Minnesota Session Laws - 1987, Regular Session

  

                         Laws of Minnesota 1987 

                        CHAPTER 209-S.F.No. 1048 
           An act relating to health; making nutrition data 
          reporting discretionary rather than mandatory; 
          governing the hazardous substance injury compensation 
          board; restructuring the commissioner's authority to 
          control activities of carriers of communicable 
          diseases; regulating licensure and inspections of 
          hospitals, nursing homes, life support transportation 
          systems, and eating places; clarifying powers of the 
          office of health facility complaints; changing certain 
          duties of the interagency board for quality assurance; 
          providing penalties; amending Minnesota Statutes 1986, 
          sections 115B.28, subdivision 4; 144.0722; 144.092; 
          144.50, subdivisions 1 and 2; 144.653, subdivision 3; 
          144.802, subdivisions 3 and 4; 144A.10, subdivisions 1 
          and 2; 144A.16; 144A.31; 144A.53, subdivision 1; 
          145.881, subdivision 1; 145.882, subdivision 4; 
          157.01; 157.02; 157.04; 157.09; and 157.14; proposing 
          coding for new law in Minnesota Statutes, chapters 144 
          and 144A; repealing Minnesota Statutes 1986, sections 
          144.422; 144.424; 144.425; 144.471; 144.49, 
          subdivision 5; 144.692; 144.801, subdivision 8; and 
          144.94. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1986, section 115B.28, 
subdivision 4, is amended to read:  
    Subd. 4.  [ADMINISTRATIVE PERSONNEL AND SERVICES.] The 
board may appoint an executive director who is not a member of 
the board.  The executive director is in the unclassified 
service.  The commissioner of health shall provide staff 
assistance, administrative services, and office space under a 
contract with the board.  The board shall reimburse the 
commissioner for the staff, services, and space provided.  In 
order to perform its duties, the board may request information 
from the supervising officer of any state agency or state 
institution of higher education.  When requesting health data as 
defined in section 13.38 or sections 144.67 to 144.69, the board 
must submit a written release signed by the subject of the data 
or, if the subject is deceased, a representative of the 
deceased, authorizing release of the data in whole or in part.  
The supervising officer shall comply with the board's request to 
the extent possible considering available agency or institution 
appropriations and may assign agency or institution employees to 
assist the board in performing its duties under sections 115B.25 
to 115B.37. 
    Sec. 2.  Minnesota Statutes 1986, section 144.0722, is 
amended to read:  
    144.0722 [RESIDENT REIMBURSEMENT CLASSIFICATIONS; 
PROCEDURES FOR RECONSIDERATION.] 
    Subdivision 1.  [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] 
The commissioner of health shall establish resident 
reimbursement classifications based upon the assessments of 
residents of nursing homes and boarding care homes conducted 
under sections 144.072 and 144.0721, or under rules established 
by the commissioner of human services under sections 256B.41 to 
256B.48.  The reimbursement classifications established by the 
commissioner must conform to the rules established by the 
commissioner of human services. 
    Subd. 2.  [NOTICE OF RESIDENT REIMBURSEMENT 
CLASSIFICATION.] The commissioner of health shall notify each 
resident, and the nursing home or boarding care home in which 
the resident resides, of the reimbursement classification 
established under subdivision 1.  The notice must inform the 
resident of the classification that was assigned, the 
opportunity to review the documentation supporting the 
classification, the opportunity to obtain clarification from the 
commissioner, and the opportunity to request a reconsideration 
of the classification.  The notice of resident classification 
must be sent by first-class mail.  The individual resident 
notices may be sent to the resident's nursing home or boarding 
care home for distribution to the resident.  The nursing home or 
boarding care home is responsible for the distribution of the 
notice to each resident, to the person responsible for the 
payment of the resident's nursing home expenses, or to another 
person designated by the resident.  This notice must be 
distributed within three working days after the facility's 
receipt of the notices from the department. 
    Subd. 3.  [REQUEST FOR RECONSIDERATION.] The resident or 
the nursing home or boarding care home may request that the 
commissioner reconsider the assigned reimbursement 
classification.  The request for reconsideration must be 
submitted in writing to the commissioner within ten working 30 
days of the receipt of the notice of resident 
classification.  For reconsideration requests submitted by or on 
behalf of the resident, the time period for submission of the 
request begins as of the date the resident or the resident's 
representative receives the classification notice.  The request 
for reconsideration must include the name of the resident, the 
name and address of the facility in which the resident resides, 
the reasons for the reconsideration, the requested 
classification changes, and documentation supporting the 
requested classification.  The documentation accompanying the 
reconsideration request is limited to documentation establishing 
that the needs of the resident at the time of the assessment 
resulting in the disputed classification justify a change of 
classification. 
    Subd. 3a.  [ACCESS TO INFORMATION.] Upon written request, 
the nursing home or boarding care home must give the resident or 
the resident's representative a copy of the assessment form and 
the other documentation that was given to the department to 
support the assessment findings.  The nursing home or boarding 
care home shall also provide access to and a copy of other 
information from the resident's record that has been requested 
by or on behalf of the resident to support a resident's 
reconsideration request.  A copy of any requested material must 
be provided within three working days of receipt of a written 
request for the information.  If a facility fails to provide the 
material within this time, it is subject to the issuance of a 
correction order and penalty assessment under sections 144.653 
and 144A.10.  Notwithstanding those sections, any correction 
order issued under this subdivision must require that the 
facility immediately comply with the request for information and 
that as of the date of the issuance of the correction order, the 
facility shall forfeit to the state a $100 fine the first day of 
noncompliance, and an increase in the $100 fine by $50 
increments for each day the noncompliance continues.  For the 
purposes of this section, "representative" includes the 
resident's guardian or conservator, the person authorized to pay 
the nursing home expenses of the resident, a representative of 
the nursing home ombudsman's office whose assistance has been 
requested, or any other individual designated by the resident. 
    Subd. 3b.  [FACILITY'S REQUEST FOR RECONSIDERATION.] In 
addition to the information required in subdivision 3, a 
reconsideration request from a nursing home or boarding care 
home must contain the following information:  the date the 
resident reimbursement classification notices were received by 
the facility; the date the classification notices were 
distributed to the resident or the resident's representative; 
and a copy of a notice sent to the resident or to the resident's 
representative.  This notice must tell the resident or the 
resident's representative that a reconsideration of the 
resident's classification is being requested, the reason for the 
request, that the resident's rate will change if the request is 
approved by the department and the extent of the change, that 
copies of the facility's request and supporting documentation 
are available for review, and that the resident also has the 
right to request a reconsideration.  If the facility fails to 
provide this information with the reconsideration request, the 
request must be denied, and the facility may not make further 
reconsideration requests on that specific reimbursement 
classification. 
    Subd. 4.  [RECONSIDERATION.] The commissioner's 
reconsideration must be made by individuals not involved in 
reviewing the assessment that established the disputed 
classification.  The reconsideration must be based upon the 
initial assessment and upon the information provided to the 
commissioner under subdivision 3.  If necessary for evaluating 
the reconsideration request, the commissioner may conduct 
on-site reviews.  In its discretion, the commissioner may review 
the reimbursement classifications assigned to all residents in 
the facility.  Within 15 working days of receiving the request 
for reconsideration, the commissioner shall affirm or modify the 
original resident classification.  The original classification 
must be modified if the commissioner determines that the 
assessment resulting in the classification did not accurately 
reflect the needs of the resident at the time of the 
assessment.  The resident and the nursing home or boarding care 
home shall be notified within five working days after the 
decision is made.  The commissioner's decision under this 
subdivision is the final administrative decision of the agency. 
