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SF 2923

1st Engrossment - 86th Legislature (2009 - 2010) Posted on 03/08/2010 11:50am

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to health; modifying provisions regulating home health care services;
amending Minnesota Statutes 2008, sections 144A.45, subdivisions 2, 4;
144A.46, subdivisions 2, 3; Minnesota Statutes 2009 Supplement, section
144A.46, subdivision 1.

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

Section 1.

Minnesota Statutes 2008, section 144A.45, subdivision 2, is amended to
read:


Subd. 2.

Regulatory functions.

(a) The commissioner shall:

(1) evaluate, monitor, and license home care providers in accordance with sections
144A.45 to 144A.47;

(2) inspect the office and records of a provider during regular business hours without
advance notice to the home care provider;

(3) with the consent of the consumer, visit the home where services are being
provided;

(4) issue correction orders and assess civil penalties in accordance with section
144.653, subdivisions 5 to 8, for violations of sections 144A.43 to 144A.47 or the rules
adopted under those sections; deleted text beginanddeleted text end

(5) new text begintake action as authorized in section 144A.46, subdivision 3; and
new text end

new text begin (6) new text endtake other action reasonably required to accomplish the purposes of sections
144A.43 to 144A.47.

(b) In the exercise of the authority granted in sections 144A.43 to 144A.47, the
commissioner shall comply with the applicable requirements of section 144.122, the
Government Data Practices Act, and the Administrative Procedure Act.

Sec. 2.

Minnesota Statutes 2008, section 144A.45, subdivision 4, is amended to read:


Subd. 4.

Medicaid reimbursement.

Notwithstanding the provisions of section
deleted text begin 256B.071deleted text endnew text begin 256B.37new text end or state plan requirements to the contrary, certification by the federal
Medicare program must not be a requirement of Medicaid payment for services delivered
under section 144A.4605.

Sec. 3.

Minnesota Statutes 2009 Supplement, section 144A.46, subdivision 1, is
amended to read:


Subdivision 1.

License required.

(a) A home care provider may not operate in the
state without a current license issued by the commissioner of health. A home care provider
may hold a separate license for each class of home care licensure.

(b) Within ten days after receiving an application for a license, the commissioner
shall acknowledge receipt of the application in writing. The acknowledgment must
indicate whether the application appears to be complete or whether additional information
is required before the application will be considered complete. Within 90 days after
receiving a complete application, the commissioner shall either grant or deny the license.
If an applicant is not granted or denied a license within 90 days after submitting a
complete application, the license must be deemed granted. An applicant whose license has
been deemed granted must provide written notice to the commissioner before providing a
home care service.

(c) Each application for a home care provider license, or for a renewal of a license,
shall be accompanied by a fee to be set by the commissioner under section 144.122new text begin and
information sufficient to show that the applicant meets the requirements of licensure
new text end.

deleted text begin (d) The commissioner of health, in consultation with the commissioner of human
services, shall provide recommendations to the legislature by February 15, 2009, for
provider standards for personal care assistant services as described in section 256B.0659.
deleted text end

Sec. 4.

Minnesota Statutes 2008, section 144A.46, subdivision 2, is amended to read:


Subd. 2.

Exemptions.

The following individuals or organizations are exempt from
the requirement to obtain a home care provider license:

(1) a person who is licensed as a registered nurse under sections 148.171 to 148.285
and who independently provides nursing services in the home without any contractual or
employment relationship to a home care provider or other organization;

(2) a personal care assistant who provides services to only one individual under the
medical assistance program as authorized under sections 256B.0625, subdivision 19a, and
256B.04, subdivision 16;

(3) a person or organization that offers, provides, or arranges for personal care
assistant services under the medical assistance program as authorized under sections
256B.0625, subdivision 19a, deleted text beginanddeleted text end 256B.04, subdivision 16, deleted text beginuntil provider standards are
implemented based on the recommendations in section 144A.46, subdivision 1, paragraph
(d)
deleted text endnew text begin and 256B.0659new text end;

