as introduced - 91st Legislature (2019 - 2020) Posted on 03/21/2019 10:52am
A bill for an act
relating to health; modifying the health care bill of rights and the home care bill
of rights; modifying home care licensing provisions; modifying the powers and
duties of the director of the Office of Health Facility Complaints; modifying house
with services registration requirements; clarifying assisted living title protection;
modifying consumer protection for vulnerable adults; modifying the Vulnerable
Adults Act; establishing task forces; requiring reports; amending Minnesota Statutes
2018, sections 144.6501, subdivision 3, by adding a subdivision; 144.651,
subdivisions 1, 2, 4, 6, 14, 16, 17, 20, 21, by adding a subdivision; 144.652, by
adding a subdivision; 144A.10, subdivision 1; 144A.441; 144A.442; 144A.45,
subdivisions 1, 2; 144A.474, subdivisions 8, 9, 11; 144A.479, by adding a
subdivision; 144A.4791, subdivision 10; 144A.53, subdivisions 1, 4, by adding
subdivisions; 144D.01, subdivision 1; 144D.02; 144D.04, subdivision 2, by adding
a subdivision; 144D.09; 144G.01, subdivision 1; 325F.71; 609.2231, subdivision
8; 626.557, subdivisions 3, 4, 9a, 9b, 9c, 12b, 14, 17; proposing coding for new
law in Minnesota Statutes, chapters 144; 144D; 144G; repealing Minnesota Statutes
2018, section 144A.479, subdivision 2.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
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Sections 1 to 58 may be cited as the "Eldercare and Vulnerable Adult Protection Act of
2019."
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Minnesota Statutes 2018, section 144.6501, subdivision 3, is amended to read:
(a) A facility shall make complete unsigned copies
of its admission contract available to potential applicants and to the state or local long-term
care ombudsman immediately upon request.
(b) A facility shall post conspicuously within the facility, in a location accessible to
public view, either a complete copy of its admission contract or notice of its availability
from the facility.
(c) An admission contract must be printed in black type of at least ten-point type size.
The facility shall give a complete copy of the admission contract to the resident or the
resident's legal representative promptly after it has been signed by the resident or legal
representative.
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(d) The admission contract must contain the name, address, and contact information of
the current owner, manager, and if different from the owner, license holder of the facility,
and the name and physical mailing address of at least one natural person who is authorized
to accept service of process.
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deleted text begin (d)deleted text end new text begin (e)new text end An admission contract is a consumer contract under sections 325G.29 to 325G.37.
deleted text begin (e)deleted text end new text begin (f)new text end All admission contracts must state in bold capital letters the following notice to
applicants for admission: "NOTICE TO APPLICANTS FOR ADMISSION. READ YOUR
ADMISSION CONTRACT. ORAL STATEMENTS OR COMMENTS MADE BY THE
FACILITY OR YOU OR YOUR REPRESENTATIVE ARE NOT PART OF YOUR
ADMISSION CONTRACT UNLESS THEY ARE ALSO IN WRITING. DO NOT RELY
ON ORAL STATEMENTS OR COMMENTS THAT ARE NOT INCLUDED IN THE
WRITTEN ADMISSION CONTRACT."
Minnesota Statutes 2018, section 144.6501, is amended by adding a subdivision
to read:
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Within 30 days of a change in ownership,
management, or license holder, the facility must provide prompt written notice to the resident
or resident's legal representative of a new owner, manager, and if different from the owner,
license holder of the facility, and the name and physical mailing address of any new or
additional natural person not identified in the admission contract who is newly authorized
to accept service of process.
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Minnesota Statutes 2018, section 144.651, subdivision 1, is amended to read:
It is the intent of the legislature and the purpose of
this section to promote the interests and well being of the patients and residents of health
care facilities. new text begin It is the intent of this section that every patient's and resident's civil and
religious liberties, including the right to independent personal decisions and knowledge of
available choices, must not be infringed and that the facility must encourage and assist in
the fullest possible exercise of these rights. The rights provided under this section are
established for the benefit of patients and residents. new text end No health care facility may require new text begin or
request new text end a patient or resident to waive new text begin any of new text end these rightsnew text begin at any time or for any reason
includingnew text end as a condition of admission to the facility. Any guardian or conservator of a patient
or resident or, in the absence of a guardian or conservator, an interested person, may seek
enforcement of these rights on behalf of a patient or resident. An interested person may also
seek enforcement of these rights on behalf of a patient or resident who has a guardian or
conservator through administrative agencies or in district court having jurisdiction over
guardianships and conservatorships. Pending the outcome of an enforcement proceeding
the health care facility may, in good faith, comply with the instructions of a guardian or
conservator. deleted text begin It is the intent of this section that every patient's civil and religious liberties,
including the right to independent personal decisions and knowledge of available choices,
shall not be infringed and that the facility shall encourage and assist in the fullest possible
exercise of these rights.
deleted text end
Minnesota Statutes 2018, section 144.651, subdivision 2, is amended to read:
new text begin (a) new text end For the purposes of this section,new text begin the terms defined in this
subdivision have the meanings given them.
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new text begin (b)new text end "Patient" meansnew text begin :
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new text begin (1)new text end a person who is admitted to an acute care inpatient facility for a continuous period
longer than 24 hours, for the purpose of diagnosis or treatment bearing on the physical or
mental health of that persondeleted text begin .deleted text end new text begin ;
new text end
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(2) a minor who is admitted to a residential program as defined in section 253C.01;
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new text begin (3)new text end for purposes of subdivisions new text begin 1, new text end 4 to 9, 12, 13, 15, 16, and 18 to 20, deleted text begin "patient" also
meansdeleted text end new text begin and 34,new text end a person who receives health care services at an outpatient surgical center
or at a birth center licensed under section 144.615deleted text begin . "Patient" also means a minor who is
admitted to a residential program as defined in section 253C.01.deleted text end new text begin ; and
new text end
new text begin (4)new text end for purposes of subdivisions 1, 3 to 16, 18, 20 deleted text begin anddeleted text end new text begin ,new text end 30, deleted text begin "patient" also meansdeleted text end new text begin and 34,new text end
any person who is receiving mental health treatment on an outpatient basis or in a community
support program or other community-based program.
new text begin (c)new text end "Resident" means a person who is admitted tonew text begin :
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new text begin (1)new text end a nonacute care facility including extended care facilitiesdeleted text begin ,deleted text end new text begin ;
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new text begin (2) anew text end nursing deleted text begin homes, anddeleted text end new text begin home;
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new text begin (3) anew text end boarding care deleted text begin homesdeleted text end new text begin homenew text end for care required because of prolonged mental or physical
illness or disability, recovery from injury or disease, or advancing agedeleted text begin .deleted text end new text begin ; and
new text end
new text begin (4)new text end for purposes of deleted text begin all subdivisions exceptdeleted text end subdivisions deleted text begin 28 and 29, "resident" also means
a person who is admitted todeleted text end new text begin 1 to 27 and 30 to 34,new text end a facility licensed as a board and lodging
facility under Minnesota Rules, deleted text begin parts 4625.0100 to 4625.2355deleted text end new text begin chapter 4625new text end , or a supervised
living facility under Minnesota Rules, deleted text begin parts 4665.0100 to 4665.9900deleted text end new text begin chapter 4665new text end , and
which operates a rehabilitation program licensed under chapter 245G or Minnesota Rules,
parts 9530.6510 to 9530.6590.
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(d) "Health care facility" or "facility" means:
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(1) an acute care inpatient facility;
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(2) a residential program as defined in section 253C.01;
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(3) for the purposes of subdivisions 1, 4 to 9, 12, 13, 15, 16, 18 to 20, and 34, an
outpatient surgical center or a birth center licensed under section 144.615;
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(4) for the purposes of subdivisions 1, 3 to 16, 18, 20, 30, and 34, a setting in which
outpatient mental health services are provided, or a community support program or other
community-based program providing mental health treatment;
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(5) a nonacute care facility, including extended care facilities;
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(6) a nursing home;
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(7) a boarding care home for care required because of prolonged mental or physical
illness or disability, recovery from injury or disease, or advancing age; or
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(8) for the purposes of subdivisions 1 to 27 and 30 to 34, a facility licensed as a board
and lodging facility under Minnesota Rules, chapter 4625, or a supervised living facility
under Minnesota Rules, chapter 4665, and which operates a rehabilitation program licensed
under Minnesota Rules, parts 9530.6510 to 9530.6590.
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Minnesota Statutes 2018, section 144.651, subdivision 4, is amended to read:
new text begin (a) new text end Patients and residents shall, at admission, be
told that there are legal rights for their protection during their stay at the facility or throughout
their course of treatment and maintenance in the community and that these are described
in an accompanying written statement new text begin in plain language and in terms patients and residents
can understand new text end of the applicable rights and responsibilities set forth in this section. new text begin The
written statement must be developed by the commissioner, in consultation with stakeholders,
and must also include the name, address, and telephone number of the state or county agency
to contact for additional information or assistance. new text end In the case of patients admitted to
residential programs as defined in section 253C.01, the written statement shall also describe
the right of a person 16 years old or older to request release as provided in section 253B.04,
subdivision 2, and shall list the names and telephone numbers of individuals and organizations
that provide advocacy and legal services for patients in residential programs.
new text begin (b) new text end Reasonable accommodations shall be made for people who have communication
disabilities and those who speak a language other than English.
new text begin (c) new text end Current facility policies, inspection findings of state and local health authorities, and
further explanation of the written statement of rights shall be available to patients, residents,
their guardians or their chosen representatives upon reasonable request to the administrator
or other designated staff person, consistent with chapter 13, the Data Practices Act, and
section 626.557, relating to vulnerable adults.
Minnesota Statutes 2018, section 144.651, subdivision 6, is amended to read:
Patients and residents shall have the right to
appropriate medical and personal care based on individual needs. Appropriate care for
residents means care designed to enable residents to achieve their highest level of physical
and mental functioningnew text begin , provided by persons who are properly trained and competent to
perform their dutiesnew text end . This right is limited where the service is not reimbursable by public
or private resources.
Minnesota Statutes 2018, section 144.651, subdivision 14, is amended to read:
new text begin (a) new text end Patients and residents shall be free from
maltreatment as defined in the Vulnerable Adults Protection Act. "Maltreatment" means
conduct described in section 626.5572, subdivision 15, or the intentional and nontherapeutic
infliction of physical pain or injury, or any persistent course of conduct intended to produce
mental or emotional distress. new text begin Patients and residents who reside in or receive care from a
facility for which the Department of Health is the lead investigative agency shall receive
notification from the Department of Health regarding a report of alleged maltreatment,
disposition of a report, and appeal rights, as provided under section 626.557, subdivision
9c.
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new text begin (b) new text end Every patient and resident shall also be free from nontherapeutic chemical and
physical restraints, except in fully documented emergencies, or as authorized in writing
after examination by a patient's or resident's physician for a specified and limited period of
time, and only when necessary to protect the resident from self-injury or injury to others.
