HF 718

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

  1.1                          A bill for an act 
  1.2             relating to professions; regulating advanced practice 
  1.3             registered nursing; amending Minnesota Statutes 1998, 
  1.4             sections 62A.15, subdivision 3a; 148.171; 148.191, 
  1.5             subdivision 2; 148.235, subdivision 3, and by adding 
  1.6             subdivisions; 148.261, subdivisions 1 and 5; 148.262, 
  1.7             subdivision 1; 148.263, subdivisions 3 and 4; 148.271; 
  1.8             148.281, subdivision 1; 148.283; 245.462, subdivision 
  1.9             18; 245.4871, subdivision 27; proposing coding for new 
  1.10            law in Minnesota Statutes, chapter 148; repealing 
  1.11            Minnesota Statutes 1998, section 148.235, subdivisions 
  1.12            1, 2, 4, 5, and 6. 
  1.13  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.14     Section 1.  Minnesota Statutes 1998, section 62A.15, 
  1.15  subdivision 3a, is amended to read: 
  1.16     Subd. 3a.  [NURSING SERVICES.] All benefits provided by a 
  1.17  policy or contract referred to in subdivision 1, relating to 
  1.18  expenses incurred for medical treatment or services of a duly 
  1.19  licensed physician must include services provided by a 
  1.20  registered nurse who is licensed pursuant to section 148.171 and 
  1.21  who is certified by the profession to engage in advanced 
  1.22  practice registered nursing practice.  "Advanced practice 
  1.23  registered nursing practice" means has the meaning given in 
  1.24  section 148.171, subdivision 2, paragraph (5), and includes the 
  1.25  performance of health services by professional registered nurses 
  1.26  who have gained additional knowledge and skills through an 
  1.27  organized program of study and clinical experience preparing 
  1.28  nurses for advanced practice registered nursing roles as nurse 
  1.29  anesthetists, nurse midwives, nurse practitioners, or clinical 
  2.1   specialists in psychiatric or mental health nursing.  The 
  2.2   program of study must be beyond the education required for 
  2.3   registered nurse licensure. and must meet criteria established 
  2.4   by the professional nursing organization having authority to 
  2.5   certify the registered nurse in advanced nursing practice.  For 
  2.6   the purposes of this subdivision, the board of nursing shall, by 
  2.7   rule, adopt a list of professional nursing organizations which 
  2.8   have the authority to certify nurses in advanced nursing 
  2.9   practice.  The advanced practice registered nurse must meet the 
  2.10  requirements of sections 148.171 to 148.285.  
  2.11     This subdivision is intended to provide payment of benefits 
  2.12  for treatment and services by a licensed registered nurse 
  2.13  certified in advanced practice registered nursing practice as 
  2.14  defined in this subdivision and is not intended to add to the 
  2.15  benefits provided for in these policies or contracts. 
  2.16     Sec. 2.  Minnesota Statutes 1998, section 148.171, is 
  2.17  amended to read: 
  2.18     148.171 [DEFINITIONS; TITLE.] 
  2.19     Subdivision 1.  [TITLE.] Sections 148.171 to 148.285 shall 
  2.20  be referred to as the Minnesota Nurse Practice Act. 
  2.21     Subd. 2.  [SCOPE.] As used in sections 148.171 to 148.285:, 
  2.22  the definitions in this section have the meanings given. 
  2.23     (1) "Board" means the Minnesota board of nursing. 
  2.24     (2) "Registered nurse," abbreviated R.N., means an 
  2.25  individual licensed by the board to practice professional 
  2.26  nursing.  
  2.27     (3) The "practice of professional nursing" means the 
  2.28  performance for compensation or personal profit of the 
  2.29  professional interpersonal service of:  (a) providing a nursing 
  2.30  assessment of the actual or potential health needs of 
  2.31  individuals, families, or communities; (b) providing nursing 
  2.32  care supportive to or restorative of life by functions such as 
  2.33  skilled ministration of nursing care, supervising and teaching 
  2.34  nursing personnel, health teaching and counseling, case finding, 
  2.35  and referral to other health resources; and (c) evaluating these 
  2.36  actions.  The practice of professional nursing includes both 
  3.1   independent nursing functions and delegated medical functions 
  3.2   which may be performed in collaboration with other health team 
  3.3   members, or may be delegated by the professional nurse to other 
  3.4   nursing personnel.  Independent nursing function may also be 
  3.5   performed autonomously.  The practice of professional nursing 
  3.6   requires that level of special education, knowledge, and skill 
  3.7   ordinarily expected of an individual who has completed an 
  3.8   approved professional nursing education program as described in 
  3.9   section 148.211, subdivision 1.  
  3.10     (4) "Advanced practice registered nurse," abbreviated APRN, 
  3.11  means an individual licensed as a registered nurse by the board 
  3.12  and certified by a national nurse certification organization 
  3.13  acceptable to the board to practice as a clinical nurse 
  3.14  specialist, nurse anesthetist, nurse midwife, or nurse 
  3.15  practitioner. 
  3.16     (5) The "practice of advanced practice registered nursing" 
  3.17  means the performance of clinical nurse specialist practice, 
  3.18  nurse midwife practice, nurse practitioner practice, or 
  3.19  registered nurse anesthetist practice as defined in paragraphs 
  3.20  (6), (9), (10), and (12).  The practice includes functioning as 
  3.21  a direct care provider, case manager, consultant, educator, and 
  3.22  researcher, autonomously and collaboratively.  The advanced 
  3.23  practice registered nurse practices within a health care system 
  3.24  that provides for consultation, collaborative management, and 
  3.25  referral as indicated by the health status of the patient. 
