1.1                          A bill for an act 
  1.2             relating to health; modifying requirements relating to 
  1.3             home care providers and elderly housing with services 
  1.4             establishments; providing for licensure of elderly 
  1.5             housing with services home care providers; eliminating 
  1.6             licensure requirement for residential care homes; 
  1.7             amending Minnesota Statutes 1996, sections 144.057, 
  1.8             subdivision 1; 144A.43, subdivision 4, and by adding 
  1.9             subdivisions; 144A.45, subdivision 1; 144A.46, 
  1.10            subdivisions 1 and 2; 144D.01, subdivisions 4, 5, and 
  1.11            6; 144D.03, subdivision 1; 144D.06; 157.17, 
  1.12            subdivisions 2, 3, and 7; 256B.071, subdivision 1; 
  1.13            256I.04, subdivision 2a; 295.50, subdivision 4; 
  1.14            299C.67, subdivision 5; and 609.7495, subdivision 1; 
  1.15            proposing coding for new law in Minnesota Statutes, 
  1.16            chapter 144A; repealing Minnesota Statutes 1996, 
  1.17            sections 144A.45, subdivision 3; 144B.01; 144B.02; 
  1.18            144B.03; 144B.04; 144B.05; 144B.06; 144B.07; 144B.08; 
  1.19            144B.09; 144B.10; 144B.11; 144B.12; 144B.13; 144B.14; 
  1.20            144B.15; 144B.16; 144B.17; and 157.17, subdivision 4. 
  1.21  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.22     Section 1.  Minnesota Statutes 1996, section 144.057, 
  1.23  subdivision 1, is amended to read: 
  1.24     Subdivision 1.  [BACKGROUND STUDIES REQUIRED.] The 
  1.25  commissioner of health shall contract with the commissioner of 
  1.26  human services to conduct background studies of individuals 
  1.27  providing services which have direct contact, as defined under 
  1.28  section 245A.04, subdivision 3, with patients and residents in 
  1.29  hospitals, boarding care homes, outpatient surgical centers 
  1.30  licensed under sections 144.50 to 144.58; nursing homes and home 
  1.31  care agencies licensed under chapter 144A; residential care 
  1.32  homes licensed under chapter 144B, and board and lodging 
  1.33  establishments that are registered to provide supportive or 
  2.1   health supervision services under section 157.17.  
  2.2      If a facility or program is licensed by the department of 
  2.3   human services and subject to the background study provisions of 
  2.4   chapter 245A and is also licensed by the department of health, 
  2.5   the department of human services is solely responsible for the 
  2.6   background studies of individuals in the jointly licensed 
  2.7   programs. 
  2.8      Sec. 2.  Minnesota Statutes 1996, section 144A.43, is 
  2.9   amended by adding a subdivision to read: 
  2.10     Subd. 2a.  [DAILY LIVING SERVICE.] "Daily living service" 
  2.11  means a service that does not ordinarily require the skills of 
  2.12  qualified technical or professional personnel unless the service 
  2.13  is part of the treatment of special medical complications.  
  2.14  Daily living services include: 
  2.15     (1) preparing modified diets; 
  2.16     (2) housekeeping in the presence of technically 
  2.17  sophisticated medical equipment, when the client is seriously 
  2.18  ill or has an infectious disease, or when the containment of 
  2.19  infectious disease is a consideration; 
  2.20     (3) assisting with personal care, including bathing, 
  2.21  dressing, grooming, hair care, and oral hygiene; 
  2.22     (4) assisting with medications; and 
  2.23     (5) supportive services as defined in chapter 144D. 