Minnesota Statutes 2018, section 144.651, subdivision 16, is amended to read:
Patients and residents shall be assured confidential
treatment of their personalnew text begin , financial,new text end and medical records, and may approve or refuse their
release to any individual outside the facility. Residents shall be notified when personal
records are requested by any individual outside the facility and may select someone to
accompany them when the records or information are the subject of a personal interview.
new text begin Patients and residents have a right to access their personal, financial, and medical records
and written information from those records. new text end Copies of records and written information from
the records shall be made available in accordance with this subdivision and sections 144.291
to 144.298. This right does not apply to complaint investigations and inspections by the
Department of Health, where required by third-party payment contracts, or where otherwise
provided by law.
Minnesota Statutes 2018, section 144.651, subdivision 17, is amended to read:
Patients and residents shall be informed,
prior to or at the time of admission and during their stay, of services which are included in
the facility's basic per diem or daily room rate and that other services are available at
additional charges. new text begin Residents have the right to 30 days' advance notice of changes in charges
that are unrelated to a resident's change in condition or change of care needs. A facility that
is subject to section 504B.178 may not collect a nonrefundable security deposit unless it is
applied to the first month's charges. Nursing facilities enrolled as medical assistance providers
are prohibited from charging, soliciting, accepting, or receiving a deposit. Facilities and
providers are prohibited from charging fees because a resident exercises the right to refuse
treatment or medication, or when the resident chooses pharmacies or other health
professionals other than the ones selected or preferred by the facility or provider. new text end Facilities
shall make every effort to assist patients and residents in obtaining information regarding
whether the Medicare or medical assistance program will pay for any or all of the
aforementioned services.
Minnesota Statutes 2018, section 144.651, subdivision 20, is amended to read:
new text begin (a) new text end Patients and residents shall be encouraged and assisted,
throughout their stay in a facility or their course of treatment, to understand and exercise
their rights as patients, residents, and citizens. Patients and residents may voice grievancesnew text begin ,
assert the rights granted under this section personally,new text end and recommend changes in policies
and services to facility staff and others of their choice, free from restraint, interference,
coercion, discrimination, new text begin retaliation, new text end or reprisal, including threat of discharge. deleted text begin Notice of the
grievance procedure of the facility or program, as well as addresses and telephone numbers
for the Office of Health Facility Complaints and the area nursing home ombudsman pursuant
to the Older Americans Act, section 307(a)(12) shall be posted in a conspicuous place.
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(b) Patients and residents have the right to complain about services that are provided,
services that are not being provided, and the lack of courtesy or respect to the patient or
resident or the patient's or resident's property. The facility must investigate and attempt
resolution of the complaint or grievance. The patient or resident has the right to be informed
of the name and contact information of the individual who is responsible for handling
grievances.
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(c) Notice must be posted in a conspicuous place of the facility's or program's grievance
procedure, as well as telephone numbers and, where applicable, addresses for the common
entry point, as defined in section 626.5572, subdivision 5, the protection and advocacy
agency, and the state long-term care ombudsman pursuant to United States Code, title 42,
sections 3058f and 3058g.
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new text begin (d) new text end Every acute care inpatient facility, every residential program as defined in section
253C.01, every nonacute care facility, and every facility employing more than two people
that provides outpatient mental health services shall have a written internal grievance
procedure that, at a minimum, sets forth the process to be followed; specifies time limits,
including time limits for facility response; provides for the patient or resident to have the
assistance of an advocate; requires a written response to written grievances; and provides
for a timely decision by an impartial decision maker if the grievance is not otherwise resolved.
Compliance by hospitals, residential programs as defined in section 253C.01 which are
hospital-based primary treatment programs, and outpatient surgery centers with section
144.691 and compliance by health maintenance organizations with section 62D.11 is deemed
to be compliance with the requirement for a written internal grievance procedure.
Minnesota Statutes 2018, section 144.651, subdivision 21, is amended to read:
Patients and residents may associate and
communicate privately with persons of their choice and enter and, except as provided by
the Minnesota Commitment Act, leave the facility as they choose. Patients and residents
shall have access, at their new text begin own new text end expensenew text begin , unless provided by the facilitynew text end , to writing instruments,
stationery, deleted text begin anddeleted text end postagenew text begin , and Internet servicenew text end . Personal mail shall be sent without interference
and received unopened unless medically or programmatically contraindicated and
documented by the physician or advanced practice registered nurse in the medical record.
There shall be access to a telephone where patients and residents can make and receive calls
as well as speak privately. Facilities which are unable to provide a private area shall make
reasonable arrangements to accommodate the privacy of patients' or residents' calls. Upon
admission to a facility where federal law prohibits unauthorized disclosure of patient or
resident identifying information to callers and visitors, the patient or resident, or the legal
guardian or conservator of the patient or resident, shall be given the opportunity to authorize
disclosure of the patient's or resident's presence in the facility to callers and visitors who
may seek to communicate with the patient or resident. To the extent possible, the legal
guardian or conservator of a patient or resident shall consider the opinions of the patient or
resident regarding the disclosure of the patient's or resident's presence in the facility. This
right is limited where medically inadvisable, as documented by the attending physician or
advanced practice registered nurse in a patient's or resident's care record. Where
programmatically limited by a facility abuse prevention plan pursuant to section 626.557,
subdivision 14, paragraph (b), this right shall also be limited accordingly.
Minnesota Statutes 2018, section 144.651, is amended by adding a subdivision
to read:
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(a) A facility or person must not retaliate against a
patient, resident, employee, or interested person who in good faith:
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(1) files a complaint or grievance or asserts any rights on behalf of the patient or resident;
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(2) submits a maltreatment report, whether mandatory or voluntary, on behalf of the
patient or resident under section 626.557, subdivision 3, 4, or 4a;
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(3) advocates on behalf of the patient or resident for necessary or improved care and
services or enforcement of rights under this section or other law; or
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(4) contracts to receive services from a service provider of the resident's choice.
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(b) Adverse action may be considered retaliation. For purposes of this section, "adverse
action" means any action taken in bad faith by a facility or person against the patient, resident,
employee, or interested person that includes but is not limited to:
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(1) discharge or transfer from the facility;
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(2) discharge from or termination of employment;
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(3) demotion or reduction in remuneration for services;
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(4) any restriction of any of the rights set forth in state or federal law;
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(5) removal, tampering with, or deprivation of technology, communication, or electronic
monitoring devices of the patient or resident;
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(6) one of the following actions if unrelated to a patient's or resident's change in condition
or change of care needs:
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(i) restriction or prohibition of access either to the facility or to the patient or resident;
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(ii) any restriction of access to or use of communities or services;
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(iii) termination of services or lease agreement, or both; or
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(iv) a sudden increase in costs for services not already contemplated at the time of the
action taken;
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(7) reporting maltreatment in bad faith; or
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(8) making any oral or written communication of false information about a person
advocating on behalf of the patient or resident.
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(a) For purposes of this section, "facility" means a facility listed in section 144.651,
subdivision 2, paragraph (d), clauses (2) to (8); a housing with services establishment
registered under chapter 144D; or an assisted living setting regulated under chapter 144G.
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(b) Deceptive marketing and business practices by a facility or by a home care provider
licensed under sections 144A.43 to 144A.482, are prohibited.
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(c) For the purposes of this section, it is a deceptive practice for a facility or home care
provider to:
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(1) make any false, fraudulent, deceptive, or misleading statements in marketing,
advertising, or written description or representation of care or services, whether in written
or electronic form;
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(2) arrange for or provide health care or services other than those contracted for;
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(3) fail to deliver any care or services the provider or facility promised that the facility
was able to provide;
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(4) fail to inform the patient, resident, or client in writing of any limitations to care
services available prior to executing a contract for admission;
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(5) discharge or terminate the lease or services of a patient or resident following a required
period of private pay who then receives benefits under the medical assistance elderly waiver
program after the facility has made a written promise to continue the same services provided
under private pay and accept medical assistance elderly waiver payments after the expiration
of the private pay period;
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(6) fail to disclose in writing the purpose of a nonrefundable community fee or other fee
prior to contracting for services with a patient, resident, or client;
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(7) advertise or represent, in writing, that the facility is or has a special care unit, such
as for dementia or memory care, without complying with training and disclosure requirements
under sections 144D.065 and 325F.72, and any other applicable law; or
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(8) define the terms "facility," "contract of admission," "admission contract," "admission
agreement," "legal representative," or "responsible party" to mean anything other than the
meanings of those terms under section 144.6501.
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Minnesota Statutes 2018, section 144.652, is amended by adding a subdivision
to read:
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Notwithstanding section 144.653 or 144A.10, the commissioner may
impose a fine in an amount equal to the amount listed in Minnesota Rules, part 4658.0193,
item F, upon a finding that the facility has violated section 144.651, subdivision 34.
new text end
Minnesota Statutes 2018, section 144A.10, subdivision 1, is amended to read:
The commissioner of health is the exclusive
state agency charged with the responsibility and duty of inspecting all facilities required to
be licensed under section 144A.02new text begin , and issuing correction orders and imposing fines as
provided in this section, Minnesota Rules, chapter 4658, or any other applicable lawnew text end . The
commissioner of health shall enforce the rules established pursuant to sections 144A.01 to
144A.155, subject only to the authority of the Department of Public Safety respecting the
enforcement of fire and safety standards in nursing homes and the responsibility of the
commissioner of human services under sections 245A.01 to 245A.16 or 252.28.
The commissioner may request and must be given access to relevant information, records,
incident reports, or other documents in the possession of a licensed facility if the
commissioner considers them necessary for the discharge of responsibilities. For the purposes
of inspections and securing information to determine compliance with the licensure laws
and rules, the commissioner need not present a release, waiver, or consent of the individual.
new text begin A nursing home's refusal to cooperate in providing lawfully requested information is grounds
for a correction order, a fine according to Minnesota Rules, part 4658.0190, item EE, or
both. new text end The identities of patients or residents must be kept private as defined by section 13.02,
subdivision 12.
Minnesota Statutes 2018, section 144A.441, is amended to read:
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 (17):
"(17) 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:
(i) the recipient of services deleted text begin 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, ordeleted text end createsnew text begin , and the home care provider can document,new text end an
abusive or unsafe work environment for the individual providing home care services;
(ii) new text begin a doctor or treating physician, certified nurse practitioner, physician assistant, or
registered nurse documents that new text end an emergency deleted text begin for the informal caregiverdeleted text end 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
(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."
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For participants receiving medical assistance waiver services, the provider must immediately
notify the participant's case manager of any termination of services.
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Minnesota Statutes 2018, section 144A.442, is amended to read:
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For the purposes of this section, "coordinated transfer" means
a plan to transfer an assisted living client, as defined in section 144G.01, subdivision 3, to
another home care provider that:
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(1) considers the needs and wants of the client;
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(2) is based on the comprehensive assessment and individual needs of the client;
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(3) includes the client, the client's case manager, and the client's representative, if any;
and
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(4) includes relevant information that allows the new home care provider to successfully
meet the needs of the client.
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(a) An arranged
home care provider may terminate services if the home care provider is implementing a
plan consistent with the client's assessed needs and a client:
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(1) engages in conduct that significantly alters the terms of the service agreement with
the home care provider and does not significantly alter the client's conduct within 30 days
of receiving written notice of the conduct; or
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(2) fails to pay the provider for services that are agreed to in the service agreement.
