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Minnesota Legislature

Office of the Revisor of Statutes

SF 971

as introduced - 91st Legislature (2019 - 2020) Posted on 03/11/2019 03:55pm

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to health; modifying provisions governing home care providers;amending
Minnesota Statutes 2018, sections 144A.43, subdivisions 11, 27, 30, by adding a
subdivision; 144A.472, subdivisions 5, 7; 144A.473; 144A.474, subdivision 2;
144A.475, subdivisions 1, 2, 5; 144A.476, subdivision 1; 144A.479, subdivision
7; 144A.4791, subdivisions 1, 3, 6, 7, 8, 9; 144A.4792, subdivisions 1, 2, 5, 10;
144A.4793, subdivision 6; 144A.4796, subdivision 2; 144A.4797, subdivision 3;
144A.4798; 144A.4799, subdivisions 1, 3; 144A.484, subdivision 1; repealing
Minnesota Statutes 2018, sections 144A.45, subdivision 6; 144A.481.

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

Section 1.

Minnesota Statutes 2018, section 144A.43, subdivision 11, is amended to read:


Subd. 11.

Medication administration.

"Medication administration" means performing
a set of tasks deleted text beginto ensure a client takes medications, and includesdeleted text endnew text begin that includenew text end the following:

(1) checking the client's medication record;

(2) preparing the medication as necessary;

(3) administering the medication to the client;

(4) documenting the administration or reason for not administering the medication; and

(5) reporting to a new text beginregistered new text endnurse new text beginor appropriate licensed health professional new text endany concerns
about the medication, the client, or the client's refusal to take the medication.

Sec. 2.

Minnesota Statutes 2018, section 144A.43, is amended by adding a subdivision to
read:


new text begin Subd. 12a. new text end

new text begin Medication reconciliation. new text end

new text begin "Medication reconciliation" means the process
of identifying the most accurate list of all medications the client is taking, including the
name, dosage, frequency, and route by comparing the client record to an external list of
medications obtained from the client, hospital, prescriber, or other provider.
new text end

Sec. 3.

Minnesota Statutes 2018, section 144A.43, subdivision 27, is amended to read:


Subd. 27.

Service deleted text beginplandeleted text endnew text begin agreementnew text end.

"Service deleted text beginplandeleted text endnew text begin agreementnew text end" means the written deleted text beginplandeleted text endnew text begin
agreement
new text end between the client or client's representative and the temporary licensee or licensee
about the services that will be provided to the client.

Sec. 4.

Minnesota Statutes 2018, section 144A.43, subdivision 30, is amended to read:


Subd. 30.

Standby assistance.

"Standby assistance" means the presence of another
person deleted text beginwithin arm's reach to minimize the risk of injury while performing daily activities
through physical intervention or cuing
deleted text endnew text begin to assist a client with an assistive task by providing
cues, oversight, and minimal physical assistance
new text end.

Sec. 5.

Minnesota Statutes 2018, section 144A.472, subdivision 5, is amended to read:


Subd. 5.

deleted text beginTransfers prohibited;deleted text end Changes in ownership.

deleted text beginAnydeleted text end new text begin(a) A new text endhome care license
issued by the commissioner may not be transferred to another party. Before acquiring
ownership of new text beginor a controlling interest in new text enda home care provider business, a prospective
deleted text begin applicantdeleted text endnew text begin ownernew text end must apply for a new deleted text begintemporarydeleted text end license. A change of ownership is a transfer
of operational control deleted text beginto a different business entitydeleted text end new text beginof the home care provider business new text endand
includes:

(1) transfer of the business to a different or new corporation;

(2) in the case of a partnership, the dissolution or termination of the partnership under
chapter 323A, with the business continuing by a successor partnership or other entity;

(3) relinquishment of control of the provider to another party, including to a contract
management firm that is not under the control of the owner of the business' assets;

(4) transfer of the business by a sole proprietor to another party or entity; or

(5) deleted text beginin the case of a privately held corporation, the change indeleted text endnew text begin transfer ofnew text end ownership or
control of 50 percent or more of the deleted text beginoutstanding voting stockdeleted text endnew text begin controlling interest of a home
care provider business not covered by clauses (1) to (4)
new text end.

new text begin (b) An employee who was employed by the previous owner of the home care provider
business prior to the effective date of a change in ownership under paragraph (a), and who
will be employed by the new owner in the same or a similar capacity, shall be treated as if
no change in employer occurred, with respect to orientation, training, tuberculosis testing,
background studies, and competency testing and training on the policies identified in
subdivision 1, clause (14), and subdivision 2, if applicable.
new text end

new text begin (c) Notwithstanding paragraph (b), a new owner of a home care provider business must
ensure that employees of the provider receive and complete training and testing on any
provisions of policies that differ from those of the previous owner within 90 days after the
date of the change in ownership.
new text end

Sec. 6.

Minnesota Statutes 2018, section 144A.472, subdivision 7, is amended to read:


Subd. 7.

Fees; application, change of ownership, and renewal.

(a) An initial applicant
seeking temporary home care licensure must submit the following application fee to the
commissioner along with a completed application:

(1) for a basic home care provider, $2,100; or

(2) for a comprehensive home care provider, $4,200.

(b) A home care provider who is filing a change of ownership as required under
subdivision 5 must submit the following application fee to the commissioner, along with
the documentation required for the change of ownership:

(1) for a basic home care provider, $2,100; or

(2) for a comprehensive home care provider, $4,200.

(c) For the period ending June 30, 2018, a home care provider who is seeking to renew
the provider's license shall pay a fee to the commissioner based on revenues derived from
the provision of home care services during the calendar year prior to the year in which the
application is submitted, according to the following schedule:

License Renewal Fee

Provider Annual Revenue
Fee
greater than $1,500,000
$6,625
greater than $1,275,000 and no more than
$1,500,000
$5,797
greater than $1,100,000 and no more than
$1,275,000
$4,969
greater than $950,000 and no more than
$1,100,000
$4,141
greater than $850,000 and no more than $950,000
$3,727
greater than $750,000 and no more than $850,000
$3,313
greater than $650,000 and no more than $750,000
$2,898
greater than $550,000 and no more than $650,000
$2,485
greater than $450,000 and no more than $550,000
$2,070
greater than $350,000 and no more than $450,000
$1,656
greater than $250,000 and no more than $350,000
$1,242
greater than $100,000 and no more than $250,000
$828
greater than $50,000 and no more than $100,000
$500
greater than $25,000 and no more than $50,000
$400
no more than $25,000
$200

(d) For the period between July 1, 2018, and June 30, 2020, a home care provider who
is seeking to renew the provider's license shall pay a fee to the commissioner in an amount
that is ten percent higher than the applicable fee in paragraph (c). A home care provider's
fee shall be based on revenues derived from the provision of home care services during the
calendar year prior to the year in which the application is submitted.