  3.26     (6) "Clinical nurse specialist practice" means the 
  3.27  provision of patient care in a particular specialty or 
  3.28  subspecialty of advanced practice registered nursing, and 
  3.29  includes:  (i) diagnosing illness and disease; (ii) prescribing, 
  3.30  administering, and dispensing pharmacologic and nonpharmacologic 
  3.31  treatment including psychotherapy; (iii) promoting wellness; and 
  3.32  (iv) preventing illness and disease.  The certified clinical 
  3.33  nurse specialist, abbreviated CCNS, is certified for advanced 
  3.34  practice registered nursing in a specific field of clinical 
  3.35  nurse specialist practice.  The standards of practice are those 
  3.36  defined by national nursing organizations or national nurse 
  4.1   certification organizations. 
  4.2      (7) "Collaborative management" means the process in which 
  4.3   an advanced practice registered nurse and one or more physicians 
  4.4   or other licensed health care practitioners jointly manage the 
  4.5   care of a patient.  The scope of collaboration may encompass the 
  4.6   physical care of the patient according to a mutually agreed upon 
  4.7   plan of care. 
  4.8      (8) "Consultation" means the process in which an advanced 
  4.9   practice registered nurse who maintains primary management 
  4.10  responsibility for a patient's care seeks advice or opinion of a 
  4.11  physician or another member of the health care team. 
  4.12     (9) "Nurse midwife practice" means the management of 
  4.13  women's primary health care, focusing on pregnancy, childbirth, 
  4.14  the postpartum period, care of the newborn, and the family 
  4.15  planning and gynecological needs of women and includes 
  4.16  diagnosing and prescribing, administering, and dispensing 
  4.17  pharmacologic and nonpharmacologic treatment.  The standards of 
  4.18  practice of the certified nurse midwife, abbreviated CNM, are 
  4.19  those defined by the American College of Nurse-Midwives or its 
  4.20  successor organization. 
  4.21     (10) "Nurse practitioner practice" means (i) diagnosing, 
  4.22  directly managing, and preventing acute and chronic illness and 
  4.23  disease; and (ii) promoting wellness, including prescribing, 
  4.24  administering, and dispensing pharmacologic and nonpharmacologic 
  4.25  treatment.  The certified nurse practitioner, abbreviated CNP, 
  4.26  is certified for advanced registered nurse practice in a 
  4.27  specific field of nurse practitioner practice.  The standards of 
  4.28  practice for each specific field are those defined by the 
  4.29  applicable national nursing organization or national nurse 
  4.30  certification organization. 
  4.31     (11) "Referral" means the process in which an advanced 
  4.32  practice registered nurse directs a patient to a physician or 
  4.33  another health care professional for management of a particular 
  4.34  problem or aspect of the patient's care. 
  4.35     (12) "Registered nurse anesthetist practice" means the 
  4.36  provision of anesthesia care and related services including 
  5.1   prescribing, selecting, obtaining, administering, and dispensing 
  5.2   drugs and therapeutic devices to facilitate diagnostic, 
  5.3   therapeutic, and surgical procedures upon request, assignment, 
  5.4   or referral by a patient's physician or other licensed health 
  5.5   care practitioner.  The standards of practice of the certified 
  5.6   registered nurse anesthetist, abbreviated CRNA, are those 
  5.7   defined by the American Association of Nurse Anesthetists or its 
  5.8   successor organization. 
  5.9      (13) "Registered nurse, certified," abbreviated RN,C, means 
  5.10  a registered nurse who has received certification from a 
  5.11  national nursing organization or national nurse certification 
  5.12  organization for practice according to paragraph (3) in a 
  5.13  specialized field of professional nursing.  A registered nurse, 
  5.14  certified, shall not practice advanced practice registered 
  5.15  nursing as described in paragraph (5), (6), (9), (10), or (12). 
  5.16     (4) (14) "Licensed practical nurse," abbreviated L.P.N., 
  5.17  means an individual licensed by the board to practice practical 
  5.18  nursing. 
  5.19     (5) (15) The "practice of practical nursing" means the 
  5.20  performance for compensation or personal profit of any of those 
  5.21  services in observing and caring for the ill, injured, or 
  5.22  infirm, in applying counsel and procedure to safeguard life and 
  5.23  health, in administering medication and treatment prescribed by 
  5.24  a licensed health professional, which are commonly performed by 
  5.25  licensed practical nurses and which require specialized 
  5.26  knowledge and skill such as are taught or acquired in an 
  5.27  approved school of practical nursing, but which do not require 
  5.28  the specialized education, knowledge, and skill of a registered 
  5.29  nurse. 
  5.30     (6) (16) "Nurse" means registered nurse, advanced practice 
  5.31  registered nurse, and licensed practical nurse unless the 
  5.32  context clearly refers to only one category. 
  5.33     (7) (17) "Nursing assistant" means an individual providing 
  5.34  nursing or nursing-related services that do not require the 
  5.35  specialized knowledge and skill of a nurse, at the direction of 
  5.36  a nurse, but does not include a licensed health professional or 
  6.1   an individual who volunteers to provide such services without 
  6.2   monetary compensation. 
  6.3      (8) (18) "Public health nurse" means a registered nurse who 
  6.4   meets the voluntary registration requirements established by the 
  6.5   board by rule.  
  6.6      (19) "Prescribing" means the act of generating a 
  6.7   prescription for the preparation, use of, or manner of using a 
  6.8   drug or therapeutic device.  Prescribing does not include 
  6.9   recommending the use of a drug or therapeutic device which is 
  6.10  not required by the federal Food and Drug Administration to meet 
  6.11  the labeling requirements for prescription drugs and devices or 
  6.12  certified registered nurse anesthetist practice preoperatively, 
  6.13  intraoperatively, or postoperatively. 
  6.14     (20) "Prescription" means a written direction or an oral 
  6.15  direction reduced to writing provided to or for an individual 
  6.16  patient for the preparation or use of a drug or therapeutic 
  6.17  device. 
