1.1A bill for an act1.2relating to health; changing licensing requirements for certain health professions; 1.3changing provisions for unlicensed complementary and alternative health care 1.4practitioners;amending Minnesota Statutes 2006, sections 147.03, subdivision 1.51; 148.512, subdivision 20; 148.5161, subdivisions 2, 3; 148.5175; 148.519, 1.6subdivision 3; 148.5194, subdivisions 7, 8; 148.5195, subdivision 3; 148.6425; 1.7148.6428; 148.6440; 148.6443, subdivisions 1, 3; 148.6445, subdivision 11; 1.8149A.01, subdivision 4; 151.01, subdivision 27; 153A.14, subdivisions 2i, 4a, 11; 1.9153A.175; Minnesota Statutes 2007 Supplement, sections 146A.08, subdivision 1.101; 146A.11, subdivision 1; 147.037, subdivision 1; 148.515, subdivision 2; 1.11proposing coding for new law in Minnesota Statutes, chapter 148B.1.12BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:1.13    Section 1. Minnesota Statutes 2007 Supplement, section 146A.08, subdivision 1, 1.14is amended to read:1.15    Subdivision 1. Prohibited conduct. The commissioner may impose disciplinary 1.16action as described in section 
         146A.09 against any unlicensed complementary and 1.17alternative health care practitioner. The following conduct is prohibited and is grounds for 1.18disciplinary action: 1.19    (a) Conviction of a crime, including a finding or verdict of guilt, an admission 1.20of guilt, or a no-contest plea, in any court in Minnesota or any other jurisdiction in the 1.21United States, reasonably related to engaging in complementary and alternative health 1.22care practices. Conviction, as used in this subdivision, includes a conviction of an offense 1.23which, if committed in this state, would be deemed a felony, gross misdemeanor, or 1.24misdemeanor, without regard to its designation elsewhere, or a criminal proceeding where 1.25a finding or verdict of guilty is made or returned but the adjudication of guilt is either 1.26withheld or not entered.2.1    (b) Conviction of any crime against a person. For purposes of this chapter, a crime 2.2against a person means violations of the following: sections 
         609.185; 
         609.19; 
         609.195; 2.3609.20
         ; 
         609.205; 
         609.21; 
         609.215; 
         609.221; 
         609.222; 
         609.223; 
         609.224; 
         609.2242; 2.4609.23
         ; 
         609.231; 
         609.2325; 
         609.233; 
         609.2335; 
         609.235; 
         609.24; 
         609.245; 
         609.25; 2.5609.255
         ; 
         609.26, subdivision 1, clause (1) or (2); 
         609.265; 
         609.342; 
         609.343; 
         609.344; 2.6609.345
         ; 
         609.365; 
         609.498, subdivision 1; 
         609.50, subdivision 1, clause (1); 
         609.561; 2.7609.562
         ; 
         609.595; and 
         609.72, subdivision 3. 2.8    (c) Failure to comply with the self-reporting requirements of section 
         146A.03, 2.9subdivision 7
         . 2.10    (d) Engaging in sexual contact with a complementary and alternative health care 2.11client or former client, engaging in contact that may be reasonably interpreted by a client 2.12as sexual, engaging in any verbal behavior that is seductive or sexually demeaning to 2.13the patient client, or engaging in sexual exploitation of a client or former client. For2.14purposes of this paragraph, "former client" means a person who has obtained services 2.15from the unlicensed complementary and alternative health care practitioner within the 2.16past two years.2.17    (e) Advertising that is false, fraudulent, deceptive, or misleading.2.18    (f) Conduct likely to deceive, defraud, or harm the public or demonstrating a willful 2.19or careless disregard for the health, welfare, or safety of a complementary and alternative 2.20health care client; or any other practice that may create danger to any client's life, health, 2.21or safety, in any of which cases, proof of actual injury need not be established.2.22    (g) Adjudication as mentally incompetent or as a person who is dangerous to 2.23self or adjudication pursuant to chapter 253B as chemically dependent, mentally ill, 2.24developmentally disabled, mentally ill and dangerous to the public, or as a sexual 2.25psychopathic personality or sexually dangerous person.2.26    (h) Inability to engage in complementary and alternative health care practices with 2.27reasonable safety to complementary and alternative health care clients.2.28    (i) The habitual overindulgence in the use of or the dependence on intoxicating 2.29liquors.2.30    (j) Improper or unauthorized personal or other use of any legend drugs as defined 2.31in chapter 151, any chemicals as defined in chapter 151, or any controlled substance 2.32as defined in chapter 152.2.33    (k) Revealing a communication from, or relating to, a complementary and alternative 2.34health care client except when otherwise required or permitted by law.3.1    (l) Failure to comply with a complementary and alternative health care client's 3.2request made under sections 
         144.291 to 144.298 or to furnish a complementary and 3.3alternative health care client record or report required by law. 3.4    (m) Splitting fees or promising to pay a portion of a fee to any other professional 3.5other than for services rendered by the other professional to the complementary and 3.6alternative health care client.3.7    (n) Engaging in abusive or fraudulent billing practices, including violations of the 3.8federal Medicare and Medicaid laws or state medical assistance laws.3.9    (o) Failure to make reports as required by section 
         146A.03 or cooperate with an 3.10investigation of the office. 3.11    (p) Obtaining money, property, or services from a complementary and alternative 3.12health care client, other than reasonable fees for services provided to the client, through 3.13the use of undue influence, harassment, duress, deception, or fraud.3.14    (q) Undertaking or continuing a professional relationship with a complementary and 3.15alternative health care client in which the objectivity of the unlicensed complementary 3.16and alternative health care practitioner would be impaired.3.17    (r)(q)  Failure to provide a complementary and alternative health care client with a 3.18copy of the client bill of rights or violation of any provision of the client bill of rights.3.19    (s)(r)  Violating any order issued by the commissioner.3.20    (t)(s)  Failure to comply with any provision of sections 
         146A.01 to 
         146A.11 and the 3.21rules adopted under those sections. 3.22    (u)(t)  Failure to comply with any additional disciplinary grounds established by 3.23the commissioner by rule.3.24    (v)(u)  Revocation, suspension, restriction, limitation, or other disciplinary action 3.25against any health care license, certificate, registration, or right to practice of the 3.26unlicensed complementary and alternative health care practitioner in this or another state 3.27or jurisdiction for offenses that would be subject to disciplinary action in this state or 3.28failure to report to the office that charges regarding the practitioner's license, certificate, 3.29registration, or right of practice have been brought in this or another state or jurisdiction.3.30    (w)(v)  Use of the title "doctor," "Dr.," or "physician" alone or in combination with 3.31any other words, letters, or insignia to describe the complementary and alternative health 3.32care practices the practitioner provides.3.33    (x)(w)  Failure to provide a complementary and alternative health care client with a 3.34recommendation that the client see a health care provider who is licensed or registered 3.35by a health-related licensing board or the commissioner of health, if there is a reasonable 3.36likelihood that the client needs to be seen by a licensed or registered health care provider.4.1    Sec. 2. Minnesota Statutes 2007 Supplement, section 146A.11, subdivision 1, is 4.2amended to read:4.3    Subdivision 1. Scope.(a) All unlicensed complementary and alternative health 4.4care practitioners shall provide to each complementary and alternative health care 4.5client prior to providing treatment a written copy of the complementary and alternative 4.6health care client bill of rights. A copy must also be posted in a prominent location 4.7in the office of the unlicensed complementary and alternative health care practitioner. 