  2.24     Sec. 3.  Minnesota Statutes 1996, section 144A.43, 
  2.25  subdivision 4, is amended to read: 
  2.26     Subd. 4.  [HOME CARE PROVIDER.] "Home care provider" means 
  2.27  an individual, organization, association, corporation, unit of 
  2.28  government, or other entity that is regularly engaged in the 
  2.29  delivery, directly or by contractual arrangement, of home care 
  2.30  services for a fee.  At least one home care service must be 
  2.31  provided directly, although additional home care services may be 
  2.32  provided by contractual arrangements.  "Home care provider" 
  2.33  includes a hospice program defined in section 144A.48.  "Home 
  2.34  care provider" does not include: 
  2.35     (1) any home care or nursing services conducted by and for 
  2.36  the adherents of any recognized church or religious denomination 
  3.1   for the purpose of providing care and services for those who 
  3.2   depend upon spiritual means, through prayer alone, for healing; 
  3.3      (2) an individual who only provides services to a relative; 
  3.4      (3) an individual not connected with a home care provider 
  3.5   who provides assistance with home management services or 
  3.6   personal care needs if the assistance is provided primarily as a 
  3.7   contribution and not as a business; 
  3.8      (4) an individual not connected with a home care provider 
  3.9   who shares housing with and provides primarily housekeeping or 
  3.10  homemaking services to an elderly or disabled person in return 
  3.11  for free or reduced-cost housing; 
  3.12     (5) an individual or agency providing home-delivered meal 
  3.13  services; 
  3.14     (6) an agency providing senior companion services and other 
  3.15  older American volunteer programs established under the Domestic 
  3.16  Volunteer Service Act of 1973, Public Law Number 98-288; 
  3.17     (7) an employee of a nursing home licensed under this 
  3.18  chapter or an employee of a boarding care home licensed under 
  3.19  sections 144.50 to 144.58 who provides emergency services to 
  3.20  individuals residing in an apartment unit attached to the 
  3.21  nursing home a residential center that is associated with the 
  3.22  nursing home or boarding care home and is composed of a building 
  3.23  or group of adjacent buildings in which clients rent or own 
  3.24  distinct living units; 
  3.25     (8) a member of a professional corporation organized under 
  3.26  sections 319A.01 to 319A.22 that does not regularly offer or 
  3.27  provide home care services as defined in subdivision 3; 
  3.28     (9) the following organizations established to provide 
  3.29  medical or surgical services that do not regularly offer or 
  3.30  provide home care services as defined in subdivision 3:  a 
  3.31  business trust organized under sections 318.01 to 318.04, a 
  3.32  nonprofit corporation organized under chapter 317A, a 
  3.33  partnership organized under chapter 323, or any other entity 
  3.34  determined by the commissioner; 
  3.35     (10) an individual or agency that provides medical supplies 
  3.36  or durable medical equipment, except when the provision of 
  4.1   supplies or equipment is accompanied by a home care service; 
  4.2      (11) an individual licensed under chapter 147; or 
  4.3      (12) an individual who provides home care services to a 
  4.4   person with a developmental disability who lives in a place of 
  4.5   residence with a family, foster family, or primary caregiver. 
  4.6      Sec. 4.  Minnesota Statutes 1996, section 144A.43, is 
  4.7   amended by adding a subdivision to read: 
  4.8      Subd. 5.  [SKILLED NURSING OR THERAPY SERVICE.] "Skilled 
  4.9   nursing or therapy service" means a home care service that must 
  4.10  be performed by a licensed nurse or therapist and may not be 
  4.11  delegated to unlicensed personnel under this chapter, or that 
  4.12  requires the skill of a licensed nurse, therapist, or other 
  4.13  health professional due to the complexity of the service or the 
  4.14  condition of the client. 
