SF 2888

2nd Engrossment - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to health; establishing requirements for assisted living services; limiting
use of the term assisted living; specifying procedures for terminating services
for assisted living clients; modifying the home care bill of rights for purposes
of assisted living; establishing the Class F home care provider category;
eliminating the Class E assisted living programs license; requiring the provision
of information on assisted living and the legal rights of assisted living clients;
appropriating money; amending Minnesota Statutes 2004, sections 144A.4605;
144D.01, by adding a subdivision; 144D.015; 144D.02; 144D.03, subdivision
2; 144D.04; 144D.05; 144D.065; proposing coding for new law in Minnesota
Statutes, chapters 144A; 144D; proposing coding for new law as Minnesota
Statutes, chapter 144G; repealing Minnesota Rules, part 4668.0215.

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

Section 1.

new text begin [144A.441] ASSISTED LIVING BILL OF RIGHTS ADDENDUM.
new text end

new text begin Assisted living clients, as defined in section 144G.01, subdivision 3, shall be
provided with the home care bill of rights required by section 144A.44, except that the
home care bill of rights provided to these clients must include the following provision in
place of the provision in section 144A.44, subdivision 1, clause (16):
new text end

new text begin "(16) the right to reasonable, advance notice of changes in services or charges,
including at least 30 days' advance notice of the termination of a service by a provider,
except in cases where:
new text end

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

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 2.

new text begin [144A.442] TERMINATION OF HOME CARE SERVICES FOR
ASSISTED LIVING CLIENTS.
new text end

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

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

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

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

new text begin (4) contact information for a reasonable number of other home care providers in
the geographic area of the assisted living client, as required by Minnesota Rules, part
4668.0050;
new text end

new text begin (5) a statement that the provider will participate in a coordinated transfer of the care
of the client to another provider or caregiver, as required by section 144A.44, subdivision
1, clause (17);
new text end

new text begin (6) the name and contact information of a representative of the home care provider
with whom the client may discuss the notice of termination;
new text end

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

new text begin (8) a statement that the notice of termination of home care services by the home care
provider does not constitute notice of termination of the housing with services contract
with a housing with services establishment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 3.

Minnesota Statutes 2004, section 144A.4605, is amended to read:

144A.4605 deleted text begin ASSISTED LIVING HOME CARE deleted text end new text begin CLASS F new text end PROVIDER.

Subdivision 1.

Definitions.

For purposes of this section, the term " deleted text begin assisted
living deleted text end new text begin class F new text end home care provider" means a home care provider who provides nursing
services, delegated nursing services, other services performed by unlicensed personnel, or
central storage of medications solely for residents of one or more housing with services
establishments registered under chapter 144D.

Subd. 2.

deleted text begin Assisted living deleted text end new text begin Class F new text end home care license established.

A home care
provider license category entitled deleted text begin assisted living deleted text end new text begin class F new text end home care provider is hereby
established. A home care provider may obtain deleted text begin an assisted living deleted text end new text begin a class F new text end license if the
program meets the following requirements:

(a) nursing services, delegated nursing services, other services performed by
unlicensed personnel, or central storage of medications under the deleted text begin assisted living deleted text end new text begin class
F new text end license are provided solely for residents of one or more housing with services
establishments registered under chapter 144D;

(b) unlicensed personnel perform home health aide and home care aide tasks
identified in Minnesota Rules, parts 4668.0100, subparts 1 and 2, and 4668.0110, subpart 1.
Qualifications to perform these tasks shall be established in accordance with subdivision 3;

(c) periodic supervision of unlicensed personnel is provided as required by rule;

(d) notwithstanding Minnesota Rules, part 4668.0160, subpart 6, item D, client
records shall include:

(1) daily records or a weekly summary of home care services provided;

(2) documentation each time medications are administered to a client; and

(3) documentation on the day of occurrence of any significant change in the client's
status or any significant incident, such as a fall or refusal to take medications.

