the extent practicable, a name
and date-of-birth search of the National Sex Offender Public website.

(b) Notwithstanding expungement by a court, the commissioner may consider information
obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice
of the petition for expungement and the court order for expungement is directed specifically
to the commissioner.

(c) The commissioner shall also review criminal case information received according
to section 245C.04, subdivision 4a, from the Minnesota court information system that relates
to individuals who have already been studied under this chapter and who remain affiliated
with the agency that initiated the background study.

(d) When the commissioner has reasonable cause to believe that the identity of a
background study subject is uncertain, the commissioner may require the subject to provide
a set of classifiable fingerprints for purposes of completing a fingerprint-based record check
with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph
shall not be saved by the commissioner after they have been used to verify the identity of
the background study subject against the particular criminal record in question.

(e) The commissioner may inform the entity that initiated a background study under
NETStudy 2.0 of the status of processing of the subject's fingerprints.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 3.

Minnesota Statutes 2018, section 256.021, subdivision 2, is amended to read:

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 deleted text begin ten deleted text end new text begin 30
calendar new text end 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 4.

Minnesota Statutes 2018, section 256R.02, subdivision 4, is amended to read:

Subd. 4.

Administrative costs.

"Administrative costs" means the identifiable costs for
administering the overall activities of the nursing home. These costs include salaries and
wages of the administrator, assistant administrator, business office employees, security
guards, new text begin purchasing and inventory employees, new text end and associated fringe benefits and payroll
taxes, fees, contracts, or purchases related to business office functions, licenses, permits
except as provided in the external fixed costs category, employee recognition, travel including
meals and lodging, all training except as specified in subdivision 17, voice and data
communication or transmission, office supplies, property and liability insurance and other
forms of insurance except insurance that is a fringe benefit under subdivision 22, personnel
recruitment, legal services, accounting services, management or business consultants, data
processing, information technology, website, central or home office costs, business meetings
and seminars, postage, fees for professional organizations, subscriptions, security services, new text begin
nonpromotional new text end advertising, board of directors fees, working capital interest expense, bad
debts, bad debt collection fees, and costs incurred for travel and housing for persons employed
by a supplemental nursing services agency as defined in section 144A.70, subdivision 6.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 5.

Minnesota Statutes 2018, section 256R.02, subdivision 17, is amended to read:

Subd. 17.

Direct care costs.

"Direct care costs" means costs for the wages of nursing
administration, direct care registered nurses, licensed practical nurses, certified nursing
assistants, trained medication aides, employees conducting training in resident care topics
and associated fringe benefits and payroll taxes; services from a new text begin Minnesota registered new text end
supplemental nursing services agency new text begin up to the maximum allowable charges under section
144A.74, excluding associated lodging and travel costs new text end ; supplies that are stocked at nursing
stations or on the floor and distributed or used individually, including, but not limited to:
alcohol, applicators, cotton balls, incontinence pads, disposable ice bags, dressings, bandages,
water pitchers, tongue depressors, disposable gloves, enemas, enema equipment, new text begin personal
hygiene new text end soap, medication cups, diapers, deleted text begin plastic waste bags, deleted text end sanitary products, new text begin disposable
new text end thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic
agents, drugs deleted text begin that are not paid deleted text end new text begin payable new text end on a separate fee schedule by the medical assistance
program or any other payer, and deleted text begin technology related deleted text end new text begin clinical software costs specific new text end to the
provision of nursing care to residents, such as electronic charting systems; costs of materials
used for resident care training, and training courses outside of the facility attended by direct
care staff on resident care topics; and costs for nurse consultants, pharmacy consultants,
and medical directors. Salaries and payroll taxes for nurse consultants who work out of a
central office must be allocated proportionately by total resident days or by direct
identification to the nursing facilities served by those consultants.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 6.

Minnesota Statutes 2018, section 256R.02, subdivision 18, is amended to read:

Subd. 18.

Employer health insurance costs.

"Employer health insurance costs" means
premium expenses for group coverage deleted text begin ; deleted text end new text begin and new text end actual expenses incurred for self-insured plans,
including deleted text begin reinsurance; deleted text end new text begin actual claims paid, stop loss premiums, plan fees, new text end and employer
contributions to employee health reimbursement and health savings accounts. new text begin Actual costs
of self-insurance plans must not include any allowance for future funding unless the plan
meets the Medicare requirements for reporting on a premium basis when the Medicare
regulations define the actual costs. new text end Premium and expense costs and contributions are
allowable for (1) all employees and (2) the spouse and dependents of those employees who
are employed on average at least 30 hours per week.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 7.

Minnesota Statutes 2018, section 256R.02, subdivision 19, is amended to read:

Subd. 19.

External fixed costs.

"External fixed costs" means costs related to the nursing
home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122;
family advisory council fee under section 144A.33; scholarships under section 256R.37;
planned closure rate adjustments under section 256R.40; consolidation rate adjustments
under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d;
single-bed room incentives under section 256R.41; property taxes, new text begin special new text end assessments, and
payments in lieu of taxes; employer health insurance costs; quality improvement incentive
payment rate adjustments under section 256R.39; performance-based incentive payments
under section 256R.38; special dietary needs under section 256R.51; deleted text begin rate adjustments for
compensation-related costs for minimum wage changes under section 256R.49 provided
on or after January 1, 2018; deleted text end and Public Employees Retirement Association employer costs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 8.

Minnesota Statutes 2018, section 256R.02, subdivision 29, is amended to read:

Subd. 29.

Maintenance and plant operations costs.

"Maintenance and plant operations
costs" means the costs for the salaries and wages of the maintenance supervisor, engineers,
heating-plant employees, and other maintenance employees and associated fringe benefits
and payroll taxes. It also includes identifiable costs for maintenance and operation of the
building and grounds, including, but not limited to, fuel, electricity, new text begin plastic waste bags, new text end
medical waste and garbage removal, water, sewer, supplies, tools, deleted text begin and deleted text end repairs new text begin , and equipment
that is not required to be included in the property allowance new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 9.

Minnesota Statutes 2018, section 256R.02, subdivision 42a, is amended to read:

Subd. 42a.

Real estate taxes.

"Real estate taxes" means the real estate tax liability shown
on the annual property tax deleted text begin statement deleted text end new text begin statements new text end of the nursing facility for the reporting
period. The term does not include personnel costs or fees for late payment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 10.

Minnesota Statutes 2018, section 256R.02, subdivision 48a, is amended to read:

Subd. 48a.

Special assessments.

"Special assessments" means the actual special
assessments and related interest paid during the reporting period new text begin that are involuntary costs new text end .
The term does not include personnel costs deleted text begin or deleted text end new text begin , new text end fees for late payment new text begin , or special assessments
for projects that are reimbursed in the property allowance new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 11.

Minnesota Statutes 2018, section 256R.07, subdivision 1, is amended to read:

Subdivision 1.

Criteria.

