2006 Minnesota Statutes

245A.143 FAMILY ADULT DAY SERVICES.
    Subdivision 1. Scope. (a) The licensing standards in this section must be met to obtain
and maintain a license to provide family adult day services. For the purposes of this section,
family adult day services means a program operating fewer than 24 hours per day that provides
functionally impaired adults, none of which are under age 55, have serious or persistent mental
illness, or have developmental disabilities, with an individualized and coordinated set of services
including health services, social services, and nutritional services that are directed at maintaining
or improving the participants' capabilities for self-care.
(b) A family adult day services license shall only be issued when the services are provided in
the license holder's primary residence, and the license holder is the primary provider of care. The
license holder may not serve more than eight adults at one time, including residents, if any, served
under a license issued under Minnesota Rules, parts 9555.5105 to 9555.6265.
(c) An adult foster care license holder may provide family adult day services if the license
holder meets the requirements of this section.
(d) When an applicant or license holder submits an application for initial licensure or
relicensure for both adult foster care and family adult day services, the county agency shall process
the request as a single application and shall conduct concurrent routine licensing inspections.
(e) Adult foster care license holders providing family adult day services under their foster
care license on March 30, 2004, shall be permitted to continue providing these services with no
additional requirements until their adult foster care license is due for renewal. At the time of
relicensure, an adult foster care license holder may continue to provide family adult day services
upon demonstration of compliance with this section. Adult foster care license holders who
provide only family adult day services on August 1, 2004, may apply for a license under this
section instead of an adult foster care license.
    Subd. 2. Definitions. (a) Scope. For the purposes of this section, the terms defined in this
subdivision have the following meanings unless otherwise provided for by text.
(b) Caregiver. "Caregiver" means a spouse, adult child, parent, relative, friend, or others who
normally provide unpaid support or care to the individual needing assistance. For the purpose of
this section, the caregiver may or may not have legal or financial responsibility for the participant.
(c) Participant. "Participant" means a functionally impaired adult receiving family adult
day services.
(d) Consultation by a health care professional. "Consultation by a health care professional"
means the review and oversight of the participant's health-related services by a registered nurse,
physician, or mental health professional.
    Subd. 3. Policy and program information requirements. (a) The license holder shall have
available for review, and shall distribute to participants and their caregivers upon admission,
written information about:
(1) the scope of the programs, services, and care offered by the license holder;
(2) a description of the population to be served by the license holder;
(3) a description of individual conditions which the license holder is not prepared to accept,
such as a communicable disease requiring isolation, a history of violence to self or others,
unmanageable incontinence, or uncontrollable wandering;
(4) the participants' rights and procedure for presenting grievances, including the name,
address, and telephone number of the Office of Ombudsman for Older Minnesotans and the
county licensing department, to which a participant or participant's caregiver may submit an
oral or written complaint;
(5) the license holder's policy on and arrangements for providing transportation;
(6) the license holder's policy on providing meals and snacks;
(7) the license holder's fees, billing arrangements, and plans for payment;
(8) the license holder's policy governing the presence of pets in the home;
(9) the license holder's policy on smoking in the home;
(10) types of insurance coverage carried by the license holder;
(11) information on orientation requirements under section 245A.65, subdivisions 1,
paragraph (c) , and 2, paragraph (a), clause (4);
(12) the terms and conditions of the license holder's license issued by the department;
(13) the license holder's plan for emergency evacuation of participants involving fire,
weather, and other disasters. The plan must include instructions for evacuation or rescue of
participants, identification of an emergency shelter area, quarterly fire drill schedule, and staff
responsibilities; and
(14) the license holder's policy for handling harmful objects, materials, or equipment
including the storage of poisonous chemicals, use of appliances, sharp instruments, matches, or
any other potentially harmful materials.
(b) The information in paragraph (a) must be provided in writing to the commissioner's
representative upon request and must be available for inspection by the commissioner's
representative at the home.
    Subd. 4. Admission screening and evaluation. (a) Before admitting an individual into the
family adult day services program, the license holder shall screen the individual to determine
how or whether the license holder can serve the individual, based on the license holder's policies,
services, expertise, and the individual's needs and condition. If possible, the screening shall
include an interview with the individual and with the individual's caregiver.
(b) The screening required under paragraph (a) shall include an evaluation of the health,
nutritional, and social services needs of the individual.
    Subd. 5. Service delivery plan. Before providing family adult day services, an individual,
the individual's caregiver, the legal representative if there is one, the county or private case
manager, if applicable, and the license holder shall develop a service delivery plan. At a minimum,
the service delivery plan shall include:
(1) a description of the health services, nutritional services, and social services to be arranged
or provided by the license holder and the frequency of those services and that the services will be
based on the needs of the individual;
(2) scheduled days and hours of participant's attendance at the license holder's home;
(3) transportation arrangements for getting the participant to and from the license holder's
home;
(4) contingency plans if scheduled services cannot be provided by the license holder;
(5) identification of responsibilities of the participant and the license holder with respect to
payment for the services;
(6) circumstances when emergency services will be called; and
(7) identification of the license holder's discharge policy when services are no longer needed
or when the participant's needs can no longer be met by the license holder.