    Subd. 5.  [AUDIT AUTHORITY.] The department of health may 
audit assessments of nursing home and boarding care home 
residents.  These audits may be in addition to the assessments 
completed by the department under section 144.0721.  The audits 
may be conducted at the facility, and the department may conduct 
the audits on an unannounced basis. 
    Sec. 3.  Minnesota Statutes 1986, section 144.092, is 
amended to read:  
    144.092 [COORDINATED NUTRITION DATA COLLECTION.] 
    The commissioner of health shall may develop and coordinate 
a reporting system to improve the state's ability to document 
inadequate nutrient and food intake of Minnesota's children and 
adults and to identify problems and determine the most 
appropriate strategies for improving inadequate nutritional 
status.  The board on aging shall may develop a method to 
evaluate the nutritional status and requirements of the elderly 
in Minnesota.  The commissioner of health and the board on aging 
shall may report to the legislature on each July 1, beginning in 
1988, on the results of their investigation and their 
recommendations on the nutritional needs of Minnesotans. 
    Sec. 4.  [144.4171] [SCOPE.] 
    Subdivision 1.  [AUTHORITY.] Under the powers and duties 
assigned to the commissioner in sections 144.05 and 144.12, the 
commissioner shall proceed according to sections 4 to 19 with 
respect to persons who pose a health threat to others or who 
engage in noncompliant behavior.  
    Subd. 2.  [PREEMPTION.] Sections 4 to 19 preempt and 
supersede any local ordinance or rule concerning persons who 
pose a health threat to others or who engage in noncompliant 
behavior.  
    Sec. 5.  [144.4172] [DEFINITIONS.] 
    Subdivision 1.  [CARRIER.] "Carrier" means a person who 
serves as a potential source of infection and who harbors or who 
the commissioner reasonably believes to be harboring a specific 
infectious agent whether or not there is present discernible 
clinical disease.  In the absence of a medically accepted test, 
the commissioner may reasonably believe an individual to be a 
carrier only when a determination based upon specific facts 
justifies an inference that the individual harbors a specific 
infectious agent. 
    Subd. 2.  [COMMUNICABLE DISEASE.] "Communicable disease" 
means a disease or condition that causes serious illness, 
serious disability, or death, the infectious agent of which may 
pass or be carried, directly or indirectly, from the body of one 
person to the body of another. 
    Subd. 3.  [COMMISSIONER.] "Commissioner" means the 
commissioner of health. 
    Subd. 4.  [CONTACT NOTIFICATION PROGRAM.] "Contact 
notification program" means an ongoing program established by 
the commissioner to encourage carriers of a communicable disease 
whose primary route of transmission is through an exchange of 
blood, semen, or vaginal secretions, such as treponema pallidum, 
neisseria gonorrhea, chlamydia trachomatis, and human 
immunodeficiency virus, to identify others who may be at risk by 
virtue of contact with the carrier.  
    Subd. 5.  [DIRECTLY TRANSMITTED.] "Directly transmitted" 
means predominately: 
    (1) sexually transmitted; 
    (2) blood-borne; or 
    (3) transmitted through direct or intimate skin contact. 
    Subd. 6.  [HEALTH DIRECTIVE.] "Health directive" means a 
written statement, or, in urgent circumstances, an oral 
statement followed by a written statement within three days, 
from the commissioner, or local board of health with delegated 
authority from the commissioner, issued to a carrier who 
constitutes a health threat to others.  A health directive must 
be individual, specific, and cannot be issued to a class of 
persons.  The directive may require a carrier to cooperate with 
health authorities in efforts to prevent or control transmission 
of communicable disease, including participation in education, 
counseling, or treatment programs, and undergoing medical tests 
necessary to verify the person's carrier status.  The written 
directive shall be served in the same manner as a summons and 
complaint under the Minnesota Rules of Civil Procedure. 
    Subd. 7.  [LICENSED HEALTH PROFESSIONAL.] "Licensed health 
professional" means a person licensed in Minnesota to practice 
those professions described in section 214.01, subdivision 2.  
    Subd. 8.  [HEALTH THREAT TO OTHERS.] "Health threat to 
others" means that a carrier demonstrates an inability or 
unwillingness to conduct himself or herself in such a manner as 
to not place others at risk of exposure to infection that causes 
serious illness, serious disability, or death.  It includes one 
or more of the following: 
    (1) with respect to an indirectly transmitted communicable 
disease: 
    (a) behavior by a carrier which has been demonstrated 
epidemiologically to transmit or which evidences a careless 
disregard for the transmission of the disease to others; or 
     (b) a substantial likelihood that a carrier will transmit a 
communicable disease to others as is evidenced by a carrier's 
past behavior, or by statements of a carrier that are credible 
indicators of a carrier's intention. 
    (2) With respect to a directly transmitted communicable 
disease: 
    (a) repeated behavior by a carrier which has been 
demonstrated epidemiologically to transmit or which evidences a 
careless disregard for the transmission of the disease to others;
     (b) a substantial likelihood that a carrier will repeatedly 
transmit a communicable disease to others as is evidenced by a 
carrier's past behavior, or by statements of a carrier that are 
credible indicators of a carrier's intention; 
    (c) affirmative misrepresentation by a carrier of his or 
her carrier status prior to engaging in any behavior which has 
been demonstrated epidemiologically to transmit the disease; or 
    (d) the activities referenced in subdivision 8, clause (1) 
if the person whom the carrier places at risk is:  (i) a minor, 
(ii) of diminished capacity by reason of mood altering 
chemicals, including alcohol, (iii) has been diagnosed as having 
significantly subaverage intellectual functioning, (iv) has an 
organic disorder of the brain or a psychiatric disorder of 
thought, mood, perception, orientation, or memory which 
substantially impairs judgment, behavior, reasoning or 
understanding; (v) adjudicated as an incompetent; or (vi) a 
vulnerable adult as defined in section 626.557. 
    (3) Violation by a carrier of any part of a court order 
issued pursuant to this chapter. 
    Subd. 9.  [INDIRECTLY TRANSMITTED.] "Indirectly transmitted"
means any transmission not defined by subdivision 5. 
    Subd. 10.  [NONCOMPLIANT BEHAVIOR.] "Noncompliant behavior" 
means a failure or refusal by a carrier to comply with a health 
directive.  
    Subd. 11.  [RESPONDENT.] "Respondent" means any person 
against whom an action is commenced under sections 4 to 19. 
    Sec. 6.  [144.4173] [CAUSE OF ACTION.] 
    Subdivision 1.  [COMPLIANCE WITH DIRECTIVE.] Failure or 
refusal of a carrier to comply with a health directive is 
grounds for proceeding under subdivision 2. 
    Subd. 2.  [COMMENCEMENT OF ACTION.] The commissioner, or a 
local board of health with express delegated authority from the 
commissioner, may commence legal action against a carrier who is 
a health threat to others and, unless a court order is sought 
under section 15, who engages in noncompliant behavior, by 
filing with the district court in the county in which respondent 
resides, and serving upon respondent, a petition for relief and 
notice of hearing. 