(e) Beginning July 1, 2020, a home care provider who is seeking to renew the provider's
license shall pay a fee to the commissioner based on revenues derived from the provision
of home care services during the calendar year prior to the year in which the application is
submitted, according to the following schedule:

License Renewal Fee

Provider Annual Revenue
Fee
greater than $1,500,000
$7,651
greater than $1,275,000 and no more than
$1,500,000
$6,695
greater than $1,100,000 and no more than
$1,275,000
$5,739
greater than $950,000 and no more than
$1,100,000
$4,783
greater than $850,000 and no more than $950,000
$4,304
greater than $750,000 and no more than $850,000
$3,826
greater than $650,000 and no more than $750,000
$3,347
greater than $550,000 and no more than $650,000
$2,870
greater than $450,000 and no more than $550,000
$2,391
greater than $350,000 and no more than $450,000
$1,913
greater than $250,000 and no more than $350,000
$1,434
greater than $100,000 and no more than $250,000
$957
greater than $50,000 and no more than $100,000
$577
greater than $25,000 and no more than $50,000
$462
no more than $25,000
$231

(f) If requested, the home care provider shall provide the commissioner information to
verify the provider's annual revenues or other information as needed, including copies of
documents submitted to the Department of Revenue.

(g) At each annual renewal, a home care provider may elect to pay the highest renewal
fee for its license category, and not provide annual revenue information to the commissioner.

(h) A temporary license or license applicant, or temporary licensee or licensee that
knowingly provides the commissioner incorrect revenue amounts for the purpose of paying
a lower license fee, shall be subject to a civil penalty in the amount of double the fee the
provider should have paid.

(i)new text begin The fee for failure to comply with the notification requirements of section 144A.473,
subdivision 2, paragraph (c), is $1,000.
new text end

new text begin (j)new text end Fees and penalties collected under this section shall be deposited in the state treasury
and credited to the state government special revenue fund. All fees are nonrefundable. Fees
collected under paragraphs (c), (d), and (e) are nonrefundable even if received before July
1, 2017, for temporary licenses or licenses being issued effective July 1, 2017, or later.

Sec. 7.

Minnesota Statutes 2018, section 144A.473, is amended to read:


144A.473 ISSUANCE OF TEMPORARY LICENSE AND LICENSE RENEWAL.

Subdivision 1.

Temporary license and renewal of license.

(a) The department shall
review each application to determine the applicant's knowledge of and compliance with
Minnesota home care regulations. Before granting a temporary license or renewing a license,
the commissioner may further evaluate the applicant or licensee by requesting additional
information or documentation or by conducting an on-site survey of the applicant to
determine compliance with sections 144A.43 to 144A.482.

(b) Within 14 calendar days after receiving an application for a license, the commissioner
shall acknowledge receipt of the application in writing. The acknowledgment must indicate
whether the application appears to be complete or whether additional information is required
before the application will be considered complete.

(c) Within 90 days after receiving a complete application, the commissioner shall issue
a temporary license, renew the license, or deny the license.

(d) The commissioner shall issue a license that contains the home care provider's name,
address, license level, expiration date of the license, and unique license number. All licensesnew text begin,
except for temporary licenses issued under subdivision 2,
new text end are valid for new text beginup to new text endone year from
the date of issuance.

Subd. 2.

Temporary license.

(a) For new license applicants, the commissioner shall
issue a temporary license for either the basic or comprehensive home care level. A temporary
license is effective for up to one year from the date of issuancenew text begin, except that a temporary
license may be extended according to subdivision 3
new text end. Temporary licensees must comply with
sections 144A.43 to 144A.482.

(b) During the temporary license deleted text beginyeardeleted text endnew text begin periodnew text end, the commissioner shall survey the temporary
licensee new text beginwithin 90 calendar daysnew text end after the commissioner is notified or has evidence that the
temporary licensee is providing home care services.

(c) Within five days of beginning the provision of services, the temporary licensee must
notify the commissioner that it is serving clients. The notification to the commissioner may
be mailed or e-mailed to the commissioner at the address provided by the commissioner. If
the temporary licensee does not provide home care services during the temporary license
deleted text begin yeardeleted text endnew text begin periodnew text end, then the temporary license expires at the end of the deleted text beginyeardeleted text endnew text begin periodnew text end and the applicant
must reapply for a temporary home care license.

(d) A temporary licensee may request a change in the level of licensure prior to being
surveyed and granted a license by notifying the commissioner in writing and providing
additional documentation or materials required to update or complete the changed temporary
license application. The applicant must pay the difference between the application fees
when changing from the basic level to the comprehensive level of licensure. No refund will
be made if the provider chooses to change the license application to the basic level.

(e) If the temporary licensee notifies the commissioner that the licensee has clients within
45 days prior to the temporary license expiration, the commissioner may extend the temporary
license for up to 60 days in order to allow the commissioner to complete the on-site survey
required under this section and follow-up survey visits.

Subd. 3.

Temporary licensee survey.

(a) If the temporary licensee is in substantial
compliance with the survey, the commissioner shall issue either a basic or comprehensive
home care license. If the temporary licensee is not in substantial compliance with the survey,
the commissioner shall new text begineither: (1) new text endnot issue a deleted text beginbasic or comprehensivedeleted text end license and deleted text beginthere will
be no contested hearing right under chapter 14.
deleted text endnew text begin terminate the temporary license; or (2)
extend the temporary license for a period not to exceed 90 days and apply conditions, as
permitted under section 144A.475, subdivision 2, to the extension of a temporary license.
If the temporary licensee is not in substantial compliance with the survey within the time
period of the extension, or if the temporary licensee does not satisfy the license conditions,
the commissioner may deny the license.
new text end

(b) If the temporary licensee whose basic or comprehensive license has been denied new text beginor
extended with conditions
new text enddisagrees with the conclusions of the commissioner, then the
new text begin temporary new text endlicensee may request a reconsideration by the commissioner or commissioner's
designee. The reconsideration request process must be conducted internally by the
commissioner or commissioner's designee, and chapter 14 does not apply.

