1.1 	A bill for an act
1.2 	relating to health; authorizing certified paraprofessionals to provide home care 
1.3 	services; directing the commissioner of human services to seek federal approval 
1.4 	for reimbursement of certified paraprofessionals who provide home care 
1.5 	services; directing the commissioner of human services to establish procedure 
1.6 	codes for reimbursement of certified paraprofessionals;amending Minnesota 
1.7 	Statutes 2014, sections 144A.43, subdivision 3, by adding a subdivision; 
1.8 	144A.471, subdivisions 6, 7; 144A.472, subdivision 2; 144A.4792, subdivision 
1.9 	6; 144A.4795, by adding a subdivision.
1.10 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.11 	Section 1. Minnesota Statutes 2014, section 144A.43, is amended by adding a 
1.12 	subdivision to read:
1.13 		Subd. 1f.Certified paraprofessional. "Certified paraprofessional" means:
1.14 	(1) a medical assistant who graduated from an accredited medical assistant training 
1.15 	program, passed a medical assistant certification examination, and is certified by a national 
1.16 	medical assistant certification organization recognized by the commissioner;
1.17 	(2) a paramedic as defined in section 144E.001, subdivision 5e; or
1.18 	(3) an emergency medical technician as defined in section 144E.001, subdivision 5c.

1.19 	Sec. 2. Minnesota Statutes 2014, section 144A.43, subdivision 3, is amended to read:
1.20 		Subd. 3.Home care service. "Home care service" means any of the following 
1.21 	services delivered in the home of a person whose illness, disability, or physical condition 
1.22 	creates a need for the service:
1.23 	(1) assistive tasks provided by unlicensed personnel;
2.1 	(2) services provided by a registered nurse or licensed practical nurse, physical 
2.2 	therapist, respiratory therapist, occupational therapist, speech-language pathologist, 
2.3 	dietitian or nutritionist, or social worker;
2.4 	(3) services provided by certified paraprofessionals;
2.5 	(3) (4) medication and treatment management services; or
2.6 	(4) (5) the provision of durable medical equipment services when provided with any 
2.7 	of the home care services listed in clauses (1) to (3) (4).

2.8 	Sec. 3. Minnesota Statutes 2014, section 144A.471, subdivision 6, is amended to read:
2.9 		Subd. 6.Basic home care license provider. Home care services that can be 
2.10 	provided with a basic home care license are assistive tasks provided by licensed or 
2.11 	unlicensed personnel or certified paraprofessionals that include:
2.12 	(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, 
2.13 	and bathing;
2.14 	(2) providing standby assistance;
2.15 	(3) providing verbal or visual reminders to the client to take regularly scheduled 
2.16 	medication, which includes bringing the client previously set-up medication, medication 
2.17 	in original containers, or liquid or food to accompany the medication;
2.18 	(4) providing verbal or visual reminders to the client to perform regularly scheduled 
2.19 	treatments and exercises;
2.20 	(5) preparing modified diets ordered by a licensed health professional; and
2.21 	(6) assisting with laundry, housekeeping, meal preparation, shopping, or other 
2.22 	household chores and services if the provider is also providing at least one of the activities 
2.23 	in clauses (1) to (5).

2.24 	Sec. 4. Minnesota Statutes 2014, section 144A.471, subdivision 7, is amended to read:
2.25 		Subd. 7.Comprehensive home care license provider. Home care services that 
2.26 	may be provided with a comprehensive home care license include any of the basic home 
2.27 	care services listed in subdivision 6, and one or more of the following:
2.28 	(1) services of an advanced practice nurse, registered nurse, licensed practical 
2.29 	nurse, physical therapist, respiratory therapist, occupational therapist, speech-language 
2.30 	pathologist, dietitian or nutritionist, or social worker;
2.31 	(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a 
2.32 	licensed health professional within the person's scope of practice;
2.33 	(3) services of a certified paraprofessional;
2.34 	(3) (4) medication management services;
3.1 	(4) (5) hands-on assistance with transfers and mobility;
3.2 	(5) (6) assisting clients with eating when the clients have complicating eating 
3.3 	problems as identified in the client record or through an assessment such as difficulty 
3.4 	swallowing, recurrent lung aspirations, or requiring the use of a tube or parenteral or 
3.5 	intravenous instruments to be fed; or
3.6 	(6) (7) providing other complex or specialty health care services.

