SF 230

1st Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 02:12am

A bill for an act
relating to occupations and professions; creating licensure for physician
assistants; amending Minnesota Statutes 2008, sections 144.1501, subdivision 1;
144E.001, subdivisions 3a, 9c; 147.09; 147A.01; 147A.02; 147A.03; 147A.04;
147A.05; 147A.06; 147A.07; 147A.08; 147A.09; 147A.11; 147A.13; 147A.16;
147A.18; 147A.19; 147A.20; 147A.21; 147A.23; 147A.24; 147A.26; 147A.27;
169.345, subdivision 2; 253B.02, subdivision 7; 253B.05, subdivision 2;
256B.0625, subdivision 28a; 256B.0751, subdivision 1; repealing Minnesota
Statutes 2008, section 147A.22.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2008, section 144.1501, subdivision 1, is amended to
read:

Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply.

(b) "Dentist" means an individual who is licensed to practice dentistry.

(c) "Designated rural area" means:

(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin,
Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead,
Rochester, and St. Cloud; or

(2) a municipal corporation, as defined under section 471.634, that is physically
located, in whole or in part, in an area defined as a designated rural area under clause (1).

(d) "Emergency circumstances" means those conditions that make it impossible for
the participant to fulfill the service commitment, including death, total and permanent
disability, or temporary disability lasting more than two years.

(e) "Medical resident" means an individual participating in a medical residency in
family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
anesthetist, advanced clinical nurse specialist, or physician assistant.

(g) "Nurse" means an individual who has completed training and received all
licensing or certification necessary to perform duties as a licensed practical nurse or
registered nurse.

(h) "Nurse-midwife" means a registered nurse who has graduated from a program of
study designed to prepare registered nurses for advanced practice as nurse-midwives.

(i) "Nurse practitioner" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse practitioners.

(j) "Pharmacist" means an individual with a valid license issued under chapter 151.

(k) "Physician" means an individual who is licensed to practice medicine in the areas
of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

(l) "Physician assistant" means a person deleted text begin registered deleted text end new text begin licensed new text end under chapter 147A.

(m) "Qualified educational loan" means a government, commercial, or foundation
loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a health care professional.

(n) "Underserved urban community" means a Minnesota urban area or population
included in the list of designated primary medical care health professional shortage areas
(HPSAs), medically underserved areas (MUAs), or medically underserved populations
(MUPs) maintained and updated by the United States Department of Health and Human
Services.

Sec. 2.

Minnesota Statutes 2008, section 144E.001, subdivision 3a, is amended to read:

Subd. 3a.

Ambulance service personnel.

"Ambulance service personnel" means
individuals who are authorized by a licensed ambulance service to provide emergency
care for the ambulance service and are:

(1) EMTs, EMT-Is, or EMT-Ps;

(2) Minnesota registered nurses who are: (i) EMTs, are currently practicing
nursing, and have passed a paramedic practical skills test, as approved by the board
and administered by a training program approved by the board; (ii) on the roster of an
ambulance service on or before January 1, 2000; or (iii) after petitioning the board,
deemed by the board to have training and skills equivalent to an EMT, as determined on
a case-by-case basis; or

(3) Minnesota deleted text begin registered deleted text end new text begin licensed new text end physician assistants who are: (i) EMTs, are
currently practicing as physician assistants, and have passed a paramedic practical skills
test, as approved by the board and administered by a training program approved by the
board; (ii) on the roster of an ambulance service on or before January 1, 2000; or (iii) after
petitioning the board, deemed by the board to have training and skills equivalent to an
EMT, as determined on a case-by-case basis.

Sec. 3.

Minnesota Statutes 2008, section 144E.001, subdivision 9c, is amended to read:

Subd. 9c.

Physician assistant.

"Physician assistant" means a person deleted text begin registered deleted text end new text begin
licensed new text end to practice as a physician assistant under chapter 147A.

Sec. 4.

Minnesota Statutes 2008, section 147.09, is amended to read:

147.09 EXEMPTIONS.

Section 147.081 does not apply to, control, prevent or restrict the practice, service,
or activities of:

(1) A person who is a commissioned medical officer of, a member of, or employed
by, the armed forces of the United States, the United States Public Health Service, the
Veterans Administration, any federal institution or any federal agency while engaged in
the performance of official duties within this state, if the person is licensed elsewhere.

(2) A licensed physician from a state or country who is in actual consultation here.

(3) A licensed or registered physician who treats the physician's home state patients
or other participating patients while the physicians and those patients are participating
together in outdoor recreation in this state as defined by section 86A.03, subdivision 3.
A physician shall first register with the board on a form developed by the board for that
purpose. The board shall not be required to promulgate the contents of that form by rule.
No fee shall be charged for this registration.

(4) A student practicing under the direct supervision of a preceptor while the student
is enrolled in and regularly attending a recognized medical school.

(5) A student who is in continuing training and performing the duties of an intern or
resident or engaged in postgraduate work considered by the board to be the equivalent of
an internship or residency in any hospital or institution approved for training by the board,
provided the student has a residency permit issued by the board under section 147.0391.

(6) A person employed in a scientific, sanitary, or teaching capacity by the state
university, the Department of Education, a public or private school, college, or other
bona fide educational institution, a nonprofit organization, which has tax-exempt status
in accordance with the Internal Revenue Code, section 501(c)(3), and is organized and
operated primarily for the purpose of conducting scientific research directed towards
discovering the causes of and cures for human diseases, or the state Department of Health,
whose duties are entirely of a research, public health, or educational character, while
engaged in such duties; provided that if the research includes the study of humans, such
research shall be conducted under the supervision of one or more physicians licensed
under this chapter.

(7) deleted text begin Physician's deleted text end new text begin Physician new text end assistants deleted text begin registered deleted text end new text begin licensed new text end in this state.

(8) A doctor of osteopathy duly licensed by the state Board of Osteopathy under
Minnesota Statutes 1961, sections 148.11 to 148.16, prior to May 1, 1963, who has not
been granted a license to practice medicine in accordance with this chapter provided that
the doctor confines activities within the scope of the license.

(9) Any person licensed by a health-related licensing board, as defined in section
214.01, subdivision 2, or registered by the commissioner of health pursuant to section
214.13, including psychological practitioners with respect to the use of hypnosis; provided
that the person confines activities within the scope of the license.

(10) A person who practices ritual circumcision pursuant to the requirements or
tenets of any established religion.

(11) A Christian Scientist or other person who endeavors to prevent or cure disease
or suffering exclusively by mental or spiritual means or by prayer.

(12) A physician licensed to practice medicine in another state who is in this state
for the sole purpose of providing medical services at a competitive athletic event. The
physician may practice medicine only on participants in the athletic event. A physician
shall first register with the board on a form developed by the board for that purpose. The
board shall not be required to adopt the contents of the form by rule. The physician shall
provide evidence satisfactory to the board of a current unrestricted license in another state.
The board shall charge a fee of $50 for the registration.

(13) A psychologist licensed under section 148.907 or a social worker licensed
under chapter 148D who uses or supervises the use of a penile or vaginal plethysmograph
in assessing and treating individuals suspected of engaging in aberrant sexual behavior
and sex offenders.

(14) Any person issued a training course certificate or credentialed by the Emergency
Medical Services Regulatory Board established in chapter 144E, provided the person
confines activities within the scope of training at the certified or credentialed level.

(15) An unlicensed complementary and alternative health care practitioner practicing
according to chapter 146A.

Sec. 5.

Minnesota Statutes 2008, section 147A.01, is amended to read:

147A.01 DEFINITIONS.

Subdivision 1.

Scope.

For the purpose of this chapter the terms defined in this
section have the meanings given them.

deleted text begin Subd. 2. deleted text end

deleted text begin Active status. deleted text end

deleted text begin "Active status" means the status of a person who has met all
the qualifications of a physician assistant, has a physician-physician assistant agreement in
force, and is registered.
deleted text end

Subd. 3.

Administer.

"Administer" means the delivery by a physician assistant
authorized to prescribe legend drugs, a single dose of a legend drug, including controlled
substances, to a patient by injection, inhalation, ingestion, or by any other immediate
means, and the delivery by a physician assistant ordered by a physician a single dose of a
legend drug by injection, inhalation, ingestion, or by any other immediate means.

Subd. 4.

Agreement.

"Agreement" means the document described in section
147A.20.

Subd. 5.

Alternate supervising physician.