A nursing facility shall keep adequate documentation. In order
to be adequate, documentation must:

(1) be maintained in orderly, well-organized files;

(2) not include documentation of more than one nursing facility in one set of files unless
transactions may be traced by the commissioner to the nursing facility's annual cost report;

(3) include a paid invoice or copy of a paid invoice with date of purchase, vendor name
and address, purchaser name and delivery destination address, listing of items or services
purchased, cost of items purchased, account number to which the cost is posted, and a
breakdown of any allocation of costs between accounts or nursing facilities. If any of the
information is not available, the nursing facility shall document its good faith attempt to
obtain the information;

(4) include contracts, agreements, amortization schedules, mortgages, other debt
instruments, and all other documents necessary to explain the nursing facility's costs or
revenues; and

(5) be retained by the nursing facility to support the five most recent annual cost reports.
The commissioner may extend the period of retention if the field audit was postponed
because of inadequate record keeping or accounting practices as in section 256R.13,
subdivisions 2 and 4, the records are necessary to resolve a pending appeal, or the records
are required for the enforcement of sections 256R.04; 256R.05, subdivision 2; 256R.06,
subdivisions 2, 6, and 7; 256R.08, subdivisions 1 deleted text begin to deleted text end new text begin and new text end 3; and 256R.09, subdivisions 3 and
4.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 12.

Minnesota Statutes 2018, section 256R.07, subdivision 2, is amended to read:

Subd. 2.

Documentation of compensation.

Compensation for personal services,
regardless of whether treated as identifiable costs or costs that are not identifiable, must be
documented on payroll records. Payrolls must be supported by time and attendance or
equivalent records for individual employees. Salaries and wages of employees which are
allocated to more than one cost category must be supported by time distribution records.
deleted text begin The method used must produce a proportional distribution of actual time spent, or an accurate
estimate of time spent performing assigned duties. The nursing facility that chooses to
estimate time spent must use a statistically valid method. The compensation must reflect
an amount proportionate to a full-time basis if the services are rendered on less than a
full-time basis. deleted text end new text begin Salary allocations are allowable using the Medicare approved allocation
basis and methodology only if the salary costs cannot be directly determined including when
employees provide shared services to noncovered operations.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 13.

Minnesota Statutes 2018, section 256R.09, subdivision 2, is amended to read:

Subd. 2.

Reporting of statistical and cost information.

All nursing facilities shall
provide information annually to the commissioner on a form and in a manner determined
by the commissioner. The commissioner may separately require facilities to submit in a
manner specified by the commissioner documentation of statistical and cost information
included in the report to ensure accuracy in establishing payment rates and to perform audit
and appeal review functions under this chapter. The commissioner may also require nursing
facilities to provide statistical and cost information for a subset of the items in the annual
report on a semiannual basis. Nursing facilities shall report only costs directly related to the
operation of the nursing facility. The facility shall not include costs which are separately
deleted text begin reimbursed deleted text end new text begin reimbursable new text end by residents, medical assistance, or other payors. Allocations of
costs from central, affiliated, or corporate office and related organization transactions shall
be reported according to sections 256R.07, subdivision 3, and 256R.12, subdivisions 1 to
7. The commissioner shall not grant facilities extensions to the filing deadline.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 14.

Minnesota Statutes 2018, section 256R.10, subdivision 1, is amended to read:

Subdivision 1.

General cost principles.

Only costs determined to be allowable shall be
used to compute the total payment rate for nursing facilities participating in the medical
assistance program. To be considered an allowable cost for rate-setting purposes, a cost
must satisfy the following criteria:

(1) the cost is ordinary, necessary, and related to resident care;

(2) the cost is what a prudent and cost-conscious business person would pay for the
specific good or service in the open market in an arm's-length transaction;

(3) the cost is for goods or services actually provided in the nursing facility;

(4) new text begin incurred costs that are not salary or wage costs must be paid within 180 days of the
end of the reporting period to be allowable costs of the reporting period;
new text end

new text begin (5) new text end the cost effects of transactions that have the effect of circumventing this chapter are
not allowable under the principle that the substance of the transaction shall prevail over
form; and

deleted text begin (5) deleted text end new text begin (6) new text end costs that are incurred due to management inefficiency, unnecessary care or
facilities, agreements not to compete, or activities not commonly accepted in the nursing
facility care field are not allowable.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 15.

Minnesota Statutes 2018, section 256R.13, subdivision 4, is amended to read:

Subd. 4.

Extended record retention requirements.

The commissioner shall extend the
period for retention of records under section 256R.09, subdivision 3, for purposes of
performing field audits as necessary to enforce sections 256R.04; 256R.05, subdivision 2;
256R.06, subdivisions 2, 6, and 7; 256R.08, subdivisions 1 deleted text begin to deleted text end new text begin and new text end 3; and 256R.09,
subdivisions 3 and 4, with written notice to the facility postmarked no later than 90 days
prior to the expiration of the record retention requirement.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 16.

Minnesota Statutes 2018, section 256R.39, is amended to read:

256R.39 QUALITY IMPROVEMENT INCENTIVE PROGRAM.

The commissioner shall develop a quality improvement incentive program in consultation
with stakeholders. The annual funding pool available for quality improvement incentive
payments shall be equal to 0.8 percent of all operating payments, not including any rate
components resulting from equitable cost-sharing for publicly owned nursing facility program
participation under section 256R.48, critical access nursing facility program participation
under section 256R.47, or performance-based incentive payment program participation
under section 256R.38. deleted text begin For the period from October 1, 2015, to December 31, 2016, rate
adjustments provided under this section shall be effective for 15 months. Beginning January
1, 2017, deleted text end Annual rate adjustments provided under this section shall be effective for one rate
year.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 17.

Minnesota Statutes 2018, 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 immediately
report the information to the common entry point. If an individual is a vulnerable adult
solely because the individual deleted text begin is admitted to a facility deleted text end new text begin receives licensed services new text end , a mandated
reporter is not required to report suspected maltreatment of the individual that occurred
prior to deleted text begin admission deleted text end new text begin receiving licensed services new text end , unless:

(1) the individual deleted text begin was admitted to the facility deleted text end new text begin received licensed services new text end from another
deleted text begin facility deleted text end new text begin licensed provider new text end and the reporter has reason to believe the vulnerable adult was
maltreated deleted text begin in the previous facility deleted text end new text begin during the time period in which the vulnerable adult
received licensed services new text end ; 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 deleted text begin a facility deleted text end new text begin licensed provider new text end , 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 deleted text begin facility deleted text end new text begin licensed provider new text end 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. 18.

Minnesota Statutes 2018, section 626.557, subdivision 3a, is amended to read:

Subd. 3a.

Report not required.

The following events are not required to be reported
under this section:

(1) A circumstance where federal law specifically prohibits a person from disclosing
patient identifying information in connection with a report of suspected maltreatment, unless
the vulnerable adult, or the vulnerable adult's guardian, conservator, or legal representative,
has consented to disclosure in a manner which conforms to federal requirements. deleted text begin Facilities deleted text end new text begin
Licensed providers new text end whose patients or residents are covered by such a federal law shall seek
consent to the disclosure of suspected maltreatment from each patient or resident, or a
guardian, conservator, or legal representative, upon the patient's or resident's deleted text begin admission to
the facility deleted text end new text begin receipt of licensed services new text end . Persons who are prohibited by federal law from
reporting an incident of suspected maltreatment shall immediately seek consent to make a
report.

