SF 3564

as introduced - 89th Legislature (2015 - 2016) Posted on 04/22/2016 09:24am

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 2014, 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 2014, 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;
new text end

new text begin (2) a paramedic as defined in section 144E.001, subdivision 5e; or
new text end

new text begin (3) an emergency medical technician as defined in section 144E.001, subdivision 5c.
new text end

Sec. 2.

Minnesota Statutes 2014, 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 2014, 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 2014, 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 2014, 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; and

new text begin (7) supervision of certified paraprofessionals; 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 2014, 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 2014, 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 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

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, paramedics, and 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 professional
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, paramedics, and 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