"Alternate supervising physician"
means a Minnesota licensed physician listed in the physician-physician assistant
new text begin delegation new text end agreement new text begin , or supplemental listing, new text end who is responsible for supervising
the physician assistant when the deleted text begin main deleted text end new text begin primary new text end supervising physician is unavailable.
The alternate supervising physician shall accept full medical responsibility for the
performance, practice, and activities of the physician assistant while under the supervision
of the alternate supervising physician.

Subd. 6.

Board.

"Board" means the Board of Medical Practice or its designee.

Subd. 7.

Controlled substances.

"Controlled substances" has the meaning given it
in section 152.01, subdivision 4.

deleted text begin Subd. 8. deleted text end

deleted text begin Delegation form. deleted text end

deleted text begin "Delegation form" means the form used to indicate the
categories of drugs for which the authority to prescribe, administer, and dispense has been
delegated to the physician assistant and signed by the supervising physician, any alternate
supervising physicians, and the physician assistant. This form is part of the agreement
described in section 147A.20, and shall be maintained by the supervising physician and
physician assistant at the address of record. Copies shall be provided to the board upon
request. "Addendum to the delegation form" means a separate listing of the schedules
and categories of controlled substances, if any, for which the physician assistant has been
delegated the authority to prescribe, administer, and dispense. The addendum shall be
maintained as a separate document as described above.
deleted text end

Subd. 9.

Diagnostic order.

"Diagnostic order" means a directive to perform
a procedure or test, the purpose of which is to determine the cause and nature of a
pathological condition or disease.

Subd. 10.

Drug.

"Drug" has the meaning given it in section 151.01, subdivision 5,
including controlled substances as defined in section 152.01, subdivision 4.

Subd. 11.

Drug category.

"Drug category" means one of the categories listed on the
new text begin physician-physician assistant new text end delegation deleted text begin form deleted text end new text begin agreement new text end .

Subd. 12.

Inactive deleted text begin status deleted text end .

"Inactive deleted text begin status deleted text end " means deleted text begin the status of a person who has
met all the qualifications of a physician assistant, and is registered, but does not have a
physician-physician assistant agreement in force deleted text end new text begin a licensed physician assistant whose
license has been placed on inactive status under section 147A.05 new text end .

deleted text begin Subd. 13. deleted text end

deleted text begin Internal protocol. deleted text end

deleted text begin "Internal protocol" means a document written by
the supervising physician and the physician assistant which specifies the policies and
procedures which will apply to the physician assistant's prescribing, administering,
and dispensing of legend drugs and medical devices, including controlled substances
as defined in section 152.01, subdivision 4, and lists the specific categories of drugs
and medical devices, with any exceptions or conditions, that the physician assistant
is authorized to prescribe, administer, and dispense. The supervising physician and
physician assistant shall maintain the protocol at the address of record. Copies shall be
provided to the board upon request.
deleted text end

Subd. 14.

Legend drug.

"Legend drug" has the meaning given it in section 151.01,
subdivision 17.

new text begin Subd. 14a. new text end

new text begin Licensed. new text end

new text begin "Licensed" means meeting the qualifications in section
147A.02 and being issued a license by the board.
new text end

new text begin Subd. 14b. new text end

new text begin Licensure. new text end

new text begin "Licensure" means the process by which the board
determines that an applicant has met the standards and qualifications in this chapter.
new text end

deleted text begin Subd. 15. deleted text end

deleted text begin Locum tenens permit. deleted text end

deleted text begin "Locum tenens permit" means time specific
temporary permission for a physician assistant to practice as a physician assistant in
a setting other than the practice setting established in the physician-physician assistant
agreement.
deleted text end

Subd. 16.

Medical device.

"Medical device" means durable medical equipment and
assistive or rehabilitative appliances, objects, or products that are required to implement
the overall plan of care for the patient and that are restricted by federal law to use upon
prescription by a licensed practitioner.

new text begin Subd. 16a. new text end

new text begin Notice of intent to practice. new text end

new text begin "Notice of intent to practice" means
a document sent to the board by a licensed physician assistant that documents the
adoption of a physician-physician assistant delegation agreement and provides the names,
addresses, and information required by section 147A.20.
new text end

Subd. 17.

Physician.

"Physician" means a person currently licensed in good
standing as a physician or osteopath under chapter 147.

new text begin Subd. 17a. new text end

new text begin Physician-physician assistant delegation agreement.
new text end

new text begin "Physician-physician assistant delegation agreement" means the document prepared and
signed by the physician and physician assistant affirming the supervisory relationship and
defining the physician assistant scope of practice. Alternate supervising physicians must be
identified on the delegation agreement or a supplemental listing with signed attestation that
each shall accept full medical responsibility for the performance, practice, and activities of
the physician assistant while under the supervision of the alternate supervising physician.
The physician-physician assistant delegation agreement outlines the role of the physician
assistant in the practice, describes the means of supervision, and specifies the categories of
drugs, controlled substances, and medical devices that the supervising physician delegates
to the physician assistant to prescribe. The physician-physician assistant delegation
agreement must comply with the requirements of section 147A.20, be kept on file at the
address of record, and be made available to the board or its representative upon request.
new text end

Subd. 18.

Physician assistant or deleted text begin registered deleted text end new text begin licensed new text end physician assistant.

"Physician assistant" or " deleted text begin registered deleted text end new text begin licensed new text end physician assistant" means a person deleted text begin registered deleted text end new text begin
licensed new text end pursuant to this chapter who deleted text begin is qualified by academic or practical training or
both to provide patient services as specified in this chapter, under the supervision of a
supervising physician deleted text end new text begin meets the qualifications in section 147A.02 new text end .

deleted text begin Subd. 19. deleted text end

deleted text begin Practice setting description. deleted text end

deleted text begin "Practice setting description" means a
signed record submitted to the board on forms provided by the board, on which:
deleted text end

deleted text begin (1) the supervising physician assumes full medical responsibility for the medical
care rendered by a physician assistant;
deleted text end

deleted text begin (2) is recorded the address and phone number of record of each supervising
physician and alternate, and the physicians' medical license numbers and DEA number;
deleted text end

deleted text begin (3) is recorded the address and phone number of record of the physician assistant
and the physician assistant's registration number and DEA number;
deleted text end

deleted text begin (4) is recorded whether the physician assistant has been delegated prescribing,
administering, and dispensing authority;
deleted text end

deleted text begin (5) is recorded the practice setting, address or addresses and phone number or
numbers of the physician assistant; and
deleted text end

deleted text begin (6) is recorded a statement of the type, amount, and frequency of supervision.
deleted text end

Subd. 20.

Prescribe.

"Prescribe" means to direct, order, or designate by means of a
prescription the preparation, use of, or manner of using a drug or medical device.

Subd. 21.

Prescription.

"Prescription" means a signed written order, deleted text begin or deleted text end an oral
order reduced to writing, new text begin or an electronic order meeting current and prevailing standards new text end
given by a physician assistant authorized to prescribe drugs for patients in the course
of the physician assistant's practice, issued for an individual patient and containing the
information required in the new text begin physician-physician assistant new text end delegation deleted text begin form deleted text end new text begin agreement new text end .

deleted text begin Subd. 22. deleted text end

deleted text begin Registration. deleted text end

deleted text begin "Registration" is the process by which the board determines
that an applicant has been found to meet the standards and qualifications found in this
chapter.
deleted text end

Subd. 23.

Supervising physician.

"Supervising physician" means a Minnesota
licensed physician who accepts full medical responsibility for the performance, practice,
and activities of a physician assistant under an agreement as described in section 147A.20.
new text begin The supervising physician who completes and signs the delegation agreement may be
referred to as the primary supervising physician. new text end A supervising physician shall not
supervise more than deleted text begin two deleted text end new text begin five new text end full-time equivalent physician assistants simultaneously.
new text begin With the approval of the board, or in a disaster or emergency situation pursuant to section
147A.23, a supervising physician may supervise more than five full-time equivalent
physician assistants simultaneously.
new text end

Subd. 24.

Supervision.

"Supervision" means overseeing the activities of, and
accepting responsibility for, the medical services rendered by a physician assistant. The
constant physical presence of the supervising physician is not required so long as the
supervising physician and physician assistant are or can be easily in contact with one
another by radio, telephone, or other telecommunication device. The scope and nature of
the supervision shall be defined by the individual physician-physician assistant new text begin delegation new text end
agreement.

Subd. 25.