(2) Verbal or physical aggression occurring between patients, residents, or clients of a
deleted text begin facility deleted text end new text begin licensed provider new text end , or self-abusive behavior by these persons does not constitute
abuse unless the behavior causes serious harm. The deleted text begin operator of the facility or a designee deleted text end new text begin
licensed provider new text end shall record incidents of aggression and self-abusive behavior to facilitate
review by licensing agencies and county and local welfare agencies.

(3) Accidents as defined in section 626.5572, subdivision 3.

(4) Events deleted text begin occurring in a facility deleted text end that result from deleted text begin an individual's deleted text end new text begin a licensed provider's
new text end error in the provision of therapeutic conduct to a vulnerable adult, as provided in section
626.5572, subdivision 17, paragraph (c), clause (4).

(5) Nothing in this section shall be construed to require a report of financial exploitation,
as defined in section 626.5572, subdivision 9, solely on the basis of the transfer of money
or property by gift or as compensation for services rendered.

Sec. 19.

Minnesota Statutes 2018, 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. deleted text begin 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. deleted text end
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. 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. The report may be a duplicate of
the initial report the deleted text begin facility deleted text end new text begin licensed provider new text end submits electronically to the commissioner
of health to comply with the reporting requirements under Code of Federal Regulations,
title 42, section 483.13. 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 EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 20.

Minnesota Statutes 2018, section 626.557, subdivision 4a, is amended to read:

Subd. 4a.

Internal reporting of maltreatment.

(a) Each deleted text begin facility deleted text end new text begin licensed provider new text end shall
establish and enforce an ongoing written procedure in compliance with applicable licensing
rules to ensure that all cases of suspected maltreatment are reported. If a deleted text begin facility deleted text end new text begin licensed
provider new text end has an internal reporting procedure, a mandated reporter may meet the reporting
requirements of this section by reporting internally. However, the deleted text begin facility deleted text end new text begin licensed provider new text end
remains responsible for complying with the immediate reporting requirements of this section.

(b) A deleted text begin facility deleted text end new text begin licensed provider new text end with an internal reporting procedure that receives an
internal report by a mandated reporter shall give the mandated reporter a written notice
stating whether the deleted text begin facility deleted text end new text begin licensed provider new text end has reported the incident to the common entry
point. The written notice must be provided within two working days and in a manner that
protects the confidentiality of the reporter.

(c) The written response to the mandated reporter shall note that if the mandated reporter
is not satisfied with the action taken by the deleted text begin facility deleted text end new text begin licensed provider new text end on whether to report
the incident to the common entry point, then the mandated reporter may report externally.

(d) A deleted text begin facility deleted text end new text begin licensed provider new text end may not prohibit a mandated reporter from reporting
externally, and a deleted text begin facility deleted text end new text begin licensed provider new text end is prohibited from retaliating against a mandated
reporter who reports an incident to the common entry point in good faith. The written notice
by the deleted text begin facility deleted text end new text begin licensed provider new text end must inform the mandated reporter of this protection from
retaliatory measures by the deleted text begin facility deleted text end new text begin licensed provider new text end against the mandated reporter for
reporting externally.

Sec. 21.

Minnesota Statutes 2018, section 626.557, subdivision 6, is amended to read:

Subd. 6.

Falsified reports.

A person or deleted text begin facility deleted text end new text begin licensed provider new text end who intentionally
makes a false report under the provisions of this section shall be liable in a civil suit for any
actual damages suffered by the reported deleted text begin facility deleted text end new text begin licensed provider new text end , person or persons and
for punitive damages up to $10,000 and attorney fees.

Sec. 22.

Minnesota Statutes 2018, section 626.557, subdivision 9, is amended to read:

Subd. 9.

Common entry point designation.

(a) deleted text begin 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. deleted text end The commissioner of human services shall
establish a common entry point deleted text begin effective July 1, 2015 deleted text end . 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. The common entry point shall use a standard intake
form that includes:

(1) the time and date of the report;

(2) new text begin the name, relationship, and identifying and contact information for the alleged victim
and alleged perpetrator;
new text end

new text begin (3) new text end the name, deleted text begin address, and telephone number of the person reporting; deleted text end new text begin relationship, and
contact information for the:
new text end

new text begin (i) reporter;
new text end

new text begin (ii) initial reporter, witnesses, and persons who may have knowledge about the
maltreatment; and
new text end

new text begin (iii) alleged victim's legal surrogate and persons who may provide support to the alleged
victim;
new text end

new text begin (4) the basis of vulnerability for the alleged victim;
new text end

deleted text begin (3) deleted text end new text begin (5) new text end the time, date, and location of the incident;

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

deleted text begin (5) whether there was a risk of imminent danger deleted text end new text begin (6) the immediate safety risk new text end to the
alleged victim;

deleted text begin (6) deleted text end new text begin (7) new text end a description of the suspected maltreatment;

deleted text begin (7) the disability, if any, of the alleged victim;
deleted text end

deleted text begin (8) the relationship of the alleged perpetrator to the alleged victim;
deleted text end

new text begin (8) the impact of the suspected maltreatment on the alleged victim;
new text end

(9) whether a deleted text begin facility deleted text end new text begin licensed provider new text end was involved and, if so, which agency licenses
the deleted text begin facility deleted text end new text begin licensed provider new text end ;

new text begin (10) the actions taken to protect the alleged victim;
new text end

deleted text begin (10) any action taken deleted text end new text begin (11) the required notifications and referrals made new text end by the common
entry point; new text begin and
new text end

deleted text begin (11) whether law enforcement has been notified;
deleted text end

(12) whether the reporter wishes to receive notification of the deleted text begin initial and final reports;
and deleted text end new text begin disposition.
new text end

deleted text begin (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.
deleted text end

(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 staff must receive training on how to screen and dispatch
reports efficiently and in accordance with this section.

(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 deleted text begin and immediately identify
and locate prior reports of abuse, neglect, or exploitation deleted text end .

(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.

(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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 23.

Minnesota Statutes 2018, 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 (g). 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 deleted text begin facility deleted text end new text begin provider new text end , 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 (g). The lead investigative agency shall
obtain the results of any investigation conducted by law enforcement officials. The lead
investigative agency has the right to enter deleted text begin facilities deleted text end new text begin licensed provider premises new text end 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 deleted text begin facilities deleted text end new text begin licensed providers new text end to the extent necessary to
conduct its investigation. Each lead investigative agency shall develop guidelines for
prioritizing reports for investigation.

Sec. 24.

Minnesota Statutes 2018, section 626.557, subdivision 9c, is amended to read:

Subd. 9c.

Lead investigative agency; notifications, dispositions, determinations.

(a)
Upon request of the reporter, 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.