(c) The temporary licensee requesting reconsideration must make the request in writing
and must list and describe the reasons why the new text begintemporary new text endlicensee disagrees with the decision
to deny the basic or comprehensive home care licensenew text begin or the decision to extend the temporary
license with conditions
new text end.

(d)new text begin The reconsideration request and supporting documentation must be received by the
commissioner within 15 calendar days after the date the temporary licensee receives the
correction order.
new text end

new text begin (e) A temporary licensee whose license is denied, is permitted to continue operating as
a home care provider during the period of time when:
new text end

new text begin (1) a reconsideration request is in process;
new text end

new text begin (2) an extension of a temporary license is being negotiated;
new text end

new text begin (3) the placement of conditions on a temporary license is being negotiated; or
new text end

new text begin (4) a transfer of home care clients from the temporary licensee to a new home care
provider is in process.
new text end

new text begin (f)new text end A temporary licensee whose license is denied must comply with the requirements
for notification and transfer of clients in section 144A.475, subdivision 5.

Sec. 8.

Minnesota Statutes 2018, section 144A.474, subdivision 2, is amended to read:


Subd. 2.

Types of home care surveys.

(a) "Initial full survey" means the survey of a
new temporary licensee conducted after the department is notified or has evidence that the
temporary licensee is providing home care services to determine if the provider is in
compliance with home care requirements. Initial full surveys must be completed within 14
months after the department's issuance of a temporary basic or comprehensive license.

(b)new text begin "Change in ownership survey" means a full survey of a new licensee due to a change
in ownership. Change in ownership surveys must be completed within six months after the
department's issuance of a new license due to a change in ownership.
new text end

new text begin (c)new text end "Core survey" means periodic inspection of home care providers to determine ongoing
compliance with the home care requirements, focusing on the essential health and safety
requirements. Core surveys are available to licensed home care providers who have been
licensed for three years and surveyed at least once in the past three years with the latest
survey having no widespread violations beyond Level 1 as provided in subdivision 11.
Providers must also not have had any substantiated licensing complaints, substantiated
complaints against the agency under the Vulnerable Adults Act or Maltreatment of Minors
Act, or an enforcement action as authorized in section 144A.475 in the past three years.

(1) The core survey for basic home care providers must review compliance in the
following areas:

(i) reporting of maltreatment;

(ii) orientation to and implementation of the home care bill of rights;

(iii) statement of home care services;

(iv) initial evaluation of clients and initiation of services;

(v) client review and monitoring;

(vi) service deleted text beginplandeleted text endnew text begin agreementnew text end implementation and changes to the service deleted text beginplandeleted text endnew text begin agreementnew text end;

(vii) client complaint and investigative process;

(viii) competency of unlicensed personnel; and

(ix) infection control.

(2) For comprehensive home care providers, the core survey must include everything
in the basic core survey plus these areas:

(i) delegation to unlicensed personnel;

(ii) assessment, monitoring, and reassessment of clients; and

(iii) medication, treatment, and therapy management.

deleted text begin (c)deleted text endnew text begin (d)new text end "Full survey" means the periodic inspection of home care providers to determine
ongoing compliance with the home care requirements that cover the core survey areas and
all the legal requirements for home care providers. A full survey is conducted for all
temporary licensees deleted text beginanddeleted text endnew text begin, for licensees that receive licenses due to an approved change in
ownership,
new text end for providers who do not meet the requirements needed for a core survey, and
when a surveyor identifies unacceptable client health or safety risks during a core survey.
A full survey must include all the tasks identified as part of the core survey and any additional
review deemed necessary by the department, including additional observation, interviewing,
or records review of additional clients and staff.

deleted text begin (d)deleted text endnew text begin (e)new text end "Follow-up surveys" means surveys conducted to determine if a home care
provider has corrected deficient issues and systems identified during a core survey, full
survey, or complaint investigation. Follow-up surveys may be conducted via phone, e-mail,
fax, mail, or on-site reviews. Follow-up surveys, other than complaint surveys, shall be
concluded with an exit conference and written information provided on the process for
requesting a reconsideration of the survey results.

deleted text begin (e)deleted text endnew text begin (f)new text end Upon receiving information alleging that a home care provider has violated or is
currently violating a requirement of sections 144A.43 to 144A.482, the commissioner shall
investigate the complaint according to sections 144A.51 to 144A.54.

Sec. 9.

Minnesota Statutes 2018, section 144A.475, subdivision 1, is amended to read:


Subdivision 1.

Conditions.

(a) The commissioner may refuse to grant a temporary
license, new text beginrefuse to grant a license as a result of a change in ownership, refuse to new text endrenew a
license, suspend or revoke a license, or impose a conditional license if the home care provider
or owner or managerial official of the home care provider:

(1) is in violation of, or during the term of the license has violated, any of the requirements
in sections 144A.471 to 144A.482;

(2) permits, aids, or abets the commission of any illegal act in the provision of home
care;

(3) performs any act detrimental to the health, safety, and welfare of a client;

(4) obtains the license by fraud or misrepresentation;

(5) knowingly made or makes a false statement of a material fact in the application for
a license or in any other record or report required by this chapter;

(6) denies representatives of the department access to any part of the home care provider's
books, records, files, or employees;

(7) interferes with or impedes a representative of the department in contacting the home
care provider's clients;

(8) interferes with or impedes a representative of the department in the enforcement of
this chapter or has failed to fully cooperate with an inspection, survey, or investigation by
the department;

(9) destroys or makes unavailable any records or other evidence relating to the home
care provider's compliance with this chapter;

(10) refuses to initiate a background study under section 144.057 or 245A.04;

(11) fails to timely pay any fines assessed by the department;

(12) violates any local, city, or township ordinance relating to home care services;

(13) has repeated incidents of personnel performing services beyond their competency
level; or

(14) has operated beyond the scope of the home care provider's license level.

(b) A violation by a contractor providing the home care services of the home care provider
is a violation by the home care provider.

Sec. 10.

Minnesota Statutes 2018, section 144A.475, subdivision 2, is amended to read:


Subd. 2.