Temporary deleted text begin registration deleted text end new text begin license new text end .

deleted text begin "Temporary registration" means the
status of a person who has satisfied the education requirement specified in this chapter;
is enrolled in the next examination required in this chapter; or is awaiting examination
results; has a physician-physician assistant agreement in force as required by this chapter,
and has submitted a practice setting description to the board. Such provisional registration
shall expire 90 days after completion of the next examination sequence, or after one year,
whichever is sooner, for those enrolled in the next examination; and upon receipt of the
examination results for those awaiting examination results. The registration shall be
granted by the board or its designee. deleted text end new text begin "Temporary license" means a license granted to a
physician assistant who meets all of the qualifications for licensure but has not yet been
approved for licensure at a meeting of the board.
new text end

Subd. 26.

Therapeutic order.

"Therapeutic order" means an order given to another
for the purpose of treating or curing a patient in the course of a physician assistant's
practice. Therapeutic orders may be written or verbal, but do not include the prescribing
of legend drugs or medical devices unless prescribing authority has been delegated within
the physician-physician assistant new text begin delegation new text end agreement.

Subd. 27.

Verbal order.

"Verbal order" means an oral order given to another for
the purpose of treating or curing a patient in the course of a physician assistant's practice.
Verbal orders do not include the prescribing of legend drugs unless prescribing authority
has been delegated within the physician-physician assistant new text begin delegation new text end agreement.

Sec. 6.

Minnesota Statutes 2008, section 147A.02, is amended to read:

147A.02 QUALIFICATIONS FOR deleted text begin REGISTRATION deleted text end new text begin LICENSURE new text end .

Except as otherwise provided in this chapter, an individual shall be deleted text begin registered deleted text end new text begin
licensed new text end by the board before the individual may practice as a physician assistant.

The board may grant deleted text begin registration deleted text end new text begin a license new text end as a physician assistant to an applicant
who:

(1) submits an application on forms approved by the board;

(2) pays the appropriate fee as determined by the board;

(3) has current certification from the National Commission on Certification of
Physician Assistants, or its successor agency as approved by the board;

(4) certifies that the applicant is mentally and physically able to engage safely in
practice as a physician assistant;

(5) has no licensure, certification, or registration as a physician assistant under
current discipline, revocation, suspension, or probation for cause resulting from the
applicant's practice as a physician assistant, unless the board considers the condition
and agrees to licensure;

(6) submits any other information the board deems necessary to evaluate the
applicant's qualifications; and

(7) has been approved by the board.

All persons registered as physician assistants as of June 30, 1995, are eligible for
continuing deleted text begin registration deleted text end new text begin license new text end renewal. All persons applying for deleted text begin registration deleted text end new text begin licensure new text end
after that date shall be deleted text begin registered deleted text end new text begin licensed new text end according to this chapter.

Sec. 7.

Minnesota Statutes 2008, section 147A.03, is amended to read:

147A.03 PROTECTED TITLES AND RESTRICTIONS ON USE.

Subdivision 1.

Protected titles.

No individual may use the titles "Minnesota
deleted text begin Registered deleted text end new text begin Licensed new text end Physician Assistant," " deleted text begin Registered deleted text end new text begin Licensed new text end Physician Assistant,"
"Physician Assistant," or "PA" in connection with the individual's name, or any other
words, letters, abbreviations, or insignia indicating or implying that the individual is
deleted text begin registered with deleted text end new text begin licensed by new text end the state unless they have been deleted text begin registered deleted text end new text begin licensed new text end according
to this chapter.

Subd. 2.

Health care practitioners.

Individuals practicing in a health care
occupation are not restricted in the provision of services included in this chapter as long as
they do not hold themselves out as physician assistants by or through the titles provided in
subdivision 1 in association with provision of these services.

deleted text begin Subd. 3. deleted text end

deleted text begin Identification of registered practitioners. deleted text end

deleted text begin Physician assistants in
Minnesota shall wear name tags which identify them as physician assistants.
deleted text end

Subd. 4.

Sanctions.

Individuals who hold themselves out as physician assistants by
or through any of the titles provided in subdivision 1 without prior deleted text begin registration deleted text end new text begin licensure new text end
shall be subject to sanctions or actions against continuing the activity according to section
214.11, or other authority.

Sec. 8.

Minnesota Statutes 2008, section 147A.04, is amended to read:

147A.04 TEMPORARY deleted text begin PERMIT deleted text end new text begin LICENSE new text end .

The board may issue a temporary deleted text begin permit deleted text end new text begin license new text end to practice to a physician assistant
eligible for deleted text begin registration deleted text end new text begin licensure new text end under this chapter only if the application for deleted text begin registration deleted text end new text begin
licensure new text end is complete, all requirements have been met, and a nonrefundable fee set by
the board has been paid. The deleted text begin permit deleted text end new text begin temporary license new text end remains valid only until the
new text begin next new text end meeting of the board at which a decision is made on the application for deleted text begin registration deleted text end new text begin
licensure new text end .

Sec. 9.

Minnesota Statutes 2008, section 147A.05, is amended to read:

147A.05 INACTIVE deleted text begin REGISTRATION deleted text end new text begin LICENSE new text end .

Physician assistants who notify the board in writing deleted text begin on forms prescribed by the board
deleted text end may elect to place their deleted text begin registrations deleted text end new text begin license new text end on an inactive status. Physician assistants
with an inactive deleted text begin registration deleted text end new text begin license new text end shall be excused from payment of renewal fees and
shall not practice as physician assistants. Persons who engage in practice while their
deleted text begin registrations are deleted text end new text begin license is new text end lapsed or on inactive status shall be considered to be practicing
without deleted text begin registration deleted text end new text begin a license new text end , which shall be grounds for discipline under section 147A.13.
new text begin Physician assistants who provide care under the provisions of section 147A.23 shall not
be considered practicing without a license or subject to disciplinary action. new text end Physician
assistants deleted text begin requesting restoration from inactive status deleted text end new text begin who notify the board of their intent to
resume active practice new text end shall be required to pay the current renewal fees and all unpaid back
fees and shall be required to meet the criteria for renewal specified in section 147A.07.

Sec. 10.

Minnesota Statutes 2008, section 147A.06, is amended to read:

147A.06 CANCELLATION OF deleted text begin REGISTRATION deleted text end new text begin LICENSE new text end FOR
NONRENEWAL.

The board shall not renew, reissue, reinstate, or restore a deleted text begin registration deleted text end new text begin license new text end that
has lapsed on or after July 1, 1996, and has not been renewed within two annual renewal
cycles starting July 1, 1997. A deleted text begin registrant deleted text end new text begin licensee new text end whose deleted text begin registration deleted text end new text begin license new text end is canceled
for nonrenewal must obtain a new deleted text begin registration deleted text end new text begin license new text end by applying for deleted text begin registration deleted text end new text begin
licensure new text end and fulfilling all requirements then in existence for an initial deleted text begin registration deleted text end new text begin license new text end
to practice as a physician assistant.

Sec. 11.

Minnesota Statutes 2008, section 147A.07, is amended to read:

147A.07 RENEWAL.

A person who holds a deleted text begin registration deleted text end new text begin license new text end as a physician assistant shall new text begin annually new text end ,
upon notification from the board, renew the deleted text begin registration deleted text end new text begin license new text end by:

(1) submitting the appropriate fee as determined by the board;

(2) completing the appropriate forms; new text begin and
new text end

(3) meeting any other requirements of the board deleted text begin ;
deleted text end

deleted text begin (4) submitting a revised and updated practice setting description showing evidence
of annual review of the physician-physician assistant supervisory agreement deleted text end .

Sec. 12.

Minnesota Statutes 2008, section 147A.08, is amended to read:

147A.08 EXEMPTIONS.

(a) This chapter does not apply to, control, prevent, or restrict the practice, service,
or activities of persons listed in section 147.09, clauses (1) to (6) and (8) to (13), persons
regulated under section 214.01, subdivision 2, or persons defined in section 144.1501,
subdivision 1, paragraphs (f), (h), and (i).

(b) Nothing in this chapter shall be construed to require deleted text begin registration deleted text end new text begin licensure new text end of:

(1) a physician assistant student enrolled in a physician assistant deleted text begin or surgeon assistant
deleted text end educational program accredited by the deleted text begin Committee on Allied Health Education and
deleted text end Accreditation new text begin Review Commission on Education for the Physician Assistant new text end or by its
successor agency approved by the board;

(2) a physician assistant employed in the service of the federal government while
performing duties incident to that employment; or

(3) technicians, other assistants, or employees of physicians who perform delegated
tasks in the office of a physician but who do not identify themselves as a physician
assistant.