(b) new text begin In making the initial disposition, the lead investigative agency may consider previous
reports of suspected maltreatment and may request and consider public information, records
maintained by a lead investigative agency or licensed providers, and information from any
other person who may have knowledge regarding the alleged maltreatment.
new text end

new text begin (c) Unless the lead investigative agency knows the information would endanger the
well-being of the vulnerable adult, during the investigation period the lead investigative
agency shall inform the vulnerable adult of the maltreatment allegation, investigation
guidelines, time frame, and evidence standards used for determinations. The lead investigative
agency must also provide the information to the vulnerable adult's guardian or health care
agent if the allegation is applicable to the guardian or health care agent.
new text end

new text begin (d) During the investigation and in the provision of adult protective services, the lead
investigative agency may coordinate with entities identified under section 626.557,
subdivision 12b, paragraph (g), and the primary support person to safeguard the welfare
and prevent further maltreatment of the vulnerable adult. The lead investigative agency
must request and consider the vulnerable adult's choice of a primary support person.
new text end

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

(1) whether the actions of the deleted text begin facility deleted text end new text begin licensed provider new text end or deleted text begin the deleted text end individual deleted text begin caregivers deleted text end new text begin
caregiver new text end 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 deleted text begin facility deleted text end new text begin
licensed provider new text end or new text begin individual new text end 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 deleted text begin facility, other caregivers, deleted text end new text begin licensed provider
or individual caregiver new text end and requirements placed upon the employee, including but not limited
to, the deleted text begin facility's deleted text end new text begin licensed provider's new text end compliance with related regulatory standards and factors
such as the adequacy of deleted text begin facility deleted text end new text begin licensed provider's new text end policies and procedures, the adequacy
of deleted text begin facility deleted text end new text begin the licensed provider's new text end training, the adequacy of an individual's participation in
the training, the adequacy of caregiver supervision, the adequacy of deleted text begin facility deleted text end new text begin the licensed
provider's new text end staffing levels, and a consideration of the scope of the individual employee's
authority; and

(3) whether the deleted text begin facility deleted text end new text begin licensed provider, employee, new text end or individual followed professional
standards in exercising professional judgment.

deleted text begin (d) deleted text end new text begin (g) new text end When substantiated maltreatment is determined to have been committed by an
individual who is also the deleted text begin facility deleted text end license holder, both the individual and the deleted text begin facility deleted text end new text begin licensed
provider new text end 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 (h) new text end The lead investigative agency shall complete its final disposition within 60
calendar days new text begin from the date of the initial disposition for the report new text end . 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 guardian or health care agent, when known, if the lead investigative
agency knows them to be aware of the investigation; and (2) the deleted text begin facility deleted text end new text begin licensed provider new text end ,
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 guardian or health care agent, when known if
the lead investigative agency knows them to be aware of the investigation, and the deleted text begin facility deleted text end new text begin
licensed provider new text end , 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 under section 145C.06 and not suspended
under section 524.5-310 and the investigation relates to a duty assigned to the health care
agent by the principal. 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 (i) When the lead investigative agency is the Department of Human Services or the
Department of Health, 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 (b), clause (1), deleted text begin when required to be completed under this section, deleted text end
to the following persons: (1) the vulnerable adult, or the vulnerable adult's guardian or health
care agent, if known, new text begin when the allegation is applicable to the surrogate's authority, new text end unless
the lead investigative agency knows that the notification would endanger the well-being of
the vulnerable adult; (2) the reporter, if the reporter requested notification 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 deleted text begin facility deleted text end new text begin licensed provider new text end ; and (5) the
ombudsman for long-term care, or the ombudsman for mental health and developmental
disabilities, as appropriate.

new text begin (j) When the lead investigative agency is a county agency, within ten calendar days of
completing the final disposition, the lead investigative agency shall provide notification of
the final disposition to the following persons: (1) the vulnerable adult, or the vulnerable
adult's guardian or health agent, if known, when the allegation is applicable to the surrogate's
authority, unless the agency knows the notification would endanger the well-being of the
vulnerable adult; (2) the alleged perpetrator, if known; and (3) the personal care provider
organization under section 256B.0659 when the alleged incident involves a personal care
assistant or provider agency.
new text end

deleted text begin (g) deleted text end new text begin (k) 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 (f).

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

deleted text begin (i) deleted text end new text begin (m) 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 (n) 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 (o) 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 25.

Minnesota Statutes 2018, section 626.557, subdivision 9d, is amended to read:

Subd. 9d.

Administrative reconsideration; review panel.

(a) Except as provided under
paragraph (e), any individual or deleted text begin facility deleted text end new text begin licensed provider new text end 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 deleted text begin facility's deleted text end new text begin licensed provider's new text end 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 deleted text begin facility's deleted text end new text begin licensed provider's new text end 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 (e) and (f), 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 or deleted text begin facility deleted text end new text begin licensed provider new text end 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. 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. new text begin The Vulnerable Adult Maltreatment Review Panel shall not conduct
a review if the interested person making the request on behalf of the vulnerable adult is also
the alleged perpetrator. new 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 (i) new text end .

(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.

(e) 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.

(f) 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.

(g) Until August 1, 2002, an individual or deleted text begin facility deleted text end new text begin licensed provider new text end 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.

(1) For purposes of compliance with the data destruction schedule under subdivision
12b, paragraph (d), 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.

(2) 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 26.

Minnesota Statutes 2018, section 626.557, subdivision 10, is amended to read:

Subd. 10.

Duties of county social service agency.

(a) When the common entry point
refers a report to the county social service agency as the lead investigative agency or makes
a referral to the county social service agency for emergency adult protective services, or
when another lead investigative agency requests assistance from the county social service
agency for adult protective services, the county social service agency shall immediately
assess and offer emergency and continuing protective social services for purposes of
preventing further maltreatment and for safeguarding the welfare of the maltreated vulnerable
adult. The county shall use a standardized tool made available by the commissioner. The
information entered by the county into the standardized tool must be accessible to the
Department of Human Services. In cases of suspected sexual abuse, the county social service
agency shall immediately arrange for and make available to the vulnerable adult appropriate
medical examination and treatment. When necessary in order to protect the vulnerable adult
from further harm, the county social service agency shall seek authority to remove the
vulnerable adult from the situation in which the maltreatment occurred. The county social
service agency may also investigate to determine whether the conditions which resulted in
the reported maltreatment place other vulnerable adults in jeopardy of being maltreated and
offer protective social services that are called for by its determination.

(b) County social service agencies may enter deleted text begin facilities deleted text end new text begin licensed provider's premises new text end and
inspect and copy records as part of an investigation. The county social service 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 deleted text begin facilities deleted text end new text begin licensed providers new text end to the extent necessary
to conduct its investigation. The inquiry is not limited to the written records of the deleted text begin facility deleted text end new text begin
licensed provider new text end , but may include every other available source of information.

(c) When necessary in order to protect a vulnerable adult from serious harm, the county
social service agency shall immediately intervene on behalf of that adult to help the family,
vulnerable adult, or other interested person by seeking any of the following:

(1) a restraining order or a court order for removal of the perpetrator from the residence
of the vulnerable adult pursuant to section 518B.01;

(2) the appointment of a guardian or conservator pursuant to sections 524.5-101 to
524.5-502, or guardianship or conservatorship pursuant to chapter 252A;

(3) replacement of a guardian or conservator suspected of maltreatment and appointment
of a suitable person as guardian or conservator, pursuant to sections 524.5-101 to 524.5-502;
or

(4) a referral to the prosecuting attorney for possible criminal prosecution of the
perpetrator under chapter 609.

The expenses of legal intervention must be paid by the county in the case of indigent
persons, under section 524.5-502 and chapter 563.