All entries must be signed by the staff providing the services and entered into the
record no later than two weeks after the end of the service day, except as specified in
clauses (2) and (3);

(e) medication and treatment orders, if any, are included in the client record and
are renewed at least every 12 months, or more frequently when indicated by a clinical
assessment;

(f) the central storage of medications in a housing with services establishment
registered under chapter 144D is managed under a system that is established by a
registered nurse and addresses the control of medications, handling of medications,
medication containers, medication records, and disposition of medications; and

(g) in other respects meets the requirements established by rules adopted under
sections 144A.45 to 144A.47.

Subd. 3.

Training or competency evaluations required.

(a) Unlicensed personnel
must:

(1) satisfy the training or competency requirements established by rule under
sections 144A.45 to 144A.47; or

(2) be trained or determined competent by a registered nurse in each task identified
under Minnesota Rules, part 4668.0100, subparts 1 and 2, when offered to clients in a
housing with services establishment as described in paragraphs (b) to (e).

(b) Training for tasks identified under Minnesota Rules, part 4668.0100, subparts
1 and 2, shall use a curriculum which meets the requirements in Minnesota Rules, part
4668.0130.

(c) Competency evaluations for tasks identified under Minnesota Rules, part
4668.0100, subparts 1 and 2, must be completed and documented by a registered nurse.

(d) Unlicensed personnel performing tasks identified under Minnesota Rules, part
4668.0100, subparts 1 and 2, shall be trained or demonstrate competency in the following
topics:

(1) an overview of sections 144A.43 to 144A.47 and rules adopted thereunder;

(2) recognition and handling of emergencies and use of emergency services;

(3) reporting the maltreatment of vulnerable minors or adults under sections 626.556
and 626.557;

(4) home care bill of rights;

(5) handling of clients' complaints and reporting of complaints to the Office of
Health Facility Complaints;

(6) services of the ombudsman for older Minnesotans;

(7) observation, reporting, and documentation of client status and of the care or
services provided;

(8) basic infection control;

(9) maintenance of a clean, safe, and healthy environment;

(10) communication skills;

(11) basic elements of body functioning and changes in body function that must be
reported to an appropriate health care professional; and

(12) physical, emotional, and developmental needs of clients, and ways to work with
clients who have problems in these areas, including respect for the client, the client's
property, and the client's family.

(e) Unlicensed personnel who administer medications must comply with rules
relating to the administration of medications in Minnesota Rules, part 4668.0100, subpart
2, except that unlicensed personnel need not comply with the requirements of Minnesota
Rules, part 4668.0100, subpart 5.

Subd. 4.

License required.

(a) A housing with services establishment registered
under chapter 144D that is required to obtain a home care license must obtain deleted text begin an assisted
living deleted text end new text begin a class F new text end home care license according to this section or a class A or class deleted text begin E deleted text end new text begin B new text end license
according to rule. A housing with services establishment that obtains a class deleted text begin E deleted text end new text begin B new text end license
under this subdivision remains subject to the payment limitations in sections 256B.0913,
subdivision 5f, paragraph (b), and 256B.0915, subdivision 3d.

(b) A board and lodging establishment registered for special services as of December
31, 1996, and also registered as a housing with services establishment under chapter
144D, must deliver home care services according to sections 144A.43 to 144A.47, and
may apply for a waiver from requirements under Minnesota Rules, parts 4668.0002 to
4668.0240, to operate a licensed agency under the standards of section 157.17. Such
waivers as may be granted by the department will expire upon promulgation of home care
rules implementing section 144A.4605.

deleted text begin (c) An adult foster care provider licensed by the Department of Human Services and
registered under chapter 144D may continue to provide health-related services under its
foster care license until the promulgation of home care rules implementing this section.
deleted text end

deleted text begin (d) An assisted living deleted text end new text begin (c) A class F new text end home care provider licensed under this section
must comply with the disclosure provisions of section 325F.72 to the extent they are
applicable.

Subd. 5.

License fees.