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(b) An arranged home care provider must provide at least 30 days' advance written notice
prior to terminating a service agreement for a reason specified in paragraph (a), clause (1),
and at least ten days' advance notice for the reason specified in paragraph (a), clause (2).
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(c) Notwithstanding paragraphs (a) and (b), the arranged home care provider may
terminate services if the client:
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(1) creates, and the provider can document, an abusive or unsafe environment for the
individual providing home care services or for other residents; or
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(2) has a comprehensive assessment by a treating physician, advanced practice registered
nurse, or physician assistant that documents, and shows, that an emergency or a significant
change in the client's condition has resulted in service needs that exceed the current service
agreement and that cannot be safely met by the home care provider.
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An arranged home care provider may not terminate services under this paragraph until the
provider has assisted a client with a coordinated transfer.
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(d) For participants receiving medical assistance waiver services, the provider must
immediately notify the participant's case manager of any termination of services.
new text end
If an arranged home care provider,
as defined in section 144D.01, subdivision 2a, who is not also Medicare certified terminates
a service agreement deleted text begin or service plandeleted text end 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 deleted text begin adeleted text end new text begin advancenew text end written notice
of termination deleted text begin whichdeleted text end new text begin , as provided under subdivision 2, thatnew text end includes the following
information:
(1) the effective date of termination;
(2) new text begin a detailed explanation of new text end the reason for termination;
(3) without extending the termination notice period, an affirmative offer to meet with
the assisted living client or client representatives deleted text begin within no more than five business days of
the date of the termination noticedeleted text end to discuss the termination;
(4) contact information for a reasonable number of other home care providers in the
geographic area of the assisted living client, as required by section 144A.4791, subdivision
10;
(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 (18);
(6) the name and contact information of a representative of the home care provider with
whom the client may discuss the notice of termination;
(7) a copy of the home care bill of rights; deleted text begin and
deleted text end
(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 establishmentdeleted text begin .deleted text end new text begin ;
new text end
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(9) a statement that the client has the right to avoid termination of services by paying
the past due service charges or by curing the alteration of the terms of the service agreement
prior to the effective date of service termination;
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(10) a statement that the recipient of the notice may contact the Office of the Ombudsman
for Long-Term Care for assistance regarding service termination and the address and
telephone number of the Office of Ombudsman for Long-Term Care, the Office of
Administrative Hearings, and the protection and advocacy agency; and
new text end
new text begin
(11) a statement of the client's right to appeal the service termination to the Office of
Administrative Hearings and an explanation about how to request an appeal.
new text end
new text begin
(a) At any time prior to the expiration
of the notice period provided under subdivision 2, paragraph (b), a client may appeal the
service termination by making a written request for a hearing to the Office of Administrative
Hearings, which must schedule the hearing no later than 14 days after receiving the appeal
request. The hearing must be held in the establishment in which the client resides, unless
impractical or the parties agree otherwise. A client may not appeal a service termination
for the reason specified in subdivision 2, paragraph (a), clause (2). A client may appeal a
termination of services for a reason specified in subdivision 2, paragraph (a), clause (1),
beginning July 1, 2019, and may appeal a termination of services for a reason specified in
subdivision 2, paragraph (c), clause (1) or (2), beginning January 1, 2020.
new text end
new text begin
(b) The arranged home care provider may not discontinue services to a client who makes
a timely appeal of a notice of service termination until the Office of Administrative Hearings
makes a final determination on the appeal in favor of the arranged home care provider.
new text end
new text begin
(c) Clients are not required to request a meeting as provided under subdivision 3, clause
(3), prior to submitting an appeal hearing request.
new text end
new text begin
(d) The commissioner of health may order the arranged home care provider to rescind
the service termination if:
new text end
new text begin
(1) the service termination was in violation of state or federal law; or
new text end
new text begin
(2) the client cures the conduct that allegedly altered the terms of the service agreement
on or before the date of the administrative hearing.
new text end
new text begin
(e) Nothing in this section limits the right of a client or the client's representative to
request or receive assistance from the Office of Ombudsman for Long-Term Care and the
protection and advocacy agency concerning the proposed service termination.
new text end
new text begin
A housing with services establishment
with which the client has a contract and the arranged home care provider must assist a client
with a coordinated transfer.
new text end
new text begin
This section is effective for all contracts for services entered into
or renewed on or after July 1, 2019.
new text end
Minnesota Statutes 2018, section 144A.45, subdivision 1, is amended to read:
The commissioner shall regulate home care providers
pursuant to sections 144A.43 to 144A.482. The regulations shall include the following:
(1) provisions to assure, to the extent possible, the health, safety, well-being, and
appropriate treatment of persons who receive home care services while respecting a client's
autonomy and choice;
(2) requirements that home care providers furnish the commissioner with specified
information necessary to implement sections 144A.43 to 144A.482;
(3) standards of training of home care provider personnel;
(4) standards for provision of home care services;
(5) standards for medication management;
(6) standards for supervision of home care services;
(7) standards for client evaluation or assessment;
(8) requirements for the involvement of a client's health care provider, the documentation
of health care providers' orders, if required, and the client's service plan;
(9) new text begin standards for new text end the maintenance of accurate, current client records;
(10) the establishment of basic and comprehensive levels of licenses based on services
provided; and
(11) provisions to enforce these regulations and the home care bill of rightsnew text begin , including
provisions for issuing penalties and fines according to section 144A.474, subdivision 11,
for violations of sections 144A.43 to 144A.482, and of the home care bill of rights under
sections 144A.44 and 144A.441new text end .
Minnesota Statutes 2018, section 144A.45, subdivision 2, is amended to read:
The commissioner shall:
(1) license, survey, and monitor without advance notice, home care providers in
accordance with sections 144A.43 to 144A.482;
(2) survey every temporary licensee within one year of the temporary license issuance
date subject to the temporary licensee providing home care services to a client or clients;
(3) survey all licensed home care providers on an interval that will promote the health
and safety of clients;
(4) with the consent of the client, visit the home where services are being provided;
(5) issue correction orders and assess civil penalties in accordance with deleted text begin sectiondeleted text end new text begin sectionsnew text end
144.653, subdivisions 5 to 8new text begin , 144A.474, and 144A.475new text end , for violations of sections 144A.43
to 144A.482new text begin , and sections 144A.44 and 144A.441new text end ;
(6) take action as authorized in section 144A.475; and
(7) take other action reasonably required to accomplish the purposes of sections 144A.43
to 144A.482.
Minnesota Statutes 2018, section 144A.474, subdivision 8, is amended to read:
(a) A correction order may be issued whenever the
commissioner finds upon survey or during a complaint investigation that a home care
provider, a managerial official, or an employee of the provider is not in compliance with
sections 144A.43 to 144A.482. The correction order shall cite the specific statute and
document areas of noncompliance and the time allowed for correction.new text begin In addition to issuing
a correction order, the commissioner may impose an immediate fine as provided in
subdivision 11.
new text end
(b) The commissioner shall mail copies of any correction order to the last known address
of the home care provider, or electronically scan the correction order and e-mail it to the
last known home care provider e-mail address, within 30 calendar days after the survey exit
date. A copy of each correction ordernew text begin , the amount of any immediate fine issued, the correction
plan,new text end and copies of any documentation supplied to the commissioner shall be kept on file
by the home care provider, and public documents shall be made available for viewing by
any person upon request. Copies may be kept electronically.
(c) By the correction order date, the home care provider must document in the provider's
records any action taken to comply with the correction order. The commissioner may request
a copy of this documentation and the home care provider's action to respond to the correction
order in future surveys, upon a complaint investigation, and as otherwise needed.
Minnesota Statutes 2018, section 144A.474, subdivision 9, is amended to read:
For providers that have Level 3 or Level 4 violations under
subdivision 11, or any violations determined to be widespread, the department shall conduct
a follow-up survey within 90 calendar days of the survey. When conducting a follow-up
survey, the surveyor will focus on whether the previous violations have been corrected and
may also address any new violations that are observed while evaluating the corrections that
have been made. If a new violation is identified on a follow-up survey, deleted text begin no fine will be
imposed unless it is not corrected on the next follow-up surveydeleted text end new text begin the surveyor shall issue a
correction order for the new violation and may impose an immediate fine for the new
violationnew text end .
Minnesota Statutes 2018, section 144A.474, subdivision 11, is amended to read:
(a) Fines and enforcement actions under this subdivision may be assessed
based on the level and scope of the violations described in paragraph (c) as follows:
(1) Level 1, no fines or enforcement;
(2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement
mechanisms authorized in section 144A.475 for widespread violations;
(3) Level 3, fines ranging from $500 to $1,000, in addition to any of the enforcement
mechanisms authorized in section 144A.475; and
(4) Level 4, fines ranging from $1,000 to $5,000, in addition to any of the enforcement
mechanisms authorized in section 144A.475.
(b) Correction orders for violations are categorized by both level and scope and fines
shall be assessed as follows:
(1) level of violation:
(i) Level 1 is a violation that has no potential to cause more than a minimal impact on
the client and does not affect health or safety;
(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential
to have harmed a client's health or safety, but was not likely to cause serious injury,
impairment, or death;
(iii) Level 3 is a violation that harmed a client's health or safety, not including serious
injury, impairment, or death, or a violation that has the potential to lead to serious injury,
impairment, or death; and
(iv) Level 4 is a violation that results in serious injury, impairment, or death;
(2) scope of violation:
(i) isolated, when one or a limited number of clients are affected or one or a limited
number of staff are involved or the situation has occurred only occasionally;
(ii) pattern, when more than a limited number of clients are affected, more than a limited
number of staff are involved, or the situation has occurred repeatedly but is not found to be
pervasive; and
(iii) widespread, when problems are pervasive or represent a systemic failure that has
affected or has the potential to affect a large portion or all of the clients.
(c) If the commissioner finds that the applicant or a home care provider required to be
licensed under sections 144A.43 to 144A.482 has not corrected violations by the date
specified in the correction order or conditional license resulting from a survey or complaint
investigation, the commissioner may impose deleted text begin adeleted text end new text begin an additionalnew text end finenew text begin for noncompliance with
a correction ordernew text end . A notice of noncompliance with a correction order must be mailed to
the applicant's or provider's last known address. The deleted text begin noncompliancedeleted text end noticenew text begin of noncompliance
with a correction ordernew text end must list the violations not correctednew text begin and any fines imposednew text end .
(d) The license holder must pay the fines assessed on or before the payment date specifiednew text begin
on a correction order or on a notice of noncompliance with a correction ordernew text end . If the license
holder fails to deleted text begin fully comply with the orderdeleted text end new text begin pay a fine by the specified datenew text end , the commissioner
may issue a deleted text begin seconddeleted text end new text begin late paymentnew text end fine or suspend the license until the license holder deleted text begin complies
by paying the finedeleted text end new text begin pays all outstanding finesnew text end . A timely appeal shall stay payment of the new text begin late
payment new text end fine until the commissioner issues a final order.