In proceedings under sections 524.5-101 to 524.5-502, if a suitable relative or other
person is not available to petition for guardianship or conservatorship, a county employee
shall present the petition with representation by the county attorney. The county shall contract
with or arrange for a suitable person or organization to provide ongoing guardianship
services. If the county presents evidence to the court exercising probate jurisdiction that it
has made a diligent effort and no other suitable person can be found, a county employee
may serve as guardian or conservator. The county shall not retaliate against the employee
for any action taken on behalf of the ward or protected person even if the action is adverse
to the county's interest. Any person retaliated against in violation of this subdivision shall
have a cause of action against the county and shall be entitled to reasonable attorney fees
and costs of the action if the action is upheld by the court.

Sec. 27.

Minnesota Statutes 2018, 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 new text begin and shall publicly post the guidelines new text end .

new text begin (b) new text end When investigating a report, the lead investigative agency shall conduct the following
activities, as appropriate new text begin without exception unless: (i) the vulnerable adult, reporter, or
witness is deceased, refuses an interview, or is unable to be contacted despite diligent
attempts; (ii) the interview was conducted by law enforcement and an additional interview
will not further the civil investigation; (iii) the alleged vulnerable adult declines an interview;
or (iv) the agency has reason to know the activity will endanger the vulnerable adult or
impede the investigation new text end :

(1) interview of the alleged victim;

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

(3) interview of the alleged perpetrator; new text begin and
new text end

deleted text begin (4) examination of the environment surrounding the alleged incident;
deleted text end

deleted text begin (5) deleted text end new text begin (4) new text end review of new text begin records and new text end pertinent documentation deleted text begin of the alleged incident; and deleted text end new text begin .
new text end

new text begin (c) The lead investigative agency shall conduct the following activities if appropriate to
further the investigation or necessary to prevent further maltreatment or to safeguard the
vulnerable adult:
new text end

new text begin (1) examine the environment surrounding the alleged incident;
new text end

deleted text begin (6) consultation deleted text end new text begin (2) consult new text end with professionals deleted text begin . deleted text end new text begin ;
new text end

new text begin (3) request the vulnerable adult's choice of the primary support person; and
new text end

new text begin (4) communicate with tribes, service providers, and the primary support person for the
vulnerable adult.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 28.

Minnesota Statutes 2018, 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 new text begin during the
provision of adult protective services new text end are welfare data under section 13.46. new text begin Investigative
data collected under this section are confidential data on individuals or protected nonpublic
data as defined under section 13.02. new text end 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 (c).

Data maintained by the common entry point are confidential data on individuals or
protected 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.

(b) 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.
Upon completion of the investigation, the data are classified as provided in clauses (1) to
(3) and paragraph (c).

(1) The investigation memorandum must contain the following data, which are public:

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

(ii) a statement of the nature of the alleged maltreatment;

(iii) pertinent information obtained from medical or other records reviewed;

(iv) the identity of the investigator;

(v) a summary of the investigation's findings;

(vi) statement of whether the report was found to be substantiated, inconclusive, false,
or that no determination will be made;

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

(viii) a statement of any action taken by the lead investigative agency; and

(ix) when a lead investigative agency's determination has substantiated maltreatment, a
statement of whether an individual, individuals, or a deleted text begin facility deleted text end new text begin licensed provider new text end 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 listed in clause (2).

(2) Data on individuals collected and maintained in the investigation memorandum are
private data, including:

(i) the name of the vulnerable adult;

(ii) the identity of the individual alleged to be the perpetrator;

(iii) the identity of the individual substantiated as the perpetrator; and

(iv) the identity of all individuals interviewed as part of the investigation.

(3) Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation. new text begin When the law
enforcement investigation is active, the data received by a lead investigative agency or
county agency responsible for protection of the vulnerable adult is confidential data on
individuals as defined in section 13.02, subdivision 3. When the law enforcement
investigation is completed, the investigative data are private data on individuals as defined
in section 13.02, subdivision 12.
new text end

(c) deleted text begin After the assessment or investigation is completed, deleted text end The name of the reporter must
be confidential. The subject of the report may compel disclosure of the name of the reporter
only with the consent of the reporter or upon a written finding by a court that the report was
false and there is evidence that the report was made in bad faith. 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.

(d) 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.

(e) The commissioners of health and human services shall annually publish on their
websites the number and type of reports of alleged maltreatment involving licensed deleted text begin facilities deleted text end new text begin
providers new text end 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.

(f) Each lead investigative agency must have a record retention policy.

(g) Lead investigative agencies, new text begin county agencies responsible for adult protective services,
new text end prosecuting authorities, and law enforcement agencies may exchange not public data, as
defined in section 13.02, new text begin with a tribe, provider, vulnerable adult, primary support person
for the vulnerable adult, state licensing board, federal or state agency, the ombudsperson
for long-term care, or the ombudsman for mental health and developmental disabilities, new text end if
the agency or authority deleted text begin requesting deleted text end new text begin providing new text end the data determines that the data are pertinent
and necessary deleted text begin to the requesting agency in initiating, furthering, or completing deleted text end new text begin to prevent
further maltreatment, to safeguard the affected vulnerable adults, or to initiate, further, or
complete new text end 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. 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. Notwithstanding section 138.17, upon completion of
the review, not public data received by the review panel must be destroyed.

(h) Each lead investigative agency shall keep records of the length of time it takes to
complete its investigations.

(i) A lead investigative agency may notify other affected parties and their authorized
representative 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 deleted text begin facility deleted text end new text begin licensed provider new text end .

(j) 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 29.

Minnesota Statutes 2018, section 626.557, subdivision 14, is amended to read:

Subd. 14.

Abuse prevention plans.

(a) Each deleted text begin facility deleted text end new text begin licensed provider new text end , except home
health agencies and personal care attendant services providers, 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 deleted text begin facility deleted text end new text begin licensed provider new text end , 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 deleted text begin facility deleted text end new text begin licensed provider new text end , 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 deleted text begin facility deleted text end new text begin licensed provider new text end and persons outside the
deleted text begin facility deleted text end new text begin licensed provider new text end , if unsupervised. Under this section, a deleted text begin facility deleted text end new text begin licensed provider new text end
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 deleted text begin facility deleted text end new text begin licensed provider new text end , another health care provider, or the deleted text begin facility's deleted text end new text begin
licensed provider's new text end ongoing assessments of the vulnerable adult.

Sec. 30.

Minnesota Statutes 2018, section 626.557, subdivision 17, is amended to read:

Subd. 17.

Retaliation prohibited.

(a) A deleted text begin facility deleted text end new text begin licensed provider new text end or person shall not
retaliate against any person who reports in good faith suspected maltreatment pursuant to
this section, or against a vulnerable adult with respect to whom a report is made, because
of the report.

(b) In addition to any remedies allowed under sections 181.931 to 181.935, any deleted text begin facility deleted text end new text begin
licensed provider new text end 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.