(4) a person who is licensed under sections 148.65 to 148.78 and who independently
provides physical therapy services in the home without any contractual or employment
relationship to a home care provider or other organization;

(5) a provider that is licensed by the commissioner of human services to provide
semi-independent living services under Minnesota Rules, parts 9525.0500 to 9525.0660
when providing home care services to a person with a developmental disability;

(6) a provider that is licensed by the commissioner of human services to provide
home and community-based services under Minnesota Rules, parts 9525.2000 to
9525.2140 when providing home care services to a person with a developmental disability;

(7) a person or organization that provides only home management services, if the
person or organization is registered under section 144A.461; or

(8) a person who is licensed as a social worker under chapter 148D and who
provides social work services in the home independently and not through any contractual
or employment relationship with a home care provider or other organization.

An exemption under this subdivision does not excuse the individual from complying
with applicable provisions of the home care bill of rights.

Sec. 5.

Minnesota Statutes 2008, section 144A.46, subdivision 3, is amended to read:


Subd. 3.

Enforcement.

(a) The commissioner may refuse to grant or renew a
license, deleted text beginordeleted text end may suspend or revoke a license, new text beginor may impose a conditional licensenew text end for
violation of statutes or rules relating to home care services or for conduct detrimental to the
welfare of the consumer. new text beginA suspension may include terms that must be completed before a
suspension is lifted. Terms for a suspension or conditional license may include one or
more of the following and the scope of each will be determined by the commissioner:
new text end

new text begin (1) requiring a consultant to review, evaluate, and make recommended changes to
the provider's practices and submit reports to the commissioner at the cost of the provider;
new text end

new text begin (2) requiring supervision of the provider's practices at the cost of the provider by an
unrelated person who has sufficient knowledge and qualifications to oversee the practices
and who will submit reports to the commissioner;
new text end

new text begin (3) requiring the provider or the provider's employees to obtain training at the cost
of the provider;
new text end

new text begin (4) requiring the provider to submit reports to the commissioner;
new text end

new text begin (5) prohibiting the provider from taking any new clients for a period of time; or
new text end

new text begin (6) any other action reasonably required to accomplish the purpose of section
144A.45, subdivision 2, and this subdivision.
new text end

new text begin (b) new text endPrior to any suspension, revocation, or refusal to renew a license, the home care
provider shall be entitled to notice and a hearing as provided by sections 14.57 to 14.69.
In addition to any other remedy provided by law, the commissioner may, without a prior
contested case hearing, temporarily suspend a license or prohibit delivery of services by
a provider for not more than 60 days if the commissioner determines that the health or
safety of a consumer is in imminent danger, providednew text begin:new text end (1) advance notice is given to the
provider; (2) after notice, the provider fails to correct the problem; (3) the commissioner
has reason to believe that other administrative remedies are not likely to be effective; and
(4) there is an opportunity for a contested case hearing within the 60 days.

new text begin (c) new text endThe process of suspending or revoking a license must include a plan for
transferring affected clients to other providersdeleted text begin.deleted text endnew text begin by the provider, which will be monitored
by the commissioner. Within three business days of being notified of the final revocation
or suspension action, the provider shall provide the commissioner, the lead agencies as
defined in section 256B.0911, and the ombudsman for long-term care with the following
information: (1) a list of all clients, including full names and all contact information
on file; (2) a list of each client's contact person, including full names and all contact
information on file; (3) the location of each client; (4) the payor sources for each client,
including payor source identification numbers; and (5) for each client, a copy of the client's
service agreement, and a list of the types of services being provided. The revocation or
suspension notification requirement is satisfied by mailing the notice to the address in the
license record. The provider shall cooperate with the commissioner and the lead agencies
during the process of transferring care of clients to qualified providers. Within three
business days of being notified of the final revocation or suspension action, the provider
must notify and disclose to each of the provider's clients, or the client's contact persons that
the commissioner is taking action against the provider's license by providing a copy of the
revocation or suspension notice issued by the commissioner. When the home care provider
voluntarily discontinues services, the provider will notify the commissioner, lead agencies,
and the ombudsman for long-term care about its clients as required in this section.
new text end