Sec. 13.

Minnesota Statutes 2008, section 147A.09, is amended to read:

147A.09 SCOPE OF PRACTICE, DELEGATION.

Subdivision 1.

Scope of practice.

Physician assistants shall practice medicine
only with physician supervision. Physician assistants may perform those duties and
responsibilities as delegated in the physician-physician assistant new text begin delegation new text end agreement
and delegation forms maintained at the address of record by the supervising physician
and physician assistant, including the prescribing, administering, and dispensing of new text begin drugs,
controlled substances, and new text end medical devices deleted text begin and drugs deleted text end , excluding anesthetics, other than
local anesthetics, injected in connection with an operating room procedure, inhaled
anesthesia and spinal anesthesia.

Patient service must be limited to:

(1) services within the training and experience of the physician assistant;

(2) services customary to the practice of the supervising physician new text begin or alternate
supervising physician new text end ;

(3) services delegated by the supervising physician new text begin or alternate supervising physician
under the physician-physician assistant delegation agreement new text end ; and

(4) services within the parameters of the laws, rules, and standards of the facilities
in which the physician assistant practices.

Nothing in this chapter authorizes physician assistants to perform duties regulated
by the boards listed in section 214.01, subdivision 2, other than the Board of Medical
Practice, and except as provided in this section.

Subd. 2.

Delegation.

Patient services may include, but are not limited to, the
following, as delegated by the supervising physician and authorized in the new text begin delegation new text end
agreement:

(1) taking patient histories and developing medical status reports;

(2) performing physical examinations;

(3) interpreting and evaluating patient data;

(4) ordering or performing diagnostic procedures, including deleted text begin radiography deleted text end new text begin the use of
radiographic imaging systems in compliance with Minnesota Rules 2007, chapter 4732 new text end ;

(5) ordering or performing therapeutic procedures new text begin including the use of ionizing
radiation in compliance with Minnesota Rules 2007, chapter 4732 new text end ;

(6) providing instructions regarding patient care, disease prevention, and health
promotion;

(7) assisting the supervising physician in patient care in the home and in health
care facilities;

(8) creating and maintaining appropriate patient records;

(9) transmitting or executing specific orders at the direction of the supervising
physician;

(10) prescribing, administering, and dispensing deleted text begin legend deleted text end drugs new text begin , controlled substances, new text end
and medical devices if this function has been delegated by the supervising physician
pursuant to and subject to the limitations of section 147A.18 and chapter 151. new text begin For
new text end physician assistants who have been delegated the authority to prescribe controlled
substances deleted text begin shall maintain a separate addendum to the delegation form which lists all
schedules and categories deleted text end new text begin such delegation shall be included in the physician-physician
assistant delegation agreement, and all schedules new text end of controlled substances deleted text begin which deleted text end the
physician assistant has the authority to prescribe deleted text begin . This addendum shall be maintained with
the physician-physician assistant agreement, and the delegation form at the address of
record deleted text end new text begin shall be specified new text end ;

(11) for physician assistants not delegated prescribing authority, administering
legend drugs and medical devices following prospective review for each patient by and
upon direction of the supervising physician;

(12) functioning as an emergency medical technician with permission of the
ambulance service and in compliance with section 144E.127, and ambulance service rules
adopted by the commissioner of health;

(13) initiating evaluation and treatment procedures essential to providing an
appropriate response to emergency situations; deleted text begin and
deleted text end

(14) certifying a deleted text begin physical disability deleted text end new text begin patient's eligibility for a disability parking
certificate new text end under section 169.345, subdivision deleted text begin 2a deleted text end new text begin 2;
new text end

new text begin (15) assisting at surgery; and
new text end

new text begin (16) providing medical authorization for admission for emergency care and
treatment of a patient under section 253B.05, subdivision 2 new text end .

Orders of physician assistants shall be considered the orders of their supervising
physicians in all practice-related activities, including, but not limited to, the ordering of
diagnostic, therapeutic, and other medical services.

Sec. 14.

Minnesota Statutes 2008, section 147A.11, is amended to read:

147A.11 EXCLUSIONS OF LIMITATIONS ON EMPLOYMENT.

Nothing in this chapter shall be construed to limit the employment arrangement of a
physician assistant deleted text begin registered deleted text end new text begin licensed new text end under this chapter.

Sec. 15.

Minnesota Statutes 2008, section 147A.13, is amended to read:

147A.13 GROUNDS FOR DISCIPLINARY ACTION.

Subdivision 1.

Grounds listed.

The board may refuse to grant deleted text begin registration deleted text end new text begin licensure new text end
or may impose disciplinary action as described in this subdivision against any physician
assistant. The following conduct is prohibited and is grounds for disciplinary action:

(1) failure to demonstrate the qualifications or satisfy the requirements for
deleted text begin registration deleted text end new text begin licensure new text end contained in this chapter or rules of the board. The burden of proof
shall be upon the applicant to demonstrate such qualifications or satisfaction of such
requirements;

(2) obtaining deleted text begin registration deleted text end new text begin a license new text end by fraud or cheating, or attempting to subvert
the examination process. Conduct which subverts or attempts to subvert the examination
process includes, but is not limited to:

(i) conduct which violates the security of the examination materials, such as
removing examination materials from the examination room or having unauthorized
possession of any portion of a future, current, or previously administered licensing
examination;

(ii) conduct which violates the standard of test administration, such as
communicating with another examinee during administration of the examination, copying
another examinee's answers, permitting another examinee to copy one's answers, or
possessing unauthorized materials; and

(iii) impersonating an examinee or permitting an impersonator to take the
examination on one's own behalf;

(3) conviction, during the previous five years, of a felony reasonably related to the
practice of physician assistant. Conviction as used in this subdivision includes a conviction
of an offense which if committed in this state would be deemed a felony without regard to
its designation elsewhere, or a criminal proceeding where a finding or verdict of guilt is
made or returned but the adjudication of guilt is either withheld or not entered;

(4) revocation, suspension, restriction, limitation, or other disciplinary action against
the person's physician assistant credentials in another state or jurisdiction, failure to
report to the board that charges regarding the person's credentials have been brought in
another state or jurisdiction, or having been refused deleted text begin registration deleted text end new text begin licensure new text end by any other
state or jurisdiction;

(5) advertising which is false or misleading, violates any rule of the board, or claims
without substantiation the positive cure of any disease or professional superiority to or
greater skill than that possessed by another physician assistant;

(6) violating a rule adopted by the board or an order of the board, a state, or federal
law which relates to the practice of a physician assistant, or in part regulates the practice
of a physician assistant, including without limitation sections 148A.02, 609.344, and
609.345, or a state or federal narcotics or controlled substance law;

(7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm
the public, or demonstrating a willful or careless disregard for the health, welfare, or
safety of a patient; or practice which is professionally incompetent, in that it may create
unnecessary danger to any patient's life, health, or safety, in any of which cases, proof
of actual injury need not be established;

(8) failure to adhere to the provisions of the physician-physician assistant new text begin delegation new text end
agreement;

(9) engaging in the practice of medicine beyond that allowed by the
physician-physician assistant new text begin delegation new text end agreement, deleted text begin including the delegation form or
the addendum to the delegation form, deleted text end or aiding or abetting an unlicensed person in the
practice of medicine;

(10) adjudication as mentally incompetent, mentally ill or developmentally disabled,
or as a chemically dependent person, a person dangerous to the public, a sexually
dangerous person, or a person who has a sexual psychopathic personality by a court of
competent jurisdiction, within or without this state. Such adjudication shall automatically
suspend a deleted text begin registration deleted text end new text begin license new text end for its duration unless the board orders otherwise;

(11) engaging in unprofessional conduct. Unprofessional conduct includes any
departure from or the failure to conform to the minimal standards of acceptable and
prevailing practice in which proceeding actual injury to a patient need not be established;

(12) inability to practice with reasonable skill and safety to patients by reason of
illness, drunkenness, use of drugs, narcotics, chemicals, or any other type of material, or
as a result of any mental or physical condition, including deterioration through the aging
process or loss of motor skills;

(13) revealing a privileged communication from or relating to a patient except when
otherwise required or permitted by law;

(14) any deleted text begin use of deleted text end new text begin identification of a physician assistant by new text end the title "Physician,"
"Doctor," or "Dr." new text begin in a patient care setting or in a communication directed to the general
public new text end ;