  4.15     Sec. 5.  Minnesota Statutes 1996, section 144A.45, 
  4.16  subdivision 1, is amended to read: 
  4.17     Subdivision 1.  [RULES.] The commissioner shall adopt rules 
  4.18  for the regulation of home care providers pursuant to sections 
  4.19  144A.43 to 144A.49.  The rules shall include the following:  
  4.20     (a) provisions to assure, to the extent possible, the 
  4.21  health, safety and well-being, and appropriate treatment of 
  4.22  persons who receive home care services; 
  4.23     (b) requirements that home care providers furnish the 
  4.24  commissioner with specified information necessary to implement 
  4.25  sections 144A.43 to 144A.49; 
  4.26     (c) standards of training of home care provider personnel, 
  4.27  which may vary according to the nature of the services provided 
  4.28  or the health status of the consumer; 
  4.29     (d) standards for medication management by unlicensed 
  4.30  personnel, including standards for: 
  4.31     (1) passive assistance with medications, including verbal 
  4.32  reminders; 
  4.33     (2) active assistance with medications, including bringing 
  4.34  or passing medications to a client and ensuring proper ingestion 
  4.35  under the delegation and supervision of a registered nurse, 
  4.36  opening a dispenser that was set up by a registered nurse or 
  5.1   licensed practical nurse, emptying contents from a dispenser set 
  5.2   up by a nurse into a client's hand, assisting the client as 
  5.3   needed, and providing liquids or nutrition to accompany the 
  5.4   medication; and 
  5.5      (3) medication administration, including the implementation 
  5.6   of a plan of medication management by unlicensed personnel under 
  5.7   the delegation and supervision of a registered nurse, that 
  5.8   involves interpreting and reading labels and dispensing 
  5.9   medications directly from the prescription containers; 
  5.10     (e) standards of supervision of home care services by a 
  5.11  registered nurse or other appropriate health care 
  5.12  professionals of personnel providing home care services, 
  5.13  which that may vary according to the nature of the services 
  5.14  provided or the health status of the consumer, but that must 
  5.15  impose a minimum interval of supervision of not less than 62 
  5.16  days for services that are not skilled nursing or therapy 
  5.17  services as defined in section 144A.43, subdivision 5, unless 
  5.18  there is a change in condition of the client; 
  5.19     (e) (f) requirements for the involvement of a consumer's 
  5.20  physician, the documentation of physicians' orders, if required, 
  5.21  and the consumer's treatment plan, and the maintenance of 
  5.22  accurate, current clinical records; 
  5.23     (f) (g) the establishment of different classes of licenses 
  5.24  for different types of providers and different standards and 
  5.25  requirements for different kinds of home care services; and 
  5.26     (g) (h) operating procedures required to implement the home 
  5.27  care bill of rights. 
  5.28     Sec. 6.  Minnesota Statutes 1996, section 144A.46, 
  5.29  subdivision 1, is amended to read: 
  5.30     Subdivision 1.  [LICENSE REQUIRED.] (a) A home care 
  5.31  provider may not operate in the state without a current license 
  5.32  issued by the commissioner of health.  A home care provider may 
  5.33  hold a separate license for each class of home care licensure.  
  5.34  If a home care provider holds more than one license, a service 
  5.35  agreement must identify under which license the client is 
  5.36  receiving services. 
  6.1      (b) Within ten days after receiving an application for a 
  6.2   license, the commissioner shall acknowledge receipt of the 
  6.3   application in writing.  The acknowledgment must indicate 
  6.4   whether the application appears to be complete or whether 
  6.5   additional information is required before the application will 
  6.6   be considered complete.  Within 90 days after receiving a 
  6.7   complete application, the commissioner shall either grant or 
  6.8   deny the license.  If an applicant is not granted or denied a 
  6.9   license within 90 days after submitting a complete application, 
  6.10  the license must be deemed granted.  An applicant whose license 
  6.11  has been deemed granted must provide written notice to the 
  6.12  commissioner before providing a home care service. 
  6.13     (c) Each application for a home care provider license, or 
  6.14  for a renewal of a license, shall be accompanied by a fee to be 
  6.15  set by the commissioner under section 144.122. 
  6.16     Sec. 7.  Minnesota Statutes 1996, section 144A.46, 
  6.17  subdivision 2, is amended to read: 
  6.18     Subd. 2.  [EXEMPTIONS.] The following individuals or 
  6.19  organizations are exempt from the requirement to obtain a home 
  6.20  care provider license: 
  6.21     (1) a person who is licensed as a registered nurse under 
  6.22  sections 148.171 to 148.285 and who independently provides 
  6.23  nursing services in the home without any contractual or 
  6.24  employment relationship to a home care provider or other 
  6.25  organization; 
  6.26     (2) a personal care assistant who provides services under 
  6.27  the medical assistance program as authorized under sections 
  6.28  256B.0625, subdivision 19, and 256B.04, subdivision 16; 
  6.29     (3) a person or organization that exclusively offers, 
  6.30  provides, or arranges for personal care assistant services under 
  6.31  the medical assistance program as authorized under sections 
  6.32  256B.0625, subdivision 19, and 256B.04, subdivision 16; 
  6.33     (4) a person who is registered under sections 148.65 to 
  6.34  148.78 and who independently provides physical therapy services 
  6.35  in the home without any contractual or employment relationship 
  6.36  to a home care provider or other organization; 
  7.1      (5) a provider that is licensed by the commissioner of 
  7.2   human services to provide semi-independent living services under 
  7.3   Minnesota Rules, parts 9525.0500 to 9525.0660 when providing 
  7.4   home care services to a person with a developmental disability; 
  7.5      (6) a provider that is licensed by the commissioner of 
  7.6   human services to provide home and community-based services 
  7.7   under Minnesota Rules, parts 9525.2000 to 9525.2140 when 
  7.8   providing home care services to a person with a developmental 
  7.9   disability; 
  7.10     (7) a person or organization that provides only home 
  7.11  management services, if the person or organization is registered 
  7.12  under section 144A.43, subdivision 3; or 
  7.13     (8) a person who is licensed as a social worker under 
  7.14  sections 148B.18 to 148B.28 and who provides social work 
  7.15  services in the home independently and not through any 
  7.16  contractual or employment relationship with a home care provider 
  7.17  or other organization; or 
  7.18     (9) an organization licensed as a nursing home under this 
  7.19  section or as a certified boarding care home under sections 
  7.20  144.50 to 144.58 that provides home care services in an elderly 
  7.21  housing with services establishment registered under chapter 
  7.22  144D. 
