SF 2474

1st Engrossment - 89th Legislature (2015 - 2016) Posted on 05/17/2016 09:24am

A bill for an act
relating to human services; positive supports; legislatively approving Minnesota
Rules, chapter 9544; making technical changes; amending Minnesota Statutes
2014, sections 245.8251, subdivision 2, by adding a subdivision; 252.275,
subdivision 1a; 253B.03, subdivisions 1, 6a; 256B.0659, subdivision 3;
256B.0951, subdivision 5; 256B.097, subdivision 4; 256B.77, subdivision 17;
626.5572, subdivision 2; Minnesota Statutes 2015 Supplement, section 626.556,
subdivision 2; repealing Minnesota Statutes 2014, section 245.825, subdivisions
1, 1b.

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

Section 1.

Minnesota Statutes 2014, section 245.8251, is amended by adding a
subdivision to read:

new text begin Subd. 1a. new text end

new text begin Legislative approval. new text end

new text begin Minnesota Rules, chapter 9544, positive support
strategies and restrictive interventions is approved.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Minnesota Statutes 2014, section 245.8251, subdivision 2, is amended to read:

Subd. 2.

Data collection.

deleted text begin (a) deleted text end The commissioner shall, with stakeholder input,
identify data elements specific to incidents of emergency use of manual restraint and
positive support transition plans for persons receiving services from licensed facilities
and licensed services under chapter 245D and in licensed facilities and licensed services
serving persons with a developmental disability or related condition as defined in
Minnesota Rules, part 9525.0016, subpart 2, effective January 1, 2014. Licensed facilities
and licensed services shall report the data in a format and at a frequency determined by the
commissioner of human services to the commissioner and the Office of the Ombudsman
for Mental Health and Developmental Disabilities.

deleted text begin (b) Beginning July 1, 2013, licensed facilities and licensed services regulated under
Minnesota Rules, parts 9525.2700 to 9525.2810, shall submit data regarding the use of all
controlled procedures identified in Minnesota Rules, part 9525.2740, in a format and at
a frequency determined by the commissioner to the commissioner and the Office of the
Ombudsman for Mental Health and Developmental Disabilities.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 3.

Minnesota Statutes 2014, section 252.275, subdivision 1a, is amended to read:

Subd. 1a.

Service requirements.

The methods, materials, and settings used to
provide semi-independent living services to a person must be designed to:

(1) increase the person's independence in performing tasks and activities by teaching
skills that reduce dependence on caregivers;

(2) provide training in an environment where the skill being taught is typically used;

(3) increase the person's opportunities to interact with nondisabled individuals who
are not paid caregivers;

(4) increase the person's opportunities to use community resources and participate in
community activities, including recreational, cultural, and educational resources, stores,
restaurants, religious services, and public transportation;

(5) increase the person's opportunities to develop decision-making skills and to make
informed choices in all aspects of daily living, including:

(i) selection of service providers;

(ii) goals and methods;

(iii) location and decor of residence;

(iv) roommates;

(v) daily routines;

(vi) leisure activities; and

(vii) personal possessions;

(6) provide daily schedules, routines, environments and interactions similar to those
of nondisabled individuals of the same chronological age; and

(7) comply with section deleted text begin 245.825, subdivision 1 deleted text end new text begin 245.8251 and the rules promulgated
pursuant to section 245.8251, subdivision 1 new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 4.

Minnesota Statutes 2014, section 253B.03, subdivision 1, is amended to read:

Subdivision 1.

Restraints.

(a) A patient has the right to be free from restraints.
Restraints shall not be applied to a patient in a treatment facility unless the head of the
treatment facility, a member of the medical staff, or a licensed peace officer who has custody
of the patient determines that they are necessary for the safety of the patient or others.

(b) Restraints shall not be applied to patients with developmental disabilities except
as permitted under section deleted text begin 245.825 deleted text end new text begin 245.8251 new text end and rules of the commissioner of human
services. Consent must be obtained from the person or person's guardian except for
emergency procedures as permitted under rules of the commissioner adopted under
section deleted text begin 245.825 deleted text end new text begin 245.8251 new text end .

(c) Each use of a restraint and reason for it shall be made part of the clinical record
of the patient under the signature of the head of the treatment facility.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 5.

Minnesota Statutes 2014, section 253B.03, subdivision 6a, is amended to read:

Subd. 6a.

Consent for treatment for developmental disability.