  6.18     Sec. 3.  Minnesota Statutes 1998, section 148.191, 
  6.19  subdivision 2, is amended to read: 
  6.20     Subd. 2.  [POWERS.] (a) The board is authorized to adopt 
  6.21  and, from time to time, revise rules not inconsistent with the 
  6.22  law, as may be necessary to enable it to carry into effect the 
  6.23  provisions of sections 148.171 to 148.285.  The board shall 
  6.24  prescribe by rule curricula and standards for schools and 
  6.25  courses preparing persons for licensure under sections 148.171 
  6.26  to 148.285.  It shall conduct or provide for surveys of such 
  6.27  schools and courses at such times as it may deem necessary.  It 
  6.28  shall approve such schools and courses as meet the requirements 
  6.29  of sections 148.171 to 148.285 and board rules.  It shall 
  6.30  examine, license, and renew the license of duly qualified 
  6.31  applicants.  It shall hold examinations at least once in each 
  6.32  year at such time and place as it may determine.  It shall by 
  6.33  rule adopt, evaluate, and periodically revise, as necessary, 
  6.34  requirements for licensure and for registration and renewal of 
  6.35  registration as defined in section 148.231.  It shall maintain a 
  6.36  record of all persons licensed by the board to practice 
  7.1   professional or practical nursing and all registered nurses who 
  7.2   hold Minnesota licensure and registration and are certified as 
  7.3   advanced practice registered nurses.  It shall cause the 
  7.4   prosecution of all persons violating sections 148.171 to 148.285 
  7.5   and have power to incur such necessary expense therefor.  It 
  7.6   shall register public health nurses who meet educational and 
  7.7   other requirements established by the board by rule, including 
  7.8   payment of a fee.  Prior to the adoption of rules, the board 
  7.9   shall use the same procedures used by the department of health 
  7.10  to certify public health nurses.  It shall have power to issue 
  7.11  subpoenas, and to compel the attendance of witnesses and the 
  7.12  production of all necessary documents and other evidentiary 
  7.13  material.  Any board member may administer oaths to witnesses, 
  7.14  or take their affirmation.  It shall keep a record of all its 
  7.15  proceedings.  
  7.16     (b) The board shall have access to hospital, nursing home, 
  7.17  and other medical records of a patient cared for by a nurse 
  7.18  under review.  If the board does not have a written consent from 
  7.19  a patient permitting access to the patient's records, the nurse 
  7.20  or facility shall delete any data in the record that identifies 
  7.21  the patient before providing it to the board.  The board shall 
  7.22  have access to such other records as reasonably requested by the 
  7.23  board to assist the board in its investigation.  Nothing herein 
  7.24  may be construed to allow access to any records protected by 
  7.25  section 145.64.  The board shall maintain any records obtained 
  7.26  pursuant to this paragraph as investigative data under chapter 
  7.27  13. 
  7.28     Sec. 4.  [148.233] [IDENTIFICATION OF CERTIFIED REGISTERED 
  7.29  NURSES.] 
  7.30     Subdivision 1.  [REGISTERED NURSE.] A registered nurse 
  7.31  certified in a specialized field of professional nursing as 
  7.32  described in section 148.171, subdivision 2, paragraph (13), 
  7.33  shall use the designation RN,C for personal identification and 
  7.34  in documentation of services provided.  Identification of 
  7.35  educational degrees and specialty fields may be added. 
  7.36     Subd. 2.  [ADVANCED PRACTICE REGISTERED NURSE.] An advanced 
  8.1   practice registered nurse certified as a certified clinical 
  8.2   nurse specialist, certified nurse midwife, certified nurse 
  8.3   practitioner, or certified registered nurse anesthetist shall 
  8.4   use the appropriate designation:  RN,CCNS; RN,CNM; RN,CNP; or 
  8.5   RN,CRNA for personal identification and in documentation of 
  8.6   services provided.  Identification of educational degrees and 
  8.7   specialty fields may be added. 
  8.8      Sec. 5.  Minnesota Statutes 1998, section 148.235, is 
  8.9   amended by adding a subdivision to read: 
  8.10     Subd. 2a.  [REQUIREMENTS.] An advanced practice registered 
  8.11  nurse who was authorized to prescribe drugs and therapeutic 
  8.12  devices on the effective date of this section may continue to 
  8.13  prescribe.  Beginning on the effective date of this section, all 
  8.14  other advanced practice registered nurses must be certified as 
  8.15  certified clinical nurse specialists, certified nurse 
  8.16  anesthetists, certified nurse midwives, or certified nurse 
  8.17  practitioners and have successfully completed a formal course of 
  8.18  study which included theory, supervised practice, and competence 
  8.19  evaluation in prescribing and therapeutic management of the 
  8.20  clinical type of clients within the advanced practice registered 
  8.21  nurse's practice prior to the nurse being authorized to 
  8.22  prescribe drugs and therapeutic devices. 
  8.23     Sec. 6.  Minnesota Statutes 1998, section 148.235, 
  8.24  subdivision 3, is amended to read: 
  8.25     Subd. 3.  [DISPENSING AUTHORITY SAMPLE DRUGS.] An advanced 
  8.26  practice registered nurse who is authorized under this section 
  8.27  sections 148.171 to 148.285 to prescribe and dispense drugs is 
  8.28  authorized to dispense drugs subject to the same requirements 
  8.29  established for the prescribing of drugs may receive and 
  8.30  dispense sample drugs.  This authority to dispense extends only 
  8.31  to those drugs described in the written agreement entered into 
  8.32  under this section.  The authority to dispense includes, but is 
  8.33  not limited to, the authority to receive and dispense sample 
  8.34  drugs. 
  8.35     Sec. 7.  Minnesota Statutes 1998, section 148.235, is 
  8.36  amended by adding a subdivision to read: 
  9.1      Subd. 7.  [FEDERAL REGISTRATION.] Any advanced practice 
  9.2   registered nurse who applies to the federal Drug Enforcement 
  9.3   Administration for a registration number shall submit to the 
  9.4   board: 
  9.5      (1) proof that requirements of this section are met; and 
  9.6      (2) a processing fee of $50. 