  7.23     An exemption under this subdivision does not excuse the 
  7.24  individual from complying with applicable provisions of the home 
  7.25  care bill of rights. 
  7.26     Sec. 8.  [144A.4605] [CLASS E ELDERLY HOUSING WITH SERVICES 
  7.27  HOME CARE PROVIDER.] 
  7.28     Subdivision 1.  [DEFINITIONS.] For purposes of this 
  7.29  section, the terms defined in this subdivision have the meanings 
  7.30  given them: 
  7.31     (1) "Class E elderly housing with services home care 
  7.32  provider" means a home care provider who provides nursing 
  7.33  services or housing aide services or both in an elderly housing 
  7.34  with services establishment as defined in chapter 144D. 
  7.35     (2) "Housing aide" means an individual who provides housing 
  7.36  aide services. 
  8.1      (3) "Housing aide service" means a home care task that is 
  8.2   defined by rule adopted by the commissioner as a home health 
  8.3   aide or home care aide task and that is performed for a resident 
  8.4   of an elderly housing with services establishment. 
  8.5      Subd. 2.  [CLASS E LICENSE.] A home care provider operating 
  8.6   an elderly housing with services establishment may obtain a 
  8.7   class E license if the establishment meets the following 
  8.8   requirements: 
  8.9      (1) nursing services or housing aide services or both under 
  8.10  the class E license are provided solely to residents of one or 
  8.11  more elderly housing with services establishments registered 
  8.12  under chapter 144D; 
  8.13     (2) housing aides are qualified to perform the housing aide 
  8.14  services that are offered to the residents of the elderly 
  8.15  housing with services establishment.  Qualifications shall be 
  8.16  established in accordance with subdivision 3; 
  8.17     (3) periodic supervision or monitoring of daily living 
  8.18  services provided by housing aides is at the discretion of a 
  8.19  registered nurse, provided the interval between periodic 
  8.20  supervision or monitoring does not exceed 62 days; 
  8.21     (4) client records include documentation of the home care 
  8.22  services provided to the resident of an elderly housing with 
  8.23  services establishment, with any significant change in the 
  8.24  status of the client noted in the documentation on the day it is 
  8.25  observed, and entered into the record no later than one week 
  8.26  after the end of the service day in which the observation was 
  8.27  made; 
  8.28     (5) medication and treatment orders, if any, are included 
  8.29  in the client record and are renewed at least every 12 months, 
  8.30  or more frequently if indicated by a clinical assessment; 
  8.31     (6) the central storage of medications in an elderly 
  8.32  housing with services establishment is permitted under a system 
  8.33  that is established by a registered nurse and addresses the 
  8.34  control of medications, the handling of medications, medication 
  8.35  containers, and medication records, and the disposition of 
  8.36  medications; and 
  9.1      (7) the elderly housing with services establishment meets 
  9.2   the requirements for class E home care licensure established by 
  9.3   rules adopted under sections 144A.45 to 144A.48. 
  9.4      Subd. 3.  [TRAINING OR COMPETENCY; DELEGATED TASKS.] (a) A 
  9.5   housing aide shall be trained for or demonstrate competency in 
  9.6   each housing aide service offered to clients in an elderly 
  9.7   housing with services establishment. 