A patient with
a developmental disability, or the patient's guardian, has the right to give or withhold
consent before:

(1) the implementation of any deleted text begin aversive or deprivation procedure deleted text end new text begin restrictive
interventions new text end except for emergency deleted text begin procedures deleted text end new text begin use of manual restraint new text end permitted in rules
of the commissioner adopted under section deleted text begin 245.825 deleted text end new text begin 245.8251 new text end ; or

(2) the administration of psychotropic medication.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 6.

Minnesota Statutes 2014, section 256B.0659, subdivision 3, is amended to read:

Subd. 3.

Noncovered personal care assistance services.

(a) Personal care assistance
services are not eligible for medical assistance payment under this section when provided:

(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal
guardian, licensed foster provider, except as allowed under section 256B.0652, subdivision
10, or responsible party;

(2) in order to meet staffing or license requirements in a residential or child care
setting;

(3) solely as a child care or babysitting service; or

(4) without authorization by the commissioner or the commissioner's designee.

(b) The following personal care services are not eligible for medical assistance
payment under this section when provided in residential settings:

(1) when the provider of home care services who is not related by blood, marriage,
or adoption owns or otherwise controls the living arrangement, including licensed or
unlicensed services; or

(2) when personal care assistance services are the responsibility of a residential or
program license holder under the terms of a service agreement and administrative rules.

(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible
for medical assistance reimbursement for personal care assistance services under this
section include:

(1) sterile procedures;

(2) injections of fluids and medications into veins, muscles, or skin;

(3) home maintenance or chore services;

(4) homemaker services not an integral part of assessed personal care assistance
services needed by a recipient;

(5) application of deleted text begin restraints or implementation of procedures deleted text end new text begin restrictive interventions
new text end under section deleted text begin 245.825 deleted text end new text begin 245.8251 new text end ;

(6) instrumental activities of daily living for children under the age of 18, except
when immediate attention is needed for health or hygiene reasons integral to the personal
care services and the need is listed in the service plan by the assessor; and

(7) assessments for personal care assistance services by personal care assistance
provider agencies or by independently enrolled registered nurses.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 7.

Minnesota Statutes 2014, section 256B.0951, subdivision 5, is amended to read:

Subd. 5.

Variance of certain standards prohibited.

The safety standards, rights,
or procedural protections under chapter 245C and sections deleted text begin 245.825 deleted text end new text begin 245.8251 new text end ; 245.91 to
245.97; 245A.09, subdivision 2, paragraph (c), clauses (2) and (5); 245A.12; 245A.13;
252.41, subdivision 9; 256B.092, subdivisions 1b, clause (7), and 10; 626.556; 626.557,
and procedures for the monitoring of psychotropic medications shall not be varied
under the alternative quality assurance licensing system. The commission may make
recommendations to the commissioners of human services and health or to the legislature
regarding alternatives to or modifications of the rules and procedures referenced in this
subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 8.

Minnesota Statutes 2014, section 256B.097, subdivision 4, is amended to read:

Subd. 4.

Regional quality councils.

(a) The commissioner shall establish, as
selected by the State Quality Council, regional quality councils of key stakeholders,
including regional representatives of:

(1) disability service recipients and their family members;

(2) disability service providers;

(3) disability advocacy groups; and

(4) county human services agencies and staff from the Department of Human
Services and Ombudsman for Mental Health and Developmental Disabilities.

(b) Each regional quality council shall:

(1) direct and monitor the community-based, person-directed quality assurance
system in this section;

(2) approve a training program for quality assurance team members under clause (13);

(3) review summary reports from quality assurance team reviews and make
recommendations to the State Quality Council regarding program licensure;

(4) make recommendations to the State Quality Council regarding the system;

(5) resolve complaints between the quality assurance teams, counties, providers,
persons receiving services, their families, and legal representatives;

(6) analyze and review quality outcomes and critical incident data reporting
incidents of life safety concerns immediately to the Department of Human Services
licensing division;

(7) provide information and training programs for persons with disabilities and their
families and legal representatives on service options and quality expectations;

(8) disseminate information and resources developed to other regional quality
councils;

(9) respond to state-level priorities;

(10) establish regional priorities for quality improvement;

(11) submit an annual report to the State Quality Council on the status, outcomes,
improvement priorities, and activities in the region;

(12) choose a representative to participate on the State Quality Council and assume
other responsibilities consistent with the priorities of the State Quality Council; and

(13) recruit, train, and assign duties to members of quality assurance teams, taking
into account the size of the service provider, the number of services to be reviewed,
the skills necessary for the team members to complete the process, and ensure that no
team member has a financial, personal, or family relationship with the facility, program,
or service being reviewed or with anyone served at the facility, program, or service.
Quality assurance teams must be comprised of county staff, persons receiving services
or the person's families, legal representatives, members of advocacy organizations,
providers, and other involved community members. Team members must complete
the training program approved by the regional quality council and must demonstrate
performance-based competency. Team members may be paid a per diem and reimbursed
for expenses related to their participation in the quality assurance process.