3.7 	Sec. 5. Minnesota Statutes 2014, section 144A.472, subdivision 2, is amended to read:
3.8 		Subd. 2.Comprehensive home care license applications. In addition to the 
3.9 	information and fee required in subdivision 1, applicants applying for a comprehensive 
3.10 	home care license must also provide verification that the applicant has the following 
3.11 	policies and procedures in place so that if a license is issued, the applicant will implement 
3.12 	the policies and procedures in this subdivision and keep them current:
3.13 	(1) conducting initial and ongoing assessments of the client's needs by a registered 
3.14 	nurse or appropriate licensed health professional, including how changes in the client's 
3.15 	conditions are identified, managed, and communicated to staff and other health care 
3.16 	providers, as appropriate;
3.17 	(2) ensuring that nurses and licensed health professionals have current and valid 
3.18 	licenses to practice;
3.19 	(3) ensuring that certified paraprofessionals have current and valid certifications;
3.20 	(3) (4) medication and treatment management;
3.21 	(4) (5) delegation of home care tasks by registered nurses or licensed health 
3.22 	professionals;
3.23 	(5) (6) supervision of registered nurses and licensed health professionals; and
3.24 	(7) supervision of certified paraprofessionals; and
3.25 	(6) (8) supervision of unlicensed personnel performing delegated home care tasks.

3.26 	Sec. 6. Minnesota Statutes 2014, section 144A.4792, subdivision 6, is amended to read:
3.27 		Subd. 6.Administration of medication. Medications may be administered by 
3.28 	a nurse, physician, or other licensed health practitioner, or certified paraprofessional
3.29 	authorized to administer medications or by unlicensed personnel who have been delegated 
3.30 	medication administration tasks by a registered nurse.

3.31 	Sec. 7. Minnesota Statutes 2014, section 144A.4795, is amended by adding a 
3.32 	subdivision to read:
4.1 		Subd. 2a.Certified paraprofessionals. Certified paraprofessionals providing home 
4.2 	care services must possess a current professional certification and must have successfully 
4.3 	completed 40 hours of training on the provision of home care services. The training 
4.4 	program must be approved by the commissioner and must provide training on at least 
4.5 	the following:
4.6 	(1) the home care bill of rights under section 144A.44;
4.7 	(2) federal and state requirements related to medical records and data privacy;
4.8 	(3) understanding appropriate boundaries between staff and clients and family 
4.9 	members;
4.10 	(4) ventilator operation and maintenance and the care of ventilator-dependent clients;
4.11 	(5) the care of clients with tracheotomies;
4.12 	(6) appropriate techniques for assisting clients with activities of daily living;
4.13 	(7) cardiopulmonary resuscitation;
4.14 	(8) appropriate infection control techniques;
4.15 	(9) sensitivity to and respect for the client's cultural background; and
4.16 	(10) reporting of maltreatment of minors under section 626.556 and maltreatment of 
4.17 	vulnerable adults under section 626.557.

4.18 	Sec. 8. DIRECTION TO COMMISSIONER; ESTABLISHING PROCEDURE 
4.19 	CODES.
 4.20 	The commissioner of human services shall establish procedure codes for certified 
4.21 	medical assistants, paramedics, and emergency medical technicians who provide home 
4.22 	care services as certified paraprofessionals to be reimbursed for services provided under 
4.23 	Minnesota Statutes, sections 256B.0651, 256B.0659, 256B.0915, 256B.092, 256B.093, 
4.24 	256B.49, and 256B.85, at a rate equal to the rate established for licensed professional 
4.25 	nurses who provide the same services.

4.26 	EFFECTIVE DATE. This section is effective upon receipt of the federal waivers 
4.27 	or approvals requested according to section 9 to allow for reimbursement of certified 
4.28 	paraprofessionals.

4.29 	Sec. 9. DIRECTION TO COMMISSIONER; FEDERAL APPROVAL.
 4.30 	The commissioner of human services shall request from the federal Centers for 
4.31 	Medicare and Medicaid Services all waivers and approvals necessary to reimburse certified 
4.32 	medical assistants, paramedics, and emergency medical technicians who provide home 
4.33 	care services as certified paraprofessionals for services provided under Minnesota Statutes, 
4.34 	sections 256B.0651, 256B.0659, 256B.0915, 256B.092, 256B.093, 256B.49, and 256B.85.