4.8Reasonable accommodations shall be made for those clients who cannot read or who 4.9have communication impairments and those who do not read or speak English. The 4.10complementary and alternative health care client bill of rights shall include the following:4.11    (1) the name, complementary and alternative health care title, business address, 4.12and telephone number of the unlicensed complementary and alternative health care 4.13practitioner;4.14    (2) the degrees, training, experience, or other qualifications of the practitioner 4.15regarding the complimentary and alternative health care being provided, followed by the 4.16following statement in bold print:4.17    "THE STATE OF MINNESOTA HAS NOT ADOPTED ANY EDUCATIONAL 4.18AND TRAINING STANDARDS FOR UNLICENSED COMPLEMENTARY AND 4.19ALTERNATIVE HEALTH CARE PRACTITIONERS. THIS STATEMENT OF 4.20CREDENTIALS IS FOR INFORMATION PURPOSES ONLY.4.21    Under Minnesota law, an unlicensed complementary and alternative health care 4.22practitioner may not provide a medical diagnosis or recommend discontinuance of 4.23medically prescribed treatments. If a client desires a diagnosis from a licensed physician, 4.24chiropractor, or acupuncture practitioner, or services from a physician, chiropractor, nurse, 4.25osteopath, physical therapist, dietitian, nutritionist, acupuncture practitioner, athletic 4.26trainer, or any other type of health care provider, the client may seek such services at 4.27any time.";4.28    (3) the name, business address, and telephone number of the practitioner's 4.29supervisor, if any;4.30    (4) notice that a complementary and alternative health care client has the right to 4.31file a complaint with the practitioner's supervisor, if any, and the procedure for filing 4.32complaints;4.33    (5) the name, address, and telephone number of the office of unlicensed 4.34complementary and alternative health care practice and notice that a client may file 4.35complaints with the office;5.1    (6) the practitioner's fees per unit of service, the practitioner's method of billing 5.2for such fees, the names of any insurance companies that have agreed to reimburse the 5.3practitioner, or health maintenance organizations with whom the practitioner contracts to 5.4provide service, whether the practitioner accepts Medicare, medical assistance, or general 5.5assistance medical care, and whether the practitioner is willing to accept partial payment, 5.6or to waive payment, and in what circumstances;5.7    (7) a statement that the client has a right to reasonable notice of changes in services 5.8or charges;5.9    (8) a brief summary, in plain language, of the theoretical approach used by the 5.10practitioner in providing services to clients;5.11    (9) notice that the client has a right to complete and current information concerning 5.12the practitioner's assessment and recommended service that is to be provided, including 5.13the expected duration of the service to be provided;5.14    (10) a statement that clients may expect courteous treatment and to be free from 5.15verbal, physical, or sexual abuse by the practitioner;5.16    (11) a statement that client records and transactions with the practitioner are 5.17confidential, unless release of these records is authorized in writing by the client, or 5.18otherwise provided by law;5.19    (12) a statement of the client's right to be allowed access to records and written 5.20information from records in accordance with sections 
         144.291 to 144.298; 5.21    (13) a statement that other services may be available in the community, including 5.22where information concerning services is available;5.23    (14) a statement that the client has the right to choose freely among available 5.24practitioners and to change practitioners after services have begun, within the limits of 5.25health insurance, medical assistance, or other health programs;5.26    (15) a statement that the client has a right to coordinated transfer when there will 5.27be a change in the provider of services;5.28    (16) a statement that the client may refuse services or treatment, unless otherwise 5.29provided by law; and5.30    (17) a statement that the client may assert the client's rights without retaliation.5.31    (b) This section does not apply to an unlicensed complementary and alternative 5.32health care practitioner who is employed by or is a volunteer in a hospital or hospice who 5.33provides services to a client in a hospital or under an appropriate hospice plan of care. 5.34Patients receiving complementary and alternative health care services in an inpatient 5.35hospital or under an appropriate hospice plan of care shall have and be made aware of 6.1the right to file a complaint with the hospital or hospice provider through which the 6.2practitioner is employed or registered as a volunteer.6.3    Sec. 3. Minnesota Statutes 2006, section 147.03, subdivision 1, is amended to read:6.4    Subdivision 1. Endorsement; reciprocity. (a) The board may issue a license to 6.5practice medicine to any person who satisfies the requirements in paragraphs (b) to (f).6.6    (b) The applicant shall satisfy all the requirements established in section 
         147.02, 6.7subdivision 1
         , paragraphs (a), (b), (d), (e), and (f). 6.8    (c) The applicant shall:6.9    (1) have passed an examination prepared and graded by the Federation of State 6.10Medical Boards, the National Board of Medical Examiners, or the United States Medical 6.11Licensing Examination (USMLE) program in accordance with section 
         147.02, subdivision 6.121
         , paragraph (c), clause (2); the National Board of Osteopathic Examiners; or the Medical 6.13Council of Canada; and 6.14    (2) have a current license from the equivalent licensing agency in another state or 6.15Canada and, if the examination in clause (1) was passed more than ten years ago, either:6.16    (i) pass the Special Purpose Examination of the Federation of State Medical Boards 6.17with a score of 75 or better within three attempts; or6.18    (ii) have a current certification by a specialty board of the American Board of 6.19Medical Specialties, of the American Osteopathic Association Bureau of Professional 6.20Education,  the Royal College of Physicians and Surgeons of Canada, or of the College of 6.21Family Physicians of Canada.; or6.22    (3) if the applicant fails to meet the requirement established in section 147.02, 6.23subdivision 1, paragraph (c), clause (2), because the applicant failed to pass each of steps 6.24one, two, and three of the USMLE within the required three attempts, the applicant may 6.25be granted a license provided the applicant:6.26    (i) has passed each of steps one, two, and three with passing scores as recommended 6.27by the USMLE program within no more than four attempts for any of the three steps;6.28    (ii) is currently licensed in another state; and6.29    (iii) has current certification by a specialty board of the American Board of Medical 6.30Specialties, the American Osteopathic Association Bureau of Professional Education, the 6.31Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians 6.32of Canada.6.33    (d) The applicant shall pay a fee established by the board by rule. The fee may 6.34not be refunded.7.1    (e) The applicant must not be under license suspension or revocation by the licensing 7.2board of the state or jurisdiction in which the conduct that caused the suspension or 7.3revocation occurred.7.4    (f) The applicant must not have engaged in conduct warranting disciplinary action 7.5against a licensee, or have been subject to disciplinary action other than as specified in 7.6paragraph (e). If an applicant does not satisfy the requirements stated in this paragraph, 7.7the board may issue a license only on the applicant's showing that the public will be 7.8protected through issuance of a license with conditions or limitations the board considers 7.9appropriate.7.10    (g) Upon the request of an applicant, the board may conduct the final interview of 7.11the applicant by teleconference.7.12EFFECTIVE DATE.This section is effective the day following final enactment.7.13    Sec. 4. Minnesota Statutes 2007 Supplement, section 147.037, subdivision 1, is 7.14amended to read:7.15    Subdivision 1. Requirements. The board shall issue a license to practice medicine 7.16to any person who satisfies the requirements in paragraphs (a) to (g).7.17    (a) The applicant shall satisfy all the requirements established in section 
         147.02, 7.18subdivision 1
         , paragraphs (a), (e), (f), (g), and (h).7.19    (b) The applicant shall present evidence satisfactory to the board that the applicant 7.20is a graduate of a medical or osteopathic school approved by the board as equivalent 7.21to accredited United States or Canadian schools based upon its faculty, curriculum, 7.22facilities, accreditation, or other relevant data. If the applicant is a graduate of a medical or 7.23osteopathic program that is not accredited by the Liaison Committee for Medical Education 7.24or the American Osteopathic Association, the applicant may use the Federation of State 7.25Medical Boards' Federation Credentials Verification Service (FCVS) or its successor. If 7.26the applicant uses this service as allowed under this paragraph, the physician application 7.27fee may be less than $200 but must not exceed the cost of administering this paragraph.7.28    (c) The applicant shall present evidence satisfactory to the board that the applicant 7.29has been awarded a certificate by the Educational Council for Foreign Medical Graduates, 7.30and the applicant has a working ability in the English language sufficient to communicate 7.31with patients and physicians and to engage in the practice of medicine.7.32    (d) The applicant shall present evidence satisfactory to the board of the completion 7.33of two years of graduate, clinical medical training in a program located in the United 7.34States, its territories, or Canada and accredited by a national accrediting organization 7.35approved by the board. This requirement does not apply:8.1    (1) to an applicant who is admitted as a permanent immigrant to the United States on 8.2or before October 1, 1991, as a person of exceptional ability in the sciences according to 8.3Code of Federal Regulations, title 20, section 
         656.22(d);8.4    (2) to an applicant holding a valid license to practice medicine in another country 8.5and issued a permanent immigrant visa after October 1, 1991, as a person of extraordinary 8.6ability in the field of science or as an outstanding professor or researcher according to 8.7Code of Federal Regulations, title 8, section 