(c) The commissioner shall monitor the safety standards, rights, and procedural
protections for the monitoring of psychotropic medications and those identified under
sections deleted text begin 245.825 deleted text end new text begin 245.8251 new text end ; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c),
clauses (2) and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b,
clause (7); 626.556; and 626.557.

(d) The regional quality councils may hire staff to perform the duties assigned in
this subdivision.

(e) The regional quality councils may charge fees for their services.

(f) The quality assurance process undertaken by a regional quality council consists of
an evaluation by a quality assurance team of the facility, program, or service. The process
must include an evaluation of a random sample of persons served. The sample must be
representative of each service provided. The sample size must be at least five percent but
not less than two persons served. All persons must be given the opportunity to be included
in the quality assurance process in addition to those chosen for the random sample.

(g) A facility, program, or service may contest a licensing decision of the regional
quality council as permitted under chapter 245A.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 9.

Minnesota Statutes 2014, section 256B.77, subdivision 17, is amended to read:

Subd. 17.

Approval of alternatives.

The commissioner may approve alternatives to
administrative rules if the commissioner determines that appropriate alternative measures
are in place to protect the health, safety, and rights of enrollees and to assure that services
are of sufficient quality to produce the outcomes described in the personal support plans.
Prior approved waivers, if needed by the demonstration project, shall be extended. The
commissioner shall not waive the rights or procedural protections under sections deleted text begin 245.825
deleted text end new text begin 245.8251 new text end ; 245.91 to 245.97; 252.41, subdivision 9; 256B.092, subdivision 10; 626.556;
and 626.557; or procedures for the monitoring of psychotropic medications. Prohibited
practices as defined in statutes and rules governing service delivery to eligible individuals
are applicable to services delivered under this demonstration project.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 10.

Minnesota Statutes 2015 Supplement, section 626.556, subdivision 2, is
amended to read:

Subd. 2.

Definitions.

As used in this section, the following terms have the meanings
given them unless the specific content indicates otherwise:

(a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected
occurrence or event which:

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

(2) if occurring while a child is receiving services from a facility, happens when the
facility and the employee or person providing services in the facility are in compliance
with the laws and rules relevant to the occurrence or event.

(b) "Commissioner" means the commissioner of human services.

(c) "Facility" means:

(1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
sanitarium, or other facility or institution required to be licensed under sections 144.50 to
144.58, 241.021, or 245A.01 to 245A.16, or chapter 245D;

(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter
124E; or

(3) a nonlicensed personal care provider organization as defined in section
256B.0625, subdivision 19a.

(d) "Family assessment" means a comprehensive assessment of child safety, risk of
subsequent child maltreatment, and family strengths and needs that is applied to a child
maltreatment report that does not allege sexual abuse or substantial child endangerment.
Family assessment does not include a determination as to whether child maltreatment
occurred but does determine the need for services to address the safety of family members
and the risk of subsequent maltreatment.

(e) "Investigation" means fact gathering related to the current safety of a child
and the risk of subsequent maltreatment that determines whether child maltreatment
occurred and whether child protective services are needed. An investigation must be used
when reports involve sexual abuse or substantial child endangerment, and for reports of
maltreatment in facilities required to be licensed under chapter 245A or 245D; under
sections 144.50 to 144.58 and 241.021; in a school as defined in section 120A.05,
subdivisions 9, 11, and 13, and chapter 124E; or in a nonlicensed personal care provider
association as defined in section 256B.0625, subdivision 19a.

(f) "Mental injury" means an injury to the psychological capacity or emotional
stability of a child as evidenced by an observable or substantial impairment in the child's
ability to function within a normal range of performance and behavior with due regard to
the child's culture.