The license fees for deleted text begin assisted living deleted text end new text begin class F new text end home care
providers shall be as follows:

(1) $125 annually for those providers serving a monthly average of 15 or fewer
clients, and for deleted text begin assisted living deleted text end new text begin class F new text end providers of all sizes during the first year of
operation;

(2) $200 annually for those providers serving a monthly average of 16 to 30 clients;

(3) $375 annually for those providers serving a monthly average of 31 to 50 clients;
and

(4) $625 annually for those providers serving a monthly average of 51 or more
clients.

Subd. 6.

Waiver.

Upon request of the home care provider, the commissioner may
waive the provisions of this section relating to registered nurse duties.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 4.

Minnesota Statutes 2004, section 144D.01, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Arranged home care provider. new text end

new text begin "Arranged home care provider" means a
home care provider licensed under Minnesota Rules, chapter 4668, that provides services
to some or all of the residents of a housing with services establishment and that is either
the establishment itself or another entity with which the establishment has an arrangement.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 5.

Minnesota Statutes 2004, section 144D.015, is amended to read:

144D.015 ASSISTED LIVING FACILITY new text begin OR ASSISTED LIVING
RESIDENCE new text end DEFINITION FOR PURPOSES OF LONG-TERM CARE
INSURANCE.

For purposes of consistency with terminology commonly used in long-term
care insurance policies new text begin and notwithstanding chapter 144G new text end , a housing with services
establishment that is registered under section 144D.03 and that holds, or deleted text begin contracts deleted text end new text begin makes
arrangements new text end with an individual or entity that holds deleted text begin , a deleted text end new text begin any type of new text end home care license and
all other licenses, permits, registrations, or other governmental approvals legally required
for delivery of the services the establishment offers or provides to its residents, constitutes
an "assisted living facility" or "assisted living residence."

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 6.

Minnesota Statutes 2004, section 144D.02, is amended to read:

144D.02 REGISTRATION REQUIRED.

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 7.

Minnesota Statutes 2004, section 144D.03, subdivision 2, is amended to read:

Subd. 2.

Registration information.

The establishment shall provide the following
information to the commissioner in order to be registered:

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

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners are not natural persons, identification of the type of business entity
of the owner or owners, and the names and addresses of the officers and members of the
governing body, or comparable persons for partnerships, limited liability corporations, or
other types of business organizations of the owner or owners;

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

(4) verification that the establishment has entered into deleted text begin an elderly deleted text end new text begin a new text end housing with
services contract, as required in section 144D.04, with each resident or resident's
representative;

(5) verification that the establishment is complying with the requirements of section
325F.72, if applicable;

(6) the name and address of at least one natural person who shall be responsible
for dealing with the commissioner on all matters provided for in sections 144D.01 to
144D.06, and on whom personal service of all notices and orders shall be made, and who
shall be authorized to accept service on behalf of the owner or owners and the managing
agent, if any; and

(7) the signature of the authorized representative of the owner or owners or, if
the owner or owners are not natural persons, signatures of at least two authorized
representatives of each owner, one of which shall be an officer of the owner.

Personal service on the person identified under clause (6) by the owner or owners in
the registration shall be considered service on the owner or owners, and it shall not be a
defense to any action that personal service was not made on each individual or entity. The
designation of one or more individuals under this subdivision shall not affect the legal
responsibility of the owner or owners under sections 144D.01 to 144D.06.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 8.

Minnesota Statutes 2004, section 144D.04, is amended to read:

144D.04 deleted text begin ELDERLY deleted text end HOUSING WITH SERVICES CONTRACTS.

Subdivision 1.

Contract required.

No deleted text begin elderly deleted text end housing with services establishment
may operate in this state unless a written deleted text begin elderly deleted text end housing with services contract, as defined
in subdivision 2, is executed between the establishment and each resident or resident's
representative and unless the establishment operates in accordance with the terms of the
contract. The resident or the resident's representative shall be given a complete copy of
the contract and all supporting documents and attachments and any changes whenever
changes are made.

Subd. 2.

Contents of contract.

