HF 2910

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 03/09/2020 05:24pm

A bill for an act
relating to health occupations; modifying respiratory care practitioner requirements;
amending Minnesota Statutes 2018, sections 147C.01, subdivisions 2, 10; 147C.05;
147C.10, subdivisions 1a, 2; 147C.15, subdivisions 1, 2; 147C.35; 256B.0659,
subdivision 27; Minnesota Statutes 2019 Supplement, sections 147.012; 147C.15,
subdivision 7.

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

Section 1.

Minnesota Statutes 2019 Supplement, section 147.012, is amended to read:

147.012 OVERSIGHT OF ALLIED HEALTH PROFESSIONS.

The board has responsibility for the oversight of the following allied health professions:
physician assistants under chapter 147A, acupuncture practitioners under chapter 147B,
respiratory deleted text begin care practitioners deleted text end new text begin therapists new text end under chapter 147C, traditional midwives under
chapter 147D, registered naturopathic doctors under chapter 147E, genetic counselors under
chapter 147F, and athletic trainers under sections 148.7801 to 148.7815.

Sec. 2.

Minnesota Statutes 2018, section 147C.01, subdivision 2, is amended to read:

Subd. 2.

Advisory council.

"Advisory council" means the Respiratory deleted text begin Care deleted text end new text begin Therapy new text end
Advisory Council established under section 147C.35.

Sec. 3.

Minnesota Statutes 2018, section 147C.01, subdivision 10, is amended to read:

Subd. 10.

Respiratory deleted text begin care deleted text end new text begin therapy new text end .

"Respiratory deleted text begin care deleted text end new text begin therapy new text end " means the provision
of services described under section 147C.05 for the assessment, treatment, education,
management, evaluation, and care of patients with deficiencies, abnormalities, and diseases
of the cardiopulmonary system, under the supervision of a physician and pursuant to a
referral, or a verbal, written, or telecommunicated order from a physician, nurse practitioner,
or physician assistant. Respiratory deleted text begin care deleted text end new text begin therapy new text end includes, but is not limited to, education
pertaining to health promotion, disease prevention and management, patient care, and
treatment.

Sec. 4.

Minnesota Statutes 2018, section 147C.05, is amended to read:

147C.05 SCOPE OF PRACTICE.

(a) The practice of respiratory deleted text begin care deleted text end new text begin therapy new text end by a licensed respiratory therapist includes,
but is not limited to, the following services:

(1) providing and monitoring therapeutic administration of medical gases, aerosols,
humidification, and pharmacological agents related to respiratory care procedures, but not
including administration of general anesthesia;

(2) carrying out therapeutic application and monitoring of mechanical ventilatory support;

(3) providing cardiopulmonary resuscitation and maintenance of natural airways and
insertion and maintenance of artificial airways;

(4) assessing and monitoring signs, symptoms, and general behavior relating to, and
general physical response to, respiratory deleted text begin care deleted text end new text begin therapy new text end treatment or evaluation for treatment
and diagnostic testing, including determination of whether the signs, symptoms, reactions,
behavior, or general response exhibit abnormal characteristics;

(5) obtaining physiological specimens and interpreting physiological data including:

(i) analyzing arterial and venous blood gases;

(ii) assessing respiratory secretions;

(iii) measuring ventilatory volumes, pressures, and flows;

(iv) testing pulmonary function;

(v) testing and studying the cardiopulmonary system; and

(vi) diagnostic and therapeutic testing of breathing patterns related to sleep disorders;

(6) assisting hemodynamic monitoring and support of the cardiopulmonary system;

(7) assessing and making suggestions for modifications in the treatment regimen based
on abnormalities, protocols, or changes in patient response to respiratory care treatment;

(8) providing cardiopulmonary rehabilitation including respiratory- deleted text begin care deleted text end new text begin therapy new text end related
educational components, postural drainage, chest physiotherapy, breathing exercises,
aerosolized administration of medications, and equipment use and maintenance;

(9) instructing patients and their families in techniques for the prevention, alleviation,
and rehabilitation of deficiencies, abnormalities, and diseases of the cardiopulmonary system;
and

(10) transcribing and implementing verbal, written, or telecommunicated orders from a
physician, nurse practitioner, or physician assistant for respiratory deleted text begin care deleted text end new text begin therapy new text end services.

(b) This section does not prohibit a respiratory therapist from performing advances in
the art and techniques of respiratory deleted text begin care deleted text end new text begin therapy new text end learned through formal or specialized
training as approved by the Respiratory deleted text begin Care deleted text end new text begin Therapy new text end Advisory Council.