  9.7      Sec. 8.  Minnesota Statutes 1998, section 148.261, 
  9.8   subdivision 1, is amended to read: 
  9.9      Subdivision 1.  [GROUNDS LISTED.] The board may deny, 
  9.10  revoke, suspend, limit, or condition the license and 
  9.11  registration of any person to practice professional, advanced 
  9.12  practice registered, or practical nursing under sections 148.171 
  9.13  to 148.285, or to otherwise discipline a licensee or applicant 
  9.14  as described in section 148.262.  The following are grounds for 
  9.15  disciplinary action: 
  9.16     (1) Failure to demonstrate the qualifications or satisfy 
  9.17  the requirements for a license contained in sections 148.171 to 
  9.18  148.285 or rules of the board.  In the case of a person applying 
  9.19  for a license, the burden of proof is upon the applicant to 
  9.20  demonstrate the qualifications or satisfaction of the 
  9.21  requirements. 
  9.22     (2) Employing fraud or deceit in procuring or attempting to 
  9.23  procure a permit, license, or registration certificate to 
  9.24  practice professional or practical nursing or attempting to 
  9.25  subvert the licensing examination process.  Conduct that 
  9.26  subverts or attempts to subvert the licensing examination 
  9.27  process includes, but is not limited to:  
  9.28     (i) conduct that violates the security of the examination 
  9.29  materials, such as removing examination materials from the 
  9.30  examination room or having unauthorized possession of any 
  9.31  portion of a future, current, or previously administered 
  9.32  licensing examination; 
  9.33     (ii) conduct that violates the standard of test 
  9.34  administration, such as communicating with another examinee 
  9.35  during administration of the examination, copying another 
  9.36  examinee's answers, permitting another examinee to copy one's 
 10.1   answers, or possessing unauthorized materials; or 
 10.2      (iii) impersonating an examinee or permitting an 
 10.3   impersonator to take the examination on one's own behalf. 
 10.4      (3) Conviction during the previous five years of a felony 
 10.5   or gross misdemeanor reasonably related to the practice of 
 10.6   professional, advanced practice registered, or practical nursing.
 10.7   Conviction as used in this subdivision includes a conviction of 
 10.8   an offense that if committed in this state would be considered a 
 10.9   felony or gross misdemeanor without regard to its designation 
 10.10  elsewhere, or a criminal proceeding where a finding or verdict 
 10.11  of guilt is made or returned but the adjudication of guilt is 
 10.12  either withheld or not entered. 
 10.13     (4) Revocation, suspension, limitation, conditioning, or 
 10.14  other disciplinary action against the person's professional or 
 10.15  practical nursing license or advanced practice registered 
 10.16  nursing credential, in another state, territory, or country; 
 10.17  failure to report to the board that charges regarding the 
 10.18  person's nursing license or other credential are pending in 
 10.19  another state, territory, or country; or having been refused a 
 10.20  license or other credential by another state, territory, or 
 10.21  country. 
 10.22     (5) Failure to or inability to perform professional or 
 10.23  practical nursing as defined in section 148.171, subdivision 2, 
 10.24  paragraph (3) or (5) (15), with reasonable skill and safety, 
 10.25  including failure of a registered nurse to supervise or a 
 10.26  licensed practical nurse to monitor adequately the performance 
 10.27  of acts by any person working at the nurse's direction. 
 10.28     (6) Engaging in unprofessional conduct, including, but not 
 10.29  limited to, a departure from or failure to conform to board 
 10.30  rules of professional or practical nursing practice that 
 10.31  interpret the statutory definition of professional or practical 
 10.32  nursing as well as provide criteria for violations of the 
 10.33  statutes, or, if no rule exists, to the minimal standards of 
 10.34  acceptable and prevailing professional or practical nursing 
 10.35  practice, or any nursing practice that may create unnecessary 
 10.36  danger to a patient's life, health, or safety.  Actual injury to 
 11.1   a patient need not be established under this clause.  
 11.2      (7) Failure of an advanced practice registered nurse to 
 11.3   practice with reasonable skill and safety or departure from or 
 11.4   failure to conform to standards of acceptable and prevailing 
 11.5   advanced practice registered nursing including standards 
 11.6   pertaining to the prescribing and dispensing of medications. 
 11.7      (7) (8) Delegating or accepting the delegation of a nursing 
 11.8   function or a prescribed health care function when the 
 11.9   delegation or acceptance could reasonably be expected to result 
 11.10  in unsafe or ineffective patient care. 
 11.11     (8) (9) Actual or potential inability to practice nursing 
 11.12  with reasonable skill and safety to patients by reason of 
 11.13  illness, use of alcohol, drugs, chemicals, or any other 
 11.14  material, or as a result of any mental or physical condition.  
 11.15     (9) (10) Adjudication as mentally incompetent, mentally 
 11.16  ill, a chemically dependent person, or a person dangerous to the 
 11.17  public by a court of competent jurisdiction, within or without 
 11.18  this state.  
 11.19     (10) (11) Engaging in any unethical conduct, including, but 
 11.20  not limited to, conduct likely to deceive, defraud, or harm the 
 11.21  public, or demonstrating a willful or careless disregard for the 
 11.22  health, welfare, or safety of a patient.  Actual injury need not 
 11.23  be established under this clause.  
 11.24     (11) (12) Engaging in conduct with a patient that is sexual 
 11.25  or may reasonably be interpreted by the patient as sexual, or in 
 11.26  any verbal behavior that is seductive or sexually demeaning to a 
 11.27  patient, or engaging in sexual exploitation of a patient or 
 11.28  former patient.  
