HF 537

as introduced - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act
  1.2             relating to health; allowing complementary and 
  1.3             alternative health care practitioners to practice in 
  1.4             certain circumstances; creating informed consent and 
  1.5             notice requirements; establishing civil penalties; 
  1.6             amending Minnesota Statutes 1998, section 147.09; 
  1.7             proposing coding for new law as Minnesota Statutes, 
  1.8             chapter 146A. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  [146A.01] [CITATION.] 
  1.11     This chapter may be cited as the Complementary and 
  1.12  Alternative Health Care Freedom of Access Act. 
  1.13     Sec. 2.  [146A.02] [DEFINITIONS.] 
  1.14     Subdivision 1.  [APPLICABILITY.] For purposes of this 
  1.15  chapter, the following terms have the meanings given to them. 
  1.16     Subd. 2.  [COMPLEMENTARY AND ALTERNATIVE HEALTH CARE CLIENT 
  1.17  OR CLIENT.] "Complementary and alternative health care client" 
  1.18  or "client" means an individual who receives services from a 
  1.19  licensed or unlicensed complementary and alternative health care 
  1.20  practitioner. 
  1.21     Subd. 3.  [COMPLEMENTARY AND ALTERNATIVE HEALTH CARE 
  1.22  PRACTICES.] (a) "Complementary and alternative health care 
  1.23  practices" means the broad domain of complementary and 
  1.24  alternative healing methods, treatments, and resources, 
  1.25  including, but not limited to:  (1) acupressure; (2) 
  1.26  anthroposophy; (3) aroma therapy; (4) ayurvedic medicine; (5) 
  1.27  cranial sacral therapy; (6) culturally traditional healing 
  2.1   practices; (7) detoxification practices and therapies; (8) 
  2.2   energetic healing; (9) environmental medicine; (10) folk 
  2.3   medicine; (11) healing practices utilizing food, food 
  2.4   supplements, nutrients, and the physical forces of heat, cold, 
  2.5   water, touch, and light; (12) Gerson therapy and colostrum 
  2.6   therapy; (13) healing touch; (14) herbal medicine; (15) 
  2.7   homeopathy; (16) iridology; (17) body work, massage, and massage 
  2.8   therapy; (18) meditation; (19) mind-body healing practices; (20) 
  2.9   naturopathy; (21) noninvasive instrumentalities; (22) 
  2.10  traditional Oriental practices, such as Qi Gong energy healing; 
  2.11  and (23) other health care and healing practices and resources 
  2.12  pursued by clients for the purpose of preventing or treating 
  2.13  illness or promoting health and well-being. 
  2.14     (b) Complementary and alternative health care practices, in 
  2.15  and of themselves, do not include surgery, x-ray radiation, 
  2.16  administering or dispensing legend drugs and controlled 
  2.17  substances, practices that invade the human body by puncture of 
  2.18  the skin, or the manipulation or adjustment of articulations of 
  2.19  joints or the spine as described in section 146.23 or 148.01. 
  2.20     Subd. 4.  [LICENSED COMPLEMENTARY AND ALTERNATIVE HEALTH 
  2.21  CARE PRACTITIONER.] "Licensed complementary and alternative 
  2.22  health care practitioner" means a person who is: 
  2.23     (1) licensed or registered by a health-related licensing 
  2.24  board, as defined in section 214.01, or by the commissioner of 
  2.25  health; 
  2.26     (2) engaging in complementary and alternative health care 
  2.27  practices that are outside the scope of practice of the person's 
  2.28  regulated profession; and 
  2.29     (3) engaging in complementary and alternative health care 
  2.30  practices for remuneration, or holding out to the public as a 
  2.31  practitioner of complementary and alternative health care 
  2.32  practices. 
  2.33     Subd. 5.  [UNLICENSED COMPLEMENTARY AND ALTERNATIVE HEALTH 
  2.34  CARE PRACTITIONER.] "Unlicensed complementary and alternative 
  2.35  health care practitioner" means a person who is: 
  2.36     (1) not licensed or registered by a health-related 
  3.1   licensing board, as defined in section 214.01, or by the 
  3.2   commissioner of health; 
  3.3      (2) engaging in complementary and alternative health care 
  3.4   practices; and 
  3.5      (3) engaging in complementary and alternative health care 
  3.6   practices for remuneration, or holding out to the public as a 
  3.7   practitioner of complementary and alternative health care 
  3.8   practices. 