(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 clause, the term "adverse
action" refers to action taken by a deleted text begin facility deleted text end new text begin licensed provider new text end 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 deleted text begin facility deleted text end new text begin licensed provider's services new text end ;

(2) discharge from or termination of employment;

(3) demotion or reduction in remuneration for services;

(4) restriction or prohibition of access to the deleted text begin facility deleted text end new text begin licensed provider's premises new text end or its
residents; or

(5) any restriction of rights set forth in section 144.651.

Sec. 31.

Minnesota Statutes 2018, section 626.5572, subdivision 2, is amended to read:

Subd. 2.

Abuse.

"Abuse" means:

(a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate,
or aiding and abetting a violation of:

(1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224;

(2) the use of drugs to injure or facilitate crime as defined in section 609.235;

(3) the solicitation, inducement, and promotion of prostitution as defined in section
609.322; and

(4) criminal sexual conduct in the first through fifth degrees as defined in sections
609.342 to 609.3451.

A violation includes any action that meets the elements of the crime, regardless of
whether there is a criminal proceeding or conviction.

(b) Conduct which is not an accident or therapeutic conduct as defined in this section,
which produces or could reasonably be expected to produce physical pain or injury or
emotional distress including, but not limited to, the following:

(1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable
adult;

(2) use of repeated or malicious oral, written, or gestured language toward a vulnerable
adult or the treatment of a vulnerable adult which would be considered by a reasonable
person to be disparaging, derogatory, humiliating, harassing, or threatening; new text begin or
new text end

(3) use new text begin , not authorized under chapter 245A or 245D or inconsistent with state and federal
patient rights, new text end of any aversive or deprivation procedure, unreasonable confinement, or
involuntary seclusion, including the forced separation of the vulnerable adult from other
persons against the will of the vulnerable adult or the legal representative of the vulnerable
adult deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (4) use of any aversive or deprivation procedures for persons with developmental
disabilities or related conditions not authorized under section 245.825.
deleted text end

(c) Any sexual contact or penetration as defined in section 609.341, between a deleted text begin facility deleted text end new text begin
licensed provider's new text end staff person or a person providing services deleted text begin in deleted text end new text begin for new text end the deleted text begin facility deleted text end new text begin licensed
provider new text end and a resident, patient, or client of deleted text begin that facility deleted text end new text begin the licensed provider new text end .

(d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against the
vulnerable adult's will to perform services for the advantage of another.

(e) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult or a person with authority to make health care decisions for the
vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C or 252A, or section
253B.03 or 524.5-313, refuses consent or withdraws consent, consistent with that authority
and within the boundary of reasonable medical practice, to any therapeutic conduct, including
any care, service, or procedure to diagnose, maintain, or treat the physical or mental condition
of the vulnerable adult or, where permitted under law, to provide nutrition and hydration
parenterally or through intubation. This paragraph does not enlarge or diminish rights
otherwise held under law by:

(1) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an
involved family member, to consent to or refuse consent for therapeutic conduct; or

(2) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct.

(f) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult, a person with authority to make health care decisions for the vulnerable
adult, or a caregiver in good faith selects and depends upon spiritual means or prayer for
treatment or care of disease or remedial care of the vulnerable adult in lieu of medical care,
provided that this is consistent with the prior practice or belief of the vulnerable adult or
with the expressed intentions of the vulnerable adult.

(g) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult, who is not impaired in judgment or capacity by mental or emotional
dysfunction or undue influence, engages in consensual sexual contact with:

(1) a person, including a deleted text begin facility deleted text end new text begin licensed provider new text end staff person, when a consensual sexual
personal relationship existed prior to the caregiving relationship; or

(2) a personal care attendant, regardless of whether the consensual sexual personal
relationship existed prior to the caregiving relationship.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 32.

Minnesota Statutes 2018, section 626.5572, subdivision 3, is amended to read:

Subd. 3.

Accident.

"Accident" means a sudden, unforeseen, and unexpected occurrence
or event which:

(1) is not likely to occur and which could not have been prevented by exercise of due
care; and

(2) if occurring while a vulnerable adult is receiving services from a deleted text begin facility deleted text end new text begin licensed
provider new text end , happens when the deleted text begin facility deleted text end new text begin licensed provider new text end and the employee or person providing
services deleted text begin in the facility deleted text end are in compliance with the laws and rules relevant to the occurrence
or event.

Sec. 33.

Minnesota Statutes 2018, section 626.5572, subdivision 4, is amended to read:

Subd. 4.

Caregiver.

"Caregiver" means new text begin a paid provider, new text end an individual new text begin , new text end or deleted text begin facility who
has responsibility for the care of a vulnerable adult as a result of a family relationship, or deleted text end new text begin
licensed provider new text end who has assumed responsibility for all or a portion of the care of a
vulnerable adult voluntarily, by contract, or by agreement.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 34.

Minnesota Statutes 2018, section 626.5572, subdivision 6, is amended to read:

Subd. 6.

deleted text begin Facility deleted text end new text begin Licensed provider new text end .

(a) " deleted text begin Facility deleted text end new text begin Licensed provider new text end " means a hospital
or other entity required to be licensed under sections 144.50 to 144.58; a nursing home
required to be licensed to serve adults under section 144A.02; a deleted text begin facility deleted text end new text begin licensed provider new text end
or service required to be licensed under chapter 245A; a home care provider licensed or
required to be licensed under sections 144A.43 to 144A.482; a hospice provider licensed
under sections 144A.75 to 144A.755; or a person or organization that offers, provides, or
arranges for personal care assistance services under the medical assistance program as
authorized under sections 256B.0625, subdivision 19a, 256B.0651 to 256B.0654, 256B.0659,
or 256B.85.

(b) For services identified in paragraph (a) that are provided in the vulnerable adult's
own home or in another unlicensed location, the term " deleted text begin facility deleted text end new text begin licensed provider new text end " refers to
the provider, person, or organization that offers, provides, or arranges for personal care
services, and does not refer to the vulnerable adult's home or other location at which services
are rendered.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 35.

Minnesota Statutes 2018, section 626.5572, subdivision 8, is amended to read:

Subd. 8.

Final disposition.

"Final disposition" is the determination of an investigation
by a lead investigative agency that a report of maltreatment under Laws 1995, chapter 229,
is substantiated, inconclusive, false, or that no determination will be made. When a lead
investigative agency determination has substantiated maltreatment, the final disposition
also identifies, if known, which individual or individuals were responsible for the
substantiated maltreatment, and whether a deleted text begin facility deleted text end new text begin licensed provider new text end was responsible for the
substantiated maltreatment.

Sec. 36.

Minnesota Statutes 2018, section 626.5572, subdivision 9, is amended to read:

Subd. 9.

Financial exploitation.

"Financial exploitation" means:

(a) In breach of a fiduciary obligation recognized elsewhere in law, including pertinent
regulations, contractual obligations, documented consent by a competent person, or the
obligations of a responsible party under section 144.6501, a person:

(1) deleted text begin engages in unauthorized expenditure of funds entrusted to the actor by the vulnerable
adult which results or is likely to result in detriment to the vulnerable adult deleted text end new text begin takes, uses, or
transfers the vulnerable adult's personal property or financial resources other than what a
reasonable person would deem the use, ownership, or obligations of the vulnerable adult new text end ;
or

(2) fails to use the financial resources of the vulnerable adult to provide food, clothing,
shelter, health care, therapeutic conduct or supervision for the vulnerable adult, and the
failure results or is likely to result in detriment to the vulnerable adult.