deleted text begin (b)deleted text endnew text begin (d)new text end The owner and managerial officials, as defined in the home care licensure
rules, Minnesota Rules, chapter 4668, of a home care provider whose Minnesota license
has not been renewed or has been revoked because of noncompliance with applicable law
or rule shall not be eligible to apply for nor will be granted a new text beginhome care new text endlicensenew text begin, including
other licenses in this chapter, or be given status as an enrolled personal care assistance
provider agency or personal care assistant by the Department of Human Services pursuant
to section 256B.0659
new text end for five years following the effective date of the nonrenewal or
revocation.new text begin If the owner and managerial officials already have enrollment status, their
enrollment will be terminated by the Department of Human Services.
new text end

deleted text begin (c)deleted text endnew text begin (e)new text end The commissioner shall not issue a license to a home care provider if an
owner or managerial official includes any individual who was an owner or managerial
official of a home care provider whose Minnesota license was not renewed or was revoked
as described in paragraph deleted text begin(b)deleted text endnew text begin (d)new text end for five years following the effective date of nonrenewal
or revocation.

deleted text begin (d)deleted text endnew text begin (f)new text end Notwithstanding the provisions of paragraph (a), the commissioner shall not
renew, or shall suspend or revoke the license of any home care provider which includes
any individual as an owner or managerial official who was an owner or managerial official
of a home care provider whose Minnesota license was not renewed or was revoked as
described in paragraph deleted text begin(b)deleted text endnew text begin (d)new text end for five years following the effective date of the nonrenewal
or revocation. The commissioner shall notify the home care provider 30 days in advance
of the date of nonrenewal, suspension, or revocation of the license. Within ten days after
the receipt of this notification, the home care provider may request, in writing, that the
commissioner stay the nonrenewal, revocation, or suspension of the license. The home
care provider shall specify the reasons for requesting the stay; the steps that will be taken
to attain or maintain compliance with the licensure laws and regulations; any limits on the
authority or responsibility of the owners or managerial officials whose actions resulted in
the notice of nonrenewal, revocation, or suspension; and any other information to establish
that the continuing affiliation with these individuals will not jeopardize client health, safety,
or well being. The commissioner shall determine whether the stay will be granted within
30 days of receiving the provider's request. The commissioner may propose additional
restrictions or limitations on the provider's license and require that the granting of the stay
be contingent upon compliance with those provisions. The commissioner shall take into
consideration the following factors when determining whether the stay should be granted:

(1) the threat that continued involvement of the owners and managerial officials in
the home care provider poses to client health, safety, and well being;

(2) the compliance history of the home care provider; and

(3) the appropriateness of any limits suggested by the home care provider.

If the commissioner grants the stay, the order shall include any restrictions or limitation
on the provider's license. The failure of the provider to comply with any restrictions or
limitations shall result in the immediate removal of the stay and the commissioner shall
take immediate action to suspend, revoke, or not renew the license.

deleted text begin (e)deleted text endnew text begin (g)new text end The provisions contained in paragraphs deleted text begin(b)deleted text endnew text begin (d)new text end and deleted text begin(c)deleted text endnew text begin (e)new text end shall apply to
any nonrenewal or revocation of a home care license occurring after June 1, 1993, the
effective date of the home care licensure rules.

deleted text begin (f)deleted text endnew text begin (h)new text end For the purposes of this subdivision, owners of a home care provider are those
individuals whose ownership interest provides sufficient authority or control to affect or
change decisions related to the operation of the home care provider. An owner includes
a sole proprietor, a general partner, or any other individual whose individual ownership
interest can affect the management and direction of the policies of the home care provider.
For the purposes of this subdivision, managerial officials are those individuals who had
the responsibility for the ongoing management or direction of the policies, services, or
employees of the home care provider relating to the areas of noncompliance which led
to the license revocation or nonrenewal.