Terms to suspension or conditional license.

new text begin(a) new text endA suspension or conditional
license designation may include terms that must be completed or met before a suspension
or conditional license designation is lifted. A conditional license designation may include
restrictions or conditions that are imposed on the provider. Terms for a suspension or
conditional license may include one or more of the following and the scope of each will be
determined by the commissioner:

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

(2) requiring supervision of the home care provider or staff practices at the cost of the
home care provider by an unrelated person who has sufficient knowledge and qualifications
to oversee the practices and who will submit reports to the commissioner;

(3) requiring the home care provider or employees to obtain training at the cost of the
home care provider;

(4) requiring the home care provider to submit reports to the commissioner;

(5) prohibiting the home care provider from taking any new clients for a period of time;
or

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

new text begin (b) A home care provider subject to this subdivision may continue operating during the
period of time home care clients are being transferred to other providers.
new text end

Sec. 11.

Minnesota Statutes 2018, section 144A.475, subdivision 5, is amended to read:


Subd. 5.

Plan required.

(a) The process of suspending or revoking a license must include
a plan for transferring affected clients to other providers by the home care provider, which
will be monitored by the commissioner. Within three business days of being notified of the
final revocation or suspension action, the home care provider shall provide the commissioner,
the lead agencies as defined in section 256B.0911, and the ombudsman for long-term care
with the following information:

(1) a list of all clients, including full names and all contact information on file;

(2) a list of each client's representative or emergency contact person, including full names
and all contact information on file;

(3) the location or current residence of each client;

(4) the payor sources for each client, including payor source identification numbers; and

(5) for each client, a copy of the client's service plan, and a list of the types of services
being provided.

(b) The revocation or suspension notification requirement is satisfied by mailing the
notice to the address in the license record. The home care provider shall cooperate with the
commissioner and the lead agencies during the process of transferring care of clients to
qualified providers. Within three business days of being notified of the final revocation or
suspension action, the home care provider must notify and disclose to each of the home
care provider's clients, or the client's representative or emergency contact persons, that the
commissioner is taking action against the home care provider's license by providing a copy
of the revocation or suspension notice issued by the commissioner.

new text begin (c) A home care provider subject to this subdivision may continue operating during the
period of time home care clients are being transferred to other providers.
new text end

Sec. 12.

Minnesota Statutes 2018, section 144A.476, subdivision 1, is amended to read:


Subdivision 1.

Prior criminal convictions; owner and managerial officials.

(a) Before
the commissioner issues a temporary licensenew text begin, issues a license new text endnew text beginas a result of an approved
change in ownership,
new text end or renews a license, an owner or managerial official is required to
complete a background study under section 144.057. No person may be involved in the
management, operation, or control of a home care provider if the person has been disqualified
under chapter 245C. If an individual is disqualified under section 144.057 or chapter 245C,
the individual may request reconsideration of the disqualification. If the individual requests
reconsideration and the commissioner sets aside or rescinds the disqualification, the individual
is eligible to be involved in the management, operation, or control of the provider. If an
individual has a disqualification under section 245C.15, subdivision 1, and the disqualification
is affirmed, the individual's disqualification is barred from a set aside, and the individual
must not be involved in the management, operation, or control of the provider.

(b) For purposes of this section, owners of a home care provider subject to the background
check requirement are those individuals whose ownership interest provides sufficient
authority or control to affect or change decisions related to the operation of the home care
provider. An owner includes a sole proprietor, a general partner, or any other individual
whose individual ownership interest can affect the management and direction of the policies
of the home care provider.

(c) For the purposes of this section, managerial officials subject to the background check
requirement are individuals who provide direct contact as defined in section 245C.02,
subdivision 11
, or individuals who have the responsibility for the ongoing management or
direction of the policies, services, or employees of the home care provider. Data collected
under this subdivision shall be classified as private data on individuals under section 13.02,
subdivision 12
.

(d) The department shall not issue any license if the applicant or owner or managerial
official has been unsuccessful in having a background study disqualification set aside under
section 144.057 and chapter 245C; if the owner or managerial official, as an owner or
managerial official of another home care provider, was substantially responsible for the
other home care provider's failure to substantially comply with sections 144A.43 to
144A.482; or if an owner that has ceased doing business, either individually or as an owner
of a home care provider, was issued a correction order for failing to assist clients in violation
of this chapter.

Sec. 13.

Minnesota Statutes 2018, section 144A.479, subdivision 7, is amended to read:


Subd. 7.

Employee records.

The home care provider must maintain current records of
each paid employee, regularly scheduled volunteers providing home care services, and of
each individual contractor providing home care services. The records must include the
following information:

(1) evidence of current professional licensure, registration, or certification, if licensure,
registration, or certification is required by this statute or other rules;

(2) records of orientation, required annual training and infection control training, and
competency evaluations;

(3) current job description, including qualifications, responsibilities, and identification
of staff providing supervision;

(4) documentation of annual performance reviews which identify areas of improvement
needed and training needs;

(5) for individuals providing home care services, verification that deleted text beginrequireddeleted text endnew text begin anynew text end health
screenings new text beginrequired by infection control programs established new text endunder section 144A.4798
have taken place and the dates of those screenings; and

(6) documentation of the background study as required under section 144.057.

Each employee record must be retained for at least three years after a paid employee, home
care volunteer, or contractor ceases to be employed by or under contract with the home care
provider. If a home care provider ceases operation, employee records must be maintained
for three years.

Sec. 14.

Minnesota Statutes 2018, section 144A.4791, subdivision 1, is amended to read:


Subdivision 1.

Home care bill of rights; notification to client.

(a) The home care
provider shall provide the client or the client's representative a written notice of the rights
under section 144A.44 before the deleted text begininitiation ofdeleted text endnew text begin date thatnew text end services new text beginare first provided new text endto that
client. The provider shall make all reasonable efforts to provide notice of the rights to the
client or the client's representative in a language the client or client's representative can
understand.

(b) In addition to the text of the home care bill of rights in section 144A.44, subdivision
1, the notice shall also contain the following statement describing how to file a complaint
with these offices.

"If you have a complaint about the provider or the person providing your home care
services, you may call, write, or visit the Office of Health Facility Complaints, Minnesota
Department of Health. You may also contact the Office of Ombudsman for Long-Term
Care or the Office of Ombudsman for Mental Health and Developmental Disabilities."