         204.5(h) and (i), or a temporary nonimmigrant 8.8visa as a person of extraordinary ability in the field of science according to Code of 8.9Federal Regulations, title 8, section 
         214.2(o),8.10provided that a person under clause (1) or (2) is admitted pursuant to rules of the United 8.11States Department of Labor; or8.12    (3) to an applicant who is licensed in another state, has practiced five years without 8.13disciplinary action in the United States, its territories, or Canada, has completed one year 8.14of the graduate, clinical medical training required by this paragraph, and has passed the 8.15Special Purpose Examination of the Federation of State Medical Boards within three 8.16attempts in the 24 months before licensing.8.17    (e) The applicant must:8.18    (1) have passed an examination prepared and graded by the Federation of State 8.19Medical Boards, the United States Medical Licensing Examination program in accordance 8.20with section 
         147.02, subdivision 1, paragraph (c), clause (2), or the Medical Council 8.21of Canada; and8.22    (2) have a current license from the equivalent licensing agency in another state or 8.23country and, if the examination in clause (1) was passed more than ten years ago, either:8.24    (i) pass the Special Purpose Examination of the Federation of State Medical Boards 8.25with a score of 75 or better within three attempts; or8.26    (ii) have a current certification by a specialty board of the American Board of 8.27Medical Specialties, of the American Osteopathic Association Bureau of Professional 8.28Education, of the Royal College of Physicians and Surgeons of Canada, or of the College 8.29of Family Physicians of Canada.; or8.30    (3) if the applicant fails to meet the requirement established in section 147.02, 8.31subdivision 1, paragraph (c), clause (2), because the applicant failed to pass each of steps 8.32one, two, and three of the USMLE within the required three attempts, the applicant may 8.33be granted a license provided the applicant:8.34    (i) has passed each of steps one, two, and three with passing scores as recommended 8.35by the USMLE program within no more than four attempts for any of the three steps;8.36    (ii) is currently licensed in another state; and9.1    (iii) has current certification by a specialty board of the American Board of Medical 9.2Specialties, the American Osteopathic Association Bureau of Professional Education, the 9.3Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians 9.4of Canada.9.5    (f) The applicant must not be under license suspension or revocation by the licensing 9.6board of the state or jurisdiction in which the conduct that caused the suspension or 9.7revocation occurred.9.8    (g) The applicant must not have engaged in conduct warranting disciplinary action 9.9against a licensee, or have been subject to disciplinary action other than as specified in 9.10paragraph (f). If an applicant does not satisfy the requirements stated in this paragraph, 9.11the board may issue a license only on the applicant's showing that the public will be 9.12protected through issuance of a license with conditions or limitations the board considers 9.13appropriate.9.14EFFECTIVE DATE.This section is effective the day following final enactment.9.15    Sec. 5. Minnesota Statutes 2006, section 148.512, subdivision 20, is amended to read:9.16    Subd. 20. Supervisor. "Supervisor" means a person who has the authority to direct 9.17or evaluate a supervisee and who:9.18(1) is a licensed speech-language pathologist or audiologist under section 148.515, 9.19148.516, or 148.517; or9.20(2) when the commissioner determines that supervision by a licensed 9.21speech-language pathologist or audiologist as required in clause (1) is unobtainable, and 9.22in other situations considered appropriate by the commissioner, is a person practicing 9.23speech-language pathology or audiology who holds a current certificate of clinical 9.24competence from the American Speech-Language-Hearing Association or board 9.25certification in audiology by the American Board of Audiology.9.26    Sec. 6. Minnesota Statutes 2007 Supplement, section 148.515, subdivision 2, is 9.27amended to read:9.28    Subd. 2. Master's or doctoral degree required for speech-language pathology 9.29applicants. (a) An applicant for speech-language pathology must possess a master's or 9.30doctoral degree that meets the requirements of paragraph (b). If completing a doctoral 9.31program in which a master's degree has not been conferred, an applicant must submit a 9.32transcript showing completion of course work equivalent to, or exceeding, a master's 9.33degree that meets the requirement of paragraph (b). In addition to the transcript, the 9.34commissioner may require a letter from the academic department chair or program 10.1director documenting that the applicant has completed coursework equivalent to or 10.2exceeding a master's degree or that the applicant is eligible for enrollment in current 10.3doctoral externship credit.10.4    (b) All of the speech-language pathology applicant's graduate coursework and 10.5clinical practicum required in the professional area for which licensure is sought must 10.6have been initiated and completed at an institution whose program meets the current 10.7requirements and was accredited by the Educational Standards Board of the Council 10.8on Academic Accreditation in Audiology and Speech-Language Pathology, a body 10.9recognized by the United States Department of Education, or an equivalent as determined 10.10by the commissioner, in the area for which licensure is sought.10.11    Sec. 7. Minnesota Statutes 2006, section 148.5161, subdivision 2, is amended to read:10.12    Subd. 2. Procedures. To be eligible for clinical fellowship licensure or doctoral 10.13externship licensure, an applicant must submit an application form provided by the 10.14commissioner, the fees required by section 
         148.5194, and evidence of successful 10.15completion of the requirements in section 
         148.515, subdivision 2 or 2a. 10.16    Sec. 8. Minnesota Statutes 2006, section 148.5161, subdivision 3, is amended to read:10.17    Subd. 3. Supervision required. (a) A clinical fellowship licensee or doctoral 10.18externship licensee must practice under the supervision of an individual who meets 10.19the requirements of section 
         148.512, subdivision 20. Supervision must conform to the 10.20requirements in paragraphs (b) to (e). 10.21(b) Supervision must include both on-site observation and other monitoring 10.22activities. On-site observation must involve the supervisor, the clinical fellowship licensee 10.23or doctoral externship licensee, and the client receiving speech-language pathology or 10.24audiology services and must include direct observation by the supervisor of treatment 10.25given by the clinical fellowship licensee or doctoral externship licensee. Other monitoring 10.26activities must involve direct or indirect evaluative contact by the supervisor of the clinical 10.27fellowship licensee or doctoral externship licensee, may be executed by correspondence, 10.28and may include, but are not limited to, conferences with the clinical fellowship licensee 10.29or doctoral externship licensee, evaluation of written reports, and evaluations by 10.30professional colleagues. Other monitoring activities do not include the client receiving 10.31speech-language pathology or audiology services.10.32(c) The clinical fellowship licensee or doctoral externship licensee must be 10.33supervised by an individual who meets the definition of section 
         148.512, subdivision 20, 10.34and: 11.1(1) when the clinical fellowship licensee or doctoral externship licensee is a 11.2speech-language pathologist, is a licensed speech-language pathologist, or holds a current 11.3certificate of clinical competence in speech-language pathology from the American 11.4Speech-Language-Hearing Association; or11.5(2) when the clinical fellowship licensee or doctoral externship licensee is an 11.6audiologist, is a licensed audiologist, or holds a current certificate of clinical competence 11.7in audiology from the American Speech-Language-Hearing Association or board 11.8certification in audiology by the American Board of Audiology.11.9(d) Clinical fellowship licensure or doctoral externship licensure shall not be granted 11.10until the applicant has completed the academic coursework and clinical training in section 11.11148.515, subdivision 2
          or 2a. In addition to the transcript, the commissioner may require 11.12a letter from the academic department chair or program director documenting that the 11.13applicant has completed coursework equivalent to or exceeding a master's degree or that 11.14the applicant is eligible for enrollment in current doctoral externship credit.11.15(e) The clinical fellowship licensee or doctoral externship licensee must provide 11.16verification of supervision on the application form provided by the commissioner.11.17    Sec. 9. Minnesota Statutes 2006, section 148.5175, is amended to read:11.18148.5175 TEMPORARY LICENSURE.11.19(a) The commissioner shall issue temporary licensure as a speech-language 11.20pathologist, an audiologist, or both, to an applicant who: 11.21(1) submits a signed and dated affidavit stating that the applicant is not the subject of 11.22a disciplinary action or past disciplinary action in this or another jurisdiction and is not 11.23disqualified on the basis of section 