  3.9      Sec. 3.  [146A.03] [PRACTITIONER RIGHTS AND 
  3.10  RESPONSIBILITIES.] 
  3.11     A licensed or unlicensed complementary and alternative 
  3.12  health care practitioner has the right to engage in 
  3.13  complementary and alternative health care practices if: 
  3.14     (1) the practitioner provides the appropriate disclosures, 
  3.15  notices, and informed consent required under section 146A.04 to 
  3.16  the client before treatment commences; and 
  3.17     (2) the practitioner receives the informed consent form 
  3.18  back from the client, signed and dated by the client, before 
  3.19  treatment commences. 
  3.20     Sec. 4.  [146A.04] [DISCLOSURES, NOTICES, AND INFORMED 
  3.21  CONSENT.] 
  3.22     Subdivision 1.  [REQUIRED CONTENT; UNLICENSED COMPLEMENTARY 
  3.23  AND ALTERNATIVE HEALTH CARE PRACTITIONER.] (a) Before providing 
  3.24  treatment to a client, an unlicensed complementary and 
  3.25  alternative health care practitioner must provide written 
  3.26  disclosures and notices to the client that include the following:
  3.27     (1) the practitioner's professional title and health care 
  3.28  services available from the practitioner; 
  3.29     (2) the practitioner's education, experience, and training, 
  3.30  and any credentials, continuing education, and professional 
  3.31  affiliations related to the complementary and alternative health 
  3.32  care practices in which the practitioner engages; 
  3.33     (3) the nature and purpose of the proposed treatment or 
  3.34  procedure; 
  3.35     (4) the benefits that may most likely be expected from the 
  3.36  proposed treatment or procedure; 
  4.1      (5) the most common risks and side effects associated with 
  4.2   the proposed treatment or procedure; and 
  4.3      (6) information regarding the fee schedule, billing 
  4.4   practices, and insurance reimbursement. 
  4.5      (b) Before providing treatment to a client, an unlicensed 
  4.6   complementary and alternative health care practitioner must 
  4.7   provide the following informed consent form to the client and 
  4.8   must receive the signed, dated form back from the client: 
  4.9      "I ...................., Client (or client's legal 
  4.10  guardian), hereby authorize .........................., 
  4.11  Practitioner, to provide complementary and alternative health 
  4.12  care to me. 
  4.13     The complementary and alternative health care practitioner 
  4.14  has provided information to me in writing and discussed with me 
  4.15  the practitioner's education, experience, and training; the 
  4.16  services the practitioner provides; the nature and purpose of 
  4.17  the proposed treatment; the benefits that may most likely be 
  4.18  expected; the common risks and side effects associated with the 
  4.19  treatment; and information regarding fees, billings, and 
  4.20  insurance practices.  I have had sufficient opportunity to 
  4.21  discuss my condition and treatment with the health care 
  4.22  practitioner, and all of my questions have been answered to my 
  4.23  satisfaction.  I believe that I have adequate information about 
  4.24  the proposed course of treatment and that I understand this 
  4.25  information. 
  4.26     I understand that THE STATE OF MINNESOTA HAS NOT ADOPTED 
  4.27  UNIFORM EDUCATIONAL AND QUALIFICATION STANDARDS FOR 
  4.28  COMPLEMENTARY AND ALTERNATIVE HEALTH CARE PRACTITIONERS.  THE 
  4.29  PRACTITIONER'S STATEMENT OF CREDENTIALS IS FOR INFORMATIONAL 
  4.30  PURPOSES ONLY. 
  4.31     I understand that (1) the practitioner is not credentialled 
  4.32  in the state of Minnesota to practice medicine, chiropractic, 
  4.33  osteopathy, nursing, physical therapy, dietetics practice, or 
  4.34  acupuncture practice; (2) the practitioner may provide me with 
  4.35  personal consultations, screenings, assessments, an explanation 
  4.36  of the practitioner's method of detection and assessment of my 
  5.1   health problems and concerns, educational services, and 
  5.2   recommendations regarding the complementary and alternative 
  5.3   health care practice to be used; and (3) these actions do not 
  5.4   constitute a diagnosis from a licensed physician, chiropractor, 
  5.5   or acupuncture practitioner. 