The statement should include the telephone number, website address, e-mail address,
mailing address, and street address of the Office of Health Facility Complaints at the
Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care, and
the Office of the Ombudsman for Mental Health and Developmental Disabilities. The
statement should also include the home care provider's name, address, e-mail, telephone
number, and name or title of the person at the provider to whom problems or complaints
may be directed. It must also include a statement that the home care provider will not retaliate
because of a complaint.

(c) The home care provider shall obtain written acknowledgment of the client's receipt
of the home care bill of rights or shall document why an acknowledgment cannot be obtained.
The acknowledgment may be obtained from the client or the client's representative.
Acknowledgment of receipt shall be retained in the client's record.

Sec. 15.

Minnesota Statutes 2018, section 144A.4791, subdivision 3, is amended to read:


Subd. 3.

Statement of home care services.

Prior to the deleted text begininitiation ofdeleted text endnew text begin date thatnew text end servicesnew text begin
are first provided to the client
new text end, a home care provider must provide to the client or the client's
representative a written statement which identifies if the provider has a basic or
comprehensive home care license, the services the provider is authorized to provide, and
which services the provider cannot provide under the scope of the provider's license. The
home care provider shall obtain written acknowledgment from the clients that the provider
has provided the statement or must document why the provider could not obtain the
acknowledgment.

Sec. 16.

Minnesota Statutes 2018, section 144A.4791, subdivision 6, is amended to read:


Subd. 6.

Initiation of services.

When a provider deleted text begininitiatesdeleted text endnew text begin provides home carenew text end services
deleted text begin anddeleted text endnew text begin to a client beforenew text end the individualized review or assessment new text beginby a licensed health
professional or registered nurse as
new text endrequired in subdivisions 7 and 8 deleted text beginhas not beendeleted text endnew text begin isnew text end completed,
the deleted text beginproviderdeleted text endnew text begin licensed health professional or registered nursenew text end must complete a temporary
plan deleted text beginand agreementdeleted text end with the client deleted text beginfor servicesdeleted text endnew text begin and orient staff assigned to deliver services
as identified in the
new text endnew text begintemporary plannew text end.

Sec. 17.

Minnesota Statutes 2018, section 144A.4791, subdivision 7, is amended to read:


Subd. 7.

Basic individualized client review and monitoring.

(a) When services being
provided are basic home care services, an individualized initial review of the client's needs
and preferences must be conducted at the client's residence with the client or client's
representative. This initial review must be completed within 30 days after the deleted text begininitiation of
the
deleted text endnew text begin date thatnew text end home care servicesnew text begin are first providednew text end.

(b) Client monitoring and review must be conducted as needed based on changes in the
needs of the client and cannot exceed 90 days from the date of the last review. The monitoring
and review may be conducted at the client's residence or through the utilization of
telecommunication methods based on practice standards that meet the individual client's
needs.

Sec. 18.

Minnesota Statutes 2018, section 144A.4791, subdivision 8, is amended to read:


Subd. 8.

Comprehensive assessment, monitoring, and reassessment.

(a) When the
services being provided are comprehensive home care services, an individualized initial
assessment must be conducted in person by a registered nurse. When the services are provided
by other licensed health professionals, the assessment must be conducted by the appropriate
health professional. This initial assessment must be completed within five days after deleted text begininitiation
of
deleted text endnew text begin the date thatnew text end home care servicesnew text begin are first providednew text end.

(b) Client monitoring and reassessment must be conducted in the client's home no more
than 14 days after deleted text begininitiation ofdeleted text endnew text begin the date that home carenew text end servicesnew text begin are first providednew text end.

(c) Ongoing client monitoring and reassessment must be conducted as needed based on
changes in the needs of the client and cannot exceed 90 days from the last date of the
assessment. The monitoring and reassessment may be conducted at the client's residence
or through the utilization of telecommunication methods based on practice standards that
meet the individual client's needs.

Sec. 19.

Minnesota Statutes 2018, section 144A.4791, subdivision 9, is amended to read:


Subd. 9.

Service deleted text beginplandeleted text endnew text begin agreementnew text end, implementation, and revisions to service deleted text beginplandeleted text endnew text begin
agreement
new text end.

(a) No later than 14 days after the deleted text begininitiation ofdeleted text endnew text begin date that home carenew text end servicesnew text begin are
first provided
new text end, a home care provider shall finalize a current written service deleted text beginplandeleted text endnew text begin agreementnew text end.

(b) The service deleted text beginplandeleted text endnew text begin agreementnew text end and any revisions must include a signature or other
authentication by the home care provider and by the client or the client's representative
documenting agreement on the services to be provided. The service deleted text beginplandeleted text endnew text begin agreementnew text end must
be revised, if needed, based on client review or reassessment under subdivisions 7 and 8.
The provider must provide information to the client about changes to the provider's fee for
services and how to contact the Office of the Ombudsman for Long-Term Care.

(c) The home care provider must implement and provide all services required by the
current service deleted text beginplandeleted text endnew text begin agreementnew text end.

(d) The service deleted text beginplandeleted text end new text beginagreement new text endand revised service deleted text beginplandeleted text end new text beginagreement new text endmust be entered into
the client's record, including notice of a change in a client's fees when applicable.

(e) Staff providing home care services must be informed of the current written service
deleted text begin plandeleted text endnew text begin agreementnew text end.

(f) The service deleted text beginplandeleted text endnew text begin agreementnew text end must include:

(1) a description of the home care services to be provided, the fees for services, and the
frequency of each service, according to the client's current review or assessment and client
preferences;

(2) the identification of the staff or categories of staff who will provide the services;

(3) the schedule and methods of monitoring reviews or assessments of the client;

(4) deleted text beginthe frequency of sessions of supervision of staff and type of personnel who will
deleted text enddeleted text begin supervise staffdeleted text enddeleted text begin; anddeleted text endnew text begin the schedule and methods of monitoring staff providing home care
services; and
new text end

(5) a contingency plan that includes:

(i) the action to be taken by the home care provider and by the client or client's
representative if the scheduled service cannot be provided;

(ii) information and a method for a client or client's representative to contact the home
care provider;

(iii) names and contact information of persons the client wishes to have notified in an
emergency or if there is a significant adverse change in the client's conditiondeleted text begin, including
identification of and information as to who has authority to sign for the client in an
emergency
deleted text end; and

(iv) the circumstances in which emergency medical services are not to be summoned
consistent with chapters 145B and 145C, and declarations made by the client under those
chapters.