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

(1) new text begin the new text end name, street address, and mailing address of the establishment;

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

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

(4) the name and address of at least one natural person who is authorized to accept
service new text begin of process new text end on behalf of the owner or owners and managing agent;

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

(6) new text begin the new text end term of the contract;

(7) new text begin a new text end description of the services to be provided to the resident in the base rate to
be paid by resident;

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

deleted text begin (9) fee schedules outlining the cost of any additional services;
deleted text end

deleted text begin (10) deleted text end new text begin (9) new text end new text begin a new text end description of the process through which the contract may be modified,
amended, or terminated;

deleted text begin (11) deleted text end new text begin (10) new text end new text begin a new text end description of the establishment's complaint resolution process available
to residents including the toll-free complaint line for the Office of Ombudsman for Older
Minnesotans;

deleted text begin (12) deleted text end new text begin (11) new text end the resident's designated representative, if any;

deleted text begin (13) deleted text end new text begin (12) new text end the establishment's referral procedures if the contract is terminated;

deleted text begin (14) criteria deleted text end new text begin (13) requirements of residency new text end used by the establishment to determine
who may new text begin reside or new text end continue to reside in the deleted text begin elderly deleted text end housing with services establishment;

deleted text begin (15) deleted text end new text begin (14) new text end billing and payment procedures and requirements;

deleted text begin (16) deleted text end new text begin (15) new text end new text begin a new text end statement regarding the ability of residents to receive services from
service providers with whom the establishment does not have an arrangement; deleted text begin and
deleted text end

deleted text begin (17) deleted text end new text begin (16) new text end new text begin a new text end statement regarding the availability of public funds for payment for
residence or services in the establishment new text begin ; and
new text end

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

Subd. 3.

Contracts in permanent files.

deleted text begin Elderly deleted text end Housing with services contracts
and related documents executed by each resident or resident's representative shall be
maintained by the establishment in files from the date of execution until three years after
the contract is terminated. The contracts and the written disclosures required under section
325F.72, if applicable, shall be made available for on-site inspection by the commissioner
upon request at any time.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 9.

new text begin [144D.045] INFORMATION CONCERNING ARRANGED HOME
CARE PROVIDERS.
new text end

new text begin If a housing with services establishment has one or more arranged home care
providers, the establishment shall arrange to have that arranged home care provider deliver
the following information in writing to a prospective resident, prior to the date on which
the prospective resident executes a contract with the establishment or the prospective
resident's move-in date, whichever is earlier:
new text end

new text begin (1) the name, mailing address, and telephone number of the arranged home care
provider;
new text end

new text begin (2) the name and mailing address of at least one natural person who is authorized to
accept service of process on behalf of the entity described in clause (1) ;
new text end

new text begin (3) a description of the process through which a home care service agreement or
service plan between a resident and the arranged home care provider, if any, may be
modified, amended, or terminated;
new text end

new text begin (4) the arranged home care provider's billing and payment procedures and
requirements; and
new text end

new text begin (5) any limits to the services available from the arranged provider.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 10.

Minnesota Statutes 2004, section 144D.05, is amended to read:

144D.05 AUTHORITY OF COMMISSIONER.

The commissioner shall, upon receipt of information which may indicate the failure
of the deleted text begin elderly deleted text end housing with services establishment, a resident, a resident's representative,
or a service provider to comply with a legal requirement to which one or more of them
may be subject, make appropriate referrals to other governmental agencies and entities
having jurisdiction over the subject matter. The commissioner may also make referrals
to any public or private agency the commissioner considers available for appropriate
assistance to those involved.

The commissioner shall have standing to bring an action for injunctive relief
in the district court in the district in which an establishment is located to compel the
deleted text begin elderly deleted text end housing with services establishment to meet the requirements of this chapter or
other requirements of the state or of any county or local governmental unit to which the
establishment is otherwise subject. Proceedings for securing an injunction may be brought
by the commissioner through the attorney general or through the appropriate county
attorney. The sanctions in this section do not restrict the availability of other sanctions.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 11.

Minnesota Statutes 2004, section 144D.065, is amended to read:

144D.065 ESTABLISHMENTS THAT SERVE PERSONS WITH
ALZHEIMER'S DISEASE OR RELATED DISORDERS.