 11.29     (12) (13) Obtaining money, property, or services from a 
 11.30  patient, other than reasonable fees for services provided to the 
 11.31  patient, through the use of undue influence, harassment, duress, 
 11.32  deception, or fraud. 
 11.33     (13) (14) Revealing a privileged communication from or 
 11.34  relating to a patient except when otherwise required or 
 11.35  permitted by law. 
 11.36     (14) (15) Engaging in abusive or fraudulent billing 
 12.1   practices, including violations of federal Medicare and Medicaid 
 12.2   laws or state medical assistance laws. 
 12.3      (15) (16) Improper management of patient records, including 
 12.4   failure to maintain adequate patient records, to comply with a 
 12.5   patient's request made pursuant to section 144.335, or to 
 12.6   furnish a patient record or report required by law.  
 12.7      (16) (17) Knowingly aiding, assisting, advising, or 
 12.8   allowing an unlicensed person to engage in the unlawful practice 
 12.9   of professional, advanced practice registered, or practical 
 12.10  nursing.  
 12.11     (17) (18) Violating a rule adopted by the board, an order 
 12.12  of the board, or a state or federal law relating to the practice 
 12.13  of professional, advanced practice registered, or practical 
 12.14  nursing, or a state or federal narcotics or controlled substance 
 12.15  law. 
 12.16     (18) (19) Knowingly providing false or misleading 
 12.17  information that is directly related to the care of that patient 
 12.18  unless done for an accepted therapeutic purpose such as the 
 12.19  administration of a placebo. 
 12.20     (19) (20) Aiding suicide or aiding attempted suicide in 
 12.21  violation of section 609.215 as established by any of the 
 12.22  following: 
 12.23     (i) a copy of the record of criminal conviction or plea of 
 12.24  guilty for a felony in violation of section 609.215, subdivision 
 12.25  1 or 2; 
 12.26     (ii) a copy of the record of a judgment of contempt of 
 12.27  court for violating an injunction issued under section 609.215, 
 12.28  subdivision 4; 
 12.29     (iii) a copy of the record of a judgment assessing damages 
 12.30  under section 609.215, subdivision 5; or 
 12.31     (iv) a finding by the board that the person violated 
 12.32  section 609.215, subdivision 1 or 2.  The board shall 
 12.33  investigate any complaint of a violation of section 609.215, 
 12.34  subdivision 1 or 2. 
 12.35     (20) (21) Practicing outside the scope of practice 
 12.36  authorized by section 148.171, subdivision 2, paragraph (3) 
 13.1   or, (5), (6), (9), (10), (12), or (15). 
 13.2      (22) Practicing outside the specific field of nursing 
 13.3   practice for which an advanced practice registered nurse is 
 13.4   certified. 
 13.5      (21) (23) Making a false statement or knowingly providing 
 13.6   false information to the board, failing to make reports as 
 13.7   required by section 148.263, or failing to cooperate with an 
 13.8   investigation of the board as required by section 148.265. 
 13.9      (22) (24) Engaging in false, fraudulent, deceptive, or 
 13.10  misleading advertising.  
 13.11     (25) Failure to inform the board of the person's 
 13.12  certification status as a nurse anesthetist, nurse midwife, 
 13.13  nurse practitioner, or clinical nurse specialist. 
 13.14     (26) The dispensing or prescribing of drugs or therapeutic 
 13.15  devices by an advanced practice registered nurse before the 
 13.16  nurse notifies the board of certification as a clinical nurse 
 13.17  specialist, nurse anesthetist, nurse midwife, or nurse 
 13.18  practitioner. 
 13.19     (27) Engaging in clinical nurse specialist practice, nurse 
 13.20  midwife practice, nurse practitioner practice, or registered 
 13.21  nurse anesthetist practice without current certification by a 
 13.22  national nurse certification organization acceptable to the 
 13.23  board, except during the period between completion of an 
 13.24  advanced practice registered nurse course of study and 
 13.25  certification, not to exceed six months. 
 13.26     Sec. 9.  Minnesota Statutes 1998, section 148.261, 
 13.27  subdivision 5, is amended to read: 
 13.28     Subd. 5.  [EXAMINATION; ACCESS TO MEDICAL DATA.] The board 
 13.29  may take the following actions if it has probable cause to 
 13.30  believe that grounds for disciplinary action exist under 
 13.31  subdivision 1, clause (8) (9) or (9) (10): 
 13.32     (a) It may direct the applicant or nurse to submit to a 
 13.33  mental or physical examination or chemical dependency 
 13.34  evaluation.  For the purpose of this subdivision, when a nurse 
 13.35  licensed under sections 148.171 to 148.285 is directed in 
 13.36  writing by the board to submit to a mental or physical 
 14.1   examination or chemical dependency evaluation, that person is 
 14.2   considered to have consented and to have waived all objections 
 14.3   to admissibility on the grounds of privilege.  Failure of the 
 14.4   applicant or nurse to submit to an examination when directed 
 14.5   constitutes an admission of the allegations against the 
 14.6   applicant or nurse, unless the failure was due to circumstances 
 14.7   beyond the person's control, and the board may enter a default 
 14.8   and final order without taking testimony or allowing evidence to 
 14.9   be presented.  A nurse affected under this paragraph shall, at 
 14.10  reasonable intervals, be given an opportunity to demonstrate 
 14.11  that the competent practice of professional, advanced practice 
 14.12  registered, or practical nursing can be resumed with reasonable 
 14.13  skill and safety to patients.  Neither the record of proceedings 
 14.14  nor the orders entered by the board in a proceeding under this 
 14.15  paragraph, may be used against a nurse in any other proceeding. 