(e) A license holder shall promptly notify the commissioner in writing when a violation
specified in deleted text begin the orderdeleted text end new text begin a notice of noncompliance with a correction ordernew text end is corrected. If upon
reinspection the commissioner determines that a violation has not been corrected as indicated
by the deleted text begin orderdeleted text end new text begin notice of noncompliance with a correction ordernew text end , the commissioner may issue
deleted text begin a seconddeleted text end new text begin an additionalnew text end finenew text begin for noncompliance with a notice of noncompliance with a
correction ordernew text end . The commissioner shall notify the license holder by mail to the last known
address in the licensing record that deleted text begin a seconddeleted text end new text begin an additionalnew text end fine has been assessed. The license
holder may appeal the deleted text begin seconddeleted text end new text begin additionalnew text end fine as provided under this subdivision.
(f) A home care provider that has been assessed a fine under this subdivisionnew text begin or
subdivision 8new text end has a right to a reconsideration or a hearing under this section and chapter 14.
(g) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder shall be liable for payment of the fine.
(h) In addition to any fine imposed under this section, the commissioner may assess
costs related to an investigation that results in a final order assessing a fine or other
enforcement action authorized by this chapter.
(i) Fines collected under this subdivision shall be deposited in the state government
special revenue fund and credited to an account separate from the revenue collected under
section 144A.472. Subject to an appropriation by the legislature, the revenue from the fines
collected must be used by the commissioner for special projects to improve home care in
Minnesota as recommended by the advisory council established in section 144A.4799.
Minnesota Statutes 2018, section 144A.479, is amended by adding a subdivision
to read:
new text begin
Deceptive marketing and
business practices by a home care provider are prohibited. For purposes of this subdivision,
it is a deceptive practice for a home care provider to engage in any conduct listed in section
144.6511.
new text end
Minnesota Statutes 2018, section 144A.4791, subdivision 10, is amended to read:
(a) new text begin Except as provided in section 144A.442, new text end if
a home care provider terminates a service plan with a client, and the client continues to need
home care services, the home care provider shall provide the client and the client's
representative, if any, with a written notice of termination which includes the following
information:
(1) the effective date of termination;
(2) the reason for termination;
(3) a list of known licensed home care providers in the client's immediate geographic
area;
(4) a statement that the home care provider will participate in a coordinated transfer of
care of the client to another home care provider, health care provider, or caregiver, as
required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);
(5) the name and contact information of a person employed by the home care provider
with whom the client may discuss the notice of termination; and
(6) if applicable, a statement that the notice of termination of home care services does
not constitute notice of termination of the housing with services contract with a housing
with services establishment.
(b) When the home care provider voluntarily discontinues services to all clients, the
home care provider must notify the commissioner, lead agencies, and ombudsman for
long-term care about its clients and comply with the requirements in this subdivision.
Minnesota Statutes 2018, section 144A.53, subdivision 1, is amended to read:
The director may:
(1) promulgate by rule, pursuant to chapter 14, and within the limits set forth in
subdivision 2, the methods by which complaints against health facilities, health care
providers, home care providers, deleted text begin or residential care homes,deleted text end or administrative agencies are
to be made, reviewed, investigated, and acted upon; provided, however, that a fee may not
be charged for filing a complaint;
(2) recommend legislation and changes in rules to the state commissioner of health,
governor, administrative agencies or the federal government;
(3) investigate, upon a complaint or upon initiative of the director, any action or failure
to act by a health care provider, home care provider, deleted text begin residential care home,deleted text end or a health
facility;
(4) request and receive access to relevant information, records, incident reports, or
documents in the possession of an administrative agency, a health care provider, a home
care provider, deleted text begin a residential care home,deleted text end or a health facility, and issue investigative subpoenas
to individuals and facilities for oral information and written information, including privileged
information which the director deems necessary for the discharge of responsibilities. For
purposes of investigation and securing information to determine violations, the director
need not present a release, waiver, or consent of an individual. The identities of patients or
residents must be kept private as defined by section 13.02, subdivision 12;
(5) enter and inspect, at any time, a health facility deleted text begin or residential care homedeleted text end and be
permitted to interview staff; provided that the director shall not unduly interfere with or
disturb the provision of care and services within the facility deleted text begin or homedeleted text end or the activities of a
patient or resident unless the patient or resident consents;
(6) issue correction orders and assess civil fines deleted text begin pursuant to sectiondeleted text end new text begin for violations of
sections 144.651,new text end 144.653new text begin , 144A.10, 144A.44, 144A.45, and 626.557, Minnesota Rules,
chapters 4655, 4658, 4664, and 4665,new text end or any other law deleted text begin whichdeleted text end new text begin thatnew text end provides for the issuance
of correction orders to health facilities or home care provider, or under section 144A.45.new text begin
The director may use the authority in section 144A.474, subdivision 11, to calculate the
fine amount.new text end A facility's or home's refusal to cooperate in providing lawfully requested
informationnew text begin within the requested time periodnew text end may also be grounds for a correction ordernew text begin or
fine at a Level 2 fine pursuant to section 144A.474, subdivision 11new text end ;
(7) recommend the certification or decertification of health facilities pursuant to Title
XVIII or XIX of the United States Social Security Act;
(8) assist patients or residents of health facilities deleted text begin or residential care homesdeleted text end in the
enforcement of their rights under Minnesota law; and
(9) work with administrative agencies, health facilities, home care providers, residential
care homes, and health care providers and organizations representing consumers on programs
designed to provide information about health facilities to the public and to health facility
residents.
Minnesota Statutes 2018, section 144A.53, subdivision 4, is amended to read:
new text begin (a) new text end If a complaint received by the director relates to
a matter more properly within the jurisdiction of new text begin law enforcement, new text end an occupational licensing
boardnew text begin ,new text end or other governmental agency, the director shall new text begin promptly new text end forward the complaint deleted text begin to
that agencydeleted text end new text begin appropriatelynew text end and shall inform the complaining party of the forwarding. deleted text begin The
deleted text end
new text begin (b) An new text end agency shall promptly act in respect to the complaint, and shall inform the
complaining party and the director of its disposition. If a governmental agency receives a
complaint which is more properly within the jurisdiction of the director, it shall promptly
forward the complaint to the director, and shall inform the complaining party of the
forwarding.
new text begin (c) new text end If the director has reason to believe that an official or employee of an administrative
agency, a home care provider, deleted text begin residential care home, ordeleted text end health facilitynew text begin , or a client or resident
of any of these entitiesnew text end has acted in a manner warranting criminal or disciplinary proceedings,
the director shall refer the matter to the state commissioner of health, the commissioner of
human services, an appropriate prosecuting authority, or other appropriate agency.
Minnesota Statutes 2018, section 144A.53, is amended by adding a subdivision
to read:
new text begin
The director shall establish
an expert technical panel to examine and make recommendations, on an ongoing basis, on
how to apply proven safety and quality improvement practices and infrastructure to settings
and providers that provide long-term services and supports. The technical panel must include
representation from nonprofit Minnesota-based organizations dedicated to patient safety or
innovation in health care safety and quality, Department of Health staff with expertise in
issues related to adverse health events, the University of Minnesota, organizations
representing long-term care providers and home care providers in Minnesota, national patient
safety experts, and other experts in the safety and quality improvement field. The technical
panel shall periodically provide recommendations to the legislature on legislative changes
needed to promote safety and quality improvement practices in long-term care settings and
with long-term care providers.
new text end
Minnesota Statutes 2018, section 144A.53, is amended by adding a subdivision
to read:
new text begin
(a) The director shall establish a training and
operations panel within the Office of Health Facility Complaints to examine and make
recommendations, on an ongoing basis, on continual improvements to the operation of the
office. The training and operations panel shall be composed of office staff, including
investigators and intake and triage staff, one or more representatives of the commissioner's
office, and employees from any other divisions in the Department of Health with relevant
knowledge or expertise. The training and operations panel may also consult with employees
from other agencies in state government with relevant knowledge or expertise.
new text end
new text begin
(b) The training and operations panel shall examine and make recommendations to the
director and the commissioner regarding introducing or refining office systems, procedures,
and staff training in order to improve office and staff efficiency; enhance communications
between the office, health care facilities, home care providers, and residents or clients; and
provide for appropriate, effective protection for vulnerable adults through rigorous
investigations and enforcement of laws. Panel duties include but are not limited to:
new text end
new text begin
(1) developing the office's training processes to adequately prepare and support
investigators in performing their duties;
new text end
new text begin
(2) developing clear, consistent internal policies for conducting investigations as required
by federal law, including policies to ensure staff meet the deadlines in state and federal laws
for triaging, investigating, and making final dispositions of cases involving maltreatment,
and procedures for notifying the vulnerable adult, reporter, and facility of any delays in
investigations; communicating these policies to staff in a clear, timely manner; and
developing procedures to evaluate and modify these internal policies on an ongoing basis;
new text end
new text begin
(3) developing and refining quality control measures for the intake and triage processes,
through such practices as reviewing a random sample of the triage decisions made in case
reports or auditing a random sample of the case files to ensure the proper information is
being collected, the files are being properly maintained, and consistent triage and
investigations determinations are being made;
new text end
new text begin
(4) developing and maintaining systems and procedures to accurately determine the
situations in which the office has jurisdiction over a maltreatment allegation;
new text end
new text begin
(5) developing and maintaining audit procedures for investigations to ensure investigators
obtain and document information necessary to support decisions;
new text end
new text begin
(6) developing and maintaining procedures to, following a maltreatment determination,
clearly communicate the appeal or review rights of all parties upon final disposition; and
new text end
new text begin
(7) continuously upgrading the information on and utility of the office's website through
such steps as providing clear, detailed information about the appeal or review rights of
vulnerable adults, alleged perpetrators, and providers and facilities.
new text end
Minnesota Statutes 2018, section 144A.53, is amended by adding a subdivision
to read:
new text begin
(a) The director shall post on the Department
of Health website the following information for the past five years:
new text end
new text begin
(1) the public portions of all substantiated reports of maltreatment of a vulnerable adult
at a facility or by a provider for which the Department of Health is the lead investigative
agency under section 626.557; and
new text end
new text begin
(2) whether the facility or provider has requested reconsideration or initiated any type
of dispute resolution or appeal of a substantiated maltreatment report.
new text end
new text begin
(b) Following a reconsideration, dispute resolution, or appeal, the director must update
the information posted under this subdivision to reflect the results of the reconsideration,
dispute resolution, or appeal.
new text end
new text begin
(c) The information posted under this subdivision must be posted in coordination with
other divisions or sections at the Department of Health and in a manner that does not duplicate
information already published by the Department of Health, and must be posted in a format
that allows consumers to search the information by facility or provider name and by the
physical address of the facility or the local business address of the provider.
new text end
Minnesota Statutes 2018, section 144D.01, subdivision 1, is amended to read:
Minnesota Statutes 2018, section 144D.02, is amended to read:
No entity may establish, operate, conduct, or maintain a housing with services
establishment in this state without registering and operating as required in deleted text begin sections 144D.01
to 144D.06deleted text end new text begin this chapternew text end .