(a) If a housing with services establishment registered under this chapter markets or
otherwise promotes services for persons with Alzheimer's disease or related disorders,
whether in a segregated or general unit, the deleted text begin facility's deleted text end new text begin establishment's new text end direct care staff and
their supervisors must be trained in dementia care.

(b) Areas of required training include:

(1) an explanation of Alzheimer's disease and related disorders;

(2) assistance with activities of daily living;

(3) problem solving with challenging behaviors; and

(4) communication skills.

(c) The establishment shall provide to consumers in written or electronic form a
description of the training program, the categories of employees trained, the frequency
of training, and the basic topics covered. This information satisfies the disclosure
requirements of section 325F.72, subdivision 2, clause (4).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 12.

new text begin [144G.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Scope; other definitions. new text end

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

new text begin Subd. 2. new text end

new text begin Assisted living. new text end

new text begin "Assisted living" means a service or package of services
advertised, marketed, or otherwise described, offered, or promoted using the phrase
"assisted living" either alone or in combination with other words, whether orally or in
writing, and which is subject to the requirements of this chapter.
new text end

new text begin Subd. 3. new text end

new text begin Assisted living client. new text end

new text begin "Assisted living client" or "client" means a housing
with services resident who receives assisted living that is subject to the requirements
of this chapter.
new text end

new text begin Subd. 4. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of health.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 13.

new text begin [144G.02] ASSISTED LIVING; PROTECTED TITLE; RESTRICTION
ON USE; REGULATORY FUNCTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Protected title; restriction on use. new text end

new text begin No person or entity may use the
phrase "assisted living," whether alone or in combination with other words and whether
orally or in writing, to advertise, market, or otherwise describe, offer, or promote itself, or
any housing, service, service package, or program that it provides within this state, unless
the person or entity is a housing with services establishment that meets the requirements of
this chapter, or is a person or entity that provides some or all components of assisted living
that meet the requirements of this chapter. A person or entity entitled to use the phrase
"assisted living" shall use the phrase only in the context of its participation in assisted
living that meets the requirements of this chapter. A housing with services establishment
offering or providing assisted living that is not made available to residents in all of its
housing units shall identify the number or location of the units in which assisted living
is available, and may not use the term "assisted living" in the name of the establishment
registered with the commissioner under chapter 144D, or in the name the establishment
uses to identify itself to residents or the public.
new text end

new text begin Subd. 2. new text end

new text begin Authority of commissioner. new text end

new text begin (a) The commissioner, upon receipt of
information that may indicate the failure of a housing with services establishment, the
arranged home care provider, an assisted living client, or an assisted living client's
representative to comply with a legal requirement to which one or more of the entities may
be subject, shall make appropriate referrals to other governmental agencies and entities
having jurisdiction over the subject matter. The commissioner may also make referrals
to any public or private agency the commissioner considers available for appropriate
assistance to those involved.
new text end

new text begin (b) In addition to the authority with respect to licensed home care providers under
sections 144A.45 and 144A.46 and with respect to housing with services establishments
under chapter 144D, the commissioner shall have standing to bring an action for injunctive
relief in the district court in the district in which a housing with services establishment
is located to compel the housing with services establishment or the arranged home care
provider to meet the requirements of this chapter or other requirements of the state or of
any county or local governmental unit to which the establishment or arranged home care
provider is otherwise subject. Proceedings for securing an injunction may be brought by
the commissioner through the attorney general or through the appropriate county attorney.
The sanctions in this section do not restrict the availability of other sanctions.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 14.