 14.16     (b) It may, notwithstanding sections 13.42, 144.651, 
 14.17  595.02, or any other law limiting access to medical or other 
 14.18  health data, obtain medical data and health records relating to 
 14.19  a registered nurse, advanced practice registered nurse, licensed 
 14.20  practical nurse, or applicant for a license without that 
 14.21  person's consent.  The medical data may be requested from a 
 14.22  provider, as defined in section 144.335, subdivision 1, 
 14.23  paragraph (b), an insurance company, or a government agency, 
 14.24  including the department of human services.  A provider, 
 14.25  insurance company, or government agency shall comply with any 
 14.26  written request of the board under this subdivision and is not 
 14.27  liable in any action for damages for releasing the data 
 14.28  requested by the board if the data are released pursuant to a 
 14.29  written request under this subdivision unless the information is 
 14.30  false and the provider giving the information knew, or had 
 14.31  reason to believe, the information was false.  Information 
 14.32  obtained under this subdivision is classified as private data on 
 14.33  individuals as defined in section 13.02.  
 14.34     Sec. 10.  Minnesota Statutes 1998, section 148.262, 
 14.35  subdivision 1, is amended to read: 
 14.36     Subdivision 1.  [FORMS OF DISCIPLINARY ACTION.] When the 
 15.1   board finds that grounds for disciplinary action exist under 
 15.2   section 148.261, subdivision 1, it may take one or more of the 
 15.3   following actions:  
 15.4      (1) deny the license, registration, or registration 
 15.5   renewal; 
 15.6      (2) revoke the license; 
 15.7      (3) suspend the license; 
 15.8      (4) impose limitations on the nurse's practice of 
 15.9   professional, advanced practice registered, or practical nursing 
 15.10  including, but not limited to, limitation of scope of practice 
 15.11  or the requirement of practice under supervision; 
 15.12     (5) impose conditions on the retention of the license 
 15.13  including, but not limited to, the imposition of retraining or 
 15.14  rehabilitation requirements or the conditioning of continued 
 15.15  practice on demonstration of knowledge or skills by appropriate 
 15.16  examination, monitoring, or other review; 
 15.17     (6) impose a civil penalty not exceeding $10,000 for each 
 15.18  separate violation, the amount of the civil penalty to be fixed 
 15.19  as to deprive the nurse of any economic advantage gained by 
 15.20  reason of the violation charged, to reimburse the board for the 
 15.21  cost of counsel, investigation, and proceeding, and to 
 15.22  discourage repeated violations; 
 15.23     (7) order the nurse to provide unremunerated service; 
 15.24     (8) censure or reprimand the nurse; or 
 15.25     (9) any other action justified by the facts in the case. 
 15.26     Sec. 11.  Minnesota Statutes 1998, section 148.263, 
 15.27  subdivision 3, is amended to read: 
 15.28     Subd. 3.  [LICENSED PROFESSIONALS.] A person licensed by a 
 15.29  health-related licensing board as defined in section 214.01, 
 15.30  subdivision 2, shall report to the board personal knowledge of 
 15.31  any conduct the person reasonably believes constitutes grounds 
 15.32  for disciplinary action under sections 148.171 to 148.285 by any 
 15.33  nurse including conduct indicating that the nurse may be 
 15.34  incompetent, may have engaged in unprofessional or unethical 
 15.35  conduct, or may be mentally or physically unable to engage 
 15.36  safely in the practice of professional, advanced practice 
 16.1   registered, or practical nursing. 
 16.2      Sec. 12.  Minnesota Statutes 1998, section 148.263, 
 16.3   subdivision 4, is amended to read: 
 16.4      Subd. 4.  [INSURERS.] Four times each year, by the first 
 16.5   day of February, May, August, and November, each insurer 
 16.6   authorized to sell insurance described in section 60A.06, 
 16.7   subdivision 1, clause (13), and providing professional liability 
 16.8   insurance to registered nurses, advanced practice registered 
 16.9   nurses, or licensed practical nurses shall submit to the board a 
 16.10  report concerning any nurse against whom a malpractice award has 
 16.11  been made or who has been a party to a settlement.  The report 
 16.12  must contain at least the following information: 
 16.13     (1) the total number of settlements or awards; 
 16.14     (2) the date settlement or award was made; 
 16.15     (3) the allegations contained in the claim or complaint 
 16.16  leading to the settlement or award; 
 16.17     (4) the dollar amount of each malpractice settlement or 
 16.18  award and whether that amount was paid as a result of a 
 16.19  settlement or of an award; and 
 16.20     (5) the name and address of the practice of the nurse 
 16.21  against whom an award was made or with whom a settlement was 
 16.22  made. 
 16.23     An insurer shall also report to the board any information 
 16.24  it possesses that tends to substantiate a charge that a nurse 
 16.25  may have engaged in conduct violating sections 148.171 to 
 16.26  148.285. 
 16.27     Sec. 13.  Minnesota Statutes 1998, section 148.271, is 
 16.28  amended to read: 
 16.29     148.271 [EXEMPTIONS.] 
 16.30     The provisions of sections 148.171 to 148.285 shall not 
 16.31  prohibit: 
 16.32     (1) The furnishing of nursing assistance in an emergency. 
 16.33     (2) The practice of professional or practical nursing by 
 16.34  any legally qualified registered or licensed practical nurse of 
 16.35  another state who is employed by the United States government or 
 16.36  any bureau, division, or agency thereof while in the discharge 
 17.1   of official duties. 
 17.2      (3) The practice of any profession or occupation licensed 
 17.3   by the state, other than professional or practical nursing, by 
 17.4   any person duly licensed to practice the profession or 
 17.5   occupation, or the performance by a person of any acts properly 
 17.6   coming within the scope of the profession, occupation, or 
 17.7   license. 
 17.8      (4) The provision of a nursing or nursing-related service 
 17.9   by a nursing assistant who has been delegated the specific 
 17.10  function and is supervised by a registered nurse or monitored by 
 17.11  a licensed practical nurse. 
 17.12     (5) The care of the sick with or without compensation when 
 17.13  done in a nursing home covered by the provisions of section 
 17.14  144A.09, subdivision 1. 