(15) improper management of medical records, including failure to maintain
adequate medical records, to comply with a patient's request made pursuant to sections
144.291 to 144.298, or to furnish a medical record or report required by law;

(16) engaging in abusive or fraudulent billing practices, including violations of the
federal Medicare and Medicaid laws or state medical assistance laws;

(17) becoming addicted or habituated to a drug or intoxicant;

(18) prescribing a drug or device for other than medically accepted therapeutic,
experimental, or investigative purposes authorized by a state or federal agency or referring
a patient to any health care provider as defined in sections 144.291 to 144.298 for services
or tests not medically indicated at the time of referral;

(19) engaging in conduct with a patient which is sexual or may reasonably be
interpreted by the patient as sexual, or in any verbal behavior which is seductive or
sexually demeaning to a patient;

(20) failure to make reports as required by section 147A.14 or to cooperate with an
investigation of the board as required by section 147A.15, subdivision 3;

(21) knowingly providing false or misleading information that is directly related
to the care of that patient unless done for an accepted therapeutic purpose such as the
administration of a placebo;

(22) aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in
violation of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an
injunction issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5; or

(iv) a finding by the board that the person violated section 609.215, subdivision 1 or
2. The board shall investigate any complaint of a violation of section 609.215, subdivision
1 or 2; or

(23) failure to maintain annually reviewed and updated physician-physician
assistant new text begin delegation new text end agreements deleted text begin , internal protocols, or prescribing delegation forms deleted text end for
each physician-physician assistant practice relationship, or failure to provide copies of
such documents upon request by the board.

Subd. 2.

Effective dates, automatic suspension.

A suspension, revocation,
condition, limitation, qualification, or restriction of a deleted text begin registration deleted text end new text begin license new text end shall be in effect
pending determination of an appeal unless the court, upon petition and for good cause
shown, orders otherwise.

A physician assistant deleted text begin registration deleted text end new text begin license new text end is automatically suspended if:

(1) a guardian of a deleted text begin registrant deleted text end new text begin licensee new text end is appointed by order of a court pursuant to
sections 524.5-101 to 524.5-502, for reasons other than the minority of the deleted text begin registrant deleted text end new text begin
licensee new text end ; or

(2) the deleted text begin registrant deleted text end new text begin licensee new text end is committed by order of a court pursuant to chapter
253B. The deleted text begin registration deleted text end new text begin license new text end remains suspended until the deleted text begin registrant deleted text end new text begin licensee new text end is restored
to capacity by a court and, upon petition by the deleted text begin registrant deleted text end new text begin licensee new text end , the suspension is
terminated by the board after a hearing.

Subd. 3.

Conditions on reissued deleted text begin registration deleted text end new text begin license new text end .

In its discretion, the board
may restore and reissue a physician assistant deleted text begin registration deleted text end new text begin license new text end , but may impose as a
condition any disciplinary or corrective measure which it might originally have imposed.

Subd. 4.

Temporary suspension of deleted text begin registration deleted text end new text begin license new text end .

In addition to any other
remedy provided by law, the board may, without a hearing, temporarily suspend the
deleted text begin registration deleted text end new text begin license new text end of a physician assistant if the board finds that the physician assistant has
violated a statute or rule which the board is empowered to enforce and continued practice
by the physician assistant would create a serious risk of harm to the public. The suspension
shall take effect upon written notice to the physician assistant, specifying the statute or
rule violated. The suspension shall remain in effect until the board issues a final order
in the matter after a hearing. At the time it issues the suspension notice, the board shall
schedule a disciplinary hearing to be held pursuant to the Administrative Procedure Act.

The physician assistant shall be provided with at least 20 days' notice of any hearing
held pursuant to this subdivision. The hearing shall be scheduled to begin no later than 30
days after the issuance of the suspension order.

Subd. 5.

Evidence.

In disciplinary actions alleging a violation of subdivision
1, clause (3) or (4), a copy of the judgment or proceeding under the seal of the court
administrator or of the administrative agency which entered it shall be admissible into
evidence without further authentication and shall constitute prima facie evidence of the
contents thereof.

Subd. 6.

Mental examination; access to medical data.

(a) If the board has
probable cause to believe that a physician assistant comes under subdivision 1, clause
(1), it may direct the physician assistant to submit to a mental or physical examination.
For the purpose of this subdivision, every physician assistant deleted text begin registered deleted text end new text begin licensed new text end under
this chapter is deemed to have consented to submit to a mental or physical examination
when directed in writing by the board and further to have waived all objections to the
admissibility of the examining physicians' testimony or examination reports on the ground
that the same constitute a privileged communication. Failure of a physician assistant to
submit to an examination when directed constitutes an admission of the allegations against
the physician assistant, unless the failure was due to circumstance beyond the physician
assistant's control, in which case a default and final order may be entered without the
taking of testimony or presentation of evidence. A physician assistant affected under this
subdivision shall at reasonable intervals be given an opportunity to demonstrate that
the physician assistant can resume competent practice with reasonable skill and safety
to patients. In any proceeding under this subdivision, neither the record of proceedings
nor the orders entered by the board shall be used against a physician assistant in any
other proceeding.

(b) In addition to ordering a physical or mental examination, the board may,
notwithstanding sections 13.384, 144.651, or any other law limiting access to medical or
other health data, obtain medical data and health records relating to a deleted text begin registrant deleted text end new text begin licensee new text end or
applicant without the deleted text begin registrant's deleted text end new text begin licensee's new text end or applicant's consent if the board has probable
cause to believe that a physician assistant comes under subdivision 1, clause (1).

The medical data may be requested from a provider, as defined in section 144.291,
subdivision 2, paragraph (h), an insurance company, or a government agency, including
the Department of Human Services. A provider, insurance company, or government
agency shall comply with any written request of the board under this subdivision and is not
liable in any action for damages for releasing the data requested by the board if the data
are released pursuant to a written request under this subdivision, unless the information
is false and the provider giving the information knew, or had reason to believe, the
information was false. Information obtained under this subdivision is classified as private
under chapter 13.

Subd. 7.

Tax clearance certificate.

(a) In addition to the provisions of subdivision
1, the board may not issue or renew a deleted text begin registration deleted text end new text begin license new text end if the commissioner of revenue
notifies the board and the deleted text begin registrant deleted text end new text begin licensee new text end or applicant for deleted text begin registration deleted text end new text begin licensure new text end that the
deleted text begin registrant deleted text end new text begin licensee new text end or applicant owes the state delinquent taxes in the amount of $500 or
more. The board may issue or renew the deleted text begin registration deleted text end new text begin license new text end only if:

(1) the commissioner of revenue issues a tax clearance certificate; and

(2) the commissioner of revenue, the deleted text begin registrant deleted text end new text begin licensee new text end , or the applicant forwards a
copy of the clearance to the board.

The commissioner of revenue may issue a clearance certificate only if the deleted text begin registrant deleted text end new text begin
licensee new text end or applicant does not owe the state any uncontested delinquent taxes.

(b) For purposes of this subdivision, the following terms have the meanings given:

(1) "Taxes" are all taxes payable to the commissioner of revenue, including penalties
and interest due on those taxes, and

(2) "Delinquent taxes" do not include a tax liability if:

(i) an administrative or court action that contests the amount or validity of the
liability has been filed or served;

(ii) the appeal period to contest the tax liability has not expired; or

(iii) the licensee or applicant has entered into a payment agreement to pay the
liability and is current with the payments.

(c) When a deleted text begin registrant deleted text end new text begin licensee new text end or applicant is required to obtain a clearance certificate
under this subdivision, a contested case hearing must be held if the deleted text begin registrant deleted text end new text begin licensee new text end or
applicant requests a hearing in writing to the commissioner of revenue within 30 days of
the date of the notice provided in paragraph (a). The hearing must be held within 45 days
of the date the commissioner of revenue refers the case to the Office of Administrative
Hearings. Notwithstanding any law to the contrary, the licensee or applicant must be
served with 20 days' notice in writing specifying the time and place of the hearing and
the allegations against the registrant or applicant. The notice may be served personally or
by mail.

