Do you operate a Home Care Agency?  If the answer is YES . . . the information below affects YOU and the FUTURE of YOUR HOME CARE AGENCY!  The Minnesota Department of Health (MDH) has publicly released a draft of proposed new home care agency rules.  The proposed rules would completely change the way current Class A, Class F, and Class B home care agencies are regulated.

It is very important that current home care providers take the time to read the 75-page proposed rules and the 3-page summary; and provide comments back to MDH.  It is our understanding that MDH intends to introduce legislation during the 2011 legislative session to adopt these new rules.  MDH has requested written comments from interested parties by December 17th, so your time is very limited to read the draft and provide written feedback.

Background – MDH convened a home care rules workgroup in 2007.  Care Providers of Minnesota has always had active representation on the workgroup.  The primary purpose of the workgroup was to “clean up” the current tangle of home care rules, make the rules more understandable, and provide greater flexibility for innovation and flexibility.

Significant Changes Contained in the Draft Rules:

• Gets rid of the Class F, Class A, and Class B categories of home care agencies. (Does anyone outside of our profession really understand what these letters mean?)  Replaces them with two categories of licensure for home care providers:  (1) Basic Home Care Provider, and (2) Comprehensive Home Care Provider.
• Removes restrictions regarding the location where home care services can be provided.  This would allow a home care provider primarily delivering services in a HWS setting to also provide home care services in the community, without a separate home care license.
• Basic Home Care would limit services to assistance with activities of daily living (ADLs) and home management type of services.  Delegated nursing services or therapies would not be permitted with a Basic Home Care license.
• Comprehensive Home Care would permit all the services of a Basic Home Care provider plus allow all nursing, delegated nursing, and therapies to the services available to be delivered under the license.
• An addition, a Comprehensive Home Care Provider can request to provide services above the Comprehensive level, defined as “Specialized Home Care Services.”  The draft defines specialized services as ventilator care and IV therapies, but leaves the window open for other services as the market and technologies change.  Specialized Home Care Services would not require any additional license, but does carry with it some additional regulations (particularly additional training).
• Removes the limits on injections (currently limited to insulin) for Comprehensive Home Care.
• Better defines Medication Management services and options.
• Increases staff in-service requirements from 8 hours per year to 12 hours per year for Comprehensive Home Care Providers – if this would economically impact your home care agency, you need to provide comments to MDH on this!
• Removes the home care TB waiver and puts the current requirements into statute.
• Creates the opportunity for MDH to issue a conditional home care license, thereby time-limiting or restricting the services a home care provider can offer when there have been significant survey issues identified that put clients at risk.
• Adds a requirement for Comprehensive Home Care to have a written Quality Assurance Program, with two issues being addressed each year – if this would economically impact your home care agency, you need to provide comments to MDH on this!
• Requires service plans for both levels of home care providers.
• Adds additional documentation requirements to client complaint investigations.
• Appears to increase the responsibility under medication management (if provided) regarding OTC products and dietary supplements – if this would be a challenge for your home care agency, you need to provide comments to MDH on this!
• Appears to require home care providers to have a contract with a different home care provider for “back-up” in cases of emergencies – if this would be a challenge for your home care agency, you need to provide comments to MDH on this!
• Creates additional requirements and clarification for retention of various types of documents.

Issues that have not been addressed in the draft (some are already scheduled for future discussion):

• Survey Frequency
• Cost Neutrality
• Transition from current license system to new license system
• Legislative strategy and supporters/challengers

As you can tell, this is a SIGNIFICANT proposal, and your feedback (both positive and negative) to MDH is CRITICAL!  Due to the very tight time constraints provided by MDH for comments, Care Providers of Minnesota will not be able to consolidate comments from our members . . . meaning we are depending on each of our home care agency members to take the time to read the draft and provide comments directly to MDH (please email a copy of your comments to dbeardsley@careproviders.org).

The future of how home care agencies are defined and regulated in Minnesota depends on your feedback, so please take the time to provide comments to MDH on these draft rules.  Comments should be sent to:  kay.hertzfeld@state.mn.us.

• Click here to read (and download) the MDH Summary Document
• Click here to read (and download) the MDH Proposed Draft Home Care Licensing Regulations
• Click here to read (and download) the comments Care Providers of Minnesota has already submitted (but we are counting on our members to submit their own comments!)

Thank you, in advance, for your assistance with this significant proposal.

Doug Beardsley
952.851.2489
dbeardsl@careproviders.org

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