 17.15     (6) Professional nursing practice or advanced practice 
 17.16  registered nursing practice by a registered nurse or practical 
 17.17  nursing practice by a licensed practical nurse licensed in 
 17.18  another state or territory who is in Minnesota as a student 
 17.19  enrolled in a formal, structured course of study, such as a 
 17.20  course leading to a higher degree, certification in a nursing 
 17.21  specialty, or to enhance skills in a clinical field, while the 
 17.22  student is practicing in the course. 
 17.23     (7) Professional or practical nursing practice by a student 
 17.24  practicing under the supervision of an instructor while the 
 17.25  student is enrolled in a nursing program approved by the board 
 17.26  under section 148.251. 
 17.27     (8) Advanced practice registered nursing as defined in 
 17.28  section 148.171, subdivision 2, paragraphs (5), (6), (9), (10), 
 17.29  and (12), except the prescribing and dispensing of medications, 
 17.30  by a registered nurse who has completed an advanced practice 
 17.31  registered nurse course of study and is awaiting certification, 
 17.32  the period not to exceed six months. 
 17.33     Sec. 14.  Minnesota Statutes 1998, section 148.281, 
 17.34  subdivision 1, is amended to read: 
 17.35     Subdivision 1.  [VIOLATIONS DESCRIBED.] It shall be 
 17.36  unlawful for any person, corporation, firm, or association, to: 
 18.1      (1) sell or fraudulently obtain or furnish any nursing 
 18.2   diploma, license or record, or aid or abet therein; 
 18.3      (2) practice professional or practical nursing or, practice 
 18.4   as a public health nurse, or practice as a certified clinical 
 18.5   nurse specialist, certified nurse midwife, certified nurse 
 18.6   practitioner, or certified registered nurse anesthetist under 
 18.7   cover of any diploma, permit, license, registration certificate, 
 18.8   advanced practice credential, or record illegally or 
 18.9   fraudulently obtained or signed or issued unlawfully or under 
 18.10  fraudulent representation; 
 18.11     (3) practice professional or practical nursing unless the 
 18.12  person has been issued a temporary permit under the provisions 
 18.13  of section 148.212 or is duly licensed and currently registered 
 18.14  to do so under the provisions of sections 148.171 to 148.285; 
 18.15     (4) use any abbreviation or other designation tending to 
 18.16  imply licensure as a registered nurse or licensed practical 
 18.17  nurse unless duly licensed and currently registered so to 
 18.18  practice professional or practical nursing under the provisions 
 18.19  of sections 148.171 to 148.285 except as authorized by the board 
 18.20  by rule; 
 18.21     (5) practice advanced practice registered nursing or use 
 18.22  any title, abbreviation, or other designation tending to imply 
 18.23  that the person is an advanced practice registered nurse, 
 18.24  clinical nurse specialist, nurse anesthetist, nurse midwife, or 
 18.25  nurse practitioner unless the person is certified for such 
 18.26  advanced practice registered nursing by a national nurse 
 18.27  certification organization or is within six months after 
 18.28  completion of an advanced practice registered nurse course of 
 18.29  study and is awaiting certification. 
 18.30     (6) use any title, abbreviation, or other designation 
 18.31  tending to imply certification as a certified registered nurse 
 18.32  as defined in section 148.171, subdivision 2, paragraph (13), 
 18.33  unless duly certified by a national nurse certification 
 18.34  organization. 
 18.35     (5) (7) use any abbreviation or other designation tending 
 18.36  to imply registration as a public health nurse unless duly 
 19.1   registered by the board; 
 19.2      (6) (8) practice professional, advanced practice 
 19.3   registered, or practical nursing in a manner prohibited by the 
 19.4   board in any limitation of a license or registration issued 
 19.5   under the provisions of sections 148.171 to 148.285; 
 19.6      (7) (9) practice professional, advanced practice 
 19.7   registered, or practical nursing during the time a license or 
 19.8   current registration issued under the provisions of sections 
 19.9   148.171 to 148.285 shall be suspended or revoked; 
 19.10     (8) (10) conduct a nursing program for the education of 
 19.11  persons to become registered nurses or licensed practical nurses 
 19.12  unless the program has been approved by the board; and 
 19.13     (9) (11) knowingly employ persons in the practice of 
 19.14  professional or practical nursing who have not been issued a 
 19.15  current permit, license, or registration certificate to practice 
 19.16  as a nurse in this state; and 
 19.17     (12) knowingly employ a person in advanced practice 
 19.18  registered nursing unless the person meets the standards and 
 19.19  practices of sections 148.171 to 148.285. 
 19.20     Sec. 15.  Minnesota Statutes 1998, section 148.283, is 
 19.21  amended to read: 
 19.22     148.283 [UNAUTHORIZED PRACTICE OF PROFESSIONAL, ADVANCED 
 19.23  PRACTICE REGISTERED, AND PRACTICAL NURSING.] 
 19.24     The practice of professional, advanced practice registered, 
 19.25  or practical nursing by any person who has not been licensed to 
 19.26  practice professional or practical nursing under the provisions 
 19.27  of sections 148.171 to 148.285, or whose license has been 
 19.28  suspended or revoked, or whose registration or national 
 19.29  credential has expired, is hereby declared to be inimical to the 
 19.30  public health and welfare and to constitute a public nuisance.  
 19.31  Upon complaint being made thereof by the board, or any 
 19.32  prosecuting officer, and upon a proper showing of the facts, the 
 19.33  district court of the county where such practice occurred may 
 19.34  enjoin such acts and practice.  Such injunction proceeding shall 
 19.35  be in addition to, and not in lieu of, all other penalties and 
 19.36  remedies provided by law.  