    Sec. 7.  [144.4174] [STANDING.] 
    Only the commissioner, or a local board of health, with 
express delegated authority from the commissioner, may commence 
an action under sections 4 to 19. 
    Sec. 8.  [144.4175] [REPORTING.] 
    Subdivision 1.  [VOLUNTARY REPORTING.] Any licensed health 
professional or other human services professional regulated by 
the state who has knowledge or reasonable cause to believe that 
a person is a health threat to others or has engaged in 
noncompliant behavior, as defined in section 5, may report that 
information to the commissioner. 
    Subd. 2.  [LIABILITY FOR REPORTING.] A licensed health 
professional or other human services professional regulated by 
the state who has knowledge or reasonable cause to believe that 
a person is a health threat to others or has engaged in 
noncompliant behavior, and who makes a report in good faith 
under subdivision 1, is not subject to liability for reporting 
in any civil, administrative, disciplinary, or criminal action. 
    Subd. 3.  [FALSIFIED REPORTS.] Any person who knowingly or 
recklessly makes a false report under the provisions of this 
section shall be liable in a civil suit for any actual damages 
suffered by the person or persons so reported and for any 
punitive damages set by the court or jury. 
    Subd. 4.  [WAIVER OF PRIVILEGE.] Any privilege otherwise 
created in section 595.02, clauses (d), (e), (g) and (j), with 
respect to persons who make a report under subdivision 1, is 
waived regarding any information about a carrier as a health 
threat to others or about a carrier's noncompliant behavior in 
any investigation or action under sections 4 to 19. 
    Sec. 9.  [144.4176] [PETITION; NOTICE.] 
    Subdivision 1.  [PETITION.] The petition must set forth the 
following:  
    (1) the grounds and underlying facts that demonstrate that 
the respondent is a health threat to others and, unless an 
emergency court order is sought under section 15, has engaged in 
noncompliant behavior; 
     (2) the petitioner's efforts to alleviate the health threat 
to others prior to the issuance of a health directive, unless an 
emergency court order is sought under section 15; 
     (3) the petitioner's efforts to issue the health directive 
to the respondent in person, unless an emergency court order is 
sought under section 15; 
    (4) the type of relief sought; and 
    (5) a request for a court hearing on the allegations 
contained in the petition. 
    Subd. 2.  [HEARING NOTICE.] The notice must contain the 
following information: 
    (1) the time, date, and place of the hearing; 
    (2) respondent's right to appear at the hearing; 
    (3) respondent's right to present and cross-examine 
witnesses; and 
    (4) respondent's right to counsel, including the right, if 
indigent, to representation by counsel designated by the court 
or county of venue. 
    Sec. 10.  [144.4177] [TIME OF HEARING AND DUTIES OF 
COUNSEL.] 
    Subdivision 1.  [TIME OF HEARING.] A hearing on the 
petition must be held before the district court in the county in 
which respondent resides as soon as possible, but no later than 
14 days from service of the petition and hearing notice. 
     Subd. 2.  [DUTIES OF COUNSEL.] In all proceedings under 
this section, counsel for the respondent shall (1) consult with 
the person prior to any hearing; (2) be given adequate time to 
prepare for all hearings; (3) continue to represent the person 
throughout any proceedings under this charge unless released as 
counsel by the court; and (4) be a vigorous advocate on behalf 
of the client. 
    Sec. 11.  [144.4178] [CRIMINAL IMMUNITY.] 
    In accordance with section 609.09, subdivision 2, no person 
shall be excused in an action under sections 4 to 19 from giving 
testimony or producing any documents, books, records, or 
correspondence, tending to be self-incriminating; but the 
testimony or evidence, or other testimony or evidence derived 
from it, must not be used against the person in any criminal 
case, except for perjury committed in the testimony. 
    Sec. 12.  [144.4179] [STANDARD OF PROOF; EVIDENCE.] 
    Subdivision 1.  [CLEAR AND CONVINCING.] The commissioner 
must prove the allegations in the petition by clear and 
convincing evidence. 
    Subd. 2.  [ALL RELEVANT EVIDENCE.] The court shall admit 
all reliable relevant evidence.  Medical and epidemiologic data 
must be admitted if it otherwise comports with section 145.30, 
chapter 600, Minnesota Rules of Evidence 803(6), or other 
statutes or rules that permit reliable evidence to be admitted 
in civil cases. 
    Subd. 3.  [CARRIER STATUS.] Upon a finding by the court 
that the commissioner's suspicion of carrier status is 
reasonable as established by presentation of facts justifying an 
inference that the respondent harbors a specific infectious 
agent, there shall exist a rebuttable presumption that the 
respondent is a carrier.  This presumption may be rebutted if 
the respondent demonstrates noncarrier status after undergoing 
medically accepted tests. 
    Subd. 4.  [FAILURE TO APPEAR.] If a party fails to appear 
at the hearing without prior court approval, the hearing may 
proceed without the absent party and the court may make its 
determination on the basis of all reliable evidence submitted at 
the hearing. 
    Subd. 5.  [RECORDS.] The court shall take and preserve an 
accurate stenographic record of the proceedings. 
    Sec. 13.  [144.4180] [REMEDIES.] 
    Subdivision 1.  [REMEDIES AVAILABLE.] Upon a finding by the 
court that the commissioner has proven the allegations set forth 
in the petition, the court may order that the respondent must: 
    (1) participate in a designated education program; 
    (2) participate in a designated counseling program; 
    (3) participate in a designated treatment program; 
    (4) undergo medically accepted tests to verify carrier 
status or for diagnosis, or undergo treatment that is consistent 
with standard medical practice as necessary to make respondent 
noninfectious; 
    (5) notify or appear before designated health officials for 
verification of status, testing, or other purposes consistent 
with monitoring; 
    (6) cease and desist the conduct which constitutes a health 
threat to others; 
    (7) live part time or full time in a supervised setting for 
the period and under the conditions set by the court; 
    (8) subject to the provisions of subdivision 2, be 
committed to an appropriate institutional facility for the 
period and under the conditions set by the court, but not longer 
than six months, until the respondent is made noninfectious, or 
until the respondent completes a course of treatment prescribed 
by the court, whichever occurs first, unless the commissioner 
shows good cause for continued commitment; and 
    (9) comply with any combination of the remedies in clauses 
(1) to (8), or other remedies considered just by the court.  In 
no case may a respondent be committed to a correctional facility.
    Subd. 2.  [COMMITMENT REVIEW PANEL.] The court may not 
order the remedy specified in subdivision 1, clause (8) unless 
it first considers the recommendation of a commitment review 
panel appointed by the commissioner to review the need for 
commitment of the respondent to an institutional facility. 
      The duties of the commitment review panel shall be to: 
    (1) review the record of the proceeding; 
    (2) interview the respondent.  If the respondent is not 
interviewed, the reasons must be documented; and 
    (3) identify, explore, and list the reasons for rejecting 
or recommending alternatives to commitment. 
    Subd. 3.  [CONSTRUCTION.] This section shall be construed 
so that the least restrictive alternative is used to achieve the 
desired purpose of preventing or controlling communicable 
disease. 