(g) "Neglect" means the commission or omission of any of the acts specified under
clauses (1) to (9), other than by accidental means:

(1) failure by a person responsible for a child's care to supply a child with necessary
food, clothing, shelter, health, medical, or other care required for the child's physical or
mental health when reasonably able to do so;

(2) failure to protect a child from conditions or actions that seriously endanger the
child's physical or mental health when reasonably able to do so, including a growth delay,
which may be referred to as a failure to thrive, that has been diagnosed by a physician and
is due to parental neglect;

(3) failure to provide for necessary supervision or child care arrangements
appropriate for a child after considering factors as the child's age, mental ability, physical
condition, length of absence, or environment, when the child is unable to care for the
child's own basic needs or safety, or the basic needs or safety of another child in their care;

(4) failure to ensure that the child is educated as defined in sections 120A.22 and
260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's
child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;

(5) nothing in this section shall be construed to mean that a child is neglected solely
because the child's parent, guardian, or other person responsible for the child's care in
good faith selects and depends upon spiritual means or prayer for treatment or care of
disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
if a lack of medical care may cause serious danger to the child's health. This section does
not impose upon persons, not otherwise legally responsible for providing a child with
necessary food, clothing, shelter, education, or medical care, a duty to provide that care;

(6) prenatal exposure to a controlled substance, as defined in section 253B.02,
subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
symptoms in the child at birth, results of a toxicology test performed on the mother at
delivery or the child at birth, medical effects or developmental delays during the child's
first year of life that medically indicate prenatal exposure to a controlled substance, or the
presence of a fetal alcohol spectrum disorder;

(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);

(8) chronic and severe use of alcohol or a controlled substance by a parent or
person responsible for the care of the child that adversely affects the child's basic needs
and safety; or

(9) emotional harm from a pattern of behavior which contributes to impaired
emotional functioning of the child which may be demonstrated by a substantial and
observable effect in the child's behavior, emotional response, or cognition that is not
within the normal range for the child's age and stage of development, with due regard to
the child's culture.

(h) "Nonmaltreatment mistake" means:

(1) at the time of the incident, the individual was performing duties identified in the
center's child care program plan required under Minnesota Rules, part 9503.0045;

(2) the individual has not been determined responsible for a similar incident that
resulted in a finding of maltreatment for at least seven years;

(3) the individual has not been determined to have committed a similar
nonmaltreatment mistake under this paragraph for at least four years;

(4) any injury to a child resulting from the incident, if treated, is treated only with
remedies that are available over the counter, whether ordered by a medical professional or
not; and

(5) except for the period when the incident occurred, the facility and the individual
providing services were both in compliance with all licensing requirements relevant to the
incident.

This definition only applies to child care centers licensed under Minnesota
Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of
substantiated maltreatment by the individual, the commissioner of human services shall
determine that a nonmaltreatment mistake was made by the individual.

(i) "Operator" means an operator or agency as defined in section 245A.02.

(j) "Person responsible for the child's care" means (1) an individual functioning
within the family unit and having responsibilities for the care of the child such as a
parent, guardian, or other person having similar care responsibilities, or (2) an individual
functioning outside the family unit and having responsibilities for the care of the child
such as a teacher, school administrator, other school employees or agents, or other lawful
custodian of a child having either full-time or short-term care responsibilities including,
but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
and coaching.

(k) "Physical abuse" means any physical injury, mental injury, or threatened injury,
inflicted by a person responsible for the child's care on a child other than by accidental
means, or any physical or mental injury that cannot reasonably be explained by the child's
history of injuries, or any aversive or deprivation procedures, or regulated interventions,
that have not been authorized under section 125A.0942 or deleted text begin 245.825 deleted text end new text begin 245.8251 new text end .

Abuse does not include reasonable and moderate physical discipline of a child
administered by a parent or legal guardian which does not result in an injury. Abuse does
not include the use of reasonable force by a teacher, principal, or school employee as
allowed by section 121A.582. Actions which are not reasonable and moderate include, but
are not limited to, any of the following:

(1) throwing, kicking, burning, biting, or cutting a child;

(2) striking a child with a closed fist;

(3) shaking a child under age three;

(4) striking or other actions which result in any nonaccidental injury to a child
under 18 months of age;

(5) unreasonable interference with a child's breathing;

(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;

(7) striking a child under age one on the face or head;

(8) striking a child who is at least age one but under age four on the face or head,
which results in an injury;

(9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
substances which were not prescribed for the child by a practitioner, in order to control or
punish the child; or other substances that substantially affect the child's behavior, motor
coordination, or judgment or that results in sickness or internal injury, or subjects the
child to medical procedures that would be unnecessary if the child were not exposed
to the substances;

(10) unreasonable physical confinement or restraint not permitted under section
609.379, including but not limited to tying, caging, or chaining; or

(11) in a school facility or school zone, an act by a person responsible for the child's
care that is a violation under section 121A.58.

(l) "Practice of social services," for the purposes of subdivision 3, includes but is
not limited to employee assistance counseling and the provision of guardian ad litem and
parenting time expeditor services.