         148.5195, subdivision 3; and 11.24(2) either:11.25(i) provides a copy of a current credential as a speech-language pathologist, an 11.26audiologist, or both, held in the District of Columbia or a state or territory of the United 11.27States; or11.28(ii) provides a copy of a current certificate of clinical competence issued by the 11.29American Speech-Language-Hearing Association or board certification in audiology by 11.30the American Board of Audiology.11.31(b) A temporary license issued to a person under this subdivision expires 90 days 11.32after it is issued or on the date the commissioner grants or denies licensure, whichever 11.33occurs first.11.34(c) Upon application, a temporary license shall be renewed oncetwice to a person 11.35who is able to demonstrate good cause for failure to meet the requirements for licensure 12.1within the initial temporary licensure period and who is not the subject of a disciplinary 12.2action or disqualified on the basis of section 
         148.5195, subdivision 3. Good cause 12.3includes but is not limed to inability to take and complete the required practical exam for 12.4dispensing hearing instruments.12.5(d) Upon application, a temporary license shall be issued to a person who meets 12.6the requirements of section 148.515, subdivisions 2a and 4, but has not completed the 12.7requirement in section 148.515, subdivision 6.12.8    Sec. 10. Minnesota Statutes 2006, section 148.519, subdivision 3, is amended to read:12.9    Subd. 3. Change of address name, employment, and addresses. A licensee who 12.10changes addresses must inform the commissioner, in writing, of the change of name, 12.11employment, or address within 30 days. A change in name must be accompanied by a 12.12copy of a marriage certificate or court order. All notices or other correspondence mailed 12.13to or served on a licensee by the commissioner at the licensee's address on file with the 12.14commissioner shall be considered as having been received by the licensee.12.15    Sec. 11. Minnesota Statutes 2006, section 148.5194, subdivision 7, is amended to read:12.16    Subd. 7. Audiologist surcharge fee. (a) The biennial surcharge fee for audiologists 12.17is $235. The commissioner shall prorate the fee for clinical fellowship, doctoral 12.18externship, temporary, and first time licensees according to the number of months that 12.19have elapsed between the date the license is issued and the date the license expires or must 12.20be renewed under section 
         148.5191, subdivision 4.12.21(b) Effective November 1, 2005, the commissioner shall collect the $235 audiologist 12.22surcharge fee prorated according to the number of months remaining until the next 12.23scheduled license renewal. The audiologist surcharge fee is for practical examination costs 12.24greater than audiologist exam fee receipts and complaint investigation, enforcement action 12.25and consumer information, and assistance expenditures related to hearing instrument 12.26dispensing.12.27    Sec. 12. Minnesota Statutes 2006, section 148.5194, subdivision 8, is amended to read:12.28    Subd. 8. Penalty fees. (a) The penalty fee for practicing speech language pathology 12.29or audiology or using protected titles without a current license after the credential has 12.30expired and before it is renewed is the amount of the license renewal fee for any part of 12.31the first month, plus the license renewal fee for any part of any subsequent month up 12.32to 36 months.13.1(b) The penalty fee for applicants who engage in the unauthorized practice of speech 13.2language pathology or audiology or using protected titles before being issued a license is 13.3the amount of the license application fee for any part of the first month, plus the license 13.4application fee for any part of any subsequent month up to 36 months. This paragraph 13.5does not apply to applicants not qualifying for a license who engage in the unauthorized 13.6practice of speech language pathology or audiology.13.7(c) The penalty fee for practicing speech language pathology or audiology and failing 13.8to submit a continuing education report by the due date with the correct number or type of 13.9hours in the correct time period is $100 plus $20 for each missing clock hour. Missing 13.10means not obtained between the effective and expiration dates of the certificate, the 13.11one-month period following the certificate expiration date, or the 30 days following notice 13.12of a penalty fee for failing to report all continuing education hours. The licensee must 13.13obtain the missing number of continuing education hours by the next reporting due date.13.14(d) Civil penalties and discipline incurred by licensees prior to August 1, 2005, for 13.15conduct described in paragraph (a), (b), or (c) shall be recorded as nondisciplinary penalty 13.16fees. For conduct described in paragraph (a) or (b) occurring after August 1, 2005, and 13.17exceeding six months, payment of a penalty fee does not preclude any disciplinary action 13.18reasonably justified by the individual case.13.19    Sec. 13. Minnesota Statutes 2006, section 148.5195, subdivision 3, is amended to read:13.20    Subd. 3. Grounds for disciplinary action by commissioner. The commissioner 13.21may take any of the disciplinary actions listed in subdivision 4 on proof that the individual 13.22has:13.23(1) intentionally submitted false or misleading information to the commissioner 13.24or the advisory council;13.25(2) failed, within 30 days, to provide information in response to a written request, 13.26via certified mail, by the commissioner or advisory council;13.27(3) performed services of a speech-language pathologist or audiologist in an 13.28incompetent or negligent manner;13.29(4) violated sections 
         148.511 to 
         148.5198;13.30(5) failed to perform services with reasonable judgment, skill, or safety due to the 13.31use of alcohol or drugs, or other physical or mental impairment;13.32(6) violated any state or federal law, rule, or regulation, and the violation is a felony 13.33or misdemeanor, an essential element of which is dishonesty, or which relates directly 13.34or indirectly to the practice of speech-language pathology or audiology. Conviction for 14.1violating any state or federal law which relates to speech-language pathology or audiology 14.2is necessarily considered to constitute a violation, except as provided in chapter 364;14.3(7) aided or abetted another person in violating any provision of sections 
         148.511 to 14.4148.5198
         ;14.5(8) been or is being disciplined by another jurisdiction, if any of the grounds for 14.6the discipline is the same or substantially equivalent to those under sections 
         148.511 to 14.7148.5198
         ;14.8(9) not cooperated with the commissioner or advisory council in an investigation 14.9conducted according to subdivision 1;14.10(10) advertised in a manner that is false or misleading;14.11(11) engaged in conduct likely to deceive, defraud, or harm the public; or 14.12demonstrated a willful or careless disregard for the health, welfare, or safety of a client;14.13(12) failed to disclose to the consumer any fee splitting or any promise to pay a 14.14portion of a fee to any other professional other than a fee for services rendered by the 14.15other professional to the client;14.16(13) engaged in abusive or fraudulent billing practices, including violations of 14.17federal Medicare and Medicaid laws, Food and Drug Administration regulations, or state 14.18medical assistance laws;14.19(14) obtained money, property, or services from a consumer through the use of 14.20undue influence, high pressure sales tactics, harassment, duress, deception, or fraud;14.21(15) performed services for a client who had no possibility of benefiting from the 14.22services;14.23(16) failed to refer a client for medical evaluation or to other health care professionals 14.24when appropriate or when a client indicated symptoms associated with diseases that 14.25could be medically or surgically treated;14.26(17) had the certification required by chapter 153A denied, suspended, or revoked 14.27according to chapter 153A;14.28(18) used the term doctor of audiology, doctor of speech-language pathology, 14.29AuD, or SLPD without having obtained the degree from an institution accredited by 14.30the North Central Association of Colleges and Secondary Schools, the Council on 14.31Academic Accreditation in Audiology and Speech-Language Pathology, the United States 14.32Department of Education, or an equivalent;14.33(19) failed to comply with the requirements of section 
         148.5192 regarding 14.34supervision of speech-language pathology assistants; or14.35(20) if the individual is an audiologist or certified hearing aidinstrument dispenser:15.1(i) prescribed or otherwise recommended to a consumer or potential consumer the use 15.2of a hearing aid instrument, unless the prescription from a physician or recommendation 15.3from an audiologist or certified dispenser is in writing, is based on an audiogram that is 15.4delivered to the consumer or potential consumer when the prescription or recommendation 15.5is made, and bears the following information in all capital letters of 12-point or larger 15.6boldface type: "THIS PRESCRIPTION OR RECOMMENDATION MAY BE FILLED 15.7BY, AND HEARING AIDS INSTRUMENTS MAY BE PURCHASED FROM, THE 15.8LICENSED AUDIOLOGIST OR CERTIFIED DISPENSER OF YOUR CHOICE";15.9(ii) failed to give a copy of the audiogram, upon which the prescription or 15.10recommendation is based, to the consumer when the consumer requests a copy;15.11(iii) failed to provide the consumer rights brochure required by section 
