SF 318

as introduced - 90th Legislature (2017 - 2018) Posted on 03/28/2017 04:24pm

A bill for an act
relating to health; authorizing certified paraprofessionals to provide home care
services; directing the commissioner of human services to seek federal approval
for reimbursement of certified paraprofessionals who provide home care services;
directing the commissioner of human services to establish procedure codes for
reimbursement of certified paraprofessionals; amending Minnesota Statutes 2016,
sections 144A.43, subdivision 3, by adding a subdivision; 144A.471, subdivisions
6, 7; 144A.472, subdivision 2; 144A.4792, subdivision 6; 144A.4795, by adding
a subdivision.

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

Section 1.

Minnesota Statutes 2016, section 144A.43, is amended by adding a subdivision
to read:

new text begin Subd. 1f. new text end

new text begin Certified paraprofessional. new text end

new text begin "Certified paraprofessional" means:
new text end

new text begin (1) a medical assistant who graduated from an accredited medical assistant training
program, passed a medical assistant certification examination, and is certified by a national
medical assistant certification organization recognized by the commissioner; or
new text end

new text begin (2) a community emergency medical technician as defined in section 144E.275,
subdivision 7.
new text end

Sec. 2.

Minnesota Statutes 2016, section 144A.43, subdivision 3, is amended to read:

Subd. 3.

Home care service.

"Home care service" means any of the following services
delivered in the home of a person whose illness, disability, or physical condition creates a
need for the service:

(1) assistive tasks provided by unlicensed personnel;

(2) services provided by a registered nurse or licensed practical nurse, physical therapist,
respiratory therapist, occupational therapist, speech-language pathologist, dietitian or
nutritionist, or social worker;

new text begin (3) services provided by certified paraprofessionals;
new text end

deleted text begin (3) deleted text end new text begin (4) new text end medication and treatment management services; or

deleted text begin (4) deleted text end new text begin (5) new text end the provision of durable medical equipment services when provided with any of
the home care services listed in clauses (1) to deleted text begin (3) deleted text end new text begin (4) new text end .

Sec. 3.

Minnesota Statutes 2016, section 144A.471, subdivision 6, is amended to read:

Subd. 6.

Basic home care license provider.

Home care services that can be provided
with a basic home care license are assistive tasks provided by licensed or unlicensed
personnel new text begin or certified paraprofessionals new text end that include:

(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, and
bathing;

(2) providing standby assistance;

(3) providing verbal or visual reminders to the client to take regularly scheduled
medication, which includes bringing the client previously set-up medication, medication in
original containers, or liquid or food to accompany the medication;

(4) providing verbal or visual reminders to the client to perform regularly scheduled
treatments and exercises;

(5) preparing modified diets ordered by a licensed health professional; and

(6) assisting with laundry, housekeeping, meal preparation, shopping, or other household
chores and services if the provider is also providing at least one of the activities in clauses
(1) to (5).

Sec. 4.

Minnesota Statutes 2016, section 144A.471, subdivision 7, is amended to read:

Subd. 7.

Comprehensive home care license provider.

Home care services that may
be provided with a comprehensive home care license include any of the basic home care
services listed in subdivision 6, and one or more of the following:

(1) services of an advanced practice nurse, registered nurse, licensed practical nurse,
physical therapist, respiratory therapist, occupational therapist, speech-language pathologist,
dietitian or nutritionist, or social worker;

(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed
health professional within the person's scope of practice;

new text begin (3) services of a certified paraprofessional;
new text end

deleted text begin (3) deleted text end new text begin (4) new text end medication management services;

deleted text begin (4) deleted text end new text begin (5) new text end hands-on assistance with transfers and mobility;

deleted text begin (5) deleted text end new text begin (6) new text end assisting clients with eating when the clients have complicating eating problems
as identified in the client record or through an assessment such as difficulty swallowing,
recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
instruments to be fed; or

deleted text begin (6) deleted text end new text begin (7) new text end providing other complex or specialty health care services.

Sec. 5.

Minnesota Statutes 2016, section 144A.472, subdivision 2, is amended to read:

Subd. 2.

Comprehensive home care license applications.