(d) The board shall require all deleted text begin registrants deleted text end new text begin licensees new text end or applicants to provide their
Social Security number and Minnesota business identification number on all deleted text begin registration deleted text end new text begin
license new text end applications. Upon request of the commissioner of revenue, the board must
provide to the commissioner of revenue a list of all deleted text begin registrants deleted text end new text begin licensees new text end and applicants,
including their names and addresses, Social Security numbers, and business identification
numbers. The commissioner of revenue may request a list of the deleted text begin registrants deleted text end new text begin licensees new text end and
applicants no more than once each calendar year.

new text begin Subd. 8. new text end

new text begin Limitation. new text end

new text begin No board proceeding against a licensee shall be instituted
unless commenced within seven years from the date of commission of some portion of the
offense except for alleged violations of subdivision 1, paragraph (19), or subdivision 7.
new text end

Sec. 16.

Minnesota Statutes 2008, section 147A.16, is amended to read:

147A.16 FORMS OF DISCIPLINARY ACTION.

When the board finds that a deleted text begin registered deleted text end new text begin licensed new text end physician assistant has violated a
provision of this chapter, it may do one or more of the following:

(1) revoke the deleted text begin registration deleted text end new text begin license new text end ;

(2) suspend the deleted text begin registration deleted text end new text begin license new text end ;

(3) impose limitations or conditions on the physician assistant's practice, including
limiting the scope of practice to designated field specialties; impose retraining or
rehabilitation requirements; require practice under additional supervision; or condition
continued practice on demonstration of knowledge or skills by appropriate examination
or other review of skill and competence;

(4) impose a civil penalty not exceeding $10,000 for each separate violation, the
amount of the civil penalty to be fixed so as to deprive the physician assistant of any
economic advantage gained by reason of the violation charged or to reimburse the board
for the cost of the investigation and proceeding;

(5) order the physician assistant to provide unremunerated professional service
under supervision at a designated public hospital, clinic, or other health care institution; or

(6) censure or reprimand the deleted text begin registered deleted text end new text begin licensed new text end physician assistant.

Upon judicial review of any board disciplinary action taken under this chapter, the
reviewing court shall seal the administrative record, except for the board's final decision,
and shall not make the administrative record available to the public.

Sec. 17.

Minnesota Statutes 2008, section 147A.18, is amended to read:

147A.18 DELEGATED AUTHORITY TO PRESCRIBE, DISPENSE, AND
ADMINISTER DRUGS AND MEDICAL DEVICES.

Subdivision 1.

Delegation.

(a) A supervising physician may delegate to a
physician assistant who is deleted text begin registered with deleted text end new text begin licensed by new text end the board, certified by the National
Commission on Certification of Physician Assistants or successor agency approved by the
board, and who is under the supervising physician's supervision, the authority to prescribe,
dispense, and administer legend drugs, deleted text begin medical devices, and deleted text end controlled substances new text begin , and
medical devices new text end subject to the requirements in this section. The authority to dispense
includes, but is not limited to, the authority to request, receive, and dispense sample drugs.
This authority to dispense extends only to those drugs described in the written agreement
developed under paragraph (b).

(b) The new text begin delegation new text end agreement between the physician assistant and supervising
physician deleted text begin and any alternate supervising physicians deleted text end must include a statement by the
supervising physician regarding delegation or nondelegation of the functions of
prescribing, dispensing, and administering deleted text begin of deleted text end legend drugs new text begin , controlled substances, new text end and
medical devices to the physician assistant. The statement must include deleted text begin a protocol
indicating deleted text end categories of drugs for which the supervising physician delegates prescriptive
and dispensing authority new text begin including controlled substances when applicable new text end . The delegation
must be appropriate to the physician assistant's practice and within the scope of the
physician assistant's training. Physician assistants who have been delegated the authority
to prescribe, dispense, and administer legend drugs new text begin , controlled substances, new text end and medical
devices shall provide evidence of current certification by the National Commission
on Certification of Physician Assistants or its successor agency when deleted text begin registering or
reregistering deleted text end new text begin applying for licensure or license renewal new text end as physician assistants. Physician
assistants who have been delegated the authority to prescribe controlled substances must
deleted text begin present evidence of the certification and deleted text end new text begin also new text end hold a valid DEA deleted text begin certificate deleted text end new text begin registration new text end .
Supervising physicians shall retrospectively review the prescribing, dispensing, and
administering of legend deleted text begin and controlled deleted text end drugs new text begin , controlled substances, new text end and medical devices
by physician assistants, when this authority has been delegated to the physician assistant as
part of the new text begin physician-physician assistant new text end delegation agreement deleted text begin between the physician and
the physician assistant. This review must take place as outlined in the internal protocol deleted text end .
The process and schedule for the review must be outlined in the new text begin physician-physician
assistant new text end delegation agreement.

(c) The board may establish by rule:

(1) a system of identifying physician assistants eligible to prescribe, administer, and
dispense legend drugs and medical devices;

(2) a system of identifying physician assistants eligible to prescribe, administer, and
dispense controlled substances;

(3) a method of determining the categories of legend deleted text begin and controlled deleted text end drugs new text begin , controlled
substances, new text end and medical devices that each physician assistant is allowed to prescribe,
administer, and dispense; and

(4) a system of transmitting to pharmacies a listing of physician assistants eligible to
prescribe legend deleted text begin and controlled deleted text end drugs new text begin , controlled substances, new text end and medical devices.

Subd. 2.

Termination and reinstatement of prescribing authority.

deleted text begin (a) deleted text end The
authority of a physician assistant to prescribe, dispense, and administer legend drugs new text begin ,
controlled substances, new text end and medical devices shall end immediately when:

(1) the new text begin physician-physician assistant delegation new text end agreement is terminated;

(2) the authority to prescribe, dispense, and administer is terminated or withdrawn
by the supervising physician; deleted text begin or
deleted text end

(3) the physician deleted text begin assistant reverts to deleted text end new text begin assistant's license is placed on new text end inactive status deleted text begin ,
loses National Commission on Certification of Physician Assistants or successor agency
certification, or loses or terminates registration status deleted text end new text begin ;
new text end

new text begin (4) the physician assistant loses National Commission on Certification of Physician
Assistants or successor agency certification; or
new text end

new text begin (5) the physician assistant loses or terminates licensure status new text end .

deleted text begin (b) The physician assistant must notify the board in writing within ten days of the
occurrence of any of the circumstances listed in paragraph (a).
deleted text end

deleted text begin (c) Physician assistants whose authority to prescribe, dispense, and administer
has been terminated shall reapply for reinstatement of prescribing authority under this
section and meet any requirements established by the board prior to reinstatement of the
prescribing, dispensing, and administering authority.
deleted text end

Subd. 3.

Other requirements and restrictions.

deleted text begin (a) The supervising physician and
the physician assistant must complete, sign, and date an internal protocol which lists each
category of drug or medical device, or controlled substance the physician assistant may
prescribe, dispense, and administer. The supervising physician and physician assistant
shall submit the internal protocol to the board upon request. The supervising physician
may amend the internal protocol as necessary, within the limits of the completed delegation
form in subdivision 5. The supervising physician and physician assistant must sign and
date any amendments to the internal protocol. Any amendments resulting in a change to
an addition or deletion to categories delegated in the delegation form in subdivision 5 must
be submitted to the board according to this chapter, along with the fee required.
deleted text end

deleted text begin (b) The supervising physician and physician assistant shall review delegation of
prescribing, dispensing, and administering authority on an annual basis at the time of
reregistration. The internal protocol must be signed and dated by the supervising physician
and physician assistant after review. Any amendments to the internal protocol resulting in
changes to the delegation form in subdivision 5 must be submitted to the board according
to this chapter, along with the fee required.
deleted text end

deleted text begin (c) deleted text end new text begin (a) new text end Each prescription initiated by a physician assistant shall indicate the
following:

(1) the date of issue;

(2) the name and address of the patient;

(3) the name and quantity of the drug prescribed;

(4) directions for use; and

(5) the name and address of the prescribing physician assistant.

deleted text begin (d) deleted text end new text begin (b) new text end In prescribing, dispensing, and administering legend drugs new text begin , controlled
substances, new text end and medical devices deleted text begin , including controlled substances as defined in section
deleted text end deleted text begin 152.01, subdivision 4 deleted text end deleted text begin , deleted text end a physician assistant must conform with the agreement, chapter
151, and this chapter.

deleted text begin Subd. 4. deleted text end

deleted text begin Notification of pharmacies. deleted text end

deleted text begin (a) The board shall annually provide to the
Board of Pharmacy and to registered pharmacies within the state a list of those physician
assistants who are authorized to prescribe, administer, and dispense legend drugs and
medical devices, or controlled substances.
deleted text end

deleted text begin (b) The board shall provide to the Board of Pharmacy a list of physician assistants
authorized to prescribe legend drugs and medical devices every two months if additional
physician assistants are authorized to prescribe or if physician assistants have authorization
to prescribe withdrawn.
deleted text end

deleted text begin (c) The list must include the name, address, telephone number, and Minnesota
registration number of the physician assistant, and the name, address, telephone number,
and Minnesota license number of the supervising physician.
deleted text end

deleted text begin (d) The board shall provide the form in subdivision 5 to pharmacies upon request.
deleted text end

deleted text begin (e) The board shall make available prototype forms of the physician-physician
assistant agreement, the internal protocol, the delegation form, and the addendum form.
deleted text end

deleted text begin Subd. 5. deleted text end

deleted text begin Delegation form for physician assistant prescribing. deleted text end

deleted text begin The delegation
form for physician assistant prescribing must contain a listing by drug category of the
legend drugs and controlled substances for which prescribing authority has been delegated
to the physician assistant.
deleted text end

Sec. 18.