    Subd. 6. Individual service plan. (a) The service plan must be coordinated with other plans
of services for the participant, as appropriate.
(b) The service plan must be dated and revised when there is a change in the needs of the
participant or annually, whichever occurs sooner.
    Subd. 7. Health services. (a) The license holder shall provide health services as specified
in the service delivery plan under the direction of the designated caregiver or county or private
case manager. Health services must include:
(1) monitoring the participant's level of function and health while participating; taking
appropriate action for a change in condition including immediately reporting changes to the
participant's caregiver, physician, mental health professional, or registered nurse; and seeking
consultation;
(2) offering information to participants and caregivers on good health and safety practices;
and
(3) maintaining a listing of health resources available for referrals as needed by participants
and caregivers.
(b) Unless the person is a licensed health care practitioner qualified to administer
medications, the person responsible for medication administration or assistance shall provide a
certificate verifying successful completion of a trained medication aid program for unlicensed
personnel approved by the Minnesota Department of Health or comparable program, or biennially
provide evidence of competency as demonstrated to a registered nurse or physician.
(c) The license holder must have secure storage and safeguarding of all medications with
storage of medications in their original container, know what information regarding medication
administration must be reported to a health care professional, and must maintain a record of all
medications administered.
    Subd. 8. Nutritional services. (a) The license holder shall ensure that food served is
nutritious and meets any special dietary needs of the participants as prescribed by the participant's
physician or dietitian as specified in the service delivery plan.
(b) Food and beverages must be obtained, handled, and properly stored to prevent
contamination, spoilage, or a threat to the health of a resident.
    Subd. 9. Social services. The license holder, in consultation with the county or private case
manager, when appropriate, shall actively assist the participant in identifying and achieving
personal goals, support the participant in maintaining personal support networks and socially
valued roles, provide assistance to the participant to enable community participation, and refer
participants to the Office of Ombudsman for Older Minnesotans and other advocacy organizations
for assistance when there is a potential conflict of interest between the license holder and the
participant.
    Subd. 10. Participant rights. (a) The license holder shall adopt and comply with a
participant bill of rights. The rights shall include the participants' right to:
(1) participate in the development of the service plan;
(2) refuse services or participation;
(3) privacy;
(4) confidentiality of participant information; and
(5) present grievances regarding treatment or services to the Office of Ombudsman for Older
Minnesotans or the county licensing department. The license holder's policies shall include
a procedure for addressing participant grievances, including the name, address, and telephone
number of the county licensing department, to which a participant or participant caregiver may
submit an oral or written complaint.
(b) The license holder shall post the participant rights in the home and shall provide a
copy to the participant and the participant's primary caregiver and legal representative if the
participant has one.
    Subd. 11. Staffing. Whenever participants are in the home, there must be present at least
one individual who is trained in basic first aid and certified in cardiopulmonary resuscitation and
the treatment of obstructed airways. Whenever there are six, seven, or eight participants present,
there must be a second staff person present.
    Subd. 12. Training. The license holder and license holder's staff must annually complete 12
hours of training related to the health, nutritional, and social needs of the license holder's target
population. License holders with six or more years of licensure under this section or as an adult
foster care provider must annually complete six hours of training. The annual training must
include training on the reporting of maltreatment of vulnerable adults under sections 626.557
and 626.5572; license holder requirements governing maltreatment of vulnerable adults under
section 245A.65; and, when a license holder serves participants who rely on medical monitoring
equipment to sustain life or monitor a medical condition, training on medical equipment as
required under section 245A.155 for foster care providers. A record of all training must be
maintained in the home.
    Subd. 13. Residential requirements. (a) The home where family adult day services are to be
provided shall be classified as a residential group R-3 occupancy under the State Building Code
and State Fire Code for purposes of building code and fire code inspections. A building code
inspection is not required for licensure under this section. The state or local fire marshal must
inspect the family adult day services home operating in the residence for compliance with the
residential group R-3 occupancy provisions of the State Fire Code.
(b) The licensed capacity of the home shall be limited by the amount of indoor space
available for use by participants. The total indoor space available for use by participants must
equal at least 35 square feet for each participant, the license holder, and each staff member present
in the home. In determining the square footage of usable indoor space available, the following
must not be counted: hallways, stairways, closets, offices, restrooms, and utility and storage areas.
The usable indoor space available must include a room or an area that can be used as private space
for providing personal hygiene services or social services to participants.
(c) The residence must comply with all applicable local ordinances.
    Subd. 14. Variances. The commissioner may grant a variance to any of the requirements in
this section if the conditions in section 245A.04, subdivision 9, are met.
History: 2004 c 288 art 1 s 27; 2005 c 56 s 1