  9.8      (b) Training for a housing aide shall use a curriculum 
  9.9   approved by the commissioner for each separate task the aide 
  9.10  will perform. 
  9.11     (c) A competency evaluation may be completed on the site of 
  9.12  a registered elderly housing with services establishment or in a 
  9.13  client's residence. 
  9.14     (d) A registered nurse shall document each competency 
  9.15  evaluation. 
  9.16     (e) All housing aides shall be trained or demonstrate 
  9.17  competency in a set of core competencies, including the 
  9.18  following: 
  9.19     (1) an orientation to home care in the registered elderly 
  9.20  housing with services establishment; 
  9.21     (2) observation, reporting, and documentation of client 
  9.22  status and of the care or services provided; 
  9.23     (3) basic infection control; 
  9.24     (4) maintenance of a clean, safe, and healthy environment; 
  9.25     (5) passive assistance with medications; 
  9.26     (6) basic elements of body functioning and changes in body 
  9.27  function that must be reported to an appropriate health care 
  9.28  professional; 
  9.29     (7) recognition of and handling of emergencies; and 
  9.30     (8) physical, emotional, and developmental needs of 
  9.31  clients, and ways to work with clients who have special 
  9.32  physical, emotional, or developmental needs. 
  9.33     Sec. 9.  Minnesota Statutes 1996, section 144D.01, 
  9.34  subdivision 4, is amended to read: 
  9.35     Subd. 4.  [ELDERLY HOUSING WITH SERVICES ESTABLISHMENT OR 
  9.36  ESTABLISHMENT.] "Elderly housing with services establishment" or 
 10.1   "establishment" means an establishment providing sleeping 
 10.2   accommodations to one or more adult residents, at least 80 
 10.3   percent of which are 55 years of age or older, and offering or 
 10.4   providing, for a fee, one or more health-related services or two 
 10.5   or more supportive service services, whether offered or provided 
 10.6   directly by the establishment or by another entity arranged for 
 10.7   by the establishment.  Offering or providing does not include 
 10.8   services which may be made available by the establishment on an 
 10.9   intermittent or incidental basis. 
 10.10     Elderly housing with services establishment does not 
 10.11  include: 
 10.12     (1) a nursing home licensed under chapter 144A; 
 10.13     (2) a hospital, boarding care home, or supervised living 
 10.14  facility licensed under sections 144.50 to 144.56; 
 10.15     (3) a board and lodging establishment licensed under 
 10.16  chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 
 10.17  9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 
 10.18  9530.4450; 
 10.19     (4) a board and lodging establishment which serves as a 
 10.20  shelter for battered women or other similar purpose; 
 10.21     (5) a family adult foster care home licensed under 
 10.22  Minnesota Rules, parts 9543.0010 to 9543.0150 by the 
 10.23  commissioner of human services; or 
 10.24     (6) private homes in which the residents are related by 
 10.25  kinship, law, or affinity with the providers of services; 
 10.26     (7) a home-sharing arrangement such as when an elderly or 
 10.27  disabled person or single-parent family makes lodging in a 
 10.28  private residence available to another person in exchange for 
 10.29  services or rent, or both; or 
 10.30     (8) a duly organized condominium, cooperative, common 
 10.31  interest community, or owners' association of the foregoing 
 10.32  where at least 80 percent of the units that comprise the 
 10.33  condominium, cooperative, or common interest community are 
 10.34  occupied by individuals who are the owners, members, or 
 10.35  shareholders of the units. 
 10.36     Sec. 10.  Minnesota Statutes 1996, section 144D.01, 
 11.1   subdivision 5, is amended to read: 
 11.2      Subd. 5.  [SUPPORTIVE SERVICES.] "Supportive services" 
 11.3   means arranging for medical services, health-related services, 
 11.4   social services, or transportation to medical or social service 
 11.5   appointments, help with personal laundry, or handling or 
 11.6   assisting with personal funds of residents.  Arranging for 
 11.7   services does not include making referrals, assisting a resident 
 11.8   in contacting a service provider of the resident's choice, or 
 11.9   contacting a service provider in an emergency. 