  5.6      I understand that if I desire a diagnosis from a licensed 
  5.7   physician, chiropractor, or acupuncture practitioner, or 
  5.8   services from a physician, chiropractor, nurse, osteopath, 
  5.9   physical therapist, dietician, acupuncture practitioner, or any 
  5.10  other type of health care provider, I may seek such services at 
  5.11  any time. 
  5.12     I understand that my health care records and communications 
  5.13  and transactions with the practitioner shall be kept 
  5.14  confidential, unless I authorize the release of records in 
  5.15  writing or as otherwise provided by law. 
  5.16     I understand that if I decide to act on the proposed 
  5.17  assessment, treatment, or recommendations of this health care 
  5.18  practitioner, I do so at my own risk.  I hereby accept these 
  5.19  possible risks and limitations. 
  5.20  ....................................     ..........  
  5.21  Client or Legal Guardian's Signature     Date"
  5.22     Subd. 2.  [REQUIRED CONTENT; LICENSED COMPLEMENTARY AND 
  5.23  ALTERNATIVE HEALTH CARE PRACTITIONER.] (a) Before providing 
  5.24  treatment to a client, a licensed complementary and alternative 
  5.25  health care practitioner who is engaging in complementary and 
  5.26  alternative health care practices outside of the scope of 
  5.27  practice of the practitioner's regulated profession must provide 
  5.28  written disclosures and notices to the client that include the 
  5.29  following: 
  5.30     (1) the practitioner's professional title, type of license 
  5.31  or other authorization to practice in the state of Minnesota, 
  5.32  and area of practice of the practitioner's licensed or 
  5.33  registered profession and any specialty credentials; 
  5.34     (2) the practitioner's education, experience, and training, 
  5.35  and any credentials, continuing education, and professional 
  5.36  affiliations related to the complementary and alternative health 
  6.1   care practices in which the practitioner engages; 
  6.2      (3) the nature and purpose of the proposed treatment or 
  6.3   procedure; 
  6.4      (4) the benefits that may most likely be expected from the 
  6.5   proposed treatment or procedure; 
  6.6      (5) the most common risks and side effects associated with 
  6.7   the proposed treatment or procedure; and 
  6.8      (6) information regarding the fee schedule, billing 
  6.9   practices, and insurance reimbursement. 
  6.10     (b) Before providing treatment to a client, a licensed 
  6.11  complementary and alternative health care practitioner who is 
  6.12  engaging in complementary and alternative health care practices 
  6.13  outside of the scope of practice of the practitioner's regulated 
  6.14  profession must provide the following informed consent form to 
  6.15  the client and must receive the signed, dated form back from the 
  6.16  client: 
  6.17     "I ...................., Client (or client's legal 
  6.18  guardian), hereby authorize .........................., 
  6.19  Practitioner, to provide complementary and alternative health 
  6.20  care to me. 
  6.21     The complementary and alternative health care practitioner 
  6.22  has provided information to me in writing and discussed with me 
  6.23  the practitioner's education, experience, and training; the 
  6.24  services the practitioner provides; the nature and purpose of 
  6.25  the proposed treatment; the benefits that may most likely be 
  6.26  expected; the common risks and side effects associated with the 
  6.27  treatment; and information regarding fees, billings, and 
  6.28  insurance practices.  I have had sufficient opportunity to 
  6.29  discuss my condition and treatment with the health care 
  6.30  practitioner, and all of my questions have been answered to my 
  6.31  satisfaction.  I believe that I have adequate information about 
  6.32  the proposed course of treatment and that I understand this 
  6.33  information. 
  6.34     I understand that THE STATE OF MINNESOTA HAS NOT ADOPTED 
  6.35  UNIFORM EDUCATIONAL AND QUALIFICATION STANDARDS FOR 
  6.36  COMPLEMENTARY AND ALTERNATIVE HEALTH CARE PRACTITIONERS.  THE 
  7.1   PRACTITIONER'S STATEMENT OF CREDENTIALS IS FOR INFORMATIONAL 
  7.2   PURPOSES ONLY. 
  7.3      I understand that THE COMPLEMENTARY AND ALTERNATIVE HEALTH 
  7.4   CARE PRACTICES RECOMMENDED TO ME BY THIS PRACTITIONER ARE NOT 
  7.5   WITHIN THE SCOPE OF PRACTICE OF THE PRACTITIONER'S LICENSED OR 
  7.6   REGISTERED PROFESSION AND THAT THESE COMPLEMENTARY AND 
  7.7   ALTERNATIVE HEALTH CARE SERVICES ARE INTENDED TO BE 
  7.8   COMPLEMENTARY TO MY OVERALL MEDICAL CARE. 
  7.9      I understand that if I decide to act on the proposed 
  7.10  assessment, treatment, or recommendations of this health care 
  7.11  practitioner, I do so at my own risk.  I hereby accept these 
  7.12  possible risks and limitations. 