(b) In the absence of legal authority a person:

(1) willfully uses, withholds, or disposes of funds or property of a vulnerable adult;

(2) obtains for the actor or another the performance of services by a third person for the
wrongful profit or advantage of the actor or another to the detriment of the vulnerable adult;

(3) acquires possession or control of, or an interest in, funds or property of a vulnerable
adult through the use of undue influence, harassment, duress, deception, or fraud; or

(4) forces, compels, coerces, or entices a vulnerable adult against the vulnerable adult's
will to perform services for the profit or advantage of another.

(c) Nothing in this definition requires a deleted text begin facility deleted text end new text begin licensed provider new text end or caregiver to provide
financial management or supervise financial management for a vulnerable adult except as
otherwise required by law.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 37.

Minnesota Statutes 2018, section 626.5572, subdivision 16, is amended to read:

Subd. 16.

Mandated reporter.

"Mandated reporter" means a professional or
professional's delegate while engaged in: (1) social services; (2) law enforcement; (3)
education; (4) the care of vulnerable adults; (5) any of the occupations referred to in section
214.01, subdivision 2; (6) an employee of a rehabilitation facility certified by the
commissioner of jobs and training for vocational rehabilitation; (7) an employee or person
providing new text begin licensed new text end services deleted text begin in a facility deleted text end as defined in subdivision 6; or (8) a person that
performs the duties of the medical examiner or coroner.

Sec. 38.

Minnesota Statutes 2018, section 626.5572, subdivision 17, is amended to read:

Subd. 17.

Neglect.

deleted text begin "Neglect" means: deleted text end new text begin Neglect includes caregiver neglect and self-neglect.
new text end

(a) new text begin "Caregiver neglect" means new text end the failure or omission by a caregiver to supply a vulnerable
adult with care or services, including but not limited to, food, clothing, shelter, health care,
or supervision which is:

(1) reasonable and necessary to obtain or maintain the vulnerable adult's physical or
mental health or safety, considering the physical and mental capacity or dysfunction of the
vulnerable adult; and

(2) which is not the result of an accident or therapeutic conduct.

(b) deleted text begin The absence or likelihood of absence of care or services, including but not limited
to, food, clothing, shelter, health care, or supervision necessary to maintain the physical
deleted text end deleted text begin and mental health of the vulnerable adult deleted text end new text begin "Self-neglect" means neglect by a vulnerable adult
of food, clothing, shelter, health care, or other services not under the responsibility of a
caregiver new text end which a reasonable person would deem essential to obtain or maintain the
vulnerable adult's health, safety, deleted text begin or deleted text end comfort deleted text begin considering the physical or mental capacity or
dysfunction deleted text end new text begin , or physical and mental health new text end of the vulnerable adult.

(c) For purposes of this section, a vulnerable adult is not neglected for the sole reason
that:

(1) the vulnerable adult or a person with authority to make health care decisions for the
vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C, or 252A, or sections
253B.03 or 524.5-101 to 524.5-502, refuses consent or withdraws consent, consistent with
that authority and within the boundary of reasonable medical practice, to any therapeutic
conduct, including any care, service, or procedure to diagnose, maintain, or treat the physical
or mental condition of the vulnerable adult, or, where permitted under law, to provide
nutrition and hydration parenterally or through intubation; this paragraph does not enlarge
or diminish rights otherwise held under law by:

(i) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an
involved family member, to consent to or refuse consent for therapeutic conduct; or

(ii) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct; or

(2) the vulnerable adult, a person with authority to make health care decisions for the
vulnerable adult, or a caregiver in good faith selects and depends upon spiritual means or
prayer for treatment or care of disease or remedial care of the vulnerable adult in lieu of
medical care, provided that this is consistent with the prior practice or belief of the vulnerable
adult or with the expressed intentions of the vulnerable adult;

(3) the vulnerable adult, who is not impaired in judgment or capacity by mental or
emotional dysfunction or undue influence, engages in consensual sexual contact with:

(i) a person including a deleted text begin facility deleted text end new text begin licensed provider new text end staff person when a consensual sexual
personal relationship existed prior to the caregiving relationship; or

(ii) a personal care attendant, regardless of whether the consensual sexual personal
relationship existed prior to the caregiving relationship; or

(4) an individual makes an error in the provision of therapeutic conduct to a vulnerable
adult which does not result in injury or harm which reasonably requires medical or mental
health care; or

(5) an individual makes an error in the provision of therapeutic conduct to a vulnerable
adult that results in injury or harm, which reasonably requires the care of a physician, and:

(i) the necessary care is provided in a timely fashion as dictated by the condition of the
vulnerable adult;

(ii) if after receiving care, the health status of the vulnerable adult can be reasonably
expected, as determined by the attending physician, to be restored to the vulnerable adult's
preexisting condition;

(iii) the error is not part of a pattern of errors by the individual;

(iv) if deleted text begin in a facility deleted text end new text begin receiving services from a licensed provider new text end , the error is immediately
reported as required under section 626.557, and recorded internally deleted text begin in deleted text end new text begin by new text end the deleted text begin facility deleted text end new text begin licensed
provider new text end ;

(v) if deleted text begin in a facility deleted text end new text begin receiving licensed services new text end , the deleted text begin facility deleted text end new text begin licensed provider new text end identifies
and takes corrective action and implements measures designed to reduce the risk of further
occurrence of this error and similar errors; and

(vi) if deleted text begin in a facility deleted text end new text begin receiving licensed services new text end , new text begin the licensed provider takes new text end the actions
required under items (iv) and (v) are sufficiently documented for review and evaluation by
the deleted text begin facility deleted text end new text begin licensed provider new text end and any applicable licensing, certification, and ombudsman
agency.

(d) Nothing in this definition requires a caregiver, if regulated, to provide services in
excess of those required by the caregiver's license, certification, registration, or other
regulation.

(e) If the findings of an investigation by a lead investigative agency result in a
determination of substantiated maltreatment for the sole reason that the actions required of
a deleted text begin facility deleted text end new text begin licensed provider new text end under paragraph (c), clause (5), item (iv), (v), or (vi), were not
taken, then the deleted text begin facility deleted text end new text begin licensed provider new text end is subject to a correction order. An individual will
not be found to have neglected or maltreated the vulnerable adult based solely on the deleted text begin facility's deleted text end new text begin
licensed provider's new text end not having taken the actions required under paragraph (c), clause (5),
item (iv), (v), or (vi). This must not alter the lead investigative agency's determination of
mitigating factors under section 626.557, subdivision 9c, paragraph deleted text begin (c) deleted text end new text begin (f) new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 39.

Minnesota Statutes 2018, section 626.5572, is amended by adding a subdivision
to read:

new text begin Subd. 17a. new text end

new text begin Primary support person. new text end

new text begin "Primary support person" means a person or
persons identified by the lead investigative agency or agency responsible for adult protective
services as best able to coordinate with the agency to support protection of the vulnerable
adult, safeguard the vulnerable adult's welfare, and prevent further maltreatment. The primary
support person may be the vulnerable adult's guardian, health care agent, or other legal
representative, person authorized by the vulnerable adult under a supported decision making
or other agreement, or another person determined by the agency. If known to the agency,
the agency must consider the vulnerable adult's choice for primary support person.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 40.