    Subd. 4.  [ADDITIONAL REQUIREMENTS.] If commitment or 
supervised living is ordered, the court shall require the head 
of the institutional facility or the person in charge of 
supervision to submit:  (a) a plan of treatment within ten days 
of initiation of commitment or supervised living; and (b) a 
written report, with a copy to both the commissioner and the 
respondent, at least 60 days, but not more than 90 days, from 
the start of respondent's commitment or supervised living 
arrangement, setting forth the following: 
    (1) the types of support or therapy groups, if any, 
respondent is attending and how often respondent attends; 
    (2) the type of care or treatment respondent is receiving, 
and what future care or treatment is necessary; 
    (3) whether respondent has been cured or made 
noninfectious, or otherwise no longer poses a threat to public 
health; 
    (4) whether continued commitment or supervised living is 
necessary; and 
    (5) other information the court considers necessary. 
    Sec. 14.  [144.4181] [APPEAL.] 
     The petitioner or respondent may appeal the decision of the 
district court.  The court of appeals shall hear the appeal 
within 30 days after service of the notice of appeal.  However, 
respondent's status as determined by the district court remains 
unchanged, and any remedy ordered by the district court remains 
in effect while the appeal is pending. 
    Sec. 15.  [144.4182] [TEMPORARY EMERGENCY HOLD.] 
     Subdivision 1.  [APPREHEND AND HOLD.] To protect the public 
health in an emergency, the court may order a health officer or 
peace officer to take a person into custody and transport the 
person to an appropriate emergency care or treatment facility 
for observation, examination, testing, diagnosis, care, 
treatment, and, if necessary, temporary detention.  If the 
person is already institutionalized, the court may order the 
institutional facility to hold the person.  These orders may be 
issued in an ex parte proceeding upon an affidavit of the 
commissioner or a designee of the commissioner.  An order shall 
issue upon a determination by the court that reasonable cause 
exists to believe that the person is:  (a) for indirectly 
transmitted diseases, an imminent health threat to others; or 
(b) for directly transmitted diseases a substantial likelihood 
of an imminent health threat to others. 
    The affidavit must set forth the specific facts upon which 
the order is sought and must be served on the person immediately 
upon apprehension or detention.  An order under this section may 
be executed on any day and at any time. 
    Subd. 2.  [DURATION OF HOLD.] No person may be held under 
subdivision 1 longer than 72 hours, exclusive of Saturdays, 
Sundays, and legal holidays, without a court hearing to 
determine if the emergency hold should continue. 
    Sec. 16.  [144.4183] [EMERGENCY HOLD HEARING.] 
    Subdivision 1.  [TIME OF NOTICE.] Notice of the emergency 
hold hearing must be served upon the person held under section 
15, subdivision 1, at least 24 hours before the hearing. 
    Subd. 2.  [CONTENTS OF NOTICE.] The notice must contain the 
following information: 
    (1) the time, date, and place of the hearing; 
    (2) the grounds and underlying facts upon which continued 
detention is sought; 
    (3) the person's right to appear at the hearing; 
    (4) the person's right to present and cross-examine 
witnesses; and 
    (5) the person's right to counsel, including the right, if 
indigent, to representation by counsel designated by the court 
or county of venue. 
    Subd. 3.  [ORDER FOR CONTINUED EMERGENCY HOLD.] The court 
may order the continued holding of the person if it finds, by a 
preponderance of the evidence, that the person would pose an 
imminent health threat to others if released.  However, in no 
case may the emergency hold continue longer than five days, 
unless a petition is filed under section 6.  If a petition is 
filed, the emergency hold must continue until a hearing on the 
petition is held under section 10.  That hearing must occur 
within five days of the filing of the petition, exclusive of 
Saturdays, Sundays, and legal holidays. 
    Sec. 17.  [144.4184] [CONTACT DATA.] 
    Identifying information voluntarily given to the 
commissioner, or an agent of the commissioner, by a carrier 
through a contact notification program must not be used as 
evidence in a court proceeding to determine noncompliant 
behavior. 
    Sec. 18.  [144.4185] [COSTS.] 
    Subdivision 1.  [COSTS OF CARE.] The court shall determine 
what part of the cost of care or treatment ordered by the court, 
if any, the respondent can pay.  The respondent shall provide 
the court documents and other information necessary to determine 
financial ability.  If the respondent cannot pay the full cost 
of care, the rest must be paid by the county in which respondent 
resides.  If the respondent provides inaccurate or misleading 
information, or later becomes able to pay the full cost of care, 
the respondent becomes liable to the county for costs paid by 
the county. 
    Subd. 2.  [COURT-APPOINTED COUNSEL.] If the court appoints 
counsel to represent respondent free of charge, counsel must be 
compensated by the county in which respondent resides, except to 
the extent that the court finds that the respondent is 
financially able to pay for counsel's services.  In these 
situations, the rate of compensation for counsel shall be 
determined by the court. 
      Subd. 3.  [REPORT.] The commissioner shall report any 
recommendations for appropriate changes in the modes of 
financing of services provided under subdivision 1 by January 
15, 1988. 
    Sec. 19.  [144.4186] [DATA PRIVACY.] 
    Subdivision 1.  [NONPUBLIC DATA.] Data contained in a 
health directive are classified as protected nonpublic data 
under section 13.02, subdivision 13, in the case of data not on 
individuals, and private under section 13.02, subdivision 12, in 
the case of data on individuals.  Investigative data shall have 
the classification accorded it under section 13.39. 
    Subd. 2.  [PROTECTIVE ORDER.] Once an action is commenced, 
any party may seek a protective order to protect the disclosure 
of portions of the court record identifying individuals or 
entities. 
     Subd. 3.  [RECORDS RETENTION.] A records retention schedule 
for records developed under sections 4 to 19 shall be 
established pursuant to section 138.17, subdivision 7. 
    Sec. 20.  Minnesota Statutes 1986, section 144.50, 
subdivision 1, is amended to read:  
    Subdivision 1.  (a) No person, partnership, association, or 
corporation, nor any state, county, or local governmental units, 
nor any division, department, board, or agency thereof, shall 
establish, operate, conduct, or maintain in the state any 
hospital, sanatorium or other institution for the 
hospitalization or care of human beings without first obtaining 
a license therefor in the manner provided in sections 144.50 to 
144.56.  No person or entity shall advertise a facility 
providing services required to be licensed under sections 144.50 
to 144.56 without first obtaining a license. 
    (b) A violation of this subdivision is a misdemeanor 
punishable by a fine of not more than $300.  The commissioner 
may seek an injunction in the district court against the 
continuing operation of the unlicensed institution.  Proceedings 
for securing an injunction may be brought by the attorney 
general or by the appropriate county attorney. 
    (c) The sanctions in this subdivision do not restrict other 
available sanctions. 
    Sec. 21.  Minnesota Statutes 1986, section 144.50, 
subdivision 2, is amended to read:  
    Subd. 2.  Hospital, sanatorium or other institution for the 
hospitalization or care of human beings, within the meaning of 
sections 144.50 to 144.56 shall mean any institution, place, 
building, or agency, in which any accommodation is maintained, 
furnished, or offered for five or more persons for:  the 
hospitalization of the sick or injured; the provision of care in 
a swing bed authorized under section 144.562; elective 
outpatient surgery for preexamined, prediagnosed low risk 
patients; emergency medical services offered 24 hours a day, 
seven days a week, in an ambulatory or outpatient setting in a 
facility not a part of a licensed hospital; or the institutional 
care of human beings.  Nothing in sections 144.50 to 144.56 
shall apply to a clinic, a physician's office or to hotels or 
other similar places that furnish only board and room, or 
either, to their guests. 