(c) This section does not prohibit an individual licensed or credentialed as a respiratory
therapist in another state or country from providing respiratory deleted text begin care deleted text end new text begin therapy new text end in an emergency
in this state, providing respiratory deleted text begin care deleted text end new text begin therapy new text end as a member of an organ harvesting team,
or from providing respiratory deleted text begin care deleted text end new text begin therapy new text end on board an ambulance as part of an ambulance
treatment team.

Sec. 5.

Minnesota Statutes 2018, section 147C.10, subdivision 1a, is amended to read:

Subd. 1a.

Unlicensed practice prohibited.

No person shall practice respiratory deleted text begin care deleted text end new text begin
therapy new text end unless the person is licensed as a respiratory therapist under this chapter except as
otherwise provided under this chapter.

Sec. 6.

Minnesota Statutes 2018, section 147C.10, subdivision 2, is amended to read:

Subd. 2.

Other health care practitioners.

(a) Nothing in this chapter shall prohibit the
practice of any profession or occupation licensed or registered by the state by any person
duly licensed or registered to practice the profession or occupation or to perform any act
that falls within the scope of practice of the profession or occupation.

(b) Nothing in this chapter shall be construed to require a respiratory deleted text begin care deleted text end new text begin therapy new text end license
for:

(1) a student enrolled in a respiratory therapy or polysomnography technology education
program accredited by the Commission on Accreditation of Allied Health Education
Programs, its successor organization, or another nationally recognized accrediting
organization;

(2) a respiratory therapist as a member of the United States armed forces while performing
duties incident to that duty;

(3) an individual employed by a durable medical equipment provider or a home medical
equipment provider who delivers, sets up, instructs the patient on the use of, or maintains
respiratory deleted text begin care deleted text end new text begin therapy new text end equipment, but does not perform assessment, education, or evaluation
of the patient;

(4) self-care by a patient or gratuitous care by a friend or relative who does not purport
to be a licensed respiratory therapist; or

(5) an individual employed in a sleep lab or center as a polysomnographic technologist
under the supervision of a licensed physician.

Sec. 7.

Minnesota Statutes 2018, section 147C.15, subdivision 1, is amended to read:

Subdivision 1.

General requirements for licensure.

To be eligible for a license, an
applicant, with the exception of those seeking licensure by reciprocity under subdivision 2,
must:

(1) submit a completed application on forms provided by the board along with all fees
required under section 147C.40 that includes:

(i) the applicant's name, Social Security number, home address, e-mail address, and
telephone number, and business address and telephone number;

(ii) the name and location of the respiratory therapy education program the applicant
completed;

(iii) a list of degrees received from educational institutions;

(iv) a description of the applicant's professional training beyond the first degree received;

(v) the applicant's work history for the five years preceding the application, including
the average number of hours worked per week;

(vi) a list of registrations, certifications, and licenses held in other jurisdictions;

(vii) a description of any other jurisdiction's refusal to credential the applicant;

(viii) a description of all professional disciplinary actions initiated against the applicant
in any jurisdiction; and

(ix) any history of drug or alcohol abuse, and any misdemeanor or felony conviction;

(2) submit a certificate of completion from an approved education program;

(3) achieve a qualifying score on a new text begin registered respiratory therapist or advanced level
respiratory therapy new text end credentialing examination within five years prior to application for
registration;

(4) submit a verified copy of a valid and current credential, issued by the National Board
for Respiratory Care or other board-approved national organization, as a deleted text begin certified respiratory
therapist, deleted text end registered respiratory therapist deleted text begin , deleted text end or other deleted text begin entry or deleted text end advanced level respiratory therapist
designation;

(5) submit additional information as requested by the board, including providing any
additional information necessary to ensure that the applicant is able to practice with
reasonable skill and safety to the public;

(6) sign a statement that the information in the application is true and correct to the best
of the applicant's knowledge and belief; and

(7) sign a waiver authorizing the board to obtain access to the applicant's records in this
or any other state in which the applicant has completed an approved education program or
engaged in the practice of respiratory therapy.

Sec. 8.

Minnesota Statutes 2018, section 147C.15, subdivision 2, is amended to read:

Subd. 2.

Licensure by reciprocity.

To be eligible for licensure by reciprocity, the
applicant must be credentialed new text begin as a registered respiratory therapist or advanced level
respiratory therapist new text end by the National Board for Respiratory Care or other board-approved
organization and have worked at least eight weeks of the previous five years as a respiratory
therapist and must:

(1) submit the application materials and fees as required by subdivision 1, clauses (1),
(4), (5), (6), and (7);

(2) provide a verified copy from the appropriate government body of a current and
unrestricted credential or license for the practice of respiratory therapy in another jurisdiction
that has initial credentialing requirements equivalent to or higher than the requirements in
subdivision 1; and

(3) provide letters of verification from the appropriate government body in each
jurisdiction in which the applicant holds a credential or license. Each letter must state the
applicant's name, date of birth, credential number, date of issuance, a statement regarding
disciplinary actions, if any, taken against the applicant, and the terms under which the
credential was issued.