 20.1      Sec. 16.  Minnesota Statutes 1998, section 245.462, 
 20.2   subdivision 18, is amended to read: 
 20.3      Subd. 18.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
 20.4   professional" means a person providing clinical services in the 
 20.5   treatment of mental illness who is qualified in at least one of 
 20.6   the following ways:  
 20.7      (1) in psychiatric nursing:  a registered nurse who is 
 20.8   licensed under sections 148.171 to 148.285, and who is certified 
 20.9   as a clinical specialist in adult psychiatric and mental health 
 20.10  nursing by the American nurses association a national nurse 
 20.11  certification organization or who has a master's degree in 
 20.12  nursing or one of the behavioral sciences or related fields from 
 20.13  an accredited college or university or its equivalent, with at 
 20.14  least 4,000 hours of post-master's supervised experience in the 
 20.15  delivery of clinical services in the treatment of mental 
 20.16  illness; 
 20.17     (2) in clinical social work:  a person licensed as an 
 20.18  independent clinical social worker under section 148B.21, 
 20.19  subdivision 6, or a person with a master's degree in social work 
 20.20  from an accredited college or university, with at least 4,000 
 20.21  hours of post-master's supervised experience in the delivery of 
 20.22  clinical services in the treatment of mental illness; 
 20.23     (3) in psychology:  a psychologist licensed under sections 
 20.24  148.88 to 148.98 who has stated to the board of psychology 
 20.25  competencies in the diagnosis and treatment of mental illness; 
 20.26     (4) in psychiatry:  a physician licensed under chapter 147 
 20.27  and certified by the American board of psychiatry and neurology 
 20.28  or eligible for board certification in psychiatry; 
 20.29     (5) in marriage and family therapy:  the mental health 
 20.30  professional must be a marriage and family therapist licensed 
 20.31  under sections 148B.29 to 148B.39 with at least two years of 
 20.32  post-master's supervised experience in the delivery of clinical 
 20.33  services in the treatment of mental illness; or 
 20.34     (6) in allied fields:  a person with a master's degree from 
 20.35  an accredited college or university in one of the behavioral 
 20.36  sciences or related fields, with at least 4,000 hours of 
 21.1   post-master's supervised experience in the delivery of clinical 
 21.2   services in the treatment of mental illness.  
 21.3      Sec. 17.  Minnesota Statutes 1998, section 245.4871, 
 21.4   subdivision 27, is amended to read: 
 21.5      Subd. 27.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
 21.6   professional" means a person providing clinical services in the 
 21.7   diagnosis and treatment of children's emotional disorders.  A 
 21.8   mental health professional must have training and experience in 
 21.9   working with children consistent with the age group to which the 
 21.10  mental health professional is assigned.  A mental health 
 21.11  professional must be qualified in at least one of the following 
 21.12  ways:  
 21.13     (1) in psychiatric nursing, the mental health professional 
 21.14  must be a registered nurse who is licensed under sections 
 21.15  148.171 to 148.285 and who is certified as a clinical specialist 
 21.16  in child and adolescent psychiatric or mental health nursing by 
 21.17  the American nurses association a national nurse certification 
 21.18  organization or who has a master's degree in nursing or one of 
 21.19  the behavioral sciences or related fields from an accredited 
 21.20  college or university or its equivalent, with at least 4,000 
 21.21  hours of post-master's supervised experience in the delivery of 
 21.22  clinical services in the treatment of mental illness; 
 21.23     (2) in clinical social work, the mental health professional 
 21.24  must be a person licensed as an independent clinical social 
 21.25  worker under section 148B.21, subdivision 6, or a person with a 
 21.26  master's degree in social work from an accredited college or 
 21.27  university, with at least 4,000 hours of post-master's 
 21.28  supervised experience in the delivery of clinical services in 
 21.29  the treatment of mental disorders; 
 21.30     (3) in psychology, the mental health professional must be a 
 21.31  psychologist licensed under sections 148.88 to 148.98 who has 
 21.32  stated to the board of psychology competencies in the diagnosis 
 21.33  and treatment of mental disorders; 
 21.34     (4) in psychiatry, the mental health professional must be a 
 21.35  physician licensed under chapter 147 and certified by the 
 21.36  American board of psychiatry and neurology or eligible for board 
 22.1   certification in psychiatry; 
 22.2      (5) in marriage and family therapy, the mental health 
 22.3   professional must be a marriage and family therapist licensed 
 22.4   under sections 148B.29 to 148B.39 with at least two years of 
 22.5   post-master's supervised experience in the delivery of clinical 
 22.6   services in the treatment of mental disorders or emotional 
 22.7   disturbances; or 
 22.8      (6) in allied fields, the mental health professional must 
 22.9   be a person with a master's degree from an accredited college or 
 22.10  university in one of the behavioral sciences or related fields, 
 22.11  with at least 4,000 hours of post-master's supervised experience 
 22.12  in the delivery of clinical services in the treatment of 
 22.13  emotional disturbances. 
 22.14     Sec. 18.  [TRANSITION.] 
 22.15     The board of nursing may, for the purpose of obtaining the 
 22.16  proper certification, grant an extension of not more than five 
 22.17  years to a registered nurse who on July 1, 1999, has completed a 
 22.18  formal course of study as an advanced practice registered nurse 
 22.19  and is practicing as an advanced practice registered nurse, but 
 22.20  is not certified by a national nurse certification organization 
 22.21  in the field of nursing in which the nurse is practicing.  One 
 22.22  additional three-year extension may be granted. 
 22.23     Sec. 19.  [REVISOR INSTRUCTION.] 
 22.24     The revisor shall alphabetize and place into subdivisions 
 22.25  the definitions in Minnesota Statutes, section 148.171, 
 22.26  subdivision 2.  
 22.27     Sec. 20.  [REPEALER.] 
 22.28     Minnesota Statutes 1998, section 148.235, subdivisions 1, 
 22.29  2, 4, 5, and 6, are repealed. 
 22.30     Sec. 21.  [EFFECTIVE DATE.] 
 22.31     Sections 1 to 18 are effective July 1, 1999.