 11.10     Sec. 11.  Minnesota Statutes 1996, section 144D.01, 
 11.11  subdivision 6, is amended to read: 
 11.12     Subd. 6.  [HEALTH-RELATED SERVICES.] "Health-related 
 11.13  services" include professional nursing services, home health 
 11.14  housing aide tasks, and home care aide tasks identified in 
 11.15  Minnesota Rules, parts 4668.0100, subparts 1 and 2; and 
 11.16  4668.0110, subpart 1 other tasks defined as licensable home care 
 11.17  services in rules developed by the commissioner, or the central 
 11.18  storage of medication for residents under section 144A.485 
 11.19  144A.4605, subdivision 2, clause (6). 
 11.20     Sec. 12.  Minnesota Statutes 1996, section 144D.03, 
 11.21  subdivision 1, is amended to read: 
 11.22     Subdivision 1.  [REGISTRATION PROCEDURES.] The commissioner 
 11.23  shall establish forms and procedures for annual registration of 
 11.24  elderly housing with services establishments.  The commissioner 
 11.25  shall charge an annual registration fee of $35.  No fee shall be 
 11.26  refunded.  A registered establishment shall notify the 
 11.27  commissioner within 30 days of any change in the business name 
 11.28  or address of the establishment, the name or mailing address of 
 11.29  the owner or owners, or the name or mailing address of the 
 11.30  managing agent.  There shall be no fee for submission of the 
 11.31  notice.  A registered establishment may provide written notice 
 11.32  to the commissioner of the date it is no longer required to be 
 11.33  registered under this chapter.  There shall be no fee for 
 11.34  submission of the notice. 
 11.35     Sec. 13.  Minnesota Statutes 1996, section 144D.06, is 
 11.36  amended to read: 
 12.1      144D.06 [OTHER LAWS.] 
 12.2      An elderly housing with services establishment shall obtain 
 12.3   and maintain all other licenses, permits, registrations, or 
 12.4   other governmental approvals required of it in addition to 
 12.5   registration under this chapter, except that an establishment 
 12.6   registered under this chapter is exempt, at its option, from the 
 12.7   requirement of obtaining and maintaining an adult foster care 
 12.8   license under Minnesota Rules, parts 9543.0010 to 9543.0150, or 
 12.9   a lodging license under chapter 157.  An elderly housing with 
 12.10  services establishment is subject to the provisions of sections 
 12.11  504.01 to 504.28 and 566.01 to 566.175.  An elderly housing with 
 12.12  services establishment which is also described in section 157.17 
 12.13  is exempt, at its option, from the requirements of that section 
 12.14  while it is registered under this chapter. 
 12.15     Sec. 14.  Minnesota Statutes 1996, section 157.17, 
 12.16  subdivision 2, is amended to read: 
 12.17     Subd. 2.  [REGISTRATION.] At the time of licensure or 
 12.18  license renewal, a boarding and lodging establishment or a 
 12.19  lodging establishment that provides supportive services or 
 12.20  health supervision services must be registered with the 
 12.21  commissioner, and must register annually thereafter.  The 
 12.22  registration must include the name, address, and telephone 
 12.23  number of the establishment, the name of the operator, the types 
 12.24  of services that are being provided, a description of the 
 12.25  residents being served, the type and qualifications of staff in 
 12.26  the facility, and other information that is necessary to 
 12.27  identify the needs of the residents and the types of services 
 12.28  that are being provided.  The commissioner shall develop and 
 12.29  furnish to the boarding and lodging establishment or lodging 
 12.30  establishment the necessary form for submitting the 
 12.31  registration.  The requirement for registration is effective 
 12.32  until the rules required by sections 144B.01 to 144B.17 are 
 12.33  effective. 
 12.34     Sec. 15.  Minnesota Statutes 1996, section 157.17, 
 12.35  subdivision 3, is amended to read: 
 12.36     Subd. 3.  [RESTRICTION ON THE PROVISION OF SERVICES.] 
 13.1   Effective July 1, 1995, and until one year after the rules 
 13.2   required under sections 144B.01 to 144B.17 are adopted, a 
 13.3   boarding and lodging establishment or lodging establishment 
 13.4   registered under subdivision 2 may provide health supervision 
 13.5   services only if a licensed nurse is on site in the 
 13.6   establishment for at least four hours a week to provide 
 13.7   monitoring of health supervision services for the residents.  A 
 13.8   boarding and lodging establishment or lodging establishment that 
 13.9   admits or retains residents using wheelchairs or walkers must 
 13.10  have the necessary clearances from the office of the state fire 
 13.11  marshal. 