         148.5197, 15.12subdivision 3
         ;15.13(iv) failed to comply with restrictions on sales of hearing aidsinstruments in sections 15.14148.5197, subdivision 3
         , and 
         148.5198;15.15(v) failed to return a consumer's hearing aidinstrument used as a trade-in or for a 15.16discount in the price of a new hearing aidinstrument when requested by the consumer 15.17upon cancellation of the purchase agreement;15.18(vi) failed to follow Food and Drug Administration or Federal Trade Commission 15.19regulations relating to dispensing hearing aids instruments;15.20(vii) failed to dispense a hearing aidinstrument in a competent manner or without 15.21appropriate training;15.22(viii) delegated hearing instrument dispensing authority to a person not authorized to 15.23dispense a hearing instrument under this chapter or chapter 153A;15.24(ix) failed to comply with the requirements of an employer or supervisor of a hearing 15.25aidinstrument dispenser trainee; or15.26(x) violated a state or federal court order or judgment, including a conciliation court 15.27judgment, relating to the activities of the individual's hearing aidinstrument dispensing; or15.28(xi) failed to include on the audiogram the practitioner's printed name, credential 15.29type, credential number, signature, and date.15.30    Sec. 14. Minnesota Statutes 2006, section 148.6425, is amended to read:15.31148.6425 RENEWAL OF LICENSURE; AFTER EXPIRATION DATE.15.32    Subdivision 1. Removal of name from list. The names of licensees who do not 15.33comply with the licensure renewal requirements of section 
         148.6423 on or before the 15.34expiration date shall be removed from the list of individuals authorized to practice 16.1occupational therapy and to use the protected titles in section 
         148.6403. The licensees 16.2must comply with the requirements of this section in order to regain licensed status. 16.3    Subd. 2. Licensure renewal after licensure expiration date. An individual 16.4whose application for licensure renewal is received after the licensure expiration date 16.5must submit the following:16.6(1) a completed and signed application for licensure following lapse in licensed 16.7status on forms provided by the commissioner;16.8(2) the renewal fee and the late fee required under section 
         148.6445; 16.9(3) proof of having met the continuing education requirements since the individual's 16.10initial licensure or last licensure renewal in section 148.6443, subdivision 1; and16.11(4) additional information as requested by the commissioner to clarify information in 16.12the application, including information to determine whether the individual has engaged in 16.13conduct warranting disciplinary action as set forth in section 
         148.6448. The information 16.14must be submitted within 30 days after the commissioner's request. 16.15    Subd. 3. Licensure renewal four years or more after licensure expiration date.16.16(a) An individual who requests licensure renewal four years or more after the licensure 16.17expiration date must submit the following:16.18(1) a completed and signed application for licensure on forms provided by the 16.19commissioner;16.20(2) the renewal fee and the late fee required under section 
         148.6445 if renewal 16.21application is based on paragraph (b), clause (1), (2), or (3), or the renewal fee required 16.22under section 
         148.6445 if renewal application is based on paragraph (b), clause (4); 16.23(3) proof of having met the continuing education requirement for the most recently 16.24completed two-year continuing education cycle in section 148.6443, subdivision 1, 16.25except the continuing education must be obtained in the two years immediately preceding 16.26application renewal; and16.27(4) at the time of the next licensure renewal, proof of having met the continuing 16.28education requirement, which shall be prorated based on the number of months licensed 16.29during the biennialtwo-year licensure period.16.30(b) In addition to the requirements in paragraph (a), the applicant must submit proof 16.31of one of the following:16.32(1) verified documentation of successful completion of 160 hours of supervised 16.33practice approved by the commissioner as described in paragraph (c);16.34(2) verified documentation of having achieved a qualifying score on the credentialing 16.35examination for occupational therapists or the credentialing examination for occupational 16.36therapy assistants administered within the past year;17.1(3) documentation of having completed a combination of occupational therapy 17.2courses or an occupational therapy refresher program that contains both a theoretical and 17.3clinical component approved by the commissioner. Only courses completed within one 17.4year preceding the date of the application or one year after the date of the application 17.5qualify for approval; or17.6(4) evidence that the applicant holds a current and unrestricted credential for the 17.7practice of occupational therapy in another jurisdiction and that the applicant's credential 17.8from that jurisdiction has been held in good standing during the period of lapse.17.9(c) To participate in a supervised practice as described in paragraph (b), clause 17.10(1), the applicant shall obtain limited licensure. To apply for limited licensure, the 17.11applicant shall submit the completed limited licensure application, fees, and agreement 17.12for supervision of an occupational therapist or occupational therapy assistant practicing 17.13under limited licensure signed by the supervising therapist and the applicant. The 17.14supervising occupational therapist shall state the proposed level of supervision on the 17.15supervision agreement form provided by the commissioner. The supervising therapist 17.16shall determine the frequency and manner of supervision based on the condition of the 17.17patient or client, the complexity of the procedure, and the proficiencies of the supervised 17.18occupational therapist. At a minimum, a supervising occupational therapist shall be on 17.19the premises at all times that the person practicing under limited licensure is working; 17.20be in the room ten percent of the hours worked each week by the person practicing 17.21under limited licensure; and provide daily face-to-face collaboration for the purpose 17.22of observing service competency of the occupational therapist or occupational therapy 17.23assistant, discussing treatment procedures and each client's response to treatment, and 17.24reviewing and modifying, as necessary, each treatment plan. The supervising therapist 17.25shall document the supervision provided. The occupational therapist participating in 17.26a supervised practice is responsible for obtaining the supervision required under this 17.27paragraph and must comply with the commissioner's requirements for supervision during 17.28the entire 160 hours of supervised practice. The supervised practice must be completed in 17.29two months and may be completed at the applicant's place of work.17.30(d) In addition to the requirements in paragraphs (a) and (b), the applicant must 17.31submit additional information as requested by the commissioner to clarify information in 17.32the application, including information to determine whether the applicant has engaged in 17.33conduct warranting disciplinary action as set forth in section 
         148.6448. The information 17.34must be submitted within 30 days after the commissioner's request. 18.1    Sec. 15. Minnesota Statutes 2006, section 148.6428, is amended to read:18.2148.6428 CHANGE OF NAME, ADDRESS, OR EMPLOYMENT.18.3A licensee who changes addresses a name, address, or employment must inform the 18.4commissioner, in writing, of the change of name, address, employment, business address, 18.5or business telephone number within 30 days. A change in name must be accompanied by 18.6a copy of a marriage certificate or court order. All notices or other correspondence mailed 18.7to or served on a licensee by the commissioner at the licensee's address on file with the 18.8commissioner shall be considered as having been received by the licensee.18.9    Sec. 16. Minnesota Statutes 2006, section 148.6440, is amended to read:18.10148.6440 PHYSICAL AGENT MODALITIES.18.11    Subdivision 1. General considerations. (a) Occupational therapists who intend 18.12to use superficial physical agent modalities must comply with the requirements in 18.13subdivision 3. Occupational therapists who intend to use electrotherapy must comply with 18.14the requirements in subdivision 4. Occupational therapists who intend to use ultrasound 18.15devices must comply with the requirements in subdivision 5. Occupational therapy 18.16assistants who intend to use physical agent modalities must comply with subdivision 6.18.17(b) Use of superficial physical agent modalities, electrical stimulation devices, and 18.18ultrasound devices must be on the order of a physician.18.19(c) Prior to any use of any physical agent modality, a licensee must obtain approval 18.20from the commissioner. The commissioner shall maintain a roster of persons licensed 18.21under sections 
         148.6401 to 
