1.1                          A bill for an act 
  1.2             relating to health; modifying noncertified boarding 
  1.3             care homes provisions, medicaid reimbursement, and 
  1.4             client records for assisted living home care 
  1.5             providers; amending Minnesota Statutes 1998, sections 
  1.6             144.56, subdivision 2b; 144A.45, subdivision 4; 
  1.7             144A.4605, subdivision 2; and 144D.01, subdivision 4. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 1998, section 144.56, 
  1.10  subdivision 2b, is amended to read: 
  1.11     Subd. 2b.  [BOARDING CARE HOMES.] The commissioner shall 
  1.12  not adopt or enforce any rule that limits: 
  1.13     (1) a certified boarding care home from providing nursing 
  1.14  services in accordance with the home's Medicaid certification; 
  1.15  or 
  1.16     (2) a noncertified boarding care home registered under 
  1.17  chapter 144D from providing home care services in accordance 
  1.18  with the home's registration. 
  1.19     Sec. 2.  Minnesota Statutes 1998, section 144A.45, 
  1.20  subdivision 4, is amended to read: 
  1.21     Subd. 4.  [MEDICAID REIMBURSEMENT.] Notwithstanding the 
  1.22  provisions of section 256B.071 or state plan requirements to the 
  1.23  contrary, certification by the federal Medicare program must not 
  1.24  be a requirement of Medicaid payment for services 
  1.25  delivered under section 144A.4605 to clients living in a housing 
  1.26  with services establishment registered under chapter 144D by a 
  2.1   home care provider licensed under sections 144A.43 to 144A.47. 
  2.2      Sec. 3.  Minnesota Statutes 1998, section 144A.4605, 
  2.3   subdivision 2, is amended to read: 
  2.4      Subd. 2.  [ASSISTED LIVING HOME CARE LICENSE ESTABLISHED.] 
  2.5   A home care provider license category entitled assisted living 
  2.6   home care provider is hereby established.  A home care provider 
  2.7   may obtain an assisted living license if the program meets the 
  2.8   following requirements: 
  2.9      (a) nursing services, delegated nursing services, other 
  2.10  services performed by unlicensed personnel, or central storage 
  2.11  of medications under the assisted living license are provided 
  2.12  solely for residents of one or more housing with services 
  2.13  establishments registered under chapter 144D; 
  2.14     (b) unlicensed personnel perform home health aide and home 
  2.15  care aide tasks identified in Minnesota Rules, parts 4668.0100, 
  2.16  subparts 1 and 2, and 4668.0110, subpart 1.  Qualifications to 
  2.17  perform these tasks shall be established in accordance with 
  2.18  subdivision 3; 
  2.19     (c) periodic supervision of unlicensed personnel is 
  2.20  provided as required by rule; 
  2.21     (d) notwithstanding Minnesota Rules, part 4668.0160, 
  2.22  subpart 6, item D, client records shall include: 
  2.23     (1) daily records or a weekly summary of the client's 
  2.24  status and home care services provided; 
  2.25     (2) documentation each time medications are administered to 
  2.26  a client; and 
  2.27     (3) documentation on the day of occurrence of any 
  2.28  significant change in the client's status or any significant 
  2.29  incident, such as a fall or refusal to take medications. 
  2.30     All entries must be signed by the staff providing the 
  2.31  services and entered into the record no later than two weeks 
  2.32  after the end of the service day, except as specified in clauses 
  2.33  (2) and (3); 
  2.34     (e) medication and treatment orders, if any, are included 
  2.35  in the client record and are renewed at least every 12 months, 
  2.36  or more frequently when indicated by a clinical assessment; 
  3.1      (f) the central storage of medications in a housing with 
  3.2   services establishment registered under chapter 144D is managed 
  3.3   under a system that is established by a registered nurse and 
  3.4   addresses the control of medications, handling of medications, 
  3.5   medication containers, medication records, and disposition of 
  3.6   medications; and 
  3.7      (g) in other respects meets the requirements established by 
  3.8   rules adopted under sections 144A.45 to 144A.48. 
  3.9      Sec. 4.  Minnesota Statutes 1998, section 144D.01, 
  3.10  subdivision 4, is amended to read: 
  3.11     Subd. 4.  [HOUSING WITH SERVICES ESTABLISHMENT OR 
  3.12  ESTABLISHMENT.] "Housing with services establishment" or 
  3.13  "establishment" means an establishment providing sleeping 
  3.14  accommodations to one or more adult residents, at least 80 
  3.15  percent of which are 55 years of age or older, and offering or 
  3.16  providing, for a fee, one or more regularly scheduled 
  3.17  health-related services or two or more regularly scheduled 
  3.18  supportive services, whether offered or provided directly by the 
  3.19  establishment or by another entity arranged for by the 
  3.20  establishment. 
  3.21     Housing with services establishment does not include: 
  3.22     (1) a nursing home licensed under chapter 144A; 
  3.23     (2) a hospital, boarding care home, or supervised living 
  3.24  facility licensed under sections 144.50 to 144.56, except that a 
  3.25  noncertified boarding care home may register as a housing with 
  3.26  services establishment under this section; 
  3.27     (3) a board and lodging establishment licensed under 
  3.28  chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 
  3.29  9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 
  3.30  9530.4450, or under chapter 245B; 
  3.31     (4) a board and lodging establishment which serves as a 
  3.32  shelter for battered women or other similar purpose; 
  3.33     (5) a family adult foster care home licensed by the 
  3.34  department of human services; 
  3.35     (6) private homes in which the residents are related by 
  3.36  kinship, law, or affinity with the providers of services; 
  4.1      (7) residential settings for persons with mental 
  4.2   retardation or related conditions in which the services are 
  4.3   licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or 
  4.4   applicable successor rules or laws; 
  4.5      (8) a home-sharing arrangement such as when an elderly or 
  4.6   disabled person or single-parent family makes lodging in a 
  4.7   private residence available to another person in exchange for 
  4.8   services or rent, or both; 
  4.9      (9) a duly organized condominium, cooperative, common 
  4.10  interest community, or owners' association of the foregoing 
  4.11  where at least 80 percent of the units that comprise the 
  4.12  condominium, cooperative, or common interest community are 
  4.13  occupied by individuals who are the owners, members, or 
  4.14  shareholders of the units; or 
  4.15     (10) services for persons with developmental disabilities 
  4.16  that are provided under a license according to Minnesota Rules, 
  4.17  parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or 
  4.18  under chapter 245B.