(m) "Report" means any communication received by the local welfare agency,
police department, county sheriff, or agency responsible for child protection pursuant to
this section that describes neglect or physical or sexual abuse of a child and contains
sufficient content to identify the child and any person believed to be responsible for the
neglect or abuse, if known.

(n) "Sexual abuse" means the subjection of a child by a person responsible for the
child's care, by a person who has a significant relationship to the child, as defined in
section 609.341, or by a person in a position of authority, as defined in section 609.341,
subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
abuse also includes any act which involves a minor which constitutes a violation of
prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
threatened sexual abuse which includes the status of a parent or household member
who has committed a violation which requires registration as an offender under section
243.166, subdivision 1b, paragraph (a) or (b), or required registration under section
243.166, subdivision 1b, paragraph (a) or (b).

(o) "Substantial child endangerment" means a person responsible for a child's care,
by act or omission, commits or attempts to commit an act against a child under their
care that constitutes any of the following:

(1) egregious harm as defined in section 260C.007, subdivision 14;

(2) abandonment under section 260C.301, subdivision 2;

(3) neglect as defined in paragraph (g), clause (2), that substantially endangers the
child's physical or mental health, including a growth delay, which may be referred to as
failure to thrive, that has been diagnosed by a physician and is due to parental neglect;

(4) murder in the first, second, or third degree under section 609.185, 609.19, or
609.195;

(5) manslaughter in the first or second degree under section 609.20 or 609.205;

(6) assault in the first, second, or third degree under section 609.221, 609.222, or
609.223;

(7) solicitation, inducement, and promotion of prostitution under section 609.322;

(8) criminal sexual conduct under sections 609.342 to 609.3451;

(9) solicitation of children to engage in sexual conduct under section 609.352;

(10) malicious punishment or neglect or endangerment of a child under section
609.377 or 609.378;

(11) use of a minor in sexual performance under section 617.246; or

(12) parental behavior, status, or condition which mandates that the county attorney
file a termination of parental rights petition under section 260C.503, subdivision 2.

(p) "Threatened injury" means a statement, overt act, condition, or status that
represents a substantial risk of physical or sexual abuse or mental injury. Threatened
injury includes, but is not limited to, exposing a child to a person responsible for the
child's care, as defined in paragraph (j), clause (1), who has:

(1) subjected a child to, or failed to protect a child from, an overt act or condition
that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
similar law of another jurisdiction;

(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph
(b), clause (4), or a similar law of another jurisdiction;

(3) committed an act that has resulted in an involuntary termination of parental rights
under section 260C.301, or a similar law of another jurisdiction; or

(4) committed an act that has resulted in the involuntary transfer of permanent
legal and physical custody of a child to a relative under Minnesota Statutes 2010, section
260C.201, subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a
similar law of another jurisdiction.

A child is the subject of a report of threatened injury when the responsible social
services agency receives birth match data under paragraph (q) from the Department of
Human Services.

(q) Upon receiving data under section 144.225, subdivision 2b, contained in a
birth record or recognition of parentage identifying a child who is subject to threatened
injury under paragraph (p), the Department of Human Services shall send the data to the
responsible social services agency. The data is known as "birth match" data. Unless the
responsible social services agency has already begun an investigation or assessment of the
report due to the birth of the child or execution of the recognition of parentage and the
parent's previous history with child protection, the agency shall accept the birth match
data as a report under this section. The agency may use either a family assessment or
investigation to determine whether the child is safe. All of the provisions of this section
apply. If the child is determined to be safe, the agency shall consult with the county
attorney to determine the appropriateness of filing a petition alleging the child is in need
of protection or services under section 260C.007, subdivision 6, clause (16), in order to
deliver needed services. If the child is determined not to be safe, the agency and the county
attorney shall take appropriate action as required under section 260C.503, subdivision 2.

(r) Persons who conduct assessments or investigations under this section shall take
into account accepted child-rearing practices of the culture in which a child participates
and accepted teacher discipline practices, which are not injurious to the child's health,
welfare, and safety.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 11.

Minnesota Statutes 2014, 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;

(3) use 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; and

(4) use of any aversive or deprivation procedures for persons with developmental
disabilities or related conditions not authorized under section deleted text begin 245.825 deleted text end new text begin 245.8251 new text end .

(c) Any sexual contact or penetration as defined in section 609.341, between a
facility staff person or a person providing services in the facility and a resident, patient,
or client of that facility.

(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 facility 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 the day following final enactment.
new text end

Sec. 12. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2014, section 245.825, subdivisions 1 and 1b, 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 the day following final enactment.
new text end