    Sec. 22.  [144.555] [HOSPITAL CLOSINGS; PATIENT 
RELOCATIONS.] 
    Subdivision 1.  [NOTICE OF CLOSING OR CURTAILING 
SERVICE.] If a facility licensed under sections 144.50 to 144.56 
voluntarily plans to cease operations or to curtail operations 
to the extent that patients or residents must be relocated, the 
controlling persons of the facility must notify the commissioner 
of health at least 90 days before the scheduled cessation or 
curtailment.  The commissioner shall cooperate with the 
controlling persons and advise them about relocating the 
patients or residents. 
    Subd. 2.  [PENALTY.] Failure to notify the commissioner 
under subdivision 1 may result in issuance of a correction order 
under section 144.653, subdivision 5. 
    Sec. 23.  Minnesota Statutes 1986, section 144.653, 
subdivision 3, is amended to read:  
    Subd. 3.  [ENFORCEMENT.] With the exception of the 
department of public safety which has the exclusive jurisdiction 
to enforce state fire and safety standards, the state 
commissioner of health is the exclusive state agency charged 
with the responsibility and duty of inspecting facilities 
required to be licensed under the provisions of sections 144.50 
to 144.58 and enforcing the rules and standards prescribed by it.
    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.  The identities of patients or 
residents must be kept private as defined by section 13.02, 
subdivision 12. 
    Sec. 24.  Minnesota Statutes 1986, section 144.802, 
subdivision 3, is amended to read:  
    Subd. 3.  (a) Each prospective licensee and each present 
licensee wishing to offer a new type or types of life support 
transportation service, to establish a new base of operation, or 
to expand a primary service area, shall make written application 
for a license to the commissioner on a form provided by the 
commissioner.  
    (b) For applications for the provision of life support 
transportation services in a service area located within a 
county, the commissioner shall promptly send notice of the 
completed application to the health systems agency or agencies, 
the county board and to each community health service agency or 
agencies board, regional emergency medical services system 
designated under section 144.8093, life support transportation 
service, and each municipality and county in the area in which 
life support transportation service would be provided by the 
applicant.  The commissioner shall publish the notice, at the 
applicant's expense, in the state register and in a newspaper in 
the municipality in which the service would be provided base of 
operation will be located, or if no newspaper is published in 
the municipality or if the service would be provided in more 
than one municipality, in a newspaper published at the county 
seat of the county or counties in which the service would be 
provided.  
    (b) (c) For applications for the provision of life support 
transportation services in a service area larger than a county, 
the commissioner shall promptly send notice of the completed 
application to the municipality in which the service's base of 
operation will be located and to each community health board, 
county board, regional emergency medical services system 
designated under section 144.8093, and life support 
transportation service located within the service area described 
by the applicant.  The commissioner shall publish this notice, 
at the applicant's expense, in the State Register and in a 
newspaper with statewide circulation.  
    (d) The commissioner shall request that the chief 
administrative law judge appoint an administrative law judge to 
hold a public hearing in the municipality in which the service's 
base of operation will be located.  The public hearing shall be 
conducted as contested case hearing under chapter 14. 
    (e) Each municipality, county, community health service, 
regional emergency medical services system, life support 
transportation service, and other person wishing to make 
recommendations concerning the disposition of the application 
shall make written recommendations to the health systems agency 
in its area administrative law judge within 30 days of the 
publication of notice of the application in the State Register.  
    (c) (f) The health systems agency or 
agencies administrative law judge shall:  
    (1) hold a public hearing in the municipality in which the 
service's base of operations is or will be located;  
    (2) provide notice of the public hearing in the newspaper 
or newspapers in which notice was published under part (a) (b) 
or (c) for two successive weeks at least ten days before the 
date of the hearing;  
    (3) allow any interested person the opportunity to be 
heard, to be represented by counsel, and to present oral and 
written evidence at the public hearing;  
    (4) provide a transcript of the hearing at the expense of 
any individual requesting it; and 
    (5) follow any further procedure not inconsistent with 
chapter 14, which it deems appropriate.  
    (d) (g) The health systems agency or 
agencies administrative law judge shall review and comment upon 
the application and shall make written recommendations as to its 
disposition to the commissioner within 90 days of receiving 
notice of the application.  In making the recommendations, 
the health systems agency or agencies administrative law judge 
shall consider and make written comments as to whether the 
proposed service, change in base of operations, or expansion in 
primary service area is needed, based on consideration of the 
following factors:  
    (1) the relationship of the proposed service, change in 
base of operations or expansion in primary service area to the 
current health systems and annual implementation plans community 
health plan as approved by the commissioner under section 
145.918;  
    (2) the recommendations or comments of the governing bodies 
of the counties and municipalities in which the service would be 
provided;  
    (3) the deleterious effects on the public health from 
duplication, if any, of life support transportation services 
that would result from granting the license;  
    (4) the estimated effect of the proposed service, change in 
base of operation or expansion in primary service area on the 
public health;  
    (5) whether any benefit accruing to the public health would 
outweigh the costs associated with the proposed service, change 
in base of operations, or expansion in primary service area.  
    The health systems agency or agencies administrative law 
judge shall recommend that the commissioner either grant or deny 
a license or recommend that a modified license be granted.  The 
reasons for the recommendation shall be set forth in detail.  
The health systems agency or agencies administrative law judge 
shall make the recommendations and reasons available to any 
individual requesting them.  
    Sec. 25.  Minnesota Statutes 1986, section 144.802, 
subdivision 4, is amended to read:  
    Subd. 4.  Within 30 days after receiving the health systems 
agency recommendations administrative law judge's report, the 
commissioner shall grant or deny a license to the applicant.  In 
granting or denying a license, the commissioner shall consider 
the health systems agency recommendations administrative law 
judge's report, the evidence contained in the application, and 
any hearing record and other applicable evidence, and whether 
any benefit accruing to the public health would outweigh the 
costs associated with the proposed service, change in base of 
operations, or expansion in primary service area.  The 
commissioner's decision shall be based on a consideration of the 
factors contained in subdivision 3, clause (f).  If the 
commissioner's decision is different from the health systems 
agency administrative law judge's recommendations, the 
commissioner shall set forth in detail the reasons for differing 
from the recommendations.  
    Sec. 26.  Minnesota Statutes 1986, section 144A.10, 
subdivision 1, is amended to read:  
    Subdivision 1.  [ENFORCEMENT AUTHORITY.] 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.02.  The commissioner of health 
shall enforce the rules established pursuant to sections 144A.01 
to 144A.17, 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 245.781 to 245.821 
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.  The identities of patients or 
residents must be kept private as defined by section 13.02, 
subdivision 12. 
    Sec. 27.  Minnesota Statutes 1986, section 144A.10, 
subdivision 2, is amended to read:  
    Subd. 2.  [INSPECTIONS.] The commissioner of health shall 
inspect each nursing home to ensure compliance with sections 
144A.01 to 144A.17 and the rules promulgated to implement them.  
The inspection shall be a full inspection of the nursing home.  