new text begin [144G.03] ASSISTED LIVING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Verification in annual registration. new text end

new text begin A registered housing with
services establishment using the phrase "assisted living," pursuant to section 144G.02,
subdivision 1, shall verify to the commissioner in its annual registration pursuant to chapter
144D that the establishment is complying with sections 144G.01 to 144G.05, as applicable.
new text end

new text begin Subd. 2. new text end

new text begin Minimum requirements for assisted living. new text end

new text begin (a) Assisted living shall
be provided or made available only to individuals residing in a registered housing with
services establishment. Except as expressly stated in this chapter, a person or entity
offering assisted living may define the available services and may offer assisted living to
all or some of the residents of a housing with services establishment. The services that
comprise assisted living may be provided or made available directly by a housing with
services establishment or by persons or entities with which the housing with services
establishment has made arrangements.
new text end

new text begin (b) A person or entity entitled to use the phrase "assisted living," according to
section 144G.02, subdivision 1, shall do so only with respect to a housing with services
establishment, or a service, service package, or program available within a housing with
services establishment that, at a minimum:
new text end

new text begin (1) provides or makes available health related services under a class A or class F
home care license. At a minimum, health related services must include:
new text end

new text begin (i) assistance with self-administration of medication as defined in Minnesota Rules,
part 4668.0003, subpart 2a, or medication administration as defined in Minnesota Rules,
part 4668.0003, subpart 21a; and
new text end

new text begin (ii) assistance with at least three of the following seven activities of daily living:
bathing, dressing, grooming, eating, transferring, continence care, and toileting.
new text end

new text begin All health related services shall be provided in a manner that complies with applicable
home care licensure requirements in chapter 144A and Minnesota Rules, chapter 4668,
and with sections 148.171 to 148.285;
new text end

new text begin (2) provides necessary assessments of the physical and cognitive needs of assisted
living clients by a registered nurse, as required by applicable home care licensure
requirements in chapter 144A and Minnesota Rules, chapter 4668, and by sections
148.171 to 148.285;
new text end

new text begin (3) has and maintains a system for delegation of health care activities to unlicensed
assistive health care personnel by a registered nurse, including supervision and evaluation
of the delegated activities as required by applicable home care licensure requirements in
chapter 144A and Minnesota Rules, chapter 4668, and by sections 148.171 to 148.285;
new text end

new text begin (4) provides staff access to an on-call registered nurse 24 hours per day, seven
days per week;
new text end

new text begin (5) has and maintains a system to check on each assisted living client at least daily;
new text end

new text begin (6) provides a means for assisted living clients to request assistance for health and
safety needs 24 hours per day, seven days per week, from the establishment or a person or
entity with which the establishment has made arrangements;
new text end

new text begin (7) has a person or persons available 24 hours per day, seven days per week, who
is responsible for responding to the requests of assisted living clients for assistance with
health or safety needs, who shall be:
new text end

new text begin (i) awake;
new text end

new text begin (ii) located in the same building, in an attached building, or on a contiguous campus
with the housing with services establishment in order to respond within a reasonable
amount of time;
new text end

new text begin (iii) capable of communicating with assisted living clients;
new text end

new text begin (iv) capable of recognizing the need for assistance;
new text end

new text begin (v) capable of providing either the assistance required or summoning the appropriate
assistance; and
new text end

new text begin (vi) capable of following directions;
new text end

new text begin (8) offers to provide or make available at least the following supportive services
to assisted living clients:
new text end

new text begin (i) two meals per day;
new text end

new text begin (ii) weekly housekeeping;
new text end

new text begin (iii) weekly laundry service;
new text end

new text begin (iv) upon the request of the client, reasonable assistance with arranging for
transportation to medical and social services appointments, and the name of or other
identifying information about the person or persons responsible for providing this
assistance;
new text end

new text begin (v) upon the request of the client, reasonable assistance with accessing community
resources and social services available in the community, and the name of or other
identifying information about the person or persons responsible for providing this
assistance; and
new text end

new text begin (vi) periodic opportunities for socialization; and
new text end

new text begin (9) makes available to all prospective and current assisted living clients information
consistent with the uniform format and the required components adopted by the
commissioner under section 144G.06. This information must be made available beginning
no later than six months after the commissioner makes the uniform format and required
components available to providers according to section 144G.06.
new text end

new text begin Subd. 3. new text end

new text begin Exemption from awake-staff requirement. new text end

new text begin A housing with services
establishment that offers or provides assisted living is exempt from the requirement in
subdivision 2, paragraph (b), clause (7), item (i), that the person or persons available and
responsible for responding to requests for assistance must be awake, if the establishment
meets the following requirements:
new text end