         148.6450 who are approved to use physical agent modalities. 18.22Prior to using a physical agent modality, licensees must inform the commissioner of 18.23the physical agent modality they will use. Persons who use physical agent modalities 18.24must indicate on their initial and renewal applications the physical agent modalities that 18.25they use.18.26(d) Licensees are responsible for informing the commissioner of any changes in the 18.27information required in this section within 30 days of any change.18.28    Subd. 2. Written documentation required.Prior to use of physical agent 18.29modalities, An occupational therapist must provide to the commissioner documentation 18.30verifying that the occupational therapist has met the educational and clinical requirements 18.31described in subdivisions 3 to 5, depending on the modality or modalities to be used. Both 18.32theoretical training and clinical application objectives must be met for each modality used. 18.33Documentation must include the name and address of the individual or organization 18.34sponsoring the activity; the name and address of the facility at which the activity was 18.35presented; and a copy of the course, workshop, or seminar description, including learning 19.1objectives and standards for meeting the objectives. In the case of clinical application 19.2objectives, teaching methods must be documented, including actual supervised practice. 19.3Documentation must include a transcript or certificate showing successful completion of 19.4the coursework. An occupational therapist who is a certified hand therapist shall document 19.5satisfaction of the requirements in subdivisions 3 to 5 by submitting to the commissioner a 19.6copy of a certificate issued by the Hand Therapy Certification Commission. Practitioners 19.7are prohibited from using physical agent modalities under supervision or independently 19.8until granted approval as provided in subdivision 7.19.9    Subd. 3. Educational and clinical requirements for use of superficial physical 19.10agent modalities. (a) An occupational therapist may use superficial physical agent 19.11modalities if the occupational therapist has received theoretical training and clinical 19.12application training in the use of superficial physical agent modalities and been granted 19.13approval as provided in subdivision 7.19.14(b) Theoretical training in the use of superficial physical agent modalities must:19.15(1) explain the rationale and clinical indications for use of superficial physical agent 19.16modalities;19.17(2) explain the physical properties and principles of the superficial physical agent 19.18modalities;19.19(3) describe the types of heat and cold transference;19.20(4) explain the factors affecting tissue response to superficial heat and cold;19.21(5) describe the biophysical effects of superficial physical agent modalities in 19.22normal and abnormal tissue;19.23(6) describe the thermal conductivity of tissue, matter, and air;19.24(7) explain the advantages and disadvantages of superficial physical agent 19.25modalities; and19.26(8) explain the precautions and contraindications of superficial physical agent 19.27modalities.19.28(c) Clinical application training in the use of superficial physical agent modalities 19.29must include activities requiring the practitioner to:19.30(1) formulate and justify a plan for the use of superficial physical agents for 19.31treatment appropriate to its use and simulate the treatment;19.32(2) evaluate biophysical effects of the superficial physical agents;19.33(3) identify when modifications to the treatment plan for use of superficial physical 19.34agents are needed and propose the modification plan;19.35(4) safely and appropriately administer superficial physical agents under the 19.36supervision of a course instructor or clinical trainer;20.1(5) document parameters of treatment, patient response, and recommendations for 20.2progression of treatment for the superficial physical agents; and20.3(6) demonstrate the ability to work competently with superficial physical agents as 20.4determined by a course instructor or clinical trainer.20.5    Subd. 4. Educational and clinical requirements for use of electrotherapy. (a) An 20.6occupational therapist may use electrotherapy if the occupational therapist has received 20.7theoretical training and clinical application training in the use of electrotherapy and been 20.8granted approval as provided in subdivision 7.20.9(b) Theoretical training in the use of electrotherapy must:20.10(1) explain the rationale and clinical indications of electrotherapy, including pain 20.11control, muscle dysfunction, and tissue healing;20.12(2) demonstrate comprehension and understanding of electrotherapeutic terminology 20.13and biophysical principles, including current, voltage, amplitude, and resistance;20.14(3) describe the types of current used for electrical stimulation, including the 20.15description, modulations, and clinical relevance;20.16(4) describe the time-dependent parameters of pulsed and alternating currents, 20.17including pulse and phase durations and intervals;20.18(5) describe the amplitude-dependent characteristics of pulsed and alternating 20.19currents;20.20(6) describe neurophysiology and the properties of excitable tissue;20.21(7) describe nerve and muscle response from externally applied electrical 20.22stimulation, including tissue healing;20.23(8) describe the electrotherapeutic effects and the response of nerve, denervated and 20.24innervated muscle, and other soft tissue; and20.25(9) explain the precautions and contraindications of electrotherapy, including 20.26considerations regarding pathology of nerve and muscle tissue.20.27(c) Clinical application training in the use of electrotherapy must include activities 20.28requiring the practitioner to:20.29(1) formulate and justify a plan for the use of electrical stimulation devices for 20.30treatment appropriate to its use and simulate the treatment;20.31(2) evaluate biophysical treatment effects of the electrical stimulation;20.32(3) identify when modifications to the treatment plan using electrical stimulation are 20.33needed and propose the modification plan;20.34(4) safely and appropriately administer electrical stimulation under supervision 20.35of a course instructor or clinical trainer;21.1(5) document the parameters of treatment, case example (patient) response, and 21.2recommendations for progression of treatment for electrical stimulation; and21.3(6) demonstrate the ability to work competently with electrical stimulation as 21.4determined by a course instructor or clinical trainer.21.5    Subd. 5. Educational and clinical requirements for use of ultrasound. (a) An 21.6occupational therapist may use an ultrasound device if the occupational therapist has 21.7received theoretical training and clinical application training in the use of ultrasound and 21.8been granted approval as provided in subdivision 7.21.9(b) The theoretical training in the use of ultrasound must:21.10(1) explain the rationale and clinical indications for the use of ultrasound, including 21.11anticipated physiological responses of the treated area;21.12(2) describe the biophysical thermal and nonthermal effects of ultrasound on normal 21.13and abnormal tissue;21.14(3) explain the physical principles of ultrasound, including wavelength, frequency, 21.15attenuation, velocity, and intensity;21.16(4) explain the mechanism and generation of ultrasound and energy transmission 21.17through physical matter; and21.18(5) explain the precautions and contraindications regarding use of ultrasound devices.21.19(c) The clinical application training in the use of ultrasound must include activities 21.20requiring the practitioner to:21.21(1) formulate and justify a plan for the use of ultrasound for treatment appropriate to 21.22its use and stimulate the treatment;21.23(2) evaluate biophysical effects of ultrasound;21.24(3) identify when modifications to the treatment plan for use of ultrasound are 21.25needed and propose the modification plan;21.26(4) safely and appropriately administer ultrasound under supervision of a course 21.27instructor or clinical trainer;21.28(5) document parameters of treatment, patient response, and recommendations for 21.29progression of treatment for ultrasound; and21.30(6) demonstrate the ability to work competently with ultrasound as determined 21.31by a course instructor or clinical trainer.21.32    Subd. 6. Occupational therapy assistant use of physical agent modalities. An 21.33occupational therapy assistant may set up and implement treatment using physical agent 21.34modalities if the assistant meets the requirements of this section, has demonstrated service 21.35competency for the particular modality used, and works under the direct supervision 21.36of an occupational therapist who has been granted approval as provided in subdivision 22.17. An occupational therapy assistant who uses superficial physical agent modalities 22.2must meet the requirements of subdivision 3. An occupational therapy assistant who 22.3uses electrotherapy must meet the requirements of subdivision 4. An occupational 22.4therapy assistant who uses ultrasound must meet the requirements of subdivision 5. An 22.5occupational therapist may not delegate evaluation, reevaluation, treatment planning, and 22.6treatment goals for physical agent modalities to an occupational therapy assistant.22.7    Subd. 7. Approval. (a) The advisory council shall appoint a committee to review 22.8documentation under subdivisions 2 to 6 to determine if established educational and 22.9clinical requirements are met. If, after review of course documentation, the committee 22.10verifies that a specific course meets the theoretical and clinical requirements in 22.11subdivisions 