If upon a reinspection provided for in subdivision 5 the 
representative of the commissioner of health finds one or more 
uncorrected violations, a second inspection of the facility 
shall be conducted.  The second inspection need not be a full 
inspection.  No prior notice shall be given of an inspection 
conducted pursuant to this subdivision.  Any employee of the 
commissioner of health who willfully gives or causes to be given 
any advance notice of an inspection required or authorized by 
this subdivision shall be subject to suspension or dismissal in 
accordance with chapter 43A.  An inspection required by a 
federal rule or statute may be conducted in conjunction with or 
subsequent to any other inspection.  Any inspection required by 
this subdivision may be in addition to or in conjunction with 
the reinspections required by subdivision 5.  Nothing in this 
subdivision shall be construed to prohibit the commissioner of 
health from making more than one unannounced inspection of any 
nursing home during its license year.  The commissioner of 
health shall coordinate inspections of nursing homes with 
inspections by other state and local agencies consistent with 
the requirements of this section and the Medicare and Medicaid 
certification programs. 
    The commissioner shall conduct inspections and 
reinspections of health facilities with a frequency and in a 
manner calculated to produce the greatest benefit to residents 
within the limits of the resources available to the 
commissioner.  In performing this function, the commissioner may 
devote proportionately more resources to the inspection of those 
facilities in which conditions present the most serious concerns 
with respect to resident health, treatment, comfort, safety, and 
well-being.  
    These conditions include but are not limited to:  change in 
ownership; frequent change in administration in excess of normal 
turnover rates; complaints about care, safety, or rights; where 
previous inspections or reinspections have resulted in 
correction orders related to care, safety, or rights; and, where 
persons involved in ownership or administration of the facility 
have been indicted for alleged criminal activity.  Any facility 
that has none of the above conditions or any other condition 
established by the commissioner that poses a risk to resident 
care, safety, or rights shall be inspected once every two years. 
    Sec. 28.  [144A.115] [VIOLATIONS; PENALTIES.] 
    Subdivision 1.  [OPERATING WITHOUT A LICENSE.] The 
operation of a facility providing services required to be 
licensed under sections 144A.02 to 144A.10 without a license is 
a misdemeanor punishable by a fine of not more than $300. 
    Subd. 2.  [ADVERTISING WITHOUT A LICENSE.] A person or 
entity that advertises a facility required to be licensed under 
sections 144A.02 to 144A.10 before obtaining a license is guilty 
of a misdemeanor. 
    Subd. 3.  [OTHER SANCTIONS.] The sanctions in this section 
do not restrict other available sanctions. 
    Sec. 29.  Minnesota Statutes 1986, section 144A.16, is 
amended to read:  
    144A.16 [CESSATION OF OPERATIONS.] 
    If a nursing home voluntarily plans to cease operations or 
to curtail operations to the extent that relocation of residents 
is necessary, the controlling persons of the facility shall 
notify the commissioner of health at least 90 days prior to the 
scheduled cessation or curtailment.  The commissioner of health 
shall cooperate with and advise the controlling persons of the 
nursing home in the resettlement of residents.  Failure to 
comply with this section shall be a violation of section 144A.10.
    Sec. 30.  Minnesota Statutes 1986, section 144A.31, is 
amended to read:  
    144A.31 [INTERAGENCY BOARD FOR QUALITY ASSURANCE.] 
    Subdivision 1.  [INTERAGENCY BOARD.] The commissioners of 
health and human services shall establish, by July 1, 1983, an 
interagency board of employees of their respective departments 
who are knowledgeable and employed in the areas of long-term 
care, geriatric care, long-term care facility inspection, or 
quality of care assurance.  The number of interagency board 
members shall not exceed seven eight; three members each to 
represent the commissioners of health and human services and one 
member each to represent the commissioner of public safety in 
the enforcement of fire and safety standards in nursing homes.  
The commissioner of human services or a designee shall chair and 
convene the board directors of state planning and housing 
finance.  The board shall identify long-term care issues 
requiring coordinated interagency policies and shall conduct 
analyses, coordinate policy development, and make 
recommendations to the commissioners for effective 
implementation of these policies.  The commissioner of human 
services and the commissioner of health or their designees shall 
annually alternate chairing and convening the board.  The board 
may utilize the expertise and time of other individuals employed 
by either department as needed.  The board may recommend that 
the commissioners contract for services as needed.  The board 
shall meet as often as necessary to accomplish its duties, but 
at least monthly quarterly.  The board shall establish 
procedures, including public hearings, for allowing regular 
opportunities for input from residents, nursing homes, and other 
interested persons.  
    Subd. 2.  [INSPECTIONS.] No later than January 1, 1984 
1988, the board shall develop and recommend implementation and 
enforcement of an effective system to ensure quality of care in 
each nursing home in the state.  Quality of care includes 
evaluating, using the resident's care plan, whether the 
resident's ability to function is optimized and should not be 
measured solely by the number or amount of services provided.  
    The board shall assist the commissioner of health in 
ensuring developing methods to ensure that inspections and 
reinspections of nursing homes are conducted with a frequency 
and in a manner calculated to most effectively and appropriately 
fulfill its quality assurance responsibilities and achieve the 
greatest benefit to nursing home residents.  The board shall 
identify and recommend criteria and methods for identifying 
those nursing homes that present the most serious concerns with 
respect to resident health, treatment, comfort, safety, and 
well-being.  The commissioner of health shall require a higher 
frequency and extent of inspections with respect to those 
nursing homes that present the most serious concerns with 
respect to resident health, treatment, comfort, safety, and 
well-being.  These concerns include but are not limited to: 
complaints about care, safety, or rights; situations where 
previous inspections or reinspections have resulted in 
correction orders related to care, safety, or rights; instances 
of frequent change in administration in excess of normal 
turnover rates; and situations where persons involved in 
ownership or administration of the nursing home have been 
convicted of engaging in criminal activity.  A nursing home that 
presents none of these concerns or any other concern or 
condition recommended by the board and established by the board 
commissioner that poses a risk to resident care, safety, or 
rights shall be inspected once every two years for compliance 
with key requirements as determined by the board. 
    The board shall develop and recommend to the commissioners 
mechanisms beyond the inspection process to protect resident 
care, safety, and rights, including but not limited to 
coordination with the office of health facility complaints and 
the nursing home ombudsman program.  
    Subd. 3.  [METHODS FOR DETERMINING RESIDENT CARE NEEDS.] 
The board shall develop and recommend to the commissioners 
definitions for levels of care and methods for determining 
resident care needs for implementation on July 1, 1985 in order 
to adjust payments for resident care based on the mix of 
resident needs in a nursing home.  The methods for determining 
resident care needs shall include assessments of ability to 
perform activities of daily living and assessments of medical 
and therapeutic needs.  