new text begin (1) the establishment has a maximum capacity to serve 12 or fewer assisted living
clients;
new text end

new text begin (2) the person or persons available and responsible for responding to requests for
assistance are physically present within the housing with services establishment in which
the assisted living clients reside;
new text end

new text begin (3) the establishment has a system in place that is compatible with the health, safety,
and welfare of the establishment's assisted living clients;
new text end

new text begin (4) the establishment's housing with services contract, as required by section
144D.04, includes a statement disclosing the establishment's qualification for, and
intention to rely upon, this exemption;
new text end

new text begin (5) the establishment files with the commissioner, for purposes of public information
but not review or approval by the commissioner, a statement describing how the
establishment meets the conditions in clauses (1) to (4), and makes a copy of this statement
available to actual and prospective assisted living clients; and
new text end

new text begin (6) the establishment indicates on its housing with services registration, under
section 144D.02 or 144D.03, as applicable, that it qualifies for and intends to rely upon the
exemption under this subdivision.
new text end

new text begin Subd. 4. new text end

new text begin Nursing assessment. new text end

new text begin (a) A housing with services establishment offering or
providing assisted living shall:
new text end

new text begin (1) offer to have the arranged home care provider conduct a nursing assessment by
a registered nurse of the physical and cognitive needs of the prospective resident and
propose a service agreement or service plan prior to the date on which a prospective
resident executes a contract with a housing with services establishment or the date on
which a prospective resident moves in, whichever is earlier; and
new text end

new text begin (2) inform the prospective resident of the availability of and contact information for
long-term care consultation services under section 256B.0911, prior to the date on which a
prospective resident executes a contract with a housing with services establishment or the
date on which a prospective resident moves in, whichever is earlier.
new text end

new text begin (b) An arranged home care provider is not obligated to conduct a nursing assessment
by a registered nurse when requested by a prospective resident if either the geographic
distance between the prospective resident and the provider, or urgent or unexpected
circumstances, do not permit the assessment to be conducted prior to the date on which
the prospective resident executes a contract or moves in, whichever is earlier. When such
circumstances occur, the arranged home care provider shall offer to conduct a telephone
conference whenever reasonably possible.
new text end

new text begin (c) The arranged home care provider shall comply with applicable home care
licensure requirements in chapter 144A and Minnesota Rules, chapter 4668, and with
sections 148.171 to 148.285 with respect to the provision of a nursing assessment prior
to the delivery of nursing services and the execution of a home care service plan or
service agreement.
new text end

new text begin Subd. 5. new text end

new text begin Assistance with arranged home care provider. new text end

new text begin The housing with services
establishment shall provide each assisted living client with identifying information about a
person or persons reasonably available to assist the client with concerns the client may
have with respect to the services provided by the arranged home care provider. The
establishment shall keep each assisted living client reasonably informed of any changes in
the personnel referenced in this subdivision. Upon request of the assisted living client,
such personnel or designee shall provide reasonable assistance to the assisted living client
in addressing concerns regarding services provided by the arranged home care provider.
new text end

new text begin Subd. 6. new text end

new text begin Termination of housing with services contract. new text end

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

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

new text begin (2) the section of the contract that authorizes the termination;
new text end

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

new text begin (4) an explanation that:
new text end

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 15.