  7.13  ....................................     ..........
  7.14  Client or Legal Guardian's Signature     Date" 
  7.15     Sec. 5.  [146A.05] [SANCTIONS AGAINST PRACTITIONERS 
  7.16  LIMITED.] 
  7.17     Subdivision 1.  [UNLICENSED COMPLEMENTARY AND ALTERNATIVE 
  7.18  HEALTH CARE PRACTITIONER.] (a) No civil remedy or disciplinary 
  7.19  action may be sought or imposed against an unlicensed 
  7.20  complementary and alternative health care practitioner by the 
  7.21  state, a political subdivision of the state, or a health-related 
  7.22  licensing board based on section 214.11 or 214.131 or other 
  7.23  civil action unless the state, political subdivision, or 
  7.24  licensing board can demonstrate by a preponderance of the 
  7.25  evidence that: 
  7.26     (1) there was no informed consent as required under section 
  7.27  146A.04; or 
  7.28     (2) the treatment method, when used as directed by the 
  7.29  complaining client, caused serious, direct, physical or mental 
  7.30  harm; the harm occurred as a result of the complementary and 
  7.31  alternative health care practice in and of itself; and the 
  7.32  client would not have otherwise suffered the harm. 
  7.33     (b) No criminal sanction may be sought or imposed against 
  7.34  an unlicensed complementary and alternative health care 
  7.35  practitioner by the state, a political subdivision of the state, 
  7.36  or a health-related licensing board for practicing medicine 
  8.1   without a license under section 147.081, subdivision 3, clause 
  8.2   (3). 
  8.3      (c) A client's choice to delay the use of conventional 
  8.4   medical care and receive complementary and alternative health 
  8.5   care practices is not, in and of itself, evidence of harm. 
  8.6      Subd. 2.  [LICENSED COMPLEMENTARY AND ALTERNATIVE HEALTH 
  8.7   CARE PRACTITIONER.] (a) No civil remedy or disciplinary action 
  8.8   may be sought or imposed against a licensed complementary and 
  8.9   alternative health care practitioner by the state, a political 
  8.10  subdivision of the state, or a health-related licensing board on 
  8.11  the grounds that the practitioner engages in complementary and 
  8.12  alternative health care practices or treatment methods that are 
  8.13  outside the scope of practice of the practitioner's regulated 
  8.14  profession unless the state, political subdivision, or licensing 
  8.15  board can demonstrate by a preponderance of the evidence that: 
  8.16     (1) there was no informed consent as required under section 
  8.17  146A.04; or 
  8.18     (2) the treatment method has no potential for promoting 
  8.19  wellness and the treatment poses a greater risk of serious, 
  8.20  direct, physical or mental harm to the client than that of the 
  8.21  prevailing or accepted conventional treatments or standard of 
  8.22  care of the practitioner's regulated profession. 
  8.23     (b) No criminal sanction may be sought or imposed against a 
  8.24  licensed complementary and alternative health care practitioner 
  8.25  by the state, a political subdivision of the state, or a 
  8.26  health-related licensing board for practicing medicine without a 
  8.27  license under section 147.081, subdivision 3, clause (3), based 
  8.28  on the practitioner's complementary and alternative health care 
  8.29  practices that are outside the scope of practice of the 
  8.30  practitioner's regulated profession. 
  8.31     (c) A client's choice to delay the use of conventional 
  8.32  medical care and receive complementary and alternative health 
  8.33  care practices is not, in and of itself, evidence of harm. 
