1.1.................... moves to amend H.F. No. 3138, the second engrossment, as follows:
1.2Page 182, delete section 5 and insert:

1.3    "Sec. 5. Minnesota Statutes 2016, section 144.651, subdivision 2, is amended to read:
1.4    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in this
1.5subdivision have the meanings given them.
1.6(b) "Patient" means:
1.7(1) a person who is admitted to an acute care inpatient facility for a continuous period
1.8longer than 24 hours, for the purpose of diagnosis or treatment bearing on the physical or
1.9mental health of that person.;
1.10(2) a minor who is admitted to a residential program as defined in section 253C.01;
1.11(3) for purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, "patient" also means
1.12a person who receives health care services at an outpatient surgical center or at a birth center
1.13licensed under section 144.615. "Patient" also means a minor who is admitted to a residential
1.14program as defined in section 253C.01.; and
1.15(4) for purposes of subdivisions 1, 3 to 16, 18, 20, and 30, "patient" also means any
1.16person who is receiving mental health treatment on an outpatient basis or in a community
1.17support program or other community-based program.
1.18(c) "Resident" means a person who is admitted to, resides in, or receives services from:
1.19(1) a nonacute care facility including extended care facilities, nursing homes, and;
1.20(2) an establishment operating under assisted living title protection;
1.21(3) a licensed home care provider in a unit registered as a housing with services
1.22establishment under chapter 144D;
1.23(4) a nursing home;
2.1(5) a boarding care homes home for care required because of prolonged mental or physical
2.2illness or disability, recovery from injury or disease, or advancing age.; and
2.3(6) for purposes of all subdivisions except subdivisions 28 and 29, "resident" also means
2.4a person who is admitted to a facility licensed as a board and lodging facility under Minnesota
2.5Rules, parts 4625.0100 to 4625.2355 chapter 4625, or a supervised living facility under
2.6Minnesota Rules, parts 4665.0100 to 4665.9900 chapter 4665, and which operates a
2.7rehabilitation program licensed under Minnesota Rules, parts 9530.6405 9530.6510 to
2.89530.6590.
2.9(d) "Facility" means:
2.10(1) an acute care inpatient facility;
2.11(2) a residential program as defined in section 253C.01;
2.12(3) an outpatient surgical center or a birth center licensed under section 144.615;
2.13(4) a community support program or other community-based program providing mental
2.14health treatment;
2.15(5) a nonacute care facility including extended care facilities;
2.16(6) an establishment operating under assisted living title protection under chapter 144G;
2.17(7) a licensed home care provider providing services in a unit registered as a housing
2.18with services establishment under chapter 144D;
2.19(8) a nursing home;
2.20(9) a boarding care home for care required because of prolonged mental or physical
2.21illness or disability, recovery from injury or disease, or advancing age; or
2.22(10) a facility licensed as a board and lodging facility under Minnesota Rules, chapter
2.234625, or a supervised living facility under Minnesota Rules, chapter 4665, and which operates
2.24a rehabilitation program licensed under Minnesota Rules, parts 9530.6510 to 9530.6590."
2.25Page 186, delete section 11 and insert:

2.26    "Sec. ... [144.6511] DECEPTIVE MARKETING AND BUSINESS PRACTICES.
2.27(a) Deceptive marketing and business practices by facilities listed in section 144.651,
2.28subdivision 2, and by home care providers are prohibited.
2.29(b) For the purposes of this section, it is a deceptive practice for a facility listed in section
2.30144.651, subdivision 2, or a home care provider to:
3.1(1) make any false, fraudulent, deceptive, or misleading statements in marketing,
3.2advertising, or any other oral or written description or representation of care or services,
3.3whether in oral, written, or electronic form;
3.4(2) arrange for or provide health care or services that are inferior to, substantially different
3.5from, or substantially more expensive than those offered, promised, marketed, or advertised;
3.6(3) fail to deliver any care or services the provider or facility promised or represented
3.7that the facility was able to provide;
3.8(4) fail to inform the patient or resident in writing of any limitations to care services
3.9available prior to executing a contract for admission;
3.10(5) discharge or terminate the lease or services of a patient or resident following a required
3.11period of private pay who then receives benefits under the medical assistance elderly waiver
3.12program after the facility has made an oral or written promise to continue the same services
3.13provided under private pay and accept medical assistance elderly waiver payments after the
3.14expiration of the private pay period;
3.15(6) fail to disclose and clearly explain the purpose of a nonrefundable community fee
3.16or other fee prior to contracting for services with a patient or resident;
3.17(7) advertise or represent, orally or in writing, that the facility is or has a special care
3.18unit, such as for dementia or memory care, without complying with training and disclosure
3.19requirements under sections 144D.065 and 325F.72, and any other applicable law; or
3.20(8) misstate the statutory definitions of the terms "facility," "contract of admission,"
3.21"admission contract," "admission agreement," "legal representative," or "responsible party"
3.22contrary to section 144.6501

3.23    Sec. ... [144.6512] ENFORCEMENT OF THE HEALTH CARE BILL OF RIGHTS.
3.24(a) In addition to the remedies otherwise provided by or available under law, a patient
3.25or resident, or an interested person on behalf of the patient or resident, may bring a civil
3.26action in state district court to recover the greater of actual, incidental, and consequential
3.27damages or $5,000, together with costs and disbursements, including costs of investigation
3.28and reasonable attorney fees, and receive other equitable relief including punitive damages
3.29as determined by the court for a violation of any provision of section 144.6501, subdivision
3.302; 144.651; or 144.6511.
3.31(b) For the purposes of this section:
3.32(1) "patient" has the meaning given in section 144.651, subdivision 2, paragraph (b);
4.1(2) "resident" has the meaning given in section 144.651, subdivision 2, paragraph (c);
4.2and
4.3(3) "interested person" has the meaning given in section 524.5-102."
4.4Page 187, delete section 12 and insert:

4.5    "Sec. ... Minnesota Statutes 2016, section 144A.10, subdivision 1, is amended to read:
4.6    Subdivision 1. Enforcement authority. The commissioner of health is the exclusive
4.7state agency charged with the responsibility and duty of inspecting all facilities required to
4.8be licensed under section 144A.02., and issuing correction orders and imposing fines as
4.9provided in this section, section 144.651, or 626.557, Minnesota Rules, chapter 4658, or
4.10any other applicable law. The commissioner of health shall enforce the rules established
4.11pursuant to sections 144A.01 to 144A.155, subject only to the authority of the Department
4.12of Public Safety respecting the enforcement of fire and safety standards in nursing homes
4.13and the responsibility of the commissioner of human services under sections 245A.01 to
4.14245A.16 or 252.28.
4.15The commissioner may request and must be given access to relevant information, records,
4.16incident reports, or other documents in the possession of a licensed facility if the
4.17commissioner considers them necessary for the discharge of responsibilities. For the purposes
4.18of inspections and securing information to determine compliance with the licensure laws
4.19and rules, the commissioner need not present a release, waiver, or consent of the individual.
4.20The identities of patients or residents must be kept private as defined by section 13.02,
4.21subdivision 12 ."
4.22Page 188, delete section 14 and insert:

4.23    "Sec. .... Minnesota Statutes 2016, section 144A.10, subdivision 6, is amended to read:
4.24    Subd. 6. Fines. A nursing home which is issued a notice of noncompliance with a
4.25correction order shall be assessed a civil fine in accordance with a schedule of fines
4.26established by the commissioner of health before December 1, 1983. A nursing home's
4.27refusal to cooperate in providing lawfully requested information is grounds for a correction
4.28order and a fine of $1,000 per instance the correct information is not provided to the
4.29commissioner in the time requested. In establishing the schedule of fines, the commissioner
4.30shall consider the potential for harm presented to any resident as a result of noncompliance
4.31with each statute or rule. The fine shall be assessed for each day the facility remains in
4.32noncompliance and until a notice of correction is received by the commissioner of health
4.33in accordance with subdivision 7. No fine for a specific violation may exceed $500 per day
4.34of noncompliance.