2 to 6, the commissioner may approve practitioner applications that include 22.12the required course documentation evidencing completion of the same course.22.13(b) Occupational therapists shall be advised of the status of their request for approval 22.14within 30 days. Occupational therapists must provide any additional information requested 22.15by the committee that is necessary to make a determination regarding approval or denial.22.16(c) A determination regarding a request for approval of training under this 22.17subdivision shall be made in writing to the occupational therapist. If denied, the reason for 22.18denial shall be provided.22.19(d) A licensee who was approved by the commissioner as a level two provider prior 22.20to July 1, 1999, shall remain on the roster maintained by the commissioner in accordance 22.21with subdivision 1, paragraph (c).22.22(e) To remain on the roster maintained by the commissioner, a licensee who was 22.23approved by the commissioner as a level one provider prior to July 1, 1999, must submit to 22.24the commissioner documentation of training and experience gained using physical agent 22.25modalities since the licensee's approval as a level one provider. The committee appointed 22.26under paragraph (a) shall review the documentation and make a recommendation to the 22.27commissioner regarding approval.22.28(f) An occupational therapist who received training in the use of physical agent 22.29modalities prior to July 1, 1999, but who has not been placed on the roster of approved 22.30providers may submit to the commissioner documentation of training and experience 22.31gained using physical agent modalities. The committee appointed under paragraph (a) 22.32shall review documentation and make a recommendation to the commissioner regarding 22.33approval.22.34    Sec. 17. Minnesota Statutes 2006, section 148.6443, subdivision 1, is amended to read:23.1    Subdivision 1. General requirements.AnA licensed occupational therapist 23.2applying for licensure renewal must have completedobtain a minimum of 24 contact 23.3hours of continuing education in the two years precedingtwo-year licensure renewal23.4period. AnA licensed occupational therapy assistant applying for licensure renewal must 23.5have completedobtain a minimum of 18 contact hours of continuing education in the two 23.6years precedingtwo-year licensure renewal period. All continuing education coursework 23.7must be obtained between the effective and expiration dates of the license. Licensees who 23.8are issued licenses for a period of less than two years shall prorate theobtain a prorated 23.9number of contact hours required for licensure renewal based on the number of months 23.10licensed during the biennialtwo-year licensure period. Licensees shall receive contact 23.11hours for continuing education activities only for the biennial licensure period in which 23.12the continuing education activity was performed.23.13To qualify as a continuing education activity, the activity must be a minimum of 23.14one contact hour. Contact hours must be earned and reported in increments of one contact 23.15hour or one-half contact hour after the first contact hour of each continuing education 23.16activity. One-half contact hour means an instructional session of 30 consecutive minutes, 23.17excluding coffee breaks, registration, meals without a speaker, and social activities.23.18Each licensee is responsible for financing the cost of the licensee's continuing 23.19education activities.23.20    Sec. 18. Minnesota Statutes 2006, section 148.6443, subdivision 3, is amended to read:23.21    Subd. 3. Activities qualifying for continuing education contact hours. (a) The 23.22activities in this subdivision qualify for continuing education contact hours if they meet all 23.23other requirements of this section.23.24(b) A minimum of one-half of the required contact hours must be directly related 23.25to the occupational therapy practice. The remaining contact hours may be related to 23.26occupational therapy practice, the delivery of occupational therapy services, or to the 23.27practitioner's current professional role. 23.28(c) A licensee may obtain an unlimited number of contact hours in any two-year 23.29continuing education period through participation in the following:23.30(1) attendance at educational programs of annual conferences, lectures, panel 23.31discussions, workshops, in-service training, seminars, and symposiums;23.32(2) successful completion of college or university courses. The licensee must obtain 23.33a grade of at least a "C" or a pass in a pass or fail course in order to receive the following 23.34continuing education credits:23.35(i) one semester credit equals 14 contact hours;24.1(ii) one trimester credit equals 12 contact hours; and24.2(iii) one quarter credit equals ten contact hours; 24.3(3) successful completion of home study courses that require the participant to 24.4demonstrate the participant's knowledge following completion of the course.24.5(d) A licensee may obtain a maximum of six contact hours in any two-year 24.6continuing education period for: 24.7(1) teaching continuing education courses that meet the requirements of this section. 24.8A licensee is entitled to earn a maximum of two contact hours as preparation time for 24.9each contact hour of presentation time. Contact hours may be claimed only once for 24.10teaching the same course in any two-year continuing education period. A course schedule 24.11or brochure must be maintained for audit;24.12(2) supervising occupational therapist or occupational therapy assistant students. A 24.13licensee may earn one contact hour for every eight hours of student supervision. Licensees 24.14must maintain a log indicating the name of each student supervised and the hours each 24.15student was supervised. Contact hours obtained by student supervision must be obtained 24.16by supervising students from an occupational therapy education program accredited by the 24.17Accreditation Council for Occupational Therapy Education;24.18(3) teaching or participating in courses related to leisure activities, recreational 24.19activities, or hobbies if the practitioner uses these interventions within the practitioner's 24.20current practice or employment; and24.21(4) engaging in research activities or outcome studies that are associated with grants, 24.22postgraduate studies, or publications in professional journals or books.24.23(e) A licensee may obtain a maximum of two contact hours in any two-year 24.24continuing education period for continuing education activities in the following areas:24.25(1) business-related topics: marketing, time management, administration, risk 24.26management, government regulations, techniques for training professionals, computer 24.27skills, payment systems, including covered services, coding, documentation, billing, 24.28and similar topics;24.29(2) personal skill topics: career burnout, communication skills, human relations, and 24.30similar topics; and24.31(3) (2) training that is obtained in conjunction with a licensee's employment, occurs 24.32during a licensee's normal workday, and does not include subject matter specific to the 24.33fundamentals of occupational therapy.24.34    Sec. 19. Minnesota Statutes 2006, section 148.6445, subdivision 11, is amended to 24.35read:25.1    Subd. 11. Penalty fees. (a) The penalty fee for practicing occupational therapy or 25.2using protected titles without a current license after the credential has expired and before it 25.3is renewed is the amount of the license renewal fee for any part of the first month, plus the 25.4license renewal fee for any part of any subsequent month up to 36 months.25.5(b) The penalty fee for applicants who engage in the unauthorized practice of 25.6occupational therapy or use protected titles before being issued a license is the amount 25.7of the license application fee for any part of the first month, plus the license application 25.8fee for any part of any subsequent month up to 36 months. This paragraph does not 25.9apply to applicants not qualifying for a license who engage in the unauthorized practice 25.10of occupational therapy.25.11(c) The penalty fee for practicing occupational therapy and failing to submit a 25.12continuing education report by the due date with the correct number or type of hours in 25.13the correct time period is $100 plus $20 for each missing clock hour. Missing means not 25.14obtained between the effective and expiration dates of the license, the one-month period 25.15following the license expiration date, or the 30 days following notice of a penalty fee for 25.16failing to report all continuing education hours. The licensee must obtain the missing 25.17number of continuing education hours by the next reporting due date.25.18(d) Civil penalties and discipline incurred by licensees prior to August 1, 2005, for 25.19conduct described in paragraph (a), (b), or (c) shall be recorded as nondisciplinary penalty 25.20fees. For conduct described in paragraph (a) or (b) occurring after August 1, 2005, and 25.21exceeding six months, payment of a penalty fee does not preclude any disciplinary action 25.22reasonably justified by the individual case.25.23    Sec. 20. [148B.195] DUTY TO WARN.25.24    A licensee must comply with the duty to warn established in section 148.975.25.25    Sec. 21. Minnesota Statutes 2006, section 149A.01, subdivision 4, is amended to read:25.26    Subd. 4. Nonlimiting.