Sec. 20.

Minnesota Statutes 2018, section 144A.4792, subdivision 1, is amended to read:


Subdivision 1.

Medication management services; comprehensive home care
license.

(a) This subdivision applies only to home care providers with a comprehensive
home care license that provide medication management services to clients. Medication
management services may not be provided by a home care provider who has a basic home
care license.

(b) A comprehensive home care provider who provides medication management services
must develop, implement, and maintain current written medication management policies
and procedures. The policies and procedures must be developed under the supervision and
direction of a registered nurse, licensed health professional, or pharmacist consistent with
current practice standards and guidelines.

(c) The written policies and procedures must address requesting and receiving
prescriptions for medications; preparing and giving medications; verifying that prescription
drugs are administered as prescribed; documenting medication management activities;
controlling and storing medications; monitoring and evaluating medication use; resolving
medication errors; communicating with the prescriber, pharmacist, and client and client
representative, if any; disposing of unused medications; and educating clients and client
representatives about medications. When controlled substances are being managed, new text beginstored,
and secured by the comprehensive home care provider,
new text endthe policies and procedures must
also identify how the provider will ensure security and accountability for the overall
management, control, and disposition of those substances in compliance with state and
federal regulations and with subdivision 22.

Sec. 21.

Minnesota Statutes 2018, section 144A.4792, subdivision 2, is amended to read:


Subd. 2.

Provision of medication management services.

(a) For each client who
requests medication management services, the comprehensive home care provider shall,
prior to providing medication management services, have a registered nurse, licensed health
professional, or authorized prescriber under section 151.37 conduct an assessment to
determine what medication management services will be provided and how the services
will be provided. This assessment must be conducted face-to-face with the client. The
assessment must include an identification and review of all medications the client is known
to be taking. The review and identification must include indications for medications, side
effects, contraindications, allergic or adverse reactions, and actions to address these issues.

(b) The assessment mustnew text begin:
new text end

new text begin (1)new text end identify interventions needed in management of medications to prevent diversion of
medication by the client or others who may have access to the medicationsdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (2) provide instructions to the client or client's representative on interventions to manage
the client's medications and prevent diversion of medications.
new text end

"Diversion of medications" means the misuse, theft, or illegal or improper disposition of
medications.

Sec. 22.

Minnesota Statutes 2018, section 144A.4792, subdivision 5, is amended to read:


Subd. 5.

Individualized medication management plan.

(a) For each client receiving
medication management services, the comprehensive home care provider must prepare and
include in the service deleted text beginplandeleted text endnew text begin agreementnew text end a written statement of the medication management
services that will be provided to the client. The provider must develop and maintain a current
individualized medication management record for each client based on the client's assessment
that must contain the following:

(1) a statement describing the medication management services that will be provided;

(2) a description of storage of medications based on the client's needs and preferences,
risk of diversion, and consistent with the manufacturer's directions;

(3) documentation of specific client instructions relating to the administration of
medications;

(4) identification of persons responsible for monitoring medication supplies and ensuring
that medication refills are ordered on a timely basis;

(5) identification of medication management tasks that may be delegated to unlicensed
personnel;

(6) procedures for staff notifying a registered nurse or appropriate licensed health
professional when a problem arises with medication management services; and

(7) any client-specific requirements relating to documenting medication administration,
verifications that all medications are administered as prescribed, and monitoring of
medication use to prevent possible complications or adverse reactions.

(b) The medication management record must be current and updated when there are any
changes.

new text begin (c) Medication reconciliation must be completed when a licensed nurse, licensed health
professional, or authorized prescriber is providing medication management.
new text end

Sec. 23.

Minnesota Statutes 2018, section 144A.4792, subdivision 10, is amended to read:


Subd. 10.

Medication management for clients who will be away from home.

(a) A
home care provider who is providing medication management services to the client and
controls the client's access to the medications must develop and implement policies and
procedures for giving accurate and current medications to clients for planned or unplanned
times away from home according to the client's individualized medication management
plan. The policy and procedures must state that:

(1) for planned time away, the medications must be obtained from the pharmacy or set
up by deleted text beginthe registereddeleted text endnew text begin a licensednew text end nurse according to appropriate state and federal laws and
nursing standards of practice;

(2) for unplanned time away, when the pharmacy is not able to provide the medications,
a licensed nurse or unlicensed personnel shall give the client or client's representative
medications in amounts and dosages needed for the length of the anticipated absence, not
to exceed deleted text begin120 hoursdeleted text endnew text begin seven calendar daysnew text end;

(3) the client or client's representative must be provided written information on
medications, including any special instructions for administering or handling the medications,
including controlled substances;

(4) the medications must be placed in a medication container or containers appropriate
to the provider's medication system and must be labeled with the client's name and the dates
and times that the medications are scheduled; and

(5) the client or client's representative must be provided in writing the home care
provider's name and information on how to contact the home care provider.

(b) For unplanned time away when the licensed nurse is not available, the registered
nurse may delegate this task to unlicensed personnel if:

(1) the registered nurse has trained the unlicensed staff and determined the unlicensed
staff is competent to follow the procedures for giving medications to clients; and

(2) the registered nurse has developed written procedures for the unlicensed personnel,
including any special instructions or procedures regarding controlled substances that are
prescribed for the client. The procedures must address:

(i) the type of container or containers to be used for the medications appropriate to the
provider's medication system;

(ii) how the container or containers must be labeled;

(iii) the written information about the medications to be given to the client or client's
representative;

(iv) how the unlicensed staff must document in the client's record that medications have
been given to the client or the client's representative, including documenting the date the
medications were given to the client or the client's representative and who received the
medications, the person who gave the medications to the client, the number of medications
that were given to the client, and other required information;

(v) how the registered nurse shall be notified that medications have been given to the
client or client's representative and whether the registered nurse needs to be contacted before
the medications are given to the client or the client's representative; deleted text beginand
deleted text end

(vi) a review by the registered nurse of the completion of this task to verify that this task
was completed accurately by the unlicensed personneldeleted text begin.deleted text endnew text begin; and
new text end

new text begin (vii) how the unlicensed staff must document in the client's record any unused medications
that are returned to the provider, including the name of each medication and the doses of
each returned medication.
new text end

Sec. 24.