Minnesota Statutes 2018, section 144D.04, subdivision 2, is amended to read:
A 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) the 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 new text begin physical mailing new text end address of at least one natural person who is authorized
to accept service of process on behalf of the owner or owners and managing agent;
(5) a 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) the term of the contract;
(7) a description of the services to be provided to the resident in the base rate to be paid
by the resident, including a delineation of the portion of the base rate that constitutes rent
and a delineation of charges for each service included in the base rate;
(8) a description of any additional services, including home care services, available for
an additional fee from the establishment directly or through arrangements with the
establishment, and a schedule of fees charged for these services;
(9) a conspicuous notice informing the tenant of the policy concerning the conditions
under which and the process through which the contract may be modified, amended, or
terminated, including whether a move to a different room or sharing a room would be
required in the event that the tenant can no longer pay the current rent;
(10) a description of the establishment's complaint resolution process available to residents
including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;
(11) the resident's designated representative, if any;
(12) the establishment's referral procedures if the contract is terminated;
(13) requirements of residency used by the establishment to determine who may reside
or continue to reside in the housing with services establishment;
(14) billing and payment procedures and requirements;
(15) a statement regarding the ability of a resident to receive services from service
providers with whom the establishment does not have an arrangement;
(16) a statement regarding the availability of public funds for payment for residence or
services in the establishment; deleted text begin and
deleted text end
(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
locateddeleted text begin .deleted text end new text begin ;
new text end
new text begin
(18) a statement that a resident has the right to request a reasonable accommodation;
and
new text end
new text begin
(19) a statement describing the conditions under which a contract may be amended.
new text end
Minnesota Statutes 2018, section 144D.04, is amended by adding a subdivision
to read:
new text begin
The housing with services establishment must provide
prompt written notice to the resident or resident's legal representative of a new owner or
manager of the housing with services establishment, and the name and physical mailing
address of any new or additional natural person not identified in the admission contract who
is authorized to accept service of process.
new text end
new text begin
Housing with services establishments are subject to the same prohibitions against
deceptive practices as are health care facilities under section 144.6511.
new text end
new text begin
A housing with services establishment must post conspicuously within the establishment,
in a location accessible to public view, the following information:
new text end
new text begin
(1) the name, mailing address, and contact information of the current 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;
new text end
new text begin
(2) the name, mailing address, and contact information of the managing agent, through
management agreement or lease agreement, of the establishment, if different from the owner
or owners, and the name and contact information of the on-site manager, if any; and
new text end
new text begin
(3) the name and mailing address of at least one natural person who is authorized to
accept service of process on behalf of the owner or owners and managing agent.
new text end
Minnesota Statutes 2018, section 144D.09, is amended to read:
deleted text begin Thedeleted text end new text begin (a) Anew text end housing with services establishment deleted text begin shall
include with notice of termination of lease information about how to contact the ombudsman
for long-term care, including the address and telephone number along with a statement of
how to request problem-solving assistance.deleted text end new text begin that terminates a resident's lease must provide
the resident with a notice that includes:
new text end
new text begin
(1) a detailed explanation of the reason for the termination;
new text end
new text begin
(2) the date termination will occur;
new text end
new text begin
(3) the location to which the resident will relocate, if known;
new text end
new text begin
(4) a statement that the resident may contact the Office of the Ombudsman for Long-Term
Care regarding the lease termination issues and the address and telephone number of the
Office of Ombudsman for Long-Term Care and the protection and advocacy agency;
new text end
new text begin
(5) a statement that the resident has the right to request a meeting with the owner or
manager of the housing with services establishment to discuss the lease termination and
attempt to avoid termination of the lease; and
new text end
new text begin
(6) a statement that the resident has the right to avoid termination of the lease for
nonpayment of rent by paying the rent in full within ten days of receiving written notice of
nonpayment.
new text end
new text begin
Prior to a resident's involuntary
relocation due to a termination of a lease, the housing with services establishment must
provide to the facility or establishment to which the resident is relocating all information
known to the establishment and related to the resident that is necessary to ensure continuity
of care and services, provided the resident consents to the transfer of information. At a
minimum, the information transferred must include:
new text end
new text begin
(1) the resident's full name, date of birth, and insurance information;
new text end
new text begin
(2) the name, telephone number, and address of the resident's representative, if any;
new text end
new text begin
(3) the resident's current documented diagnoses;
new text end
new text begin
(4) the resident's known allergies;
new text end
new text begin
(5) the name and telephone number of the resident's physician, advanced practice
registered nurse, or physician assistant and their current medical orders, if known;
new text end
new text begin
(6) all medication administration records;
new text end
new text begin
(7) the most recent resident assessment; and
new text end
new text begin
(8) copies of health care directives, "do not resuscitate" orders, and any guardianship
orders or powers of attorney.
new text end
new text begin
A termination of services initiated by an arranged home care provider is governed by
section 144A.442.
new text end
Minnesota Statutes 2018, section 144G.01, subdivision 1, is amended to read:
For purposes of deleted text begin sections 144G.01 to 144G.05deleted text end new text begin
this chapternew text end , the following definitions apply. In addition, the definitions provided in section
144D.01 also apply to deleted text begin sections 144G.01 to 144G.05deleted text end new text begin this chapternew text end .
new text begin
A lease termination initiated by a registered housing with services establishment using
"assisted living" is governed by section 144D.09.
new text end
new text begin
A termination of services initiated by an arranged home care provider as defined in
section 144D.01, subdivision 2a, is governed by section 144A.442.
new text end
Minnesota Statutes 2018, section 325F.71, is amended to read:
For the purposes of this section, the following words have
the meanings given them:
(a) "Senior citizen" means a person who is 62 years of age or older.
(b) "deleted text begin Disableddeleted text end Personnew text begin with a disabilitynew text end " means a person who has an impairment of physical
or mental function or emotional status that substantially limits one or more major life
activities.
(c) "Major life activities" means functions such as caring for one's self, performing
manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working.
new text begin
(d) "Vulnerable adult" has the meaning given in section 626.5572, subdivision 21, except
that vulnerable adult does not include an inpatient of a hospital licensed under sections
144.50 to 144.58.
new text end
(a) In addition to any liability for a civil penalty
pursuant to sections 325D.43 to 325D.48, regarding deceptive trade practices; 325F.67,
regarding false advertising; and 325F.68 to 325F.70, regarding consumer fraud; a person
who engages in any conduct prohibited by those statutes, and whose conduct is perpetrated
against one or more senior citizensnew text begin , vulnerable adults,new text end or deleted text begin disableddeleted text end personsnew text begin with a disabilitynew text end ,
is liable for an additional civil penalty not to exceed $10,000 for each violation, if one or
more of the factors in paragraph (b) are present.
(b) In determining whether to impose a civil penalty pursuant to paragraph (a), and the
amount of the penalty, the court shall consider, in addition to other appropriate factors, the
extent to which one or more of the following factors are present:
(1) whether the defendant knew or should have known that the defendant's conduct was
directed to one or more senior citizensnew text begin , vulnerable adults,new text end or deleted text begin disableddeleted text end personsnew text begin with a
disabilitynew text end ;
(2) whether the defendant's conduct caused new text begin one or more new text end senior citizensnew text begin , vulnerable adults,new text end
or deleted text begin disableddeleted text end persons new text begin with a disability new text end to suffer: loss or encumbrance of a primary residence,
principal employment, or source of income; substantial loss of property set aside for
retirement or for personal or family care and maintenance; substantial loss of payments
received under a pension or retirement plan or a government benefits program; or assets
essential to the health or welfare of the senior citizennew text begin , vulnerable adult,new text end or deleted text begin disableddeleted text end personnew text begin
with a disabilitynew text end ;
(3) whether one or more senior citizensnew text begin , vulnerable adults,new text end or deleted text begin disableddeleted text end persons new text begin with a
disability new text end are more vulnerable to the defendant's conduct than other members of the public
because of age, poor health or infirmity, impaired understanding, restricted mobility, or
disability, and actually suffered physical, emotional, or economic damage resulting from
the defendant's conduct; or
(4) whether the defendant's conduct caused senior citizensnew text begin , vulnerable adults,new text end or deleted text begin disableddeleted text end
persons new text begin with a disability new text end to make an uncompensated asset transfer that resulted in the person
being found ineligible for medical assistance.
Restitution ordered pursuant to the statutes
listed in subdivision 2 shall be given priority over imposition of civil penalties designated
by the court under this section.
A person injured by a violation of this section may bring a
civil action and recover damages, together with costs and disbursements, including costs
of investigation and reasonable attorney's fees, and receive other equitable relief as
determined by the court.
Minnesota Statutes 2018, section 609.2231, subdivision 8, is amended to read:
(a) As used in this subdivision, "vulnerable adult" has the
meaning given in section 609.232, subdivision 11.
(b) Whoever assaults deleted text begin and inflicts demonstrable bodily harm ondeleted text end a vulnerable adult,
knowing or having reason to know that the person is a vulnerable adult, is guilty of a gross
misdemeanor.
new text begin
(c) A person who uses restraints on a vulnerable adult does not violate this subdivision
if (1) the person complies with applicable requirements in state and federal law regarding
the use of restraints; and (2) any force applied in imposing restraints is reasonable.
new text end
new text begin
This section is effective August 1, 2019, and applies to crimes
committed on or after that date.
new text end
Minnesota Statutes 2018, section 626.557, subdivision 3, is amended to read:
(a) A mandated reporter who has reason to believe that a
vulnerable adult is being or has been maltreated, or who has knowledge that a vulnerable
adult has sustained a physical injury which is not reasonably explained shall deleted text begin immediatelydeleted text end
report the information to the common entry pointnew text begin as soon as possible but in no event longer
than 24 hoursnew text end . If an individual is a vulnerable adult solely because the individual is admitted
to a facility, a mandated reporter is not required to report suspected maltreatment of the
individual that occurred prior to admission, unless:
(1) the individual was admitted to the facility from another facility and the reporter has
reason to believe the vulnerable adult was maltreated in the previous facility; or
(2) the reporter knows or has reason to believe that the individual is a vulnerable adult
as defined in section 626.5572, subdivision 21, paragraph (a), clause (4).
(b) A person not required to report under the provisions of this section may voluntarily
report as described above.
(c) Nothing in this section requires a report of known or suspected maltreatment, if the
reporter knows or has reason to know that a report has been made to the common entry
point.
(d) Nothing in this section shall preclude a reporter from also reporting to a law
enforcement agency.
(e) A mandated reporter who knows or has reason to believe that an error under section
626.5572, subdivision 17, paragraph (c), clause (5), occurred must make a report under this
subdivision. If the reporter or a facility, at any time believes that an investigation by a lead
investigative agency will determine or should determine that the reported error was not
neglect according to the criteria under section 626.5572, subdivision 17, paragraph (c),
clause (5), the reporter or facility may provide to the common entry point or directly to the
lead investigative agency information explaining how the event meets the criteria under
section 626.5572, subdivision 17, paragraph (c), clause (5). The lead investigative agency
shall consider this information when making an initial disposition of the report under
subdivision 9c.
Minnesota Statutes 2018, section 626.557, subdivision 4, is amended to read:
(a) Except as provided in paragraph (b), a mandated reporter shall
immediately make an oral report to the common entry point. The common entry point may
accept electronic reports submitted through a web-based reporting system established by
the commissioner. Use of a telecommunications device for the deaf or other similar device
shall be considered an oral report. The common entry point may not require written reports.
To the extent possible, the report must be of sufficient content to identify the vulnerable
adult, the caregiver, the nature and extent of the suspected maltreatment, any evidence of
previous maltreatment, the name and address of the reporter, the time, date, and location of
the incident, and any other information that the reporter believes might be helpful in
investigating the suspected maltreatment. new text begin The common entry point must provide a way to
record that the reporter has electronic evidence to submit. new text end A mandated reporter may disclose
not public data, as defined in section 13.02, and medical records under sections 144.291 to
144.298, to the extent necessary to comply with this subdivision.