In addition to the information
and fee required in subdivision 1, applicants applying for a comprehensive home care license
must also provide verification that the applicant has the following policies and procedures
in place so that if a license is issued, the applicant will implement the policies and procedures
in this subdivision and keep them current:

(1) conducting initial and ongoing assessments of the client's needs by a registered nurse
or appropriate licensed health professional, including how changes in the client's conditions
are identified, managed, and communicated to staff and other health care providers, as
appropriate;

(2) ensuring that nurses and licensed health professionals have current and valid licenses
to practice;

new text begin (3) ensuring that certified paraprofessionals have current and valid certifications;
new text end

deleted text begin (3) deleted text end new text begin (4) new text end medication and treatment management;

deleted text begin (4) deleted text end new text begin (5) new text end delegation of home care tasks by registered nurses or licensed health professionals;

deleted text begin (5) deleted text end new text begin (6) new text end supervision of registered nurses and licensed health professionals; deleted text begin and
deleted text end

new text begin (7) supervision of certified paraprofessionals at the level of supervision that applies to
licensed practical nurses under Medicare certification standards; and
new text end

deleted text begin (6) deleted text end new text begin (8) new text end supervision of unlicensed personnel performing delegated home care tasks.

Sec. 6.

Minnesota Statutes 2016, section 144A.4792, subdivision 6, is amended to read:

Subd. 6.

Administration of medication.

Medications may be administered by a nurse,
physician, deleted text begin or deleted text end other licensed health practitioner new text begin , or certified paraprofessional new text end authorized to
administer medications or by unlicensed personnel who have been delegated medication
administration tasks by a registered nurse.

Sec. 7.

Minnesota Statutes 2016, section 144A.4795, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Certified paraprofessionals. new text end

new text begin (a) Certified paraprofessionals providing home
care services must possess a current professional certification and must have successfully
completed 40 hours of training on the provision of home care services. The training program
must be approved by the commissioner and must provide training on at least the following:
new text end

new text begin (1) the home care bill of rights under section 144A.44;
new text end

new text begin (2) federal and state requirements related to medical records and data privacy;
new text end

new text begin (3) understanding appropriate boundaries between staff and clients and family members;
new text end

new text begin (4) ventilator operation and maintenance and the care of ventilator-dependent clients;
new text end

new text begin (5) the care of clients with tracheotomies;
new text end

new text begin (6) appropriate techniques for assisting clients with activities of daily living;
new text end

new text begin (7) cardiopulmonary resuscitation;
new text end

new text begin (8) appropriate infection control techniques;
new text end

new text begin (9) sensitivity to and respect for the client's cultural background; and
new text end

new text begin (10) reporting of maltreatment of minors under section 626.556 and maltreatment of
vulnerable adults under section 626.557.
new text end

new text begin The training program for community emergency medical technicians satisfies the training
program requirements of this paragraph.
new text end

new text begin (b) Services provided by certified paraprofessionals are limited to services within the
scope of regular home care nursing, as that scope is determined by the Department of Human
Services. Services provided by certified paraprofessionals must be ordered by a physician,
delegated by a registered nurse, and provided under the direction and supervision of a
registered nurse. A home care provider is responsible for ensuring certified paraprofessionals
working under the home care provider's license satisfy competency requirements and are
appropriately supervised, and for addressing complaints regarding services of a certified
paraprofessional.
new text end

Sec. 8. new text begin DIRECTION TO COMMISSIONER; ESTABLISHING PROCEDURE
CODES.
new text end

new text begin The commissioner of human services shall establish procedure codes for certified medical
assistants, and community emergency medical technicians who provide home care services
as certified paraprofessionals to be reimbursed for services provided under Minnesota
Statutes, sections 256B.0651, 256B.0659, 256B.0915, 256B.092, 256B.093, 256B.49, and
256B.85, at a rate equal to the rate established for licensed practical nurses who provide the
same services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon receipt of the federal waivers or
approvals requested according to section 9 to allow for reimbursement of certified
paraprofessionals.
new text end

Sec. 9. new text begin DIRECTION TO COMMISSIONER; FEDERAL APPROVAL.
new text end

new text begin The commissioner of human services shall request from the federal Centers for Medicare
and Medicaid Services all waivers and approvals necessary to reimburse certified medical
assistants and community emergency medical technicians who provide home care services
as certified paraprofessionals for services provided under Minnesota Statutes, sections
256B.0651, 256B.0659, 256B.0915, 256B.092, 256B.093, 256B.49, and 256B.85.
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