(a) Nothing in this chapter shall be construed to limit the 25.27powers granted to the commissioner of health, commissioner of commerce, state attorney 25.28general, or a county attorney in any other statute, law, or rule, except as described in 25.29paragraph (b).25.30    (b) A county, within its jurisdiction as a coroner or medical examiner, may establish 25.31transportation standards for transporting a dead human body from the death scene to the 25.32place where an autopsy is to be conducted, so long as the standards do not specifically 25.33require that the transporter be a licensed funeral director.26.1    Sec. 22. Minnesota Statutes 2006, section 151.01, subdivision 27, is amended to read:26.2    Subd. 27. Practice of pharmacy. "Practice of pharmacy" means:26.3    (1) interpretation and evaluation of prescription drug orders;26.4    (2) compounding, labeling, and dispensing drugs and devices (except labeling by 26.5a manufacturer or packager of nonprescription drugs or commercially packaged legend 26.6drugs and devices);26.7    (3) participation in clinical interpretations and monitoring of drug therapy for 26.8assurance of safe and effective use of drugs;26.9    (4) participation in drug and therapeutic device selection; drug administration for 26.10first dosage and medical emergencies; drug regimen reviews; and drug or drug-related 26.11research;26.12    (5) participation in administration of influenza and pneumococcal vaccinevaccines 26.13to all eligible individuals over 18ten years of age and all other vaccines to patients 18 26.14years of age and older under standing orders from a physician licensed under chapter 147 26.15or by written protocol with a physician provided that:26.16    (i) the pharmacist is trained in a program approved by the American Council of 26.17Pharmaceutical Education for the administration of immunizations or graduated from a 26.18college of pharmacy in 2001 or thereafter; and26.19    (ii) the pharmacist reports the administration of the immunization to the patient's 26.20primary physician or clinic;26.21    (6) participation in the practice of managing drug therapy and modifying drug 26.22therapy, according to section 
         151.21, subdivision 1, on a case-by-case basis according to a 26.23written protocol between the specific pharmacist and the individual dentist, optometrist, 26.24physician, podiatrist, or veterinarian who is responsible for the patient's care and 26.25authorized to independently prescribe drugs. Any significant changes in drug therapy must 26.26be reported by the pharmacist to the patient's medical record; 26.27    (7) participation in the storage of drugs and the maintenance of records;26.28    (8) responsibility for participation in patient counseling on therapeutic values, 26.29content, hazards, and uses of drugs and devices; and26.30    (9) offering or performing those acts, services, operations, or transactions necessary 26.31in the conduct, operation, management, and control of a pharmacy.26.32    Sec. 23. Minnesota Statutes 2006, section 153A.14, subdivision 2i, is amended to read:26.33    Subd. 2i. Continuing education requirement. On forms provided by the 26.34commissioner, each certified dispenser must submit with the application for renewal of 26.35certification evidence of completion of ten course hours of continuing education earned 27.1within the 12-month period of JulyNovember 1 to June 30 immediately preceding renewal27.2October 31, between the effective and expiration dates of certification. Continuing 27.3education courses must be directly related to hearing instrument dispensing and 27.4approved by the International Hearing Society, the American Speech-Language-Hearing 27.5Association, or the American Academy of Audiology. Evidence of completion of the 27.6ten course hours of continuing education must be submitted with renewal applications27.7by October December 1 of each year. This requirement does not apply to dispensers 27.8certified for less than one year. The first report of evidence of completion of the continuing 27.9education credits shall be due October 1, 1997.27.10    Sec. 24. Minnesota Statutes 2006, section 153A.14, subdivision 4a, is amended to read:27.11    Subd. 4a. Trainees. (a) A person who is not certified under this section may dispense 27.12hearing instruments as a trainee for a period not to exceed 12 months if the person:27.13(1) submits an application on forms provided by the commissioner;27.14(2) is under the supervision of a certified dispenser meeting the requirements of 27.15this subdivision; and27.16(3) meets all requirements for certification except passage of the examination 27.17required by this section; and27.18(4) uses the title "dispenser trainee" in contacts with the patients, clients, or 27.19consumers.27.20(b) A certified hearing instrument dispenser may not supervise more than two 27.21trainees at the same time and may not directly supervise more than one trainee at a time. 27.22The certified dispenser is responsible for all actions or omissions of a trainee in connection 27.23with the dispensing of hearing instruments. A certified dispenser may not supervise a 27.24trainee if there are any commissioner, court, or other orders, currently in effect or issued 27.25within the last five years, that were issued with respect to an action or omission of a 27.26certified dispenser or a trainee under the certified dispenser's supervision.27.27Until taking and passing the practical examination testing the techniques described 27.28in subdivision 2h, paragraph (a), clause (2), trainees must be directly supervised in all 27.29areas described in subdivision 4b, and the activities tested by the practical examination. 27.30Thereafter, trainees may dispense hearing instruments under indirect supervision until 27.31expiration of the trainee period. Under indirect supervision, the trainee must complete two 27.32monitored activities a week. Monitored activities may be executed by correspondence, 27.33telephone, or other telephonic devices, and include, but are not limited to, evaluation 27.34of audiograms, written reports, and contracts. The time spent in supervision must be 27.35recorded and the record retained by the supervisor.28.1    Sec. 25. Minnesota Statutes 2006, section 153A.14, subdivision 11, is amended to read:28.2    Subd. 11. Requirement to maintain current information. A dispenser must notify 28.3the commissioner in writing within 30 days of the occurrence of any of the following:28.4(1) a change of name, address, home or business telephone number, or business 28.5name;28.6(2) the occurrence of conduct prohibited by section 
         153A.15; 28.7(3) a settlement, conciliation court judgment, or award based on negligence, 28.8intentional acts, or contractual violations committed in the dispensing of hearing 28.9instruments by the dispenser; and28.10(4) the cessation of hearing instrument dispensing activities as an individual or a 28.11business.28.12    Sec. 26. Minnesota Statutes 2006, section 153A.175, is amended to read:28.13153A.175 PENALTY FEES.28.14(a) The penalty fee for holding oneself out as a hearing instrument dispenser without 28.15a current certificate after the credential has expired and before it is renewed is one-half 28.16the amount of the certificate renewal fee for any part of the first day, plus one-half the 28.17certificate renewal fee for any part of any subsequent days up to 30 days.28.18(b) The penalty fee for applicants who hold themselves out as hearing instrument 28.19dispensers after expiration of the trainee period and before being issued a certificate is 28.20one-half the amount of the certificate application fee for any part of the first day, plus 28.21one-half the certificate application fee for any part of any subsequent days up to 30 days. 28.22This paragraph does not apply to applicants not qualifying for a certificate who hold 28.23themselves out as hearing instrument dispensers.28.24(c) The penalty fee for practicing hearing instrument dispensing and failing to submit 28.25a continuing education report by the due date with the correct number or type of hours in 28.26the correct time period is $200 plus $200 for each missing clock hour. "Missing" means 28.27not obtained between the effective and expirations dates of the certificate, the one-month 28.28period following the certificate expiration date, or the 30 days following notice of a 28.29penalty fee for failing to report all continuing education hours. The certificate holder must 28.30obtain the missing number of continuing education hours by the next reporting due date.28.31(d) Civil penalties and discipline incurred by certificate holders prior to August 28.321, 2005, for conduct described in paragraph (a), (b), or (c) shall be recorded as 28.33nondisciplinary penalty fees. Payment of a penalty fee does not preclude any disciplinary 28.34action reasonably justified by the individual case.29.1    Sec. 27. EXEMPTION.29.2    The Board of Physical Therapy shall grant a waiver of the examination requirements 29.3under Minnesota Statutes, section 148.723, to an applicant applying for licensure before 29.4July 1, 2008, who has been issued physical therapy licenses between 1980 and 1995 in at 29.5least three other states and one or more foreign countries. The licenses issued by the other 29.6states and foreign country must be in good standing or were in good standing at the time 29.7the license expired. The applicant must meet all other requirements of Minnesota Statutes, 29.8section 148.705. This waiver expires on September 1, 2008.29.9EFFECTIVE DATE.This section is effective the day following final enactment.