Minnesota Statutes 2018, section 144A.4793, subdivision 6, is amended to read:


Subd. 6.

new text beginTreatment and therapy new text endorders deleted text beginor prescriptionsdeleted text end.

There must be an up-to-date
written or electronically recorded order deleted text beginor prescriptiondeleted text endnew text begin from an authorized prescribernew text end for
all treatments and therapies. The order must contain the name of the client, a description of
the treatment or therapy to be provided, and the frequencynew text begin, duration,new text end and other information
needed to administer the treatment or therapy.new text begin Treatment and therapy orders must be renewed
at least every 12 months.
new text end

Sec. 25.

Minnesota Statutes 2018, section 144A.4796, subdivision 2, is amended to read:


Subd. 2.

Content.

(a) The orientation must contain the following topics:

(1) an overview of sections 144A.43 to 144A.4798;

(2) introduction and review of all the provider's policies and procedures related to the
provision of home care servicesnew text begin by the individual staff personnew text end;

(3) handling of emergencies and use of emergency services;

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

(5) home care bill of rights under section 144A.44;

(6) handling of clients' complaints, reporting of complaints, and where to report
complaints including information on the Office of Health Facility Complaints and the
Common Entry Point;

(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
Ombudsman at the Department of Human Services, county managed care advocates, or
other relevant advocacy services; and

(8) review of the types of home care services the employee will be providing and the
provider's scope of licensure.

(b) In addition to the topics listed in paragraph (a), orientation may also contain training
on providing services to clients with hearing loss. Any training on hearing loss provided
under this subdivision must be high quality and research-based, may include online training,
and must include training on one or more of the following topics:

(1) an explanation of age-related hearing loss and how it manifests itself, its prevalence,
and challenges it poses to communication;

(2) health impacts related to untreated age-related hearing loss, such as increased
incidence of dementia, falls, hospitalizations, isolation, and depression; or

(3) information about strategies and technology that may enhance communication and
involvement, including communication strategies, assistive listening devices, hearing aids,
visual and tactile alerting devices, communication access in real time, and closed captions.

Sec. 26.

Minnesota Statutes 2018, section 144A.4797, subdivision 3, is amended to read:


Subd. 3.

Supervision of staff providing delegated nursing or therapy home care
tasks.

(a) Staff who perform delegated nursing or therapy home care tasks must be supervised
by an appropriate licensed health professional or a registered nurse periodically where the
services are being provided to verify that the work is being performed competently and to
identify problems and solutions related to the staff person's ability to perform the tasks.
Supervision of staff performing medication or treatment administration shall be provided
by a registered nurse or appropriate licensed health professional and must include observation
of the staff administering the medication or treatment and the interaction with the client.

(b) The direct supervision of staff performing delegated tasks must be provided within
30 days after the new text begindate on which the new text endindividual begins working for the home care providernew text begin
and first performs delegated tasks for clients
new text end and thereafter as needed based on performance.
This requirement also applies to staff who have not performed delegated tasks for one year
or longer.

Sec. 27.

Minnesota Statutes 2018, section 144A.4798, is amended to read:


144A.4798 deleted text beginEMPLOYEE HEALTH STATUSdeleted text endnew text begin DISEASE PREVENTION AND
INFECTION CONTROL
new text end.

Subdivision 1.

Tuberculosis (TB) deleted text beginprevention anddeleted text endnew text begin infectionnew text end control.

new text begin(a) new text endA home care
provider must establish and maintain a deleted text beginTB prevention anddeleted text end new text begincomprehensive tuberculosis
infection
new text endcontrol program deleted text beginbased ondeleted text endnew text begin according tonew text end the most current new text begintuberculosis infection
control
new text endguidelines issued by the new text beginUnited States new text endCenters for Disease Control and Prevention
(CDC)new text begin, Division of Tuberculosis Elimination, as published in the CDC's Morbidity and
Mortality Weekly Report
new text end. deleted text beginComponents of a TB prevention and control program include
screening all staff providing home care services, both paid and unpaid, at the time of hire
for active TB disease and latent TB infection, and developing and implementing a written
TB infection control plan. The commissioner shall make the most recent CDC standards
available to home care providers on the department's website.
deleted text endnew text begin This program must include
a tuberculosis infection control plan that covers all paid and unpaid employees, contractors,
students, and volunteers. The commissioner shall provide technical assistance regarding
implementation of the guidelines.
new text end

new text begin (b) The home care provider must maintain written evidence of compliance with this
subdivision.
new text end

Subd. 2.

Communicable diseases.

A home care provider must follow current deleted text beginfederal
or state guidelines
deleted text endnew text begin state requirementsnew text end for prevention, control, and reporting of deleted text beginhuman
immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other
deleted text end
communicable diseases as defined in Minnesota Rules, deleted text beginpartdeleted text endnew text begin partsnew text end 4605.7040new text begin, 4605.7044,
4605.7050, 4605.7075, 4605.7080, and 4605.7090
new text end.

new text begin Subd. 3. new text end

new text begin Infection control program. new text end

new text begin A home care provider must establish and maintain
an effective infection control program that complies with accepted health care, medical,
and nursing standards for infection control.
new text end

Sec. 28.

Minnesota Statutes 2018, section 144A.4799, subdivision 1, is amended to read:


Subdivision 1.

Membership.

The commissioner of health shall appoint eight persons
to a home care and assisted living program advisory council consisting of the following:

(1) three public members as defined in section 214.02 who shall be deleted text begineitherdeleted text end persons who
are currently receiving home care services deleted text beginordeleted text endnew text begin, persons who have received home care services
within five years of the application date,
new text endnew text beginpersons whonew text end have family members receiving home
care services, or persons who have family members who have received home care services
within five years of the application date;

(2) three Minnesota home care licensees representing basic and comprehensive levels
of licensure who may be a managerial official, an administrator, a supervising registered
nurse, or an unlicensed personnel performing home care tasks;

(3) one member representing the Minnesota Board of Nursing; and

(4) one member representing the new text beginOffice of new text endOmbudsman for Long-Term Care.

Sec. 29.

Minnesota Statutes 2018, section 144A.4799, subdivision 3, is amended to read:


Subd. 3.