5.1    Sec. .... Minnesota Statutes 2016, section 144A.44, is amended to read:
5.2144A.44 HOME CARE BILL OF RIGHTS.
5.3    Subdivision 1. Statement of rights Scope. A person who receives home care services
5.4has these rights: All home care providers, including those exempt under section 144A.471,
5.5subdivision 8, must comply with this section.
5.6    Subd. 1a. Statement of rights. (a) A person who receives home care services has the
5.7right to:
5.8(1) the right to receive written information about rights before receiving services,
5.9including what to do if rights are violated;
5.10(2) the right to receive care and services according to a suitable and up-to-date plan, and
5.11subject to accepted health care, medical or nursing standards, to take an active part in
5.12developing, modifying, and evaluating the plan and services;
5.13(3) the right to be told before receiving services the type and disciplines of staff who
5.14will be providing the services, the frequency of visits proposed to be furnished, other choices
5.15that are available for addressing home care needs, and the potential consequences of refusing
5.16these services;
5.17(4) the right to be told in advance of any recommended changes by the provider in the
5.18service plan and to take an active part in any decisions about changes to the service plan;
5.19(5) the right to refuse services or treatment;
5.20(6) the right to know, before receiving services or during the initial visit, any limits to
5.21the services available from a home care provider;
5.22(7) the right to be told before services are initiated what the provider charges for the
5.23services; to what extent payment may be expected from health insurance, public programs,
5.24or other sources, if known; and what charges the client may be responsible for paying;
5.25(8) the right to know that there may be other services available in the community,
5.26including other home care services and providers, and to know where to find information
5.27about these services;
5.28(9) the right to choose freely among available providers and to change providers after
5.29services have begun, within the limits of health insurance, long-term care insurance, medical
5.30assistance, or other health programs;
5.31(10) the right to have personal, financial, and medical information kept private, and to
5.32be advised of the provider's policies and procedures regarding disclosure of such information;
6.1(11) the right to access the client's own records and written information from those
6.2records in accordance with sections 144.291 to 144.298;
6.3(12) the right to be served by people who are properly trained and competent to perform
6.4their duties;
6.5(13) the right to be treated with courtesy and respect, and to have the client's property
6.6treated with respect;
6.7(14) the right to be free from physical and verbal abuse, neglect, financial exploitation,
6.8and all forms of maltreatment covered under the Vulnerable Adults Act and the Maltreatment
6.9of Minors Act;
6.10(15) the right to reasonable, advance notice of changes in services or charges;
6.11(16) the right to know the provider's reason for termination of services;
6.12(17) the right to at least ten 30 days' advance notice of the termination of a service by a
6.13provider, except in cases where:
6.14(i) the client engages in conduct that significantly alters the terms of the service plan
6.15with the home care provider;
6.16(ii) the client, person who lives with the client, or others create an abusive or unsafe
6.17work environment for the person providing home care services; or
6.18(iii) an emergency or a significant change in the client's condition has resulted in service
6.19needs that exceed the current service plan and that cannot be safely met by the home care
6.20provider;
6.21(18) the right to a coordinated transfer when there will be a change in the provider of
6.22services;
6.23(19) the right to complain about services that are provided, or fail to be provided, and
6.24the lack of courtesy or respect to the client or the client's property;
6.25(20) the right to know how to contact an individual associated with the home care provider
6.26who is responsible for handling problems and to have the home care provider investigate
6.27and attempt to resolve the grievance or complaint;
6.28(21) the right to know the name and address of the state or county agency to contact for
6.29additional information or assistance; and
6.30(22) the right to assert these rights personally, or have them asserted by the client's
6.31representative or by anyone on behalf of the client, without retaliation.; and
7.1(23) reasonable access at reasonable times to available rights protection or legal and
7.2advocacy services so that the client may receive assistance in understanding, exercising,
7.3and protecting the rights in this section and other law.
7.4(b) A home care provider shall:
7.5(1) encourage and assist in the fullest possible exercise of these rights;
7.6(2) provide the names and telephone numbers of at least three individuals and
7.7organizations that provide advocacy and legal services for clients;
7.8(3) make every effort to assist clients in obtaining information regarding whether the
7.9Medicare or medical assistance program will pay for services;
7.10(4) make reasonable accommodations for people who have communication disabilities
7.11and those who speak a language other than English; and
7.12(5) provide all information and notices in plain language and in terms the client can
7.13understand.
7.14    Subd. 2. Interpretation and enforcement of rights. These rights are established for
7.15the benefit of clients who receive home care services. All home care providers, including
7.16those exempted under section 144A.471, must comply with this section. The commissioner
7.17shall enforce this section and the home care bill of rights requirement against home care
7.18providers exempt from licensure in the same manner as for licensees. A home care provider
7.19may not request or require a client to surrender any of these rights as a condition of receiving
7.20services. This statement of rights does not replace or diminish other rights and liberties that
7.21may exist relative to clients receiving home care services, persons providing home care
7.22services, or providers licensed under sections 144A.43 to 144A.482. The rights provided
7.23under this section are established for the benefit of clients who receive home care services
7.24whether in an assisted living setting or not; do not replace or diminish other rights and
7.25liberties that may exist relative to clients receiving home care services, persons providing
7.26home care services, or providers licensed under sections 144A.43 to 144A.482; and may
7.27not be waived. Any oral or written waiver of the rights provided under this section is void
7.28and unenforceable.
7.29    Subd. 3. Deceptive marketing and business practices. (a) Deceptive marketing and
7.30business practices are prohibited.
7.31(b) For purposes of this section, it is a deceptive marketing and business practice to:
7.32(1) engage in any conduct listed in section 144.6511;
8.1(2) seek or collect a nonrefundable deposit, unless the deposit is applied to the first
8.2month's charges;
8.3(3) fail to disclose and clearly explain the purpose of a nonrefundable community fee
8.4or other fee prior to contracting for services with a client; or
8.5(4) make any oral or written statement or representation, either directly or in marketing
8.6or advertising materials that contradict, conflict with, or otherwise are inconsistent with the
8.7provisions in the admissions agreement, service agreement, contract, lease, or Uniform
8.8Consumer Information Guide under section 144G.06.
8.9    Subd. 4. Enforcement of rights. The commissioner shall enforce this section and the
8.10requirements of the home care bill of rights against home care providers exempt from
8.11licensure in the same manner as for licensees.
8.12    Subd. 6. Private enforcement of rights. In addition to the remedies otherwise available
8.13under law, a person who receives home care services, an assisted living client, or an interested
8.14person on behalf of the person may bring a civil action in state district court and recover
8.15damages, together with costs and disbursements, including costs of investigation, and
8.16reasonable attorney fees, and receive other equitable relief including punitive damages as
8.17determined by the court for a violation of this section and section 144A.441. For purposes
8.18of this section, an interested person has the meaning given to the term resident representative
8.19in Code of Federal Regulations, title 42, section 483.5.

8.20    Sec. .... Minnesota Statutes 2016, section 144A.441, is amended to read:
8.21144A.441 ASSISTED LIVING BILL OF RIGHTS ADDENDUM.
8.22Assisted living clients, as defined in section 144G.01, subdivision 3, shall be provided
8.23with the home care bill of rights required by section 144A.44, except that the home care
8.24bill of rights provided to these clients must include the following provision in place of the
8.25provision in section 144A.44, subdivision 1 1a, clause (17):
8.26"(17) the right to reasonable, advance notice of changes in services or charges, including
8.27at least 30 days' advance notice of the termination of a service by a provider, except in cases
8.28where:
8.29(i) the recipient of services engages in conduct that alters the conditions of employment
8.30as specified in the employment contract between the home care provider and the individual
8.31providing home care services, or creates and the home care provider can document an
8.32abusive or unsafe work environment for the individual providing home care services;
9.1(ii) a doctor or treating physician documents that an emergency for the informal caregiver
9.2or a significant change in the recipient's condition has resulted in service needs that exceed
9.3the current service provider agreement and that cannot be safely met by the home care
9.4provider; or
9.5(iii) the provider has not received payment for services, for which at least ten days'
9.6advance notice of the termination of a service shall be provided.""
9.7Page 193, after line 19, insert:

9.8    "Sec. .... Minnesota Statutes 2016, section 144A.474, subdivision 1, is amended to read:
9.9    Subdivision 1. Surveys. The commissioner shall conduct surveys of each home care
9.10provider. By June 30, 2016, The commissioner shall conduct a survey of home care providers
9.11on a frequency of at least once every three years. Survey frequency may be based on the
9.12license level, the provider's compliance history, the number of clients served, or other factors
9.13as determined by the department deemed necessary to ensure the health, safety, and welfare
9.14of clients and compliance with the law. The commissioner shall conduct an annual health
9.15environment and physical plant survey for assisted living licenses effective on February 1,
9.162020."
9.17Page 195, delete sections 20 and 21, and insert:

9.18    "Sec. .... Minnesota Statutes 2016, section 144A.474, subdivision 8, is amended to read:
9.19    Subd. 8. Correction orders. (a) A correction order may be issued whenever the
9.20commissioner finds upon survey or during a complaint investigation that a home care
9.21provider, a managerial official, or an employee of the provider is not in compliance with
9.22sections 144A.43 to 144A.482. The correction order shall cite the specific statute and
9.23document areas of noncompliance and the time allowed for correction.
9.24(b) The commissioner shall mail copies of any correction order to the last known address
9.25of the home care provider, or electronically scan the correction order and e-mail it to the
9.26last known home care provider e-mail address, within 30 calendar days after the survey exit
9.27date. A copy of each correction order, the amount of any fine issued, and copies of any
9.28documentation supplied to the commissioner shall be kept on file by the home care provider,
9.29and public these documents shall be made available for viewing by any person upon request.
9.30Copies may be kept electronically.
9.31(c) By the correction order date, the home care provider must document in the provider's
9.32records and submit in writing to the commissioner any action taken to comply with the
9.33correction order. The commissioner may request a copy of this documentation and the home
10.1care provider's action to respond to the correction order in future surveys, upon a complaint
10.2investigation, and as otherwise needed.

10.3    Sec. .... Minnesota Statutes 2016, section 144A.474, subdivision 9, is amended to read:
10.4    Subd. 9. Follow-up surveys. For providers that have Level 3 or Level 4 violations under
10.5subdivision 11, or any violations determined to be widespread, the department shall conduct
10.6a follow-up survey within 90 calendar days of the survey. When conducting a follow-up
10.7survey, the surveyor will focus on whether the previous violations have been corrected and
10.8may also address any new violations that are observed while evaluating the corrections that
10.9have been made. If a new violation is identified on a follow-up survey, no a fine will may
10.10be immediately imposed unless it is not corrected on the next follow-up survey."
10.11Page 196, delete section 22 and insert:

10.12    "Sec. .... Minnesota Statutes 2017 Supplement, section 144A.474, subdivision 11, is
10.13amended to read:
10.14    Subd. 11. Fines. (a) Fines and enforcement actions under this subdivision may be assessed
10.15based on the level and scope of the violations described in paragraph (c) as follows:
10.16    (1) Level 1, no fines or enforcement;
10.17    (2) Level 2, fines ranging from $0 to $500 $1,000, in addition to any of the enforcement
10.18mechanisms authorized in section 144A.475 for widespread violations;
10.19    (3) Level 3, fines ranging from $500 to $1,000 to $5,000, in addition to any of the
10.20enforcement mechanisms authorized in section 144A.475; and
10.21    (4) Level 4, fines ranging from $1,000 to $5,000 to $10,000, in addition to any of the
10.22enforcement mechanisms authorized in section 144A.475.
10.23    (b) Correction orders for violations are categorized by both level and scope and fines
10.24shall be assessed as follows:
10.25    (1) level of violation:
10.26    (i) Level 1 is a violation that has no potential to cause more than a minimal impact on
10.27the client and does not affect health or safety;
10.28    (ii) Level 2 is a violation that did not harm a client's health or safety but had the potential
10.29to have harmed a client's health or safety, but was not likely to cause serious injury,
10.30impairment, or death;
11.1    (iii) Level 3 is a violation that harmed a client's health or safety, not including serious
11.2injury, impairment, or death, or a violation that has the potential to lead to serious injury,
11.3impairment, or death; and
11.4    (iv) Level 4 is a violation that results in serious injury, impairment, or death.
11.5    (2) scope of violation:
11.6    (i) isolated, when one or a limited number of clients are affected or one or a limited
11.7number of staff are involved or the situation has occurred only occasionally;
11.8    (ii) pattern, when more than a limited number of clients are affected, more than a limited
11.9number of staff are involved, or the situation has occurred repeatedly but is not found to be
11.10pervasive; and
11.11    (iii) widespread, when problems are pervasive or represent a systemic failure that has
11.12affected or has the potential to affect a large portion or all of the clients.
11.13    (c) If the commissioner finds that the applicant or a home care provider required to be
11.14licensed under sections 144A.43 to 144A.482 has not corrected violations by the date
11.15specified in the correction order or conditional license resulting from a survey or complaint
11.16investigation, the commissioner may impose a an additional fine. A notice of noncompliance
11.17with a correction order must be mailed to the applicant's or provider's last known address.
11.18The noncompliance notice must list the violations not corrected.
11.19    (d) The license holder must pay the fines assessed on or before the payment date specified.
11.20If the license holder fails to fully comply with the order, the commissioner may issue a
11.21second fine or suspend the license until the license holder complies by paying the fine. A
11.22timely appeal shall stay payment of the fine until the commissioner issues a final order.
11.23    (e) A license holder shall promptly notify the commissioner in writing when a violation
11.24specified in the order is corrected. If upon reinspection the commissioner determines that
11.25a violation has not been corrected as indicated by the order, the commissioner may issue a
11.26second an additional fine. The commissioner shall notify the license holder by mail to the
11.27last known address in the licensing record that a second an additional fine has been assessed.
11.28The license holder may appeal the second additional fine as provided under this subdivision.
11.29    (f) A home care provider that has been assessed a fine under this subdivision has a right
11.30to a reconsideration or a hearing under this section and chapter 14.
11.31    (g) When a fine has been assessed, the license holder may not avoid payment by closing,
11.32selling, or otherwise transferring the licensed program to a third party. In such an event, the
11.33license holder shall be liable for payment of the fine.
12.1    (h) In addition to any fine imposed under this section, the commissioner may assess
12.2costs related to an investigation that results in a final order assessing a fine or other
12.3enforcement action authorized by this chapter.
12.4    (i) Fines collected under this subdivision shall be deposited in the state government
12.5special revenue fund and credited to an account separate from the revenue collected under
12.6section 144A.472. Subject to an appropriation by the legislature, the revenue from the fines
12.7collected must be used by the commissioner for special projects to improve home care in
12.8Minnesota as recommended by the advisory council established in section 144A.4799.
12.9(j) For nursing homes licensed by the commissioner, this section may be used to calculate
12.10the fine amount on nursing homes violating the Vulnerable Adults Act in section 626.557
12.11or other licensing violations."
12.12Page 198, delete section 24 and insert:

12.13    "Sec. .... Minnesota Statutes 2016, section 144A.53, subdivision 1, is amended to read:
12.14    Subdivision 1. Powers. The director may:
12.15(a) Promulgate by rule, pursuant to chapter 14, and within the limits set forth in
12.16subdivision 2, the methods by which complaints against health facilities, health care
12.17providers, home care providers, or residential care homes, or administrative agencies are
12.18to be made, reviewed, investigated, and acted upon; provided, however, that a fee may not
12.19be charged for filing a complaint.
12.20(b) Recommend legislation and changes in rules to the state commissioner of health,
12.21governor, administrative agencies or the federal government.
12.22(c) Investigate, upon a complaint or upon initiative of the director, any action or failure
12.23to act by a health care provider, home care provider, residential care home, or a health
12.24facility.
12.25(d) Request and receive access to relevant information, records, incident reports, or
12.26documents in the possession of an administrative agency, a health care provider, a home
12.27care provider, a residential care home, or a health facility, and issue investigative subpoenas
12.28to individuals and facilities for oral information and written information, including privileged
12.29information which the director deems necessary for the discharge of responsibilities. For
12.30purposes of investigation and securing information to determine violations, the director
12.31need not present a release, waiver, or consent of an individual. The identities of patients or
12.32residents must be kept private as defined by section 13.02, subdivision 12.
13.1(e) Enter and inspect, at any time, a health facility or residential care home and be
13.2permitted to interview staff; provided that the director shall not unduly interfere with or
13.3disturb the provision of care and services within the facility or home or the activities of a
13.4patient or resident unless the patient or resident consents.
13.5(f) Issue correction orders and assess civil fines pursuant to section for violations of
13.6sections 144.651, 144.653, 144A.10, 144A.44, 144A.45, and 626.557, Minnesota Rules,
13.7chapters 4655, 4658, 4664, and 4665, or any other law which that provides for the issuance
13.8of correction orders to health facilities or home care provider, or under section 144A.45.The
13.9director may use the authority in section 144A.474, subdivision 11, to calculate the fine
13.10amount. A facility's or home's refusal to cooperate in providing lawfully requested
13.11information within the requested time period may also be grounds for a correction order or
13.12fine at a Level 2 fine pursuant to section 144A.474, subdivision 11.
13.13(g) Recommend the certification or decertification of health facilities pursuant to Title
13.14XVIII or XIX of the United States Social Security Act.
13.15(h) Assist patients or residents of health facilities or residential care homes in the
13.16enforcement of their rights under Minnesota law.
13.17(i) Work with administrative agencies, health facilities, home care providers, residential
13.18care homes, and health care providers and organizations representing consumers on programs
13.19designed to provide information about health facilities to the public and to health facility
13.20residents."
13.21Page 204, delete section 33 and insert:

13.22    "Sec. .... [144D.085] RELOCATION WITHIN FACILITY.
13.23    Subdivision 1. Notification prior to relocation. A housing with services establishment
13.24or assisted living setting must:
13.25(1) notify a resident and the resident's representative at least ten days prior to a proposed
13.26nonemergency relocation within the facility; and
13.27(2) obtain consent from the resident or the resident's representative to the relocation.
13.28    Subd. 2. Restriction on relocation. A person who has been a private pay resident for
13.29at least one year, who resides in a private room, and whose payments subsequently will be
13.30made under the medical assistance program may not be relocated to a shared room without
13.31the consent of the resident or the resident's representative.

14.1    Sec. .... Minnesota Statutes 2016, section 144D.09, is amended to read:
14.2144D.09 TERMINATION OF LEASE.
14.3    Subdivision 1. Legislative intent. The housing with services establishment shall include
14.4with notice of termination of lease information about how to contact the ombudsman for
14.5long-term care, including the address and telephone number along with a statement of how
14.6to request problem-solving assistance. It is the intent of the legislature to ensure to the
14.7greatest extent possible housing stability for persons residing in housing with services
14.8establishments or assisted living settings, and to avoid unnecessary moves either within or
14.9from the housing with services establishments or assisted living settings.
14.10    Subd. 2. Permissible reasons to terminate lease. (a) Notwithstanding chapter 504B, a
14.11housing with services establishment or assisted living setting may terminate a resident's
14.12lease only if:
14.13(1) the resident breaches the lease, which includes failure to pay rent as required, and
14.14has not cured the breach within 30 days of receipt of the notice required under subdivision
14.153. A breach of a services contract does not constitute a breach of a lease;
14.16(2) the resident holds over beyond the date to vacate mutually agreed upon in writing
14.17by the resident and the housing with services establishment or assisted living setting; or
14.18(3) the resident holds over beyond the date provided by the resident in a notice of
14.19voluntary termination of the lease provided to the housing with services establishment or
14.20assisted living setting.
14.21(b) Notwithstanding paragraph (a), a housing with services establishment or assisted
14.22living setting may immediately commence an eviction if the breach involves any of the acts
14.23listed in section 504B.171, subdivision 1.
14.24    Subd. 3. Notice of lease termination. A housing with services establishment or assisted
14.25living setting must provide at least 30 days' notice prior to terminating a residential lease,
14.26unless the resident commits a breach of the lease involving any of the acts listed in section
14.27504B.171, subdivision 1.
14.28    Subd. 4. Contents of notice. The notice of lease termination required under subdivision
14.293 must include:
14.30(1) the reason for the termination;
14.31(2) the date termination shall occur;
15.1(3) a statement that a lease cannot be terminated without providing the resident an
15.2opportunity to cure the breach of lease, including failure to pay rent;
15.3(4) information on how to contact the Office of Ombudsman for Long-Term Care and
15.4a protection and advocacy agency, including the address and telephone number of both
15.5offices, along with a statement of how to request problem-solving assistance;
15.6(5) a statement that the resident has the right to avoid termination of the lease by paying
15.7the rent in full or curing any breach prior to expiration of 30 days after receipt of the notice;
15.8(6) a statement that the resident has the right to request a meeting with the owner or
15.9manager of the housing with services establishment or assisted living setting to discuss and
15.10attempt to resolve the alleged breach to avoid termination; and
15.11(7) a statement that the resident has the right to appeal the termination of the lease to
15.12the Office of Administrative Hearings and provide the contact information for the Office
15.13of Administrative Hearings including the address, fax number, e-mail, and telephone number.
15.14    Subd. 5. Right to appeal termination of lease. (a) At any time prior to the expiration
15.15of the notice period provided under subdivision 3, a resident may appeal the termination by
15.16making a written request for a hearing to the Office of Administrative Hearings. The Office
15.17of Administrative Hearings must conduct the hearing no later than 14 days after the office
15.18receives the appeal request from the resident. The hearing must be held in the establishment
15.19in which the resident resides, unless impractical or the parties agree to a different place.
15.20Attorney representation is not required at the hearing, nor does appearing without an attorney
15.21constitute the unauthorized practice of law. The hearing shall not be construed as a formal
15.22evidentiary hearing. The hearing may also be attended by telephone as allowed by the
15.23administrative law judge. The hearing shall be limited to the amount of time necessary for
15.24the participants to expeditiously present the facts about the proposed termination. The
15.25administrative law judge shall issue a recommendation to the commissioner within ten
15.26business days after the hearing.
15.27(b) A resident who timely appeals a notice of lease termination may not be evicted by
15.28the housing with services establishment or assisted living setting until the Office of
15.29Administrative Hearings has made a final determination on the appeal in favor of the housing
15.30with services establishment or assisted living setting.
15.31(c) The commissioner of health may direct the housing with services establishment or
15.32assisted living setting to rescind the lease termination or readmit the resident if the Office
15.33of Administrative Hearings holds that the lease termination was in violation of state or
15.34federal law.
16.1(d) The housing with services establishment or assisted living setting must readmit the
16.2resident following a hospitalization if the resident is hospitalized for medical necessity
16.3before resolution of the appeal.
16.4(e) Residents are not required to request a meeting under subdivision 4, prior to submitting
16.5an appeal hearing request.
16.6(f) Nothing in this section limits the right of a resident or the resident's representative
16.7to request or receive assistance from the Office of Ombudsman for Long-Term Care and
16.8the protection and advocacy agency concerning the proposed lease termination.
16.9    Subd. 6. Discharge plan and transfer of information to new residence. (a) A housing
16.10with services establishment or assisted living setting discharging a resident must prepare
16.11an adequate discharge plan that proposes a safe discharge location, is based on the resident's
16.12discharge goals, includes the resident and the resident's case manager and representative,
16.13if any, in discharge planning, and contains a plan for appropriate and sufficient postdischarge
16.14care. A housing with services establishment or assisted living setting may not discharge a
16.15resident if upon discharge the resident will become a homeless individual, as defined in
16.16section 116L.361, subdivision 5.
16.17(b) A housing with services establishment or assisted living setting that proposes to
16.18discharge a resident must assist the resident with applying for and locating a new housing
16.19with services establishment, assisted living setting, or skilled nursing facility in which to
16.20live, including coordinating with the case manager, if any.
16.21(c) Prior to discharge, a housing with services establishment or assisted living setting
16.22must provide to the receiving facility or establishment all information known to the housing
16.23with services establishment or assisted living setting related to the resident that is necessary
16.24to ensure continuity of care and services, including at a minimum:
16.25(1) the resident's full name, date of birth, and insurance information;
16.26(2) the name, telephone number, and address of the resident's representative, if any;
16.27(3) the resident's current documented diagnoses;
16.28(4) the resident's known allergies, if any;
16.29(5) the name and telephone number of the resident's physician and current physician
16.30orders;
16.31(6) medication administration records;
16.32(7) the most recent resident assessment; and
17.1(8) copies of health care directives, "do not resuscitate" orders, and guardianship orders
17.2or powers of attorney, if any.
17.3(d) For the purposes of this subdivision, "discharge" means the involuntary relocation
17.4of a resident due to a termination of a lease.
17.5    Subd. 7. Final accounting; return of money and property. Within 30 days of the date
17.6of discharge, the housing with services establishment or assisted living setting shall:
17.7(1) provide to the resident or the resident's representative a final statement of account;
17.8(2) provide any refunds due; and
17.9(3) return any money, property, or valuables held in trust or custody by the establishment.