    Subd. 4.  [ENFORCEMENT.] The board shall develop and 
recommend for implementation effective methods of enforcing 
quality of care standards.  When it deems necessary, and when 
all other methods of enforcement are not appropriate, the board 
shall recommend to the commissioner of health closure of all or 
part of a nursing home or certified boarding care home and 
revocation of the license.  The board shall develop and monitor, 
and the commissioner of human services shall implement, a 
resident relocation plan that instructs the a county in which 
the a nursing home or certified boarding care home is located of 
procedures to ensure that the needs of residents in nursing 
homes or certified boarding care homes about to be closed are 
met.  The duties of a county under the relocation plan also 
apply when residents are to be discharged from a nursing home or 
certified boarding care home as a result of a change in 
certification, closure, or loss or termination of the facility's 
medical assistance provider agreement.  The resident relocation 
plans and county duties required in this subdivision apply to 
the voluntary or involuntary closure, or reduction in services 
or size of, an intermediate care facility for the mentally 
retarded.  The relocation plan for intermediate care facilities 
for the mentally retarded must conform to Minnesota Rules, parts 
4655.6810 to 4655.6830, 9525.0015 to 9525.0165, and 9546.0010 to 
9546.0060, or their successors.  The commissioners of health and 
human services may waive a portion of existing rules that the 
commissioners determine does not apply to persons with mental 
retardation or related conditions.  The county shall ensure 
appropriate placement in swing beds in hospitals, placement in 
unoccupied beds in other nursing homes, utilization of residents 
in licensed and certified facilities or other alternative care 
such as home health care on a temporary basis, and foster care 
placement, or other appropriate alternative care.  In preparing 
for relocation, the board shall ensure that residents and their 
families or guardians are involved in planning the relocation.  
    Subd. 5.  [REPORTS.] The board shall prepare a report and 
the commissioners of health and human services shall deliver 
this report to the legislature no later than January 15, 1984, 
on the board's proposals and progress on implementation of the 
methods required under subdivisions subdivision 2, 3, and 4.  
The commissioners shall recommend changes in or additions to 
legislation necessary or desirable to fulfill their 
responsibilities.  The board shall prepare an annual report and 
the commissioners shall deliver this report annually to the 
legislature, beginning in January, 1985, on the implementation 
and enforcement of the provisions of this section. 
    Subd. 6.  [DATA.] The interagency board may have access to 
data from the commissioners of health, human services, and 
public safety for carrying out its duties under this section. 
The commissioner of health and the commissioner of human 
services may each have access to data on persons, including data 
on vendors of services, from the other to carry out the purposes 
of this section.  If the interagency board, the commissioner of 
health, or the commissioner of human services receives data on 
persons, including data on vendors of services, that is 
collected, maintained, used or disseminated in an investigation, 
authorized by statute and relating to enforcement of rules or 
law, the board or the commissioner shall not disclose that 
information except:  
     (a) pursuant to section 13.05;  
     (b) pursuant to statute or valid court order; or 
     (c) to a party named in a civil or criminal proceeding, 
administrative or judicial, for preparation of defense.  
     Data described in this subdivision is classified as public 
data upon its submission to an administrative law judge or court 
in an administrative or judicial proceeding.  
    Sec. 31.  Minnesota Statutes 1986, section 144A.53, 
subdivision 1, is amended to read:  
    Subdivision 1.  [POWERS.] The director may: 
    (a) 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 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;. 
    (b) Recommend legislation and changes in rules to the state 
commissioner of health, legislature, governor, administrative 
agencies or the federal government;. 
    (c) Investigate, upon a complaint or upon initiative of the 
director, any action or failure to act by a health care provider 
or a health facility;. 
    (d) Request and receive access to relevant information, 
records, incident reports, or documents in the possession of an 
administrative agency, a health care provider, 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. 
    (e) Enter and inspect, at any time, a health facility 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 or the activities of a patient 
or resident unless the patient or resident consents;.  
    (f) Issue a correction order pursuant to section 144.653 or 
any other law which provides for the issuance of correction 
orders to health care facilities;.  A facility's refusal to 
cooperate in providing lawfully requested information may also 
be grounds for a correction order. 
    (g) Recommend the certification or decertification of 
health facilities pursuant to Title XVIII or Title XIX of the 
United States Social Security Act;. 
    (h) Assist patients or residents of health facilities in 
the enforcement of their rights under Minnesota law; and.  
    (i) Work with administrative agencies, health facilities, 
health care providers and organizations representing consumers 
on programs designed to provide information about health 
facilities to the public and to health facility residents.  
    Sec. 32.  Minnesota Statutes 1986, section 145.881, 
subdivision 1, is amended to read:  
    Subdivision 1.  [COMPOSITION OF TASK FORCE.] The 
commissioner shall establish and appoint a maternal and child 
health advisory task force consisting of 15 members who will 
provide equal representation from:  
    (1) professionals with expertise in maternal and child 
health services;  
    (2) representatives of local health boards as defined in 
section 145.913; and 
    (3) consumer representatives interested in the health of 
mothers and children.  
    No members shall be employees of the state department of 
health.  Task force members shall be appointed and removed as 
provided in section 15.059, subdivision 6.  Notwithstanding 
section 15.059, subdivisions 5 and 6, 2 and 4.  The maternal and 
child health advisory task force shall terminate on June 30, 
1987 the date provided by section 15.059, subdivision 5, and 
members shall receive compensation as provided in section 
15.059, subdivision 6. 
    Sec. 33.  Minnesota Statutes 1986, section 145.882, 
subdivision 4, is amended to read:  
    Subd. 4.  [DISTRIBUTION FORMULA.] The amount available for 
each community health services area is determined according to 
the following formula:  
    (a) Each community health services area is allocated an 
amount based on the following three variables:  
    (1) the proportion of resident mothers within the city, 
county, or counties who are under 20 years of age or over 35 
years of age, as determined by averaging the data available for 
the three most current years; 
    (2) the proportion of resident infants within the city, 
county, or counties whose weight at birth is less than 2,500 
grams, as determined by averaging the data available for the 
three most current years; and 
    (3) the proportion of resident children within the city, 
county, or counties under the age of 19 who are on general 
assistance or medical assistance and the proportion of resident 
women within the city, county, or counties aged 19 to 49 who are 
on general assistance or medical assistance, as determined by 
using the data available for the most current year.  
    (b) Each variable is expressed as a city or county score 
consisting of the city or county frequency of each variable 
divided by the statewide frequency of the variable.  
    (c) A total score for each city or county jurisdiction is 
computed by totaling the scores of the three factors and 
dividing the total by three.  The resulting amount is added to 
the total score for the most recent two-year grant period and 
the sum is divided by two.  
    (d) Each community health services area is allocated an 
amount equal to the total score obtained above for the city, 
county, or counties in its area multiplied by the amount of 
money available for special projects of local significance.  
    Sec. 34.  Minnesota Statutes 1986, section 157.01, is 
amended to read:  
    157.01 [DEFINITIONS.] 
    Subdivision 1.  [TYPES OF ESTABLISHMENTS.] Every building 
or structure or enclosure, or any part thereof, kept, used as, 
maintained as, or advertised as, or held out to the public to be 
an enclosure where sleeping accommodations are furnished to the 
public and furnishing accommodations for periods of less than 
one week shall for the purpose of this chapter be deemed an 
hotel.  
    Every building or other structure or enclosure, or any part 
thereof and all buildings in connection, kept, used or 
maintained as, or advertised as, or held out to the public to be 
an enclosure where meals or lunches are served or prepared for 
service elsewhere shall for the purpose of this chapter be 
deemed to be a restaurant, and the person in charge thereof, 
whether as owner, lessee, manager or agent, for the purpose of 
this chapter shall be deemed the proprietor of the restaurant, 
and whenever the word "restaurant" occurs in this chapter, it 
shall be construed to mean a structure as described in this 
section.  
    Every building or structure, or any part thereof, kept, 
used as, maintained as, advertised as, or held out to be a place 
where sleeping accommodations are furnished to the public as 
regular roomers, for periods of one week or more, and having 
five or more beds to let to the public, shall, for the purpose 
of this chapter, be deemed a lodging house.  