Minnesota Statutes 2018, section 626.5572, subdivision 20, is amended to read:

Subd. 20.

Therapeutic conduct.

"Therapeutic conduct" means the provision of program
services, health care, or other personal care services done in good faith in the interests of
the vulnerable adult by: (1) an individual, deleted text begin facility deleted text end new text begin licensed provider new text end , or employee or person
providing services deleted text begin in deleted text end new text begin for new text end a deleted text begin facility deleted text end new text begin licensed provider new text end under the rights, privileges and
responsibilities conferred by state license, certification, or registration; or (2) a caregiver.

Sec. 41.

Minnesota Statutes 2018, section 626.5572, subdivision 21, is amended to read:

Subd. 21.

Vulnerable adult.

(a) "Vulnerable adult" means any person 18 years of age
or older who:

(1) is a resident or inpatient of a deleted text begin facility deleted text end new text begin licensed provider new text end ;

(2) receives services required to be licensed under chapter 245A, except that a person
receiving outpatient services for treatment of chemical dependency or mental illness, or one
who is served in the Minnesota sex offender program on a court-hold order for commitment,
or is committed as a sexual psychopathic personality or as a sexually dangerous person
under chapter 253B, is not considered a vulnerable adult unless the person meets the
requirements of clause (4);

(3) receives services from a home care provider required to be licensed under sections
144A.43 to 144A.482; or from a person or organization that offers, provides, or arranges
for personal care assistance services under the medical assistance program as authorized
under section 256B.0625, subdivision 19a, 256B.0651, 256B.0653, 256B.0654, 256B.0659,
or 256B.85; or

(4) regardless of residence or whether any type of service is received, possesses a physical
or mental infirmity or other physical, mental, or emotional dysfunction:

(i) that impairs the individual's ability to provide adequately for the individual's own
care without assistance, including the provision of food, shelter, clothing, health care, or
supervision; and

(ii) because of the dysfunction or infirmity and the need for care or services, the individual
has an impaired ability to protect the individual's self from maltreatment.

(b) For purposes of this subdivision, "care or services" means care or services for the
health, safety, welfare, or maintenance of an individual.

Sec. 42. new text begin DIRECTION TO COMMISSIONER; PROVIDER STANDARD
EVALUATION.
new text end

new text begin By January 1, 2020, the commissioner of human services shall evaluate provider standards
for companion, homemaker, and respite services covered by the home and community-based
waivers under Minnesota Statutes, sections 256B.0915, 256B.092, and 256B.49, and shall
make recommendations to the legislative committees with jurisdiction over elderly waiver
services for adjustments to these provider standards. The goal of this evaluation is to promote
access to services by developing standards that ensure the well-being of participants while
being minimally burdensome to providers.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

Sec. 43. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 256R.08, subdivision 2; and 256R.49, new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2019.
new text end

APPENDIX

Repealed Minnesota Statutes: 19-4566

256R.08 REPORTING OF FINANCIAL STATEMENTS.

Subd. 2.

Extensions.

The commissioner may grant up to a 15-day extension of the reporting deadline to a nursing facility for good cause. To receive such an extension, a nursing facility shall submit a written request by January 1. The commissioner shall notify the nursing facility of the decision by January 15. Between January 1 and February 1, the nursing facility may request a reporting extension for good cause by telephone and followed by a written request.

256R.49 RATE ADJUSTMENTS FOR COMPENSATION-RELATED COSTS FOR MINIMUM WAGE CHANGES.

Subdivision 1.

Rate adjustments for compensation-related costs.

(a) Rate increases provided under this section before October 1, 2016, expire effective January 1, 2018, and rate increases provided on or after October 1, 2016, expire effective January 1, 2019.

(b) Nursing facilities that receive approval of the applications in subdivision 2 must receive rate adjustments according to subdivision 4. The rate adjustments must be used to pay compensation costs for nursing facility employees paid less than $14 per hour.

Subd. 2.

Application process.

To receive a rate adjustment, nursing facilities must submit applications to the commissioner in a form and manner determined by the commissioner. The applications for the rate adjustments shall include specified data, and spending plans that describe how the funds from the rate adjustments will be allocated for compensation to employees paid less than $14 per hour. The applications must be submitted within three months of the effective date of any operating payment rate adjustment under this section. The commissioner may request any additional information needed to determine the rate adjustment within three weeks of receiving a complete application. The nursing facility must provide any additional information requested by the commissioner within six months of the effective date of any operating payment rate adjustment under this section. The commissioner may waive the deadlines in this section under extraordinary circumstances.

Subd. 3.

Additional application requirements for facilities with employees represented by an exclusive bargaining representative.

For nursing facilities in which employees are represented by an exclusive bargaining representative, the commissioner shall approve the applications submitted under subdivision 2 only upon receipt of a letter or letters of acceptance of the spending plans in regard to members of the bargaining unit, signed by the exclusive bargaining agent and dated after May 31, 2014. Upon receipt of the letter or letters of acceptance, the commissioner shall deem all requirements of this section as having been met in regard to the members of the bargaining unit.

Subd. 4.

Determination of the rate adjustments for compensation-related costs.

Based on the application in subdivision 2, the commissioner shall calculate the allowable annualized compensation costs by adding the totals of clauses (1), (2), and (3). The result must be divided by the standardized or resident days from the most recently available cost report to determine per day amounts, which must be included in the operating portion of the total payment rate and allocated to direct care or other operating as determined by the commissioner:

(1) the sum of the difference between $9.50 and any hourly wage rate less than $9.50 for October 1, 2016; and between the indexed value of the minimum wage, as defined in section 177.24, subdivision 1, paragraph (f), and any hourly wage less than that indexed value for rate years beginning on and after October 1, 2017; multiplied by the number of compensated hours at that wage rate;

(2) using wages and hours in effect during the first three months of calendar year 2014, beginning with the first pay period beginning on or after January 1, 2014; 22.2 percent of the sum of items (i) to (viii) for October 1, 2016;

(i) for all compensated hours from $8 to $8.49 per hour, the number of compensated hours is multiplied by $0.13;

(ii) for all compensated hours from $8.50 to $8.99 per hour, the number of compensated hours is multiplied by $0.25;

(iii) for all compensated hours from $9 to $9.49 per hour, the number of compensated hours is multiplied by $0.38;

(iv) for all compensated hours from $9.50 to $10.49 per hour, the number of compensated hours is multiplied by $0.50;

(v) for all compensated hours from $10.50 to $10.99 per hour, the number of compensated hours is multiplied by $0.40;

(vi) for all compensated hours from $11 to $11.49 per hour, the number of compensated hours is multiplied by $0.30;

(vii) for all compensated hours from $11.50 to $11.99 per hour, the number of compensated hours is multiplied by $0.20; and

(viii) for all compensated hours from $12 to $13 per hour, the number of compensated hours is multiplied by $0.10; and

(3) the sum of the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, pensions, and contributions to employee retirement accounts attributable to the amounts in clauses (1) and (2).