Minnesota Statutes 2008, section 147A.19, is amended to read:

147A.19 IDENTIFICATION REQUIREMENTS.

Physician assistants deleted text begin registered deleted text end new text begin licensed new text end under this chapter shall keep their
deleted text begin registration deleted text end new text begin license new text end available for inspection at their primary place of business and shall,
when engaged in their professional activities, wear a name tag identifying themselves as
a "physician assistant."

Sec. 19.

Minnesota Statutes 2008, section 147A.20, is amended to read:

147A.20 deleted text begin PHYSICIAN AND PHYSICIAN deleted text end new text begin PHYSICIAN-PHYSICIAN new text end
ASSISTANT AGREEMENT new text begin DOCUMENTS new text end .

new text begin Subdivision 1. new text end

new text begin Physician-physician assistant delegation agreement. new text end

(a) A
physician assistant and supervising physician must sign deleted text begin an deleted text end new text begin a physician-physician assistant
delegation new text end agreement which specifies scope of practice deleted text begin and amount deleted text end and manner of
supervision as required by the board. The agreement must contain:

(1) a description of the practice setting;

(2) deleted text begin a statement of practice type/specialty;
deleted text end

deleted text begin (3) deleted text end a listing of categories of delegated duties;

deleted text begin (4) deleted text end new text begin (3) new text end a description of supervision type deleted text begin , amount, and frequency deleted text end ; and

deleted text begin (5) deleted text end new text begin (4) new text end a description of the process and schedule for review of prescribing,
dispensing, and administering legend and controlled drugs and medical devices by the
physician assistant authorized to prescribe.

(b) The agreement must be maintained by the supervising physician and physician
assistant and made available to the board upon request. If there is a delegation of
prescribing, administering, and dispensing of legend drugs, controlled substances, and
medical devices, the agreement shall include deleted text begin an internal protocol and delegation form deleted text end new text begin a
description of the prescriptive authority delegated to the physician assistant new text end . Physician
assistants shall have a separate agreement for each place of employment. Agreements
must be reviewed and updated on an annual basis. The supervising physician and
physician assistant must maintain the new text begin physician-physician assistant delegation new text end agreement deleted text begin ,
delegation form, and internal protocol deleted text end at the address of record. deleted text begin Copies shall be provided to
the board upon request.
deleted text end

(c) Physician assistants must provide written notification to the board within 30
days of the following:

(1) name change;

(2) address of record change; new text begin and
new text end

(3) telephone number of record change deleted text begin ; and
deleted text end

deleted text begin (4) addition or deletion of alternate supervising physician provided that the
information submitted includes, for an additional alternate physician, an affidavit of
consent to act as an alternate supervising physician signed by the alternate supervising
physician deleted text end .

deleted text begin (d) Modifications requiring submission prior to the effective date are changes to the
practice setting description which include:
deleted text end

deleted text begin (1) supervising physician change, excluding alternate supervising physicians; or
deleted text end

deleted text begin (2) delegation of prescribing, administering, or dispensing of legend drugs,
controlled substances, or medical devices.
deleted text end

deleted text begin (e) The agreement must be completed and the practice setting description submitted
to the board before providing medical care as a physician assistant.
deleted text end

new text begin (d) Any alternate supervising physicians must be identified in the physician-physician
assistant delegation agreement, or a supplemental listing, and must sign the agreement
attesting that they shall provide the physician assistant with supervision in compliance
with this chapter, the delegation agreement, and board rules.
new text end

new text begin Subd. 2. new text end

new text begin Notification of intent to practice. new text end

new text begin A licensed physician assistant shall
submit a notification of intent to practice to the board prior to beginning practice. The
notification shall include the name, business address, and telephone number of the
supervising physician and the physician assistant. Individuals who practice without
submitting a notification of intent to practice shall be subject to disciplinary action under
section 147A.13 for practicing without a license, unless the care is provided in response to
a disaster or emergency situation pursuant to section 147A.23.
new text end

Sec. 20.

Minnesota Statutes 2008, section 147A.21, is amended to read:

147A.21 RULEMAKING AUTHORITY.

The board shall adopt rules:

(1) setting deleted text begin registration deleted text end new text begin license new text end fees;

(2) setting renewal fees;

(3) deleted text begin setting fees for locum tenens permits;
deleted text end

deleted text begin (4) deleted text end setting fees for temporary deleted text begin registration deleted text end new text begin licenses new text end ; and

deleted text begin (5) deleted text end new text begin (4) new text end establishing renewal dates.

Sec. 21.

Minnesota Statutes 2008, section 147A.23, is amended to read:

147A.23 RESPONDING TO DISASTER SITUATIONS.

(a) A deleted text begin registered physician assistant or a deleted text end physician assistant duly licensed or
credentialed in a United States jurisdiction new text begin or by a federal employer new text end who is responding
to a need for medical care created by new text begin an emergency according to section 604A.01, or new text end a
state or local disaster may render such care as the physician assistant is deleted text begin able deleted text end new text begin trained new text end to
provide, under the physician assistant's license deleted text begin , registration, deleted text end or credential, without the
need of a deleted text begin physician and physician deleted text end new text begin physician-physician new text end assistant new text begin delegation new text end agreement new text begin or
a notice of intent to practice new text end as required under section 147A.20. deleted text begin Physician supervision,
as required under section 147A.09, must be provided under the direction of a physician
licensed under chapter 147 who is involved with the disaster response. The physician
assistant must establish a temporary supervisory agreement with the physician providing
supervision before rendering care. deleted text end new text begin A physician assistant may provide emergency care
without physician supervision or under the supervision that is available. new text end

(b) The physician who provides supervision to a physician assistant while the
physician assistant is rendering care deleted text begin in a disaster deleted text end in accordance with this section may do
so without meeting the requirements of section 147A.20.

(c) The supervising physician who otherwise provides supervision to a physician
assistant under a deleted text begin physician and physician deleted text end new text begin physician-physician new text end assistant new text begin delegation new text end
agreement described in section 147A.20 shall not be held medically responsible for the
care rendered by a physician assistant pursuant to paragraph (a). Services provided by
a physician assistant under paragraph (a) shall be considered outside the scope of the
relationship between the supervising physician and the physician assistant.

Sec. 22.

Minnesota Statutes 2008, section 147A.24, is amended to read:

147A.24 CONTINUING EDUCATION REQUIREMENTS.

Subdivision 1.

Amount of education required.

Applicants for deleted text begin registration deleted text end new text begin license new text end
renewal deleted text begin or reregistration deleted text end must either new text begin meet standards for continuing education through
current certification by the National Commission on Certification of Physician Assistants,
or its successor agency as approved by the board, or new text end deleted text begin attest to and document deleted text end new text begin provide
evidence of new text end successful completion of at least 50 contact hours of continuing education
within the two years immediately preceding deleted text begin registration deleted text end new text begin license new text end renewal deleted text begin , reregistration,
or attest to and document taking the national certifying examination required by this
chapter within the past two years deleted text end .

Subd. 2.

Type of education required.

deleted text begin Approved deleted text end Continuing education is approved
if it is equivalent to category 1 credit hours as defined by the American Osteopathic
Association Bureau of Professional Education, the Royal College of Physicians and
Surgeons of Canada, the American Academy of Physician Assistants, or by organizations
that have reciprocal arrangements with the physician recognition award program of the
American Medical Association.

Sec. 23.

Minnesota Statutes 2008, section 147A.26, is amended to read:

147A.26 PROCEDURES.