 13.12     Sec. 16.  Minnesota Statutes 1996, section 157.17, 
 13.13  subdivision 7, is amended to read: 
 13.14     Subd. 7.  [EXEMPTION FOR CERTAIN ESTABLISHMENTS WITH A 
 13.15  HUMAN SERVICES LICENSE.] This section does not apply to a 
 13.16  boarding and lodging establishment or lodging establishment that 
 13.17  is licensed by the commissioner of human services under chapter 
 13.18  245A.  Elderly housing with services establishments registered 
 13.19  under chapter 144D shall be considered registered under this 
 13.20  section for all purposes except that: 
 13.21     (1) the establishments shall operate under the requirements 
 13.22  of chapter 144D; and 
 13.23     (2) the criminal background check requirements of sections 
 13.24  299C.67 to 299C.71 apply to the establishments.  The criminal 
 13.25  background check requirements of section 144.057 apply only to 
 13.26  personnel providing home care services under sections 144A.43 to 
 13.27  144A.48 in the establishments. 
 13.28     Sec. 17.  Minnesota Statutes 1996, section 256B.071, 
 13.29  subdivision 1, is amended to read: 
 13.30     Subdivision 1.  [DEFINITION.] (a) "Dual entitlees" means 
 13.31  recipients eligible for either the medical assistance program or 
 13.32  the alternative care program who are also eligible for the 
 13.33  federal Medicare program.  
 13.34     (b) For purposes of this section, "home care services" 
 13.35  means home health agency services, private duty nursing 
 13.36  services, personal care assistant services, waivered services, 
 14.1   alternative care program services, hospice services, 
 14.2   rehabilitation therapy services, and medical supplies and 
 14.3   equipment, except those services provided by class E home care 
 14.4   agencies licensed under chapter 144A. 
 14.5      Sec. 18.  Minnesota Statutes 1996, section 256I.04, 
 14.6   subdivision 2a, is amended to read: 
 14.7      Subd. 2a.  [LICENSE REQUIRED.] A county agency may not 
 14.8   enter into an agreement with an establishment to provide group 
 14.9   residential housing unless:  
 14.10     (1) the establishment is licensed by the department of 
 14.11  health as a hotel and restaurant; a board and lodging 
 14.12  establishment; a residential care home; a boarding care home 
 14.13  before March 1, 1985; or a supervised living facility, and the 
 14.14  service provider for residents of the facility is licensed under 
 14.15  chapter 245A.  However, an establishment licensed by the 
 14.16  department of health to provide lodging need not also be 
 14.17  licensed to provide board if meals are being supplied to 
 14.18  residents under a contract with a food vendor who is licensed by 
 14.19  the department of health; or 
 14.20     (2) the residence is licensed by the commissioner of human 
 14.21  services under Minnesota Rules, parts 9555.5050 to 9555.6265, or 
 14.22  certified by a county human services agency prior to July 1, 
 14.23  1992, using the standards under Minnesota Rules, parts 9555.5050 
 14.24  to 9555.6265. 
 14.25     The requirements under clauses (1) and (2) do not apply to 
 14.26  establishments exempt from state licensure because they are 
 14.27  located on Indian reservations and subject to tribal health and 
 14.28  safety requirements. 
 14.29     Sec. 19.  Minnesota Statutes 1996, section 295.50, 
 14.30  subdivision 4, is amended to read: 
 14.31     Subd. 4.  [HEALTH CARE PROVIDER.] (a) "Health care 
 14.32  provider" means: 
 14.33     (1) a person furnishing any or all of the following goods 
 14.34  or services directly to a patient or consumer:  medical, 
 14.35  surgical, optical, visual, dental, hearing, nursing services, 
 14.36  drugs, medical supplies, medical appliances, laboratory, 
 15.1   diagnostic or therapeutic services, or any goods and services 
 15.2   not listed above that qualify for reimbursement under the 
 15.3   medical assistance program provided under chapter 256B.  For 
 15.4   purposes of this clause, "directly to a patient or consumer" 
 15.5   includes goods and services provided in connection with 
 15.6   independent medical examinations under section 65B.56 or other 
 15.7   examinations for purposes of litigation or insurance claims; 
 15.8      (2) a staff model health plan company; or 
 15.9      (3) an ambulance service required to be licensed. 