    Every building or structure or enclosure, or any part 
thereof, used as, maintained as, or advertised as, or held out 
to be an enclosure where meals or lunches are furnished to five 
or more regular boarders, whether with or without sleeping 
accommodations, for periods of one week or more, shall, for the 
purpose of this chapter, be deemed a boarding house.  
    Every building or structure, or any part thereof, used as, 
maintained as, or advertised as, or held out to be a place where 
confectionery, ice cream, or drinks of various kinds are made, 
sold or served at retail, shall, for the purpose of this 
chapter, be deemed to be a place of refreshment.  This chapter 
shall not be applicable in any manner to a general merchandise 
store, grocery store, oil station, cigar stand, confectionery 
store, or drug store not providing meals, lunches, lodging, or 
fountain, bar, booth, or table service.  
    For the purpose of this chapter, a resort means any 
building, structure, or enclosure, or any part thereof, located 
on, or on property neighboring, any lake, stream, or skiing or 
hunting area for purposes of providing convenient access 
thereto, kept, used, maintained, or advertised as, or held out 
to the public to be an enclosure where sleeping accommodations 
are furnished to the public, and primarily to those seeking 
recreation, for periods of one day, one week, or longer, and 
having for rent five or more cottages, rooms, or enclosures.  
    Subd. 2.  [LEVELS OF RISK.] (a) "High-risk establishment" 
means any lodging house, hotel, motel, restaurant, boarding 
house, place of refreshment, or resort that:  
    (1) serves potentially hazardous foods that require 
extensive processing on the premises, including manual handling, 
cooling, reheating, or holding for service;  
    (2) prepares foods several hours or days before service;  
    (3) serves menu items that epidemiologic experience has 
demonstrated to be common vehicles of food-borne illness; 
    (4) has a public swimming pool; 
    (5) draws its drinking water from a surface water supply; 
or 
    (6) has an on-site sewage disposal system and is located in 
an area where conditions are less favorable for the successful 
operation of such a system. 
    (b) "Medium-risk establishment" means a hotel, motel, 
restaurant, lodging house, boarding house, place of refreshment, 
or resort that: 
    (1) serves potentially hazardous foods but with minimal 
holding between preparation and service; 
    (2) serves low-risk foods that may or may not be 
potentially hazardous but require extensive handling, such as 
baked goods and pizzas; 
    (3) serves large volumes of food even though the food-borne 
illness risk is low; or 
    (4) is a lodging establishment with 25 or more units. 
    (c) "Low-risk establishment" means a hotel, motel, 
restaurant, lodging house, boarding house, place of refreshment, 
or resort that is not a high-risk or medium-risk establishment.  
    Sec. 35.  Minnesota Statutes 1986, section 157.02, is 
amended to read:  
    157.02 [HOTEL INSPECTOR INSPECTION RECORDS.] 
    The hotel inspector commissioner of health shall keep a set 
of books for public use and inspection showing the condition of 
all hotels, motels, restaurants, lodging houses, boarding 
houses, resorts, and places of refreshment, together with the 
name of the owner, proprietor, or manager thereof, showing their 
sanitary condition, and any other information that may be for 
the betterment of the public service, and likewise assist in the 
enforcement of any orders promulgated by the state commissioner 
of health and the department of agriculture issue orders for 
correction of violations relating to hotels, motels, 
restaurants, lodging houses, boarding houses, resorts, and 
places of refreshment. 
    Sec. 36.  Minnesota Statutes 1986, section 157.04, is 
amended to read:  
    157.04 [ANNUAL INSPECTION.] 
    It shall be the duty of the hotel inspector commissioner of 
health to inspect, or cause to be inspected, at least once 
annually, every hotel, motel, restaurant, lodging house, 
boarding house, or resort, or place of refreshment in this 
state.  The frequency of inspections must be based on the degree 
of hazard to the public.  High-risk establishments must be 
inspected at least once a year.  Medium-risk establishments must 
be inspected at least once every 18 months.  Low-risk 
establishments must be inspected at least once every two years.  
For this the purpose of conducting inspections, the inspector 
commissioner shall have the right to enter and have access 
thereto at any time during the conduct of business and when, 
upon inspection, it shall be found that the business and 
property so inspected is not being conducted, or is not 
equipped, in the manner required by the provisions of this 
chapter or the rules of the state commissioner of health, or is 
being conducted in violation of any of the laws of this state 
pertaining to the business, it shall thereupon be the duty of 
the hotel inspector commissioner to notify the owner, 
proprietor, or agent in charge of the business, or the owner or 
agent of the buildings so occupied, of the condition so found.  
Each owner, proprietor, or agent shall forthwith comply with the 
provisions of this chapter or the rules of the commissioner, 
unless otherwise herein provided.  A reasonable time may be 
granted by the hotel inspector commissioner for compliance with 
the provisions of this chapter. 
    Sec. 37.  Minnesota Statutes 1986, section 157.09, is 
amended to read:  
    157.09 [REVOCATION OF LICENSE.] 
    It shall be the duty of the state hotel inspector 
commissioner of health to revoke a license, on the inspector's 
commissioner's finding that a place of business is being 
operated in violation of the provisions of this chapter or rules 
of the state commissioner of health, so as to constitute a 
filthy, unclean, and insanitary condition and dangerous to 
public health; or, if the owner or proprietor persistently 
refuses or fails to comply with the provisions of this chapter 
or rules of the commissioner.  Upon revocation of a license, the 
place of business shall be immediately closed to public 
patronage until such time as the owner or proprietor shall have 
complied with the provisions of this chapter, as certified to by 
the issuance of a new license. 
    The third revocation of license in any one year and on any 
one proprietor shall be made permanent for a period of one year 
from the date of the last revocation. 
    Sec. 38.  Minnesota Statutes 1986, section 157.14, is 
amended to read:  
    157.14 [EXEMPTIONS.] 
    This chapter shall not be construed to apply to interstate 
carriers under the supervision of the United States Department 
of Health, Education and Welfare or to any building constructed 
and primarily used for religious worship, nor to any building 
owned, operated and used by a college or university in 
accordance with regulations promulgated by the college or 
university.  Any person, firm or corporation whose principal 
mode of business is licensed under sections 28A.04 and 28A.05 is 
exempt at that premises from licensure as a place of refreshment 
or restaurant; provided, that the holding of any license 
pursuant to sections 28A.04 and 28A.05 shall not exempt any 
person, firm, or corporation from the applicable provisions of 
the chapter or the rules of the state commissioner of health 
relating to food and beverage service establishments.  This 
chapter does not apply to family day-care homes or group family 
day-care homes governed by sections 245.781 to 245.812. 
    Sec. 39.  [INSTRUCTION TO REVISOR.] 
    In the next and later editions of Minnesota Statutes, the 
revisor of statutes shall change the words "life support 
transportation service" to "ambulance service" in sections 
144.801 to 144.8093 and 174.29. 
    Sec. 40.  [REPEALER.] 
    Minnesota Statutes 1986, sections 144.422; 144.424; 144.425;
144.471; 144.49, subdivision 5; 144.692; 144.801, subdivision 8; 
and 144.94, are repealed. 
    Sec. 41.  [EFFECTIVE DATE.] 
    Sections 1 to 40 are effective July 1, 1987. 
    Approved May 26, 1987