17.10    Sec. .... [144D.095] TERMINATION OF SERVICES.
17.11    Subdivision 1. Legislative intent. It is the intent of the legislature to ensure to the greatest
17.12extent possible consistent and stable services for persons residing in housing with services
17.13establishments and assisted living settings.
17.14    Subd. 2. Notice; permissible reasons to terminate services. (a) Except as provided in
17.15paragraph (b), an arranged home care provider must provide at least 30 days' notice prior
17.16to terminating a service contract. Notwithstanding any other provision of law, an arranged
17.17home care provider may terminate services only if:
17.18(1) the resident engages in conduct that interferes with the home care provider's ability
17.19to carry out the terms of the service plan and cannot be cured by updating or changing the
17.20terms of the service plan; or
17.21(2) the resident breaches the services agreement, including failure to pay for services,
17.22provided the resident has not cured the breach within 30 days of receiving written notice
17.23of the nonpayment.
17.24(b) Notwithstanding paragraph (a), the arranged home care provider may terminate
17.25services with ten days' notice if:
17.26(1) the resident creates, and the provider documents, an abusive or unsafe work
17.27environment for the individual providing home care services; or
17.28(2) a doctor or treating physician documents that an emergency or a significant change
17.29in the resident's condition has resulted in service needs that exceed the current service plan
17.30and that cannot be safely met by the home care provider.
18.1    Subd. 3. Contents of service termination notice. (a) If an arranged home care provider
18.2who is not also Medicare certified terminates a service agreement or service plan with a
18.3resident in a housing with services establishment and assisted living setting, the home care
18.4provider shall provide the resident and the legal or designated representatives of the resident,
18.5if any, with advance written notice of service termination according to subdivision 2, that
18.6must include:
18.7(1) the effective date of service termination;
18.8(2) the reason for service termination;
18.9(3) without extending the termination notice period, an affirmative offer to meet with
18.10the resident or resident's representatives within no more than five business days of the date
18.11of the service termination notice to discuss the termination;
18.12(4) contact information for other home care providers in the geographic area of the
18.13resident, as required by section 144A.4791, subdivision 10;
18.14(5) a statement that the provider will participate in a coordinated transfer of the care of
18.15the client to another provider or caregiver, as required by section 144A.44, subdivision 1a,
18.16clause (18);
18.17(6) a statement that the resident has the right to request a meeting with the arranged
18.18home care provider to discuss and attempt to avoid the service termination;
18.19(7) the name and contact information of a representative of the arranged home care
18.20provider with whom the resident may discuss the notice of service termination;
18.21(8) a copy of the home care bill of rights;
18.22(9) a statement that the notice of service termination of home care services by the home
18.23care provider does not constitute notice of termination of the housing with services
18.24establishment or assisted living setting lease; and
18.25(10) a statement that the resident has the right to appeal the service termination to the
18.26Office of Administrative Hearings and provide the contact information for the Office of
18.27Administrative Hearings including the address, fax number, e-mail, and telephone number.
18.28    Subd. 4. Right to appeal service termination. (a) At any time prior to the expiration
18.29of the notice period provided under subdivision 2 and section 144A.441, a resident may
18.30appeal the service termination by making a written request for a hearing to the Office of
18.31Administrative Hearings. The Office of Administrative Hearings must conduct the hearing
18.32no later than 14 days after the office receives the appeal request from the resident. The
19.1hearing must be held in the place where the resident resides, unless it is impractical or the
19.2parties agree to a different place. Attorney representation is not required at the hearing, nor
19.3does appearing without an attorney constitute the unauthorized practice of law. The hearing
19.4shall not be construed as a formal evidentiary hearing. The hearing may also be attended
19.5by telephone as allowed by the administrative law judge. The hearing shall be limited to
19.6the amount of time necessary for the participants to expeditiously present the facts about
19.7the proposed termination. The administrative law judge shall issue a recommendation to
19.8the commissioner within ten business days after the hearing.
19.9(b) The arranged home care provider may not discontinue services to a resident who
19.10timely appeals a notice of service termination until the Office of Administrative Hearings
19.11has made a final determination on the appeal in favor of the housing with services
19.12establishment or assisted living setting.
19.13(c) Residents are not required to request a meeting under subdivision 3, clause (6), prior
19.14to submitting an appeal hearing request.
19.15(d) The commissioner of health may direct the facility to rescind the service contract
19.16termination if the Office of Administrative Hearings holds that the proposed termination
19.17was in violation of state or federal law.
19.18(e) Nothing in this section limits the right of a resident or the resident's representative
19.19to request or receive assistance from the Office of Ombudsman for Long-Term Care and
19.20the protection and advocacy agency concerning the proposed service termination."
19.21Page 205, line 10, delete "section 144A.442" and insert "sections 144A.442 and
19.22144D.095"
19.23Page 205, delete section 37 and insert:

19.24    "Sec. .... Minnesota Statutes 2017 Supplement, section 256.045, subdivision 3, is amended
19.25to read:
19.26    Subd. 3. State agency hearings. (a) State agency hearings are available for the following:
19.27(1) any person applying for, receiving or having received public assistance, medical
19.28care, or a program of social services granted by the state agency or a county agency or the
19.29federal Food Stamp Act whose application for assistance is denied, not acted upon with
19.30reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed
19.31to have been incorrectly paid;
19.32(2) any patient or relative aggrieved by an order of the commissioner under section
19.33252.27 ;
20.1(3) a party aggrieved by a ruling of a prepaid health plan;
20.2(4) except as provided under chapter 245C,:
20.3(i) any individual or facility determined by a lead investigative agency to have maltreated
20.4a vulnerable adult under section 626.557 after they have exercised their right to administrative
20.5reconsideration under section 626.557; and
20.6(ii) any vulnerable adult who is the subject of a maltreatment investigation under section
20.7626.557 or an interested person unless restricted by the vulnerable adult or by a court, after
20.8the right to administrative reconsideration under section 626.557, subdivision 9d, has been
20.9exercised. For purposes of this section, "interested person" has the meaning given to the
20.10term resident representative in the Code of Federal Regulations, title 42, section 483.5;
20.11(5) any person whose claim for foster care payment according to a placement of the
20.12child resulting from a child protection assessment under section 626.556 is denied or not
20.13acted upon with reasonable promptness, regardless of funding source;
20.14(6) any person to whom a right of appeal according to this section is given by other
20.15provision of law;
20.16(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
20.17under section 256B.15;
20.18(8) an applicant aggrieved by an adverse decision to an application or redetermination
20.19for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
20.20(9) except as provided under chapter 245A, an individual or facility determined to have
20.21maltreated a minor under section 626.556, after the individual or facility has exercised the
20.22right to administrative reconsideration under section 626.556;
20.23(10) except as provided under chapter 245C, an individual disqualified under sections
20.24245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
20.25on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
20.26individual has committed an act or acts that meet the definition of any of the crimes listed
20.27in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
20.28626.556, subdivision 3 , or 626.557, subdivision 3. Hearings regarding a maltreatment
20.29determination under clause (4) or (9) and a disqualification under this clause in which the
20.30basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
20.31a single fair hearing. In such cases, the scope of review by the human services judge shall
20.32include both the maltreatment determination and the disqualification. The failure to exercise
20.33the right to an administrative reconsideration shall not be a bar to a hearing under this section
21.1if federal law provides an individual the right to a hearing to dispute a finding of
21.2maltreatment;
21.3(11) any person with an outstanding debt resulting from receipt of public assistance,
21.4medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
21.5Department of Human Services or a county agency. The scope of the appeal is the validity
21.6of the claimant agency's intention to request a setoff of a refund under chapter 270A against
21.7the debt;
21.8(12) a person issued a notice of service termination under section 245D.10, subdivision
21.93a, from residential supports and services as defined in section 245D.03, subdivision 1,
21.10paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a;
21.11(13) an individual disability waiver recipient based on a denial of a request for a rate
21.12exception under section 256B.4914; or
21.13(14) a person issued a notice of service termination under section 245A.11, subdivision
21.1411, that is not otherwise subject to appeal under subdivision 4a.
21.15(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
21.16is the only administrative appeal to the final agency determination specifically, including
21.17a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
21.18under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
21.19after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
21.20to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
21.21proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
21.22clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
21.23hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
21.24available when there is no district court action pending. If such action is filed in district
21.25court while an administrative review is pending that arises out of some or all of the events
21.26or circumstances on which the appeal is based, the administrative review must be suspended
21.27until the judicial actions are completed. If the district court proceedings are completed,
21.28dismissed, or overturned, the matter may be considered in an administrative hearing.
21.29(c) For purposes of this section, bargaining unit grievance procedures are not an
21.30administrative appeal.
21.31(d) The scope of hearings involving claims to foster care payments under paragraph (a),
21.32clause (5), shall be limited to the issue of whether the county is legally responsible for a
21.33child's placement under court order or voluntary placement agreement and, if so, the correct
22.1amount of foster care payment to be made on the child's behalf and shall not include review
22.2of the propriety of the county's child protection determination or child placement decision.
22.3(e) The scope of hearings under paragraph (a), clauses (12) and (14), shall be limited to
22.4whether the proposed termination of services is authorized under section 245D.10,
22.5subdivision 3a , paragraph (b), or 245A.11, subdivision 11, and whether the requirements
22.6of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision 2a,
22.7paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of
22.8termination of services, the scope of the hearing shall also include whether the case
22.9management provider has finalized arrangements for a residential facility, a program, or
22.10services that will meet the assessed needs of the recipient by the effective date of the service
22.11termination.
22.12(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
22.13under contract with a county agency to provide social services is not a party and may not
22.14request a hearing under this section, except if assisting a recipient as provided in subdivision
22.154.
22.16(g) An applicant or recipient is not entitled to receive social services beyond the services
22.17prescribed under chapter 256M or other social services the person is eligible for under state
22.18law.
22.19(h) The commissioner may summarily affirm the county or state agency's proposed
22.20action without a hearing when the sole issue is an automatic change due to a change in state
22.21or federal law.
22.22(i) Unless federal or Minnesota law specifies a different time frame in which to file an
22.23appeal, an individual or organization specified in this section may contest the specified
22.24action, decision, or final disposition before the state agency by submitting a written request
22.25for a hearing to the state agency within 30 days after receiving written notice of the action,
22.26decision, or final disposition, or within 90 days of such written notice if the applicant,
22.27recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
22.2813, why the request was not submitted within the 30-day time limit. The individual filing
22.29the appeal has the burden of proving good cause by a preponderance of the evidence.

22.30    Sec. ... Minnesota Statutes 2017 Supplement, section 256.045, subdivision 3b, is amended
22.31to read:
22.32    Subd. 3b. Standard of evidence for maltreatment and disqualification hearings. (a)
22.33The state human services judge shall determine that maltreatment has occurred if a
23.1preponderance of evidence exists to support the final disposition under sections 626.556
23.2and 626.557. For purposes of hearings regarding disqualification, the state human services
23.3judge shall affirm the proposed disqualification in an appeal under subdivision 3, paragraph
23.4(a), clause (10), if a preponderance of the evidence shows the individual has:
23.5(1) committed maltreatment under section 626.556 or 626.557, which is serious or
23.6recurring;
23.7(2) committed an act or acts meeting the definition of any of the crimes listed in section
23.8245C.15 , subdivisions 1 to 4; or
23.9(3) failed to make required reports under section 626.556 or 626.557, for incidents in
23.10which the final disposition under section 626.556 or 626.557 was substantiated maltreatment
23.11that was serious or recurring.
23.12(b) If the disqualification is affirmed, the state human services judge shall determine
23.13whether the individual poses a risk of harm in accordance with the requirements of section
23.14245C.22 , and whether the disqualification should be set aside or not set aside. In determining
23.15whether the disqualification should be set aside, the human services judge shall consider
23.16all of the characteristics that cause the individual to be disqualified, including those
23.17characteristics that were not subject to review under paragraph (a), in order to determine
23.18whether the individual poses a risk of harm. A decision to set aside a disqualification that
23.19is the subject of the hearing constitutes a determination that the individual does not pose a
23.20risk of harm and that the individual may provide direct contact services in the individual
23.21program specified in the set aside.
23.22(c) If a disqualification is based solely on a conviction or is conclusive for any reason
23.23under section 245C.29, the disqualified individual does not have a right to a hearing under
23.24this section.
23.25(d) For purposes of hearings under subdivision 4, if the state human services judge
23.26determines that maltreatment has occurred, the state human services judge shall recommend
23.27an order to the commissioner of health or human services that the lead investigative agency
23.28determines responsibility in accordance with section 626.557, subdivision 9c, who shall
23.29issue a final order.
23.30(d) (e) The state human services judge shall recommend an order to the commissioner
23.31of health, education, or human services, as applicable, who shall issue a final order. The
23.32commissioner shall affirm, reverse, or modify the final disposition. Any order of the
23.33commissioner issued in accordance with this subdivision is conclusive upon the parties
23.34unless appeal is taken in the manner provided in subdivision 7. In any licensing appeal under
24.1chapters 245A and 245C and sections 144.50 to 144.58 and 144A.02 to 144A.482, the
24.2commissioner's determination as to maltreatment is conclusive, as provided under section
24.3245C.29 ."
24.4Page 208, delete section 38 and insert:

24.5    "Sec. .... Minnesota Statutes 2017 Supplement, section 256.045, subdivision 4, is amended
24.6to read:
24.7    Subd. 4. Conduct of hearings. (a) All hearings held pursuant to subdivision 3, 3a, 3b,
24.8or 4a shall be conducted according to the provisions of the federal Social Security Act and
24.9the regulations implemented in accordance with that act to enable this state to qualify for
24.10federal grants-in-aid, and according to the rules and written policies of the commissioner
24.11of human services. County agencies shall install equipment necessary to conduct telephone
24.12hearings. A state human services judge may schedule a telephone conference hearing when
24.13the distance or time required to travel to the county agency offices will cause a delay in the
24.14issuance of an order, or to promote efficiency, or at the mutual request of the parties. Hearings
24.15may be conducted by telephone conferences unless the applicant, recipient, former recipient,
24.16person, or facility contesting maltreatment objects. A human services judge may grant a
24.17request for a hearing in person by holding the hearing by interactive video technology or
24.18in person. The human services judge must hear the case in person if the person asserts that
24.19either the person or a witness has a physical or mental disability that would impair the
24.20person's or witness's ability to fully participate in a hearing held by interactive video
24.21technology. The hearing shall not be held earlier than five days after filing of the required
24.22notice with the county or state agency. The state human services judge shall notify all
24.23interested persons of the time, date, and location of the hearing at least five days before the
24.24date of the hearing. Interested persons may be represented by legal counsel or other
24.25representative of their choice, including a provider of therapy services, at the hearing and
24.26may appear personally, testify and offer evidence, and examine and cross-examine witnesses.
24.27The applicant, recipient, former recipient, person, or facility contesting maltreatment shall
24.28have the opportunity to examine the contents of the case file and all documents and records
24.29to be used by the county or state agency at the hearing at a reasonable time before the date
24.30of the hearing and during the hearing. In hearings under subdivision 3, paragraph (a), clauses
24.31(4), (9), and (10), either party may subpoena the private data relating to the investigation
24.32prepared by the agency under section 626.556 or 626.557 that is not otherwise accessible
24.33under section 13.04, provided the identity of the reporter may not be disclosed.
24.34(b) The private data obtained by subpoena in a hearing under subdivision 3, paragraph
24.35(a), clause (4), (9), or (10), must be subject to a protective order which prohibits its disclosure
25.1for any other purpose outside the hearing provided for in this section without prior order of
25.2the district court. Disclosure without court order is punishable by a sentence of not more
25.3than 90 days imprisonment or a fine of not more than $1,000, or both. These restrictions on
25.4the use of private data do not prohibit access to the data under section 13.03, subdivision
25.56 . Except for appeals under subdivision 3, paragraph (a), clauses (4), (5), (9), and (10), upon
25.6request, the county agency shall provide reimbursement for transportation, child care,
25.7photocopying, medical assessment, witness fee, and other necessary and reasonable costs
25.8incurred by the applicant, recipient, or former recipient in connection with the appeal. All
25.9evidence, except that privileged by law, commonly accepted by reasonable people in the
25.10conduct of their affairs as having probative value with respect to the issues shall be submitted
25.11at the hearing and such hearing shall not be "a contested case" within the meaning of section
25.1214.02, subdivision 3 . The agency must present its evidence prior to or at the hearing, and
25.13may not submit evidence after the hearing except by agreement of the parties at the hearing,
25.14provided the petitioner has the opportunity to respond.
25.15(c) In hearings under subdivision 3, paragraph (a), clauses (4), (9), and (10), involving
25.16determinations of maltreatment or disqualification made by more than one county agency,
25.17by a county agency and a state agency, or by more than one state agency, the hearings may
25.18be consolidated into a single fair hearing upon the consent of all parties and the state human
25.19services judge.
25.20(d) For hearings under subdivision 3, paragraph (a), clause (4) or (10), involving a
25.21vulnerable adult, the human services judge shall notify: (1) the vulnerable adult who is the
25.22subject of the maltreatment determination and an interested person, if known, a guardian
25.23of the vulnerable adult appointed under section 524.5-310, or a health care agent designated
25.24by the vulnerable adult in a health care directive that is currently effective under section
25.25145C.06 and whose authority to make health care decisions is not suspended under section
25.26524.5-310 , of the hearing requested by the individual or facility determined to have maltreated
25.27a vulnerable adult under section 626.557; and (2) the facility or individual who is the alleged
25.28perpetrator of maltreatment of the hearing requested by the vulnerable adult who is the
25.29subject of the maltreatment determination or an interested person.
25.30The notice must be sent by certified mail and inform the vulnerable adult, the facility, or
25.31the alleged perpetrator of the right to file a signed written statement in the proceedings. A
25.32guardian or health care agent who prepares or files a written statement for the vulnerable
25.33adult must indicate in the statement that the person is the vulnerable adult's guardian or
25.34health care agent and sign the statement in that capacity. The vulnerable adult, the guardian,
25.35or the health care agent may file a written statement with the human services judge hearing
26.1the case no later than five business days before commencement of the hearing. The human
26.2services judge shall include the written statement in the hearing record and consider the
26.3statement in deciding the appeal. This subdivision does not limit, prevent, or excuse the
26.4vulnerable adult or alleged perpetrator from being called as a witness testifying at the hearing
26.5or grant the vulnerable adult, the guardian, the alleged perpetrator, or health care agent a
26.6right to participate in the proceedings or appeal the human services judge's decision in the
26.7case. The lead investigative agency must consider including the vulnerable adult victim of
26.8maltreatment as a witness in the hearing. If the lead investigative agency determines that
26.9participation in the hearing would endanger the well-being of the vulnerable adult or not
26.10be in the best interests of the vulnerable adult, the lead investigative agency shall inform
26.11the human services judge of the basis for this determination, which must be included in the
26.12final order. If the human services judge is not reasonably able to determine the address of
26.13the vulnerable adult, the guardian, the alleged perpetrator, or the health care agent, the
26.14human services judge is not required to send a hearing notice under this subdivision."
26.15Page 231, delete section 55 and insert:

26.16    "Sec. .... ASSISTED LIVING LICENSURE.
26.17    Subdivison 1. Definitions. For the purposes of this section:
26.18(1) "commissioner" means the commissioner of health; and
26.19(2) "multiunit residential dwelling" means a residential dwelling containing two or more
26.20units intended for use as a residence.
26.21    Subd. 2. Requirement of license. (a) After January 1, 2020, no provider of assisted
26.22living may operate without first having obtained a license.
26.23(b) By February 1, 2019, the commissioner shall propose for codification assisted living
26.24licensing standards, which may include licensing tiers that correspond to designated levels
26.25of care and services to replace housing with services registration under Minnesota Statutes,
26.26chapter 144D, and assisted living title protection under Minnesota Statutes, chapter 144G.
26.27The commissioner shall recommend draft legislation to implement all proposed changes to
26.28Minnesota Statutes. The draft legislation shall:
26.29(1) replace in Minnesota Statutes the term "housing with services" with "assisted living"
26.30and replace the term "assisted living client" with "assisted living resident";
26.31(2) consolidate and recodify Minnesota Statutes, chapters 144D and 144G, and all other
26.32associated and relevant statutes and rules; and
27.1(3) add "assisted living" to the definition of facilities in Minnesota Statutes, sections
27.2144.651, subdivision 2, and 626.5572, subdivision 6, and all other applicable statutes or
27.3rules.
27.4The commissioner shall solicit public comment on the proposed licensing standards and
27.5provide a comment period of no less than 30 days.
27.6    Subd. 3. Collaboration and consultation. In developing the licensing structure, the
27.7commissioner must:
27.8(1) collaborate with the commissioner of human services and the ombudsman for
27.9long-term care;
27.10(2) consult with an equal number of service providers, consumer advocates, and assisted
27.11living and housing with services residents and their families or agents; and
27.12(3) review and evaluate other state's licensing systems related to assisted living.
27.13    Subd. 4. Single license for housing and services. (a) The commissioner must create a
27.14single assisted living license for both housing and services offered in a multiunit residential
27.15dwelling that is not otherwise licensed by the Department of Human Services or the
27.16Department of Health that offers:
27.17(1) services comparable to those of a comprehensive home care services provider under
27.18Minnesota Statutes, section 144A.471, subdivision 7;
27.19(2) health-related services under Minnesota Statutes, section 144D.01, subdivision 6;
27.20or
27.21(3) supportive services under Minnesota Statutes, section 144D.01, including daily life
27.22checks, transportation, social work services, and dietary services.
27.23(b) A multiunit residential dwelling must obtain an assisted living license if at least 30
27.24percent of the residents receive home care, health-related services, or supportive care services.
27.25    Subd. 5. Single contract. (a) The commissioner must establish a single contract for the
27.26provision of housing and care services in an assisted living facility. The provisions of
27.27Minnesota Statutes, chapter 504B, apply.
27.28(b) Nothing in this subdivision precludes a resident from separately contracting with a
27.29provider other than the assisted living facility.
27.30(c) Nothing in this subdivision precludes the assisted living facility from separating
27.31housing costs from care costs when billing.
28.1    Subd. 6. Forms and procedures. The commissioner must establish forms and procedures
28.2for the processing of assisted living license applications. An application for an assisted
28.3living license must, at a minimum, include the following information:
28.4(1) the names and addresses of all controlling persons and managerial employees of the
28.5facility to be licensed, and any affiliated corporate entities;
28.6(2) the address and legal property description of the facility;
28.7(3) a copy of the architectural and engineering plans and specifications of the facility as
28.8prepared and certified by an architect or engineer registered to practice in this state;
28.9(4) whether the applicant's license or authority to provide assisted living in any other
28.10state has ever been revoked or suspended; and
28.11(5) any other relevant information the commissioner determines necessary, including
28.12the number of beds and other data necessary to determine number and type of residents
28.13being served.
28.14    Subd. 7. Appeals and reconsiderations. The commissioner must establish criteria and
28.15a process for reconsideration and appeal under which a license may be denied, suspended,
28.16nonrenewed, or revoked.
28.17    Subd. 8. Fines and penalties. The commissioner must establish a schedule of license
28.18fees and penalties for compliance failures.
28.19    Subd. 9. Standards. The commissioner must establish licensing standards that must
28.20include, at a minimum:
28.21(1) building design;
28.22(2) physical environment;
28.23(3) dietary services, including both the type, appropriateness, and quality of food;
28.24(4) support services, including social work and transportation;
28.25(5) staffing guidelines, including establishing 24 hours a day, seven days a week awake
28.26staff, taking into account:
28.27(i) the acuity level of the residents;
28.28(ii) the number of residents;
28.29(iii) evening and weekend needs; and
29.1(iv) existing requirements under Minnesota Statutes, section 144A.4795, and Code of
29.2Federal Regulations, title 42, section 483.30;
29.3(6) training for:
29.4(i) owners, financial officers, administrators, and management on Minnesota Statutes,
29.5section 626.557, and on best practices and standards for long-term care; and
29.6(ii) all staff, management, and controlling persons in the best practices for courteous
29.7treatment of residents, resolution of conflict, and collaboration with all staff positions,
29.8assisted living residents, and families;
29.9(7) admission criteria, including but not limited to:
29.10(i) admission contract language or definitions; and
29.11(ii) an assessment to be conducted prior to admission to best meet the needs of residents;
29.12(8) retention criteria, including criteria based on the provisions of Minnesota Statutes,
29.13section 144A.4791, subdivision 4, as to when a resident's needs are beyond the scope of
29.14care and practice in an assisted living facility;
29.15(9) care and services, including but not limited to centralized, core criteria for dementia
29.16care and coordination of care among medical providers for residents, based on the needs of
29.17the resident, including carrying out any medical orders;
29.18(10) discharge criteria, including discharge planning to a safe location and appeal rights,
29.19incorporating Minnesota Statutes, sections 144D.09, 144D.095, 144G.07, and 144G.08;
29.20(11) resident rights in the assisted living setting, including those currently found in
29.21Minnesota Statutes, sections 144.651, 144A.44, 144A.441, or other statement of rights
29.22under law;
29.23(12) establishment of resident or family councils, or both, based on Minnesota Statutes,
29.24section 144A.33; and
29.25(13) safety criteria, including abuse prevention plans under Minnesota Statutes, section
29.26626.557, subdivision 14.
29.27    Subd. 10. Licensing tiers. The commissioner may establish separate licensing levels
29.28and, if levels are established, the criteria for the licenses. Examples of levels include:
29.29(1) Tier 1, basic level service offering any supportive service, including daily life checks,
29.30transportation, dietary services, or social work services, or any health-related service or
29.31supportive service in an independent unit within a continuing care campus model;
30.1(2) Tier 2, medium level service offering, in addition to Tier 1 offerings, any
30.2health-related service, including dementia care, assistance with two or fewer activities of
30.3daily living that do not include a two-person transfer, and the ability to engage in
30.4self-preservation; and
30.5(3) Tier 3, high level service offering, in addition to Tier 1 and Tier 2 offerings, assistance
30.6with three or more activities of daily living, two-person transfers, diagnoses requiring
30.7specialty care, or the need for assistance with self-preservation.
30.8    Subd. 11. Other considerations and actions. The commissioner, in establishing a
30.9licensing structure, must:
30.10(1) consider federal home and community-based service requirements necessary to
30.11preserve access to assisted living care and services for individuals who rely on the medical
30.12assistance elderly waiver program, including the customized living rates and other waivered
30.13programs;
30.14(2) determine if any changes are required to the medical assistance elderly waiver benefit
30.15program or group residential housing program to ensure, to the extent possible, the programs
30.16cover the housing costs and meet the service needs of an assisted living resident, including
30.17the customized living rates; and
30.18(3) seek federal approval as necessary for the assisted living license developed by the
30.19commissioner.
30.20    Subd. 12. Exceptions. The commissioner shall exclude providers and facilities currently
30.21licensed by the Department of Human Services from the requirements of the new assisted
30.22living license. Nothing may be construed to affect the governance under Minnesota Statutes,
30.23sections 144A.43 to 144A.483, of home care providers who do not dedicate their services
30.24to a particular multiunit residential dwelling.
30.25    Subd. 13. Licensing of executive directors and administrators. After January 1, 2020,
30.26no person may serve as an executive director or administrator of an assisted living facility
30.27without first obtaining a license from the commissioner. The commissioner shall establish
30.28licensing criteria and a fee schedule in consultation with the Board of Examiners for Nursing
30.29Home Administrators under Minnesota Statutes, section 144A.19.
30.30    Subd. 14. Enforcement authority. The commissioner has the authority to enforce any
30.31statute or rule governing licensing of assisted living facilities.

31.1    Sec. .... DEMENTIA CARE CERTIFICATION.
31.2(a) For the purposes of this section, "commissioner" means the commissioner of health.
31.3(b) By February 1, 2019, the commissioner shall establish core criteria in all care and
31.4service settings for the provision of dementia care as well as criteria to operate a dementia
31.5care unit, to recommend legislation to implement dementia care after first providing a 30-day
31.6public comment period. In establishing the core criteria for dementia care in these settings,
31.7the commissioner must:
31.8(1) collaborate with the commissioner of human services and the ombudsman for
31.9long-term care;
31.10(2) consult with an equal number of service providers, consumer advocates, and residents
31.11diagnosed with dementia and their families or agents;
31.12(3) review and evaluate other state's dementia care systems; and
31.13(4) meet standards based on best practice recommendations for dementia care developed
31.14by the Alzheimer's Association and other state and national organizations providing services,
31.15information, and advocacy regarding persons with dementia and their families.
31.16(c) After January 1, 2020, all providers must meet core criteria for dementia care as
31.17developed by the commissioner. After January 1, 2020, no provider may advertise, offer,
31.18or use the term "memory care unit" or "dementia care unit" without having first obtained a
31.19dementia care unit certification. If 30 percent or more of the residents in any particular unit
31.20in the residential setting are diagnosed with dementia, the provider must obtain the dementia
31.21care unit certification in order to serve the residents.
31.22(d) In developing core criteria for dementia care across all settings, the commissioner
31.23must, at a minimum:
31.24(1) evaluate existing requirements under Minnesota Statutes, sections 144.6503,
31.25144A.4795, 144A.4796, and 144D.065, and chapter 144G;
31.26(2) propose a single statute that identifies minimum safety and quality of service standards
31.27for dementia special care, including dementia training, assessment, care planning, therapeutic
31.28activities, and a residential setting's physical design and environment by combining concepts
31.29and provisions found in Minnesota Statutes, sections 144.6503, 144A.4791, 144A.4796,
31.30144D.065, and 325F.72; and
31.31(3) develop comprehensive dementia care training curriculum, including evaluation of
31.32competency of the individual worker, continuing education, portability for workers across
32.1employers, and minimum standards for trainers. The curriculum must incorporate principles
32.2of person-centered dementia care, including thorough knowledge of the person and the
32.3person's abilities and needs, advancement of optimal functioning and a high quality of life,
32.4and use of problem-solving approaches to care. Training requirements and curriculum must
32.5reflect cultural competency, both for the provider and the recipient of the care.
32.6(e) The commissioner must establish additional requirements beyond core criteria for
32.7facilities and providers operating a dementia care unit in the residential setting, including
32.8but not limited to the following:
32.9(1) criteria for certification for the provision of dementia care and training for all care
32.10providers employed by any facility, provider, or program who are involved in the delivery
32.11of care to, or have regular contact with, persons with Alzheimer's disease or related
32.12dementias; and
32.13(2) training on behavioral approaches.
32.14(f) The commissioner may adopt rules to implement this section.
32.15(g) The commissioner has the authority to monitor and enforce compliance with any
32.16certification statutes enacted or rules adopted."
32.17Renumber the sections in sequence and correct the internal references
32.18Amend the title accordingly