 15.10     (b) Health care provider does not include hospitals, 
 15.11  nursing homes licensed under chapter 144A or licensed in any 
 15.12  other jurisdiction, pharmacies, surgical centers, bus and 
 15.13  taxicab transportation, or any other providers of transportation 
 15.14  services other than ambulance services required to be licensed, 
 15.15  supervised living facilities for persons with mental retardation 
 15.16  or related conditions, licensed under Minnesota Rules, parts 
 15.17  4665.0100 to 4665.9900, residential care homes licensed under 
 15.18  chapter 144B, board and lodging establishments providing only 
 15.19  custodial services that are licensed under chapter 157 and 
 15.20  registered under section 157.17 to provide supportive services 
 15.21  or health supervision services, adult foster homes as defined in 
 15.22  Minnesota Rules, part 9555.5105, day training and habilitation 
 15.23  services for adults with mental retardation and related 
 15.24  conditions as defined in section 252.41, subdivision 3, and 
 15.25  boarding care homes, as defined in Minnesota Rules, part 
 15.26  4655.0100. 
 15.27     Sec. 20.  Minnesota Statutes 1996, section 299C.67, 
 15.28  subdivision 5, is amended to read: 
 15.29     Subd. 5.  [OWNER.] "Owner" has the meaning given in section 
 15.30  566.18, subdivision 3.  However, "owner" does not include a 
 15.31  person who owns, operates, or is in control of a health care 
 15.32  facility or a home health agency licensed by the commissioner of 
 15.33  health or human services under chapter 144, 144A, 144B, or 245A, 
 15.34  or a board and lodging establishment with special services 
 15.35  registered under section 157.17.  
 15.36     Sec. 21.  Minnesota Statutes 1996, section 609.7495, 
 16.1   subdivision 1, is amended to read: 
 16.2      Subdivision 1.  [DEFINITIONS.] For the purposes of this 
 16.3   section, the following terms have the meanings given them. 
 16.4      (a) "Facility" means any of the following: 
 16.5      (1) a hospital or other health institution licensed under 
 16.6   sections 144.50 to 144.56; 
 16.7      (2) a medical facility as defined in section 144.561; 
 16.8      (3) an agency, clinic, or office operated under the 
 16.9   direction of or under contract with the commissioner of health 
 16.10  or a community health board, as defined in section 145A.02; 
 16.11     (4) a facility providing counseling regarding options for 
 16.12  medical services or recovery from an addiction; 
 16.13     (5) a facility providing emergency shelter services for 
 16.14  battered women, as defined in section 611A.31, subdivision 3, or 
 16.15  a facility providing transitional housing for battered women and 
 16.16  their children; 
 16.17     (6) a residential care home or home as defined in section 
 16.18  144B.01, subdivision 5; 
 16.19     (7) a facility as defined in section 626.556, subdivision 
 16.20  2, paragraph (f); 
 16.21     (8) (7) a facility as defined in section 626.5572, 
 16.22  subdivision 6, where the services described in that paragraph 
 16.23  are provided; 
 16.24     (9) (8) a place to or from which ambulance service, as 
 16.25  defined in section 144.801, is provided or sought to be 
 16.26  provided; and 
 16.27     (10) (9) a hospice program licensed under section 144A.48. 
 16.28     (b) "Aggrieved party" means a person whose access to or 
 16.29  egress from a facility is obstructed in violation of subdivision 
 16.30  2, or the facility. 
 16.31     Sec. 22.  [REPEALER.] 
 16.32     Minnesota Statutes 1996, sections 144A.45, subdivision 3; 
 16.33  144B.01; 144B.02; 144B.03; 144B.04; 144B.05; 144B.06; 144B.07; 
 16.34  144B.08; 144B.09; 144B.10; 144B.11; 144B.12; 144B.13; 144B.14; 
 16.35  144B.15; 144B.16; 144B.17; and 157.17, subdivision 4, are 
 16.36  repealed.