The board shall establish, in writing, internal operating procedures for receiving and
investigating complaints, accepting and processing applications, granting deleted text begin registrations deleted text end new text begin
licenses new text end , and imposing enforcement actions. The written internal operating procedures
may include procedures for sharing complaint information with government agencies in
this and other states. Procedures for sharing complaint information must be consistent
with the requirements for handling government data under chapter 13.

Sec. 24.

Minnesota Statutes 2008, section 147A.27, is amended to read:

147A.27 PHYSICIAN ASSISTANT ADVISORY COUNCIL.

Subdivision 1.

Membership.

(a) The Physician Assistant Advisory Council is
created and is composed of seven persons appointed by the board. The seven persons
must include:

(1) two public members, as defined in section 214.02;

(2) three physician assistants deleted text begin registered deleted text end new text begin licensed new text end under this chapter new text begin who meet the
criteria for a new applicant under section 147A.02 new text end ; and

(3) two licensed physicians with experience supervising physician assistants.

(b) No member shall serve more than deleted text begin a total of deleted text end two new text begin consecutive new text end terms. If a member
is appointed for a partial term and serves more than half of that term it shall be considered
a full term. deleted text begin Members serving on the council as of July 1, 2000, shall be allowed to
complete their current terms.
deleted text end

Subd. 2.

Organization.

The council shall be organized and administered under
section 15.059.

Subd. 3.

Duties.

The council shall advise the board regarding:

(1) physician assistant deleted text begin registration deleted text end new text begin licensure new text end standards;

(2) enforcement of grounds for discipline;

(3) distribution of information regarding physician assistant deleted text begin registration deleted text end new text begin licensure new text end
standards;

(4) applications and recommendations of applicants for deleted text begin registration deleted text end new text begin licensure new text end or
deleted text begin registration deleted text end new text begin license new text end renewal; deleted text begin and
deleted text end

(5) complaints and recommendations to the board regarding disciplinary matters and
proceedings concerning applicants and deleted text begin registrants deleted text end new text begin licensees new text end according to sections 214.10;
214.103; and 214.13, subdivisions 6 and 7 new text begin ; and
new text end

new text begin (6) issues related to physician assistant practice and regulation new text end .

The council shall perform other duties authorized for the council by chapter 214
as directed by the board.

Sec. 25.

Minnesota Statutes 2008, section 169.345, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) For the purpose of section 168.021 and this section, the
following terms have the meanings given them in this subdivision.

(b) "Health professional" means a licensed physician, deleted text begin registered deleted text end new text begin licensed new text end physician
assistant, advanced practice registered nurse, or licensed chiropractor.

(c) "Long-term certificate" means a certificate issued for a period greater than 12
months but not greater than 71 months.

(d) "Organization certificate" means a certificate issued to an entity other than a
natural person for a period of three years.

(e) "Permit" refers to a permit that is issued for a period of 30 days, in lieu of the
certificate referred to in subdivision 3, while the application is being processed.

(f) "Physically disabled person" means a person who:

(1) because of disability cannot walk without significant risk of falling;

(2) because of disability cannot walk 200 feet without stopping to rest;

(3) because of disability cannot walk without the aid of another person, a walker, a
cane, crutches, braces, a prosthetic device, or a wheelchair;

(4) is restricted by a respiratory disease to such an extent that the person's forced
(respiratory) expiratory volume for one second, when measured by spirometry, is less
than one liter;

(5) has an arterial oxygen tension (PAO2) of less than 60 mm/Hg on room air at rest;

(6) uses portable oxygen;

(7) has a cardiac condition to the extent that the person's functional limitations are
classified in severity as class III or class IV according to standards set by the American
Heart Association;

(8) has lost an arm or a leg and does not have or cannot use an artificial limb; or

(9) has a disability that would be aggravated by walking 200 feet under normal
environmental conditions to an extent that would be life threatening.

(g) "Short-term certificate" means a certificate issued for a period greater than six
months but not greater than 12 months.

(h) "Six-year certificate" means a certificate issued for a period of six years.

(i) "Temporary certificate" means a certificate issued for a period not greater than
six months.

Sec. 26.

Minnesota Statutes 2008, section 253B.02, subdivision 7, is amended to read:

Subd. 7.

Examiner.

"Examiner" means a person who is knowledgeable, trained, and
practicing in the diagnosis and assessment or in the treatment of the alleged impairment,
and who is:

(1) a licensed physician;

(2) a licensed psychologist who has a doctoral degree in psychology or who became
a licensed consulting psychologist before July 2, 1975; or

(3) an advanced practice registered nurse certified in mental health new text begin or a licensed
physician assistant new text end , except that only a physician or psychologist meeting these
requirements may be appointed by the court as described by sections 253B.07, subdivision
3; 253B.092, subdivision 8, paragraph (b); 253B.17, subdivision 3; 253B.18, subdivision
2; and 253B.19, subdivisions 1 and 2, and only a physician or psychologist may conduct
an assessment as described by Minnesota Rules of Criminal Procedure, rule 20.

Sec. 27.

Minnesota Statutes 2008, section 253B.05, subdivision 2, is amended to read:

Subd. 2.

Peace or health officer authority.

(a) A peace or health officer may take a
person into custody and transport the person to a licensed physician or treatment facility if
the officer has reason to believe, either through direct observation of the person's behavior,
or upon reliable information of the person's recent behavior and knowledge of the person's
past behavior or psychiatric treatment, that the person is mentally ill or developmentally
disabled and in danger of injuring self or others if not immediately detained. A peace or
health officer or a person working under such officer's supervision, may take a person
who is believed to be chemically dependent or is intoxicated in public into custody and
transport the person to a treatment facility. If the person is intoxicated in public or is
believed to be chemically dependent and is not in danger of causing self-harm or harm to
any person or property, the peace or health officer may transport the person home. The
peace or health officer shall make written application for admission of the person to the
treatment facility. The application shall contain the peace or health officer's statement
specifying the reasons for and circumstances under which the person was taken into
custody. If danger to specific individuals is a basis for the emergency hold, the statement
must include identifying information on those individuals, to the extent practicable. A
copy of the statement shall be made available to the person taken into custody.

(b) As far as is practicable, a peace officer who provides transportation for a person
placed in a facility under this subdivision may not be in uniform and may not use a vehicle
visibly marked as a law enforcement vehicle.

(c) A person may be admitted to a treatment facility for emergency care and
treatment under this subdivision with the consent of the head of the facility under the
following circumstances: (1) a written statement shall only be made by the following
individuals who are knowledgeable, trained, and practicing in the diagnosis and treatment
of mental illness or developmental disability; the medical officer, or the officer's designee
on duty at the facility, including a licensed physician, a deleted text begin registered deleted text end new text begin licensed new text end physician
assistant, or an advanced practice registered nurse who after preliminary examination has
determined that the person has symptoms of mental illness or developmental disability
and appears to be in danger of harming self or others if not immediately detained; or (2) a
written statement is made by the institution program director or the director's designee
on duty at the facility after preliminary examination that the person has symptoms
of chemical dependency and appears to be in danger of harming self or others if not
immediately detained or is intoxicated in public.

Sec. 28.

Minnesota Statutes 2008, section 256B.0625, subdivision 28a, is amended to
read:

Subd. 28a.

deleted text begin Registered deleted text end new text begin Licensed new text end physician assistant services.

Medical assistance
covers services performed by a deleted text begin registered deleted text end new text begin licensed new text end physician assistant if the service is
otherwise covered under this chapter as a physician service and if the service is within the
scope of practice of a deleted text begin registered deleted text end new text begin licensed new text end physician assistant as defined in section 147A.09.

Sec. 29.

Minnesota Statutes 2008, section 256B.0751, subdivision 1, is amended to
read:

Subdivision 1.

Definitions.

(a) For purposes of sections 256B.0751 to 256B.0753,
the following definitions apply.

(b) "Commissioner" means the commissioner of human services.

(c) "Commissioners" means the commissioner of humans services and the
commissioner of health, acting jointly.

(d) "Health plan company" has the meaning provided in section 62Q.01, subdivision
4.

(e) "Personal clinician" means a physician licensed under chapter 147, a physician
assistant deleted text begin registered deleted text end new text begin licensed new text end and practicing under chapter 147A, or an advanced practice
nurse licensed and registered to practice under chapter 148.

(f) "State health care program" means the medical assistance, MinnesotaCare, and
general assistance medical care programs.

Sec. 30. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2008, section 147A.22, new text end new text begin is repealed.
new text end

Sec. 31. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 to 30 are effective July 1, 2009.
new text end