(b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified
under Title 19 of the Social Security Act, a nursing home that is licensed under section
144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a hospital
that is licensed under sections 144.50 to 144.58 and has swing beds certified under Code
of Federal Regulations, title 42, section 482.66, may submit a report electronically to the
common entry point instead of submitting an oral report. deleted text begin The report may be a duplicate of
the initial report the facility submits electronically to the commissioner of health to comply
with the reporting requirements under Code of Federal Regulations, title 42, section 483.13.deleted text end
The commissioner of health may modify these reporting requirements to include items
required under paragraph (a) that are not currently included in the electronic reporting form.
new text begin
(c) All reports must be directed to the common entry point, including reports from
federally licensed facilities.
new text end
Minnesota Statutes 2018, section 626.557, subdivision 9a, is amended to read:
(a) The
common entry point must screen the reports of alleged or suspected maltreatment for
immediate risk and make all necessary referrals as follows:
(1) if the common entry point determines that there is an immediate need for emergency
adult protective services, the common entry point agency shall immediately notify the
appropriate county agency;
(2) new text begin if the common entry point determines an immediate need exists for response by law
enforcement or new text end if the report contains suspected criminal activity against a vulnerable adult,
the common entry point shall immediately notify the appropriate law enforcement agency;
(3) the common entry point shall refer all reports of alleged or suspected maltreatment
to the appropriate lead investigative agency as soon as possible, but in any event no longer
than two working days;
(4) if the report contains information about a suspicious death, the common entry point
shall immediately notify the appropriate law enforcement agencies, the local medical
examiner, and the ombudsman for mental health and developmental disabilities established
under section 245.92. Law enforcement agencies shall coordinate with the local medical
examiner and the ombudsman as provided by law; and
(5) for reports involving multiple locations or changing circumstances, the common
entry point shall determine the county agency responsible for emergency adult protective
services and the county responsible as the lead investigative agency, using referral guidelines
established by the commissioner.
(b) If the lead investigative agency receiving a report believes the report was referred
by the common entry point in error, the lead investigative agency shall immediately notify
the common entry point of the error, including the basis for the lead investigative agency's
belief that the referral was made in error. The common entry point shall review the
information submitted by the lead investigative agency and immediately refer the report to
the appropriate lead investigative agency.
Minnesota Statutes 2018, section 626.557, subdivision 9b, is amended to read:
Law enforcement is the primary agency to conduct
investigations of any incident in which there is reason to believe a crime has been committed.
Law enforcement shall initiate a response immediately. If the common entry point notified
a county agency for emergency adult protective services, law enforcement shall cooperate
with that county agency when both agencies are involved and shall exchange data to the
extent authorized in subdivision 12b, paragraph deleted text begin (g)deleted text end new text begin (k)new text end . County adult protection shall initiate
a response immediately. Each lead investigative agency shall complete the investigative
process for reports within its jurisdiction. A lead investigative agency, county, adult protective
agency, licensed facility, or law enforcement agency shall cooperate with other agencies in
the provision of protective services, coordinating its investigations, and assisting another
agency within the limits of its resources and expertise and shall exchange data to the extent
authorized in subdivision 12b, paragraph deleted text begin (g)deleted text end new text begin (k)new text end . The lead investigative agency shall obtain
the results of any investigation conducted by law enforcement officialsnew text begin , and law enforcement
shall obtain the results of any investigation conducted by the lead investigative agency to
determine if criminal action is warrantednew text end . The lead investigative agency has the right to
enter facilities and inspect and copy records as part of investigations. The lead investigative
agency has access to not public data, as defined in section 13.02, and medical records under
sections 144.291 to 144.298, that are maintained by facilities to the extent necessary to
conduct its investigation. Each lead investigative agency shall develop guidelines for
prioritizing reports for investigation.new text begin Nothing in this subdivision alters the duty of the lead
investigative agency to serve as the agency responsible for investigating reports made under
this section.
new text end
Minnesota Statutes 2018, section 626.557, subdivision 9c, is amended to read:
(a)
deleted text begin Upon request of the reporter,deleted text end The lead investigative agency shall notify the reporter that it
has received the report, and provide information on the initial disposition of the report within
five business days of receipt of the report, provided that the notification will not endanger
the vulnerable adult or hamper the investigation.
(b) new text begin Except to the extent prohibited by federal law, when the Department of Health is the
lead investigative agency, the agency must provide the following information to the
vulnerable adult or the vulnerable adult's guardian or health care agent, if known, within
five days after the initiation of an investigation, provided that the provision of the information
will not hamper the investigation or harm the vulnerable adult:
new text end
new text begin
(1) the maltreatment allegations by types: abuse, neglect, financial exploitation, and
drug diversion;
new text end
new text begin
(2) the name of the facility or other location at which alleged maltreatment occurred;
new text end
new text begin
(3) the dates of the alleged maltreatment if identified in the report at the time of the lead
investigative agency disclosure;
new text end
new text begin
(4) the name and contact information for the investigator or other information as requested
and allowed under law; and
new text end
new text begin
(5) confirmation of whether the lead investigative agency is investigating the matter
and, if so:
new text end
new text begin
(i) an explanation of the process;
new text end
new text begin
(ii) an estimated timeline for the investigation;
new text end
new text begin
(iii) a notification that the vulnerable adult or the vulnerable adult's guardian or health
care agent may electronically submit evidence to support the maltreatment report, including
but not limited to photographs, videos, and documents; and
new text end
new text begin
(iv) a statement that the lead investigative agency will provide an update on the
investigation upon request by the vulnerable adult or the vulnerable adult's guardian or
health care agent and a report when the investigation is concluded.
new text end
new text begin
(c) If the Department of Health is the lead investigative agency, the Department of Health
shall provide maltreatment information, to the extent allowed under state and federal law,
including any reports, upon request of the vulnerable adult that is the subject of a
maltreatment report or upon request of that vulnerable adult's guardian or health care agent.
new text end
new text begin
(d) If the common entry point data indicates that the reporter has electronic evidence,
the lead investigative agency shall seek to receive such evidence prior to making a
determination that the lead investigative agency will not investigate the matter. Nothing in
this provision requires the lead investigative agency to stop investigating prior to receipt of
the electronic evidence nor prevents the lead investigative agency from closing the
investigation prior to receipt of the electronic evidence if, in the opinion of the investigator,
the evidence is not necessary to the determination.
new text end
new text begin
(e) The lead investigative agency may assign multiple reports of maltreatment for the
same or separate incidences related to the same vulnerable adult to the same investigator,
as deemed appropriate.
new text end
new text begin
(f) Reports related to the same vulnerable adult, the same incident, or the same alleged
perpetrator, facility, or licensee must be cross-referenced.
new text end
new text begin (g) new text end Upon conclusion of every investigation it conducts, the lead investigative agency
shall make a final disposition as defined in section 626.5572, subdivision 8.
deleted text begin (c)deleted text end new text begin (h)new text end When determining whether the facility or individual is the responsible party for
substantiated maltreatment or whether both the facility and the individual are responsible
for substantiated maltreatment, the lead investigative agency shall consider at least the
following mitigating factors:
(1) whether the actions of the facility or the individual caregivers were in accordance
with, and followed the terms of, an erroneous physician order, prescription, resident care
plan, or directive. This is not a mitigating factor when the facility or caregiver is responsible
for the issuance of the erroneous order, prescription, plan, or directive or knows or should
have known of the errors and took no reasonable measures to correct the defect before
administering care;
(2) the comparative responsibility between the facility, other caregivers, and requirements
placed upon the employee, including but not limited to, the facility's compliance with related
regulatory standards and factors such as the adequacy of facility policies and procedures,
the adequacy of facility training, the adequacy of an individual's participation in the training,
the adequacy of caregiver supervision, the adequacy of facility staffing levels, and a
consideration of the scope of the individual employee's authority; and
(3) whether the facility or individual followed professional standards in exercising
professional judgment.
deleted text begin (d)deleted text end new text begin (i)new text end When substantiated maltreatment is determined to have been committed by an
individual who is also the facility license holder, both the individual and the facility must
be determined responsible for the maltreatment, and both the background study
disqualification standards under section 245C.15, subdivision 4, and the licensing actions
under section 245A.06 or 245A.07 apply.
deleted text begin (e)deleted text end new text begin (j)new text end The lead investigative agency shall complete its final disposition within 60 calendar
days. If the lead investigative agency is unable to complete its final disposition within 60
calendar days, the lead investigative agency shall notify the following persons provided
that the notification will not endanger the vulnerable adult or hamper the investigation: (1)
the vulnerable adult or the vulnerable adult's guardian or health care agent, when known,
if the lead investigative agency knows them to be aware of the investigation; and (2) the
facility, where applicable. The notice shall contain the reason for the delay and the projected
completion date. If the lead investigative agency is unable to complete its final disposition
by a subsequent projected completion date, the lead investigative agency shall again notify
the vulnerable adult or the vulnerable adult's guardian or health care agent, when known if
the lead investigative agency knows them to be aware of the investigation, and the facility,
where applicable, of the reason for the delay and the revised projected completion date
provided that the notification will not endanger the vulnerable adult or hamper the
investigation. The lead investigative agency must notify the health care agent of the
vulnerable adult only if the health care agent's authority to make health care decisions for
the vulnerable adult is currently effective deleted text begin under section 145C.06deleted text end and not suspended under
section 524.5-310 deleted text begin and the investigation relates to a duty assigned to the health care agent
by the principaldeleted text end . A lead investigative agency's inability to complete the final disposition
within 60 calendar days or by any projected completion date does not invalidate the final
disposition.
deleted text begin (f)deleted text end new text begin (k)new text end Within ten calendar days of completing the final disposition, the lead investigative
agency shall provide a copy of the public investigation memorandum under subdivision
12b, paragraph deleted text begin (b), clause (1)deleted text end new text begin (d)new text end , when required to be completed under this section, to the
following persons:
(1) the vulnerable adult, or the vulnerable adult's guardian or health care agent, if known,
unless the lead investigative agency knows that the notification would endanger the
well-being of the vulnerable adult;
(2) the reporter, deleted text begin ifdeleted text end new text begin unless new text end the reporter requested deleted text begin notificationdeleted text end new text begin otherwise new text end when making the
report, provided this notification would not endanger the well-being of the vulnerable adult;
(3) the alleged perpetrator, if known;
(4) the facility; deleted text begin and
deleted text end
(5) the ombudsman for long-term care, or the ombudsman for mental health and
developmental disabilities, as appropriatedeleted text begin .deleted text end new text begin ;
new text end
new text begin
(6) law enforcement; and
new text end
new text begin
(7) the county attorney, as appropriate.
new text end
deleted text begin (g)deleted text end new text begin (l)new text end If, as a result of a reconsideration, review, or hearing, the lead investigative agency
changes the final disposition, or if a final disposition is changed on appeal, the lead
investigative agency shall notify the parties specified in paragraph deleted text begin (f)deleted text end new text begin (k)new text end .
deleted text begin (h)deleted text end new text begin (m)new text end The lead investigative agency shall notify the vulnerable adult who is the subject
of the report or the vulnerable adult's guardian or health care agent, if known, and any person
or facility determined to have maltreated a vulnerable adult, of their appeal or review rights
under this section or section 256.021.
deleted text begin (i)deleted text end new text begin (n)new text end The lead investigative agency shall routinely provide investigation memoranda
for substantiated reports to the appropriate licensing boards. These reports must include the
names of substantiated perpetrators. The lead investigative agency may not provide
investigative memoranda for inconclusive or false reports to the appropriate licensing boards
unless the lead investigative agency's investigation gives reason to believe that there may
have been a violation of the applicable professional practice laws. If the investigation
memorandum is provided to a licensing board, the subject of the investigation memorandum
shall be notified and receive a summary of the investigative findings.
deleted text begin (j)deleted text end new text begin (o)new text end In order to avoid duplication, licensing boards shall consider the findings of the
lead investigative agency in their investigations if they choose to investigate. This does not
preclude licensing boards from considering other information.
deleted text begin (k)deleted text end new text begin (p)new text end The lead investigative agency must provide to the commissioner of human services
its final dispositions, including the names of all substantiated perpetrators. The commissioner
of human services shall establish records to retain the names of substantiated perpetrators.