Duties.

(a) At the commissioner's request, the advisory council shall provide
advice regarding regulations of Department of Health licensed home care providers in this
chapter, including advice on the following:

(1) community standards for home care practices;

(2) enforcement of licensing standards and whether certain disciplinary actions are
appropriate;

(3) ways of distributing information to licensees and consumers of home care;

(4) training standards;

(5) identifying emerging issues and opportunities in deleted text beginthedeleted text end home care deleted text beginfield, includingdeleted text endnew text begin and
assisted living;
new text end

new text begin (6) identifyingnew text end the use of technology in home and telehealth capabilities;

deleted text begin (6)deleted text endnew text begin (7)new text end allowable home care licensing modifications and exemptions, including a method
for an integrated license with an existing license for rural licensed nursing homes to provide
limited home care services in an adjacent independent living apartment building owned by
the licensed nursing home; and

deleted text begin (7)deleted text endnew text begin (8)new text end recommendations for studies using the data in section 62U.04, subdivision 4,
including but not limited to studies concerning costs related to dementia and chronic disease
among an elderly population over 60 and additional long-term care costs, as described in
section 62U.10, subdivision 6.

(b) The advisory council shall perform other duties as directed by the commissioner.

(c) The advisory council shall annually review the balance of the account in the state
government special revenue fund described in section 144A.474, subdivision 11, paragraph
(i), and make annual recommendations by January 15 directly to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services regarding appropriations to the commissioner for the purposes in section 144A.474,
subdivision 11, paragraph (i).

Sec. 30.

Minnesota Statutes 2018, section 144A.484, subdivision 1, is amended to read:


Subdivision 1.

Integrated licensing established.

deleted text begin (a) From January 1, 2014, to June 30,
2015, the commissioner of health shall enforce the home and community-based services
standards under chapter 245D for those providers who also have a home care license pursuant
to this chapter as required under Laws 2013, chapter 108, article 8, section 60, and article
11, section 31. During this period, the commissioner shall provide technical assistance to
achieve and maintain compliance with applicable law or rules governing the provision of
home and community-based services, including complying with the service recipient rights
notice in subdivision 4, clause (4). If during the survey, the commissioner finds that the
licensee has failed to achieve compliance with an applicable law or rule under chapter 245D
and this failure does not imminently endanger the health, safety, or rights of the persons
served by the program, the commissioner may issue a licensing survey report with
recommendations for achieving and maintaining compliance.
deleted text end

deleted text begin (b) Beginning July 1, 2015,deleted text end A home care provider applicant or license holder may apply
to the commissioner of health for a home and community-based services designation for
the provision of basic support services identified under section 245D.03, subdivision 1,
paragraph (b). The designation allows the license holder to provide basic support services
that would otherwise require licensure under chapter 245D, under the license holder's home
care license governed by sections 144A.43 to deleted text begin144A.481deleted text endnew text begin 144A.4799new text end.

Sec. 31. new text beginREVISOR'S INSTRUCTIONS.
new text end

new text begin (a) The revisor of statutes shall change the terms "service plan or service agreement"
and "service agreement or service plan" to "service agreement" in the following sections of
Minnesota Statutes: sections 144A.442; 144D.045; 144G.03, subdivision 4, paragraph (c);
and 144G.04.
new text end

new text begin (b) The revisor of statutes shall change the term "service plan" to "service agreement"
and the term "service plans" to "service agreements" in the following sections of Minnesota
Statutes: sections 144A.44; 144A.45; 144A.475; 144A.4791; 144A.4792; 144A.4793;
144A.4794; 144D.04; and 144G.03, subdivision 4, paragraph (a).
new text end

Sec. 32. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 144A.45, subdivision 6; and 144A.481, new text end new text begin are repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: 19-0554

144A.45 REGULATION OF HOME CARE SERVICES.

Subd. 6.

Home care providers; tuberculosis prevention and control.

(a) A home care provider must establish and maintain a comprehensive tuberculosis infection control program according to the most current tuberculosis infection control guidelines issued by the United States Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination, as published in CDC's Morbidity and Mortality Weekly Report (MMWR). This program must include a tuberculosis infection control plan that covers all paid and unpaid employees, contractors, students, and volunteers. The Department of Health shall provide technical assistance regarding implementation of the guidelines.

(b) Written compliance with this subdivision must be maintained by the home care provider.

144A.481 HOME CARE LICENSING IMPLEMENTATION FOR NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.

Subdivision 1.

Temporary home care licenses and changes of ownership.

(a) Beginning January 1, 2014, all temporary license applicants must apply for either a temporary basic or comprehensive home care license.

(b) Temporary home care licenses issued beginning January 1, 2014, shall be issued according to sections 144A.43 to 144A.4798, and the fees in section 144A.472. Temporary licensees must comply with the requirements of this chapter.

(c) No temporary license applications will be accepted nor temporary licenses issued between December 1, 2013, and December 31, 2013.

(d) Beginning October 1, 2013, changes in ownership applications will require payment of the new fees listed in section 144A.472. Providers who are providing nursing, delegated nursing, or professional health care services, must submit the fee for comprehensive home care providers, and all other providers must submit the fee for basic home care providers as provided in section 144A.472. Change of ownership applicants will be issued a new home care license based on the licensure law in effect on June 30, 2013.

Subd. 2.

Current home care licensees with licenses as of December 31, 2013.

(a) Beginning July 1, 2014, department licensed home care providers must apply for either the basic or comprehensive home care license on their regularly scheduled renewal date.

(b) By June 30, 2015, all home care providers must either have a basic or comprehensive home care license or temporary license.

Subd. 3.

Renewal application of home care licensure during transition period.

(a) Renewal and change of ownership applications of home care licenses issued beginning July 1, 2014, will be issued according to sections 144A.43 to 144A.4798 and, upon license renewal or issuance of a new license for a change of ownership, providers must comply with sections 144A.43 to 144A.4798. Prior to renewal, providers must comply with the home care licensure law in effect on June 30, 2013.

(b) The fees charged for licenses renewed between July 1, 2014, and June 30, 2016, shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000 increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625.

(c) For fiscal year 2014 only, the fees for providers with revenues greater than $25,000 and no more than $100,000 will be $313 and for providers with revenues no more than $25,000 the fee will be $125.