  8.34     Sec. 6.  [146A.06] [PROFESSIONAL CONDUCT; UNLICENSED 
  8.35  COMPLEMENTARY AND ALTERNATIVE HEALTH CARE PRACTITIONERS.] 
  8.36     Subdivision 1.  [PROHIBITED CONDUCT.] The following conduct 
  9.1   by an unlicensed complementary and alternative health care 
  9.2   practitioner is prohibited: 
  9.3      (1) engaging in sexual conduct with a client, engaging in 
  9.4   any verbal behavior that is seductive or sexually demeaning to a 
  9.5   client, or engaging in sexual exploitation of a client; 
  9.6      (2) improper or unauthorized personal or other use of any 
  9.7   legend drugs as defined in section 151.01 or any controlled 
  9.8   substances as defined in section 152.01; 
  9.9      (3) revealing a communication from or relating to a client 
  9.10  without the client's express written authorization; or 
  9.11     (4) splitting fees or promising to pay a portion of a fee 
  9.12  to anyone other than for services rendered to a client by 
  9.13  another health care practitioner. 
  9.14     Subd. 2.  [PROHIBITED PRACTICE.] An unlicensed 
  9.15  complementary and alternative health care practitioner is 
  9.16  prohibited from engaging in complementary and alternative health 
  9.17  care practices if the practitioner: 
  9.18     (1) was convicted of a crime within the past five years, 
  9.19  including a finding or verdict of guilt, an admission of guilt, 
  9.20  or a no contest plea, in any court in Minnesota or any other 
  9.21  jurisdiction in the United States, reasonably related to 
  9.22  engaging in complementary and alternative health care 
  9.23  practices.  Conviction, as used in this clause, includes a 
  9.24  conviction of an offense which, if committed in this state, 
  9.25  would be deemed a felony or gross misdemeanor without regard to 
  9.26  its designation elsewhere, or a criminal proceeding where a 
  9.27  finding or verdict of guilty is made or returned but the 
  9.28  adjudication of guilt is either withheld or not entered; 
  9.29     (2) was convicted of criminal acts against persons within 
  9.30  the past five years.  For purposes of this clause, a crime 
  9.31  against a person means violations of the following:  sections 
  9.32  609.185; 609.19; 609.195; 609.20; 609.205; 609.21; 609.215; 
  9.33  609.221; 609.222; 609.223; 609.224; 609.2242; 609.23; 609.231; 
  9.34  609.2325; 609.233; 609.2335; 609.235; 609.24; 609.245; 609.25; 
  9.35  609.255; 609.26, subdivision 1, clause (1) or (2); 609.265; 
  9.36  609.342; 609.343; 609.344; 609.345; 609.365; 609.498, 
 10.1   subdivision 1; 609.50, subdivision 1, clause (1); 609.561; 
 10.2   609.562; 609.595; and 609.72, subdivision 3; or 
 10.3      (3) is currently adjudicated as mentally incompetent or as 
 10.4   a person who is dangerous to self, or adjudication pursuant to 
 10.5   chapter 253B as chemically dependent, mentally retarded, 
 10.6   mentally ill and dangerous to the public, or a sexual 
 10.7   psychopathic personality or sexually dangerous person. 
 10.8      Subd. 3.  [ENFORCEMENT.] A city attorney or county attorney 
 10.9   shall enforce the provisions of subdivisions 1 and 2 by seeking 
 10.10  civil penalties against, or by seeking injunctive relief to 
 10.11  enjoin, limit, or condition the practice of, any unlicensed 
 10.12  complementary and alternative health care practitioner who 
 10.13  violates any provision of subdivision 1 or 2. 
 10.14     Sec. 7.  [146A.07] [PROFESSIONAL CONDUCT; LICENSED 
 10.15  COMPLEMENTARY AND ALTERNATIVE HEALTH CARE PRACTITIONER.] 
 10.16     A licensed complementary and alternative health care 
 10.17  practitioner shall abide by standards for ethical conduct 
 10.18  according to the requirements of the practitioner's 
 10.19  health-related licensing board or as established by the 
 10.20  commissioner of health, provided that the board or commissioner 
 10.21  does not initiate a disciplinary action alleging a violation of 
 10.22  ethical conduct against a practitioner for engaging in 
 10.23  complementary and alternative health care practices as set forth 
 10.24  in this chapter. 
 10.25     Sec. 8.  Minnesota Statutes 1998, section 147.09, is 
 10.26  amended to read: 
 10.27     147.09 [EXEMPTIONS.] 