Minnesota Statutes 2018, section 626.557, subdivision 12b, is amended to read:
(a) In performing any of the duties of this section as a
lead investigative agency, the county social service agency shall maintain appropriate
records. Data collected by the county social service agency under this section are welfare
data under section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data
under this paragraph that are inactive investigative data on an individual who is a vendor
of services are private data on individuals, as defined in section 13.02. The identity of the
reporter may only be disclosed as provided in paragraph deleted text begin (c)deleted text end new text begin (g)new text end .
new text begin (b) new text end Data maintained by the common entry point are deleted text begin confidentialdeleted text end new text begin privatenew text end data on
individuals or deleted text begin protecteddeleted text end nonpublic data as defined in section 13.02new text begin , provided that the name
of the reporter is confidential data on individualsnew text end . Notwithstanding section 138.163, the
common entry point shall maintain data for three calendar years after date of receipt and
then destroy the data unless otherwise directed by federal requirements.
deleted text begin (b)deleted text end new text begin (c)new text end The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section. County
social service agencies must maintain private data on individuals but are not required to
prepare an investigation memorandum. During an investigation by the commissioner of
health or the commissioner of human services, data collected under this section are
confidential data on individuals or protected nonpublic data as defined in section 13.02new text begin ,
provided that data, other than data on the reporter, may be shared with the vulnerable adult
or guardian or health care agent if the lead investigative agency determines that sharing of
the data is needed to protect the vulnerable adultnew text end . Upon completion of the investigation, the
data are classified as provided in deleted text begin clauses (1) to (3) and paragraph (c)deleted text end new text begin paragraphs (d) to (g)new text end .
deleted text begin (1)deleted text end new text begin (d) new text end The investigation memorandum must contain the following data, which are public:
deleted text begin (i)deleted text end new text begin (1)new text end the name of the facility investigated;
deleted text begin (ii)deleted text end new text begin (2)new text end a statement of the nature of the alleged maltreatment;
deleted text begin (iii)deleted text end new text begin (3)new text end pertinent information obtained from medical or other records reviewed;
deleted text begin (iv)deleted text end new text begin (4)new text end the identity of the investigator;
deleted text begin (v)deleted text end new text begin (5)new text end a summary of the investigation's findings;
deleted text begin (vi)deleted text end new text begin (6)new text end statement of whether the report was found to be substantiated, inconclusive,
false, or that no determination will be made;
deleted text begin (vii)deleted text end new text begin (7)new text end a statement of any action taken by the facility;
deleted text begin (viii)deleted text end new text begin (8)new text end a statement of any action taken by the lead investigative agency; and
deleted text begin (ix)deleted text end new text begin (9)new text end when a lead investigative agency's determination has substantiated maltreatment,
a statement of whether an individual, individuals, or a facility were responsible for the
substantiated maltreatment, if known.
The investigation memorandum must be written in a manner which protects the identity
of the reporter and of the vulnerable adult and may not contain the names or, to the extent
possible, data on individuals or private data new text begin on individuals new text end listed in deleted text begin clause (2)deleted text end new text begin paragraph
(e)new text end .
deleted text begin (2)deleted text end new text begin (e)new text end Data on individuals collected and maintained in the investigation memorandum
are private datanew text begin on individualsnew text end , including:
deleted text begin (i)deleted text end new text begin (1)new text end the name of the vulnerable adult;
deleted text begin (ii)deleted text end new text begin (2)new text end the identity of the individual alleged to be the perpetrator;
deleted text begin (iii)deleted text end new text begin (3) new text end the identity of the individual substantiated as the perpetrator; and
deleted text begin (iv)deleted text end new text begin (4)new text end the identity of all individuals interviewed as part of the investigation.
deleted text begin (3)deleted text end new text begin (f)new text end Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.
deleted text begin (c)deleted text end new text begin (g) new text end After the assessment or investigation is completed, the name of the reporter must
be confidentialdeleted text begin .deleted text end new text begin , except:
new text end
new text begin (1) new text end the subject of the report may compel disclosure of the name of the reporter only with
the consent of the reporternew text begin ;new text end or
new text begin (2) new text end upon a written finding by a court that the report was false and there is evidence that
the report was made in bad faith.
This subdivision does not alter disclosure responsibilities or obligations under the Rules
of Criminal Procedure, except that where the identity of the reporter is relevant to a criminal
prosecution, the district court shall do an in-camera review prior to determining whether to
order disclosure of the identity of the reporter.
deleted text begin (d)deleted text end new text begin (h)new text end Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be maintained under the following
schedule and then destroyed unless otherwise directed by federal requirements:
(1) data from reports determined to be false, maintained for three years after the finding
was made;
(2) data from reports determined to be inconclusive, maintained for four years after the
finding was made;
(3) data from reports determined to be substantiated, maintained for seven years after
the finding was made; and
(4) data from reports which were not investigated by a lead investigative agency and for
which there is no final disposition, maintained for three years from the date of the report.
deleted text begin (e)deleted text end new text begin (i)new text end The commissioners of health and human services shall annually publish on their
websites the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigation under this section,
and the resolution of those investigations. On a biennial basis, the commissioners of health
and human services shall jointly report the following information to the legislature and the
governor:
(1) the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigations under this section,
the resolution of those investigations, and which of the two lead agencies was responsible;
(2) trends about types of substantiated maltreatment found in the reporting period;
(3) deleted text begin if there are upward trends for types of maltreatment substantiated,deleted text end recommendations
fornew text begin preventing,new text end addressingnew text begin ,new text end and responding to deleted text begin themdeleted text end new text begin substantiated maltreatmentnew text end ;
(4) efforts undertaken or recommended to improve the protection of vulnerable adults;
(5) whether and where backlogs of cases result in a failure to conform with statutory
time frames and recommendations for reducing backlogs if applicable;
(6) recommended changes to statutes affecting the protection of vulnerable adults; and
(7) any other information that is relevant to the report trends and findings.
deleted text begin (f)deleted text end new text begin (j)new text end Each lead investigative agency must have a record retention policy.
deleted text begin (g)deleted text end new text begin (k)new text end Lead investigative agencies, prosecuting authorities, and law enforcement agencies
may exchange not public data, as defined in section 13.02, if the agency or authority
requesting the data determines that the data are pertinent and necessary to the requesting
agency in initiating, furthering, or completing an investigation under this section. Data
collected under this section must be made available to prosecuting authorities and law
enforcement officials, local county agencies, and licensing agencies investigating the alleged
maltreatment under this section. The lead investigative agency shall exchange not public
data with the vulnerable adult maltreatment review panel established in section 256.021 if
the data are pertinent and necessary for a review requested under that section.
Notwithstanding section 138.17, upon completion of the review, not public data received
by the review panel must be destroyed.
deleted text begin (h)deleted text end new text begin (l)new text end Each lead investigative agency shall keep records of the length of time it takes to
complete its investigations.
deleted text begin (i)deleted text end new text begin (m) Notwithstanding paragraph (a) or (b),new text end a lead investigative agency may new text begin share
common entry point or investigative data and may new text end notify other affected partiesnew text begin , including
the vulnerable adultnew text end and their authorized representativenew text begin ,new text end if the lead investigative agency has
reason to believe maltreatment has occurred and determines the information will safeguard
the well-being of the affected parties or dispel widespread rumor or unrest in the affected
facility.
deleted text begin (j)deleted text end new text begin (n)new text end Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead investigative agency may
not provide any notice unless the vulnerable adult has consented to disclosure in a manner
which conforms to federal requirements.
Minnesota Statutes 2018, section 626.557, subdivision 14, is amended to read:
(a) Each facility, except home health agencies and
personal care deleted text begin attendant services providersdeleted text end new text begin assistance provider agenciesnew text end , shall establish and
enforce an ongoing written abuse prevention plan. The plan shall contain an assessment of
the physical plant, its environment, and its population identifying factors which may
encourage or permit abuse, and a statement of specific measures to be taken to minimize
the risk of abuse. The plan shall comply with any rules governing the plan promulgated by
the licensing agency.
(b) Each facility, including a home health care agency and personal care attendant
services providers, shall develop an individual abuse prevention plan for each vulnerable
adult residing there or receiving services from them. The plan shall contain an individualized
assessment of: (1) the person's susceptibility to abuse by other individuals, including other
vulnerable adults; (2) the person's risk of abusing other vulnerable adults; and (3) statements
of the specific measures to be taken to minimize the risk of abuse to that person and other
vulnerable adults. For the purposes of this paragraph, the term "abuse" includes self-abuse.
(c) If the facility, except home health agencies and personal care attendant services
providers, knows that the vulnerable adult has committed a violent crime or an act of physical
aggression toward others, the individual abuse prevention plan must detail the measures to
be taken to minimize the risk that the vulnerable adult might reasonably be expected to pose
to visitors to the facility and persons outside the facility, if unsupervised. Under this section,
a facility knows of a vulnerable adult's history of criminal misconduct or physical aggression
if it receives such information from a law enforcement authority or through a medical record
prepared by another facility, another health care provider, or the facility's ongoing
assessments of the vulnerable adult.
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(d) The commissioner of health must issue a correction order and may impose an
immediate fine in an amount equal to the amount listed in Minnesota Rules, part 4658.0193,
item E, upon a finding that the facility has failed to comply with this subdivision.
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Minnesota Statutes 2018, section 626.557, subdivision 17, is amended to read:
(a) A facility or person shall not retaliate against any
person who reports in good faith suspected maltreatment pursuant to this section, or against
a vulnerable adult with respect to whom a report is made, because of the report.
(b) In addition to any remedies allowed under sections 181.931 to 181.935, any facility
or person which retaliates against any person because of a report of suspected maltreatment
is liable to that person for actual damages, punitive damages up to $10,000, and attorney
fees.