Sec. 9.

Minnesota Statutes 2019 Supplement, section 147C.15, subdivision 7, is amended
to read:

Subd. 7.

Renewal.

(a) To be eligible for license renewal a licensee must:

(1) annually, or as determined by the board, complete a renewal application on a form
provided by the board;

(2) submit the renewal fee;

(3) provide evidence every two years of a total of 24 hours of continuing education
approved by the board as described in section 147C.25; and

(4) submit any additional information requested by the board to clarify information
presented in the renewal application. The information must be submitted within 30 days
after the board's request, or the renewal request is nullified.

(b) Applicants for renewal who have not practiced the equivalent of eight full weeks
during the past five years must achieve a passing score on retaking the credentialing
examination new text begin required under subdivision 1 new text end .

(c) A licensee must maintain a correct mailing address with the board for receiving board
communications, notices, and license renewal documents. Placing the license renewal
application in first-class United States mail, addressed to the licensee at the licensee's last
known address with postage prepaid, constitutes valid service. Failure to receive the renewal
documents does not relieve a licensee of the obligation to comply with this section.

(d) The name of a licensee who does not return a complete license renewal application,
annual license fee, or late application fee, as applicable, within the time period required by
this section shall be removed from the list of individuals authorized to practice during the
current renewal period. If the licensee's license is reinstated, the licensee's name shall be
placed on the list of individuals authorized to practice.

new text begin (e) An applicant for renewal after July 1, 2020, is eligible for license renewal if the
applicant has a valid and current certified or registered respiratory therapist credential
designation, or other entry or advanced level respiratory therapy designation, issued by the
National Board of Respiratory Care or other board-approved organization.
new text end

Sec. 10.

Minnesota Statutes 2018, section 147C.35, is amended to read:

147C.35 RESPIRATORY deleted text begin CARE deleted text end new text begin THERAPY new text end ADVISORY COUNCIL.

Subdivision 1.

Membership.

The board shall appoint a seven-member Respiratory deleted text begin Care deleted text end new text begin
Therapy new text end Advisory Council consisting of two public members as defined in section 214.02,
three licensed respiratory therapists, and two licensed physicians with expertise in respiratory
care.

Subd. 2.

Organization.

The advisory council shall be organized and administered under
section 15.059.

Subd. 3.

Duties.

The advisory council shall:

(1) advise the board regarding standards for respiratory therapists;

(2) provide for distribution of information regarding respiratory therapy standards;

(3) advise the board on enforcement of sections 147.091 to 147.162;

(4) review applications and recommend granting or denying licensure or license renewal;

(5) advise the board on issues related to receiving and investigating complaints,
conducting hearings, and imposing disciplinary action in relation to complaints against
respiratory therapists;

(6) advise the board regarding approval of continuing education programs using the
criteria in section 147C.25, subdivision 3; and

(7) perform other duties authorized for advisory councils by chapter 214, as directed by
the board.

Sec. 11.

Minnesota Statutes 2018, section 256B.0659, subdivision 27, is amended to read:

Subd. 27.

Personal care assistance provider agency.

(a) The personal care assistance
provider agency is required to provide training for the personal care assistant responsible
for working with a recipient who is ventilator dependent. All training must be administered
by a respiratory therapist, nurse, or physician. Qualified professional supervision by a nurse
must be completed and documented on file in the personal care assistant's employment
record and the recipient's health record. If offering personal care services to a
ventilator-dependent recipient, the personal care assistance provider agency shall demonstrate
and document the ability to:

(1) train the personal care assistant;

(2) supervise the personal care assistant in the care of a ventilator-dependent recipient;

(3) supervise the recipient and responsible party in the care of a ventilator-dependent
recipient; and

(4) provide documentation of the training and supervision in clauses (1) to (3) upon
request.

(b) A personal care assistant shall not undertake any clinical services, patient assessment,
patient evaluation, or clinical education regarding the ventilator or the patient on the
ventilator. These services may only be provided by health care professionals licensed or
registered in this state.

(c) A personal care assistant may only perform tasks associated with ventilator
maintenance that are approved by the Board of Medical Practice in consultation with the
Respiratory deleted text begin Care Practitioner deleted text end new text begin Therapy new text end Advisory Council and the Department of Human
Services.

Sec. 12. new text begin REVISOR INSTRUCTION.
new text end

new text begin The title of Minnesota Statutes, chapter 147C, shall be changed to "Respiratory
Therapists."
new text end