 10.28     Section 147.081 does not apply to, control, prevent or 
 10.29  restrict the practice, service, or activities of:  
 10.30     (1) A person who is a commissioned medical officer of, a 
 10.31  member of, or employed by, the armed forces of the United 
 10.32  States, the United States Public Health Service, the Veterans 
 10.33  Administration, any federal institution or any federal agency 
 10.34  while engaged in the performance of official duties within this 
 10.35  state, if the person is licensed elsewhere.  
 10.36     (2) A licensed physician from a state or country who is in 
 11.1   actual consultation here.  
 11.2      (3) A licensed or registered physician who treats the 
 11.3   physician's home state patients or other participating patients 
 11.4   while the physicians and those patients are participating 
 11.5   together in outdoor recreation in this state as defined by 
 11.6   section 86A.03, subdivision 3.  A physician shall first register 
 11.7   with the board on a form developed by the board for that 
 11.8   purpose.  The board shall not be required to promulgate the 
 11.9   contents of that form by rule.  No fee shall be charged for this 
 11.10  registration.  
 11.11     (4) A student practicing under the direct supervision of a 
 11.12  preceptor while the student is enrolled in and regularly 
 11.13  attending a recognized medical school.  
 11.14     (5) A student who is in continuing training and performing 
 11.15  the duties of an intern or resident or engaged in postgraduate 
 11.16  work considered by the board to be the equivalent of an 
 11.17  internship or residency in any hospital or institution approved 
 11.18  for training by the board, provided the student has a residency 
 11.19  permit issued by the board under section 147.0391. 
 11.20     (6) A person employed in a scientific, sanitary, or 
 11.21  teaching capacity by the state university, the department of 
 11.22  children, families, and learning, or by any public or private 
 11.23  school, college, or other bona fide educational institution, or 
 11.24  the state department of health, whose duties are entirely of a 
 11.25  public health or educational character, while engaged in such 
 11.26  duties. 
 11.27     (7) Physician's assistants registered in this state.  
 11.28     (8) A doctor of osteopathy duly licensed by the state board 
 11.29  of osteopathy under Minnesota Statutes 1961, sections 148.11 to 
 11.30  148.16, prior to May 1, 1963, who has not been granted a license 
 11.31  to practice medicine in accordance with this chapter provided 
 11.32  that the doctor confines activities within the scope of the 
 11.33  license. 
 11.34     (9) Any person licensed by a health related licensing 
 11.35  board, as defined in section 214.01, subdivision 2, or 
 11.36  registered by the commissioner of health pursuant to section 
 12.1   214.13, including psychological practitioners with respect to 
 12.2   the use of hypnosis; provided that the person confines 
 12.3   activities within the scope of the license.  
 12.4      (10) A person who practices ritual circumcision pursuant to 
 12.5   the requirements or tenets of any established religion. 
 12.6      (11) A Christian Scientist or other person who endeavors to 
 12.7   prevent or cure disease or suffering exclusively by mental or 
 12.8   spiritual means or by prayer. 
 12.9      (12) A physician licensed to practice medicine in another 
 12.10  state who is in this state for the sole purpose of providing 
 12.11  medical services at a competitive athletic event.  The physician 
 12.12  may practice medicine only on participants in the athletic 
 12.13  event.  A physician shall first register with the board on a 
 12.14  form developed by the board for that purpose.  The board shall 
 12.15  not be required to adopt the contents of the form by rule.  The 
 12.16  physician shall provide evidence satisfactory to the board of a 
 12.17  current unrestricted license in another state.  The board shall 
 12.18  charge a fee of $50 for the registration.  
 12.19     (13) A psychologist licensed under section 148.907 or a 
 12.20  social worker licensed under section 148B.21 who uses or 
 12.21  supervises the use of a penile or vaginal plethysmograph in 
 12.22  assessing and treating individuals suspected of engaging in 
 12.23  aberrant sexual behavior and sex offenders. 
 12.24     (14) Any person issued a training course certificate or 
 12.25  credentialed by the emergency medical services regulatory board 
 12.26  established in chapter 144E, provided the person confines 
 12.27  activities within the scope of training at the certified or 
 12.28  credentialed level. 
 12.29     (15) An unlicensed complementary and alternative care 
 12.30  practitioner practicing according to chapter 146A.