new text begin [144G.04] RESERVATION OF RIGHTS.
new text end

new text begin Subdivision 1. new text end

new text begin Use of services. new text end

new text begin Nothing in this chapter requires an assisted living
client to utilize any service provided or made available in assisted living.
new text end

new text begin Subd. 2. new text end

new text begin Housing with services contracts. new text end

new text begin Nothing in this chapter requires a
housing with services establishment to execute or refrain from terminating a housing with
services contract with a prospective or current resident who is unable or unwilling to meet
the requirements of residency, with or without assistance.
new text end

new text begin Subd. 3. new text end

new text begin Provision of services. new text end

new text begin Nothing in this chapter requires the arranged home
care provider to offer or continue to provide services under a service agreement or service
plan to a prospective or current resident of the establishment whose needs cannot be
met by the arranged home care provider.
new text end

new text begin Subd. 4. new text end

new text begin Altering operations; service packages. new text end

new text begin Nothing in this chapter requires
a housing with services establishment or arranged home care provider offering assisted
living to fundamentally alter the nature of the operations of the establishment or the
provider in order to accommodate the request or need for facilities or services by any
assisted living client, or to refrain from requiring, as a condition of residency, that an
assisted living client pay for a package of assisted living services even if the client does
not choose to utilize all or some of the services in the package.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 16.

new text begin [144G.05] REIMBURSEMENT UNDER ASSISTED LIVING SERVICE
PACKAGES.
new text end

new text begin Notwithstanding the provisions of this chapter, the requirements for the Elderly
Waiver program's assisted living payment rates under section 256B.0915, subdivision
3e, shall continue to be effective and providers who do not meet the requirements of
this chapter may continue to receive payment under section 256B.0915, subdivision 3e,
as long as they continue to meet the definitions and standards for assisted living and
assisted living plus set forth in the federally approved Elderly Home and Community
Based Services Waiver Program (Control Number 0025.91).
new text end

new text begin Providers of assisted living for the Community Alternatives for Disabled Individuals
(CADI) and Traumatic Brain Injury (TBI) waivers shall continue to receive payment as
long as they continue to meet the definitions and standards for assisted living and assisted
living plus set forth in the federally approved CADI and TBI waiver plans.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 17.

new text begin [144G.06] UNIFORM CONSUMER INFORMATION GUIDE.
new text end

new text begin (a) The commissioner of health shall establish an advisory committee consisting
of representatives of consumers, providers, county and state officials, and other
groups the commissioner considers appropriate. The advisory committee shall present
recommendations to the commissioner on:
new text end

new text begin (1) a format for a guide to be used by individual providers of assisted living, as
defined in Minnesota Statutes, section 144G.01, that includes information about services
offered by that provider, service costs, and other relevant provider-specific information, as
well as a statement of philosophy and values associated with assisted living, presented in
uniform categories that facilitate comparison with guides issued by other providers; and
new text end

new text begin (2) requirements for informing assisted living clients, as defined in Minnesota
Statutes, section 144G.01, of their applicable legal rights.
new text end

new text begin (b) The commissioner, after reviewing the recommendations of the advisory
committee, shall adopt a uniform format for the guide to be used by individual providers,
and the required components of materials to be used by providers to inform assisted
living clients of their legal rights, and shall make the uniform format and the required
components available to assisted living providers.
new text end

Sec. 18. new text begin APPROPRIATION.
new text end

new text begin $140,000 is appropriated from the state government special revenue fund to the
commissioner of health for the biennium ending June 30, 2007, to enforce the standards
established in sections 1 to 17. This appropriation shall not become part of base level
funding for the biennium beginning July 1, 2007.
new text end

Sec. 19. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin (a) new text end

new text begin The revisor of statutes shall strike all references to the "Class E assisted living
home care programs license, "Class E license," and similar terms in Minnesota Rules,
chapters 4668 and 4669. In sections affected by this instruction, the revisor may make
changes necessary to correct the punctuation, grammar, or structure of the remaining text
and preserve its meaning.
new text end

new text begin (b) new text end

new text begin The revisor of statutes shall change the term "assisted living home care provider,"
"assisted living license," and similar terms to "Class F home care provider," "Class F
license," and similar terms to "Class F home care provider," "Class F license," and similar
terms, in Minnesota Rules, chapter 4668. In sections affected by this instruction, the
revisor may make changes necessary to correct the punctuation, grammar, or structure of
the remaining text and preserve its meaning.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2007.
new text end

Sec. 20. new text begin REPEALER.
new text end

new text begin Minnesota Rules, part 4668.0215, new text end new text begin is repealed, effective January 1, 2007.
new text end