(c) There shall be a rebuttable presumption that any adverse action, as defined below,
within 90 days of a report, is retaliatory. For purposes of this deleted text begin clausedeleted text end new text begin paragraphnew text end , the term
"adverse action" refers to action taken by a facility or person involved in a report against
the person making the report or the person with respect to whom the report was made because
of the report, and includes, but is not limited to:
(1) discharge or transfer from the facility;
(2) discharge from or termination of employment;
(3) demotion or reduction in remuneration for services;
(4) restriction or prohibition of access to the facility or its residents; or
(5) any restriction of rights set forth in section 144.651new text begin , 144A.44, or 144A.441new text end .
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(a) The Assisted Living Licensure and Dementia Care Task
Force consists of 15 members, including the following:
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(1) one senator appointed by the majority leader;
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(2) one senator appointed by the minority leader;
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(3) one member of the house of representatives appointed by the speaker of the house;
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(4) one member of the house of representatives appointed by the minority leader;
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(5) the ombudsman for long-term care or a designee;
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(6) the ombudsman for mental health and developmental disabilities or a designee;
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(7) one member appointed by ARRM;
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(8) one member appointed by AARP Minnesota;
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(9) one member appointed by the Alzheimer's Association Minnesota-North Dakota
Chapter;
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(10) one member appointed by Elder Voice Family Advocates;
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(11) one member appointed by Minnesota Elder Justice Center;
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(12) one member appointed by Care Providers of Minnesota;
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(13) one member appointed by LeadingAge Minnesota;
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(14) one member appointed by Minnesota HomeCare Association; and
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(15) one member appointed by the Minnesota Council on Disability.
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(b) The appointing authorities must appoint members by July 1, 2019.
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(c) The ombudsman for long-term care or a designee shall act as chair of the task force
and convene the first meeting no later than August 1, 2019.
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(a) The Assisted Living Licensure and Dementia
Care Task Force shall consider and make recommendations on a new regulatory framework
for assisted living establishments and dementia care. In developing the licensing framework,
the task force must address at least the following:
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(1) the appropriate level of regulation, including licensure, registration, or certification;
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(2) coordination of care;
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(3) the scope of care to be provided and limits on acuity levels of residents;
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(4) consumer rights;
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(5) building design and physical environment;
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(6) dietary services;
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(7) support services;
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(8) transition planning;
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(9) the installation and use of electronic monitoring in settings in which assisted living
or dementia care services are provided;
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(10) staff training and qualifications;
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(11) options for the engagement of seniors and their families;
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(12) notices and financial requirements;
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(13) compliance with federal Medicaid waiver requirements for home and
community-based services settings;
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(14) policies for providing advance notice to patients and residents of changes in services
or charges unrelated to changes in patient or resident service or care needs;
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(15) survey frequency for home care providers;
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(16) terminations of services and lease terminations;
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(17) appeals of terminations of services and leases; and
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(18) relocations within a housing with services establishment or assisted living setting.
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(b) The task force shall also:
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(1) develop standards in the following areas that nursing homes, boarding care homes,
and housing with services establishments offering care for clients diagnosed with Alzheimer's
disease or other dementias must meet in order to obtain dementia care certification, including
staffing, egress control, access to secured outdoor spaces, specialized therapeutic activities,
and specialized life enrichment programming;
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(2) develop requirements for disclosing dementia care certification standards to
consumers; and
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(3) develop mechanisms for enforcing dementia care certification standards.
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(c) Facilities and providers licensed by the commissioner of human services shall be
exempt from licensing requirements for assisted living recommended under this section.
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The ombudsman for long-term care or a designee shall convene the
first meeting of the task force no later than August 1, 2019. The members of the task force
shall elect a chair from among the task force's members at the first meeting, and the
ombudsman for long-term care or a designee shall serve as the task force's chair until a chair
is elected. Meetings of the task force shall be open to the public.
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Members of the task force appointed under subdivision 1,
paragraph (b), shall serve without compensation or reimbursement for expenses.
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The commissioner of health shall provide
administrative support for the task force and arrange meeting space.
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By February 1, 2020, the task force must submit an interim report with
findings, recommendations, and draft legislation to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services policy and
finance. By January 15, 2021, the task force must submit a final report with findings,
recommendations, and draft legislation to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and finance.
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The task force expires January 16, 2021, or the day after the task
force submits the final report required under subdivision 6, whichever is later.
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(a) An assisted living report card working
group, tasked with researching and making recommendations on the development of an
assisted living report card, is established.
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(b) The commissioner of human services shall appoint the following members of the
working group:
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(1) two persons who reside in senior housing with services establishments, one residing
in an establishment in the seven-county metropolitan area and one residing in an
establishment outside the seven-county metropolitan area;
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(2) four representatives of the senior housing with services profession, two providing
services in the seven-county metropolitan area and two providing services outside the
seven-county metropolitan area;
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(3) one family member of a person who resides in a senior housing with services
establishment in the seven-county metropolitan area, and one family member of a person
who resides in a senior housing with services establishment outside the seven-county
metropolitan area;
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(4) a representative from the Home Care and Assisted Living Program Advisory Council;
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(5) a representative from the University of Minnesota with expertise in data and analytics;
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(6) a representative from Care Providers of Minnesota; and
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(7) a representative from LeadingAge Minnesota.
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(c) The following individuals shall also be appointed to the working group:
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(1) the commissioner of human services or a designee;
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(2) the commissioner of health or a designee;
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(3) the ombudsman for long-term care or a designee;
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(4) one member of the Minnesota Board on Aging, appointed by the board; and
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(5) the executive director of the Minnesota Board on Aging who shall serve on the
working group as a nonvoting member.
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(d) The appointing authorities under this subdivision must complete the appointments
no later than July 1, 2019.
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The assisted living report card working group shall consider and make
recommendations on the development of an assisted living report card. The quality metrics
considered shall include, but are not limited to:
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(1) an annual customer satisfaction survey measure using the CoreQ questions for
assisted-living residents and family members;
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(2) a measure utilizing level 3 or 4 citations from Department of Health home care survey
findings and substantiated Office of Health Facility Complaints findings against a home
care provider;
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(3) a home care staff retention measure; and
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(4) a measure that scores a provider's staff according to their level of training and
education.
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The commissioner of human services or a designee shall convene
the first meeting of the working group no later than August 1, 2019. The members of the
working group shall elect a chair from among the group's members at the first meeting, and
the commissioner of human services or a designee shall serve as the working group's chair
until a chair is elected. Meetings of the working group shall be open to the public.
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Members of the working group shall serve without compensation
or reimbursement for expenses.
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The commissioner of human services shall provide
administrative support and arrange meeting space for the working group.
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By January 15, 2020, the working group must submit a report with
findings, recommendations, and draft legislation to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services policy and
finance.
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The working group expires January 16, 2020, or the day after the
working group submits the report required in subdivision 6, whichever is later.
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(a) The Crimes Against Vulnerable
Adults Advisory Task Force is established and consists of the following members:
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(1) the commissioner of public safety or a designee;
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(2) the commissioner of human services or a designee;
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(3) the commissioner of health or a designee;
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(4) the attorney general or a designee;
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(5) a representative from the Minnesota Bar Association;
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(6) a representative from the Minnesota judicial branch;
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(7) one member appointed by the Minnesota County Attorneys Association;
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(8) one member appointed by the Minnesota Association of City Attorneys;
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(9) one member appointed by the Minnesota Elder Justice Center;
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(10) one member appointed by the Minnesota Home Care Association;
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(11) one member appointed by Care Providers of Minnesota;
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(12) one member appointed by LeadingAge Minnesota;
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(13) one member appointed by ARC Minnesota;
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(14) one member appointed by AARP Minnesota; and
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(15) one representative from a union that represents persons working in long-term care
settings.
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(b) The advisory task force may appoint additional members that it deems would be
helpful in carrying out its duties under subdivision 2.
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(c) The appointing authorities must complete the appointments listed in paragraph (a)
by July 1, 2019.
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(d) At its first meeting, the task force shall elect a chair from among the members listed
in paragraph (a).
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(a) The advisory task force's duties
are to review and evaluate laws relating to crimes against vulnerable adults, and any other
information the task force deems relevant.
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(b) By December 1, 2019, the advisory task force shall submit a report to the chairs and
ranking minority members of the legislative committees with primary jurisdiction over
health and human services and criminal policy. The report must contain the task force's
findings and recommendations, including a discussion of the benefits and problems associated
with proposed changes. The report must include draft legislation to implement any
recommended changes to statute.
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(a) The commissioner of human services shall
provide meeting space and administrative support to the advisory task force.
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(b) The commissioners of human services and health and the attorney general shall
provide technical assistance to the advisory task force.
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(c) Advisory task force members shall serve without compensation and shall not be
reimbursed for expenses.
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The advisory task force expires May 20, 2020.
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By March 1, 2020, the commissioner of health must submit a report to the chairs and
ranking minority members of the legislative committees with jurisdiction over health, human
services, or aging on the progress toward implementing each recommendation of the Office
of the Legislative Auditor with which the commissioner agreed in the commissioner's letter
to the legislative auditor dated March 1, 2018. The commissioner shall include in the report
existing data collected in the course of the commissioner's continuing oversight of the Office
of Health Facility Complaints sufficient to demonstrate the implementation of the
recommendations with which the commissioner agreed.
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(a) On a quarterly basis until January 2021, and annually thereafter, the commissioner
of health must publish on the Department of Health website, a report on the Office of Health
Facility Complaints' response to allegations of maltreatment of vulnerable adults. The report
must include:
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(1) a description and assessment of the office's efforts to improve its internal processes
and compliance with federal and state requirements concerning allegations of maltreatment
of vulnerable adults, including any relevant timelines;
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(2)(i) the number of reports received by type of reporter; (ii) the number of reports
investigated; (iii) the percentage and number of reported cases awaiting triage; (iv) the
number and percentage of open investigations; (v) the number and percentage of reports
that have failed to meet state or federal timelines for triaging, investigating, or making a
final disposition of an investigation by cause of delay; and (vi) processes the office will
implement to bring the office into compliance with state and federal timelines for triaging,
investigating, and making final dispositions of investigations;
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(3) a trend analysis of internal audits conducted by the office; and
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(4) trends and patterns in maltreatment of vulnerable adults, licensing violations by
facilities or providers serving vulnerable adults, and other metrics as determined by the
commissioner.
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(b) The commissioner shall maintain on the Department of Health website reports
published under this section for at least the past three years.
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By January 15, 2020, the safety and quality improvement technical panel established
under Minnesota Statutes, section 144A.53, subdivision 5, shall provide recommendations
to the legislature on legislative changes needed to promote safety and quality improvement
practices in long-term care settings and with long-term care providers. The recommendations
must address:
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(1) how to implement a system for adverse health events reporting, learning, and
prevention in long-term care settings and with long-term care providers; and
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(2) interim actions to improve systems for the timely analysis of reports and complaints
submitted to the Office of Health Facility Complaints to identify common themes and key
prevention opportunities, and to disseminate key findings to providers across the state for
the purposes of shared learning and prevention.
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Minnesota Statutes 2018, section 144A.479, subdivision 2,
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is repealed.
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Repealed Minnesota Statutes: 19-1267
Home care providers shall not use false, fraudulent, or misleading advertising in the marketing of services. For purposes of this section, advertising includes any verbal, written, or electronic means of communicating to potential clients about the availability, nature, or terms of home care services.